| Course | NR 326 Mental Health Nursing |
|---|---|
| Week | 4 |
| Paper type | Mental status write-up |
| Length | About 1,120 words, 5 pages |
| Format | APA 7 student paper |
| School | Chamberlain University |
| Program | BSN (pre-licensure) |
| Updated | October 2026 |
Free sample paper for NR 326 Week 4
Mental Status Write-Up: A 31-Year-Old Man on His Second Day After Readmission for Schizophrenia, Described Domain by Domain
Student Name
College of Nursing, Chamberlain University
NR 326: Mental Health Nursing
Instructor Name
Month Day, Year
Mental Status Write-Up: A 31-Year-Old Man on His Second Day After Readmission for Schizophrenia, Described Domain by Domain
The Interview
Mr. D. is 31 and was readmitted two days ago with schizophrenia after about three months without his medication; identifying details have been changed. I spoke with him for about 20 minutes at 1400 at a table in the day room, with my instructor present for the second half. The write-up follows the order in which Snyderman and Rovner (2009) set out the examination, starting with how he looked and moved, then his speech, then his mood and the face that went with it, then the form and the content of his thinking, then perception and cognition, and last his insight and judgment. Where a clinical term appears, the observation it rests on comes before it. Each domain gives what was seen or heard first and any judgment after it, so a second reader could check the judgment against the description.
Appearance and Behavior
Mr. D. was wearing a gray hospital sweatshirt over a black T-shirt, dark jeans and unit socks with no shoes. The day room was warm, about 74 degrees on the wall thermostat, and he kept the sweatshirt hood up for the whole interview. His hair was uncombed and his beard was about two weeks' growth; his hands and nails were clean. He had a faint smell of cigarettes although he has not smoked since admission. He sat with his chair turned at an angle to the table, facing the corridor rather than me, and looked at me directly for no more than a second or two at a time, mostly when I asked a question. He accepted a cup of water and drank all of it.
Motor Activity
His right knee bounced for most of the interview, stopping when he spoke and starting again when I did. He did not pace. When a door closed loudly down the corridor he turned toward it and watched the corridor for about ten seconds before turning back. I saw no tremor or unusual movements of his mouth or tongue.
Speech
His speech was quiet, at a volume I had to lean toward to hear over the television, and slightly slower than conversational rate. There was a pause of two to four seconds before most answers. Answers to simple questions, such as his age or where he lived, were one to five words. Answers to open questions ran longer, three or four sentences, and drifted as described under thought process below. His speech was clear and not slurred.
Mood and Affect
Asked how he was feeling today, he said, "Tired. Tired of people looking at me." His face while he said this showed little change: his expression stayed flat, his voice did not rise or fall, and he did not smile at any point in the interview, including when my instructor made a light comment about the unit's coffee. His affect was restricted in range. It fit the content of "tired" but not "tired of people looking at me," which he said in the same tone as his age.
Thought Process
Asked what brought him back to the hospital, he said: "My mother called them. She says I stopped the pills, which, I did, because the pills make the television louder. The TV at her place is always on the news channel. The news is mostly about the same five people." Each sentence connected to the one before it, but the answer moved away from the question and did not come back to it. Andreasen (1979) defines tangentiality as a reply to a question that is oblique or irrelevant, and derailment as ideas slipping onto related or unrelated tracks during spontaneous speech. His answers to open questions fit derailment more closely than tangentiality, since each began on the question and then slid step by step to another subject. When I asked a second, narrower question ("How many days ago did you stop?"), he answered it directly: "Since June."
Thought Content
Asked about the people looking at him, he said that the people on television "talk about me sometimes, not by name," and that he could tell because they "say things that only I would know." He held this firmly and did not accept my question about whether it could be coincidence: "That's what they want you to think." I asked the unit's standard questions about thoughts of hurting himself or others. He said, "No, I just want them to stop," to both, without hesitation. I reported these answers to my instructor and to his nurse at 1430.
Perception
Asked whether he heard things other people did not, he said he sometimes heard "a man's voice, low," commenting on what he was doing, and that it was quieter in the hospital than at home. During the interview he twice looked briefly to his left, toward an empty corner of the room, and paused mid-sentence. I did not ask whether he was hearing the voice at those moments, and I should have.
Cognition
Asked the date, he gave the correct month and year but said the 20th when it was the 24th. He named the hospital and the city correctly. I asked him to remember three words, apple, table and penny; he repeated all three at once and recalled two of them, apple and penny, about five minutes later. Asked to spell "world" backward, he spelled "d-l-o-w" and stopped. I did not test abstract reasoning.
Insight and Judgment
Asked why he thought he was in the hospital, he said, "Because my mother worries," and, asked whether he thought he had an illness, "I have a problem with the TV, not with me." This suggests limited insight into the symptoms as symptoms. On judgment, he said that if he left the hospital today he would "go to my mother's and unplug the TV," which shows a plan to reduce what distresses him but not a plan to seek treatment.
