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Subjective: What details did the patient provide regarding their chief complaint and symptomology to derive your differential diagnosis? What is the duration and severity of their symptoms? How are their symptoms impacting their functioning in life?

Objective: What observations did you make during the psychiatric assessment?

Assessment: Discuss the patient’s mental status examination results. What were your differential diagnoses? Provide a minimum of three possible diagnoses with supporting evidence, listed in order from highest priority to lowest priority. Compare the DSM-5-TR diagnostic criteria for each differential diagnosis and explain what DSM-5-TR criteria rules out the differential diagnosis to find an accurate diagnosis. Explain the critical-thinking process that led you to the primary diagnosis you selected. Include pertinent positives and pertinent negatives for the specific patient case.

Reflection notes: What would you do differently with this client if you could conduct the session over? Also include in your reflection a discussion related to legal/ethical considerations (demonstrate critical thinking beyond confidentiality and consent for treatment!), health promotion and disease prevention taking into consideration patient factors (such as age, ethnic group, etc.), PMH, and other risk factors (e.g., socioeconomic, cultural background, etc.).

Training Title 134

Name: Mrs. Patricia Warren

Gender: female

Age: 42 years old

Background: Patricia was brought in under a emergency evaluation order after her best friend,

Felicia, after the police for Patricia locking herself in a closet and screaming loudly for over an

hour. EMS was able to calm her with a small dose of Ativan enroute to the emergency

department. This is Patricia’s third presentation to the emergency room in 2 weeks. She had one

psychiatric hospitalization around this same last year. No self-harm behaviors but has assaulted

other in the past. No hx of TBI. Sleeps 1–2-hour increments for total of 6 hrs. daily, refuses to

sleep at night. Refused vitals, wt., refuses labs, not cooperative. She obtains SSDI. She lives in

Cameron, Montana. She denies ever using any drugs and drinks one glass wine weekly. She has

a sister who is five years older, both parents deceased in the last three years. She has no children,

her husband is out of town, truck driver. Family history includes that her father had two previous

inpatient psychiatric hospitalizations for paranoia Mother had history of bipolar depression.

Paternal grandmother had “shock therapy”. Denies history of trauma experience, but her friend

reports parents death was extremely difficulty for Patricia. no current legal charges. dropped out

of high school in 11th grade, was pregnant and had abortion. allergies: Clozaril


Symptom Media. (Producer). (2018). Training title 134 [Video]. https://video-alexanderstreetcom.ezp.waldenulibrary.org/watch/training-title-134



Week (enter week #): (Enter assignment title)


Student Name
College of Nursing-PMHNP, Walden University
NRNP 6635: Psychopathology and Diagnostic Reasoning
Faculty Name
Assignment Due Date






CC (chief complaint):
Past Psychiatric History:
• General Statement:
• Caregivers (if applicable):
• Hospitalizations:
• Medication trials:
• Psychotherapy or Previous Psychiatric Diagnosis:
Substance Current Use and History:
Family Psychiatric/Substance Use History:
Psychosocial History:
Medical History:

• Current Medications:
• Allergies:
• Reproductive Hx:
Physical exam: if applicable
Diagnostic results:
Mental Status Examination:
Differential Diagnoses:



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