Marginal Practitioners and Limited Practitioners

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Marginal Practitioners and Limited Practitioners

Marginal Practitioners and Limited Practitioners

Chiropractic is a healthcare profession that focuses on the diagnosis and treatment of musculoskeletal disorders, primarily those affecting the spine. The chiropractic profession is regulated by state laws and includes a range of practitioners, from those with limited training to those with advanced degrees and specialized training. Within the chiropractic profession, there are distinctions made between marginal practitioners and limited practitioners, which are based on their level of education, training, and professional status. This essay will explore the concepts of marginal and limited practitioners in chiropractic, examine the impact of these distinctions on the profession, and consider whether or not such distinctions should be applied to the chiropractic profession.

The concept of marginal practitioners in chiropractic

Definition and characteristics of marginal practitioners

Marginal practitioners in chiropractic refer to individuals who practice chiropractic techniques but do not have the required education or training to be considered legitimate chiropractic practitioners. According to the textbook “Chiropractic: An Illustrated History,” marginal practitioners are often self-taught or have received only brief or incomplete training from unaccredited schools or programs. These individuals may have some knowledge of chiropractic techniques but are not licensed or registered to practice as chiropractors. They may be massage therapists, physical trainers, or other healthcare professionals who incorporate chiropractic techniques into their practice without being licensed chiropractors. Marginal practitioners may also include individuals who have completed a short course or seminar on chiropractic techniques but lack the comprehensive education and training required for chiropractic licensure.

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Examples of marginal practitioners in chiropractic

Examples of marginal practitioners in chiropractic include massage therapists who offer spinal manipulation as part of their massage therapy practice, personal trainers who use chiropractic techniques as part of their training regimen, and acupuncturists who incorporate spinal manipulation into their treatments.

Impact of marginal practitioners on the chiropractic profession

The existence of marginal practitioners in chiropractic can have several negative impacts on the profession. Marginal practitioners may offer substandard care or even cause harm to patients due to their lack of education and training. Patients may also be misled by these practitioners, believing that they are receiving chiropractic care from a licensed practitioner when in fact they are not. This can damage the reputation of the chiropractic profession and lead to public distrust of licensed chiropractors.

The concept of limited practitioners in chiropractic

Definition and characteristics of limited practitioners

Limited practitioners in chiropractic refer to individuals who have completed a limited education and training program in chiropractic techniques but are not licensed to practice as full-fledged chiropractors. Limited practitioners may have completed a course or program in chiropractic techniques that do not meet the full requirements for licensure as a chiropractor. According to the textbook “Chiropractic: A Modern Way to Health,” limited practitioners may have graduated from accredited schools or programs, and may hold valid licenses to practice chiropractic. However, they may be limited in their ability to diagnose or treat certain conditions, or to perform certain procedures, such as ordering diagnostic tests, prescribing medications, or performing surgery. These limitations may be imposed by state or federal laws, insurance policies, or professional standards.

Examples of limited practitioners in chiropractic

Examples of limited practitioners in chiropractic include medical doctors, osteopaths, and nurse practitioners who have completed a course or program in chiropractic techniques and incorporate these techniques into their practice. These individuals are not licensed chiropractors but may be authorized to use certain chiropractic techniques as part of their broader scope of practice.

Impact of limited practitioners on the chiropractic profession

Limited practitioners in chiropractic can have a positive impact on the profession by increasing awareness and acceptance of chiropractic techniques among other healthcare professionals. This can lead to more referrals and collaborations between chiropractors and other healthcare providers. However, it is important to ensure that limited practitioners have adequate education and training in chiropractic techniques to provide safe and effective care to their patients.

What are the factors that contribute to marginalization?

The marginalization of some chiropractors in the US may be influenced by several factors, including:

  • Lack of standardized education and training: One of the factors that contribute to marginalization in chiropractic is the lack of standardized education and training requirements for chiropractors in the US. Unlike other healthcare professions, such as medicine or nursing, chiropractic education, and training is not standardized across all states. As a result, there is a wide range of educational programs and training options available, some of which may be of lower quality or accreditation standards. This lack of standardization can lead to variability in the knowledge and skills of chiropractors, which can contribute to the marginalization of some practitioners.
  • Inadequate regulation and oversight: Another factor that contributes to marginalization in chiropractic is the inadequate regulation and oversight of the profession in some states. While all states require chiropractors to be licensed, the requirements for licensure, including education, training, and examination, vary widely across states. Moreover, the enforcement of licensure requirements and disciplinary actions against non-compliant or unethical practitioners can also vary widely. This lack of consistent regulation and oversight can create opportunities for marginal and unethical practitioners to operate without consequences, which can contribute to their marginalization.
  • Bias and stereotypes: Another factor that contributes to marginalization in chiropractic is bias and stereotypes against the profession, especially from other healthcare providers and the public. Some healthcare providers and the public may view chiropractic as a pseudoscientific or alternative therapy, rather than a legitimate healthcare profession. This bias can lead to skepticism, mistrust, and stigma against chiropractors, especially those who operate outside the mainstream of the profession.
  • Economic and political pressures: Another factor that contributes to marginalization in chiropractic is economic and political pressures, such as those from insurance companies and government agencies. Insurance companies may limit or deny coverage for chiropractic care or require higher levels of documentation or justification for coverage, which can limit the financial viability of chiropractors. Government agencies may also restrict the scope of practice or reimbursement rates for chiropractors, which can limit their ability to provide comprehensive and affordable care. These pressures can create barriers to entry or sustainability for some chiropractors, which can contribute to their marginalization.

What are the implications of these distinctions?

The distinction between marginal practitioners and limited practitioners has several implications for the profession of chiropractic, as well as for the quality of care and reputation of the profession. These implications include:

Divisiveness: The distinction between marginal practitioners and limited practitioners creates a division within the chiropractic community, based on education, training, and status. This division can lead to rivalries, conflicts, and fragmentation, which can undermine the unity, coherence, and effectiveness of the profession.

Stigma: The distinction between marginal practitioners and limited practitioners also creates a stigma, or a negative label, that can be applied to chiropractors who are perceived as unqualified, unethical, or dangerous. This stigma can harm the reputation of the profession, and discourage patients from seeking chiropractic care.

Safety: The distinction between marginal practitioners and limited practitioners raises concerns about the safety of chiropractic care, especially for patients who may be treated by unqualified or unethical practitioners. Marginal practitioners, in particular, may lack the knowledge, skills, and ethical standards required to provide safe and effective care, which can put patients at risk of harm.

Quality of care: The distinction between marginal practitioners and limited practitioners also raises concerns about the quality of chiropractic care, especially for patients who may be treated by practitioners who are limited in their scope of practice. Limited practitioners, in particular, may not be able to provide the full range of diagnostic, therapeutic, and preventive services that patients may need, which can result in suboptimal outcomes and higher costs of care.

Should such distinctions be applied to the profession?

In my opinion, the distinction between marginal practitioners and limited practitioners should not be applied to the profession of chiropractic, as it is arbitrary, divisive, and detrimental to the quality of care and reputation of the profession. Here are some reasons why:

Lack of evidence: There is little empirical evidence to support the distinction between marginal practitioners and limited practitioners, or to demonstrate its validity or usefulness. Most studies on chiropractic education and practice have focused on accredited or mainstream practitioners, rather than on marginal or limited practitioners, making it difficult to draw definitive conclusions about their education, training, or outcomes.

Inadequate regulation: The distinction between marginal practitioners and limited practitioners highlights the need for better regulation and oversight of the chiropractic profession, especially in terms of education, training, licensure, and scope of practice. However, relying on this distinction as a basis for regulation may be inadequate or ineffective, as it does not address the underlying causes of poor quality or unethical practices, such as inadequate standards, poor enforcement, or lack of accountability.

Professional identity: The distinction between marginal practitioners and limited practitioners may also undermine the professional identity and autonomy of chiropractors, by imposing external or arbitrary criteria on their education, training, or scope of practice. Chiropractors should be able to define and develop their own standards and competencies, based on their knowledge, skills, and values, rather than on external or imposed criteria.

Patient-centered care: The distinction between marginal practitioners and limited practitioners may also neglect the perspective and needs of patients, who may not be aware of or concerned with the education, training, or status of their chiropractor, but rather with the quality, safety, and effectiveness of their care. Chiropractors should prioritize patient-centered care, which is based on the principles of partnership, responsiveness, respect, and empowerment, rather than on the distinction between marginal practitioners and limited practitioners.

Conclusion

The distinctions between marginal and limited practitioners in chiropractic can have both positive and negative impacts on the profession and on patients. While these distinctions can help ensure that patients receive safe and effective care from qualified practitioners, they can also create social hierarchies and limit access to care in some areas. It is important for the chiropractic profession to continue to address these issues and work towards providing high-quality care for all patients, regardless of the practitioner’s level of education or training. This can be achieved through increased access to education and training programs, resources for continuing education and professional development, and efforts to address bias and discrimination within the profession.

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NRNP 6635 Week 6: Neurocognitive, Neurodevelopmental, Eating, and Somatic Symptom-Related Disorders Example

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NRNP 6635 Week 6: Neurocognitive, Neurodevelopmental, Eating, and Somatic Symptom-Related Disorders Example

NRNP 6635 Week 6: Neurocognitive, Neurodevelopmental, Eating, and Somatic Symptom-Related Disorders ExampleNRNP 6635 Week 6: Neurocognitive, Neurodevelopmental, Eating, and Somatic Symptom-Related Disorders Assignment

NRNP 6635 Week 6: Neurocognitive, Neurodevelopmental, Eating, and Somatic Symptom-Related Disorders Assignment Brief

Assignment Instructions Overview

This assignment focuses on assessing and diagnosing patients with neurocognitive and neurodevelopmental disorders. Neurodevelopmental disorders, which typically manifest during childhood, include conditions like ADHD, autism spectrum disorder, and intellectual disabilities. Neurocognitive disorders, such as Alzheimer’s and vascular dementia, represent a decline in previous cognitive abilities and may emerge later in life. Students will use a case study from a video to assess a patient, develop differential diagnoses, and create a comprehensive psychiatric evaluation using DSM-5-TR guidelines.

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Understanding Assignment Objectives

The primary goal of this assignment is to apply theoretical knowledge to real-world cases of neurocognitive and neurodevelopmental disorders. Students will analyze the patient’s symptoms, gather relevant medical history, and perform mental status examinations. Based on these findings, they will explore potential differential diagnoses and identify a primary diagnosis using DSM-5-TR criteria. Critical thinking is emphasized in ruling out other conditions and justifying diagnostic decisions.

The Student’s Role

Students will assume the role of a psychiatric nurse practitioner tasked with performing a thorough evaluation. This includes engaging with the patient’s subjective experience, observing objective behaviors, conducting a mental status exam, and providing evidence-based differential diagnoses. Students will reflect on the session and incorporate legal, ethical, and health promotion considerations in their treatment plans.

Competencies Measured

This assignment will assess the student’s ability to:

  • Evaluate neurocognitive and neurodevelopmental symptoms and presentations.
  • Perform a comprehensive psychiatric assessment, utilizing diagnostic tools.
  • Differentiate between various disorders using DSM-5-TR criteria.
  • Formulate accurate primary diagnoses with supporting evidence.
  • Apply ethical considerations and critical thinking in patient care planning.

