{"id":131982,"date":"2024-01-29T11:11:39","date_gmt":"2024-01-29T11:11:39","guid":{"rendered":"https:\/\/learnexams.com\/blog\/?p=131982"},"modified":"2024-01-29T11:11:42","modified_gmt":"2024-01-29T11:11:42","slug":"exam-2-nr548-nr-548-latest-update-2024-2025-psychiatric-assessment-for-the-psychiatric-mental-health-nurse-practitioner-review-weeks-3-4-covered-questions-and-verified-answers-100-correct-cha","status":"publish","type":"post","link":"https:\/\/www.learnexams.com\/blog\/2024\/01\/29\/exam-2-nr548-nr-548-latest-update-2024-2025-psychiatric-assessment-for-the-psychiatric-mental-health-nurse-practitioner-review-weeks-3-4-covered-questions-and-verified-answers-100-correct-cha\/","title":{"rendered":"Exam 2: NR548\/ NR 548 (Latest Update 2024\/ 2025) Psychiatric Assessment for the Psychiatric-Mental Health Nurse Practitioner Review |Weeks 3-4 Covered| Questions and Verified Answers| 100% Correct- Chamberlain"},"content":{"rendered":"\n<p>Exam 2: NR548\/ NR 548 (Latest Update 2024\/ 2025) Psychiatric Assessment for the Psychiatric-Mental Health Nurse Practitioner Review |Weeks 3-4 Covered| Questions and Verified Answers| 100% Correct- Chamberlain<\/p>\n\n\n\n<p>Exam 2: NR548\/ NR 548 (Latest Update<br>2024\/ 2025) Psychiatric Assessment for the<br>Psychiatric-Mental Health Nurse<br>Practitioner Review |Weeks 3-4 Covered|<br>Questions and Verified Answers| 100%<br>Correct- Chamberlain<br>Q: Reduction of guilt<br>Answer:<br>seeks to directly reduce a patient&#8217;s guilt about a specific behavior in order to discover what they<br>have been doing<br>-useful in obtaining a hx of domestic violence &amp; other antisocial behavior<br>Domestic Violence<br>-&#8220;Have you ever been in situations where fights occurred and you were affected?&#8221;<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>If patient answers &#8220;yes,&#8221; you can flesh out whether role was being a witness, victim, or<br>perpetrator<br>Q: According to Peplau&#8217;s Theory of Interpersonal Relations, establishing early rapport allows<br>the role of the nurse to evolve from stranger to:<br>Answer:<br>resource person, teacher, leader, surrogate, technical expert, and counselor<br>Q: Establishing the Relationship<br>Answer:<br>-Trust is essential for a therapeutic alliance<br>-First impressions are important<br>-PMHNP should take time to make introductions and ensure the client is comfortable<br>-Ask general questions to arrive at an empathic understanding of how the client feels<\/li>\n<\/ul>\n\n\n\n<p>-Listen carefully and communicate an appreciation for the client&#8217;s concerns<br>-Building a trusting relationship based on respect, kindness, and acceptance will break down<br>barriers and allow for client needs to be the center of the plan of care<br>-Being present and openly engaged will enhance the communication experience<br>Q: three phases of the psychiatric interview<br>Answer:<\/p>\n\n\n\n<ol class=\"wp-block-list\">\n<li>Opening phase<\/li>\n\n\n\n<li>Body of the Interview<\/li>\n\n\n\n<li>Closing the Interview<br>Q: Opening phase<br>Answer:<br>-first 5-10 minutes<br>-establish rapport &amp; therapeutic alliance<br>-often most important phase<\/li>\n<\/ol>\n\n\n\n<ul class=\"wp-block-list\">\n<li>establishes the foundation<br>-begins with PMHNP asking &#8220;what brought you in to see me today?&#8221;<br>Q: Body of the Interview<br>Answer:<br>-30-40 minutes<br>-Chief Complaint Established<\/li>\n\n\n\n<li>additional Q&#8217;s asked to elicit info r\/t the complaint<br>-ask about HPI, family hx, social\/developmental hx, medical hx, psychiatric ROS<br>-basis for dx and tx formulation<br>Q: Closing the Interview<br>Answer:<\/li>\n<\/ul>\n\n\n\n<p>-5-10 minutes, final phase<br>Should include 2 components: discussion of your assessment using patient education techniques<br>&amp; negotiated agreement about tx or f\/u plans<br>-wrap-up statement and inquiry about missing info that may be of value<br>-Patient education regarding working dx &amp; recommended plan of tx<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>education about meds if recommended<br>-Homework may be assigned<\/li>\n\n\n\n<li>especially in CBT<br>-Return visit agreed upon<br>Q: Four Tasks of the Diagnostic Interview<br>Answer:<\/li>\n<\/ul>\n\n\n\n<ol class=\"wp-block-list\">\n<li>Build a therapeutic alliance<\/li>\n\n\n\n<li>Obtain the psychiatric database<\/li>\n\n\n\n<li>Interview for diagnosis<\/li>\n\n\n\n<li>Negotiate a tx plan with your patient<br>Q: Obtain the Psychiatric Database<br>Answer:<br>Also known as the psychiatric history<br>-includes historical information relevant to the current clinical presentation<\/li>\n<\/ol>\n\n\n\n<ul class=\"wp-block-list\">\n<li>history of present illness, psychiatric history, medical history, family psychiatric history, and<br>aspects of the social and developmental history<br>Q: Tricks for Improving Patient Recall<br>Answer:<br>-Anchor Questions to