NR 548 Week 4: (Latest 2026/2027 Update) Psychiatric History Taking &
Documentation | Q&A | Grade A | 100% Correct (Verified Answers) –
Chamberlain University
Subject: Psychiatric-Mental Health Nurse Practitioner (PMHNP) – Chief Complaint, History of Present
Illness (HPI), OLDCARTS, Social History, Family History, Review of Systems, Documentation
Source: NR 548 Week 4 / Chamberlain University / Clinical Documentation Guidelines (2026/2027
Update)
Format: Q&A Guide with Clinical Rationales | Grade A Guaranteed
1. What is the Chief Complaint in a psychiatric evaluation?
Correct Answer: The primary problem that prompted the client to schedule a visit. Use the client's own
words.
1. The chief complaint should be documented in quotation marks using the patient's exact words
whenever possible.
2. It provides the focus for the entire evaluation and treatment plan.
2. What is the History of Present Illness (HPI)?
Correct Answer: A concise, clear, and chronological description of the chief complaint which
prompted the client's visit. A symptom analysis guided by the mnemonic OLDCARTS reveals
information regarding onset, location, duration, characteristics, aggravating factors, relieving factors,
treatments, and severity of symptoms.
1. HPI is the narrative that expands the chief complaint into a full symptom story.
2. Chronological order helps identify triggers, patterns, and progression.
3. What are pertinent positives in a psychiatric assessment?
Correct Answer: Symptoms that are expected with a potential diagnosis related to the chief complaint.
1. Pertinent positives support a specific diagnostic hypothesis.
2. Example: For depression, pertinent positives include anhedonia and sleep disturbance.
4. What are pertinent negatives in a psychiatric assessment?
Correct Answer: Symptoms the client does not have that are expected with a potential diagnosis
related to the chief complaint.
1. Pertinent negatives help rule out alternative diagnoses.
2. Example: For mania, absence of grandiosity or decreased need for sleep helps rule out a manic
episode.
, 5. What does the mnemonic OLDCARTS stand for in symptom analysis?
Correct Answer: Onset, Location, Duration, Characteristics, Aggravating factors, Relieving factors,
Treatments, and Severity of the symptoms.
1. OLDCARTS ensures systematic and complete symptom characterization.
2. Used in both psychiatric and medical history taking.
6. What question should be asked to assess ONSET according to OLDCARTS?
Correct Answer: "When did this start?"
1. Identifies precipitating events and time course of illness.
2. Acute vs. gradual onset helps differentiate diagnoses (e.g., delirium vs. dementia).
7. What question should be asked to assess LOCATION according to OLDCARTS?
Correct Answer: "Where did the problem start; does it move anywhere?"
1. In mental health, location refers to context (e.g., symptoms at home, work, social situations).
2. For physical symptoms, location helps localize pathology.
8. What question should be asked to assess DURATION according to OLDCARTS?
Correct Answer: "How long does the problem last or is it constant?"
1. Duration helps distinguish episodic vs. continuous symptoms.
2. Important for mood disorders (e.g., mania must last 1 week; hypomania at least 4 days).
9. What question should be asked to assess CHARACTERISTICS according to OLDCARTS?
Correct Answer: "Can you describe what the problem feels like?"
1. Quality of symptoms (e.g., sad mood, racing thoughts, auditory hallucinations).
2. Patients may use metaphors to describe their internal experience.
10. What question should be asked to assess AGGRAVATING FACTORS according to
OLDCARTS?
Correct Answer: "Does anything make it worse?"
1. Identifies triggers that worsen symptoms (e.g., stress, substances, interpersonal conflict).
2. Important for developing safety plans and relapse prevention strategies.
11. What question should be asked to assess RELIEVING FACTORS according to OLDCARTS?
Correct Answer: "Does anything make it better?"
1. Identifies effective coping strategies and what has already been tried.
2. Informs treatment planning by building on existing strengths.
Documentation | Q&A | Grade A | 100% Correct (Verified Answers) –
Chamberlain University
Subject: Psychiatric-Mental Health Nurse Practitioner (PMHNP) – Chief Complaint, History of Present
Illness (HPI), OLDCARTS, Social History, Family History, Review of Systems, Documentation
Source: NR 548 Week 4 / Chamberlain University / Clinical Documentation Guidelines (2026/2027
Update)
Format: Q&A Guide with Clinical Rationales | Grade A Guaranteed
1. What is the Chief Complaint in a psychiatric evaluation?
Correct Answer: The primary problem that prompted the client to schedule a visit. Use the client's own
words.
1. The chief complaint should be documented in quotation marks using the patient's exact words
whenever possible.
2. It provides the focus for the entire evaluation and treatment plan.
2. What is the History of Present Illness (HPI)?
Correct Answer: A concise, clear, and chronological description of the chief complaint which
prompted the client's visit. A symptom analysis guided by the mnemonic OLDCARTS reveals
information regarding onset, location, duration, characteristics, aggravating factors, relieving factors,
treatments, and severity of symptoms.
1. HPI is the narrative that expands the chief complaint into a full symptom story.
2. Chronological order helps identify triggers, patterns, and progression.
3. What are pertinent positives in a psychiatric assessment?
Correct Answer: Symptoms that are expected with a potential diagnosis related to the chief complaint.
1. Pertinent positives support a specific diagnostic hypothesis.
2. Example: For depression, pertinent positives include anhedonia and sleep disturbance.
4. What are pertinent negatives in a psychiatric assessment?
Correct Answer: Symptoms the client does not have that are expected with a potential diagnosis
related to the chief complaint.
1. Pertinent negatives help rule out alternative diagnoses.
2. Example: For mania, absence of grandiosity or decreased need for sleep helps rule out a manic
episode.
, 5. What does the mnemonic OLDCARTS stand for in symptom analysis?
Correct Answer: Onset, Location, Duration, Characteristics, Aggravating factors, Relieving factors,
Treatments, and Severity of the symptoms.
1. OLDCARTS ensures systematic and complete symptom characterization.
2. Used in both psychiatric and medical history taking.
6. What question should be asked to assess ONSET according to OLDCARTS?
Correct Answer: "When did this start?"
1. Identifies precipitating events and time course of illness.
2. Acute vs. gradual onset helps differentiate diagnoses (e.g., delirium vs. dementia).
7. What question should be asked to assess LOCATION according to OLDCARTS?
Correct Answer: "Where did the problem start; does it move anywhere?"
1. In mental health, location refers to context (e.g., symptoms at home, work, social situations).
2. For physical symptoms, location helps localize pathology.
8. What question should be asked to assess DURATION according to OLDCARTS?
Correct Answer: "How long does the problem last or is it constant?"
1. Duration helps distinguish episodic vs. continuous symptoms.
2. Important for mood disorders (e.g., mania must last 1 week; hypomania at least 4 days).
9. What question should be asked to assess CHARACTERISTICS according to OLDCARTS?
Correct Answer: "Can you describe what the problem feels like?"
1. Quality of symptoms (e.g., sad mood, racing thoughts, auditory hallucinations).
2. Patients may use metaphors to describe their internal experience.
10. What question should be asked to assess AGGRAVATING FACTORS according to
OLDCARTS?
Correct Answer: "Does anything make it worse?"
1. Identifies triggers that worsen symptoms (e.g., stress, substances, interpersonal conflict).
2. Important for developing safety plans and relapse prevention strategies.
11. What question should be asked to assess RELIEVING FACTORS according to OLDCARTS?
Correct Answer: "Does anything make it better?"
1. Identifies effective coping strategies and what has already been tried.
2. Informs treatment planning by building on existing strengths.
