Week 1: Psychiatric Assessment of the Adult and Older Adult

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

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

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

Learning Resources

Required Readings

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

Standard 5C “Consultation” (page 57)

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

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

Section 5.1, “Psychiatric Interview, Mental Status Examination” (pp. 192–211)

Section 5.2, “The Psychiatric Report and Medical Record” (pp. 211–217)

Section 5.3, “Psychiatric Rating Scales” (pp. 217–236)

Section 5.5, “Personality Assessment: Adults and Children” (pp. 246–257)

Section 5.7, “Medical Assessment and Laboratory Testing in Psychiatry” (pp. 266–275)

Chapter 6, “Classification in Psychiatry” (pp. 290–308)

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

“Cautionary Statement for Forensic Use of DSM-5”

“Assessment Measures”

“Cultural Formulation”

“Glossary of Technical Terms”

“Glossary of Cultural Concepts of Distress”

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

American Psychiatric Association. (2016). Practice guidelines for the psychiatric evaluation of adults.

Document: Practicum Journal Template (Word document)

Document: NP Student Clinical Orientation (PowerPoint file)

Required Media

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

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

Kundla, M. (Producer). (2015). The Mental Status Examination: Description and Demonstration [Video file]. Alexandria, VA: Microtraining Associates.

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

Optional Resources

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

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

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

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

Note: This document is available as a free download.

Discussion: Interview Format

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

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

Learning Objectives

Students will:

Develop formats for initial interviews of mental health clients

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

To prepare for this Discussion:

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

By Day 3

Post:

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

By Day 6

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

Submission and Grading Information

Grading Criteria

To access your rubric:

Week 1 Discussion Rubric

Post by Day 3 and Respond by Day 6

To participate in this Discussion:

Week 1 Discussion

Name: NURS_6670_Week1_Discussion_Rubric

	Outstanding Performance	Excellent Performance	Competent Performance	Proficient Performance	Room for Improvement
Main Posting: Response to the discusion question is reflecive with critical analysis and synthesis representive of knowledg gained from the course readings for the module and current credible sources.	Points Range: 44 (44%) – 44 (44%) * Thoroughly responds to the discusion question(s) is reflecive with critical analysis and synthesis representive of knowledg gained from the course readings for the module and current credible sources. supported by at least 3 current, credible sources	Points Range: 40 (40%) – 43 (43%) * Responds to the discusion question(s) is reflecive with critical analysis and synthesis representive of knowledg gained from the course readings for the module. 75% of post has exceptional depth and breadth * supported by at least 3 credible references	Points Range: 35 (35%) – 39 (39%) * Responds to most of the discusion question(s) is somewhat reflecive with critical analysis and synthesis representive of knowledg gained from the course readings for the module. 50% of post has exceptional depth and breadth * supported by at least 3 credible references	Points Range: 31 (31%) – 34 (34%) * Responds to some of the discusion question(s) * one to two criteria are not addressed or are superficially addresed is somewhat lacking reflection and critical analysis and synthesis somewhat represents knowledge gained from the course readings for the module. * post is cited with fewer than 2 credible references	Points Range: 0 (0%) – 30 (30%) * Does not respond to the discusion question(s) * lacks depth or superficially addresses criteria lacks reflection and critical analysis and synthesis does not represent knowledge gained from the course readings for the module. * contains only 1 or no credible references
Main Posting: Writing	Points Range: 6 (6%) – 6 (6%) * Written clearly and concisely * Contains no grammatical or spelling errors * Fully adheres to current APA manual writing rules and style	Points Range: 5.5 (5.5%) – 5.5 (5.5%) * Written clearly and concisely * May contain one or no grammatical or spelling error * Adheres to current APA manual writing rules and style	Points Range: 5 (5%) – 5 (5%) * Written concisely * May contain one to two grammatical or spelling error * Adheres to current APA manual writing rules and style	Points Range: 4 (4%) – 5 (5%) Writtten somewhat concisely May contain more than two2 spelling or grammatical errors * Contains some APA formatting erros	Points Range: 0 (0%) – 4 (4%) * Not written clearly or concisely * Contains more than two spelling or grammatical errors * Does not adhere to current APA manual writing rules and style
Main Posting: Timely and full participation	Points Range: 10 (10%) – 10 (10%) * meets requirements for timely and full participation * posts main discussion by due date	Points Range: 0 (0%) – 0 (0%)	Points Range: 0 (0%) – 0 (0%)	Points Range: 0 (0%) – 0 (0%)	Points Range: 0 (0%) – 6 (6%) * does not meet requirement for full participation
First Reponse Post to colleague’s main post that is reflective and justified with credible sources.	Points Range: 9 (9%) – 9 (9%) * response exhibits critical thinking and application to practice settings * responds to questions posed by faculty * the use of scholarly sources to support ideas demonstrates synthesis and understanding of learning objectives	Points Range: 8.5 (8.5%) – 8.5 (8.5%) * response exhibits critical thinking and application to practice settings	Points Range: 7.5 (7.5%) – 8 (8%) * response has some depth and may exhibit critical thinking or application to practice setting	Points Range: 6.5 (6.5%) – 7 (7%) * response is on topic, may have some depth	Points Range: 0 (0%) – 6 (6%) * reponse may not be on topic, lacks depth
First Reponse: Writing	Points Range: 6 (6%) – 6 (6%) * Communication is professional and respectful to colleagues * Response to faculty questions are fully answered if posed * Provides clear, concise opinions and ideas that are supported by two or more credible sources * Response is effectively written in Standard Edited English	Points Range: 5.5 (5.5%) – 5.5 (5.5%) * Communication is professional and respectful to colleagues * Response to faculty questions are answered if posed * Provides clear, concise opinions and ideas that are supported by two or more credible sources * Response is effectively written in Standard Edited English	Points Range: 5 (5%) – 5 (5%) * Communication is mostly professional and respectful to colleagues * Response to faculty questions are mostly answered if posed * Provides opinions and ideas that are supported by few credible sources * Response is written in Standard Edited English	Points Range: 4.5 (4.5%) – 4.5 (4.5%) * Responses posted in the discussion may lack effective professional communication * Response to faculty questions are somewhat answered if posed * Few or no credible sources are cited	Points Range: 0 (0%) – 4 (4%) * Responses posted in the discussion lack effective * Response to faculty questions are missing * No credible sources are cited
First Reponse: Timely and full participation	Points Range: 5 (5%) – 5 (5%) * meets requirements for timely and full participation * posts by due date	Points Range: 0 (0%) – 0 (0%)	Points Range: 0 (0%) – 0 (0%)	Points Range: 0 (0%) – 0 (0%)	Points Range: 0 (0%) – 0 (0%) * does not meet requirement for full participation
Second Reponse: Post to colleague’s main post that is reflective and justified with credible sources.	Points Range: 9 (9%) – 9 (9%) * response exhibits critical thinking and application to practice settings * responds to questions posed by faculty * the use of scholarly sources to support ideas demonstrates synthesis and understanding of learning objectives	Points Range: 8.5 (8.5%) – 8.5 (8.5%) * response exhibits critical thinking and application to practice settings	Points Range: 7.5 (7.5%) – 8 (8%) * response has some depth and may exhibit critical thinking or application to practice setting	Points Range: 6.5 (6.5%) – 7 (7%) * response is on topic, may have some depth	Points Range: 0 (0%) – 6 (6%) * reponse may not be on topic, lacks depth
Second Reponse: Writing	Points Range: 6 (6%) – 6 (6%) * Communication is professional and respectful to colleagues * Response to faculty questions are fully answered if posed * Provides clear, concise opinions and ideas that are supported by two or more credible sources * Response is effectively written in Standard Edited English	Points Range: 5.5 (5.5%) – 5.5 (5.5%) * Communication is professional and respectful to colleagues * Response to faculty questions are answered if posed * Provides clear, concise opinions and ideas that are supported by two or more credible sources * Response is effectively written in Standard Edited English	Points Range: 5 (5%) – 5 (5%) * Communication is mostly professional and respectful to colleagues * Response to faculty questions are mostly answered if posed * Provides opinions and ideas that are supported by few credible sources * Response is written in Standard Edited English	Points Range: 4.5 (4.5%) – 4.5 (4.5%) * Responses posted in the discussion may lack effective professional communication * Response to faculty questions are somewhat answered if posed * Few or no credible sources are cited	Points Range: 0 (0%) – 4 (4%) * Responses posted in the discussion lack effective * Response to faculty questions are missing * No credible sources are cited
Second Reponse: Timely and full participation	Points Range: 5 (5%) – 5 (5%) * meets requirements for timely and full participation * posts by due date	Points Range: 0 (0%) – 0 (0%)	Points Range: 0 (0%) – 0 (0%)	Points Range: 0 (0%) – 0 (0%)	Points Range: 0 (0%) – 0 (0%) * does not meet requirement for full participation

Total Points: 100

Name: NURS_6670_Week1_Discussion_Rubric

Assignment: Week 1 Practicum Journal Entry: Certification Plan

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

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

Learning Objectives

Students will:

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

**Assigned in Week 1 but submitted in Week 4

To prepare for this Practicum Journal:

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

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

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

By Day 7

Submit by Day 7 of Week 4.

Making Connections

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

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

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

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

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

To go to the next week:

Week 2

Week 2: Depressive Disorders

I have no one. My wife died suddenly 4 years ago and I know it was my fault. She had been complaining she was sick for a year, but the doctors kept saying it was nothing. When they finally found the cancer, it had spread throughout her body. I should have listened to her. She might have survived and I would not be alone. I seem to cry for no reason and my children don’t understand why I don’t want to go out of the house. This is where her memories are. Why would I want to leave?

Jose, age 75

The National Institutes of Mental Health acknowledges that depression is one of the most common mental disorders in the United States. It is associated with significant disability, fiscal impact, and considerable personal suffering. It may have significant impact on the individual, their family, and their social network. The PMHNP must be capable of providing comprehensive care for depressive disorders, including both psychotherapy and psychopharmacologic approaches.

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

Learning Resources

Required Readings

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

Chapter 8, “Mood Disorders” (pp. 347–386)

Gabbard, G. O. (2014). Gabbard’s treatment of psychiatric disorders (5th ed.). Washington, DC: American Psychiatric Publications.

Chapter 12, “Psychotherapy of Mood Disorders”

Chapter 14, “Pharmacological and Somatic Treatments for Major Depressive Disorder”

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

“Depressive Disorders”

Major Depressive Disorder

Persistent Depressive Disorder (dysthymia)

Premenstrual Dysphoric Disorder

Substance/Medication-Induced Depressive Disorder

Depressive Disorder Due to Another Medical Condition

Other Specified Depressive Disorder

Unspecified Depressive Disorder

Stahl, S. M. (2014). Prescriber’s Guide: Stahl’s Essential Psychopharmacology (5th ed.). New York, NY: Cambridge University Press.

Note: All Stahl resources can be accessed through the Walden Library using the link below. This link will take you to a login page for the Walden Library. Once you log in to the library, the Stahl website will appear. http://ezp.waldenulibrary.org/login?url=http://stahlonline.cambridge.org/

To access information on specific medications, click on The Prescriber’s Guide, 5th Ed. tab on the Stahl Online website and select the appropriate medication.

Depression			Premenstrual dysphoric disorder	Seasonal affective disorder (MDD with Seasonal Variation)
agomelatine amisulpride amitriptyline amoxapine amphetamine (d) amphetamine (d,l) aripiprazole (adjunct) asenapine atomoxetine bupropion buspirone (adjunct) citalopram clomipramine cyamemazine desipramine desvenlafaxine dothiepin paroxetine phenelzine protriptyline	quetiapine (adjunct) reboxetine selegiline sertindole sertraline sulpiride tianeptine tranylcypromine triiodothyronine trazodone trimipramine venlafaxine vilazodone vortioxetine doxepin duloxetine escitalopram fluoxetine flupenthixol fluvoxamine	iloperidone imipramine isocarboxazid ketamine lisdexamfetamine lithium (adjunct) l-methylfolate (adjunct) lofepramine lurasidone maprotiline methylphenidate (d) methylphenidate (d,l) mianserin milnacipran mirtazapine moclobemide modafinil (adjunct) nefazodone nortriptyline olanzapine	citalopram desvenlafaxine escitalopram fluoxetine paroxetine sertraline venlafaxine	bupropion

Grieve, S. M., Korgaonkar, M. S., Koslow, S. H., Gordon, E., Williams, L. M. (2013). Widespread reductions in gray matter volume in depression. NeuroImage: Clinical, 3, 332-339. doi:10.1016/j.nicl.2013.08.016

Lach, H. W., Chang, Y-P., & Edwards, D. (2010). Can older adults with dementia accurately report depression using brief forms? Reliability and validity of the Geriatric Depression Scale. Journal of Gerontological Nursing, 36(5), 30–37. doi:10.3928/00989134-20100303-01

Steffens, D. C., McQuoid, D. R., & Potter, G. G. (2014). Amnestic mild cognitive impairment and incident dementia and Alzheimer’s disease in geriatric depression. International Psychogeriatrics, 26(12), 2029–2036. doi:10.1017/S1041610214001446

Drug Enforcement Administration. (n.d.). Drug schedules. Retrieved June 14, 2016, from https://www.dea.gov/druginfo/ds.shtml

Required Media

Classroom Productions (Producer). (2015). Depressive Disorders [Video file]. San Luis Obispo, CA: Microtraining Associates.

