Walden NURS6650 Week 11 Final Exam

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Walden NURS6650 Week 11 Final Exam


NURS6650 Psychotherapy With Groups and Families

Week 11 Final Exam

• Question 1

When completing this exam, did
you comply with Walden University’s Code of Conduct including the expectations
for academic integrity?

• Question 2

Members of group therapy have
been meeting for several weeks. The PMHNP often starts sentences with a thank
you or compliment such as, “Good observation.” The PMHNP notices that some of
the group members having been starting their statements with compliments. To
which principle can the PMHNP attribute this process?

• Question 3

A PMHNP notices that adolescents
in a therapy group have not been getting along. They are divided into two main
groups and each automatically dislikes members of the other group. What is an
appropriate step for the PMHNP to take?

• Question 4

Jane has been attending group
therapy for the past year; she and the therapist have determined that she has
met her goals. Jane has been arriving to group late or not coming to group at
all. How does the PMHNP correctly interpret Jane’s behavior?

• Question 5

A PMHNP is leading a group
therapy session for patients with substance abuse problems. After one member
shares a problem, other members offer support, concern, and observations. The
PMHNP points out that the group is offering many truthful reactions and helpful
feedback. Which principle does this illustrate?

• Question 6

In the parent consultation
session, the parent discusses her son “Blake” who has changed since his 13th
birthday. Dr. Carlson discusses the power conflict that the parent appears to
be getting into with her son. When they discuss approaches they can use to help
Blake experience increased responsibility, Dr. Carlson explains that the parent
must make a commitment with her son by agreeing to:

• Question 7

During therapy, a patient named
Maria states she is unhappy that other members did not express missing her
while she was away the previous week. She confronted the PMHNP by saying,
“Nobody here cares about this stupid group!” What might the PMHNP say to
increase group cohesiveness?

• Question 8

Gregory is a middle-aged veteran
participant in a group led by the PMHNP. Since Gregory has been attending
group, he frequently interrupts others and seems to take much of the group time
for himself. The PMHNP identifies Gregory as a monopolist and confronts him.
She explains that she does not want him to talk less; instead, she actually
encourages him to talk more. What is the likely cause of the PMHNP’s

• Question 9

The homogenous mode of
composition involves a theory that relates to group composition. When applying
this theory, the PMHNP is aware that the group will most likely consist of
which of the following?

• Question 10

A 9-year-old child who witnessed
a fatal car accident has come to therapy with her parents to get treatment. The
child has been irritable since the event and has not wanted to talk about it.
Utilizing a trauma-focused cognitive behavior therapy (TF-CBT) approach, the
PMHNP has reviewed skills that the parents may use to help their child at home.
Based on the PMHNP’s suggestion, which is a statement the parents might make
after the child has a temper tantrum?

• Question 11

A 36-year-old client attends
group therapy regularly but is consistently tardy. The client explains that job
and family obligations interfere with attendance to the group. What is the most
appropriate intervention by the PMHNP?

• Question 12

A PNHNP is holding a group
therapy session. Today, several members have expressed fears about being
unlovable. Based on this information, what is an appropriate step by the PMHNP
to raise the members’ self-esteem

• Question 13

The social microcosm theory is a
theory that relates to group composition. In accordance with this theory, the
PMHNP is aware that the group must consist of which of the following?

• Question 14

During his second group therapy
session, a member, who was quiet the previous week, becomes very judgmental. He
criticizes another member by saying, “Mary, you are always late because you
don’t respect our group.” Then he adds, “In fact, all of you are disrespectful
and uncaring.” What is an appropriate step by the PMHNP?

• Question 15

Group participation is an
important aspect of how successful group therapy will be. The PMHNP recognizes
that the gender of group participants can play a role in the likelihood of group
participation. Which statement about gender and group composition does the
PMHNP take into account?

