Question 1 The role of the therapist during Stage 4 of the...

Question 1

The role of the therapist during Stage 4 of the Dialectical Behavior Therapy procession model includes which of the following?

A.

Prepare the patient to safely let go of therapy.

B.

Maintain calmness without over-reacting to the patient's behavior. 

C.

Reassure the patient that extinction bursts are reasonable and normal. 

Question 2

Which of the following statements would be consistent with Trauma-Informed Care when treating patients with comorbid PTSD and Substance Use Disorder?

A.

Evidence suggests the substance use issues be addressed first as substances can mask the issues and symptoms of PTSD.

B.

Evidence suggests symptoms of PTSD be addressed before initiating any substance abuse issues as PTSD symptoms are what typically trigger substance abuse.

C.

Clinicians need to learn evidence-based treatment approaches to simultaneously treat the underlying PTSA while addressing substance use.

D.

Evidence suggests a low dose antipsychotic medication is most effective in treating PTSD symptoms and can also minimize alcohol and other drug abuse.

Question 3

The purpose of Mindfulness-Based Stress Reduction in the older adult is

A.

To avoid using psychotropic medications

B.

To escape from stressful situations and relationships

C.

To learn to be present in the moment non-judgmentally.

D.

To avoid stigma of traditional psychotherapy

Question 4

The advanced practice psychiatric nurse using supportive psychotherapy with a patient with a preoccupied attachment style would use which of the following interventions?

A.

Active interventions to facilitate emotional expression and connection.

B.

Supportive interventions to help the patient contain overwhelming emotions.

C.

Any interventions on the psychodynamic continuum with not customizations.

D.

None of the above. Attachment style has no bearing on psychodynamic therapy.

Question 5

The patient in Dialectical Behavior Therapy with a history of self-harming through cutting, has shown progress in effectively using skills to manage urges integrating skills to manage emotions and behaviors with increased awareness of self. The advanced practice psychiatric nurse recognizes the patient is ready for which of the following?

A.

The patient is ready to focus on self-fulfillment

B.

The patient is ready to focus on self-efficacy

C.

The patient is ready to begin exposure therapy.

D.

The patient is ready to begin termination from therapy.

Question 6

In child psychotherapy consideration of systems that promote a child's ongoing development include which of the following? Pg 602/791

A.

Peers

B.

Family

C.

School

D.

Community

The third underlying assumption of child psychotherapy is consideration of the systems that promote a child's development (i.e., family, school, peers, and community). Since interaction in these systems is key to ongoing development, a child's competence in these systems must also be facilitated.

Question 7

The advanced practice psychiatric nurse is using a Dialectical Behavior Therapy (DBT) approach with a patient who has experienced trauma. In which stage of the DBT model would the advanced practice psychiatric nurse begin exposure therapy?

A.

Stage 1

B.

Stage 2

C.

Stage 3

D.

Stage 4

Question 8

In working with a patient with borderline personality disorder, the Dialectical Behavior Therapy (DBT) therapist emphasizes suicidal and self-harming behaviors are problems to be solved and are the highest priority for treatment. Which of the following would be inconsistent with DBT therapy?

A.

The patient must agree to reduce self-harming behaviors as a goal for therapy.

B.

The patient must agree to work with the therapist before acting on self-harming urges.

C.

 If the patient engages in the self-harming behavior and is admitted to the hospital the therapist can continue to support the patient through scheduled telephone or in-person sessions.

D.

If the patient engages in the self-harming behavior and is admitted to the hospital the therapist suspends direct consultation with the patient until 24 hours after the patient is discharged from the hospital.

Question 9

Which of the following is true about pharmacological withdrawal?

A.

Pharmacological withdrawal indicates addiction to a prescribed medication

B.

Characteristic signs and symptoms occur when a particular medication is discontinued

C.

A normal physiological response to discontinuation of certain prescribed medications.

D.

B and C

Question 10

Addiction is now recognized as which of the following? 

A.

A preventable personality disorder 

B.

A family disorder due to poor parenting

C.

A volitional behavior that can be managed independently'

D.

A primary disease of the brain's neurocircuitry.

Question 11

Which of the following describes the basic neurobiological pathways of the reward system in the brain?

A.

Projections from the ventral tegmental area, through the median forebrain and terminate in the nucleus accumbens where there is a proliferation of dopamine neurons.

B.

Projections through the median forebrain, to the ventral tegmental area where there is a proliferation of dopamine neurons, to the nucleus accumbens.

C.

Projections from the nucleus accumbens to the median forebrains where there is a proliferation of dopamine neurons to the ventral tegmental area.

D.

Projections from the median forebrain through the ventral tegmental area to the nucleus accumbens where there is a proliferation of dopamine neurons.

Question 12

The patient in Dialectical Behavior Therapy (DBT) complains the skills being taught in DBT don't work, struggles with keeping diary cards, and doing assigned homework. This is consistent with which stage of treatment within the DBT model?

A.

Stage 1

B.

Stage 2

C.

Stage 3

D.

Stage 4

Question 13

A specific type of CBT therapies aimed to reduce distress as a person experiences sensation with danger is known as which of the following?

A.

 Shame-Attacking

B.

Exposure Therapy

C.

Cognitive Rehearsal

D.

Guided relaxation and meditation

Question 14

Which of the following is not consistent with the Principles of Effective Treatment for Addiction according to the NIH?

A.

Treatment needs to be readily accessible.

B.

Psychotropic medication should be stopped prior to treatment.

C.

Treatment does not need to be voluntary to be effective.