Note: The approximate length of this media piece is 22 minutes.

Optional Resources

Gabbard, G. O. (2014). Gabbard’s treatment of psychiatric disorders (5th ed.). Washington, DC: American Psychiatric Publications.

Chapter 15, “Brain Stimulation Treatments for Mood Disorders”

Ahern, E., & Semkovska, M. (2017). Cognitive functioning in the first-episode of major depressive disorder: A systematic review and meta-analysis. Neuropsychology, 31(1), 52–72. doi:10.1037/neu0000319

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

Anderson, N. D., Damianakis, T., Kröger, E., Wagner, L. M., Dawson, D. R., Binns, M. A., . . . Cook, S. L. (2014). The benefits associated with volunteering among seniors: A critical review and recommendations for future research. Psychological Bulletin, 140(6), 1505–1533. doi:10.1037/a0037610

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

Inoue, J., Hoshino, R., Nojima, H., Ishida, W., & Okamoto, N. (2016). Additional donepezil treatment for patients with geriatric depression who exhibit cognitive deficit during treatment for depression. Psychogeriatrics, 16(1), 54–61. doi:10.1111/psyg.12121

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

Sachs-Ericsson, N., Corsentino, E., Moxley, J., Hames, J. L., Rushing, N. C., Sawyer, K., . . . Steffens, D. C. (2013). A longitudinal study of differences in late- and early-onset geriatric depression: Depressive symptoms and psychosocial, cognitive, and neurological functioning. Aging & Mental Health, 17(1), 1–11. doi:10.1080/13607863.2012.717253

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

Shallcross, A. J., Gross, J. J., Visvanathan, P. D., Kumar, N., Palfrey, A., Ford, B. Q., . . . Mauss, I. B. (2015). Relapse prevention in major depressive disorder: Mindfulness-based cognitive therapy versus an active control condition. Journal of Consulting and Clinical Psychology, 83(5), 964–975. doi:10.1037/ccp0000050

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

Wanklyn, S. G., Pukay-Martin, N. D., Belus, J. M., St. Cyr, K., Girard, T. A., & Monson, C. M. (2016). Trauma types as differential predictors of posttraumatic stress disorder (PTSD), major depressive disorder (MDD), and their comorbidity. Canadian Journal of Behavioural Science / Revue Canadienne Des Sciences Du Comportement, 48(4), 296–305. doi:10.1037/cbs0000056

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

Assignment 1: “Captain of the Ship” Project – Depressive Disorder

As nurse practitioners strive to achieve full-autonomous practice across the country, it should be noted that many states grant this ability to practice independently to psychiatric mental health nurse practitioners. To that end, you will be engaging in projects this semester that assume that you are practicing in a state that allows full-practice authority for NPs, meaning that the PMHNP may be the “captain of the ship” concerning caring for a patient population. The “captain of the ship” is the one who makes referrals to specialists, coordinates care for their patients/clients, and is responsible and accountable for patient/client outcomes overall. This is a decided change from a few decades ago when physicians were the “captain of the ship” and NPs played a peripheral role.

In this Assignment, you will become the “captain of the ship” as you provide treatment recommendations and identify medical management, community support resources, and follow-up plans for a client with a depression disorder.

Learning Objectives

Students will:

Recommend psychopharmacologic treatments based on therapeutic endpoints for clients with depression disorders
Recommend psychotherapy based on therapeutic endpoints for clients with depression disorders
Identify medical management needs for clients with depression disorders
Identify community support resources for clients with depression disorders
Recommend follow-up plans for clients with depression disorders

To prepare for this Assignment:

Select an adult or older adult client with a depressive disorder you have seen in your practicum.

In 3–4 pages, write a treatment plan for your client in which you do the following:

Describe the HPI and clinical impression for the client.
Recommend psychopharmacologic treatments and describe specific and therapeutic endpoints for your psychopharmacologic agent. (This should relate to HPI and clinical impression.)
Recommend psychotherapy choices (individual, family, and group) and specific therapeutic endpoints for your choices.
Identify medical management needs, including primary care needs, specific to this client.
Identify community support resources (housing, socioeconomic needs, etc.) and community agencies that are available to assist the client.
Recommend a plan for follow-up intensity and frequency and collaboration with other providers.

By Day 7

Submit your Assignment.

Submission and Grading Information

To submit your completed Assignment for review and grading, do the following:

Please save your Assignment using the naming convention “WK2Assgn1+last name+first initial.(extension)” as the name.
Click the Week 2 Assignment 1 Rubric to review the Grading Criteria for the Assignment.
Click the Week 2 Assignment 1 link. You will also be able to “View Rubric” for grading criteria from this area.
Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK2Assgn1+last name+first initial.(extension)” and click Open.
If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
Click on the Submit button to complete your submission.

Grading Criteria

To access your rubric:

Week 2 Assignment 1 Rubric

Check Your Assignment Draft for Authenticity

To check your Assignment draft for authenticity:

Submit your Week 2 Assignment 1 draft and review the originality report.

Submit Your Assignment by Day 7

To submit your Assignment:

Week 2 Assignment 1

Assignment 2: Week 2 Practicum Journal: Safe Prescribing

There is probably no greater responsibility that the psychiatric mental health nurse practitioner assumes than the responsibility of prescribing medications. While someone can be harmed by psychotherapy, the level and intensity of the harm generally does not come to the same level of harm that can occur from improper prescribing. The PMHNP must understand his/her responsibility both at a state and federal level when it comes to prescribing medications.

In this Practicum Journal Assignment, you will explore the legalities associated with prescribing controlled substances, as well as what a DEA number is, how to obtain one, and, most importantly, how to prescribe controlled substances in your state.

Learning Objectives

Students will:

Analyze roles of the Drug Enforcement Administration
Analyze PMHNP responsibilities when issued a DEA number
Analyze DEA number application procedures
Analyze state requirements for safe prescribing and prescription monitoring
Analyze PMHNP responsibilities for safe prescribing and prescription monitoring
Analyze Schedule II-V drug levels

** Assigned in Week 2 and submitted in Week 4.

To prepare for this Practicum Journal:

Review the Learning Resources.

In 2-3 pages:

Describe the role of the Drug Enforcement Administration (DEA) as it pertains to the PMHNP.
Explain your responsibilities when having a DEA number.
Explain how you apply for a DEA number.
Explain your state’s requirements for a safe prescribing and prescription monitoring program. Explain your responsibility as a PMHNP to follow these requirements.
Provide an example of a drug you may prescribe from each of the Schedule II-V drug levels.

By Day 7

Submit by Day 7 of Week 4.

Making Connections

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

Next week, you will explore the many personality disorders and use the DSM-5 criteria for diagnosing individuals with specific personality disorders. You will use the Decision Tree format to diagnose and treat a client with a personality disorder. You also will complete the Fitzgerald University Exit Comprehensive Exam to determine your readiness for the certification exam.

To go to the next week:

Week 3

Week 3: Personality Disorders

I cannot believe these people. Don’t they know who I am? I deserve better treatment than this. That hostess should have seated me immediately, but I had to wait for 10 minutes and then she put me at this table right by the kitchen. I see an empty table right in the middle where I should be. I am just going to get up and move there. I don’t care what the hostess says, rules don’t apply to me.

Ashley, age 25

Personality disorders represent perhaps the most challenging disorders that the psychiatric mental health nurse practitioner will have to address in their professional careers. Personality disorders can co-occur in every mental health disorder and, in some cases, can mask as disorder . Although difficult to treat, the PMHNP must be able to identify personality disorders and endeavor to work with the client to not only recognize the disorder, but to treat a disorder that clients often do not believe they have.

This week, you will explore the many personality disorders and use the DSM-5 criteria for diagnosing individuals with specific personality disorders. You will use the Decision Tree format to diagnose and treat a client with a personality disorder. You also will complete the Fitzgerald University Exit Comprehensive Exam to determine your readiness for the certification exam.

Learning Resources

Required Readings

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

Standard 12 “Leadership” (pages 76-77)

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

Chapter 4, “Theories of Personality and Psychopathology” (pp. 151–191)

Chapter 22, “Personality Disorders” (pp. 742–762)

Chapter 13, “Psychosomatic Medicine” (pp. 465–503)

Gabbard, G. O. (2014). Gabbard’s treatment of psychiatric disorders (5th ed.). Washington, DC: American Psychiatric Publications.

Chapter 68, “Paranoid, Schizotypal, and Schizoid Personality Disorders”

Chapter 69, “Antisocial Personality Disorder”

Chapter 70, “Borderline Personality Disorder”

Chapter 71, “Histrionic Personality Disorder”

Chapter 72, “Narcissistic Personality Disorder”

Chapter 73, “Cluster C Personality Disorders

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

“Personality Disorders”

Perry, J. C., Presniak, M. D., & Olson, T. R. (2013). Defense mechanisms in schizotypal, borderline, antisocial, and narcissistic personality disorders. Psychiatry: Interpersonal & Biological Processes, 76(1), 32–52. doi:10.1521/psyc.2013.76.1.32

Rees, C. S., & Pritchard, R. (2015). Brief cognitive therapy for avoidant personality disorder. Psychotherapy, 52(1), 45–55. doi:10.1037/a0035158

Required Media

Laureate Education. (2017a). A woman with personality disorder [Interactive media file]. Baltimore, MD: Author.

Optional Resources

Kernberg, O. (n.d.). Psychoanalytic psychotherapy [Video file]. Mill Valley, CA: Psychotherapy.net.

Discussion: Treatment of Personality Disorders

Personality disorders occur in 10–20% of the population. 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.

In this Discussion, you will explore personality disorders in greater detail and discuss treatment options using evidence-based research.

Learning Objectives

Students will:

Analyze diagnostic criteria for personality disorders
Analyze evidence-based psychotherapy and psychopharmacologic treatments for personality disorders
Analyze clinical features of clients with personality disorders
Align clinical features with DSM-5 criteria
Compare differential diagnostic features of personality disorders

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

To prepare for this Discussion:

By Day 5 of Week 2, your Instructor will have assigned you a personality disorder, which will be your focus for your initial post for this Discussion.
Review the Learning Resources.

By Day 3

Post:

Explain the diagnostic criteria for your assigned personality disorder.
Explain the evidenced-based psychotherapy and psychopharmacologic treatment for your assigned personality disorder.
Describe clinical features from a client that led you to believe this client had this disorder. Align the clinical features with the DSM-5 criteria.
Support your rationale with references to the Learning Resources or other academic resources.

By Day 6

Respond to at least two of your colleagues by comparing the differential diagnostic features of the disorder you were assigned to the diagnostic features of the disorder your colleagues were assigned. What are their similarities and differences? How might you differentiate the two diagnoses?

Submission and Grading Information

Grading Criteria

To access your rubric:

Week 3 Discussion Rubric

Post by Day 3 and Respond by Day 6

To participate in this Discussion:

Week 3 Discussion

Assignment 1: Decision Tree

For this Assignment, as you examine the client case study in this week’s Learning Resources, consider how you might assess and treat adult and older adult clients presenting symptoms of a mental health disorder.

Learning Objectives

Students will:

Evaluate clients for treatment of mental health disorders
Analyze decisions made throughout diagnosis and treatment of clients with mental health disorders

** Assigned in Week 3 and submitted in Week 4

Examine Case 1: You will be asked to make three decisions concerning the diagnosis and treatment for this client. Be sure to consider co-morbid physical as well as mental factors that might impact the client’s diagnosis and treatment.

At each Decision Point, stop to complete the following:

Decision #1: Differential Diagnosis
- Which Decision did you select?
- Why did you select this Decision? Support your response with evidence and references to the Learning Resources.
- What were you hoping to achieve by making this Decision? Support your response with evidence and references to the Learning Resources.
- Explain any difference between what you expected to achieve with Decision #1 and the results of the Decision. Why were they different?
Decision #2: Treatment Plan for Psychotherapy
- Why did you select this Decision? Support your response with evidence and references to the Learning Resources.
- What were you hoping to achieve by making this Decision? Support your response with evidence and references to the Learning Resources.
- Explain any difference between what you expected to achieve with Decision #2 and the results of the Decision. Why were they different?
Decision #3: Treatment Plan for Psychopharmacology
- Why did you select this Decision? Support your response with evidence and references to the Learning Resources.
- What were you hoping to achieve by making this Decision? Support your response with evidence and references to the Learning Resources.
- Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different?
Also include how ethical considerations might impact your treatment plan and communication with clients and their family.

Note: Support your rationale with a minimum of three academic resources. While you may use the course text to support your rationale, it will not count toward the resource requirement.

By Day 7

Submit by Day 7 of Week 4.

Assignment 2: Fitzgerald Health Education Associates (FHEA) PMHNP 150 University Exit Comprehensive Exam

In Weeks 1 or 2 of this course, you received an e-mail from Fitzgerald Health Education Associates (FHEA) explaining how to access the Fitzgerald Health Education Associates (FHEA) PMHNP 150 University Exit Comprehensive Exam. Please follow the directions FHEA provided and complete the exam. You must complete the exam by Day 7 of Week 3 to receive a grade. Each exam is worth 100 points and 10% of your grade. The 3-hour exam is required and will provide you with an overall view of your preparedness for the certification exam.

