Therapeutic Modalities in Psychiatric Nursing
Exam Answer Key
Course Introduction
This course explores various therapeutic modalities used in psychiatric nursing to support individuals with mental health disorders. Emphasizing both theoretical frameworks and practical applications, it covers modalities such as cognitive-behavioral therapy, group therapy, pharmacotherapy, and crisis intervention. Students will learn to assess patient needs, select appropriate interventions, and evaluate outcomes while considering ethical, cultural, and legal aspects of care. The course also highlights the importance of therapeutic communication, empathy, and the nurse-patient relationship in fostering recovery and promoting mental well-being.
Recommended Textbook
Psychiatric Advanced Practice Nursing 1st Edition by Perese
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19 Chapters
203 Verified Questions
203 Flashcards
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Page 2
Chapter 1: Theoretical Framework of Practice
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Sample Questions
Q1) Which attachment pattern is more likely to be found among children who have been abused?
A) Secure
B) Inhibited
C) Disorganized
D) Avoidant
Answer: C
Q2) Brain plasticity, which refers to the brain's capacity to change in response to an event,
A) Is the same for all individuals
B) Involves physical changes of the brain
C) Is absent in older adults
D) Is independent of genetic influence
Answer: B
Q3) In a cantilevered model of needs such as Hansell's model,
A) Basic needs must be met first
B) There is a hierarchy of needs
C) Each need supports all other needs
D) Self-actualization is the last need to be met
Answer: C
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Brain Functioning, Brain Development and Prenatal and
Perinatal Factors Disrupting Brain Development
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Sample Questions
Q1) Which of these brain structures puts emotional meaning on a stimulus, forms emotional memories, and is involved with rage and fear?
A) Hippocampus
B) Temporal lobe
C) Amygdala
D) Midbrain
Answer: C
Q2) Which structure of the brain is involved in learning, processing information into memories, and assigning the time and the place to memories?
A) Hippocampus
B) Olfactory bulb
C) Limbic system
D) Occipital lobe
Answer: A
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4
Chapter 3: Postnatal Influences on Development of
Psychopathology
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Sample Questions
Q1) Among children who use an accommodating response to maltreatment, there is increased likelihood of impaired capacity for
A) Controlling impulsivity
B) Knowing their own feelings and emotions
C) Showing regressive behaviors
D) Integrating memories of pain and fear
Answer: B
Q2) Following prenatal exposure to neurotoxic drugs, an adverse effect that is shared by many infants is
A) Abnormalities of finger ridges
B) High-steepled palate
C) Microencephaly
D) Curved little finger
Answer: C
Q3) It is known that childhood exposure to maltreatment
A) Is associated with increased rates of physical and psychiatric disorders
B) Occurs in 10% of U.S. children
C) Is most often exposure to sexual abuse
D) Usually involves a perpetrator who is unknown to the child
Answer: A
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Chapter 4: Communicating, Interviewing and Assessing
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Sample Questions
Q1) During the initial assessment of a patient with schizophrenia, in response to the question "What brought you to the clinic today?" a patient's response of "the van" is an example of
A) Poverty of speech
B) Concrete thinking
C) Oppositional behavior
D) Tangentiality
Q2) To encourage the patient to talk freely during the interview, the clinician
A) Uses direct questioning
B) Explains behavior/brain interaction theory
C) Takes notes conscientiously
D) Provides empathetic response.
Q3) During an initial assessment, the relevant features of communication are its ability to
A) Promote a therapeutic alliance and increase understanding.
B) Prompt a disclosure of past successes and failures.
C) Bring about changes in behavior.
D) Educate the patient about what is important to disclose.
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6
Chapter 5: Case Formulation and Diagnosis, Differential
Diagnoses and Developing a Biopsychosocial Plan of Care
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Sample Questions
Q1) In developing a biopsychosocial plan of treatment, focus in the biological domain is on
A) Identification and treatment of comorbid medical illnesses
B) Social skills training and social support enhancement
C) Vocational rehabilitation and supported employment
D) Interpersonal therapy or cognitive behavioral therapy
Q2) In the problem-oriented method of case formulation, the patient's problems are defined as a solvable target of treatment. Which of the following is an example of a problem-oriented case formulation description?
