| Course | NR 548 Psychiatric Assessment for Psychiatric-Mental Health Nurse Practitioner |
|---|---|
| Week | 6 |
| Paper type | Psychiatric evaluation note |
| Length | About 1,110 words, 2 pages |
| Format | APA 7 student paper |
| School | Chamberlain University |
| Program | MSN, Psychiatric-Mental Health Nurse Practitioner (PMHNP) |
| Updated | September 2026 |
Free sample paper for NR 548 Week 6
Psychiatric Evaluation Note: A Community Clinic First Evaluation of a 52-Year-Old With Depression, Nightly Suicidal Thoughts and Heavy Drinking, Joined Into One Note With a Summary That Interprets Rather Than Repeats
Student Name
College of Nursing, Chamberlain University
NR 548: Psychiatric Assessment for Psychiatric-Mental Health Nurse Practitioner
Instructor Name
Month Day, Year
Psychiatric Evaluation Note: A Community Clinic First Evaluation of a 52-Year-Old With Depression, Nightly Suicidal Thoughts and Heavy Drinking, Joined Into One Note With a Summary That Interprets Rather Than Repeats
Identification and Reason for Evaluation
Fifty-two-year-old warehouse operations manager, recently laid off, separated, living alone, referred by the primary care provider for evaluation of depression. Seen for 55 minutes with the preceptor present.
History of Present Illness
Low mood for about three months, beginning around the separation and worsening sharply after a layoff six weeks ago. The patient describes feeling "at the bottom of a hole," has lost interest in fishing and in a weekly card game, sleeps four to five hours with early waking at 3 or 4 a.m., eats one meal a day and has lost about 5 kg. Concentration is poor, and the patient has stopped applying for jobs after two rejections. Feels like a failure as a provider and believes the family would do better without the patient. For two weeks, near-nightly thoughts of suicide involving the handgun kept in the house; no stated intent or plan; took the handgun out of its case once two weeks ago and put it back. The Patient Health Questionnaire-9 score was 21.
Substance Use
Beer, six to eight on most nights for about two months, up from two or three on weekends before the separation; drinking is mainly alone at home to get to sleep. Scored 19 on the Alcohol Use Disorders Identification Test, in the zone suggesting brief counseling and further evaluation (Saunders et al., 1993). Last drink the night before the evaluation. No withdrawal symptoms reported between drinks, no morning drinking and no history of seizures or delirium tremens. No other substances; former smoker.
Past Psychiatric History
No previous psychiatric treatment, hospitalization or suicide attempts. A period of low mood after the parent's suicide at age 19, not treated.
Family History
One parent took their own life when the patient was 19. The other parent had "a drinking problem." A younger brother is well.
Social History
High school graduate; worked 24 years at the same warehouse, the last 11 as operations manager. Separated from a spouse of 26 years three months ago; the spouse moved out. Two adult children; a daughter visits weekly. Lives alone with a dog. Financial pressure from the layoff; severance ends in six weeks. No legal problems. Owns one handgun, kept for hunting.
Medical History and Medications
Hypertension on lisinopril, 10 mg once a day. No known head injury or seizures. Last primary care visit two weeks ago; the referral note reports normal thyroid function and a normal blood count, with a mildly raised liver enzyme (gamma-glutamyl transferase).
Mental Status Examination
Unshaven, stained T-shirt, work jacket; faint alcohol odor at the start. Leaned forward, turning keys in one hand; sat back and folded arms when firearms were raised. Speech low, slow, with long latencies for questions about mood. Mood described as sunk in a hole with no way out. Affect restricted, sad, tearful twice, congruent. Thought process coherent. Content preoccupied with failure and burden; nightly suicidal ideation with an identified method, no intent or plan; no homicidal ideation; no delusions. No perceptual disturbance. Oriented; two of three words recalled after a five-minute delay; serial sevens broke down after three steps. Insight partial: recognizes depression, not the role of drinking. Judgment partly impaired by keeping a firearm accessible while suicidal; improved during the visit.
