Psychiatric Mental Health Nursing Exam Questions and Answers, Exams of Psychiatry

A set of questions and answers designed for students preparing for psychiatric mental health nursing exams. It covers various topics relevant to advanced practice in psychiatric nursing, including family therapy, psychosocial stages of development, therapeutic approaches, legal considerations, and cultural competence. The questions are structured to test understanding of key concepts and their application in clinical practice, making it a valuable resource for exam preparation and review. This material is useful for university students.

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2025/2026

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Advanced Psychiatric Mental Health Nursing
Exam
1.
During the initial phase of family therapy, one person is
identified as “the problem”. The family therapist challenges
linearity by which of the following
Answer: D Asking how others in the family are involved in or affected
by “the problem”.
2.
Staff in an independent living facility notice that Mr. Smith, a
75-year- old male resident is alone most of the time and seems
to have alienated most of the other residents and staff. The
advanced practice psychiatric nurse understands that from
Erikson’s psychosocial stages perspective, he is dealing with
which psychosocial stage of development?
Answer: B Ego integrity vs. despair
3.
The advanced practice psychiatric nurse realizes which of the
following regarding workbook exercises in therapy?
a)
Workbook exercises are only an adjunct to treatment.
b)
Workbook exercises simplify the real work in therapy.
c)
Treatment manuals consistently correlate positively with
treatment outcomes.
d)
Use of workbook exercises and approaches promotes
creativity and flexibility in the therapeutic process.
4.
During the initial phase of family therapy one person is
identified as “the problem”. the family therapist challenges
linearity by which of the following?
Answer: D Asking how others in the family are involved in or
affected by “the problem”.
5.
While working with a patient who exhibits parasuicidal
behaviors of cutting, the advanced practice psychiatric nurse
has the patient sign a no-suicide contract. Which of the
following is true from a legal perspective about a no-suicidal
contract?
Answer a) It is NOT a substitute for good clinical judgment;
accurate assessment is imperative.
6.
Common patterns of behavior and experience derived
from the settings in which people live is known as which
of the following? Answer: B Culture
7.
The advanced practice psychiatric nurse using a Bowenian
Therapy approach in working with families realizes:
A Problem-solving is a primary goal of therapy.
B Understanding is the primary goal of therapy.
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Advanced Psychiatric Mental Health Nursing

Exam

  1. During the initial phase of family therapy, one person is identified as “the problem”. The family therapist challenges linearity by which of the following Answer: D Asking how others in the family are involved in or affected by “the problem”.
  2. Staff in an independent living facility notice that Mr. Smith, a 75-year- old male resident is alone most of the time and seems to have alienated most of the other residents and staff. The advanced practice psychiatric nurse understands that from Erikson’s psychosocial stages perspective, he is dealing with which psychosocial stage of development? Answer: B Ego integrity vs. despair
  3. The advanced practice psychiatric nurse realizes which of the following regarding workbook exercises in therapy? a) Workbook exercises are only an adjunct to treatment. b) Workbook exercises simplify the real work in therapy. c) Treatment manuals consistently correlate positively with treatment outcomes. d) Use of workbook exercises and approaches promotes creativity and flexibility in the therapeutic process.
  4. During the initial phase of family therapy one person is identified as “the problem”. the family therapist challenges linearity by which of the following? Answer: D Asking how others in the family are involved in or affected by “the problem”.
  5. While working with a patient who exhibits parasuicidal behaviors of cutting, the advanced practice psychiatric nurse has the patient sign a no-suicide contract. Which of the following is true from a legal perspective about a no-suicidal contract? Answer a) It is NOT a substitute for good clinical judgment; accurate assessment is imperative.
  6. Common patterns of behavior and experience derived from the settings in which people live is known as which of the following? Answer: B Culture
  7. The advanced practice psychiatric nurse using a Bowenian Therapy approach in working with families realizes: A Problem-solving is a primary goal of therapy. B Understanding is the primary goal of therapy.

