One composite man's tardive dyskinesia, from recognition to a supported apartment, runs through all six documents of the MN667 Unit 10 portfolio, each addressed to whoever reads it next. Searches like "mn 667 unit 10 assignment example", "mn667 unit 10 sample" and "mn667 unit 10 example" land here.
Capstone Case Portfolio: Tardive Dyskinesia Found After Three Years Without a Scale in a 54-Year-Old Man With Schizophrenia
[Student Name]
Purdue University Global
MN667: PMHNP Diagnosis and Management Across the Lifespan III
Unit 10 Assignment
[Instructor Name]
[Date]
Composite patient written as a model document. Every regimen is bracketed; nothing here is a prescribing instruction.
Cover Memo
The thread. A composite 54-year-old man with schizophrenia, treated with antipsychotics for 22 years, developed involuntary movements of his mouth and tongue that staff at his group home had taken for a habit. When they were finally measured, his score on the Abnormal Involuntary Movement Scale was 14. The five documents follow one line: recognizing tardive dyskinesia, confirming it, treating it without destabilizing his psychosis, carrying the plan into his move to his own apartment, telling the people around him what they are seeing, and asking why it took years to find.
Map. Document 1, the evaluation note, records the finding and the diagnosis. Document 2, the consultation page, records why one atypical movement was sent to neurology and what came back. Document 3, the management plan, records the treatment decision and the options rejected. Document 4, the transition plan, carries that decision into his move. Document 5, the plain-language communication, prepares his new support staff. The memo closes with a practice note on the delay.
Test. Each document was written so that its own reader could act on it without the author.
Document 1: Evaluation Note
Composite 54-year-old man with schizophrenia, living in a group home, seen for a routine visit. Staff report "lip smacking and tongue rolling" for about a year, which they thought was a habit. He says his mouth "moves by itself sometimes" and that it embarrasses him at the day program.
Antipsychotic history: [a first-generation agent] for 12 years, then [a second-generation agent] for 10 years to date, at [a composite dose]. One relapse of psychosis, with hospitalization, eight years ago when he stopped medication.
Examination: repetitive lip smacking, tongue movements and chewing movements at rest, increasing when he is distracted; mild writhing movements of the fingers; a separate, brief sideways jerk of the neck, observed twice. AIMS total 14, with moderate to severe scores for the lips, tongue and jaw (Guy, 1976). Psychosis stable; no hallucinations in the past year. No other new medicines.
Diagnosis: tardive dyskinesia, moderate, with one atypical feature (the neck movement), referred for consultation.
Document 2: Consultation Page
Why neurology was asked. The mouth and finger movements fit tardive dyskinesia well, but the brief sideways jerk of the neck did not fit the usual pattern, and that one atypical feature crossed the line from psychiatric scope into neurology's. Other causes of involuntary movements, including Huntington disease and other neurologic disorders, can look similar.
Question asked: "Is the neck movement part of tardive dyskinesia, or is there another movement disorder that needs its own evaluation?"
What came back. The neurologist examined him, reviewed his family history, which includes no known movement disorders, and found the neck movement consistent with a tardive dystonic component. No further testing was recommended. The neurologist agreed with a trial of a VMAT2 inhibitor.
Document 3: Management Plan
Options weighed:
Stop the antipsychotic outright. Rejected. His psychosis relapsed and he was hospitalized the last time he stopped, and stopping can also make tardive dyskinesia worse in the short term.
Lower the dose or switch to an antipsychotic with lower risk. Considered and kept as a second step. A switch could destabilize eight years of stable psychosis, and evidence that switching reverses tardive dyskinesia is limited.
Add a VMAT2 inhibitor. Chosen. Two were approved by the FDA in 2017 for tardive dyskinesia: valbenazine and deutetrabenazine. In a six-week phase 3 trial, valbenazine at its higher dose reduced AIMS scores more than placebo (Hauser et al., 2017). In a 12-week phase 3 trial, deutetrabenazine reduced AIMS scores more than placebo (Anderson et al., 2017). The American Psychiatric Association's 2020 guideline for schizophrenia recommends a VMAT2 inhibitor for moderate to severe or disabling tardive dyskinesia (Keepers et al., 2020).
Choice: [valbenazine at a composite dose], once daily, chosen because once-daily dosing suits a man moving to his own apartment, where no staff will give medicines at midday. Its antipsychotic is continued unchanged.
Monitoring: AIMS at 4, 8 and 12 weeks, and every six months after; sleepiness, since it can occur with VMAT2 inhibitors; mood and suicidal thoughts at each visit; psychosis symptoms at each visit.
Document 4: Transition Plan
He moves from the group home to a supported apartment in [month]. Owners and dates:
Medication: pharmacy blister packs for both medicines, starting the week before the move. Owner: clinic nurse.
Support staff: a visit three times a week from the supported housing team, who will check that blister packs are used. Owner: housing case manager.
AIMS at the 8-week visit, timed to fall after the move so that any change is seen. Owner: prescriber.
