NR-605 Diagnosis & Management
in Psychiatric-Mental Health across
the Lifespan I Practicum
Midterm Exam (Weeks 1 – 4)
Question:
Treatment Hierarchy Framework
Answer:
therapeutic aims at the base of the model must be addressed before the
client can move up the triangle
Top: Stabilization
Internal resources
External resources
Bottom: Foundational needs
Question:
Strategies to support resource development and stabilization:
Answer:
-case management
-provision of safety
-stress management
-management of physiological arousal
-exercise
-cognitive or dialectical behavioral therapy
-role play
Question:
Processing
Answer:
involves helping clients explore the meaning of adverse life events
-adapting memory, cognition, behavior, affect, and beliefs surrounding
traumatic events
• achieve positive change
Question:
Cultural Considerations
Answer:
Culture shapes one's perceptions, attributions, emotions, and judgments in
ways that are both conscious and unconscious
-PMHNP must consider ethnicity, religion, race, class, cultural identity, and
the cultural explanations of illness to effectively diagnose and treat mental
health conditions
-Outline for Cultural Formulation includes an assessment of the following
categories:
• cultural identity of the individual
• cultural conceptualizations of distress
• psychosocial stressors and cultural features of vulnerability and resilience
• cultural features of the relationship between the individual and clinician
• overall cultural assessment
Question:
Illness Perception
Answer:
psychodynamic approach
-attributes mental illness to environmental and psychosocial problems
biophysiological model
-attributes mental illnesses to chemical imbalances of neurotransmitters
Question:
Epigenetics
Answer:
the study of how the environment and other factors change the way genes
are expressed
Question:
Documentation requirements
Answer:
-standard format of chief complaint, history of present illness, review of
systems, past psychiatric history, mental status exam, diagnostic
formulation, and treatment plan
-Psychotherapy sessions must include the following:
• target symptoms
• goals of therapy
• method of monitoring outcomes
• frequency of treatment
• clinical records to support relevant medical history
• results of diagnostic tests or
• procedures
• prognosis or progress to date
• estimated duration of treatment
Question:
Reimbursement
Answer:
Clinical procedural terminology (CPT) codes
-standardized codes used to communicate services completed to Medicare
and other insurance companies for reimbursement
-PMHNPs can bill for stand-alone psychotherapy using psychiatry specialty
codes
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