| Course | NU 671 Clinical Decision-Making in Psychiatric Mental Health |
|---|---|
| Unit | Unit 5 |
| Paper type | Diagnostic criteria mapping |
| Length | About 810 words, 5 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 5
Mapping Mr. K.'s Record Against the Criteria for Major Depressive Disorder: Six Symptoms Present, One Exclusion Unresolved
Student Name
Department of Nursing, Herzing University
NU 671: Clinical Decision-Making in Psychiatric Mental Health
Instructor Name
February 19, 2026
Mapping Mr. K.'s Record Against the Criteria for Major Depressive Disorder: Six Symptoms Present, One Exclusion Unresolved
Purpose and Method
This mapping places each criterion for major depressive disorder in the current diagnostic manual (American Psychiatric Association, 2022) beside the evidence in Mr. K.'s record that answers it. Criteria are referred to by their labels and summarized briefly rather than quoted. Unmet criteria are left in place. Duration, frequency, and functional impact are treated as separate questions, because a symptom that is present but not nearly every day, or not for two weeks, does not count. Evidence comes from the intake interview, the mental status examination, his wife's account at the second visit, and the medical exclusion log.
Criterion A: The Symptom Count
At least five of nine symptoms must be present during the same two-week period, nearly every day for most items, and at least one must be depressed mood or loss of interest or pleasure.
| Label | Evidence in the record | Frequency and duration | Counted? |
|---|---|---|---|
| A1, depressed mood | Describes mood as "flat, not really sad"; wife says he seems "down" but not tearful | Unclear whether most of the day, nearly every day | Not counted; uncertain |
| A2, markedly diminished interest or pleasure | "I just don't care about anything"; stopped fishing; wife confirms withdrawal from activities | Nearly every day for about a year | Yes |
| A3, significant weight or appetite change | About 20 pounds gained over two years | Gradual; does not meet the pace the criterion describes | No |
| A4, insomnia or hypersomnia | Seven hours at night plus naps; unrefreshing sleep | Nearly every day | Yes, with a caution (see Criterion C) |
| A5, psychomotor agitation or retardation observable by others | Pauses of three to four seconds before answers; wife reports he moves slowly | Observed at two visits; wife says daily | Yes |
| A6, fatigue or loss of energy | Falls asleep in chair, naps in truck | Nearly every day | Yes, with a caution |
| A7, worthlessness or excessive guilt | Denied when asked directly | Not applicable | No |
| A8, diminished ability to think or concentrate | Loses train of thought; errors at work; serial sevens with two errors | Nearly every day per patient and wife | Yes, with a caution |
| A9, recurrent thoughts of death or suicidal ideation | Passive thoughts of not waking up; no plan or intent | Several times a week for months | Yes |
Criterion A, Summarized
Six of nine symptoms are counted: A2, A4, A5, A6, A8, and A9, including the required loss of interest. Criterion A is met on the record as it stands. Depressed mood, A1, is left uncounted rather than inferred, because his own description is of flatness rather than sadness and the frequency is unclear; the count does not depend on it.
Criterion B: Distress or Impairment
Met. He has made errors at work that his manager has noticed, has stopped activities he enjoyed, and his wife reports strain at home. He describes distress about his condition and fear of dementia.
Criterion C: Physiological Effects of a Substance or Medical Condition Ruled Out
Unresolved, and this is the crux of the mapping. The exclusion log established two conditions that can produce several of the counted symptoms. Severe obstructive sleep apnea, with an apnea-hypopnea index of 32 events per hour, can cause unrefreshing sleep, daytime fatigue, poor concentration, and low mood; sleep apnea and depression share many symptoms and frequently occur together, and depressive symptoms may improve with apnea treatment (Harris et al., 2009). Hazardous drinking, about 16 drinks a week with an AUDIT score of 11, is also linked to depressive symptoms, and the relationship between alcohol use and depression is thought to run at least partly from alcohol to depression (Boden & Fergusson, 2011).
Three of the six counted symptoms, A4, A6, and A8, could be largely explained by the apnea and alcohol. If they were set aside, three symptoms would remain, A2, A5, and A9, below the five required. The symptoms that are least explained by apnea or alcohol, loss of interest and thoughts of death, are also among the most specific to depression. The honest answer to Criterion C is that it cannot be settled until the apnea is treated and drinking is reduced.
Criteria D and E
Criterion D, not better explained by a psychotic disorder: met; no psychotic symptoms elicited. Criterion E, no manic or hypomanic episode ever: met by his and his wife's report; neither he nor his wife recalls any stretch of unusually high spirits, days of little sleep without tiredness, or out-of-character spending or risk-taking.
Specifiers and Severity
If the diagnosis is confirmed, the specifiers matter for treatment. Severity is rated moderate on the current record: six symptoms, clear impairment at work and home, and passive rather than active thoughts of death. The episode is the first; there is no history of prior episodes. No psychotic features are present. Melancholic features are not supported, since he reports flatness rather than a distinct quality of despair and his mood is not worse in the morning. The anxious distress specifier is not supported either; he denied feeling keyed up or tense, and his worry is focused on his memory rather than diffuse. Recording these negatives is as useful as recording the positives, because each specifier carries different implications for treatment choice and prognosis. The specifiers will be reassessed alongside Criterion C, since symptoms driven by sleep apnea could inflate the apparent severity.
