NURBN2024 Mental Health Nursing

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Video case study

Background information about Ben

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Ben was brought into the Emergency Department by the Police 3 days ago following an aggressive episode involving his girlfriend outside their house.  Ben’s behaviour led to the Police believing that he was mentally unwell and a risk to himself and/or others. The police detained Ben and took him to the local health service.

Ben is 25 years old and is a qualified builder. He has a history of depression, borderline personality disorder with known suicide attempts. Ben’s depression has been ongoing since he was 21 years old and he is known to use substances since the age of 14 years. His girlfriend told police that his substance use had got “much worse” in recent months and “has started acting strangely”.

On admission to the Emergency Department, Ben had a mixture of alcohol, ice and cannabis in his system and experiencing a psychotic episode.

Ben is now subject to the Mental Health Act Vic (2014) and is in the Acute Mental Health Inpatient Unit. Ben has been commenced on several medications for his depression, alcohol withdrawal and psychosis.

Erin is the registered nurse looking after Ben today. She notices that Ben is becoming increasingly anxious and is unsettled. Erin has worked in the Acute Unit for 2 years.

Instructions:

This assessment functionally is an open book online test.  There is one multiple-choice question and the rest are short answer questions.

The layout resembles how you may document a mental state and risk assessment in an Electronic Medical Record (EMR) and then your identification and brief discussion (150 words) of the communication techniques that worked in the scenario and if there were some that didn't.

It will be open for 11 days. You can go back into the test as often as you want within those 11 days.

There is no rubric for this assessment, all entries (questions) undergo moderation amongst markers before final marking occurs.

There is no word count

In the test is a video of a client called Ben.  Based on your observations of the client you will answer the questions about

  • Risk assessment
  • Ben’s mental state
  • Communication challenges.

You are expected to provide  (7 separate) in text references in your responses to short answer questions to support your answers.

AND upload a Word doc Reference list in APA 7 style.  See Fedcite for APA 7 details and requirements. (link)

Upload your Reference list document inside the test on the last page (the Reference Page).

Please note: You are required to provide text book or peer-reviewed academic references (this is approx. 1 or more references per answer), no more than 7 years old is required. Reuse of the same references for multiple questions is acceptable as long as appropriate. Generic health or consumer health information is not appropriate, eg Mayo clinic, WebMD etc. 

This page contains the sections of a Mental State Exam (MSE)

For each section you need to succinctly describe the Phenomena observed or stated, utilise the appropriate MSE/mental health terminology and reference its use.

Check each sections marks allocation, some sections will require more content that others.

Question 1 (marked out of 2.0)

Appearance: grooming, hygiene, clothing, build, hair, distinguishing features, facial expression, gait, posture, selfcare, weight, mobility, tattoos

Question 2 (marked out of 3.0)

Behaviour: hostile, friendly, withdrawn, restless, posture, uncommunicative, pacing, tremors, eye contact, rapport.

Question 3 (marked out of 2.0)

Mood: What the person describes themselves as, e.g. depressed, sad, elated

Question 4 (marked out of 3.0)

Affect: emotional reactions e.g. normal, sad, restricted, blunted, flat, labile

Question 5 (marked out of 2.0)

Speech: Rate- pressures, rapid, slow, stammer, slurring, mute Volume, Clarity, and Tone

Question 6 (marked out of 5.0)

Perception: Hallucinations (auditory, tactile, commands) derealisation, depersonalisation

Question 7 (marked out of 3.0)

Thought Form: amount of thoughts and rate of production, continuity of ideas, disturbances in language and meaning.

Question 8 (marked out of 5.0)

Thought Content: delusions, suicidal, thoughts of harm to self or others, paranoia, persecutory thoughts

Question 9 (marked out of 2.0)

Cognition: Orientation, concentration, memory

Question 10 (Marked out of 4.0)

Insight: Awareness, understanding of illness and current situations

Question 11 (marked out of 4.0)

Judgement: Ability to assess a situation correctly and respond accordingly.

This page contains the sections of the risk assessment.

The layout is the same as the MSE risk document

Your answers should contain identifying the risks, nursing managment of those risks and your determination of the risk (low med, high immediate) you are to reference your answers for each section.

Question 12 (marked out of 10.0)

Suicide/ self-harm: intent, access, history, plan

Question 13 (marked out of 10.0)

Aggression/violence:

e.g. property, assault, sexual offences, bullying

Question 14 (marked out of 10.0)

Accidental self- harm: e.g. neglect and vulnerability.

Question 15 (marked out of 10.0)

Absconding

Question 16 (marked out of 10.0)

Concordance: with care and treatment, level of engagement

Question 17 (marked out of 10.0)

Concordance: with care and treatment, level of engagement

Question 18 (marked out of 5.0)

Protective factors: e.g. stable housing, supportive cares, positive attitude, willingness to seek help.

Identify Ben's protective factors

Question 19 (marked out of 5.0)

What would you determine as Bens overall level of risk?

  1. Medium
  2. Low
  3. Medium
  4. High
  5. Immediate

Question 20 (marked out of 5.0)

Identify the communication strategies that Erin has used.

Which ones were successful and which ones were not?

If you were the nurse would you do anything differently?

  • 150 words,
  • 5 points required
  • nil references required for this section

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