nurs6645/ Nurs 6645
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Question 1
According to Freud’s Psychosexual Stages framework a patient exhibiting excessive envy and jealousy failed to successfully manage anxiety during which stage?
A. Oral
B. Anal
C. Latency
Phallic/Oedipal
Question 2
The advanced practice psychiatric nurse psychotherapist is informed by the managed care company that authorization for additional treatment with a patient has been denied. The advanced practice psychiatric nurse is concerned stopping treatment will jeopardize the patient’s safety and realizes which of the following are ethical options?
A. It is incumbent on the therapist to ensure that treatment continues.
B. Stop treatment immediately.
C. Attempt to work out a payment plan with the patient.
D. A and C
uestion 3
Which of the following is consistent with the aims of supportive psychotherapy?
A. Restructure defenses
B. Strengthen defenses
C. Promote problem-solving
D. B and C
Question 4
Which of the following is consistent regarding termination in brief psychodynamic therapy?
A. The termination date is set within 10 weeks of anticipated termination.
B. The termination date is set in the beginning of treatment within 30 sessions
C. The termination date is set in the beginning of treatment within 60 sessions.
D. The termination date is flexible and is set mutually by the therapist and patient once major issues have been addressed.
Question 5
In therapy groups where group members gain through receiving help from group members and giving help to group members, which of Yalom’s therapeutic benefits is being realized?
A. Altruism
B. Catharsis
C. Imparting Information
D. Development of socializing techniques
Question 6
The skilled psychotherapist assists the patient to stay in the Resilience Zone. Which of the following symptoms are consistent with hypoarousal?
A. Pain, anxiety, fatigue
B. Emptiness, emotional paralysis, emotional numbness
C. Euphoria, irritability, panic
D. Angry outbursts, anxiety, exhaustion
Question 7
According to Peplau’s Interpersonal Relations Model for nursing, a cornerstone for the psychotherapeutic process is understanding, assessing, and managing which of the following?
A. Anger
B. Anxiety
C. Resilience
D. Holism
Question 8
According to Freud, failure to successfully accomplish the tasks of learning independence and control is associated with which of the following problematic traits?
A. Excessive dependency
B. Orderliness
C. Sexual identity issues
D. Excessive guilt
Question 9
The advanced practice psychiatric nurse may intervene as appropriate with agencies or persons in order to advocate for the patient; do for the patient what he or she cannot do for self, always with an aim toward maximum independence and growth which is consistent with which basic strategy of dynamic supportive therapy?
A. Make connections
B. Encourage patient activity
C. Manipulate the environment
D. Maximize adaptive coping mechanisms
Question 10
Optimal family development is thought to take place in which of the following circumstances?
A. Family members are differentiated, anxiety is low, and partners maintain emotional contact with their own families.
B. Family members lack differentiation, anxiety is low, and partners maintain emotional contact with their own families.
C. Family members are differentiated, anxiety is moderate, and partners reduce emotional contact with their parents and siblings.
D. Family members lack differentiation, avoid anxiety and partners avoid emotional contact with parents and siblings.
Question 11
The therapist using a CBT approach in which the therapist encourages the patient to investigate whether their thoughts are based on facts or assumptions is known as which of the following?
A. Labeling of Distortions
B. Questioning the Evidence
C. Advantages and Disadvantages
D. Examining Options and Alternatives
Question 12
Cultural relativity (Horowitz, 1982) refers to
A. How we relate to those from other culture
B. Similarities between various cultures
C. Differences between Eastern and Western cultures
D. Behavior considered normal or abnormal depends on social and cultural norms.
uestion 13
Patients who would not be considered ideal candidates for psychoanalytic psychotherapy are which of the following?
A. Patients with primarily primitive defenses
B. Patients with primarily mature defense mechanisms
C. Patients with neurotic to healthy personality organization.
D. Patients with the capability to engage in a therapeutic alliance
Question 14
During the initial phase of family therapy one person is identified as “the problem”. The family therapist challenges linearity by which of the following?