 

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 3 Assignment: Assessing and Diagnosing Patients With Mood Disorders Paper Example

NRNP 6635 Week 4: Assessing and Diagnosing Patients With Anxiety Disorders, PTSD, and OCD Paper Example

NRNP 6635 Week 5: Comprehensive Psychiatric Evaluation and Patient Case Presentation Example

NRNP 6635 Week 8: Assessing and Diagnosing Patients With Substance-Related and Addictive Disorders Example

NRNP 6635 Week 6: Neurocognitive, Neurodevelopmental, Eating, and Somatic Symptom-Related Disorders Example

Introduction

Neurocognitive and neurodevelopmental disorders are complex conditions that require careful assessment and differentiation to ensure proper diagnosis and management. Neurodevelopmental disorders often present in childhood and can persist into adulthood, encompassing conditions like attention deficit hyperactivity disorder (ADHD) and autism spectrum disorders (ASD). In contrast, neurocognitive disorders represent a decline from previous functioning due to conditions like Alzheimer’s disease, brain injury, or stroke. This paper will provide a comprehensive psychiatric evaluation of Harold Brown, a 60-year-old male presenting with potential neurocognitive symptoms. The assessment will explore his clinical presentation, differential diagnosis, and develop a treatment plan based on evidence and DSM-5-TR criteria.

Subjective Data

Chief Complaint:

Harold Brown reports mild difficulty with attention and short-term memory, particularly when recalling recent events. He has expressed concerns about these issues affecting his daily activities, although he continues to work part-time as an engineer. He denies significant interference with basic functioning but mentions occasional lapses in attention and memory at work and in social settings. He was encouraged by his brother to seek evaluation after noticing a pattern of forgetfulness and distraction.

History of Present Illness (HPI):

Mr. Brown states that his symptoms began approximately 18 months ago and have gradually worsened. He reports difficulty maintaining focus during long tasks and trouble recalling names or recent conversations. He denies any abrupt changes in memory, mood disturbances, or significant changes in his personality. He describes himself as independent, though he acknowledges his brother’s concerns regarding his recent forgetfulness. His symptoms do not seem to vary based on time of day or specific activities. He denies any head trauma, seizures, or major medical illnesses contributing to his cognitive difficulties.

Medical History:

  • Hypertension: Controlled with Cozaar (Losartan) 100mg daily
  • Hypertriglyceridemia: Managed with fenofibrate 160mg daily
  • Benign Prostatic Hyperplasia (BPH): Managed with tamsulosin 0.4mg at bedtime
  • Angina: Taking aspirin 81mg daily

Medications:

  • Cozaar (Losartan) 100mg daily
  • Fenofibrate 160mg daily
  • Tamsulosin 0.4mg at bedtime
  • Aspirin 81mg daily

Allergies:

Allergic to Dilaudid.

Family History:

His father had hypertension and passed away at the age of 75 due to complications from a stroke. His mother died of Alzheimer’s disease at the age of 80. He has one younger brother, who is in good health.

Social History:

Mr. Brown lives alone, has never married, and has no children. He casually dates and reports a healthy social life. He enjoys having a scotch and cigar on weekends. He denies any history of drug use. He continues to work part-time and maintains good relationships with his colleagues and family members.

Developmental History:

No developmental delays or learning difficulties reported in childhood or adolescence.

Objective Data

General Appearance and Behavior:

Mr. Brown presents as a well-groomed, alert, and oriented male who appears his stated age. He is cooperative and maintains good eye contact throughout the interview. No abnormal movements or signs of agitation were observed. His speech was fluent and coherent, with normal rate and rhythm.

Vital Signs:

  • Temperature: 98.8°F
  • Pulse: 74 bpm
  • Respiration: 18 breaths/min
  • Blood Pressure: 134/70 mmHg
  • Height: 5’10”
  • Weight: 170 lbs

Neurological/Cognitive Observations:

  • Montreal Cognitive Assessment (MoCA): Score of 28/30, indicating mild cognitive impairment. Notable difficulty was observed in the attention and delayed recall sections of the test.
  • Attention Deficit: He had trouble sustaining attention during long tasks, such as performing serial 7s.
  • Memory: Delayed recall was impaired, as he struggled to remember words presented earlier during the MoCA. Immediate memory, however, remained intact.

Mental Status Examination (MSE)

Appearance:

Well-groomed, appropriately dressed for the weather and occasion.

Behavior:

Cooperative, calm, and maintains appropriate eye contact throughout the interview.

Speech:

Normal rate, volume, and tone, with no evidence of aphasia.

Mood:

Euthymic. He denies experiencing low mood or anxiety.

Affect:

Appropriate and full range.

Thought Process:

Logical, coherent, and goal-directed. No evidence of thought blocking or tangential thinking.

Thought Content:

Denies any hallucinations, delusions, or paranoia. No suicidal or homicidal ideation.

Cognition:

Oriented to person, place, time, and situation. Mild impairment observed in delayed recall and sustained attention.

Insight and Judgment:

Good. He demonstrates understanding of his symptoms and the need for evaluation.

Assessment and Differential Diagnoses

Based on the patient’s history, clinical presentation, and mental status examination, the following differential diagnoses are considered:

  1. Mild Neurocognitive Disorder due to Alzheimer’s Disease

Supporting Evidence: His family history of Alzheimer’s (mother) and his subtle cognitive decline over the last 18 months support this diagnosis. His MOCA score of 28/30 with difficulty in attention and delayed recall aligns with mild neurocognitive disorder, which is often an early sign of Alzheimer’s disease. The DSM-5-TR criteria for mild neurocognitive disorder (memory impairment and cognitive decline without significant impairment of daily functioning) fit the presentation.

  1. Vascular Cognitive Impairment

Supporting Evidence: Mr. Brown has a history of hypertension, a major risk factor for vascular dementia. Cognitive impairments such as attention deficits and executive function difficulties are consistent with vascular cognitive impairment. However, the lack of a history of stroke or other clear vascular events makes this less likely.

  1. Major Depressive Disorder with Cognitive Impairment

Supporting Evidence: Depression can sometimes present as cognitive impairment in older adults. Mr. Brown does not report any mood changes or depressive symptoms, but mild cognitive impairment can sometimes be misdiagnosed as early Alzheimer’s disease in the context of mood disorders. The absence of significant mood changes, however, rules this out as the primary diagnosis.

Primary Diagnosis:

The most likely diagnosis is Mild Neurocognitive Disorder due to Alzheimer’s Disease, given the gradual onset, specific memory and attention deficits, and family history.

Plan and Recommendations

Pharmacological Treatment:

Initiate cholinesterase inhibitors such as donepezil (5mg daily) to slow cognitive decline. Consider an NMDA receptor antagonist like memantine if cognitive decline progresses.

Non-Pharmacological Interventions:

Cognitive Behavioral Therapy (CBT): To assist with adapting to cognitive changes and reducing anxiety around his symptoms.

Cognitive Training and Memory Exercises: Regular cognitive exercises, such as puzzles or memory games, may help slow further cognitive decline.

Lifestyle Modifications: Encourage regular physical exercise, a heart-healthy diet (such as the Mediterranean diet), and social engagement to reduce cognitive decline risk.

Follow-up:

Monitor the patient every 3 months for changes in cognitive functioning and reassess the treatment plan. Discuss potential lifestyle changes and engage family members in the care plan.

Reflection

What I Would Do Differently:

If I were to conduct this session again, I would explore more thoroughly Mr. Brown’s daily life and work challenges to assess the extent to which his cognitive decline affects his functional capacity. I would also probe further into his emotional responses to his cognitive changes, as denial or minimization of symptoms can sometimes obscure significant distress.

Legal and Ethical Considerations:

Given Mr. Brown’s independence, it’s essential to discuss future planning, such as advance directives, while he still has the cognitive capacity to make informed decisions. His family history of Alzheimer’s suggests the need for discussions around eventual caregiving needs.

Health Promotion and Disease Prevention:

Education on managing hypertension and hyperlipidemia is crucial to reduce further vascular risks. Continued control of these conditions may help slow cognitive decline. Additionally, promoting brain-healthy habits, such as regular exercise, a nutritious diet, and cognitive activities, will be emphasized.

Conclusion

The evaluation of Harold Brown’s cognitive functioning demonstrates the complexity of diagnosing neurocognitive disorders. While mild cognitive impairment is present, the primary diagnosis of mild neurocognitive disorder due to Alzheimer’s disease is supported by his clinical presentation, family history, and DSM-5-TR criteria. Through careful assessment and early intervention, Mr. Brown’s cognitive decline can be managed with appropriate treatment and lifestyle modifications.

Detailed Assessment Instructions for the NRNP 6635 Week 6: Neurocognitive, Neurodevelopmental, Eating, and Somatic Symptom-Related Disorders Assignment

Description

Assignment: Assessing and Diagnosing Patients With Neurocognitive and Neurodevelopmental Disorders

Photo Credit: Getty Images

Neurodevelopmental disorders begin in the developmental period of childhood and may continue through adulthood. They may range from the very specific to a general or global impairment, and often co-occur (APA, 2022). They include specific learning and language disorders, attention deficit hyperactivity disorder (ADHD), autism spectrum disorders, and intellectual disabilities. Neurocognitive disorders, on the other hand, represent a decline in one or more areas of prior mental function that is significant enough to impact independent functioning. They may occur at any time in life and be caused by factors such brain injury; diseases such as Alzheimer’s, Parkinson’s, or Huntington’s; infection; or stroke, among others.

For this Assignment, you will assess a patient in a case study who presents with a neurocognitive or neurodevelopmental disorder.

TO PREPARE:

  • Review this week’s Learning Resources and consider the insights they provide. Consider how neurocognitive impairments may have similar presentations to other psychological disorders.
  • Review the Comprehensive Psychiatric Evaluation template, which you will use to complete this Assignment.
  • 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 10

Complete and submit your Comprehensive Psychiatric Evaluation, including your differential diagnosis and critical-thinking process to formulate 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-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.
  • 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.).
  • Required Readings (click to expand/reduce)

American Psychiatric Association. (2022). Neurocognitive disorders. In Diagnostic and statistical manual of mental disorders (5th ed., text rev.). https://go.openathens.net/redirector/waldenu.edu?u…https://dsm.psychiatryonline.org/doi/full/10.1176/…

American Psychiatric Association. (2022). Neurodevelopmental disorders. In Diagnostic and statistical manual of mental disorders (5th ed., text rev.). https://go.openathens.net/redirector/waldenu.edu?u…https://dsm.psychiatryonline.org/doi/full/10.1176/…

Sadock, B. J., Sadock, V. A., & Ruiz, P. (2015). Kaplan & Sadock’s synopsis of psychiatry (11th ed.). Wolters Kluwer.

    • Chapter 21, Neurocognitive Disorders
    • Chapter 31, Child Psychiatry

Document: Comprehensive Psychiatric Evaluation Template

Document: Comprehensive Psychiatric Evaluation Exemplar

 

Required Media (click to expand/reduce)

Classroom Productions. (Producer). (2016). Neurocognitive disorders [Video]. Walden University.

Classroom Productions. (Producer). (2016). Neurodevelopmental disorders [Video]. Walden University.

MedEasy. (2016). Progressive neurocognitive disorders. | USMLE & COMLEX[Video]. YouTube.

 

 

Video Case Selections for Assignment (click to expand/reduce) Select one of the following videos to use for your Assignment this week. Then, access the document “Case History Reports” and review the additional data about the patient in the specific video number you selected.

