PMHNP Case Study Questions and Answers, Exams of Nursing

Download PMHNP Case Study Questions and Answers and more Exams Nursing in PDF only on Docsity! NRNP 6640 EXAM Questions & Answers best exam solutions guaranteed success latest upd ate 2024 GRADED A+ Question 1 1 out of 1 points During cognitive behavioral therapy (CBT), a 64-year-old male patient states, “I get so frustrated sometimes and I just blow up at everybody!” Which response by the PMHNP demonstrates translation of Socratic dialogue (SD)? Selecte d Answe r: Question 2 1 out of 1 points B. “When you say blow up, what exactly does blow up mean and how does it feel to you?” A 62-year-old patient has been diagnosed with borderline personality disorder. Upon assessment, the PMHNP learns that he participates in spending sprees and occasional binge eating, accompanied by rapid changes in self-image. Which evidence-based psychotherapeutic model does the PMHNP identify as effective and beneficial? Selected Answer: C. Dialectical behavior therapy Question 3 1 out of 1 points The PMHNP is working with a school-aged child who has been diagnosed with depression. The child has attended several sessions with the PMNHP, but recently presents with avoidant behavior by showing increased distress and being late to sessions. What approach does the PMHNP need to employ with the child to continue making therapeutic progress? Selected Answer: B. Using communication techniques that are expressive Question 7 1 out of 1 points The PMHNP has been assisting a shy and timid 23-year-old male patient struggling with esteem and self-concept issues. Over the weekend, this patient was given the task of completing an exercise that would usually cause him distress and shame, also called a shame- attacking exercise. The PMHNP determines that this task has successfully been achieved when the patient states: Selected Answer: A. “I was able to eat in public yesterday despite how loudly I chew.” Question 8 1 out of 1 points The PMHNP is meeting with a new patient who is a young veteran back from serving two tours overseas. When reviewing the patient’s health history file that was sent from the VA, the PMHNP learns that several months ago, the patient was diagnosed with PTSD, but never followed up with treatment for it. After a comprehensive mental health assessment, the PMHNP confirms the PTSD diagnosis and understands that which therapeutic approach will be the most effective as a first-line treatment modality? Selected Answer: B. Employing cognitive behavioral therapy with the patient Question 9 1 out of 1 points An initial evaluation reveals that an 11-year-old patient has moved to a new school after her parents’ recent divorce, and is having trouble making friends. The patient has normal mental status and exhibits appropriate After informing a prospective patient about limits of confidentiality, the patient consents to the “conditions” of confidentiality and signs an informed consent form. Several weeks later, a lawyer representing the patient’s spouse for a court case, asks the PMHNP for the disclosure of information about the patient. The PMHNP should: Selected Answer: C. Limit disclosure to the extent legally possible Question 12 1 out of 1 points The PMHNP is working with a patient who has insomnia and battles going to sleep. The patient reports consistent self-defeating behaviors, and hates trying to go to sleep. Which action made by the PMHNP demonstrates the use of a paradoxical intervention? Selected Answer: B. Telling the patient to resist sleep and stay awake Question 13 1 out of 1 points The PMHNP is working with a patient who seems dissatisfied with the therapeutic relationship. The PMHNP invites the patient to discuss her feelings regarding the PMHNP openly and honestly. It becomes clear to the PMHNP that they are experiencing an alliance rupture. How does the PMHNP repair the therapeutic alliance? Selected Answer: D. All of the above Question 14 1 out of 1 points One of the strategies the PMHNP wants to try includes sleep restriction. What will the PMHNP suggest to follow sleep restriction therapy? Selected Answer: B. “Restrict the amount of time you spend in bed.” Question 15 1 out of 1 points Selected Answer: D. “I feel frustrated when I come home and we argue.” Question 17 1 out of 1 points The PMHNP is conducting a peer review of another PMHNP’s medical charts. Upon review, the PMHNP notes that the peer often begins patient sessions late, as well as ends them later than scheduled. The PMHNP also found a comment in the chart regarding the patient sending text messages while in the middle