A. Asking the children how they would fix or deal with the problem person.
B. Asking the person identified as the problem to meet privately prior to the next meeting.
C. Asking the person identified as the problem how they think the problem could be fixed.
D. Asking how others in the family are involved in or effected by “the problem”.
Question 15
Yalom states the group therapy analogue to relationship in individual therapy is which of the following?
A. Universality
B. Cohesiveness
C. Social microcosm
D. The corrective emotional experience
Question 16
The nurse psychotherapist realizes that “true presence” in a therapeutic relationship involves which of the following? Check all that apply.
A. Listening to what is important to the patient.
B. Listening to what the meaning of a situation is in the moment.
C. “Being with” the patient rather than “doing to” the patient.
D. Acceptance, nonjudgmental attitude and empathy.
Question 32
Strategies for working with anxiety are central to all therapy approaches. Which strategy would be consistent with a behavioral therapy approach?
A. Restructuring
B. Interpretations
C. Desensitization
D. Exploring wishes
Which technique would be helpful to use with individuals who blame themselves for most bad outcomes?
A. Reattribution
B. Decatastrophizing
C. Advantages and Disadvantages
D. Examining options and alternatives
Question 34
The quality of the therapeutic relationship is most closely linked to which school of therapy?
A. Freudian
B. Gestalt
C. CBT
D. None of the above
Question 35
Which of the following is a responsible way for the therapist to safely set appropriate limits on availability.
A. The therapist just needs to notify either in person or by mail that they will not be available at certain times.
B. The therapist has an answering machine that clearly states that if this is an emergency, the ???? patient should go to the ED or call a crises hotline.
C. Ask another therapist to cover for vacations and time off, as this is for emergency only ???? specifics about patients should not be shared.
D. Both A and B
Question 36
A patient being treated with supportive psychodynamic psychotherapy has been missing sessions and coming late when coming to sessions. The advanced practice psychiatric nurse recognizes this behavior as which of the following?
A. Avoidance
B. A sign the patient has met goals.
C. The patient is ready to talk about termination of therapy.
D. The patient is bored because the sessions have not been very interesting.
uestion 37
Which of the following is consistent with use of direct advice as a strategy of imparting of information?
A. Specific advice-giving supports intimate group engagement.
B. The most effective form of direct advice is direct suggestion.
C. Direct advice is often an important clue in elucidation of interpersonal pathology in the group.
D. The least effective form of direct advice was a series of alternative suggestion for goal achievement.
Question 38
In psychodynamic case formulation three personality organization levels have been identified along a continuum. A patient who primarily uses primitive defenses is likely to be in which personality range?
A. Healthy
B. Neurotic
C. Psychotic
D. Borderline
Question 39
The advanced practice psychiatric nurse helps the patient to identify and name feelings, focus on somatic sensations associated with emotions, and encourages use of metaphor to describe feelings. This is consistent with which basic strategy of supportive psychodynamic therapy?
A. Make connections
B. Decrease alexithymia
C. Encourage patient activity
D. Maximize adaptive coping mechanisms
Question 40
There is evidence that suggests certain individuals may obtain greater benefit from group therapy than from other approaches. These include which of the following individuals? Check all that apply.
A. Individuals dealing with stigma
B. Individuals dealing with social isolation
C. Individuals seeking new coping skills
D. B and C only
Question 41
According to Yalom, which of the following is consistent with the therapeutic benefit of imitative behavior?
A. Imitative behavior generally plays a more important role in early stages of a group.
B. Imitative behavior may allow an individual to experiment with a new behavior.
C. Finding out what we are not is progress toward finding out what we are.
D. All of the above
Question 42
A group member becomes angry with the group leader accusing the leader of being too controlling and showing favoritism. This behavior is consistent with which of Yalom’s therapeutic factors?
A. Catharsis
B. Interpersonal learning
C. Development of socializing techniques
D. Question 43
Family dialogue is encouraged.
