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NRNP 6645 MIDTERM EXAM The advanced practice psychiatric nurse realizes which of the following regarding workbook exercises in therapy? c A Workbook exercises are only an adjunct to treatment. ec B Workbook exercises simplify the real work in therapy. © Treatment manuals consistently correlate positively with treatment outcome. Use of workbook exercises and approaches promotes creativity and flexibility in the € therapeutic process. 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 é dependency B Orderliness fey G Sexual identity issues he} ._ DExcessive guilt During the initial phase of family therapy one person is identified as “the problem”. The family therapist challenges linearity by which of the following? ry 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 D Family + | structure The advanced practice psychiatric nurse using a Bowenian Therapy approach in working with families realizes: A Problem-solving is the primary goal of - | therapy B Understanding is the primary goal of + _ therapy. z C Behavior change is the primary goal of + _ therapy c D Family dialogue is encouraged. Recommending or prescribing specific readings related to the individual's difficulties is known as which of the following? A Cognitive _ Rehearsal fe} mind-Reading C pw é Bibliotherapy c D Reattribution The capacity to be alone is known as which of the following? c A Oneness c B Autonomy « ¢c Independence cD Object + _ constancy “lf | was in a relationship, all of my problems would be solved” is an example of which type of cognitive distortion? c A Fallacy of attachment Be, a c ‘allacy of worrying @ © Fallacy of perfect effect D Fallacy of the change of - | othe Hildegard Peplau developed the psychodynamic interpersonal model for psychiatric nursing based on which theorist’s framework? c A Erie Erickson Ba c Sigmund Freud c ¢ Margaret Mahler D Harry Stack “Sullivan Which of the following is not consistent with the underlying assumptions of psychodynamic psychotherapy? C A What has happened in the past determines what we do today. c 5 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 impowered to make more + | conscious decisions. The change agent in relational psychodynamic therapy is which of the following? c A Insight c B \indfulness c c Wish/ defense conflicts A The therapeutic value is that early familial conflicts are simply relived. ao e B The therapeutic value is that early familial conflicts are relived correctively. ral c Fixed roles must be constantly explored and challenged. 2 D Working out problems in the group setting is also working through unfinished + business from long ago. According to Freud’s Psychosexual Stages framework a patient exhibiting excessive envy and jealousy failed to successfully manage anxiety during which stage? ew A Oral ral 5 Anal ral c Latency D Phallic/Oedip . al Evidenced based guidelines for patient treatment are based on which of the following? Fal A Consensus of expert panel c 5 Systematic reviews of case studies. a C Systematic reviews of randomized controlled + | studies (RTC). «@ Paandc Which of the following is consistent with Cognitive-Behavioral Therapy (CBT)? Check all that apply. A CBT is a system of psychotherapy based on a theoretical framework which maintains r how an individual structures one’s experiences largely determines how one feels and behaves. B Maladaptive thoughts relating to the “cognitive triad” are rooted in irrational or a) illogical assumptions. r c By changing one’s thoughts, emotions and behaviors can be changed. w Paandc 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 A Therapeutic change is an intricate interplay of human “experiences. _« B The distinctions among these factors are well - | delineated. c c The distinctions among these factors are arbitrary. c D The factors are interdependent 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 i _ psychiatric nurse during the initial patient contact. B More that half of those who commit suicide do not have known mental health ¥ _ Problem. rc c The highest risk factor for suicide is a relationship problem. i] D Suicidality can be assessed by using reliable and valid self-report questionnaires. What distinguishes psychoanalytic therapy from other types of therapies? A The focus on problem-solving B The focus on irrational thoughts © The focus on dreams and wishes hey e D The deep analysis of the patient relationship with the + _ therapist. Cognitive Behavioral Therapy (CBT) interventions focus on c A The person’s relationships and family dynamics fo} B The person's thoughts, beliefs, or behaviors a PwandB The decision to use supportive psychotherapy should be based on which of the following? Check all that apply. r A Recent losses iJ 5 Present coping skills C The patient’s ego strength and _ weaknesses D Highest level of functioning previously _ achieved | Which of the following is true about the therapeutic benefit of groups in the development of socializing techniques? c 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. © AU of the above Which of the following is not consistent cross-cultural research related to mental health and mental illness. Cc A Culture determines what is considered a psychiatric disorder. c B Neurobiological mechanisms linked to stress and trauma vary across cultures. wa ( Individuals from different cultural backgrounds vary in their interoceptive + awareness. D Individuals from different cultural backgrounds are similar in their _ interoceptive awareness. 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? cA Itis appropriate to use relaxation techniques in between exposures B It is appropriate to use relaxation techniques during the actual exposures conducted + | by the therapist. Cc c It is appropriate to use relaxation techniques after the exposures we Padandc 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. fel C Allows for nurse-patient boundaries to be safely ignored to better meet _ Patient needs. fey c D Undermines objectivity Recognizing that many factors may have contributed to a patient’s current situation is an example of which of the following? ce A Biomedical model B Psychosocial _ framework fot © Overdeterminism fey c D Resiliency A Hispanic woman whose mother recently died reports that she continues to hear the voice of her deceased mother. The advanced practice psychiatric nurse considering the woman’s Hispanic culture determines which of the following? J A The woman is likely grieving according to her Hispanic social norms. Cc B The