NRNP 6675 Full Course Discussions & Assignments (Week 1-10)
NRNP 6675 Full Course Discussions & Assignments (Week 1-10)
NRNP 6675 Week 1 Assignment: Certification and Licensure Plan
Now that you are in the final course in your program, it is time to turn in earnest to preparing for certification and licensure. You will need to take and pass the national PMHNP certification exam. Once certified, you will then be eligible to apply for licensure as an advanced practice registered nurse (APRN) in the state desired. It will be up to you to ensure you are knowledgeable about the practice agreements, scope of practice, and prescriptive authority in your state.
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Although a movement called the APRN Consensus Model is attempting to standardize NP regulations nationally, it is still the case that requirements vary state to state. In some states, NPs may establish an independent practice without the supervision of an MD. Additionally, states are currently categorized as either allowing full practice, reduced practice, or restricted practice. Full practice states allow NPs to evaluate, order diagnostics, diagnose, and treat patients. They are licensed under the exclusive authority of the state board of nursing for the appropriate state. Many states may require prescriptive authority protocols in addition to collaborative agreement.
Another important area to consider and plan for is prescriptive authority. The appropriate board, which may be the medical board, state board of pharmacy, or nursing board, grants prescriptive authority under state law for the appropriate state licensure. The federal government grants the authority to write for a controlled substance, and the Drug Enforcement Administration (DEA) verifies this action through by the appropriate state board. Drug Enforcement Agency registration is granted at the federal level and has additional requirements/fees for the registration process.
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In this Discussion, you will locate and review the practice agreements in the state in which you plan to practice, identify potential collaboration requirements in your state, and understand the certification and licensing process that you will need to follow.
Resources
Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.
WEEKLY RESOURCES
Learning Resources
Required Readings
American Association of Nurse Practitioners. (2020). State practice environment
Links to an external site.. https://www.aanp.org/advocacy/state/state-practice-environment
On the map on the webpage, click on your state and review. After you complete the PMHNP Program, pass the certification exam, and get a job, you will need to revisit this website to apply for the privilege to practice as an APRN with your state Board of Nursing.
American Psychiatric Association. (2020). Telepsychiatry
Links to an external site.. https://www.psychiatry.org/psychiatrists/practice/telepsychiatry
Buppert, C. (2021). Nurse practitioner’s business practice and legal guide (7th ed.). Jones & Bartlett Learning.
Chapter 1, “What Is a Nurse Practitioner?”
Chapter 2, “Nurse Practitioner Scope of Practice”
Chapter 3, “State Regulation of the Nurse Practitioner Practice”
Chapter 4, “Federal Regulation of the Nurse Practitioner Profession”
Chapter 5, “Prescribing”
Centers for Disease Control and Prevention. (2020). Using telehealth to expand access to essential health services during the COVID-19 pandemic
Links to an external site.. https://www.cdc.gov/coronavirus/2019-ncov/hcp/telehealth.html
Centers for Medicare & Medicaid Services. (2019). National provider identifier standard (NPI)
Links to an external site.. https://www.cms.gov/Regulations-and-Guidance/Administrative-Simplification/NationalProvIdentStand
The National Provider Identifier (NPI) is a Health Insurance Portability and Accountability Act (HIPAA) Administrative Simplification Standard. The NPI is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions.
Drug Enforcement Administration Diversion Control Division. (2020). Registration
Links to an external site.. https://www.deadiversion.usdoj.gov/drugreg/index.html
This site contains information about applying for your DEA registration number. This number is required for writing prescriptions.
After completing PMHNP Program and passing the PMHNP certification exam, complete the DEA application to request prescriptive privileges. Your DEA number will be renewable every five years.
National Panel for Psychiatric Mental Health NP Competencies. (2003). Psychiatric-mental health nurse practitioner competencies
Links to an external site.. National Organization of Nurse Practitioner Faculties (NONPF). https://cdn.ymaws.com/www.nonpf.org/resource/resmgr/imported/PMHNPcomps03.pdf
Stewart, J. G., & DeNisco, S. M. (2019). Role development for the nurse practitioner (2nd ed.). Jones & Bartlett Learning.
Chapter 1, “Historical Perspectives: The Art and Science of Nurse Practitionering”
Nurse Practitioner Core Competencies
Nurse Practitioners’ Unique Role
Chapter 13, “Quality, Safety, and Prescriptive Authority”
Substance Abuse and Mental Health Services Administration. (2020). Become a buprenorphine waivered practitioner
Links to an external site.. https://www.samhsa.gov/medication-assisted-treatment/buprenorphine-waiver-management/apply-for-practitioner-waiver
This site contains information about applying for a practitioner waiver to prescribe or dispense buprenorphine under the Drug Addiction Treatment Act of 2000 (DATA 2000).
After you obtain a Drug Enforcement Agency (DEA) number and completed 24-hour medication-assisted treatment (MAT) waiver training, you may apply to Substance Abuse and Mental Health Services Administration (SAMSHA) for MAT waiver to be able to prescribe Schedule III, IV, or V opioid drugs for the maintenance and detoxification treatment of opioid use disorders relapse prevention.
Zakhari, R. (2021). The psychiatric-mental health nurse practitioner certification review manual. Springer Publishing Company.
Chapter 2, “The Role of the Psychiatric-Mental Health Nurse Practitioner: Regulations and Scope of Practice”
Chapter 3, “Theoretical Foundations of Care and Nonpharmacological Therapies”
Recommended Resources
Consult these professional organization websites as needed.
American Psychiatric Nurse Association
Links to an external site. (APNA) https://www.apna.org
International Society of Psychiatric-Mental Health Nurses
Links to an external site. (ISPN) www.ispn-psych.org
National Alliance on Mental Illness
Links to an external site. (NAMI) https://www.nami.org
National Council for Behavioral Health
Links to an external site. (NCBH) www.thenationalcouncil.org
National Institute of Mental Health
Links to an external site. (NIMH) https://www.nimh.nih.gov/index.shtml
Substance Abuse and Mental Health Services Administration
Links to an external site. (SAMHSA) www.samhsa.gov
To Prepare:
Review practice agreements in your state.
Identify whether your state requires physician collaboration or supervision for nurse practitioners, and if so, what those requirements are.
Research the following:
How do you get certified and licensed as an Advanced Practice Registered Nurse (APRN) in your state?
What is the application process for certification in your state?
What is your state’s board of nursing website?
How does your state define the scope of practice of a nurse practitioner?
What is included in your state practice agreement?
How do you get a DEA license?
Does your state have a prescription monitoring program (PMP)?
How does your state describe a nurse practitioner’s controlled-substance prescriptive authority, and what nurse practitioner drug schedules are nurse practitioners authorized to prescribe?
By Day 3 of Week 1
Post a summary of your findings on your state based on the questions listed above. Explain the types of regulations that exist and the barriers that may impact nurse practitioner independent practice in your state. Be specific. Also, describe what surprised you from your research.
Read a selection of your colleagues’ responses.
By Day 6 of Week 1
Respond to at least two of your colleagues on 2 different days in one or more of the ways listed below.
Share an insight from having viewed your colleagues’ posts.
Suggest additional actions or perspectives.
Share insights after comparing state processes, roles, and limitations.
Suggest a way to advocate for the profession.
Share resources with those who are in your state.
Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the Reply button to complete your initial post. Remember, once you click on Post Reply, you cannot delete or edit your own posts and you cannot post anonymously. Please check your post carefully before clicking on Post Reply!
NRNP 6675 Week 1 Discussion: Certification and Licensure Plan
Discussion: Certification and Licensure Plan
Now that you are in the final course in your program, it is time to turn in earnest to preparing for certification and licensure. You will need to take and pass the national PMHNP certification exam. Once certified, you will then be eligible to apply for licensure as an advanced practice registered nurse (APRN) in the state desired. It will be up to you to ensure you are knowledgeable about the practice agreements, scope of practice, and prescriptive authority in your state.
