EXAM 2 NR 548 PSYCHIATRIC ASSESSMENT REVIEW SHEET COMPLETE QUESTIONS
ANSWERS GRADED A PLUS
Question:
Therapeutic Alliance.
Answer:
a feeling that you should create over the course of the diagnostic interview, a sense of rapport, trust,
and warmth most important goal of the interview process the cooperative working relationship
between the therapist and client begins during the initial or opening phase of the interview
fundamental component of successful therapy Without trust, adherence to treatment
recommendations may be compromised interview may not elicit the information needed to
formulate an appropriate dx & plan of care without rapport & trust
Question:
Creating rapport: tips.
Answer:
-Be Yourself Be Warm, Courteous, and Emotionally Sensitive Actively Defuse the Strangeness of
the Clinical Situation Give Your Patient the Opening Word Gain Your Patient's Trust by Projecting
Competence
Question:
How to approach threatening topics (sensitive/embarrassing material).
Answer:
-Normalization Symptom Expectation Symptom Exaggeration Reduction of Guilt Use Familiar
Language When Asking about Behaviors
Question:
Normalization.
,Answer:
Introducing Q with some type of normalizing statement two principal ways to do this: 1. start the
question by implying that the behavior is a normal or understandable response to a mood or situation
ex: Sometimes when people are very depressed, they think of hurting themselves. Has this been true
for you? 2. Begin by describing another patient (or patients) who has engaged in the behavior,
showing your patient that she is not alone ex: I've talked to several patients who'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?
Question:
Symptom Expectation.
Answer:
communicate that a behavior is in some way normal or expected Phrase your Q'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 high index of suspicion of some self-destructive activity 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 "Have you had any thoughts
that you'd be better off dead?" you might decide to use symptom expectation. "What kinds of ways
to hurt yourself have you thought about?" *reserve this technique for situations in which it seems
appropriate
Question:
Symptom Exaggeration.
Answer:
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
"bad." helpful in clarifying the severity of symptoms *reserve this technique for situations in which
it seems appropriate
Question:
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
Question:
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
Question:
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
Question:
three phases of the psychiatric interview.
Answer:
1. Opening phase 2. Body of the Interview 3. Closing the Interview
Question:
Opening phase.
Answer:
ANSWERS GRADED A PLUS
Question:
Therapeutic Alliance.
Answer:
a feeling that you should create over the course of the diagnostic interview, a sense of rapport, trust,
and warmth most important goal of the interview process the cooperative working relationship
between the therapist and client begins during the initial or opening phase of the interview
fundamental component of successful therapy Without trust, adherence to treatment
recommendations may be compromised interview may not elicit the information needed to
formulate an appropriate dx & plan of care without rapport & trust
Question:
Creating rapport: tips.
Answer:
-Be Yourself Be Warm, Courteous, and Emotionally Sensitive Actively Defuse the Strangeness of
the Clinical Situation Give Your Patient the Opening Word Gain Your Patient's Trust by Projecting
Competence
Question:
How to approach threatening topics (sensitive/embarrassing material).
Answer:
-Normalization Symptom Expectation Symptom Exaggeration Reduction of Guilt Use Familiar
Language When Asking about Behaviors
Question:
Normalization.
,Answer:
Introducing Q with some type of normalizing statement two principal ways to do this: 1. start the
question by implying that the behavior is a normal or understandable response to a mood or situation
ex: Sometimes when people are very depressed, they think of hurting themselves. Has this been true
for you? 2. Begin by describing another patient (or patients) who has engaged in the behavior,
showing your patient that she is not alone ex: I've talked to several patients who'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?
Question:
Symptom Expectation.
Answer:
communicate that a behavior is in some way normal or expected Phrase your Q'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 high index of suspicion of some self-destructive activity 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 "Have you had any thoughts
that you'd be better off dead?" you might decide to use symptom expectation. "What kinds of ways
to hurt yourself have you thought about?" *reserve this technique for situations in which it seems
appropriate
Question:
Symptom Exaggeration.
Answer:
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
"bad." helpful in clarifying the severity of symptoms *reserve this technique for situations in which
it seems appropriate
Question:
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
Question:
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
Question:
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
Question:
three phases of the psychiatric interview.
Answer:
1. Opening phase 2. Body of the Interview 3. Closing the Interview
Question:
Opening phase.
Answer:
