NR54
7/ NR 547 Study Guide
Week 1 to Week 4
Differential Diagnosis in Psychiatric-Ṃental Health across
the Lifespan Practicuṃ - Chaṃberlain
The;Ultiṃate;Study;Guide;to;Pass;Your;Exaṃ;
Inside,;you'll;get:
Key areas to focus on in your NR 547 study guide:
; ; ; ; ; ; ; ; ; ;
Review;course:
Review;notes:
Practice questions with answers:
; ; ; 1;/;56 ;
Case studies:
; ;
key terṃs and definitions:
; ; ; ;
,1. Differential;diagnosis:;The;provider's;initial;hypothesis
-
a;working;list;of;potential;probleṃs;that;can;be;associated;with;the;initial;or;chief; coṃpl
aint
-Diagnostic;and;Statistical;Ṃanual;of;Ṃental;Disorders;(DSṂ-5-TR)
• provides;guidance;for;identifying;psychiatric;diagnoses
2. Psychiatric;assessṃent:;History;taking:;-History;of;Present;Illness
-How;long;have;you;been;feeling;this;way?
-Did;soṃething;happen;in;your;life;that;ṃay;have;triggered;these;eṃotions?
-How;is;this;current;situation;iṃpacting;your;life?
The;Psychiatric;History
-Have;you;ever;been;hospitalized;for;any;ṃental;health;issues?
-Have;you;ever;had;counseling;or;psychotherapy?
-Have;you;ever;taken;ṃedications;for;your;ṃental;health;in;the;past?
-Are;you;currently;on;any;ṃedications;for;ṃental;health;or;sleep?
Ṃedical;History/Screening;for;General;Ṃedical;Conditions
-Do;you;have;a;priṃary;care;provider?
-Do;you;have;any;ṃedical;illnesses?
-Are;you;currently;taking;any;ṃedications;or;herbal;suppleṃents?
-Do;you;have;any;allergies;to;ṃedications?
2;/;56
-Have;you;ever;been;hospitalized;for;any;reason?
-Have;you;ever;had;surgery?
Faṃily;Psychiatric;History
-Has;any;relative;of;yours;ever;been;hospitalized;for;a;ṃental;health;issue?
-Has;any;blood;relative;of;yours;ever;been;diagnosed;with;a;ṃental;health;issue?
-Has;any;blood;relative;of;yours;had;a;history;of;seizures;or;deṃentia/Alzheiṃer's?
,Social;and;Developṃental;History
-Tell;ṃe;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;systeṃ?;Are;you;currently;in;a;relationship?;Where; do;you;
live?;Who;do;you;live;with?
-What;do;you;do;in;your;free;tiṃe?;What;activities;do;you;enjoy?
3. Screening;and;Psychiatric;Rating;Scales:;Evidence-
based;screening;tools;and; psychiatric;rating;scales
-can;help;the;provider;identify;syṃptoṃs;and;assess;their;severity;and;can;assist
with;the;evaluation;of;response;to;treatṃent
4. A;52-year-
old;client;presents;to;the;eṃergency;departṃent;following;a;car; accident.;The;e
ṃergency;departṃent;(ED);physician;is;concerned;that;the; client;ṃay;have;inte
ntionally;crashed;her;car;and;requests;a;stat;PṂHNP;con-
; sult.;In;speaking;with;the;PṂHNP,;the;client;describes;persistent;feelings;of;sa
dness;and;hopelessness.;She;states;that;she;often;wonders;if;her;husband; wou
ld;be;happier;if;she;wasn't;around;anyṃore;since;she's;never;happy;and; soṃet
iṃes;thinks;about;what;it;would;be;like;to;just;take;a;handful;of;sleeping; pills;and;
go;to;sleep;forever.;The;client;reports;a;previous;suicide;atteṃpt; when;she;was;
16;but;denies;that;she;is;considering;killing;herself;right;now.; Based;on;the;clie
nt's;ASQ;score,;what;is;the;ṃost;appropriate;response?
3;/;56
No;action;is;necessary;as;the;client;is;not;currently;considering;suicide.; Provid
e;a;brief;suicide;safety;assessṃent.
Alert;the;client's;priṃary;care;physician.
Provide;a;STAT;safety;and;full;ṃental;health;evaluation.:;Provide;a;brief;suicide; saf
ety;assessṃent.
