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Category: Nursing

  • Third-Party Payments Distort the Market Discussion comment

    Purpose:
    Comment
    on the Discussion

    Thing to Remember:

    Answer this discussion with opinions/ideas creatively and clearly. Supports post using several outside, peer-reviewed sources.

    1 References, find resources that are 5 years or less

    No errors with APA format 6 Edition

     

    To Comment:

    Topic 1: Third-party Payment

    Third-Party Payments Distort the Market

                
    Third-party payment systems are what we commonly refer to as the insurance of today’s society.  This term has a specific and precise meaning.  Insurance coverage in which a company (third party), pays a provider (second party), to deliver the health care services to the patient (first party) (Scandlen, 2012).  This system did not exist until the 1930’s and was created by hospitals due to the Depression of this era, commonly known today as BlueCross (Scandlen, 2012).

    Third-party payments distort the market in many ways.  With any insurance, it can only cover what is classified as insurable risks, this includes three factors, first being the chances of loss are small; secondly, the magnitude of the loss is devastating financially; lastly, when the risks are spread across a large group, premiums are affordable (Buff, Terrell, 2014).  With these three sections identified, most insurances no longer fall into this category and are now required to cover predictable expenses for minor care as outlined by the Patient Protection and Affordable Care Act (PPACA).

     

    Use of Third-Party Intermediaries for Health Care

    With the use of these third-party payer systems, consumers are immune to the costs of the health care which is being provided.  Most of us go to the doctors or to the hospital for a procedure and we just pay our deductible and go about our day.  Do we really need that test or know what it is going to cost?  Most hospitals have a chargemaster that is an itemized list of services (Arora, Moriates, Shah, 2015). This list is usually set at a much higher rate than the services actually cost.  This practice allows for hospitals to negotiate with the large third-party payers to come to a settlement on the cost, this often offsets the price of the underinsured or noninsured (Arora, Moriates, Shah, 2015).

                
    Doctors and patients do not know what is really paid or what a service will cost because of these negotiations that occur, and it varies from patient to patient, dependent on their coverage (Arora, Moriates, Shah, 2015).  There is a national movement for price transparency and charges easily accessible to be seen by all (Arora, Moriates, Shah, 2015).

    Elderly Citizens Separate Payment Program

    It is estimated that 95% of all persons over the age of 65 is covered by the government health care insurance known as Medicare (Gilford, 1988). This program was designed to explicitly cover major costs associated with acute illness and chronic illness, to the extent of long-term care (Gilford, 1988).  This program is attached to the Social Security system and has three parts, A for hospitalization, B for medical insurance, C is a privately purchased supplement, and D for prescriptions (Smith, 2015).  There is no eligibility requirement for Medicare, only age, and disability (Smith, 2015).

     

    References

    Arora, V., Moriates, C., & Shah, N. (2015, November). 
    The Challenge of Understanding Health Care Costs and Charges.
     Retrieved from AMA Journal of Ethics: http://journalofethics.ama-assn.org/2015/11/stas1-1511.html

    Buff, M., & Terrell, T. (2014). The Role of Third-Party Payers in Medical Cost Increases. 
    Journal of American Physicians and Surgeons , 19
    (2), 75-79. Retrieved from Journal of American Physicians and Surgeons : http://www.jpands.org/vol19no3/buff.pdf

    Scandlen, G. (2012). 
    Myth Buster #20: Third-Party Payment.
     Retrieved from National Center for Policy Analysis: http://healthblog.ncpa.org/myth-buster-20-third-party-payment/#sthash.4zdGvIj3.dpbs

    Smith, L. (2015). 
    What’s The Difference Between Medicare And Medicaid?
     Retrieved from Investopedia: http://www.investopedia.com/articles/pf/07/medicare-vs-medicaid.asp

  • The Evidence Based Practice (EBP) Project Essay

    The Evidence Based Practice (EBP) Project Part 3: Literature Review and Nursing Implications

    Now that you’ve found your evidence, summarized the material, and completed your TOE, it’s time to do your critical literature review and nursing implications sections. Use the data from your TOE to help you.

    Submit to the Assignments section the following:

    The names of all group members.

    Restate your PICO question (in question format only).

    Complete the Literature Review section

    Include 5-10 paragraphs demonstrating that you have fully read and analyzed all of the evidence. You will likely need to use subheadings to organize your review. Consider questions such as:

    What were the common themes throughout the articles?

    Were the articles studying the same/different variables?

    Were the findings the same/different?

    How do the main objectives/purposes of the researchers affect how the studies were designed/carried out?

    Discuss the levels of evidence and how that affects the credibility of the findings.

    How did the design of the studies affect the outcomes?

    Discuss reliability and validity of findings.
     (Focus heavily on this part. It doesn’t matter what the findings say if they aren’t reliable/valid, so fully evaluate them based on the criteria from the textbook. Discuss the different types of reliability/validity. Be very specific.)

    Is the evidence contradictory? If so, why might this be so? (i.e. One study is more reliable than the other.)

    Complete the Implications for Nursing Practice section

    Include 1-2 paragraphs of implications for nursing practice.

    Consider such questions as:

    How can/should nursing practice change based on these findings?

    How should nurses respond to these findings?

    Can current nursing practices be improved with these findings?

    Etc.

    Note: This is the crux of your entire paper, so make sure to focus on it. Nursing research is only important if you can use it to improve nursing practice. This section doesn’t have to be long, but make it count.

  • Medicaid and Medicare discussion comment

    Medicaid and Medicare discussion comment

    Purpose:
    Comment
    on the Discussion

    Thing to Remember:

    Answer this discussion with opinions/ideas creatively and clearly. Supports post using several outside, peer-reviewed sources.

    1 References, find resources that are 5 years or less

    No errors with APA format 6 Edition

     

    To Comment:

    Discussion Topic 2: Medicaid and Medicare

    Health Insurance Failure for the Elderly

    Health insurance fails the elderly greatly since they do not cover routine checkups and tests directly related to the checkups which are very common in elderly patients. Most of the time you find that an elderly patient has gone for more than twenty checkups in a month and even though the patient has a health insurance, he or she has to pay for the checkups (Stein, 2014).

    Health insurance also fails to pay for custodial care such as helping the patient in walking, bathing and dressing. Although aged people greatly require custodial care health insurance should cover this so that the elderly can be able to enjoy the services as long as they are insured. Orderly people are also excluded consistently from clinical trials even though they are the largest beneficiaries of approved drugs. There is incomplete treatment and inappropriate treatment for older patients since the proven medical interventions for older patients is often ignored (In Cohen, In Colby, In Wailoo & In Zelizer, 2015).

    Difference Between Medicaid and Medicare

    Medicaid is a joint state and federal program that gives help with medical costs for people with low income and resources. Medicare is an insurance program providing medical care to people over 65years. Medicare is run by the federal government whereas Medicaid is run by individual states. Medicare program gives patients multiple coverage options and is composed of several different sub-parts each providing different type of healthcare service. Medicaid recipients usually have a lot of choices to make and they may choose whether or not to apply or accept Medicaid coverage (In Fichtner & Mercatus Center, 2014).

    Medicaid Expansion in Florida and Why Some States Refuse It

    The state of Florida has not yet expanded Medicaid care and hence currently offering no coverage options to the single adults who are below 100% poverty line. The senate in 2015 in Florida approved the Medicaid expansion plan which was rejected by the statehouse and Gov. Rick Scott(R). the state almost shut down a budget impasse linked to the issue but the state lawmakers reached an agreement to be without the expansion in June 2015.States are opting not to expand Medicaid since this may lead to unstable growth and unexpanded states have unique eligibility requirements (Stein, 2014).

    References

    In Cohen, A. B., In Colby, D. C., In Wailoo, K., & In Zelizer, J. E. (2015). Medicare and Medicaid at 50: America’s entitlement programs in the age of affordable care.

    In Fichtner, J. J., & Mercatus Center,. (2014). The economics of Medicaid: Assessing the costs and consequences.

    Stein, J. A. (2014). Medicare handbook. Place of publication not identified: Kluwer Law International

  • Benchmark effective approaches in leadership and management

    In this benchmark effective approaches in leadership and management assignment, you will be writing a 1,000-1,250-word essay describing the differing approaches of nursing leaders and managers to issues in practice. To complete this assignment, do the following:

    Select an issue from the following list: nursing shortage and nurse turn-over, nurse staffing ratios, unit closures and restructuring, use of contract employees (i.e., registry and travel nurses), continuous quality improvement and patient satisfaction, and magnet designation.

    Compare and contrast how you would expect nursing leaders and managers to approach your selected issue. Support your rationale by using the theories, principles, skills, and roles of the leader versus manager described in your readings.

    Identify the approach that best fits your personal and professional philosophy of nursing and explain why the approach is suited to your personal leadership style.

    Use at least two references other than your text and those provided in the course.

    Prepare this benchmark effective approaches in leadership and management assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

    This assignment uses a grading rubric. Instructors will be using the rubric to grade the assignment; therefore, students should review the rubric prior to beginning the assignment to become familiar with the assignment criteria and expectations for successful completion of the assignment.

