NR 548 Psychiatric Assessment Exam 2 | PMHNP | Week 3-4 Covered | Verified Questions & Correct Answers | Latest Update | A+ Graded

NR 548 Psychiatric Assessment for

Psychiatric-Mental Health Nurse Practitioner

Exam 2 Week 3-4 Covered




1. Psychiatric interview: the process by which psychiatric assessment is conduct- ed

-primary tasks

• building a therapeutic alliance between the PMHNP & client

• obtaining a database of psychiatric info about the client

• establishing a dx

• negotiating a tx plan

2. Therapeutic Alliance: a feeling that you should create over the course of the

diagnostic interview, a sense of rapport, trust, and warmth

-most important goal of the interview process

,-the cooperative working relationship between the therapist and client
X X X X X X X X




• begins during the initial or opening phase of the interview
X X X X X X X X X




-fundamental component of successful therapy X X X X




• Without trust, adherence to treatment recommendations may be compromised
X X X X X X X X




• interview may not elicit the information needed to formulate an appropriate dx &
X X X X X X X X X X X X




X plan of care without rapport & trust
X X X X X X




3. Creating rapport: tips: -Be Yourself
X X X X




-Be Warm, Courteous, and Emotionally Sensitive
X X X X X




-Actively Defuse the Strangeness of the Clinical Situation
X X X X X X X




-Give Your Patient the Opening Word
X X X X X




-Gain Your Patient's Trust by Projecting Competence
X X X X X X




4. How to approach threatening topics (sensitive/embarrassing material): -
X X X X X X X




-Normalization

-Symptom Expectation X




-Symptom Exaggeration X




-Reduction of Guilt X X




-Use Familiar Language When Asking about Behaviors
X X X X X X




5. Normalization: Introducing Q with some type of normalizing statement
X X X X X X X X

,-two principal ways to do this:
X X X X X




1. start the question by implying that the behavior is a normal or understandable
X X X X X X X X X X X X




X response to a mood or situation
X X X X X




• ex: Sometimes when people are very depressed, they think of hurting themselves. Has
X X X X X X X X X X X X




X this been true for you?
X X X X




2. Begin by describing another patient (or patients) who has engaged in the behavior,
X X X X X X X X X X X X




showing your patient that she is not alone
X X X X X X X X




• ex: I've talked to several patients who've said that their depression causes them to have
X X X X X X X X X X X X X X




strange experiences, like hearing voices or thinking that strangers are laughing at them.
X X X X X X X X X X X X X




Has that been happening to you?
X X X X X X

, 6. Symptom Expectation: communicate that a behavior is in some way normal or
X X X X X X X X X X X




X expected

-Phrase your Q's to imply that you already assume the patient has engaged in some behavio
X X X X X X X X X X X X X X X




X and that you will not be offended by a positive response
X X X X X X X X X X




-high index of suspicion of some self-destructive activity
X X X X X X X




-Ex: patient is profoundly depressed and has expressed feelings of hopelessness. You
X X X X X X X X X X X




X suspect suicidality, but you sense that the patient may be too ashamed to admit it. Rather
X X X X X X X X X X X X X X X




X than gingerly asking "Have you had any thoughts that you'd be better off dead?" you
X X X X X X X X X X X X X X




X might decide to use symptom expectation. "What kinds of ways to hurt yourself have
X X X X X X X X X X X X X




X you thought about?"
X X




*reserve this technique for situations in which it seems appropriate
X X X X X X X X X




7. Symptom Exaggeration: suggesting a frequency of a problematic behavior that is
X X X X X X X X X X




X higher than your expectation, so that the patient feels that their actual, lower
X X X X X X X X X X X X




X frequency of the behavior will not be perceived by you as being "bad."
X X X X X X X X X X X X




-helpful in clarifying the severity of symptoms
X X X X X X




*reserve this technique for situations in which it seems appropriate
X X X X X X X X X




8. Reduction of guilt: seeks to directly reduce a patient's guilt about a specific
X X X X X X X X X X X X