NURS6640 Full Course (March 2019)

NURS 6640 Psychotherapy With Individuals

 

Week 1 Discussion

Does Psychotherapy Have a Biological Basis?

Many studies have found that psychotherapy is as effective as psychopharmacology in terms of influencing changes in behaviors, symptoms of anxiety, and changes in mental state. Changes influenced by psychopharmacology can be explained by the biological basis of treatments. But how does psychotherapy achieve these changes? Does psychotherapy share common neuronal pathways with psychopharmacology? For this Discussion, consider whether psychotherapy also has a biological basis.

 

NURS 6640 Week 2 Discussion

Assessment Tools

Assessment tools have two primary purposes: 1) to measure illness and diagnose clients, and 2) to measure a client’s response to treatment. Often, you will find that multiple assessment tools are designed to measure the same condition or response. Not all tools, however, are appropriate for use in all clinical situations. You must consider the strengths and weaknesses of each tool to select the appropriate assessment tool for your client. For this Discussion, as you examine the assessment tool assigned to you by the Course Instructor, consider its use in psychotherapy.

 

NURS 6640 Week 5 Discussion

Posttraumatic Stress Disorder

It is estimated that more than 6% of the U.S. population will experience posttraumatic stress disorder (PTSD) in their lifetime (National Center for PTSD, 2010). This debilitating disorder often interferes with an individual’s ability to function in daily life. Common symptoms of anxiousness and depression frequently lead to substance abuse issues and even physical ailments. For this Discussion, as you examine the Thompson Family Case Study in this week’s Learning Resources, consider how you might assess and treat clients presenting with PTSD.

 

NURS 6640 Week 8 Discussion

Clinical Supervision

Clinical Supervision is an essential component of your development as a psychiatric mental health nurse practitioner. It provides an opportunity for professional collaboration as you share experiences with and gain insights from colleagues. For this Clinical Supervision, consider a client whom you do not think is adequately progressing according to expected clinical outcomes.

 

NURS 6640 Week 9 Discussion

Counseling Adolescents

The adolescent population is often referred to as “young adults,” but in some ways, this is a misrepresentation. Adolescents are not children, but they are not yet adults either. This transition from childhood to adulthood often poses many unique challenges to working with adolescent clients, particularly in terms of disruptive behavior. In your role, you must overcome these behaviors to effectively counsel clients. For this Discussion, as you examine the Disruptive Behaviors media in this week’s Learning Resources, consider how you might assess and treat adolescent clients presenting with disruptive behavior.

 

NURS 6640 Week 10 Discussion

Clinical Supervision

Personal reflection and discussion with colleagues is essential to your development as a psychiatric mental health nurse practitioner. In Week 8, you collaborated with colleagues as you participated in your first Clinical Supervision. This week, you have the opportunity to continue your collaboration as you reflect on and discuss your experiences with counseling older adults. Keep in mind that although there may be challenges to counseling this population, these clients offer unique learning opportunities. For this Clinical Supervision, consider an older client you are counseling whom you do not think is adequately progressing according to expected clinical outcomes.

 

NURS 6640 Week 11 Discussion

Therapy for Clients With Personality Disorders

Clients with personality disorders often find it difficult to overcome their problems and function in daily life. Even when these clients are aware that they have a dysfunction with their personality and are open to counseling, treatment can be challenging for both the client and the therapist. For this Discussion, as you examine personality disorders, consider therapeutic approaches you might use with clients.

 

NURS 6640 Week 3 Assignment 1

Applying Current Literature to Clinical Practice

Literature in psychotherapy differs from other areas of clinical practice. Generally, there are no clinical trials in psychotherapy because it is often neither appropriate nor ethical to have controls in psychotherapy research. This sometimes makes it more difficult to translate research findings into practice. In your role, however, you must be able to synthesize current literature and apply it to your own clients. For this Assignment, you begin practicing this skill by examining current literature on psychodynamic therapy and considering how it might translate into your own clinical practice.

Learning Objectives

Students will:

Evaluate the application of current literature to clinical practice

To prepare:

Review this week’s Learning Resources and reflect on the insights they provide.

Select one of the psychodynamic therapy articles from the Learning Resources to evaluate for this Assignment.