of the session. Based on these findings, the feedback that the PMHNP will provide to the peer involves which therapeutic principle? Selecte d Answe r: D. Maintaining the frame 32.The PMHNP is mentoring a student. After working with a patient during a session, the student laments about all the things she should have, or could have, said to the patient. “I feel guilty that I didn’t speak up more about the patient’s concern toward her son,” says the student. The PMHNP understands that the student is exhibiting signs of which therapeutic concept? Question 18 1 out of 1 points The PMHNP employs psychodynamic psychotherapy with a patient who experiences anxiety and depression. As the process enters the psychoanalytic end of the psychodynamic continuum, the PMNHP will focus on: Selected Answer: A. Interpreting unconscious conflict in the patient Question 19 1 out of 1 points The PMHNP is working with an adult patient who has somatic complaints caused by a history of childhood abuse. As part of the therapeutic process, what does the PMHNP do to assess and Question 23 1 out of 1 points The PMHNP is mentoring a student. After working with a patient during a session, the student laments about all the things she should have, or could have, said to the patient. “I feel guilty that I didn’t speak up more about the patient’s concern toward her son,” says the student. The PMHNP understands that the student is exhibiting signs of which therapeutic concept? Selected Answer: A. Countertransference Question 24 1 out of 1 points True or false: A PMHNP may ask his patient to describe her relationship with her father, both as a child and now, in order to assess interpersonal style. Selected Answer: False Question 25 1 out of 1 points The PMHNP is working with a patient who experiences anxiety around her parents that later leads to poor impulse control. What will the PMHNP do to employ psychodynamic psychotherapy properly for this patient? Selected Answer: D. All of the above Question 26 1 out of 1 points In your office, you see a 58-year-old patient with PTSD who reports having nightmares, making it impossible for her to sleep. What recommendations based on principles of sleep hygiene will the PMHNP make? Selected Answer: C. Avoid watching television or reading in bed admits to having difficulty forming and maintaining relationships throughout her life. Understanding maladaptive schemas, which statement does the PMHNP predict that the patient is likely to make? Selected Answer: C. “It takes me a while to warm up to people; people often wear masks.” Question 29 1 out of 1 points The PMHNP understands that anxiety and depression are two disorders in which their symptoms may overlap. When discussing this, you explain that the autonomic nervous system is activated and further helps distinguish anxiety symptoms by making the following points: Selected Answer: B. “You may experience fear, sweating, and muscle tension.” Question 30 1 out of 1 points At the initial interview with a patient, the PMHNP reviews the condition of receiving services, including limits that will be imposed on confidentiality. During the discussion, the patient shares information that the PMHNP is legally required to report. True or false: If the PMHNP does not report information that s/he is legally required to report, state laws govern the consequences which include penalties for not reporting, especially child and elder abuse. Selected Answer: True Question 31 1 out of 1 points The PMHNP has a session with a patient who was injured and traumatized from an explosion at the industrial plant where he used to work. During the session, an outside noise startles the patient and he experiences a flashback of the loud boom from the explosion. The PMHNP witnesses the patient present with anxiety and belabored breathing. What is the appropriate action of the PMHNP? Selecte d Answe r: Question 32 1 out of 1 points “No, I am not sure what you are saying. Can you please explain?” Question 34 1 out of 1 points The PMHNP is working with a patient who is living in poverty and abusing substances. According to the treatment hierarchy framework, what needs does the PMHNP need to attend to first? Selected Answer: A. Provide safety through case management strategies Question 35 1 out of 1 points The PMHNP is having a therapy session with Charlotte, a 20-year-old victim of date rape. The patient states, “I shouldn’t have been there; I should have just gone home. This was all my fault; how could I have been so stupid?” Using the Socratic method, what is the PMHNP’s best response? Selecte d Answe r: Question 36 A. “If this had happened to someone else with the exact same circumstances, would you say this was her fault?” 