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A comprehensive overview of various techniques and approaches used by psychiatric-mental health nurse practitioners (pmhnp) in their practice. It covers topics such as focusing, motivational interviewing, mindfulness, holding and containing, raising self-esteem, psychodynamic psychotherapy, interpersonal psychotherapy, affirming communication, termination, emotion-focused therapy, integrated approach, assessment process, therapeutic communication skills, depression treatment, child abuse and neglect, feeling-state addiction protocol, and dynamic supportive therapy. The document also discusses the application of these techniques in different scenarios and the pmhnp's role in various patient situations.
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- Question 1 1 out of 1 points - Question 2 1 out of 1 points - Question 3 1 out of 1 points
Course NURS-6640 Psychotherapy Individ Attempt Score 74 out of 75 points Results Displaye d Submitted Answers A PMHNP is using Gestalt therapy to communicate with a 50-year-old patient who is going through a divorce. As he is calmly sharing the details of his divorce, the PMHNP notices that Dave is tapping his fingers on his legs. What is an appropriate response by the PMHNP using the technique of focusing? Selecte d Answer :
“I noticed that your fingers were tapping. Can you give a voice to your fingers?” A 25-year-old female states, “I really need to lose weight. I know I’m the cause of our problems, if I could just lose weight he might be more attracted to me. Then we could start a family and we would be happy. I’m sure of it, right, we would definitely be happy!” Which statement shows the PMHNP’s ability to apply “summarizing”? Selecte d Answer :
“You have identified your weight as a problem in your marriage and but believe that losing weight will gain happiness.” As part of the PMHNP’s role in the clinic, the PMHNP oversees students that gain clinical experience at the agency. The student is instructed to use the supportive psychodynamic therapy approach with the patient. Which action made by the student causes the PMHNP to intervene, after observing the student interacting with the patient?
- Question 4 1 out of 1 points Selecte d Answer:
Focusing too heavily on defenses
because she is nervous about company layoffs. “I feel like I need to work myself to death in order to prove that I am valuable
- Question 9 1 out of 1 points - Question 10 1 out of 1 points - Question 11 1 out of 1 points - Question 12 1 out of 1 points to the organization,” the woman says. Using the supportive psychodynamic therapy approach, how does the PMHNP respond? Selecte d Answer :
“That must be a very tiring work schedule. How do you feel about working so much?” When preparing to terminate a patient, what does the PMHNP do to organize thoughts about the patient’s progress made during treatment? Selecte d Answer :
Reviews the patient’s file to identify issues and important themes that were highlighted throughout treatment Linda is a 65-year-old patient who has completed initial treatment for alcohol addiction and anxiety problems. She is motivated to continue her treatment gains and have a healthy lifestyle. How would the PMHNP apply a mindfulness approach to this case? Selecte d Answer :
Help Linda develop an awareness of triggers in order to have greater control over physical and emotional responses The PMHNP is caring for a young adult patient with whom the PMHNP decides to use a dynamic supportive therapy approach in addition to pharmacological intervention. Which therapeutic action will the PMHNP take to employ the strategy of holding and containing the patient? Selecte d Answer:
Asking the patient how the patient feels The PMHNP is caring for an adult male patient whose wife left him several months ago. He recently learned that his ex-wife is dating someone much younger. The man feels belittled, sad, and lonely. He talks about trying to meet other women, but says, “I can’t compete with the younger guys these days, with the cool clothes and the vegan diets. I’m bald and overweight, and what woman is going to want to be with me?” How does
- Question 13 1 out of 1 points - Question 14 1 out of 1 points - Question 15 1 out of 1 points - Question 16 1 out of 1 points Selecte d Answer:
All of the above A 43-year-old single mother is seeing the PMHNP at the request of her sister. “My sister thinks I need to come here to talk about my feelings,” the patient reports. The PMHNP learns that the patient has three children from three different men, but is unable to collect appropriate child support payments from any of the biological fathers. Additionally, the woman is barely able to afford her apartment or utilities payments. What is the appropriate response from the PMHNP when using the psychodynamic psychotherapy technique? Selecte d Answer:
Suggesting that the patient seek professional legal help The PMHNP has been providing interpersonal psychotherapy (IPT) for a patient who the PMHNP observes implementing new ways of being, such as interacting more with peers and being less isolated in social scenarios. The PMHNP understands that the patient is approaching termination. How does the PMHNP address termination with this patient? Selecte d Answer:
Embed the termination into the work of the therapeutic phase A PMHNP has been treating a 14-year-old patient using interpersonal psychotherapy. The patient has been depressed since the death of his grandmother. To help the patient recover, the PMHNP has told the parents: Selecte d Answer:
“Modify your expectations at home and school until the depression lifts.” In the planning phase of change, a 42-year-old male client who struggles with gambling discusses how he plans to abstain from gambling. He tells the PMHNP, “I am no longer going to carry cash to the casino because you can’t spend what you don’t have.” The PMHNP uses an affirming communication skill when she states: Selecte d Answer:
A. “Not gambling is a tough habit to break; not carrying cash is a big step in the right direction.”
- Question 17
None of the above
- Question^22 1 out of 1 points - Question 23 1 out of 1 points - Question 24 1 out of 1 points - Question 25 1 out of 1 points - Question^26 1 out of 1 points A PMHNP is using emotion-focused therapy to help a 38-year-old patient who says, “I’ve been feeling angry lately, but I’m not sure why.” The first attempt by the PMHNP is to say: Selecte d Answer:
“Focus on your anger, take a deep breath, and allow an image to emerge.” The PMHNP uses the Adult Attachment Interview (AAI) with a male patient who reports having had a difficult time being separated from his parents during his childhood. He explains that going to school or visiting his relatives without his parents was troublesome. The PMHNP characterizes the patient as unresolved/disorganized, according to his outcomes on the AAI. What does the PMHNP anticipate from the patient? Selecte d Answer:
He will have lapses in his memory of his childhood. The PMHNP is interviewing a patient who is in the process of successfully completing a substance abuse program. During the interview, the patient states, “I wish I was strong enough to keep the same friends I had before I came here for treatment. I’m really afraid of being discharged because I’ll probably run into my old friends again.” The PMHNP offers a complex reflection when she states the following: Selecte d Answer :
“You’d like to keep your old friends but know being around them may lead you to abuse substances again.” A PMHNP is using interpersonal psychotherapy with a 40-year-old patient having relationship problems with his extended family. The patient shares that he has been using the strategies they identified to reduce his distress, but they have not been helping. He is frustrated and is considering stopping treatment. What would be an appropriate step by the PMHNP? Selecte d Answer:
Encourage the patient to continue treatment by using alternative strategies
Selected D.
- Question 32 1 out of 1 points - Question 33 1 out of 1 points - Question 34 1 out of 1 points - Question 35 1 out of 1 points Answer: There is a lower incidence of inconsistent behaviors with motivational interviewing. This is related to client engagement and better outcomes. A PMHNP is treating a 12-year-old girl who witnessed the physical abuse of her sibling. She has been anxious and irritable since the experience. After speaking with the PMHNP, the patient says she keeps having anxiety-causing thoughts about the experience. Using the PRACTICE technique, which skill will best help the patient interrupt these negative thoughts? Selecte d Answer:
Affect modulation The PMHNP is working with a patient who describes having a painful and traumatic childhood experience, which causes her to have anxiety as an adult. When asked how she manages her anxiety, the patient dismisses it and denies that it is a problem. Using the supportive psychotherapy approach, the PMHNP will do which of the following when assessing the patient’s ego strength? Selecte d Answer:
Identify the primary defenses the patient uses to ward off anxiety The PMHNP uses therapeutic communication skills while ensuring that the patient understands that he has choices. The PMHNP comprehends and practices motivational interviewing. This is best understood as which of the following? Selecte d Answer :
A statement that both challenges the patient’s resistance and offers an opportunity to discuss the issues allows the patient to argue with him/herself to help produce a desired change. While assessing a patient using a humanistic-existential approach, a patient tells the PMHNP, “For the past few weeks, I’ve felt anxious almost every single day.” What would be an appropriate next step by the PMHNP? Selecte d Answer:
Encourage the patient to clarify by asking, “You constantly feel anxious?”
- Question 37 1 out of 1 points - Question 38 1 out of 1 points - Question 39 1 out of 1 points - Question 40 1 out of 1 points The PMHNP is meeting with a patient who has been diagnosed with depression. The patient is having trouble adjusting to her new job and hasn’t made any new friends there. What would an appropriate response be by the PMHNP using the interpersonal psychotherapy approach? Selecte d Answer:
“Tell me more about why you’re having trouble making new friends at work.” A 38-year-old patient tells the PMHNP that her father went to jail for selling drugs when she was a child. The patient is visibly upset when discussing what happened. Using a humanistic-existential approach to psychotherapy, which of the following is the most appropriate response by the PMHNP? Selecte d Answer:
“What are you experiencing now as you share this story?” The PMHNP is assessing an older adult male patient with depression and comorbidities. According to the medical chart, the patient takes medication to manage joint and bone pain. The patient reports feeling “forgetful” and complains that he has a hard time remembering where he puts things. What is the primary action by the PMHNP? Selecte d Answer:
Determining if the patient’s medications can be causing memory problems A 35-year-old male patient is being treated for alcohol addiction. He asks for the PMHNP’s cell phone number to use in case of an emergency. When the PMHNP responds that giving her number would be against therapeutic rules, the patient threatens an act of violence to the therapist. What would be the most appropriate response by the PMHNP? Selecte d Answer:
Immediately report the threat to the local police department The PMHNP is caring for a geriatric patient who expresses symptoms of gastrointestinal problems, aches and pains, and loss of appetite. The patient reports feeling lonely, as more of his friends have been passing away over the recent months and years. The PMHNP focuses on which therapeutic approach for this patient?
