NR 547 Differential Dx Midterm Exam Actual
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Differential Diagnosis in Psychiatric- n n n
Mental Health across the Lifespan Practicum
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Questions and Answers | 100% Correct | Grade A n n n n n n n n
1. Differential Dx: Diagnostic reasoning is the process of questioning one's thinking to
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n determine if all possible avenues have been explored and if the conclusions that are d
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rawn are based on evidence.This is a critical step for providers who are trying to uncover
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a cause, or diagnosis, for their clients' signs and symptoms. The provider's initial hypo
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hesis is known as the differential diagnosis. The differential diagnosis, or differential,
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s a working list of potential problems that can be associated with the initial or chief co
n n n n n n n n n n n n n n n n
mplaint. Establishing a differential diagnosis is a critical step in providing safe, quality
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care. This evolving process of clinical reasoning and decision making involves examin
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ing the client's presentation, clinical data, and when appro-
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n priate, screening and diagnostic test results to distinguish one disease from another a
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nd arrive at the correct diagnosis. The Diagnostic and Statistical Manual of Mental Dis
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orders (DSM-5-TR)provides guidance for identifying psychiatric diagnosest
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2. History of Present Illness: How long have you been feeling this way?
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1n/n78
,Did something happen in your life that may have triggered these emotions? How
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is this current situation impacting your life?
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3. The Psychiatric History: Have you ever been hospitalized for any mental health is
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sues?
Have you ever had counseling or psychotherapy?
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Have you ever taken medications for your mental health in the past? Ar
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e you currently on any medications for mental health or sleep?
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4. Medical History/Screening for General Medical Conditions: Do you have a p
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rimary care provider? n n
Do you have any medical illnesses?
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Are you currently taking any medications or herbal supplements? Do
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n you have any allergies to medications?
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Have you ever been hospitalized for any reason? Have
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n you ever had surgery?
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5. Family Psychiatric History: Has any relative of yours ever been hospitalized for a
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mental health issue? n n
Has any blood relative of yours ever been diagnosed with a mental health issue? Has
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ny blood relative of yours had a history of seizures or dementia/Alzheimer's?
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6. Social and Developmental History: Tell me a little bit about your childhood and ho
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2n/n78
,w you grew up.
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How was your experience in school when you were younger? Did you enjoy school? Ho
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do you support yourself with your finances?
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Do you have a good support system? Are you currently in a relationship? Where do you
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ve? Who do you live with?
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What do you do in your free time? What activities do you enjoy?
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7. Which of the following should be included when providing client education a
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bout medication regimens? Select all that apply.: A)Explain how the medication tar
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gets the symptoms, specific benefits, and expected time course. (Correct answer)
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B) Identify potential side effects, duration of side effects, and adverse effects. (Correct a
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nswer)
C) Explain the instructions, dosing, and special requirements. (Correct answer)
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D) Use teach-back methods to ensure client understanding. (Correct answer)
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8. Apply the Ask Suicide- n n n
Screening Questions (ASQ) Suicide Risk Screening Tool (Links to an external
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site.) to the scenario below.
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A 52-year-old client presents to the emergency department following a car ac-
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cident.T he emergency department (ED) physician is concerned that the client
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may have intentionally crashed her car and requests a stat PMHNP consult. In sp
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3n/n78
, eaking with the PMHNP, the client describes persistent feelings of sadness and
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hopelessness. She states that she often wonders if her husband would be happi n n n n n n n n n n n n
er if she wasn't around anymore since she's never happy and sometimes thinks a
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bout what it would be like to just take a handful of sleeping pills and go to sleep
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forever. The client reports a previous suicide attempt when she was 16 but den
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es that she is considering killing herself right now.
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Based on the client's ASQ score, what is the most appropriate response?
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A) No action is necessary as the client is not currently considering suicide.
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B) Provide a brief suicide safety assessment. n n n n n
C) Alert the client's primary care physician.
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D) Provide a STAT safety and full mental health evaluation.: B)Provide a brief s
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uicide safety assessment. n n
Rationale: While the client's responses do not indicate a need for a stat full safety and
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mental health evaluation, the client requires a brief suicide safety assessment to dete
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mine whether a full mental health evaluation in necessary. It is also important to notify th
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e client's physician or the clinician responsible for the client's care.
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9. Complete Blood Count: The CBC is a serum diagnostic test that measures red b
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ood cells, white blood cells, hemoglobin, hematocrit, and platelets. The CBC includes
n n n n n n n n n n n
n a differential of the white blood cells.
