Examination for Professional Practice in Psychology (EPPP) — Health Service Psychologist (HSP) — Questions and Answers

Question 1: A psychologist reviewing a study notes that participants in the intervention group received more attention from therapists than controls. This is an example of which threat to internal validity?

Attention/contact confound (Correct answer)
Instrumentation drift
Demand characteristics
Diffusion of treatment

Correct answer: Attention/contact confound

When the intervention group receives more therapist contact than controls, any effects could be due to nonspecific attention rather than the specific treatment.

Question 2: Under HIPAA's minimum necessary standard, a health service psychologist sharing records with a consulting colleague should disclose:

Only the information reasonably needed for the consultation purpose (Correct answer)
The complete treatment record to ensure full context
Only the diagnosis without any session notes
Any information the patient has previously consented to share with anyone

Correct answer: Only the information reasonably needed for the consultation purpose

HIPAA's minimum necessary standard requires limiting disclosures to only the PHI reasonably needed for the specific purpose of the disclosure.

Question 3: According to the hierarchy of controls for infection prevention in healthcare settings, which control type is most effective?

PPE use
Administrative controls
Engineering controls
Elimination of the hazard (Correct answer)

Correct answer: Elimination of the hazard

Elimination—removing the hazard entirely—sits at the top of the hierarchy of controls as the most effective infection prevention strategy.

Question 4: A psychology practice receives a complaint from a client about visible mold in the therapy room. The psychologist's primary responsibility is to:

Apply over-the-counter mold spray and continue sessions
Temporarily relocate sessions and arrange for professional mold remediation (Correct answer)
Document the complaint in the client's chart and monitor
Reassure the client that indoor mold is rarely harmful

Correct answer: Temporarily relocate sessions and arrange for professional mold remediation

Mold in clinical spaces poses respiratory and health risks; the appropriate response is to cease use of the space and arrange professional remediation.

Question 5: A psychologist reads a study reporting a hazard ratio (HR) of 1.45 (95% CI: 1.12–1.87) for depression predicting cardiac events. This means:

A 45% risk reduction occurs when depression is treated before cardiac events
Depressed patients have 45% higher instantaneous risk of a cardiac event at any given time (Correct answer)
Depressed patients have a 45% absolute increase in cardiac event rates
The study proves depression causes cardiac events in clinical populations

Correct answer: Depressed patients have 45% higher instantaneous risk of a cardiac event at any given time

A hazard ratio of 1.45 means depressed individuals have a 45% higher hazard (instantaneous event rate) compared to non-depressed individuals at any given time point.

Question 6: Which division of the peripheral nervous system carries sensory information from the body to the central nervous system?

Afferent division (Correct answer)
Efferent division
Somatic motor division
Motor division

Correct answer: Afferent division

The afferent (sensory) division carries impulses from sensory receptors toward the CNS, providing information about internal and external environments.

Question 7: In confirmatory factor analysis (CFA), the root mean square error of approximation (RMSEA) value of ≤ .06 is generally interpreted as indicating:

Perfect model fit with no residual error
Adequate reliability but insufficient validity
Poor model fit requiring respecification
Acceptable to good model fit (Correct answer)

Correct answer: Acceptable to good model fit

RMSEA ≤ .06 is considered indicative of close fit; values ≤ .08 are acceptable, while values > .10 indicate poor fit.

Question 8: When conducting neurofeedback therapy, a technician observes 60 Hz electrical noise contaminating the EEG signal. What is the BEST intervention?

Apply a notch filter at 60 Hz and check for grounding issues (Correct answer)
Reduce session duration to minimize artifact accumulation
Use higher-impedance electrodes
Increase amplifier gain settings

Correct answer: Apply a notch filter at 60 Hz and check for grounding issues

60 Hz artifact is electromagnetic interference from power lines and is best addressed with a notch filter combined with proper equipment grounding.

Question 9: When conducting a forensic psychological evaluation for the court, informed consent differs from clinical practice because:

The evaluee must be informed that the evaluation is for the court, not for their benefit, and confidentiality is limited (Correct answer)
Results can be shared only with the evaluee after the evaluation is complete
No consent is required since the court ordered the evaluation
The psychologist owes the same therapeutic duty to the evaluee as to a client

Correct answer: The evaluee must be informed that the evaluation is for the court, not for their benefit, and confidentiality is limited

In forensic contexts, psychologists must clarify the non-treatment nature of the evaluation, who will receive the report, and the limits of confidentiality, even when consent to evaluate is legally compelled.

Question 10: An electronic health record system used by a psychologist is breached, exposing 600 client records. Under HIPAA's Breach Notification Rule, the psychologist must notify:

Only HHS within 30 days with no obligation to notify clients
The state licensing board within 24 hours
Only the affected clients within 180 days
Affected clients, HHS, and prominent local media within 60 days (Correct answer)

Correct answer: Affected clients, HHS, and prominent local media within 60 days

Breaches affecting 500 or more individuals require notification to affected individuals, HHS, and prominent media outlets in the state, all within 60 days of discovery.