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

Making Connections

This week, you explored the many personality disorders and used the DSM-5 criteria for diagnosing individuals with specific personality disorders. You used the Decision Tree format to diagnose and treat a client with a personality disorder. You also completed the Fitzgerald University Exit Comprehensive Exam to determine your readiness for the certification exam.

Next week, you will analyze clients presenting for treatment of substance-related and addictive disorders and evaluate effectiveness of therapeutic approaches for clients diagnosed with substance-related and addictive disorders.

To go to the next week:

Week 4

Week 4: Substance-Related and Addictive Disorders

I can’t believe that stupid horse lost! My inside man told me it was a sure bet at 20:1 odds. I thought for sure that I would be able to make back the money I lost yesterday. What am I going to tell my wife? That was the money for the mortgage payment…well, the last three mortgage payments. She does not know I have been spending my days at the track. I lost my job at the company because a few hundred dollars went missing. I just need a break. I know this next horse will be my winner!

Michael, age 37

Substance abuse and addiction affects persons in all walks of life; every ethnic and economic group is affected in some way by addiction or substance abuse. In your practice as a PMHNP, you will encounter patients with substance abuse and dependence. Some of the people who present for treatment are at a low point in their lives and want to turn things around. They may present for other conditions such as depression or bipolar disorder, anxiety, PTSD, or personality disorders. One of the most common ways of self-medicating a mental illness is with alcohol and illicit drugs. Marijuana is a common substance used by clients to treat various symptoms. To effectively treat clients with addictive disorders and substance use disorders, the provider needs to examine their own values and thoughts about the use of substances.

This week, you will analyze clients presenting for treatment of substance-related and addictive disorders and evaluate effectiveness of therapeutic approaches for clients diagnosed with substance-related and addictive disorders.

Learning Resources

Required Readings

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

Chapter 20, “Substance Use and Addictive Disorders” (pp. 616–693)

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

Stahl, S. M. (2014). Prescriber’s Guide: Stahl’s Essential Psychopharmacology (5th ed.). New York, NY: Cambridge University Press.

Note: All Stahl resources can be accessed through the Walden Library using the link below. This link will take you to a login page for the Walden Library. Once you log in to the library, the Stahl website will appear. http://ezp.waldenulibrary.org/login?url=http://stahlonline.cambridge.org/

To access information on specific medications, click on The Prescriber’s Guide, 5th Ed. tab on the Stahl Online website and select the appropriate medication.

Alcohol abstinence	Alcohol dependence	Alcohol withdrawal	Nicotine addiction	Opioid dependence	Reversal of benzodiazepine effects
acamprosate disulfiram	nalmefene naltrexone	chlordiazepoxide clonidine clorazepate diazepam lorazepam oxazepam	bupropin varenicline	buprenorphine naltrexone	flumazenil

Note: For more information about buprenorphine, see https: //www.samhsa.gov/medication-assisted-treatment/qualify-nps-pas-waivers

Required Media

Ashwood, D. (Producer). (n.d.-a). Mindfulness-based relapse prevention for addictions: Volume I [Video file]. Mill Valley, CA: Psychotherapy.net.

Ashwood, D. (Producer). (n.d.-b). Mindfulness-based relapse prevention for addictions: Volume II [Video file]. Mill Valley, CA: Psycotherapy.net.

Optional Resources

Gabbard, G. O. (2014). Gabbard’s treatment of psychiatric disorders (5th ed.). Washington, DC: American Psychiatric Publications.

Chapter 46, “Alcohol-Related Disorders”

Chapter 47, “Sedative-, Hypnotic-, or Anxiolytic-Related Disorders”

Chapter 48, “Opioid-Related Disorders: Opioid Detoxification”

Chapter 49, “Opioid-Related Disorders: Antagonist Treatment”

Chapter 50, “Opioid-Related Disorders: Agonist Maintenance Treatment”

Chapter 51, “Hallucinogen-Related Disorders

Chapter 52, “Cannabis-Related Disorders”

Chapter 53, “Club Drug Addiction”

Chapter 54, “Stimulant-Related Disorders”

Chapter 55, “Nicotine-Related Disorders”

Chapter 56, “Individual Therapy for Substance Use Disorders”

Chapter 57, “Cognitive, Behavioral, and Motivational Therapies for Substance Use Disorders”

Chapter 58, “Group Therapy for Substance Use Disorders”

Chapter 59, “Family Therapy in Substance Abuse Treatment”

Chapter 60, “Network Therapy for Substance Use Disorders”

Chapter 61, “Pain and Addiction”

Chapter 62, “Gambling Disorder”

Bechtold, J., Simpson, T., White, H. R., & Pardini, D. (2015). Chronic adolescent marijuana use as a risk factor for physical and mental health problems in young adult men. Psychology of Addictive Behaviors, 29(3), 552–563. doi:10.1037/adb0000103

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

Substance Abuse and Mental Health Services Administration (SAMHSA). (2013b). TIP 48: Managing depressive symptoms in substance abuse clients during early recovery. Retrieved from http://store.samhsa.gov/product/TIP-48-Managing-Depressive-Symptoms-in-Substance-Abuse-Clients-During-Early-Recovery/SMA13-4353

Note: This document is available as free download.

Substance Abuse and Mental Health Services Administration (SAMHSA). (2013b). TIP 42: Substance abuse treatment for persons with co-occurring disorders. Retrieved from http://store.samhsa.gov/product/TIP-42-Substance-Abuse-Treatment-for-Persons-With-Co-Occurring-Disorders/SMA13-3992

Note: This document is available as free download.

Borchardt, D. (2017). National Academy of Sciences pushes for rescheduling of marijuana. Forbes. Retrieved from https://www.forbes.com/sites/debraborchardt/2017/01/18/national-academy-of-sciences-suggests-removing-barriers-to-cannabis-research-basically-deschedule/#22269c753f76

Discussion: Clinical Supervision – Kaltura

Substance use disorders are complicated psychiatric and medical conditions that involve physical addiction as well as psychological or emotional dependence. Substance use disorders are some of the most difficult to treat. It takes a great deal of patience on the part of the provider and the client. It may take several attempts before a client is successfully able to “kick the habit.” Your guidance and patience can help the client to persevere through difficult times during the journey to recovery.

Clinical Supervision is an essential component of your development as a psychiatric mental health nurse practitioner. It provides an opportunity for professional collaboration as you share experiences with and gain insights from colleagues. For this Clinical Supervision, consider a client with a substance abuse disorder whom you do not think is adequately progressing according to expected clinical outcomes.

Learning Objectives

Students will:

Analyze clients presenting for treatment of substance-related and addictive disorders
Evaluate effectiveness of therapeutic approaches for clients diagnosed with substance-related and addictive disorders
Recommend treatment plans

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

To prepare for this Discussion:

Review this week’s Learning Resources concerning treating patients with substance-related and addictive disorders.
Reflect on a client you are currently counseling or have previously counseled at your practicum site who has been diagnosed with substance-related and addictive disorders.

By Day 3

Post a 3- to 5-minute Kaltura video in which you do the following:

Describe the client. Note: Do not use the client’s actual name.
Explain your therapeutic approach with the client, including the perceived effectiveness of your approach.
Identify any additional information about this client that may potentially impact expected outcomes.
Provide specific recommendations for the client to help them in determining why they are not progressing and what your suggested treatment plan consists of. It is useful to consult the Prochaska and DiClement model.

Note: Nurse practitioners must have strong oral communication skills. This Discussion is designed to help you hone these skills. When filming your Kaltura video, be sure to dress and speak in a professional manner.

View a selection of your colleagues’ responses.

By Day 6

Respond to at least two of your colleagues by suggesting an alternate therapeutic approach. Support your feedback with evidence-based literature and/or your own experiences with clients.

Submission and Grading Information

Grading Criteria

To access your rubric:

Week 4 Discussion Rubric

Post by Day 3 and Respond by Day 6

To participate in this Discussion:

Week 4 Discussion

Assignment 1: Week 1 Practicum Journal Entry: Certification Plan

By Day 7

Submit your Assignment. Refer to Week 1 for additional guidance.

Submission and Grading Information

To submit your completed Assignment for review and grading, do the following:

Please save your Assignment using the naming convention “WK4Assgn1+last name+first initial.(extension)” as the name.
Click the Week 4 Assignment 1 Rubric to review the Grading Criteria for the Assignment.
Click the Week 4 Assignment 1 link. You will also be able to “View Rubric” for grading criteria from this area.
Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK4Assgn1+last name+first initial.(extension)” and click Open.
If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
Click on the Submit button to complete your submission.

Grading Criteria

To access your rubric:

Week 4 Assignment 1 Rubric

Check Your Assignment Draft for Authenticity

To check your Assignment draft for authenticity:

Submit your Week 4 Assignment 1 draft and review the originality report.

Submit Your Assignment by Day 7

To submit your Assignment:

Week 4 Assignment 1

Assignment 2: Week 2 Practicum Journal: Safe Prescribing

By Day 7

Submit your Assignment. Refer to Week 2 for additional guidance.

Submission and Grading Information

To submit your completed Assignment for review and grading, do the following:

Please save your Assignment using the naming convention “WK4Assgn2+last name+first initial.(extension)” as the name.
Click the Week 4 Assignment 2 Rubric to review the Grading Criteria for the Assignment.
Click the Week 4 Assignment 2 link. You will also be able to “View Rubric” for grading criteria from this area.
Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK4Assgn2+last name+first initial.(extension)” and click Open.
If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
Click on the Submit button to complete your submission.

Grading Criteria

To access your rubric:

Week 4 Assignment 2 Rubric

Check Your Assignment Draft for Authenticity

To check your Assignment draft for authenticity:

Submit your Week 4 Assignment 2 draft and review the originality report.

Submit Your Assignment by Day 7

To submit your Assignment:

Week 4 Assignment 2

Assignment 3: Week 3 Practicum Journal: Decision Tree

By Day 7

Submit your Assignment. Refer to Week 3 for additional guidance.

Submission and Grading Information

To submit your completed Assignment for review and grading, do the following:

Please save your Assignment using the naming convention “WK4Assgn3+last name+first initial.(extension)” as the name.
Click the Week 4 Assignment 3 Rubric to review the Grading Criteria for the Assignment.
Click the Week 4 Assignment 3 link. You will also be able to “View Rubric” for grading criteria from this area.
Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK4Assgn3+last name+first initial.(extension)” and click Open.
If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
Click on the Submit button to complete your submission.

Grading Criteria

To access your rubric:

Week 4 Assignment 3 Rubric

Check Your Assignment Draft for Authenticity

To check your Assignment draft for authenticity:

Submit your Week 4 Assignment 3 draft and review the originality report.

Submit Your Assignment by Day 7

To submit your Assignment:

Week 4 Assignment 3

Practicum Reminder

Time Logs: You are required to keep a log of the time you spend related to your practicum experience and enter every patient you see each day. You can access your time log from the Welcome Page in your Meditrek account. You will track time individually for each patient you work with. Please make sure to continuously input your hours throughout the term.

Making Connections

This week, you analyzed clients presenting for treatment of substance-related and addictive disorders and evaluated effectiveness of therapeutic approaches for clients diagnosed with substance-related and addictive disorders.

Next week, you will, once again, become “captain of the ship” as you take full responsibility for a client with a bipolar disorder by recommending psychopharmacologic treatment and psychotherapy, identifying medical management needs and community support, and recommending follow-up plans. You will use the decision tree format to justify your rationale for diagnosis, pharmacological treatment, and psychotherapy of a patient with a mental illness. You also will evaluate the results of your Fitzgerald University Exit Comprehensive Exam and, based on those results, develop a plan of action to prepare for the certification exam.

To go to the next week:

Week 5

Week 5: Bipolar Disorders

I am finally doing everything right. I stayed up all night studying for my final exams and even managed to clean out my closet and order a whole new bedroom from the Internet. I know I will ace all my exams. Nothing can go wrong like they did a few months ago. I was so low and was sleeping all the time. I did not think I would ever be happy again, but now I know I can do anything.

Jessica, age 22

Bipolar disorder is relatively rare with around only 3% of the population diagnosed with one of them. Although being relatively rare in terms of lifetime prevalence, bipolar disorder is burdensome to the individual and health care system because of its early onset, severity, and chronic nature. The average age of onset is around 25 and affects men and women equally. The importance of evidence-based intervention for treatment in persons with bipolar disorder cannot be underestimated. Unstable mood can result in repeat chronic hospitalizations. Developing a good rapport and relationship with the client can make a difference in the course, symptom management, and stability of the person with bipolar disorder.

This week, you will once again become “cCaptain of the Sship” as you take full responsibility for a client with a bipolar disorder by recommending psychopharmacologic treatment and psychotherapy, identifying medical management needs and community support, and recommending follow-up plans. You will use the decision tree format to justify your rationale for diagnosis, pharmacological treatment, and psychotherapy of a patient with a mental illness. You also will evaluate the results of your Fitzgerald University Exit Comprehensive Exam and, based on those results, develop a plan of action to prepare for the certification exam.

Learning Resources

Required Readings

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

Standard 13 “Collaboration” (pages 78-79)

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

Chapter 8, “Mood Disorders” (pp. 347–386)

Note: This is review from the Learning Resource in Week 2.

