PMHNP Therapeutic Approaches: Identifying the Right Model for Different Patient Scenarios, Exams of Nursing

Download PMHNP Therapeutic Approaches: Identifying the Right Model for Different Patient Scenarios and more Exams Nursing in PDF only on Docsity! NRNP 6640 Final Exam Latest updated Guide 2024 Guaranteed Success For Grade A+ A Interviews the patient’s family, caregiver, or friends regarding the patient’s . progress outside of the sessions B Reviews the patient’s file to identify issues and important themes that were . highlighted throughout treatment C Requests a peer to review the patient’s file to double check that the PMHNP has . not overlooked anything D All of the above . 1 points QUESTION 2 1. The PMHNP is caring for an older adult patient who is in the acute phase of schizophrenia. Which therapeutic model will the PMHNP employ with this patient? A Individual CBT . B Group CBT . C Both A and B . D None of the above . 1 points QUESTION 3 1. A 55-year-old patient recovering from substance abuse tells the PMHNP, “It’s impossible to meet new people. I really hate being single.” Using existential psychotherapy, what might the PMHNP say next? A “Where are you experiencing unhappiness in your body? . B “So you feel frustrated and unhappy being single. Is that right?” . C “Are you willing to say, ‘I’m having a hard time meeting people’?” . D “What might help you to live a more meaningful life?” . 1 points QUESTION 1 1. When preparing to terminate a patient, what does the PMHNP do to organize thoughts about the patient’s progress made during treatment? NRNP 6640 Final Exam Latest updated Guide 2024 Guaranteed Success For Grade A+ QUESTION 4 1. The PMHNP has been providing interpersonal psychotherapy (IPT) for a patient who the PMHNP observes implementing new ways of being, such as interacting more with peers and being less isolated in social scenarios. The PMHNP understands that the NRNP 6640 Final Exam Latest updated Guide 2024 Guaranteed Success For Grade A+ 1 points QUESTION 8 1. A PMHNP is using interpersonal psychotherapy with a 40-year-old patient having relationship problems with his extended family. The patient shares that he has been using the strategies they identified to reduce his distress, but they have not been helping. He is frustrated and is considering stopping treatment. What would be an appropriate step by the PMHNP? 1 points QUESTION 9 1. The PMHNP is caring for a geriatric patient who expresses symptoms of gastrointestinal problems, aches and pains, and loss of appetite. The patient reports feeling lonely, as more of his friends have been passing away over the recent months and years. The PMHNP focuses on which therapeutic approach for this patient? A “Keep your expectations high to show that you believe in his abilities.” . B “Modify your expectations at home and school until the depression lifts.” . C “Don’t put expectations on him while he is showing signs of depression.” . D “Allow him to be an active participant by setting his own expectations.” . A Encourage the patient to continue treatment by using alternative strategies . B Restart the process at the assessment phase to formulate a new treatment . plan C Explain how the originally identified strategies will address the focus problem . D None of the above . A Supportive therapy . B Problem-solving therapy . C Cognitive behavioral . therapy 1 points QUESTION 7 1. A PMHNP has been treating a 14-year-old patient using interpersonal psychotherapy. The patient has been depressed since the death of his grandmother. To help the patient recover, the PMHNP has told the parents: NRNP 6640 Final Exam Latest updated Guide 2024 Guaranteed Success For Grade A+ D All of the above . NRNP 6640 Final Exam Latest updated Guide 2024 Guaranteed Success For Grade A+ 1 points QUESTION 11 1. A 21-year-old patient has been having trouble adjusting to college life. She tells the PMHNP that she had five alcoholic drinks at a party this past weekend. She also acknowledges that she drank the same amount of alcohol at a party the previous month. Based on this information, what would the PMHNP most likely recommend? 