Note: In nursing practice, it is not uncommon to review current literature and share findings with your colleagues. Approach this Assignment as though you were presenting the information to your colleagues.

The Assignment

In a 5- to 10-slide PowerPoint presentation, address the following:

Provide an overview of the article you selected.

What population is under consideration?

What was the specific intervention that was used? Is this a new intervention or one that was already used?

What were the author’s claims?

Explain the findings/outcomes of the study in the article. Include whether this will translate into practice with your own clients. If so, how? If not, why?

Explain whether the limitations of the study might impact your ability to use the findings/outcomes presented in the article. Support your position with evidence-based literature.

Note: The presentation should be 5–10 slides, not including the title and reference slides. Include presenter notes (no more than ½ page per slide) and use tables and/or diagrams where appropriate. Be sure to support your work with specific citations from the article you selected. Support your approach with evidence-based literature.

By Day 7

Submit your Assignment.

Submission and Grading Information

To submit your completed Assignment for review and grading, do the following:

Please save your Assignment using the naming convention “WK3Assgn1+last name+first initial.(extension)” as the name.

Click the Week 3 Assignment 1 Rubric to review the Grading Criteria for the Assignment.

Click the Week 3 Assignment link. You will also be able to “View Rubric” for grading criteria from this area.

Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK3Assgn1+last name+first initial.(extension)” and click Open.

If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.

Click on the Submit button to complete your submission.

 

NURS 6640 Week 3 Assignment 2

Practicum – Assessing Clients

Learning Objectives

Students will:

Assess clients presenting for psychotherapy

Develop genograms for clients presenting for psychotherapy

To prepare:

Select a client whom you have observed or counseled at your practicum site.

Review pages 137–142 of the Wheeler text and the Hernandez Family Genogram video in this week’s Learning Resources. Reflect on elements of writing a Comprehensive Client Assessment and creating a genogram for the client you selected.

The Assignment

Part 1: Comprehensive Client Family Assessment

With this client in mind, address the following in a Comprehensive ClientAssessment (without violating HIPAA regulations):

Demographic information

Presenting problem

History or present illness

Past psychiatric history

Medical history

Substance use history

Developmental history

Family psychiatric history

Psychosocial history

History of abuse/trauma

Review of systems

Physical assessment

Mental status exam

Differential diagnosis

Case formulation

Treatment plan

Part 2: Family Genogram

Prepare a genogram for the client you selected. The genogram should extend back by at least three generations (great grandparents, grandparents, and parents).

By Day 7 of Week 3

Submit your Assignment.

Submission and Grading Information

To submit your completed Assignment for review and grading, do the following:

Please save your Assignment using the naming convention “WK3Assgn2+last name+first initial.(extension)” as the name.

Click the Week 3 Assignment 2 Rubric to review the Grading Criteria for the Assignment.

Click the Week 3 Assignment 2 link. You will also be able to “View Rubric” for grading criteria from this area.

Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK3Assgn2+last name+first initial.(extension)” and click Open.

If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.

Click on the Submit button to complete your submission.

 

NURS 6640 Week 4 Assignment 1

Cognitive Behavioral Theory Versus Rational Emotive Behavioral Theory

While cognitive behavioral therapy (CBT) and rational emotive behavioral therapy (REBT) have many similarities, they are distinctly different therapeutic approaches. When assessing clients and selecting one of these therapies, you must recognize the importance of not only selecting the one that is best for the client, but also the approach that most aligns to your own skill set. For this Assignment, as you examine the similarities and differences between CBT and REBT, consider which therapeutic approach you might use with your clients.

Learning Objectives

Students will:

Compare cognitive behavioral therapy and rational emotive behavioral therapy

Recommend cognitive behavioral therapies for clients

To prepare:

 

Review the media in this week’s Learning Resources.

Reflect on the various forms of cognitive behavioral therapy.

The Assignment

In a 1- to 2-page paper, address the following:

Briefly describe how cognitive behavioral therapy (CBT) and rational emotive behavioral therapy (REBT) are similar.

Explain at least three differences between CBT and REBT. Include how these differences might impact your practice as a mental health counselor.