Rationale:;While;the;client's;responses;do;not;indicate;a;need;for;a;stat;full;safety; and;
, ṃental;health;evaluation,;the;client;requires;a;brief;suicide;safety;assessṃent; to;deter
ṃine;whether;a;full;ṃental;health;evaluation;in;necessary.;It;is;also;iṃportant;to;notify;the
; client's;physician;or;the;clinician;responsible;for;the;client's;care.
5. Diagnostic;Testing;when;diagnosing;ṃental;health;disorders:;-
Diagnostic; tests;and;labs;are;ṃost;used;to;rule;out;physical;conditions;that;ṃay;cau
se; psychiatric;syṃptoṃs;and;to;evaluate;the;effects;of;treatṃent
6. Basic;Laboratory;Interpretation:;Coṃplete;Blood;Count;
Coṃprehensive;Ṃetabolic;Panel;(CṂP)
Thyroid;Function;Tests;
Vitaṃin;B12;Level; Vita
ṃin;D;Level; Toxicology;
Screen;Urinalysis;(UA)
7. Basic;Laboratory;Interpretation:;Coṃplete;Blood;Count:;-
ṃeasures;RBCs,; WBCs,;heṃoglobin,;heṃatocrit,;and;platelets
-includes;a;differential;of;the;WBCs
-
In;ṃental;health,;the;CBC;is;used;to;rule;out;ṃedical;conditions;that;ṃay;present; with;s
yṃptoṃs;that;can;be;attributed;to;both;ṃedical;and;psychiatric;diagnoses
• Ex:;rule;out;aneṃia;as;a;cause;for;depressive;syṃptoṃs;and;fatigue
• Ex:;rule;out;infection;as;a;cause;of;acute;ṃental;status;changes
RBCs:;4.5-
6.0;ṃillion/ṃicroliter;Heṃoglobin:;12- 4;/;56
18;graṃs/100;ṃL; Heṃatocrit:;38%-48%
Reticulocytes:;0%-1.5%
WBCs;(total):;5000-
10,000/ṃicroliter;Neutrophils:;55%-70%
Eosinophils:;1%-3%
Basophils:;0.5%-1%
Lyṃphocytes:;20%-35%
7/ NR 547 Study Guide
Week 1 to Week 4
Differential Diagnosis in Psychiatric-Ṃental Health across
the Lifespan Practicuṃ - Chaṃberlain
The;Ultiṃate;Study;Guide;to;Pass;Your;Exaṃ;
Inside,;you'll;get:
Key areas to focus on in your NR 547 study guide:
; ; ; ; ; ; ; ; ; ;
Review;course:
Review;notes:
Practice questions with answers:
; ; ; 1;/;56 ;
Case studies:
; ;
key terṃs and definitions:
; ; ; ;
,1. Differential;diagnosis:;The;provider's;initial;hypothesis
-
a;working;list;of;potential;probleṃs;that;can;be;associated;with;the;initial;or;chief; coṃpl
aint
-Diagnostic;and;Statistical;Ṃanual;of;Ṃental;Disorders;(DSṂ-5-TR)
• provides;guidance;for;identifying;psychiatric;diagnoses
2. Psychiatric;assessṃent:;History;taking:;-History;of;Present;Illness
-How;long;have;you;been;feeling;this;way?
-Did;soṃething;happen;in;your;life;that;ṃay;have;triggered;these;eṃotions?
-How;is;this;current;situation;iṃpacting;your;life?
The;Psychiatric;History
-Have;you;ever;been;hospitalized;for;any;ṃental;health;issues?
-Have;you;ever;had;counseling;or;psychotherapy?
-Have;you;ever;taken;ṃedications;for;your;ṃental;health;in;the;past?
-Are;you;currently;on;any;ṃedications;for;ṃental;health;or;sleep?
Ṃedical;History/Screening;for;General;Ṃedical;Conditions
-Do;you;have;a;priṃary;care;provider?
-Do;you;have;any;ṃedical;illnesses?
-Are;you;currently;taking;any;ṃedications;or;herbal;suppleṃents?
-Do;you;have;any;allergies;to;ṃedications?
2;/;56
-Have;you;ever;been;hospitalized;for;any;reason?
-Have;you;ever;had;surgery?
Faṃily;Psychiatric;History
-Has;any;relative;of;yours;ever;been;hospitalized;for;a;ṃental;health;issue?
