| Course | NU245 Mental Health Nursing |
|---|---|
| Unit | Unit 4 |
| Paper type | Case study analysis |
| Length | About 900 words, 6 pages double-spaced |
| Format | APA 7 student paper |
| School | Purdue University Global |
| Program | BSN (prelicensure) |
| Updated | October 2026 |
Free sample paper for NU245 Unit 4
Burned Toast, a Fire Alarm Test and a Flashlight at Night: A Case Study Analysis of Posttraumatic Stress in a Composite Thirty-Three-Year-Old Woman Five Months After an Apartment Fire, With a Trauma-Informed Plan Built Around Her Three Triggers
[Student Name]
Purdue University Global
NU245: Mental Health Nursing
Unit 4 Case Study Analysis
[Instructor Name]
[Date]
The patient is composite; diagnosis belongs to the treatment team, and therapy is provided by trained clinicians, with nursing care supporting it.
Presentation
[Ms. A.], composite, 33, a dental hygienist, was admitted after a panic episode at work that ended in an emergency visit. Five months ago she escaped a fire in her apartment building by the stairwell, carrying her cat; a neighbor died. Since then she has nightmares about the fire most nights, sleeps four to five hours, avoids cooking and has moved to a building where she will not use the stairwell. She startles at loud sounds, especially alarms. She says, "I smell smoke when there isn't any." She has stopped seeing friends and says she feels "like the person who left that building isn't me."
Assessment Against the Diagnostic Criteria
The DSM-5-TR describes posttraumatic stress disorder through exposure to a traumatic event and four symptom clusters, lasting more than one month and causing distress or impairment (American Psychiatric Association, 2022).
1. Exposure: she directly experienced a fire in which a person died.
2. Intrusion: nightmares most nights, smelling smoke, distress at reminders.
3. Avoidance: avoids cooking and stairwells.
4. Negative changes in thinking and mood: withdrawal from friends, feeling detached from herself.
5. Changes in arousal and reactivity: startle at alarms, poor sleep.
Duration: five months. Impairment: panic at work, emergency visit. Her symptoms meet each cluster; the team makes the diagnosis.
Her Triggers, in Her Words
1. "When someone burns toast in the kitchen, I'm back in the hallway."
2. "The alarm test on Tuesday, I couldn't breathe."
3. "When the light hit my face at night, I thought it was the firefighters."
Priority Problems
1. Anxiety and risk of panic related to trauma reminders on the unit.
2. Disturbed sleep pattern related to nightmares and night checks.
3. Social isolation and detachment.
4. Risk for avoidance of treatment.
Plan, Organized as Trauma-Informed Care
Trauma-informed care rests on principles of safety, trustworthiness and transparency, peer support, collaboration, empowerment and choice, and attention to cultural and historical issues (Substance Abuse and Mental Health Services Administration, 2014). Each intervention below applies one of them to a trigger. Burned toast (safety, collaboration): ask the unit to use the toaster in the kitchen with the door closed and the fan on; offer her a seat away from the kitchen at breakfast; agree with her on what she will do if she smells smoke, such as stepping onto the patio with a staff member. Fire alarm test (transparency, choice): tell her the day and time of the next test in advance, and offer her the choice of being on the far side of the unit with a staff member and headphones during it.
A fire alarm she knows is coming at 10:00 on Tuesday is a test; the same alarm without warning is the fire again.
Night checks (safety, empowerment): observation continues as required, but the method changes. Staff check from the doorway using the hall light rather than sweeping a flashlight across her face, and she is told who will check and how often. Observation is kept; only the way it is done changes.
Sleep: a regular bedtime, reduced caffeine, and a grounding routine she can use after a nightmare: naming five things she can see and four she can hear. Isolation: invite her to one group each day, with the choice to sit near the door. Therapy: trauma-focused psychotherapy, such as prolonged exposure or cognitive processing therapy, is provided by trained therapists. The nurse's role is to support attendance, help her use coping skills between sessions and report changes, not to conduct exposure work (Halter, 2022).
Why Not a Standard Anxiety Plan
A standard plan for anxiety would list relaxation breathing, a calm environment and as-needed medication. Each has a place, but none addresses why her anxiety spikes at particular moments on this unit. A generic plan would also keep the flashlight checks unchanged and leave her to discover the alarm test without warning, repeating the very experiences that send her back into the fire. Organizing the plan around her named triggers makes the unit itself less frightening and teaches her that her reactions are predictable and can be prepared for, which is part of recovery from trauma.
The Nurse's Own Approach
Asking about trauma can itself be distressing. The nurse asks permission before asking about the fire, lets her decide how much to say, avoids pressing for details and watches for signs of becoming overwhelmed, such as staring or shallow breathing, offering to pause. Being predictable and keeping small promises, such as returning at the time said, builds the trust that trauma-informed care depends on.
