NR-548 Psychiatric Assessment for Psychiatric-Mental Health Nurse Practitioner
Exam 2
Question:
Reduction of guilt
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
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Question:
According to Peplau's Theory of Interpersonal Relations, establishing early
rapport allows the role of the nurse to evolve from stranger to:
Answer:
resource person, teacher, leader, surrogate, technical expert, and counselor
Question:
Establishing the Relationship
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
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Question:
Three phases of the psychiatric interview
Answer:
- Opening phase
- Body of the Interview
- Closing the Interview
Question:
Opening phase
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?"
Question:
Body of the Interview
Answer:
-30-40 minutes -Chief Complaint Established • additional Q's asked to elicit info r/t the complaint 3 / 4
-ask about HPI, family hx, social/developmental hx, medical hx, psychiatric ROS -basis for dx and tx formulation
Question:
Closing the Interview
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
Question:
Four Tasks of the Diagnostic Interview
Answer:
- Build a therapeutic alliance
- Obtain the psychiatric database
- Interview for diagnosis
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