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. 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 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 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. . A Give the patient an option about terminating the therapy . B Allow the patient to bring up termination on his/her own . C Embed the termination into the work of the therapeutic . phase D None of the above . 1 points QUESTION 5 1. The PMHNP is caring for a patient who is histrionic. Using the supportive psychodynamic therapy model, what is the best statement made by the PMHNP? A “Express your emotion, and do not hold anything back.” . B “Let’s not think too much about emotion right now. Let’s focus on what got you . upset in the first place.” C A and B . D None of the above . 1 points QUESTION 6 1. A PMHNP is treating a 12-year-old girl who witnessed the physical abuse of her sibling. She has been anxious and irritable since the experience. After speaking with the PMHNP, the patient says she keeps having anxiety-causing thoughts about the experience. Using the PRACTICE technique, which skill will best help the patient interrupt these negative thoughts? A Relaxation B Affect . modulation C Enhancing . safety D Trauma . narrative patient is approaching termination. How does the PMHNP address termination with this patient? NRNP 6640 Final Exam Latest updated Guide 2024. 1 points QUESTION 14 1. The PMHNP assesses a 27-year-old patient named Jeff, who was a victim of child abuse and neglect. Jeff says that he remembers a traumatic situation that he wants to share, but is having trouble talking about it. Which statement made by the PMHNP demonstrates the use of emotion-focused therapy? 1 points QUESTION 15 1. A patient is finishing the active treatment phase of interpersonal psychotherapy (IPT). After the PMHNP reminds the patient that she has three sessions left, the patient says nothing, but looks distressed. What would be the best reply by the PMHNP following IPT protocol? A Correcting cognitive distortions . B Using role-playing techniques . C Unraveling unconscious guilt . D All of the above . A “Let’s see if we can come up with some ideas for you to feel safe telling your . story.” B “Jeff, it’s okay for you to not talk about your past here; this is a safe space, . whether you feel like sharing or not.” C “Jeff, can you tell me what was going on during your childhood that caused you to . be a victim of neglect and abuse?” D None of the above. . A “Maybe we should extend your active treatment phase.” . B “Remember that the end of treatment is not a time to grieve.” . C “Don’t worry. Finishing therapy means you’ve met your goals.” . 1 points QUESTION 13 1. The PMHNP is caring for an adult male patient whose wife left him several months ago. He recently learned that his ex-wife is dating someone much younger. The man feels belittled, sad, and lonely. He talks about trying to meet other women, but says, “I can’t compete with the younger guys these days, with the cool clothes and the vegan diets. I’m bald and overweight, and what woman is going to want to be with me?” How does the PMHNP help raise the man’s self-esteem? NRNP 6640 Final Exam Latest updated Guide 2024. 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?” C “You can try taking natural supplements in addition to the medicine I prescribe NRNP 6640 Final Exam Latest updated Guide 2024. . 1 points 1 points QUESTION 20 1. A patient’s depression is affecting her relationship with her spouse. What might the PMHNP ask during the initial sessions of interpersonal psychotherapy treatment? 1 points QUESTION 21 1. The PMHNP has been treating a patient who is now being transferred to another provider. What is the appropriate action made by the PMHNP? . you.” D All of the above. . QUESTION 19 1. A PMHNP has been treating a 9-year-old patient who was referred by her school. Students are asked to raise their hands before speaking during group discussion, but the patient seems to blurt out what she wants to say without being called on. She also interrupts other children while they are talking instead of waiting her turn. When the patient gets frustrated, she has trouble controlling her emotions and cries often. Based on the initial information provided, the first focus by PMHNP is the child’s . A memory B self- . regulation C language . skills D social . system A “What expectations do you have of your spouse?” . B “How is your depression affecting the relationship with your spouse?” . C “What changes would you and your spouse like to see in the . relationship?” D All of the above. . NRNP 6640 Final Exam Latest updated Guide 2024. 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. A Makes a list of all the positive things the patient gained from treatment . B Does not recognize the patient’s emotions so as to not encourage the onset of . anger C Emphasizes and validates the patient’s feelings of anger that may emerge . D Avoids upsetting the patient by keeping an open door policy . 