Evaluation
After [five] days: alarm test tolerated with advance notice and headphones, rating distress [4] of 10 compared with [9] the week before; sleeping six hours on four nights; attended three groups; first therapy session completed.
What Would Change the Plan
New thoughts of self-harm, increased use of alcohol to sleep or refusal to attend therapy would be reported to the team at once.
References
American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.). American Psychiatric Publishing.
Halter, M. J. (2022). Varcarolis' foundations of psychiatric-mental health nursing: A clinical approach (9th ed.). Elsevier.
Substance Abuse and Mental Health Services Administration. (2014). SAMHSA's concept of trauma and guidance for a trauma-informed approach (HHS Publication No. SMA 14-4884). Substance Abuse and Mental Health Services Administration.
Reading the NU 245 Unit 4 instructions
Unit 4 cases often involve trauma or anxiety, and the analysis is expected to cover presentation, assessment against diagnostic criteria, priority problems, a plan and evaluation. Many prompts ask students to apply trauma-informed care principles. Instructors look for criteria checked symptom by symptom, interventions tailored to the patient's specific triggers, respect for safety requirements on the unit and a clear line between nursing support and psychotherapy. Diagnosis is the team's, so students show how symptoms align with criteria rather than declaring a diagnosis. Around six pages under the case headings is common, drawing on the DSM-5-TR and SAMHSA's trauma guidance. Evaluation should use numbers the patient reports herself.
How this NU245 Unit 4 example is built
Presentation summarizes the fire, her sleep, avoidance, startle and panic at work. The criteria section lists exposure and the four clusters with her examples, plus duration and impairment. Her three triggers follow in quotation marks. Four priority problems lead into a plan organized by trauma-informed principles from SAMHSA, each intervention tied to a trigger, with a highlighted line on the alarm test and a margin note on keeping observation while changing its method. Sleep, isolation and therapy are addressed, with a note separating nursing from therapy roles. A section explains why a standard anxiety plan falls short, another covers the nurse's own approach, then evaluation.
Reading the NU245 Unit 4 grading rubric
Case study rubrics in NU 245 generally reward accurate assessment, correct use of diagnostic criteria, appropriate priorities, individualized interventions with rationale, evaluation and scholarly writing. Assessment credit depends on symptoms described in specific terms. Criteria credit goes to each cluster matched to the patient's examples, with duration and impairment noted. Priority credit rewards ranking anxiety around reminders and sleep disruption. Intervention credit is earned by plans tied to her triggers and to named trauma-informed principles. Evaluation credit requires measurable change, such as distress ratings during the next alarm test. Writing credit covers headings and citations. Plans that keep required safety checks while changing how they are done show mature judgment.
NU245 Unit 4 help: mistakes that cost points
PTSD case studies often lose credit by writing a generic anxiety plan of breathing exercises and as-needed medication that ignores the patient's actual triggers. Another frequent error is suspending safety checks to avoid distress, rather than changing how they are done. Some students describe nurses conducting exposure therapy, which belongs to trained therapists. Others declare a diagnosis instead of matching symptoms to criteria. Check each cluster with her examples, record triggers in her words, build each intervention from a trauma-informed principle, keep safety requirements while adapting methods, define the nursing role clearly and measure progress with numbers she reports. Ask permission before discussing the trauma, and let her decide how much detail to share on any given day.
Get an NU245 Unit 4 example written to your instructions
Panic disorder, obsessive-compulsive disorder, generalized anxiety, trauma after violence or disaster: anxiety and trauma cases take many shapes. Copy the case and its questions into your request, along with the grading criteria and the plan layout your instructor wants. Expect a plan built around the triggers of an invented patient whose presentation matches your case. First custom sample free, back within 24-48h. 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.
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NU245 Unit 4 questions, answered
Where can I find a free NU245 Unit 4 sample paper?
The full NU245 Unit 4 case study analysis is on this page, planning trauma-informed care around three triggers for a composite fire survivor, with criteria, priorities, evaluation and three sources. A case with different triggers can be planned the same way if you send it to us.
What are the four PTSD symptom clusters?
Intrusion, avoidance, negative changes in thinking and mood, and changes in arousal and reactivity, lasting more than a month after a traumatic event.
What is trauma-informed care in NU245 Unit 4 terms?
Care organized around safety, trustworthiness and transparency, peer support, collaboration, empowerment and choice, and cultural awareness, applied to each trigger.
Why change how night checks are done?
A flashlight across her face brought back the fire. Checking from the doorway with the hall light keeps the required observation without the trigger.
Do nurses provide exposure therapy for PTSD?
Trained therapists provide trauma-focused therapy. Nurses support attendance, help with coping skills between sessions and report changes.