woman is psychotic as Hispanic people tend to somaticize conflicts. c c The woman is psychotic and needs to be hospitalized for further evaluation. B Developing a sensitivity to some of the issues faced by those in ¥ other cultures. w c Learning to recognize the therapist’s own blind spots and biases. r o Becoming an expert on ethni. nternal resources include which of the following? al 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. hOF ‘al D Are intuitive and easily measured Controlled studies of psychotherapy outcome have shown which of the following? c A The average person typically does not engage in psychotherapy 5 The average person who receives psychotherapy is significantly improved. hoy c The average person who receives psychotherapy shows no significant improvement. ao D The average person who receives psychotherapy shows some improvement, but + | results are not statistically significant. in classical psychodynamic therapy the therapist’s role is which of the following? a Objective cB subjective C Participant- - | Observer ral D enmeshed 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: fal A People do things because of what happens in their brain. c B Biological events cause human actions. C One can learn to activate their prefrontal cortex and retrain - _ emotional reactions. hey © Biological events always over-rides free will. 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? Fal A Be a good parent B Foster and protect the therapeutic alliance hoy c c Hold and contain the patient D Provide a role model for + identification Diverting conflict between two people by involving a third is known as the concept of: Emotional c reactivity Relationship triangles c Differentiation of c self -~ DEnmeshment Which of the following are consistent with research about adverse childhood experiences (ACE)? You can tell me, but you will need to bring this up yourself in the next therapy ¢ session 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 hey B Lend psychic structure - © Hold and contain the patient D Foster and protect the therapeutic G alliance. Over the past 40 years many controlled studies of psychotherapy outcome have demonstrated which of the following? The outcome from group therapy is virtually identical to that of individual C therapy. B The outcome from group therapy is slightly less than outcome of individual ¢ therapy. The outcome from group therapy is significantly better than outcomes of é individual therapy The outcome from group therapy is significantly less than outcomes of ¢ ‘individual therapy. 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. Cc 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 C goal achievement. According to Structural Family Therapy model, family structure refers to which of the following? A Birth order. e B How individuals in the family balance individuality and togetherness. Cc How individuals in the family experience and express their real CG feelings. D The way families are organized into subsystems separated by c emotional boundaries. The process of a group member benefitting by observing the therapy of another member with similar problems is a phenomenon referred to as which of the following: « AModeling « B Spectator therapy Copy-cat ¢ phenomenon ¢¢ D Universality Good practice habits that are relevant for legal and ethical professional responsibility include which of the following? Check all that apply. 7 A It is essential that emergency coverage is in place. B How the patient contacts you between sessions and in emergencies should be iv included in the contract given to the patient during the initial session. Explicitly state whether you will be available for phone calls between sessions and i adhere to clear limits. J D Check messages at least once per day and call back within 24 hours. 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 | mean.” The CBT therapist responds saying “No, | 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? A Questioning the ¢ Evidence B Downward Arrow mh Cc Idiosyncratic Meaning fey D Labeling of c Distortions. rd D Acceptance, nonjudgmental attitude and empathy. The skilled psychotherapist assists the patient to stay in the Resilience Zone. Which of the following symptoms are consistent with hypoarousal? ec A Pain, anxiety, fatigue B Emptiness, emotional paralysis, emotional q numbness « C Euphoria, irritability, panic D Angry outbursts, anxiety, exhaustion fey he advanced practice psychiatric nurse working with a patient from another culture is recommended to do which of the following? -) A Ask the individual how he or she feels about working with you. c B Automatically refer patient to a provider of the same or similar culture. Cc Research the individual’s culture and let the patient know you are an expert in that ¢ culture. The Advanced practice psychiatric nurse explains her own culture to the patient to Cc minimize misunderstandings. 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. oq Cc Most psychodynamic research consists of case studies which limits the ability to generalize to other situations and populations. fe} D Psychodynamic techniques do not lend themselves to the precision required for a inical trial. 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 A B Anxiety c Resilien a © ce c¢ DHolism During the middle phase of family therapy treatment much of the treatment is devoted to which of the following: c A Identifying major conflicts and focusing on structures that perpetuate them. B The therapist serving as a conduit for most of the communication to keep conflict at a ¢ minimum during the session. @ Helping the family members to deal more constructively with each other in the @ sessions. D Preventing family members from feeling anxiety as they are working through their issues. fey Which of the following is consistent regarding termination in brief psychodynamic therapy? - AThe 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 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 é major issues have been addressed. Which of the following is true about Automatic Thought Records (ATR)? Check all that apply. r A The ATR is a key component of CBT This is a homework technique in which troubling situations and resulting emotions r and thoughts are captured. The therapist and patient work on clarification and development of “rational” Cr responses to challenge the original responses. md D All the above According to Bowen, lack of differentiation in a family may be manifest as Emotional C overinvolvement cB Emotional distance 