A) "Lack of interpersonal communication skills"
B) "Due to early childhood conflicts"
C) "Due to use of immature defense mechanisms"
D) "Caused by stigma and discrimination"
Q3) A predisposing event would be all of the following except
A) Early prolonged separation from the mother
B) Having been born unwanted
C) Recent arrests or incarcerations
D) History of childhood neglect or abuse
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Chapter 6: Psychopharmacotherapy
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Sample Questions
Q1) Because of the severe problems caused by chronic extrapyramidal side effects (EPSs), patients receiving long-term use of antipsychotics must be carefully monitored for the development of EPS symptoms. One of the most commonly used screeners is
A) Beck's inventory scale
B) Ham-D scale
C) Zung scale
D) AIMS scale
Q2) Among the following statements, which best describes the action of older typical antipsychotic medications such as Haldol?
A) They block dopamine receptors in all four dopamine pathways.
B) They decrease available amounts of serotonin and norepinephrine.
C) They decrease the metabolism of dopamine in the synaptic cleft.
D) They selectively block reuptake of dopamine.
Q3) The tricyclic antidepressant class of medications can be characterized by all of the following properties except
A) Long half-life
B) Inexpensive cost
C) Safety in overdose
D) High rate of side effects
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Page 8
Chapter 7: Psychotherapies
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Sample Questions
Q1) The primary purpose of psychotherapy is to facilitate changes by the patient in order to
A) Reduce symptoms of distress
B) Address identified problems
C) Reduce burden on the family
D) Improve vocational functioning
Q2) In supportive therapy, the focus is on
A) Strengthening self-esteem and ego functioning
B) Promoting insight
C) Remediating cognitive functioning
D) Exposure and response prevention
Q3) The core principle of relational therapies that include psychodynamic psychotherapy and interpersonal psychotherapy is that current problems reflect A) Learned behavioral responses
B) Failure to integrate life experiences
C) Problems with relationships with others
D) Distorted perceptions of ability to cope
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Chapter 8: Psychosocial Interventions
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Sample Questions
Q1) The primary goal of compensatory interventions is to help patients improve coping through the use of all of the following except
A) Brief dynamic therapy
B) Social skills training
C) Stress management
D) Problem-solving therapy
Q2) Effective interventions to build social networks have been found to include all of the following except
A) Participating in groups that focus on adherence to medication
B) Building new relationships
C) Strengthening existing networks
D) Using ready-made friends or companions
Q3) Research has found that sleep therapy is effective in reducing symptoms of which of the following disorders?
A) Social anxiety disorder (nongeneralized)
B) Agoraphobia
C) Depression
D) Obsessive-compulsive disorder
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10
Chapter 9: Response to Stressors: Bridging Normal
Responses and Psychiatric Disorders
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Sample Questions
Q1) Patients who use direct methods of coping strategies when confronted with a stressful event would likely engage in
A) Seeking to understand the value to be extracted from negative experiences
B) Following the steps of problem-solving
C) Increasing their sense of control over the situation
D) Asking other people to manage the situation
Q2) An important evidence-based finding about adjustment disorder among adolescents and young adults is that
A) Pharmacotherapy is the frontline for treatment.
B) The course of adjustment disorder is brief, with good outcomes.
C) There is a short time between thoughts of suicide and carrying out suicide.
D) Academic functioning is well preserved.
Q3) The process of allostasis includes
A) Mobilization of energy, activation of cognition, and behavioral changes
B) Reduction of production of cortisol
C) Decreased levels of norepinephrine
D) Development of a state of exhaustion
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Page 11
Chapter 10: Phobias, Generalized Anxiety Disorder, Social Anxiety
Disorder and Panic Disorder
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Sample Questions
Q1) Leonard avoids going out to eat with his family at restaurants. He is concerned that others may watch him and criticize his table manners. Which is the most likely diagnosis?
