UPDATE 2024/ 2025 PSYCHIATRIC
ASSESSMENT FOR THE PSYCHIATRIC-
MENTAL HEALTH NURSE PRACTITIONER
REVIEW |WEEKS 3-4 QUESTIONS AND
VERIFIED ANSWERS| A GRADE
Symptom Exaggeration - CORRECT ANSWER✔✔suggesting a
frequency of a problematic behavior that is higher than your
expectation, so that the patient 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 situations in which it seems
appropriate
Reduction of guilt - CORRECT ANSWER✔✔seeks to directly
reduce a patient's guilt about a specific behavior in order to
discover what they have been doing
-useful in obtaining a hx of domestic violence & other antisocial
behavior
Domestic Violence
-"Have you ever been in situations where fights occurred and you
were affected?"
• If patient answers "yes," you can flesh out whether role was
being a witness, victim, or perpetrator
According to Peplau's Theory of Interpersonal Relations,
establishing early rapport allows the role of the nurse to evolve
,from stranger to: - CORRECT ANSWER✔✔resource person,
teacher, leader, surrogate, technical expert, and counselor
Establishing the Relationship - CORRECT ANSWER✔✔-Trust is
essential for a therapeutic alliance
-First impressions are important
-PMHNP should take time to make introductions and ensure the
client is comfortable
-Ask general questions to arrive at an empathic understanding of
how the client feels
-Listen carefully and communicate an appreciation for the client's
concerns
-Building a trusting relationship based on respect, kindness, and
acceptance will break down barriers and allow for client needs to
be the center of the plan of care
-Being present and openly engaged will enhance the
communication experience
three phases of the psychiatric interview - CORRECT ANSWER
✔✔1. Opening phase
2. Body of the Interview
3. Closing the Interview
Opening phase - CORRECT ANSWER✔✔-first 5-10 minutes
-establish rapport & therapeutic alliance
-often most important phase
• establishes the foundation
-begins with PMHNP asking "what brought you in to see me
today?"
Body of the Interview - CORRECT ANSWER✔✔-30-40 minutes
-Chief Complaint Established
• additional Q's asked to elicit info r/t the complaint
, -ask about HPI, family hx, social/developmental hx, medical hx,
psychiatric ROS
-basis for dx and tx formulation
Closing the Interview - CORRECT ANSWER✔✔-5-10 minutes,
final phase
Should include 2 components: discussion of your assessment
using patient education techniques & negotiated agreement about
tx or f/u plans
-wrap-up statement and inquiry about missing info that may be of
value
-Patient education regarding working dx & recommended plan of
tx
• education about meds if recommended
-Homework may be assigned
• especially in CBT
-Return visit agreed upon
Four Tasks of the Diagnostic Interview - CORRECT ANSWER✔
✔1. Build a therapeutic alliance
2. Obtain the psychiatric database
3. Interview for diagnosis
4. Negotiate a tx plan with your patient
Obtain the Psychiatric Database - CORRECT ANSWER✔✔Also
known as the psychiatric history
-includes historical information relevant to the current clinical
presentation
• history of present illness, psychiatric history, medical history,
family psychiatric history, and aspects of the social and
developmental history
Tricks for Improving Patient Recall - CORRECT ANSWER✔✔-
Anchor Questions to Memorable Events