NRNP 6645 Final Exam

Question 28: 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? Answer: D. Maximize adaptive coping mechanisms Question 29: Which of the following is consistent with literature regarding suicide? Check all that apply: Answers: A. Assessing patient is of paramount importance for the advanced practice psychiatric nurse during the initial patient contact D. Suicidality can be assessed by using reliable and valid self-report questionnaires Question 30: Common ancestry through which individuals have evolved shared values and customs is knowns as which of the following? Answer: B. Ethnicity Question 31 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? Answer: B. Questioning the Evidence Question 32 Which of the following is not consistent with the underlying assumptions of psychodynamic psychotherapy? Answer: A. What happened in the past determine what we do today Question 33 The advanced practice psychiatric nurse is meeting with a patient who is in the process of an unwanted divorce. The patient endorses persistent suicidal ideations, with strong intent. The advanced practice psychiatric nurse recognizes the patient is a high suicide risk and recommends which of the following? Answer: B. Hospital psychiatric admission and suicide precautions. Question 34: Which of the following assumptions would the therapist be safe in making about cultural influences in a family? Answer: D. The cultural context of families is complicated by the fact that most families are influenced by multiple contexts. Question 35: The focus of exploration in a relational psychodynamic therapy includes which one of the following? Answer: C. Here and now Question 36 The CBT therapist ask the patient on the scale of "0 -10 how would you rate your depression today? " And how that compare to 2 months ago?" This is an example of what type of question type in Socratic dialogue? Answer: D. This would not be a question consistent with Socratic Dialogue Question 37 Which of the following best describes the difference between standards of care and practice guidelines? Answer: B. Standards of care are legally binding while practice guidelines are not. Question 38: Strategies for working with anxiety are central to all therapy approaches. Which strategy would be consistent with a behavioral therapy approach? Answer: A. Restructuring Question 39: Which of the following is consistent with Cognitive Behavioral Therapy (CBT)? Select all that apply: A. CBT is a system of psychotherapy based on theoretical framework which maintains how and individual structures one 's experience largely determines how one feels and behaves B. Maladaptive thoughts relating to "the cognitive triad" are rooted in irrational or illogical assumptions C. By changing one 's thoughts, emotions and behaviors can be changed D. A and C Question 40: According to Structural Family Therapy model, family structure refers to which of the following? Answer: D. The way families are organized into subsystems separated by emotional boundaries Question 41: "They probably think I am stupid" is an example of which type of cognitive distortion? Answer: B. Mind reading Question 42: In the 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? Answer: A. Altruism Question 43: 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? Answer: A. Catharsis Question 44: A group member is relieved to realize that others in the group share feelings of incompetency similar to his own. This is an example of which of the following therapeutic factors? Answer: B. Universality Question 45: Good practice habits that are relevant for legal and ethical professional responsibility include which of the following? Check all that apply A. It is essential that emergency coverage is in place B. How patients contact you between sessions and emergencies should be included in the contract given to the patient during the initial session C. Explicitly stated whether you will be available for phone calls between sessions and adhere to clear limits. D. Check message at least once per day and call back within 24 hours. Rationale: All are correct. Question 46: A Hispanic woman whose mother recently died reports that she continues to hear voice of her deceased mother. The advanced practice psychiatric nurse considering the Hispanic woman's culture determines which of the following? A. The woman is likely grieving according to her Hispanic social norms Rationale: The woman is not necessarily being psychotic because she is still in the process of bereavement and grieving which is a stressful life event. Question : 47 Which of The following is consistent research related to posttraumatic growth? A. Resilience and Posttraumatic growth are inversely related Question 48: Which of the following is not consistent with the current research related to psychotherapy and psychotropic medication? C. Studies comparing medications with psychotherapy found both produce psychological, but brain changes are different for medications than psychotherapy Question 49 Which of the following is not consistent with the resilience model proposed by Miller-Krauss? C. We feel our best when we have a strong sympathetic system to regulate emotions Question 50: A family has been court-ordered to family therapy. The family does not want to participate in therapy. The advanced