Gabbard, G. O. (2014). Gabbard’s treatment of psychiatric disorders (5th ed.). Washington, DC: American Psychiatric Publications.

Chapter 13, “Acute and Maintenance Treatment of Bipolar and Related Disorders”

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

“Bipolar and Related Disorders”

Stahl, S. M. (2014). Prescriber’s Guide: Stahl’s Essential Psychopharmacology (5th ed.). New York, NY: Cambridge University Press.

Note: All Stahl resources can be accessed through the Walden Library using the link below. This link will take you to a login page for the Walden Library. Once you log in to the library, the Stahl website will appear. http://ezp.waldenulibrary.org/login?url=http://stahlonline.cambridge.org/

To access information on specific medications, click on The Prescriber’s Guide, 5th Ed. tab on the Stahl Online website and select the appropriate medication.

Bipolar depression	Bipolar disorder		Bipolar maintenance	Mania
amoxapine aripiprazole armodafinil asenapine bupropion carbamazepine fluoxetine iloperidone lamotrigine lithium lurasidone modafinil olanzapine olanzapine-fluoxetine combination quetiapine risperidone sertindole valproate (divalproex) ziprasidone	alprazolam (adjunct) amoxapine aripiprazole asenapine bupropion carbamazepine chlorpromazine clonazepam (adjunct) cyamemazine doxepin fluoxetine flupenthixol fluphenazine gabapentin (adjunct) haloperidol iloperidone lamotrigine levetiracetam lithium lorazepam (adjunct)	loxapine lurasidone molindone olanzapine olanzapine-fluoxetine combination oxcarbazepine paliperidone perphenazine pipothiazine quetiapine risperidone sertindole thiothixene topiramate (adjunct) trifluoperazine valproate (divalproex) ziprasidone zonisamide zotepine zuclopenthixol	aripiprazole asenapine carbamazepine iloperidone lamotrigine lithium lurasidone olanzapine olanzapine-fluoxetine combination quetiapine risperidone (injectable) sertindole valproate (divalproex) ziprasidone	alprazolam (adjunct) aripiprazole asenapine carbamazepine chlorpromazine clonazepam (adjunct) iloperidone lamotrigine levetiracetam lithium lorazepam (adjunct) lurasidone olanzapine quetiapine risperidone sertindole valproate (divalproex) ziprasidone zotepine

Marsee, K., & Gross, A. F. (2013). Bipolar disorder or something else? Current Psychiatry, 12(2), 43–49. Retrieved from http://www.mdedge.com/currentpsychiatry/article/66320/bipolar-disorder/bipolar-disorder-or-something-else

Miller, L. J., Ghadiali, N. Y., Larusso, E. M., Wahlen, K. J., Avni-Barron, O., Mittal, L., & Greene, J. A. (2015). Bipolar disorder in women. Health Care for Women International, 36(4), 475–498. doi:10.1080/07399332.2014.962138

Schouws, S. M., Comijs, H. C., Dols, A., Beekman, A. F., & Stek, M. L. (2016). Five-year follow-up of cognitive impairment in older adults with bipolar disorder. Bipolar Disorders, 18(2), 148–154. doi:10.1111/bdi.12374

Ward, I. (2017). Pharmacologic options for bipolar disorder. Clinical Advisor, 20(3), 17–25.

Required Media

Laureate Education (Producer). (2017d). A young woman with depression [Multimedia file]. Baltimore, MD: Author.

Redfield Jamison, K. (Producer). (n.d.). Assessment & psychological treatment of bipolar disorder [Video file]. Mill Valley, CA: Psychotherapy.net.

Optional Resources

Malhi, G. S., McAulay, C., Gershon, S., Gessler, D., Fritz, K., Das, P., & Outhred, T. (2016). The lithium battery: Assessing the neurocognitive profile of lithium in bipolar disorder. Bipolar Disorders, 18(2), 102–115. doi:10.1111/bdi.12375

Samalin, L., de Chazeron, I., Vieta, E., Bellivier, F., & Llorca, P. (2016). Residual symptoms and specific functional impairments in euthymic patients with bipolar disorder. Bipolar Disorders, 18(2), 164–173. doi:10.1111/bdi.12376

Assignment 1: “Captain of the Ship” Project – Bipolar Disorders

Bipolar disorders are severe disorders of mood that include both depressive episodes and expansive, grandiose, or manic episodes. During these times, the person may engage in activities with little awareness of the consequences because of accompanying psychosis. A diagnosis of bipolar disorder includes periods of mania or hypomania and periods of depression where the mood is down, hopeless, and suicidal. The neurovegetative symptoms of bipolar depression can be incapacitating. It is also important to differentiate the psychosis of bipolar disorder from schizophrenia.

Learning Objectives

Students will:

Recommend psychopharmacologic treatments based on therapeutic end points for clients with bipolar disorders
Recommend psychotherapy based on therapeutic end points for clients with bipolar disorders
Identify medical management needs for clients with bipolar disorders
Identify community support resources for clients with bipolar disorders
Recommend follow-up plans for clients with bipolar disorders

To prepare for this Assignment:

Select an adult or older adult client with a bipolar disorder that you have seen in your practicum.

In 3-4 pages, write a treatment plan for your client. In which you do the following:

Describe the HPI and clinical impression for the client.
Recommend psychopharmacologic treatments and describe specific and therapeutic end points for your psychopharmacologic agent. (This should relate to HPI and clinical impression.).
Recommend psychotherapy choices (individual, family, and group) and specific therapeutic endpoints for your choices.
Identify medical management needs, including primary care needs, specific to this client.
Identify community support resources (housing, socioeconomic needs, etc.) and community agencies that are available to assist the client.
Recommend a plan for follow-up intensity and frequency and collaboration with other providers.

By Day 7

Submit your Assignment.

Submission and Grading Information

To submit your completed Assignment for review and grading, do the following:

Please save your Assignment using the naming convention “WK5Assgn1+last name+first initial.(extension)” as the name.
Click the Week 5 Assignment 1 Rubric to review the Grading Criteria for the Assignment.
Click the Week 5 Assignment 1 link. You will also be able to “View Rubric” for grading criteria from this area.
Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK5Assgn1+last name+first initial.(extension)” and click Open.
If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
Click on the Submit button to complete your submission.

Grading Criteria

To access your rubric:

Week 5 Assignment 1 Rubric

Check Your Assignment Draft for Authenticity

To check your Assignment draft for authenticity:

Submit your Week 5 Assignment 1 draft and review the originality report.

Submit Your Assignment by Day 7

To submit your Assignment:

Week 5 Assignment 1

Assignment 2: FHEA Exam Follow-up

In Week 3 you completed the Fitzgerald University Exit Comprehensive Exam and you should have received your results. This exam is an example of the certification exam you may be required to take in order to be licensed as a PMHNP in your state. Your results from the exam may reflect how you would do in the actual certification exam.

In this Assignment, you will develop a plan of action to address any areas of the exam where you may have scored less than acceptable.

Learning Objectives

Students will:

Develop plan of action for certification exam preparation

To prepare for this Assignment:

Develop plan of action for certification exam preparation

In 1 page:

Based on your results from the FHEA Exam, develop a plan of action, including an academic study plan, which will help you maintain your areas of strength and address the areas that need improvement, and help you prepare for the Certification Exam. Address each area of the exam including:

Foundations of Advanced Practice Nursing
Independent Practice Competencies
Professional Role and Policy

By Day 7

Submit your Assignment.

Submission and Grading Information

To submit your completed Assignment for review and grading, do the following:

Please save your Assignment using the naming convention “WK5Assgn2+last name+first initial.(extension)” as the name.
Click the Week 5 Assignment 2 Rubric to review the Grading Criteria for the Assignment.
Click the Week 5 Assignment 2 link. You will also be able to “View Rubric” for grading criteria from this area.
Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK5Assgn2+last name+first initial.(extension)” and click Open.
If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
Click on the Submit button to complete your submission.

Grading Criteria

To access your rubric:

Week 5 Assignment 2 Rubric

Check Your Assignment Draft for Authenticity

To check your Assignment draft for authenticity:

Submit your Week 5 Assignment 2 draft and review the originality report.

Submit Your Assignment by Day 7

To submit your Assignment:

Week 5 Assignment 2

Assignment 3: Practicum: Decision Tree

Learning Objectives

Students will:

Evaluate clients for treatment of mental health disorders
Analyze decisions made throughout diagnosis and treatment of clients with mental health disorders

Examine Case 2: You will be asked to make three decisions concerning the diagnosis and treatment for this client. Be sure to consider co-morbid physical, as well as mental factors that might impact the client’s diagnosis and treatment.

At each Decision Point stop to complete the following:

- Decision #1: Differential Diagnosis
  - Which Decision did you select?
  - Why did you select this Decision? Support your response with evidence and references to the Learning Resources.
  - What were you hoping to achieve by making this Decision? Support your response with evidence and references to the Learning Resources.
  - Explain any difference between what you expected to achieve with Decision #1 and the results of the Decision. Why were they different?
- Decision #2: Treatment Plan for Psychotherapy
  - Why did you select this Decision? Support your response with evidence and references to the Learning Resources.
  - What were you hoping to achieve by making this Decision? Support your response with evidence and references to the Learning Resources.
  - Explain any difference between what you expected to achieve with Decision #2 and the results of the Decision. Why were they different?
- Decision #3: Treatment Plan for Psychopharmacology
  - Why did you select this Decision? Support your response with evidence and references to the Learning Resources.
  - What were you hoping to achieve by making this Decision? Support your response with evidence and references to the Learning Resources.
  - Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different?

Also include how ethical considerations might impact your treatment plan and communication with clients and their family.

Note: Support your rationale with a minimum of three academic resources. While you may use the course text to support your rationale, it will not count toward the resource requirement.

By Day 7 of Week 7

Submit your Assignment.

Making Connections

This week, you once again became “captain of the ship” as you took full responsibility for a client with a bipolar disorder by recommending psychopharmacologic treatment and psychotherapy, identifying medical management needs, community support, and recommending follow-up plans. You used the decision tree format to justify your rationale for diagnosis, pharmacological treatment, and psychotherapy of a patient with a mental illness. You also evaluated the results of your Fitzgerald University Exit Comprehensive Exam and, based on those results, developed a plan of action to help you prepare for the certification exam.

Next week, you will explore evidence-based treatment methods for clients with anxiety disorders. You will complete a midterm exam and analyze reimbursement rates for treatment of mental health disorders.

To go to the next week:

Week 6

Week 6: Anxiety Disorders, PTSD, and Related Disorders

Oh no! It is happening again. I am having a heart attack… I know it. My heart is racing, I can’t breathe, and I am shaking all over. I can’t go to the ER again. They will say what they always say… I am not having a heart attack. It is all in my head.

Barbara, age 68

The anxiety disorders provide us a good opportunity to take a close look at the nature/nurture debate as well as the gene/environment interactions that influence the nervous system and neurochemistry. A significant part of most of Sigmund Freud’s theories, the concept of anxiety has been debated and discussed over many years in the psychiatric literature. While Freud’s theories focused on the “mind” and the unconscious, another way to look at anxiety is with Hans Selye’s concept of “fight or flight” in which the sympathetic nervous system is activated as a response to stress. As you explore the concept of anxiety, you will notice that no two cases of anxiety are the same.

This week, you will explore evidence-based treatment methods for clients with anxiety disorders. You will complete a midterm exam and analyze reimbursement rates for treatment of mental health disorders.

Learning Resources

Required Readings

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

Chapter 9, “Anxiety Disorders” (pp. 387–417)

Chapter 11, “Trauma- and Stressor-Related Disorders” (pp. 437–451)

Gabbard, G. O. (2014). Gabbard’s treatment of psychiatric disorders (5th ed.). Washington, DC: American Psychiatric Publications.

Chapter 16, “Panic Disorder”

Chapter 18, “Social Anxiety Disorder (Social Phobia)”

Chapter 19, “Generalized Anxiety Disorder”

Chapter 20, “Specific Phobia”

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

“Anxiety Disorders”

“Trauma- and Stressor-Related Disorders”

Stahl, S. M. (2014). Prescriber’s Guide: Stahl’s Essential Psychopharmacology (5th ed.). New York, NY: Cambridge University Press.

Note: All Stahl resources can be accessed through the Walden Library using the link below. This link will take you to a login page for the Walden Library. Once you log in to the library, the Stahl website will appear. http://ezp.waldenulibrary.org/login?url=http://stahlonline.cambridge.org/

To access information on specific medications, click on The Prescriber’s Guide, 5th Ed. tab on the Stahl Online website and select the appropriate medication.