C Behavior change is the primary goal of therapy. D Family dialogue is encouraged

  1. Recommending or prescribing specific readings related to the individual’s difficulties is known as which of the following? Answer: Bibliotherapy
  2. the capacity to be alone is known as which of the following? Answer: D Object constancy
  3. “If I was in a relationship, all of my problems would be solved” is an example of which type of cognitive distortion? Answer: Fallacy of attachment
  4. Hildegard Peplau developed the psychodynamic interpersonal model for psychiatric nursing based on which theorist’s framework? Answer: Harry Stock Sullivan
  5. Which of the following is not consistent with the underlying assumptions of psychodynamic psychotherapy? A. What has happened in the past determines what we do today. B B. Psychodynamic psychotherapy is rooted in developmental theory C. By changing one’s thoughts, emotions, and behaviors can be changed. D. Through understanding the past, the individual is empowered to make more conscious decisions.
  6. The change agent in relational psychodynamic therapy is which of the following? A Insight. B Mindfulness. C Wish/defense conflicts.
  7. According to Erikson’s Psychosocial stages failure to successfully resolve trust vs mistrust conflict is associated with which of the following pathological outcomes? A. Psychosis, addictions, depression. B. Paranoia, obsessions, compulsions. C. Phobias, psychosomatic disorders. D Inertia, creative inhibition
  8. The quality of the therapeutic relationship is most closely linked to which school of therapy? A Freudian. B Gestalt. C CBT. D None of the above.
  9. According to Freud’s Psychosexual stages development of sexual identity occurs during what age range? A .18 months to 3 years.

D 13 years to 20 years.

  1. According to Freud’s Psychosexual Stages framework a patient exhibiting excessive envy and jealousy failed to successfully manage anxiety during which stage? A Oral. B Anal. C Latency. D Phallic/Oedip
  2. Evidenced based guidelines for patient treatment are based on which of the following? A Consensus of Expert Panel. B Systematic reviews of case studies. C Systematic reviews of randomized controlled studies (RTC). D A and C
  3. Which of the following is consistent with Cognitive-Behavioral Therapy (CBT)? Check all that apply. A CBT is a system of psychotherapy based on a theoretical framework which maintains how an individual structures one’s experiences largely determines how one feels and behaves. B Maladaptive thoughts relating to the “cognitive triad” are rooted in irrational or illogical assumptions. C By changing one’s thoughts, emotions and behaviors can be changed.
  4. Yalom identifies eleven primary factors to describe the therapeutic benefit of group psychotherapy. Which of the following statements is not consistent with these factors? A Therapeutic change is an intricate interplay of human experiences. B The distinctions among these factors are well delineated. C The distinctions among these factors are arbitrary. D The factors are interdependent
  5. What distinguishes psychoanalytic therapy from other types of therapies? A The focus is on problem-solving. B The focus on irrational thoughts. C The focus is on dreams and wishes. D The deep analysis of the patient's relationship with the
  6. Cognitive Behavioral Therapy (CBT) interventions focus on A The person’s relationships and family dynamics. B The person’s thoughts, beliefs, or behaviors

C The person’s understanding of how the past gets triggered and plays out in the present. D The person’s body, beliefs, images, and emotions to process trauma

  1. Which of the following is inconsistent with Socratic Dialogue basic rules for the therapist? A. The collaborative dialogue is goal-directed and specific. B. The therapist may use everyday experiences as therapeutic metaphors. C. Self-disclosure is frequently used to motivate the patient in problem-solving. D. Socratic Dialogue questions should be framed in a way to elicit an affirmative response.
  2. An advanced practice psychiatric nurse is sued for continuing to work with a patient despite the treatment not working. the advanced practice psychiatric nurse realizes that which of the following will be considered in this case? A Was the standard of care followed? B Was there harm to the patient? C This is a frivolous lawsuit. The advanced practice psychiatric nurse cannot be sued for this. D. A and B
  3. Which of the following is consistent with the literature regarding suicide. Check all that apply. A. Assessing patient safety is of paramount importance for the advanced practice psychiatric nurse during the initial patient contact. B. More than half of those who commit suicide do not have known mental health problems. C. The highest risk factor for suicide is a relationship problem. D. Suicidality can be assessed by using reliable and valid self- report questionnaires.
  4. Which of the following is true about the therapeutic benefit of groups in the development of socializing techniques? A. Social learning is a therapeutic factor that operates in all therapy groups. B. Groups permit members to understand there is a huge discrepancy between their intent and their actual impact on others. C. Social skills learned in therapy groups can serve individuals well in future social interactions outside of the group setting. D. All of the above

further evaluation.

  1. It is important for the new nurse psychotherapist to become comfortable with which of the following? A Learning to be directive to help the patient feel better. B Letting the psychotherapeutic process unfold over time. C Helping the patient feel better is the main goal of psychotherapy. D Building a therapeutic toolbox for a variety of “fix it” solutions for a variety of problem
  2. In psychodynamic case formulation three personality organization levels have been identified along a continuum. A patient who primarily uses primitive defenses is likely to be in which personality range? A Healthy. B Neurotic. C Psychotic. D Borderline
  3. When treating a family in which a child has been sexually abused the primary goals include which of the following? Check all that apply. A Ensure the abuse doesn’t recur. B Reduce the long-term effects of the trauma. C Preserve the integrity of the family at all costs. D A and B
  4. The challenges of a family therapist in working with families of different cultures include which of the following? Check all that apply. A. Learning to respect diversity in each unique family. B. Developing a sensitivity to some of the issues faced by those in other cultures. C. Learning to recognize the therapist’s own blind spots and biases. D. Becoming an expert on ethnicity.
  5. Internal resources include which of the following? A. Internal resources are more tangible than external resources. B. Internal resources consist of the person’s ability to manage primarily negative emotions. C. Internal resources include the person’s ability to self- soothe, demonstrate adequate impulse control, and regulate moods. D. Are intuitive and easily measured
  6. Controlled studies of psychotherapy outcomes have shown which of the following? A. The average person typically does not engage in psychotherapy.

C. The average person who receives psychotherapy shows no significant improvement. D. The average person who receives psychotherapy shows some improvement, but

  1. In classical psychodynamic therapy the therapist’s role is which of the following A. Objective. B. Subjective. C. Participant-Observer D. Enmeshed.
  2. The advanced practice psychiatric nurse is working with a couple on conflict management. They report during a recent argument the husband threw a plate across the room. Based on the current advances in neuroscience the advanced practice psychiatric nurse explains: A. People do things because of what happens in their brain. B. Biological events cause human actions. C. One can learn to activate their prefrontal cortex and retrain emotional reactions. D. Biological events always over-rides free will.
  3. In supportive psychotherapy where the patient is functioning at a child-like level in significant domains of life which basic strategy of dynamic supportive therapy would most likely be used? Diverting conflict between two people by involving a third is known as the concept of: A Emotionale a good parentBA.reactivity. Boster and protect the therapeutic Relationship triangleslliance. C Differentiation of old and contain the patient C Hself..Provide a role model rD Enmeshmentfo entificationD.
  4. Which of the following are consistent with research about adverse childhood experiences (ACE)? A. Toxic stress in early childhood plays a role in intergenerational transmission of disparities in health outcomes. B. Long-term sequelae related to neurobiological responses to childhood stress and. trauma may be inherited by subsequent generations. C. Higher maternal ACE score have been associated with psychopathology in her offspring. D All of the above.

Adverse Childhood Experiences (ACEs) have been consistently

linked to a range of negative outcomes in research, including:

1. Increased risk of mental health issues such as depression,

anxiety, and PTSD.

2. Higher likelihood of engaging in risky behaviors, including

substance abuse and unsafe sexual practices.

3. Greater incidence of chronic health conditions like heart

disease, diabetes, and obesity.

4. Impacts on brain development, leading to difficulties in

learning and memory.

5. Potential for intergenerational transmission of trauma and

health disparities.

Explanation: Research on Adverse Childhood Experiences (ACEs)

has shown that these early life stressors can have profound and

lasting effects on an individual's physical and mental health.

ACEs include experiences such as abuse, neglect, and

household dysfunction. The stress from these experiences can

disrupt brain development and lead to changes in how the body

responds to stress, which can increase the risk of various health

problems. Additionally, individuals with high ACE scores are

more likely to engage in behaviors that can further harm their

health. The concept of intergenerational transmission suggests

that the effects of ACEs can extend beyond the individual,

influencing the health and well-being of future generations. This

body of research underscores the importance of early

intervention and support to mitigate the long-term impacts of

ACEs.

