Page 1 of 50
NR548 / NR 548 Exam 2 (Latest 2025): Psychiatric
Assessment for Psychiatric-Mental Health Nurse
Practitioner - Chamberlain
Psychiatric interview .....ANSWER.....the process by which
psychiatric assessment is conducted
-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
Therapeutic Alliance .....ANSWER.....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
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-the cooperative working relationship between the therapist and
client
• begins during the initial or opening phase of the interview
-fundamental component of successful therapy
• Without trust, adherence to treatment recommendations may be
compromised
• interview may not elicit the information needed to formulate an
appropriate dx & plan of care without rapport & trust
Creating rapport: tips .....ANSWER.....-Be Yourself
-Be Warm, Courteous, and Emotionally Sensitive
-Actively Defuse the Strangeness of the Clinical Situation
-Give Your Patient the Opening Word
-Gain Your Patient's Trust by Projecting Competence
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How to approach threatening topics (sensitive/embarrassing
material) .....ANSWER.....-Normalization
-Symptom Expectation
-Symptom Exaggeration
-Reduction of Guilt
-Use Familiar Language When Asking about Behaviors
Normalization .....ANSWER.....Introducing Q with some type of
normalizing statement
-two principal ways to do this:
1. start the question by implying that the behavior is a normal or
understandable response to a mood or situation
• ex: Sometimes when people are very depressed, they think of
hurting themselves. Has this been true for you?
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2. Begin by describing another patient (or patients) who has
engaged in the behavior, showing your patient that she is not
alone
• ex: I've talked to several patients 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 Expectation .....ANSWER.....communicate that a
behavior is in some way normal or expected
-Phrase your Q's to imply that you already assume the patient
has engaged in some behavior and that you will not be offended
by a positive response
-high index of suspicion of some self-destructive activity
-Ex: patient is profoundly depressed and has expressed feelings
of hopelessness. You suspect suicidality, but you sense that the
patient may be too ashamed to admit it. Rather than gingerly
NR548 / NR 548 Exam 2 (Latest 2025): Psychiatric
Assessment for Psychiatric-Mental Health Nurse
Practitioner - Chamberlain
Psychiatric interview .....ANSWER.....the process by which
psychiatric assessment is conducted
-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
Therapeutic Alliance .....ANSWER.....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
,Page 2 of 50
-the cooperative working relationship between the therapist and
client
• begins during the initial or opening phase of the interview
-fundamental component of successful therapy
• Without trust, adherence to treatment recommendations may be
compromised
• interview may not elicit the information needed to formulate an
appropriate dx & plan of care without rapport & trust
Creating rapport: tips .....ANSWER.....-Be Yourself
-Be Warm, Courteous, and Emotionally Sensitive
-Actively Defuse the Strangeness of the Clinical Situation
-Give Your Patient the Opening Word
-Gain Your Patient's Trust by Projecting Competence
,Page 3 of 50
How to approach threatening topics (sensitive/embarrassing
material) .....ANSWER.....-Normalization
-Symptom Expectation
-Symptom Exaggeration
-Reduction of Guilt
-Use Familiar Language When Asking about Behaviors
Normalization .....ANSWER.....Introducing Q with some type of
normalizing statement
-two principal ways to do this:
1. start the question by implying that the behavior is a normal or
understandable response to a mood or situation
• ex: Sometimes when people are very depressed, they think of
hurting themselves. Has this been true for you?
, Page 4 of 50
2. Begin by describing another patient (or patients) who has
engaged in the behavior, showing your patient that she is not
alone
• ex: I've talked to several patients 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 Expectation .....ANSWER.....communicate that a
behavior is in some way normal or expected
-Phrase your Q's to imply that you already assume the patient
has engaged in some behavior and that you will not be offended
by a positive response
-high index of suspicion of some self-destructive activity
-Ex: patient is profoundly depressed and has expressed feelings
of hopelessness. You suspect suicidality, but you sense that the
patient may be too ashamed to admit it. Rather than gingerly