1 points QUESTION 31 1. A PMHNP is assessing a 40-year-old patient named Sarah who has a severe cocaine addiction and mild depression. Using the four-quadrant model, what would be the most appropriate setting to help the patient? A Primary health care settings with some specialized care . B State psychiatric hospitals and emergency rooms . C Substance abuse treatment system . D The mental health system of care . 1 points QUESTION 32 1. A cocaine-addicted female patient is entering residential treatment for substance abuse. Using the 10 guiding principles of recovery, an appropriate step by the PMHNP is to . A focus on the substance abuse problem before addressing any . trauma B integrate services that encompass mind, body, spirit, and community . C help the patient use fear of relapse to provide motivation for recovery . D none of the above . 1 points QUESTION 33 1. The PMHNP uses the Adult Attachment Interview (AAI) with a male patient who reports having had a difficult time being separated from his parents during his 1. The PMHNP is terminating treatment with a patient who is aggressive and has a history of anger. What does the PMHNP do when terminating treatment with this patient? NRNP 6640 Final Exam Latest updated Guide 2024. 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. 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 . C Pyschoeducational 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. 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. 1 points QUESTION 48 1. A PMHNP is using motivational interviewing (MI) with a 50-year-old patient named Dave to commit to a healthy drug-free lifestyle. By using “change talk,” the PMHNP hopes to help the patient build self-esteem and hope. True or false: If Dave is resisting change, the PMHNP should challenge his resistance in order for MI to be successful. True False 1 points QUESTION 49 1. The PMHNP is interviewing a patient with a history of substance abuse. He has attempted to stop abusing drugs three times before. He states to the PMHNP, “I just cannot change. How can you help me?!” As it applies to change, the PMHNP understands the principle of evocation to mean: A The patient can choose to leave the program whenever he wants because . changing is his choice. B The patient already has everything needed and the PMHNP would like to help . him facilitate his own inner coping. C If the patient tries, he will one day become successful; he must not give up. . D The patient must evolve and change with the times to successfully change his . way of thinking. 1 points QUESTION 50 1. A PMHNP is using emotion-focused therapy to help a 38-year-old patient who says, “I’ve been feeling angry lately, but I’m not sure why.” The first attempt by the PMHNP is to say: A “Focus on your anger, take a deep breath, and allow an image to emerge.” . B “Sit in these two chairs to have a conversation with your anger.” . C “Please tell me in detail about your anger and confusion.” . D “Your experience of anger and confusion is normal.” . True False NRNP 6640 Final Exam Latest updated Guide 2024. 1 points QUESTION 57 1. An 8-year-old has been having trouble making friends at school. His parents initiated treatment when he also started acting out at home. Which is the most appropriate step that the PMHNP takes during the assessment process when using an integrated approach? 1 points QUESTION 58 1. Linda is a 65-year-old patient who has completed initial treatment for alcohol addiction and anxiety problems. She is motivated to continue her treatment gains and have a healthy lifestyle. How would the PMHNP apply a mindfulness approach to this case? 1 points QUESTION 59 1. The PMHNP has been providing supportive psychodynamic psychotherapy to a patient and is nearing the termination stage. The PMHNP will use which criteria for determining that the patient is ready for termination? C Review the therapeutic treatment frame . Call the patient the next day to follow up D . A Collect information from the patient, his parents, and school . B Rule out medical issues that may affect behavior . C Get a measure of the patient’s developmental level . D All of the above . A Help Linda develop an awareness of triggers in order to have greater control over . physical and emotional responses B Encourage Linda to have her husband and children participate in family therapy . to facilitate her integration into the community C Ask Linda to do homework to elicit any other feelings related to her addictive . behavior and evaluate her progress D All of the above . A Transference neurosis has been resolved. . NRNP 6640 Final Exam Latest updated Guide 2024. 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. 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. 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. 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?” . C “Are you upset with someone here? Tell me more about this.” . 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? NRNP 6640 Final Exam Latest updated Guide 2024. 1 points D “Are you sure you no longer want to go to therapy?” .