MSN-674-001-2026-030 Mid term exam 3 Northern Kentucky University

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Free MSN-674-001-2026-030 Mid term exam 3 Northern Kentucky University Questions

1. Therapists using this type of theoretical framework help clients to see how the client has incorporated many irrational beliefs into their thinking and encourages the client to engage in activities to counter self-defeating beliefs by replacing "woulda/coulda/shoulda" thinking with rational preferences:
  • Psychodynamic Therapy

  • Existential Therapy

  • Person-Centered Therapy

  • Rational Emotive Behavior Therapy

Explanation

Explanation
Correct Answer: D) Rational Emotive Behavior Therapy
Rational Emotive Behavior Therapy (REBT), developed by Albert Ellis, is built on the premise that psychological distress arises from irrational beliefs people hold about themselves and the world. A hallmark of REBT is challenging "musturbatory" thinking — the rigid demands expressed as "should," "must," "ought," "coulda," and "woulda" — and replacing them with flexible, rational preferences. Therapists actively dispute these irrational beliefs and assign homework activities to reinforce rational thinking patterns.
Psychodynamic therapy focuses on unconscious processes and past experiences. Existential therapy explores meaning, freedom, and responsibility. Person-Centered therapy emphasizes unconditional positive regard and self-actualization — none of these specifically target irrational beliefs or "shoulda/coulda/woulda" thinking the way REBT does.
2. Jill is able to understand the concept of "You can lead a horse to water but you can't make him drink." What is, most likely, her age (according to Piaget)?
  • 5

  • 22

  • 12

  • 7

Explanation

Explanation
Correct Answer: C) 12
According to Piaget's stages of cognitive development, understanding abstract concepts, metaphors, and proverbs requires formal operational thinking, which begins around age 11–12. The saying "you can lead a horse to water but you can't make him drink" is an abstract metaphor meaning you cannot force someone to do something against their will. A child of 5 or 7 would be in the preoperational or concrete operational stage, where thinking is literal and they would interpret the statement as being literally about a horse. At age 12, the child has entered formal operations and can grasp the abstract, figurative meaning. Age 22 would also be correct neurologically, but 12 is the earliest and most precise developmental milestone according to Piaget.
3. Match the following brain structures with the known alterations in brain development/function from traumatic experiences and/or adverse events, or physiological structure:
  • Thalamus
  • Cerebellum
  • Locus Coeruleus
  • Hippocampus
  • Amygdala
  • Activated by stress response, makes norepinephrine, triggers cascade allowing instinctual responses to override cognition

  • Reduced size of this brain structure and association with ADHD, depression, bipolar disorder, schizophrenia, and autism diagnoses

  • Irritability of this part of the brain has been implicated in ADHD, PTSD, substance use disorders, and borderline personality disorder

  • Closely associated with the amygdala, decreased functioning due to elevated cortisol levels

  • Significant memory problems and inability to integrate memories into the present

Explanation

Explanation
Correct Matches:
Thalamus → C) Trauma-related irritability of the thalamus has been implicated in ADHD, PTSD, substance use disorders, and borderline personality disorder — as it plays a central role in sensory processing and emotional regulation.
Cerebellum → B) Trauma is associated with reduced cerebellar size, which has been linked to ADHD, depression, bipolar disorder, schizophrenia, and autism spectrum diagnoses.
Locus Coeruleus → A) The locus coeruleus is the brain's primary norepinephrine-producing center and is activated during stress, triggering cascades that allow survival-based instinctual responses to override higher cognitive functioning.
Hippocampus → D) The hippocampus is closely associated with the amygdala and is particularly vulnerable to elevated cortisol from chronic stress, leading to decreased volume and impaired functioning.
Amygdala → E) Trauma disrupts the amygdala's role in memory processing, leading to significant memory problems and difficulty integrating traumatic memories into a coherent present-tense narrative.
4. The ANA issued a statement regarding the use of social media by health care providers. Which venue do they encourage nurses to work to protect the confidentiality of all patient information? Choose the BEST answer:
  • Place of Employment

  • Social media

  • General Communication

  • Private groups

  • Public venues

Explanation

Explanation
Correct Answer: A) Place of Employment
The ANA's social media guidelines emphasize that nurses are responsible for protecting patient confidentiality in all venues, but the primary and most critical setting where these protections must be actively enforced is the place of employment. The workplace is where patient information is accessed, discussed, and documented — making it the foundational venue where confidentiality policies, HIPAA compliance, and professional conduct standards must be upheld at all times.
5. A therapeutic alliance has no relationship to increased adherence to pharmacologic interventions.
  • True