Anxiety		Generalized anxiety disorder	Panic disorder
alprazolam amitriptyline amoxapine buspirone chlordiazepoxide citalopram clomipramine clonazepam clonidine clorazepate cyamemazine desipramine diazepam dothiepin doxepin duloxetine escitalopram fluoxetine fluvoxamine gabapentin (adjunct) hydroxyzine imipramine isocarboxazid lofepramine	loflazepate lorazepam maprotiline mianserin mirtazapine moclobemide nefazodone nortriptyline oxazepam paroxetine phenelzine pregabalin reboxetine sertraline tiagabine tianeptine tranylcypromine trazodone trifluoperazine trimipramine venlafaxine vilazodone	alprazolam citalopram desvenlafaxine duloxetine escitalopram fluoxetine fluvoxamine mirtazapine paroxetine pregabalin sertraline tiagabine (adjunct) venlafaxine	alprazolam citalopram clonazepam desvenlafaxine escitalopram fluoxetine fluvoxamine isocarboxazid lorazepam mirtazapine nefazodone paroxetine phenelzine pregabalin reboxetine sertraline tranylcypromine venlafaxine

Posttraumatic stress disorder	Reversal of benzodiazepine effects	Social anxiety disorder
citalopram clonidine desvenlafaxine escitalopram fluoxetine fluvoxamine mirtazapine nefazodone paroxetine prazosin (nightmares) propranolol (prophylactic) sertraline venlafaxine	flumazenil	citalopram clonidine desvenlafaxine escitalopram fluoxetine fluvoxamine isocarboxazid moclobemide paroxetine phenelzine pregabalin sertraline tranylcypromine venlafaxine

Maples-Keller, J. L., Price, M., Rauch, S., Gerardi, M., & Rothbaum, B. O. (2017). Investigating relationships between PTSD symptom clusters within virtual reality exposure therapy for OEF/OIF veterans. Behavior Therapy, 48(2), 147–155. doi:10.1016/j.beth.2016.02.011

Hayes, J. P., Logue, M. W., Reagan, A., Salat, D., Wolf, E. J., Sadeh, N., & … Miller, M. W. (2017). COMT Val158Met polymorphism moderates the association between PTSD symptom severity and hippocampal volume. Journal of Psychiatry & Neuroscience: JPN, 42(2), 95–102. doi:10.1503/jpn.150339

Quinn, B. L., & Peters, A. (2017). Strategies to reduce nursing student test anxiety: A literature review. Journal of Nursing Education, 56(3), 145–151. doi:10.3928/01484834-20170222-05

Document: Reimbursement Rate Template (Word document)

Required Media

Wolpe, J. (Producer). (n.d.). Joseph Wolpe on systematic desensitization [Video file]. Mill Valley, CA: Psychotherapy.net.

Optional Resources

Acosta, M. C., Possemato, K., Maisto, S. A., Marsch, L. A., Barrie, K., Lantinga, L., . . . Rosenblum, A. (2017). Web-delivered CBT reduces heavy drinking in OEF-OIF veterans in primary care with symptomatic substance use and PTSD. Behavior Therapy, 48(2), 262-–276. doi:10.1016/j.beth.2016.09.001

Substance Abuse and Mental Health Services Association (SAMHSA). (2014). TIP 57: Trauma-informed care in behavioral health services. Retrieved from: http://store.samhsa.gov/product/TIP-57-Trauma-Informed-Care-in-Behavioral-Health-Services/SMA14-4816

Note: This document is available as a free download.

Discussion: Treatment of Anxiety Disorders

Anxiety disorders are common in both primary care and psychiatric practice. Clients with anxiety disorders including generalized anxiety disorders, agoraphobia, and other specific phobias will present to the PMHNP’s office with a significant level of distress. Successful recognition and treatment of anxiety disorders includes an accurate diagnostic assessment with a treatment plan that includes a combination of psychopharmacology and psychotherapy. Although psychoanalytic theories are based on the concept of anxiety, the more recent standard of care is with the cognitive-behavioral therapies.

In this Discussion, you will analyze evidence-based treatment plans for clients with anxiety disorders.

Learning Objectives

Students will:

Analyze differences between adjustments disorders and anxiety disorders
Analyze diagnostic criteria for anxiety disorders
Analyze evidence-based psychotherapy and psychopharmacologic treatment for anxiety disorders
Compare differential diagnostic features of anxiety disorders

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

To prepare for this Discussion:

By Day 5 of Week 5, your Instructor will have assigned you an anxiety disorder, which will be your focus for your initial post for this Discussion.
Review the Learning Resources.

By Day 3

Post:

Explain the difference between an adjustment disorder and anxiety disorder. Provide examples to illustrate your rationale.
Explain the diagnostic criteria for your assigned anxiety disorder.
Explain the evidenced-based psychotherapy and psychopharmacologic treatment for your assigned anxiety disorder.
Support your rationale with references to the Learning Resources or other academic resource.

By Day 6

Submission and Grading Information

Grading Criteria

To access your rubric:

Week 6 Discussion Rubric

Post by Day 3 and Respond by Day 6

To participate in this Discussion:

Week 6 Discussion

Assignment 1: Midterm Exam

This exam is designed to assess how well you have synthesized the information from all your PMHNP courses. It draws upon the material from all the textbooks from NURS 6630, NURS 6640, NURS 6670, NURS 6660, and NURS 6670. It is very similar to what you will experience in your certification exam.

Learning Objectives

Students will:

Assess knowledge of adult and older adult psychotherapy concepts and principles

This exam will cover the following topics:

Psychiatric Assessment of the Adult and Older Adult
Depressive Disorders
Personality Disorders
Substance-Related and Addictive Disorders
Bipolar Disorders
Anxiety Disorders, PTSD, & Related Disorders

By Day 7

Complete the Midterm Exam. Prior to starting the exam, you should review all of your materials. There is a 2-hour time limit to complete this 75-question exam. You may only attempt this exam once.

This exam is a test of your knowledge in preparation for your certification exam. No outside resources including books, notes, websites, or any other type of resource are to be used to complete this exam. You are expected to comply with Walden University’s Code of Conduct.

By Day 7

Submission and Grading Information

Submit Your Exam by Day 7

To submit your Exam:

Week 6 Midterm Exam

Assignment 2: Week 6 Practicum Journal: Reimbursement Rates

Reimbursement rates and medical coding can be almost as complicated as treating some mental illnesses. As a PMHNP, you will be faced with varying rates that may be different than other health care providers you may work with.

In this Practicum Journal Assignment, you will analyze reimbursement rates for mental health treatments you will likely use in your practice and compare those rates to other provider rates.

Learning Objectives

Students will:

Analyze reimbursement rates for mental health treatments

To prepare for this Practicum Journal:

Research reimbursement rates for various treatment modalities.
Compare NP rates to other provider rates.

For this Practicum Journal:

Complete the Reimbursement Rate Template in your Learning Resources using the five types of services you are likely to use in your practice.

By Day 7 of Week 7

Submit your Assignment.

Making Connections

This week, you explored evidence-based treatment methods for clients with anxiety disorders. You completed a midterm exam and analyzed reimbursement rates for treatment of mental health disorders.

Next week, you will, once again, become “captain of the ship” as you take full responsibility for a client with an obsessive-compulsive disorder by recommending psychopharmacologic treatment and psychotherapy, identifying medical management needs and community support, and recommending follow-up plans.

To go to the next week:

Week 7

Week 7: Obsessive-Compulsive Disorders

It is getting embarrassing to go to my hair stylist. She always comments on the bald patches on my head. They keep getting bigger as I continue to pull out one strand of hair at a time. I even do it in my sleep. I can’t help myself. It all started when I was in high school when I would pull just from the back. Now I have to wear my hair a specific way so the bald patches don’t show. I don’t even color my hair anymore. I don’t want anyone to notice me.

Michelle, age 27

Although actual statistics vary, obsessive-compulsive disorder impacts approximately 1.2% of the population in the United States (APA, 2013, p. 239). It is characterized by the presence of obsessive thoughts, which are manifested as persistent thoughts, images, or even “urges.” The only way that the individual can disperse the anxiety of these persistent thoughts/images or urges is to perform a behavior (the compulsion). The compulsion could be checking things, counting, reciting a silent prayer, or repeating a number of phrases. The disorder becomes so pervasive that the person can spend a significant amount of time each day attending to the compulsion in order to relieve the anxiety caused by the obsession.

This week, you will, once again, become “captain of the ship” as you take full responsibility for a client with an obsessive-compulsive disorder by recommending psychopharmacologic treatment and psychotherapy, identifying medical management needs and community support, and recommending follow-up plans. You also will evaluate your progress in completing your certification plan.

Learning Resources

Required Readings

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

Standard 14 “Professional Practice Evaluation” (pages 80-81)

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

Chapter 10, “Obsessive-Compulsive and Related Disorders” (pp. 418–436)

Gabbard, G. O. (2014). Gabbard’s treatment of psychiatric disorders (5th ed.). Washington, DC: American Psychiatric Publications.

Chapter 21, “Obsessive-Compulsive Disorder”

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

“Obsessive-Compulsive and Related Disorders”

Stahl, S. M. (2014). Prescriber’s Guide: Stahl’s Essential Psychopharmacology (5th ed.). New York, NY: Cambridge University Press.

Note: All Stahl resources can be accessed through the Walden Library using the link below. This link will take you to a login page for the Walden Library. Once you log in to the library, the Stahl website will appear. http://ezp.waldenulibrary.org/login?url=http://stahlonline.cambridge.org/

To access information on specific medications, click on The Prescriber’s Guide, 5th Ed. tab on the Stahl Online website and select the appropriate medication.

Obsessive-compulsive disorder
citalopram clomipramine escitalopram fluoxetine fluvoxamine paroxetine sertraline venlafaxine vilazodone

Thompson-Hollands, J., Edson, A., Tompson, M. C., & Comer, J. S. (2014). Family involvement in the psychological treatment of obsessive-compulsive disorder: A meta-analysis. Journal of Family Psychology, 28(3), 287–298. doi:10.1037/a0036709

Required Media

Obsessive-Compulsive Disorder. (2015). [Video file] Naples, FL: National Educational Video, Inc.

Note: The approximate length of this media piece is 20 minutes.

Optional Resources

Himle, J. A., Chatters, L. M., Taylor, R. J., & Nguyen, A. (2013). The relationship between obsessive-compulsive disorder and religious faith: Clinical characteristics and implications for treatment. Spirituality in Clinical Practice, 1(S), 53–70. doi:10.1037/2326-4500.1.S.53

Wheaton, M. G., Rosenfield, D., Foa, E. B., & Simpson, H. B. (2015). Augmenting serotonin reuptake inhibitors in obsessive–compulsive disorder: What moderates improvement? Journal of Consulting and Clinical Psychology, 83(5), 926–937. doi:10.1037/ccp0000025

Assignment 1: “Captain of the Ship” Project – Obsessive-Compulsive Disorders

In earlier weeks, you were introduced to the concept of the “captain of the ship.” In this Assignment, you become the “captain of the ship” as you provide treatment recommendations and identify medical management, community support resources, and follow-up plans for a client with an obsessive-compulsive disorder.

Students will:

Recommend psychopharmacologic treatments based on therapeutic endpoints for clients with obsessive-compulsive disorders
Recommend psychotherapy based on therapeutic endpoints for clients with obsessive-compulsive disorders
Identify medical management needs for clients with obsessive-compulsive disorders
Identify community support resources for clients with obsessive-compulsive disorders
Recommend follow-up plans for clients with depression disorders

To prepare for this Assignment:

Select an adult or older adult client with an obsessive-compulsive disorder you have seen in your practicum.

In 3–4 pages, write a treatment plan for your client in which you do the following:

Describe the HPI and clinical impression for the client.
Recommend psychopharmacologic treatments and describe specific and therapeutic endpoints for your psychopharmacologic agent. (This should relate to HPI and clinical impression.)
Recommend psychotherapy choices (individual, family, and group) and specific therapeutic endpoints for your choices.
Identify medical management needs, including primary care needs, specific to this client.
Identify community support resources (housing, socioeconomic needs, etc.) and community agencies that are available to assist the client.
Recommend a plan for follow-up intensity and frequency and collaboration with other providers.

By Day 7

Submit your Assignment.

Submission and Grading Information

To submit your completed Assignment for review and grading, do the following:

Please save your Assignment using the naming convention “WK7Assgn1+last name+first initial.(extension)” as the name.
Click the Week 7 Assignment 1 Rubric to review the Grading Criteria for the Assignment.
Click the Week 7 Assignment 1 link. You will also be able to “View Rubric” for grading criteria from this area.
Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK7Assgn1+last name+first initial.(extension)” and click Open.
If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
Click on the Submit button to complete your submission.

Grading Criteria

To access your rubric:

Week 7 Assignment 1 Rubric

Check Your Assignment Draft for Authenticity

To check your Assignment draft for authenticity:

Submit your Week 7 Assignment 1 draft and review the originality report.

Submit Your Assignment by Day 7

To submit your Assignment:

Week 7 Assignment 1

Assignment 2: Week 7 Practicum Journal: Checkpoint for Certification Plan

Students will:

Evaluate progress on certification plans

Report your progress on the Certification Plan completed in Week 1 and submitted in Week 4.

What have you done to prepare for your certification?
Have you completed the scheduled tasks assigned on your timeline? If not, what are your plans to stay on schedule?

By Day 7

Submit your Assignment.

Submission and Grading Information

To submit your completed Assignment for review and grading, do the following:

Please save your Assignment using the naming convention “WK7Assgn2+last name+first initial.(extension)” as the name.
Click the Week 7 Assignment 2 Rubric to review the Grading Criteria for the Assignment.
Click the Week 7 Assignment 2 link. You will also be able to “View Rubric” for grading criteria from this area.
Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK7Assgn2+last name+first initial.(extension)” and click Open.
If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
Click on the Submit button to complete your submission.

