PMHNP Case Studies: Therapy Approaches and Techniques, Exams of Nursing

Download PMHNP Case Studies: Therapy Approaches and Techniques and more Exams Nursing in PDF only on Docsity! NURS 6640 Final Exam 300 Questions with Answers Question 1 1 out of 1 points 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 . Answer: B. self-regulation Question 2 1 out of 1 points 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? Answer: C. “It’s important to be mindful of how you feel and then to determine what causes those feelings.” Question 3 1 out of 1 points 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? Answer: A. “I noticed that your fingers were tapping. Can you give a voice to your fingers?” Question 4 1 out of 1 points 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? Answer: B. “The type of treatment depends on the stage of dementia and safety considerations.” Question 5 1 out of 1 points 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? Answer: D. All of the above Question 6 1 out of 1 points 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? Answer: A. Immediately report the threat to the local police department Answer: D. A and C Question 14 0 out of 1 points 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? Selected Answer: B. “So you feel frustrated and unhappy being single. Is that right?” Question 15 1 out of 1 points 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? Answer: A. “Although it’s your first session, we will discuss how termination of your treatment will go.” Question 16 1 out of 1 points 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? Answer: B. “Let’s not think too much about emotion right now. Let’s focus on what got you upset in the first place.” Question 17 1 out of 1 points 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? Answer: A. Build a therapeutic alliance Question 18 1 out of 1 points 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? Answer: C. Guide the patient to examine her feelings and explore the underlying meaning Question 19 1 out of 1 points 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? Answer: C. Exception question Question 20 1 out of 1 points The PMHNP is treating an older adult patient who reports symptoms of late-life anxiety. What type of treatment(s) will the PMHNP consider? Answer: A. Employ cognitive behavioral therapy Question 21 1 out of 1 points 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 . Answer: B. integrate services that encompass mind, body, spirit, and community Question 22 1 out of 1 points 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. Answer: False Question 23 1 out of 1 points 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 . Answer: C. ask the patient to reflect on and explore what she is experiencing Question 24 1 out of 1 points 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 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? Answer: D. Encourage the patient to clarify by asking, “You constantly feel anxious?” Question 32 1 out of 1 points 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? Answer: A. Identify the primary defenses the patient uses to ward off anxiety Question 33 1 out of 1 points A 38-year-old patient tells the PMHNP that her father went to jail for selling drugs when she was a child. The patient is visibly upset when discussing what happened. Using a humanistic-existential approach to psychotherapy, which of the following is the most appropriate response by the PMHNP? Answer: B. “What are you experiencing now as you share this story?” Question 34 1 out of 1 points 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. Answer: True Question 35 1 out of 1 points 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: Answer: B. The patient already has everything needed and the PMHNP would like to help him facilitate his own inner coping. Question 36 0 out of 1 points 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? Selected Answer: C. The patient can be weaned off from therapy, but cannot receive treatment indefinitely. Question 37 0 out of 1 points 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 patient is approaching termination. How does the PMHNP address termination with this patient? Selected Answer: A. Give the patient an option about terminating the therapy Question 38 1 out of 1 points 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? Answer: D. All of the above Question 39 1 out of 1 points 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? Answer: A. Encourage the patient to continue treatment by using alternative strategies Question 40 1 out of 1 points 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? Answer: B. Manage termination issues as part of the treatment Question 41 1 out of 1 points 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 . Answer: D. mental health system of care Question 49 1 out of 1 points The PMHNP continues to meet with Gerald, who is the patient with depression and mood disorder. The PMHNP uses the CBT approach. Gerald is now meeting with the PMHNP for his fifth session and feels comfortable with how the therapy works. What does the PMHNP plan to do with Gerald over the course of the next several sessions? Answer: C. Develop cognitive skills to challenge Gerald’s negative thinking Question 50 1 out of 1 points 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, “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 . Answer: D. all of the above Question 51 1 out of 1 points A 43-year-old single mother is seeing the PMHNP at the request of her sister. “My sister thinks I need to come here to talk about my feelings,” the patient reports. The PMHNP learns that the patient has three children from three different men, but is unable to collect appropriate child support payments from any of the biological fathers. Additionally, the woman is barely able to afford her apartment or utilities payments. What is the appropriate response from the PMHNP when using the psychodynamic psychotherapy technique? Answer: C. Suggesting that the patient seek professional legal help Question 52 1 out of 1 points 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? Answer: D. “That must be a very tiring work schedule. How do you feel about working so much?” Question 53 0 out of 1 points 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? Selected Answer: C. Inviting the patient to emote about thoughts and fantasies Question 54 1 out of 1 points 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? Answer: B. Help the patient be aware of his anxiety and embrace it Question 55 1 out of 1 points 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? Answer: C. Compliment the patient on his academic achievement Question 56 1 out of 1 points 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? Answer: C. “Let’s talk about what kinds of things are triggering you now.” Question 57 1 out of 1 points 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? Answer: D. None of the above Question 58 1 out of 1 points The PMHNP is meeting with a patient who has been diagnosed with depression. The patient is having trouble adjusting to her new job and hasn’t made any new friends there. What would an appropriate response be by the PMHNP using the interpersonal psychotherapy approach? Answer: C. “Tell me more about why you’re having trouble making new friends at work.” Question 66 1 out of 1 points 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? Answer: D. All of the above Question 67 1 out of 1 points The PMHNP is interviewing a patient who is in the process of successfully completing a substance abuse program. During the interview, the patient states, “I wish I was strong enough to keep the same friends I had before I came here for treatment. I’m really afraid of being discharged because I’ll probably run into my old friends again.” The PMHNP offers a complex reflection when she states the following: Answer: C. “You’d like to keep your old friends but know being around them may lead you to abuse substances again.” Question 68 0 out of 1 points In the planning phase of change, a 42-year-old male client who struggles with gambling discusses how he plans to abstain from gambling. He tells the PMHNP, “I am no longer going to carry cash to the casino because you can’t spend what you don’t have.” The PMHNP uses an affirming communication skill when she states: Selected Answer: C. “This is a great technique, though it may not work if there is an ATM in the casino you go to.” Question 69 1 out of 1 points 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? Answer: C. Substance abuse treatment system Question 70 0 out of 1 points 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? Selected Answer: A. “What specific improvements have you noticed in your mood since you made the call to see me?” Question 71 1 out of 1 points 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? Answer: B. Empty-chair dialogue Question 72 1 out of 1 points When preparing to terminate a patient, what does the PMHNP do to organize thoughts about the patient’s progress made during treatment? Answer: B. Reviews the patient’s file to identify issues and important themes that were highlighted throughout treatment Question 73 1 out of 1 points 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 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? Answer: A. He will have lapses in his memory of his childhood. Question 74 0 out of 1 points 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? Selected Answer: A. makes a list of all the positive things the patient gained from treatment Question 75 0 out of 1 points The PMHNP is actively listening to Ms. Thomas who is detoxing from alcohol. Ms. Thomas is currently discussing with the PMHNP the reasons why she feels guilty about her drinking. Ms. Thomas tearfully states, “I have driven my family and friends away : Question 82 1 out of 1 points 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? Answer : B. “Let’s not think too much about emotion right now. Let’s focus on what got you upset in the first place.” Question 83 1 out of 1 points The PMHNP is meeting with a patient who has been diagnosed with depression. The patient is having trouble adjusting to her new job and hasn’t made any new friends there. What would an appropriate response be by the PMHNP using the interpersonal psychotherapy approach? Answer: C. “Tell me more about why you’re having trouble making new friends at work.” Question 84 1 out of 1 points 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? Answer : D. All of the above Question 85 1 out of 1 points 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? Answer : C. Substance abuse treatment system Question 86 0 out of 1 points A 25-year-old female states, “I really need to lose weight. I know I’m the cause of our problems, if I could just lose weight he might be more attracted to me. Then we could start a family and we would be happy. I’m sure of it, right, we would definitely be happy!” Which statement shows the PMHNP’s ability to apply “summarizing”? Selected Answer: A. “You believe that your weight is a cause of your marital problems.” Question 87 1 out of 1 points 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? Answer : D. All of the above Question 88 1 out of 1 points 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 . Answer : C. ask the patient to reflect on and explore what she is experiencing Question 89 1 out of 1 points 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: Answer : C. “Please tell me in detail about your anger and confusion.” Question 90 1 out of 1 points 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. Answer: False Question 91 1 out of 1 points approaching termination. How does the PMHNP address termination with this patient? Answer : C. Embed the termination into the work of the therapeutic phase Question 98 0 out of 1 points The PMHNP is actively listening to Ms. Thomas who is detoxing from alcohol. Ms. Thomas is currently discussing with the PMHNP the reasons why she feels guilty about her drinking. Ms. Thomas tearfully states, “I have driven my family and friends away with this terrible habit. I have no one left. I had more than enough chances and now my children won’t even talk to me.” Which of the following statements demonstrate