Risk Assessment
The risk factors and protective factors described above lead to a judgment of elevated suicide risk requiring same-day action, not emergency hospitalization. The key features are the nightly ideation with an accessible firearm and one episode of preparatory behavior, drinking most nights, solitary living and a parent lost to suicide, balanced by no intent or plan, a strong reason for living in the children, a brother available to help and full engagement in safety planning. Actions: firearm, ammunition and key removed to the brother's home the same evening, confirmed by text; a written safety plan completed (Stanley & Brown, 2012); agreement not to drink alone at home for three days; a nurse phone call the next day; a return visit in three days. There is no current risk of harm to others identified.
Summary
This is a 52-year-old with a first major depressive episode, now severe, which began after a separation and deepened after a layoff, in a person with a parental history of suicide and of alcohol problems. The episode is complicated by heavy drinking that began as self-treatment for sleep and has escalated over two months, and by nightly suicidal thoughts with an accessible firearm. The picture is best explained by major depressive disorder, single episode, severe, without psychotic features, with alcohol use that likely meets criteria for an alcohol use disorder of at least moderate severity, pending a fuller review of criteria at the next visit.
Three questions remain open. First, how much of the depression is driven by alcohol, which can only be judged after a period of reduced drinking. Second, whether the mild memory and attention findings resolve with treatment of mood and drinking. Third, whether the protective factors hold through the next few weeks, particularly as severance ends.
The summary does not repeat the sections above; it interprets them. The history explains why the risk section focuses on firearms and alcohol, and the examination supplies the observable evidence of slowing and hopelessness that supports the severity rating.
Plan
Safety steps as above, with risk reassessed at each contact. Discuss treatment options for depression at the next visit, taking alcohol into account. Offer a referral to an outpatient alcohol program and discuss the options with the patient. Coordinate with the primary care provider regarding the liver enzyme and blood pressure. Follow-up in three days, then weekly. A safety plan paired with planned outreach calls cut suicidal behavior and raised outpatient attendance in an emergency department cohort (Stanley et al., 2018).
The note is meant to let a covering clinician who is new to the patient pick up care at the next visit. The history sections explain why the risk assessment concentrates on firearms and alcohol, the examination gives observable evidence for the severity rating, and the summary states what remains uncertain. If the covering clinician disagreed with any conclusion, the facts needed to reach a different one are all in the note.
References
Saunders, J. B., Aasland, O. G., Babor, T. F., de la Fuente, J. R., & Grant, M. (1993). Development of the Alcohol Use Disorders Identification Test (AUDIT): WHO collaborative project on early detection of persons with harmful alcohol consumption-II. Addiction, 88(6), 791-804. https://doi.org/10.1111/j.1360-0443.1993.tb02093.x
Stanley, B., & Brown, G. K. (2012). Safety planning intervention: A brief intervention to mitigate suicide risk. Cognitive and Behavioral Practice, 19(2), 256-264. https://doi.org/10.1016/j.cbpra.2011.01.001
Stanley, B., Brown, G. K., Brenner, L. A., Galfalvy, H. C., Currier, G. W., Knox, K. L., Chaudhury, S. R., Bush, A. L., & Green, K. L. (2018). Comparison of the safety planning intervention with follow-up vs usual care of suicidal patients treated in the emergency department. JAMA Psychiatry, 75(9), 894-900. https://doi.org/10.1001/jamapsychiatry.2018.1776
NR 548 Week 6 instructions, in plain terms
This week asks you to write a complete psychiatric evaluation note. The instructions usually request identifying information and reason for referral, the present illness, the past psychiatric, substance, medical, family and social background, an examination of mental status, risk assessment, a diagnostic impression and a plan. State the reason for evaluation briefly. Include every required section, giving the most space to the ones relevant to this presentation. Record the examination as observation, so the summary has evidence to rest on. Let the risk section refer back to material already in the note rather than repeating it. Write a summary that interprets the sections above: what the presentation appears to be, what remains open and why. Tie the plan to the summary. Cite screening tools and safety planning evidence in APA 7.
