Assessment 3: Case-study Exercise Template

This document provides a case-study exercise template for Assessment 3. It includes instructions for completing the exercise, a case-study scenario, and questions to answer related to the scenario. The document also mentions the importance of safety issues, communication techniques, mental health nursing standards, and specific interventions for recovery-oriented practice.

Assessment 3: Case-study Exercise Template
 Complete answers only in the white sections (minimum of 12 font size).
 Upload this document to the Assessment 3: Case-study exercise drop box.
 This document will also be submitted into a quiz tool, in session 10.
Student Name: Student ID: Date:
Case- Study one You are working in the Emergency Department with the short-term treatment team. It is 10pm and Greg has been
bought the Emergency Department by his daughter who is worried that her father has had a heart attack. The
father and daughter have been in the waiting room for one hour. You have been asked to accompany the
registered nurse as she conducts an assessment with Greg and his daughter.
Greg’s daughter provides the background to the events that bought them to the Emergency Department this
evening. She had visited her parents earlier today and her father was in bed and his wife had told her that Greg
had been unable to get out of bed all week except to go to work. He had stopped doing any household chores
because he complained of being so tired all the time. Only when quizzed by his daughter did Greg begin to tell her
that he thought that he had something terrible happen following an outing to the library. Greg has not been
talking to his wife about what has been happening because he didn’t want to worry her.
Greg is a 64-year-old male, dressed in unkempt casual clothes, who reports that his biggest problem is
worrying. He worries all of the time and about “everything under the sun.” For example, he reports equal worry
about his wife who is undergoing treatment for breast cancer and his home garden water consumption. He is
aware that his worrying in way that is unhealthy and difficult but he can’t stop it at the moment. He is observed to
have motor restlessness, and continually wringing his hands. In the Emergency Department waiting room he was
unable to sit for any length of time, rather he paced about, sat down, got back up, and in the cubicle now he is
trying to stand and sit and keeps moving about in the chair. It is observed that he looks perplexed and anxious.
Greg reports feeling low in mood. He also states he is often worried about small things, for example whether he
has returned his book by the due date to the library.
Greg reports that on his last trip to the library he experienced a frightening surge of adrenaline and associated
anxiety symptoms - an increase in heartbeat, feeling hot & sweaty, rapid breathing and trouble getting his
thoughts together. This experience has not left him, and he continues to have periods of time at night and day

whereby he feels that his heart is going to explode. He has also had trouble with breathing and often gets puffed
out with minimal exertion. Greg recognises that his wife is more important than a book, and is bothered that he
doesn’t seem to be able to stop worrying. In fact one of the worst things is that his mind keeps churning over and
over, this is what keeps him awake at night because he can’t seem to switch his brain off. Greg thinks he is unable
to control his anxiety. Accompanying this excessive and uncontrollable worry are difficulties falling asleep,
irritability and impatience with others, difficulty focusing at work, and significant back and muscle tension. This
worry has stopped Greg from going out with friends and even family. Greg has had a lifelong problem with worry,
recalling that his mother called him a “worry wart.” His worrying over the years does fluctuate in severity, and has
worsened since his wife’s recent diagnosis of breast cancer.
In the past month, Greg’s wife has learnt that she will be unable to work for the next 12 months due to her
compromised immune system when the breast cancer treatment starts. This will require Greg to do the shopping
and management of the family’s day to day affairs. Greg is so worried that his wife will die that he can’t imagine
how he is going to cope and he doesn’t want to let his wife and family down. Greg is also worried that he will lose
his job and therefore the family will fall into homelessness and poverty. He feels overwhelmed with what is
happening to his family currently but cannot articulate it and doesn’t want discuss it because he is the
breadwinner, father and husband and he doesn’t have a diagnosis of cancer. He is deeply ashamed of what is
happening currently.
Answer the questions below and relate to the case-study.
1. Identify key safety issues
within the case-study.
Include consideration of
the environment as well
as the consumer, family
and clinician.
(10 marks)
It has been analysed from the case study that registered nurse needs to be engaged completely in providing
quality of care to Greg. They must make sure that the safety and protection of child is kept on priority. Registered
nurse must be involved in providing service user with person centred care so that health outcome of patient can
be improved. When patients, their families, other caregivers, and the public are full, active participants in care,
health, the experience of care and economic outcomes can be substantially improved. Greg’s daughter also has
the responsibility to provide emotional support to Greg so that this will reduce patient’s emotional stress and
tension (Varcarolis, (2016). It will help the family member of Greg in reducing the aspect of anxiety that has been
faced by Greg. Registered nurse needs to make sure better and safe environment is been provided to Greg so that
quality of services which has been provided by them gets improved. Clinician also needs to be involved with
patient’s family so that they can be engaged in considering all of the issues affecting patients care. Needs and
preferences of patient also be taken in consideration. The other safety issue that needs to be taken in
consideration are as it has been analysed that Greg is also facing an increase in heartbeat, feeling hot & sweaty,
rapid breathing and trouble getting. So special emphasis must be laid on this by clinicians. They also needs to
make sure that patient is not been engaged in consuming g alcohol, as this will make sure that patients is been in