What the Mapping Supports
The record supports a provisional diagnosis of major depressive disorder, single episode, moderate, with Criterion C unresolved, alongside confirmed diagnoses of obstructive sleep apnea and hazardous alcohol use. The diagnosis will be reassessed after three months of positive airway pressure therapy and reduced drinking. If loss of interest, psychomotor slowing, and thoughts of death persist with at least two other symptoms once sleep and alcohol are addressed, Criterion C is met and the diagnosis is confirmed; his lack of response to sertraline would then call for a change in antidepressant treatment. If most symptoms resolve, the depressive episode was substantially driven by the medical conditions, and the diagnosis and treatment change accordingly. Writing the diagnosis as provisional, with the specific unresolved criterion named, prevents a label from being carried forward in the record as settled when it is not.
References
American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.). American Psychiatric Association. https://doi.org/10.1176/appi.books.9780890425787
Boden, J. M., & Fergusson, D. M. (2011). Alcohol and depression. Addiction, 106(5), 906-914. https://doi.org/10.1111/j.1360-0443.2010.03351.x
Harris, M., Glozier, N., Ratnavadivel, R., & Grunstein, R. R. (2009). Obstructive sleep apnea and depression. Sleep Medicine Reviews, 13(6), 437-444. https://doi.org/10.1016/j.smrv.2009.04.001
What the NU 671 Unit 5 instructions ask for
Unit 5 asks you to map a patient's findings against the diagnostic criteria for a disorder. Expect to state each criterion, mark it met, not met or unresolved, cite the evidence from the record and draw a conclusion about the diagnosis, including specifiers. Many versions ask how much criteria text may be quoted; usually brief references by letter and number are enough. Check which edition your section expects; DSM-5-TR is current. Where the record does not answer a criterion, say so rather than assuming. Exclusion criteria often matter most, because medical conditions and substances can produce the same symptoms. A provisional diagnosis with a clearly named open question is a legitimate and often correct conclusion.
Inside the NU 671 Unit 5 example
The mapping opens with its purpose and method, explaining that each criterion will be marked with evidence. Criterion A is worked symptom by symptom, giving the evidence for each and noting which are counted and which are not. A short summary totals the count. Criterion B is addressed with examples from work and family. Criterion C gets the most space because it is unresolved, and the paper explains how sleep apnea and alcohol could account for fatigue, poor concentration and sleep problems. Criteria D and E are brief. Specifiers and severity are discussed conditionally. The final section states the provisional diagnosis and what would settle Criterion C, such as reassessment after sleep apnea treatment and reduced drinking.
NU 671 Unit 5 rubric: what full points look like
Herzing's rubric for criteria mapping typically covers accurate use of current criteria, evidence for each criterion, handling of exclusions, specifiers and severity, the conclusion and writing. Evidence for each criterion is read line by line, and a symptom counted without supporting detail loses credit. Accuracy points require DSM-5-TR criteria applied correctly, including the required core symptom. Exclusion handling often separates top papers, rewarding honest treatment of unresolved medical and substance contributors. Specifier points go to correct, conditional use. The conclusion earns credit when it matches the evidence, provisional where appropriate. Cite DSM-5-TR and Boden and Fergusson's review in APA 7. Graders also check that the required core symptom, depressed mood or loss of interest, is identified explicitly.
Common NU 671 Unit 5 mistakes, and how to avoid them
Criteria mappings in Unit 5 commonly lose points by counting symptoms without evidence from the record. Another frequent problem is ignoring Criterion C, so medical and substance explanations are never addressed. Students often quote large blocks of criteria text instead of referring to criteria by letter. Specifiers are applied without support. The conclusion is more certain than the record allows. Criteria the record cannot answer are marked met anyway. Finally, accept a provisional diagnosis when an exclusion is open, because graders reward accurate uncertainty more than a confident diagnosis built on an unresolved criterion. Severity ratings are often given without counting symptoms or describing impairment. The single-episode specifier also needs a statement that no prior episode was found in history or collateral.
Get a NU 671 Unit 5 example written to your instructions
Send the Unit 5 instructions and the rubric from your NU 671 classroom, naming the condition and the criteria set in play. We write a custom example with the edition identified, one criterion to a row, evidence taken only from the record, unmet rows left visible, and a verdict naming what is missing. First custom sample free, returned in 24 to 48 hours.
More NU 671 papers and PMHNP samples
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- NU 671 Unit 6: Rating instrument administration note
- NU 671 Unit 7: Collateral information summary
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- NU 673 Unit 5: Medication and cognition review
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NU 671 Unit 5 questions, answered
How much of the criteria text can be quoted?
Enough to make the row answerable, which is usually a short phrase rather than a full element, cited properly. Copying long stretches of a published manual into an assignment raises a permissions question and rarely improves the mapping. Refer to criteria by their labels where your course allows it, and put the effort into the evidence column instead.
What if the record does not answer a criterion?
Leave the row empty and say so in the verdict. An unanswered criterion is itself a finding, since it names the question a following appointment has to settle. Filling the gap with a reasonable assumption is the error making a mapping worthless, because a later reader cannot tell which rows rest on documentation and which on inference.
Does the mapping settle the diagnosis?
It settles whether the criteria are met on the evidence available, which is a narrower claim. A diagnosis rests on that mapping plus the exclusions, the timeline, collateral where it exists and clinical judgment, and it stays revisable. Write the verdict in those terms and say what would prompt the question to be reopened later.
Where can I find a free NU 671 Unit 5 sample paper?
You can read the whole NU 671 Unit 5 criteria mapping here for free, every criterion marked with evidence and the open exclusion explained. A mapping for another disorder, such as generalized anxiety or PTSD, can be written on request.
What is Criterion C for major depressive disorder?
It requires that the episode is not attributable to the physiological effects of a substance or another medical condition. In this sample, severe sleep apnea and heavy drinking leave Criterion C unresolved, so the diagnosis stays provisional.