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4n/n78
n n n n n n
Differential Diagnosis in Psychiatric- n n n
Mental Health across the Lifespan Practicum
n n n n n n
Questions and Answers | 100% Correct | Grade A n n n n n n n n
1. Differential Dx: Diagnostic reasoning is the process of questioning one's thinking to
n n n n n n n n n n n
n determine if all possible avenues have been explored and if the conclusions that are d
n n n n n n n n n n n n n n
rawn are based on evidence.This is a critical step for providers who are trying to uncover
n n n n n n n n n n n n n n n n
a cause, or diagnosis, for their clients' signs and symptoms. The provider's initial hypo
n n n n n n n n n n n n n
hesis is known as the differential diagnosis. The differential diagnosis, or differential,
n n n n n n n n n n n n
s a working list of potential problems that can be associated with the initial or chief co
n n n n n n n n n n n n n n n n
mplaint. Establishing a differential diagnosis is a critical step in providing safe, quality
n n n n n n n n n n n n
care. This evolving process of clinical reasoning and decision making involves examin
n n n n n n n n n n n
ing the client's presentation, clinical data, and when appro-
n n n n n n n n
n priate, screening and diagnostic test results to distinguish one disease from another a
n n n n n n n n n n n n
nd arrive at the correct diagnosis. The Diagnostic and Statistical Manual of Mental Dis
n n n n n n n n n n n n n
orders (DSM-5-TR)provides guidance for identifying psychiatric diagnosest
n n n n n n
2. History of Present Illness: How long have you been feeling this way?
n n n n n n n n n n n
1n/n78
,Did something happen in your life that may have triggered these emotions? How
n n n n n n n n n n n n n
is this current situation impacting your life?
n n n n n n
3. The Psychiatric History: Have you ever been hospitalized for any mental health is
n n n n n n n n n n n n
sues?
Have you ever had counseling or psychotherapy?
n n n n n n
Have you ever taken medications for your mental health in the past? Ar
n n n n n n n n n n n n
e you currently on any medications for mental health or sleep?
n n n n n n n n n n
4. Medical History/Screening for General Medical Conditions: Do you have a p
n n n n n n n n n n
rimary care provider? n n
Do you have any medical illnesses?
n n n n n
Are you currently taking any medications or herbal supplements? Do
n n n n n n n n n
n you have any allergies to medications?
n n n n n
Have you ever been hospitalized for any reason? Have
n n n n n n n n
n you ever had surgery?
n n n
5. Family Psychiatric History: Has any relative of yours ever been hospitalized for a
n n n n n n n n n n n n
mental health issue? n n
Has any blood relative of yours ever been diagnosed with a mental health issue? Has
n n n n n n n n n n n n n n
ny blood relative of yours had a history of seizures or dementia/Alzheimer's?
n n n n n n n n n n n
6. Social and Developmental History: Tell me a little bit about your childhood and ho
n n n n n n n n n n n n n
2n/n78
,w you grew up.
n n n
How was your experience in school when you were younger? Did you enjoy school? Ho
n n n n n n n n n n n n n n
do you support yourself with your finances?
n n n n n n
Do you have a good support system? Are you currently in a relationship? Where do you
n n n n n n n n n n n n n n n
ve? Who do you live with?
n n n n n
What do you do in your free time? What activities do you enjoy?
n n n n n n n n n n n n
7. Which of the following should be included when providing client education a
n n n n n n n n n n n
bout medication regimens? Select all that apply.: A)Explain how the medication tar
n n n n n n n n n n n
gets the symptoms, specific benefits, and expected time course. (Correct answer)
n n n n n n n n n n
B) Identify potential side effects, duration of side effects, and adverse effects. (Correct a
n n n n n n n n n n n n
nswer)
C) Explain the instructions, dosing, and special requirements. (Correct answer)
n n n n n n n n
D) Use teach-back methods to ensure client understanding. (Correct answer)
n n n n n n n n
8. Apply the Ask Suicide- n n n
Screening Questions (ASQ) Suicide Risk Screening Tool (Links to an external
n n n n n n n n n n n
site.) to the scenario below.
n n n n
A 52-year-old client presents to the emergency department following a car ac-
n n n n n n n n n n n
cident.T he emergency department (ED) physician is concerned that the client
n n n n n n n n n n n n
may have intentionally crashed her car and requests a stat PMHNP consult. In sp
n n n n n n n n n n n n n
3n/n78
, eaking with the PMHNP, the client describes persistent feelings of sadness and
n n n n n n n n n n n
hopelessness. She states that she often wonders if her husband would be happi n n n n n n n n n n n n
er if she wasn't around anymore since she's never happy and sometimes thinks a
n n n n n n n n n n n n n
bout what it would be like to just take a handful of sleeping pills and go to sleep
n n n n n n n n n n n n n n n n n
forever. The client reports a previous suicide attempt when she was 16 but den
n n n n n n n n n n n n n
es that she is considering killing herself right now.
n n n n n n n n
Based on the client's ASQ score, what is the most appropriate response?
n n n n n n n n n n n
A) No action is necessary as the client is not currently considering suicide.
n n n n n n n n n n n
B) Provide a brief suicide safety assessment. n n n n n
C) Alert the client's primary care physician.
n n n n n
D) Provide a STAT safety and full mental health evaluation.: B)Provide a brief s
n n n n n n n n n n n n
uicide safety assessment. n n
Rationale: While the client's responses do not indicate a need for a stat full safety and
n n n n n n n n n n n n n n n
mental health evaluation, the client requires a brief suicide safety assessment to dete
n n n n n n n n n n n n
mine whether a full mental health evaluation in necessary. It is also important to notify th
n n n n n n n n n n n n n n n
e client's physician or the clinician responsible for the client's care.
n n n n n n n n n n
9. Complete Blood Count: The CBC is a serum diagnostic test that measures red b
n n n n n n n n n n n n n
ood cells, white blood cells, hemoglobin, hematocrit, and platelets. The CBC includes
n n n n n n n n n n n
n a differential of the white blood cells.
n n n n n n
4n/n78