safe and secure condition.
2. Describe the
communication
techniques that build
rapport and the
therapeutic relationship
between the nurse and
the consumer.
(10 marks)
It has been analysed that as Greg is suffering from problem of anxiety. Patient worries about every situation a lot.
He is also worried about his wife’s disease and condition of his home if he falls seriously ill. In order to improve
the health outcome of patients, registered nurses must make use of effective communication so that therapeutic
relationship can be built. In order to build rapport with Greg, registered nurses needs to be involved in taking up
a little extra time in order to connect with their patient. They must also be involved in knowing about their
thoughts so that emotional support can be provided to service user. Communication must also be done by health
care professionals to family members of patients so that they have an idea about the patient’s exact mental
condition. Registered nurses in order to build with therapeutic relationship with Greg, they should also be
involved in doing active listening. This will help patient in having a feeling of satisfaction and will assist him to
recover from the depression. Registered nurses also need to be empathetic towards their patients so that they
will be able to understand the situation level of Greg. They will also be able to know about the Greg’s feelings and
emotions. This can assist them in improvising the health outcome of patient. Eye contact also needs to be
maintained while treating Greg as this communicates care and compassion.
3. Describe how mental
health nursing standards,
the Victorian (2014)
Mental Health Act
legislation can support
the delivery of care.
(10 marks)
Mental health act 2014 can assist registered nurses in improvising the quality of care that has been provided to
Greg who is suffering from anxiety, stress. Victoria’s mental health system has provided with the details that
special care needs to be provided to those service suers facing problems related to mental health disorder. The
act promotes that better decision needs to be taken by health care professional by engaging in communicating
effectively by service users (Holmberg, Caro, & Sobis, (2018). In the present case registered nurse must be
involved in doing effective communication with Greg so that therapeutical relationship can be build. This will
assist nurses in analysing the situation of Greg and can provide them with better care and support through this.
Mental health act 2014, also provides that recovery oriented practices must be used by registered nurses while
providing treatment to patients suffering from anxiety and depression. It has also been analysed that health care
professionals also needs to engaged in Greg for treatment decisions and also about his needs and preferences.
Registered nurses must be involved in protecting the rights and duties of patients according to this law. In order to
treat Greg, registered nurses can make use of holistic care; this will support them in taking better decisions and
also will help them in improvising health outcome of patients. Victoria’s mental health also lays emphasis on that
registered nurses needs to be engaged in building rapport with patients so that they can be able to have their
views and preferences considered and respected.
4. Describe specific
interventions related to
recovery orientated
practice that can assist in
making the consumer
central in care delivery.
According to the mental health act, 2014 it has been analysed that recovery oriented approaches needs to be
used by registered nurses in order to treat patients suffering from mental health disorders. Recovery oriented
approaches are basically those approaches that can be useful to analyse one’s abilities that support people to
recognise and take their responsibility of their own health. It will assist them in recovering from various diseases
and it will also support patients in defining their goals as well as aspirations. In the case of Greg, registered nurse
can make use of various type of recovery based approaches so that their quality of services improved and also