    You are required to submit this benchmark effective approaches in leadership and management assignment to Turnitin. Refer to the directions in the Student Success Center. Only Word documents can be submitted to Turnitin.

  • Cognitive Behavioral Theory & Rational Emotive Behavioral Theory – Practicum Journal

    Cognitive Behavioral Theory & Rational Emotive Behavioral Theory – Practicum Journal

    Reflect on your overall practicum experience in this course. Then, address the following in your Practicum Journal.

    : Explain whether your therapeutic theory has changed as a result of your

    practicum experiences.
    Recall the theories you selected in Week 1 which is

    (Cognitive Behavioral Theory & Rational Emotive Behavioral Theory)

    : Explain how you integrated the therapeutic approaches from this course in your

    clinical practice. Include how this helped you achieve the goals and objectives

    you developed in Week 1 ( For this assignment, just make up any goals)

    : Explain how you might impact social change through your work with clients who

    have mental health issues.

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    : Support your approach with evidence-based literature.

    NOTE: PLEASE SEE AND PAY ATTENTION TO THE ATTACHED
    Practicum Journal Template AND
    JOURNAL SAMPLE (TIME LOG & JOURNAL ENTRIES) FOR WRITING THIS ASSIGNMENT…..ALSO FOR THE TIME LOG AND JOURNAL ENTRIES, JUST MAKE UP A REASONABLE INFORMATION AND CLIENT INFORMATION IN MENTAL HEALTH NURSING

    AND INCLUDE REFERENCES

     

    Learning Resources

    Required Readings

    Wheeler, K. (Ed.). (2014).
    Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice
    (2nd ed.). New York, NY: Springer Publishing Company.

    Chapter      17, “Psychotherapy With Children” (pp. 597–624)

    American Psychiatric Association. (2013).
    Diagnostic and statistical manual of mental disorders
    (5th ed.). Washington, DC: Author.

    Bass, C., van Nevel, J., & Swart, J. (2014). A comparison between dialectical behavior therapy, mode deactivation therapy, cognitive behavioral therapy, and acceptance and commitment therapy in the treatment of adolescents.
    International Journal of Behavioral Consultation and Therapy, 9
    (2), 4–8. doi:10.1037/h0100991

    Koocher, G. P. (2003). Ethical issues in psychotherapy with adolescents.
    Journal of Clinical Psychology, 59
    (11), 1247–1256. PMID:14566959

    McLeod, B. D., Jensen-Doss, A., Tully, C. B., Southam-Gerow, M. A., Weisz, J. R., & Kendall, P. C. (2016). The role of setting versus treatment type in alliance within youth therapy.
    Journal of Consulting and Clinical Psychology, 84
    (5), 453–464. doi:10.1037/ccp0000081

    Zilberstein, K. (2014). The use and limitations of attachment theory in child psychotherapy.
    Psychotherapy, 51
    (1), 93–103. doi:10.1037/a0030930

     

    SAMPLE PRACTICUM JOURNAL – PSYCHOTHERAPY FOR ADDICTIVE DISORDERS

     

    Time Log

    Week

     

    Dates

    Times

     

    Total Hours for This Time Frame

    Activities/Comments

    Learning Objective(s) Addressed

    6

    10/02/ 2017

    8am- 6pm

    10 hrs

    Admissions, evaluations, follow-ups, medications management

    Diagnostic and statistical manual of mental disorders (DSM-5) was utilized, Motivational Enhancement Therapy (MET) was used, Contingency Management (CM) & Cognitive Behavioral Therapy

    6

    10/05/ 2017

    10am- 6am

    8 hrs

    Follow-ups, evaluations medications management, Discharge instructions.

    Diagnostic and statistical manual of mental disorders (DSM-5) was utilized, Motivational Enhancement Therapy (MET) was used, Contingency Management (CM) & Cognitive Behavioral Therapy, discharged

    Total Hours Completed: 18

     

     

     

                                                                             The Client

    The client in this practicum was a 24-year-old female who was in her freshman year in College. The client arrived to the clinic due to her concern about are alcohol use, and how drinking affects her health. He has recently noticed changes in her sleeping patterns, family problems due to her obscure drinking habit, frequent headaches, recent trauma, and motor vehicle accidents that led to the death of her grandparents. During an integral therapy session with the 24-year-old client, at first, the client appeared excited. Per the client’s statement, “So, help me get this out”. My response to her was, since you are exhausted of hassles and demand a life without troubles, but on the other hand, you were advice to come this clinic due to the of the drink-driving charges, and your employer has threatened to terminate you if you are once found to be drunk at job. I am contemplating how continuing in this manner with alcohol will help keep your life problem-free.

                                                                         Diagnosis

    During the diagnosis process, the primary responsibility of the counselor is to respect the dignity and promote the welfare of clients. Using DSM-5 was useful in this mental diagnosis as it provides standards for clinicians able to communicate about psychiatric disorders as a result of substance addiction (Fisher, 2016). Basing on the client’s complaints which is related to DSM-5 Category Substance Related and Addictive Disorders, the client presents with symptoms of Substance Related and Addictive Disorders based on the classifications of the Diagnostic and Statistical Manual of Mental Heal Disorders 5
    th
    Ed. (DSM-5) (Wheeler, 2014). The client have had several episodes of slurred speech, poor balance, dizziness, headache and nausea, was recently admitted to the hospital for alcohol intoxication. The most common symptoms of alcohol intoxication are slurred speech, impaired coordination, trouble with balance and walking, involuntary eye movement, impaired attention or memory and loss of consciousness (American Psychiatric Association, 2013). Intoxicated individuals may also experience nausea, vomiting, vertigo, headache and present with bloodshot eyes (Vonghia, et al., 2008). However, it is crucial to know that the DSM-5 also explains that alcohol intoxication can produce problematic psychological or behavioral changes such as impaired judgment, unusual mood changes, inappropriate sexual behavior, and aggression (Wheeler, 2014).

                           Effectiveness of Motivational interviewing to the client

                
    As a nurse practitioner student, I was at lookout for motivational statements the client may make. These may recognize the problem in a cognitive way, however during the therapy, she expressed some optimistic stance when she said, “I’m pretty sure that I can do it if I try.” Recent research has proven that psychoanalytically qualified general practitioner operating in rehabilitation programs for addictive patients has hypothesized that integrating psychoanalysis practices to dependence management would improve the results (American Psychiatric Association, 2013). Clinical studies have shown a consistent improvement when psychotherapy programs are efficiently applied. It has been helpful to patients with addictive disorders, with an effect size ranging from mild to moderate. The baseline of starting this programs for addictive patients is to review their background information on psychotherapy and drug counseling presentation.

    Moreover, Motivational Enhancement Therapy (MET) strives to induce from clients their own enthusiasm for change and to combine an individual decision and strategy to adjustment (Wheeler, 2014). This therapy program is used by experts entirely centered onto patients with planned directions. It is based on principles of cognitive and social psychology. Work of the counselor is to elicit and consolidate the client’s intrinsic motivations for change. Most of the substance dependence according to many research has identified a range of behavioral therapies that have been recorded to be most effective. This review highlights the roles played by behavioral treatments discussed below as compared to pharmacotherapies. Behavioral therapies that will be considered are the family and interpersonal approaches, clinical management, coping skills management, as well as motivational interviews.

    Behavioral approaches such as contingency management (CM) are based on the formed standards of behavioral pharmacology and operant training and therefore have a founding principle that behaviors that are strengthened are more expected to be repetitive (Albrecht et al., 2017). Behavioral approaches help people engage in drug abuse therapies, provide incentives for the patients to remain abstinent, modify their attitudes and behavior related to addiction.

    Contingency Management (CM) as a therapy functions under the conviction that substance use is significantly influenced by societal, environmental, and biological causes. Clinicians who are using psychotherapy treatment method make the patient move away from substance use so as to enter into a recovery process (Wheeler, 2014). The recovering process must face a much-stressed relation, poor financial conditions, and ill mental and physical health consequential from the drug misuse.

    Another form of therapy is the cognitive behavioral therapy which works under the principle of non-twelve phase recovery plan which focuses on the notion that overcoming dependence and maintaining long-term sobriety is based on abandoning the unhealthy behaviors and moving on without considering the illicit substances to initiate positive changes (American Psychiatric Association, 2013).

                                                 Legal and Ethical Implications

    The legal and ethical considerations a counselor has to maintain is to ensure there are proper and safe records keeping and documentation (Fisher, 2016). A counselor must have an informed consent in the counseling relationship to safeguard the welfare of the clients. A counselor must avoid imposing harm and values to the clients especially beliefs and behaviors. In essence maintaining and managing boundaries and professional relationships is the primary goal of ensuring there is the protection of client’s rights and exploitation from the counselors. Following the APA ethics of measures will help the counselor maintain the confidentiality of the client which promotes the therapeutic association and reveals the professional’s respect for the privacy and self-respect of clients.

     

     
     

     

     

     

    References

    American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

    Albrecht, U., Kirschner, N. E., & Grusser, S. M. (2007). Diagnostic instruments for behavioral addiction: An overview. German Medical Science Psycho-Social-Medicine, 4, 1–11. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2736529/

    Fisher, M. A. (2016). The ethical ABCs of conditional confidentiality. In Confidentiality limits in psychotherapy: Ethics checklists for mental health professionals (pp. 13–25). Washington, DC: American Psychological Association. Doi: 10.1037/14860-002

    Vonghia, L., Leggio, L., Ferrulli, A., Bertini, M., Gasbarrini, G. & Addolorato, G. (2008). Acute alcohol intoxication. European Journal of Internal Medicine. 19(8): 561-567

    Wheeler, K. (Ed.). (2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice (2nd ed.). New York, NY: Springer Publishing Company.

     

     

    Practicum Experience Time Log and Journal Template

     

    Student Name:

    E-mail Address:

    Practicum Placement Agency’s Name:

    Preceptor’s Name:

    Preceptor’s Telephone:

    Preceptor’s E-mail Address:

     

     

     

     

     

    (Continued next page)

    Time Log

     

    List the objective(s) met and
    briefly
    describe the activities you completed during each time period. If you are not on-site for a specific week, enter “
    Not on site”
    for that week in the
    Total Hours for This Time Frame
    column. Journal entries are due in Weeks 4, 8, and 11; include your Time Log with all hours logged (for current and previous weeks) each time you submit a journal entry.

     

    You are encouraged to complete your practicum hours on a regular schedule, so you will complete the required hours by the
    END of WEEK 11
    .

     

    Time Log

    Week

     

    Dates

    Times

     

    Total Hours for This Time Frame

    Activities/Comments

    Learning Objective(s) Addressed

     

    Total Hours Completed:

     

    Journal Entries

     

    Include references immediately following the content.

    Use APA style for your journal entry and references.

  • Protecting patients from abuse, negligence, and violence

    Avoiding  Violation of Legal Reporting Obligation 

    As a health care administrator, you must  protect your patients  from abuse, negligence, and violence. Health care  professionals are required  by law to report all suspected illegal  activity to the concerned authorities.

    Research the legal and reporting obligations in your state.  Accordingly, respond to the following:

    Analyze       and explain the legal and reporting  requirements as they apply to the       providers, suppliers, and payers  that make up the health care system of       your state.

    What       are the legal reporting obligations that  impact the health care       environment and are of concern to the  health care administrator?

    Describe       an example, either real or  fictitious, where the legal reporting       obligations were violated.  What were the legal reporting obligations       violated? How could the  violation have been avoided?

    Compile your report in a 6-to-10-page Word document.

  • Health care beliefs of the Russian, Polish and Thai heritage cultures and how they are related to the delivery of health care

    Health care beliefs of the Russian, Polish and Thai heritage cultures and how they are related to the delivery of health care

    Read chapter 
    22
    , 
    24
     and 
    36
     and review the attached Power Point Presentations.  Read content chapter 36 in Davis Plus Online Website.  Once done answer the following questions;

    1. Describe the health care beliefs of the Russian, Polish and Thai heritage and how they are related to the delivery of health care.

    2. Is there any similarity between these 3 cultures. If yes or no, please explain.

    3. Give your opinion on how the beliefs of these 3 cultures influence the delivery of health care.

    present assignment in an APA format word document on an Arial 12 font,  A minimum of 3 evidence based references no older than years 5 years are required. A minimum of 500 words are required without counting the first and last page.

  • Health Information Management Essay – cultural competence, assumptions, biases, and stereotypes

    Health Information Management Essay – cultural competence, assumptions, biases, and stereotypes

    Assignment Purpose:

    To increase awareness of cultural competence, assumptions, biases, and stereotypes.

    Assignment Requirements:

    Part One:

    Perform an internet search on cultural competence, assumptions, biases, and stereotypes. Locate at least three
    peer reviewed
    references.

    Part Two:

    From the information that you have located create a Power Point presentation. Your presentation must include the following:

    At least four slides that explains cultural competence and its importance

    At least three slides that explains assumptions  – at least one slide must contain examples

    At least three slides that explains biases  – at least one slide must contain examples

    At least three slides that explains stereotypes  – at least one slide must contain examples

    A title slide and a reference slide

    Slides must be presentation ready

    Easy to read  – at least 24 point font

    Contain speaker notes (Use notes section)

    Contain graphics

    Background and font colors are not distracting from the materials being presented.

  • Psychiatric Nursing Questions and Answers

    Psychiatric Nursing Mid-Term and Final Exam Questions and Answers

    This exam will cover the following topics from the Wheeler textbook, which relate to psychotherapy of individuals:(Psychiatric Nursing Questions and Answers)

     

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    Supportive and Psychodynamic Psychotherapy

    Interpersonal Psychotherapy

    Humanistic-Existential and Solution-Focused Approaches to Psychotherapy

    Psychotherapy With Children

    Psychotherapy With Older Adults

    Termination and Outcome EvaluationLearning ResourcesRequired Readings

    Wheeler, K. (Ed.). (2014).
    Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice
    (2nd ed.). New York, NY: Springer Publishing Company. Psychiatric Nursing Questions and Answers

    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 PMHNP can use feeling-state therapy to help Monique ___________.

    A.

    return to a normal system of functioning

    B.

    C.

    use more appropriate ways to satisfy needs

    D.

    1 points

    Question 2

    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?

    A.

    Suggesting that the patient goes to church to pray for God’s help

    B.

    C.

    D.

    Asking the patient why she thinks it is so hard to get the money she deserves

    1 points

    Question 3

    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?

    A.

    Immediately report the threat to the local police department

    B.

    Allow the patient to explore his feelings

    C.

    Review the therapeutic treatment frame

    D.

    Call the patient the next day to follow up

    1 points

    Question 4

    The PMHNP is caring for a patient who is histrionic. Using the supportive psychodynamic therapy model, what is the best statement made by the PMHNP?

    A.

    B.

    C.

    A and B

    D.

    None of the above

    1 points

    Question 5

    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?

    A.

    B.

    “What are you experiencing now as you share this story?”

    C.

    “Did you allow yourself to feel anger when your father left?”

    D.

    1 points

    Question 6

    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?

    A.

    Give the patient as much time needed to respond to questions and comments.

    B.

    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.

    C.

    You must give full attention to the patient because nonverbal and verbal reactions are equally important.

    D.

    The PMHNP should be ready with a response when communicating with the patient. She understands that silence is also a therapeutic response.

    1 points

    Question 7

    The PMHNP who practices motivational interviewing understands its relationship to patient behaviors and/or outcomes to mean which of the following?

    A.

    An increased use of motivational interviewing is linked to inconsistent behaviors in the patient. This is related to decreased client engagement and poor outcomes.

    B.

    A decreased use of motivational interviewing is linked to more consistent behaviors in the patient. This is related to decreased client engagement and poor outcomes.

    C.

    There is a higher incidence of inconsistent behaviors with motivational interviewing. This is related to client engagement and better outcomes.

    D.

    There is a lower incidence of inconsistent behaviors with motivational interviewing. This is related to client engagement and better outcomes.

    1 points

    Question 8

    The PMHNP is assessing a new geriatric patient who reports symptoms of depression. The PMHNP wants to identify the patient’s symptom severity over time. Which assessment tool will the PMHNP use to collect this data on the patient? Psychiatric Nursing Questions and Answers

    A.

    B.

    Montgomery-Asberg Depression Rating Scale

    C.

    D.

    Brief Psychiatric Rating Scale

    1 points

    Question 9

    A PMHNP is assessing a 60-year-old patient named Carlos. He has severe PTSD and mild substance abuse issues. The most appropriate setting to treat Carlos would be a _________.

    A.

    primary health care setting with some specialized care

    B.

    C.

    substance abuse treatment system

    D.

    1 points

    Question 10

    A cocaine-addicted female patient is entering residential treatment for substance abuse. Using the 10 guiding principles of recovery, an appropriate step by the PMHNP is to ______________.

    A.

    B.

    C.

    help the patient use fear of relapse to provide motivation for recovery

    D.

    none of the above. Psychiatric Nursing Questions and Answers

    1 points

    Question 11

    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?

    A.

    “I noticed that your fingers were tapping. Can you give a voice to your fingers?”

    B.

    C.

    “Explor…. What are you experiencing right now?”

    D.

    None of the above.

    1 points

    Question 12

    The PMHNP is communicating with a middle-aged male patient who has a history of addiction to Percocet (acetaminophen/oxycodone). The patient suddenly yells, “I do not have a problem with pain pills! I’ve never had an overdose and no one even knows that I take them unless I tell them.” The PMHNP understands that there are phases of change and can best demonstrate “focusing” by responding with:

    A.

    “I sincerely commend you for being here and seeking treatment; this is a great first step.”

    B.

    C.

    “Just because no one knows about your drug usage does not mean you do not have a problem.”

    D.

    1 points

    Question 13

    A PMHNP is treating a 10-year-old boy who is exhibiting signs of aggression and attention problems. What type of intervention will the PMHNP consider using a common elements approach? Psychiatric Nursing Questions and Answers

    A.

    B.

    C.

    Pyschoeducational

    D.

