The document describes an assignment to evaluate and treat a client presenting with a mental health disorder. It provides a case study of a 32-year-old woman, Rhonda, exhibiting various personality disorder symptoms. The student is asked to make three diagnostic and treatment decisions. For the first decision, the student diagnoses Rhonda with antisocial personality disorder. For the second decision, the student refers Rhonda for psychological testing. Testing confirms antisocial personality disorder traits. For the third decision, the student refers Rhonda to group cognitive behavioral therapy, as there are no FDA-approved medications for her condition.

1. Assignment 5: Decision Tree
Assignment 5: Decision TreeAssignment 5: Decision TreeFor this Assignment, as you
examine the client case study1 (See Below) in this week’s Learning Resources, consider how
you might assess and treat adult and older adult clients presenting symptoms of a mental
health disorder.Learning ObjectivesStudents will:· Evaluate clients for treatment of mental
health disorders· Analyze decisions made throughout diagnosis and treatment of clients
with mental health disordersTHE ASSIGNMENTExamine Case 1: You will be asked to make
three decisions concerning the diagnosis and treatment for this client. Be sure to consider
co-morbid physical as well as mental factors that might impact the client’s diagnosis and
treatment.(N: B. A CASE STUDY WITH ANSWER SAMPLE IS ATTACHED WITH THIS
ASSIGNMENTAt each Decision Point, stop to complete the following:ORDER NOW FOR
CUSTOMIZED, PLAGIARISM-FREE PAPERSDecision #1: Differential Diagnosis· Which
Decision did you select?· Why did you select this Decision? your response with evidence
and references to the Learning Resources.· What were you hoping to achieve by making this
Decision? your response with evidence and references to the Learning Resources.· Explain
any difference between what you expected to achieve with Decision #1 and the results of
the Decision. Why were they different?Decision #2: Treatment Plan for Psychotherapy· Why
did you select this Decision? your response with evidence and references to the Learning
Resources.· What were you hoping to achieve by making this Decision? your response
with evidence and references to the Learning Resources. Assignment 5: Decision Tree·
Explain any difference between what you expected to achieve with Decision #2 and the
results of the Decision. Why were they different?Decision #3: Treatment Plan for
Psychopharmacology· Why did you select this Decision? your response with evidence and
references to the Learning Resources.· What were you hoping to achieve by making this
Decision? your response with evidence and references to the Learning Resources.· Explain
any difference between what you expected to achieve with Decision #3 and the results of
the decision. Why were they different?· Also include how ethical considerations might
impact your treatment plan and communication with clients and their family.Note: your
rationale with a minimum of three academic resources. While you may use the course text
to your rationale, it will not count toward the resource requirement.PLEASE INCLUDE
INTRODUCTION, CONCLUSION AND REFERENCES LESS THAN 5 YEARS OLDCase #1 A
woman with personality disorderA woman with personality disorder SUBJECTIVERhonda is
a 32-year-old Hispanic female who presents to your office for her initial appointment. When
you ask what brought her to your office, she states: “I’m at the end of my rope, I don’t know

2. what else to do.” She then bursts into tears. Rhonda explains that she has very few friends
left, and everyone seems to have “abandoned” her. Rhonda explains that she goes out of her
way to help other people, and to be nice to them, but this does not seem to help.Rhonda
then stands up and begins to pace around your office at times using wild hand gestures to
explain the circumstances that led up to her making the appointment with you. She
describes the recent breakup with her boyfriend as traumatic and explains “when we first
met, he was the best guy in the world. He treated me really well. But he just became a
complete monster! Even though he broke off the relationship with me, I was glad to see it
end. I hate his guts!”Rhonda explains that her current financial situation is also precarious.
She states that she recently purchased an automobile, and is not certain how she is going to
pay for it. She states that she had a car that was repossessed last year at that time, and that
she borrowed some money from a friend to help pay for the car; the friend later turned
around and accused her of theft. “It was my friend’s fault. She told me she would loan me
the money and then backed out. I only took the money because she said she would loan it to
me … people just can’t go back on their word like that when other people are counting on
them.”Rhonda reports that she was “always in trouble” as a kid. She states that people were
always picking on her, to which she adds: “the other kids my age were just stupid. They
didn’t know how to have fun.” She says “I have always been impulsive, but it’s fun.
Sometimes people can be such prudes … you only go around life once, so you have to make
the best of it.” Assignment 5: Decision TreeOBJECTIVERhonda is currently single. She has no
children. Educationally, she had completed two semesters toward her bachelor of arts
degree in fine arts. Rhonda currently works as a waitress at a local restaurant. She has held
this job for about 2 weeks. Prior to this, Rhonda worked as a housekeeper for a local hotel
chain. She states that she was fired from this job because her coworkers were jealous of her
and “planted” evidence of her stealing from hotel patrons. She was also arrested for cashing
checks under an alias, for which she spent 120 days in jail.Rhonda has a history of multiple
incarcerations for offences ranging from larceny to possession of controlled substances to
possession of an illegal firearm. She was also arrested several times for fighting and on at
least one occasion, used a baseball bat to beat up a girl who she thought was trying to “set
her up” with the police.MENTAL STATUS EXAMRhonda is alert and oriented × 4 spheres.
Her speech is clear, coherent, goal directed, and spontaneous. She reports her mood as
“terrible!” Affect is labile and seems to change rapidly with the subject being discussed. Her
eye contact is normal, but at times, she appears to stare at you. Rhonda is oriented to
person, place, and time. She denies visual/auditory hallucinations, no overt paranoia or
delusional thought processes noted. Rhonda denies any suicidal or homicidal
ideation.Decision Point OneBASED ON THE INFORMATION PROVIDED IN THE SCENARIO
ABOVE, WHICH OF THE FOLLOWING DIAGNOSES WOULD THE PSYCHIATRIC/MENTAL
HEALTH NURSE PRACTITIONER (PMHNP) GIVE TO RHONDA?In your write-up of this case,
be certain to link specific symptoms presented in the case to DSM–5 criteria to your
diagnosis. Assignment 5: Decision TreeBorderline Personality DisorderHistrionic
Personality DisorderAntisocial Personality DisorderAnswer Chosen:Antisocial Personality
DisorderDecision Point TwoBASED ON THIS DIAGNOSIS, SELECT YOUR CHOICE OF
ACTIONS:https://mym.cdn.laureate-