(10 marks)
health outcome of service user can be enhanced. One of the mist effective recovery oriented approach that can
be used by registered nurse includes making use of holistic approach. In this practice they need to be involved in
knowing about the medical history of patient and motivate them to participate in treatment process. This will help
them in reducing stress level of service user. Holistic approach basically means that taking care of service users in
all aspects. It covers everything that supports them to be happy and satisfied. It means health related to entire
body and mind is been taken in consideration by health care professional. The other recovery based approach
which can be used in case of Greg is that mental health nurses can be involved in providing and supporting
recovery that is personal. This can assist in making central in care delivery.
Case-study two Sonia is a 24 year old woman who recently lost her job as a store manager (3 months ago) due to the closure of
the business. Sonia has been unable to pay her rent for the last two months and is struggling with her real estate
agent, about staying where she is until she can organise a new place to live. Sonia thought that she had managed
the stress of the last two months quite well. She has been trying to keep healthy and has been exercising every
day for two hours. In the last two weeks she has been having difficulties sleeping because of stress about her
financial situation. Sonia has increased her exercising in the last two weeks to over 4 hours a day and has is trying
to eat only one meal a day to budget, to manage her stress. She feels like she has broken her left foot but she is
continuing to exercise despite the pain she feels. Sonia is continuing to get bills, in particular her car registration
which she doesn't know how she will pay, and is due and she doesn’t how she will look for houses or move
without the car. Three days ago her boyfriend of seven years rang Sonia to say that he was leaving town. He said
he couldn't explain to her now, but he wanted to have a break from the relationship. Sonia had been noticing that
he had been more distant lately, however the call came as a complete surprise and for the past 2 days Sonia has
been unable to stop a thought in her head that keeps repeating. "What is the point, you may as well give up".
Another quieter voice has been saying “you are a bad person, you are unlovable, and this is all your fault”. Sonia
does not want to tell anyone about these voices because she feels she will be punished in some way, if she reveals
their existence.
Sonia was found on the overpass of a busy freeway at 0300am in the morning and has been brought to the
Emergency Department. A passer-by noticed that Sonia was standing in the middle of the overpass stationary and
they were concerned that she was thinking about jumping out onto the freeway below. The ambulance was called
and because Sonia was almost unresponsive on assessment, the paramedics had brought her in for a psychiatric
assessment.
You are required to assess Sonia with the registered nurse on duty. While Sonia has been in the emergency
department behavioural assessment room you have noticed that she has not moved at all since being placed
there forty minutes ago. Sonia has not drunk any fluids or moved from the spot on the couch. When you observe
her through the video feed in the security guard room, Sonia appears to be talking to herself. However, when you
enter the room, Sonia doesn’t seem to notice you. She does not seem to be talking to anyone when you examine

her she just seems to sit motionless. When you ask her if she could answer some questions to help with the
assessment you are trying to do she appears to not hear you. A couple of minutes later Sonia starts to smile and
nod her head as if she is listening to someone. She does not answer your questions. Sonia appears to be very frail
and not in good health. You speak to the medical officer and he is querying a diagnosis of psychosis. Sonia has no
known psychiatric history. You go back to sit with Sonia to try to get the assessment completed.
Following further assessment by the psychiatrist. It is planned that Sonia will be admitted to the hospitals mental
health unit. You are required to document your assessment (mental state examination and risk assessment),
potential treatments and care interventions below.
1. Using all of the mental
state examination
framework, document
the consumer’s mental
state.
(10 marks)
From the case study, it has been analyzed that Sonia is really stressed because she has left her job and has no
money to pay the rent or even afford the food. She is also facing emotional trauma has her boyfriend has broken
up with her. Helath acre professionals have seen her talking to herself. They are presuming that Sonia might be
suffering from psychosis. Patients mental state can be described in following ways:
Appearance and physical activity: Sonia has been exercising for 4 hours so that she can reduce her stress level. It
has been analyzed that’ she also got injured but continue to exercise instead of the pain. It has been analyzed that
after admitting to hospital she has been talking to herself and not discussing anything with any other. She seems
to be really depressed and also found at highway (Happel et.al., (2020)..
Perception: Sonia felt like someone is talking to her even when she was alone in the hospital room. She has unreal
feelings and also going through feeling of depression. Health care professional feels like Sonia is been suffering
from psychosis. Also she has suicidal thoughts as she was seen in highway. She feels depressed and sad.
Judgment: It has been analyzed that Sonia is unable to make her own decision as she is not in her senses. It has
also been analyses that patient are been that she is suffering from psychosis. She is also having un-realful
situation. She has no understanding about the right and wrong choices.
2. Based on the information
provided, include a risk
assessment and identify
other assessments that
There is various type of risk assessment that needs to be taken by health care professionals while providing
treatment to Sonia. It has been analyzed that Sonia has suicidal tendencies as she was found in highway in an
unconscious situation. In this they need to identify hazards. They need to lay emphasis on psychological
conditions of service users. In this health care professionals needs to analyze employments status, relationship

may be required.
(10 marks)
status of Sonia. They need to analyze wants and demand of patient so that risk of harm to themselves and other
individual can be analyzed. This will help them in assessing the risk factors that can hamper the quality of care of
health care professionals. It will also reduce health outcome of patients. It will also support health care
professional in knowing about whether the patient assess threat to others or themselves. Treatment given by
registered nurses will be fully based on risk assessment therapy. It will help them in knowing about emotional and
mental conditions of patients. It has been analyzed that in this case risk assessment related to service user is
really necessary. Other assessment can such as mental health assessment can also be used by health care
professionals (Barker, (2017). This will help registered nurses in analyzing problems such as depression, anxiety,
bipolar disorder, psychosis, learning disorder. These problems can reduce health outcome and quality of life of
patients who are suffering from it. It can also reduce physical and mental abilities of service user. They will not be
able to think.
3. Identify the disorder the
person is experiencing
and describe treatments
that are recommended
for this disorder.
(10 marks)
From the case study, it has been analyzed that Sonia is suffering from psychosis as she is been talking to herself
and not sharing her problems. It has also been analyzed that patient is really depressed and anxious as she has
lost her job and has no money to pay the rent. She also has no money to have food. She is also stressed as her
boyfriend from 7 years as left her. Sonia also have suicidal tendencies that has reduced her quality of life. In the
present case registered nurse must be involved in doing effective communication with Sonia so that therapeutical
relationship can be build. Various interventions can be used by health care professionals in order to improve the
mental health condition of Sonia. Health care professionals can make use of evidence based interventions in order
to improve health outcome of service user. They can also engage in building a rapport so that psychosis can be
treated. Health care professionals can also engage in providing supportive care so that empathy can be shown to