Symptom Media. (Producer). (2017). Training title 48 [Video]. https://go.openathens.net/redirector/waldenu.edu?u…

Symptom Media. (Producer). (2017). Training title 50 [Video]. https://go.openathens.net/redirector/waldenu.edu?u…

Document: Case History Reports

Week 10 Neurocognitive and Neurodevelopmental Disorders Training Title 48
Name: Sarah Higgins
Gender: female
Age: 11 years old
T- 97.4 P- 58 R 14 98/62 Ht 4’5 Wt 65lbs
Background: no history of treatment, developmental milestones met on time, vaccinations up to date. Sleeps 9-10hrs/night, meals are difficult as she has hard time sitting for meals, she does get proper nutrition per PCP. she has a younger brother. lives with her parents in Washington,
D.C. No hx of head trauma.
Symptom Media. (Producer). (2017). Training title 48 [Video]. https://video-alexanderstreet- com.ezp.waldenulibrary.org/watch/training-title-48
Training Title 50
Name: Harold Brown
Gender: male
Age:60 years old
T- 98.8 P- 74 R 18 134/70 Ht 5’10 Wt 170lbs Background:
Has bachelor’s degree in engineering. He dates casually, never married, no children. Has one younger brother. Sleeps 7 hours, appetite good. Denied legal issues; MOCA 28/30 difficulty with attention and delayed recall; ASRS-5 21/24; denied hx of drug use; enjoys one scotch drink on the weekends with a cigar. Allergies Dilaudid; history HTN blood pressure controlled with Cozaar 100mg daily, angina prescribed ASA 81mg po daily, valsartan 80mg daily. Hypertriglyceridemia prescribed fenofibrate 160mg daily, has BPH prescribed tamsulosin 0.4mg po bedtime.
Symptom Media. (Producer). (2017). Training title 50 [Video]. https://video-alexanderstreet- com.ezp.waldenulibrary.org/watch/training-title-50

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NRNP 6635 Week 5: Comprehensive Psychiatric Evaluation and Patient Case Presentation Example

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NRNP 6635 Week 5: Comprehensive Psychiatric Evaluation and Patient Case Presentation Example

NRNP 6635 Week 5: Comprehensive Psychiatric Evaluation and Patient Case Presentation ExampleNRNP 6635 Week 5: Comprehensive Psychiatric Evaluation and Patient Case Presentation; Midterm Clinical Evaluation

NRNP 6635 Week 5: Comprehensive Psychiatric Evaluation and Patient Case Presentation Assignment Brief

Assignment Instructions Overview:

This assignment requires students to conduct a comprehensive psychiatric evaluation of a patient they have encountered in the last five weeks of their practicum. Using the provided template, the student must document the evaluation and present the case in a recorded video. The video should include the chief complaint, the history of present illness, and pertinent medical and psychiatric history, among other elements. Students should submit the written evaluation alongside the signed pages from their preceptor.

Understanding Assignment Objectives:

The objective of this assignment is to demonstrate the ability to assess a patient’s psychiatric health comprehensively. Students will apply their knowledge from the Learning Resources to analyze a patient case, develop a working diagnosis, and present a differential diagnosis. This assignment connects real-life practicum experience with academic learning, fostering critical thinking in psychiatric evaluation and diagnosis.

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The Student’s Role:

The student acts as the primary evaluator, documenting the patient’s case thoroughly, presenting clinical findings, and showcasing their diagnostic reasoning skills. The student must demonstrate professionalism, clinical competence, and the ability to synthesize patient information while adhering to ethical standards, including maintaining patient confidentiality as per HIPAA regulations.

Competencies Measured:

This assignment measures several competencies, including the ability to conduct a thorough psychiatric evaluation, utilize critical thinking for diagnosis, present cases professionally, and develop a comprehensive care plan. Students are also expected to apply scholarly resources to support their diagnostic and treatment decisions, reinforcing evidence-based practice.

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 3 Assignment: Assessing and Diagnosing Patients With Mood Disorders Paper Example

NRNP 6635 Week 4: Assessing and Diagnosing Patients With Anxiety Disorders, PTSD, and OCD Paper Example

NRNP 6635 Week 5: Comprehensive Psychiatric Evaluation and Patient Case Presentation Example

NRNP 6635 Week 6: Neurocognitive, Neurodevelopmental, Eating, and Somatic Symptom-Related Disorders Example

NRNP 6635 Week 8: Assessing and Diagnosing Patients With Substance-Related and Addictive Disorders Example

NRNP 6635 Week 5: Comprehensive Psychiatric Evaluation and Patient Case Presentation Example

Chief Complaint (CC):

  • A 36-year-old male presenting with restlessness, agitation, disorganized speech, impaired cognition, and periodic delusions.

History of Present Illness (HPI):

  • Symptoms have fluctuated over three weeks with episodes of restlessness alternating with lack of motivation and withdrawal. Delusions and hallucinations have persisted for four weeks.

Past Psychiatric History:

  • Diagnosed with bipolar disorder 10 years ago and schizophrenia at age 30. Non-adherence to medication is a noted issue.
  • History of one hospitalization following a suicide attempt.
  • Previous and current medications are detailed, including issues experienced with fluphenazine.

Substance Use History:

  • History of binge drinking, cigarette, and cannabis use since his undergraduate years. Still smokes cigarettes and drinks alcohol occasionally.

Family Psychiatric/Substance Use History:

  • Schizophrenia in the paternal grandfather and a family history of substance use (cigarette smoking, alcohol).

Psychosocial History:

  • Married with one child, working as a software engineer. History of violent behavior leading to arrest and imprisonment.

Medical History:

  • History of head injuries from violent behavior and a minor car accident, as well as past hospitalization for malaria.

Current Medications:

  • Sodium valproate, sertraline, alprazolam, and aripiprazole.

Allergies:

  • None.

Reproductive History:

  • Heterosexual, married with one child, sexually active with occasional withdrawal during symptom flares.

Review of Systems (ROS):

  • General: Weight gain.
  • HEENT: Normal.
  • Skin: Warm, normal turgor.
  • Cardiovascular: Normal BP and heart rate.
  • Respiratory: Normal.
  • Gastrointestinal: Normal.
  • Neurological: Tingling in limbs and difficulty moving feet.
  • Musculoskeletal: Stiffness in lower extremities.
  • Other systems are unremarkable.

Diagnostic Results:

  • Head CT scan showed no physical injury.
  • Blood tests revealed positive for alcohol, cigarette, and cannabis use.

Mental Status Examination:

  • Appropriately dressed, aware of time and occasion.
  • Admitted to suicidal ideation.

Differential Diagnoses:

  • Schizophrenia, Bipolar Disorder, Major Depressive Disorder.
  • Schizophrenia is diagnosed based on DSM-5 criteria.

Reflections:

  • The diagnosis of schizophrenia requires careful assessment, supported by symptom clusters and appropriate diagnostics. The case reinforced the need for a compassionate approach to psychiatric care, emphasizing public education on modifiable risk factors like substance abuse.

Detailed Assessment Instructions for the NRNP 6635 Week 5: Comprehensive Psychiatric Evaluation and Patient Case Presentation Assignment

Assignment 2: Comprehensive Psychiatric Evaluation and Patient Case Presentation 

Photo Credit: Pexels

Comprehensive psychiatric evaluations are a way to reflect on your practicum experiences and connect the experiences to the learning you gain from your weekly Learning Resources. Comprehensive notes, such as the ones required in this practicum course, are often used in clinical settings to document patient care.

For this Assignment, you will document information about a patient that you examined during the last 5 weeks, using the Comprehensive Psychiatric Evaluation Template provided. You will then use this note to develop and record a case presentation for this patient.

To Prepare

  • Select a patient that you examined during the last 5 weeks. Review prior resources on the disorder this patient has. Also review the Kaltura Media Uploader resource in the left-hand navigation of the classroom for help creating your self-recorded Kaltura video.
  • Conduct a Comprehensive Psychiatric Evaluation on this patient using the template provided in the Learning Resources. There is also a completed exemplar document in the Learning Resources so that you can see an example of the types of information a completed evaluation document should contain. All psychiatric evaluations must be signed, and each page must be initialed by your Preceptor. When you submit your document, you should include the complete Comprehensive Psychiatric Evaluation as a Word document, as well as a PDF/images of each page that is initialed and signed by your Preceptor. You must submit your document using SafeAssign.Please Note:Electronic signatures are not accepted. If both files are not received by the due date, Faculty will deduct points per the Walden Late Policies.
  • Develop a video case presentation, based on your progress note of this patient, that includes chief complaint; history of present illness; any pertinent past psychiatric, substance use, medical, social, family history; most recent mental status exam; and current psychiatric diagnosis, including differentials that were ruled out.
  • Include at least five (5) scholarly resources to support your assessment and diagnostic reasoning.
  • Ensure that you have the appropriate lighting and equipment to record the presentation.

Assignment

Record yourself presenting the complex case for your clinical patient. In your presentation:

  • Dress professionally with a lab coat and present yourself in a professional manner.
  • Display your photo ID at the start of the video when you introduce yourself.
  • Ensure that you do not include any information that violates the principles of HIPAA (i.e., don’t use the patient’s name or any other identifying information).
  • Present the full case. Include chief complaint; history of present illness; any pertinent past psychiatric, substance use, medical, social, family history; most recent mental status exam; and current psychiatric diagnosis, including differentials that were ruled out.
  • Report normal diagnostic results as the name of the test and “normal” (rather than specific value). Abnormal results should be reported as a specific value.

Be succinct in your presentation, and do not exceed 8 minutes. Address the following:

  • Subjective: What details did the patient provide regarding their personal and medical history? What are their symptoms of concern? How long have they been experiencing them, and what is the severity? How are their symptoms impacting their functioning?
  • Objective: What observations did you make during the interview and review of systems?
  • Assessment:What were your differential diagnoses? Provide a minimum of three (3) possible diagnoses. List them from highest to lowest priority. What was your primary diagnosis, and why?
  • Reflection notes:What would you do differently in a similar patient evaluation?

By Day 7

Submit your Video and Comprehensive Psychiatric Evaluation. You must submit two (2) files for the evaluation, including a Word document and scanned PDF/images of each page that is initialed and signed by your Preceptor.

Learning Resources

Required Readings (click to expand/reduce)

HSoft Corporation. (2020). Meditrek: Home. https://edu.meditrek.com/Default.html  Note: Use this website to log into Meditrek to report your clinical hours and patient encounters.

HYPERLINK “https://class.content.laureate.net/1e563a49109e04e68af6cce117ed2d58.doc” \o “Comprehensive Psychiatric Evaluation Template”

Document: Comprehensive Psychiatric Evaluation Template (Word document)

HYPERLINK “https://class.content.laureate.net/feb2627c3a7610b39580d603c1c9a879.doc” \o “Comprehensive Psychiatric Evaluation Exemplar”

Document: Comprehensive Psychiatric Evaluation Exemplar (Word document)

Recommended Resources

American Psychiatric Association. (2013). Disruptive, impulse-control, and conduct disorders. In Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: Author. doi:10.1176/appi.books.9780890425596.dsm15

American Psychiatric Association. (2013). Dissociative disorders. In Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: Author. doi:10.1176/appi.books.9780890425596.dsm08

 

American Psychiatric Association. (2013). Somatic symptom and related disorders. In Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: Author. doi:10.1176/appi.books.9780890425596.dsm09

Sadock, B. J., Sadock, V. A., & Ruiz, P. (2015). Kaplan and Sadock’s synopsis of psychiatry: Behavioral sciences/clinical psychiatry (11th ed.). Wolters Kluwer.

 

Walden University. (2020). College of Nursing practicum manual: Master of science in nursing (MSN) and post-master’s certificate programs. https://academicguides.waldenu.edu/fieldexperience/son/formsanddocuments

HYPERLINK “https://academicguides.waldenu.edu/fieldexperience/son/home” \o “College of Nursing” \t “_blank”

Walden University Field Experience. (2020a). Field experience: College of Nursing. https://academicguides.waldenu.edu/fieldexperience/son/home  

HYPERLINK “https://academicguides.waldenu.edu/StudentPracticum/NP_StudentOrientation” \o “Student practicum resources: NP student ” \t “_blank”

Walden University Field Experience. (2020b). Student practicum resources: NP student orientation. https://academicguides.waldenu.edu/StudentPracticum/NP_StudentOrientation

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NRNP 6635 Week 4: Assessing and Diagnosing Patients With Anxiety Disorders, PTSD, and OCD Paper Example

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NRNP 6635 Week 4: Assessing and Diagnosing Patients With Anxiety Disorders, PTSD, and OCD Paper Example

NRNP 6635 Week 4: Assessing and Diagnosing Patients With Anxiety Disorders, PTSD, and OCD Paper ExampleAssignment: Assessing and Diagnosing Patients With Anxiety Disorders, PTSD, and OCD

NRNP 6635 Week 4: Assessing and Diagnosing Patients With Anxiety Disorders, PTSD, and OCD Assignment Brief

Assignment Instructions Overview:

This assignment focuses on developing the skills necessary for assessing and diagnosing anxiety disorders, post-traumatic stress disorder (PTSD), and obsessive-compulsive disorder (OCD). Students are required to conduct a thorough psychiatric evaluation using a comprehensive approach. The evaluation should include both subjective and objective data, along with critical-thinking steps that guide diagnostic decision-making based on DSM-5 criteria.