• Question 16

The PMHNP conducts a specialized
individual interview with a patient named Sandy. During this interview, Sandy
expresses her want of the other members to like her, and she has a deep dread
for the first group meeting. How does the PMHNP correctly interpret Sandy’s
interpersonal circumplex?

• Question 17

During a group therapy session,
a member comments that another member named Ted had no compassion. Ted replies,
“Why does it matter if I care one way or another. I can’t solve their
problems.” The other member starts crying and blames Ted for this. He shrugs
and answers, “I don’t understand why you are crying.” Based on this information,
what is the most likely determination the PMHNP can make about Ted?

• Question 18

A PMHNP is meeting with the
mother of a 10-year-old boy named Malik, who has been depressed since his
parents’ divorce. The mother explains that her goal for treatment is to help
Malik feel better so he can become his “usual outgoing self.” She insists that
she does not want him on medication. Which is the best response by the PMHNP?

• Question 19

The PMHNP recognizes that
extragroup behavior involves behavior that occurs outside of the group or
during subgrouping. Which statement best describes extragroup behavior as it
pertains to group therapy?

• Question 20

A patient has attended three
group therapy sessions and has remained silent throughout each. The patient
has, however, been listening to the other members. When the therapist makes eye
contact with the patient, he or she forces a smile but has clenched fists. What
is the most appropriate response by the PMHNP to help the patient?

• Question 21

Peter, a successful businessman,
is introduced to the group during the twelfth week. Following Peter’s
introduction, Joseph, a long-term member in the group, begins to lead the group
and discuss all of the things that he has personally accomplished. In what way
does the PMHNP correctly interpret Joseph’s behavior?

• Question 22

A 21-year-old client with
narcissistic traits is noted to continuously disrupt the group by speaking
while others are speaking. It becomes evident that the client is purposely
disrupting the group and decreasing the group’s productivity. What does the
PMHNP identify as a cause of the client’s behavior?

• Question 23

The PMHNP is meeting with an
adult woman and her father, who is 85 years old. The father stays quiet most of
the session. The daughter explains he is mad at her for “bringing him to a see
a shrink.” The daughter reports that things have been tense in the house since
her father moved in. The father has a history of depression, though he does not
take any medication for it. In addition, lately the father seems to never
sleep. “I hear him rummaging around in the kitchen, the garage, the living
room, at all hours of the night. Sometimes he’ll nap during the day, but not
much. This is putting a strain on my marriage, because my husband can’t sleep
with all of this going on.” Which therapeutic approach does the PMHNP identify
as most appropriate for the 85-year-old father?

• Question 24

The PMHNP provides cognitive
behavioral therapy (CBT) to an older adult patient with depression. The
patient’s 41-year-old daughter and 32-year-old son attend one of his sessions
with the PMHNP so that they can learn more about how to help their father. What
does the PMHNP say to the daughter and son about the goals of their father’s

• Question 25

Two PMHNPs are in charge of a
therapy group that has experienced several maladaptive interpersonal dramas
lately. One of the patients has been described by other members as
argumentative. After a particularly awkward session, one of the therapists
feels that his own interpersonal distortion of the session may be clouding his
observation. What is an appropriate step by that PMHNP?

• Question 26

A narcissistic patient was
unhappy that other members did not seem concerned about his or her dating
problems, which the patient spent half the session talking about. The patient
confronted the group by saying, “All of you are rude and uncaring!” When group
members ignored this comment, the patient said, “And no one said anything nice
about my new haircut either!” What is an appropriate response by the PMHNP?

• Question 27

One group member is identified
by the PMHNP as the monopolist of the group. Which behavior does the PMHNP
believe this member is most likely to display?

• Question 28

Harold Wyman is a 74-year-old
man who is trying to mend a relationship with his adult daughter. Based on his
intake assessment, the PMHNP believes that the father has depression. The
daughter and Harold meet with the PMNHP, and the daughter explains that her
father always appears mopey and withdrawn and refuses to do anything about it.
When asked, the father reports feeling sad all the time. Which action will the
PMNHP employ with Harold using the interpersonal psychotherapy approach throughout
the various sessions?

