NURS 6630 WEEK 10 ASSIGNMENT 2026/2027 |
Assessing & Treating Impulsivity Compulsivity
Addiction | Puerto Rican Woman with Comorbid |
Pass Guaranteed - A+ Graded
Part One: Case Presentation & Initial Assessment (Puerto Rican
Woman with Comorbid Conditions) (10 Questions)
Q1: A 34-year-old Puerto Rican woman presents to the psychiatric mental health
clinic with her sister. She reports feeling "out of control" for the past six months. She
describes episodes of intense anger where she throws objects, screams at her
children, and once punched a hole in the wall—followed by immediate remorse.
Between episodes, she describes herself as "fine" and denies persistent low mood.
Her sister adds that she also drinks wine "most nights" to calm down. What is your
first priority in the initial assessment?
A. Prescribe an SSRI for presumed major depressive disorder and schedule follow-up
in two weeks
B. Order liver function tests and immediately initiate inpatient detoxification for
alcohol dependence
C. Conduct a comprehensive assessment including substance use screening, trauma
history, and cultural formulation [CORRECT]
D. Diagnose intermittent explosive disorder and start a mood stabilizer immediately
Correct Answer: C
Rationale: The presentation is complex with possible impulsivity, substance use, and
cultural factors. A thorough assessment must precede diagnosis and treatment.
Option A assumes depression without evidence. Option B is premature—drinking
"most nights" doesn't automatically require inpatient detox. Option D jumps to
diagnosis and treatment without adequate assessment.
,Q2: During the interview, the patient reveals she immigrated from Puerto Rico five
years ago and lives with her sister's family. She speaks Spanish at home and English
at work, where she feels "constantly judged." She attends Mass weekly and describes
her faith as central to her identity, though she feels "ashamed" to discuss her
problems with her priest. Which cultural factor is most relevant to her current
distress?
A. Her religious faith is causing delusional guilt that requires antipsychotic treatment
B. Acculturative stress, language barriers, and stigma around mental health in her
community may contribute to her coping patterns [CORRECT]
C. Her living arrangement with extended family is pathological and indicates
dependent personality disorder
D. Her bilingualism is a cognitive deficit that explains her impulsive behavior
Correct Answer: B
Rationale: Acculturative stress, navigating dual cultural expectations, and mental
health stigma in Latino communities are well-documented factors that can
exacerbate distress and influence help-seeking behavior. Option A pathologizes
normal religious practice. Option C mischaracterizes a culturally normative living
arrangement. Option D misinterprets bilingualism as deficit.
Q3: You administer the CAGE-AID questionnaire. The patient answers "yes" to two
questions: feeling she should cut down on her drinking, and feeling guilty about her
drinking. She answers "no" to being annoyed by criticism and drinking in the
morning. What does this CAGE-AID score indicate?
A. No significant substance use concern; two positive responses is below clinical
threshold
B. Possible alcohol use disorder requiring further assessment with AUDIT or DSM-5
criteria [CORRECT]
, C. Definitive diagnosis of severe alcohol use disorder requiring immediate inpatient
treatment
D. The questionnaire is invalid because she denied the "eye-opener" question
Correct Answer: B
Rationale: A score of 2 or more on CAGE-AID is considered positive and warrants
further assessment, but it does not constitute a diagnosis alone. The AUDIT or DSM-
5 criteria are needed for definitive diagnosis. Option A is incorrect—2 is the clinical
threshold. Option C overstates the screening result. Option D is wrong—denying one
question doesn't invalidate the entire screen.
Q4: The patient describes her drinking pattern: 2-3 glasses of wine nightly,
occasionally 4 on weekends. She denies withdrawal symptoms, blackouts, or drinking
at work. She has tried to cut back twice in the past year but resumed within days. She
scored 14 on the AUDIT. How would you classify her alcohol use?
A. No alcohol use disorder; her drinking is within social norms
B. Mild alcohol use disorder (2-3 symptoms) [CORRECT]
C. Moderate alcohol use disorder (4-5 symptoms)
D. Severe alcohol use disorder (6 or more symptoms)
Correct Answer: B
Rationale: An AUDIT score of 14 in women indicates hazardous drinking. Based on
DSM-5 criteria, she likely meets 2-3 symptoms: drinking more than intended,
unsuccessful attempts to cut down, and possibly craving or continued use despite
problems. This qualifies as mild AUD. Option A ignores the failed quit attempts and
elevated AUDIT score. Options C and D overstate the severity based on the
information provided.