  • False

Explanation

Explanation
Correct Answer: B) False
Research consistently demonstrates that a strong therapeutic alliance — the collaborative, trusting relationship between clinician and client — significantly improves medication adherence. When clients feel heard, respected, and understood, they are far more likely to follow through with prescribed pharmacologic treatment plans, attend follow-up appointments, and report side effects honestly.
6. Which theorist's approach is most commonly associated with the nursing process?
  • Peplau

  • Freud

  • Frankl

  • Yalom

Explanation

Explanation
Correct Answer: A) Peplau
Hildegard Peplau is widely regarded as the "mother of psychiatric nursing" and her interpersonal relations theory is most directly associated with the nursing process. Peplau's framework — which outlines the therapeutic nurse-patient relationship through the phases of orientation, working, and termination — provided the foundational structure upon which the systematic nursing process (assessment, diagnosis, planning, implementation, evaluation) was built. Her work emphasized the nurse's role as a therapeutic agent and shaped modern nursing practice fundamentally.
Option B, Freud, is associated with psychoanalytic/psychodynamic theory. Option C, Frankl, is associated with logotherapy and existential meaning-making. Option D, Yalom, is associated with existential psychotherapy and group therapy — none of which are primarily linked to the nursing process.
7. Behavioral practitioners recognize that the role of the therapeutic relationship between the client and the therapist, so behavioral therapists assert that:
  • Acceptance of the client by the therapist is all that is required for change to occur

  • Warmth, empathy, authenticity and acceptance of the client by the therapist are necessary but not sufficient for change to occur

  • therapist and client should have personal engagement and kind personal regard

  • therapist and client may have a collaborative working relationship

Explanation

Explanation
Correct Answer: D) therapist and client may have a collaborative working relationship
Behavioral therapists view the therapeutic relationship as a collaborative working partnership focused on identifying target behaviors and implementing evidence-based interventions. Unlike humanistic approaches, behaviorists do not see the relationship itself as the agent of change, but rather as a professional alliance that supports the structured application of behavioral techniques.
Option A reflects an oversimplification inconsistent with behavioral theory. Option B describes the humanistic/person-centered view (Rogers), where core conditions are necessary but not sufficient — this belongs to existential-humanistic frameworks, not behavioral ones. Option C describing personal engagement and kind personal regard is more aligned with person-centered or relational approaches.
8. The Nurse Practitioner (NP) role was introduced in ________ at the University of Colorado by Loretta Ford, EdD and Henry Silver, MD.
  • 1910

  • 1965

  • 1985

  • 1945

Explanation

Explanation
Correct Answer: B) 1965
The Nurse Practitioner role was formally established in 1965 at the University of Colorado through a collaborative program created by Loretta Ford, a nurse educator, and Henry Silver, a pediatrician. This landmark program marked the beginning of the advanced practice nursing movement in the United States, expanding the scope of nursing practice to include primary care functions previously performed only by physicians.
9. According to Maslow's Hierarchy of Needs, rank the needs from the most basic (Level 1) to the highest (Level 5):
  • Physiological Needs
  • Safety & Security
  • Love & Belonging
  • Self-esteem
  • Self-actualization

Explanation

Explanation
Correct Ranking:

Physiological Needs → Level 1 The most fundamental survival needs — food, water, sleep, warmth, and air — must be met before any other needs can be addressed.

Safety & Security → Level 2 Once physiological needs are met, the person seeks physical safety, stability, freedom from fear, and a secure environment.

Love & Belonging → Level 3 Social needs including friendship, intimacy, family connection, and a sense of belonging become the focus once safety is established.

Self-esteem → Level 4 The need for self-respect, achievement, recognition, and the esteem of others becomes prominent once social needs are fulfilled.

Self-actualization → Level 5 The highest level — realizing one's fullest potential, pursuing personal growth, creativity, and purpose — can only be reached when all lower needs are sufficiently met.

10. Aaron Beck's original research showed that clients were best helped when the therapist:
  • helped clients become aware of and change negative thought patterns

  • showed empathy and unconditional kind regard

  • accepted the client where the client is

  • gradually exposed the client to a phobia

Explanation

Explanation
Correct Answer: A) helped clients become aware of and change negative thought patterns
Aaron Beck, the founder of Cognitive Therapy (CT), discovered through his research that clients improved most when therapists helped them identify and restructure distorted or negative thought patterns. This became the foundation of Cognitive Behavioral Therapy (CBT), which targets automatic negative thoughts and cognitive distortions to reduce psychological distress.
Showing empathy and unconditional positive regard is associated with Carl Rogers' Person-Centered Therapy, not Beck's approach. Accepting the client where they are is also a humanistic/person-centered concept. Gradual exposure to phobias is a behavioral technique associated with systematic desensitization, developed by Joseph Wolpe, not Aaron Beck.

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