- Question 41 1 out of 1 points - Question 42 1 out of 1 points - Question 43 1 out of 1 points - Question 44 1 out of 1 points - Question 45 1 out of 1 points Selecte d Answer:
All of the above A 12-year-old girl was referred for treatment after witnessing the physical abuse of her sibling by their mother. The patient has been anxious and irritable since the experience. What evidence-based treatment would be most appropriate for the PMHNP to use? Selecte d Answer:
Trauma-focused CBT The PMHNP uses the cognitive behavioral therapy model with Gerald, an older adult patient who is being treated for depression and mood disorder. What will the PMHNP do with the patient during the first three sessions? Selecte d Answer:
Build a therapeutic alliance The PMHNP is initiating a plan of care for a patient who requires comprehensive psychotherapy to manage his depression and mood disorder. Throughout the initial sessions, the patient reports feeling as though he cannot be helped. The PMHNP is concerned about premature termination initiated by the patient. What strategy can the PMHNP employ to prevent or reduce premature termination? Selecte d Answer:
All of the above How does the PMHNP approach termination with the patient who has been receiving intermittent therapy? Selecte d Answer:
A and C A PMHNP is treating a 25-year-old patient who has a compulsive urge to exercise to excess. When asked to describe why she does so much exercise, she says, “I like the compliments I receive from others on my new level of fitness, and the excitement of getting more attention.” The
- Question 46 1 out of 1 points - Question 47 1 out of 1 points - Question 48 1 out of 1 points - Question^49 1 out of 1 points Selecte d Answer:
all of the above A 19-year-old female patient named Anna, who was the victim of child abuse and neglect, is also in treatment for substance abuse. At her most recent appointment, Anna confesses to the PMHNP that she is having romantic fantasies about him, and explains the he is one of the few people she trusts. She believes that he is interested in her as well. What is the most appropriate response by the PMHNP in this situation? Selecte d Answer :
Guide the patient to examine her feelings and explore the underlying meaning A 21-year-old patient is worried about starting a new job. She talks about her fears of failure and not making friends at the office. Using a person- centered approach, an appropriate response by the PMHNP is to. Selecte d Answer:
ask the patient to reflect on and explore what she is experiencing The PMHNP initiates feeling-state therapy to help a 25-year-old patient named Monique who has a compulsive urge to exercise. Using the Feeling-State Addiction Protocol, what is an appropriate next step the PMHNP should take after identifying the specific positive feeling linked with the addictive behavior and its Positive Feeling Score level? Selecte d Answer:
Locate and identify any physical sensations created by the positive feelings The PMHNP is caring for an older adult patient who presents with mixed dysphoric states and whose daughter reports “is becoming more irritable more easily.” When talking with the patient, the PMHNP also recognizes displays of cognitive dysfunction. Which treatment options will the PMHNP most likely suggest? Selected D.
- Question 50 1 out of 1 points - Question 51 1 out of 1 points - Question 52 1 out of 1 points - Question 53 1 out of 1 points - Question 54 1 out of 1 points Answer: Combination of CBT and medication Following an attempted suicide, Mr. Durham was admitted to an acute psychiatric facility. After 4 weeks in treatment, he is preparing for discharge. He is beginning to miss individual and group therapy sessions and has refused medications twice in the past 2 days. The PMHNP demonstrates understanding in this phase by saying which of the following statements? Selecte d Answer:
“Have you thought of how you will continue your treatment plans?” The PMHNP assesses a 27-year-old patient named Jeff, who was a victim of child abuse and neglect. Jeff says that he remembers a traumatic situation that he wants to share, but is having trouble talking about it. Which statement made by the PMHNP demonstrates the use of emotion- focused therapy? Selecte d Answer :
“Let’s see if we can come up with some ideas for you to feel safe telling your story.” The PMHNP has been providing supportive psychodynamic psychotherapy to a patient and is nearing the termination stage. The PMHNP will use which criteria for determining that the patient is ready for termination? Selecte d Answer:
Symptoms have improved. The PMHNP has been treating a patient who is now being transferred to another provider. What is the appropriate action made by the PMHNP? Selecte d Answer:
A and C A PMHNP has been treating a 9-year-old patient who was referred by her school. Students are asked to raise their hands before speaking during group discussion, but the patient seems to blurt out what she wants to say without being called on. She also interrupts other children while they are talking