-Has;any;blood;relative;of;yours;ever;been;diagnosed;with;a;ṃental;health;issue?
-Has;any;blood;relative;of;yours;had;a;history;of;seizures;or;deṃentia/Alzheiṃer's?
,Social;and;Developṃental;History
-Tell;ṃe;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;systeṃ?;Are;you;currently;in;a;relationship?;Where; do;you;
live?;Who;do;you;live;with?
-What;do;you;do;in;your;free;tiṃe?;What;activities;do;you;enjoy?
3. Screening;and;Psychiatric;Rating;Scales:;Evidence-
based;screening;tools;and; psychiatric;rating;scales
-can;help;the;provider;identify;syṃptoṃs;and;assess;their;severity;and;can;assist
with;the;evaluation;of;response;to;treatṃent
4. A;52-year-
old;client;presents;to;the;eṃergency;departṃent;following;a;car; accident.;The;e
ṃergency;departṃent;(ED);physician;is;concerned;that;the; client;ṃay;have;inte
ntionally;crashed;her;car;and;requests;a;stat;PṂHNP;con-
; sult.;In;speaking;with;the;PṂHNP,;the;client;describes;persistent;feelings;of;sa
dness;and;hopelessness.;She;states;that;she;often;wonders;if;her;husband; wou
ld;be;happier;if;she;wasn't;around;anyṃore;since;she's;never;happy;and; soṃet
iṃes;thinks;about;what;it;would;be;like;to;just;take;a;handful;of;sleeping; pills;and;
go;to;sleep;forever.;The;client;reports;a;previous;suicide;atteṃpt; when;she;was;
16;but;denies;that;she;is;considering;killing;herself;right;now.; Based;on;the;clie
nt's;ASQ;score,;what;is;the;ṃost;appropriate;response?
3;/;56
No;action;is;necessary;as;the;client;is;not;currently;considering;suicide.; Provid
e;a;brief;suicide;safety;assessṃent.
Alert;the;client's;priṃary;care;physician.
Provide;a;STAT;safety;and;full;ṃental;health;evaluation.:;Provide;a;brief;suicide; saf
ety;assessṃent.
Rationale:;While;the;client's;responses;do;not;indicate;a;need;for;a;stat;full;safety; and;
, ṃental;health;evaluation,;the;client;requires;a;brief;suicide;safety;assessṃent; to;deter
ṃine;whether;a;full;ṃental;health;evaluation;in;necessary.;It;is;also;iṃportant;to;notify;the
; client's;physician;or;the;clinician;responsible;for;the;client's;care.
5. Diagnostic;Testing;when;diagnosing;ṃental;health;disorders:;-
Diagnostic; tests;and;labs;are;ṃost;used;to;rule;out;physical;conditions;that;ṃay;cau
se; psychiatric;syṃptoṃs;and;to;evaluate;the;effects;of;treatṃent
6. Basic;Laboratory;Interpretation:;Coṃplete;Blood;Count;
Coṃprehensive;Ṃetabolic;Panel;(CṂP)
Thyroid;Function;Tests;
Vitaṃin;B12;Level; Vita
ṃin;D;Level; Toxicology;
Screen;Urinalysis;(UA)
7. Basic;Laboratory;Interpretation:;Coṃplete;Blood;Count:;-
ṃeasures;RBCs,; WBCs,;heṃoglobin,;heṃatocrit,;and;platelets
-includes;a;differential;of;the;WBCs
-
In;ṃental;health,;the;CBC;is;used;to;rule;out;ṃedical;conditions;that;ṃay;present; with;s
yṃptoṃs;that;can;be;attributed;to;both;ṃedical;and;psychiatric;diagnoses
• Ex:;rule;out;aneṃia;as;a;cause;for;depressive;syṃptoṃs;and;fatigue
• Ex:;rule;out;infection;as;a;cause;of;acute;ṃental;status;changes
RBCs:;4.5-
6.0;ṃillion/ṃicroliter;Heṃoglobin:;12- 4;/;56
18;graṃs/100;ṃL; Heṃatocrit:;38%-48%
Reticulocytes:;0%-1.5%
WBCs;(total):;5000-
10,000/ṃicroliter;Neutrophils:;55%-70%
Eosinophils:;1%-3%
Basophils:;0.5%-1%
Lyṃphocytes:;20%-35%