Explain which version of cognitive behavioral therapy you might use with clients and why. Support your approach with evidence-based literature.

Note: The School of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The Sample Paper provided at the Writing Center provides an example of those required elements (available at http://writingcenter.waldenu.edu/57.htm). All papers submitted must use this formatting.

By Day 7

Submit your Assignment.

Submission and Grading Information

To submit your completed Assignment for review and grading, do the following:

Please save your Assignment using the naming convention “WK4Assgn1+last name+first initial.(extension)” as the name.

Click the Week 4 Assignment 1 Rubric to review the Grading Criteria for the Assignment.

Click the Week 4 Assignment 1 link. You will also be able to “View Rubric” for grading criteria from this area.

Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK4Assgn1+last name+first initial.(extension)” and click Open.

If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.

Click on the Submit button to complete your submission.

 

NURS 6640 Week 4 Assignment 2

Practicum – Week 1 Journal Entry and Journal Submission

Learning Objectives

Students will:

Analyze nursing and counseling theories to guide practice in psychotherapy

Develop goals and objectives for personal practicum experiences

Create timelines for practicum activities

Develop diagnoses for clients receiving psychotherapy

Analyze legal and ethical implications of counseling clients with psychiatric disorders

Develop diagnoses for clients receiving psychotherapy

Evaluate the efficacy of cognitive behavioral therapy for clients

Analyze legal and ethical implications of counseling clients with psychiatric disorders

The Learning Objectives are related to the Practicum Journal Assignments presented in Weeks 1, 2, and 4.

Week 4 Journal Entry

Select a client that you observed or counseled this week. Then, address the following in your Practicum Journal:

Describe the client (without violating HIPAA regulations) and identify any pertinent history or medical information, including prescribed medications.

Using the DSM-5, explain and justify your diagnosis for this client.

Explain whether cognitive behavioral therapy would be effective with this client. Include expected outcomes based on this therapeutic approach. Support your approach with evidence-based literature.

Explain any legal and/or ethical implications related to counseling this client.

Note: Be sure to use the Practicum Journal Template, located in the Learning Resources.

By Day 7

Submit your Practicum Journal entries for Weeks 1, 2, and 4. Refer to the weekly instructions for additional guidance.

Submission

To submit your completed Assignment for review and grading, do the following:

Please save your Assignments using the following naming convention:

“WK4Journal1+lastname+firstinitial,” “WK4Journal2+lastname+firstinitial,” and“WK4Journal4+lastname+firstinitial.”

Click the Week 4 Assignment 2 link.

Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK4Journal1+last name+first initial.(extension)” and click Open. Repeat for each of the Practicum Journal submissions.

Click on the Submit button to complete your submission.

 

 

NURS 6640 Week 6 Assignment

Assessing Clients With Addictive Disorders

Addictive disorders can be particularly challenging for clients. Not only do these disorders typically interfere with a client’s ability to function in daily life, but they also often manifest as negative and sometimes criminal behaviors. Sometime clients with addictive disorders also suffer from other mental health issues, creating even greater struggles for them to overcome. In your role, you have the opportunity to help clients address their addictions and improve outcomes for both the clients and their families. For this Assignment, as you examine the Levy Family video in this week’s Learning Resources, consider how you might assess and treat clients presenting with addiction.

Learning Objectives

Students will:

Assess clients presenting with addictive disorders

Analyze therapeutic approaches for treating clients with addictive disorders

Evaluate outcomes for clients with addictive disorders

To prepare:

Review this week’s Learning Resources and consider the insights they provide.

Review the Levy Family video Episodes 1 through 5.

The Assignment

In a 2- to 3-page paper, address the following:

After watching Episode 1, describe:

What is Mr. Levy’s perception of the problem?

What is Mrs. Levy’s perception of the problem?

What can be some of the implications of the problem on the family as a whole?

After watching Episode 2, describe:

What did you think of Mr. Levy’s social worker’s ideas?

What were your thoughts of her supervisor’s questions about her suggested therapies and his advice to Mr. Levy’s supervisor?

After watching Episode 3, discuss the following:

What were your thoughts about the way Mr. Levy’s therapist responded to what Mr. Levy had to say?