The goal is to apply clinical knowledge and diagnostic tools to assess the severity, duration, and impact of symptoms, as well as differentiate between possible diagnoses.

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Understanding Assignment Objectives:

The main objectives of this assignment are to:

  • Evaluate patients presenting with symptoms of anxiety, PTSD, and OCD.
  • Use DSM-5 criteria to guide diagnostic decisions.
  • Develop a differential diagnosis process by comparing symptoms and identifying the most accurate primary diagnosis.
  • Apply ethical considerations and health promotion strategies during patient evaluation.
  • Through this assignment, students will gain experience in recognizing various anxiety-related disorders and trauma-related conditions while practicing the art of patient-centered care.

The Student’s Role:

Students are expected to assume the role of a healthcare provider conducting a psychiatric assessment. This involves gathering a comprehensive history, performing mental status examinations, and documenting observations. Students will need to consider the patient’s background, experiences, and presenting symptoms when determining a differential diagnosis and developing an appropriate care plan.

The role also includes reflecting on the patient interaction, considering alternative approaches, and addressing any legal, ethical, or cultural factors that could influence diagnosis and treatment.

Competencies Measured:

This assignment will assess the following competencies:

  • Clinical Evaluation: Ability to gather detailed subjective and objective data from patient history and psychiatric assessments.
  • Diagnostic Reasoning: Application of DSM-5 criteria to identify and rule out potential mental health disorders.
  • Critical Thinking: Development of a structured thought process in diagnosing anxiety disorders, PTSD, and OCD, supported by evidence-based practice.
  • Ethical Considerations: Understanding of the legal and ethical dimensions of mental health treatment, including consent, confidentiality, and culturally competent care.
  • Health Promotion: Integration of health promotion strategies into patient care, considering factors like age, ethnicity, and socioeconomic status that may impact diagnosis and treatment planning.

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 3 Assignment: Assessing and Diagnosing Patients With Mood Disorders Paper Example

NRNP 6635 Week 5: Comprehensive Psychiatric Evaluation and Patient Case Presentation Example

NRNP 6635 Week 6: Neurocognitive, Neurodevelopmental, Eating, and Somatic Symptom-Related Disorders Example

NRNP 6635 Week 8: Assessing and Diagnosing Patients With Substance-Related and Addictive Disorders Example

NRNP 6635 Week 4: Assessing and Diagnosing Patients With Anxiety Disorders, PTSD, and OCD Paper Example

Assessing and Diagnosing Patients With Anxiety Disorders, PTSD, and OCD

Subjective:

Chief Complaint (CC):

The patient reports that he “cannot handle negative situations.”

History of Present Illness (HPI):

Sergeant Berry Sullivan, a 27-year-old male, has presented for a mental health evaluation following an eight-year service in the military, during which he completed three extended tours in various war zones. He describes a challenging transition to civilian life after his military discharge, which occurred less than a year ago. During his service, Mr. Sullivan was exposed to multiple traumatic events, though he has refrained from providing detailed descriptions of these incidents. He reports that his symptoms, including an inability to cope with negative situations, have progressively worsened since leaving active duty. He denies experiencing flashbacks or nightmares, but notes feelings of irritability and hypervigilance. Additionally, he discloses a troubled childhood marked by an abusive, alcoholic father. Despite these stressors, he has never engaged in substance use due to his father’s alcoholism. Mr. Sullivan denies any prior history of psychiatric disorders, stating that he has never experienced anxiety, PTSD, or major depressive disorder (MDD) symptoms before his recent struggles.

Past Psychiatric History:

General Statement:

The patient was raised in a low-income family with an abusive, alcoholic father. After high school, he joined the military, where he served for eight years, experiencing combat in multiple war zones. He has no documented psychiatric history, but mentions that his paternal grandfather also served in the military and suffered from depression.

 

Hospitalizations:

No history of psychiatric hospitalizations or mental health treatment.

Medication Trials:

Mr. Sullivan has not undergone any medication trials for mental health conditions.

Psychotherapy or Previous Psychiatric Diagnosis:

The patient denies having previously received any form of psychotherapy or psychiatric diagnosis.

Substance Use History:

Mr. Sullivan has abstained from alcohol and illicit drugs throughout his life due to his father’s severe alcoholism.

Family Psychiatric/Substance Use History:

Paternal History:

The patient’s father is an alcoholic and exhibited abusive behavior during his childhood. His paternal grandfather, also a military veteran, reportedly suffered from depression but never sought professional help.

Psychosocial History:

Mr. Sullivan was raised in a low-income household, and his upbringing was deeply affected by his father’s alcoholism and abuse. His mother remains in good health, but his father suffers from diabetes, liver cirrhosis, and hypertension (HTN). Mr. Sullivan has two siblings, an older sister and a younger brother. He lives with his fiancée and expresses a desire to have children in the future. He is currently unemployed and finding it difficult to adjust to civilian life, contributing to his increased stress and anxiety.

Medical History:

Current Medications:

Mr. Sullivan takes medication for asthma, a condition exacerbated by seasonal allergies, which he attributes to his time in the military.

Allergies:

The patient denies any known allergies.

Reproductive History (Hx):

Mr. Sullivan is not currently a parent, but he and his fiancée hope to have children.

Review of Systems (ROS):

General:

The patient is alert and oriented, with an appropriate appearance and demeanor for the interview. He does not appear to be in any acute distress.

HEENT (Head, Eyes, Ears, Nose, Throat):

No reports of trauma or injury.

Skin:

No rashes or skin irritations.

Cardiovascular:

Denies chest pain or discomfort, no evidence of edema in extremities.

Respiratory:

Reports shortness of breath and occasional difficulty breathing, which he attributes to his asthma and military-related allergies.

Gastrointestinal:

The patient has experienced occasional nausea and vomiting.

Genitourinary:

Denies any genitourinary symptoms, including abnormal urination.

Neurological:

No reported neurological symptoms such as numbness or tingling.

Musculoskeletal:

Denies joint or muscle pain, and no visible signs of swelling or discomfort.

Hematologic:

No history of unusual bruising, bleeding, or blood disorders.

Lymphatic:

Denies enlarged lymph nodes.

Endocrinologic:

No symptoms of polyuria, polydipsia, or polyphagia.

Objective:

Physical Examination:

Temperature (T): 98.8°F

Pulse (P): 86 beats per minute

Respiratory Rate (R): 18 breaths per minute

Blood Pressure (BP): 122/78 mmHg

Height (Ht): 5’8”

Weight (Wt): 160 lbs

Diagnostic Results:

A comprehensive psychiatric assessment is recommended, including standardized tools for evaluating depression, anxiety, and PTSD. Blood work should also be conducted to assess thyroid function (thyroid-stimulating hormone) and rule out any underlying medical conditions that could contribute to psychiatric symptoms.

Assessment:

Mental Status Examination (MSE):

Appearance: The patient appeared well-groomed, with appropriate hygiene for the situation.

Eye Contact: Eye contact was fair throughout the interview.

Speech: Speech was clear and normal in tone, rhythm, and volume.

Behavior: Cooperative and calm demeanor.

Psychomotor Activity: No evidence of involuntary movements.

Mood: Reported feeling “depressed.”

Thought Process: Thought processes were logical, goal-directed, and organized.

Thought Content: No delusions or evidence of psychosis. Denied suicidal ideation.

Perception: No hallucinations were reported or observed.

Cognition: The patient was alert and oriented to person, place, time, and situation.

Memory: Both short-term and long-term memory appeared intact based on the patient’s recollection of events.

Insight: Insight into his condition appeared fair.

Judgment: Judgment was assessed as fair.

Differential Diagnoses:

Post-Traumatic Stress Disorder (PTSD):

Mr. Sullivan exhibits several hallmark symptoms of PTSD, including hypervigilance, irritability, and difficulty adjusting to civilian life following traumatic combat experiences. His military history suggests prolonged exposure to traumatic events, making PTSD a highly likely diagnosis. PTSD is defined by the DSM-5 as occurring after exposure to actual or threatened death, serious injury, or sexual violence, either directly or indirectly. Symptoms may include intrusive memories, avoidance behaviors, negative mood changes, and hyperarousal.

Generalized Anxiety Disorder (GAD):

Anxiety disorders are common among veterans, especially those transitioning back into civilian life. Mr. Sullivan has reported difficulty coping with negative situations and has shown signs of persistent worry, which could indicate generalized anxiety disorder. According to the DSM-5, GAD is characterized by excessive worry about various events or activities for at least six months, along with symptoms such as restlessness, fatigue, difficulty concentrating, irritability, and muscle tension.

Major Depressive Disorder (MDD):

Mr. Sullivan’s report of a depressed mood, feelings of hopelessness, and loss of interest in activities could suggest a diagnosis of MDD. According to the DSM-5, MDD is characterized by a two-week period of pervasive low mood and anhedonia, with associated symptoms like changes in appetite, sleep disturbances, fatigue, and difficulty concentrating.

Reflection:

In reflecting on this case, I would ensure a more thorough exploration of Mr. Sullivan’s emotional responses to his traumatic experiences, particularly focusing on any potential avoidance behaviors or emotional numbing. Additionally, I would ask more specific questions about his daily functioning and relationships, which could provide further insight into the severity of his PTSD symptoms. Legal and ethical considerations include the importance of addressing the stigma associated with mental health in military populations and ensuring that the patient feels supported in seeking treatment. Culturally sensitive care is also essential, considering the patient’s background and military service.

References

Bryant, R. A. (2019). Post‐traumatic stress disorder: A state‐of‐the‐art review of evidence and challenges. World Psychiatry, 18(3), 259-269.

Chin, D. L., & Zeber, J. E. (2020). Mental health outcomes among military service members after severe injury in combat and TBI. Military Medicine, 185(5-6), e711-e718.

Koyuncu, A., İnce, E., Ertekin, E., & Tükel, R. (2019). Comorbidity in social anxiety disorder: Diagnostic and therapeutic challenges. Drugs in Context, 8.

Smith, G. P., & Hartelius, G. (2020). Resolution of dissociated ego states relieves flashback-related symptoms in combat-related PTSD: A brief mindfulness-based intervention. Military Psychology, 32(2), 135-148.

Waitzkin, H., Cruz, M., Shuey, B., Smithers, D., Muncy, L., & Noble, M. (2018). Military personnel who seek health and mental health services outside the military. Military Medicine, 183(5-6), e192-e200.

Detailed Assessment Instructions for the NRNP 6635 Week 4: Assessing and Diagnosing Patients With Anxiety Disorders, PTSD, and OCD Paper Assignment

Assignment: Assessing and Diagnosing Patients With Anxiety Disorders, PTSD, and OCD

Description

Fear,” according to the DSM-5, “is the emotional response to real or perceived imminent threat, whereas anxiety is anticipation of future threat” (APA, 2013). All anxiety disorders contain some degree of fear or anxiety symptoms (often in combination with avoidant behaviors), although their causes and severity differ. Trauma-related disorders may also, but not necessarily, contain fear and anxiety symptoms, but their primary distinguishing criterion is exposure to a traumatic event. Trauma can occur at any point in life. It might not surprise you to discover that traumatic events are likely to have a greater effect on children than on adults. Early-life traumatic experiences, such as childhood sexual abuse, may influence the physiology of the developing brain. Later in life, there is a chronic hyperarousal of the stress response, making the individual vulnerable to further stress and stress-related disease.

