NR 548 EXAM PSYCHIATRIC ASSESSMENT FOR PSYCHIATR
MENTAL HEALTH NURSE PRACTITIONER
ANSWERED 2023/2024
• What are the four main components of a psychiatric assessment? (4
marks)Answer: The four main components of a psychiatric assessment
are:
• History: This includes the patient's personal, family, medical, and psychiatric history, as well as their
current symptoms, stressors, coping skills, and goals.
• Mental status examination: This is a systematic observation of the patient's appearance, behavior, mood,
affect, speech, thought process, thought content, perception, cognition, insight, and judgment.
• Physical examination: This is a general examination of the patient's vital signs, organ systems, and
neurological functions to rule out any medical causes or complications of their mental condition.
• Diagnostic tests: These are laboratory tests, imaging studies, or psychological tests that may help to
confirm orrule out a specific diagnosis or to monitor the patient's response to treatment.
• What are the three main types of psychiatric interviews and when are they used? (6
marks)Answer: The three main types of psychiatric interviews are:
• Screening interview: This is a brief interview that aims to identify the presence or absence of a mental
disorderor a need for further evaluation. It is usually used in primary care settings or in emergency
situations.
• Diagnostic interview: This is a comprehensive interview that aims to establish a diagnosis or a
differential diagnosis based on the criteria of a diagnostic manual such as the DSM-5 or the ICD-10. It
is usually used in specialty mental health settings or in research settings.
• Therapeutic interview: This is an ongoing interview that aims to establish a therapeutic alliance,
explore thepatient's problems and feelings, and facilitate change and recovery. It is usually used in
psychotherapy or counseling settings.
• What are some of the advantages and disadvantages of using structured or semi-structured interviews
versusunstructured interviews for psychiatric diagnosis? (10 marks)
Answer: Some of the advantages and disadvantages of using structured or semi-structured interviews
versusunstructured interviews for psychiatric diagnosis are:
• Advantages of structured or semi-structured interviews: They are more reliable, valid, and standardized
than unstructured interviews. They ensure that all relevant information is covered and that no important
details aremissed. They reduce the influence of interviewer bias or subjectivity. They facilitate
communication and documentation among clinicians and researchers.
• Disadvantages of structured or semi-structured interviews: They are more time-consuming, rigid, and
artificialthan unstructured interviews. They may limit the rapport and flexibility between the interviewer
, and the patient. They may overlook some aspects of the patient's individuality, context, or complexity.
They may not capture the nuances or subtleties of the patient's experience.
• What are some of the common rating scales or instruments that are used to measure the severity or
outcome ofpsychiatric disorders? Give an example for each of the following categories: mood disorders,
anxiety disorders, psychotic disorders, substance use disorders, and personality disorders. (10 marks)
Answer: Some of the common rating scales or instruments that are used to measure the severity or outcome of
psychiatric disorders are:
• Mood disorders: Hamilton Depression Rating Scale (HDRS), Beck Depression Inventory (BDI),
Montgomery-Asberg Depression Rating Scale (MADRS), Young Mania Rating Scale (YMRS), Altman
Self-Rating Mania Scale (ASRM).
• Anxiety disorders: Hamilton Anxiety Rating Scale (HARS), Beck Anxiety Inventory (BAI), Generalized
Anxiety Disorder 7-item scale (GAD-7), Panic Disorder Severity Scale (PDSS), Social Phobia
Inventory(SPIN).
• Psychotic disorders: Positive and Negative Syndrome Scale (PANSS), Brief Psychiatric Rating Scale
(BPRS), Scale for the Assessment of Positive Symptoms (SAPS), Scale for the Assessment of Negative
Symptoms (SANS), Clinical Global Impression Scale for Schizophrenia (CGI-SCH).
• Substance use disorders: Addiction Severity Index (ASI), Alcohol Use Disorders Identification Test
(AUDIT), Drug Abuse Screening Test (DAST), Severity of Dependence Scale (SDS), Clinical Institute
Withdrawal Assessment for Alcohol (CIWA-Ar).
• Personality disorders: Minnesota Multiphasic Personality Inventory 2nd edition (MMPI-2), Millon
Clinical Multiaxial Inventory 3rd edition (MCMI-III), Personality Assessment Inventory (PAI),
Structured ClinicalInterview for DSM-5 Personality Disorders (SCID-5-PD), Personality Disorder
Questionnaire 4th edition (PDQ-4).
• A nurse wants to reinforce positive self-esteem for a patient diagnosed with major depressive
disorder.Today, the patient is wearing a new shirt and has neat, clean hair. Which remark is most
appropriate?
• You look nice this morning.
• You are wearing a new shirt.
• I like the shirt youre wearing.
• You must be feeling better today.
• An adult diagnosed with major depressive disorder was treated with medication and cognitive
behavioral therapy. The patient now recognizes how passivity contributed to the depression. Which
intervention shouldthe nurse suggest?
• Social skills training
• Relaxation training classes
• Use of complementary therapy
• Learning desensitization techniques
• A priority nursing intervention for a patient diagnosed with major depressive disorder is:
• distracting the patient from self-absorption.