What were your impressions of how the therapist worked with Mr. Levy? What did you think about the therapy session as a whole?

Informed by your knowledge of pathophysiology, explain the physiology of deep breathing (a common technique that we use in helping clients to manage anxiety). Explain how changing breathing mechanics can alter blood chemistry.

Describe the therapeutic approach his therapist selected. Would you use exposure therapy with Mr. Levy? Why or why not? What evidence exists to support the use of exposure therapy (or the therapeutic approach you would consider if you disagree with exposure therapy)?

In Episode 4, Mr. Levy tells a very difficult story about Kurt, his platoon officer.

Discuss how you would have responded to this revelation.

Describe how this information would inform your therapeutic approach. What would you say/do next?

In Episode 5, Mr. Levy’s therapist is having issues with his story.

Imagine that you were providing supervision to this therapist, how would you respond to her concerns?

Support your approach with evidence-based literature.

Note: The School of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The Sample Paper provided at the Writing Center provides an example of those required elements (available at http://writingcenter.waldenu.edu/57.htm). All papers submitted must use this formatting.

By Day 7

Submit your Assignment.

Submission and Grading Information

To submit your completed Assignment for review and grading, do the following:

Please save your Assignment using the naming convention “WK6Assgn+last name+first initial.(extension)” as the name.

Click the Week 6 Assignment Rubric to review the Grading Criteria for the Assignment.

Click the Week 6 Assignment link. You will also be able to “View Rubric” for grading criteria from this area.

Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK6Assgn+last name+first initial.(extension)” and click Open.

If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.

Click on the Submit button to complete your submission.

 

NURS 6640 Week 7 Assignment 1

Supportive Psychotherapy Versus Interpersonal Psychotherapy

Although supportive psychotherapy and interpersonal psychotherapy share some similarities, these therapeutic approaches have many differences. When assessing clients and selecting therapies, it is important to recognize these differences and how they may impact your clients. For this Assignment, as you compare supportive and interpersonal psychotherapy, consider which therapeutic approach you might use with your clients.

Learning Objectives

Students will:

Compare supportive psychotherapy and interpersonal psychotherapy

Recommend therapeutic approaches for clients presenting for psychotherapy

To prepare:

Review the media in this week’s Learning Resources.

Reflect on supportive and interpersonal psychotherapeutic approaches.

The Assignment

In a 1- to 2-page paper, address the following:

Briefly describe how supportive and interpersonal psychotherapies are similar.

Explain at least three differences between these therapies. Include how these differences might impact your practice as a mental health counselor.

Explain which therapeutic approach you might use with clients and why. Support your approach with evidence-based literature.

Note: The School of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The Sample Paper provided at the Writing Center provides an example of those required elements (available at http://academicguides.waldenu.edu/writingcenter/templates ). All papers submitted must use this formatting.

By Day 7

Submit your Assignment.

Submission and Grading Information

To submit your completed Assignment for review and grading, do the following:

Please save your Assignment using the naming convention “WK7Assgn1+last name+first initial.(extension)” as the name.

Click the Week 7 Assignment Rubric to review the Grading Criteria for the Assignment.

Click the Week 7 Assignment 1 link. You will also be able to “View Rubric” for grading criteria from this area.

Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK7Assgn1+last name+first initial.(extension)” and click Open.

If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.

Click on the Submit button to complete your submission.

 

 

NURS 6640 Week 7 Assignment 2

Practicum – Assessing Client Progress

Learning Objectives

Students will:

Assess progress for clients receiving psychotherapy

Differentiate progress notes from privileged notes

Analyze preceptor’s use of privileged notes

To prepare:

Reflect on the client you selected for the Week 3 Practicum Assignment.

Review the Cameron and Turtle-Song (2002) article in this week’s Learning Resources for guidance on writing case notes using the SOAP format.

The Assignment

Part 1: Progress Note

Using the client from your Week 3 Assignment, address the following in a progress note (without violating HIPAA regulations):

Treatment modality used and efficacy of approach

Progress and/or lack of progress toward the mutually agreed-upon client goals (reference the Treatment plan—progress toward goals)

Modification(s) of the treatment plan that were made based on progress/lack of progress

Clinical impressions regarding diagnosis and/or symptoms

Relevant psychosocial information or changes from original assessment (i.e., marriage, separation/divorce, new relationships, move to a new house/apartment, change of job, etc.)

