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Exam (elaborations)

NURS 6640N MIDTERM EXAM WITH ANSWERS.

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NURS 6640N MIDTERM EXAM WITH ANSWERS.

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  • April 18, 2022
  • 17
  • 2021/2022
  • Exam (elaborations)
  • Questions & answers
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• Question 1 I

1 Iout Iof I1 Ipoints
An I11-year-old Ipatient Ihas Ibeen Iexhibiting Ilow Iself-esteem Iat Ischool Iand Iacting Iout.
IAccording Ito IMaslow’s Ihierarchy Iof Ineeds, Iwhich Iof Ithe Ifollowing Iquestions Iwould

Ibest Ibe Iaddressed Ifirst Iby Ithe IPMHNP?



Selected IAnswer: C. I
“Is IJoel Igetting Ienough Isleep Iat Ihome?”
• Question 2 I

1 Iout Iof I1 Ipoints
The Ipatient Iattempts Ithe IPMHNP’s Isleep Ihygiene Irecommendations Ifor I2 Iweeks, Ibut
Idoes Inot Imake Iany Iprogress Imitigating Inightmares Iand Ihyperarousal. IWhich

Ibehavioral Istrategy Idoes Ithe IPMHNP Isuggest Inext?



Selected IAnswer: D. I
All Iof Ithe Iabove
• Question 3 I

0 Iout Iof I1 Ipoints
The IPMHNP Iis Icaring Ifor Ia Ipatient Iwho Ihas Iacute Istress Idisorder Iafter Iexperiencing Ia
Itraumatic Ievent I1 Iweek Iprior. IThe IPMHNP Iwants Ito Ibegin Iwith Ia Itherapeutic

Iframework Ithat Ifollows Ithe Iadaptive Iinformation Iprocessing I(AIP) Imodel. IWhat Iis Ithe

Ipriority Iaction Ifor Ithe IPMHNP Ito Itake?



Selected IAnswer: B. I
Help Ithe Ipatient Iprocess Ipainful Imemories
• Question 4 I

1 Iout Iof I1 Ipoints
When Ithe Ipatient Icomes Iinto Ithe Ioffice, Ishe Isays, I“I Ijust Isaw Ia Ifriend Iof Imine Iout Iin Ithe
Iwaiting Iroom. IWhat’s Iwrong Iwith Ihim?” IThe IPMHNP Isays, I“He’ll Ibe Ifine. IHe Ihas Imild

Idepression.” IWhich Iof Ithe Ifollowing Istatement Iis Icorrect Irelated Ito Iconfidentiality

Irights?



Selected IAnswer: A. I
The IPMHNP Iwas Inot Iprotecting Ipatient Iconfidentially Irights.
• Question 5 I

1 Iout Iof I1 Ipoints
The IPMHNP Ihas Ibeen Iassisting Ia Ishy Iand Itimid I23-year-old Imale Ipatient Istruggling
Iwith Iesteem Iand Iself-concept Iissues. IOver Ithe Iweekend, Ithis Ipatient Iwas Igiven Ithe

Itask Iof Icompleting Ian Iexercise Ithat Iwould Iusually Icause Ihim Idistress Iand Ishame, Ialso

Icalled Ia Ishame-attacking Iexercise. IThe IPMHNP Idetermines Ithat Ithis Itask Ihas

Isuccessfully Ibeen Iachieved Iwhen Ithe Ipatient Istates:



Selected IAnswer: A. I
“I Iwas Iable Ito Ieat Iin Ipublic Iyesterday Idespite Ihow Iloudly II Ichew.”

,• Question 6 I

1 Iout Iof I1 Ipoints
During Ia Itherapy Isession Ithe Ipatient Iis Iasked Ihow Ishe Icurrently Ideals Iwith Istress, Iand
Ishe Isays, I“Well, II Idon’t. II Ijust Ilet Iit Ibuild Iand Ibuild.” IThe IPMHNP Iresponds Iby Iasking

Ihow Iwell Ithis Ihas Ibeen Iworking Iout Ifor Iher. IThe Ipatient Istates, I“Well, Ito Ibe Ihonest, Iit

Ijust Ifeels Ilike II’m Idrowning, Iyou Iknow Iwhat II Imean.” IIllustrating Iidiosyncratic Imeaning,

Ithe IPMHNP Iresponds Iwith:



Selected IAnswer: B. I
“No, II Iam Inot Isure Iwhat Iyou Iare Isaying. ICan Iyou Iplease Iexplain?”
• Question 7 I

1 Iout Iof I1 Ipoints
During Ia Iclinical Iassessment Iof Ia I15-year-old Ipatient, Ithe IPMHNP Iasks, I“How Ican II
Ihelp Iyou?” IThe Ipatient Ianswers Iby Isaying, I“Honestly, II Idon’t Ireally Ithink II Ineed Iany

Ihelp.” IWhich Iof Ithe Ifollowing Iis Ithe Imost Iappropriate Iresponse Iby Ithe IPMHNP?



Selected B. I
IAnswer: “Since Iyou’re Ialready Ihere, Imaybe Iwe Ican Itry Ito Ifigure Iout Iif Ithere Iis
Ianything Ielse II Ican Ihelp Iyou Iwith.”



