PMHNP Case Studies & Therapeutic Approaches, Exams of Nursing

Download PMHNP Case Studies & Therapeutic Approaches and more Exams Nursing in PDF only on Docsity! NURS 6640 Final Exam Questions and Answers Latest Update 2024 Guaranteed Success Question 1 1. 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? A . “You feel that your children have given you many chances.” B . “You believe that you have no one to support you through this.” C . “You feel that your use of alcohol is a terrible habit.” D . All the above. D 1 point Question 2 1. A 13-year-old patient and his parents are meeting with a PMHNP. When the PMHNP says hello, the boy just nods. His parents tell the PMHNP that he didn’t want to come to the session, but they insisted. They explain that their son has been moody and depressed at home, but are still getting good grades at school. Which of the following would be the best response by the PMHNP? A . Ask the patient to leave the room to speak with his parents B . Tell the patient that he shouldn’t be upset at his parents C . Compliment the patient on his academic achievement D . All of the above C 1 point Question 3 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 1 point Question 6 1. 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? A . Helps the patient create a future template B . Discusses all issues that have been addressed C . Asks the patient to take a new assessment D . All of the above B 1 point Question 7 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 . Encouraging and nurturing the patient B . Asking the patient how the patient feels C . Discussing why the patient is not taking the medication as directed D . Teaching the patient about medication side effects B 1 point Question 8 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 B 1 point Question 9 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 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? 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. 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 point C Question 13 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 . DreamWorks D . Focusi ng B 1 point Question 14 1. 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”? A . “You believe that your weight is a cause of your marital problems.” B “How would starting a family contribute to your overall . happiness? C . “You have identified your weight as a problem in your marriage and but believe that losing weight will gain happiness.” D . “Part of you believes that losing weight will bring you happiness, while the other part believes that may not be true.” C 1 point Question 15 1. The PMHNP is treating an older adult patient who reports experiencing nightmares associated with an automobile accident he was in 20 years ago. As the PMHNP 1 point Question 18 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?” D 1 point Question 19 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? A . Managing health and substance abuse B . Maintaining meaningful relationships C . Skills for daily living D . All of the above D 1 point Question 20 1. A PMHNP is treating a 25-year-old patient who has a compulsive urge to exercise to excess. When asked to describe why she does so much exercise, she says, “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 . A . return to a normal system of functioning B . break the feeling/behavior connection C . use more appropriate ways to satisfy needs D . all of the above D 1 point Question 21 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 point Question 22 help raise the man’s self-esteem? A . Correcting cognitive distortions B . Using role-playing techniques C . Unraveling unconscious guilt D . All of the above D 1 point Question 25 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? 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 C 1 point Question 26 1. The PMHNP is caring for an older adult patient who presents with mixed dysphonic 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? A . Cognitive behavioral therapy (CBT) B . Interpersonal psychotherapy (IPT) C . Combination of CBT and IPT D Combination of CBT and . medication D 1 point Question 27 1. A 35-year-old male patient is being treated for alcohol addiction. He asks for the PMHNP‟s cell phone number to use in case of an emergency. When the PMHNP responds that giving her number would be against therapeutic rules, the patient threatens an act of violence to the therapist. What would be the most appropriate response by the PMHNP? A . Immediately report the threat to the local police department Question 30 1. A PMHNP is using Gestalt therapy to communicate with a 50- year-old patient who is going through a divorce. As he is calmly sharing the details of his divorce, the PMHNP notices that Dave is tapping his fingers on his legs. What is an appropriate response by the PMHNP using the technique of focusing? A . “I noticed that your fingers were tapping. Can you give a voice to your fingers?” B . “I’m going to ask you to exaggerate the movement of tapping your fingers.” C . “Explore what is emerging in your body now. What are you experiencing right now?” D . None of the above. A 1 point Question 31 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. Tru e Fal se True 1 point Question 32 1. 