Week 1: Psychiatric Assessment of the Adult and Older Adult

Many assessment principles are the same for children and adults; however, with adults/older adults, consent for participation in the assessment comes from the actual client and not parents or guardians. The exception to this is adults/older adults who have been determined incapacitated by a court of competent jurisdiction. Some adults may be easier to assess than children/adolescents as they are more psychologically minded. That is, they have better insights into themselves and their motivations than children/adolescents (although this is not universally true).

Older adults present some of their own unique assessment challenges in that they may have higher levels of stigma associated with seeking psychiatric care. Additionally, there are higher rates of neurocognitive disorders superimposed on other clinical conditions such as depression or anxiety, which creates additional diagnostic challenges.

This week, you will develop your own personal format for initial interviews of mental health clients. You also will explore the restrictions and limitations for practice as a PMHNP in your home state and create a plan for passing the national certification exam.

Learning Resources

Required Readings

American Nurses Association. (2014). Psychiatric-mental health nursing: Scope and standards of practice (2nd ed.). Washington, DC: Author.

• Standard 5C “Consultation” (page 57)

Note: Throughout the program you will be reading excerpts from the ANA’s Scope & Standards of Practice for Psychiatric-Mental Health Nursing. It is essential to your success on the ANCC board certification exam for Psychiatric/Mental Health Nurse Practitioners that you know the scope of practice of the advanced practice psychiatric/mental health nurse. You should also be able to differentiate between the generalist RN role in psychiatric/mental health nursing and the advanced practice nurse role.

Sadock, B. J., Sadock, V. A., & Ruiz, P. (2014). Kaplan & Sadock’s synopsis of psychiatry: Behavioral sciences/clinical psychiatry (11th ed.). Philadelphia, PA: Wolters Kluwer.

• Section 5.1, “Psychiatric Interview, Mental Status Examination” (pp. 192–211)
• Section 5.2, “The Psychiatric Report and Medical Record” (pp. 211–217)
• Section 5.3, “Psychiatric Rating Scales” (pp. 217–236)
• Section 5.5, “Personality Assessment: Adults and Children” (pp. 246–257)
• Section 5.7, “Medical Assessment and Laboratory Testing in Psychiatry” (pp. 266–275)
• Chapter 6, “Classification in Psychiatry” (pp. 290–308)

• “Cautionary Statement for Forensic Use of DSM-5”
• “Assessment Measures”
• “Cultural Formulation”
• “Glossary of Technical Terms”
• “Glossary of Cultural Concepts of Distress”

Barton Associates. (2017). Nurse practitioner scope of practice laws. Retrieved from https://www.bartonassociates.com/locum-tenens-resources/nurse-practitioner-scope-of-practice-laws/

Document: Practicum Journal Template (Word document)

Document: NP Student Clinical Orientation (PowerPoint file)

Required Media

Laureate Education (Producer). (2017b). Working with Adults and Older Adults” [Video file]. Baltimore, MD: Author.

 

Note: The approximate length of this media piece 3 minutes.

 

Note: The approximate length of this media piece is 31 minutes.

Optional Resources

American Psychological Association. (2008). Assessment of older adults with diminished capacity. Retrieved from https://www.apa.org/pi/aging/programs/assessment/capacity-psychologist-handbook.pdf

Rosen, S. L., & Reuben, D. B. (2011). Geriatric assessment tools. Mount Sinai Journal of Medicine, 78(4), 489–497. doi:10.1002/msj.20277

 

Note: You will access this article through the Walden Library databases.

Substance Abuse and Mental Health Services Administration (SAMHSA). (2015). TIP 59: Improving cultural competence. Retrieved from http://store.samhsa.gov/product/TIP-59-Improving-Cultural-Competence/SMA15-4849

 

Note: This document is available as a free download.

Discussion: Interview Format

Despite what you may believe (or may have been told), there is no such thing as one “right” way to do an interview. In fact, there are numerous books written about the various ways of conducting the clinical interview. In actual clinical practice, you will find the format that “works” best for you and addresses your unique strengths and the needs of the client.