• Question 29

During a group therapy session,
a member shares that she often feels lonely and depressed. She has been turning
down invitations to spend time with friends lately, because she does not want
to leave the house. What is an appropriate step for the PMHNP to take?

• Question 30

The PMHNP is working with an
older adult woman and her adult children. The children report that the mother
was diagnosed with dementia, and they are all concerned about her welfare. The
plan is for the mother to move in with one of the children, but they are still
worried about how the mother will manage during the day when she is left alone.
What does the PMHNP identify as the focus
of the family therapy?

• Question 31

In a group therapy session for
adolescents, a 15-year-old patient says he has trouble making conversation with
people he does not know well. Based on the principle of development of
socializing techniques, what explicit approach might the PMHNP take?

• Question 32

A PNHNP is holding a group
therapy session for a father and his 10-year-old son, whom the father explains
has been acting out lately. The son says, “He is always telling me what to do
and never listens when I have an idea.” Which solution would the PMHNP most
likely suggest as an approach to the problem?

• Question 33

During the “mid-group debrief”
the clinical supervisor focused on the following areas with the two counselors

• Question 34

When the counselor discussed
assertiveness with the group members, she began the session by providing
definitions and asking group members to line up consistent with where they feel
they are currently in terms of assertiveness. Why did she do this?

• Question 35

Members of a therapy group have
been meeting for several weeks. While a member named Margaret is talking about
how her spouse ignores her when she tries to tell him what to do, another
member named Nicole interrupts and says, “Maybe he thinks you are being bossy.”
Margaret replies by saying, “At least I’m not an alcoholic like you are!” What
is an appropriate response by the PMHNP?

• Question 36

A patient has had a problem with
substance use and has been receiving treatment for addiction. Which additional
step might the PMHMP suggest to help the patient maintain abstinence from drugs
during and after treatment?

• Question 37

A PMHNP is putting together a
heterogeneous, interactional therapy group. During an initial screening, a
patient explains that he is unemployed because he keeps getting fired from new
jobs after several months. The therapist asks, “Why do you think those
companies let you go?” The patient’s reply is, “Those companies are all
terrible. They don’t know how to treat employees.” After asking the patient if
he thought about his role in getting fired, the patient says, “Why should I? I
am not part of the problem.” Based on this information, what is an appropriate
observation by the PMHNP?

• Question 38

Many key principles assist with
composing intensive interactional psychotherapy groups. When composing a
psychotherapy group, utilizing the intensive interactional approach, which key
principle does the PMHNP identify as being false?

• Question 39

A client has attended five group
therapy sessions yet has not engaged verbally with others in the group. The
PMHNP has identified the client as a “silent member.” Which statement is true
about silent members as related to group therapy?

• Question 40

The leader begins a group
meeting by doing the “names activity.” At the completion of the activity, the
leader explains that the activity is useful for all of the following reasons,

• Question 41

When forming a group for
therapy, which action would the PMHNP likely take as a predictor for group

• Question 42

For several months, a patient in
group therapy always participated in conversation but only shared positive
stories about her own life. During the next session, she finally confessed that
she has been depressed and cutting herself. What is the best response by the

• Question 43

Members of a therapy group have
been meeting for several months. During group therapy, a patient is bossy and
controlling. During this week’s session, she is confronted by another group
member about her behavior and replies, “This is not how I normally act. You are
not my family and friends. I don’t act the same way around them.” What can the
PMHNP deduce from her behavior?

• Question 44

The PMHNP is meeting with a
married couple. The husband is 81 years old, and the wife is 78 years old. They
tell the PMHNP that many of their friends have passed away over the last couple
of years, and it’s making them feel sentimental about their lives and the fact
that they are getting older. Hearing this, the PMHNP uses a life review
approach with the couple. What action will the PMHNP employ?

