NR 548 EXAM PREP
LATEST
Psychiatric Assessment for
Psychiatric-Mental Health
Nurse Practitioner
ANSWERED
2023/2024
,1. What are the four main components of a psychiatric assessment? (4 marks)
Answer: The four main components of a psychiatric assessment are:
- History: This includes the patient's personal, family, medical, and psychiatric history, as well as their current
symptoms, stressors, coping skills, and goals.
- Mental status examination: This is a systematic observation of the patient's appearance, behavior, mood, affect,
speech, thought process, thought content, perception, cognition, insight, and judgment.
- Physical examination: This is a general examination of the patient's vital signs, organ systems, and neurological
functions to rule out any medical causes or complications of their mental condition.
- Diagnostic tests: These are laboratory tests, imaging studies, or psychological tests that may help to confirm or
rule out a specific diagnosis or to monitor the patient's response to treatment.
2. What are the three main types of psychiatric interviews and when are they used? (6 marks)
Answer: The three main types of psychiatric interviews are:
- Screening interview: This is a brief interview that aims to identify the presence or absence of a mental disorder
or a need for further evaluation. It is usually used in primary care settings or in emergency situations.
- Diagnostic interview: This is a comprehensive interview that aims to establish a diagnosis or a differential
diagnosis based on the criteria of a diagnostic manual such as the DSM-5 or the ICD-10. It is usually used in
specialty mental health settings or in research settings.
- Therapeutic interview: This is an ongoing interview that aims to establish a therapeutic alliance, explore the
patient's problems and feelings, and facilitate change and recovery. It is usually used in psychotherapy or
counseling settings.
3. What are some of the advantages and disadvantages of using structured or semi-structured interviews versus
unstructured interviews for psychiatric diagnosis? (10 marks)
Answer: Some of the advantages and disadvantages of using structured or semi-structured interviews versus
unstructured interviews for psychiatric diagnosis are:
- Advantages of structured or semi-structured interviews: They are more reliable, valid, and standardized than
unstructured interviews. They ensure that all relevant information is covered and that no important details are
missed. They reduce the influence of interviewer bias or subjectivity. They facilitate communication and
documentation among clinicians and researchers.
- Disadvantages of structured or semi-structured interviews: They are more time-consuming, rigid, and artificial
than unstructured interviews. They may limit the rapport and flexibility between the interviewer and the
patient. They may overlook some aspects of the patient's individuality, context, or complexity. They may not
capture the nuances or subtleties of the patient's experience.
4. What are some of the common rating scales or instruments that are used to measure the severity or outcome of
psychiatric disorders? Give an example for each of the following categories: mood disorders, anxiety
disorders, psychotic disorders, substance use disorders, and personality disorders. (10 marks)
Answer: Some of the common rating scales or instruments that are used to measure the severity or outcome of
psychiatric disorders are:
- Mood disorders: Hamilton Depression Rating Scale (HDRS), Beck Depression Inventory (BDI), Montgomery-
Asberg Depression Rating Scale (MADRS), Young Mania Rating Scale (YMRS), Altman Self-Rating Mania
Scale (ASRM).
- Anxiety disorders: Hamilton Anxiety Rating Scale (HARS), Beck Anxiety Inventory (BAI), Generalized
, Anxiety Disorder 7-item scale (GAD-7), Panic Disorder Severity Scale (PDSS), Social Phobia Inventory
(SPIN).
- Psychotic disorders: Positive and Negative Syndrome Scale (PANSS), Brief Psychiatric Rating Scale (BPRS),
Scale for the Assessment of Positive Symptoms (SAPS), Scale for the Assessment of Negative Symptoms
(SANS), Clinical Global Impression Scale for Schizophrenia (CGI-SCH).
- Substance use disorders: Addiction Severity Index (ASI), Alcohol Use Disorders Identification Test (AUDIT),
Drug Abuse Screening Test (DAST), Severity of Dependence Scale (SDS), Clinical Institute Withdrawal
Assessment for Alcohol (CIWA-Ar).
- Personality disorders: Minnesota Multiphasic Personality Inventory 2nd edition (MMPI-2), Millon Clinical
Multiaxial Inventory 3rd edition (MCMI-III), Personality Assessment Inventory (PAI), Structured Clinical
Interview for DSM-5 Personality Disorders (SCID-5-PD), Personality Disorder Questionnaire 4th edition
(PDQ-4).
1. A nurse wants to reinforce positive self-esteem for a patient diagnosed with major depressive disorder.
Today, the patient is wearing a new shirt and has neat, clean hair. Which remark is most appropriate?
a. You look nice this morning.
b. You are wearing a new shirt.
c. I like the shirt youre wearing.
d. You must be feeling better today.
2. An adult diagnosed with major depressive disorder was treated with medication and cognitive behavioral
therapy. The patient now recognizes how passivity contributed to the depression. Which intervention should
the nurse suggest?
a. Social skills training
b. Relaxation training classes
c. Use of complementary therapy
d. Learning desensitization techniques
3. A priority nursing intervention for a patient diagnosed with major depressive disorder is:
a. distracting the patient from self-absorption.
b. carefully and inconspicuously observing the patient around the clock.
c. allowing the patient to spend long periods alone in self-reflection.
d. offering opportunities for the patient to assume a leadership role in the therapeutic milieu.
4. When counseling patients diagnosed with major depressive disorder, an advanced practice nurse will
address the negative thought patterns by using:
a. psychoanalytic therapy.
b. desensitization therapy.
c. cognitive behavioral therapy.
d. alternative and complementary therapies.