Memorable Events<\/li>\n\n\n\n<li>major transitions (graduations and birthdays), holidays, accidents or illnesses, major purchases<br>(a house or a car), seasonal events (&#8220;hurricane Katrina&#8221;), or public events (such as 9\/11 or<br>President Obama&#8217;s election)<br>-Tag Questions with Specific Examples<br>Powered by<a href=\" https:\/\/learnexams.com\/search\/study?query=\"> https:\/\/learnexams.com\/search\/study?query=<\/a><\/li>\n\n\n\n<li><\/li>\n<\/ul>\n\n\n\n<p>Psychiatric interview<br>the process by which psychiatric assessment is conducted<br>-primary tasks<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>building a therapeutic alliance between the PMHNP &amp; client<\/li>\n\n\n\n<li>obtaining a database of psychiatric info about the client<\/li>\n\n\n\n<li>establishing a dx<\/li>\n\n\n\n<li>negotiating a tx plan<\/li>\n<\/ul>\n\n\n\n<p>Therapeutic Alliance<br>a feeling that you should create over the course of the diagnostic interview, a sense of rapport, trust, and warmth<br>-most important goal of the interview process<br>-the cooperative working relationship between the therapist and client<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>begins during the initial or opening phase of the interview<br>-fundamental component of successful therapy<\/li>\n\n\n\n<li>Without trust, adherence to treatment recommendations may be compromised<\/li>\n\n\n\n<li>interview may not elicit the information needed to formulate an appropriate dx &amp; plan of care without rapport &amp; trust<\/li>\n<\/ul>\n\n\n\n<p>Creating rapport: tips<br>-Be Yourself<br>-Be Warm, Courteous, and Emotionally Sensitive<br>-Actively Defuse the Strangeness of the Clinical Situation<br>-Give Your Patient the Opening Word<br>-Gain Your Patient&#8217;s Trust by Projecting Competence<\/p>\n\n\n\n<p>How to approach threatening topics (sensitive\/embarrassing material)<br>-Normalization<br>-Symptom Expectation<br>-Symptom Exaggeration<br>-Reduction of Guilt<br>-Use Familiar Language When Asking about Behaviors<\/p>\n\n\n\n<p>Normalization<br>Introducing Q with some type of normalizing statement<br>-two principal ways to do this:<\/p>\n\n\n\n<ol class=\"wp-block-list\">\n<li>start the question by implying that the behavior is a normal or understandable response to a mood or situation<\/li>\n<\/ol>\n\n\n\n<ul class=\"wp-block-list\">\n<li>ex: Sometimes when people are very depressed, they think of hurting themselves. Has this been true for you?<\/li>\n<\/ul>\n\n\n\n<ol class=\"wp-block-list\">\n<li>Begin by describing another patient (or patients) who has engaged in the behavior, showing your patient that she is not alone<\/li>\n<\/ol>\n\n\n\n<ul class=\"wp-block-list\">\n<li>ex: I&#8217;ve talked to several patients who&#8217;ve said that their depression causes them to have strange experiences, like hearing voices or thinking that strangers are laughing at them. Has that been happening to you?<\/li>\n<\/ul>\n\n\n\n<p>Symptom Expectation<br>communicate that a behavior is in some way normal or expected<br>-Phrase your Q&#8217;s to imply that you already assume the patient has engaged in some behavior and that you will not be offended by a positive response<br>-high index of suspicion of some self-destructive activity<br>-Ex: patient is profoundly depressed and has expressed feelings of hopelessness. You suspect suicidality, but you sense that the patient may be too ashamed to admit it. Rather than gingerly asking &#8220;Have you had any thoughts that you&#8217;d be better off dead?&#8221; you might decide to use symptom expectation. &#8220;What kinds of ways to hurt yourself have you thought about?&#8221;<\/p>\n\n\n\n<p>*reserve this technique for situations in which it seems appropriate<\/p>\n\n\n\n<p>Symptom Exaggeration<br>suggesting a frequency of a problematic behavior that is higher than your expectation, so that the patient feels that their actual, lower frequency of the behavior will not be perceived by you as being &#8220;bad.&#8221;<br>-helpful in clarifying the severity of symptoms<\/p>\n\n\n\n<p>*reserve this technique for situations in which it seems appropriate<\/p>\n\n\n\n<p>Reduction of guilt<br>seeks to directly reduce a patient&#8217;s guilt about a specific behavior in order to discover what they have been doing<br>-useful in obtaining a hx of domestic violence &amp; other antisocial behavior<\/p>\n\n\n\n<p>Domestic Violence<br>-&#8220;Have you ever been in situations where fights occurred and you were affected?&#8221;<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>If patient answers &#8220;yes,&#8221; you can flesh out whether role was being a witness, victim, or perpetrator<\/li>\n<\/ul>\n\n\n\n<p>According to Peplau&#8217;s Theory of Interpersonal Relations, establishing early rapport allows the role of the nurse to evolve from stranger to:<br>resource person, teacher, leader, surrogate, technical expert, and counselor<\/p>\n\n\n\n<p>Establishing the Relationship<br>-Trust is essential for a therapeutic alliance<br>-First impressions are important<br>-PMHNP should take time to make introductions and ensure the client is comfortable<br>-Ask general questions to arrive at an empathic understanding of how the client feels<br>-Listen carefully and communicate an appreciation for the client&#8217;s concerns<br>-Building a trusting relationship based on respect, kindness, and acceptance will break down barriers and allow for client needs to be the center of the plan of care<br>-Being present and openly engaged will enhance the communication experience<\/p>\n\n\n\n<p>three phases of the psychiatric interview<\/p>\n\n\n\n<ol class=\"wp-block-list\">\n<li>Opening phase<\/li>\n\n\n\n<li>Body of the Interview<\/li>\n\n\n\n<li>Closing the Interview<\/li>\n<\/ol>\n\n\n\n<p>Opening phase<br>-first 5-10 minutes<br>-establish rapport &amp; therapeutic alliance<br>-often most important phase<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>establishes the foundation<br>-begins with PMHNP asking &#8220;what brought you in to see me today?&#8221;<\/li>\n<\/ul>\n\n\n\n<p>Body of the Interview<br>-30-40 minutes<br>-Chief Complaint Established<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>additional Q&#8217;s asked to elicit info r\/t the complaint<br>-ask about HPI, family hx, social\/developmental hx, medical hx, psychiatric ROS<br>-basis for dx and tx formulation<\/li>\n<\/ul>\n\n\n\n<p>Closing the Interview<br>-5-10 minutes, final phase<br>Should include 2 components: discussion of your assessment using patient education techniques &amp; negotiated agreement about tx or f\/u plans<br>-wrap-up statement and inquiry about missing info that may be of value<br>-Patient education regarding working dx &amp; recommended plan of tx<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>education about meds if recommended<br>-Homework may be assigned<\/li>\n\n\n\n<li>especially in CBT<br>-Return visit agreed upon<\/li>\n<\/ul>\n\n\n\n<p>Four Tasks of the Diagnostic Interview<\/p>\n\n\n\n<ol class=\"wp-block-list\">\n<li>Build a therapeutic alliance<\/li>\n\n\n\n<li>Obtain the psychiatric database<\/li>\n\n\n\n<li>Interview for diagnosis<\/li>\n\n\n\n<li>Negotiate a tx plan with your patient<\/li>\n<\/ol>\n\n\n\n<p>Obtain the Psychiatric Database<br>Also known as the psychiatric history<br>-includes historical information relevant to the current clinical presentation<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>history of present illness, psychiatric history, medical history, family psychiatric history, and aspects of the social and developmental history<\/li>\n<\/ul>\n\n\n\n<p>Tricks for Improving Patient Recall<br>-Anchor Questions to Memorable Events<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>major transitions (graduations and birthdays), holidays, accidents or illnesses, major purchases (a house or a car), seasonal events (&#8220;hurricane Katrina&#8221;), or public events (such as 9\/11 or President Obama&#8217;s election)<\/li>\n<\/ul>\n\n\n\n<p>-Tag Questions with Specific Examples<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>similar to posing multiple-choice questions, specifically for areas in which your patient is having trouble with recall<\/li>\n<\/ul>\n\n\n\n<p>-Define Technical Terms<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>patient&#8217;s vague recall may be a lack of understanding of terms<\/li>\n<\/ul>\n\n\n\n<p>How to Change Topics with Style<br>-Smooth Transition<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>cue off something the patient just said to introduce a new topic<\/li>\n<\/ul>\n\n\n\n<p>-Referred Transition<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>refer to something the patient said earlier in the interview to move to a new topic<\/li>\n<\/ul>\n\n\n\n<p>-Introduced Transition<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>introduce the next topic or series of topics before actually launching into it<\/li>\n<\/ul>\n\n\n\n<p>Techniques for the Reluctant Patient<br>-Open-Ended Questions and Commands<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>increase the flow of information<\/li>\n<\/ul>\n\n\n\n<p>-Continuation Techniques, keep the flow coming:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Go on.<\/li>\n\n\n\n<li>Uh huh.<\/li>\n\n\n\n<li>Continue with what you were saying about\u2026<\/li>\n\n\n\n<li>Really?<\/li>\n\n\n\n<li>Wow<\/li>\n<\/ul>\n\n\n\n<p>-Neutral Ground<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>changing the subject to something nonpsychiatric, with the intention of sidling back into your territory once you&#8217;ve gained the patient&#8217;s trust.