NR548/ NR 548 EXAM 2 NEW LATEST UPDATE 2024/
2025 PSYCHIATRIC ASSESSMENT FOR THE
PSYCHIATRIC MENTAL HEALTH NURSE
PRACTITIONER REVIEW |WEEKS 3-4 QUESTIONS
AND VERIFIED ANSWERS| A GRADE
Psychiatric Interview versus the Medical Interview - CORRECT ANSWER>>most notable difference is
that the psychiatric interview is the primary diagnostic tool used to identify psychiatric conditions.
-Unlike the diagnostic process in physical medicine, psychiatric diagnoses are not generally established
or validated by physical examinations, laboratory tests, or other diagnostic procedures
• such processes may be used to rule out physical causes for psychiatric symptoms
-need for privacy and confidentiality may be heightened in psychiatric interviewing due to the sensitive
nature of the information shared
• mental health diagnoses are associated with stigma in certain cultures
• Safeguarding privacy is critical for building trust and protecting the client from adverse outcomes
Preparing for the Psychiatric Interview - CORRECT ANSWER>>consideration of the setting and timing of
the interview, as well as the client's unique needs.
-secure a space
-protect your time
secure a space - CORRECT ANSWER>>-Schedule the same time every week
-Make your room your own in some way
-Arrange the seating so that you can see a clock
protect your time - CORRECT ANSWER>>-Arrive Earlier than the Patient
-Prevent Interruptions
-Don't Overbook Patients
-Leave Plenty of Time for Notes and Paperwork
Psychiatric interview setting - CORRECT ANSWER>>typically in either the inpatient or outpatient setting
-inpatient interviews in the emergency department, psychiatric unit, or any unit in the hospital, often
serving in a consultation-liaison role
-Outpatient care: clinics, community mental health centers, residential care facilities, private practice,
primary care, homeless shelters, or homecare
• may self-refer or be referred by another provider for support, guidance, and medication management, or
court-ordered therapy
psychiatric interview - CORRECT ANSWER>>the process by which psychiatric assessment is conducted
-primary tasks
• building a therapeutic alliance between the PMHNP & client
• obtaining a database of psychiatric info about the client
• establishing a dx
• negotiating a tx plan
, Therapeutic Alliance - CORRECT 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
Creating rapport: tips - CORRECT 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
How to approach threatening topics (sensitive/embarrassing material) - CORRECT ANSWER>>-
Normalization
-Symptom Expectation
-Symptom Exaggeration
-Reduction of Guilt
-Use Familiar Language When Asking about Behaviors
Normalization - CORRECT 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?
Symptom Expectation - CORRECT 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
2025 PSYCHIATRIC ASSESSMENT FOR THE
PSYCHIATRIC MENTAL HEALTH NURSE
PRACTITIONER REVIEW |WEEKS 3-4 QUESTIONS
AND VERIFIED ANSWERS| A GRADE
Psychiatric Interview versus the Medical Interview - CORRECT ANSWER>>most notable difference is
that the psychiatric interview is the primary diagnostic tool used to identify psychiatric conditions.
-Unlike the diagnostic process in physical medicine, psychiatric diagnoses are not generally established
or validated by physical examinations, laboratory tests, or other diagnostic procedures
• such processes may be used to rule out physical causes for psychiatric symptoms
-need for privacy and confidentiality may be heightened in psychiatric interviewing due to the sensitive
nature of the information shared
• mental health diagnoses are associated with stigma in certain cultures
• Safeguarding privacy is critical for building trust and protecting the client from adverse outcomes
Preparing for the Psychiatric Interview - CORRECT ANSWER>>consideration of the setting and timing of
the interview, as well as the client's unique needs.
-secure a space
-protect your time
secure a space - CORRECT ANSWER>>-Schedule the same time every week
-Make your room your own in some way
-Arrange the seating so that you can see a clock
protect your time - CORRECT ANSWER>>-Arrive Earlier than the Patient
-Prevent Interruptions
-Don't Overbook Patients
-Leave Plenty of Time for Notes and Paperwork
Psychiatric interview setting - CORRECT ANSWER>>typically in either the inpatient or outpatient setting
-inpatient interviews in the emergency department, psychiatric unit, or any unit in the hospital, often
serving in a consultation-liaison role
-Outpatient care: clinics, community mental health centers, residential care facilities, private practice,
primary care, homeless shelters, or homecare
• may self-refer or be referred by another provider for support, guidance, and medication management, or
court-ordered therapy
psychiatric interview - CORRECT ANSWER>>the process by which psychiatric assessment is conducted
-primary tasks
• building a therapeutic alliance between the PMHNP & client
• obtaining a database of psychiatric info about the client
• establishing a dx
• negotiating a tx plan
, Therapeutic Alliance - CORRECT 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
Creating rapport: tips - CORRECT 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
How to approach threatening topics (sensitive/embarrassing material) - CORRECT ANSWER>>-
Normalization
-Symptom Expectation
-Symptom Exaggeration
-Reduction of Guilt
-Use Familiar Language When Asking about Behaviors
Normalization - CORRECT 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?
Symptom Expectation - CORRECT 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