A) Agoraphobia
B) Specific situational phobia
C) Social anxiety disorder
D) Generalized anxiety disorder
Q2) In considering maintenance treatment for a patient with GAD who is anxious, agitated, and irritable and has sleep problems, which medication(s) might you select?
A) Bupropion (Wellbutrin)
B) A dopamine agonist
C) Paroxetine (Paxil) or sertraline (Zoloft)
D) Alprazolam (Xanax)
Q3) In GAD, which of the following is true?
A) GAD is rare in older adults.
B) Worrying may be associated with the belief that it keeps the family safe.
C) Worrying is usually limited to one type of worry, such as locking doors.
D) Worrying is usually accompanied by ritualistic behaviors.
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Chapter 11: Acute Stress Disorder and Posttraumatic Stress Disorder
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Sample Questions
Q1) The primary goal of treatment for patients with post-traumatic stress disorder is to help them to
A) Eradicate memories of the traumatic event
B) Prevent response to triggers of the traumatic event
C) Learn to live with intrusive images
D) Place the trauma in the larger perspective of their lives
Q2) The current frontline treatment for acute stress disorder is
A) Mood stabilizer medications
B) Interpersonal psychotherapy
C) Antianxiety medications
D) Trauma-focused cognitive behavioral therapy
Q3) Following exposure to a traumatic event, post-traumatic stress disorder occurs more often
A) Among men
B) Among individuals who have experienced prior traumas
C) Among individuals with high levels of education
D) Among those who are married or in a stable relationship
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Page 13
Chapter 12: Obsessive-Compulsive Disorder and
Obsessive-Compulsive
Spectrum Disorders
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Sample Questions
Q1) It can be said of the obsession of hoarding that it is associated with
A) A fear of making a wrong decision in discarding things that might be needed in the future
B) Abnormalities of the fear/anxiety circuitry
C) A feeling that hoarding is ego-syntonic
D) Less severe symptoms and impairment of functioning than other obsessions
Q2) On clinical presentation, patients with OCD tend to
A) Be eager to discuss their symptoms
B) Have good insight into their obsessions and compulsions
C) Describe a sudden intrusion of unwanted distressful thoughts and the need to do something to reduce their distress
D) Be aware of the influence of their symptoms on their families
Q3) In obsessive-compulsive disorder, obsession/compulsion symptom cluster types include all of the following except
A) Dirt and contamination
B) Counting and checking
C) Lying and stealing
D) Hoarding and collecting, saving
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Chapter 13: Depressive Disorders
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Sample Questions
Q1) Post's theory of depression states that early experience may make the brain more sensitive to future stressors and to recurrence of depressive episodes. This theory is often referred to as
A) Kindling theory
B) Dysregulation theory
C) Anger turned inward theory
D) Learned helplessness theory
Q2) The patient says that for the last 5 years, she has begun to feel depressed around the time the golf season ends in November and begins to feel better when she is able to get outdoors to play again in April. When she is depressed, she craves carbohydrates, overeats, and gains weight. She has no energy and wants to sleep all the time and she is irritable and snaps at people. The psychiatric advanced practice nurse considers which of the following diagnoses?
A) Dysthymia
B) Major depressive disorder with seasonal pattern
C) Adjustment disorder with depressed mood
D) Major depressive disorder with atypical features
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15
Chapter 14: Bipolar Disorder
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Sample Questions
Q1) The course of bipolar disorder is characterized by
A) Difficulty achieving good vocational functioning
B) Patient adherence to treatment
C) Infrequent recurrences
D) Good interpersonal and social functioning
Q2) In the prodromal phase of bipolar disorder, patients' behaviors often include
A) Putting their affairs in order
B) Sleeping more than usual
C) Increased talkativeness
D) A decrease of social activities
Q3) Compared with unipolar depression, the depressed phase of bipolar disorder is associated with
A) A greater degree of insomnia
B) More melancholic features
C) Greater weight loss
D) More symptoms of anxiety and tearfulness
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16
Chapter 15: Schizophrenia and Schizoaffective Disorder
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Sample Questions
Q1) Which of the following features is associated with positive outcome among patients with schizophrenia?