practice nurse using a solution focused therapy model would most likely do which of the following? B. Review the case and offer suggestions for solving the issue Question 51: According to Freud, failure to successfully accomplish the task of learning independence and control is associated with which of the following problematic traits? A. Excessive dependency Rationale: Developing this control to accomplish things leads to a sense of accomplishment and independence. Failure to this will lead to dependence Question 52: 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 53: In classical psychodynamic Therapy, the therapist's role is which one of the following? C. Participant-Observer Rationale: The therapist plays this role by encouraging the client to talk about the emotions they are feeling and helping the client to identify recurring patterns in their thoughts, emotions, and behaviors. Question 54: The advance psychiatric nurse is working with couple using a Cognitive Behavioral Family therapy model. The wife states that her husband must be having an affair because he comes home late from work . The advanced practice nurse recognizes as a cognitive distortion knowns as : D. Arbitrary Inference Question 55: According to Peplau s' Interpersonal Relations Model for nursing, a cornerstone for the psychotherapeutic process is understanding, assessing and managing which of the following? B. Anxiety 2) which supports which therapeutic group factor? A. Imitative behavior B. Interpersonal learning C. Imparting of information D. Development of socializing techniques Question 3 Recognizing that many factors may have contributed to a patient's current situation is an example of which of the following? A. Biomedical model B. Psychosocial framework C. Over determinism D. Resiliency Question 4 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. Question 5 Yalom identifies eleven primary factors to describe the therapeutic benefit of group psychotherapy. Which of the following statements is not consistent with these factors? A. Therapeutic change is an intricate interplay of human experiences. B. The distinctions among these factors are well delineated. C. The distinctions among these factors are arbitrary. D. The factors are interdependent Question 6 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 7 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. Bui Question 8 Internal resources include which of the following? A. Internal resources are more tangible than external resources B. Internal resources consist of the person's ability to manage primarily negative emotions C. Internal resources include the person's ability to self-soothe, demonstrate adequate impulse control, and regulate moods. D. Are intuitive and easily measured Question 9 When assessing families of a different culture from the therapist for treatment, the therapist should consider which of the following with respect to culture? A. The therapist should consider the unique subculture of the family. B. The therapist should consider assumptions of the larger cultural background of the family. C. The therapist should ask the family to share their experiences and traditions D. All of the above Question 10 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 g Question 11 "If I was in a relationship, all of my problems would be solved" is an example of which type of cognitive distortion? A. Fallacy of attachment B. Fallacy of worrying C. Fallacy of perfect effect D. Fallacy of the change of others. Question 12 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 13 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 14 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 15 According to Freud's Psychosexual stages development of sexual identity occurs during what age range? A. 18 months to 3 years B. 3 years to 6 years C. 6 years to 12 years D. 13 years to 20 years Question 16 The aim in relational psychodynamic therapy is which of the following? A. Make the unconscious conscious B. Resolve ruptures in the therapeutic alliance. C. Provide interpretation based on past experiences D. Provide interpretation of wish/defense conflicts. Question 17 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 18 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 19 According to Erikson's Psychosocial stages failure to successfully resolve trust vs mistrust conflict is associated with which of the following pathological outcomes? A.Psychosis, addictions, depression B. Paranoia, obsessions, compulsions C. Phobias, psychosomatic disorders D. Inertia, creative inhibition Question 20 The goal in a holistic paradigm is to A. Cure B. Minimize symptoms C. Eliminate symptoms with medication D. Question 21 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 22 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 23 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 24 Object relations theorists work from a framework which includes which of the following? A. The central motivating force in development is the drive for gratification. B. Primary maternal preoccupation will lead to development of a false sense of self. C. The central motivating force in development is that people are primarily motived to seek other people. D. The good enough mother creates a dynamic in which the person feels never good enough