5. A patient says to the nurse, My life does not have any happiness in it anymore. I once enjoyed holidays, but
now theyre just another day. How would the nurse document the complaint?
a. Vegetative symptom
b. Anhedonia
c. Euphoria
d. Anergia
LATEST
Psychiatric Assessment for
Psychiatric-Mental Health
Nurse Practitioner
ANSWERED
2023/2024
,1. What are the four main components of a psychiatric assessment? (4 marks)
Answer: The four main components of a psychiatric assessment are:
- History: This includes the patient's personal, family, medical, and psychiatric history, as well as their current
symptoms, stressors, coping skills, and goals.
- Mental status examination: This is a systematic observation of the patient's appearance, behavior, mood, affect,
speech, thought process, thought content, perception, cognition, insight, and judgment.
- Physical examination: This is a general examination of the patient's vital signs, organ systems, and neurological
functions to rule out any medical causes or complications of their mental condition.
- Diagnostic tests: These are laboratory tests, imaging studies, or psychological tests that may help to confirm or
rule out a specific diagnosis or to monitor the patient's response to treatment.
2. What are the three main types of psychiatric interviews and when are they used? (6 marks)
Answer: The three main types of psychiatric interviews are:
- Screening interview: This is a brief interview that aims to identify the presence or absence of a mental disorder
or a need for further evaluation. It is usually used in primary care settings or in emergency situations.
- Diagnostic interview: This is a comprehensive interview that aims to establish a diagnosis or a differential
diagnosis based on the criteria of a diagnostic manual such as the DSM-5 or the ICD-10. It is usually used in
specialty mental health settings or in research settings.
- Therapeutic interview: This is an ongoing interview that aims to establish a therapeutic alliance, explore the
patient's problems and feelings, and facilitate change and recovery. It is usually used in psychotherapy or
counseling settings.
3. What are some of the advantages and disadvantages of using structured or semi-structured interviews versus
unstructured interviews for psychiatric diagnosis? (10 marks)
Answer: Some of the advantages and disadvantages of using structured or semi-structured interviews versus
unstructured interviews for psychiatric diagnosis are:
- Advantages of structured or semi-structured interviews: They are more reliable, valid, and standardized than
unstructured interviews. They ensure that all relevant information is covered and that no important details are
missed. They reduce the influence of interviewer bias or subjectivity. They facilitate communication and
documentation among clinicians and researchers.
- Disadvantages of structured or semi-structured interviews: They are more time-consuming, rigid, and artificial
than unstructured interviews. They may limit the rapport and flexibility between the interviewer and the
patient. They may overlook some aspects of the patient's individuality, context, or complexity. They may not
capture the nuances or subtleties of the patient's experience.
4. What are some of the common rating scales or instruments that are used to measure the severity or outcome of
psychiatric disorders? Give an example for each of the following categories: mood disorders, anxiety
disorders, psychotic disorders, substance use disorders, and personality disorders. (10 marks)
Answer: Some of the common rating scales or instruments that are used to measure the severity or outcome of
psychiatric disorders are:
- Mood disorders: Hamilton Depression Rating Scale (HDRS), Beck Depression Inventory (BDI), Montgomery-
Asberg Depression Rating Scale (MADRS), Young Mania Rating Scale (YMRS), Altman Self-Rating Mania
Scale (ASRM).
- Anxiety disorders: Hamilton Anxiety Rating Scale (HARS), Beck Anxiety Inventory (BAI), Generalized
, Anxiety Disorder 7-item scale (GAD-7), Panic Disorder Severity Scale (PDSS), Social Phobia Inventory
(SPIN).
- Psychotic disorders: Positive and Negative Syndrome Scale (PANSS), Brief Psychiatric Rating Scale (BPRS),
Scale for the Assessment of Positive Symptoms (SAPS), Scale for the Assessment of Negative Symptoms
(SANS), Clinical Global Impression Scale for Schizophrenia (CGI-SCH).
- Substance use disorders: Addiction Severity Index (ASI), Alcohol Use Disorders Identification Test (AUDIT),
Drug Abuse Screening Test (DAST), Severity of Dependence Scale (SDS), Clinical Institute Withdrawal
Assessment for Alcohol (CIWA-Ar).
- Personality disorders: Minnesota Multiphasic Personality Inventory 2nd edition (MMPI-2), Millon Clinical
Multiaxial Inventory 3rd edition (MCMI-III), Personality Assessment Inventory (PAI), Structured Clinical
Interview for DSM-5 Personality Disorders (SCID-5-PD), Personality Disorder Questionnaire 4th edition
(PDQ-4).
1. A nurse wants to reinforce positive self-esteem for a patient diagnosed with major depressive disorder.
Today, the patient is wearing a new shirt and has neat, clean hair. Which remark is most appropriate?
a. You look nice this morning.
b. You are wearing a new shirt.
c. I like the shirt youre wearing.
d. You must be feeling better today.
2. An adult diagnosed with major depressive disorder was treated with medication and cognitive behavioral
therapy. The patient now recognizes how passivity contributed to the depression. Which intervention should
the nurse suggest?
a. Social skills training
b. Relaxation training classes
c. Use of complementary therapy
d. Learning desensitization techniques
3. A priority nursing intervention for a patient diagnosed with major depressive disorder is:
a. distracting the patient from self-absorption.
b. carefully and inconspicuously observing the patient around the clock.
c. allowing the patient to spend long periods alone in self-reflection.
d. offering opportunities for the patient to assume a leadership role in the therapeutic milieu.
4. When counseling patients diagnosed with major depressive disorder, an advanced practice nurse will
address the negative thought patterns by using:
a. psychoanalytic therapy.
b. desensitization therapy.
c. cognitive behavioral therapy.
d. alternative and complementary therapies.
5. A patient says to the nurse, My life does not have any happiness in it anymore. I once enjoyed holidays, but
now theyre just another day. How would the nurse document the complaint?
a. Vegetative symptom
b. Anhedonia
c. Euphoria
d. Anergia