<\/li>\n<\/ul>\n\n\n\n<p>-Second Interview<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>When all else fails<br>*must feel comfortable that the patient is not at imminent risk of suicide or other dangerous behaviors<\/li>\n<\/ul>\n\n\n\n<p>Techniques for the Overly Talkative Patient<br>-Closed-ended and multiple-choice questions<\/p>\n\n\n\n<p>-Redirecting questions to another topic<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>The Art of the Gentle Interruption<\/li>\n\n\n\n<li>redirecting statement<\/li>\n\n\n\n<li>empathic interruption, you add an empathic statement to soften the blow<\/li>\n\n\n\n<li>educating interruption incorporates a structuring statement in which you educate the patient about the sorts of questions you have yet to ask and the time constraints you&#8217;re both working under<\/li>\n<\/ul>\n\n\n\n<p>-Structuring statements regarding information required and\/or clinical procedures<\/p>\n\n\n\n<p>-brisk, highly controlling style<\/p>\n\n\n\n<p>therapeutic or nontherapeutic communication &amp; communication technique it represents: Why are you so anxious?<br>Nontherapeutic<br>communication technique: Asking for Explanations<\/p>\n\n\n\n<p>therapeutic or nontherapeutic communication &amp; communication technique it represents: Why don&#8217;t you and John get married?<br>Nontherapeutic<br>communication technique: Asking Personal Questions<\/p>\n\n\n\n<p>therapeutic or nontherapeutic communication &amp; communication technique it represents: What would you like to talk about today?<br>Therapeutic<br>communication technique: Broad Openings<\/p>\n\n\n\n<p>therapeutic or nontherapeutic communication &amp; communication technique it represents: What do you think you should do about it?<br>Therapeutic<br>communication technique: Reflecting<\/p>\n\n\n\n<p>therapeutic or nontherapeutic communication: Older adults are always confused.<br>Nontherapeutic<\/p>\n\n\n\n<p>therapeutic or nontherapeutic communication &amp; communication technique it represents: I don&#8217;t see anyone else in the room.<br>Therapeutic<br>communication technique: Presenting Reality<\/p>\n\n\n\n<p>therapeutic or nontherapeutic communication &amp; communication technique it represents: If I was you, I&#8217;d take a break from school.<br>Nontherapeutic<br>communication technique: Giving Advice<\/p>\n\n\n\n<p>therapeutic or nontherapeutic communication &amp; communication technique it represents: I&#8217;m so sorry about your mastectomy; it must be terrible to lose a breast.<br>Therapeutic<br>communication technique: Sympathy<\/p>\n\n\n\n<p>therapeutic or nontherapeutic communication &amp; communication technique it represents: Today we have talked about a plan for you to manage feelings of anger.<br>Therapeutic<br>communication technique: Summarizing<\/p>\n\n\n\n<p>therapeutic or nontherapeutic communication &amp; communication technique it represents: You shouldn&#8217;t even think about assisted suicide; it&#8217;s not right.<br>Nontherapeutic<br>communication technique: Disapproval<\/p>\n\n\n\n<p>therapeutic or nontherapeutic communication &amp; communication technique it represents: You seem upset about something.<br>Therapeutic<br>communication technique: Making an Observation<\/p>\n\n\n\n<p>therapeutic or nontherapeutic communication &amp; communication technique it represents: No one here would intentionally lie to you.<br>Nontherapeutic<br>communication technique: Defensive Responses<\/p>\n\n\n\n<p>therapeutic or nontherapeutic communication &amp; communication technique it represents: Don&#8217;t worry, everything will be all right.<br>Nontherapeutic<br>communication technique: False Reassurance<\/p>\n\n\n\n<p>Translating emotions:<br>Sharing observations<br>Sharing empathy<br>Sharing hope<br>Sharing humor<br>Sharing feelings<\/p>\n\n\n\n<p>Non-verbal communication:<br>Active listening<br>Using touch<br>Using silence<\/p>\n\n\n\n<p>Information verification\/dissemination:<br>Providing information<br>Clarifying<br>Focusing<br>Paraphrasing<br>Validation<br>Asking relevant questions<\/p>\n\n\n\n<p>Psychiatric Interview versus the Medical Interview<br>most notable difference is that the psychiatric interview is the primary diagnostic tool used to identify psychiatric conditions.<br>-Unlike the diagnostic process in physical medicine, psychiatric diagnoses are not generally established or validated by physical examinations, laboratory tests, or other diagnostic procedures<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>such processes may be used to rule out physical causes for psychiatric symptoms<br>-need for privacy and confidentiality may be heightened in psychiatric interviewing due to the sensitive nature of the information shared<\/li>\n\n\n\n<li>mental health diagnoses are associated with stigma in certain cultures<\/li>\n\n\n\n<li>Safeguarding privacy is critical for building trust and protecting the client from adverse outcomes<\/li>\n<\/ul>\n\n\n\n<p>Preparing for the Psychiatric Interview<br>consideration of the setting and timing of the interview, as well as the unique needs of the client.