How the NR 548 Week 6 example is put together
The note opens with a one-line identification and reason. The history of present illness covers three months of worsening mood, sleep, appetite, concentration, guilt and near-nightly suicidal thoughts involving a handgun, with a PHQ-9 of 21. Substance use gives quantity, pattern and an AUDIT score of 19. Past psychiatric, family, social and medical sections are brief but complete. The mental status examination is written as observation. The risk section summarizes the formulation and actions, including firearm removal and a safety plan. The summary names a severe first depressive episode with probable alcohol use disorder and lists three open questions. The plan ties safety, treatment discussion, alcohol referral and coordination with primary care to the summary.
Reading the NR 548 Week 6 grading rubric
Evaluation notes are generally evaluated on completeness, relevance and weighting of history, an observation-based examination, a coherent risk section, an interpretive summary and a plan that follows from it. The summary decides most of the marks, and one that interprets the sections above rather than repeating them shows integration. Weighting history by relevance shows judgment. Examination findings that support the summary make the note credible. A risk section that draws on reported material keeps the note efficient. Stating open questions honestly reads as mature assessment. A plan tied to each part of the summary, supported by APA 7 citations to screening and safety evidence, completes a note another clinician could act on.
NR 548 Week 6 help: mistakes that cost points
Evaluation notes often have a summary that restates the history in shorter form. Interpret instead: say what the presentation appears to be and what is still uncertain. Another weakness is giving every section equal length, which buries what matters; expand the relevant sections and keep the rest brief. Some students repeat the full history in the risk section; refer back to it. Mental status written as labels leaves the summary circular. Avoid a plan that lists generic steps unconnected to the summary. Make sure substance use is quantified. Include what would change your impression. Read the note as a covering clinician would and check that they could act on it without calling you.
Get a NR 548 Week 6 example written to your instructions
Send the Week 6 instructions and the evaluation template your section issues, and a custom example is written into your headings and returned inside 24 to 48 hours. The first one is free. The encounter behind any real evaluation is yours to conduct and yours to record.
More NR 548 papers and PMHNP samples
- NR 548 Week 1: Difficult Question Discussion
- NR 548 Week 2: Interview Technique Write-Up
- NR 548 Week 3: Mental Status Write-Up
- NR 548 Week 4: Suicide Risk Assessment Note
- NR 548 Week 5: Screening Tool Appraisal
- NR 548 Week 7: Case Analysis
- NR 548 Week 8: Assessment Reflection
- NR 547 Week 6: Lifespan Variation Write-Up
- NR 546 Week 6: Adverse Effect Brief
NR 548 Week 6 questions, answered
How long should a full evaluation note be?
Longer than any single section and shorter than all of them combined, because joining involves cutting. Where the same material appears in the history and the risk section, one of them refers to the other. Sections that set a page limit are usually testing exactly that skill, so the limit is worth treating as part of the assignment.
Can I reuse my earlier assignments in this note?
Practice differs, and a few sections treat your own earlier work as needing citation, so read the instructions before copying anything across. Even where it is allowed, the material has to be rewritten until the sections refer to each other. A note that reads as four assignments in sequence fails the one thing this week is testing.
What goes in the summary if the picture is unclear?
Say so, and say what would clarify it. An honest summary naming two possibilities, the evidence for each and the information that would separate them reads as competent. A summary that forces a conclusion the note does not support is the more common error and the more costly one, because the evidence sits right above it.
Where can I find a free NR 548 Week 6 sample paper?
The joined psychiatric evaluation note appears above as the NR 548 Week 6 sample, readable from top to bottom. If your patient's evaluation needs writing up, send us your findings and a note with an interpretive summary can be drafted.
What makes the NR 548 Week 6 summary strong?
It interprets the note rather than repeating it: what the presentation appears to be, what is still open and why. The sample names three open questions and ties the plan to them.