The Domain Nobody Reached
Abstract reasoning was not tested. By the time we reached cognition he had turned further toward the corridor and his answers had shortened, and my instructor and I agreed to stop rather than add questions he was finding tiring. It should be tested on a later day, when his attention may allow it. I also did not ask about the voice at the two moments he looked away, which leaves the perception section weaker than it could have been.
References
Andreasen, N. C. (1979). Thought, language, and communication disorders: I. Clinical assessment, definition of terms, and evaluation of their reliability. Archives of General Psychiatry, 36(12), 1315-1321. https://doi.org/10.1001/archpsyc.1979.01780120045006
Snyderman, D., & Rovner, B. (2009). Mental status exam in primary care: A review. American Family Physician, 80(8), 809-814.
NR 326 Week 4 instructions, in plain terms
The Week 4 assignment asks you to complete a mental status examination on a patient and write it up domain by domain. Plan on covering every standard domain, objective descriptions supported by observation and quotation, correct terminology, a brief summary of findings and APA references. Describe before you name: what he wore, how fast he spoke, what he said in his own words. Keep mood in quotation marks and describe affect as what you saw while he spoke. Quote examples of thought process and content so a reader can judge the term you use. Record what you tested and how. If a domain was not assessed, say so and give the reason rather than leaving it out.
Inside the NR 326 Week 4 example
The interview section sets the time, place and length of the conversation and notes that the instructor was present. Appearance includes the gray sweatshirt with the hood kept up in a warm room, and motor activity records the bouncing knee and the head turned toward a closing door. Speech is described by volume, rate and the pause before most answers. Mood is "Tired. Tired of people looking at me," with a flat affect described beside it. Thought process quotes his answer about the pills and the television, and thought content records the belief that newsreaders talk about him. Perception covers the low male voice, cognition the three-word recall, and insight his statement that the problem is the television. The last section explains the missed domain.
Where the points sit in the NR 326 Week 4 rubric
Mental status write-ups are usually graded on completeness across domains, objective description, accurate use of terms, evidence such as quotations, organization and APA. The largest share of points tends to sit in objective description, so the paper describes the hood, the knee and the pauses before any label. Accurate terminology is credited when each term follows the evidence, as when Andreasen's definitions support the description of thought process. Completeness is met because every domain appears, and the abstract reasoning gap is named rather than hidden, which graders reward over a silent omission. Quotation earns points in mood, thought content and insight. A domain-by-domain layout covers organization, and the two references with in-text citations satisfy the APA row.
NR 326 Week 4 help from the desk
Adjectives cost more points than anything else in this write-up: cooperative, appropriate, intact and oriented tell an instructor nothing that could be checked. Close behind are domains that begin with a verdict and then look for evidence, or never supply any. Students also merge mood and affect into one sentence, write mood in their own words instead of the patient's, or describe thought content without a quotation. Skipping a domain without comment looks like a gap in knowledge rather than a judgment. Change identifying details, as this paper does. Keep the write-up to what you observed in one interview. Our writers can take your own interview notes and lay them out domain by domain in the NR 326 Week 4 format.
Get a NR 326 Week 4 example written to your instructions
Send the Week 4 template your section uses along with the kind of presentation you have to write up, and a custom example is filled into that template and returned inside 24 to 48 hours. The first one is free. Whatever you observed yourself belongs in your own document, so we work from a presentation type instead.
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NR 326 Week 4 questions, answered
Do I have to describe a domain that was unremarkable?
In this course, almost always. The write-up is there to make describing automatic, so a rubric built around observation rewards an ordinary domain given in its own terms and credits nothing for a phrase that clears it. Two plain sentences about speech that was unexceptional cost less time than the mark they protect, and they prove the domain was examined at all.
What if the patient would not answer the mood question?
Then that is the entry: what was asked and what came back, including a shrug, a refusal or a change of subject. A blank line invites a grader to assume the question never happened. Recording the attempt and its result is a genuine observation about the encounter, and most rubrics credit it above a mood inferred from the way somebody looked.
Can I write this on a patient from my clinical day?
Your own observations are yours to write up and the document you submit has to come from what you saw. Strip names, dates, ages, the unit and anything unusual enough to make a person recognizable, since a single distinctive feature undoes everything else you took out. If a recorded or simulated encounter arrived with the assignment, work from that one, since it carries none of the same exposure.
Where can I find a free NR 326 Week 4 sample paper?
The full Week 4 mental status write-up for Mr. D., from appearance through insight and judgment, with the section on the missed domain and its references, is shown on this page.
Why does the NR 326 Week 4 paper leave abstract reasoning untested?
Mr. D. was turning toward the corridor and giving shorter answers by the cognition questions, so the student and instructor agreed to stop and recommended testing it at a later interview.