A. Genogram
B. Family schema
C. Family drawing
D. Family sculpting
Question 44
An advanced practice psychiatric nurse is sued for continuing to work with a patient despite the treatment not working. The advanced practice psychiatric nurse realizes that which of the following will be considered in this case?
A. Was the standard of care followed?
B. Was there harm to the patient?
C. This is a frivolous lawsuit. The advanced practice psychiatric nurse cannot be sued for this.
D. A and B
Question 49
Staff in an independent living facility notice that Mr. Smith, a 75-year-old male resident is alone most of the time and seems to have alienated most of the other residents and staff. The advanced practice psychiatric nurse understands that from Erikson’s psychosocial stages perspective he is dealing with which psychosocial stage of development?
A. Intimacy vs. isolation
B. Ego integrity vs. despair
C. Generativity vs. stagnation
D. Autonomy vs. alienation
Question 50
“They probably think I am stupid” is an example of which type of cognitive distortion?
A. Comparing
B. Mind reading
C. Objectifying the subjective
D. Externalization of self-worth
Question 51
While working with a patient who exhibits parasuicidal behaviors of cutting, the advanced practice psychiatric nurse has the patient sign a no-suicide contract. Which of the following is true from a legal perspective about a no-suicidal contract?
A. This is a legally binding document
B. It proves the therapist has good clinical judgment.
C. It absolves the therapist of any responsibility should the patient commit suicide.
D. It is not a substitute for good clinical judgment; accurate assessment is imperative.
uestion 52
When treating a family in which a child has been sexually abused the primary goals include which of the following? Check all that apply.
A. Ensure the abuse doesn’t recur
B. Reduce the long-term effects of the trauma
C. Preserve the integrity of the family at all cost.
D. A and B
Question 53
Groups with a greater sense of solidarity exhibit which of the following? Check all that apply.
A. Higher rate of attendance
B. Acceptance for a variable level of active participation
C. A concrete system for measuring cohesiveness
D. A and B
Question 54
A group of co-occurring, relatively invariant symptoms found in a specific cultural group, community or context, which may or may not be recognized as an illness within the culture but such cultural patterns of distress and features of illness may be recognizable by the outside observer is known as which of the following?
A. Cultural syndrome
B. Cultural formulation
C. Cultural idiom of distress
D. Cultural explanation or perceived cause
Question 55
The therapist using a CBT approach says to the patient: “You say you become depressed. Explain to me what depressed feels like to you.” This is an example of what question type in Socratic Dialogue?
A. Memory question
B. Translation question
C. Application question
D. Interpretation question
Question 56
Which of the following is not consistent with the resilience model proposed by Miller-Kraus?
A. This resilience model is based on neurophysiology.
B. The resilience zone in an internal state of adaptability and flexibility.
C. We feel our best when we have a strong sympathetic system to regulate emotions.
D. We feel our best and deal effectively with life when we are in our resilience zone.
Question 57
Bowen emphasized the family therapist
A. Remain neutral, focus on content
B. Focus on metacommunication
C. Create a psychodrama
D. Become immersed in the family dynamics
Question 58
Which of the following is true about the CBT cognitive processes of primary and secondary thinking?
A. Primary thinking recognizes the indeterminate, negative and irrational thinking as forever part of human action.
B. Secondary thinking recognizes the indeterminate, negative and irrational thinking as foremost.
C. Primary thinking views the social and cultural world in determinate, positive and rational terms.
D. B and C
Question 59
Which of the following is consistent with literature regarding suicide. Check all that apply.
A. Assessing patient safety is of paramount importance for the advanced practice psychiatric nurse during the initial patient contact.
B. More that half of those who commit suicide do not have known mental health problem.
C. The highest risk factor for suicide is a relationship problem.
D. Suicidality can be assessed by using reliable and valid self-report questionnaires.
Question 60
In supportive psychodynamic psychotherapy the content of the sessions most often focuses on which of the following?
