NRNP 6634 Week 5 Differential Analysis Example

Course	NRNP 6634 Psychiatric Mental Health Advanced Practice Nursing Care of Adults and Older Adults
Week	Week 5
Paper type	Differential analysis paper
Length	About 770 words, 5 pages
Format	APA 7 student paper
School	Walden University
Program	MSN Psychiatric Mental Health Nurse Practitioner (PMHNP)
Updated	October 2026

Free sample paper for NRNP 6634 Week 5

Differential Analysis: Five Candidates for Low Mood and Forgetfulness at 72, Each Settled or Left Open by a Quoted Finding

Student Name

College of Nursing, Walden University

NRNP 6634: Psychiatric Mental Health Advanced Practice Nursing Care of Adults and Older Adults

Instructor Name

Month Day, Year

What this page is doingThe title promises that each candidate is settled by a specific quoted finding. An analysis earns its reasoning marks at the point of exclusion, and a phrase saying a candidate does not fit gives the grader nothing to check.

Differential Analysis: Five Candidates for Low Mood and Forgetfulness at 72, Each Settled or Left Open by a Quoted Finding

Presentation Summary

Composite patient: woman of 72, widowed, living alone, 4 months of low mood, anhedonia, early waking, weight loss, and guilt after her sister's sudden death in March, with concentration and memory complaints for the past 2 months. One prior depressive episode at 48 that responded to an antidepressant. Passive death wish without plan or intent. Nightly wine since March; a diphenhydramine sleep aid bought over the counter, used on most nights since April. MoCA 23 of 30 with a retrieval pattern on delayed recall. Her mother developed Alzheimer disease late in life. TSH, returned this week: 2.1 mIU/L on her usual levothyroxine dose; vitamin B12: 540 pg/mL; sodium, calcium, and glucose normal.

Why These Five, in This Order

The candidates are ordered by how seriously each was entertained at the first visit, not by how the analysis ended. Depression came first because the full syndrome was present and a prior episode had responded to treatment. Prolonged grief came second because the loss was recent and central to her account, and because it is the diagnosis most easily confused with depression after a death. Alzheimer disease came third because it was her own fear and her mother's illness, and because a missed neurocognitive disorder would change her safety planning, her driving, and her family's decisions. Medication and substance effects came fourth, and hypothyroidism fifth, because in an older adult these are common, reversible, and easy to miss if the analysis stops at the psychiatric candidates. Each block below uses the same three parts so that no candidate is dismissed more lightly than another.

Candidate 1: Major Depressive Disorder, Recurrent

For: five or more symptoms for more than 2 weeks, including depressed mood ("empty") and loss of interest, with early waking, weight loss, guilt, poor concentration, and passive death wish, and clear loss of function (American Psychiatric Association, 2022); a prior episode at 48. Against: the episode began after a bereavement, which requires the clinician to judge whether the response exceeds expected grief. Settling finding: her description of an emptiness that does not lift even with her grandchildren, a pervasive anhedonia that extends to her grandchildren, and guilt focused on having failed her sister, describe a depressive episode rather than grief waves that ease between reminders. Retained.

Candidate 2: Prolonged Grief Disorder

For: intense yearning for her sister and preoccupation with the death. Against: DSM-5-TR requires that at least 12 months have passed since the death for adults (American Psychiatric Association, 2022). Settling finding: the death was 4 months ago. Excluded by the time criterion; grief is recorded as a context of the depressive episode, not a separate diagnosis.

Candidate 3: Major Neurocognitive Disorder Due to Alzheimer Disease

For: memory complaints, a MoCA below the cutoff, and a first-degree relative with Alzheimer disease. Against: onset of cognitive complaints about 2 months after the mood change; no functional decline before March; recall improved from 2 of 5 to 5 of 5 with cues; worse in the mornings with her mood. Settling finding, from collateral: her daughter, "The forgetting started after Aunt Ruth died." Not retained now; left open for reassessment after treatment of the depression, because late-life depression can be a prodrome of dementia (Byers & Yaffe, 2011).

Candidate 4: Medication and Substance Effects on Cognition

For: regular diphenhydramine at bedtime since April, and a glass of wine each evening since March; both can impair attention and memory in older adults. Diphenhydramine is a strongly anticholinergic antihistamine that the American Geriatrics Society Beers Criteria advise against in people her age (2023 American Geriatrics Society Beers Criteria Update Expert Panel, 2023). Against: her mood symptoms began before either substance increased. Settling finding: the timing, sleep aid started in April, which places it after the mood change but before the cognitive complaints. Retained as a contributor to the cognitive symptoms, not as the cause of the depression.

Candidate 5: Hypothyroidism

For: known hypothyroidism, fatigue, slowed thinking, and weight change. Against: weight loss rather than gain. Settling finding: TSH 2.1 mIU/L on her usual dose this week. Excluded.

What this page is doingEach candidate has the same three parts, for, against, and the single finding that settled it, and medical and substance causes are ranked alongside psychiatric ones. An analysis raising only psychiatric candidates would lose the breadth point.

The Retained Diagnosis, Left Open Where It Should Be

Retained: major depressive disorder, recurrent episode, moderate, with onset after bereavement, and with a probable anticholinergic and alcohol contribution to her cognitive symptoms. Left open: major neurocognitive disorder, to be revisited with a repeat MoCA after remission and after diphenhydramine and alcohol have been stopped for at least a month. If her cognition does not improve by then, formal neuropsychological testing is the next step.