Photo Credit: AndreyPopov / iStock / Getty Images Plus / Getty Images
Although a movement called the APRN Consensus Model is attempting to standardize NP regulations nationally, it is still the case that requirements vary state to state. In some states, NPs may establish an independent practice without the supervision of an MD. Additionally, states are currently categorized as either allowing full practice, reduced practice, or restricted practice. Full practice states allow NPs to evaluate, order diagnostics, diagnose, and treat patients. They are licensed under the exclusive authority of the state board of nursing for the appropriate state. Many states may require prescriptive authority protocols in addition to collaborative agreement.
Another important area to consider and plan for is prescriptive authority. The appropriate board, which may be the medical board, state board of pharmacy, or nursing board, grants prescriptive authority under state law for the appropriate state licensure. The federal government grants the authority to write for a controlled substance, and the Drug Enforcement Administration (DEA) verifies this action through by the appropriate state board. Drug Enforcement Agency registration is granted at the federal level and has additional requirements/fees for the registration process.
In this Discussion, you will locate and review the practice agreements in the state in which you plan to practice, identify potential collaboration requirements in your state, and understand the certification and licensing process that you will need to follow.
To Prepare:
• Review practice agreements in your state.
• Identify whether your state requires physician collaboration or supervision for nurse practitioners, and if so, what those requirements are.
• Research the following:
o How do you get certified and licensed as an Advanced Practice Registered Nurse (APRN) in your state?
o What is the application process for certification in your state?
o What is your state’s board of nursing website?
o How does your state define the scope of practice of a nurse practitioner?
o What is included in your state practice agreement?
o How do you get a DEA license?
o Does your state have a prescription monitoring program (PMP)?
o How does your state describe a nurse practitioner’s controlled-substance prescriptive authority, and what nurse practitioner drug schedules are nurse practitioners authorized to prescribe?
Post a summary of your findings on your state based on the questions listed above. Explain the types of regulations that exist and the barriers that may impact nurse practitioner independent practice in your state. Be specific. Also, describe what surprised you from your research.
NRNP 6675 Week 2 Assignment: Evaluation and Management (E/M)
Insurance coding and billing is complex, but it boils down to how to accurately apply a code, or CPT (current procedural terminology), to the service that you provided. The payer then reimburses the service at a certain rate. As a provider, you will have to understand what codes to use and what documentation is necessary to support coding.
For this Assignment, you will review evaluation and management (E/M) documentation for a patient and perform a crosswalk of codes from DSM-5-TR to ICD-10.
Resources
Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.
WEEKLY RESOURCES
Learning Resources
Required Readings
American Psychiatric Association. (2022). ICD-10-CM Codes Update
Links to an external site.. https://www.psychiatry.org/psychiatrists/practice/dsm/updates-to-dsm/updates-to-dsm-5-tr-criteria-text
American Psychiatric Association. (2022). Changes to ICD-10-CM Codes for DSM-5 Diagnoses
Links to an external site.. https://www.psychiatry.org/psychiatrists/practice/dsm/updates-to-dsm/coding-updates
American Psychiatric Association. (2020). Updates to DSM–5 criteria, text and ICD-10 codes
Links to an external site.. https://www.psychiatry.org/psychiatrists/practice/dsm/updates-to-dsm-5
American Psychiatric Association. (2013). Insurance implications of DSM-5
Links to an external site.. https://www.psychiatry.org/File%20Library/Psychiatrists/Practice/DSM/APA_DSM_Insurance-Implications-of-DSM-5.pdf
Clicking on this link will initiate the download of the PDF.
American Psychiatric Association. (2020). Coding and reimbursement
Links to an external site..
https://www.psychiatry.org/psychiatrists/practice/practice-management/coding-reimbursement-medicare-and-medicaid/coding-and-reimbursement
American Psychiatric Association. (2022). Numerical listing of DSM-5 diagnoses and codes (ICD-10-CM). In Diagnostic and statistical manual of mental disorders
Links to an external site. (5th ed., text rev.). https://go.openathens.net/redirector/waldenu.edu?url=https://dsm.psychiatryonline.org/doi/book/10.1176/appi.books.9780890425787
Buppert, C. (2021). Nurse practitioner’s business practice and legal guide (7th ed.). Jones & Bartlett Learning.
Chapter 9, “Reimbursement for Nurse Practitioner Services”
Centers for Medicare & Medicaid Services. (2020). Your billing responsibilities
Links to an external site.. https://www.cms.gov/Medicare/Coordination-of-Benefits-and-Recovery/ProviderServices/Your-Billing-Responsibilities
Stewart, J. G., & DeNisco, S. M. (2019). Role development for the nurse practitioner (2nd ed.). Jones & Bartlett Learning.
Chapter 15, “Reimbursement for Nurse Practitioner Services”
Walden University Academic Skills Center. (2017). Developing SMART goals
Links to an external site.. https://academicguides.waldenu.edu/ld.php?content_id=51901492
Zakhari, R. (2021). The psychiatric-mental health nurse practitioner certification review manual. Springer Publishing Company.
Chapter 4 “Neuroanatomy, Physiology, and Mental Illness”
Document: E/M Patient Case Study
Download E/M Patient Case Study
To Prepare
Review this week’s Learning Resources on coding, billing, reimbursement.
Review the E/M patient case scenario provided.
The Assignment
Assign DSM-5-TR and ICD-10 codes to services based upon the patient case scenario.
Then, in 1–2 pages address the following. You may add your narrative answers to these questions to the bottom of the case scenario document and submit altogether as one document.
Explain what pertinent information, generally, is required in documentation to support DSM-5-TR and ICD-10 coding.
Explain what pertinent documentation is missing from the case scenario, and what other information would be helpful to narrow your coding and billing options.
Finally, explain how to improve documentation to support coding and billing for maximum reimbursement.
By Day 7 of Week 2
Submit your Assignment.
submission information
Before submitting your final assignment, you can check your draft for authenticity. To check your draft, access the Turnitin Drafts from the Start Here area.
To submit your completed assignment, save your Assignment as WK2Assgn1_LastName_Firstinitial
Then, click on Start Assignment near the top of the page.
Next, click on Upload File and select Submit Assignment for review.
Rubric
NRNP_6675_Week2_Assignment1_Rubric
NRNP_6675_Week2_Assignment1_Rubric
Criteria Ratings Pts
This criterion is linked to a Learning Outcome In the E/M patient case scenario provided:• Assign DSM-5 and ICD-10 codes to services based upon the patient case scenario.
20 to >17.0 pts
Excellent 90%–100%
DSM-5 and ICD-10 codes assigned to the scenario are correct, with no more than a minor error.
17 to >15.0 pts
Good 80%–89%
DSM-5 and ICD-10 codes assigned to the scenario are mostly correct, with a few minor errors.
15 to >13.0 pts
Fair 70%–79%
DSM-5 and ICD-10 codes assigned to the scenario contain several errors.
13 to >0 pts
Poor 0%–69%
DSM-5 and ICD-10 codes assigned to the scenario contain significant errors, or response is missing.
20 pts
This criterion is linked to a Learning Outcome In 1–2 pages, address the following: • Explain what pertinent information, generally, is required in documentation to support DSM-5 and ICD-10 coding.
25 to >22.0 pts
Excellent 90%–100%
The response accurately and concisely explains what pertinent documentation information is required to support DSM-5 and ICD-10 coding.
22 to >19.0 pts
Good 80%–89%
The response accurately explains what pertinent documentation information is required to support DSM-5 and ICD-10 coding.
19 to >17.0 pts
Fair 70%–79%
The response somewhat vaguely or inaccurately explains what pertinent documentation information is required to support DSM-5 and ICD-10 coding.
17 to >0 pts
Poor 0%–69%
The response vaguely or inaccurately explains what pertinent documentation information is required to support DSM-5 and ICD-10 coding, or the explanation is incomplete or missing.
25 pts
This criterion is linked to a Learning Outcome • Explain what pertinent documentation is missing from the case scenario, and what other information would be helpful to narrow your coding and billing options.
