A+ Graded Paper
NR548 Exam 2 –2025 Update | Complete Verified
Q&A with Detailed Explanations
Questions and Mark scheme
Version: Final 1.1
,2. Begin by describing another patient (or patients) who has engaged in the behavior, showing your patient that she is
not alone
• ex: I've talked to several patients who've said that their depression causes them to have strange experiences, like
hearing voices or thinking that strangers are laughing at them. Has that been happening to you?
Symptom Expectation - ✔✔communicate that a behavior is in some way normal or expected
-Phrase your Q's to imply that you already assume the patient has engaged in some behavior and that you will not be
offended by a positive response
-high index of suspicion of some self-destructive activity
-Ex: patient is profoundly depressed and has expressed feelings of hopelessness. You suspect suicidality, but you sense
that the patient may be too ashamed to admit it. Rather than gingerly asking "Have you had any thoughts that you'd be
better off dead?" you might decide to use symptom expectation. "What kinds of ways to hurt yourself have you thought
about?"
*reserve this technique for situations in which it seems appropriate
Symptom Exaggeration - ✔✔suggesting a frequency of a problematic behavior that is higher than your expectation, so
that the patient feels that their actual, lower frequency of the behavior will not be perceived by you as being "bad."
-helpful in clarifying the severity of symptoms
*reserve this technique for situations in which it seems appropriate
Reduction of guilt - ✔✔seeks to directly reduce a patient's guilt about a specific behavior in order to discover what they
have been doing
-useful in obtaining a hx of domestic violence & other antisocial behavior
Domestic Violence
-"Have you ever been in situations where fights occurred and you were affected?"
• If patient answers "yes," you can flesh out whether role was being a witness, victim, or perpetrator
According to Peplau's Theory of Interpersonal Relations, establishing early rapport allows the role of the nurse to evolve
from stranger to: - ✔✔resource person, teacher, leader, surrogate, technical expert, and counselor
Establishing the Relationship - ✔✔-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
three phases of the psychiatric interview - ✔✔1. Opening phase
2. Body of the Interview
3. Closing the Interview
Opening phase - ✔✔-first 5-10 minutes
-establish rapport & therapeutic alliance
-often most important phase
• establishes the foundation
-begins with PMHNP asking "what brought you in to see me today?"
Body of the Interview - ✔✔-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
Closing the Interview - ✔✔-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
NR548 Exam 2 –2025 Update | Complete Verified
Q&A with Detailed Explanations
Questions and Mark scheme
Version: Final 1.1
,2. Begin by describing another patient (or patients) who has engaged in the behavior, showing your patient that she is
not alone
• ex: I've talked to several patients who've said that their depression causes them to have strange experiences, like
hearing voices or thinking that strangers are laughing at them. Has that been happening to you?
Symptom Expectation - ✔✔communicate that a behavior is in some way normal or expected
-Phrase your Q's to imply that you already assume the patient has engaged in some behavior and that you will not be
offended by a positive response
-high index of suspicion of some self-destructive activity
-Ex: patient is profoundly depressed and has expressed feelings of hopelessness. You suspect suicidality, but you sense
that the patient may be too ashamed to admit it. Rather than gingerly asking "Have you had any thoughts that you'd be
better off dead?" you might decide to use symptom expectation. "What kinds of ways to hurt yourself have you thought
about?"
*reserve this technique for situations in which it seems appropriate
Symptom Exaggeration - ✔✔suggesting a frequency of a problematic behavior that is higher than your expectation, so
that the patient feels that their actual, lower frequency of the behavior will not be perceived by you as being "bad."
-helpful in clarifying the severity of symptoms
*reserve this technique for situations in which it seems appropriate
Reduction of guilt - ✔✔seeks to directly reduce a patient's guilt about a specific behavior in order to discover what they
have been doing
-useful in obtaining a hx of domestic violence & other antisocial behavior
Domestic Violence
-"Have you ever been in situations where fights occurred and you were affected?"
• If patient answers "yes," you can flesh out whether role was being a witness, victim, or perpetrator
According to Peplau's Theory of Interpersonal Relations, establishing early rapport allows the role of the nurse to evolve
from stranger to: - ✔✔resource person, teacher, leader, surrogate, technical expert, and counselor
Establishing the Relationship - ✔✔-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
three phases of the psychiatric interview - ✔✔1. Opening phase
2. Body of the Interview
3. Closing the Interview
Opening phase - ✔✔-first 5-10 minutes
-establish rapport & therapeutic alliance
-often most important phase
• establishes the foundation
-begins with PMHNP asking "what brought you in to see me today?"
Body of the Interview - ✔✔-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
Closing the Interview - ✔✔-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