Grading Criteria

To access your rubric:

Week 7 Assignment 2 Rubric

Check Your Assignment Draft for Authenticity

To check your Assignment draft for authenticity:

Submit your Week 7 Assignment 2 draft and review the originality report.

Submit Your Assignment by Day 7

To submit your Assignment:

Week 7 Assignment 2

Assignment 3: Week 5 Practicum: Decision Tree

By Day 7

Submit your Assignment. Refer to Week 5 for additional guidance.

Submission and Grading Information

To submit your completed Assignment for review and grading, do the following:

Please save your Assignment using the naming convention “WK7Assgn3+last name+first initial.(extension)” as the name.
Click the Week 7 Assignment 3 Rubric to review the Grading Criteria for the Assignment.
Click the Week 7 Assignment 3 link. You will also be able to “View Rubric” for grading criteria from this area.
Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK7Assgn3+last name+first initial.(extension)” and click Open.
If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
Click on the Submit button to complete your submission.

Grading Criteria

To access your rubric:

Week 7 Assignment 3 Rubric

Check Your Assignment Draft for Authenticity

To check your Assignment draft for authenticity:

Submit your Week 7 Assignment 3 draft and review the originality report.

Submit Your Assignment by Day 7

To submit your Assignment:

Week 7 Assignment 3

Assignment 4: Week 6 Practicum Journal – Reimbursement Rates

By Day 7

Submit your Assignment. Refer to Week 6 for additional guidance.

Submission and Grading Information

To submit your completed Assignment for review and grading, do the following:

Please save your Assignment using the naming convention “WK7Assgn4+last name+first initial.(extension)” as the name.
Click the Week 7 Assignment 4 Rubric to review the Grading Criteria for the Assignment.
Click the Week 7 Assignment 4 link. You will also be able to “View Rubric” for grading criteria from this area.
Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK7Assgn4+last name+first initial.(extension)” and click Open.
If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
Click on the Submit button to complete your submission.

Grading Criteria

To access your rubric:

Week 7 Assignment 4 Rubric

Check Your Assignment Draft for Authenticity

To check your Assignment draft for authenticity:

Submit your Week 7 Assignment 4 draft and review the originality report.

Submit Your Assignment by Day 7

To submit your Assignment:

Week 7 Assignment 4

Practicum Reminder

Making Connections

This week, you, once again, became “captain of the ship” as you took full responsibility for a client with an obsessive-compulsive disorder by recommending psychopharmacologic treatment and psychotherapy, identifying medical management needs and community support, and recommending follow-up plans.

Next week, you will explore evidence-based psychotherapy and psychopharmacologic treatment for neurocognitive disorders. You will complete your final Decision Tree as you rationalize and justify your diagnosis and treatment of a patient with a mental health disorder.

To go to the next week:

Week 8

Week 8: Neurocognitive Disorders

My mother used to be a teacher—an elementary school teacher. We were all so proud of her when she completed her PhD when she was 50. Now she is 75 and has begun to have times when she does not know what day it is. We found her wandering around the neighborhood because she could not find her way home. Once, she forgot where she parked her car at the grocery store. She thought someone had stolen it. The manager was so kind to drive her around the parking lot until she recognized her car. We are afraid she might get hurt or lost.

Gary, age 50, son of Dorothy, age 75

The neurocognitive disorders are unique among the other psychiatric disorders you have studied in that the diseases that are to blame for the neurocognitive manifestations that have been extensively studied. Additionally, these conditions are also acquired and represent a decline from a previous level of functioning. The neurocognitive disorders present a diagnostic challenge to the PMHNP in that many of the signs and symptoms overlap.

This week, you will explore evidence-based psychotherapy and psychopharmacologic treatment for neurocognitive disorders. You will complete your final Decision Tree as you rationalize and justify your diagnosis and treatment of a patient with a mental health disorder.

Learning Resources

Required Readings

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

Chapter 21, “Neurocognitive Disorders” (pp. 694–741)

Gabbard, G. O. (2014). Gabbard’s treatment of psychiatric disorders (5th ed.). Washington, DC: American Psychiatric Publications.

Chapter 63, “Delirium”

Chapter 64, “Neurocognitive Disorder Due to Alzheimer’s Disease”

Chapter 65, “Frontotemporal Neurocognitive Disorder”

Chapter 66, “Vascular Neurocognitive Disorder”

Chapter 67, “Neurocognitive Disorder Due to Parkinson’s Disease”

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

“Neurocognitive Disorders”

Stahl, S. M. (2014). Prescriber’s Guide: Stahl’s Essential Psychopharmacology (5th ed.). New York, NY: Cambridge University Press.

Note: All Stahl resources can be accessed through the Walden Library using the link below. This link will take you to a login page for the Walden Library. Once you log in to the library, the Stahl website will appear. http://ezp.waldenulibrary.org/login?url=http://stahlonline.cambridge.org/

To access information on specific medications, click on The Prescriber’s Guide, 5th Ed. tab on the Stahl Online website and select the appropriate medication.

Alzheimer disease Delirium Dementia Parkinson’s disease dementia

caprylidene
donepezil
galantamine
memantine
rivastigmine haloperidol (adjunct)
lorazepam (adjunct) donepezil
galantamine
memantine
rivastigmine rivastigmine
pimavanserin

Note: For more information on Pimavanserin, see:

Acadia Pharmaceuticals. (2017). Transform the treatment of Parkinson’s disease psychosis with NUPLAZID. Retrieved from https://www.nuplazidhcp.com/?gclid=CIHS5auvwtMCFQkaaQodrU0FGQ

U.S. Food and Drug Administration. (n. d.). Highlights of prescribing information: Nuplazid. Retrieved from https://www.accessdata.fda.gov/drugsatfda_docs/label/2016/207318lbl.pdf

Hopkins, S. A., & Chan, D. (2016). Key emerging issues in frontotemporal dementia. Journal of Neurology, 263(2), 407–413. doi:10.1007/s00415-015-7880-7

Walker, Z., Possin, K. L., Boeve, B. F., & Aarsland, D. (2015). Lewy body dementias. The Lancet, 386(10004), 1683-1697.

Required Media

Laureate Education (Producer). (2017a). A gentleman with a neurocognitive disorder [Multimedia file]. Baltimore, MD: Author.

Bolin, P. (2015, December 31). Neurocognitive disorders – CRASH! Medical review series [Video file]. Retrieved from https://www.youtube.com/watch?v=bQXOPITY9XM

Note: The approximate length of this media piece is 57 minutes.

Optional Resources

Kota, L. N., Bharath, S., Purushottam, M., Moily, N. S., Sivakumar, P. T., Varghese, M., . . . Jain, S. (2015). Reduced telomere length in neurodegenerative disorders may suggest shared biology. The Journal of Neuropsychiatry and Clinical Neurosciences, 27(2), e92–e96. doi:10.1176/appi.neuropsych.13100240

Lepkowsky, C. M. (2016). Neurocognitive disorder with Lewy bodies: Evidence-based diagnosis and treatment. Practice Innovations, 1(4), 234–242. doi:10.1037/pri0000031

Oltra-Cucarella, J., Pérez-Elvira, R., Espert, R., & Sohn McCormick, A. (2016). Are cognitive interventions effective in Alzheimer’s disease? A controlled meta-analysis of the effects of bias. Neuropsychology, 30(5), 631–652. doi:10.1037/neu0000283

Discussion: Treatment of Neurocognitive Disorders

Neurocognitive disorders (NCD) such as delirium, dementia, and amnestic disorders are more prevalent in older adults. As the population ages and as life expectancy in the United States continues to increase, the incidence of these disorders will continue to increase. Cognitive functioning such as memory, language, orientation, judgment, and problem solving are affected in clients with NCDs. Caring for someone with a neurocognitive disorder is not only challenging for the clinician, but also stressful for the family. The PMHNP needs to consider not only the client but also the “family as client.” Collaboration with primary care providers and specialty providers is essential. Anticipatory guidance also becomes extremely important.

In this Discussion, you will integrate several sources of knowledge specific to NCDs as you discuss evidenced-based therapies used to treat these disorders.

Learning Objectives

Students will:

Analyze diagnostic criteria for neurocognitive disorders

Analyze evidence-based psychotherapy and psychopharmacologic treatment for neurocognitive disorders

Evaluate benefits and risks of neurocognitive therapies

Compare differential diagnostic features of neurocognitive disorders

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

To prepare for this Discussion:

By Day 5 of Week 7, your Instructor will have assigned you a neurocognitive disorder, which will be the focus for your initial post for this Discussion.

Review the Learning Resources.

By Day 3

Post:

Explain the diagnostic criteria for your assigned neurocognitive disorder.

Explain the evidenced-based psychotherapy and psychopharmacologic treatment for your assigned neurocognitive disorder.

Identify the risks of different types of therapy and explain how the benefits of the therapy that might be achieved might outweigh the risks.

Support your rationale with references to the Learning Resources or other academic resource.

By Day 6

Respond to at least two of your colleagues by comparing the differential diagnostic features of the disorder you were assigned to the diagnostic features of the disorder your colleagues were assigned.

Submission and Grading Information

Grading Criteria

To access your rubric:

Week 8 Discussion Rubric

Post by Day 3 and Respond by Day 6

To participate in this Discussion:

Week 8 Discussion

Assignment: Practicum: Decision Tree

For this Assignment, as you examine the client case study in this week’s Learning Resources, consider how you might assess and treat adult and older adult clients presenting symptoms of a mental health disorder.

The Assignment:

Learning Objectives

Students will:

Evaluate clients for treatment of mental health disorders

Analyze decisions made throughout diagnosis and treatment of clients with mental health disorders

Examine Case 3: You will be asked to make three decisions concerning the diagnosis and treatment for this client. Be sure to consider co-morbid physical as well as mental factors that might impact the client’s diagnosis and treatment.

At each Decision Point, stop to complete the following:

Decision #1: Differential Diagnosis

Which Decision did you select?

Why did you select this Decision? Support your response with evidence and references to the Learning Resources.

What were you hoping to achieve by making this Decision? Support your response with evidence and references to the Learning Resources.

Explain any difference between what you expected to achieve with Decision #1 and the results of the Decision. Why were they different?

Decision #2: Treatment Plan for Psychotherapy

Why did you select this Decision? Support your response with evidence and references to the Learning Resources.

What were you hoping to achieve by making this Decision? Support your response with evidence and references to the Learning Resources.

Explain any difference between what you expected to achieve with Decision #2 and the results of the Decision. Why were they different?

Decision #3: Treatment Plan for Psychopharmacology

Why did you select this Decision? Support your response with evidence and references to the Learning Resources.

What were you hoping to achieve by making this Decision? Support your response with evidence and references to the Learning Resources.

Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different?

Also include how ethical considerations might impact your treatment plan and communication with clients and their family.

Note: Support your rationale with a minimum of three academic resources. While you may use the course text to support your rationale, it will not count toward the resource requirement.

By Day 7 of Week 10

Submit your Assignment.

Making Connections

This week, you explored evidence-based psychotherapy and psychopharmacologic treatment for neurocognitive disorders. You completed your final Decision Tree as you rationalized and justified your diagnosis and treatment of a patient with a mental health disorder.

Next week, you will explore a wide variety of disorders along the schizophrenia spectrum as you become “captain of the ship” once again. You also will analyze issues involved with state practice agreements.

To go to the next week:

Week 9

Week 9: Schizophrenia Spectrum and Other Psychotic Disorders

I am being followed. They are even in my home. I am crouched in the corner of my apartment, but they know I am here and are just waiting to get me. I have a secret and they are trying to get it. The secret is hidden in my brain and they are going to open my skull to get it out. I have to block them from getting into my brain. Hiding in the closet, behind all the clothes, they will not see me….

Jamie, age 26

There are many disorders that result in the development of “positive” symptoms, such as hallucinations and delusions, but not all of these conditions represent schizophrenia. When treating schizophrenia spectrum and other psychotic disorders, emphasis should be placed not only on treating the positive symptoms but the negative and residual symptoms as well.

This week, you will explore a wide variety of disorders along the schizophrenia spectrum as you become “captain of the ship” once again. You also will analyze issues involved with state practice agreements.

Learning Resources

Required Readings

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

Standard 15 “Resource Utilization” (pages 82-83)

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

Chapter 7, “Schizophrenia Spectrum and other Psychotic Disorders” (pp. 300–346)

Gabbard, G. O. (2014). Gabbard’s treatment of psychiatric disorders (5th ed.). Washington, DC: American Psychiatric Publications.

Chapter 8, “Early-Stage Schizophrenia”

Chapter 9, “Toward a Dimensional Understanding of Psychosis and Its Treatment”

Chapter 10, “Psychosocial Treatments for Chronic Psychosis”

Chapter 11, “Pharmacological Treatment of Psychosis”

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

“Schizophrenia Spectrum and other Psychotic Disorders”

Stahl, S. M. (2014). Prescriber’s Guide: Stahl’s Essential Psychopharmacology (5th ed.). New York, NY: Cambridge University Press.

Note: All Stahl resources can be accessed through the Walden Library using the link below. This link will take you to a login page for the Walden Library. Once you log in to the library, the Stahl website will appear.

To access information on specific medications, click on The Prescriber’s Guide, 5^th Ed. tab on the Stahl Online website and select the appropriate medication.