Sonia. In order to treat mental health problems various type of therapy can also be used by them. It can include
making use of cognitive therapy. This therapy can assist mental health professionals in improvising the thinking
capabilities of Sonia. It will assist hear in making and taking her own decision. They must also be involved in
knowing about their thoughts so that emotional support can be provided to service user
4. Identify key issues/needs
for the consumer within
the case-study and
develop an individualised
care plan.
(30 marks)
Below in the care plan document the consumer needs, treatment goals, specific nursing interventions and how
you would evaluate effectiveness and consumer outcomes.
Needs: (Identify the consumers’ needs/issues)
Goals: (Expected consumer and clinician goals)
Interventions: (Specific nursing interventions)
Evaluation: (Make an overall statement of how will you evaluate care delivered)
Identified consumer issue/need Goals Interventions Evaluation
1. In order to provide emotional support, various
interventions can be used by health care professionals.
This can be evaluated when
the health outcome of

Emotional support The goal is to improve
mental health condition
of Sonia.
They can be engaged in building rapport so that
emotional state of patient can be known as well as
support can be provided. It has also been analyzed that
health care professionals will also be engaged in making
use of effective communication so that emotional
support can be provided (Townsend & Morgan, (2017).
patient or service user is
been enhanced.
2.
Medical support
The goal is to improve
mental health condition
of Sonia.
Health care professionals will also be engaged in giving
Sonia medical support. In this various type of
interventions can be used by them. They will make use of
person centered and holistic approach so that health
outcome of Sonia is been enhanced. It can include
making use of cognitive therapy. This therapy can assist
mental health professionals in improvising the thinking
capabilities of Sonia.
This can be evaluated when
the health outcome of
patient or service user is
been enhanced.
3.
Decision making support
The goal is to improve
mental health condition
of Sonia.
From the case study, it has been analyzed
that Sonia is been suffering from psychosis,
she is unable to take her own decision. In
these health care professionals will be
engaged in taking better decisions for her by
analyzing Sonia’s needs and preferences. This
is because patient has no judgment
capabilities; she has been talking to herself. In
this health care professionals needs to analyze
employments status, relationship status of Sonia. This
will help them in taking better decisions.
This can be evaluated when
the health outcome of
patient or service user is
been enhanced.
4. The goal is to improve
mental health condition
of Sonia.
It has been analyzed from case study, that no one is
paying attention to situation of Sonia which has
made her depressed. Her boyfriend has left her. It is
This can be evaluated when
the health outcome of
patient or service user is

Attention need suggested to nurses to been involved in
communicating with patient so her needs and
demands can be known. This will also help them in
making her satisfied so that problems related to
psychosis and depression can be solved.
been enhanced.
5.
Psycho-education need
The goal is to improve
mental health condition
of Sonia.
In this health care professionals can make use of
psycho-education as an intervention so that Sonia
can know about the facts and figures that has made
her depressed. This will also help them in
improvising her mental and physical abilities.
This can be evaluated when
the health outcome of
patient or service user is
been enhanced.
Reference List: APA 7th Edition
Townsend, M. C., & Morgan, K. I. (2017). Psychiatric mental health nursing: Concepts of care in evidence-based practice. FA Davis.
Barker, P. (2017). Psychiatric and mental health nursing: The craft of caring. CRC Press.
Holmberg, C., Caro, J., & Sobis, I. (2018). Job satisfaction among Swedish mental health nursing personnel: Revisiting the two‐factor
theory. International journal of mental health nursing, 27(2), 581-592.
Holmberg, C., Caro, J., & Sobis, I. (2018). Job satisfaction among Swedish mental health nursing personnel: Revisiting the two‐factor
theory. International journal of mental health nursing, 27(2), 581-592.
Happell, B., Foster, K., Lawman, B., Moxham, L., Powell, M., Ryan, T., ... & Muir-Cochrane, E. (2020). Mental health nursing education in
undergraduate and postgraduate programs: Time for change.
Varcarolis, E. M. (2016). Essentials of Psychiatric Mental Health Nursing-E-Book: A Communication Approach to Evidence-Based Care. Elsevier
Health Sciences.