Question 11: Which factor most significantly inflates test scores on intelligence measures for individuals from minority cultural backgrounds, potentially leading to misdiagnosis?

Reduced processing speed due to cultural factors
Lower working memory capacity in minorities
Stereotype threat during testing
Normative sample underrepresentation (Correct answer)

Correct answer: Normative sample underrepresentation

When normative samples underrepresent minority groups, scores may be compared to non-representative norms, distorting interpretation.

Question 12: Which evidence-based treatment is specifically indicated for children with Autism Spectrum Disorder (ASD) to build functional communication and reduce problem behaviors?

Applied Behavior Analysis (ABA) (Correct answer)
Play Therapy
Narrative Exposure Therapy
Child-Centered Therapy

Correct answer: Applied Behavior Analysis (ABA)

ABA is the most empirically supported intervention for ASD, using principles of reinforcement to build adaptive skills and reduce maladaptive behaviors.

Question 13: A psychologist's patient dies by suicide. Which action BEST reflects ethical and legal obligations regarding the patient's records?

Retain records according to applicable state law and professional guidelines, typically 7–10 years (Correct answer)
Transfer all records to the patient's family without restriction
Release records only to the patient's attorney upon death
Destroy all records immediately to protect the deceased patient's privacy

Correct answer: Retain records according to applicable state law and professional guidelines, typically 7–10 years

Records must be retained according to state law (commonly 7–10 years post-termination, longer for minors) even after a patient's death, and disclosure is governed by applicable statutes and the estate's authority.

Question 14: A telehealth platform used for therapy sessions shows a 2-second audio delay. Which factor is MOST likely causing this latency?

Expired SSL certificate on the server
Incorrect screen resolution settings
Insufficient network bandwidth or high packet loss (Correct answer)
Outdated webcam firmware

Correct answer: Insufficient network bandwidth or high packet loss

Audio latency in video conferencing is predominantly caused by insufficient bandwidth or network congestion rather than hardware or certificate issues.

Question 15: In Dialectical Behavior Therapy (DBT), which module specifically targets interpersonal conflict and relationship skills?

Mindfulness
Distress Tolerance
Interpersonal Effectiveness (Correct answer)
Emotion Regulation

Correct answer: Interpersonal Effectiveness

The Interpersonal Effectiveness module teaches skills for navigating relationships, setting limits, and maintaining self-respect in interactions.

Question 16: Which of the following threats to internal validity involves participants changing over the course of a study due to natural developmental processes?

Instrumentation
Maturation (Correct answer)
Selection bias
History

Correct answer: Maturation

Maturation refers to natural changes in participants over time (e.g., aging, fatigue) that may explain outcome differences independent of the intervention.

Question 17: In a hospital-based psychology unit, a patient is placed on contact precautions for MRSA. Which PPE is required before entering the patient's room?

Surgical mask and gown
Gown and gloves (Correct answer)
N95 respirator only
Face shield and gloves

Correct answer: Gown and gloves

Contact precautions for MRSA require a gown and gloves to prevent transmission through direct contact with the patient or environment.

Question 18: Which regulatory standard MOST directly governs the electrical safety requirements for biofeedback and psychophysiological devices used in clinical settings in the United States?

IEC 60601-1 medical electrical equipment safety standard, adopted by the FDA for medical device clearance (Correct answer)
APA Ethics Code Section 9 on assessment only
HIPAA Security Rule for electronic protected health information
OSHA 1910.303 general electrical safety standards only

Correct answer: IEC 60601-1 medical electrical equipment safety standard, adopted by the FDA for medical device clearance

IEC 60601-1 is the internationally recognized standard for medical electrical equipment safety that the FDA uses as the basis for evaluating biofeedback and psychophysiological device clearance in the US.

Question 19: Which phase of the general adaptation syndrome (GAS) is characterized by the body's resistance to a stressor being at its highest?

Resistance phase (Correct answer)
Recovery phase
Alarm phase
Exhaustion phase

Correct answer: Resistance phase

During the resistance (adaptation) phase of Selye's GAS, the body has mobilized resources and maintains heightened physiological resistance to the ongoing stressor.

Question 20: Which structure in the brainstem is responsible for regulating basic life-sustaining functions such as breathing, heart rate, and blood pressure?

Medulla oblongata (Correct answer)
Pons
Midbrain
Cerebellum

Correct answer: Medulla oblongata

The medulla oblongata contains vital control centers for respiration, cardiovascular function, and other autonomic reflexes necessary for survival.

Question 21: A psychologist notices that a patient's PHQ-9 score improved from 18 to 7 after treatment. According to PHQ-9 scoring, this represents a shift from:

Severe to mild depression (Correct answer)
Moderate to minimal depression
Moderately severe to mild depression
Moderate to none/minimal depression

Correct answer: Severe to mild depression

A PHQ-9 score of 15–19 indicates moderately severe depression, and a score of 5–9 indicates mild depression.