• carefully and inconspicuously observing the patient around the clock.
• allowing the patient to spend long periods alone in self-reflection.
• offering opportunities for the patient to assume a leadership role in the therapeutic milieu.
• When counseling patients diagnosed with major depressive disorder, an advanced practice
nurse will address the negative thought patterns by using:
, • psychoanalytic therapy.
• desensitization therapy.
• cognitive behavioral therapy.
• alternative and complementary therapies.
• A patient says to the nurse, My life does not have any happiness in it anymore. I once enjoyed
holidays, butnow theyre just another day. How would the nurse document the complaint?
• Vegetative symptom
• Anhedonia
• Euphoria
• Anergia
• A patient diagnosed with major depressive disorder is taking a tricyclic antidepressant. The patient
says, Idont think I can keep taking these pills. They make me so, especially when I stand up. The nurse
should:
• explain how to manage postural hypotension, and educate the patient that side effects go away after
several weeks.
• tell the patient that the side effects are a minor inconvenience compared with the feelings of depression.
• withhold the drug, force oral fluids, and notify the health care provider to examine the patient.
• teach the patient how to use pursed-lip breathing.
• A patient diagnosed with major depressive disorder is receiving imipramine (Tofranil) 200 mg every
nightat bedtime. Which assessment finding would prompt the nurse to collaborate with the health care
provider regarding potentially hazardous side effects of this drug?
• Dry mouth
• Blurred vision
• Nasal congestion
• Urinary retention
• A patient diagnosed with major depressive disorder tells the nurse, Bad things that happen are
always myfault. To assist the patient in reframing this overgeneralization, the nurse should respond:
• I really doubt that one person can be blamed for all the bad things that happen.
• Lets look at one bad thing that happened to see if another explanation exists.
• You are being exceptionally hard on yourself when you say those things.
• How does your belief in fate relate to your cultural heritage?
• A nurse worked with a patient diagnosed with major depressive disorder who was severely
withdrawn anddependent on others. After 3 weeks, the patient did not improve. The nurse is at risk for
feelings of:
• overinvolvement.
• guilt and despair.
• interest and pleasure.
• ineffectiveness and frustration.
• A patient diagnosed with major depressive disorder begins selective serotonin reuptake inhibitor
(SSRI)antidepressant therapy. Priority information given to the patient and family should include a
directive to:
• avoid exposure to bright sunlight.
• report increased suicidal thoughts.
• restrict sodium intake to 1 g daily.
• maintain a tyramine-free diet.
• A nurse teaching a patient about a tyramine-restricted diet would approve which meal?
• Mashed potatoes, ground beef patty, corn, green beans, apple pie
MENTAL HEALTH NURSE PRACTITIONER
ANSWERED 2023/2024
• What are the four main components of a psychiatric assessment? (4
marks)Answer: The four main components of a psychiatric assessment
are:
• History: This includes the patient's personal, family, medical, and psychiatric history, as well as their
current symptoms, stressors, coping skills, and goals.
• Mental status examination: This is a systematic observation of the patient's appearance, behavior, mood,
affect, speech, thought process, thought content, perception, cognition, insight, and judgment.
• Physical examination: This is a general examination of the patient's vital signs, organ systems, and
neurological functions to rule out any medical causes or complications of their mental condition.
• Diagnostic tests: These are laboratory tests, imaging studies, or psychological tests that may help to
confirm orrule out a specific diagnosis or to monitor the patient's response to treatment.
• What are the three main types of psychiatric interviews and when are they used? (6
marks)Answer: The three main types of psychiatric interviews are:
• Screening interview: This is a brief interview that aims to identify the presence or absence of a mental
disorderor a need for further evaluation. It is usually used in primary care settings or in emergency
situations.
• Diagnostic interview: This is a comprehensive interview that aims to establish a diagnosis or a
differential diagnosis based on the criteria of a diagnostic manual such as the DSM-5 or the ICD-10. It
is usually used in specialty mental health settings or in research settings.
• Therapeutic interview: This is an ongoing interview that aims to establish a therapeutic alliance,
explore thepatient's problems and feelings, and facilitate change and recovery. It is usually used in
psychotherapy or counseling settings.
• What are some of the advantages and disadvantages of using structured or semi-structured interviews
versusunstructured interviews for psychiatric diagnosis? (10 marks)
Answer: Some of the advantages and disadvantages of using structured or semi-structured interviews
versusunstructured interviews for psychiatric diagnosis are:
• Advantages of structured or semi-structured interviews: They are more reliable, valid, and standardized
than unstructured interviews. They ensure that all relevant information is covered and that no important
details aremissed. They reduce the influence of interviewer bias or subjectivity. They facilitate
communication and documentation among clinicians and researchers.
• Disadvantages of structured or semi-structured interviews: They are more time-consuming, rigid, and
artificialthan unstructured interviews. They may limit the rapport and flexibility between the interviewer
, and the patient. They may overlook some aspects of the patient's individuality, context, or complexity.
They may not capture the nuances or subtleties of the patient's experience.
