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NURS 6640: MIDTERM3 EXAM WITH ANSWERS/2023.Qualified WALDEN UNIVERSITY, Exams of Nursing

NURS 6640: MIDTERM3 EXAM WITH ANSWERS/2023.Qualified WALDEN UNIVERSITY

Typology: Exams

2022/2023

Available from 07/05/2023

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NURS 6640: MIDTERM3 EXAM WITH ANSWERS/2023.Qualified
WALDEN UNIVERSITY
A patient named Steve is seeking therapy to get help
with his home situation, stating that he has been
stressed since his mother-in-law moved into the house.
What can the PMHNP do to assist the patient in
constructing a narrative?
B Elicit details so Steve becomes more self-disclosing and
. self-examining
A new patient has been informed of the limits of
confidentiality, and has signed informed consent forms.
No consent, however, has been obtained for voluntary
“Release of Information.” The patient is 20 years old and
still lives at home with his parents. He is being treated for
depression, which he attributes to the trouble he’s had
finding employment.
True or false: If the patient’s mother calls the PMHNP to check up on
her son to see how he is doing, the therapist is required to protect
patient confidentiality and not disclose information.
True
The PMHNP is caring for a patient with borderline
personality disorder. Using a psychoanalytic
psychotherapy approach, the PMHNP attempts to
intensify the patient’s transference to enhance emotional
processing by:
A Developing increased boundaries
.
B Decreasing supportive
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NURS 6640: MIDTERM3 EXAM WITH ANSWERS/2023.Qualified

WALDEN UNIVERSITY

 A patient named Steve is seeking therapy to get help with his home situation, stating that he has been stressed since his mother-in-law moved into the house. What can the PMHNP do to assist the patient in constructing a narrative? B (^) Elicit details so Steve becomes more self-disclosing and . self-examining  A new patient has been informed of the limits of confidentiality, and has signed informed consent forms. No consent, however, has been obtained for voluntary “Release of Information.” The patient is 20 years old and still lives at home with his parents. He is being treated for depression, which he attributes to the trouble he’s had finding employment. True or false: If the patient’s mother calls the PMHNP to check up on her son to see how he is doing, the therapist is required to protect patient confidentiality and not disclose information. True  The PMHNP is caring for a patient with borderline personality disorder. Using a psychoanalytic psychotherapy approach, the PMHNP attempts to intensify the patient’s transference to enhance emotional processing by: A (^) Developing increased boundaries . B (^) Decreasing supportive 1 points 1 points

NURS 6640: MIDTERM3 EXAM WITH ANSWERS/2023.Qualified

WALDEN UNIVERSITY

psychotherapy C (^) Scaling back contact with the patient . D (^) Increasing the number of sessions . per week  True or false: A PMHNP may ask his patient to describe her relationship with her father, both as a child and now, in order to assess interpersonal style. Tru e Fal se QUESTION 1

  1. The PMHNP understands that anxiety and depression are two disorders in which their symptoms may overlap. When discussing this, you explain that the autonomic nervous system is activated and further helps distinguish anxiety symptoms by making the following points:
  2. A^ “You may experience an elevated heart rate, constant worrying, . and diarrhea.” B (^) “You may experience fear, sweating, and muscle tension.” . C (^) “You may experience an elevated heart rate, the need to urinate, . and fear.” D (^) “You may experience sleepiness, decreased blood pressure, and 1 points 1 points

NURS 6640: MIDTERM3 EXAM WITH ANSWERS/2023.Qualified

WALDEN UNIVERSITY

QUESTION 4

  1. In your office, you see a 58-year-old patient with PTSD who reports having nightmares, making it impossible for her to sleep. What recommendations based on principles of sleep hygiene will the PMHNP make? C (^) Avoid watching television or reading . 1 points

in bed QUESTION 5

  1. An 11-year-old patient has been exhibiting low self-esteem at school and acting out. According to Maslow’s hierarchy of needs, which of the following questions would best be addressed first by the PMHNP?
  2. C (^) “Is Joel getting enough sleep at . home?” QUESTION 10
  3. The PMHNP has a session with a patient who was injured and traumatized from an explosion at the industrial plant where he used to work. During the session, an outside noise startles the patient and he experiences a flashback of the loud boom from the explosion. The PMHNP witnesses the patient present with anxiety and belabored breathing. What is the appropriate action of the PMHNP?
  4. A^ Telling the patient there is no reason to be startled . B (^) Avoiding interrupting the flashback as it occurs . C (^) Asking the patient to describe the flashbacks 1 points 1 points

The PMHNP asks the patient to draw his family genogram as a next step to .