in relationships. Question 25 The concept that reminds us that families are open systems, and our interpretations are shaped by assumptions we absorb from the culture is known as: A. Constructivism B. Systems Theory C. Attachment Theory D. Social Constructionism Question 26 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 27 The decision to use supportive psychotherapy should be based on which of the following? Check all that apply: A. Recent losses B. Present coping skills C. The patient's ego strength and weaknesses D. Highest level of functioning previously achieved. Question 31 Factors that distinguish psychodynamic therapy from cognitive behavioral therapy include which of the following factors. A. Emphasis on the past; Focus on expression of emotion; Emphasis on transference B. Focus on here and now, focus on current relationships, exploration of intra psychic issues. C. Emphasis on here and now; exploring and working with resistance to treatment, the working alliance. D. Identification of patterns in actions, thoughts, feelings, experiences; Focus on current relationships. Question 32 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. The corrective recapitulation of the primary family group. Question 33 Which of the following is not consistent with current research related to psychotherapy and psychotropic medication? A. Research suggests that psychotherapy enhances the effects of psychotropic medication. B. Studies comparing medication with psychotherapy found both produce similar physiological changes in the brain. C. Studies comparing medication with psychotherapy found both produce physiological changes but brain changes are different for medications than for psychotherapy. D. Research suggests psychotropic medications may interfere with the learning that takes place during psychotherapy. Question 34 The advanced practice psychiatric nurse realizes which of the following regarding workbook exercises in therapy? A. Workbook exercises are only an adjunct to treatment. B. Workbook exercises simplify the real work in therapy. C. Treatment manuals consistently correlate positively with treatment outcome. D. Use of workbook exercises and approaches promotes creativity and flexibility in the therapeutic process. Question 39 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 40 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 44 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 45 According to Erikson's Psychosocial stages failure to successfully resolve trust vs mistrust conflict is associated with which of the following pathological outcomes? A. Psychosis, addictions, depression B. Paranoia, obsessions, compulsions C. Phobias, psychosomatic disorders D. Inertia, creative inhibition Question 46 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 48 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 D. Phallic/Oedipal Question 49 The advanced practice psychiatric nurse is working with a couple on conflict management. They report during a recent argument the husband threw a plate across the room. Based on the current advances in neuroscience the advanced practice psychiatric nurse explains: A. People do things because of what happens in their brain. B. Biological events cause human actions. C. One can learn to activate their prefrontal cortex and retrain emotional reactions. D. Biological events always over-rides free will. Question 53 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 1. 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 2. Schizoid personality is a pathological outcome associated with which of Erickson's psychosocial stages? A. Autonomy vs. self-doubt B. Industry vs. inferiority C. Identity vs. role confusion D. Intimacy vs. isolation 3. What distinguishes psychoanalytic therapy from other types of therapies? A. The focus on problem-solving B. The focus on irrational thoughts C. The focus on dreams and wishes D. The deep analysis of the patient relationship with the therapist. 4. 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 5. Good practice habits that are relevant for legal and ethical professional responsibility include which of the following? Check all that apply. A. It is essential that emergency coverage is in place. B. How the patient contacts you between sessions and in emergencies should be included in the contract given to the patient during the initial session. C. Explicitly state whether you will be available for phone calls between sessions and adhere to clear limits. D. Check messages at least once per day and call back within 24 hours. 6. For severe trauma and phobias it is recommended to teach the patient some relation techniques prior to beginning exposure therapy. When is it appropriate to use these relaxation techniques? A. It is appropriate to use relaxation techniques in between exposures B. It is appropriate to use relaxation techniques during the actual exposures conducted by the therapist. C. It is appropriate to use relaxation techniques after the exposures D. A and C 7. 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. 8. Cognitive Behavioral Therapy (CBT) interventions focus on A. The person's relationships and family dynamics B. The person's thoughts, beliefs, or behaviors C. The person's understanding of how the past gets triggered and plays out in the present D. The person's body, beliefs, images, and emotions to process trauma 9. 