Photo Credit: Hill Street Studios / Blend Images / Getty Images

For this Assignment, you practice assessing and diagnosing patients with anxiety disorders, PTSD, and OCD. Review the DSM-5 criteria for the disorders within these classifications before you get started, as you will be asked to justify your differential diagnosis with DSM-5 criteria. 

To Prepare:

  • Review this week’s Learning Resources and consider the insights they provide about assessing and diagnosing anxiety, obsessive-compulsive, and trauma- and stressor-related 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 4

Complete and submit your Comprehensive Psychiatric Evaluation, including your differential diagnosis and critical-thinking process to formulate 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 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.).

https://ezp.waldenulibrary.org/login?qurl=https://video.alexanderstreet.com/watch/training-title-21?account_id=14872&usage_group_id=95102

<iframe src=”https://ezp.waldenulibrary.org/login?qurl=https://video.alexanderstreet.com/embed/training-title-21?account_id=14872&usage_group_id=95102″ width=”640″ height=”390″ frameborder=”0″ allow=”encrypted-media” allowfullscreen></iframe>

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NRNP 6635 week 3 Assignment: Assessing and Diagnosing Patients With Mood Disorders Paper Example

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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 Paper ExampleNRNP 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 4: Assessing and Diagnosing Patients With Anxiety Disorders, PTSD, and OCD Paper Example

NRNP 6635 Week 5: Comprehensive Psychiatric Evaluation and Patient Case Presentation Example

NRNP 6635 Week 6: Neurocognitive, Neurodevelopmental, Eating, and Somatic Symptom-Related Disorders Example

NRNP 6635 Week 8: Assessing and Diagnosing Patients With Substance-Related and Addictive Disorders 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:
• Chief complaint
• History of present illness (HPI)
• Past psychiatric history
• Medication trials and current medications
• Psychotherapy or previous psychiatric diagnosis
• Pertinent substance use, family psychiatric/substance use, social, and medical history
• Allergies
• ROS

 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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NRNP 6635 Week 2: Practicum Experience Plan (PEP) Paper Example

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NRNP 6635 Week 2: Practicum Experience Plan (PEP) Paper Example

NRNP 6635 Week 2: Practicum Experience Plan (PEP) Paper ExampleNRNP 6635 Week 2: Practicum Experience Plan (PEP) Paper Assignment

NRNP 6635 Week 2: Practicum Experience Plan (PEP) Paper Assignment Brief

Assignment Instructions Overview:

This assignment involves developing a Practicum Experience Plan (PEP) to guide your clinical learning as an advanced practice nurse. The PEP is essential to organize your goals and activities in a psychiatric-mental health clinical setting, ensuring that you can assess your skills, set measurable objectives, and apply knowledge to real-world patient care. Your PEP will serve as a structured roadmap for achieving specific outcomes related to psychiatric assessment, diagnostic reasoning, and collaborative practice in the clinical setting.

Understanding Assignment Objectives:

The purpose of this assignment is to help you establish clear, specific, and measurable learning goals for your practicum experience. These objectives will be based on your self-assessed strengths and areas for growth in psychiatric-mental health nursing. By framing your experience around focused learning outcomes, you will work toward achieving proficiency in skills such as mental health evaluations, psychoeducation, and diagnostic reasoning, while also considering interpersonal collaboration in clinical practice.

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The Student’s Role:

As a student, you are responsible for creating a personalized learning plan based on your unique needs and goals. This includes identifying key competencies to develop, collaborating with your preceptor to confirm the availability of resources, and actively engaging in clinical activities that support your learning. Additionally, you will record and assess your progress throughout the practicum by documenting patient encounters, reflecting on your experiences, and receiving feedback from your preceptor.

Your PEP will also require you to develop objectives that follow the SMART format (Specific, Measurable, Attainable, Results-focused, Time-bound), ensuring that your goals are clearly defined and achievable within the scope of the practicum.

Competencies Measured:

Your Practicum Experience Plan will focus on advancing your skills in psychiatric-mental health nursing, including:

  • Clinical reasoning: Demonstrating the ability to assess and interpret mental health conditions accurately.
  • Psychiatric evaluations: Enhancing your capability to conduct comprehensive evaluations using standardized tools.
  • Diagnostic reasoning: Formulating differential diagnoses and treatment plans based on a solid understanding of psychopathology.
  • Psychoeducation: Developing strategies to educate patients and caregivers, enhancing adherence to treatment plans.
  • Interpersonal collaboration: Working effectively with colleagues to ensure patient-centered care and improve clinical outcomes.

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 3 Assignment: Assessing and Diagnosing Patients With Mood Disorders Paper Example

NRNP 6635 Week 4: Assessing and Diagnosing Patients With Anxiety Disorders, PTSD, and OCD Paper Example

NRNP 6635 Week 5: Comprehensive Psychiatric Evaluation and Patient Case Presentation Example

NRNP 6635 Week 6: Neurocognitive, Neurodevelopmental, Eating, and Somatic Symptom-Related Disorders Example

NRNP 6635 Week 8: Assessing and Diagnosing Patients With Substance-Related and Addictive Disorders Example

NRNP 6635 Week 2: Practicum Experience Plan (PEP) Paper Example

Practicum Experience Plan (PEP)

Part 1: Quarter/Term/Year and Contact Information

Section A

  • Quarter/Term/Year: Summer 2024

Student Contact Information:

  • Name:
  • Street Address:
  • City, State, Zip:
  • Cell Phone:
  • E-mail:

Preceptor Contact Information:

  • Name:
  • Organization:
  • Street Address:
  • City, State, Zip:
  • Work Phone:
  • Professional/Work E-mail:

Part 2: Individualized Practicum Learning Objectives

Objective 1:

By the end of the practicum, demonstrate comprehensive psychiatric evaluation skills by performing and interpreting a mental status examination on a diverse patient population, completing at least 80 assessments using standard assessment tools and guidelines to enhance diagnostic accuracy and treatment planning.

Planned Activities:

  • Conducting mock psychiatric evaluations under supervision.
  • Review and practice using standard assessment tools such as the Mini-Mental State Examination (MMSE), Hamilton Depression Rating Scale (HAM-D), and Patient Health Questionnaire-9 (PHQ-9).
  • Participating in case conferences to discuss assessment findings and treatment plans.

Mode of Assessment:

  • Observation and feedback from the preceptor documented in Meditrek.
  • Case study analysis and written reports on evaluation findings.
  • Objective Structured Clinical Examinations (OSCEs) to evaluate clinical competency.

PRAC Course Outcome(s) Addressed:

  • Develop professional plans in advanced nursing practice for the practicum experience.
  • Assess psychiatric-mental health advanced practice nursing skills for strengths and opportunities.

Objective 2:

Within 6 weeks of the practicum, demonstrate diagnostic reasoning skills by discussing the psychopathology of mental illnesses across different age groups and disorders, contributing to the formulation of accurate differential diagnoses for at least 10 patients per week across the lifespan.

Planned Activities:

  • Participating in didactic sessions focused on the psychopathology of various mental illnesses.
  • Engaging in case discussions with preceptors and colleagues to explore differential diagnoses and treatment implications.
  • Conducting literature reviews on mental illness presentations across different age groups.

Mode of Assessment:

  • Participation in case discussions and presentations documented in Meditrek.
  • Written reflections on didactic sessions and their application to clinical practice.
  • Preceptor evaluations of diagnostic reasoning during patient assessments.

PRAC Course Outcome(s) Addressed:

  • Apply advanced practice nursing assessment and diagnosis skills in mental health settings.
  • Formulate differential diagnoses for patients across the lifespan.

Objective 3:

Within 8 weeks of the practicum, provide psychoeducation to individuals and/or caregivers as part of psychotherapeutic treatment planning for at least 10 patients per week, incorporating evidence-based strategies to enhance understanding and adherence to treatment recommendations.

Planned Activities:

  • Attending psychoeducation workshops or seminars.
  • Developing psychoeducational materials tailored to the needs of patients and caregivers.
  • Conducting individual or group psychoeducation sessions under supervision.

Mode of Assessment:

  • Feedback from patients and caregivers on understanding and application of psychoeducational materials documented in Meditrek.
  • Self-reflection journals on the effectiveness of psychoeducation provided.
  • Patient satisfaction surveys regarding the psychoeducation received.

PRAC Course Outcome(s) Addressed:

  • Develop professional plans in advanced nursing practice for the practicum experience.
  • Assess psychiatric-mental health advanced practice nursing skills for strengths and opportunities.

Nursing Theory

Orem’s Self-Care Deficit Theory emphasizes the importance of patient self-care in nursing practice. It highlights that nursing interventions are required when patients are unable to meet their own self-care needs (Gligor & Domnariu, 2020). This theory is applicable to psychiatric-mental health nursing, as it supports the promotion of patient independence and self-management of mental health conditions (Hartweg & Metcalfe, 2022). Evidence shows that empowering patients to engage in self-care activities can lead to improved mental health outcomes, such as reduced symptoms of depression and anxiety (Tanaka, 2022). By assessing self-care deficits and implementing individualized care plans, nurses can foster patient autonomy and recovery.

Counseling Theory

Motivational Interviewing (MI) is an evidence-based approach focused on enhancing patients’ motivation to change. It is particularly effective in addressing ambivalence and resistance, which are common challenges in psychiatric-mental health care (Bischof et al., 2021). The core principles of MI—expressing empathy, developing discrepancy, rolling with resistance, and supporting self-efficacy—are instrumental in helping patients explore their motivations for change (Gary et al., 2022). Research has demonstrated that MI improves treatment adherence and outcomes in conditions like substance use disorders and depression (Li et al., 2020). MI’s focus on patient-centered conversations and motivation aligns with psychoeducation and supports collaborative care planning.

Part 3: Projected Timeline/Schedule

A total of 144 clinical hours are planned to be completed over 11 weeks, with weekly time commitments as follows:

Week                   Clinical Hours     Professional Development Hours Practicum Coursework Hours
Week 1                               16 hours 5 hours 5 hours
Week 2 16  hours 5 hours 5 hours
Week 3 16 hours 5 hours 5 hours
Week 4 16 hours 5 hours 5 hours
Week 5 16 hours 5 hours 5 hours
Week 6 16 hours 5 hours 5 hours
Week 7 16 hours 5 hours 5 hours
Week 8 16 hours 5 hours 5 hours
Week 9 16 hours 5 hours 5 hours
Week 10 8 hours 5 hours 5 hours
Week 11 8 hours 5 hours 5 hours

Part 4: Signatures

Student Signature (electronic):

Date:

Practicum Faculty Signature (electronic):

Date:

References

Bischof, G., et al. (2021). Motivational interviewing for mental health. Springer.

Gary, K., et al. (2022). Enhancing motivation for change in psychiatric settings: Principles of MI. Journal of Psychiatric Practice.

Gligor, C., & Domnariu, C. (2020). Orem’s self-care deficit theory and its application to psychiatric nursing. Nursing Science Quarterly.

Hartweg, D. L., & Metcalfe, S. E. (2022). Promoting mental health self-care: Applying Orem’s theory. Journal of Advanced Nursing.

Kiskac, M., & Oz, A. (2023). Integrating theory into psychiatric nursing practice: The role of self-care and motivational interviewing. Journal of Psychiatric Nursing.

Li, M., et al. (2020). Motivational interviewing and treatment adherence: A meta-analysis. Journal of Clinical Psychology.