Psychosis Schizoaffective disorder

alprazolam (adjunct)
amisulpride
aripiprazole
asenapine
blonanserin
carbamazepine (adjunct)
chlorpromazine
clonazepam (adjunct)
clozapine
cyamemazine
flupenthixol
fluphenazine
haloperidol
iloperidone
lamotrigine (adjunct)
lorazepam (adjunct)
loxapine
lurasidone mesoridazine
molindone
olanzapine
paliperidone
perospirone
perphenazine
pimozide
pipothiazine
quetiapine
risperidone
sertindole
sulpiride
thioridazine
thiothixene
trifluoperazine
valproate (divalproex) (adjunct)
ziprasidone
zotepine
zuclopenthixol amisulpride
aripiprazole
asenapine
carbamazepine (adjunct)
chlorpromazine
clozapine
cyamemazine
flupenthixol
haloperidol
iloperidone
lamotrigine (adjunct)
l-methylfolate (adjunct)
loxapine
lurasidone
mesoridazine
molindone
olanzapine
paliperidone perospirone
perphenazine
pipothiazine
quetiapine
risperidone
sertindole
sulpiride
thioridazine
thiothixene
trifluoperazine
valproate (divalproex) (adjunct)
ziprasidone
zotepine
zuclopenthixol

Schizophrenia Cataplexy syndrome Catatonia Extrapyramidal side effects

amisulpride
aripiprazole
asenapine
carbamazepine (adjunct)
chlorpromazine
clozapine
cyamemazine
flupenthixol
haloperidol
iloperidone
lamotrigine (adjunct)
l-methylfolate (adjunct)
loxapine
lurasidone
mesoridazine
molindone
olanzapine
paliperidone
perospirone perphenazine
pipothiazine
quetiapine
risperidone
sertindole
sulpiride
thioridazine
thiothixene
trifluoperazine
valproate (divalproex) (adjunct)
ziprasidone
zotepine
zuclopenthixol
Seasonal affective disorder
bupropion
Sedation-induction
hydroxyzine
midazolam clomipramine
imipramine
sodium oxybate alprazolam
chlordiazepoxide
clonazepam
clorazepate
diazepam
estazolam
flunitrazepam
flurazepam
loflazepate
lorazepam
midazolam
oxazepam
quazepam
temazepam
triazolam benztropine
diphenhydramine
trihexyphenidyl

Ferreira, C. D., de Souza, M. G. D., Fernández-Calvo, B., Machado-de-Sousa, J. P., Cecilio Hallak, J. E., & Torro-Alves, N. (2016). Neurocognitive functions in schizophrenia: A systematic review of the effects of typical and atypical antipsychotic drugs. Psychology & Neuroscience, 9(1), 12–31. doi:10.1037/pne0000045

Granholm, E., Holden, J., Link, P. C., & McQuaid, J. R. (2014). Randomized clinical trial of cognitive behavioral social skills training for schizophrenia: Improvement in functioning and experiential negative symptoms. Journal of Consulting and Clinical Psychology, 82(6), 1173–1185. doi:10.1037/a0037098

Required Media

Murphy, L. (2011, July 21). Types of schizophrenia – A day in the life (scary) [Video file]. Retrieved from https://www.youtube.com/watch?v=LWYwckFrksg

Assignment 1: “Captain of the Ship” Project – Schizophrenia Spectrum and Other Psychotic Disorders

In earlier weeks, you were introduced to the concept of the “captain of the ship.” In this Assignment, you become the “captain of the ship” once again as you provide treatment recommendations and identify medical management, community support resources, and follow-up plans for a client with a schizophrenia spectrum/other psychotic disorder.

Learning Objectives

Students will:

Recommend psychopharmacologic treatments based on therapeutic endpoints for clients with schizophrenia spectrum and other psychotic disorders

Recommend psychotherapy based on therapeutic endpoints for clients with schizophrenia spectrum and other psychotic disorders

Identify medical management needs for clients with schizophrenia spectrum and other psychotic disorders

Identify community support resources for clients with schizophrenia spectrum and other psychotic disorders

Recommend follow-up plans for clients with schizophrenia spectrum and other psychotic disorders

To prepare for this Assignment:

Select an adult or older adult client with a schizophrenia spectrum and other psychotic disorder you have seen in your practicum.

In 3–4 pages, write a treatment plan for your client in which you do the following:

Describe the HPI and clinical impression for the client.

Recommend psychopharmacologic treatments and describe specific and therapeutic endpoints for your psychopharmacologic agent. (This should relate to HPI and clinical impression.)

Recommend psychotherapy choices (individual, family, and group) and specific therapeutic endpoints for your choices.

Identify medical management needs, including primary care needs, specific to this client.

Identify community support resources (housing, socioeconomic needs, etc.) and community agencies that are available to assist the client.

Recommend a plan for follow-up intensity and frequency and collaboration with other providers.

By Day 7

Submit your Assignment.

Submission and Grading Information

To submit your completed Assignment for review and grading, do the following:

Please save your Assignment using the naming convention “WK9Assgn1+last name+first initial.(extension)” as the name.

Click the Week 9 Assignment 1 Rubric to review the Grading Criteria for the Assignment.

Click the Week 9 Assignment 1 link. You will also be able to “View Rubric” for grading criteria from this area.

Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK9Assgn1+last name+first initial.(extension)” and click Open.

If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.

Click on the Submit button to complete your submission.

Grading Criteria

To access your rubric:

Week 9 Assignment 1 Rubric

Check Your Assignment Draft for Authenticity

To check your Assignment draft for authenticity:

Submit your Week 9 Assignment 1 draft and review the originality report.

Submit Your Assignment by Day 7

To submit your Assignment:

Week 9 Assignment 1

Assignment 2: Week 9 Practicum Journal: State Practice Agreements

In many states, nurse practitioners are completely autonomous professionals. In other states, however, NPs have a wide range of “restrictive” practice ranging from requirements for a “supervising” physician to requirements for a “collaborative” agreement with a physician.

In this Practicum Journal Assignment, you will examine the requirements of your own state in order to prepare yourself for the realities of practice upon graduation.

Learning Objectives

Students will:

Analyze state PMHNP practice agreements

Analyze physician collaboration issues

Analyze barriers to PMHNP independent practice

Create plans for addressing state PMHNP practice issues

**Assigned in Week 9 and submitted in Week 10

To Prepare for this Practicum Journal:

Review practice agreements in your state.

Identify at least two physician collaboration issues in your state.

For this Practicum Journal:

Briefly describe the practice agreements for PMHNPs in your state.

Explain the two physician collaboration issues that you identified.

Explain what you think are the barriers to PMHNPs practicing independently in your state.

Outline a plan for how you might address PMHNP practice issues in your state.

By Day 7 of Week 10

Submit your Practicum Journal.

Making Connections

This week, you explored a wide variety of disorders along the schizophrenia spectrum as you became “captain of the ship” once again. You also analyzed issues involved with state practice agreements.

Next week, you will analyze the diagnostic criteria and treatment options of insomnia, hypersomnolence, narcolepsy, sleep apnea, non-rapid eye movement, nightmare disorder, sleep behavior disorder, and other DSM-5 sleep and parasomnic disorders.

To go to the next week:

Week 10

Alzheimer disease	Delirium	Dementia	Parkinson’s disease dementia
caprylidene donepezil galantamine memantine rivastigmine	haloperidol (adjunct) lorazepam (adjunct)	donepezil galantamine memantine rivastigmine	rivastigmine pimavanserin

Psychosis	Schizoaffective disorder
alprazolam (adjunct) amisulpride aripiprazole asenapine blonanserin carbamazepine (adjunct) chlorpromazine clonazepam (adjunct) clozapine cyamemazine flupenthixol fluphenazine haloperidol iloperidone lamotrigine (adjunct) lorazepam (adjunct) loxapine lurasidone	mesoridazine molindone olanzapine paliperidone perospirone perphenazine pimozide pipothiazine quetiapine risperidone sertindole sulpiride thioridazine thiothixene trifluoperazine valproate (divalproex) (adjunct) ziprasidone zotepine zuclopenthixol	amisulpride aripiprazole asenapine carbamazepine (adjunct) chlorpromazine clozapine cyamemazine flupenthixol haloperidol iloperidone lamotrigine (adjunct) l-methylfolate (adjunct) loxapine lurasidone mesoridazine molindone olanzapine paliperidone	perospirone perphenazine pipothiazine quetiapine risperidone sertindole sulpiride thioridazine thiothixene trifluoperazine valproate (divalproex) (adjunct) ziprasidone zotepine zuclopenthixol

Schizophrenia	Cataplexy syndrome	Catatonia	Extrapyramidal side effects
amisulpride aripiprazole asenapine carbamazepine (adjunct) chlorpromazine clozapine cyamemazine flupenthixol haloperidol iloperidone lamotrigine (adjunct) l-methylfolate (adjunct) loxapine lurasidone mesoridazine molindone olanzapine paliperidone perospirone	perphenazine pipothiazine quetiapine risperidone sertindole sulpiride thioridazine thiothixene trifluoperazine valproate (divalproex) (adjunct) ziprasidone zotepine zuclopenthixol Seasonal affective disorder bupropion Sedation-induction hydroxyzine midazolam	clomipramine imipramine sodium oxybate	alprazolam chlordiazepoxide clonazepam clorazepate diazepam estazolam flunitrazepam flurazepam loflazepate lorazepam midazolam oxazepam quazepam temazepam triazolam	benztropine diphenhydramine trihexyphenidyl

Week 10: Sleep/Wake Disorders and Parasomnias

Tick, tock, and here we go again. I have been in bed trying to go to sleep for three hours now. I have not gotten more than a few hours of sleep a night in months. My work is being affected and so is my relationship with my wife. She’s over there sleeping like a baby and cannot understand why I can’t sleep. ‘Just close your eyes and relax’, she says. When I close my eyes, all I see is all the work I have to do.

Riley, age 34

Sleep is essential for a healthy mind and body, and lack of quality sleep can cause distress during the daytime. Sleep disorders can involve difficulties with quality, timing, and amount of sleep and frequently accompany other disorders, especially depression, anxiety, and PTSD. Obtaining a good sleep history is essential to diagnosing sleep disorders, prescribing a treatment plan, and monitoring the plan’s effectiveness. Understanding and managing sleep problems frequently leads to improvement in other mental health disorders that the patient is experiencing.

This week, you will analyze the diagnostic criteria and treatment options of insomnia, hypersomnolence, narcolepsy, sleep apnea, non-rapid eye movement, nightmare disorder, sleep behavior disorder, and other DSM-5 sleep and parasomnic disorders.

Learning Resources

Required Readings

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

Chapter 13, “Psychosomatic Medicine” (pp. 465–503)

Chapter 16, “Normal Sleep and Sleep-Wake Disorders” (pp. 533–563)

Note: This is review from the Learning Resource in Week 3.

Gabbard, G. O. (2014). Gabbard’s treatment of psychiatric disorders (5th ed.). Washington, DC: American Psychiatric Publications.

Chapter 36, “Sleep-Wake Disorders”

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

“Sleep-Wake Disorders”

Stahl, S. M. (2014). Prescriber’s Guide: Stahl’s Essential Psychopharmacology (5th ed.). New York, NY: Cambridge University Press.

Note: All Stahl resources can be accessed through the Walden Library using the link below. This link will take you to a login page for the Walden Library. Once you log in to the library, the Stahl website will appear.

To access information on specific medications, click on The Prescriber’s Guide, 5^th Ed. tab on the Stahl Online website and select the appropriate medication.

Excessive sleepiness in narcolepsy, obstructive sleep apnea/hypopnea syndrome, shift work sleep disorder	Insomnia	Narcolepsy	Restless leg syndrome
armodafinil modafinil sodium oxybate (in narcolepsy only)	agomelatine alprazolam amitriptyline amoxapine clomipramine clonazepam desipramine diazepam dothiepin doxepin estazolam eszopiclone flunitrazepam flurazepam hydroxyzine imipramine lofepramine lorazepam maprotiline mianserin nortriptyline quazepam ramelteon temazepam trazodone triazolam trimipramine zaleplon zolpidem zopiclone	amphetamine (d) amphetamine (d,l) lisdexamfetamine methylphenidate (d) methylphenidate (d,l) modafinil sodium oxybate	gabapentin ER

Optional Resources

Bélanger, L., Harvey, A. G., Fortier-Brochu, É., Beaulieu-Bonneau, S., Eidelman, P., Talbot, L., . . . Morin, C. M. (2016). Impact of comorbid anxiety and depressive disorders on treatment response to cognitive behavior therapy for insomnia. Journal of Consulting and Clinical Psychology, 84(8), 659–667. doi:10.1037/ccp0000084

Olaithe, M., Nanthakumar, S., Eastwood, P. R., & Bucks, R. S. (2015). Cognitive and mood dysfunction in adult obstructive sleep apnoea (OSA): Implications for psychological research and practice. Translational Issues in Psychological Science, 1(1), 67–78. doi:10.1037/tps0000021

Discussion: Treatment of Sleep/Wake Disorders

The power of sleep to heal the body cannot be underestimated. Most research indicates that 7–8 hours of sleep are a minimum that people need to stay healthy. Clients who come to the PMHNP’s office frequently complain of sleep problems. It is estimated that 10–20% of patients report some type of sleeping problem.

