NRP-547 Differential Diagnosis in Psychiatric-Mental Health across the Lifespan Practicum Questions And Answers

NR547 / NR 547 (Latest Update )
Differential Diagnosis in Psychiatric-Mental Health
across the Lifespan Practicum | Questions & Answers
| 100% Correct | Grade A+

A 52-year-old client presents to the emergency department following a car accident. The emergency
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department (ED) physician is concerned that the client may have intentionally crashed her car and
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requests a stat PMHNP consult. In speaking with the PMHNP, the client describes persistent feelings of
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sadness and hopelessness. She states that she often wonders if her husband would be happier if she
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wasn't around anymore since she's never happy and sometimes thinks about what it would be like to
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just take a handful of sleeping pills and go to sleep forever. The client reports a previous suicide attempt
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when she was 16 but denies that she is considering killing herself right now.
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Based on the client's ASQ score, what is the most appropriate response?
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No action is necessary as the client is not currently considering suicide.
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Provide a brief suicide safety assessment.
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Alert the client's primary care physician.
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Provide a ST - ANSWER-Provide a brief suicide safety assessment.
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Rationale: While the client's responses do not indicate a need for a stat full safety and mental health
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evaluation, the client requires a brief suicide safety assessment to determine whether a full mental
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health evaluation in necessary. It is also important to notify the client's physician or the clinician
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responsible for the client's care.
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Basic Laboratory Interpretation - ANSWER-Complete Blood Count
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Comprehensive Metabolic Panel (CMP) B B B




Thyroid Function Tests B B




Vitamin B12 Level B B




Vitamin D Level B B




Toxicology Screen B




Urinalysis (UA) B




Basic Laboratory Interpretation: Complete Blood Count - ANSWER--measures RBCs, WBCs, hemoglobin,
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hematocrit, and platelets
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, -includes a differential of the WBCs B B B B B




-In mental health, the CBC is used to rule out medical conditions that may present with symptoms that
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Bcan be attributed to both medical and psychiatric diagnoses
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• Ex: rule out anemia as a cause for depressive symptoms and fatigue
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• Ex: rule out infection as a cause of acute mental status changes
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RBCs: 4.5-6.0 million/microliter
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Hemoglobin: 12-18 grams/100 mL B B B




Hematocrit: 38%-48% B




Reticulocytes: 0%-1.5% B




WBCs (total): 5000-10,000/microliter
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Neutrophils: 55%-70% B




Eosinophils: 1%-3% B




Basophils: 0.5%-1% B




Lymphocytes: 20%-35% B




Monocytes: 3%-8% B




Platelets: 150,000-300,000/microliter B




Basic Laboratory Interpretation: Comprehensive Metabolic Panel (CMP) - ANSWER-common blood test
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used to determine general health status
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-fluid and electrolyte balance, status of the body's metabolism, liver function, and kidney function
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-used to monitor the effects of medications, such as antipsychotics, on liver function and glucose levels
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-rule out medical conditions that could cause symptoms
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• Ex: changes in mood or cognition
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Sodium (Na+): 136-145 mEq/L B B B




Postassium (K+): 3.5-5.0 mEq/L B B B




Chloride (Cl-): 95-105 mEq/L B B B




Bicarbonate (HCO3-): 22-28 mEq/L B B B




Calcium, serum (Ca 2+) 8.4-10.2 mg/dl B B B B B