2024 NR548 FINAL EXAM WITH
CORRECT ANSWERS
Which theory would the psychiatric mental health nurse practitioner (PMHNP)
most need to consider when conducting a psychiatric interview in the
following situations?
A 35-year-old homeless client is in the emergency department with suicidal
ideations.
Hierarchy of Needs Theory
Psychosocial Development Theory
Cognitive development Theory - CORRECT-ANSWERSHierarchy of Needs
Theory
Rationale: To attend to higher-level needs, a client must first meet
foundational needs. A homeless client may be struggling to meet
physiological and safety needs.
Which theory would the PMHNP most need to consider when conducting a
psychiatric interview in the following situations?
A 14-year-old foster child struggling to develop trusting relationships with his
foster parents.
Hierarchy of Needs Theory
Psychosocial Development Theory
Cognitive development Theory - CORRECT-ANSWERSPsychosocial
Development Theory
Rationale: According to Erickson's theory, a developmental crisis in infancy
trust vs. mistrust. When basic trust in caregivers is not developed in early
life, it can impact the creation of trusting relationships later.
Which theory would the PMHNP most need to consider when conducting a
psychiatric interview in the following situations?
A 4-year-old is struggling to understand what she has seen on television
about civil protests.
Hierarchy of Needs Theory
Psychosocial Development Theory
Cognitive development Theory - CORRECT-ANSWERSCognitive development
Theory
,Rationale: According to Piaget, children in early childhood do not have the
cognitive ability to understand abstract concepts, such as justice.
Special Considerations: Children - CORRECT-ANSWERS-Legislation regarding
minors and informed consent is based on state law
• be familiar with the req in state of practice
• Children under 17 typically cannot provide informed consent
-Parents must give permission for tx in most circumstances, exceptions:
• under 18 and married
• serving in the military
• able to provide financial independence
• mother of a child (married or not)
-A parent may not be allowed to access info. in the following circumstances:
• info. is contained in the therapist's psychotherapy notes
• parent not designated as the child's personal representative
• parent voluntarily agrees that info can be kept confidential
• provider has a reasonable belief that abuse or neglect exists or parent is a
danger to the child
• provider believes it is not in the child's best interest to treat the parent as
the child's representative
Interviewing children and adolescents - CORRECT-ANSWERS-PMHNP may
need to speak with family members separately from the child to gain
additional information about the child's mental health concern
-Family issues and family dynamics often play a role in the child's or
adolescent's psychiatric disorder
-Common topics to cover in an adolescent interview include:
• interests
• school and activities
• drug and alcohol use
• sexual activity
• conduct problems
In which of these situations would it be appropriate to share a child or
adolescent's protected health information with a parent?
A 12-year-old who has designated the parent to be the personal
representative in a state allowing adolescents to consent to their treatment.
Rationale: In states where consent to treat is required and the child has
indicated that the parent should be the personal representative, it would be
, appropriate to share the information so long as the PMHNP does not suspect
abuse, neglect, or that sharing would not be in the child's best interests.
In which of these situations would it be appropriate to share a child or
adolescent's protected health information with a parent?
A 17-year-old on active duty in the Navy.
Rationale: Under most state laws, an adolescent serving in the military would
be considered emancipated, therefore, the parent would not have the right
to view the records without the adolescent's permission.
In which of these situations would it be appropriate to share a child or
adolescent's protected health information with a parent?
A parent requesting to see the therapist's psychotherapy notes from sessions
with a 6-year-old child.
Rationale: Parents and clients do not have a right to view a therapist's
private psychotherapy notes.
Special Considerations: Older Adults - CORRECT-ANSWERSWhen conducting
a psychiatric interview with an older adult, the PMHNP must consider the
following:
-developmental issues of older adulthood
-generational perspectives and beliefs
-comorbid physical illness
-polypharmacy
-cognitive or sensory impairments
-history of physical/mental disorders
Sociocultural factors that may influence the experience and expression of
health and of psychological problems in later life - CORRECT-
ANSWERSgender
race
ethnicity
socioeconomic status
sexual orientation
disability status
urban/rural residence
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