| Course | NU 671 Clinical Decision-Making in Psychiatric Mental Health |
|---|---|
| Unit | Unit 1 |
| Paper type | Annotated psychiatric intake interview |
| Length | About 940 words, 6 pages |
| Format | APA 7 student paper |
| School | Herzing University |
| Program | MSN Psychiatric Mental Health Nurse Practitioner |
| Updated | October 2026 |
Free sample paper for NU 671 Unit 1
Annotated Intake Interview: A 56-Year-Old Man Referred for Depression That Has Not Responded to Sertraline
Student Name
Department of Nursing, Herzing University
NU 671: Clinical Decision-Making in Psychiatric Mental Health
Instructor Name
January 22, 2026
Annotated Intake Interview: A 56-Year-Old Man Referred for Depression That Has Not Responded to Sertraline
Setting and Approach
Mr. K. is a composite 56-year-old man referred by his primary care clinician to an outpatient psychiatric clinic for depression that has not improved after four months of sertraline, now 150 mg. The interview lasted 55 minutes. Questions appear below in the order and wording used, condensed answers beside them, and a note after each exchange explaining what the question was testing and why the next one followed. The approach follows standard guidance for psychiatric evaluation of adults, which includes the history of present illness, psychiatric and medical history, substance use, family and social history, and a suicide risk assessment (American Psychiatric Association, 2016).
Opening and Chief Concern
Q: "Dr. Lee sent me a note, but I would rather hear it from you. What has been happening?" A: "I just don't care about anything. I sit in front of the TV. My wife says I've changed."
Why: an open question lets him name the problem in his own words before any framing from the referral. His phrasing emphasized loss of interest and a change noticed by others, both of which shaped what came next.
Q: "When did your wife first notice the change?" A: "About a year ago, maybe more. She says I stopped doing things before I felt sad."
Why: onset relative to mood matters. Apathy that came before sadness raises other possibilities besides a primary depressive episode, including a neurological process, a medical condition, or a sleep disorder. This answer turned the interview toward testing the diagnosis.
History of the Present Illness
Q: "Walk me through a typical day now." A: Wakes at 6 feeling "like I didn't sleep," drags himself to work as a warehouse supervisor, naps in his truck at lunch, falls asleep in the evening in his chair.
Q: "How do you sleep at night?" A: "Seven hours, but it's not restful. My wife says I snore like a freight train and sometimes stop breathing."
Why: daytime sleepiness out of proportion to sleep time, loud snoring, and witnessed pauses in breathing are the core features of obstructive sleep apnea, which can cause fatigue, poor concentration, and low mood that resemble depression. I noted this for the exclusion work and asked about thinking next.
Q: "How is your memory and concentration compared with two years ago?" A: "I lose my train of thought. I forget what I went into a room for. At work I make mistakes on the schedules."
Q: "Do you feel sad, down, or hopeless much of the time?" A: "More than before. Mostly I feel flat. Sometimes I think my family would be better off without me having to be dealt with."
Why: the last answer required a direct follow-up on suicide before anything else.
Suicide Risk
Q: "When you think your family would be better off, do you ever think about ending your life?" A: "I've thought about not waking up. I wouldn't do anything. My grandkids."
Q: "Have you thought about how you might do it, or done anything to prepare?" A: "No. I have hunting rifles, but I've never thought of using them that way."
Why: questions followed the structure of a standardized suicide severity assessment, moving from passive wishes to active ideation, method, intent, and preparation (Posner et al., 2011). He reported passive death wishes without active ideation, plan, or intent, with a protective factor in his grandchildren, but with access to firearms. Firearm storage was addressed at the end of the visit with him and, with his permission, his wife.
Psychiatric, Medical, and Medication History
Q: "Have you ever felt like this before, or been treated for your mood?" A: "Never. This is the first time."
Q: "What medical problems do you have, and what do you take?" A: High blood pressure on metoprolol for eight years; weight up about 20 pounds in two years; told his thyroid was "fine" some years ago; sertraline.
Why: first-onset depression in the mid-fifties, without prior episodes, raises the priority of medical and neurological causes. Metoprolol, weight gain, and the unknown date of the last thyroid test each went on the exclusion list. Beta-blockers have been linked to fatigue, though the link to depression is debated.
Substances, Family, and Social History
Q: "How much alcohol do you drink in a typical week?" A: "Two beers, five or six nights a week. Saturdays it's more like six."
Why: about 16 or more drinks a week can cause or worsen low mood, sleep problems, and cognitive complaints, and alcohol worsens sleep apnea. A structured screen was planned.
Q: "Has anyone in your family had depression, memory problems, or other mental health conditions?" A: His mother had "dementia" starting in her sixties; a brother drinks heavily.
Q: "What has changed at home and at work in the last two years?" A: Promoted to supervisor, longer hours; his daughter moved back home with two children; he stopped fishing, which he used to love.
Closing
Q: "What worries you most about all this?" A: "That I'm losing my mind, like my mother."
Why: asking what the person fears most often reveals the concern that brought him in and determines what reassurance or information he needs. His fear of dementia will be addressed directly as testing proceeds.
Plan from the interview: mental status examination; screening for sleep apnea with a validated questionnaire (Chung et al., 2008); laboratory tests including thyroid function, vitamin B12, and a metabolic panel; a structured alcohol screen; a cognitive screen; collateral history from his wife; and a safety plan with firearm storage.
