NRNP 6635 week 3 Assignment: Assessing and Diagnosing Patients With Mood Disorders Paper Example
NRNP 6635 week 3 Assignment: Assessing and Diagnosing Patients With Mood Disorders Assignment
NRNP 6635 week 3 Assignment: Assessing and Diagnosing Patients With Mood Disorders Assignment Brief
Assignment Instructions Overview:
In this assignment, students are required to assess and diagnose patients with mood disorders, focusing on accurate diagnostic methods and critical thinking. The assignment highlights the complexities of diagnosing depressive and bipolar disorders, considering that these conditions often present with periodic and cyclic symptomology. Diagnosis may also be influenced by external stressors and cultural backgrounds, potentially impacting the client’s treatment-seeking behavior.
Students are expected to utilize the Comprehensive Psychiatric Evaluation Template to conduct a thorough evaluation, incorporating subjective and objective data, differential diagnoses, and a reflective analysis of the patient’s case.
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Understanding Assignment Objectives:
The primary objective of this assignment is to develop a detailed understanding of mood disorders through practical assessment and diagnosis. Students will evaluate patients via case studies, identifying patterns and symptoms of mood disorders such as major depressive disorder (MDD) and bipolar disorder. This task also aims to enhance students’ ability to apply diagnostic criteria from the DSM-5-TR and to navigate the complexities of mental health treatment with cultural sensitivity and ethical awareness.
The Student’s Role:
Students are responsible for:
- Selecting and reviewing a video case study.
- Gathering and analyzing a patient’s subjective and objective history.
- Conducting a comprehensive psychiatric evaluation.
- Formulating at least three differential diagnoses using the DSM-5-TR.
- Explaining the reasoning behind the primary diagnosis.
- Reflecting on the diagnostic process and identifying areas for improvement.
The assignment also requires students to demonstrate clinical judgment, legal/ethical considerations, and awareness of health promotion strategies tailored to individual patients’ socioeconomic, cultural, and medical backgrounds.
Competencies Measured:
- Clinical Reasoning & Critical Thinking: Ability to apply psychiatric assessment skills to real-world case studies and generate differential diagnoses.
- Diagnostic Proficiency: Knowledge of DSM-5-TR criteria and its application in assessing mood disorders.
- Cultural Competence & Ethical Awareness: Sensitivity to cultural factors influencing mood disorders and adherence to ethical standards in psychiatric practice.
- Patient-Centered Care: Designing treatment plans that address mental health issues while considering broader aspects of patient health and well-being, including prevention strategies.
You can also read other assignment examples for the NRNP 6635 – Psychopathology and Diagnostic Reasoning Course below:
NRNP 6635 Week 1: Competencies of Advanced Nursing Practice Paper Example
NRNP 6635 Week 1 Assignment 2: Clinical Skills Self-Assessment Paper Example
NRNP 6635 Week 2: Practicum Experience Plan (PEP) Paper Example
NRNP 6635 Week 5: Comprehensive Psychiatric Evaluation and Patient Case Presentation Example
NRNP 6635 week 3 Assignment: Assessing and Diagnosing Patients With Mood Disorders Paper Example
Comprehensive Psychiatric Evaluation
Patient Information:
- Name: A.M.
- Age: 34
- Gender: Male
- Race: African-American
- Marital Status: Divorced
Chief Complaint (CC):
“I feel like I’m always in a bad mood, and it’s hard for me to concentrate or enjoy anything. It’s been like this for months.”
History of Present Illness (HPI):
A.M. is a 34-year-old African-American male who presents with complaints of persistent low mood, lack of interest in daily activities, and difficulty concentrating. These symptoms began approximately eight months ago, following his divorce, and have progressively worsened. He reports feeling “exhausted all the time” despite sleeping excessively, yet he continues to wake up feeling fatigued. He mentions that his appetite has decreased, resulting in an unintentional weight loss of about 10 pounds over the past three months. His mood is often irritable, and he finds himself getting easily frustrated with family members and coworkers.