    All of the above

    1 points

    Question 14

    The PMHNP is assessing a patient who has been receiving months of outpatient psychotherapy. According to the PMHNP’s assessment, the patient is nearing the termination phase of their therapeutic relationship because the patient’s symptoms have improved, and the patient shows progress managing behaviors and decision-making abilities according to the diagnosis. How does the PMHNP approach termination with this patient?

    A.

    Address the termination phase with the patient at the last session

    B.

    C.

    Determine the PMHNP’s readiness to terminate the therapeutic relationship

    D.

    None of the above

    1 points

    Question 15

    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?

    A.

    B.

    Interpersonal psychotherapy (IPT)

    C.

    D.

    Combination of CBT and medication

    1 points

    Question 16

    The PMHNP is caring for an older patient with major depressive disorder, seasonal pattern. The patient has been resolute about not taking medication to manage the depression brought on by his illness, stating that it is against his yogic lifestyle. In addition to psychotherapy, what can the PMHNP suggest to this patient?

    A.

    “You may want to look into therapeutic oils and aromatherapy as an alternative to medication.”

    B.

    C.

    “You can try taking natural supplements in addition to the medicine I prescribe you.”

    D.

    All of the above.

    1 points

    Question 17

    The PMHNP is caring for an older adult patient who is in the acute phase of schizophrenia. Which therapeutic model will the PMHNP employ with this patient?

    A.

    B.

    C.

    Both A and B

    D.

    None of the above

    1 points

    Question 18

    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?

    A.

    B.

    C.

    “Jeff, can you tell me what was going on during your childhood that caused you to be a victim of neglect and abuse?”

    D.

    None of the above.

    1 points

    Question 19

    The PMHNP is treating an older adult patient who reports symptoms of late-life anxiety. What type of treatment(s) will the PMHNP consider?

    A.

    Employ cognitive behavioral therapy

    B.

    C.

    D.

    All of the above

    1 points

    Question 20

    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?

    A.

    Trauma-focused CBT

    B.

    Interpersonal psychotherapy

    C.

    Psychodynamic therapy

    D.

    Behavioral parent training

    1 points

    Question 21

    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?

    A.

    He will have lapses in his memory of his childhood.

    B.

    C.

    D.

    None of the above.

    1 points

    Question 22

    The PMHNP is caring for a patient who experiences depression caused by the traumatic experience of her dog passing away. She reports not being able to eat or sleep, and sometimes doesn’t want to leave the house at all. Which statement is most appropriate for the PMHNP to maximize the patient’s adaptive coping mechanisms?

    A.

    “Think of something funny every time you feel sad.”

    B.

    “My cat passed away last year, and it’s been hard to adjust to her being gone.”

    C.

    “It’s important to be mindful of how you feel and then to determine what causes those feelings.”

    D.

    B and C

    1 points

    “A” is the correct answer. According to the therapeutic frame, counseling is terminated if “threats are made or acts of violence are committed against the counselor,” but the immediate threat calls for notification of the police. The safety of the PMHNP is essential. “B,” “C,” and “D,” are incorrect—the patient has made threats to the PMHNP, so the most appropriate response would be reporting the threat to the local police. See Wheeler, K.,
    Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice
    , Chapter 16 pages 587-588 for further information.

    The correct answer is “B.” For patients who are histrionic or overly emotional, the PMHNP contains the emotion rather than allowing it to be expressed freely. For histrionic patients, affect regulation strategies may need to be employed.  See Wheeler, K.,
    Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice
    , Chapter 5 page 242 for further information

    “A” is the correct answer. “Focusing” is a Gestalt therapy technique used to deepen contact with alienated aspects of self. “B” is incorrect—exaggerating body movements is part of the “body awareness” technique. “C” is incorrect—asking Dave what his is experiencing in his body is also part of body awareness. “D” is incorrect because “A” is the correct answer.  See Wheeler, K.,
    Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice
    , Chapter 10 page 382 for further information.

    Question 23

    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”?

    A.

    “You believe that your weight is a cause of your marital problems.”

    B.

    C.

    “You have identified your weight as a problem in your marriage and but believe that losing weight will gain happiness.”

    D.

    1 points

    Question 24

    The PMHNP is initiating a plan of care for Holly, a 73-year-old female patient who has late-life bipolar disorder and reports consuming alcoholic beverages four times per week. What is the focus of Holly’s therapy going to be?

    A.

    B.

    Maintaining meaningful relationships

    C.

    D.

    All of the above

    1 points

    Question 25

    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?

    A.

    Encourage the patient to continue treatment by using alternative strategies

    B.

    C.

    Explain how the originally identified strategies will address the focus problem

    D.

    None of the above

    1 points

     

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    Question 26

    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?

    A.

    Build a therapeutic alliance

    B.

    Build behavioral skills to increase pleasant activities

    C.

    Build cognitive skills to challenge negative thinking

    D.

    Build social skills to improve problem solving

    1 points

    Question 27

    When preparing to terminate a patient, what does the PMHNP do to organize thoughts about the patient’s progress made during treatment?

    A.

    Interviews the patient’s family, caregiver, or friends regarding the patient’s progress outside of the sessions

    B.

    C.

    Requests a peer to review the patient’s file to double check that the PMHNP has not overlooked anything

    D.

    All of the above

    1 points

    Question 28

    A 55-year-old patient recovering from substance abuse tells the PMHNP, “It’s impossible to meet new people. I really hate being single.” Using existential psychotherapy, what might the PMHNP say next?

    A.

    “Where are you experiencing unhappiness in your body?

    B.

    C.

    “Are you willing to say, ‘I’m having a hard time meeting people’?”

    D.

    1 points

    Question 29

    The PMHNP is assessing a 30-year-old client who reports feeling stressed out due to his current employment situation. When asked about how he manages this work-related stress, the patient says that exercise helps him feel less anxious, so he often spends 2 or more hours at the gym each night. After completing the patient assessment, the PMHNP has determined that an existential psychotherapy approach may best benefit this client. What is the PMHNP’s goal in employing this treatment approach?

    A.

    B.

    Help the patient be aware of his anxiety and embrace it

    C.

    D.

    None of the above

    1 points

    Question 30

    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?

    A.

    Incorporate patient preferences as to the type of therapy used

    B.

    C.

    D.

    All of the above

    1 points

    Question 31

    The PMHNP is terminating treatment with a patient who is aggressive and has a history of anger. What does the PMHNP do when terminating treatment with this patient?

    A.

    Makes a list of all the positive things the patient gained from treatment

    B.

    Does not recognize the patient’s emotions so as to not encourage the onset of anger

    C.

    Emphasizes and validates the patient’s feelings of anger that may emerge

    D.

    Avoids upsetting the patient by keeping an open door policy

    1 points

    Question 32

    A 13-year-old patient and his parents are meeting with a PMHNP. When the PMHNP says hello, the boy just nods. His parents tell the PMHNP that he didn’t want to come to the session, but they insisted. They explain that their son has been moody and depressed at home, but is still getting good grades at school. Which of the following would be the best response by the PMHNP? Psychiatric Nursing Questions and Answers

    A.

    Ask the patient to leave the room to speak with his parents

    B.

    C.

    Compliment the patient on his academic achievement

    D.

    All of the above

    1 points

    Question 33

    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?

    A.

    “For homework, please write a list of qualities you’d find in a good friend.”

    B.

    C.

    “Tell me more about why you’re having trouble making new friends at work.”

    D.

    All of the above.

    1 points

    Question 34

    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?

    A.

    Evaluate the patient for having the coping skills to manage feelings

    B.

    C.

    D.

    Have the patient visualize performing the addictive behavior

    1 points

    Question 35

    A PMHNP has been working with a 50-year-old patient who has a stressful job and goes to the casino on weekends to play poker with his friends, which he says relieves his stress. Tim admits that he sometimes misses work on Monday when he stays out too late at the casino on Sunday nights. In addition, he once was an avid runner, and has given up running to spend more time gambling. True or false: According to the PMHNP, the desired goal after treatment is not complete abstinence from gambling, but reaching a healthy level of the behavior.

    True

    False

    1 points

    Question 36

    When recalling the phases of change, the PMHNP demonstrates “open questioning” in the “engagement” phase by making which statement?

    A.

    B.

    C.

    “What concerns you the most about these subjects?”

    D.

    “What do you want do you want be different?”

    1 points

    Question 37

    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:

    A.

    “Focus on your anger, take a deep breath, and allow an image to emerge.”

    B.

    C.

    D.

    “Your experience of anger and confusion is normal.”

    1 points

    Question 38

    A 38-year-old patient has been having trouble communicating with his teenage daughter. Using a solution-focused therapy approach, the PMHNP responds by saying, “When was a time that a communication problem could have occurred, but did not?” In this case, what type of question is the PMHNP asking?

    A.

    Coping question

    B.

    C.

    Exception question

    D.

    1 points

    Question 39

    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?

    A.

    Transference neurosis has been resolved.

    B.

    C.

    Core conflicts have been reduced.

    D.

    1 points

    Question 40

    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?

    A.

    Collaborating with the patient’s caregiver to discuss a treatment approach

    B.

    C.

    D.

    All of the above

    1 points

    Question 41

    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? Psychiatric Nursing Questions and Answers

    A.