Safety issues

Clinical emergencies/actions taken

Medications used by the patient (even if the nurse psychotherapist was not the one prescribing them)

Treatment compliance/lack of compliance

Clinical consultations

Collaboration with other professionals (i.e., phone consultations with physicians, psychiatrists, marriage/family therapists, etc.)

Therapist’s recommendations, including whether the client agreed to the recommendations

Referrals made/reasons for making referrals

Termination/issues that are relevant to the termination process (i.e., client informed of loss of insurance or refusal of insurance company to pay for continued sessions)

Issues related to consent and/or informed consent for treatment

Information concerning child abuse, and/or elder or dependent adult abuse, including documentation as to where the abuse was reported

Information reflecting the therapist’s exercise of clinical judgment

Note: Be sure to exclude any information that should not be found in a discoverable progress note.

Part 2: Privileged Note

Based on this week’s readings, prepare a privileged psychotherapy note that you would use to document your impressions of therapeutic progress/therapy sessions for your client from the Week 3 Practicum Assignment.

The privileged note should include items that you would not typically include in a note as part of the clinical record.

Explain why the items you included in the privileged note would not be included in the client’s progress note.

Explain whether your preceptor uses privileged notes, and if so, describe the type of information he or she might include. If not, explain why.

By Day 7

Submit your Assignment.

Submission

To submit your completed Assignment for review and grading, do the following:

Please save your Assignment using the following naming convention: “WK7Assgn2+lastname+first initial”.

Click the Week 7 Assignment 2 link.

Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK7Assgn2+last name+first initial.(extension)” and click Open. If you are submitting multiple files, repeat until all files are attached.

Click on the Submit button to complete your submission.

 

NURS 6640 Week 7 Assignment 3

Practicum – Week 5 and Week 6 Journal Submission

Learning Objectives

Students will:

Develop diagnoses for clients receiving psychotherapy*

Evaluate the efficacy of therapeutic approaches for clients*

Analyze legal and ethical implications of counseling clients with psychiatric disorders*

By Day 7

Submit your Journal Entries for Week 5 and Week 6. Refer to Week 5 and Week 6 for additional guidance.

Submission

To submit your completed Assignment for review and grading, do the following:

Please save your Assignments using the following naming convention: WK7Journal1+lastname+first initial,” and “WK7Journal2+lastname+firstinitial.”

Click the Week 7 Assignment 3 link.

Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK7Assgn3+last name+first initial.(extension)” and click Open. Repeat for each of the Practicum Journal submissions. If you are submitting multiple files, repeat until all files are attached.

Click on the Submit button to complete your submission.

 

NURS 6640 Week 10 Assignment 1

Practicum – Client Termination Summary

Learning Objectives

Students will:

Develop client termination summaries

To prepare:

For guidance on writing a Client Termination Summary, review pages 693–712 of the Wheeler text in this week’s Learning Resources.

Identify a client who may be ready to complete therapy.

The Assignment

With the client you selected in mind, address the following in a client termination summary (without violating HIPAA regulations):

Identifying information of client (i.e., hypothetical name, age, etc.)

Date initially contacted therapist, date therapy began, duration of therapy, and date therapy will end

Total number of sessions, including number of missed sessions

Termination planned or unplanned

Presenting problem

Major psychosocial issues

Types of services rendered (i.e., individual, couple/family therapy, group therapy, etc.)

Overview of treatment process

Goal status (goals met, partially met, unmet)

Treatment limitations (if any)

Remaining difficulties and/or concerns

Recommendations

Follow-up plan (if indicated)

Instructions for future contact

Signatures

By Day 7

Submit your Assignment.

Submission

To submit your completed Assignment for review and grading, do the following:

Please save your Assignment using the following naming convention: “WK10Assgn1+lastname+first initial”.

Click the Week 10 Assignment 1 link.

Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK10Assgn1+last name+first initial.(extension)” and click Open. If you are submitting multiple files, repeat until all files are attached.

Click on the Submit button to complete your submission.