a simple reflection? Selected Answer: C. “You feel that your use of alcohol is a terrible habit.” Question 99 1 out of 1 points 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? Answer : D. “What might help you to live a more meaningful life?” Question 100 1 out of 1 points 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? Answer : C. “It’s important to be mindful of how you feel and then to determine what causes those feelings.” Question 101 1 out of 1 points The PMHNP is interviewing a patient who is in the process of successfully completing a substance abuse program. During the interview, the patient states, “I wish I was strong enough to keep the same friends I had before I came here for treatment. I’m really afraid of being discharged because I’ll probably run into my old friends again.” The PMHNP offers a complex reflection when she states the following: Answer : C. “You’d like to keep your old friends but know being around them may lead you to abuse substances again.” Question 102 1 out of 1 points 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: Answer : D. “I am wondering if your use of pain medication has ever prompted you to seek medical attention.” Question 103 1 out of 1 points 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? Answer : 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. Question 104 1 out of 1 points 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? Answer : B. “The type of treatment depends on the stage of dementia and safety considerations.” Question 105 0 out of 1 points 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? Selected Answer: B. “Now that you are feeling more stable, let’s talk about terminating these sessions.” Question 106 1 out of 1 points 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? Question 113 1 out of 1 points The PMHNP is treating an older adult patient who reports symptoms of late-life anxiety. What type of treatment(s) will the PMHNP consider? Answer : A. Employ cognitive behavioral therapy Question 114 1 out of 1 points 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? Answer : D. Encourage the patient to clarify by asking, “You constantly feel anxious?” Question 115 1 out of 1 points 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? Answer : C. Locate and identify any physical sensations created by the positive feelings Question 116 1 out of 1 points 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? Answer : A. Help Linda develop an awareness of triggers in order to have greater control over physical and emotional responses Question 117 1 out of 1 points 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? Answer: B. Help the patient be aware of his anxiety and embrace it Question 118 1 out of 1 points 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? Answer : A. Build a therapeutic alliance Question 119 1 out of 1 points 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? Answer : D. All of the above Question 120 1 out of 1 points The PMHNP who practices motivational interviewing understands its relationship to patient behaviors and/or outcomes to mean which of the following? Answer : D. There is a lower incidence of inconsistent behaviors with motivational interviewing. This is related to client engagement and better outcomes. Question 121 1 out of 1 points 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? Answer : D. None of the above Question 122 1 out of 1 points The PMHNP has been treating a patient who is now being transferred to another provider. What is the appropriate action made by the PMHNP? Question 129 1 out of 1 points When recalling the phases of change, the PMHNP demonstrates “open questioning” in the “engagement” phase by making which statement? Answer : B. “What occurred to cause you to seek treatment?” Question 130 1 out of 1 points 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. Answer : True Question 131 1 out of 1 points 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 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? Answer : A. He will have lapses in his memory of his childhood. Question 132 0 out of 1 points How does the PMHNP approach termination with the patient who has been receiving intermittent therapy? Selected Answer: A. Uses the word “interrupt” instead of “terminate” with the patient Question 133 1 out of 1 points 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? Answer : A. Identify the primary defenses the patient uses to ward off anxiety Question 134 1 out of 1 points 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? Answer: A. Immediately report the threat to the local police department Question 135 1 out of 1 points 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 . Answer : B. self-regulation Question 136 0 out of 1 points 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? Selected Answer: A. Correcting cognitive distortions Question 137 1 out of 1 points 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? Answer : C. Determining if the patient’s medications can be causing memory problems Question 144 1 out of 1 points A patient’s depression is affecting her relationship with her spouse. What might the PMHNP ask during the initial sessions of interpersonal psychotherapy treatment? Answer: D. All of the above. Question 145 1 out of 1 points 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? Answer : C. Guide the patient to examine her feelings and explore the underlying meaning Question 146 0 out of 1 points 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? Selected C. Answer: “What needs to happen today in order for you to feel that is was a productive session?” Question 147 1 out of 1 points 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? Answer : A. Focusing too heavily on defenses Question 148 1 out of 1 points The PMHNP continues to meet with Gerald, who is the patient with depression and mood disorder. The PMHNP uses the CBT approach. Gerald is now meeting with the PMHNP for his fifth session and feels comfortable with how the therapy works. What does the PMHNP plan to do with Gerald over the course of the next several sessions? Answer: C. Develop cognitive skills to challenge Gerald’s negative thinking Question 149 1 out of 1 points 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? Answer : C. Compliment the patient on his academic achievement Question 150 1 out of 1 points 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? Answer : A. “I noticed that your fingers were tapping. Can you give a voice to your fingers?” Question 151 1 out of 1 points 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 . Answer : B. integrate services that encompass mind, body, spirit, and community Question 152 1 out of 1 points 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: Answer : B. The patient already has everything needed and the PMHNP would like to help him facilitate his own inner coping. 