<br>-secure a space<br>-protect your time<\/p>\n\n\n\n<p>Secure a space<br>-Schedule the same time every week<br>-Make your room your own in some way<br>-Arrange the seating so that you can see a clock<\/p>\n\n\n\n<p>protect your time<br>-Arrive Earlier than the Patient<br>-Prevent Interruptions<br>-Don&#8217;t Overbook Patients<br>-Leave Plenty of Time for Notes and Paperwork<\/p>\n\n\n\n<p>Psychiatric interview setting<br>typically in either the inpatient or outpatient setting<br>-inpatient interviews in the emergency department, psychiatric unit, or any unit in the hospital, often serving in a consultation-liaison role<br>-Outpatient care: clinics, community mental health centers, residential care facilities, private practice, primary care, homeless shelters, or homecare<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>may self-refer or be referred by another provider for support, guidance, and medication management, or court-ordered therapy<\/li>\n<\/ul>\n\n\n\n<p>interview environment<br>-comfortable, clean space to put provider &amp; client at ease<br>-a visible clock to monitor time<br>-access to alarms or other safety measures<br>-provider access to the door for safe exiting<br>-removal of sharp objects such as scissors or letter openers<br>-a noise-canceling device for privacy<\/p>\n\n\n\n<p>Interview: Time Considerations<br>Be on time.<br>-Don&#8217;t be late!<br>-Schedule appointments thoughtfully to ensure promptness.<\/p>\n\n\n\n<p>Stay on time.<br>-builds trust and communicates that respect for the client.<\/p>\n\n\n\n<p>Discuss follow-up visits in the closure phase of the interview<br>-The timing of subsequent visits is informed by the client&#8217;s unique circumstances, diagnosis and treatment, and medication regimens.<\/p>\n\n\n\n<p>Therapeutic Communication<br>Verbal<br>-Active Listening: listening attentively to insure understanding<br>-Broad Openings: allow clients to take initiative<br>-Accepting: indicate you heard the client without judgment<br>-Clarifying: make vague topics clear<br>-Exploring: examine topics deeper<br>-Focusing: putting attention into a single topic<br>-Reflecting: direct the client&#8217;s thoughts and feelings back to the client<br>-Restating: repeat the client&#8217;s words in a different way to make more clear<\/p>\n\n\n\n<p>Nonverbal<br>-Positive techniques<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>relaxed movements<\/li>\n\n\n\n<li>open arm gestures<\/li>\n\n\n\n<li>smiles<\/li>\n\n\n\n<li>respect for personal space<\/li>\n\n\n\n<li>eye contact<\/li>\n\n\n\n<li>nods when clients talk can communicate agreement or understanding<br>-negative body language<\/li>\n\n\n\n<li>finger-pointing<\/li>\n\n\n\n<li>crossed arms<\/li>\n\n\n\n<li>looking at a watch<\/li>\n<\/ul>\n\n\n\n<p>Psychiatric Interview Long Form<br>adapted from the one used by Anthony Erdmann, an attending psychiatrist at MGH. He takes notes on it while talking to patients and puts it in his chart<\/p>\n\n\n\n<p>Advantages<br>-ensures a thorough data evaluation and saves time, because notes can be placed directly into the chart<\/p>\n\n\n\n<p>Disadvantages<br>-patients may be alienated if you seem more interested in completing a form than in getting to know them<\/p>\n\n\n\n<p>Psychiatric Interview Short Form<br>can be used for rough notes<br>-when you are going to dictate the evaluation or write it up in a longer version later.<\/p>\n\n\n\n<p>Advantages<br>-presents less of a barrier between clinician and patient<br>-easy to refer to while dictating.<\/p>\n\n\n\n<p>Disadvantages<br>-may lead to a less thorough evaluation<\/p>\n\n\n\n<p>Psychiatric Interview Pocket Card<br>used to remind you of all the topics to cover<br>-jot rough notes on a blank piece of paper or not take notes at all<\/p>\n\n\n\n<p>Advantages<br>-card allows maximum interaction between clinician and patient<\/p>\n\n\n\n<p>Disadvantages<br>-Required information not fully spelled out on pocket card<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>more use of memory is required<\/li>\n<\/ul>\n\n\n\n<p>Patient Questionnaire<br>decrease the time needed to acquire basic information<\/p>\n\n\n\n<p>Advantages<br>-allows more time during the first session to focus on issues of immediate concern to the patient<br>-may heighten patient&#8217;s sense they&#8217;re actively participating in their care<\/p>\n\n\n\n<p>Disadvantages<br>-invalid information may be collected<br>-Some patients may view filling out the questionnaire as a burden<\/p>\n\n\n\n<p>Patient Handouts<br>written information about disorder<\/p>\n\n\n\n<p>Advantages<br>-increase patients&#8217; understanding of their diagnosis<br>-sense that they are collaborating in their tx<\/p>\n\n\n\n<p>Disadvantages<br>-may present more info than some patients can handle<br>-Info may be misinterpreted<\/p>\n\n\n\n<p>Active Listening<br>involves preparing to be fully attentive to the interaction<br>-note verbal and non-verbal cues<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>including