• Question 45

The PMHNP explains during a
discussion that subgrouping has the potential to make group therapy more complicated
and less rewarding. Tara, a member of the group, angrily states, “Well, Jack
and I have been meeting outside of the group for weeks now.” What is the PMHNP’s
most appropriate response?

• Question 46

During a group session, a member
turns to the PMHNP and says, “I need some advice. My manager asked me to take
on an extra project, and now I’m overwhelmed. I don’t want to seem incompetent,
so I agreed to the extra work. What do you recommend I do?” What is the best
response by the PMHNP in order to shape group behavior?

• Question 47

A PMHNP is treating a 7-year-old
child exhibiting signs of aggression and attention problems. Before suggesting
an intervention using a common elements approach, what may the PMHNP consider?

• Question 48

A patient named Tyrone was
nervous sharing personal information with the group. To compensate, he makes
comments on other members’ problems as if he were the therapist. Another member
of the group asked him, “Do you think you’re better than everyone here?” What
might the PMHNP help Tyrone gain from this exchange?

• Question 49

The PMHNP is meeting with an
older married couple. The couple reports having concerns about becoming
dependent on their adult children someday, since several of their other friends
have had to move in with their kids. They make it clear to the PMHNP that they
aren’t keen on therapy or taking medicine but would be willing to try some
alternative therapies. What does the PMHNP suggest for evidence-based CAM modalities?

• Question 50

The anticipation of the first
meeting among psychotherapy group attendees may cause feelings of dread and
uneasiness among clients. How does the PMHNP demonstrate awareness and promote
the success of this first psychotherapy meeting?

• Question 51

A PMHNP is creating a therapy
group and is including a patient with borderline personality disorder. Which
action would most likely reduce the patient’s chance of separation anxiety?

• Question 52

A patient in group therapy,
Monique, describes another member, Anna, as bossy and selfish; however, the
PMHNP does not notice this behavior at all. In addition, other members have
expressed how thoughtful and caring Anna is to them. Based on this information,
what is an appropriate observation by the PMHNP?

• Question 53

During the first group meeting,
a client states, “I am here because I am very shy. I don’t mesh well with
others and I rarely get invitations to go anywhere.” Which statement about the
client’s reason for seeking help and treatment best applies?

• Question 54

A client diagnosed with
depression has begun to feel despair and expresses a desire to leave the group
because he or she does not believe it is helpful. Which action by the PMHNP
will most likely contribute to the client staying in the group?

• Question 55

A PMHNP is meeting with parents
and their 10-year-old child. The child is having trouble paying attention at
school and has been getting easily frustrated at home when doing homework,
which often results in everyone arguing. What step might the PMHNP take as part
of a family-centered, solution-oriented approach?

• Question 56

A PMHNP is evaluating a patient
who has problems with authority and has trouble accepting criticism. The
patient is aware of these problems and wants to change. Based on this, what is
an appropriate action by the PMHNP?

• Question 57

Following the PMHNP’s
cancellation of a group session, he or she notices a decrease in compliance and
attendance within the group. What does the PMHNP identify as the group’s reason
for noncompliance?

• Question 58

A PMHNP has a therapy group in
which many members have been dropping out over the past several weeks. Members
have complained that they do not feel part of the group. What is an appropriate
step for the PMHNP to take?

• Question 59

A patient who has been depressed
is seeing a PMHNP for individual therapy. The patient explains that he has been
avoiding most social activities for the past few months. He is divorced and has
joint custody of his 10-year-old daughter. Based on this information, what
recommendation by the PMHNP would most benefit the patient?

• Question 60

Self-disclosure is a very
important part of group therapy. Which of the following conditions does the
PMHNP identify in his or her own life as a possible hindrance to

• Question 61

A PMHNP is treating a patient in
individual therapy and thinks the patient may be a good candidate for group
therapy. The patient is motivated to start group therapy, which meets twice a
month. Then the patient adds, “I can come to the first two meetings, but then
will be away on business for at least a month, maybe longer. But then I can
come to the at least one meeting before my next trip.” Based on this
information, what is the most likely recommendation by the PMHNP?

• Question 62

A patient in group therapy named
Ted shares personal information for the first time. He seems nervous but
continues to talk. How might the PMHNP use nonverbal positive reinforcement to
support Ted’s feeling more comfortable?

• Question 63

A client is observed discussing
many problems and complaints during group therapy. However, when other group
members attempt to offer advice, the client does not accept it. Based on this
observation, what can the PMHNP determine about the client?

• Question 64

In a group therapy session for
patients with anxiety problems, a patient named Eve was afraid to disclose to
the other members that she was a victim of sexual abuse. She kept the secret
for months, although she hinted at it to other members. During a meeting,
another member tried to pressure Eve to disclose her secret, but she was
flustered and not ready to share. What is an appropriate response by the PMHNP?

• Question 65

The PMHNP understands that
conflicts within the psychotherapy group can be troublesome for clients and
have the potential to reduce the effectiveness of the group process. As it
pertains to group meetings, the PMHNP understands which statement to be true
about conflict?

• Question 66

A member in group therapy named
Tom asked others for suggestions to a problem he was having. He did not think a
suggestion by a member named Steve would work, and for the rest of session, the
group took sides arguing why the idea would work or would not work. The session
ended with Tom agreeing to try the suggestion and report back to the group the
following week. Based on this session, what is an appropriate step by the

• Question 67

A PMHNP is leading a group
therapy session for patients with substance abuse problems. After a productive
session in which all members participated, the following week was not as
productive. In order to help the group members assume responsibility for
evaluating the meeting, what is an appropriate comment for the PMHNP to make?

• Question 68

When discussing the role of the
consultant in the parenting group session, Dr. Carlson explains that the
consultant should use several skills in order to help keep the group going and
should enable group members to become very engaged with one another. The
consultant should use all of the following skills to achieve this, except:

• Question 69 A patient in group therapy for people dealing with panic
disorder is describing a recent panic attack. He says, “During this attack, I
felt like I was dying.” What is an appropriate response by the PMHNP using
didactic instruction?

• Question 70

During a first group therapy
session, a member is outgoing and participates actively. Based on this
information, what is an appropriate prediction about this group member by the

• Question 71

A PMHNP has been holding group
therapy sessions for several weeks and notices that a patient is timid and
predictable in his or her responses. When the patient does speak, he or she
avoids saying anything to contradict anyone in the group. Based on this
information, what is an appropriate question the PMHNP should ask herself?

• Question 72

One member of a therapy group
had been quiet for the first several sessions. The member revealed to the other
members feeling of depression and emptiness. This week, the member was full of
energy and talking very quickly. The member became irritated with another
member tried to interrupt, started yelling, and then broke into a fit of
laughter. Based on the situation, what can the PMHNP determine about the

• Question 73

During an initial meeting, a
PMHNP spends time speaking with a patient who suffers from social anxiety. The
therapist finds the patient extremely loud and overbearing. The PMHNP’s
negative feelings continue no matter how hard he or she tries to feel
differently toward the patient. What is the most appropriate next step by the

• Question 74

During an initial meeting, a
patient who has been discussing suicide says to the PMHNP, “I’m so depressed
that I don’t want to leave my house. All I want to do is stay in bed.” What
type of therapy would the PMHNP most likely recommend to this patient?

• Question 75

During an initial screening
session, the PMHNP is considering a patient for group therapy. The patient is
recently divorced and says he is lonely and depressed. What is the best
referral by the PMHNP?

• Question 76

A group member who suffers from
depression and anxiety says during the session, “I don’t see how any of this is
going to help. I am still too anxious to leave the house and do the things I
want to do.” What is an appropriate response by the PMHNP?

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