Assessing & Treating Impulsivity Compulsivity
Addiction | Puerto Rican Woman with Comorbid |
Pass Guaranteed - A+ Graded
Part One: Case Presentation & Initial Assessment (Puerto Rican
Woman with Comorbid Conditions) (10 Questions)
Q1: A 34-year-old Puerto Rican woman presents to the psychiatric mental health
clinic with her sister. She reports feeling "out of control" for the past six months. She
describes episodes of intense anger where she throws objects, screams at her
children, and once punched a hole in the wall—followed by immediate remorse.
Between episodes, she describes herself as "fine" and denies persistent low mood.
Her sister adds that she also drinks wine "most nights" to calm down. What is your
first priority in the initial assessment?
A. Prescribe an SSRI for presumed major depressive disorder and schedule follow-up
in two weeks
B. Order liver function tests and immediately initiate inpatient detoxification for
alcohol dependence
C. Conduct a comprehensive assessment including substance use screening, trauma
history, and cultural formulation [CORRECT]
D. Diagnose intermittent explosive disorder and start a mood stabilizer immediately
Correct Answer: C
Rationale: The presentation is complex with possible impulsivity, substance use, and
cultural factors. A thorough assessment must precede diagnosis and treatment.
Option A assumes depression without evidence. Option B is premature—drinking
"most nights" doesn't automatically require inpatient detox. Option D jumps to
diagnosis and treatment without adequate assessment.
,Q2: During the interview, the patient reveals she immigrated from Puerto Rico five
years ago and lives with her sister's family. She speaks Spanish at home and English
at work, where she feels "constantly judged." She attends Mass weekly and describes
her faith as central to her identity, though she feels "ashamed" to discuss her
problems with her priest. Which cultural factor is most relevant to her current
distress?
A. Her religious faith is causing delusional guilt that requires antipsychotic treatment
B. Acculturative stress, language barriers, and stigma around mental health in her
community may contribute to her coping patterns [CORRECT]
C. Her living arrangement with extended family is pathological and indicates
dependent personality disorder
D. Her bilingualism is a cognitive deficit that explains her impulsive behavior
Correct Answer: B
Rationale: Acculturative stress, navigating dual cultural expectations, and mental
health stigma in Latino communities are well-documented factors that can
exacerbate distress and influence help-seeking behavior. Option A pathologizes
normal religious practice. Option C mischaracterizes a culturally normative living
arrangement. Option D misinterprets bilingualism as deficit.
Q3: You administer the CAGE-AID questionnaire. The patient answers "yes" to two
questions: feeling she should cut down on her drinking, and feeling guilty about her
drinking. She answers "no" to being annoyed by criticism and drinking in the
morning. What does this CAGE-AID score indicate?
A. No significant substance use concern; two positive responses is below clinical
threshold
B. Possible alcohol use disorder requiring further assessment with AUDIT or DSM-5
criteria [CORRECT]
, C. Definitive diagnosis of severe alcohol use disorder requiring immediate inpatient
treatment
D. The questionnaire is invalid because she denied the "eye-opener" question
Correct Answer: B
Rationale: A score of 2 or more on CAGE-AID is considered positive and warrants
further assessment, but it does not constitute a diagnosis alone. The AUDIT or DSM-
5 criteria are needed for definitive diagnosis. Option A is incorrect—2 is the clinical
threshold. Option C overstates the screening result. Option D is wrong—denying one
question doesn't invalidate the entire screen.
Q4: The patient describes her drinking pattern: 2-3 glasses of wine nightly,
occasionally 4 on weekends. She denies withdrawal symptoms, blackouts, or drinking
at work. She has tried to cut back twice in the past year but resumed within days. She
scored 14 on the AUDIT. How would you classify her alcohol use?
A. No alcohol use disorder; her drinking is within social norms
B. Mild alcohol use disorder (2-3 symptoms) [CORRECT]
C. Moderate alcohol use disorder (4-5 symptoms)
D. Severe alcohol use disorder (6 or more symptoms)
Correct Answer: B
Rationale: An AUDIT score of 14 in women indicates hazardous drinking. Based on
DSM-5 criteria, she likely meets 2-3 symptoms: drinking more than intended,
unsuccessful attempts to cut down, and possibly craving or continued use despite
problems. This qualifies as mild AUD. Option A ignores the failed quit attempts and
elevated AUDIT score. Options C and D overstate the severity based on the
information provided.