A. Feelings and defenses
B. Life stresses and feelings
C. Life stresses and problem-solving
D. B and C
Question 61
The focus of therapy in brief psychodynamic psychotherapy is on which of the following?
A. The focus is on structured homework assignments.
B. The focus in on the rupture of the therapeutic alliance
C. The focus in on transference that naturally occurs during the sessions.
D. The focus is on interpersonal relationships outside of the therapeutic relationship.
Question 62
Common patterns of behavior and experience derived from the settings in which people live is known as which of the following?
A. Race
B. Culture
C. Ethnicity
D. Family structure
uestion 63
During the initial contact with an individual seeking family therapy it is important for the family therapist to:
A. Identify the presenting problem and arrange a consultation with everyone living in the family household.
B. Identify the presenting problem and arrange a consultation with the caller to ensure family therapy is really necessary.
C. Identify the presenting problem and arrange to meet with the caller and the family member that is creating most of the problem.
D. Identify the presenting problem and arrange a consultation with the parents of the family to develop a therapeutic alliance and strategy for fixing the problem.
Question 64
In a family session a teenager whose parents deny him a night out states angrily “See they never let me do anything!” The advanced practice psychiatric nurse using a Cognitive Behavioral Family Therapy framework recognizes this as cognitive distortion known as:
A. Labeling and mislabeling
B. Overgeneralization
C. Personalization
D. Magnification and minimization
Question 65
A basic strategy of dynamic supportive therapy in which the advanced practice psychiatric nurse assists the patient with reality testing, problem-solving, impulse control, affect modulation, interpersonal awareness, social skills, and empathy is most specifically known as which of the following?
A. Manage transference
B. Lend psychic structure
C. Hold and contain the patient
D. Foster and protect the therapeutic alliance.
Question 66
Controlled studies of psychotherapy outcome have shown which of the following?
A. The average person typically does not engage in psychotherapy
B. The average person who receives psychotherapy is significantly improved.
C. The average person who receives psychotherapy shows no significant improvement.
D. The average person who receives psychotherapy shows some improvement, but results are not statistically significant.
Question 67
Which of the following best describes the difference between standards of care and practice guidelines?
A. Practice guidelines are legally binding while standards of care are not.
B. Standards of care are legally binding while practice guidelines are not.
C. There is no difference between standards of care and practice guidelines.
D. Practice guidelines should be followed as written while standards of care are more flexible.
Question 68
Which of the following is true regarding the difference between brief and long-term psychodynamic psychotherapy?
A. Brief psychotherapy is more effective than long-term psychodynamic psychotherapy.
B. Long-term psychodynamic psychotherapy is more effective than brief psychotherapy.
C. There is no qualitative difference between brief and long-term psychodynamic psychotherapy.
D. Brief and long-term psychodynamic psychotherapy cannot be compared.
uestion 69
According to Minuchin two patterns common to troubled families are:
A. Victims and rescuers
B. Entitlement and indebtedness
C. Enmeshed and disengaged
D. Leaders and followers
Question 70
Which of the following is not consistent with evidence-based research on psychodynamic therapy?
A. Research demonstrates psychodynamic therapy is not effective.
B. Research reflects inherent difficulties in experimental controlled design for this approach.
C. Most psychodynamic research consists of case studies which limits the ability to generalize to other situations and populations.
D. Psychodynamic techniques do not lend themselves to the precision required for a clinical trial.
uestion 71
According to Benner’s role acquisition model, the advanced practice psychiatric nurse with 2-5 years of experience, who coordinates complex care and sees situations as wholes with long-term solutions, is functioning at which level of competency?
A. Novice
B. Advanced beginner
C. Competency/proficiency
D. Expert
Question 72
According to the Stages of the Family Life Cycle the key emotional process of transition for single young adults is:
A. Commitment to a new system.
B. Accepting the shifting generational roles.
C. Accepting new members into the system.
D. Accepting emotional and financial responsibility for self.
Question 73
Which of the following is true about the therapeutic benefit of groups in the development of socializing techniques?