A) Younger age of onset
B) Male gender
C) Living in an industrialized country
D) Having positive symptoms
Q2) An atypical antipsychotic would be expected to work better than a typical antipsychotic for which of the following symptoms?
A) Hallucinations
B) Delusions
C) Paranoia
D) Cognitive dysfunction
Q3) A patient who is being evaluated in the emergency room says that she is a mother deity, the earth mother god who is all-powerful. The psychiatric advanced practice nurse states that the patient is
A) Experiencing a delusion
B) Experiencing a hallucination
C) Experiencing impaired impulse control
D) Experiencing an acute stress reaction
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Chapter 16: Delirium and Dementia
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Sample Questions
Q1) Among patients with dementia, early impairment of functioning is frequently seen in
A) Managing finances
B) Self-care deficits such as feeding themselves
C) Limitations of physical activities
D) Recognizing loved ones
Q2) Medications that are frequently used for patients with dementia are
A) Selective serotonin reuptake inhibitors
B) Selective norepinephrine reuptake inhibitors
C) Acetylcholinesterase inhibitors
D) Monoamine oxidase inhibitors
Q3) Which of the following is classified as a subcortical dementia?
A) Dementia of Alzheimer's type
B) Dementia due to Pick's disease
C) Dementia due to Parkinson's disease
D) Dementia due to vascular dementia
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18
Chapter 17: Dual Diagnosis
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Sample Questions
Q1) Current treatment approaches for dual diagnosis or co-occurring disorders focuses on
A) Identifying primary disorders and treating them first
B) Treating psychiatric disorders and substance-related disorders separately
C) Treating all co-occurring disorders as primary disorders
D) Treating psychiatric disorders first
Q2) The clinical effects and withdrawal symptoms of amphetamines are similar to those of
A) Heroine
B) Alcohol
C) Cocaine
D) Marijuana
Q3) Symptoms of alcohol withdrawal
A) Are most severe 8 to 10 hours after last drink
B) Are most severe 24 to 28 hours after last drink
C) Include hallucinations among 50% of individuals
D) Are evidenced as delirium tremens 2 weeks after the last drink
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Chapter 18: Personality Disorders
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Sample Questions
Q1) Narcissistic personality disorder is characterized by symptoms that
A) Are similar to the negative symptoms of schizophrenia
B) Include attitudes of grandiosity and entitlement
C) Include anxiety and fear of abandonment
D) Are influenced by time change such as jet lag
Q2) Avoidant personality disorder is distinguished from schizoid personality disorder by which of the following characteristics?
A) Desire to socialize with others but fear of rejection
B) Lack of desire to socialize with others
C) Disregard for social norms and the rights of others
D) Focus on rules, orderliness, and perfectionism
Q3) In which of the following personality disorders would there likely be a lower rate of soft neurological signs?
A) Schizotypal
B) Dependent
C) Antisocial
D) Borderline
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Chapter 19: Prevention of Psychiatric Disorders
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Sample Questions
Q1) At this time, in the prevention of schizophrenia, the focus is on
A) Preventing adverse circumstances of birth
B) Promoting childhood resilience
C) Preventing prodromal symptoms from converting to schizophrenia
D) Preventing late-onset schizophrenia
Q2) Preventive interventions that have been found to be associated with a sustained reduction of late-life depression include
A) Life review and reminiscence therapy
B) Exposure and response prevention therapy
C) Social skills training
D) Problem-solving therapy
Q3) A factor that has frequently been associated with children's increased risk of experiencing maltreatment is
A) Having two or more children in the family
B) Having a parent with mental illness and substance abuse
C) Having grandparents living with the family
D) Having a limited family budget for leisure activities
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