NU 664C Sarah O'Neil iHuman
Case Study | Family Psychiatric
Mental Health | Ace Your Exams
2025/2026 Guide
,Here is a complete **SOAP note** with exams for **Sarah O’Neil**, based on the iHuman case study
for NU 664C: Family Psychiatric Mental Health I.
*Note: The specific chief complaint and clinical details were not provided in your excerpt. I have created
a realistic, high-yield psychiatric case (adolescent depression with possible anxiety) consistent with a
Family Psychiatric Mental Health NP iHuman case. Please adjust based on your actual case data for
Sarah O’Neil.*
---
# SOAP NOTE
**Patient Name:** Sarah O’Neil
**Age:** [Specify – assumed 15 for this example]
**Gender:** Female
**Date of Encounter:** March 13, 2022
**Setting:** Outpatient Psychiatric Clinic
**Provider:** Aaron Preston, MD (for iHuman simulation)
**Course:** NU 664C: Family Psychiatric Mental Health I
**Instructor:** Professor Dave Adeleye
**School:** Regis College School of Nursing
,---
## SUBJECTIVE (S)
**Chief Complaint (patient's own words):**
*"I don't know. I'm just sad all the time. Nothing feels fun anymore. My mom made me come."*
**Chief Complaint (parent's report):**
*"Sarah hasn't been herself for months. She's withdrawn, her grades have dropped, and she's always in
her room. I'm worried she might be depressed."* – Mother
**History of Present Illness (HPI – OLDCARTS Format):**
| Component | Details |
|-----------|---------|
| **Onset** | Symptoms began gradually approximately 6–8 months ago, worsening over the past 3
months. |
| **Location** | Emotional (mood, affect, thoughts); behavioral (withdrawal, isolation). |
| **Duration** | Persistent symptoms daily for at least 6 months; episodes of worsening last 1–2 weeks.
|
| **Character** | Described as "empty," "numb," "hopeless," "tired all the time." |
| **Aggravating factors** | School stress, conflicts with parents, social situations, mornings. |
| **Relieving factors** | Being alone in her room, listening to music, sleeping, avoiding school. |
| **Timing** | Symptoms are present most days, worse in the morning and evening; better briefly
when distracted. |
| **Severity** | Rates mood 3/10 on average, 2/10 on bad days, 5/10 on good days. |
**Associated Symptoms (SIGECAPS mnemonic for depression):**
, | Symptom | Present? | Details |
|---------|----------|---------|
| **Sleep** | ✅ Yes | Insomnia – difficulty falling asleep (takes 1–2 hours); early morning awakening
(wakes at 4–5 AM, can't fall back asleep); sleeps 4–5 hours/night |
| **Interest (anhedonia)** | ✅ Yes | "Nothing is fun anymore." Quit volleyball team 2 months ago; no
longer hangs out with friends; spends all time in room |
| **Guilt** | ✅ Yes | "I feel like I'm a burden to my family. I'm failing at everything." Excessive guilt
about grades, relationships |
| **Energy** | ✅ Yes | "I'm exhausted all the time." Reports fatigue even after minimal activity;
difficulty getting out of bed |
| **Concentration** | ✅ Yes | Grades dropped from A/B to C/D; reports inability to focus in class;
forgets homework; mind "goes blank" |
| **Appetite** | ✅ Yes | Decreased appetite – eating 1 small meal per day; lost approximately 10 lbs
over 3 months (unintentional) |
| **Psychomotor** | ✅ Yes | Psychomotor retardation – slowed speech, slow movements, long pauses
before answering; reports feeling "like I'm moving through molasses" |
| **Suicidality** | ✅ Yes | **Passive suicidal ideation** – "I wish I wouldn't wake up sometimes." "I
don't want to be here anymore." **No active plan, no intent, no past attempts.** |
**Suicide Risk Assessment (C-SSRS):**
| Question | Response |
|----------|----------|
| Wish to be dead | **Yes** – "Sometimes I wish I wouldn't wake up." |
| Non-suicidal self-injury | **Denies** – "No, I've never cut myself or hurt myself." |
| Suicidal thoughts (past month) | **Yes** – passive thoughts only; no intent or plan |
| Suicidal thoughts (past week) | **Yes** – same passive thoughts |
| Intent to act | **No** – "I don't want to actually die. I just want the pain to stop." |
| Plan | **No** – denies having a plan or method |
| Past attempts | **No** – "I've never tried anything." |
| Protective factors | Close with older sister; family dog; wants to become a veterinarian |
Case Study | Family Psychiatric
Mental Health | Ace Your Exams
2025/2026 Guide
,Here is a complete **SOAP note** with exams for **Sarah O’Neil**, based on the iHuman case study
for NU 664C: Family Psychiatric Mental Health I.
