NR547 MIDTERM EXAM LATEST 2024-2025
QUESTIONS AND CORRECT ANSWERS WITH
RATIONALES|ALREADY GRADED A+
differential diagnosis - ANSWER-The provider's initial hypothesis
-a working list of potential problems that can be associated with the
initial or chief complaint
-Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR)
• provides guidance for identifying psychiatric diagnoses
Psychiatric assessment: History taking - ANSWER--History of Present
Illness
-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?
The Psychiatric History
-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?
,Medical History/Screening for General Medical Conditions
-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?
Family Psychiatric History
-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?
Social and Developmental History
-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?
,Screening and Psychiatric Rating Scales - ANSWER-Evidence-based
screening tools and psychiatric rating scales
-can help the provider identify symptoms and assess their severity
and can assist with the evaluation of response to treatment
A 52-year-old client presents to the emergency department following
a car accident. The emergency department (ED) physician is
concerned that the client may have intentionally crashed her car and
requests a stat PMHNP consult. In speaking with the PMHNP, the
client describes persistent feelings of sadness and hopelessness. She
states that she often wonders if her husband would be happier if she
wasn't around anymore since she's never happy and sometimes
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
attempt when she was 16 but denies that she is considering killing
herself right now.
Based on the client's ASQ score, what is the most appropriate
response?
No action is necessary as the client is not currently considering
suicide.
Provide a brief suicide safety assessment.
Alert the client's primary care physician.
Provide a ST - ANSWER-Provide a brief suicide safety assessment.
Rationale: While the client's responses do not indicate a need for a
stat full safety and mental health evaluation, the client requires a
, brief suicide safety assessment to determine whether a full mental
health evaluation in necessary. It is also important to notify the
client's physician or the clinician responsible for the client's care.
Diagnostic Testing when diagnosing mental health disorders -
ANSWER--Diagnostic tests and labs are most used to rule out physical
conditions that may cause psychiatric symptoms and to evaluate the
effects of treatment
Basic Laboratory Interpretation - ANSWER-Complete Blood Count
Comprehensive Metabolic Panel (CMP)
Thyroid Function Tests
Vitamin B12 Level
Vitamin D Level
Toxicology Screen
Urinalysis (UA)
Basic Laboratory Interpretation: Complete Blood Count - ANSWER--
measures RBCs, WBCs, hemoglobin, hematocrit, and platelets
-includes a differential of the WBCs
-In mental health, the CBC is used to rule out medical conditions that
may present with symptoms that can be attributed to both medical
and psychiatric diagnoses
• Ex: rule out anemia as a cause for depressive symptoms and fatigue
• Ex: rule out infection as a cause of acute mental status changes
QUESTIONS AND CORRECT ANSWERS WITH
RATIONALES|ALREADY GRADED A+
differential diagnosis - ANSWER-The provider's initial hypothesis
-a working list of potential problems that can be associated with the
initial or chief complaint
-Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR)
• provides guidance for identifying psychiatric diagnoses
Psychiatric assessment: History taking - ANSWER--History of Present
Illness
-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?
The Psychiatric History
-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?
,Medical History/Screening for General Medical Conditions
-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?
Family Psychiatric History
-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?
Social and Developmental History
-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?
,Screening and Psychiatric Rating Scales - ANSWER-Evidence-based
screening tools and psychiatric rating scales
-can help the provider identify symptoms and assess their severity
and can assist with the evaluation of response to treatment
A 52-year-old client presents to the emergency department following
a car accident. The emergency department (ED) physician is
concerned that the client may have intentionally crashed her car and
requests a stat PMHNP consult. In speaking with the PMHNP, the
client describes persistent feelings of sadness and hopelessness. She
states that she often wonders if her husband would be happier if she
wasn't around anymore since she's never happy and sometimes
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
attempt when she was 16 but denies that she is considering killing
herself right now.
Based on the client's ASQ score, what is the most appropriate
response?
No action is necessary as the client is not currently considering
suicide.
Provide a brief suicide safety assessment.
Alert the client's primary care physician.
Provide a ST - ANSWER-Provide a brief suicide safety assessment.
Rationale: While the client's responses do not indicate a need for a
stat full safety and mental health evaluation, the client requires a
, brief suicide safety assessment to determine whether a full mental
health evaluation in necessary. It is also important to notify the
client's physician or the clinician responsible for the client's care.
Diagnostic Testing when diagnosing mental health disorders -
ANSWER--Diagnostic tests and labs are most used to rule out physical
conditions that may cause psychiatric symptoms and to evaluate the
effects of treatment
Basic Laboratory Interpretation - ANSWER-Complete Blood Count
Comprehensive Metabolic Panel (CMP)
Thyroid Function Tests
Vitamin B12 Level
Vitamin D Level
Toxicology Screen
Urinalysis (UA)
Basic Laboratory Interpretation: Complete Blood Count - ANSWER--
measures RBCs, WBCs, hemoglobin, hematocrit, and platelets
-includes a differential of the WBCs
-In mental health, the CBC is used to rule out medical conditions that
may present with symptoms that can be attributed to both medical
and psychiatric diagnoses
• Ex: rule out anemia as a cause for depressive symptoms and fatigue
• Ex: rule out infection as a cause of acute mental status changes