A.M. denies any suicidal ideation or previous suicide attempts but admits to occasional fleeting thoughts of death. He reports that these thoughts are not persistent or distressing enough to act upon. His symptoms have negatively impacted his performance at work, leading to several warnings from his supervisor about his reduced productivity and absenteeism.
He reports no previous history of mood disorders and has never sought psychiatric treatment before. He occasionally uses alcohol to “calm down,” drinking approximately 4–5 drinks per night for the past six months, which began after his divorce.
Past Psychiatric History:
- Previous Diagnosis: None reported.
- Previous Hospitalizations: None.
- Previous Treatments: None.
- Previous Medications: None.
Substance Use History:
- Alcohol: Drinks 4–5 alcoholic beverages per night, daily for the past six months. Denies drinking in the mornings or at work. He has not experienced withdrawal symptoms, but he acknowledges that he drinks to cope with stress and sadness.
- Drugs: Denies the use of illicit drugs or recreational drugs.
- Tobacco: Non-smoker.
- Caffeine: Drinks two cups of coffee daily.
Family Psychiatric/Substance Use History:
- Mother: Diagnosed with Major Depressive Disorder at age 45. Currently on medication.
- Father: No history of psychiatric illness.
- Siblings: Younger brother diagnosed with Generalized Anxiety Disorder.
- Substance Use: No history of substance use disorders in the immediate family.
Social History:
A.M. was born and raised in a middle-class African-American family. He is the eldest of three siblings and maintains a good relationship with them, although he is currently estranged from his ex-wife. He has a 7-year-old daughter from his marriage and shares custody with his ex-wife. A.M. completed college and has been working as a sales manager at a tech company for the past five years.
His divorce, finalized eight months ago, was contentious, and he describes the relationship as “emotionally draining.” He currently lives alone in an apartment and has limited social interactions outside of work and co-parenting responsibilities. He reports that he stopped engaging in his hobbies, such as playing basketball and attending social events, around the same time his symptoms began.
A.M. has no legal issues or history of trauma. He denies any history of physical or emotional abuse.
Medical History:
- Current Medical Conditions: Mild hypertension, managed with a low-sodium diet. No medications.
- Past Medical Conditions: None significant.
- Surgical History: None.
- Chronic Illnesses: None.
- Allergies: No known drug allergies.
Review of Systems (ROS):
- General: Reports feeling fatigued and weak. Unintentional weight loss of 10 pounds in the last three months.
- Cardiovascular: No chest pain, palpitations, or shortness of breath.
- Respiratory: No cough or difficulty breathing.
- Gastrointestinal: Reduced appetite; no nausea or vomiting.
- Neurological: No headaches, dizziness, or seizures.
- Musculoskeletal: No joint or muscle pain.
- Endocrine: No changes in temperature tolerance, no excessive thirst or urination.
- Psychiatric: Persistent low mood, loss of interest in previously enjoyable activities, feelings of worthlessness, irritability, concentration difficulties, occasional thoughts of death.
Mental Status Examination (MSE):
- General Appearance: A.M. is a well-groomed, appropriately dressed male who appears his stated age. He has good hygiene and maintains eye contact throughout the interview.
- Behavior: Cooperative but reserved during the interview. Fidgeted with his hands.
- Mood: Reports feeling “down” and “numb.”
- Affect: Blunted, restricted range of emotional expression.
- Speech: Normal rate and tone, though answers are brief and monotone.
- Thought Process: Linear but slowed; no evidence of flight of ideas or loose associations.
- Thought Content: No delusions, hallucinations, or paranoia. Denies current suicidal ideation but acknowledges occasional passive thoughts of death without intent or plan.
- Cognition: Alert and oriented to person, place, and time. Mild difficulty with concentration and focus during the interview.
- Insight: Fair; acknowledges that his mood is affecting his work and personal life but feels unsure about treatment options.
- Judgment: Intact; able to make reasonable decisions regarding his care.
Diagnostic Results:
No lab results were available at the time of the psychiatric evaluation. However, routine labs, including thyroid function tests (TFTs) and a complete blood count (CBC), were ordered to rule out any medical conditions contributing to his depressive symptoms.
