NR548 EXAM 2 QUESTIONS AND
VERIFIED SOLUTIONS 2024/2025
UPDATE | RATED A+
Psychiatric interview
The process by which psychiatric assessment is conducted
-primary tasks
• building a therapeu;c alliance between the PMHNP & client
• obtaining a database of psychiatric info about the client
• establishing a dx
• nego;a;ng a tx plan
Therapeu;c Alliance
A feeling that you should create over the course of the diagnos;c interview, a
sense of rapport, trust, and warmth
-most important goal of the interview process
-the coopera;ve working rela;onship between the therapist and client
• begins during the ini;al or opening phase of the interview
-fundamental component of successful therapy
• Without trust, adherence to treatment recommenda;ons may be
compromised
• interview may not elicit the informa;on needed to formulate an appropriate
dx & plan of care without rapport & trust
Crea;ng rapport: ;ps
-Be Yourself
-Be Warm, Courteous, and Emo;onally Sensi;ve
-Ac;vely Defuse the Strangeness of the Clinical Situa;on
,-Give Your Pa;ent the Opening Word
-Gain Your Pa;ent's Trust by Projec;ng Competence
How to approach threatening topics (sensi;ve/embarrassing material)
-Normaliza;on
-Symptom Expecta;on
-Symptom Exaggera;on
-Reduc;on of Guilt
-Use Familiar Language When Asking about Behaviors
Normaliza;on
Introducing Q with some type of normalizing statement
-two principal ways to do this:
1. Start the ques;on by implying that the behavior is a normal or
understandable response to a mood or situa;on
• ex: Some;mes when people are very depressed, they think of hur;ng
themselves. Has this been true for you?
2. Begin by describing another pa;ent (or pa;ents) who has engaged in the
behavior, showing your pa;ent that she is not alone
• ex: i've talked to several pa;ents 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 Expecta;on
Communicate that a behavior is in some way normal or expected
-Phrase your Q's to imply that you already assume the pa;ent has engaged in
some behavior and that you will not be offended by a posi;ve response
-high index of suspicion of some self-destruc;ve ac;vity
-Ex: pa;ent is profoundly depressed and has expressed feelings of
, hopelessness. You suspect suicidality, but you sense that the pa;ent may be
too ashamed to admit it. Rather than gingerly asking "Have you had any
thoughts that you'd be beaer off dead?" you might decide to use symptom
expecta;on. "What kinds of ways to hurt yourself have you thought about?"
*reserve this technique for situa;ons in which it seems appropriate
Symptom Exaggera;on
Sugges;ng a frequency of a problema;c behavior that is higher than your
expecta;on, so that the pa;ent 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 situa;ons in which it seems appropriate
Reduc;on of guilt
Seeks to directly reduce a pa;ent's guilt about a specific behavior in order to
discover what they have been doing
-useful in obtaining a hx of domes;c violence & other an;social behavior
Domes;c Violence
-"Have you ever been in situa;ons where fights occurred and you were
affected?"
• If pa;ent answers "yes," you can flesh out whether role was being a witness,
vic;m, or perpetrator
According to Peplau's Theory of Interpersonal Rela;ons, establishing early
rapport allows the role of the nurse to evolve from stranger to:
Resource person, teacher, leader, surrogate, technical expert, and counselor
Establishing the Rela;onship
VERIFIED SOLUTIONS 2024/2025
UPDATE | RATED A+
Psychiatric interview
The process by which psychiatric assessment is conducted
-primary tasks
• building a therapeu;c alliance between the PMHNP & client
• obtaining a database of psychiatric info about the client
• establishing a dx
• nego;a;ng a tx plan
Therapeu;c Alliance
A feeling that you should create over the course of the diagnos;c interview, a
sense of rapport, trust, and warmth
-most important goal of the interview process
-the coopera;ve working rela;onship between the therapist and client
• begins during the ini;al or opening phase of the interview
-fundamental component of successful therapy
• Without trust, adherence to treatment recommenda;ons may be
compromised
• interview may not elicit the informa;on needed to formulate an appropriate
dx & plan of care without rapport & trust
Crea;ng rapport: ;ps
-Be Yourself
-Be Warm, Courteous, and Emo;onally Sensi;ve
-Ac;vely Defuse the Strangeness of the Clinical Situa;on
,-Give Your Pa;ent the Opening Word
-Gain Your Pa;ent's Trust by Projec;ng Competence
How to approach threatening topics (sensi;ve/embarrassing material)
-Normaliza;on
-Symptom Expecta;on
-Symptom Exaggera;on
-Reduc;on of Guilt
-Use Familiar Language When Asking about Behaviors
Normaliza;on
Introducing Q with some type of normalizing statement
-two principal ways to do this:
1. Start the ques;on by implying that the behavior is a normal or
understandable response to a mood or situa;on
• ex: Some;mes when people are very depressed, they think of hur;ng
themselves. Has this been true for you?
2. Begin by describing another pa;ent (or pa;ents) who has engaged in the
behavior, showing your pa;ent that she is not alone
• ex: i've talked to several pa;ents 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 Expecta;on
Communicate that a behavior is in some way normal or expected
-Phrase your Q's to imply that you already assume the pa;ent has engaged in
some behavior and that you will not be offended by a posi;ve response
-high index of suspicion of some self-destruc;ve ac;vity
-Ex: pa;ent is profoundly depressed and has expressed feelings of
, hopelessness. You suspect suicidality, but you sense that the pa;ent may be
too ashamed to admit it. Rather than gingerly asking "Have you had any
thoughts that you'd be beaer off dead?" you might decide to use symptom
expecta;on. "What kinds of ways to hurt yourself have you thought about?"
*reserve this technique for situa;ons in which it seems appropriate
Symptom Exaggera;on
Sugges;ng a frequency of a problema;c behavior that is higher than your
expecta;on, so that the pa;ent 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 situa;ons in which it seems appropriate
Reduc;on of guilt
Seeks to directly reduce a pa;ent's guilt about a specific behavior in order to
discover what they have been doing
-useful in obtaining a hx of domes;c violence & other an;social behavior
Domes;c Violence
-"Have you ever been in situa;ons where fights occurred and you were
affected?"
• If pa;ent answers "yes," you can flesh out whether role was being a witness,
vic;m, or perpetrator
According to Peplau's Theory of Interpersonal Rela;ons, establishing early
rapport allows the role of the nurse to evolve from stranger to:
Resource person, teacher, leader, surrogate, technical expert, and counselor
Establishing the Rela;onship