  1. The advanced practice psychiatric nurse helps the patient to identify and name feelings, focus on somatic sensations associated with emotions, and encourages use of metaphor to describe feelings. This is consistent with which basic strategy of supportive psychodynamic therapy? A Make connections. B Decrease alexithymia. C Encourage patient activity. D Maximize adaptive coping mechanisms.
  2. The idea that nothing happens by chance, that every thought and all behavior has a cause refers to which of the following concepts? A Id vs ego conflict. B Super ego actions to censor and. Restrain C Psychic determinism. D Ego synchronym

D. The way families are organized into subsystems separated by emotional boundaries.

  1. The process of a group member benefitting by observing the therapy of another member with similar problems is a phenomenon refer A Modeling. B Spectator therapy. C Copy-cat. Phenomenon D Universality
  2. Good practice habits that are relevant for legal and ethical professional responsibility include which of thefollowing?Check all that apply. A. It is essential that emergency coverage is in place. B. How the patient contacts you between sessions and in emergencies should be included in the contract given to the patient during the initial session. C. Explicitly state whether you will be available for phone calls between sessions and adhere to clear limits. D. Check messages at least once per day and call back within 24 hours.
  3. The patient talking about her husband states “By the time he comes home late for the zillionth time I’m just beside myself… you know what I mean.” The CBT therapist responds saying “No, I don’t know what you mean. A Questioning the Evidence. B Downward Arrow. C Idiosyncratic Meaning. D Labeling of Distortions.
  4. A group of co-occurring, relatively invariant symptoms found in a specific cultural group, community or context, which may or may not be recognized as an illness within the culture but such cultural patterns of distress and features of illness may be recognizable by the outside observer is known as which of the following? A Cultural syndrome. B Cultural formulation. C Cultural idiom of distress. D Cultural explanation or perceived cause
  5. “They probably think I am stupid” is an example of which type of cognitive distortion? A. Comparing.

B. Mind reading. C. Objectifying the subjective. D. Externalization of self-worth.

  1. Patients who would not be considered ideal candidates for psychoanalytic psychotherapy are which of the following? A Patients with primarily primitive defenses. B Patients with primarily mature defense mechanisms. C Patients with neurotic to healthy personality organization. D Patients with the capability to engage in a therapeutic alliance.
  2. The nurse psychotherapist realizes that “true presence” in a therapeutic relationship involves which of thefollowing? Check all that apply. A. Listening to what is important to the patient. B. Listening to what the meaning of a situation is in the moment. C. “Being with” the patient rather than “doing to” the patient. d. Acceptance of nonjudgmental attitude and empathy
  3. The skilled psychotherapist assists the patient to stay in the Resilience Zone. Which of the following symptoms are consistent with hypoarousal? A Pain, anxiety, fatigue. B Emptiness, emotional paralysis, emotional numbness. C Euphoria, irritability, panic. D Angry outbursts, anxiety, exhaustion.
  4. The advanced practice psychiatric nurse working with a patient from another culture is recommended to do which of the following? A Ask the individual how he or she feels about working with you. B Automatically refer patients to a provider of the same or similar culture. C. Research the individual’s culture and let the patient know you are an expert in that culture. D. Advanced practice psychiatric nurse explains her own culture to the patient to minimize misunderstandings.
  5. Which of the following is not consistent with evidence-based research on psychodynamic therapy? A Research demonstrates psychodynamic therapy is not effective. B. Research reflects inherent difficulties in experimental controlled design for this approach. C. Most psychodynamic research consists of case studies which limits the ability to generalize to other situations and populations.

