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NR548 Exam 2 questions with correct answers
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NR548 Exam 2 questions with correct answers
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NR548 Exam 2 questions with correctanswers
Psychiatric interview - ** VERIFIED 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 - ** VERIFIED 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 - ** VERIFIED 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) - ** VERIFIED ANSWERS
**✔✔-Normalization
-Symptom Expectation
-Symptom Exaggeration
-Reduction of Guilt
-Use Familiar Language When Asking about Behaviors
Normalization - ** VERIFIED 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 - ** VERIFIED 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 - ** VERIFIED 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 - ** VERIFIED 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
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: - ** VERIFIED ANSWERS **✔✔resource person, teacher,
leader, surrogate, technical expert, and counselor
Establishing the Relationship - ** VERIFIED ANSWERS **✔✔-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 - ** VERIFIED ANSWERS **✔✔1. Opening phase
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