1 points QUESTION 12 1. The PMHNP uses therapeutic communication skills while ensuring that the patient understands that he has choices. The PMHNP comprehends and practices motivational interviewing. This is best understood as which of the following? A “I noticed that your fingers were tapping. Can you give a voice to your fingers?” . B “I’m going to ask you to exaggerate the movement of tapping your fingers.” . C “Explore what is emerging in your body now. What are you experiencing right . now?” D None of the above. . A Group therapy . B Peer support . C Hospitalization . D None of the above . A Give the patient as much time needed to respond to questions and comments. . B A statement that both challenges the patient’s resistance and offers an . opportunity to discuss the issues allows the patient to argue with him/herself to help produce a desired change. C You must give full attention to the patient because nonverbal and verbal reactions . are equally important. D The PMHNP should be ready with a response when communicating with the 1 points QUESTION 10 1. A PMHNP is using Gestalt therapy to communicate with a 50-year-old patient who is going through a divorce. As he is calmly sharing the details of his divorce, the PMHNP notices that Dave is tapping his fingers on his legs. What is an appropriate response by the PMHNP using the technique of focusing? NRNP 6640 Final Exam Latest updated Guide 2024 Guaranteed Success For Grade A+ C “Don’t worry. Finishing therapy means you’ve met your goals.” . NRNP 6640 Final Exam Latest updated Guide 2024 Guaranteed Success For Grade A+ 1 points QUESTION 16 1. The PMHNP is working with a patient who describes having a painful and traumatic childhood experience, which causes her to have anxiety as an adult. When asked how she manages her anxiety, the patient dismisses it and denies that it is a problem. Using the supportive psychotherapy approach, the PMHNP will do which of the following when assessing the patient’s ego strength? 1 points QUESTION 17 1. A 21-year-old patient is worried about starting a new job. She talks about her fears of failure and not making friends at the office. Using a person-centered approach, an appropriate response by the PMHNP is to . 1 points QUESTION 18 1. The PMHNP is caring for an older patient with major depressive disorder, seasonal pattern. The patient has been resolute about not taking medication to manage the depression brought on by his illness, stating that it is against his yogic lifestyle. In addition to psychotherapy, what can the PMHNP suggest to this patient? D “You seem upset. Tell me what seems to be bothering you.” . A Identify the primary defenses the patient uses to ward off anxiety . B Focus on the patient’s attachment to the anxiety and memories of her childhood . C Identify whether the patient has an unresolved or disorganized attachment style . D All of the above . A give the patient advice based on the therapist’s experiences . B persuade the patient to release her unfounded fears and worries . C ask the patient to reflect on and explore what she is . experiencing D all of the above . A “You may want to look into therapeutic oils and aromatherapy as an alternative to . medication.” B “Some patients have good results with medicine. Are you sure you don’t want to . try it?” NRNP 6640 Final Exam Latest updated Guide 2024 Guaranteed Success For Grade A+ C “You can try taking natural supplements in addition to the medicine I prescribe NRNP 6640 Final Exam Latest updated Guide 2024 Guaranteed Success For Grade A+ A “For homework, please write a list of qualities you’d find in a good friend.” . B “Describe the friendships you had growing up, both as a child and teenager.” . C “Tell me more about why you’re having trouble making new friends at work.” . D All of the above. . 1 points QUESTION 25 1. Mia is a 75-year-old patient who has completed initial treatment for depression. What might a PMHNP ask Mia when using a solution-focused therapy approach? A “What specific improvements have you noticed in your mood since you made the . call to see me?” B “On a scale of 1–10 (with 1 being little to no improvement to 10 being a great . deal of improvement) how much has your mood changed since we started working together?” C “What needs to happen today in order for you to feel that is was a productive . session?” D All of the above. . 1 points QUESTION 26 1. When recalling the phases of change, the PMHNP demonstrates “open questioning” in the “engagement” phase by making which statement? A “What plans have you made to make this change?” . B “What occurred to cause you to seek treatment?” . C “What concerns you the most about these subjects?” . D “What do you want do you want be different?” . 