Question 22: A psychologist working in a group practice wants to share a client's record with a colleague for peer consultation. The APPROPRIATE approach under HIPAA is to:

Use de-identified information when possible; if not, use the minimum necessary PHI (Correct answer)
Restrict all peer consultation because it violates confidentiality
Share the full record freely since both providers are in the same practice
Obtain written authorization from the client before any consultation

Correct answer: Use de-identified information when possible; if not, use the minimum necessary PHI

Peer consultation for treatment purposes is permitted under HIPAA's treatment exception, but the minimum necessary standard still applies, so de-identified information should be used when feasible.

Question 23: Acceptance and Commitment Therapy (ACT) differs from traditional CBT primarily because it:

Uses medication as a primary tool
Focuses on challenging and correcting distorted thoughts
Aims to eliminate negative emotions entirely
Encourages acceptance of thoughts without trying to change their content (Correct answer)

Correct answer: Encourages acceptance of thoughts without trying to change their content

ACT promotes psychological flexibility by teaching clients to accept inner experiences and defuse from unhelpful thoughts rather than disputing them.

Question 24: In which situation may a psychologist ethically WITHHOLD a copy of records from a client who requests them?

When the psychologist believes access could cause substantial harm to the client or a third party (Correct answer)
When the records were created more than five years ago
When the client has an outstanding balance for services rendered
When the client is currently involved in active litigation

Correct answer: When the psychologist believes access could cause substantial harm to the client or a third party

APA Ethics Code 6.02 and HIPAA permit denial of record access when a licensed professional determines that access could cause substantial harm to the client or another person.

Question 25: In multiple regression, multicollinearity is most problematic because it:

Inflates Type I error rates for the overall F-test
Reduces the R² of the model to near zero
Increases standard errors of individual regression coefficients (Correct answer)
Violates the assumption of normally distributed residuals

Correct answer: Increases standard errors of individual regression coefficients

Multicollinearity inflates standard errors of regression coefficients, making individual predictors appear non-significant even when they have real effects.

Question 26: During a structured clinical interview, a patient endorses persistent worry about multiple life domains lasting more than 6 months with difficulty controlling it. The most likely diagnosis is:

Generalized Anxiety Disorder (Correct answer)
Adjustment Disorder with Anxious Mood
Panic Disorder
Obsessive-Compulsive Disorder

Correct answer: Generalized Anxiety Disorder

GAD requires at least 6 months of excessive, difficult-to-control worry about multiple areas accompanied by physical symptoms.

Question 27: When interpreting psychological test scores, a psychologist must consider the concept of regression to the mean. This concept is most clinically relevant when:

Selecting a normative sample for comparison
Determining whether a patient has met criteria for a diagnosis
Interpreting the overall profile elevation on the MMPI-2
Re-evaluating a patient after initial extreme test scores to determine true change (Correct answer)

Correct answer: Re-evaluating a patient after initial extreme test scores to determine true change

Extreme scores on initial testing tend to move toward the population mean on retesting regardless of intervention, which must be distinguished from genuine improvement.

Question 28: A psychologist notices they have developed strong romantic feelings for a current therapy client. The FIRST action should be:

Seek personal therapy or supervision to address the feelings and protect the client (Correct answer)
Transfer the client to a colleague without explanation
Immediately terminate therapy and pursue the relationship after 2 years
Disclose the feelings to the client to maintain transparency

Correct answer: Seek personal therapy or supervision to address the feelings and protect the client

When experiencing countertransference feelings, psychologists must seek supervision or personal therapy to prevent harm to the client and protect professional boundaries.

Question 29: Evidence-based treatment for Panic Disorder typically includes which core component?

Avoidance of all anxiety-provoking situations
Hypnotherapy for root-cause identification
Interoceptive exposure to feared bodily sensations (Correct answer)
Long-term anxiolytic medication as primary treatment

Correct answer: Interoceptive exposure to feared bodily sensations

Interoceptive exposure involves deliberately inducing panic-like sensations (e.g., hyperventilating, spinning) to reduce fear of physical symptoms.

Examination for Professional Practice in Psychology (EPPP) — Health Service Psychologist (HSP)

The EPPP is the required standardized licensing examination for Health Service Psychologists (HSP), assessing knowledge across eight domains including biological bases, assessment and diagnosis, treatment, ethics, and research methods to qualify for independent psychology practice.

Questions

35 min

Time Limit

70%

To Pass

Checking for saved progress...

Exam Rules

You can skip questions and return to them later
Flag questions for review before submitting
No feedback shown until you submit the entire exam
Unanswered questions count as wrong — answer everything
10 pretest questions are mixed in and don't affect your score
Timer auto-submits when time runs out
Your progress is auto-saved every 30 seconds