Psychotic disorders and schizophrenia are some of the most complicated and challenging diagnoses in the DSM. The symptoms of psychotic disorders may appear quite vivid in some patients; with others, symptoms may be barely observable. Additionally, symptoms may overlap among disorders. For example, specific symptoms, such as neurocognitive impairments, social problems, and illusions may exist in patients with schizophrenia but are also contributing symptoms for other psychotic disorders.

For this Assignment, you will analyze a case study related to schizophrenia, another psychotic disorder, or a medication-induced movement disorder.

To Prepare:

Review this week’s Learning Resources and consider the insights they provide about assessing and diagnosing psychotic disorders. Consider whether experiences of psychosis-related symptoms are always indicative of a diagnosis of schizophrenia. Think about alternative diagnoses for psychosis-related symptoms.
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.

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.).

NRNP/PRAC 6635 Comprehensive Psychiatric Evaluation Exemplar

INSTRUCTIONS ON HOW TO USE EXEMPLAR AND TEMPLATE—READ CAREFULLY

If you are struggling with the format or remembering what to include, follow the Comprehensive Psychiatric Evaluation Template
AND
the Rubric as your guide. It is also helpful to review the rubric in detail in order not to lose points unnecessarily because you missed something required. Below highlights by category are taken directly from the grading rubric for the assignment in Weeks 4–10. After reviewing the full details of the rubric, you can use it as a guide.

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

· Read rating descriptions to see the grading standards!

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.

· Read rating descriptions to see the grading standards!

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 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

.

· Read rating descriptions to see the grading standards!

Reflect on this case. Include: 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

!), 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.).

(The comprehensive evaluation is typically the initial new patient evaluation. You will practice writing this type of note in this course. You will be ruling out other mental illnesses so often you will write up what symptoms are present and what symptoms are not present from illnesses to demonstrat

NRNP/PRAC 6635 Comprehensive Psychiatric Evaluation Template

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:

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

Rubric Detail

Select Grid View or List View to change the rubric’s layout.