    Encouraging and nurturing the patient

    B.

    C.

    Discussing why the patient is not taking the medication as directed

    D.

    1 points

    Question 42

    A PMHNP is using motivational interviewing (MI) with a 50-year-old patient named Dave to commit to a healthy drug-free lifestyle. By using “change talk,” the PMHNP hopes to help the patient build self-esteem and hope. True or false: If Dave is resisting change, the PMHNP should challenge his resistance in order for MI to be successful.

    True

    False

    1 points

    Question 43

    The PMHNP is meeting with an older, female adult patient and her daughter. The patient has early onset dementia. The daughter expresses concern, saying, “I don’t want you to just stick my mother in a home and give her medicine. I’m worried that’s what people are going to want to do.” What is the best response by the PMHNP to the daughter?

    A.

    “Most of the time, institutionalization cannot be prevented.”

    B.

    “The type of treatment depends on the stage of dementia and safety considerations.”

    C.

    “Don’t worry; I do not believe in hospitalizing my patients.”

    D.

    “The treatment decision will be up to your mother and what she wants.”

    1 points

    Question 44

    Mia is a 75-year-old patient who has completed initial treatment for depression. What might a PMHNP ask Mia when using a solution-focused therapy approach?

    A.

    “What specific improvements have you noticed in your mood since you made the call to see me?”

    B.

    “On a scale of 1–10 (with 1 being little to no improvement to 10 being a great deal of improvement) how much has your mood changed since we started working together?”

    C.

    “What needs to happen today in order for you to feel that is was a productive session?”

    D.

    All of the above.

    1 points

    Question 45

    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:

    A.

    “Keep your expectations high to show that you believe in his abilities.”

    B.

    C.

    “Don’t put expectations on him while he is showing signs of depression.”

    D.

    1 points

    Question 46

    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 ______________.

    A.

    give the patient advice based on the therapist’s experiences

    B.

    C.

    ask the patient to reflect on and explore what she is experiencing

    D.

    all of the above

    1 points

    Question 47

    A 21-year-old patient has been having trouble adjusting to college life. She tells the PMHNP that she had five alcoholic drinks at a party this past weekend. She also acknowledges that she drank the same amount of alcohol at a party the previous month. Based on this information, what would the PMHNP most likely recommend?

    A.

    B.

    C.

    Hospitalization

    D.

    None of the above

    1 points

    Question 48

    The PMHNP is treating an older adult patient who reports experiencing nightmares associated with an automobile accident he was in 20 years ago. As the PMHNP formulates the case using the dynamic supportive therapy model, what questions will the PMHNP use during the session?

    A.

    “What can you tell me about this room?”

    B.

    “You might benefit from a sleep aid.”

    C.

    “Let’s talk about what kinds of things are triggering you now.”

    D.

    “Do I have your permission to advocate for you with your primary care physician?”

    1 points

    Question 49

    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?

    A.

    B.

    C.

    Embed the termination into the work of the therapeutic phase

    D.

    None of the above

    1 points

    Question 50

    The PMHNP continues to meet with Gerald, who is the patient with depression and mood disorder. The PMHNP uses the CBT approach. Gerald is now meeting with the PMHNP for his fifth session and feels comfortable with how the therapy works. What does the PMHNP plan to do with Gerald over the course of the next several sessions?

    A.

    B.

    C.

    Develop cognitive skills to challenge Gerald’s negative thinking

    D.

    None of the above

    1 points

    Question 51

    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?

    A.

    Supportive therapy

    B.

    Problem-solving therapy

    C.

    Cognitive behavioral therapy

    D.

    All of the above

    1 points

    Question 52

    The PMHNP is interviewing a patient with a history of substance abuse. He has attempted to stop abusing drugs three times before. He states to the PMHNP, “I just cannot change. How can you help me?!” As it applies to change, the PMHNP understands the principle of evocation to mean:

    A.

    B.

    The patient already has everything needed and the PMHNP would like to help him facilitate his own inner coping.

    C.

    D.

    The patient must evolve and change with the times to successfully change his way of thinking.

    1 points

    Question 53

    A patient’s depression is affecting her relationship with her spouse. What might the PMHNP ask during the initial sessions of interpersonal psychotherapy treatment?

    A.

    B.

    “How is your depression affecting the relationship with your spouse?”

    C.

    D.

    All of the above.

    1 points

    Question 54

    The PMHNP is terminating treatment for a patient who has been receiving eye movement desensitization and reprocessing (EMDR) therapy. What action does the PMHNP take at the final session to terminate treatment?

    A.

    Helps the patient create a future template

    B.

    Discusses all issues that have been addressed

    C.

    Asks the patient to take a new assessment

    D.

    All of the above

    1 points

    Question 55

    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:

    A.

    “You feel as though you are weak and you wish that you were strong.”

    B.

    C.

    “You’d like to keep your old friends but know being around them may lead you to abuse substances again.”

    D.

    1points

    Question 56

    The PMHNP is assessing a patient who requires cognitive behavioral therapy (CBT). Which of the following statements made by the PMHNP approach the termination phase for this patient?

    A.

    “Although it’s your first session, we will discuss how termination of your treatment will go.”

    B.

    “Now that you are feeling more stable, let’s talk about terminating these sessions.”

    C.

    “We will wait to discuss terminating the treatment until you’ve attended at least five sessions.”

    D.

    None of the above.

    1 points

    Question 57

    The PMHNP is actively listening to Ms. Thomas who is detoxing from alcohol. Ms. Thomas is currently discussing with the PMHNP the reasons why she feels guilty about her drinking. Ms. Thomas tearfully states, “I have driven my family and friends away with this terrible habit. I have no one left. I had more than enough chances and now my children won’t even talk to me.” Which of the following statements demonstrate a simple reflection?

    A.

    “You feel that your children have given you many chances.”

    B.

    C.

    “You feel that your use of alcohol is a terrible habit.”

    D.

    All the above.

    1 points

    Question 58

    How does the PMHNP approach termination with the patient who has been receiving intermittent therapy?

    A.

    Uses the word “interrupt” instead of “terminate” with the patient

    B.

    C.

    Encourages the patient to check in with the PMHNP about his/her progress

    D.

    A and C

    1 points

    Question 59

    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?

    A.

    Relaxation

    B.

    Affect modulation

    C.

    Enhancing safety

    D.

    Trauma narrative

    1 points

    Question 60

    The PMHNP is in the process of terminating treatment with a patient who witnessed the death of her parent who used to sexually abuse her. What does the PMHNP understand about terminating this patient?

    A.

    The patient should be made aware that he/she may have trouble managing the trauma.

    B.

    C.

    The patient can be weaned off from therapy, but cannot receive treatment indefinitely.

    D.

    1 points

    Question 61

    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?

    A.

    B.

    Explain that he must terminate counseling because of the therapeutic frame

    C.

    D.

    None of the above

    1 points

    Question 62

    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?

    A.

    Help Linda develop an awareness of triggers in order to have greater control over physical and emotional responses

    B.

    Encourage Linda to

    C.

    Ask Linda to … and evaluate her progress

    D.

    All of the above

    1 points

    Question 63

    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?

    A.

    B.

    Talking to the patient about the use of problem-solving strategies

    C.

    D.

    Asking the patient about the patient’s work stress

    1 points

    Question 64

    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 instead of waiting her turn. When the patient gets frustrated, she has trouble controlling her emotions and cries often. Based on the initial information provided, the first focus by PMHNP is the child’s ____________.

    A.

    B.

    C.

    language skills

    D.

    social system

    1 points

    Question 65

    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 the PMHNP help raise the man’s self-esteem?

    A.

    B.

    Using role-playing techniques

    C.

    D.

    All of the above

    1 points

    Question 66

    The PMHNP meets with a 31-year-old woman who reports feeling as though she is “at her breaking point” with work. The PMHNP learns that the woman works 12-hour days, including one day on the weekend, 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 to the organization,” the woman says. Using the supportive psychodynamic therapy approach, how does the PMHNP respond?

    A.

    “You need to find a new place to work.”

    B.

    “Who cares about getting laid off? Then you can collect unemployment benefits.”

    C.

    D.

    1 points

    Question 67

    The PMHNP has been treating a patient who is now being transferred to another provider. What is the appropriate action made by the PMHNP?

    A.

    B.

    C.

    Having the new provider come to a few sessions

    D.

    A and C

    1 points

    Question 68

    A patient is finishing the active treatment phase of interpersonal psychotherapy (IPT). After the PMHNP reminds the patient that she has three sessions left, the patient says nothing, but looks distressed. What would be the best reply by the PMHNP following IPT protocol?

    A.

    B.

    “Remember that the end of treatment is not a time to grieve.”

    C.

    D.

    “You seem upset. Tell me what seems to be bothering you.”

    1 points

    Question 69

    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:

    A.

    B.

    “Are you saying that you will still go to a casino: however, you will only have a debit card in terms of funds?”

    C.

    D.

    “Why don’t we try to deal with your addiction to gambling before you go into a casino to decrease your temptation?”