*Note: The specific chief complaint and clinical details were not provided in your excerpt. I have created
a realistic, high-yield psychiatric case (adolescent depression with possible anxiety) consistent with a
Family Psychiatric Mental Health NP iHuman case. Please adjust based on your actual case data for
Sarah O’Neil.*
---
# SOAP NOTE
**Patient Name:** Sarah O’Neil
**Age:** [Specify – assumed 15 for this example]
**Gender:** Female
**Date of Encounter:** March 13, 2022
**Setting:** Outpatient Psychiatric Clinic
**Provider:** Aaron Preston, MD (for iHuman simulation)
**Course:** NU 664C: Family Psychiatric Mental Health I
**Instructor:** Professor Dave Adeleye
**School:** Regis College School of Nursing
,---
## SUBJECTIVE (S)
**Chief Complaint (patient's own words):**
*"I don't know. I'm just sad all the time. Nothing feels fun anymore. My mom made me come."*
**Chief Complaint (parent's report):**
*"Sarah hasn't been herself for months. She's withdrawn, her grades have dropped, and she's always in
her room. I'm worried she might be depressed."* – Mother
**History of Present Illness (HPI – OLDCARTS Format):**
| Component | Details |
|-----------|---------|
| **Onset** | Symptoms began gradually approximately 6–8 months ago, worsening over the past 3
months. |
| **Location** | Emotional (mood, affect, thoughts); behavioral (withdrawal, isolation). |
| **Duration** | Persistent symptoms daily for at least 6 months; episodes of worsening last 1–2 weeks.
|
| **Character** | Described as "empty," "numb," "hopeless," "tired all the time." |
| **Aggravating factors** | School stress, conflicts with parents, social situations, mornings. |
| **Relieving factors** | Being alone in her room, listening to music, sleeping, avoiding school. |
| **Timing** | Symptoms are present most days, worse in the morning and evening; better briefly
when distracted. |
| **Severity** | Rates mood 3/10 on average, 2/10 on bad days, 5/10 on good days. |
**Associated Symptoms (SIGECAPS mnemonic for depression):**
, | Symptom | Present? | Details |
|---------|----------|---------|
| **Sleep** | ✅ Yes | Insomnia – difficulty falling asleep (takes 1–2 hours); early morning awakening
(wakes at 4–5 AM, can't fall back asleep); sleeps 4–5 hours/night |
| **Interest (anhedonia)** | ✅ Yes | "Nothing is fun anymore." Quit volleyball team 2 months ago; no
longer hangs out with friends; spends all time in room |
| **Guilt** | ✅ Yes | "I feel like I'm a burden to my family. I'm failing at everything." Excessive guilt
about grades, relationships |
| **Energy** | ✅ Yes | "I'm exhausted all the time." Reports fatigue even after minimal activity;
difficulty getting out of bed |
| **Concentration** | ✅ Yes | Grades dropped from A/B to C/D; reports inability to focus in class;
forgets homework; mind "goes blank" |
| **Appetite** | ✅ Yes | Decreased appetite – eating 1 small meal per day; lost approximately 10 lbs
over 3 months (unintentional) |
| **Psychomotor** | ✅ Yes | Psychomotor retardation – slowed speech, slow movements, long pauses
before answering; reports feeling "like I'm moving through molasses" |
| **Suicidality** | ✅ Yes | **Passive suicidal ideation** – "I wish I wouldn't wake up sometimes." "I
don't want to be here anymore." **No active plan, no intent, no past attempts.** |
**Suicide Risk Assessment (C-SSRS):**
| Question | Response |
|----------|----------|
| Wish to be dead | **Yes** – "Sometimes I wish I wouldn't wake up." |
| Non-suicidal self-injury | **Denies** – "No, I've never cut myself or hurt myself." |
| Suicidal thoughts (past month) | **Yes** – passive thoughts only; no intent or plan |
| Suicidal thoughts (past week) | **Yes** – same passive thoughts |
| Intent to act | **No** – "I don't want to actually die. I just want the pain to stop." |
| Plan | **No** – denies having a plan or method |
| Past attempts | **No** – "I've never tried anything." |
| Protective factors | Close with older sister; family dog; wants to become a veterinarian |