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 10. 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 11 Evidenced based guidelines for patient treatment are based on which of the following? A. Consensus of expert panel B. Systematic reviews of case studies. C. Systematic reviews of randomized controlled studies (RTC). D. A and C Question 12 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 13 Internal resources include which of the following? A.Internal resources are more tangible than external resources B. Internal resources consist of the person's ability to manage primarily negative emotions C. Internal resources include the person's ability to self-soothe, demonstrate adequate impulse control, and regulate moods. D. Are intuitive and easily measured Question 14 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 longterm solutions, is functioning at which level of competency? A. Novice B. Advanced beginner C. Competency/proficiency D. Expert Question 15 According to H. Peplau (1991) self-awareness for the advanced practice psychiatric nurse A. Is key to understanding others B. Increases likelihood therapist acts out their own agenda. C. Allows for nurse-patient boundaries to be safely ignored to better meet patient needs. D. Undermines objectivity Question 16 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 19 If a health care professional terminates treatment because of managed care failure to authorize the session who is liable for harm based upon abandonment of the treatment. A. The health care provider Question 20 Which of the following is not consistent with therapeutic process of the corrective recapitulation of the primary family group in group psychotherapy? A. The therapeutic value is that early familial conflicts are simply relived. B. The therapeutic value is that early familial conflicts are relived correctively. C. Fixed roles must be constantly explored and challenged. Question 55 The patient talking about her husband states "By the time he comes home late for the zillionth time I'm just beside my self ... you know what I mean." The CBT therapist responds saying "No, I don't know what you mean. Please explain what you mean by "beside yourself". The therapist is using a technique known as which of the following? B. Downward Arrow Question 57 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 58 Role play in the context of the therapy session is an example of which of the following behavioral techniques: A. Bibliotherapy B. Behavioral rehearsal C. Contingency management D. Cognitive restructure Question 59 Which of the following is not consistent with the underlying assumptions of psychodynamic psychotherapy? A. What has happened in the past determines what we do today. B. Psychodynamic psychotherapy is rooted in developmental theory C. By changing one's thoughts, emotions and behaviors can be changed. D. Through understanding the past, the individual is empowered to make more conscious decisions. Question 61 "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 62 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 63 The technique used by the CBT therapist to help the individual uncover underlying assumptions in logic and sequence through careful questioning by the therapist asking," If this is true then what happens?" A. Idiosyncratic Meaning B. Labeling of distortions, C. Downward Arrow D. Questioning the Evidence Question 64 In general, the lower the patient is on Maslow's hierarchy of needs A. The less active the therapist must be. B. The more active the therapist must be. C. The more neutral the therapist must be. D. The more enmeshed the therapist must be. Question 65 A descriptive/biological approach of specialized knowledge that treats individuals as members of a diagnostic group is based on A. biomedical model Question 66 According to Mahler's stages of separation-individuation the phase of "normal autism" occurs during what age range? A. Birth to 1 month B. 10 to 16 months C. 16 to 24 months D. 24 to 36 months Question 67 Psychodynamic psychotherapy interventions focus on which of the following? A. The person's thoughts beliefs and behaviors B. The person's relationships and family dynamics C. The person's emotions and thoughts, deepening understanding of triggers form the past played out in the present. D. The person's body, beliefs, images, and emotions to process trauma Question 68 When working with a couple the therapist observes the wife seems to have more power in the relationship and the husband seems disengaged. The advanced practice psychiatric nurse can safely assume which of the following based on the couple's Appalachian culture/roots? A. This is a culturally consistent framework where the wife is typically the decision maker in thefamily. B. This is not culturally consistent with Appalachian norms and is an issue for the couple's therapy. C. The couple is aware of the gender inequality in the family and is fine with it. D. The advanced practice psychiatric nurse cannot assume any of the above and needs to further assess roles in the relationship. Question 70 The decision to use supportive psychotherapy should be based on which of the following? Check all that apply. A. Recent losses B. Present coping skills