Assessment:
Differential Diagnoses:
Major Depressive Disorder (MDD):
- Supporting Evidence: A.M. presents with a depressed mood, loss of interest or pleasure in activities (anhedonia), fatigue, sleep disturbances (hypersomnia), weight loss, and concentration difficulties. These symptoms have persisted for more than two weeks, meeting the DSM-5-TR criteria for MDD.
- DSM-5 Criteria Met: Depressed mood most of the day, nearly every day; markedly diminished interest in activities; significant weight loss without dieting; insomnia or hypersomnia; fatigue or loss of energy; diminished ability to think or concentrate; feelings of worthlessness.
- Ruled Out Factors: No manic or hypomanic episodes present, ruling out bipolar disorders.
Adjustment Disorder with Depressed Mood:
- Supporting Evidence: A.M. experienced a significant life stressor (divorce), which may have triggered his symptoms. However, the severity and duration of his symptoms extend beyond what is typically seen in adjustment disorder, and he meets more criteria for MDD.
- DSM-5 Criteria Met: Emotional or behavioral symptoms in response to an identifiable stressor. However, A.M.’s symptoms are more severe and persistent than what is typically seen in Adjustment Disorder.
Alcohol Use Disorder:
- Supporting Evidence: A.M. reports using alcohol daily to cope with stress, and this behavior has persisted for six months. However, he does not meet the full criteria for Alcohol Use Disorder at this time as his alcohol use has not resulted in significant impairment or distress. It is important to monitor his alcohol consumption as it may exacerbate his depressive symptoms.
- DSM-5 Criteria Not Met: He does not exhibit loss of control over drinking or significant negative consequences directly attributed to alcohol use.
Plan:
Pharmacological:
- Initiate fluoxetine (Prozac) 20 mg PO daily, given its favorable side effect profile and effectiveness in treating MDD.
- Educate the patient on the potential side effects of fluoxetine, including gastrointestinal disturbances, headaches, and sexual side effects.
Therapy:
- Refer to Cognitive Behavioral Therapy (CBT) to address negative thought patterns and promote healthy coping strategies.
Substance Use Monitoring:
- Encourage a reduction in alcohol consumption, as it may worsen depressive symptoms. A referral to substance use counseling or Alcoholics Anonymous should be offered if drinking escalates.
Follow-Up:
- Schedule follow-up in two weeks to assess medication efficacy and monitor for side effects.
- Obtain lab results to rule out any medical causes of depression.
Reflection:
In hindsight, I would have explored A.M.’s family history in more detail, particularly his relationship with his mother, who has a history of Major Depressive Disorder. This could provide insight into how family dynamics may influence his view on seeking mental health treatment. From an ethical perspective, discussing A.M.’s alcohol use in a non-judgmental manner was important, as there is a potential for substance use to worsen his mental health if left unaddressed. A culturally sensitive approach to discussing his alcohol use should be maintained, given the stigma that may be present in his community. Additionally, I would focus more on A.M.’s role as a father and how his mental health may affect his relationship with his daughter, aiming to incorporate this into health promotion and disease prevention discussions.
References
American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.). https://doi.org/10.1176/appi.books.9780890425787
Beck, A. T., & Alford, B. A. (2020). Depression: Causes and treatment. University of Pennsylvania Press.
Stahl, S. M. (2021). Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (5th ed.). Cambridge University Press.
Detailed Assessment Instructions for the NRNP 6635 week 3 Assignment: Assessing and Diagnosing Patients With Mood Disorders Paper Assignment
NRNP 6635 week 3 Assignment: Assessing and Diagnosing Patients With Mood Disorders
Assignment: Assessing and Diagnosing Patients With Mood Disorders
Accurately diagnosing depressive disorders can be challenging given their periodic and, at times, cyclic nature. Some of these disorders occur in response to stressors and, depending on the cultural history of the client, may affect their decision to seek treatment. Bipolar disorders can also be difficult to properly diagnose. While clients with a bipolar or related disorder will likely have to contend with the disorder indefinitely, many find that the use of medication and evidence-based treatments have favorable outcomes.