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: A . “You feel as though you are weak and you wish that you were strong.” B . “The thought of being discharged scares you because you don’t feel strong enough.” C . “You’d like to keep your old friends but know being around them may lead you to abuse substances again.” D . “You believe that you’ll run into your old friends if you’re discharged.” C 1 point Question 33 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.” A 1 point Question 34 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 B 1 point Question 37 1. When recalling the phases of change, the PMHNP demonstrates “open questioning” in the “engagement” phase by making which statement? A . “What plans have you made to make this change?” B . “What occurred to cause you to seek treatment?” C . “What concerns you the most about these subjects?” D . “What do you want do you want be different?” B 1 point Question 38 1. A PMHNP is assessing a 60-year-old patient named Carlos. He has severe PTSD and mild substance abuse issues. The most appropriate setting to treat Carlos would be a . A . primary health care setting with some specialized care B . state psychiatric hospital and/or emergency room C . substance abuse treatment system D . mental health system of care D 1 point Question 39 1. While assessing a patient using a humanistic-existential approach, a patient tells the PMHNP, “For the past few weeks, I’ve felt anxious almost every single day.” What would be an appropriate next step by the PMHNP? A . Try to provide a diagnosis based on the patient’s description of daily anxiety B . Give the patient some possible solutions they might use for feeling less anxious C . Use traditional assessment procedures, such as giving a psychometric test D . Encourage the patient to clarify by asking, “You constantly feel anxious?” D 1. The PMHNP is assessing a patient who has been receiving months of outpatient psychotherapy. According to the PMHNP‟s assessment, the patient is nearing the termination phase of their therapeutic relationship because the patient’s symptoms have improved, and the patient shows progress managing behaviors and decision-making abilities according to the diagnosis. How does the PMHNP approach termination with this patient? A . Address the termination phase with the patient at the last session B . Manage termination issues as part of the treatment C . Determine the PMHNP‟s readiness to terminate the therapeutic relationship D . None of the above B 1 point Question 43 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? A . Coping question B . Joining question C . Exception question D Miracle . question C 1 point Question 44 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? A . Trauma-focused CBT B . Interpersonal psychotherapy C . Psychodynamic therapy D . Behavioral parent training 1 points A Question 45 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? 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 1 points A Question 46 1. The PMHNP is caring for a geriatric patient who expresses symptoms of gastrointestinal problems, aches and pains, and loss of appetite. The patient reports feeling lonely, as more of his friends have been passing away over the recent months and years. The PMHNP focuses on which therapeutic approach for this 1 point Question 49 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? A . Introducing the patient to the new provider B . Leaving the door open for the patient to return at any time C . Having the new provider come to a few sessions D . A and C D 1 point Question 50 1. 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? A . Suggesting that the patient goes to church to pray for God’s help B . Telling the patient to write letters to the biological fathers requesting money C . Suggesting that the patient seek professional legal help D . Asking the patient why she thinks it is so hard to get the money she deserves C 1 point Question 51 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. B 1 point Question 52 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, D . none of the above B 1 point Question 55 1. How does the PMHNP approach termination with the patient who has been receiving intermittent therapy? A . Uses the word “interrupt” instead of “terminate” with the patient B . Requires the therapy be resumed in several months C . Encourages the patient to check in with the PMHNP about his/her progress D . A and C D 1 point Question 56 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? 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 C 1 point Question 57 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? A . “Let’s see if we can come up with some ideas for you to feel safe telling your story.” B . “Jeff, its 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 1 point Question 58 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? 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 A 1 point Question 59 Question 62 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? 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. D 1 point Question 63 1. The PMHNP uses the cognitive behavioral therapy model with Gerald, an older adult patient who is being treated for depression and mood disorder. What will the PMHNP do with the patient during the first three sessions? A . Build a therapeutic alliance B . Build behavioral skills to increase pleasant activities C . Build cognitive skills to challenge negative thinking D . Build social skills to improve problem solving 1 points A Question 64 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 . “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.” D . “You seem upset. Tell me what seems to be bothering you.” D 1 point Question 65 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.” 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 C 1 point Question 69 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 B 1 point Question 70 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? 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 D 1 point Question 71 1. 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? A . “For homework, please write a list of qualities you’d find in a good friend.” B . “Describe the friendships you had growing up, both as a child and teenager.” C . “Tell me more about why you’re having trouble making new friends at work.” D . All of the above. C 1 point Question 72 1. A 21-year-old patient has been having trouble adjusting to college life. She tells the PMHNP that she had five alcoholic drinks at a party this past weekend. She also acknowledges that she drank the same amount of alcohol at a party the previous month. Based on this information, what would the PMHNP most likely recommend? A . Group therapy B . Peer support C . Hospitalization D . None of the above D 1 point