1 out of 1 points An 11-year-old patient has been exhibiting low self-esteem at school and acting out. According to Maslow’s hierarchy of needs, which of the following questions would best be addressed first by the PMHNP? Selected Answer: C. “Is Joel getting enough sleep at home?” Question 37 1 out of 1 points points A 28-year-old male patient is experiencing distress related to the workplace. What might the PMHNP ask to assess affective development? Selected Answer: D. All of the above. Question 41 1 out of 1 points The PMHNP meets with an adolescent patient who has depression and often presents with resistance when discussing his parent’s divorce. For the past couple of sessions, the patient has been quiet, sometimes refusing to speak. To further support the therapeutic relationship, the PMNHP: Selected Answer: A. Observes and points out the behavior Question 42 1 out of 1 points A PMHNP is preparing confidentiality forms for his patients. What is the most appropriate first step he should take? Selected Answer: B. Research his profession’s ethics code and state/federal laws Question 43 1 out of 1 points The PMHNP is caring for a patient who the PMHNP believes would benefit from a relational psychodynamic approach to therapy. Which action made by the PMHNP demonstrates appropriate use and understanding of the relationship psychodynamic model? Selected Answer: C. Focusing the exploration on here and now Question 46 1 out of 1 points The patient is a 56-year-old female patient diagnosed with panic disorder and reports symptoms that include heart palpitations, frequent trembling, and feelings of choking in stressful situations. What special consideration does the PMHNP make? Selected Answer: D. A and B Question 47 1 out of 1 points A 41-year-old male patient is meeting with the PMHNP and reveals that he is homosexual. He begins telling the PMHNP about his feelings as a homosexual, middle-aged man. The PMHNP nods understandingly. Before long, the patient asks, “Are you gay? Are you married? Do you have kids?” What is the best response by the PMHNP? Selecte d Answe r: Question 48 0 out of 0 points B. Mention that the patient seems quite curious, and ask him to discuss more about himself When completing this exam, did you comply with Walden University’s Code of Conduct including the expectations for academic integrity? Selected Answer: Yes Question 49 1 out of 1 points During cognitive behavioral therapy (CBT), a 64-year-old male patient, states, “My wife hates me! She’s just waiting for me to die.” Using Socratic dialogue (SD) the PMHNP demonstrates understanding of analysis when she A 35-year-old patient seeks treatment for depression and anxiety after an abusive relationship. To help empower the patient, the PMHNP wants to teach the safe-place exercise to create a feeling of calm. In order to walk the patient through the exercise, the PMHNP first says: Selected Answer: A. “Identify an image of a safe place that makes you feel calm.” Question 52 1 out of 1 points The PMHNP is caring for a patient with borderline personality disorder. Using a psychoanalytic psychotherapy approach, the PMHNP attempts to intensify the patient’s transference to enhance emotional processing by: Selected Answer: D. Increasing the number of sessions per week Question 53 0 out of 1 points The PMHNP is working with a 43-year-old male patient who develops idiosyncratic transference over weeks of therapy. The best way for the PMHNP to respond to this patient is to : Selected Answer: C. utilize intersubjectivity Question 54 1 out of 1 points A new patient has been informed of the limits of confidentiality, and has signed informed consent forms. No consent, however, has been obtained for voluntary “Release of Information.” The patient is 20 years old and still lives at home with his parents. He is being treated for depression, which he attributes to the trouble he’s had finding employment. True or false: If the patient’s mother calls the PMHNP to check up on her son to see how he is doing, the therapist is required to protect patient confidentiality and not disclose information. Selected Answer: True Question 58 1 out of 1 points The PMHNP is meeting with a 42-year-old man with depression brought on by the recent passing of his wife. As he describes the circumstances surrounding his late wife’s death, the PMHNP begins to feel sad. The sadness lingers for several hours, and the PMHNP finds it difficult to focus on other patients for the rest of the