To Prepare:
- Review this week’s Learning Resources. Consider the insights they provide about assessing and diagnosing mood disorders.
- Download the Comprehensive Psychiatric Evaluation Template, which you will use to complete this Assignment. Also review the Comprehensive Psychiatric Evaluation Exemplar to see an example of a completed evaluation document.
- By Day 1 of this week, select a specific video case study to use for this Assignment from the Video Case Selections choices in the Learning Resources. View your assigned video case and review the additional data for the case in the “Case History Reports” document, keeping the requirements of the evaluation template in mind.
- Consider what history would be necessary to collect from this patient.
- Consider what interview questions you would need to ask this patient.
- Identify at least three possible differential diagnoses for the patient.
By Day 7 of Week 3
Complete and submit your Comprehensive Psychiatric Evaluation, including your differential diagnosis and critical-thinking process to formulate a primary diagnosis. Incorporate the following into your responses in the template:
- Subjective: What details did the patient provide regarding their chief complaint and symptomology to derive your differential diagnosis? What is the duration and severity of their symptoms? How are their symptoms impacting their functioning in life?
- Objective: What observations did you make during the psychiatric assessment?
- Assessment: Discuss the patient’s mental status examination results. What were your differential diagnoses? Provide a minimum of three possible diagnoses with supporting evidence, listed in order from highest priority to lowest priority. Compare the DSM-5-TR diagnostic criteria for each differential diagnosis and explain what DSM-5 criteria rules out the differential diagnosis to find an accurate diagnosis. Explain the critical-thinking process that led you to the primary diagnosis you selected. Include pertinent positives and pertinent negatives for the specific patient case.
- Reflection notes: What would you do differently with this client if you could conduct the session over? Also include in your reflection a discussion related to legal/ethical considerations (demonstrate critical thinking beyond confidentiality and consent for treatment!), health promotion and disease prevention taking into consideration patient factors (such as age, ethnic group, etc.), PMH, and other risk factors (e.g., socioeconomic, cultural background, etc.).
Consider what history would be necessary to collect from this patient.
Consider what interview questions you would need to ask this patient.
Identify at least three possible differential diagnoses for the patient.
references x 3 to include
American Psychiatric Association. (2022). Bipolar and related disorders. In Diagnostic and statistical manual of mental disordersLinks to an external site. (5th ed., text rev.). https://go.openathens.net/redirector/waldenu.edu?url= https://dsm.psychiatryonline.org/doi/full/10.1176/appi.books.9780890425787.x03_Bipolar_and_Related_Disorders
SUBMISSION INFORMATION
Before submitting your final assignment, you can check your draft for authenticity. To check your draft, access the Turnitin Draft
Video Case selections for the Assignment
https://video.alexanderstreet.com/p/XQ51BX9oA
https://video.alexanderstreet.com/p/LZP6O7Yw4
https://video.alexanderstreet.com/p/Og8VpmVGN
https://video.alexanderstreet.com/p/ywmrYzzQn
Required Media
https://video.alexanderstreet.com/p/Z8WOvJyZ6
https://video.alexanderstreet.com/p/nRO2pKBpY
https://video.alexanderstreet.com/p/GR9vAWjML
https://video.alexanderstreet.com/p/nROLX6Ppp
Submission and Grading Information
To submit your completed Assignment for review and grading, do the following:
- Please save your Assignment using the naming convention “WK3Assgn+last name+first initial.(extension)” as the name.
- Click the Week 3 Assignment Rubric to review the Grading Criteria for the Assignment.
- Click the Week 3 Assignment link. You will also be able to “View Rubric” for grading criteria from this area.
- Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK3Assgn+last name+first initial.(extension)” and click Open.
- If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
- Click on the Submit button to complete your submission.
NRNP_6635_Week3_Assignment_Rubric
| Excellent | Good | Fair | Poor | ||
| Create documentation in the Comprehensive Psychiatric Evaluation Template about the patient you selected.