    1 points

    Question 70

    A PMHNP is using Gestalt therapy to communicate with a 42-year-old patient who is upset with her mother. She says, “I want to tell her how hurt I feel when she doesn’t call me, but I don’t want to upset her.” What technique can the PMHNP use to help Sasha express herself?

    A.

    Language of responsibility

    B.

    Empty-chair dialogue

    C.

    Dreamwork

    D.

    Focusing

    1 points

    Question 71

    A PMHNP is assessing a 40-year-old patient named Sarah who has a severe cocaine addiction and mild depression. Using the four-quadrant model, what would be the most appropriate setting to help the patient?

    A.

    Primary health care settings with some specialized care

    B.

    C.

    D.

    The mental health system of care

    1 points

    Question 72

    An 8-year-old has been having trouble making friends at school. His parents initiated treatment when he also started acting out at home. Which is the most appropriate step that the PMHNP takes during the assessment process when using an integrated approach?

    A.

    Collect information from the patient, his parents, and school

    B.

    Rule out medical issues that may affect behavior

    C.

    Get a measure of the patient’s developmental level

    D.

    All of the above

    1 points

    Question 73

    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?

    A.

    B.

    “Have you thought of how you will continue your treatment plans?”

    C.

    D.

    “Are you sure you no longer want to go to therapy?”

    1 points

    Question 74

    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?

    A.

    B.

    Focus on the patient’s attachment to the anxiety and memories of her childhood

    C.

    Identify whether the patient has an unresolved or disorganized attachment style

    D.

    All of the above

    1 points

    Question 75

    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?

    A.

    B.

    C.

    Use traditional assessment procedures, such as giving a psychometric test

    D.

    Encourage the patient to clarify by asking, “You constantly feel anxious?”

    1 out of 1 points

    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 PMHNP can use feeling-state therapy to help Monique ___________.

    Question 2

     

    1 out of 1 points

    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?

    Question 3

     

    0 out of 1 points

    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?

     

    Response Feedback:

    Question 4

     

    0 out of 1 points

    The PMHNP is caring for a patient who is histrionic. Using the supportive psychodynamic therapy model, what is the best statement made by the PMHNP?

     

    Response Feedback:

    Question 5

     

    1 out of 1 points

    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?

    Question 6

     

    1 out of 1 points

    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?

    Psychiatric Nursing Questions and Answers

    Question 7

     

    1 out of 1 points

    The PMHNP who practices motivational interviewing understands its relationship to patient behaviors and/or outcomes to mean which of the following?

    Question 8

     

    1 out of 1 points

    The PMHNP is assessing a new geriatric patient who reports symptoms of depression. The PMHNP wants to identify the patient’s symptom severity over time. Which assessment tool will the PMHNP use to collect this data on the patient?

    Question 9

     

    1 out of 1 points

    A PMHNP is assessing a 60-year-old patient named Carlos. He has severe PTSD and mild substance abuse issues. The most appropriate setting to treat Carlos would be a _________.

    Question 10

     

    1 out of 1 points

    A cocaine-addicted female patient is entering residential treatment for substance abuse. Using the 10 guiding principles of recovery, an appropriate step by the PMHNP is to ______________.

    Question 11

     

    0 out of 1 points

    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?

     

    Response Feedback:

    Question 12

     

    0 out of 1 points

    The PMHNP is communicating with a middle-aged male patient who has a history of addiction to Percocet (acetaminophen/oxycodone). The patient suddenly yells, “I do not have a problem with pain pills! I’ve never had an overdose and no one even knows that I take them unless I tell them.” The PMHNP understands that there are phases of change and can best demonstrate “focusing” by responding with:

     

    Response Feedback:

    Question 13

     

    1 out of 1 points

    A PMHNP is treating a 10-year-old boy who is exhibiting signs of aggression and attention problems. What type of intervention will the PMHNP consider using a common elements approach?

    Question 14

     

    1 out of 1 points

    The PMHNP is assessing a patient who has been receiving months of outpatient psychotherapy. According to the PMHNP’s assessment, the patient is nearing the termination phase of their therapeutic relationship because the patient’s symptoms have improved, and the patient shows progress managing behaviors and decision-making abilities according to the diagnosis. How does the PMHNP approach termination with this patient?

    Question 15

     

    1 out of 1 points

    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?

    Question 16

     

    1 out of 1 points

    The PMHNP is caring for an older patient with major depressive disorder, seasonal pattern. The patient has been resolute about not taking medication to manage the depression brought on by his illness, stating that it is against his yogic lifestyle. In addition to psychotherapy, what can the PMHNP suggest to this patient?

    Question 17

     

    0 out of 1 points

    The PMHNP is caring for an older adult patient who is in the acute phase of schizophrenia. Which therapeutic model will the PMHNP employ with this patient?

     

    Response Feedback:

    Question 18

     

    0 out of 1 points

    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?

     

    Response Feedback:

    Question 19

     

    0 out of 1 points

    The PMHNP is treating an older adult patient who reports symptoms of late-life anxiety. What type of treatment(s) will the PMHNP consider?

     

    Response Feedback:

    Question 20

     

    1 out of 1 points

    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?

    Question 21

     

    0 out of 1 points

    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?

     

    Response Feedback:

    “” is the correct answer. For persons with unresolved/disorganized attachment styles,

    Question 22

     

    0 out of 1 points

    The PMHNP is caring for a patient who experiences depression caused by the traumatic experience of her dog passing away. She reports not being able to eat or sleep, and sometimes doesn’t want to leave the house at all. Which statement is most appropriate for the PMHNP to maximize the patient’s adaptive coping mechanisms?

     

    Response Feedback:

    The correct answer is “C.” The most appropriate action is for the PMHNP to teach the patient about developing mindfulness in order to maximize adaptive coping mechanisms. Encouraging the patient to use humor as a way to deny her sadness is not therapeutic, so “A” is incorrect. Using self-disclosure to discuss how the PMHNP lost a pet recently is not therapeutic in this instance, so “B” is incorrect. Therefore, “D” is incorrect. See Wheeler, K.,
    Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice
    , Chapter 5 pages 240-241 for further information.

    Question 23

     

    1 out of 1 points

    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”?

    Question 24

     

    1 out of 1 points

    The PMHNP is initiating a plan of care for Holly, a 73-year-old female patient who has late-life bipolar disorder and reports consuming alcoholic beverages four times per week. What is the focus of Holly’s therapy going to be?

    Question 25

     

    0 out of 1 points

    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?

     

    Response Feedback:

    “A” is the correct answer. During the active treatment phase of interpersonal psychotherapy, the patient is encouraged to use alternative strategies in the case that originally identified strategies are not helping to reduce the distress surrounding the focus problem. “B” is incorrect—the PMHNP does not need to restart the assessment phase to treat a patient. “C” is incorrect—if a strategy is not successful, it does not need to be adhered to. “D” is incorrect because “A” is the correct answer. See Wheeler, K.,
    Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice
    , Chapter 9 page 360 for further information. Psychiatric Nursing Questions and Answers.

    Question 26

     

    0 out of 1 points

    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?

     

    Response Feedback:

    Question 27

     

    0 out of 1 points

    When preparing to terminate a patient, what does the PMHNP do to organize thoughts about the patient’s progress made during treatment?

     

    Response Feedback:

    The correct answer is “B.” The PMHNP organizes thoughts about the patient’s progress that was made during treatment, by reviewing the patient’s file to identify issues and important themes that were highlighted throughout treatment. The PMHNP also reflects and reminisces with the patient regarding how the patient is functioning better. “A” is incorrect, as the PMHNP does not interview the patient’s family, friends, or caregiver as part of organizing thoughts about the patient’s progress. “C” is incorrect, as the PMHNP does not request a peer to evaluate the decision to terminate by reviewing the patient’s file. Therefore, “D” is incorrect.   See Wheeler, K.,
    Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice
    , Chapter 20 page 699 for further information.

    Question 28

    “A” is the correct answer. When assessing the strength of the ego, the PMHNP will identify the primary defenses the patient uses to ward off anxiety. “B” and “C” are incorrect, as attachment style has to do with the person’s fear of rejection, intimacy, and interpersonal distance in relationships, and is not involved in assessing the strength of the patient’s ego. See Wheeler, K.,
    Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice
    , Chapter 5 page 239 for further information.

     

    The correct answer is “A.” When using the CBT approach with geriatric patients, there are three phases for which the sessions take place. The first three sessions are the first phase, and focus on building a therapeutic alliance and getting the patient familiar with psychotherapy. Answers “B,” “C,” and “D” are incorrect, as these actions come during the second phase of CBT, which is after the first three sessions. See Wheeler, K.,
    Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice
    , Chapter 18 page 641 for further information.

    “B” is the correct answer. Empty-chair dialogue is a Gestalt therapy technique used to help a person who is having trouble expressing feelings to another person. “A” is incorrect—the language of responsibility technique is used to help increase awareness. “C” is incorrect—dreamwork is a technique used to focus on dreams. “D” is incorrect—focusing is a technique used to deepen contact with alienated aspects of self.  See Wheeler, K.,
    Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice
    , Chapter 10 page 382 for further information

    1 out of 1 points

    A 55-year-old patient recovering from substance abuse tells the PMHNP, “It’s impossible to meet new people. I really hate being single.” Using existential psychotherapy, what might the PMHNP say next? Psychiatric Nursing Questions and Answers.