Content

Name: NRNP_6635_Week7_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	Points: Points Range: 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. Feedback:	Points: Points Range: 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. Feedback:	Points: Points Range: 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. Feedback:	Points: Points Range: 0 (0%) – 13 (13%) The response provides an incomplete or inaccurate description of the patient’s subjective complaint, history o Week 7 Schizophrenia and Other Psychotic Disorders; Medication Induced Movement Disorders Training Title 9 Name: Ms. Nijah Branning Gender: female Age: 25 years old T- 98.4 P- 80 R 18 128/78 Ht 5’0 Wt 120lbs Background: Raised by parents, lives alone in Santa Monica, CA. Only child. Works in office supply sales, has a bachelor’s in business degree. Has medical history of hypothyroidism, currently treated with daily levothyroxine. Guarded and declined to discuss past psychiatric history. Denied family mental health issues, declined to allow you to speak to parents for collaborative information. Allergies: medical tape; menses regular Symptom Media. (Producer). (2016). Training title 9 [Video]. https://video-alexanderstreetcom.ezp.waldenulibrary.org/watch/training-title-9 Training Title 24 Name: Ms. Jess Cunningham Gender: female Age: 28 years old T- 98.6 P- 86 R 20 120/70 Ht 5’2 Wt 126lbs Background: Jess is brought for evaluation by her 2 roommates who are concerned with behaviors that began 12 days after Jess’s younger brother committed suicide in front of her via GSW after his girlfriend broke up with him. She is estranged from her parents and her brother was her only sibling. She is only sleeping 1–2 hours/24hrs; she will only canned foods. She smokes cannabis daily since she was 16, goes out on weekdays 2–3 times with her roommates and has couple drinks of beer. She was prescribed alprazolam 1mg twice daily as needed by her PCP for 15 days. She works as a bartender. Symptom Media. (Producer). (2016). Training title 24 [Video]. https://video-alexanderstreetcom.ezp.waldenulibrary.org/watch/training-title-24 Training Title 29 Name: Mr. Jay Feldman Gender: male Age:19 years old T- 98.3 P- 69 R 16 106/72 Ht 5’7 Wt 117lbs Background: European-American male. He has two younger brothers, one with history of ADHD, the other with history of anxiety. His mother has anxiety; his father has paranoia schizophrenia. He is home for spring break. He has no previous medical problems. Developmental milestones met as child. Appetite is inconsistent and it seems he has lost 18lbs since first going back to school in the fall. Jason has not acted this way before but did have a short trial of aripiprazole in the last six months of high school for mild paranoia. He stopped the medication after graduation as he could not tolerate due to side effects of akathisia. Jason has several friends but has not kept in touch with them since being back home. He has not been showering. Sleeping 4–5 hrs. Symptom Media. (Producer). (2016). Training title 29 [Video]. https://video-alexanderstreetcom.ezp.waldenulibrary.or CASE HISTORY REPORT TRAINING 9 00:00:00BEGIN TRANSCRIPT: 00:00:00[sil.] 00:00:15OFF CAMERA Ms. Branning, Mr. Nehring asked suggested you see me. He said your having some issues at work. 00:00:20MS. BRANNING You could call them that. 00:00:20OFF CAMERA What kind of difficulty are you having at work? 00:00:25MS. BRANNING Well Mr. Nehring wants to fire me. 00:00:30OFF CAMERA Why do you think Mr. Nehring wants to fire you? 00:00:30MS. BRANNING Because Eric is in love with me. And it’s probably getting in the way. And he wants to fire me. 00:00:40OFF CAMERA Who is Eric? 00:00:40MS. BRANNING Eric is my supervisor. 00:00:45OFF CAMERA Are the two of you in a relationship? 00:00:45MS. BRANNING No! Eric has his own girlfriend; I have my own boyfriend. But Mr. Nehring got it in his head that this is my fault. And they’ve been ganging up against me. 00:01:00OFF CAMERA What happened to make you feel this way? 00:01:00MS. BRANNING Eric is lustful for me. Lust. Lustful. 00:01:10OFF CAMERA Well has Eric done anything inappropriate? 00:01:10MS. BRANNING No, he doesn’t have to. 00:01:15OFF CAMERA What do you mean? 00:01:15MS. BRANNING Well, he has this way of walking toward me and he gives me the easiest assignments to do and he asks me to voice my opinion a lot in our weekly meetings. And I’m beautiful. I mean, not to be boastful or anything but I’m a strong woman. And people are attracted to that. And others, like Mr. Nehring feel threatened by it. He probably feels I could replace him in a couple years. And I could. 00:01:45OFF CAMERA But there have been no instances of sexual harassment. 00:01:50MS. BRANNING No. And now they want to fire me, and it’s probably because they don’t want me to get in the way of their day. I’m probably a distraction or something. 00:02:00OFF CAMERA According to Mr. Nehring you haven’t made a sale in three weeks. 00:02:05MS. BRANNING Oh, it’s been a slow time period. I guess it wouldn’t be bad thing if they fired me. I mean after all of this, all the bad it’s done for my health. You know I should really sue for discrimination; you know the stress and the health problems. 00:02:25OFF CAMERA You’ve been having health problems? 00:02:25MS. BRANNING Yes. Yes. It keeps getting worse. 00:02:30OFF CAMERA Can you describe it for me? 00:02:30MS. BRANNING Well you know there’s this pain in my neck, it aches, it spreads to my back, I think there’s a lump, right here. I’m really worried. 00:02:55OFF CAMERA And what do you feel is the cause? 00:02:55MS. BRANNING I told you, pain, suffering, broken heart. I think it’s cancer. 00:03:05OFF CAMERA Have you been seen by a doctor? 00:03:10MS. BRANNING No. But it’s probably cancer. And it’s slowly ki PLEASE FOLLOW THE INSTRUCTIONS AS INDICATED BELOW: 1). ZERO (0) PLAGIARISM. 2). AT LEAST 5 REFERENCES, NO MORE THAN 5 YEARS (WITHIN 5YRS, OR LESS THAN 5YRS) 3). PLEASE SEE THE ATTACHED RUBRIC DETAILS, Comprehensive Psychiatric Evaluation Exemplar, Comprehensive Psychiatric Evaluation Template, Patient History Report, Training 9, 24, 29, & 134 Transcripts. 4). Please review and follow the grading rubric details, and include each component in the assignment as required. Also, follow the APA 7 writing rules and style/Format. Thank you. Why work with us? Authenticity: All of our papers are authentic, as each paper of ours is composed according to your unique requirements. Confidentiality: We value you data. Our company is extremely efficient in guarding the privacy of our clients. 100% Money Back Guarantee: In the event you cancel your order, you get your money back as soon as possible, we give a 100% refund. 24/7 Support: Our team members are available via email, live chat, and phone. Revision Policy: You can apply for a revision if you think your paper could be better. In this case, your paper will be revised either by the specialist assigned to you or by another writer. How the Platform Works Click on 'Place Your Order' tab on the menu or click on 'Order Now' tab at the bottom and a new order page will appear Fill in your requirements depending on your needs under the 'PAPER DETAILS' area In the next section, fill in the academic level, required number of pages, paper deadline as provided in the drop-down menus. To enter your registration details, click on 'CREATE ACCOUNT & SIGN IN'. This step allows you to create an account with us for purposes of record-keeping. 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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