3. media.com/2dett4d/Walden/NURS/6670/03/mm/decision_tree/img/pill-red.pngRefer to
psychologist for psychological testinghttps://mym.cdn.laureate-
media.com/2dett4d/Walden/NURS/6670/03/mm/decision_tree/img/pill-blue.pngBegin
Haldol 5 mg orally dailyhttps://mym.cdn.laureate-
media.com/2dett4d/Walden/NURS/6670/03/mm/decision_tree/img/pill-yellow.pngRefer
for psychodynamic psychotherapyAnswer Chosen:Refer to psychologist for psychological
testingRESULTS OF DECISION POINT TWO· Client returns to clinic in four weeks· The
psychologist’s report indicates that a comprehensive psychological battery was performed
for the purposes of diagnostic clarification. The end result suggested that Rhonda has traits
of multiple personality disorders, but scores highest in antisocial personality traits,
suggesting antisocial personality disorder.· When Rhonda returns to the office, you review
the psychologist’s report with her. Rhonda seems upset, but also states “well, that’s why I
am here, to get better … what do I need to do?”Decision Point ThreeBASED ON THE ABOVE
INFORMATION, SELECT YOUR NEXT ACTION. BE CERTAIN TO DISCUSS THE RATIONALE
FOR YOUR DECISION.https://mym.cdn.laureate-
media.com/2dett4d/Walden/NURS/6670/03/mm/decision_tree/img/pill-red.pngRefer to
group-based cognitive behavior therapyhttps://mym.cdn.laureate-
media.com/2dett4d/Walden/NURS/6670/03/mm/decision_tree/img/pill-blue.pngBegin
Latuda 40 mg orally dailyhttps://mym.cdn.laureate-
media.com/2dett4d/Walden/NURS/6670/03/mm/decision_tree/img/pill-yellow.pngRefer
for dialectical behavior therapyAnswer Chosen:Refer to group-based cognitive behavior
therapySome Guidance and Rationale for Answer to ChosenRhonda has APD; however, as
you can see, she has signs/symptoms of other personality disorders. In many cases,
individuals with personality disorders can demonstrate features of several personality
disorders.Referral to a psychologist was appropriate for the purposes of diagnostic
clarification. Psychological tests can help tease out the actual personality disorder that
Rhonda has. In this case, Rhonda’s symptoms are most consistent with antisocial
personality disorder, but as you can see, she has signs/symptoms of other personality
disorders.There are currently no FDA-approved medications to treat APD, thus Risperdal
would not be useful. Also, prescribing medications to someone with antisocial personality
disorder could lead to misuse or diversion.Of the available choices, group-based cognitive
behavior therapy may be useful in treating individuals with this personality disorder, but all
“improvement” in signs/symptoms should be met with great skepticism.Beginning Latuda is
not appropriate, as there are currently no FDA-approved medications to treat APD. Also,
prescribing medications to someone with antisocial personality disorder could lead to
misuse or diversion. Assignment 5: Decision TreeLearning ResourcesRequired
ReadingsSadock, B. J., Sadock, V. A., & Ruiz, P. (2014). Kaplan & Sadock’s synopsis of
psychiatry: Behavioral sciences/clinical psychiatry (11th ed.). Philadelphia, PA: Wolters
Kluwer.· Chapter 4, “Theories of Personality and Psychopathology” (pp. 151–191)· Chapter
22, “Personality Disorders” (pp. 742–762)· Chapter 13, “Psychosomatic Medicine” (pp. 451–
464)Gabbard, G. O. (2014). Gabbard’s treatment of psychiatric disorders (5th ed.).
Washington, DC: American Psychiatric Publications.· Chapter 68, “Paranoid, Schizotypal,
and Schizoid Personality Disorders”· Chapter 69, “Antisocial Personality Disorder”· Chapter

4. 70, “Borderline Personality Disorder”· Chapter 71, “Histrionic Personality Disorder”·
Chapter 72, “Narcissistic Personality Disorder”· Chapter 73, “Cluster C Personality
DisordersAmerican Psychiatric Association. (2013). Diagnostic and statistical manual of
mental disorders (5th ed.). Washington, DC: Author.· “Personality Disorders”Perry, J. C.,
Presniak, M. D., & Olson, T. R. (2013). Defense mechanisms in schizotypal, borderline,
antisocial, and narcissistic personality disorders. Psychiatry: Interpersonal & Biological
Processes, 76(1), 32–52. doi:10.1521/psyc.2013.76.1.32Rees, C. S., & Pritchard, R. (2015).
Brief cognitive therapy for avoidant personality disorder. Psychotherapy, 52(1), 45–55.
doi:10.1037/a0035158.Required MediaLaureate Education. (2017a). A woman with
personality disorder [Interactive media file]. Baltimore, MD: Author. (See Case 1
(Rhonda)Above)Kernberg, O. (n.d.). Psychoanalytic psychotherapy for personality
disorders: An Interview with Otto Kernberg, MD. [Video file]. Mill Valley, CA:
Psychotherapy.net Assignment 5: Decision Tree