• Question 8 I

1 Iout Iof I1 Ipoints
During Ia Itherapy Isession Iwith Ian I18-year-old Ifemale Ithe IPMHNP Ilearns Ithat Ishe Ihas
Ilived Iin Isix Idifferent Ifoster Ihomes Iin Ithe Ilast I24 Imonths. IShe Istates Ithat Iher Imother Iis

Iin Ia Icorrectional Ifacility Ifor Idrug Iabuse Iand Iprostitution. IDuring Ithe Iassessment, Ithe

IPMHNP Inotices Imultiple Isuperficial Icuts Ito Ieach Iwrist. IThe Ipatient Iappears Itearful,

Iwithdrawn, Iand Inever Imakes Idirect Ieye Icontact. IThe IPMHNP Ibelieves Ithat Ithis Ipatient

Imay Ihave Ifeelings Iof Iinsecurities Ias Iwell Ias Iabandonment Iissues Iand Iis Iaware Ithat

Iwhich Idiagnosis Iis Ilikely Ipossible?



Selected IAnswer: C. I
Borderline Ipersonality Idisorder
• Question 9 I

1 Iout Iof I1 Ipoints
The IPMHNP Iis Iworking Iwith Ia Ischool-aged Ichild Iwho Ihas Ibeen Idiagnosed Iwith
Idepression. IThe Ichild Ihas Iattended Iseveral Isessions Iwith Ithe IPMNHP, Ibut Irecently

Ipresents Iwith Iavoidant Ibehavior Iby Ishowing Iincreased Idistress Iand Ibeing Ilate Ito

Isessions. IWhat Iapproach Idoes Ithe IPMHNP Ineed Ito Iemploy Iwith Ithe Ichild Ito Icontinue

Imaking Itherapeutic Iprogress?



Selected IAnswer: B. I
Using Icommunication Itechniques Ithat Iare Iexpressive
• Question 10 I

1 Iout Iof I1 Ipoints

, The IPMHNP Iis Iworking Iwith Ia Ipatient Iwho Iexperiences Iabreactions Iwhen Idiscussing
Irepressed Ifeelings Iof Ihis Isexual Iabuse Ias Ia Ichild. IWhat Ican Ithe IPMHNP Ido Ito

Imanage Ithe Ipatient’s Iintense Iemotional Ireactions?



Selected IAnswer: C. I
Suggest Ia Irelaxation Itechnique, Isuch Ias Iyoga Ior Imeditation
• Question 11 I

1 Iout Iof I1 Ipoints
The IPMHNP Iis Iworking Iwith Ia Iveteran Iwho Ihas Iposttraumatic Istress Idisorder I(PTSD).
IThe IPMHNP Ibelieves Ithat Idual Iawareness Iwill Ibe Ibeneficial Iin Iallowing Ithe Ipatient Ito

Ifocus Ion Ithe Ihere Iand Inow. IWhat Istrategies Ican Ithe IPMHNP Iuse Ito Idevelop Idual

Iawareness Iin Ithe Ipatient?



Selected IAnswer: D. I
All Iof Ithe Iabove
• Question 12 I

1 Iout Iof I1 Ipoints
A Inew Ipatient Ihas Ibeen Iinformed Iof Ithe Ilimits Iof Iconfidentiality, Iand Ihas Isigned
Iinformed Iconsent Iforms. INo Iconsent, Ihowever, Ihas Ibeen Iobtained Ifor Ivoluntary

I“Release Iof IInformation.” IThe Ipatient Iis I20 Iyears Iold Iand Istill Ilives Iat Ihome Iwith Ihis

Iparents. IHe Iis Ibeing Itreated Ifor Idepression, Iwhich Ihe Iattributes Ito Ithe Itrouble Ihe’s Ihad

Ifinding Iemployment. I

True Ior Ifalse: IIf Ithe Ipatient’s Imother Icalls Ithe IPMHNP Ito Icheck Iup Ion Iher Ison Ito Isee
Ihow Ihe Iis Idoing, Ithe Itherapist Iis Irequired Ito Iprotect Ipatient Iconfidentiality Iand Inot

Idisclose Iinformation.


Selected IAnswer: True
• Question 13 I

0 Iout Iof I1 Ipoints
The IPMHNP Imeets Iwith Ia I47-year-old Imale Ipatient Iwho Iis Ifearful Iof Ileaving Ithe Ihouse
Iafter Ihaving Iwitnessed Ihis Ineighbor Igetting Irun Iover Iby Ia Icar. IWhen Ithe IPMHNP Iasks

Iwhy Ihe Iis Iafraid Ito Ileave Ihis Ihouse, Ithe Ipatient Ireplies, I“Because Ianother Iaccident

Imight Ioccur.” IWhich Icognitive Ibehavioral Itherapy I(CBT) Istrategy Idoes Ithe IPMHNP

Iemploy?



Selected IIAnswer: C. II
Dialectical IIbehavior IItherapy
• Question 14 I

1 Iout Iof I1 Ipoints
The IPMHNP Iis Itreating Ia Ipatient Iwith Ia Isubstantial Ifear Iof Ifeeling Iclosed Iin
I(claustrophobia). IThus, Ithe Ipatient Iwill Inot Iget Iinto Ian Ielevator. IThe Ioffice Iwhere Ihe

Iworks Iis Ion Ithe I10th Ifloor Iand Ithis Irequires Ithat Ihe Iwalk Iup Iand Idown Ithe Istairs Iin Ithe

Imorning Iand Ievening Ito Iget Ito Ihis Ioffice. IWith Ipermission Ifrom Ithe Ipatient, Ithe

IPMHNP Iis Ibeginning Isystematic Idesensitization Ito Iaddress Ithe Ipatient’s Ineed Ito Iuse

Ithe Ielevator. IWhat Iis Ithe IPMHNP’s Ibest Iplan Iof Iaction?

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