Tanaka, T. (2022). Self-care in psychiatric nursing: Implications for patient outcomes. Journal of Psychiatric and Mental Health Nursing.

Detailed Assessment Instructions for the NRNP 6635 Week 2: Practicum Experience Plan (PEP) Paper Assignment

Description

Assignment 2: Practicum Experience Plan (PEP)

Photo Credit: Getty Images

As you establish your goals and objectives for this course, you are committing to an organized plan that will frame your practicum experience in a clinical setting, including planned activities, assessment, and achievement of defined outcomes. In particular, they must address the categories of clinical reasoning, quality in your clinical specialty, and interpersonal collaborative practice. 

For this Assignment, you will consider the areas you aim to focus on to gain practical experience as an advanced practice nurse. Then, you will develop a Practicum Experience Plan (PEP) containing the objectives you will fulfill in order to achieve your aims. In this practicum experience, when developing your goals and objectives, be sure to keep psychiatric assessment and diagnostic reasoning in mind. 

To Prepare

  • Review your Clinical Skills Self-Assessment Form you submitted last week and think about areas for which you would like to gain application-level experience and/or continued growth as an advanced practice nurse. How can your experiences in the Practicum help you achieve these aims?? 
  • Review the information related to developing objectives provided in this week’s Learning Resources.? Your practicum?learning objectives that you want to achieve during your Practicum experience must be: 
    • Specific? 
    • Measurable? 
    • Attainable? 
    • Results-focused? 
    • Time-bound 
    • Reflective of the higher-order domains of Bloom’s taxonomy (i.e., application level and above)? 

Note: Please make sure your objectives are outlined in your Practicum Experience Plan (PEP).? 

  • Discuss your professional aims and your proposed practicum objectives with your Preceptor to ascertain if the necessary resources are available at your practicum site. 

Assignment

Record the required information in each area of the Practicum Experience Plan template, including three to four (3–4) practicum learning objectives you will use to facilitate your learning during the practicum experience.

American Psychiatric Association. (2013). Section I: DSM-5 basics. In Diagnostic and statistical manual of mental disorders (5th ed., pp. 5–29). Author.

Sadock, B. J., Sadock, V. A., & Ruiz, P. (2015). Kaplan and Sadock’s synopsis of psychiatry: Behavioral sciences/clinical psychiatry (11th ed.). Wolters Kluwer.
Chapter 5, “Examination and Diagnosis of the Psychiatric Patient”

Walden University. (2020). College of Nursing practicum manual: Master of science in nursing (MSN) and post-master’s certificate programs. https://academicguides.waldenu.edu/fieldexperience…

Walden University Field Experience. (2020a).?Field experience: College of Nursing.? https://academicguides.waldenu.edu/fieldexperience…

Walden University Field Experience. (2020b). Student practicum resources: NP student orientation. https://academicguides.waldenu.edu/StudentPracticu… 

Part 2: Individualized Practicum Learning Objectives

Refer to the instructions in Week 2 to create individualized practicum learning objectives that meet the requirements for this course. These objectives should be aligned specifically to your Practicum experience. Your objectives should address your self-assessment of the skills found in the “PMHNP Clinical Skills Self-Assessment Form” you completed in Week 1.

As you develop your individualized practicum learning objective, be sure to write them using the SMART format. Use the resources found in Week 2 to guide your development. Once you review your resources, continue and complete the following. Note: Please make sure each of your objectives are connected to your self-assessment. Also, consider that you will need to demonstrate how you are advancing your knowledge in the clinical specialty.

Objective 1:<write your objective here> (Note: this objective should relate to a specific skill you would like to improve from your self-assessment)

Planned Activities:
Mode of Assessment:(Note: Verification will be documented in Meditrek)

PRAC Course Outcome(s) Addressed:

  • (for example) Develop professional plans in advanced nursing practice for the practicum experience
  • (for example) Assess advanced practice nursing skills for strengths and opportunities 

Objective 2: <write your objective here> (Note: this objective should relate to a specific skill you would like to improve from your self-assessment)

Planned Activities:

Mode of Assessment:(Note: Verification will be documented in Meditrek)

PRAC Course Outcome(s) Addressed:

Objective 3:<write your objective here> (Note: this objective should relate to a specific skill you would like to improve from your self-assessment)

Planned Activities:

Mode of Assessment:(Note: Verification will be documented in Meditrek)

PRAC Course Outcome(s) Addressed:

Part 3: Projected Timeline/Schedule

Estimate how many hours you expect to work on your Practicum each week.*Note: All of your hours and activities must be supervised by your Preceptor and completed onsite. Your Preceptor will approve all hours, but your activities will be approved by both your Preceptor and Instructor. Any changes to this plan must be approved.

This timeline is intended as a planning tool; your actual schedule may differ from the projections you are making now.

I intend to complete the 144 or 160Practicum hours (as applicable) according to the following timeline/schedule. I also understand that I must see at least 80 patients during my practicum experience. I understand that I may not complete my practicum hours sooner than 8 weeks. I understand I may not be in the practicum setting longer than 8 hours per day unless pre-approved by my faculty.

Number of ClinicalHours Projected for Week Number of Weekly Hours for ProfessionalDevelopment Number of Weekly Hours for Practicum Coursework
Week 1
Week 2
Week 3
Week 4
Week 5
Week 6
Week 7
Week 8
Week 9
Week 10
Week 11
Total Hours(must meet the following requirements) 144 or 160 Hours

Part 4 – Signatures

Student Signature (electronic):                                Date:

Practicum Faculty Signature (electronic)**:         Date:

** Faculty signature signifies approval of Practicum Experience Plan (PEP)

Submit your Practicum Experience Plan on or before Day 7 of Week 2for faculty review and approval.

Once approved, you will receive a copy of the PEP for your records. You must share an approved copy with your Preceptor. The Preceptor is not required to sign this form.

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Best History Paper Writing Guide: Expert Writing Tips

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Best History Paper Writing Guide: Expert Writing Tips

American History Paper Writing ServicesHistory paper writing guide to assist students in the writing process.

A history paper requires a systematic approach to writing. Writing an outstanding history paper takes time and effort rather than a single stroke of inspiration. It’s normal to feel nervous or unprepared after reading the question or topic for your paper.

Writing a history paper is easier and more fun if you view it as a process and divide it down into smaller steps. Writing a history paper lets you dig into the past like a true historian.

There’s no denying that writing a history paper is a laborious endeavor that calls for deep dives into relevant primary and secondary sources. Students writing papers on it need to do a lot of reading to make sure they’re including relevant details and drawing reasonable conclusions.

Writing a history paper requires students to engage with a lot of material on many different topics and events. Writing a high-quality history paper takes time and practice, so students should allow themselves plenty of both as they work toward their deadlines.

So, What is Exactly a History Paper?

Writing a history paper is all about making a case. Even if you are not required to conduct research for your paper, you will still need to make a case if you are writing it for a history class. For instance, your professor assigns a paper in which you’re to compare and contrast colonial New England and Virginia.

At first glance, it could appear that the “correct answer” is all that’s needed for this paper and that no convincing argument is necessary. However, even in this case, you should build your paper around a central thesis. One may argue that divergent colonialist ideals were at the heart of the disparities between New England and Virginia during the early modern period.

You could also argue that geography or regional Indian alliances caused the differences. Alternatively, you could develop a case that incorporates each of these arguments.

Whatever the case may be, such claims constitute an argument that calls for supporting evidence from the past. Every argument in a history paper needs to be supported with evidence from primary sources.

Purpose of our history paper writing guide:

This history paper writing guide is meant to be useful for any form of a history paper, but you should always be sure to follow your instructor’s specific directions for your assignment. Keep in mind that you can rely on our history paper writing services for help at any point in the process.

Check out another post on our paper writing experts aimed at assisting students on how to get better at writing papers.

Common Types of History Papers

There are many different types of history papers.

There are two main types of academic writing: narrative (which follows a story-like structure based on a chronological order of events) and analytical (which follows an essay-like structure based on the topic’s underlying logic).

Some studies focus on historical events (including, of course, the causes and consequences of those events) while others examine historiographical issues (the differences between, and approaches taken by, various authors, historians, and schools of thought in the writing of history).

Other studies focus on intellectual or economic history, while others focus on political or military history.

Basic Structure for History Papers

A history paper, like any other essay, consists of an introduction, the main body, and a conclusion.

Basic Steps of Writing a History Paper

When composing your history research papers, always follow the following steps:

Start off on the Right Foot

Pretentious, vapid starts should be avoided. “There have been a lot of long-running disagreements about government policy and diplomacy in history, which has made historians curious and led to a lot of different historical theories.” This is utter trash, boring the reader, and shows you have nothing to say. Get straight to the point. Better start: “The 1857 uprising forced the British to reassess their Indian colonial administration.” This line tells the reader what your work is about and sets the stage for your thesis statement in the next paragraph. To put it another way, more British sensitivity to Indian customs was hypocritical.

Clearly State Your Thesis

A thesis is required whether writing an exam essay or a senior thesis. So don’t just repeat the homework or start writing down everything you know. “What am I attempting to prove?” When you write a paper, your thesis statement tells the reader what you think, why, or how. “Famine struck Ireland in the 1840s,” is a fact, but not a conclusion. “The English caused the 1840s famine in Ireland” is a thesis (whether defensible or not is another matter). An excellent thesis answers a key research question regarding what happened. (“Who caused the 1840s Irish famine?”) Don’t forget your thesis once you’ve written it. Paragraph after paragraph, develop your thesis. Your reader should always know the origin, current, and future of your argument.

Select an Excellent Research Topic

The success of your research will be determined by the topic you choose, regardless of your field of study. Choosing a research topic that interests you and completing a well-written paper are both within the capabilities of our company’s experts, who have undergone extensive training. The topic can be honed to your specifications until you are satisfied with it and feel confident writing about it. Because we know you won’t be interested in reading about anything you don’t care about, we choose the topic for you based on your interests. With us, you can pick a broad topic, like world history, and we can tailor it to your needs.

Let us know what you need help with writing a history paper and we’ll accomplish it in the best way possible. There are so many topics we can cover. We will gladly explain the topic to the point where you are comfortable presenting your work if you don’t grasp it.

Conduct Appropriate Research and Analysis

Students sometimes wonder why professors penalize them for summarizing or narrating rather than analyzing. What is analysis? Analyzing means breaking down into bits and understanding their interrelationships. Analyzing water yields hydrogen and oxygen. History describes the origins and significance of events. Historical study reveals hidden connections and distinctions. An important part of historical analysis is evaluating sources, causes, and opposing explanations. Don’t confuse summary and analysis, rather think about them this way: Summary is who, what, when, and where; analysis is how, why, and how much. To show the professor that they know the information, many students believe they must offer a detailed synopsis first. Instead, start your analysis as soon as feasible, without any synopsis. A good analysis will “show” the facts. You can’t analyze without knowing the facts, but you can describe them without knowing them. For this reason, a summary alone never gets an “A.”

We will help you look through the evidence and choose the best sources once we have chosen a topic and a theme that fits. You can always count on our team of experts to give the most relevant information and back it up with acceptable citations. The quality of your work is guaranteed, and our quality assurance team is on hand to make sure that the most relevant sources are used. In the event that you aren’t satisfied with some of the sources utilized, we’ll be happy to switch them out for better ones.

Analyze Evidence Critically

Like detectives, historians doubt their sources. Not a single detective who exclusively investigated an alibi with a suspect’s archenemy is trustworthy. You wouldn’t trust a historian who blamed the French for WWI’s origins. Consider these two points concerning WWI’s origins: The Germans ruined 1914. No one would deny…” “Neither the people nor the government wanted war…” No way can they both be right, so investigate.