References

2023 American Geriatrics Society Beers Criteria Update Expert Panel. (2023). American Geriatrics Society 2023 updated AGS Beers Criteria for potentially inappropriate medication use in older adults. Journal of the American Geriatrics Society, 71(7), 2052-2081. https://doi.org/10.1111/jgs.18372

American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.). https://doi.org/10.1176/appi.books.9780890425787

Byers, A. L., & Yaffe, K. (2011). Depression and risk of developing dementia. Nature Reviews Neurology, 7(6), 323-331. https://doi.org/10.1038/nrneurol.2011.60

Reading the NRNP 6634 Week 5 instructions

Week 5 of NRNP 6634 commonly asks for a differential diagnosis analysis for a psychiatric presentation. You summarize the case, justify the candidates and their order, evaluate each against specific findings, and state the retained diagnosis and its open questions. Faculty reward careful exclusion. DSM-5-TR criteria and the grief and thyroid literature should be cited in APA 7. Medical and medication causes belong on the list. Excluded diagnoses deserve real space. The analysis may lead into a treatment plan in a later week. NRNP 6634 faculty want each candidate assessed with at least one quoted or measured finding. Explain why the five were chosen and why others were not. State the retained diagnosis and its open questions. Name the tests that remain.

How the NRNP 6634 Week 5 example is put together

The finished analysis starts from a single paragraph summing up the presentation, drawn from a composite adult and cleared of anything identifying, so a reader can hold the evidence in mind while the candidates are worked. Four candidates follow, ordered by how seriously each was entertained. Every one occupies a block with the same three parts: what in the record supports it, what in the record argues against it, and the single item that settled the matter, quoted rather than summarized. Medical and substance related contributors are carried as candidates in their own right instead of mentioned in passing. The retained diagnosis comes last with its criteria mapped item by item to the patient's own evidence, a severity statement, and a short paragraph naming what remains unknown and what would reopen the question. Citations sit inside the blocks.

Where the marks sit in the NRNP 6634 Week 5 rubric

The rubric rewards exclusion, and exclusion is where an analysis usually thins out. Candidates dismissed with a phrase about the presentation not fitting give the reasoning criterion nothing to mark, while a rejection anchored to a dated finding earns that row outright. Analyses raising only psychiatric candidates lose the breadth point, because in adults a medication effect, a metabolic cause or a substance is a live candidate and its absence reads as oversight. Uneven treatment across blocks costs consistency, particularly where the favored diagnosis is examined generously and the rest are handled in a line apiece. Sources older than the range your section sets cost currency. The analyses holding full marks are the ones where a reader could reverse the conclusion using only what the document itself supplies.

Common NRNP 6634 Week 5 mistakes, and how to avoid them

Differential analyses thin out at exclusion, dismissing candidates with a phrase. Quote the finding that settles each one. Another common gap is missing medical causes such as hypothyroidism or B12 deficiency. Include them with tests. Writers also forget medications, especially anticholinergic drugs in older adults. Review her list. Avoid stating the retained diagnosis with more certainty than the evidence supports. Leave open what is open. Keep findings consistent with earlier weeks. Close with the tests that would settle the remaining questions. Writers also forget prolonged grief, a newer diagnosis that fits some bereaved patients better than depression. Weigh it with the timing criteria. Another frequent slip is leaving thyroid or B12 tests unordered. Order them. Keep the dates of her losses consistent with earlier weeks.

Get a NRNP 6634 Week 5 example written to your instructions

Send the Week 5 prompt, the presentation your classroom supplied and its rubric, and the desk writes the differential out as a finished document with every candidate blocked, evidenced and closed. The first custom sample is free and comes back inside 24-48 hours, built on your own case rather than on the composite described above.

More NRNP 6634 papers and PMHNP samples

NRNP 6634 Week 5 questions, answered

How many candidates should appear?

The example carries four, which is enough to show a standard being applied consistently without turning the document into a catalog. Prompts vary and some name a number outright, in which case that number governs. What the criteria reward is not the count but whether each candidate was examined at the same depth and closed against something specific in the record.

Why are excluded diagnoses given so much space?

Because they are the argument. A retained diagnosis stated on its own is an assertion, and it becomes reasoning only once a reader can see what else was considered and what closed it. Markers looking for clinical judgment read the rejection blocks first. The example gives every rejected candidate the same three parts the retained one gets, and that symmetry is what earns credit.

Does the analysis lead into a treatment plan?

Not inside this document. The example ends at the retained diagnosis, its severity and what remains uncertain, because a differential that starts prescribing has left its own rubric behind. Later weeks in many sections pick the plan up from there. Nothing on this page states what any patient should receive, and the same boundary holds in anything the desk writes.

Where can I find a free NRNP 6634 Week 5 sample paper?

The five-candidate analysis is reproduced here with the reasons for each candidate and order, quoted findings that settle or leave them open, and the retained diagnosis.

Which candidates are weighed in NRNP 6634 Week 5?

Recurrent major depression, prolonged grief disorder, Alzheimer disease, a medical cause and others, explained in order of likelihood.