what is said and how it is said<br>-indicate attentiveness through their feedback and body language<\/li>\n<\/ul>\n\n\n\n<p>Observation<br>may include client presentation, grooming, and facial expressions<br>-Observation skills are also used to collect objective data<\/p>\n\n\n\n<p>Advanced communication skills<br>critical listening<br>critical questioning<br>critical thinking<\/p>\n\n\n\n<p>Much of the information collected during the interview is obtained through <strong><em><strong><em>__<\/em><\/strong><\/em><\/strong> &amp; <strong><em><strong><em>__<\/em><\/strong><\/em><\/strong><br>active listening &amp; observation<\/p>\n\n\n\n<p>Delusional clients require:<br>patience and understanding during the psychiatric interview<br>-Avoid disagreeing with them or denying the reality of their delusions<\/p>\n\n\n\n<p>Client Considerations: mute or catatonic clients<br>use of observation techniques will help in formulating a potential diagnosis.<\/p>\n\n\n\n<p>pitfalls that can subvert the therapeutic alliance<br>-rushing the interview<br>-giving advice<br>-transference and countertransference<\/p>\n\n\n\n<p>pitfalls: transference and countertransference<br>two phenomena that can impact the therapeutic alliance<\/p>\n\n\n\n<p>-Transference: a client&#8217;s displacement or projection of feelings or wishes towards important individuals in the client&#8217;s past, such as parents, onto the therapist<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>not always (-), provides opportunity to bring repressed feelings to the surface, If client is reminded of someone for whom they have fond memories, may allow for a (+) experience during the initial interview. If the feelings are (-) the client may appear angry or make provocative statements<\/li>\n<\/ul>\n\n\n\n<p>-Countertransference: a therapist&#8217;s conscious or unconscious reactions to a client based on the therapist&#8217;s psychological needs or conflicts.<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>can be positive or negative<\/li>\n<\/ul>\n\n\n\n<p>HPI<br>history of the present illness<br>-concise, clear, and chronological description of the chief complaint which prompted the client&#8217;s visit<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>details what the client believes to be causing the present symptoms<br>-guided by the mnemonic &#8220;OLDCARTS&#8221;<br>-gather information about the timeframe of symptom onset or exacerbation, triggers or stressful life events, and recent treatment and treatment changes<br>-nature of the symptoms, when they emerged, and how they have progressed<\/li>\n<\/ul>\n\n\n\n<p>-Documentation:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>opening statement<\/li>\n\n\n\n<li>characterization of the chief complaint in chronological order<\/li>\n\n\n\n<li>pertinent positive symptoms<\/li>\n\n\n\n<li>pertinent negative symptoms<\/li>\n\n\n\n<li>other relevant info. from the hx<br>symptom characteristics should be described in detail<\/li>\n<\/ul>\n\n\n\n<p>Obtaining the HPI<br>Two approaches:<\/p>\n\n\n\n<p>-History of present crisis approach<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Often, psychiatric crises occur over a 1- to 4-week period, so focus your initial questions on this period.<\/li>\n\n\n\n<li>What has been happening over the past week or two that has brought you into the clinic?<\/li>\n\n\n\n<li>Tell me about some of the stressors you&#8217;ve dealt with over the past couple of weeks.<\/li>\n<\/ul>\n\n\n\n<p>-History of the syndrome approach<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>ascertaining when the patient first remembers signs of the illness.<\/li>\n\n\n\n<li>When did you first begin having these kinds of problems?<\/li>\n\n\n\n<li>When was the last time you remember feeling perfectly well?<\/li>\n<\/ul>\n\n\n\n<p>PMH<br>-past medical history includes all current and old medical problems<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>childhood illness<\/li>\n\n\n\n<li>adult illness<\/li>\n\n\n\n<li>surgical<\/li>\n\n\n\n<li>obstetric\/gynecologic<\/li>\n\n\n\n<li>psychiatric<\/li>\n\n\n\n<li>health maintenance<\/li>\n<\/ul>\n\n\n\n<p>-major medical illness or surgery may precipitate a psychiatric disturbance<br>-name and dosing schedule for all currently meds to avoid risk of adverse interactions with new psychiatric prescriptions<\/p>\n\n\n\n<p>Family Hx<br>Document info about the client&#8217;s parents, grandparents, siblings, children, and grandchildren<br>-regarding age, health, &amp; cause of death.<br>-Include whether they have conditions such as hypertension, coronary artery disease, stroke, diabetes, or cancer.