25 to >22.0 pts
Excellent 90%–100%
The response accurately and concisely identifies the pertinent misssing information from the case scenario and clearly identifies what additional information would narrow coding and billing options.
22 to >19.0 pts
Good 80%–89%
The response accurately identifies the pertinent misssing information from the case scenario and identifies what additional information would narrow coding and billing options.
19 to >17.0 pts
Fair 70%–79%
The response somewhat vaguely or inaccurately identifies the pertinent misssing information from the case scenario and identifies what additional information would narrow coding and billing options.
17 to >0 pts
Poor 0%–69%
The response vaguely or inaccurately identifies the pertinent misssing information from the case scenario or partially identifies what additional information would narrow coding and billing options, or this information is incomplete or missing.
25 pts
This criterion is linked to a Learning Outcome • Finally, explain how to improve documentation to support coding and billing for maximum reimbursement.
15 to >13.0 pts
Excellent 90%–100%
The response accurately and concisely explains how to improve documentation to support coding and billing for maximum reimbursement.
13 to >11.0 pts
Good 80%–89%
The response accurately explains how to improve documentation to support coding and billing for maximum reimbursement.
11 to >10.0 pts
Fair 70%–79%
The response somewhat vaguely or inaccurately explains how to improve documentation to support coding and billing for maximum reimbursement.
10 to >0 pts
Poor 0%–69%
The response vaguely or inaccurately explains how to improve documentation to support coding and billing for maximum reimbursement, or response may be incomplete or missing.
15 pts
This criterion is linked to a Learning Outcome 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 to >4.0 pts
Excellent 90%–100%
Paragraphs and sentences follow writing standards for flow, continuity, and clarity…. A clear and comprehensive purpose statement, introduction, and conclusion are provided that delineate all required criteria.
4 to >3.5 pts
Good 80%–89%
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time…. Purpose, introduction, and conclusion of the assignment are stated, yet are brief and not descriptive.
3.5 to >3.0 pts
Fair 70%–79%
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time…. Purpose, introduction, and conclusion of the assignment are vague or off topic.
3 to >0 pts
Poor 0%–69%
Paragraphs and sentences follow writing standards for flow, continuity, and clarity <60% of the time…. Purpose statement, introduction, and conclusion were not provided.
5 pts
This criterion is linked to a Learning Outcome Written Expression and Formatting – English Writing Standards: Correct grammar, mechanics, and proper punctuation
5 to >4.0 pts
Excellent 90%–100%
Uses correct grammar, spelling, and punctuation with no errors
4 to >3.5 pts
Good 80%–89%
Contains 1-2 grammar, spelling, and punctuation errors
3.5 to >3.0 pts
Fair 70%–79%
Contains 3-4 grammar, spelling, and punctuation errors
3 to >0 pts
Poor 0%–69%
Contains five or more grammar, spelling, and punctuation errors that interfere with the reader’s understanding
5 pts
This criterion is linked to a Learning Outcome Written Expression and Formatting – The paper follows correct APA format for parenthetical/in-text citations and reference list.
5 to >4.0 pts
Excellent 90%–100%
Uses correct APA format with no errors
4 to >3.5 pts
Good 80%–89%
Contains 1-2 APA format errors
3.5 to >3.0 pts
Fair 70%–79%
Contains 3-4 APA format errors
3 to >0 pts
Poor 0%–69%
Contains five or more APA format errors
5 pts
Total Points: 100
NRNP 6675 Week 3 Assignment: Focused SOAP Note for Anxiety, PTSD, and OCD
In assessing patients with anxiety, obsessive-compulsive, and trauma and stressor-related disorders, you will continue the practice of looking to understand chief symptomology in order to develop a diagnosis. With a differential diagnosis in mind, you can then move to a treatment and follow-up plan that may involve both psychopharmacologic and psychotherapeutic approaches.
In this Assignment, you use a case study to develop a focused SOAP note based on evidence-based approaches.
Resources
Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.
WEEKLY RESOURCES
Learning Resources
Required Readings
Boland, R. Verdiun, M. L. & Ruiz, P. (2022). Kaplan & Sadock’s synopsis of psychiatry (12th ed.). Wolters Kluwer.
Chapter 2, “Neurodevelopmental Disorders and Other Childhood Disorders”
Section 2.8, “Trauma- and Stressor-Related Disorders in Children” (pp. 167-173)
Section 2.13, “Anxiety Disorders of Infancy, Childhood, and Adolescence: Separation Anxiety Disorder, Generalized Anxiety Disorder, and Social Anxiety Disorder (Social Phobia)” (pp. 194-200”)
Section 2.14, “Selective Mutism” (pp. 201-202)
Section 2.15, “Obsessive-Compulsive Disorder in Childhood and Adolescence” (pp. 203-206)
Chapter 8, “Anxiety Disorders”
Chapter 9, “Obsessive-Compulsive and Related Disorders”
Chapter 10, “Trauma- and Stressor-Related Disorders
Thapar, A., Pine, D. S., Leckman, J. F., Scott, S., Snowling, M. J., & Taylor, E. A. (Eds.). (2015). Rutter’s child and adolescent psychiatry (6th ed.). Wiley Blackwell.
Chapter 26, “Psychosocial Adversity”
Chapter 27, “Resilience: Concepts, Findings, and Clinical Implications”
Chapter 29, “Child Maltreatment”
Chapter 30, Child Sexual Abuse”
Chapter 58, “Disorders of Attachment and Social engagement Related to Deprivation”
Chapter 59, “Post Traumatic Stress Disorder”
Zakhari, R. (2021). The psychiatric-mental health nurse practitioner certification review manual. Springer Publishing Company.
Chapter 6, “Physical Assessment, Diagnostic Tests, and Differential Diagnosis”
Chapter 12, “Anxiety Disorders”
Document: Career Planner Guide
Download Career Planner Guide
Document: Focused SOAP Note Template
Download Focused SOAP Note Template
Document: Focused SOAP Note Exemplar
Download Focused SOAP Note Exemplar
Required Media
Centers for Disease Control and Prevention. (2020, April 3). Adverse childhood experiences (ACEs)
Links to an external site. [Video].
https://www.cdc.gov/violenceprevention/aces/index.html
Dartmouth Films. (2018, September 25). Resilience
Links to an external site.[Video]. YouTube.
https://www.youtube.com/watch?v=bAXZVYDNURY
NCTSN. (2007). The promise of trauma-focused therapy for childhood sexual abuse
Links to an external site. [Video].
https://www.nctsn.org/resources/promise-trauma-focused-therapy-childhood-sexual-abuse-video
Walden University. (2021). Case study: Dev Cordoba. Walden University Canvas. https://waldenu.instructure.com
To Prepare
Review this week’s Learning Resources. Consider the insights they provide about assessing and diagnosing anxiety, obsessive compulsive, and trauma-related disorders.
Review the Focused SOAP Note template, which you will use to complete this Assignment. There is also a Focused SOAP Note Exemplar provided as a guide for Assignment expectations.
Review the video, Case Study: Dev Cordoba. You will use this case as the basis of this Assignment. In this video, a Walden faculty member is assessing a mock patient. The patient will be represented onscreen as an avatar.
Consider what history would be necessary to collect from this patient.
Consider what interview questions you would need to ask this patient.
The Assignment
Develop a Focused SOAP Note, 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-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.
Plan: What is your plan for psychotherapy? What is your plan for treatment and management, including alternative therapies? Include pharmacologic and nonpharmacologic treatments, alternative therapies, and follow-up parameters, as well as a rationale for this treatment and management plan. Also incorporate one health promotion activity and one patient education strategy.
Reflection notes: What would you do differently with this patient if you could conduct the session again? Discuss what your next intervention would be if you could follow up with this patient. 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.).
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).
By Day 7 of Week 3
Submit your Focused SOAP Note.
submission information
Before submitting your final assignment, you can check your draft for authenticity. To check your draft, access the Turnitin Drafts from the Start Here area.
To submit your completed assignment, save your Assignment as WK3Assgn_LastName_Firstinitial
Then, click on Start Assignment near the top of the page.