In this Discussion, you will practice finding the interview format that works for you and share those ideas with your colleagues for feedback.

Students will:

• Develop formats for initial interviews of mental health clients

Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link and then select “Create Thread” to complete your initial post. Remember, once you click submit, you cannot delete or edit your own posts and cannot post anonymously. Please check your post carefully before clicking Submit!

To prepare for this Discussion:

• Review the Learning Resources.
• Develop an interview format you would use for an initial interview of a client.

By Day 3

Post:

• Attach the interview format document you would use for an initial interview of a client.
• Describe what interview format your preceptor uses for the initial interview of a client.
• Describe which element of your interview format is most helpful in your practice.

By Day 6

Respond to at least two of your colleagues by constructively critiquing their interview format and providing feedback.

Submission and Grading Information

Grading Criteria

To access your rubric:

Week 1 Discussion Rubric

Post by Day 3 and Respond by Day 6

To participate in this Discussion:

Week 1 Discussion

Assignment: Week 1 Practicum Journal Entry: Certification Plan

Psychiatric/mental health nurse practitioners currently have only one choice for certification, which is through the American Nurses Credentialing Center (ANCC). The ANCC offers the “psychiatric/mental-health nurse practitioner (across the lifespan)” board certification (PMHNP-BC). In many states, board certification is needed as a prerequisite to being granted an NP license. Even if board certification is not a requirement for state licensure, it may be a requirement to receive privileges in various hospitals and other health care facilities. It may also be required by malpractice insurance providers prior to issuing coverage to NPs.

In this Practicum Journal Assignment, you will develop a plan, which will serve as the road map for you to follow to attain your certification.

Students will:

• Analyze state restrictions or limitations for practice
• Compare PMHNP practice environments in various states
• Analyze clinical practice issues
• Create plans for passing national certification exams

**Assigned in Week 1 but submitted in Week 4

To prepare for this Practicum Journal:

• Review the interactive nurse practitioner (NP) scope of practice law guide in your Learning Resources.
• Review your state regulations and a neighboring state or state in which you would like to practice.
• Reflect on how to approach relocating licensure from one state to another.
• Review certification exam requirements for PMHNPs.

Write a 2- to 3-page paper in which you do the following:

• Describe the PMHNP practice environment for your home state, highlighting restrictions or limitations for practice.
• Compare the PMHNP practice environment in your home state with a neighboring state or a state in which you would like to practice.
• Describe a professional and/or clinical practice issue a new PMHNP will need to consider and address with the certification, licensure, credentialing, or relocation process.
• Develop a checklist for passing the national certification exam, including a detailed timeline that includes academic preparation (study plan), registration, financial preparation, etc.

By Day 7

Submit by Day 7 of Week 4.

Making Connections

This week, you developed your own personal format for initial interviews of mental health clients. You also explored the restrictions and limitations for practice as a PMHNP in your home state and created a plan for passing the national certification exam.

Next week, you will become “captain of the ship” as you take full responsibility for a client with a depressive disorder by recommending psychopharmacologic treatment and psychotherapy, identifying medical management needs and community support, and recommending follow-up plans. You will also explore how to obtain a DEA license and the responsibilities for safe prescribing and prescription monitoring.

Fitzgerald Health Education Associates (FHEA) PMHNP 150 University Exit Comprehensive Exam

Walden has selected the Fitzgerald Health Education Associates (FHEA) PMHNP 150 University Exit Comprehensive Exam to provide you with an opportunity to take practice exams and complete sample test questions. While passing your certification exam is not guaranteed, FHEA suggests that a score of 85% or higher is predictive of success on your NP board examination. The FHEA PMHNP 150 University Exit Comprehensive Exam is used in this course as an assessment in Week 3. Each exam is worth 100 points and 10% of your grade.

Note: Your instructor receives the results and will inform you when the results are available. Do not e-mail the Fitzgerald site.

To go to the next week:

Week 2