<br>-Many psychiatric disorders have a genetic component<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>info about family psych hx including tx that was successful\/unsuccessful may help form dx\/tx plan, can help ID those available for support, ID stresses\/contributing factors to clients condition<\/li>\n<\/ul>\n\n\n\n<p>Personal and Social Hx<br>Personal Hx:<br>-personality and interests, sources of support, coping style, strengths, and concerns<br>-sexual orientation and gender identification, occupation and education, relationships, safety, spirituality, and support systems<br>-older adults\/clients with diabilities: level of function and activities of daily living<\/p>\n\n\n\n<p>Social Hx:<br>-tobacco, illicit drug, and alcohol use<br>-sexuality &amp; risk-taking sexual practices<br>-Five Ps+<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Partners (gender &amp; # of partners)<\/li>\n\n\n\n<li>Practices (oral, vaginal, anal)<\/li>\n\n\n\n<li>Protection from STIs<\/li>\n\n\n\n<li>Past hx of STIs<\/li>\n\n\n\n<li>Pregnancy plans<\/li>\n\n\n\n<li>+Plus (assess for trauma, violence, sexual health concerns &amp; provide support for sexual orientation and gender identity)<\/li>\n<\/ul>\n\n\n\n<p>ROS<br>review of systems used to obtain additional info about client&#8217;s CC &amp; HPI &amp; to uncover any additional symptoms r\/t potential problems in systems unrelated to the CC<br>-follow a head-to-toe approach with yes or no questions<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>follow up when there is a response that indicates an abnormality with open-ended questions<br>-subjective<\/li>\n\n\n\n<li>constitutional<\/li>\n\n\n\n<li>skin<\/li>\n\n\n\n<li>head<\/li>\n\n\n\n<li>eyes<\/li>\n\n\n\n<li>ears<\/li>\n\n\n\n<li>nose\/sinuses<\/li>\n\n\n\n<li>allergies<\/li>\n\n\n\n<li>mouth\/throat<\/li>\n\n\n\n<li>neck<\/li>\n\n\n\n<li>breast<\/li>\n\n\n\n<li>respiratory\/cardiac<\/li>\n\n\n\n<li>gastrointestinal<\/li>\n\n\n\n<li>urinary<\/li>\n\n\n\n<li>peripheral vascular<\/li>\n\n\n\n<li>musculoskeletal<\/li>\n\n\n\n<li>neurological<\/li>\n\n\n\n<li>hematologic<\/li>\n\n\n\n<li>endocrine<\/li>\n\n\n\n<li>psychiatric<\/li>\n<\/ul>\n\n\n\n<p>Social and developmental hx<br>helps the PMHNP gain insight into the client&#8217;s home life, childhood experiences, and relationships<br>-Info about relationships with parents, siblings, and others outside the family can help the provider ID available systems &amp; assess the client&#8217;s ability to form and maintain long-term relationships<br>-education &amp; employment histories<\/p>\n\n\n\n<p>match the assessment question with the related symptom attribute:<\/p>\n\n\n\n<p>Onset:<br>Location:<br>Duration:<br>Characteristics:<br>Aggravating Factors:<br>Relieving Factors:<br>Treatments:<br>Severity of the Symptoms:<\/p>\n\n\n\n<p>&#8220;How bothersome is this problem?&#8221;<br>&#8220;Have you taken any medications or nonpharmaceutical treatments for this problem?&#8221;<br>&#8220;Does anything make it better?&#8221;<br>&#8220;When did this start?&#8221;<br>&#8220;Where did the problem start; does it move anywhere?&#8221;<br>&#8220;How long does the problem last or is it constant?&#8221;<br>&#8220;Can you describe what the problem feels like?&#8221;<br>&#8220;Does anything make it worse?&#8221;<br>-Onset: &#8220;When did this start?&#8221;<br>-Location: &#8220;Where did the problem start; does it move anywhere?&#8221;<br>-Duration: &#8220;How long does the problem last or is it constant?&#8221;<br>-Characteristics: &#8220;Can you describe what the problem feels like?&#8221;<br>-Aggravating Factors: &#8220;Does anything make it worse?&#8221;<br>-Relieving Factors: &#8220;Does anything make it better?&#8221;<br>-Treatments: &#8220;Have you taken any medications or nonpharmaceutical treatments for this problem?&#8221;<br>-everity of the Symptoms: &#8220;How bothersome is this problem?&#8221;<\/p>\n\n\n\n<p>The psychiatric history<br>-describes previous episodes of mental health symptoms<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>whether treated or not<br>-should detail the initial onset of symptoms and progress chronologically to the current episode<\/li>\n\n\n\n<li>characteristics and progression should be described in detail<br>-distinguish chronic disorders from isolated episodes<br>-gather info on prior treatments<br>-note which drug(s) prescribed, dosage &amp; length of tx, &amp; client&#8217;s response to tx<br>-which meds therapeutic &amp; if adverse effects<br>-if client received psychotherapy, note which modality was used, frequency, length of therapy, any benefits<br>-hospitalizations<br>-suicide attempts, ideations, episodes of self-harm<br>-any emotions revealed through the inquiry<\/li>\n<\/ul>\n\n\n\n<p>Medical diagnoses may present with psychiatric symptoms: hyperthyroidism<br>anxiety, panic attacks, and mood swings<\/p>\n\n\n\n<p>Medical diagnoses may present with psychiatric symptoms: hypothyroidism<br>depression, difficulty sleeping, and loss of appetite<\/p>\n\n\n\n<p>Medical diagnoses may present with psychiatric symptoms: diabetes<br>mood disturbances<\/p>\n\n\n\n<p>Medical diagnoses may present with psychiatric symptoms: chronic pain<br>depression, anxiety, poor sleep<\/p>\n\n\n\n<p>Medical diagnoses may present with psychiatric symptoms: serious or terminal illnesses such as cancer or chronic autoimmune disorders<br>anxiety and depression<\/p>\n\n\n\n<p>Focused Questions for The Psychiatric Assessment: The Psychiatric History<br>-Have you ever been hospitalized for any mental health issues?