Handover: the group home's staff write down what they have noticed about his movements and mood and give it to the housing team. Owner: group home manager.
Document 5: Plain-Language Communication for Support Staff
What you may see: movements of his lips, tongue and jaw, like chewing or smacking, and sometimes his fingers and neck. They are called tardive dyskinesia. They are a side effect of medicine he has taken for many years, not a habit, and he cannot stop them by trying.
What is being done: he has started a new medicine to reduce the movements. It is taken once a day in the morning.
What to tell us: if the movements get worse, if he seems very sleepy, if he seems sad or talks about hurting himself, or if he stops taking either medicine.
What not to do: please do not remind him to stop the movements or comment on them in front of others. It embarrasses him.
Cover Memo, Closing: Practice Note
His chart shows no AIMS entries for three years before this visit. Guidelines recommend regular assessment for abnormal movements in people taking antipsychotics (Keepers et al., 2020). In his case, three years without a scale meant that movements present for about a year were first described by staff as a habit rather than measured. The practice note asks three questions for the clinic: how many other patients on long-term antipsychotics lack a recent AIMS, whether the scale can be added to the annual visit template, and whether group home staff can be taught to report new movements. The clinic's quality committee will review the first question next month.
References
Anderson, K. E., Stamler, D., Davis, M. D., Factor, S. A., Hauser, R. A., Isojärvi, J., Jarskog, L. F., Jimenez-Shahed, J., Kumar, R., McEvoy, J. P., Ochudlo, S., Ondo, W. G., & Fernandez, H. H. (2017). Deutetrabenazine for treatment of involuntary movements in patients with tardive dyskinesia (AIM-TD): A double-blind, randomised, placebo-controlled, phase 3 trial. The Lancet Psychiatry, 4(8), 595-604. https://doi.org/10.1016/S2215-0366(17)30236-5
Guy, W. (1976). ECDEU assessment manual for psychopharmacology (Rev. ed.). U.S. Department of Health, Education, and Welfare.
Hauser, R. A., Factor, S. A., Marder, S. R., Knesevich, M. A., Ramirez, P. M., Jimenez, R., Burke, J., Liang, G. S., & O'Brien, C. F. (2017). KINECT 3: A phase 3 randomized, double-blind, placebo-controlled trial of valbenazine for tardive dyskinesia. American Journal of Psychiatry, 174(5), 476-484. https://doi.org/10.1176/appi.ajp.2017.16091037
Keepers, G. A., Fochtmann, L. J., Anzia, J. M., Benjamin, S., Lyness, J. M., Mojtabai, R., Servis, M., Walaszek, A., Buckley, P., Lenzenweger, M. F., Young, A. S., Degenhardt, A., & Hong, S.-H. (2020). The American Psychiatric Association practice guideline for the treatment of patients with schizophrenia. American Journal of Psychiatry, 177(9), 868-872. https://doi.org/10.1176/appi.ajp.2020.177901
How this MN667 Unit 10 example is structured
The cover memo is the portfolio's spine, because a capstone is judged on whether its pieces make one case rather than six assignments. It states the thread in a paragraph, then maps each document to the decision it records. Every document is written for its own reader and passes the test used across the course: could that reader act without the author? The evaluation is filed as a note, not an essay. The consultation page shows the scope line and why one atypical feature crossed it. Its management plan keeps a record of options considered and rejected, including stopping the antipsychotic outright, set aside because his psychosis relapsed the last time. The staff communication tests the whole portfolio from outside the profession, and the practice note asks why three years passed without the scale that would have caught this sooner.
Get an MN667 Unit 10 example written to your instructions
Capstone prompts in MN667 Unit 10 often build on earlier units, so gather anything you wrote before about this patient, along with the Unit 10 case and rubric. The first custom portfolio is free within 24-48h, joined by a cover memo and written document by document for the next reader. The paper above is an original model document written by our desk, not a submitted student paper and not an official Purdue University Global document.
MN667 Unit 10 questions, answered
How should a capstone portfolio reuse earlier coursework?
Draw on it, then revise it for the portfolio's thread. Earlier assignments were written to show understanding; the capstone expects documents that work in practice and fit together. Update facts that changed, cut explanation aimed at a grader and add the links between pieces. A cover memo mapping each document to its decision makes the connections visible.
Does a portfolio need a practice-level section?
It is often required at the capstone, and where it is optional it usually strengthens the work. Step back from the patient to the system that shaped the case, such as a monitoring gap or a scheduling barrier, and propose one correction. Keep it brief, describe causes rather than blame, and strip out anything tying it to an actual practice or colleague.
Can the portfolio include my own clinical hours or site documents?
No. The sample portfolio uses a composite case and covers written work only: evaluations, plans, communications and analysis. Your practicum hours and logs, real encounter records and every form a preceptor attests to remain yours and your site's. Your own portfolio will draw on your coursework; a sample shows the form and reasoning, not your clinical record.