Next, click on Upload File and select Submit Assignment for review.
Rubric
NRNP_6675_Week3_Assignment_Rubric
NRNP_6675_Week3_Assignment_Rubric
Criteria Ratings Pts
This criterion is linked to a Learning Outcome Create documentation in the Focused SOAP Note Template about your assigned patient.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
15 to >13.0 pts
Excellent 90%–100%
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.
13 to >11.0 pts
Good 80%–89%
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.
11 to >10.0 pts
Fair 70%–79%
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.
10 to >0 pts
Poor 0%–69%
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 the subjective documentation is missing.
15 pts
This criterion is linked to a Learning Outcome 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
15 to >13.0 pts
Excellent 90%–100%
The response thoroughly and accurately documents the patient’s physical exam for pertinent systems. Diagnostic tests and their results are thoroughly and accurately documented.
13 to >11.0 pts
Good 80%–89%
The response accurately documents the patient’s physical exam for pertinent systems. Diagnostic tests and their results are accurately documented.
11 to >10.0 pts
Fair 70%–79%
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.
10 to >0 pts
Poor 0%–69%
The response provides incomplete or inaccurate documentation of the patient’s physical exam. Systems may have been unnecessarily reviewed. Or the objective documentation is missing.
15 pts
This criterion is linked to a Learning Outcome 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.
20 to >17.0 pts
Excellent 90%–100%
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.
17 to >15.0 pts
Good 80%–89%
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.
15 to >13.0 pts
Fair 70%–79%
The response documents the results of the mental status exam with some vagueness or innacuracy…. 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 innacuracy.
13 to >0 pts
Poor 0%–69%
The response provides an incomplete or inaccurate description of the results of the mental status exam and explanation of the differential diagnoses. Or the assessment documentation is missing.
20 pts
This criterion is linked to a Learning Outcome In the Plan section, provide:• Your plan for psychotherapy• Your plan for treatment and management, including alternative therapies. Include pharmacologic and nonpharmacologic treatments, alternative therapies, and follow-up parameters as well as a rationale for this treatment and management plan. • Incorporate one health promotion activity and one patient education strategy.
25 to >22.0 pts
Excellent 90%–100%
The response provides an evidence-based, detailed, and appropriate plan for psychotherapy for the patient…. The response provides an evidence-based, detailed, and appropriate plan for treatment and management, including pharmacologic and nonpharmacologic treatments, alternative therapies, and follow-up parameters. A strong rationale for the plan is provided that demonstrates critical thinking and content understanding…. The response includes at least one evidence-based health promotion activity and one evidence-based patient education strategy.
22 to >19.0 pts
Good 80%–89%
The response provides an evidence-based and appropriate plan for psychotherapy for the patient…. The response provides an evidence-based and appropriate plan for treatment and management, including pharmacologic and nonpharmacologic treatments, alternative therapies, and follow-up parameters. An adequate rationale for the plan is provided…. The response includes at least one health promotion activity and one patient education strategy.
19 to >17.0 pts
Fair 70%–79%
The response provides a somewhat vague or inaccurate plan for psychotherapy for the patient…. The response provides a somewhat vague or inaccurate plan for treatment and management, including pharmacologic and nonpharmacologic treatments, alternative therapies, and follow-up parameters. The rationale for the plan is weak or general…. The response includes one health promotion activity and one patient education strategy, but it may contain some vagueness or innacuracy.
17 to >0 pts
Poor 0%–69%
The response provides an incomplete or inaccurate plan for psychotherapy for the patient…. The response provides an incomplete or inaccurate plan for treatment and management, including pharmacologic and nonpharmacologic treatments, alternative therapies, and follow-up parameters. The rationale for the plan is inaccurate or missing…. The health promotion and patient education strategies are incomplete or missing.
25 pts
This criterion is linked to a Learning Outcome • Discussion include what may be done differently with this patient if student conducted the session again. Discussed the next intervention if you could follow up with this patient. The discussion was related to legal/ethical considerations (demonstrated critical thinking beyond confidentiality and consent for treatment!), social determinates of health, health promotion, and disease prevention that take into consideration patient factors (such as age, ethnic group, etc.), PMH, and other risk factors (e.g., socioeconomic, cultural background, etc.).
5 to >4.0 pts
Excellent 90%–100%
Reflections are thorough, thoughtful, and demonstrate critical thinking. Reflections contain a discussion of all elements described within assignment directions.
4 to >3.5 pts
Good 80%–89%
Reflections demonstrate critical thinking. Reflections contain 2 out of 3 (legal/ethical considerations, social determinate of health, health promotion) with consideration of patient factors and risk factors.
3.5 to >3.0 pts
Fair 70%–79%
Reflections are somewhat general or do not demonstrate critical thinking. Reflections contain 2 out of 3 (legal/ethical considerations, social determinate of health, health promotion) without consideration of patient factors and risk factors.
3 to >0 pts
Poor 0%–69%
Reflections are incomplete, inaccurate, or missing.
5 pts
This criterion is linked to a Learning Outcome 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).
10 to >8.0 pts
Excellent 90%–100%
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.
8 to >7.0 pts
Good 80%–89%
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.
7 to >6.0 pts
Fair 70%–79%
Three evidence-based resources are provided to support the assessment and diagnosis of the patient in the assigned case study, but they may only provide vague or weak justification.
6 to >0 pts
Poor 0%–69%
Two or fewer resources are provided to support the assessment and diagnosis decisions. The resources may not be current or evidence based.
10 pts
This criterion is linked to a Learning Outcome Written Expression and Formatting – The paper follows correct APA format for parenthetical/in-text citations and reference list.
5 to >4.0 pts
Excellent 90%–100%
Uses correct APA format with no errors
4 to >3.5 pts
Good 80%–89%
Contains 1-2 APA format for parenthetical/in-text citations and reference list errors
3.5 to >3.0 pts
Fair 70%–79%
Contains 3-4 APA format for parenthetical/in-text citations and reference list errors
3 to >0 pts
Poor 0%–69%
Contains five or more APA format for parenthetical/in-text citations and reference list errors
5 pts
This criterion is linked to a Learning Outcome Written Expression and Formatting – English Writing Standards: Correct grammar, mechanics, and punctuation
5 to >4.0 pts
Excellent 90%–100%
Uses correct grammar, spelling, and punctuation with no errors
4 to >3.5 pts
Good 80%–89%
Contains 1-2 grammar, spelling, and punctuation format errors
3.5 to >3.0 pts
Fair 70%–79%
Contains 3-4 grammar, spelling, and punctuation format errors
3 to >0 pts
Poor 0%–69%
Contains five or more grammar, spelling, and punctuation format errors that interfere with the reader’s understanding
5 pts
Total Points: 100
NRNP 6675 Week 5 Assignment: Focused SOAP Note for Schizophrenia Spectrum, Other Psychotic, and Medication-Induced Movement Disorders
Psychotic disorders change one’s sense of reality and cause abnormal thinking and perception. Patients presenting with psychotic disorders may suffer from delusions or hallucinations or may display negative symptoms such as lack of emotion or withdraw from social situations or relationships. Symptoms of medication-induced movement disorders can be mild or lethal and can include, for example, tremors, dystonic reactions, or serotonin syndrome.
For this Assignment, you will complete a focused SOAP note for a patient in a case study who has either a schizophrenia spectrum, other psychotic, or medication-induced movement disorder.
Resources
Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.
WEEKLY RESOURCES
Learning Resources
Required Readings
Boland, R. Verdiun, M. L. & Ruiz, P. (2022). Kaplan & Sadock’s synopsis of psychiatry (12th ed.). Wolters Kluwer.
Chapter 2, “Neurodevelopmental Disorders and Other Childhood Disorders”
Section 2.16, “Early-Onset Schizophrenia” (pp. 207-210)
Chapter 5, “Schizophrenia Spectrum and Other Psychotic Disorders”
Thapar, A., Pine, D. S., Leckman, J. F., Scott, S., Snowling, M. J., & Taylor, E. A. (Eds.). (2015). Rutter’s child and adolescent psychiatry (6th ed.). Wiley Blackwell.