In the Subjective section, provide: |
18 (18%) – 20 (20%)
The response throughly and accurately describes the patient’s subjective complaint, history of present illness, past psychiatric history, medication trials and current medications, psychotherapy or previous psychiatric diagnosis, pertinent histories, allergies, and review of all systems that would inform a differential diagnosis. |
16 (16%) – 17 (17%)
The response accurately describes the patient’s subjective complaint, history of present illness, past psychiatric history, medication trials and current medications, psychotherapy or previous psychiatric diagnosis, pertinent histories, allergies, and review of all systems that would inform a differential diagnosis. |
14 (14%) – 15 (15%)
The response describes the patient’s subjective complaint, history of present illness, past psychiatric history, medication trials and current medications, psychotherapy or previous psychiatric diagnosis, pertinent histories, allergies, and review of all systems that would inform a differential diagnosis, but is somewhat vague or contains minor innacuracies. |
0 (0%) – 13 (13%)
The response provides an incomplete or inaccurate description of the patient’s subjective complaint, history of present illness, past psychiatric history, medication trials and current medications, psychotherapy or previous psychiatric diagnosis, pertinent histories, allergies, and review of all systems that would inform a differential diagnosis. Or, subjective documentation is missing. |
|
| In the Objective section, provide: • Physical exam documentation of systems pertinent to the chief complaint, HPI, and history • Diagnostic results, including any labs, imaging, or other assessments needed to develop the differential diagnoses. |
18 (18%) – 20 (20%)
The response thoroughly and accurately documents the patient’s physical exam for pertinent systems. Diagnostic tests and their results are thoroughly and accurately documented. |
16 (16%) – 17 (17%)
The response accurately documents the patient’s physical exam for pertinent systems. Diagnostic tests and their results are accurately documented. |
14 (14%) – 15 (15%)
Documentation of the patient’s physical exam is somewhat vague or contains minor innacuracies. Diagnostic tests and their results are documented but contain minor innacuracies. |
0 (0%) – 13 (13%)
The response provides incomplete or inaccurate documentation of the patient’s physical exam. Systems may have been unnecessarily reviewed, or, objective documentation is missing. |
|
| In the Assessment section, provide: • Results of the mental status examination, presented in paragraph form. • At least three differentials with supporting evidence. List them from top priority to least priority. Compare the DSM-5-TR diagnostic criteria for each differential diagnosis and explain what DSM-5-TR criteria rules out the differential diagnosis to find an accurate diagnosis. Explain the critical-thinking process that led you to the primary diagnosis you selected. Include pertinent positives and pertinent negatives for the specific patient case. |
23 (23%) – 25 (25%)
The response thoroughly and accurately documents the results of the mental status exam. Response lists at least three distinctly different and detailed possible disorders in order of priority for a differential diagnosis of the patient in the assigned case study, and it provides a thorough, accurate, and detailed justification for each of the disorders selected. |
20 (20%) – 22 (22%)
The response accurately documents the results of the mental status exam. Response lists at least three distinctly different and detailed possible disorders in order of priority for a differential diagnosis of the patient in the assigned case study, and it provides an accurate justification for each of the disorders selected. |
18 (18%) – 19 (19%)
The response documents the results of the mental status exam with some vagueness or inaccuracy. Response lists at least three different possible disorders for a differential diagnosis of the patient and provides a justification for each, but may contain some vagueness or inaccuracy. |
0 (0%) – 17 (17%)
The response provides an incomplete or inaccurate description of the results of the mental status exam and explanation of the differential diagnoses. Or, assessment documentation is missing. |
|