• What are some of the common rating scales or instruments that are used to measure the severity or
outcome ofpsychiatric disorders? Give an example for each of the following categories: mood disorders,
anxiety disorders, psychotic disorders, substance use disorders, and personality disorders. (10 marks)
Answer: Some of the common rating scales or instruments that are used to measure the severity or outcome of
psychiatric disorders are:
• Mood disorders: Hamilton Depression Rating Scale (HDRS), Beck Depression Inventory (BDI),
Montgomery-Asberg Depression Rating Scale (MADRS), Young Mania Rating Scale (YMRS), Altman
Self-Rating Mania Scale (ASRM).
• Anxiety disorders: Hamilton Anxiety Rating Scale (HARS), Beck Anxiety Inventory (BAI), Generalized
Anxiety Disorder 7-item scale (GAD-7), Panic Disorder Severity Scale (PDSS), Social Phobia
Inventory(SPIN).
• Psychotic disorders: Positive and Negative Syndrome Scale (PANSS), Brief Psychiatric Rating Scale
(BPRS), Scale for the Assessment of Positive Symptoms (SAPS), Scale for the Assessment of Negative
Symptoms (SANS), Clinical Global Impression Scale for Schizophrenia (CGI-SCH).
• Substance use disorders: Addiction Severity Index (ASI), Alcohol Use Disorders Identification Test
(AUDIT), Drug Abuse Screening Test (DAST), Severity of Dependence Scale (SDS), Clinical Institute
Withdrawal Assessment for Alcohol (CIWA-Ar).
• Personality disorders: Minnesota Multiphasic Personality Inventory 2nd edition (MMPI-2), Millon
Clinical Multiaxial Inventory 3rd edition (MCMI-III), Personality Assessment Inventory (PAI),
Structured ClinicalInterview for DSM-5 Personality Disorders (SCID-5-PD), Personality Disorder
Questionnaire 4th edition (PDQ-4).
• A nurse wants to reinforce positive self-esteem for a patient diagnosed with major depressive
disorder.Today, the patient is wearing a new shirt and has neat, clean hair. Which remark is most
appropriate?
• You look nice this morning.
• You are wearing a new shirt.
• I like the shirt youre wearing.
• You must be feeling better today.
• An adult diagnosed with major depressive disorder was treated with medication and cognitive
behavioral therapy. The patient now recognizes how passivity contributed to the depression. Which
intervention shouldthe nurse suggest?
• Social skills training
• Relaxation training classes
• Use of complementary therapy
• Learning desensitization techniques
• A priority nursing intervention for a patient diagnosed with major depressive disorder is:
• distracting the patient from self-absorption.
• carefully and inconspicuously observing the patient around the clock.
• allowing the patient to spend long periods alone in self-reflection.
• offering opportunities for the patient to assume a leadership role in the therapeutic milieu.
• When counseling patients diagnosed with major depressive disorder, an advanced practice
nurse will address the negative thought patterns by using:
, • psychoanalytic therapy.
• desensitization therapy.
• cognitive behavioral therapy.
• alternative and complementary therapies.
• A patient says to the nurse, My life does not have any happiness in it anymore. I once enjoyed
holidays, butnow theyre just another day. How would the nurse document the complaint?
• Vegetative symptom
• Anhedonia
• Euphoria
• Anergia
• A patient diagnosed with major depressive disorder is taking a tricyclic antidepressant. The patient
says, Idont think I can keep taking these pills. They make me so, especially when I stand up. The nurse
should:
• explain how to manage postural hypotension, and educate the patient that side effects go away after
several weeks.
• tell the patient that the side effects are a minor inconvenience compared with the feelings of depression.
• withhold the drug, force oral fluids, and notify the health care provider to examine the patient.
• teach the patient how to use pursed-lip breathing.
• A patient diagnosed with major depressive disorder is receiving imipramine (Tofranil) 200 mg every
nightat bedtime. Which assessment finding would prompt the nurse to collaborate with the health care
provider regarding potentially hazardous side effects of this drug?
• Dry mouth
• Blurred vision
• Nasal congestion
• Urinary retention
• A patient diagnosed with major depressive disorder tells the nurse, Bad things that happen are
always myfault. To assist the patient in reframing this overgeneralization, the nurse should respond:
• I really doubt that one person can be blamed for all the bad things that happen.
• Lets look at one bad thing that happened to see if another explanation exists.
• You are being exceptionally hard on yourself when you say those things.
• How does your belief in fate relate to your cultural heritage?
• A nurse worked with a patient diagnosed with major depressive disorder who was severely
withdrawn anddependent on others. After 3 weeks, the patient did not improve. The nurse is at risk for
feelings of:
• overinvolvement.
• guilt and despair.
• interest and pleasure.
• ineffectiveness and frustration.
• A patient diagnosed with major depressive disorder begins selective serotonin reuptake inhibitor
(SSRI)antidepressant therapy. Priority information given to the patient and family should include a
directive to:
• avoid exposure to bright sunlight.
• report increased suicidal thoughts.
• restrict sodium intake to 1 g daily.
• maintain a tyramine-free diet.
• A nurse teaching a patient about a tyramine-restricted diet would approve which meal?
• Mashed potatoes, ground beef patty, corn, green beans, apple pie
