Exam 2: NR54 8/ NR 54 8 (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 Q: Reduction of guilt Answer: seeks to directly reduce a patient's guilt about a specific behavior in order to discover what they have been doing -useful in obtaining a hx of domestic violence & other antisocial behavior Domestic Violence -"Have you ever been in situations where fights occurred and you were affected?" • If patient answers "yes," you can flesh out whether role was being a witness, victim, or perpetrator Q: According to Peplau's Theory of Interpersonal Relations, establishing early rapport allows the role of the nurse to evolve from stranger to: Answer: resource person, teacher, leader, surrogate, technical expert, and counselor Q: Establishing the Relationship Answer: -Trust is essential for a therapeutic alliance -First impressions are important -PMHNP should take time to make introductions and ensure the client is comfortable -Ask general questions to arrive at an empathic understanding of how the client feels -Listen carefully and communicate an appreciation for the client's concerns -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 -Being present and openly engaged will enhance the communication experience Q: three phases of the psychiatric interview Answer: 1. Opening phase 2. Body of the Interview 3. Closing the Interview Q: Opening phase Answer: -first 5 -10 minutes -establish rapport & therapeutic alliance -often most important phase • establishes the foundation -begins with PMHNP asking "what brought you in to see me today?" Q: Body of the Interview Answer: -30-40 minutes -Chief Complaint Established • additional Q's asked to elicit info r/t the complaint -ask about HPI, family hx, social/developmental hx, medical hx, psychiatric ROS -basis for dx and tx formulation Q: Closing the Interview Answer: -5-10 minutes, final phase Should include 2 components: discussion of your assessment using patient education techniques & negotiated agreement about tx or f/u plans -wrap -up statement and inquiry about missing info that may be of value -Patient education regarding working dx & recommended plan of tx • education about meds if recommended -Homework may be assigned • especially in CBT -Return visit agreed upon Q: Four Tasks of the Diagnostic Interview Answer: 1. Build a therapeutic alliance 2. Obtain the psychiatric database 3. Interview for diagnosis 4. Negotiate a tx plan with your patient Q: Obtain the Psychiatric Database Answer: Also known as the psychiatric history -includes historical information relevant to the current clinical presentation • history of present illness, psychiatric history, medical history, family psychiatric history, and aspects of the social and developmental history Q: Tricks for Improving Patient Recall Answer: -Anchor Questions to Memorable Events • major transitions (graduations and birthdays), holidays, accidents or illnesses, major purchases (a house or a car), seasonal events ("hurricane Katrina"), or public events (such as 9/11 or President Obama's election) -Tag Questions with Specific Examples