E A, B, and C

  1. Which of thefollowing is consistent research related to resilience and posttraumatic growth? A. Resilience and posttraumatic growth are inversely related. B. There is a curvilinear relationship between posttraumatic growth and resilience. C. Moderate resilience and emotional intelligence is associated with the most growth. D All of the above
  2. Which of thefollowing is not consistent with current research related to psychotherapy and psychotropic medication? A Research suggests that psychotherapy enhances the effects of psychotropic medication. B Studies comparing medication with psychotherapy found both produce similar physiological changes in the brain. C Studies comparing medication with psychotherapy found both produce physiological. changes but brain changes are different for medications than for psychotherapy. D Research suggests psychotropic medications may interfere with the learning that takes place during psychotherapy.
  3. Object relations theorists work from a framework which includes which of the following? A The central motivating force in development is the drive for gratification.. B Primary maternal preoccupation will lead to development of a false sense of self. C The central motivating force in development is that people are primarily motivated to seek other people. D. The good-enough mother creates a dynamic in which the person feels never good enough in relationships.
  4. Borderline pathology is thought to evolve from problems in which of Mahler’s stages of separation- individualization? A. Practicing B. Consolidation. C. Differentiation. D. Rapprochement.
  5. The change agent in relational psychodynamic therapy is which of the following? A. Insight. B. Interpretation of past experiences. C. Exploration of genetic roots of the problem. D. Mindfulness
  6. Cross-cultural research supports which of the following?

A. Culture determines what is considered a psychiatric disorder. B. Neurobiological mechanisms linked to stress and trauma are consistent across cultures. C. Neurobiological mechanisms linked to stress and trauma vary across cultures. D. A and B. E. A and C

  1. Which of the following is consistent with the aims of supportive psychotherapy? A. Restructure defenses. B. Strengthen defenses. C. Promote problem-solving. D. B and C
  2. The goal in a holistic paradigm is to A Cure. B Minimize symptoms. C Eliminate symptoms with medication. D Heal
  3. A patient involved in expressive psychotherapy is having intense emotional reactions to painful experiences that have been expressed. This is known as which of thefollowing? A. Immediacy. B Abreaction. C Differentiation. D. Rapprochement
  4. Which of thefollowing is true regarding the difference between brief and long-term psychodynamic psychotherapy? A. Brief psychotherapy is more effective than long-term psychodynamic psychotherapy. B. Long-term psychodynamic psychotherapy is more effective than brief psychotherapy. C. There is no qualitative difference between brief and long-term psychodynamic psychotherapy. D. Brief and long-term psychodynamic psychotherapy cannot be compared.
  5. We all have preconceptions that are brought into every situation. As a nurse psychotherapist, it is important to do which of the following? A. Eliminate all preconceptions before meeting with the patient. B Always be transparent with the patient regarding any preconceptions. C Be aware of preconceptions, what they are and how they influence our work. D Discuss preconceptions you have with the patient as others likely have preconceptions about the patient.

A. the higher the overall levels of cohesiveness are associated with significantly better. total outcome than groups with low cohesiveness. B. Group member with little sense of belonging or attraction to a group is unlikely to. have a negative outcome. C. the attraction to the group is a powerful determinant of outcome. D. A and C.

  1. The advanced practice psychiatric nurse solution-focused therapy with a family will do which of the following? A Focus on the etiology of the problem. B Focus on problem formation. C Clearly define the problem for the family and then focus on potential solutions for the family D;;
  2. Which of the following is a responsible way for the therapist to safely set appropriate limits on availability. A The therapist just needs to notify either in person or by mail that they will not be available at certain times. B The therapist has an answering machine that clearly states that if this is an emergency, the patient should go to the ED or call a crises hotline. C Ask another therapist to cover for vacations and time off, as this is for emergency only specifics about patients should not be shared. D Both A and B
  3. A therapist has decided to terminate treatment for a patient due to the patient continuing to miss scheduled appointments. a. The therapist Write a termination letter indicating only that the therapy is being terminated effective immediately. b. Send a termination letter to the patient indicating therapist concern, reason for termination, reason for patient to continue in treatment and referral to another provider if patient wants to continue in treatment and put a copy of this in the patient. Chart c. Make sure patient not in crisis and refer to a specific provider. d. B and C
  4. According to Benner’s role acquisition model, the advanced practice psychiatric nurse with 2-5 years of experience, who coordinates complex care and sees situations

as wholes with long-term solutions, is functioning at which level of competency? A Novice. B Advanced beginner. C Competency/proficiency. D Expert