Chapter 43, “Pharmacological, Medically-Led and Related Disorders”
Chapter 57, “Schizophrenia and Psychosis”
Zakhari, R. (2021). The psychiatric-mental health nurse practitioner certification review manual. Springer Publishing Company.
Chapter 9, “Psychotic Disorders and Delusions”
Document: Focused SOAP Note Template
Download Focused SOAP Note Template
Document: Focused SOAP Note Exemplar
Download Focused SOAP Note Exemplar
Required Media
PsychScene Hub. (2017, April 24). Movement disorders with antipsychotic medication
Links to an external site. – Conversations with Dr. Stephen Stahl [Video]. YouTube. https://www.youtube.com/watch?v=ipW5AcbFzzE
Vallejo, E. (2020). Realistic schizophrenia simulation
Links to an external site. [Video]. YouTube. https://www.youtube.com/watch?v=63lHuGMbscU
Walden University. (2021). Case study: Sherman Tremaine. Walden University Canvas. https://waldenu.instructure.com
To Prepare
Review the Focused SOAP Note template, which you will use to complete this Assignment. There is also a Focused SOAP Note Exemplar provided as a guide for Assignment expectations.
Review the video, Case Study: Sherman Tremaine. You will use this case as the basis of this Assignment. In this video, a Walden faculty member is assessing a mock patient. The patient will be represented onscreen as an avatar.
Consider what history would be necessary to collect from this patient.
Consider what interview questions you would need to ask this patient.
The Assignment
Develop a focused SOAP note, 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, and list them 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.
Plan: What is your plan for psychotherapy? What is your plan for treatment and management, including alternative therapies? Include pharmacologic and nonpharmacologic treatments, alternative therapies, and follow-up parameters, as well as a rationale for this treatment and management plan. Also incorporate one health promotion activity and one patient education strategy.
Reflection notes: What would you do differently with this patient if you could conduct the session again? Discuss what your next intervention would be if you were able to follow up with this patient. 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.).
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).
By Day 7 of Week 5
Submit your Focused SOAP Note.
submission information
Before submitting your final assignment, you can check your draft for authenticity. To check your draft, access the Turnitin Drafts from the Start Here area.
To submit your completed assignment, save your Assignment as WK5Assgn_LastName_Firstinitial
Then, click on Start Assignment near the top of the page.
Next, click on Upload File and select Submit Assignment for review.
Rubric
NRNP_6675_Week5_Assignment_Rubric
NRNP_6675_Week5_Assignment_Rubric
Criteria Ratings Pts
This criterion is linked to a Learning Outcome Create documentation in the Focused SOAP Note Template about your assigned patient.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
15 to >13.0 pts
Excellent 90%–100%
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.
13 to >11.0 pts
Good 80%–89%
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.
11 to >10.0 pts
Fair 70%–79%
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.
10 to >0 pts
Poor 0%–69%
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 the subjective documentation is missing.
15 pts
This criterion is linked to a Learning Outcome 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
15 to >13.0 pts
Excellent 90%–100%
The response thoroughly and accurately documents the patient’s physical exam for pertinent systems. Diagnostic tests and their results are thoroughly and accurately documented.
13 to >11.0 pts
Good 80%–89%
The response accurately documents the patient’s physical exam for pertinent systems. Diagnostic tests and their results are accurately documented.
11 to >10.0 pts
Fair 70%–79%
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.
10 to >0 pts
Poor 0%–69%
The response provides incomplete or inaccurate documentation of the patient’s physical exam. Systems may have been unnecessarily reviewed. Or the objective documentation is missing.
15 pts
This criterion is linked to a Learning Outcome 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.
20 to >17.0 pts
Excellent 90%–100%
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.
17 to >15.0 pts
Good 80%–89%
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.
15 to >13.0 pts
Fair 70%–79%
The response documents the results of the mental status exam with some vagueness or innacuracy…. 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 innacuracy.
13 to >0 pts
Poor 0%–69%
The response provides an incomplete or inaccurate description of the results of the mental status exam and explanation of the differential diagnoses. Or the assessment documentation is missing.
20 pts
This criterion is linked to a Learning Outcome In the Plan section, provide:• Your plan for psychotherapy• Your plan for treatment and management, including alternative therapies. Include pharmacologic and nonpharmacologic treatments, alternative therapies, and follow-up parameters as well as a rationale for this treatment and management plan. • Incorporate one health promotion activity and one patient education strategy.
25 to >22.0 pts
Excellent 90%–100%
The response provides an evidence-based, detailed, and appropriate plan for psychotherapy for the patient…. The response provides an evidence-based, detailed, and appropriate plan for treatment and management, including pharmacologic and nonpharmacologic treatments, alternative therapies, and follow-up parameters. A strong rationale for the plan is provided that demonstrates critical thinking and content understanding…. The response includes at least one evidence-based health promotion activity and one evidence-based patient education strategy.
22 to >19.0 pts
Good 80%–89%
The response provides an evidence-based and appropriate plan for psychotherapy for the patient…. The response provides an evidence-based and appropriate plan for treatment and management, including pharmacologic and nonpharmacologic treatments, alternative therapies, and follow-up parameters. An adequate rationale for the plan is provided…. The response includes at least one health promotion activity and one patient education strategy.
19 to >17.0 pts
Fair 70%–79%
The response provides a somewhat vague or inaccurate plan for psychotherapy for the patient…. The response provides a somewhat vague or inaccurate plan for treatment and management, including pharmacologic and nonpharmacologic treatments, alternative therapies, and follow-up parameters. The rationale for the plan is weak or general…. The response includes one health promotion activity and one patient education strategy, but it may contain some vagueness or innacuracy.
17 to >0 pts
Poor 0%–69%
The response provides an incomplete or inaccurate plan for psychotherapy for the patient…. The response provides an incomplete or inaccurate plan for treatment and management, including pharmacologic and nonpharmacologic treatments, alternative therapies, and follow-up parameters. The rationale for the plan is inaccurate or missing…. The health promotion and patient education strategies are incomplete or missing.
25 pts
This criterion is linked to a Learning Outcome • Discussion include what may be done differently with this patient if student conducted the session again. Discussed the next intervention if you could follow up with this patient. The discussion was related to legal/ethical considerations (demonstrated critical thinking beyond confidentiality and consent for treatment!), social determinates of health, health promotion, and disease prevention that take into consideration patient factors (such as age, ethnic group, etc.), PMH, and other risk factors (e.g., socioeconomic, cultural background, etc.).
5 to >4.0 pts
Excellent 90%–100%
Reflections are thorough, thoughtful, and demonstrate critical thinking. Reflections contain a discussion of all elements described within assignment directions.
4 to >3.5 pts
Good 80%–89%
Reflections demonstrate critical thinking. Reflections contain 2 out of 3 (legal/ethical considerations, social determinate of health, health promotion) with consideration of patient factors and risk factors.
3.5 to >3.0 pts
Fair 70%–79%
Reflections are somewhat general or do not demonstrate critical thinking. Reflections contain 2 out of 3 (legal/ethical considerations, social determinate of health, health promotion) without consideration of patient factors and risk factors.
3 to >0 pts
Poor 0%–69%
Reflections are incomplete, inaccurate, or missing.
5 pts
This criterion is linked to a Learning Outcome 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).
10 to >8.0 pts
Excellent 90%–100%
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.
8 to >7.0 pts
Good 80%–89%
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.
7 to >6.0 pts
Fair 70%–79%
Three evidence-based resources are provided to support the assessment and diagnosis of the patient in the assigned case study, but they may only provide vague or weak justification.
6 to >0 pts
Poor 0%–69%
Two or fewer resources are provided to support the assessment and diagnosis decisions. The resources may not be current or evidence based.
10 pts
This criterion is linked to a Learning Outcome Written Expression and Formatting – The paper follows correct APA format for parenthetical/in-text citations and reference list.