D.

Drug use during treatment must be monitored continuously as lapses may occur during treatment.

Question 15

The advanced practice psychiatric nurse proficient in Interpersonal Psychotherapy (IPT) is working with an older adult who does not realize she has depression. Which of the following is true?

A.

IPT is not an appropriate model for treating depression in older adults.

B.

This is a common IPT issue with older adults during the initial sessions.

C.

The advanced practice psychiatric nurse should consider using a standardized scale to quantify the depression and use this to educate the patient and the family.

D.

B and C

Question 16

Challenges assessing psychiatric symptoms in the elderly include which of the follow 

A.

Denial of symptoms.

B.

Age-related variations in symptom presentation.

C.

Making of symptoms by comorbid disorder and medications.

D.

Difficulty in obtaining an accurate mental health history.

Question 17

Which of the following is not consistent with the Psychoanalyst's perspective when treating and individual with a personality disorder?

A.

It is important to identify and then modify "core" problems when treating individuals with personality disorders.

B.

Personality structures are unconscious and thus mostly unavailable to the individual.

C.

Personality products and processes are within the realm of awareness, accessible to the individual.

D.

Psychoanalytic therapy is an effective treatment for Borderline personality disorder

Question 18

Evidence supports use of Dialectical Behavior Therapy patients with which of the following diagnoses?

A.

Schizophrenia

B.

New onset depression

C.

Bipolar Affective Disorder

D.

Borderline Personality Disorder

Question 19

In using trauma-focused cognitive behavioral therapy with a child exposed to domestic violence the advanced practice psychiatric nurse realizes the first component of this structured approach includes which of the following?

A.

Relaxation skills 

B.

Problem solving skills 

C.

Constructing the trauma narrative

D.

Psychoeducation with child and parent about trauma response and what causes it.

Question 20

In working with an older adult female patient, the advanced practice psychiatric nurse notices that the patient starts bringing her baked goods, and says "You remind me so much of my daughter, you are so easy to talk to." The advanced practice psychiatric nurse recognizes this as

A.

Gerotranscendence

B.

Transference

C.

Countertransference

D.

Time for termination

Question 21

The therapeutic frame supports the clinician in which of the following ways? Select all that apply.

A.

Maintaining a therapeutic stance of neutrality.

B.

Maintaining a therapeutic stance of anonymity.

C.

Maintaining a therapeutic stance of non-intrusiveness.

D.

A and C 

Question 22

Dialectical Behavior Therapists realize which of the following:

A.

Everyone with borderline personality has comorbid posttraumatic stress disorder (PTSD

B.

Everyone diagnosed with PTSD can be diagnosed with comorbid borderline personality disorder.

C.

There are important overlapping symptoms and neuropsychological correlates that PTSD and borderline personality disorder have in common.

D.

DBT should only be used with individuals diagnosed with personality disorder or those with chronic suicidal thoughts.

Question 23

McGovern et al (2014) have found which of the following therapeutic approaches helpful In working with post-stroke patients experiencing depression?

A.

Interpersonal Therapy for Mild Cognitive Impairment (IPT-CT)

B.

Problem-Solving Therapy for Executive Dysfunction (PST-ED)

C.

Cognitive Behavioral Therapy for Mild Dementia (CBT-MD)

D.

Ecosystem-Focused therapy (EFT)

Question 24

Functional status refers to

A.

A person's capacity to manage activities of daily living independently

B.

A person's positive perspective on their own capabilities

C.

A person's expected increase in dependency as one ages

D.

A person's expected decrease in independence as one ages

Question 25

Evidence-based therapeutic modalities for treating older adults with anxiety include which of the following:

A.

Cognitive Behavioral Therapy, Relaxation training, Biofeedback

B.

Dialectical Behavior Therapy, Reminiscence Therapy, Biofeedback

C.

Guided Imagery, Music Therapy, Yoga

D.

A and C

Question 26

Which of the following is a philosophical approach to psychotherapy which deals with universal themes of life?

A.

Gestalt Therapy

B.

Psychoanalysis

C.

Existential psychotherapy

D.

Person-Centered Psychotherapy

Question 27

The advanced practice psychiatric nurse is working with the patient on maintaining treatment outcomes and developing a guide for surviving difficult times. These strategies are consistent with which phase in the CBT process?

A.

Introductory phase

B.

Middle phase

C.

Late middle phase

D.

Termination

Question 28

Which of the following medications may be recommended for patients with insomnia due to PTSD?

A.

Any antidepressant can offer as first-line treatment in adults for PTSD.

B.

Non-benzodiazepines such as trazodone (Desyrel)

C.

Prazosin (Minipress) may be helpful if nightmares are present.

D.

B and C

Question 29

Which of the following is not consistent with a humanistic-existential approach?

A.

Awareness allows one freedom to make choices. 

B.

Authenticity allows a person to be fully response for choices. 

C.

Given the appropriate conditions a person will automatically grow in positive ways.

D.

Part of aliveness is living with feelings of dread, guilt, and anxiety.

Question 30

The advanced practice psychiatric nurse using a Dialectical Behavior Therapy approach with a patient with Borderline Personality Disorder explains the four essential elements which includes all but which of the following?

A.

Bi-weekly individual therapy sessions for the patient of about 1 hour each.

B.

Weekly group skills training sessions for the patient of 2.5 hours each.

C.

Skills coaching via telephone or other electronic means as needed by the patient to manage I vivo situations

D.

Team consultation to the therapist to maintain treatment fidelity and adherence