  1. A^ assess the patient’s mental health status and . functioning B (^) explore the interpersonal styles of each family member . C (^) provide background information for the patient’s family . structure D (^) measure the patient’s quality of well-being and . productivity QUESTION 13
  2. You are seeing a 29-year-old widow whose husband recently died overseas while serving his country in the military. She has been mourning the loss of her husband for several months, and continues to grieve. She refuses to go to group grieving sessions, but reports that she is still able to go to work and her fitness classes sometimes, and even makes attempts to stay social. She says, “Sometimes it’s like he’s not even gone. Other times it feels like it’s been an eternity since I’ve seen him. It’s hard to talk about this type of stuff with my girlfriends, especially since all of their husbands are still alive.” The PMHNP understands that it is appropriate to employ which therapeutic principle?
  3. A^ Encouraging catharsis . B (^) Encouraging abreaction to repressed . feelings 1 points

C (^) Identifying conflict-resolution . techniques D (^) All of the above . QUESTION 14

  1. A 65-year-old patient has suffered the loss of his wife. He is in a state of hyperarousal with increased sympathetic nervous system arousal. One or more interventions may help the patient to deal with this arousal. To decrease sympathetic nervous system arousal, the PMHNP’s treatment strategy is.
  2. A^ mindfulness . techniques B (^) deep breathing . exercises C (^) self-regulation . strategies D (^) all of the above 1 points

C (^) Brings in a colleague to help get the

. (^) patient to talk D (^) None of the above . QUESTION 17

  1. The patient is a 56-year-old female patient diagnosed with panic disorder and reports symptoms that include heart palpitations, frequent trembling, and feelings of choking in stressful situations. What special consideration does the PMHNP make?
  2. A^ Using a special focus on transference as the agent . promoting change B (^) Confronting the emotional significance of the patient’s . symptoms C (^) Employing psychodynamic therapy combined with . (^) pharmacotherapy D (^) A and B . 1 points 1 points

QUESTION 18

  1. A 35-year-old patient seeks treatment for depression and anxiety after an abusive relationship. To help empower the patient, the PMHNP wants to teach the safe-place exercise to create a feeling of calm. In order to walk the patient through the exercise, the PMHNP first says:
  2. A^ “Identify an image of a safe place that makes you . feel calm.” B (^) “Think about the things that cause you anxiety and . let them go.” C (^) “Take a deep breath and start to relax with each new . breath.” D (^) “Picture a beautiful beach and describe to me what . you see.” QUESTION 19
  3. The PMHNP is meeting with a 38-year-old divorced, single mother who has been seeing the PMHNP for anxiety and anger management. During one of the sessions, the patient tells the PMHNP that she is having a problem getting her child support payments from her ex-husband, which is triggering increased anxiety and anger, which she admittedly takes out on her children. How does the PMHNP respond in a way that upholds the supportive psychodynamic psychotherapy approach?
  4. A^ Telling the patient to take a vacation to get away and relax . B (^) Suggesting that she seek legal help . 1 points