Always ask: Who wrote it? Why? When? Who? Georges Clemenceau, former French president, wrote the first quote in 1929. In 1870, Clemenceau vowed vengeance on Germany. From 1917 until 1920, he presided over the Paris Peace Conference. He wasn’t a bystander. 2 93 eminent German professors signed a manifesto in 1914. Germany was accused of brutality. They were not aloof bystanders. However, analyzing and cross-checking sources is always valid. With passions and self-interests at play, the more sources you can consult, the better. A historian should be suspicious and critical, not cynical (self-interest isn’t everything).

Competent historians may weigh the same data in various ways. There is no historical “Truth” with a capital T. You can learn to discriminate between differing interpretations.

Be precise

Vague remarks and generalizations reveal ignorance. Consider: “The French Revolution overthrew the regime. It shows people need freedom.” Who? Peasants? Nomads? Lawyers? Which? When? Who needed freedom, and what did it mean? The French Revolution in more detail: Price rises and food shortages spurred the Paris sans-culottes to press the Convention in 1793. Unlike grandiose Revolution generalizations, this remark can lead to a relevant Revolution analysis. Use broad abstractions like people, society, freedom, and government with care, especially as antecedents for the pronouns they and it. Recall cause and effect. People or groups cause or necessitate abstractions. Avoid broad historical generalizations. Be precise and detailed when in doubt.

Make Sure your Conclusion is Strong

Obviously, you can’t just stop because you’re out of time or ideas. Your conclusion must be conclusive. Reiterating what you wrote in your paper gives the appearance that you are unsure of its significance. Your reader will be unhappy and confused after reading your work. A strong ending adds to your opening statement. A solid conclusion summarizes the content. In a strong conclusion, your reader cares about what you stated and considers its broader ramifications. “So what?” asks your reader.

Revise and Proofread

Your professor may recognize a “one-draft wonder,” so don’t rush. Allow lots of time for revision and editing. Show your work to a writing tutor or someone else who is good at writing. Reading the draft out loud may also be beneficial. The truth is that no matter how careful you are, there are bound to be a few slip-ups. But watch out for blunders. The lack of proofreading indicates a lack of effort. Tip: Proofread your text both online and offline. Your eyes see them as distinct. Never rely solely on the spell checker to catch all of your typos. When it comes to spilling or rite-reeling, a computer is your best friend.

Valuable History Paper Writing Guide Tips

When writing history research papers, you must be aware of the various types of evidence that exist. We have two important types of evidence, which are classified as follows:

  1. Primary Evidence

You can get first-hand information about a time in history by looking at things from the past that was there at the time. This could be things like diaries or weapons or letters or oral evidence. Evidence like this can be used in your research to talk about and show direct evidence from the past. You can then use them to compare your topic to a time in the future. Our experts can use this evidence in your paper to make it top-notch and real.

  1. Secondary Evidence

When you write a history research paper, you use this kind of evidence to talk about something that happened after the time you are talking about it! Websites, books, and magazines are all examples of important things. It doesn’t matter if your research paper is about ancient history or not. Our writers use all of these types of evidence to make sure that your paper is written to your specifications and that your topic is well-covered, even if it is.

Things to Avoid During History Paper Writing

Avoid making blanket statements or generalizations

In the eyes of historians, vague expressions like “once upon a time” or “people usually claim that…” are worthless. Whenever you find yourself unsure of the acceptable level of specificity or depth, choose the option of including “too much” of both.

Avoid sounding too modern or too archaic

Don’t be tempted to bring all arguments or concerns from the past back to the present. The past should be explored on its own terms. Make sure you don’t mix up the order of events.

Avoid popular works in your research

Popular works are rarely scholarly, so avoid them when researching. Popular history merely aims to inform and entertain the masses. As a result, in popular histories, the art of the story often triumphs over the science of history; the simplicity of the facts over the complexity of the times; and the broad brush over the finer details.

Avoid abusing your sources

While there are many places to find useful information, it is often easy to abuse them.

Avoid “twenty-dollar words.”

Don’t use a word in an essay that you would never use in speech, and create something that you’d like to read. Don’t just throw any old word into your history paper; be sure you know what it means.

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NRNP 6635 Week 1 Assignment 2: Clinical Skills Self-Assessment Paper Example

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NRNP 6635 Week 1 Assignment 2: Clinical Skills Self-Assessment Paper Example

NRNP 6635 Week 1 Assignment 2: Clinical Skills Self-Assessment Paper ExampleNRNP 6635 Week 1 Assignment 2: Clinical Skills Self-Assessment Assignment

NRNP 6635 Week 1 Assignment 2: Clinical Skills Self-Assessment Paper Assignment Brief

Overview of Assignment Instructions

This assignment is designed to promote self-reflection on clinical skills, focusing on areas of strength and opportunities for improvement. It encourages students to assess their current knowledge and clinical competencies in relation to advanced practice nursing. The assignment also serves as a tool for students to set measurable goals for professional development during their practicum experiences.

Understanding Assignment Objectives

The primary objective of this self-assessment is to evaluate the student’s level of confidence and proficiency in performing key clinical skills required for advanced nursing practice. By identifying strengths and areas for improvement, students can formulate specific goals to enhance their clinical capabilities. This process is important for aligning personal development with the requirements of the practicum and the broader nursing profession. Additionally, the assignment helps students become more self-aware and deliberate in their approach to professional growth.

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The Student’s Role

Students are expected to critically assess their current skill set using the PMHNP Clinical Skills Self-Assessment Form. This involves evaluating their confidence in performing various clinical procedures and diagnosing psychiatric conditions. After rating themselves, students must summarize their key strengths and highlight areas where improvement is needed. Based on this analysis, students will develop three to four measurable goals for their practicum. These goals should reflect their aspirations for developing specific clinical skills, such as diagnostic reasoning, patient assessment, and therapeutic planning.

Competencies Measured

This assignment measures several competencies critical to advanced practice nursing. These include:

  • Clinical assessment and diagnostic reasoning: Students will assess their ability to perform comprehensive evaluations, develop differential diagnoses, and utilize clinical reasoning in decision-making.
  • Patient care planning: Competence in developing personalized care plans and delivering evidence-based treatments is evaluated. This encompasses the selection of appropriate interventions and the ability to monitor patient outcomes.
  • Professional development: Students are also evaluated on their ability to set realistic, measurable goals for continuous improvement, demonstrating a commitment to lifelong learning in their nursing practice.

NRNP 6635 Week 1 Assignment 2: Clinical Skills Self-Assessment Paper Example

Introduction

Advanced practice nurses, including Psychiatric-Mental Health Nurse Practitioners (PMHNPs), require a strong foundation of clinical skills to provide quality care. Clinical training allows PMHNPs to develop essential skills in patient assessment, diagnosis, and treatment of mental health conditions. Regular self-assessment helps identify strengths and areas needing improvement, enhancing clinical proficiency. Developing goals based on these self-assessments aligns with improving professional practice (Kleinpell et al., 2018). This self-assessment focuses on evaluating current competencies, identifying growth opportunities, and establishing objectives for further development during the practicum experience.

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 2: Practicum Experience Plan (PEP) Paper Example

NRNP 6635 week 3 Assignment: Assessing and Diagnosing Patients With Mood Disorders Paper Example

NRNP 6635 Week 4: Assessing and Diagnosing Patients With Anxiety Disorders, PTSD, and OCD Paper Example

NRNP 6635 Week 5: Comprehensive Psychiatric Evaluation and Patient Case Presentation Example

NRNP 6635 Week 6: Neurocognitive, Neurodevelopmental, Eating, and Somatic Symptom-Related Disorders Example

NRNP 6635 Week 8: Assessing and Diagnosing Patients With Substance-Related and Addictive Disorders Example

Clinical Skills Self-Assessment

The PMHNP Clinical Skills Self-Assessment form evaluates competency in various areas of psychiatric practice, ranging from comprehensive psychiatric evaluations to psychotherapeutic treatment planning.

  • Comprehensive Psychiatric Evaluation Skills I rate myself as confident in recognizing the clinical signs and symptoms of psychiatric illness, which is fundamental for making accurate diagnoses. However, I am mostly confident in differentiating between pathophysiological and psychopathological conditions, indicating a need for further knowledge and practice in this area. Performing and interpreting mental status examinations is a skill where I am still developing, needing supervision for confidence, while psychosocial assessments and family psychiatric histories are areas where I am more experienced.
  • Diagnostic Reasoning My current ability to develop and prioritize differential diagnoses is at a beginning level. This reflects a need for more focused practice in applying the DSM-5 criteria and formulating diagnoses based on comprehensive assessments. Understanding the nuances between normal and abnormal psychological changes in different age groups is another area where improvement is necessary (Price & Reichert, 2017).
  • Psychotherapeutic Treatment Planning Psychotherapeutic planning is essential in patient care, and I currently need to further enhance my skills in providing psychoeducation and promoting disease prevention techniques to clients and their caregivers. Although I am confident in some aspects, more practice is needed in selecting and implementing appropriate treatment strategies based on individualized patient assessments.

Summary of Strengths

One of my main strengths is my ability to deliver patient-centered care, enabling effective communication and empathetic interactions with patients from diverse backgrounds. This skill allows me to gather comprehensive patient histories and perform thorough assessments. I also have strong professional skills, maintaining boundaries, fostering therapeutic relationships, and collaborating effectively with multidisciplinary teams. My ability to document clinical findings accurately has proven valuable in creating detailed patient records and forming clinical judgments, particularly when diagnostic tests are unavailable (Chambers & Ryder, 2018).

Opportunities for Improvement

One key area for improvement is mastering the diagnostic reasoning process, particularly the development of differential diagnoses and the interpretation of mental status examinations. Increasing proficiency in these areas is crucial for accurate and efficient patient evaluation. Another area of growth is conducting comprehensive assessments in complex cases involving hostile or cognitively impaired patients. Further training and exposure to such challenging scenarios will enhance my confidence and skill set (Phillips, 2020).

Goals and Objectives for Practicum

Based on this self-assessment, I have set the following goals for my practicum experience:

  • Goal 1: Improve diagnostic reasoning skills
    • Objective 1: Recognize and interpret clinical signs of various psychiatric disorders.
    • Objective 2: Develop and prioritize differential diagnoses using DSM-5 criteria.
    • Objective 3: Apply knowledge of psychopathology to evaluate patients accurately.
  • Goal 2: Enhance mental status examination competency
    • Objective 1: Perform and interpret mental status exams independently.
    • Objective 2: Differentiate between normal and abnormal psychological symptoms across different age groups.
    • Objective 3: Use evidence-based assessment techniques to inform treatment plans.
  • Goal 3: Develop psychotherapeutic treatment planning skills
    • Objective 1: Provide tailored psychoeducation to patients and caregivers.
    • Objective 2: Apply health promotion strategies and preventive techniques effectively.
    • Objective 3: Select and implement appropriate psychotherapeutic interventions based on patient assessments.

Conclusion

The clinical self-assessment provides valuable insights into current competencies and areas for growth, which form the foundation for setting clear, achievable goals for professional development during the practicum. By focusing on diagnostic reasoning, mental status examination, and psychotherapeutic planning, I aim to advance my clinical skills and provide high-quality, evidence-based care to patients with mental health disorders.

References

Chambers, C., & Ryder, E. (2018). Compassion and caring in nursing. Routledge.

Kleinpell, R., Cook, M. L., & Padden, D. L. (2018). American Association of Nurse Practitioners National Nurse Practitioner sample survey: Update on acute care nurse practitioner practice. Journal of the American Association of Nurse Practitioners, 30(3), 140-149.

Phillips, K. (2020). Mental illness is not anyone’s fault: A review of NAMI, the National Alliance on Mental Illness. Journal of Consumer Health on the Internet, 24(1), 75-81.