 

NURS 6640 Week 10 Assignment 2

Practicum – Week 8 Journal Entry

Students will:

Develop diagnoses for clients receiving psychotherapy

Evaluate the efficacy of existential-humanistic therapy for clients

Analyze legal and ethical implications of counseling clients with psychiatric disorders

Analyze clinical supervision experiences

Analyze how nursing and counseling theories guided personal practice in psychotherapy

Analyze goals and objectives for personal practicum experiences

Analyze the impact of psychotherapy on social change

The Learning Objectives are related to the Practicum Journal Assignments presented in Weeks 8, 9, and 10.

Week 10 Journal Entry

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.

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.

Explain how you might impact social change through your work with clients who have mental health issues.

Support your approach with evidence-based literature.

Note: Be sure to use the Practicum Journal Template, located in the Learning Resources.

By Day 7

Submit your Practicum Journal entries for Weeks 8, 9, and 10. Refer to the weekly instructions for additional guidance.

Submission

To submit your completed Assignment for review and grading, do the following:

Please save your Assignments using the following naming convention: “WK10Journal1+lastname+first initial,” “WK10Journal2+lastname+first initial,” and “WK10Journal3+lastname+first initial.”

Click the Week 10 Assignment 2 link.

Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK10Journal1+last name+first initial.(extension)” and click Open. Repeat for each of the Practicum Journal submissions.

Click on the Submit button to complete your submission.

 

NURS 6640 Midterm Exam

Question 1The PMHNP is mentoring a student. After working with a patient during a session, the student laments about all the things she should have, or could have, said to the patient. “I feel guilty that I didn’t speak up more about the patient’s concern toward her son,” says the student. The PMHNP understands that the student is exhibiting signs of which therapeutic concept?

Question 2 The PMHNP is working with a 56-year-old man who is being seen because of his anxiety and depression. During the therapy sessions, the PMHNP assists the patient in discussing his experiences and expanding on his thoughts and feelings. He tells the PMHNP stories about how he used to be teased by his coworkers at the office for becoming too anxious in large conference rooms. The PMHNP listens to the patient and helps focus on his strengths to promote self-understanding. Which principle best accounts for the PMHNP’s interactions with the patient?

Question 3 During a therapy session the patient is asked how she currently deals with stress, and she says, “Well, I don’t. I just let it build and build.” The PMHNP responds by asking how well this has been working out for her. The patient states, “Well, to be honest, it just feels like I’m drowning, you know what I mean.” Illustrating idiosyncratic meaning, the PMHNP responds with:

Question 4 The PMHNP is working with a 43-year-old male patient who develops idiosyncratic transference over weeks of therapy. The best way for the PMHNP to respond to this patient is to ___________ :

Question 5 The PMHNP is working with a patient who has insomnia and battles going to sleep. The patient reports consistent self-defeating behaviors, and hates trying to go to sleep. Which action made by the PMHNP demonstrates the use of a paradoxical intervention?

Question 6

The PMHNP understands that anxiety and depression are two disorders in which their symptoms may overlap. When discussing this, you explain that the autonomic nervous system is activated and further helps distinguish anxiety symptoms by making the following points:

Question 7

A new patient has been informed of the limits of confidentiality, and has signed informed consent forms. No consent, however, has been obtained for voluntary “Release of Information.” The patient is 20 years old and still lives at home with his parents. He is being treated for depression, which he attributes to the trouble he’s had finding employment.

True or false: If the patient’s mother calls the PMHNP to check up on her son to see how he is doing, the therapist is required to protect patient confidentiality and not disclose information. Selected Answer:

Question 8

A PMHNP is taking a history and wants to assess how the patient copes with adversity. To do so, the therapist asks questions about the patient’s belief system. What would be an appropriate question to ask?

Question 9

In your office, you see a 58-year-old patient with PTSD who reports having nightmares, making it impossible for her to sleep. What recommendations based on principles of sleep hygiene will the PMHNP make?

Question 10

A patient who has borderline personality disorder is meeting with the PMHNP. When asked about future goals, the patient responds, “I’d like to go back to school to do what you

do. You know, talk to people all day about their problems. It seems pretty easy.” How does the PHMNP respond to the client in a way that is free from any stigmatizing beliefs or judgments?