Points:

Points Range:
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.

Feedback:

Points:

Points Range:
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.

Feedback:

Points:

Points Range:
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.

Feedback:

Points:

Points Range:
0 (0%) – 13 (13%)

The response provides an incomplete or inaccurate description of the patient’s subjective complaint, history o

Week 7 Schizophrenia and Other Psychotic Disorders; Medication Induced Movement Disorders

Training Title 9

Name: Ms. Nijah Branning

Gender: female

Age: 25 years old

T- 98.4 P- 80 R 18 128/78 Ht 5’0 Wt 120lbs

Background: Raised by parents, lives alone in Santa Monica, CA. Only child. Works in office

supply sales, has a bachelor’s in business degree. Has medical history of hypothyroidism,

currently treated with daily levothyroxine. Guarded and declined to discuss past psychiatric

history. Denied family mental health issues, declined to allow you to speak to parents for

collaborative information. Allergies: medical tape; menses regular

Symptom Media. (Producer). (2016). Training title 9 [Video]. https://video-alexanderstreetcom.ezp.waldenulibrary.org/watch/training-title-9

Training Title 24

Name: Ms. Jess Cunningham

Gender: female

Age: 28 years old

T- 98.6 P- 86 R 20 120/70 Ht 5’2 Wt 126lbs

Background: Jess is brought for evaluation by her 2 roommates who are concerned with

behaviors that began 12 days after Jess’s younger brother committed suicide in front of her via

GSW after his girlfriend broke up with him. She is estranged from her parents and her brother

was her only sibling. She is only sleeping 1–2 hours/24hrs; she will only canned foods. She

smokes cannabis daily since she was 16, goes out on weekdays 2–3 times with her roommates

and has couple drinks of beer. She was prescribed alprazolam 1mg twice daily as needed by her

PCP for 15 days. She works as a bartender.

Symptom Media. (Producer). (2016). Training title 24 [Video]. https://video-alexanderstreetcom.ezp.waldenulibrary.org/watch/training-title-24

Training Title 29

Name: Mr. Jay Feldman

Gender: male

Age:19 years old

T- 98.3 P- 69 R 16 106/72 Ht 5’7 Wt 117lbs

Background: European-American male. He has two younger brothers, one with history of

ADHD, the other with history of anxiety. His mother has anxiety; his father has paranoia

schizophrenia. He is home for spring break. He has no previous medical problems.

Developmental milestones met as child. Appetite is inconsistent and it seems he has lost 18lbs

since first going back to school in the fall. Jason has not acted this way before but did have a

short trial of aripiprazole in the last six months of high school for mild paranoia. He stopped the

medication after graduation as he could not tolerate due to side effects of akathisia. Jason has

several friends but has not kept in touch with them since being back home. He has not been

showering. Sleeping 4–5 hrs.

Symptom Media. (Producer). (2016). Training title 29 [Video]. https://video-alexanderstreetcom.ezp.waldenulibrary.or

CASE HISTORY REPORT

TRAINING 9

00:00:00BEGIN TRANSCRIPT:

00:00:00[sil.]

00:00:15OFF CAMERA Ms. Branning, Mr. Nehring asked suggested you see me. He said your having some issues at work.

00:00:20MS. BRANNING You could call them that.

00:00:20OFF CAMERA What kind of difficulty are you having at work?

00:00:25MS. BRANNING Well Mr. Nehring wants to fire me.

00:00:30OFF CAMERA Why do you think Mr. Nehring wants to fire you?

