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NR 548 Exam 2 (Latest 2024 / 2025): |Questions and Verified Answers| 100% Correct - Chamberlain
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NR 548 Exam 2 (Latest 2024 / 2025): |Questions and Verified Answers| 100% Correct - Chamberlain
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NR 548 Exam 2 (Latest ): |Questions andVerified Answers| 100% Correct - Chamberlain
According to Peplau's Theory of Interpersonal Relations, establishing early rapport
allows the role of the nurse to evolve from stranger to: - ANSWERresource person,
teacher, leader, surrogate, technical expert, and counselor
Active Listening - ANSWERinvolves preparing to be fully attentive to the interaction
-note verbal and non-verbal cues
• including what is said and how it is said
-indicate attentiveness through their feedback and body language
Advanced communication skills - ANSWERcritical listening
critical questioning
critical thinking
Body of the Interview - 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
chief complaint - ANSWERclient's reason for seeking treatment or evaluation
-Using the client's own words
• even if improbable or nonsensical, conveys valuable information about the client's
capacity for self-observation and insight.
Client Considerations: mute or catatonic clients - ANSWERuse of observation
techniques will help in formulating a potential diagnosis.
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
Common precipitants of psychiatric syndromes - ANSWER-arguments with friends or
relatives
-rejection or abandonment
-death or major illness of loved ones
,-anniversary of a negative event, such as a death or divorce
-major medical illness or age-related deterioration in functioning
-stressful events at work or school
-mental health clinician going on vacation
-medication noncompliance
-substance abuse
Comprehensive Health History - ANSWER-Chief Complaint
-History of Present Illness
-Past Medical History
-Medications and Allergies
-Family History
-Personal and Social History
-Review of Systems
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
Delusional clients require: - ANSWERpatience and understanding during the psychiatric
interview
-Avoid disagreeing with them or denying the reality of their delusions
essential questions: Syndromal history - ANSWERHow old were you when you first had
these symptoms?
How many episodes have you had?
When was the last episode?
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
Family Hx - ANSWERDocument info about the client's parents, grandparents, siblings,
children, and grandchildren
-regarding age, health, & cause of death.
-Include whether they have conditions such as hypertension, coronary artery disease,
stroke, diabetes, or cancer.
-Many psychiatric disorders have a genetic component
, • info about family psych hx including tx that was successful/unsuccessful may help
form dx/tx plan, can help ID those available for support, ID stresses/contributing factors
to clients condition
Focused Questions for The Psychiatric Assessment: Family Psychiatric History -
ANSWER-Has any relative of yours ever been hospitalized for a mental health issue?
-Has any blood relative of yours ever been diagnosed with a mental health issue?
-Has any blood relative of yours had a history of seizures or dementia/Alzheimer's?
Focused Questions for The Psychiatric Assessment: History of Present Illness -
ANSWER-How long have you been feeling this way?
-Did something happen in your life that may have triggered these emotions?
-How is this current situation impacting your life?
Focused Questions for The Psychiatric Assessment: Medical History/Screening for
General Medical Conditions - ANSWER-Do you have a primary care provider?
-Do you have any medical illnesses?
-Are you currently taking any medications or herbal supplements?
-Do you have any allergies to medications?
-Have you ever been hospitalized for any reason?
-Have you ever had surgery?
Focused Questions for The Psychiatric Assessment: Social and Developmental History
- ANSWER-Tell me a little bit about your childhood and how you grew up.
-How was your experience in school when you were younger? Did you enjoy school?
-How do you support yourself with your finances?
-Do you have a good support system? Are you currently in a relationship? Where do
you live? Who do you live with?
-What do you do in your free time? What activities do you enjoy?
Focused Questions for The Psychiatric Assessment: The Psychiatric History -
ANSWER-Have you ever been hospitalized for any mental health issues?
-Have you ever had counseling or psychotherapy?
-Have you ever taken medications for your mental health in the past?
-Are you currently on any medications for mental health or sleep?
Four Tasks of the Diagnostic Interview - ANSWER1. Build a therapeutic alliance
2. Obtain the psychiatric database
3. Interview for diagnosis
4. Negotiate a tx plan with your patient
Go CHaMP - ANSWERMnemonic for tx hx:
General questions
Current caregivers
Hospitalization history
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