5 to >4.0 pts
Excellent 90%–100%
Uses correct APA format with no errors
4 to >3.5 pts
Good 80%–89%
Contains 1-2 APA format for parenthetical/in-text citations and reference list errors
3.5 to >3.0 pts
Fair 70%–79%
Contains 3-4 APA format for parenthetical/in-text citations and reference list errors
3 to >0 pts
Poor 0%–69%
Contains five or more APA format for parenthetical/in-text citations and reference list errors
5 pts
This criterion is linked to a Learning Outcome Written Expression and Formatting – English Writing Standards: Correct grammar, mechanics, and punctuation
5 to >4.0 pts
Excellent 90%–100%
Uses correct grammar, spelling, and punctuation with no errors
4 to >3.5 pts
Good 80%–89%
Contains 1-2 grammar, spelling, and punctuation format errors
3.5 to >3.0 pts
Fair 70%–79%
Contains 3-4 grammar, spelling, and punctuation format errors
3 to >0 pts
Poor 0%–69%
Contains five or more grammar, spelling, and punctuation format errors that interfere with the reader’s understanding
5 pts
Total Points: 100
ORDER A CUSTOMIZED, PLAGIARISM-FREE NRNP 6675 Full Course Discussions & Assignments (Week 1-10) HERE
NRNP 6675 Week 7 Assignment: Controversy Associated with Personality and Paraphilic Disorders
Assignment: Controversy Associated with Personality and Paraphilic Disorders
Between 10% and 20% of the population experience personality disorders. They are difficult to treat as individuals with personality disorders are less likely to seek help than individuals with other mental health disorders. Treatment can be challenging as they do not see their symptoms as painful to themselves or others.
Photo Credit: Joe Houghton – www.joehoughtonphotography.ie / Moment / Getty Images
Paraphilic disorders are far more common in men than in women, and generally quite chronic, lasting at least two years. Treatment of these disorders usually involves both psychotherapeutic and pharmacologic treatments.
In this Assignment, you will explore personality and paraphilic disorders in greater detail. You will research potentially controversial elements of the diagnosis and/or treatment and explain ethical and legal considerations when working with these disorders.
To Prepare
• Review this week’s Learning Resources and consider the insights they provide on assessing, diagnosing, and treating personality and paraphilic disorders.
• Select a specific personality or paraphilic disorder from the DSM-5 to use for this Assignment.
• Use the Walden Library to investigate your chosen disorder further, including controversial aspects of the disorder, maintaining the therapeutic relationship, and ethical and legal considerations.
The Assignment
In 2–3 pages:
• Explain the controversy that surrounds your selected disorder.
• Explain your professional beliefs about this disorder, supporting your rationale with at least three scholarly references from the literature.
• Explain strategies for maintaining the therapeutic relationship with a patient that may present with this disorder.
• Finally, explain ethical and legal considerations related to this disorder that you need to bring to your practice and why they are important.
NRNP 6675 Week 8 Assignment: Legal and Ethical Issues Related to Psychiatric Emergencies
The diagnosis of psychiatric emergencies can include a wide range of problems—from serious drug reactions to abuse and suicidal ideation/behaviors. Regardless of care setting, the PMHNP must know how to address emergencies, coordinate care with other members of the health care team and law enforcement officials (when indicated), and effectively communicate with family members who are often overwhelmed in emergency situations. In their role, PMHNPs can ensure a smooth transition from emergency mental health care to follow-up care, and also bridge the physical–mental health divide in healthcare.
In this week’s Assignment, you explore legal and ethical issues surrounding psychiatric emergencies, and identify evidence-based suicide and violence risk assessments.
To Prepare
Review this week’s Learning Resources and consider the insights they provide about psychiatric emergencies and the ethical and legal issues surrounding these events.
Resources
Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.
WEEKLY RESOURCES
Learning Resources
Required Readings
Buppert, C. (2021). Nurse practitioner’s business practice and legal guide (7th ed.). Jones & Bartlett Learning.
Chapter 7, “Negligence and Malpractice”
Chapter 8, “Risk Management”
Chapter 16, “Resolving Ethical Dilemmas”
National Institute for Health and Care Excellence (2019). Brøset violence checklist
Links to an external site.. http://riskassessment.no/
Boland, R. Verdiun, M. L. & Ruiz, P. (2022). Kaplan & Sadock’s synopsis of psychiatry (12th ed.). Wolters Kluwer.
Chapter 25, “Consultation to Other Disciplines”
Chapter 26, “Level Of Care”
Chapter 27, “Ethics and Professionalism”
Thapar, A., Pine, D. S., Leckman, J. F., Scott, S., Snowling, M. J., & Taylor, E. A. (Eds.). (2015). Rutter’s child and adolescent psychiatry (6th ed.). Wiley Blackwell.
Chapter 19, “Legal Issues in the Care and Treatment of Children With Mental Health Problems”
Chapter 64, “Suicidal Behavior and Self-Harm”
U.S. Department of Veterans Affairs. (2019). VA/DoD clinical practice guidelines
Links to an external site.: Assessment and management of patients at risk for suicide (2019).
https://www.healthquality.va.gov/guidelines/MH/srb/
Zakhari, R. (2021). The psychiatric-mental health nurse practitioner certification review manual. Springer Publishing Company.
Chapter 15, “Violence and Abuse”
The Assignment
In 2–3 pages, address the following:
Explain your state laws for involuntary psychiatric holds for child and adult psychiatric emergencies. Include who can hold a patient and for how long, who can release the emergency hold, and who can pick up the patient after a hold is released.
Explain the differences among emergency hospitalization for evaluation/psychiatric hold, inpatient commitment, and outpatient commitment in your state.
Explain the difference between capacity and competency in mental health contexts.
Select one of the following topics, and explain one legal issue and one ethical issue related to this topic that may apply within the context of treating psychiatric emergencies: patient autonomy, EMTALA, confidentiality, HIPAA privacy rule, HIPAA security rule, protected information, legal gun ownership, career obstacles (security clearances/background checks), and payer source.
Identify one evidence-based suicide risk assessment that you could use to screen patients.
Identify one evidence-based violence risk assessment that you could use to screen patients.
By Day 7 of Week 8
Submit your Assignment. Attach copies of or links to the suicide and violence risk assessments you selected.
submission information
Before submitting your final assignment, you can check your draft for authenticity. To check your draft, access the Turnitin Drafts from the Start Here area.
To submit your completed assignment, save your Assignment as WK8Assgn_LastName_Firstinitial
Then, click on Start Assignment near the top of the page.
Next, click on Upload File and select Submit Assignment for review.
Rubric
NRNP_6675_Week8_Assignment_Rubric
NRNP_6675_Week8_Assignment_Rubric
Criteria Ratings Pts
This criterion is linked to a Learning Outcome In 2–3 pages, address the following: • Explain your state laws for involuntary psychiatric holds for child and adult psychiatric emergencies. Include who can hold a patient and for how long, who can release the emergency hold, and who can pick up the patient after a hold is released.
15 to >13.0 pts
Excellent 90%–100%
The response includes a thorough and well-organized explanation of student’s state laws for involuntary psychiatric holds for child and adult emergencies.
13 to >11.0 pts
Good 80%–89%
The response includes an accurate explanation of student’s state laws for involuntary psychiatric holds for child and adult emergencies.
11 to >10.0 pts
Fair 70%–79%
The response includes a somewhat vague or inaccurate explanation of student’s state laws for involuntary psychiatric holds for child and adult emergencies.
10 to >0 pts
Poor 0%–69%
The response includes a vague or inaccurate explanation of student’s state laws for involuntary psychiatric holds for child and adult emergencies. Or the response is missing.
15 pts
This criterion is linked to a Learning Outcome • Explain the differences among emergency hospitalization for evaluation/psychiatric hold, inpatient commitment, and outpatient commitment in your state.
15 to >13.0 pts
Excellent 90%–100%
The response includes an accurate and concise explanation of the differences among emergency hospitalization for evaluation/psychiatric hold, inpatient commitment, and outpatient commitment in your state.