00:00:30MS. BRANNING Because Eric is in love with me. And it’s probably getting in the way. And he wants to fire me.

00:00:40OFF CAMERA Who is Eric?

00:00:40MS. BRANNING Eric is my supervisor.

00:00:45OFF CAMERA Are the two of you in a relationship?

00:00:45MS. BRANNING No! Eric has his own girlfriend; I have my own boyfriend. But Mr. Nehring got it in his head that this is my fault. And they’ve been ganging up against me.

00:01:00OFF CAMERA What happened to make you feel this way?

00:01:00MS. BRANNING Eric is lustful for me. Lust. Lustful.

00:01:10OFF CAMERA Well has Eric done anything inappropriate?

00:01:10MS. BRANNING No, he doesn’t have to.

00:01:15OFF CAMERA What do you mean?

00:01:15MS. BRANNING Well, he has this way of walking toward me and he gives me the easiest assignments to do and he asks me to voice my opinion a lot in our weekly meetings. And I’m beautiful. I mean, not to be boastful or anything but I’m a strong woman. And people are attracted to that. And others, like Mr. Nehring feel threatened by it. He probably feels I could replace him in a couple years. And I could.

00:01:45OFF CAMERA But there have been no instances of sexual harassment.

00:01:50MS. BRANNING No. And now they want to fire me, and it’s probably because they don’t want me to get in the way of their day. I’m probably a distraction or something.

00:02:00OFF CAMERA According to Mr. Nehring you haven’t made a sale in three weeks.

00:02:05MS. BRANNING Oh, it’s been a slow time period. I guess it wouldn’t be bad thing if they fired me. I mean after all of this, all the bad it’s done for my health. You know I should really sue for discrimination; you know the stress and the health problems.

00:02:25OFF CAMERA You’ve been having health problems?

00:02:25MS. BRANNING Yes. Yes. It keeps getting worse.

00:02:30OFF CAMERA Can you describe it for me?

00:02:30MS. BRANNING Well you know there’s this pain in my neck, it aches, it spreads to my back, I think there’s a lump, right here. I’m really worried.

00:02:55OFF CAMERA And what do you feel is the cause?

00:02:55MS. BRANNING I told you, pain, suffering, broken heart. I think it’s cancer.

00:03:05OFF CAMERA Have you been seen by a doctor?

00:03:10MS. BRANNING No. But it’s probably cancer. And it’s slowly ki

PLEASE FOLLOW THE INSTRUCTIONS AS INDICATED BELOW:

1). ZERO (0) PLAGIARISM.

2). AT LEAST 5 REFERENCES, NO MORE THAN 5 YEARS (WITHIN 5YRS, OR LESS THAN 5YRS)

3). PLEASE SEE THE ATTACHED RUBRIC DETAILS, Comprehensive Psychiatric Evaluation Exemplar, Comprehensive Psychiatric Evaluation Template, Patient History Report, Training 9, 24, 29, & 134 Transcripts.

4). Please review and follow the grading rubric details, and include each component in the assignment as required. Also, follow the APA 7 writing rules and style/Format.

Thank you.

Why work with us?

Authenticity:

All of our papers are authentic, as each paper of ours is composed according to your unique requirements. Confidentiality: We value you data. Our company is extremely efficient in guarding the privacy of our clients. 100% Money Back Guarantee: In the event you cancel your order, you get your money back as soon as possible, we give a 100% refund. 24/7 Support: Our team members are available via email, live chat, and phone. Revision Policy: You can apply for a revision if you think your paper could be better. In this case, your paper will be revised either by the specialist assigned to you or by another writer.

How the Platform Works

Click on 'Place Your Order' tab on the menu or click on 'Order Now' tab at the bottom and a new order page will appear
Fill in your requirements depending on your needs under the 'PAPER DETAILS' area
In the next section, fill in the academic level, required number of pages, paper deadline as provided in the drop-down menus.
To enter your registration details, click on 'CREATE ACCOUNT & SIGN IN'. This step allows you to create an account with us for purposes of record-keeping. Click on 'PROCEED TO CHECK OUT' at the bottom of the page
The next section requires you to fill in the payment details. Follow the guided process and soon your order will be available for our team to work on.

Assignment: assessing and diagnosing patients with schizophrenia,

To Prepare:

Rubric Detail

Content

Name: NRNP_6635_Week7_Assignment_Rubric

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