1 points there. What would an appropriate response be by the PMHNP using the interpersonal psychotherapy approach? NRNP 6640 Final Exam Latest updated Guide 2024 Guaranteed Success For Grade A+ QUESTION 27 1. The PMHNP is treating an older adult patient who reports experiencing nightmares associated with an automobile accident he was in 20 years ago. As the PMHNP formulates the case using the dynamic supportive therapy model, what questions will the PMHNP use during the session? NRNP 6640 Final Exam Latest updated Guide 2024 Guaranteed Success For Grade A+ 1 points QUESTION 28 1. The PMHNP is caring for an older adult patient who presents with mixed dysphoric states and whose daughter reports “is becoming more irritable more easily.” When talking with the patient, the PMHNP also recognizes displays of cognitive dysfunction. Which treatment options will the PMHNP most likely suggest? 1 points QUESTION 29 1. As part of the PMHNP’s role in the clinic, the PMHNP oversees students that gain clinical experience at the agency. The student is instructed to use the supportive psychodynamic therapy approach with the patient. Which action made by the student causes the PMHNP to intervene, after observing the student interacting with the patient? 1 points QUESTION 30 A “What can you tell me about this room?” . B “You might benefit from a sleep aid.” . C “Let’s talk about what kinds of things are triggering you now.” . D “Do I have your permission to advocate for you with your primary care . physician?” A Cognitive behavioral therapy (CBT) . B Interpersonal psychotherapy (IPT) . C Combination of CBT and IPT . D Combination of CBT and medication . A Focusing too heavily on defenses . B Talking to the patient about the use of problem-solving strategies . C Inviting the patient to emote about thoughts and fantasies . D Asking the patient about the patient’s work stress . NRNP 6640 Final Exam Latest updated Guide 2024 Guaranteed Success For Grade A+ A He will have lapses in his memory of his childhood. . B He will be able to describe his childhood in great detail. . C He will need less active interventions. . D None of the above. . 1 points QUESTION 34 1. The PMHNP is treating an older adult patient who reports symptoms of late-life anxiety. What type of treatment(s) will the PMHNP consider? A Employ cognitive behavioral therapy . B Use relaxation training . C Initiate modular interventions . D All of the above . 1 points QUESTION 35 1. The PMHNP is caring for a patient who experiences depression caused by the traumatic experience of her dog passing away. She reports not being able to eat or sleep, and sometimes doesn’t want to leave the house at all. Which statement is most appropriate for the PMHNP to maximize the patient’s adaptive coping mechanisms? A “Think of something funny every time you feel sad.” . B “My cat passed away last year, and it’s been hard to adjust to her being gone.” . C “It’s important to be mindful of how you feel and then to determine what causes . those feelings.” D B and C . 1 points QUESTION 36 childhood. He explains that going to school or visiting his relatives without his parents was troublesome. The PMHNP characterizes the patient as unresolved/disorganized, according to his outcomes on the AAI. What does the PMHNP anticipate from the patient? NRNP 6640 Final Exam Latest updated Guide 2024 Guaranteed Success For Grade A+ A primary health care setting with some specialized care . B state psychiatric hospital and/or emergency room . C substance abuse treatment system . D mental health system of care . 1 points QUESTION 37 1. How does the PMHNP approach termination with the patient who has been receiving intermittent therapy? A Uses the word “interrupt” instead of “terminate” with the patient . B Requires the therapy be resumed in several months . C Encourages the patient to check in with the PMHNP about his/her progress . D A and C . 1 points QUESTION 38 1. The PMHNP is assessing a patient who has been receiving months of outpatient psychotherapy. According to the PMHNP’s assessment, the patient is nearing the termination phase of their therapeutic relationship because the patient’s symptoms have improved, and the patient shows progress managing behaviors and decision-making abilities according to the diagnosis. How does the PMHNP approach termination with this patient? A Address the termination phase with the patient at the last session . B Manage termination issues as part of the treatment . C Determine the PMHNP’s readiness to terminate the therapeutic relationship . D None of the above . 1 points 1. A PMHNP is assessing a 60-year-old patient named Carlos. He has severe PTSD and mild substance abuse issues. The most appropriate setting to treat Carlos would be a . NRNP 6640 Final Exam Latest updated Guide 2024 Guaranteed Success For Grade A+ QUESTION 39 NRNP 6640 Final Exam Latest updated Guide 2024 Guaranteed Success For Grade A+ A “You need to find a new place to work.” . B “Who cares about getting laid off? Then you can collect unemployment benefits.” . C “I’m sure you have parents or a husband to take care of you if you lose your job.” . “That must be a very tiring work schedule. How do you feel about working so much?” D . 