    Question 29

     

     

     

     

     

     

     

    0 out of 1 points

    The PMHNP is assessing a 30-year-old client who reports feeling stressed out due to his current employment situation. When asked about how he manages this work-related stress, the patient says that exercise helps him feel less anxious, so he often spends 2 or more hours at the gym each night. After completing the patient assessment, the PMHNP has determined that an existential psychotherapy approach may best benefit this client. What is the PMHNP’s goal in employing this treatment approach?

     

    Response Feedback:

    “B” is the correct answer. The goal of existential psychotherapy is to be aware of anxiety and embrace it, not to eliminate it. Therefore, “A” is incorrect, as the PMHNP does not aim to help the patient eliminate anxiety from his life completely, as this is not the goal of existential psychotherapy. “C” is incorrect, because although it is helpful for patients to have multiple outlets for coping with stress, this is not the primary goal of employing existential psychotherapy. “D” is incorrect because there is clearly a correct answer here. See Wheeler, K.,
    Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice
    , Chapter 10 page 386 for further information.

    Question 30

     

    1 out of 1 points

    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?

    Question 31

     

    1 out of 1 points

    The PMHNP is terminating treatment with a patient who is aggressive and has a history of anger. What does the PMHNP do when terminating treatment with this patient?

    Question 32

     

    1 out of 1 points

    A 13-year-old patient and his parents are meeting with a PMHNP. When the PMHNP says hello, the boy just nods. His parents tell the PMHNP that he didn’t want to come to the session, but they insisted. They explain that their son has been moody and depressed at home, but is still getting good grades at school. Which of the following would be the best response by the PMHNP?

    Question 33

     

    0 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?

     

    Response Feedback:

    “C” is the correct answer. Interpersonal psychotherapy (IPT) focuses on the patient’s current life. “A” is incorrect—specific homework is not part of IPT. “B” is incorrect—IPT focuses on the present, not the past causes of problems. “D” is incorrect because “C” is the only correct answer. See Wheeler, K.,
    Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice
    , Chapter 9 page 354 for further information. Psychiatric Nursing Questions and Answers

    Question 34

     

    0 out of 1 points

    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?

     

    Response Feedback:

    “C” is the correct answer. Using the Feeling-State Addiction Protocol, after identifying the specific positive feeling linked with the addictive behavior and its Positive Feeling Score level, the PMHNP should have the patient locate and identify any physical sensations created by the positive feelings. “A” is incorrect—that step comes before “identifying the specific positive feeling linked with the addictive behavior and its Positive Feeling Score level.” “B” and “D” are incorrect—those steps come after the patient locates and identifies any physical sensations created by the positive feelings. See Wheeler, K.,
    Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice
    , Chapter 16 page 585 for further information. Psychiatric Nursing Questions and Answers

    Question 35

     

    1 out of 1 points

    A PMHNP has been working with a 50-year-old patient who has a stressful job and goes to the casino on weekends to play poker with his friends, which he says relieves his stress. Tim admits that he sometimes misses work on Monday when he stays out too late at the casino on Sunday nights. In addition, he once was an avid runner, and has given up running to spend more time gambling. True or false: According to the PMHNP, the desired goal after treatment is not complete abstinence from gambling, but reaching a healthy level of the behavior.

    Question 36

     

    0 out of 1 points

    When recalling the phases of change, the PMHNP demonstrates “open questioning” in the “engagement” phase by making which statement?

     

    Response Feedback:

    Question 37

     

    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: Psychiatric Nursing Questions and Answers

    Question 38

     

    0 out of 1 points

    A 38-year-old patient has been having trouble communicating with his teenage daughter. Using a solution-focused therapy approach, the PMHNP responds by saying, “When was a time that a communication problem could have occurred, but did not?” In this case, what type of question is the PMHNP asking?

     

    Response Feedback:

    “C” is the correct answer. An exception question encourages the patient to describe what has worked in the past to make future improvements. “A” is incorrect—a coping question includes a validating statement and question about the patient’s coping skills that have gone unnoticed. “B” is incorrect—a joining question’s purpose is to connect and accommodate to the patient’s world. “D” is incorrect—a miracle question asks the patient to imagine a future if the problem were solved. See Wheeler, K.,
    Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice
    , Chapter 10 page 395 for further information.

    Question 39

     

    1 out of 1 points

    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?

    Question 40

     

    ORDER AN ESSAY NOW

     

    0 out of 1 points

    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?

     

    Response Feedback:

    “” is the correct answer. Because many older adult patients have

    Question 41

     

    0 out of 1 points

    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?

     

    Response Feedback:

    B” is the correct answer. For treating adolescent depression with interpersonal psychotherapy (IPT), parents are encouraged to modify home and school expectations while depression is active. “A” is incorrect—expectations should be modified until the depression lifts. “C” and “D” are incorrect—the IPT model does not recommend eliminating expectations or having adolescents set their own expectations. See Wheeler, K.,
    Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice
    , Chapter 9 page 357 for further information.

    “B” is the correct answer. Affect modulation provides the patient with skills to control thoughts related to anxious feelings. “A” is incorrect—relaxation skills help the patient learn to feel calm, but do not directly teach how to interrupt anxiety-causing thoughts. “C” is incorrect—enhancing safety teaches the patient safety skills. “D” is incorrect—trauma narrative helps the patient correct inaccuracies about the trauma experience. See Wheeler, K.,
    Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice
    , Chapter 17 page 609 for further information.

    “B” is the correct answer. Empty-chair dialogue is a Gestalt therapy technique used to help a person who is having trouble expressing feelings to another person. “A” is incorrect—the language of responsibility technique is used to help increase awareness. “C” is incorrect—dreamwork is a technique used to focus on dreams. “D” is incorrect—focusing is a technique used to deepen contact with alienated aspects of self.  See Wheeler, K.,
    Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice
    , Chapter 10 page 382 for further information.

    “B” is the correct answer. For dynamic supportive therapy, the PMHNP allows the patient to emote by asking the patient how the patient feels as part of the holding and containing strategy. For the holding and containing approach, the PMHNP provides empathy and understanding, as well as by restricting the patient when the patient becomes impulsive or acts out. “A” is incorrect—encouraging and nurturing the patient is assuming a parental role and is part of the “be a good parent” strategy. “C” is incorrect—discussing why the patient is not taking the medication as directed is addressing treatment noncompliance, which is part of focusing on the here and now. “D” is incorrect—teaching the patient about medication side effects is part of educating the patient and family, which is not part of holding and containing the patient. See Wheeler, K.,
    Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice
    , Chapter 5 pages 240-241 for further information.

    Question 42

     

    1 out of 1 points

    A PMHNP is using motivational interviewing (MI) with a 50-year-old patient named Dave to commit to a healthy drug-free lifestyle. By using “change talk,” the PMHNP hopes to help the patient build self-esteem and hope. True or false: If Dave is resisting change, the PMHNP should challenge his resistance in order for MI to be successful.

    Question 43

     

    1 out of 1 points

    The PMHNP is meeting with an older, female adult patient and her daughter. The patient has early onset dementia. The daughter expresses concern, saying, “I don’t want you to just stick my mother in a home and give her medicine. I’m worried that’s what people are going to want to do.” What is the best response by the PMHNP to the daughter? Psychiatric Nursing Questions and Answers

    Question 44

     

    1 out of 1 points

    Mia is a 75-year-old patient who has completed initial treatment for depression. What might a PMHNP ask Mia when using a solution-focused therapy approach?

    Question 45

     

    0 out of 1 points

    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:

     

    Response Feedback:

    Question 46

     

    1 out of 1 points

    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 ______________.

    Question 47

     

    0 out of 1 points

    A 21-year-old patient has been having trouble adjusting to college life. She tells the PMHNP that she had five alcoholic drinks at a party this past weekend. She also acknowledges that she drank the same amount of alcohol at a party the previous month. Based on this information, what would the PMHNP most likely recommend?

     

    Response Feedback:

    “D” is the correct answer. The patient has been binge drinking, which is when a person consumes five or more drinks on one occasion at least one time during the past month. Binge drinking twice over a period of 2 months is not enough to be considered a maladaptive pattern of substance abuse. Therefore, though the patient might need individual therapy to help her adjust to college life, the PMHNP would not recommend group therapy, peer support, or hospitalization for an alcohol-related problem. See Wheeler, K.,
    Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice
    , Chapter 16 pages 567 and 569 for further information.

    Question 48

     

    1 out of 1 points

    The PMHNP is treating an older adult patient who reports experiencing nightmares associated with an automobile accident he was in 20 years ago. As the PMHNP formulates the case using the dynamic supportive therapy model, what questions will the PMHNP use during the session?

    Question 49

     

    1 out of 1 points

    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?

    Question 50

    “B” is correct—this is an example of open questioning in the engagement phase. The engagement phase is the introductory phase and is meant to establish a relationship as well as trust. “A” is incorrect—this is an example of open questioning in the planning phase. “C” is incorrect—this is an example of open questioning in in the focusing phase. “D” is incorrect—this is an example of open questioning in the evoking phase. See Wheeler, K.,
    Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice,
    Chapter 7 pages 303-305 for further information.