Price, S., & Reichert, C. (2017). The importance of continuing professional development to career satisfaction and patient care: Meeting the needs of novice to mid-to late-career nurses throughout their career span. Administrative Sciences, 7(2), 17.

Detailed Assessment Instructions for the NRNP 6635 Week 1 Assignment 2: Clinical Skills Self-Assessment Assignment

Assignment 2: Clinical Skills Self-Assessment

Before embarking on any professional or academic activity, it is important to understand the background, knowledge, and experience you bring to it. You might ask yourself, “What do I already know? What do I need to know? And what do I want to know?” This critical self-reflection is especially important for developing clinical skills such as those for advanced practice nursing.  

The Psychiatric-Mental Health Nurse Practitioner (PMHNP) Clinical Skills List and Clinical Skills Self-Assessment Form provided in the Learning Resources can be used to celebrate your progress throughout your practicum and identify skills gaps. The list covers all necessary skills you should demonstrate during your practicum experiences.

Just as you did in PRAC 6635, for this Assignment, you assess where you are now in your clinical skill development and make plans for this practicum. Specifically, you will identify strengths and opportunities for improvement regarding the required practicum skills. In this practicum experience, when developing your goals and objectives, be sure to keep assessment and diagnostic reasoning in mind.

Instructions Assignment

  1. Use the PMHNP Clinical Skills Self-Assessment Form to complete the following:
  • Rate yourself according to your confidence level performing the procedures identified on the Clinical Skills Self-Assessment Form.  
  • Based on your ratings, summarize your strengths and opportunities for improvement.   
  • Based on your self-assessment and theory of nursing practice, develop 3–4 measurable goals and objectives for this practicum experience. Include them on the designated area of the form.  
  • Use at least 3 references.
  1. Please review the Self-Assessment for the previous class NRNP – 6635 (See attachment), so you don’t repeat the strengths and opportunities for improvement and the goals  

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NRNP 6635 Week 1: Competencies of Advanced Nursing Practice Paper Example

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NRNP 6635 Week 1: Competencies of Advanced Nursing Practice Paper Example

NRNP 6635 Week 1: Competencies of Advanced Nursing Practice Paper ExampleNRNP 6635 Week 1: Competencies of Advanced Nursing Practice Assignment

NRNP 6635 Week 1: Competencies of Advanced Nursing Practice Assignment Brief

Assignment Instructions Overview:

In this week’s assignment, students will explore the key competencies required for advanced nursing practice. These competencies are essential for nurse practitioners and focus on developing the skills, knowledge, and attitudes necessary to provide high-quality patient care. By engaging in reflective practice and analyzing both strengths and challenges, students will assess their readiness for clinical practice and how this course aligns with their career goals. The assignment aims to foster a deeper understanding of how to effectively apply these competencies in real-world and virtual patient care environments.

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Understanding Assignment Objectives:

The primary objective of this assignment is to help students reflect on and evaluate their current nursing competencies. Through self-assessment, students will identify their strengths and challenges, as well as areas for improvement. Additionally, the assignment encourages students to consider how the course will help them progress toward their professional goals in advanced nursing practice. This reflection is supported by credible research and scholarly sources to ensure students apply evidence-based thinking to their self-evaluation.

The Student’s Role:

Students are expected to actively engage with course materials and reflect critically on their practice competencies. The reflection must be thoughtful, evidence-based, and aligned with the professional competencies that define advanced nursing practice. Additionally, students are responsible for offering insights and feedback to peers, promoting a collaborative learning environment. Through this process, students will identify personal learning needs, build upon their clinical expertise, and align their competencies with their future roles as nurse practitioners.

Competencies Measured:

This assignment will focus on measuring the following advanced nursing practice competencies:

  • Patient-Centered Care: The ability to deliver care that respects and responds to individual patient preferences, needs, and values.
  • Evidence-Based Practice: The integration of the best research evidence with clinical expertise and patient values in decision-making.
  • Interprofessional Collaboration: The ability to work effectively within healthcare teams to improve patient outcomes.
  • Leadership and Advocacy: Competency in leading initiatives that improve patient care and advocating for changes in healthcare policy.
  • Complex Decision-Making: The ability to analyze patient cases, consider multiple factors, and make informed decisions in diverse and complex situations.

You can also read other assignment examples for the NRNP 6635 – Psychopathology and Diagnostic Reasoning Course below:

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 3 Assignment: Assessing and Diagnosing Patients With Mood Disorders Paper Example

NRNP 6635 Week 4: Assessing and Diagnosing Patients With Anxiety Disorders, PTSD, and OCD Paper Example

NRNP 6635 Week 5: Comprehensive Psychiatric Evaluation and Patient Case Presentation Example

NRNP 6635 Week 6: Neurocognitive, Neurodevelopmental, Eating, and Somatic Symptom-Related Disorders Example

NRNP 6635 Week 8: Assessing and Diagnosing Patients With Substance-Related and Addictive Disorders Example

NRNP 6635 Week 1: Competencies of Advanced Nursing Practice Paper Example

Advanced nursing practice competencies are essential in equipping nurse practitioners with the skills, knowledge, and attitudes necessary to deliver high-quality care. These competencies are particularly crucial when providing care to adult patients across the lifespan, as they ensure patient safety, collaboration, and ethical standards. This paper will analyze my strengths and challenges in relation to these competencies and how this course will help me achieve my career goals as an Adult-Gerontology Primary Care Nurse Practitioner (AGPCNP).

Strengths in Advanced Nursing Practice Competencies

Patient-Centered Care

One of my strengths is my ability to deliver patient-centered care, an essential competency in nursing practice. This competency involves working collaboratively with patients and their families to develop personalized care plans. By actively listening to patients’ needs, I can provide care that respects their preferences and values, which improves patient outcomes. Research supports that patient-centered care enhances patient satisfaction and adherence to treatment plans (Delaney, 2018). This skill is crucial for nurse practitioners, particularly when managing chronic conditions in adult patients.

Evidence-Based Practice

Another key strength I possess is my commitment to evidence-based practice. This competency requires integrating the best available research with clinical expertise and patient preferences to guide decision-making. Evidence-based practice is linked to improved patient outcomes, reduced healthcare costs, and enhanced healthcare quality (Melnyk & Fineout-Overholt, 2018). I am confident in my ability to access, appraise, and apply current research in my clinical practice, which will be vital as I work with diverse populations of adult patients.

Interprofessional Collaboration

Collaboration with other healthcare professionals is an essential competency in advanced practice nursing. My ability to work as part of an interdisciplinary team is a strength that supports patient safety and quality care. According to research, interprofessional collaboration reduces medical errors and improves patient outcomes (Institute of Medicine, 2011). My ability to communicate effectively with other healthcare providers, patients, and their families will ensure that I provide comprehensive care that meets the needs of my patients.

Challenges in Advanced Nursing Practice Competencies

Complex Decision-Making

One of the challenges I face is in complex decision-making, particularly when dealing with patients with multiple comorbidities. As patients age, their health conditions become more complex, requiring advanced diagnostic and therapeutic skills. The challenge arises in balancing evidence-based practice with patient preferences and clinical judgment. Research indicates that decision-making in geriatric care is often complicated by cognitive decline, polypharmacy, and chronic illness management (Tinetti & Studenski, 2011). I aim to strengthen this competency through the course by engaging with case study simulations and seeking feedback from experienced practitioners.

Leadership and Advocacy

Another challenge I encounter is related to leadership and advocacy within healthcare settings. While I have experience working in a collaborative environment, I recognize that advocating for systemic changes and leading initiatives to improve care delivery is an area where I need further development. The National Organization of Nurse Practitioner Faculties (NONPF) identifies leadership as a critical competency for nurse practitioners (NONPF, 2017). Enhancing my leadership skills will empower me to advocate for policy changes that promote better healthcare access and outcomes for older adults.

Career Goals and the Role of this Course

This course aligns with my goal of becoming a skilled AGPCNP, focusing on providing comprehensive care to older adults. By engaging in this course, I expect to strengthen my diagnostic and therapeutic skills, particularly in managing complex cases involving comorbidities. Additionally, the virtual simulations and case studies will allow me to practice clinical decision-making in a controlled environment, which will prepare me for real-world clinical experiences.

Furthermore, the course will enhance my understanding of advanced nursing competencies, which are essential in achieving my long-term career goals of improving healthcare delivery for older adults. By gaining deeper insights into patient-centered care, evidence-based practice, and interprofessional collaboration, I will be better equipped to meet the complex needs of my patients.

Conclusion

Advanced nursing practice competencies serve as a foundation for providing high-quality care to patients across the lifespan. My strengths in patient-centered care, evidence-based practice, and interprofessional collaboration will support my career as an AGPCNP. However, I must address challenges related to complex decision-making and leadership to become a well-rounded practitioner. This course will play a critical role in helping me achieve my career goals by enhancing my competencies in these areas.

References

Delaney, L. J. (2018). Patient-centered care as an approach to improving health care in Australia. Collegian, 25(1), 119-123. https://doi.org/10.1016/j.colegn.2017.02.005

Institute of Medicine. (2011). The Future of Nursing: Leading Change, Advancing Health. The National Academies Press.

Melnyk, B. M., & Fineout-Overholt, E. (2018). Evidence-based practice in nursing & healthcare: A guide to best practice. Wolters Kluwer Health.

National Organization of Nurse Practitioner Faculties (NONPF). (2017). Nurse practitioner core competencies content. https://www.nonpf.org

Detailed Assessment Instructions for the NRNP 6635 Week 1: Competencies of Advanced Nursing Practice Assessment

Week 1: Competencies of Advanced Nursing Practice

Advanced nursing practice competencies emphasize the essential skills, knowledge, and attitudes that nurse practitioners must demonstrate in clinical settings as they work with adult patients across the lifespan. These competencies, developed by experts in the field, guide practitioners toward success in their careers. Practicing these competencies in both real-world and virtual environments is crucial for addressing a wide range of patient situations. For example, during this course, you will engage with virtual i-Human patients in case study simulations, where you will encounter a variety of medical conditions. These simulations provide vital practice to prepare you for clinical experiences.

This week, you will explore advanced nursing practice competencies and reflect on your strengths and challenges related to these competencies. Additionally, you will evaluate how this course may help you achieve your career goals.

Learning Objectives:

  • Analyze strengths and challenges related to nursing practice competencies
  • Define professional career goals and objectives

Discussion: Career Goals and Competencies Reflection

As an advanced practice nurse, collaboration with patients, families, and healthcare professionals is vital to ensure patient safety and maintain ethical standards. Competencies serve as a framework to help nurses understand the skills and knowledge they need to provide high-quality care.

For this discussion, reflect on your strengths and challenges regarding nursing practice competencies. Consider how this course will help you accomplish your career goals as a Family Nurse Practitioner (FNP) or Adult-Gerontology Primary Care Nurse Practitioner (AGPCNP).

To Prepare:

  • Review the advanced nursing practice competencies for this week.
  • Reflect on your strengths and challenges when working with adults across the lifespan.

Discussion Instructions:

  • By Day 3, post your expectations for this course, and share a brief summary of your strengths and challenges related to nursing practice competencies. Include any career goals this course may help you achieve and explain why. Support your explanation with credible and scholarly sources.
  • By Day 6, respond to at least two colleagues, offering suggestions or resources to help them address their strengths, challenges, or career goals. Use research to support your suggestions and provide at least three current scholarly sources.

Assignment: Practicum Manual Acknowledgment Download and review the MSN Nurse Practitioner Practicum Manual to understand the program’s requirements for completing the practicum experience.

What’s Coming in Week 2: Next week, you will analyze a case study in i-Human involving an adult patient with an integumentary condition. This will help you develop a differential diagnosis and create an appropriate treatment plan.

Ensure you can log in to i-Human and review the student manual to familiarize yourself with the platform.

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