13 to >11.0 pts
Good 80%–89%
The response includes a well-organized explanation of the differences among emergency hospitalization for evaluation/psychiatric hold, inpatient commitment, and outpatient commitment in your state.
11 to >10.0 pts
Fair 70%–79%
The response includes a somewhat vague explanation of the differences among emergency hospitalization for evaluation/psychiatric hold, inpatient commitment, and outpatient commitment in your state.
10 to >0 pts
Poor 0%–69%
The response includes a vague explanation of the differences among emergency hospitalization for evaluation/psychiatric hold, inpatient commitment, and outpatient commitment in your state. Or the response is missing.
15 pts
This criterion is linked to a Learning Outcome • Explain the difference between capacity and competency in mental health contexts.
10 to >8.0 pts
Excellent 90%–100%
The response includes an accurate and concise explanation of the difference between capacity and competency in mental health contexts.
8 to >7.0 pts
Good 80%–89%
The response includes an accurate explanation of the difference between capacity and competency in mental health contexts.
7 to >6.0 pts
Fair 70%–79%
The response includes a somewhat vague or incomplete explanation of the difference between capacity and competency in mental health contexts.
6 to >0 pts
Poor 0%–69%
The response includes a vague or inaccurate explanation of the difference between capacity and competency in mental health contexts. Or the response is missing.
10 pts
This criterion is linked to a Learning Outcome • Select one of the following topics and explain one legal issue and one ethical issue related to this topic that may apply within the context of treating psychiatric emergencies: patient autonomy, EMTALA, confidentiality, HIPAA privacy rule, HIPAA security rule, protected information, legal gun ownership, career obstacles (security clearances/background checks), and payer source.
15 to >13.0 pts
Excellent 90%–100%
The response accurately and concisely explains one legal and one ethical issue related to the selected topic, within the context of treating psychiatric emergencies.
13 to >11.0 pts
Good 80%–89%
The response accurately explains one legal and one ethical issue related to the selected topic, within the context of treating psychiatric emergencies.
11 to >10.0 pts
Fair 70%–79%
The response somewhat vaguely or innacurately explains one legal and one ethical issue related to the selected topic, within the context of treating psychiatric emergencies.
10 to >0 pts
Poor 0%–69%
The response vaguely or innacurately explains one legal and one ethical issue related to the selected topic, within the context of treating psychiatric emergencies. Or, response is missing.
15 pts
This criterion is linked to a Learning Outcome •Identify one evidence-based suicide risk assessment that you could use to screen patients. Attach a copy or a link to the assessment you identified.
15 to >13.0 pts
Excellent 90%–100%
The response identifies and explains an appropriate, evidence-based suicide risk assessment that could be used to screen patients. A copy of or a link to the assessment is included.
13 to >11.0 pts
Good 80%–89%
The response identifies an appropriate, evidence-based suicide risk assessment that could be used to screen patients. A copy of or a link to the assessment is included.
11 to >10.0 pts
Fair 70%–79%
The risk assessment identified is somewhat inappropriate for the intended use or dated. A copy of or a link to the assessment may be missing.
10 to >0 pts
Poor 0%–69%
The risk assessment identified is inappropriate for the intended use, not evidence based, or dated. Or, response is missing.
15 pts
This criterion is linked to a Learning Outcome • Identify one evidence-based violence risk assessment that you could use to screen patients. Attach a copy or a link to the assessment you identified.
15 to >13.0 pts
Excellent 90%–100%
The response identifies and explains an appropriate, evidence-based violence risk assessment that could be used to screen patients. A copy of or a link to the assessment is included.
13 to >11.0 pts
Good 80%–89%
The response identifies an appropriate, evidence-based violence risk assessment that could be used to screen patients. A copy of or a link to the assessment is included.
11 to >10.0 pts
Fair 70%–79%
The risk assessment identified is somewhat inappropriate for the intended use or dated. A copy of or a link to the assessment may be missing.
10 to >0 pts
Poor 0%–69%
The risk assessment identified is inappropriate for the intended use, not evidence based, or dated. Or, response is missing.
15 pts
This criterion is linked to a Learning Outcome 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 to >4.0 pts
Excellent 90%–100%
Paragraphs and sentences follow writing standards for flow, continuity, and clarity…. A clear and comprehensive purpose statement, introduction, and conclusion are provided that delineate all required criteria.
4 to >3.5 pts
Good 80%–89%
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time…. Purpose, introduction, and conclusion of the assignment are stated, yet they are brief and not descriptive.
3.5 to >3.0 pts
Fair 70%–79%
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time…. Purpose, introduction, and conclusion of the assignment are vague or off topic.
3 to >0 pts
Poor 0%–69%
Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time…. No purpose statement, introduction, or conclusion were provided.
5 pts
This criterion is linked to a Learning Outcome Written Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation
5 to >4.0 pts
Excellent 90%–100%
Uses correct grammar, spelling, and punctuation with no errors
4 to >3.5 pts
Good 80%–89%
Contains 1-2 grammar, spelling, and punctuation errors
3.5 to >3.0 pts
Fair 70%–79%
Contains 3-4 grammar, spelling, and punctuation errors
3 to >0 pts
Poor 0%–69%
Contains five or more grammar, spelling, and punctuation errors that interfere with the reader’s understanding
5 pts
This criterion is linked to a Learning Outcome Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, parenthetical/in-text citations, and reference list.
5 to >4.0 pts
Excellent 90%–100%
Uses correct APA format with no errors
4 to >3.5 pts
Good 80%–89%
Contains 1-2 APA format errors
3.5 to >3.0 pts
Fair 70%–79%
Contains 3-4 APA format errors
3 to >0 pts
Poor 0%–69%
Contains five or more APA format errors
5 pts
Total Points: 100
NRNP 6675 Week 9 Discussion : Prescribing for Older Adults and Pregnant Women
Discussion: Prescribing for Older Adults and Pregnant Women
After assessing and diagnosing a patient, PMHNPs must take into consideration special characteristics of the patient before determining an appropriate course of treatment. For pharmacological treatments that are not FDA-approved for a particular use or population, off-label use may be considered when the potential benefits could outweigh the risks.
In this Discussion, you will investigate a specific disorder and determine potential appropriate treatments for when it occurs in an older adult or pregnant woman.
Photo Credit: Getty Images/Blend Images
To Prepare:
Choose one of the two following specific populations: either pregnant women or older adults. Then, select a specific disorder from the DSM-5 to use.
Use the Walden Library to research evidence-based treatments for your selected disorder in your selected population (either older adults or pregnant women). You will need to recommend one FDA-approved drug, one non-FDA-approved “off-label†drug, and one nonpharmacological intervention for treating the disorder in that population.
By Day 3 of Week 9
Recommend one FDA-approved drug, one off-label drug, and one nonpharmacological intervention for treating your chosen disorder in older adults or pregnant women.
Explain the risk assessment you would use to inform your treatment decision making. What are the risks and benefits of the FDA-approved medicine? What are the risks and benefits of the off-label drug?
Explain whether clinical practice guidelines exist for this disorder, and if so, use them to justify your recommendations. If not, explain what information you would need to take into consideration.
Support your reasoning with at least three current, credible scholarly resources, one each on the FDA-approved drug, the off-label, and a nonpharmacological intervention for the disorder.
NRNP 6675 Week 10 Assignment: Nurse Practitioner Professional Career Planner
As you approach the end of your Master of Science in Nursing program and prepare for a career as a nurse practitioner, you will want to create a cover letter, resume, and portfolio that best represent your knowledge, skills, and abilities as a professional in the field of nursing.
For this Assignment, you will create a Career Planner, which includes these elements, that you can use as you pursue your next professional role.
To Prepare
Review the Career Planner Guide. This document contains the requirements for the Assignment as well as resources to consult.
Seek out other resources on cover letters, resumes, and other professional resources, as needed. The Walden University Career Planning and Development site has information on many topics of relevance
Resources
Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.