A. Social learning is a therapeutic factor that operates in all therapy groups.
B. Groups permit members to understand there is a huge discrepancy between their intent and their actual impact on others.
C. Social skills learned in therapy groups can serve individuals well in future social interactions outside of the group setting.
D. All of the above
Question 74
Which of the following is inconsistent with Socratic Dialogue basic rules for the therapist?
A. The collaborative dialogue is goal-directed and specific.
B. The therapist may use everyday experiences as therapeutic metaphors.
C. Self-disclosure is frequently used to motivate the patient in problem solving.
D. Socratic Dialogue questions should be framed in a way to elicit an affirmative response.
Question 75
Diverting conflict between two people by involving a third is known as the concept of:
A. Emotional reactivity
B. Relationship triangles
C. Differentiation of self
D. Enmeshment
Question 76
In classical psychodynamic therapy the therapist’s role is which of the following?
A. Objective
B. Subjective
C. Participant-Observer
D. Enmeshed
Question 77
In relational psychodynamic psychotherapy the therapist helps the patient with which of the following?
A. To understand the patient’s impact on others.
B. To deepen the patient’s understanding of others.
C. Both A and B
D. Neither A nor B is consistent with the focus of relational psychodynamic psychotherapy.
Question 92
Borderline pathology is thought to evolve from problems in which of Mahler’s stages of separation-individualization?
A. Practicing
B. Consolidation
C. Differentiation
D. Rapprochement
uestion 93
In multi-cultural groups, therapists must address the clinical factor of universality by doing which of the following?
A. Assist group members in learning about the cultural differences.
B. Minimize the cultural differences within the group.
C. Help the group move past a focus on concrete cultural differences to transcultural human responses to situations.
D. The therapist should do nothing as that would be interfering in the group process.
Question 94
It is important for the new nurse psychotherapist to become comfortable with which of the following?
A. Learning to be directive to help the patient feel better.
B. Letting the psychotherapeutic process unfold over time.
C. Helping the patient feel better is the main goal of psychotherapy
D. Building a therapeutic toolbox for a variety of “fix it” solutions for a variety of problems.
Question 95
A patient comments at the end of their group therapy how important it was for them to have observed the improvement of others. This is consistent with which of Yalom’s therapeutic factors?
A. Altruism
B. Universality
C. Instillation of hope
D. Imparting of information
Question 96
Cross-cultural research supports which of the following?
A. Culture determines what is considered a psychiatric disorder
B. Neurobiological mechanisms linked to stress and trauma are consistent across cultures
C. Neurobiological mechanisms linked to stress and trauma vary across cultures
D. A and B
E. A and C
Question 97
In supportive psychotherapy where the patient is functioning at a child-like level in significant domains of life which basic strategy of dynamic supportive therapy would most likely be used?
A. Be a good parent
B. Foster and protect the therapeutic alliance
C. Hold and contain the patient
D. Provide a role model for identification
Question 98
Hildegard Peplau developed the psychodynamic interpersonal model for psychiatric nursing based on which theorist’s framework?
A. Eric Erickson
B. Sigmund Freud
C. Margaret Mahler
D. Harry Stack Sullivan
Question 99
In patients with chronic hyperarousal their Resilience Zone may be too narrow. Strategies to widen the Resilience Zone would include which of the following?
A. Exercise, decreasing caffeine intake, and imagery
B. Relaxation exercises, increasing caffeine intake and imagery
C. Both A and B
D. None of the above because actually their Resilience Zone is too wide.
Question 100
We all have preconceptions that are brought into every situation. As a nurse psychotherapist it is important to do which of the following?
A. Eliminate all preconceptions before meeting with the patient.
B. Always be transparent with the patient regarding any preconceptions.
C. Be aware of preconceptions, what they are and how they influence our work.
D. Discuss preconceptions you have with the patient as others likely have similar preconceptions about the patient.