day. What is the most appropriate explanation for the reaction that the PMHNP is experiencing? Selected Answer: C. Concordant identification Question 59 1 out of 1 points A PMHNP is treating a 50-year-old patient who suffers from depression. When he was growing up, he was often responsible for taking care of his three younger siblings. Since then, the patient puts other people’s needs before his own. Based on this information, the PMHNP would conclude that his interpersonal style is . Selected Answer: A. overly nurturing Question 60 1 out of 1 points A 65-year-old patient has suffered the loss of his wife. He is in a state of hyperarousal with increased sympathetic nervous system arousal. One or more interventions may help the patient to deal with this arousal. To decrease sympathetic nervous system arousal, the PMHNP’s treatment strategy is . Selected Answer: D. all of the above Question 61 1 out of 1 points 1 out of 1 points A PMHNP is assessing ego functioning of his 40-year-old patient by asking what she feels is the cause of her problems. She attributes her problems to her overprotective parents not letting her have enough freedom growing up. Based on her answer, the PMHNP is testing . Selected Answer: C. defensive and interpersonal functioning Question 64 1 out of 1 points The PMHNP is working with a patient who witnessed her father pass away after suffering for several months from terminal cancer. The PMHNP sees this as a traumatic event. The patient reports sometimes feeling out of touch with surroundings; almost as if things feel like a dream. “Sometimes that sensation lingers for a while,” the patient says, “and other times I snap out of it quickly.” What does the PMHNP infer about the condition based on psychotherapy concepts for trauma? Selected Answer: B. The patient is reporting signs of dissociation. Question 65 1 out of 1 points A PMHNP is caring for a 21-year-old woman who is suffering from anxiety and is having difficulty managing stress. Which of the following would be an appropriate step by the PMHNP? Selected Answer: D. All of the above Question 66 1 out of 1 points The PMHNP meets with a 47-year-old male patient who is fearful of leaving the house after having witnessed his neighbor getting run over by a car. When the PMHNP asks why he is afraid to leave his house, the patient replies, “Because another accident might occur.” Which cognitive behavioral therapy (CBT) strategy does the PMHNP employ? Selected Answer: B. Stress inoculation therapy Question 69 1 out of 1 points The PMHNP is caring for a patient who seems to seek affection and attention from the PMHNP and others in the clinic, as well as displays heightened emotional responses to feelings of being excluded. What therapeutic approach does the PMHNP use to decrease autonomic arousal in the patient? Selected Answer: C. A safe-place exercise Question 70 1 out of 1 points The PMHNP is working with a patient who has dissociative disorder and requests pharmacological interventions for dealing with her trauma. What education does the PMHNP provide to the patient regarding medication therapy? Selecte d Answe r: Question 71 1 out of 1 points C. “T he me dic ation may provide symptom relief, but you still need psychotherapy.” The PMHNP is working with a patient who experiences abreactions when discussing repressed feelings of his sexual abuse as a child. What can the PMHNP do to manage the patient’s intense emotional reactions? supportive psychodynamic psychotherapy approach? Selected Answer: B. Suggesting that she seek legal help Question 75 1 out of 1 points A PMHNP is treating a 45-year-old female patient who is upset that her brother has not been calling since his divorce. When asked to describe her brother and what prompts him not to call as frequently, she says, “Everything is about him, not me. I think he’s jealous that I have a good marriage and he wants me to be unhappy, too. So he doesn’t call to upset me and ruin my relationships.” Based on this information, the PMHNP can conclude that the patient . Selected Answer: A. may lack ability to see independent motivations Question 76 1 out of 1 points A 16-year-old female patient has had a stable therapeutic relationship with the PMHNP for several months. The PMHNP notices what appears to be fresh cigarette burns on the patient’s arm. When asked, the patient admits to this self-injurious behavior. Although the patient is still depressed, her mood seems to be somewhat better this week. True or false: The PMHNP would most likely consider this patient stabilized and ready to move to Stage II. Selected Answer: False