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Week (enter week #): (Enter assignment title)

Student Name

College of Nursing-PMHNP, Walden University

NRNP 6635: Psychopathology and Diagnostic Reasoning

Faculty Name

Assignment Due Date

Subjective:

NRNP/PRAC 6635 Comprehensive Psychiatric Evaluation Template

CC (chief complaint):

HPI:

Past Psychiatric History:

General Statement:

Caregivers (if applicable):

Hospitalizations:

Medication trials:

Psychotherapy or Previous Psychiatric Diagnosis:

Substance Current Use and History:

Family Psychiatric/Substance Use History:

Psychosocial History:

Medical History:

Current Medications:

Allergies:

Reproductive Hx:

ROS:

GENERAL:

HEENT:

SKIN:

CARDIOVASCULAR:

RESPIRATORY:

GASTROINTESTINAL:

GENITOURINARY:

NEUROLOGICAL:

MUSCULOSKELETAL:

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NRNP/PRAC 6635 Comprehensive Psychiatric Evaluation Template

HEMATOLOGIC:

LYMPHATICS:

ENDOCRINOLOGIC:

Objective:

Physical exam: if applicable

Diagnostic results:

Assessment:

Mental Status Examination:

Differential Diagnoses:

Reflections:

References