NR548 Exam 2 Questions and answers Newest RATED A+ 100% VERIFIED CORRECT

NR548 Exam 2 Questions and answers Newest RATED A+
100% VERIFIED CORRECT
Psychiatric interview - Correct Answers the process by which psychiatric assessment is
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conducted
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-primary tasks Il`




• building a therapeutic alliance between the PMHNP & client
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• obtaining a database of psychiatric info about the client
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• establishing a dx
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• negotiating a tx plan
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Il` Therapeutic Alliance - Correct Answers a feeling that you should create over the course of the
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Il` diagnostic interview, a sense of rapport, trust, and warmth
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-most important goal of the interview process
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-the cooperative working relationship between the therapist and client
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• begins during the initial or opening phase of the interview
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-fundamental component of successful therapy Il` Il` Il` Il`




• Without trust, adherence to treatment recommendations may be compromised
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• interview may not elicit the information needed to formulate an appropriate dx & plan of care
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without rapport & trust
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Il` Creating rapport: tips - Correct Answers -Be Yourself
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-Be Warm, Courteous, and Emotionally Sensitive
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-Actively Defuse the Strangeness of the Clinical Situation
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-Give Your Patient the Opening Word
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-Gain Your Patient's Trust by Projecting Competence
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,How to approach threatening topics (sensitive/embarrassing material) - Correct Answers -
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Normalization

-Symptom Expectation Il`




-Symptom Exaggeration Il`




-Reduction of Guilt Il` Il`




-Use Familiar Language When Asking about Behaviors
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Il` Normalization - Correct Answers Introducing Q with some type of normalizing statement Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il`




-two principal ways to do this:
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1. start the question by implying that the behavior is a normal or understandable response to a
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mood or situation
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• ex: Sometimes when people are very depressed, they think of hurting themselves. Has this been
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true for you?
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2. Begin by describing another patient (or patients) who has engaged in the behavior, showing
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your patient that she is not alone
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• ex: I've talked to several patients who've said that their depression causes them to have strange
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experiences, like hearing voices or thinking that strangers are laughing at them. Has that been
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happening to you?
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Il` Symptom Expectation - Correct Answers communicate that a behavior is in some way normal or
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Il` expected

-Phrase your Q's to imply that you already assume the patient has engaged in some behavior and
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that you will not be offended by a positive response
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-high index of suspicion of some self-destructive activity
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-Ex: patient is profoundly depressed and has expressed feelings of hopelessness. You suspect
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suicidality, but you sense that the patient may be too ashamed to admit it. Rather than gingerly
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asking "Have you had any thoughts that you'd be better off dead?" you might decide to use
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symptom expectation. "What kinds of ways to hurt yourself have you thought about?"
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, *reserve this technique for situations in which it seems appropriate
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Il` Symptom Exaggeration - Correct Answers suggesting a frequency of a problematic behavior that
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Il` is higher than your expectation, so that the patient feels that their actual, lower frequency of the
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Il` behavior will not be perceived by you as being "bad." Il` Il` Il` Il` Il` Il` Il` Il` Il`




-helpful in clarifying the severity of symptoms Il` Il` Il` Il` Il` Il`




*reserve this technique for situations in which it seems appropriate
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Il` Reduction of guilt - Correct Answers seeks to directly reduce a patient's guilt about a specific
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Il` behavior in order to discover what they have been doing Il` Il` Il` Il` Il` Il` Il` Il` Il`




-useful in obtaining a hx of domestic violence & other antisocial behavior
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Domestic Violence Il`




-"Have you ever been in situations where fights occurred and you were affected?"
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• If patient answers "yes," you can flesh out whether role was being a witness, victim, or
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perpetrator
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Il` According to Peplau's Theory of Interpersonal Relations, establishing early rapport allows the role
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Il` of the nurse to evolve from stranger to: - Correct Answers resource person, teacher, leader,
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Il` surrogate, technical expert, and counselor Il` Il` Il` Il`




Il` Establishing the Relationship - Correct Answers -Trust is essential for a therapeutic alliance Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il`




-First impressions are important Il` Il` Il`




-PMHNP should take time to make introductions and ensure the client is comfortable
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-Ask general questions to arrive at an empathic understanding of how the client feels
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-Listen carefully and communicate an appreciation for the client's concerns
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