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? Answer: A. Correcting cognitive distortions Question 160 1 out of 1 points 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? Answer: 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. Question 161 1 out of 1 points The PMHNP is terminating treatment for a patient who has been receiving eye movement desensitization and reprocessing (EMDR) therapy. What action does the PMHNP take at the final session to terminate treatment? Answer: B. Discusses all issues that have been addressed Question 162 1 out of 1 points 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? Answer: C. Determining if the patient’s medications can be causing memory problems Question 163 1 out of 1 points 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? Answer: D. None of the above Question 164 0 out of 1 points The PMHNP is assessing a new geriatric patient who reports symptoms of depression. The PMHNP wants to identify the patient’s symptom severity over time. Which assessment tool will the PMHNP use to collect this data on the patient? Selected Answer: C. AB Clinician Depression Screen Question 165 1 out of 1 points How does the PMHNP approach termination with the patient who has been receiving intermittent therapy? Answer: D. A and C Question 166 1 out of 1 points 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? Answer: D. Encourage the patient to clarify by asking, “You constantly feel anxious?” Question 167 1 out of 1 points 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? Answer: A. Identify the primary defenses the patient uses to ward off anxiety Question 168 1 out of 1 points A 38-year-old patient tells the PMHNP that her father went to jail for selling drugs when she was a child. The patient is visibly upset when discussing what happened. Using a humanistic-existential approach to psychotherapy, which of the following is the most appropriate response by the PMHNP? Answer: B. “What are you experiencing now as you share this story?” Question 169 1 out of 1 points 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. Question 177 1 out of 1 points 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: Answer: D. “I am wondering if your use of pain medication has ever prompted you to seek medical attention.” Question 178 0 out of 1 points 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? Selected Answer: C. The patient can be weaned off from therapy, but cannot receive treatment indefinitely. Question 179 0 out of 1 points 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 patient is approaching termination. How does the PMHNP address termination with this patient? Selected Answer: A. Give the patient an option about terminating the therapy Question 180 1 out of 1 points 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? Answer: C. Guide the patient to examine her feelings and explore the underlying meaning Question 181 1 out of 1 points 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? Answer: C. Exception question Question 182 1 out of 1 points The PMHNP is treating an older adult patient who reports symptoms of late-life anxiety. What type of treatment(s) will the PMHNP consider? Answer: A. Employ cognitive behavioral therapy Question 183 1 out of 1 points 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 . Answer: B. integrate services that encompass mind, body, spirit, and community Question 184 1 out of 1 points 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. Answer: False Question 185 1 out of 1 points 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 . Answer: C. ask the patient to reflect on and explore what she is experiencing Question 186 1 out of 1 points 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? Answer: D. All of the above Question 187 1 out of 1 points 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? Answer: A. Trauma-focused CBT Question 195 1 out of 1 points 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? Answer: A. Help Linda develop an awareness of triggers in order to have greater control over physical and emotional responses Question 195 1 out of 1 points 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? Answer: A. “Let’s see if we can come up with some ideas for you to feel safe telling your story.” Question 196 1 out of 1 points 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? Answer: A. “You may want to look into therapeutic oils and aromatherapy as an alternative to medication.” Question 197 1 out of 1 points 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? Answer: C. Locate and identify any physical sensations created by the positive feelings Question 198 1 out of 1 points A patient’s depression is affecting her relationship with her spouse. What might the PMHNP ask during the initial sessions of interpersonal psychotherapy treatment? Answer: D. All of the above. Question 199 1 out of 1 points 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 . Answer: D. mental health system of care Question 200 1 out of 1 points 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? Answer: C. Substance abuse treatment system Question 201 0 out of 1 points 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? Selected Answer: A. “What specific improvements have you noticed in your mood since you made the call to see me?” Question 202 1 out of 1 points 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? Answer: B. Empty-chair dialogue Question 203 1 out of 1 points 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? Answer: C. Inviting the patient to emote about thoughts and fantasies Question 204 1 out of 1 points Question 211 1 out of 1 points 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? Answer: B. Symptoms have improved. Question 212 1 out of 1 points When completing this exam, did you comply with Walden University’s Code of Conduct including the expectations for academic integrity? Answer: Yes Question 213 1 out of 1 points 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? Answer: D. “You seem upset. Tell me what seems to be bothering you.” Question 214 0 out of 1 points The PMHNP has been treating a patient who is now being transferred to another provider. What is the appropriate action made by the PMHNP? Selected Answer: A. Introducing the patient to the new provider Question 215 1 out of 1 points The PMHNP who practices motivational interviewing understands its relationship to patient behaviors and/or outcomes to mean which of the following? Answer: D. There is a lower incidence of inconsistent behaviors with motivational interviewing. This is related to client engagement and better outcomes. Question 216 1 out of 1 points 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? Answer: B. Affect modulation Question 217 0 out of 1 points 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? Selected Answer: A. Encouraging and nurturing the patient Question 218 1 out of 1 points The PMHNP is meeting with a patient who has been diagnosed with depression. The patient is having trouble adjusting to her new job and hasn’t made any new friends there. What would an appropriate response be by the PMHNP using the interpersonal psychotherapy approach? Answer: C. “Tell me more about why you’re having trouble making new friends at work.” Question 219 1 out of 1 points 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? Answer: D. All of the above Question 220 1 out of 1 points The PMHNP is interviewing a patient who is in the process of successfully completing a substance abuse program. During the interview, the patient states, “I wish I was strong enough to keep the same friends I had before I came here for treatment. I’m really afraid of being discharged because I’ll probably run into my old friends again.” The PMHNP offers a complex reflection when she states the following: Answer: C. “You’d like to keep your old friends but know being around them may lead you to abuse substances again.” Question 221 0 out of 1 points Selected Answer: A. “You believe that your weight is a cause of your marital problems.” Question 228 1 out of 1 points The PMHNP is actively listening to Ms. Thomas who is detoxing from alcohol. Ms. Thomas is currently discussing with the PMHNP the reasons why she feels guilty about her drinking. Ms. Thomas tearfully states, “I have driven my family and friends away with this terrible habit. I have no one left. I had more than enough chances and now my children won’t even talk to me.” Which of the following statements demonstrate a simple reflection? Answer: D. All the above. Question 229 1 out of 1 points The PMHNP continues to meet with Gerald, who is the patient with depression and mood disorder. The PMHNP uses the CBT approach. Gerald is now meeting with the PMHNP for his fifth session and feels comfortable with how the therapy works. What does the PMHNP plan to do with Gerald over the course of the next several sessions? Answer : C. Develop cognitive skills to challenge Gerald’s negative thinking Question 230 1 out of 1 points The PMHNP is assessing a new geriatric patient who reports symptoms of depression. The PMHNP wants to identify the patient’s symptom severity over time. Which assessment tool will the PMHNP use to collect this data on the patient? Answer: B. Montgomery-Asberg Depression Rating Scale Question 231 1 out of 1 points 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 . Answer : B. integrate services that encompass mind, body, spirit, and community Question 232 1 out of 1 points 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 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? Answer: A. He will have lapses in his memory of his childhood. Question 233 1 out of 1 points 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? Answer: D. None of the above Question 234 1 out of 1 points 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? Answer B. “Have you thought of how you will continue your treatment : plans?” Question 235 1 out of 1 points 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? Answer : D. Encourage the patient to clarify by asking, “You constantly feel anxious?” Question 236 1 out of 1 points A patient’s depression is affecting her relationship with her spouse. What might the PMHNP ask during the initial sessions of interpersonal psychotherapy treatment? Answer: D. All of the above. Question 237 1 out of 1 points How does the PMHNP approach termination with the patient who has been receiving intermittent therapy? Answer: D. A and C Question 238 1 out of 1 points The PMHNP who practices motivational interviewing understands its relationship to patient behaviors and/or outcomes to mean which of the following? Answer : D. There is a lower incidence of inconsistent behaviors with motivational interviewing. This is related to client engagement Question 246 1 out of 1 points 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: Answer : D. “I am wondering if your use of pain medication has ever prompted you to seek medical attention.” Question 247 1 out of 1 points 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 . Answer : C. ask the patient to reflect on and explore what she is experiencing Question 248 1 out of 1 points 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? Answer : D. “That must be a very tiring work schedule. How do you feel about working so much?” Question 249 1 out of 1 points 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? Answer : A. “Although it’s your first session, we will discuss how termination of your treatment will go.” Question 250 1 out of 1 points The PMHNP is terminating treatment for a patient who has been receiving eye movement desensitization and reprocessing (EMDR) therapy. What action does the PMHNP take at the final session to terminate treatment? Answer : B. Discusses all issues that have been addressed Question 251 1 out of 1 points 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? Answer: A. Trauma-focused CBT Question 252 1 out of 1 points 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? Answer : D. Combination of CBT and medication Question 253 1 out of 1 points A 38-year-old patient tells the PMHNP that her father went to jail for selling drugs when she was a child. The patient is visibly upset when discussing what happened. Using a humanistic-existential approach to psychotherapy, which of the following is the most appropriate response by the PMHNP? Answer: B. “What are you experiencing now as you share this story?” Question 254 1 out of 1 points 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? Answer: D. All of the above Question 255 1 out of 1 points 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? Answer : A. Identify the primary defenses the patient uses to ward off anxiety Selected Answer: B. State psychiatric hospitals and emergency rooms Question 262 1 out of 1 points 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? Answer: B. Symptoms have improved. Question 263 1 out of 1 points 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? Answer : B. “Let’s not think too much about emotion right now. Let’s focus on what got you upset in the first place.” Question 264 1 out of 1 points When recalling the phases of change, the PMHNP demonstrates “open questioning” in the “engagement” phase by making which statement? Answer : B. “What occurred to cause you to seek treatment?” Question 265 1 out of 1 points 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? Answer : B. “The type of treatment depends on the stage of dementia and safety considerations.” Question 266 0 out of 1 points 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? Selected Answer: A. Individual CBT Question 267 1 out of 1 points When completing this exam, did you comply with Walden University’s Code of Conduct including the expectations for academic integrity? Answer : Yes Question 268 1 out of 1 points 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 patient is approaching termination. How does the PMHNP address termination with this patient? Answer : C. Embed the termination into the work of the therapeutic phase Question 269 1 out of 1 points 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? Answer : A. “Let’s see if we can come up with some ideas for you to feel safe telling your story.” Question 270 1 out of 1 points 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? Answer: B. Affect modulation Question 271 1 out of 1 points 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? Answer : A. Encourage the patient to continue treatment by using alternative strategies Question 272 1 out of 1 points The PMHNP is treating an older adult patient who reports symptoms of late-life anxiety. What type of treatment(s) will the PMHNP consider? Answer: A. Employ cognitive behavioral therapy Question 280 1 out of 1 points When preparing to terminate a patient, what does the PMHNP do to organize thoughts about the patient’s progress made during treatment? Answer : B. Reviews the patient’s file to identify issues and important themes that were highlighted throughout treatment Question 281 1 out of 1 points 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? Answer: D. All of the above Question 282 1 out of 1 points 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? Answer : C. Emphasizes and validates the patient’s feelings of anger that may emerge Question 283 1 out of 1 points 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. Answer: Question 284 1 out of 1 points 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? Answer: D. Question 285 1 out of 1 points 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? Answer : A. Help Linda develop an awareness of triggers in order to have greater control over physical and emotional responses Question 286 1 out of 1 points 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 . Answer: D. mental health system of care All of the above True Question 287 1 out of 1 points 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? Answer: B. Manage termination issues as part of the treatment Question 288 1 out of 1 points 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? Answer : C. Locate and identify any physical sensations created by the positive feelings Question 289 1 out of 1 points 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? Answer: D. All of the above Question 290 1 out of 1 points did not?” In this case, what type of question is the PMHNP asking? Answer: C. Exception question Question 298 1 out of 1 points 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? Answer : D. “You seem upset. Tell me what seems to be bothering you.” Question 299 1 out of 1 points 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? Answer : 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. Question 300 1 out of 1 points 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? Answer: A. Build a therapeutic alliance Question 301 1 out of 1 points 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: Answer : B. The patient already has everything needed and the PMHNP would like to help him facilitate his own inner coping. Question 302 1 out of 1 points A 43-year-old single mother is seeing the PMHNP at the request of her sister. “My sister thinks I need to come here to talk about my feelings,” the patient reports. The PMHNP learns that the patient has three children from three different men, but is unable to collect appropriate child support payments from any of the biological fathers. Additionally, the woman is barely able to afford her apartment or utilities payments. What is the appropriate response from the PMHNP when using the psychodynamic psychotherapy technique? Answer: C. Suggesting that the patient seek professional legal help