NUR7055: Advanced Mental Health Practice & Diagnostic Reasoning

Welcome to the second major assessment for this semester. This task is designed to be a “capstone” style written report where you pull together your skills in history taking, physical assessment, and diagnostic formulation. We want to see you thinking like a Nurse Practitioner or a Clinical Nurse Specialist.

Assessment 2: Complex Clinical Case Study Analysis

• Type: Written Clinical Report (Case Study)
• Word Limit: 2,500 words (+/- 10%) excluding references and appendices.
• Weighting: 50% of total grade.
• Due Date: Week 10 (See Learning Management System for specific date/time).
• Format: .DOCX or .PDF, standard university formatting (12pt font, double spaced).

Assignment Overview

For this assessment, you are required to select one of the three complex patient scenarios provided in the Week 5 Learning Module (Pediatric Anxiety, Adult Treatment-Resistant Depression, or Geriatric Delirium vs. Dementia). Your goal is to critically analyze the case through a bio-psycho-social-spiritual lens.

We are not just looking for a list of symptoms. We want to read a narrative that demonstrates your ability to synthesize clinical data, apply evidence-based guidelines, and formulate a safe, therapeutic plan of care.

Structural Requirements & Guidelines

Please structure your paper using the following headings to ensure you cover all grading criteria. This helps us grade your work efficiently and ensures you don’t miss any critical sections.

1. Introduction (approx. 200 words)

Briefly introduce the chosen patient and the primary clinical problem. Outline the scope of your paper and the specific framework (e.g., Recovery Model, Trauma-Informed Care) you will use to guide your analysis.

2. Pathophysiology and Psychopathology (approx. 600 words)

This is the science section. Critically discuss the biological underpinnings of the patient’s presentation. You must:

• Analyze the neurobiology relevant to the diagnosis (e.g., neurotransmitter dysregulation, HPA axis involvement).
• Discuss any relevant physical comorbidities (e.g., metabolic syndrome, thyroid dysfunction) and how they intersect with the mental health presentation.
• Link this theory directly back to the specific symptoms your patient is displaying.

3. Diagnostic Reasoning and Differential Diagnosis (approx. 500 words)

Walk us through your thinking process. How did you arrive at your provisional diagnosis?

• Identify at least two differential diagnoses that you considered and rejected.
• Provide the clinical evidence (subjective and objective data) that supports your final decision, referencing the DSM-5-TR or ICD-11 criteria.

4. Pharmacological Management (approx. 500 words)

Propose a pharmacological regimen. If the patient is already on medication, critique its efficacy.

• Discuss the mechanism of action, pharmacokinetics, and potential side effects of the chosen drug(s).
• Address “Safe Prescribing” principles—consider drug-drug interactions, adherence issues, and monitoring requirements (e.g., lithium levels, metabolic screening).

5. Therapeutic Interventions and Holistic Care (approx. 500 words)

Nursing is never just about pills. Detail the non-pharmacological interventions.

• Include specific psychotherapeutic modalities (e.g., CBT, DBT, ACT) suitable for this patient.
• Address social determinants of health (housing, employment, social support).
• Include a brief risk management plan (suicide/self-harm mitigation).

6. Conclusion (approx. 200 words)

Summarize the key priorities for this patient’s journey and the expected prognosis based on your interventions.

Grading Rubric Highlights (What we look for)

To achieve a High Distinction (HD) or A-grade, your paper needs to demonstrate:

• Critical Analysis: Moving beyond description to analyze why specific symptoms are occurring and why a specific treatment is chosen.
• Evidence Base: Use of high-quality, current clinical practice guidelines (CPGs) and systematic reviews (published within the last 5-7 years).
• Academic Tone: Clear, professional language free of colloquialisms, with perfect adherence to referencing standards.

Write a 2,500-word comprehensive clinical case study analysis for the Master of Nursing program, focusing on advanced health assessment, differential diagnosis, and psychopharmacology. Create a holistic care plan that addresses complex mental health comorbidities in a primary care setting.

Recommended Learning Resources

Buppert, C., 2024. Nurse Practitioner’s Business Practice and Legal Guide. 8th ed. Burlington, MA: Jones & Bartlett Learning. (Focuses on the scope of practice and legalities of prescribing).

Goforth, C. and Langman-Embry, P., 2023. ‘Diagnostic reasoning in advanced practice nursing: A cognitive approach’. Journal for Nurse Practitioners, 19(4), pp. 104-110. https://doi.org/10.1016/j.nurpra.2023.01.018

Happell, B., et al., 2022. Mental Health Nursing: Crafting a Recovery-Oriented Approach. 2nd ed. Melbourne: Cambridge University Press. (Excellent for the holistic/social recovery sections).

Stahl, S.M., 2021. Stahl’s Essential Psychopharmacology: Neuroscientific Basis and Practical Applications. 5th ed. Cambridge: Cambridge University Press. (The gold standard for the Pathophysiology and Pharmacology sections).

World Health Organization, 2022. World mental health report: transforming mental health for all. Geneva: World Health Organization. Available at: https://www.who.int/publications/i/item/9789240049338 (Great for global context and social determinants data).