     

    “D” is the correct answer. Cognitive behavioral therapy, including individual and group CBT, can be an effective treatment approach for geriatric patients with schizophrenia who are at a stable point in their illness, but CBT is not a good option for patients at recent onset of symptoms, or who are in an acute phase of their symptoms, such as the patient in this scenario. Therefore, neither individual nor group CBT would be appropriate for this patient. See Wheeler, K.,
    Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice
    , Chapter 18 page 635 for further information.

    0 out of 1 points

    The PMHNP continues to meet with Gerald, who is the patient with depression and mood disorder. The PMHNP uses the CBT approach. Gerald is now meeting with the PMHNP for his fifth session and feels comfortable with how the therapy works. What does the PMHNP plan to do with Gerald over the course of the next several sessions?

     

    Response Feedback:

    The correct answer is “C.” Once patients are comfortable with how the therapy works, it is appropriate to move into the second phase of CBT, in which the PMHNP will focus on developing cognitive skills to challenge the patient’s negative thinking. “A” and “B” are incorrect, as these are actions the PMHNP takes during the first phase of CBT.   See Wheeler, K.,
    Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice
    , Chapter 18 page 641 for further information. Psychiatric Nursing Questions and Answers

    Question 51

     

    1 out of 1 points

    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 52

     

    WE CAN HELP WITH ONLINE EXAMS, PLACE YOUR ORDER

     

    0 out of 1 points

    The PMHNP is interviewing a patient with a history of substance abuse. He has attempted to stop abusing drugs three times before. He states to the PMHNP, “I just cannot change. How can you help me?!” As it applies to change, the PMHNP understands the principle of evocation to mean:

     

    Response Feedback:

    “B” is correct—the principle of evocation suggests that the patient has all the tools needed to change and the PMHNP just needs to “draw it out” of the patient. “A” is incorrect—this is the patient’s right; however, it does not apply to the principle of evocation. “C” is incorrect—this is not the principle of evocation and it also a form of nontherapeutic communication because it offers false reassurance. “D” is incorrect—this is not the principle of evocation. See Wheeler, K.,
    Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice
    , Chapter 7 page 299 for further information.

    Question 53

     

    1 out of 1 points

    A patient’s depression is affecting her relationship with her spouse. What might the PMHNP ask during the initial sessions of interpersonal psychotherapy treatment?

    Question 54

     

    0 out of 1 points

    The PMHNP is terminating treatment for a patient who has been receiving eye movement desensitization and reprocessing (EMDR) therapy. What action does the PMHNP take at the final session to terminate treatment?

     

    Response Feedback:

    “B” is the correct answer. For patients receiving EMDR, the PMHNP discusses all issues that have been addressed throughout the treatment at the final session to prepare for termination. “A” is incorrect, as the future template is developed during therapy prior to the final session. “C” is incorrect, as the patient is not asked to take a new assessment. Rather, during the final session, the patient is asked to retake assessment measures that were taken at the beginning of therapy. Therefore, “D” is also incorrect. See Wheeler, K.,
    Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice
    , Chapter 20 page 695 for further information.

    Question 55

     

    1 out of 1 points

    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:

    Question 56

     

    1 out of 1 points

    The PMHNP is assessing a patient who requires cognitive behavioral therapy (CBT). Which of the following statements made by the PMHNP approach the termination phase for this patient?

    Question 57

     

    1 out of 1 points

    The PMHNP is actively listening to Ms. Thomas who is detoxing from alcohol. Ms. Thomas is currently discussing with the PMHNP the reasons why she feels guilty about her drinking. Ms. Thomas tearfully states, “I have driven my family and friends away with this terrible habit. I have no one left. I had more than enough chances and now my children won’t even talk to me.” Which of the following statements demonstrate a simple reflection?

    Question 58

     

    1 out of 1 points

    How does the PMHNP approach termination with the patient who has been receiving intermittent therapy?

    Question 59

     

    0 out of 1 points

    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?

     

    Response Feedback:

    Question 60

     

    1 out of 1 points

    The PMHNP is in the process of terminating treatment with a patient who witnessed the death of her parent who used to sexually abuse her. What does the PMHNP understand about terminating this patient?

    Question 61

     

    0 out of 1 points

    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?

     

    Response Feedback:

    “” is the correct answer. Because the patient is a victim

    Question 62

     

    0 out of 1 points

    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?

     

    Response Feedback:

    “A” is the correct answer. A mindfulness approach helps the patient develop an awareness of triggers in order to have greater control over physical and emotional responses. “B” is incorrect—though family therapy can be integrated with other therapies, it is not a part of the mindfulness approach. “C” is incorrect—it is part of the feeling-state addiction therapy, not the mindfulness approach. “D” is incorrect because “A” is correct. See Wheeler, K.,
    Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice
    , Chapter 16 page 587 for further information.

    Question 63

     

    1 out of 1 points

    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 64

     

    1 out of 1 points

    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 instead of waiting her turn. When the patient gets frustrated, she has trouble controlling her emotions and cries often. Based on the initial information provided, the first focus by PMHNP is the child’s ____________.

    Question 65

     

    1 out of 1 points

    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 the PMHNP help raise the man’s self-esteem?

    Question 66

     

    1 out of 1 points

    The PMHNP meets with a 31-year-old woman who reports feeling as though she is “at her breaking point” with work. The PMHNP learns that the woman works 12-hour days, including one day on the weekend, 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 to the organization,” the woman says. Using the supportive psychodynamic therapy approach, how does the PMHNP respond? Psychiatric Nursing Questions and Answers

    Question 67

     

    1 out of 1 points

    The PMHNP has been treating a patient who is now being transferred to another provider. What is the appropriate action made by the PMHNP?

    Question 68

     

    1 out of 1 points

    A patient is finishing the active treatment phase of interpersonal psychotherapy (IPT). After the PMHNP reminds the patient that she has three sessions left, the patient says nothing, but looks distressed. What would be the best reply by the PMHNP following IPT protocol?

    Question 69

     

    1 out of 1 points

    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:

    Question 70

    ORDER AN ESSAY OR ONLINE EXAM WRITING HELP HERE

    0 out of 1 points

    A PMHNP is using Gestalt therapy to communicate with a 42-year-old patient who is upset with her mother. She says, “I want to tell her how hurt I feel when she doesn’t call me, but I don’t want to upset her.” What technique can the PMHNP use to help Sasha express herself?

     

    Response Feedback:

    Question 71

     

    1 out of 1 points

    A PMHNP is assessing a 40-year-old patient named Sarah who has a severe cocaine addiction and mild depression. Using the four-quadrant model, what would be the most appropriate setting to help the patient? Psychiatric Nursing Questions and Answers.

    Question 72

     

    1 out of 1 points

    An 8-year-old has been having trouble making friends at school. His parents initiated treatment when he also started acting out at home. Which is the most appropriate step that the PMHNP takes during the assessment process when using an integrated approach?

    Question 73

     

    1 out of 1 points

    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?

    Question 74

     

    0 out of 1 points

    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?

     

    Response Feedback:

    Question 75

     

    1 out of 1 points

    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?

    Psychiatric Nursing Questions and Answers

  • Essay on pros and cons of continuing nursing education and making it mandatory

    Essay on pros and cons of continuing nursing education and making it mandatory

    create a PowerPoint presentation of 15 slides in which you compare the pros and cons of continuing nursing education related to the following (and from the viewpoint that continuing nursing education should be mandatory):

    Impact on competency.

    Impact on knowledge and attitudes.

    Relationship to professional certification.

    Relationship to ANA Scope and Standards of Practice.

    Relationship to ANA Code of Ethics.

    To get the max points for each topic, here are the expectations: 

    1 – Thoughtfully compares most of the pros and cons of continuing nursing education related to the impact on competency, and supports comparisons with logical reasoning and research. Clearly and persuasively presents group’s position on continuing nursing education, and draws support from specific examples from the pro/con comparison.

    2- Thoughtfully compares most of the pros and cons of continuing nursing education related to the impact on knowledge and attitudes, and supports comparisons with logical reasoning and research. Clearly and persuasively presents group’s position on continuing nursing education, and draws support from specific examples from the pro/con comparison.

    3 – Thoughtfully compares most of the pros and cons of continuing nursing as it relates to professional certification, and supports comparisons with logical reasoning and research. Clearly and persuasively presents group’s position on continuing nursing education, and draws support from specific examples from the pro/con comparison.

    4 – Thoughtfully compares most of the pros and cons of continuing nursing education related to the ANA Scope and Standards of Practice, and supports comparisons with logical reasoning and research. Clearly and persuasively presents group’s position on continuing nursing education, and draws support from specific examples from the pro/con comparison.

    5 – Thoughtfully compares most of the pros and cons of continuing nursing education related to the ANA Code of Ethics, and supports comparisons with logical reasoning and research. Clearly and persuasively presents group’s position on continuing nursing education, and draws support from specific examples from the pro/con comparison.