CMN 548 Official Study Guide test
UNIT 2 STUGY GUIDE CARLAT READINGS
Required Readings for this Unit:
Chapters 1-13, 19-20
Chapter 1-13:
1. What are the four tasks of the diagnostic interview? P. 4
• Build a therapeutic alliance
• Obtain a psychiatric database
• Interview for diagnoses
• Negotiate a tmt plan and communicate it to your pt
1 Complete the table below to create an overview of the phases of the
diagnostic interview: p. 6
Phase Time Allotted Major Tasks
Opening Phase 5-10 min Meet pt
Learn about them
Let them talk about self
Body 30-40 min - Come up with initial diagnostic hypothesis Ch
20
- Map out interview
strategy Hx of present
illness Ch14
- Hx of depression, SI, subst abuse Ch 23,23,26
- Family hx
- Asmt that pt meets DSM criteria Ch 20, 21, 24
- Social/development hx Ch 18
- Medical hx Ch 16
- Psychiatric ROS section III
Closing Tasks 5-10 min - Discussion of assessment
- Come up with negotiated agreement
1 Complete the table below which identifies strategies related to
preparation for the diagnostic interview: p. 9-11
Strategy Rationale (how does facilitate the interview process)
Arrive earlier than the Prep allows for reduced stress, sets up mellower
patient interview
Prevent interruptions ▪ Ask the clinic secretary to take messages for you.
▪ Ask the page operator to hold all but urgent
pages.
,CMN 548 Official Study Guide test
▪ Put your pager on vibrate mode and only answer
urgent pages.
▪ Sign your pages out to a colleague
Don’t overbook patients Allows for time to evaluate and write up/dictate notes
Leave time for notes Schedule enough time for charting-know how much you
need
1 From the information on using paper tools effectively, complete
the following table:
Tool Purpose Advantages Disadvantages
Long Takes notes on it Ensures Pts may feel alienated
Form P11 during interview thorough data when notes being
process evaluation, completed in front of
saves time them
Short Used for rough notes Presents less Less thorough evaluation
Form P11 of barrier
between
clinician and
pt
Pocket Card Reminds clinicians Allows for max Information not clearly
what topics to cover interaction spelled out, requires more
btween clinician memory from clinician
and pt
Patient Given to pt before Allows more time Some pts may view
Questionnai first appt to focus on questionnaire as a
re issues during burden
appt
Patient Pts like receiving, a Increases pts May provide too much
Handout tool that often helps sense of actively info, pts may be
s to increase pt participation in overwhelmed with all the
compliance tmt info provided.
1 What are the “rules” regarding the patients contacting the provider?
• Never give out personal phone number
• If you give out phone specify times when you’re available to be called
• If you have voice mail, have pts call there instead of personal phone
• When on vacation, sign pts out to a clinician.
1 How should the provider handle missed appointments?
Inform you at least 24 hrs in advance of any missed appointments or
there will be a charge.
Repeated missed sessions- figure out why pt is missing continued
,CMN 548 Official Study Guide test
appts. Is it for legitimate reasons, or is pt acting out feelings of anxiety
or hostility.
, CMN 548 Official Study Guide test
If clinician just returned from vacation, pt may be acting out feelings
of abandonment.
2. What are some strategies for “being warm, courteous, and
emotionally sensitive”?
• Empathic or sympathetic statements P.19
• Direct feelings questions P.19
• Reflective statements P.19
If you do not like pt, Ch 13.
1 What can the advanced practice nurse do to “actively defuse the
strangeness of the clinical situation”? P.20
• Greet pt naturally
• Get to know pt as a first patient
• Educate the pt about the nature of the interview
• Address your pts projections
1 What is the benefit in the advanced practice nurse allowing the
patient to “give the opening word?” P.23
- gives pt feeling clinican is interested in listening, establishes rapport
How long should this portion of the
interview last? Allow pt 5 mins of free
speech
What is a good type of “opening
question”? P.23 Open-ended questions
- that invite pt to tell story. What was it
- that brought you to the clinic today What
- brings you to see me today
- What sorts of things have been
- troubling you How can I be of help to
you
What can I do for you
Solution-focused interviewing is exploring what the pts goals are for
the interview. Instead of asking what brings you in? or what troubles
you?
Ask…what would make this a helpful visit?
or… what would you like to see different from
coming here? this approach may work well with
reluctant patients.
Miracle question:
Imagine that tonight you go to bed like you normally would then
imagine while youre asleep… a miracle happens…imagine that
because of the miracle your problem (depression or whatever) goes
UNIT 2 STUGY GUIDE CARLAT READINGS
Required Readings for this Unit:
Chapters 1-13, 19-20
Chapter 1-13:
1. What are the four tasks of the diagnostic interview? P. 4
• Build a therapeutic alliance
• Obtain a psychiatric database
• Interview for diagnoses
• Negotiate a tmt plan and communicate it to your pt
1 Complete the table below to create an overview of the phases of the
diagnostic interview: p. 6
Phase Time Allotted Major Tasks
Opening Phase 5-10 min Meet pt
Learn about them
Let them talk about self
Body 30-40 min - Come up with initial diagnostic hypothesis Ch
20
- Map out interview
strategy Hx of present
illness Ch14
- Hx of depression, SI, subst abuse Ch 23,23,26
- Family hx
- Asmt that pt meets DSM criteria Ch 20, 21, 24
- Social/development hx Ch 18
- Medical hx Ch 16
- Psychiatric ROS section III
Closing Tasks 5-10 min - Discussion of assessment
- Come up with negotiated agreement
1 Complete the table below which identifies strategies related to
preparation for the diagnostic interview: p. 9-11
Strategy Rationale (how does facilitate the interview process)
Arrive earlier than the Prep allows for reduced stress, sets up mellower
patient interview
Prevent interruptions ▪ Ask the clinic secretary to take messages for you.
▪ Ask the page operator to hold all but urgent
pages.
,CMN 548 Official Study Guide test
▪ Put your pager on vibrate mode and only answer
urgent pages.
▪ Sign your pages out to a colleague
Don’t overbook patients Allows for time to evaluate and write up/dictate notes
Leave time for notes Schedule enough time for charting-know how much you
need
1 From the information on using paper tools effectively, complete
the following table:
Tool Purpose Advantages Disadvantages
Long Takes notes on it Ensures Pts may feel alienated
Form P11 during interview thorough data when notes being
process evaluation, completed in front of
saves time them
Short Used for rough notes Presents less Less thorough evaluation
Form P11 of barrier
between
clinician and
pt
Pocket Card Reminds clinicians Allows for max Information not clearly
what topics to cover interaction spelled out, requires more
btween clinician memory from clinician
and pt
Patient Given to pt before Allows more time Some pts may view
Questionnai first appt to focus on questionnaire as a
re issues during burden
appt
Patient Pts like receiving, a Increases pts May provide too much
Handout tool that often helps sense of actively info, pts may be
s to increase pt participation in overwhelmed with all the
compliance tmt info provided.
1 What are the “rules” regarding the patients contacting the provider?
• Never give out personal phone number
• If you give out phone specify times when you’re available to be called
• If you have voice mail, have pts call there instead of personal phone
• When on vacation, sign pts out to a clinician.
1 How should the provider handle missed appointments?
Inform you at least 24 hrs in advance of any missed appointments or
there will be a charge.
Repeated missed sessions- figure out why pt is missing continued
,CMN 548 Official Study Guide test
appts. Is it for legitimate reasons, or is pt acting out feelings of anxiety
or hostility.
, CMN 548 Official Study Guide test
If clinician just returned from vacation, pt may be acting out feelings
of abandonment.
2. What are some strategies for “being warm, courteous, and
emotionally sensitive”?
• Empathic or sympathetic statements P.19
• Direct feelings questions P.19
• Reflective statements P.19
If you do not like pt, Ch 13.
1 What can the advanced practice nurse do to “actively defuse the
strangeness of the clinical situation”? P.20
• Greet pt naturally
• Get to know pt as a first patient
• Educate the pt about the nature of the interview
• Address your pts projections
1 What is the benefit in the advanced practice nurse allowing the
patient to “give the opening word?” P.23
- gives pt feeling clinican is interested in listening, establishes rapport
How long should this portion of the
interview last? Allow pt 5 mins of free
speech
What is a good type of “opening
question”? P.23 Open-ended questions
- that invite pt to tell story. What was it
- that brought you to the clinic today What
- brings you to see me today
- What sorts of things have been
- troubling you How can I be of help to
you
What can I do for you
Solution-focused interviewing is exploring what the pts goals are for
the interview. Instead of asking what brings you in? or what troubles
you?
Ask…what would make this a helpful visit?
or… what would you like to see different from
coming here? this approach may work well with
reluctant patients.
Miracle question:
Imagine that tonight you go to bed like you normally would then
imagine while youre asleep… a miracle happens…imagine that
because of the miracle your problem (depression or whatever) goes