D (^) None of the above. . QUESTION 21

  1. The PMHNP meets with a 47-year-old male patient who is fearful of leaving the house after having witnessed his neighbor getting run over by a car. When the PMHNP asks why he is afraid to leave his house, the patient replies, “Because another accident might occur.” Which cognitive behavioral therapy (CBT) strategy does the PMHNP employ?
  2. A^ Pharmacological . therapy B (^) Stress inoculation . (^) therapy C (^) Dialectical behavior . therapy D (^) All of the above . QUESTION 22
  3. A PMHNP is assessing ego functioning of his 40-year-old patient by asking what she feels is the cause of her problems. She attributes her problems to her overprotective parents not letting her have enough freedom growing up. Based on her answer, the PMHNP is testing.
  4. A^ adaptive regression in the service of 1 points 1 points

the ego B (^) regulation and control of affects and . impulses C (^) defensive and interpersonal . functioning D (^) sense of reality of the world and of the . self QUESTION 23

  1. The PMHNP is working with a patient who has insomnia and battles going to sleep. The patient reports consistent self-defeating behaviors, and hates trying to go to sleep. Which action made by the PMHNP demonstrates the use of a paradoxical intervention?
  2. A^ Telling the patient to start trying to go to sleep earlier, since it takes . long to fall asleep B (^) Telling the patient to resist sleep and stay awake . C (^) Having the patient perform a relaxing ritual before bedtime . D (^) Instructing the patient to avoid stimulants and sugars for 3 hours before 1 points

you.” D (^) “What has your wife done to make you . believe this?” QUESTION 26

  1. An elderly patient in a nursing home has been losing interest in activities and now refuses to leave his room. After a physical exam, he is referred to a PMHNP for an initial assessment. True or false: After speaking with the patient, an appropriate screening tool for the PMHNP to use would be the Geriatric Depression Scale. Tru e Fal se QUESTION 27
  2. When the patient comes into the office, she says, “I just saw a friend of mine out in the waiting room. What’s wrong with him?” The PMHNP says, 1 points 1 points

“He’ll be fine. He has mild depression.” Which of the following statement is correct related to confidentiality rights?

  1. A^ The PMHNP was not protecting patient confidentially rights. . B (^) The PMHNP was not using identifying information in the patient situation . above. C (^) Because the patient signed a consent form, the PMHNP was legally allowed . to share information. D (^) The PMHNP’s response was ethical and legal because she was trying to . answer the question. QUESTION 28
  2. During a clinical assessment of a 15-year-old patient, the PMHNP asks, “How can I help you?” The patient answers by saying, “Honestly, I don’t really think I need any help.” Which of the following is the most appropriate response by the PMHNP?
  3. A^ “That’s fine. Can you describe the depressive symptoms you’ve been . having the past few months?” B (^) “Since you’re already here, maybe we can try to figure out if there is . anything else I can help you with.” C (^) “You wouldn’t be here if you didn’t actually need help, right? So tell me, . how can I be of assistance?” 1 points

D (^) “I believe in systems; I have to have order and rules in my everyday life. If . a task must be completed, I will often complete it myself versus depending on someone else.” QUESTION 30

  1. The patient attempts the PMHNP’s sleep hygiene recommendations for 2 weeks, but does not make any progress mitigating nightmares and hyperarousal. Which behavioral strategy does the PMHNP suggest next?
  2. A^ Progressive muscle relaxation . exercises B (^) Paradoxical interventions . C (^) Biofeedback . D (^) All of the above . QUESTION 31
  3. The PMHNP is working with a patient who experiences anxiety around her parents that later leads to poor impulse control. What will the PMHNP do to employ psychodynamic psychotherapy properly for this patient?
  4. A^ Emphasize the past . 1 points 1 points

B (^) Focus on expressions of . emotion C (^) Identify patterns in . relationships D (^) All of the above . QUESTION 32

  1. The PMHNP is working with a 56-year-old man who is being seen because of his anxiety and depression. During the therapy sessions, the PMHNP assists the patient in discussing his experiences and expanding on his thoughts and feelings. He tells the PMHNP stories about how he used to be teased by his coworkers at the office for becoming too anxious in large conference rooms. The PMHNP listens to the patient and helps focus on his strengths to promote self-understanding. Which principle best accounts for the PMHNP’s interactions with the patient?
  2. A^ Therapeutic . communication B (^) Maintaining the frame . C (^) Working with resistance 1 points