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2024 NR548 EXAM 2 WITH CORRECT ANSWERS
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2024 NR548 EXAM 2 WITH CORRECT ANSWERS
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2024 NR548 EXAM 2 WITH CORRECTANSWERS
Obtain the Psychiatric Database - CORRECT ANSWERS- 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
Psychiatric interview - CORRECT ANSWERS- 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 - CORRECT ANSWERS- 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
• 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 - CORRECT ANSWERS- -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
How to approach threatening topics (sensitive/embarrassing material) - CORRECT
ANSWERS- -Normalization
-Symptom Expectation
-Symptom Exaggeration
-Reduction of Guilt
-Use Familiar Language When Asking about Behaviors
Four Tasks of the Diagnostic Interview - CORRECT ANSWERS- 1. Build a therapeutic
alliance
2. Obtain the psychiatric database
3. Interview for diagnosis
4. Negotiate a tx plan with your patient
Normalization - CORRECT ANSWERS- 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?
, 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 - CORRECT ANSWERS- 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 asking "Have you had any thoughts that you'd be
better off dead?" you might decide to use symptom expectation. "What kinds of
ways to hurt yourself have you thought about?"
*reserve this technique for situations in which it seems appropriate
Symptom Exaggeration - CORRECT ANSWERS- 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 ANSWERS- 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
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