NR 574 ACUTE CARE PRACTICUM MIDTERM
EXAM 2026 WEEK 1 TO 4 COMPREHENSIVE
STUDY GUIDE SOLVED QUESTION SET
◉ Psychiatric assessment: History taking. Answer: -History of Present
Illness
-How long have you been feeling this way?
-Did something happen in your life that may have triggered these
emotions?
-How is this current situation impacting your life?
The Psychiatric History
-Have you ever been hospitalized for any mental health issues?
-Have you ever had counseling or psychotherapy?
-Have you ever taken medications for your mental health in the past?
-Are you currently on any medications for mental health or sleep?
Medical History/Screening for General Medical Conditions
-Do you have a primary care provider?
-Do you have any medical illnesses?
-Are you currently taking any medications or herbal supplements?
-Do you have any allergies to medications?
-Have you ever been hospitalized for any reason?
,-Have you ever had surgery?
Family Psychiatric History
-Has any relative of yours ever been hospitalized for a mental health
issue?
-Has any blood relative of yours ever been diagnosed with a mental
health issue?
-Has any blood relative of yours had a history of seizures or
dementia/Alzheimer's?
Social and Developmental History
-Tell me a little bit about your childhood and how you grew up.
-How was your experience in school when you were younger? Did you
enjoy school?
-How do you support yourself with your finances?
-Do you have a good support system? Are you currently in a
relationship? Where do you live? Who do you live with?
-What do you do in your free time? What activities do you enjoy?
◉ Screening and Psychiatric Rating Scales. Answer: Evidence-based
screening tools and psychiatric rating scales
-can help the provider identify symptoms and assess their severity and
can assist with the evaluation of response to treatment
,◉ A 52-year-old client presents to the emergency department following
a car accident. The emergency department (ED) physician is concerned
that the client may have intentionally crashed her car and requests a stat
PMHNP consult. In speaking with the PMHNP, the client describes
persistent feelings of sadness and hopelessness. She states that she often
wonders if her husband would be happier if she wasn't around anymore
since she's never happy and sometimes thinks about what it would be
like to just take a handful of sleeping pills and go to sleep forever. The
client reports a previous suicide attempt when she was 16 but denies that
she is considering killing herself right now.
Based on the client's ASQ score, what is the most appropriate response?
No action is necessary as the client is not currently considering suicide.
Provide a brief suicide safety assessment.
Alert the client's primary care physician.
Provide a ST. Answer: Provide a brief suicide safety assessment.
Rationale: While the client's responses do not indicate a need for a stat
full safety and mental health evaluation, the client requires a brief
suicide safety assessment to determine whether a full mental health
evaluation in necessary. It is also important to notify the client's
physician or the clinician responsible for the client's care.
◉ Diagnostic Testing when diagnosing mental health disorders. Answer:
-Diagnostic tests and labs are most used to rule out physical conditions
, that may cause psychiatric symptoms and to evaluate the effects of
treatment
◉ Basic Laboratory Interpretation. Answer: Complete Blood Count
Comprehensive Metabolic Panel (CMP)
Thyroid Function Tests
Vitamin B12 Level
Vitamin D Level
Toxicology Screen
Urinalysis (UA)
◉ Basic Laboratory Interpretation: Complete Blood Count. Answer: -
measures RBCs, WBCs, hemoglobin, hematocrit, and platelets
-includes a differential of the WBCs
-In mental health, the CBC is used to rule out medical conditions that
may present with symptoms that can be attributed to both medical and
psychiatric diagnoses
• Ex: rule out anemia as a cause for depressive symptoms and fatigue
• Ex: rule out infection as a cause of acute mental status changes
RBCs: 4.5-6.0 million/microliter
Hemoglobin: 12-18 grams/100 mL
Hematocrit: 38%-48%
EXAM 2026 WEEK 1 TO 4 COMPREHENSIVE
STUDY GUIDE SOLVED QUESTION SET
◉ Psychiatric assessment: History taking. Answer: -History of Present
Illness
-How long have you been feeling this way?
-Did something happen in your life that may have triggered these
emotions?
-How is this current situation impacting your life?
The Psychiatric History
-Have you ever been hospitalized for any mental health issues?
-Have you ever had counseling or psychotherapy?
-Have you ever taken medications for your mental health in the past?
-Are you currently on any medications for mental health or sleep?
Medical History/Screening for General Medical Conditions
-Do you have a primary care provider?
-Do you have any medical illnesses?
-Are you currently taking any medications or herbal supplements?
-Do you have any allergies to medications?
-Have you ever been hospitalized for any reason?
,-Have you ever had surgery?
Family Psychiatric History
-Has any relative of yours ever been hospitalized for a mental health
issue?
-Has any blood relative of yours ever been diagnosed with a mental
health issue?
-Has any blood relative of yours had a history of seizures or
dementia/Alzheimer's?
Social and Developmental History
-Tell me a little bit about your childhood and how you grew up.
-How was your experience in school when you were younger? Did you
enjoy school?
-How do you support yourself with your finances?
-Do you have a good support system? Are you currently in a
relationship? Where do you live? Who do you live with?
-What do you do in your free time? What activities do you enjoy?
◉ Screening and Psychiatric Rating Scales. Answer: Evidence-based
screening tools and psychiatric rating scales
-can help the provider identify symptoms and assess their severity and
can assist with the evaluation of response to treatment
,◉ A 52-year-old client presents to the emergency department following
a car accident. The emergency department (ED) physician is concerned
that the client may have intentionally crashed her car and requests a stat
PMHNP consult. In speaking with the PMHNP, the client describes
persistent feelings of sadness and hopelessness. She states that she often
wonders if her husband would be happier if she wasn't around anymore
since she's never happy and sometimes thinks about what it would be
like to just take a handful of sleeping pills and go to sleep forever. The
client reports a previous suicide attempt when she was 16 but denies that
she is considering killing herself right now.
Based on the client's ASQ score, what is the most appropriate response?
No action is necessary as the client is not currently considering suicide.
Provide a brief suicide safety assessment.
Alert the client's primary care physician.
Provide a ST. Answer: Provide a brief suicide safety assessment.
Rationale: While the client's responses do not indicate a need for a stat
full safety and mental health evaluation, the client requires a brief
suicide safety assessment to determine whether a full mental health
evaluation in necessary. It is also important to notify the client's
physician or the clinician responsible for the client's care.
◉ Diagnostic Testing when diagnosing mental health disorders. Answer:
-Diagnostic tests and labs are most used to rule out physical conditions
, that may cause psychiatric symptoms and to evaluate the effects of
treatment
◉ Basic Laboratory Interpretation. Answer: Complete Blood Count
Comprehensive Metabolic Panel (CMP)
Thyroid Function Tests
Vitamin B12 Level
Vitamin D Level
Toxicology Screen
Urinalysis (UA)
◉ Basic Laboratory Interpretation: Complete Blood Count. Answer: -
measures RBCs, WBCs, hemoglobin, hematocrit, and platelets
-includes a differential of the WBCs
-In mental health, the CBC is used to rule out medical conditions that
may present with symptoms that can be attributed to both medical and
psychiatric diagnoses
• Ex: rule out anemia as a cause for depressive symptoms and fatigue
• Ex: rule out infection as a cause of acute mental status changes
RBCs: 4.5-6.0 million/microliter
Hemoglobin: 12-18 grams/100 mL
Hematocrit: 38%-48%