1 points QUESTION 43 1. A PMHNP is using Gestalt therapy to communicate with a 42-year-old patient who is upset with her mother. She says, “I want to tell her how hurt I feel when she doesn’t call me, but I don’t want to upset her.” What technique can the PMHNP use to help Sasha express herself? A Language of responsibility . B Empty-chair dialogue . C Dreamwork . D Focusing . 1 points QUESTION 44 1. A PMHNP is treating a 10-year-old boy who is exhibiting signs of aggression and attention problems. What type of intervention will the PMHNP consider using a common elements approach? A Behavioral . B Cognitive . 1. The PMHNP meets with a 31-year-old woman who reports feeling as though she is “at her breaking point” with work. The PMHNP learns that the woman works 12-hour days, including one day on the weekend, because she is nervous about company layoffs. “I feel like I need to work myself to death in order to prove that I am valuable to the organization,” the woman says. Using the supportive psychodynamic therapy approach, how does the PMHNP respond? NRNP 6640 Final Exam Latest updated Guide 2024 Guaranteed Success For Grade A+ C Pyschoeducational NRNP 6640 Final Exam Latest updated Guide 2024 Guaranteed Success For Grade A+ 1 points QUESTION 45 1. The PMHNP is meeting with an older, female adult patient and her daughter. The patient has early onset dementia. The daughter expresses concern, saying, “I don’t want you to just stick my mother in a home and give her medicine. I’m worried that’s what people are going to want to do.” What is the best response by the PMHNP to the daughter? 1 points QUESTION 46 1. A 38-year-old patient has been having trouble communicating with his teenage daughter. Using a solution-focused therapy approach, the PMHNP responds by saying, “When was a time that a communication problem could have occurred, but did not?” In this case, what type of question is the PMHNP asking? 1 points QUESTION 47 1. A PMHNP has been working with a 50-year-old patient who has a stressful job and goes to the casino on weekends to play poker with his friends, which he says relieves his stress. Tim admits that he sometimes misses work on Monday when he stays out too late at the casino on Sunday nights. In addition, he once was an avid runner, and has given up running to spend more time gambling. True or false: According to the PMHNP, the desired goal after treatment is not complete abstinence from gambling, but reaching a healthy level of the behavior. . D All of the above . A “Most of the time, institutionalization cannot be prevented.” . B “The type of treatment depends on the stage of dementia and safety . considerations.” C “Don’t worry; I do not believe in hospitalizing my patients.” . D “The treatment decision will be up to your mother and what she wants.” . A Coping question . B Joining question . C Exception question . D Miracle question . NRNP 6640 Final Exam Latest updated Guide 2024 Guaranteed Success For Grade A+ 1 points QUESTION 52 1. A 13-year-old patient and his parents are meeting with a PMHNP. When the PMHNP says hello, the boy just nods. His parents tell the PMHNP that he didn’t want to come to the session, but they insisted. They explain that their son has been moody and depressed at home, but is still getting good grades at school. Which of the following would be the best response by the PMHNP? 1 points QUESTION 53 1. While assessing a patient using a humanistic-existential approach, a patient tells the PMHNP, “For the past few weeks, I’ve felt anxious almost every single day.” What would be an appropriate next step by the PMHNP? A “I sincerely commend you for being here and seeking treatment; this is a great . first step.” B “If no one knows about your substance usage, why are you here?” . C “Just because no one knows about your drug usage does not mean you do not . have a problem.” D “I am wondering if your use of pain medication has ever prompted you to seek . medical attention.” A Ask the patient to leave the room to speak with his . parents B Tell the patient that he shouldn’t be upset at his parents . C Compliment the patient on his academic achievement . D All of the above . A Try to provide a diagnosis based on the patient’s description of daily anxiety . B Give the patient some possible solutions they might use for feeling less . anxious C Use traditional assessment procedures, such as giving a psychometric test 1 points QUESTION 51 1. The PMHNP is communicating with a middle-aged male patient who has a history of addiction to Percocet (acetaminophen/oxycodone). The patient suddenly yells, “I do not have a problem with pain pills! I’ve never had an overdose and no one even knows that I take them unless I tell them.” The PMHNP understands that there are phases of change and can best demonstrate “focusing” by responding with: NRNP 6640 Final Exam Latest updated Guide 2024 Guaranteed Success For Grade A+ . NRNP 6640 Final Exam Latest updated Guide 2024 Guaranteed Success For Grade A+ 1 points QUESTION 54 1. The PMHNP is initiating a plan of care for a patient who requires comprehensive psychotherapy to manage his depression and mood disorder. Throughout the initial sessions, the patient reports feeling as though he cannot be helped. The PMHNP is concerned about premature termination initiated by the patient. What strategy can the PMHNP employ to prevent or reduce premature termination? 1 points QUESTION 55 1. The PMHNP uses the cognitive behavioral therapy model with Gerald, an older adult patient who is being treated for depression and mood disorder. What will the PMHNP do with the patient during the first three sessions? 1 points QUESTION 56 1. A 35-year-old male patient is being treated for alcohol addiction. He asks for the PMHNP’s cell phone number to use in case of an emergency. When the PMHNP responds that giving her number would be against therapeutic rules, the patient threatens an act of violence to the therapist. What would be the most appropriate response by the PMHNP? D Encourage the patient to clarify by asking, “You constantly feel anxious?” . A Incorporate patient preferences as to the type of therapy used . B Educate the patient about the duration and pattern of change . C Foster a therapeutic alliance with the patient . D All of the above . A Build a therapeutic alliance . B Build behavioral skills to increase pleasant activities . C Build cognitive skills to challenge negative thinking . D Build social skills to improve problem solving . A Immediately report the threat to the local police department . B Allow the patient to explore his feelings NRNP 6640 Final Exam Latest updated Guide 2024 Guaranteed Success For Grade A+ . NRNP 6640 Final Exam Latest updated Guide 2024 Guaranteed Success For Grade A+ 1 points QUESTION 60 1. The PMHNP is initiating a plan of care for Holly, a 73-year-old female patient who has late-life bipolar disorder and reports consuming alcoholic beverages four times per week. What is the focus of Holly’s therapy going to be? 1 points QUESTION 61 1. A 19-year-old female patient named Anna, who was the victim of child abuse and neglect, is also in treatment for substance abuse. At her most recent appointment, Anna confesses to the PMHNP that she is having romantic fantasies about him, and explains the he is one of the few people she trusts. She believes that he is interested in her as well. What is the most appropriate response by the PMHNP in this situation? 1 points QUESTION 62 1. The PMHNP is assessing a 30-year-old client who reports feeling stressed out due to his current employment situation. When asked about how he manages this work- related stress, the patient says that exercise helps him feel less anxious, so he often spends 2 or more hours at the gym each night. After completing the patient assessment, the PMHNP has determined that an existential psychotherapy approach may best benefit this client. What is the PMHNP’s goal in employing this treatment approach? B Symptoms have improved. . C Core conflicts have been reduced. . D Self-analytic capacity has been developed. . A Managing health and substance abuse . B Maintaining meaningful relationships . C Skills for daily living . D All of the above . A Encourage her to focus on therapy and keep the conversation professional . B Explain that he must terminate counseling because of the therapeutic frame . C Guide the patient to examine her feelings and explore the underlying . meaning D None of the above . NRNP 6640 Final Exam Latest updated Guide 2024 Guaranteed Success For Grade A+ 1 points QUESTION 63 1. The PMHNP is in the process of terminating treatment with a patient who witnessed the death of her parent who used to sexually abuse her. What does the PMHNP understand about terminating this patient? 1 points QUESTION 64 1. The PMHNP who practices motivational interviewing understands its relationship to patient behaviors and/or outcomes to mean which of the following? 