| Reflect on this case. Discuss what you learned and what you might do differently. Also include in your reflection a discussion related to legal/ethical considerations (demonstrate critical thinking beyond confidentiality and consent for treatment!), social determinates of health, health promotion and disease prevention taking into consideration patient factors (such as age, ethnic group, etc.), PMH, and other risk factors (e.g., socioeconomic, cultural background, etc.). | 9 (9%) – 10 (10%)
Reflections are thorough, thoughtful, and demonstrate critical thinking. |
8 (8%) – 8 (8%)
Reflections demonstrate critical thinking. |
7 (7%) – 7 (7%)
Reflections are somewhat general or do not demonstrate critical thinking. |
0 (0%) – 6 (6%)
Reflections are incomplete, inaccurate, or missing. |
|
| Provide at least three evidence-based, peer-reviewed journal articles or evidenced-based guidelines that relate to this case to support your diagnostics and differential diagnoses. Be sure they are current (no more than 5 years old). | 14 (14%) – 15 (15%)
The response provides at least three current, evidence-based resources from the literature to support the assessment and diagnosis of the patient in the assigned case study. The resources reflect the latest clinical guidelines and provide strong justification for decision making. |
12 (12%) – 13 (13%)
The response provides at least three current, evidence-based resources from the literature that appropriately support the assessment and diagnosis of the patient in the assigned case study. NRNP 6635 week 3 Assignment: Assessing and Diagnosing Patients With Mood Disorders |
11 (11%) – 11 (11%)
Three evidence-based resources are provided to support assessment and diagnosis of the patient in the assigned case study, but they may only provide vague or weak justification. |
0 (0%) – 10 (10%)
Two or fewer resources are provided to support assessment and diagnosis decisions. The resources may not be current or evidence based. |
|
| Written Expression and Formatting—Paragraph development and organization: Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction are provided that delineate all required criteria. |
5 (5%) – 5 (5%)
A clear and comprehensive purpose statement, introduction, and conclusion are provided that delineate all required criteria. Paragraphs and sentences follow writing standards for flow, continuity, and clarity. |
4 (4%) – 4 (4%)
Purpose, introduction, and conclusion of the assignment are stated, yet they are brief and not descriptive. Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time. |
3.5 (3.5%) – 3.5 (3.5%)
Purpose, introduction, and conclusion of the assignment is vague or off topic. Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%-79% of the time. |
0 (0%) – 3 (3%)
No purpose statement, introduction, or conclusion were provided. Paragraphs and sentences follow writing standards for flow, continuity, and clarity less than 60% of the time. |
|
| Written Expression and Formatting—English writing standards: Correct grammar, mechanics, and punctuation |
5 (5%) – 5 (5%)
Uses correct grammar, spelling, and punctuation with no errors |
4 (4%) – 4 (4%)
Contains a few (one or two) grammar, spelling, and punctuation errors |
3 (3%) – 3 (3%)
Contains several (three or four) grammar, spelling, and punctuation errors |
0 (0%) – 2 (2%)
Contains many (≥ five) grammar, spelling, and punctuation errors that interfere with the reader’s understanding |
|
| Total Points: 100 | |||||
Name: NRNP_6635_Week3_Assignment_Rubric
Week (enter week #): (Enter assignment title)
Student Name
College of Nursing-PMHNP, Walden University
NRNP 6635: Psychopathology and Diagnostic Reasoning
Faculty Name
Assignment Due Date
Subjective:
CC (chief complaint):
HPI:
Past Psychiatric History:
- General Statement:
- Caregivers (if applicable):
- Hospitalizations:
- Medication trials:
- Psychotherapy or Previous Psychiatric Diagnosis:
Substance Current Use and History:
Family Psychiatric/Substance Use History:
Psychosocial History:
NRNP 6635 week 3 Assignment: Assessing and Diagnosing Patients With Mood Disorders
Medical History:
- Current Medications:
- Allergies:
- Reproductive Hx:
ROS:
- GENERAL:
- HEENT:
- SKIN:
- CARDIOVASCULAR:
- RESPIRATORY:
- GASTROINTESTINAL:
- GENITOURINARY:
- NEUROLOGICAL:
- MUSCULOSKELETAL:
- HEMATOLOGIC:
- LYMPHATICS:
- ENDOCRINOLOGIC:
Objective:
Physical exam: if applicable
Diagnostic results:
Assessment:
Mental Status Examination:
Differential Diagnoses:
Reflections:
References
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