Question 11

A 62-year-old patient has been diagnosed with borderline personality disorder. Upon assessment, the PMHNP learns that he participates in spending sprees and occasional binge eating, accompanied by rapid changes in self-image. Which evidence-based psychotherapeutic model does the PMHNP identify as effective and beneficial?

Question 12

An elderly patient in a nursing home has been losing interest in activities and now refuses to leave his room. After a physical exam, he is referred to a PMHNP for an initial assessment.

True or false: After speaking with the patient, an appropriate screening tool for the PMHNP to use would be the Geriatric Depression Scale.

Question 13

A PMHNP has been working with a young female patient who suffers from depression to change self-defeating behaviors. By creating a presence of acceptance and using good listening skills, the PMHNP’s overall goal is to __________.

Question 14

The PMHNP is working with a school-aged child who has been diagnosed with depression. The child has attended several sessions with the PMNHP, but recently presents with avoidant behavior by showing increased distress and being late to sessions. What approach does the PMHNP need to employ with the child to continue making therapeutic progress?

Question 15

A PMHNP’s patients have already signed confidentiality agreements, including limits that will be imposed on confidentiality. Months later, the state’s laws have changed that affect confidentiality promises the PMHNP has already made. What is an appropriate step for the PMHNP to take after finding out this information?

Question 16

An initial evaluation reveals that an 11-year-old patient has moved to a new school after her parents’ recent divorce, and is having trouble making friends. The patient has normal mental status and exhibits appropriate behavior. What is the most appropriate scale for the PMHNP to use to get more information?

Question 17

During cognitive behavioral therapy (CBT), a 64-year-old male patient, states, “My wife hates me! She’s just waiting for me to die.” Using Socratic dialogue (SD) the PMHNP demonstrates understanding of analysis when she responds:

Question 18

A 41-year-old male patient is meeting with the PMHNP and reveals that he is homosexual. He begins telling the PMHNP about his feelings as a homosexual, middle-aged man. The PMHNP nods understandingly. Before long, the patient asks, “Are you gay? Are you married? Do you have kids?” What is the best response by the PMHNP?

Question 19

The PMHNP is working with a patient who is living in poverty and abusing substances. According to the treatment hierarchy framework, what needs does the PMHNP need to attend to first?

Question 20

The PMHNP is having a therapy session with Charlotte, a 20-year-old victim of date rape. The patient states, “I shouldn’t have been there; I should have just gone home. This was all my fault; how could I have been so stupid?” Using the Socratic method, what is the PMHNP’s best response?

Question 21

The PMHNP is working with an adult patient who has somatic complaints caused by a history of childhood abuse. As part of the therapeutic process, what does the PMHNP do to assess and organize a trauma history?

Question 22

The PMHNP employs psychodynamic psychotherapy with a patient who experiences anxiety and depression. As the process enters the psychoanalytic end of the psychodynamic continuum, the PMNHP will focus on:

Question 23

True or false: A PMHNP may ask his patient to describe her relationship with her father, both as a child and now, in order to assess interpersonal style.

Question 24

A 35-year-old patient has been seeking treatment for depression for several months. The PMHNP does an assessment to see if processing has led to adaptive change. The patient’s self-references are positive in relation to past events, work is productive, relationships are adaptive, and there is congruence between behavior, thoughts, and affect. Based on this information, the PMHNP decides the patient ____________.

Question 25

A 65-year-old patient has suffered the loss of his wife. He is in a state of hyperarousal with increased sympathetic nervous system arousal. One or more interventions may help the patient to deal with this arousal. To decrease sympathetic nervous system arousal, the PMHNP’s treatment strategy is ___________.

 

 

 

 

NURS 6640 Final Exam

• Question 1 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?

• Question 2 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?

• Question 3 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 4 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 5 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:

• Question 6 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 7 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?

• Question 8 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 9 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 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 ______________.

• Question 11 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 12 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?

• 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?

• Question 14 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:

• Question 15 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?

• Question 16 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?

• Question 17 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:

• Question 18 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 19 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?

• Question 20 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?

• Question 21 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?

• Question 22 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?

• Question 23 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 24 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 25 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?