1 points QUESTION 65 1. The PMHNP is caring for a young adult patient with whom the PMHNP decides to use a dynamic supportive therapy approach in addition to pharmacological intervention. Which therapeutic action will the PMHNP take to employ the strategy of holding and containing the patient? A Help the patient eliminate anxiety from his life . B Help the patient be aware of his anxiety and embrace . it C Help the patient find alternative ways to de-stress . D None of the above . A The patient should be made aware that he/she may have trouble managing the . trauma. B The patient will have to resume treatment with a different provider for further . treatment. C The patient can be weaned off from therapy, but cannot receive treatment . indefinitely. D The patient may need to have follow-up sessions every few months. . A An increased use of motivational interviewing is linked to inconsistent behaviors . in the patient. This is related to decreased client engagement and poor outcomes. B A decreased use of motivational interviewing is linked to more consistent . behaviors in the patient. This is related to decreased client engagement and poor outcomes. C There is a higher incidence of inconsistent behaviors with motivational . interviewing. This is related to client engagement and better outcomes. D There is a lower incidence of inconsistent behaviors with motivational . interviewing. This is related to client engagement and better outcomes. NRNP 6640 Final Exam Latest updated Guide 2024 Guaranteed Success For Grade A+ QUESTION 71 1. A PMHNP is treating a 25-year-old patient who has a compulsive urge to exercise to excess. When asked to describe why she does so much exercise, she says, NRNP 6640 Final Exam Latest updated Guide 2024 Guaranteed Success For Grade A+ A return to a normal system of functioning . B break the feeling/behavior connection . C use more appropriate ways to satisfy needs . all of the above D . 1 points QUESTION 72 1. The PMHNP is assessing a patient who requires cognitive behavioral therapy (CBT). Which of the following statements made by the PMHNP approach the termination phase for this patient? A “Although it’s your first session, we will discuss how termination of your treatment . will go.” B “Now that you are feeling more stable, let’s talk about terminating these . sessions.” C “We will wait to discuss terminating the treatment until you’ve attended at least . five sessions.” D None of the above. . 1 points QUESTION 73 1. The PMHNP initiates feeling-state therapy to help a 25-year-old patient named Monique who has a compulsive urge to exercise. Using the Feeling-State Addiction Protocol, what is an appropriate next step the PMHNP should take after identifying the specific positive feeling linked with the addictive behavior and its Positive Feeling Score level? A Evaluate the patient for having the coping skills to manage feelings . B Perform eye movement sets until the Positive Feeling Score level drops . C Locate and identify any physical sensations created by the positive feelings . D Have the patient visualize performing the addictive behavior . “I like the compliments I receive from others on my new level of fitness, and the excitement of getting more attention.” The PMHNP can use feeling-state therapy to help Monique . NRNP 6640 Final Exam Latest updated Guide 2024 Guaranteed Success For Grade A+ 1 points QUESTION 75 1. A 12-year-old girl was referred for treatment after witnessing the physical abuse of her sibling by their mother. The patient has been anxious and irritable since the experience. What evidence-based treatment would be most appropriate for the PMHNP to use? 1 points QUESTION 76 1. Following an attempted suicide, Mr. Durham was admitted to an acute psychiatric facility. After 4 weeks in treatment, he is preparing for discharge. He is beginning to miss individual and group therapy sessions and has refused medications twice in the past 2 days. The PMHNP demonstrates understanding in this phase by saying which of the following statements? A Collaborating with the patient’s caregiver to discuss a treatment approach . B Prescribing an antidepressant to address the patient’s symptoms . C Determining if the patient’s medications can be causing memory problems . D All of the above . A Trauma-focused CBT . B Interpersonal psychotherapy . C Psychodynamic therapy . D Behavioral parent training . A “It is your choice whether to continue to take your medications.” . B “Have you thought of how you will continue your treatment plans?” . 1 points QUESTION 74 1. The PMHNP is assessing an older adult male patient with depression and comorbidities. According to the medical chart, the patient takes medication to manage joint and bone pain. The patient reports feeling “forgetful” and complains that he has a hard time remembering where he puts things. What is the primary action by the PMHNP?