In this Discussion, you will analyze the diagnostic criteria and evidence-based psychotherapy and psychopharmacologic treatment for sleep/wake disorders.

Learning Objectives

Students will:

Analyze diagnostic criteria for sleep/wake disorders
Analyze evidence-based psychotherapy and psychopharmacologic treatment for sleep/wake disorders
Analyze criteria for referring clients to primary care physicians for treatment of sleep/wake disorders
Compare differential diagnostic features of sleep/wake disorders

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

To prepare for this Discussion:

By Day 5 of Week 9, your Instructor will have assigned you a sleep/wake disorder, which will be the focus of your original post for this Discussion.
Review the Learning Resources.

By Day 3

Post:

Explain the diagnostic criteria for your assigned sleep/wake disorder.
Explain the evidenced-based psychotherapy and psychopharmacologic treatment for your assigned sleep/wake disorder.
Describe at what point you would refer the client to their primary care physician for an additional referral to a neurologist, pulmonologist, or physician specializing in sleep disorders and explain why.
Support your rationale with references to the Learning Resources or other academic resource.

By Day 6

Submission and Grading Information

Grading Criteria

To access your rubric:

Week 10 Discussion Rubric

Post by Day 3 and Respond by Day 6

To participate in this Discussion:

Week 10 Discussion

Assignment 1: Week 10 Practicum Journal: Checkpoint for Certification Plan

Learning Objectives

Students will:

Evaluate progress on certification plans

Report your progress on the Certification Plan completed in Week 1 and submitted in Week 4.

What have you done to prepare for your certification?
Have you completed the scheduled tasks assigned on your timeline? If not, what are your plans to stay on schedule?

By Day 7

Submit your Assignment.

Submission and Grading Information

To submit your completed Assignment for review and grading, do the following:

Please save your Assignment using the naming convention “WK10Assgn1+last name+first initial.(extension)” as the name.
Click the Week 10 Assignment 1 Rubric to review the Grading Criteria for the Assignment.
Click the Week 10 Assignment 1 link. You will also be able to “View Rubric” for grading criteria from this area.
Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK10Assgn1+last name+first initial.(extension)” and click Open.
If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
Click on the Submit button to complete your submission.

Grading Criteria

To access your rubric:

Week 10 Assignment 1 Rubric

Check Your Assignment Draft for Authenticity

To check your Assignment draft for authenticity:

Submit your Week 10 Assignment 1 draft and review the originality report.

Submit Your Assignment by Day 7

To submit your Assignment:

Week 10 Assignment 1

Assignment 2: Week 8 Practicum: Decision Tree

By Day 7

Submit your Assignment. Refer to Week 8 for additional guidance.

Submission and Grading Information

To submit your completed Assignment for review and grading, do the following:

Please save your Assignment using the naming convention “WK10Assgn2+last name+first initial.(extension)” as the name.
Click the Week 10 Assignment 2 Rubric to review the Grading Criteria for the Assignment.
Click the Week 10 Assignment 2 link. You will also be able to “View Rubric” for grading criteria from this area.
Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK10Assgn2+last name+first initial.(extension)” and click Open.
If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
Click on the Submit button to complete your submission.

Grading Criteria

To access your rubric:

Week 10 Assignment 2 Rubric

Check Your Assignment Draft for Authenticity

To check your Assignment draft for authenticity:

Submit your Week 10 Assignment 2 draft and review the originality report.

Submit Your Assignment by Day 7

To submit your Assignment:

Week 10 Assignment 2

Assignment 3: Week 9 Practicum Journal: State Practice Agreements

By Day 7

Submit your Assignment. Refer to Week 9 for additional guidance.

Submission and Grading Information

To submit your completed Assignment for review and grading, do the following:

Please save your Assignment using the naming convention “WK10Assgn3+last name+first initial.(extension)” as the name.
Click the Week 10 Assignment 3 Rubric to review the Grading Criteria for the Assignment.
Click the Week 10 Assignment 3 link. You will also be able to “View Rubric” for grading criteria from this area.
Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK10Assgn3+last name+first initial.(extension)” and click Open.
If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
Click on the Submit button to complete your submission.

Grading Criteria

To access your rubric:

Week 10 Assignment 3 Rubric

Check Your Assignment Draft for Authenticity

To check your Assignment draft for authenticity:

Submit your Week 10 Assignment 3 draft and review the originality report.

Submit Your Assignment by Day 7

To submit your Assignment:

Week 10 Assignment 3

Practicum Reminder

Time Logs: You are required to keep a log of the time you spend related to your practicum experience and enter every patient you see each day. You can access your time log from the Welcome Page in your Meditrek account. You will track time individually for each patient you work with. Please make sure to continuously input your hours throughout the term.

Making Connections

This week, you analyzed the diagnostic criteria and treatment options of insomnia, hypersomnolence, narcolepsy, sleep apnea, non-rapid eye movement, nightmare disorder, sleep behavior disorder, and other DSM-5 sleep and parasomnic disorders.

Next week, you will analyze how to assess and care for individuals with sexual disorders. You also will analyze the concept of gender dysphoria and how to guide individuals through the process of establishing their sexual identity and preferred sexual orientation.

To go to the next week:

Week 11

Week 11: Gender Dysphoria, Paraphilic Disorders, and Sexual Dysfunction

I have been under a lot of stress lately. Between my job, the house and kids, and my wife complaining, I don’t seem to have the “staying power” I used to. Our sex life used to be perfect, but now I cannot perform as well or as often as I used to. My wife does not seem to understand and now I am feeling inadequate. I have a long life in front of me and I don’t want to live without feeling like a true man.”

Larry, age 40

This week’s topics include gender dysphoria, paraphilic disorders, and sexual dysfunction. The term gender dysphoria is the diagnosis describing those persons who experience incongruence between their gender assigned at birth and their experienced gender. Paraphilic disorders include pedophilia, exhibitionism, fetishism, and voyeurism, for example. Sexual dysfunction disorders include, most commonly, male erectile disorder, female orgasmic disorder, and other disorders. These diagnoses may be treated with pharmacologic and psychotherapy modalities.

This week, you will explore ways to assess and care for persons with gender dysphoria, paraphilic disorders, and sexual dysfunction disorders as outlined in the DSM-5.

Learning Resources

Required Readings

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

Standard 16 “Environmental Health” (pages 84-85)

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

Chapter 17, “Human Sexuality and Sexual Dysfunctions” (pp. 564–599)

Chapter 18, “Gender Dysphoria” (pp. 600–607)

Note: This is review from the Learning Resource in Week 3.

Gabbard, G. O. (2014). Gabbard’s treatment of psychiatric disorders (5th ed.). Washington, DC: American Psychiatric Publications.

Chapter 37, “Sexual Dysfunctions”

Chapter 38, “Paraphilias and Paraphilic Disorders”

Chapter 39, “Gender Dysphoria”

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

“Gender Dysphoria”

“Paraphilic Disorders”

“Sexual Dysfunctions”

Stahl, S. M. (2014). Prescriber’s Guide: Stahl’s Essential Psychopharmacology (5th ed.). New York, NY: Cambridge University Press.

Note: All Stahl resources can be accessed through the Walden Library using the link below. This link will take you to a login page for the Walden Library. Once you log in to the library, the Stahl website will appear.

To access information on specific medications, click on The Prescriber’s Guide, 5^th Ed. tab on the Stahl Online website and select the appropriate medication.

Sexual dysfunction
bupropion

Johnson, L., Shipherd, J., & Walton, H. M. (2016). The psychologist’s role in transgender-specific care with U.S. veterans. Psychological Services, 13(1), 69–76. doi:10.1037/ser0000030

Levenson, J. S., & Grady, M. D. (2016). The influence of childhood trauma on sexual violence and sexual deviance in adulthood. Traumatology, 22(2), 94–103. doi:10.1037/trm0000067

Hawes, S. W., Boccaccini, M. T., & Murrie, D. C. (2013). Psychopathy and the combination of psychopathy and sexual deviance as predictors of sexual recidivism: Meta-analytic findings using the Psychopathy Checklist—Revised. Psychological Assessment, 25(1), 233–243. doi:10.1037/a0030391

Required Media

Governors State University (Producer). (2009). Emotionally focused couples therapy [Video file]. Chicago, IL: Author.

Note: The approximate length of this media piece is 1 hour 55 minutes.

Scott, R. (Producer). (2005). Relationships, Families and Couples Counseling [Video file]. Psychotherapy.net.

Note: The approximate length of this media piece is 38 minutes.

Discussion: Assessment and Treatment of Gender Dysphoria, Paraphilic Disorders, and Sexual Dysfunction

Sexuality is an important part of each person’s quality of life. Research indicates that awareness of sexual identity and its importance may begin as early as age 3. However, individuals with varying diagnoses, disorders, or dysfunctions may grapple with issues related to their sexuality in their teen years, as well as into adulthood.

In this Discussion, you will explore the assessment and treatment of gender dysphoria, paraphilic disorders, and sexual dysfunction.

Learning Objectives

Students will:

Analyze diagnostic criteria for gender dysphoria, paraphilic disorders and sexual dysfunction
Analyze evidence-based psychotherapy and psychopharmacologic treatments for gender/sexual disorders
Compare differential diagnostic features of gender/sexual disorders

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

To prepare for this Discussion:

Select a gender dysphoria, paraphilic disorder, or sexual dysfunction that interests you.
Review the Learning Resources.

By Day 3

Post:

Explain the diagnostic criteria for the gender dysphoria, paraphilic disorder, or sexual dysfunction you selected.
Explain the evidenced-based psychotherapy and psychopharmacologic treatment for the gender dysphoria, paraphilic disorder, or sexual dysfunction you selected.
Support your rationale with references to the Learning Resources or other academic resource.

By Day 6

Respond to at least two of your colleagues by comparing the differential diagnostic features of the disorder you selected to the diagnostic features of the disorder your colleagues were assigned.

Submission and Grading Information

Grading Criteria

To access your rubric:

Week 11 Discussion Rubric

Post by Day 3 and Respond by Day 6

To participate in this Discussion:

Week 11 Discussion

Assignment: Final Exam

Learning Objectives

Students will:

Assess knowledge of adult and older adult psychotherapy concepts and principles (E)

This exam will cover the following topics:

Obsessive-Compulsive Disorders
Neurocognitive Disorders
Schizophrenia Spectrum and Other Psychotic Disorders
Sleep/Wake Disorders, Parasomnias
Gender Dysphoria, Paraphilic Disorders, & Sexual Dysfunction

By Day 7

Complete the Final Exam by. Prior to starting the exam, you should review all of your materials. There is a 2-hour time limit to complete this 75-question exam. You may only attempt this exam once.

Submission and Grading Information

Submit Your Exam by Day 7

To submit your Exam:

Week 11 Exam

Making Connections

This week, you explored ways to assess and care for persons with gender dysphoria, paraphilic disorders, and sexual dysfunction disorders as outlined in the DSM-5.

Congratulations! After you have finished all of the assignments for this week, you have completed the course. Please submit your Course Evaluation by Day 7.

NURS 6670: Psychiatric Mental Health Nurse Practitioner Role II: Adults and Older Adults

Week 1: Psychiatric Assessment of the Adult and Older Adult

Learning Resources

Required Readings

Required Media

Optional Resources

Discussion: Interview Format

Learning Objectives

Students will:

By Day 3

By Day 6

Submission and Grading Information

Grading Criteria

Post by Day 3 and Respond by Day 6

Name: NURS_6670_Week1_Discussion_Rubric

Name: NURS_6670_Week1_Discussion_Rubric

Assignment: Week 1 Practicum Journal Entry: Certification Plan

Learning Objectives

Students will:

By Day 7

Making Connections

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

Week 2: Depressive Disorders

Learning Resources

Required Readings

Required Media

Optional Resources

Assignment 1: “Captain of the Ship” Project – Depressive Disorder

Learning Objectives

Students will:

By Day 7

Submission and Grading Information

Grading Criteria

Check Your Assignment Draft for Authenticity

Submit Your Assignment by Day 7

Assignment 2: Week 2 Practicum Journal: Safe Prescribing

Learning Objectives

Students will:

By Day 7

Making Connections

Week 3: Personality Disorders

Learning Resources

Required Readings

Required Media

Optional Resources

Discussion: Treatment of Personality Disorders

Learning Objectives

Students will:

By Day 3

By Day 6

Submission and Grading Information

Grading Criteria

Post by Day 3 and Respond by Day 6

Assignment 1: Decision Tree

Learning Objectives

Students will:

By Day 7

Assignment 2: Fitzgerald Health Education Associates (FHEA) PMHNP 150 University Exit Comprehensive Exam

Making Connections

Week 4: Substance-Related and Addictive Disorders

Learning Resources

Required Readings

Required Media

Optional Resources

Discussion: Clinical Supervision – Kaltura

Learning Objectives

Students will:

By Day 3

By Day 6

Submission and Grading Information

Grading Criteria

Post by Day 3 and Respond by Day 6

Assignment 1: Week 1 Practicum Journal Entry: Certification Plan

By Day 7

Submission and Grading Information

Grading Criteria

Check Your Assignment Draft for Authenticity

Submit Your Assignment by Day 7

Assignment 2: Week 2 Practicum Journal: Safe Prescribing

By Day 7