WEEKLY RESOURCES
Learning Resources
Required Readings
American Nurses Credentialing Center. (n.d.). Psychiatric-mental health nurse practitioner (across the lifespan) certification
Links to an external site. (PMHNP-BC).
https://www.nursingworld.org/our-certifications/psychiatric-mental-health-nurse-practitioner/
Scroll to ANCC Study Aids – Free for sample test questions and study guides to help you prepare for your certification exam.
Buppert, C. (2021). Nurse practitioner’s business practice and legal guide
Links to an external site. (7th ed.). Jones & Bartlett Learning.
Chapter 12, “Lawmaking and Health Policy”
Chapter 14, “Standards of Care for Nurse Practitioner Practice”
Chapter 15, “Measuring Nurse Practitioner Performance”
The National Organization of Nurse Practitioner Faculties. (2017). Nurse practitioner core competencies
Links to an external site.. https://cdn.ymaws.com/www.nonpf.org/resource/resmgr/competencies/20170516_NPCoreCompsContentF.pdf
The National Organization of Nurse Practitioner Faculties. (n.d.). National organization of nurse practitioner faculties
Links to an external site.. https://www.nonpf.org/
Stewart, J. G., & DeNisco, S. M. (2019). Role development for the nurse practitioner (2nd ed.). Jones & Bartlett Learning.
Chapter 11, “Concepts of the Professional”
Chapter 12, “Health Policy and the Nurse Practitioner”
Chapter 14, “Mentoring”
Zakhari, R. (2021). The psychiatric-mental health nurse practitioner certification review manual. Springer Publishing Company.
Chapter 1, “Preparing to Pass the Psychiatric-Mental Health Nurse Practitioner Certification Exam” (for review as needed)
Chapter 16, “Practice Test”
Document: Career Planner Guide
Download Career Planner Guide
Required Media
APRN Central. (2019, October 27). Goal digger: Test taking strategies
Links to an external site. [Video].
YouTube. https://www.youtube.com/watch?v=STAT1WpQgSM
DrRegisteredNurse. (2020, February 16). Test-taking strategies to pass the NCLEX in 75 questions part 1
Links to an external site. [Video]. YouTube. https://www.youtube.com/watch?v=81E3dAxrO2c
Walden Graduation and Next Steps
In this video, Dr. Judi Kuric discusses important topics related to the transition from coursework to advanced nursing practice.
Walden University. (2020). Test taking strategies: Preparation for your certification exam
Links to an external site. [Video]. https://event.on24.com/wcc/r/3640795/98D4198C2B42D16C50C4F0A5D13122B6?partnerref=fac2022
The Assignment
Develop a cover letter, resume, philosophy statement, and other professional resources that meet the requirements outlined in the Career Planner Guide.
By Day 7 of Week 10
Submit your Career Planner.
submission information
Before submitting your final assignment, you can check your draft for authenticity. To check your draft, access the Turnitin Drafts from the Start Here area.
To submit your completed assignment, save your Assignment as WK10Assgn1_LastName_Firstinitial
Then, click on Start Assignment near the top of the page.
Next, click on Upload File and select Submit Assignment for review.
Rubric
NRNP_6675_Week10_Assignment1_Rubric
NRNP_6675_Week10_Assignment1_Rubric
Criteria Ratings Pts
This criterion is linked to a Learning Outcome The cover letter is: • Presented and formatted in professional business manner • Addressed properly • Clear and concise (no more than one page) and includes an introduction, body, and conclusion• Written in a professional tone
10 to >8.0 pts
Excellent 90%–100%
Response is presented and formatted in a very clear and professional business manner…. Response is addressed properly…. Response is clear and concise (no more than one page) and includes a well-written and compelling introduction, body, and conclusion…. Response uses a professional tone.
8 to >7.0 pts
Good 80%–89%
Response is presented and formatted in a clear and professional business manner…. Response is addressed properly…. Response is clear and concise (no more than one page) and includes an appropriate introduction, body, and conclusion…. Response uses a professional tone.
7 to >6.0 pts
Fair 70%–79%
Presentation and formatting are somewhat uneven or inappropriate for the context…. Response is addressed adequately but may be missing one or more components…. Response contains an introduction, body, and conclusion but may be somewhat vague or unclear. May not adhere to the one-page limit…. Tone is not uniformly professional.
6 to >0 pts
Poor 0%–69%
Presentation and formatting are uneven or inappropriate for the context…. Response is not addressed appropriately…. Response may be missing an introduction, body, and/or conclusion. Does not adhere to the one-page limit…. Tone is not appropriate or response is missing.
10 pts
This criterion is linked to a Learning Outcome The Resume is clear, concise and well organized and includes: • Name, location (city/town and state), business phone number, and email address (centered at top of resume) • Objective: 2–3 sentences describing your goal/objective for employment• Certifications & licenses • Education • Professional experience • Honors/Awards • References
30 to >26.0 pts
Excellent 90%–100%
Response is presented and formatted in a very clear and professional business manner…. Response is addressed properly…. Response contains a clear and well-written objective for employment…. Response clearly, accurately, and concisely describes certifications, licenses, education, professional experience, and honors/awards…. Response provides three references.
26 to >23.0 pts
Good 80%–89%
Response is presented and formatted in a clear and professional business manner…. Response is addressed properly…. Response contains a clear objective for employment…. Response clearly and accurately describes certifications, licenses, education, professional experience, and honors/awards…. Response provides three references.
23 to >20.0 pts
Fair 70%–79%
Response may contain minor errors in presentation and formatting…. Response is addressed but may be missing a component…. Response contains an objective for employment…. Response describes certifications, licenses, education, professional experience, and honors/awards, as applicable, but may be somewhat unclear or disorganized…. Response provides two references.
20 to >0 pts
Poor 0%–69%
Response contains errors in presentation and formatting…. Response is not addressed…. Response does not contain an objective for employment…. Response is missing two or more of the following components: certifications, licenses, education, professional experience, and honors/awards…. Response provides one or no references.
30 pts
This criterion is linked to a Learning Outcome The Portfolio is clear, concise and well organized and includes: • Personal philosophy statement • Personal goals (short term and long term) • Self-assessment
50 to >44.0 pts
Excellent 90%–100%
Response is presented and formatted in a very clear and professional business manner…. Response contains a well-articulated philosophy statement that reflects synthesis of concepts…. Response contains clear and well-written personal goals and self-assessment.
44 to >39.0 pts
Good 80%–89%
Response is presented and formatted in a clear and professional business manner…. Response contains a clear philosophy statement that reflects synthesis of concepts…. Response contains clear personal goals and self-assessment.
39 to >34.0 pts
Fair 70%–79%
Presentation and formatting detracts from the content and/or is somewhat inappropriate for business…. Response contains a somewhat general philosophy statement…. Personal goals and self-assessment are somewhat vague or unclear.
34 to >0 pts
Poor 0%–69%
Presentation and formatting detracts from the content and/or are inappropriate for business…. Several or all components are vague, inaccurate, or missing.
50 pts
This criterion is linked to a Learning Outcome Written Expression and Formatting – The paper follows correct APA format for parenthetical/in-text citations and reference list.
5 to >4.0 pts
Excellent 90%–100%
Uses correct APA format with no errors
4 to >3.5 pts
Good 80%–89%
Contains 1-2 APA format errors
3.5 to >3.0 pts
Fair 70%–79%
Contains 3-4 APA format errors
3 to >0 pts
Poor 0%–69%
Contains ≥ 5 APA format errors
5 pts
This criterion is linked to a Learning Outcome Written Expression and Formatting – English Writing Standards: Correct grammar, mechanics, and punctuation
5 to >4.0 pts
Excellent 90%–100%
Uses correct grammar, spelling, and punctuation with no errors
4 to >3.5 pts
Good 80%–89%
Contains 1-2 grammar, spelling, and punctuation errors
3.5 to >3.0 pts
Fair 70%–79%
Contains 3-4 grammar, spelling, and punctuation errors
3 to >0 pts
Poor 0%–69%
Contains ≥ 5 grammar, spelling, and punctuation errors that interfere with the reader’s understanding
5 pts
Total Points: 100
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