NURS 6670 Assignment 2: Week 2 Practicum Journal: Safe Prescribing Essay

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.

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Assignment 2: Week 2 Practicum Journal: Safe Prescribing – NURS 6670 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.

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To prepare for this Assignment 2: Week 2 Practicum Journal: Safe Prescribing – NURS 6670 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 of Assignment 2: Week 2 Practicum Journal: Safe Prescribing – NURS 6670

Submit by Day 7 of Week 4.

Assignment 3: Board Vitals

This week you will be responding to twenty Board Vitals questions that cover a broad review of your Nurse Practitioner program courses up to this point.

These review questions will provide practice that is critical in your preparation for the national certification exam that’s required to certify you to practice as a nurse practitioner. These customized test questions are designed to help you prepare for your Nurse Practitioner certification exam. It is in your best interest to take your time, do your best, and answer each question to the best of your ability.

You can access Board Vitals through the link sent to you in email or by following the link below:

By Day 7

Complete the Board Vitals questions.

Making Connections – Assignment 2: Week 2 Practicum Journal: Safe Prescribing – NURS 6670

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.

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.

Photo Credit: kaisersosa67 / iStock / Getty Images Plus / Getty Images

Learning Resources

Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.

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

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

Chapter 13, “Psychosomatic Medicine” (pp. 451–464)

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

Note: You will access this book from Walden Library databases.

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

“Personality Disorders”

Note: You will access this book from Walden Library databases.

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

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

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

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

Required Media

Laureate Education. (2017a). A woman with personality disorder [Interactive media file]. Baltimore, MD: Author. NURS 6670 Exams, Discussions and Assignments..

Kernberg, O. (n.d.). Psychoanalytic psychotherapy for personality disorders: An Interview with Otto Kernberg, MD. [Video file]. Mill Valley, CA: Psychotherapy.net

Note: This video is approximately 94 minutes of length. You will access this article from Walden Library databases.

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
NURS 6670 Exams, Discussions and Assignments.
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.

Assignment 3: Board Vitals

This week you will be responding to twenty Board Vitals questions that cover a broad review of your Nurse Practitioner program courses up to this point.

By Day 7

Complete the Board Vitals questions.

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.

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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.

Photo Credit: ianmcdonnell / iStock / Getty Images Plus

Learning Resources

Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.

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.

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

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.

Note: The approximate length of this media piece is 69 minutes. You will access this video through the Walden Library databases.

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

Note: The approximate length of this media piece is 126 minutes. You will access this video through the Walden Library databases.

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”

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

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

NURS 6670 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

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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. Assignment 2: Week 2 Practicum Journal: Safe Prescribing – NURS 6670