References
American Psychiatric Association. (2016). The American Psychiatric Association practice guidelines for the psychiatric evaluation of adults (3rd ed.). American Psychiatric Association. https://doi.org/10.1176/appi.books.9780890426760
Chung, F., Yegneswaran, B., Liao, P., Chung, S. A., Vairavanathan, S., Islam, S., Khajehdehi, A., & Shapiro, C. M. (2008). STOP questionnaire: A tool to screen patients for obstructive sleep apnea. Anesthesiology, 108(5), 812-821. https://doi.org/10.1097/ALN.0b013e31816d83e4
Posner, K., Brown, G. K., Stanley, B., Brent, D. A., Yershova, K. V., Oquendo, M. A., Currier, G. W., Melvin, G. A., Greenhill, L., Shen, S., & Mann, J. J. (2011). The Columbia-Suicide Severity Rating Scale: Initial validity and internal consistency findings from three multisite studies with adolescents and adults. American Journal of Psychiatry, 168(12), 1266-1277. https://doi.org/10.1176/appi.ajp.2011.10111704
Reading the NU 671 Unit 1 instructions
Unit 1 asks you to conduct or construct a psychiatric intake interview and annotate it to show your clinical reasoning. Expect to cover the chief concern, history of present illness, suicide and safety assessment, psychiatric, medical and medication history, substance use, family and social history, and a closing. Annotations should explain why each question was asked and what the answer suggests. Many versions ask you to follow the APA practice guideline for psychiatric evaluation. Check whether your section wants a verbatim transcript or a summarized exchange. Use a composite patient. Suicide risk questions should use validated wording, such as the Columbia scale. Notice answers that point beyond the referral diagnosis, because the intake is where alternative explanations first appear.
Inside the NU 671 Unit 1 example
The interview opens with a question that invites the patient's own account rather than repeating the referral. Each section pairs questions with answers and a margin note, which shows reasoning as the interview moves. The present illness section uses a typical day to draw out sleep, energy and work details. The suicide section moves from passive to active thoughts with structured wording and documents protective factors. The medical history picks up snoring and daytime sleepiness, which the annotation flags. Substance questions quantify alcohol rather than accepting social drinking. The family section records his mother's dementia. The closing question about worries brings out a fear the rest of the interview had not reached, which becomes central to later units.
NU 671 Unit 1 rubric: what full points look like
Herzing's rubric for the annotated intake usually covers completeness of the interview domains, quality of questions, suicide and safety assessment, the annotations, rapport and communication, and writing. Completeness points require every standard domain. Question quality rewards open questions that invite detail and focused follow-ups that quantify. Suicide assessment is read most closely and needs structured wording, risk and protective factors and a disposition. Annotation points go to notes that explain reasoning and flag findings that suggest other diagnoses. Rapport criteria look for respectful, patient-centered language. Writing covers clear formatting of exchanges. The APA practice guideline and Posner's Columbia scale belong in the APA 7 list.
NU 671 Unit 1 help: mistakes that cost points
Intake interviews in Unit 1 commonly lose points by asking closed questions throughout, which yields yes and no answers and little history. Another frequent problem is a suicide assessment that stops at asking whether the patient is suicidal. Students often accept vague answers about alcohol, such as socially. Annotations restate the answer rather than explaining reasoning. Medical history is thin, so physical contributors are missed. Family history is skipped. The closing is abrupt. Finally, let the annotations show what you noticed, because graders look for a clinician who spots findings that do not fit the referral diagnosis, such as snoring in a man said to have depression. Social history is another common gap; work, family and money pressures often explain as much as the symptoms do.
Get a NU 671 Unit 1 example written to your instructions
Send the Unit 1 instructions and the rubric from your NU 671 classroom, with the setting and presentation the interview should cover. We write a custom example with the questions printed as asked, the annotation column beside the exchange, the repairs left in, and the unreached ground named at the close. First custom sample free, returned in 24 to 48 hours.
More NU 671 papers and PMHNP samples
- NU 671 Unit 2: Mental status examination record
- NU 671 Unit 3: Diagnostic weighting table
- NU 671 Unit 4: Medical mimic exclusion log
- NU 671 Unit 5: Diagnostic criteria mapping
- NU 671 Unit 6: Rating instrument administration note
- NU 671 Unit 7: Collateral information summary
- NU 671 Unit 8: Biopsychosocial formulation
- NU 674 Unit 1: Service disagreement resolution record
- NU 670 Unit 1: Receptor activity brief
- NU 672 Unit 1: Therapeutic modality comparison
- NU 673 Unit 1: Presenting problem profile
NU 671 Unit 1 questions, answered
Should the interview be verbatim?
Close enough that the questions are real and the sequence is genuine, which is not the same thing as a recording. Compose the exchange rather than reproducing one, keep the questions exactly as an interviewer would put them, and condense answers wherever nothing turns on the wording. The question is the part being assessed, so that is the part that stays intact.
How much of the exchange should the annotation cover?
The moments where something was decided, rather than every line. A note beside a routine question wastes the column, while a pivot point deserves two sentences: what shifted, what it ruled out, and why the following question went where it did. Annotating roughly a third of the exchange, weighted toward the turns, is a workable proportion.
Can the interview be based on someone I saw?
Not directly. Build a composite from patterns rather than from an encounter, carrying no identifiers, no timeline anybody could match and no detail unique to one person. Clinical hours and the records made during them belong to the site and stay there. A composite is easier to write well anyway, since it can be shaped to hold the difficulty the assignment needs.
Where can I find a free NU 671 Unit 1 sample paper?
The full NU 671 Unit 1 annotated intake is free on this page, every question paired with a note on why it was asked. An intake for a different presenting problem, such as anxiety or psychosis, can be written on request.
How do I ask about suicide in a psychiatric intake interview?
Ask directly, moving from passive thoughts to active thoughts, plans and intent, using validated wording such as the Columbia scale, and document protective factors. This sample's annotation explains each step for a man with passive thoughts of not waking up.