<br>-Have you ever had counseling or psychotherapy?<br>-Have you ever taken medications for your mental health in the past?<br>-Are you currently on any medications for mental health or sleep?<\/p>\n\n\n\n<p>Focused Questions for The Psychiatric Assessment: Family Psychiatric History<br>-Has any relative of yours ever been hospitalized for a mental health issue?<br>-Has any blood relative of yours ever been diagnosed with a mental health issue?<br>-Has any blood relative of yours had a history of seizures or dementia\/Alzheimer&#8217;s?<\/p>\n\n\n\n<p>Focused Questions for The Psychiatric Assessment: Social and Developmental History<br>-Tell me a little bit about your childhood and how you grew up.<br>-How was your experience in school when you were younger? Did you enjoy school?<br>-How do you support yourself with your finances?<br>-Do you have a good support system? Are you currently in a relationship? Where do you live? Who do you live with?<br>-What do you do in your free time? What activities do you enjoy?<\/p>\n\n\n\n<p>Focused Questions for The Psychiatric Assessment: Medical History\/Screening for General Medical Conditions<br>-Do you have a primary care provider?<br>-Do you have any medical illnesses?<br>-Are you currently taking any medications or herbal supplements?<br>-Do you have any allergies to medications?<br>-Have you ever been hospitalized for any reason?<br>-Have you ever had surgery?<\/p>\n\n\n\n<p>Focused Questions for The Psychiatric Assessment: History of Present Illness<br>-How long have you been feeling this way?<br>-Did something happen in your life that may have triggered these emotions?<br>-How is this current situation impacting your life?<\/p>\n\n\n\n<p>Common precipitants of psychiatric syndromes<br>-arguments with friends or relatives<br>-rejection or abandonment<br>-death or major illness of loved ones<br>-anniversary of a negative event, such as a death or divorce<br>-major medical illness or age-related deterioration in functioning<br>-stressful events at work or school<br>-mental health clinician going on vacation<br>-medication noncompliance<br>-substance abuse<\/p>\n\n\n\n<p>To assess overall functioning:<br>ask about the three basic aspects of life:<\/p>\n\n\n\n<p>love<br>-important relationships: family, spouse, close friends<\/p>\n\n\n\n<p>work<br>-paid employment, school, volunteer activities, structured day activities<\/p>\n\n\n\n<p>fun<br>-hobbies and recreational pursuits<\/p>\n\n\n\n<p>essential questions: Syndromal history<br>How old were you when you first had these symptoms?<br>How many episodes have you had?<br>When was the last episode?<\/p>\n\n\n\n<p>Go CHaMP<br>Mnemonic for tx hx:<\/p>\n\n\n\n<p>General questions<br>Current caregivers<br>Hospitalization history<br>Medication history<br>Psychotherapy history<\/p>\n\n\n\n<p>MIDAS<br>Mnemonic to ask about medical hx:<\/p>\n\n\n\n<p>Medications<br>Illness hx<br>primary care Doctor<br>Allergies<br>Surgical hx<\/p>\n\n\n\n<p>Relative risk<br>compares the risk for people with such a family history against the risk of people in the general population, who are assigned a relative risk of 1.0.<br>-example, relative risk of developing bipolar disorder is 25; patient&#8217;s father is bipolar, she is 25 times more likely to develop bipolar disorder than the average person<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Exam 2: NR548\/ NR 548 (Latest Update 2024\/ 2025) Psychiatric Assessment for the Psychiatric-Mental Health Nurse Practitioner Review |Weeks 3-4 Covered| Questions and Verified Answers| 100% Correct- Chamberlain Exam 2: NR548\/ NR 548 (Latest Update2024\/ 2025) Psychiatric Assessment for thePsychiatric-Mental Health NursePractitioner Review |Weeks 3-4 Covered|Questions and Verified Answers| 100%Correct- ChamberlainQ: Reduction of guiltAnswer:seeks to [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"footnotes":""},"categories":[25],"tags":[],"class_list":["post-131982","post","type-post","status-publish","format-standard","hentry","category-exams-certification"],"_links":{"self":[{"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/posts\/131982","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/comments?post=131982"}],"version-history":[{"count":0,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/posts\/131982\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/media?parent=131982"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/categories?post=131982"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/tags?post=131982"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}