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NR605 MIDTERM EXAM QUESTIONS AND ANSWERS WITH SOLUTIONS 2024

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NR605 MIDTERM EXAM QUESTIONS AND ANSWERS WITH SOLUTIONS 2024

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  • August 31, 2024
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NR605 MIDTERM EXAM QUESTIONS
AND ANSWERS WITH SOLUTIONS 2024
Psychotherapy - ANSWER -nonpharmacological intervention

-used to tx mental health diagnoses or distress

-help clients improve functioning and well-being

-talk therapy

-provided by psychiatrists, psychologists, social workers, marriage and family therapists, counselors, and
PMHNPs

-may include individual, couple, family, or group sessions

-Goals: symptom reduction, improvement in functioning, relapse prevention, empowerment,
achievement of collaborative goals set by the client & therapist.



Methods of Collaboration - ANSWER Intraprofessional Collaboration

-the interaction and efforts between two disciplines with the same profession

• Potential barriers: tension, large team size, high turnover, lack of familiarity and common goals, role
ambiguity, generational differences, and lack of undergraduate nursing education on intraprofessional
practice.



Transprofessional Collaboration

-includes communication with various disciplines: physicians, physical/occupational therapy, and social
services, along with others to ensure care is delivered safely

• Potential barrier: lack of training



Role of PMHNPs in Psychotherapy - ANSWER -unique, full-spectrum approach

-may provide psychotherapy in addition to prescribing medications

-providing client and family education

-coordinating care and referrals as a part of the treatment plan

-provide psychotherapy in a variety of ambulatory, emergency department, inpatient, and outpatient
settings

,Holistic Paradigm of Healing - ANSWER -holistic model of care with a focus on healing

-Holistic therapy respects the complexity of each unique individual

• appreciating the relationship between the client's mind, body, and spirit

• recognizing the interdependence of all parts of the human system

-Foundational to healing is the relationship between the client and therapist

• Emotional connection in the relationship is critical to the success of psychotherapy

• PMHNP approaches the nurse-client relationship with acceptance, empathy, patience, and kindness to
create a space for healing

-psychotherapy can help the individual accept dysregulation and disharmony in the present moment

• achieves acceptance of the present, they may be able to let go of resistance, relax, and release fears



Theoretical Models in Psychotherapy - ANSWER Maslow's Hierarchy of Needs

Health Belief Model

Transtheoretical Model of Change



Maslow's Hierarchy of Needs - ANSWER framework for understanding client motivation

-first four levels of need in the hierarchy (physiological needs, safety, love and belonging, and esteem)
are sometimes referred to as deficiency needs (D-needs)

• Motivation decreases once D-needs are met

-highest level of need, self-actualization, is considered a growth or being need (B-need)

• Once D-needs are met, clients can focus on self-actualization and personal growth

• As the B-need is met, motivation for further growth increases



self-actualized person - ANSWER is self-fulfilled

-Qualities exhibited by the self-actualized person include independence, autonomy, creativity, and
maturity



Maslow's Hierarchy of Needs Pyramid - ANSWER TOP: Self-actualization

-Morality, creativity, spontaneity, lack of prejudice, acceptance of facts

,Esteem

-Self-esteem, respect, achievement, confidence



Love/Belonging

-Friendship, family, intimacy, sense of connection with others



Safety

-Security of body, of employment, of resources, of morality, of the family, and of health, of property



Bottom: Physiological

-Air, food, water, shelter, clothing, sleep



Health Belief Model - ANSWER -used to explain and predict health behaviors

-a person's belief about a perceived threat of illness combined with belief in the effectiveness of the
recommended action predict the person's willingness to change

-constructs:

• perceived seriousness

• perceived susceptibility

• perceived benefits of treatment

• perceived barriers to treatment

• cues to action

• self-efficacy



Transtheoretical Model of Change - ANSWER assumes that behavior changes take place over time and
that people move through stages of decision-making to make changes to behavior

-stages:

• precontemplation

• contemplation

• preparation

, • action

• maintenance



Nancy is a 64-year-old who is wondering if losing weight might benefit her self-esteem and self-
confidence. Based on the transtheoretical model of change, which of the following actions by the
PMHNP would be appropriate for Nancy if she is in the contemplation stage of change?



Ask Nancy to create a list of reasons that she wants to lose weight.



Refer Nancy to her primary provider to obtain medical clearance for an exercise program.



Explore Nancy's anxiety and emotional responses related to be - ANSWER Ask Nancy to create a list of
reasons that she wants to lose weight.



Rationale: Creating a list of reasons to lose weight would be appropriate for the contemplation phase.
Obtaining medical clearance for exercise is a part of the preparation phase of the Transtheoretical Model
of Change. Exploring emotional responses to being overweight would be appropriate for the
precontemplation phase. Addressing rewards for reinforcement of behaviors would occur in the action
phase.



Treatment Hierarchy Framework - ANSWER therapeutic aims at the base of the model must be
addressed before the client can move up the triangle



Top: Stabilization

Internal resources

External resources

Bottom: Foundational needs



strategies to support resource development and stabilization: - ANSWER -case management

-provision of safety

-stress management

-management of physiological arousal

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