HLT54115 Diploma of Nursing
Unit of competency:
HLTENN009 - Implement and monitor care
for a person with mental health conditions
Assessment task 1 Knowledge questions
Context of assessment:
This assessment needs to be completed in your own time as part of your self-paced
learning. You need to undertake the knowledge questions at home (and/or during class
time, if time permits).
You must submit the completed knowledge answers individually and plagiarism,
collusion and cheating will not be tolerated.
Planning the assessment:
Time allowed for this assessment is 3 - 4 hours. This is a guide only and you may take
more or less time to complete this assessment.
A mutually agreeable time will be set by the assessor to provide feedback to you.
You will be advised of this knowledge questions assessment during session 1. All
questions are to be answered by the designated due date.
Required resources
Computer with internet connection to access online resources.
Log in credentials to access the Moodle platform.
Textbook reference:
Alexander, L. (2016). Chapter 39 Mental health and mental illness. In. Koutoukidis, G,
Stainton, K & Hughson,J., Tabbners nursing care. (7
ed.). Chatswood, NSW:
Churchill Livingstone..
Website reference:
Government of South Australia - Attorney-General's Department. (n.d.). Mental Health
2009. Retrieved from
The Department of Health. (2014). A National framework for recovery-oriented mental
health services: guide for practitioners and providers. Retrieved from
The Department of Health. (2013). National practice standards for the mental health
2013. Retrieved from
Nursing theory. (n.d.). Tidal Model. Retrieved from
WedMD. (2014). The ten principles of recovery. Retrieved from INFORMIT
Evidence submission:
The knowledge questions are required to be answered on Moodle.
Ensure you log in to the Moodle platform using the user credential provided to you.
Answers must be entered in the space provided for each question.
Competency assessment:
To be deemed Satisfactory for this assessment, you must provide satisfactory answers
to all knowledge questions. To authenticate the veracity of your work, the assessor will
query you on the answers provided.
Any student not achieving a Satisfactory outcome for any question, will be allowed to
repeat the question and resubmit the assessment tool through Moodle (second
If the assessment outcome is Not Yet Satisfactory after the second attempt, any further
intervention strategies will be planned in accordance with EQUALS’ Assessment
You must use Harvard referencing style where required, e.g. when using direct quotes,
although you are encouraged to keep these to a minimum. For more information, refer
to EQUALS’ Style Guide available from the Student Centre in Moodle.
You must answer questions fully and accurately while keeping within the requirements
of word limits.
Reasonable adjustment provided, if applicable (to be completed by the assessor):
Knowledge questions
Part A Short-answer questions:
1. Define the following key terms associated with mental illness (in 35 60 words each).
a. Mental health:
Mental health encompasses a state of well being where an individual is mentally,
physically and socially well. The state of being mentally healthy is furthermore
associated with the ability to realize one’s capabilities, work productively, deal with the
normal challenges of life and make positive contribution to the society.
Satisfactory Not Yet Satisfactory
b. Mental illness:
Mental illness refers to a condition that affects how an individual feels, thinks, acts or
relate to other people and surroundings. The Mental Health Act of 2009 in South
Australia describes mental illness as any disorder involving the mind.
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c. Delusion:
Delusion is a condition where an individual has false beliefs that show an
inconsistency with how the person thinks. The false belief furthermore, is not an effect
of the individual’s background such as cultural, religious or intellectual.
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d. Phobia:
Phobia involves a type of anxiety disorder where the individual affected has an
extreme and unfounded fear of a specific item or a certain situation that the average
person would consider having no risk. The fear makes the individual uncomfortable
and the condition is identified as an anxiety disorder as anxiety is the main symptom
that the sufferer experiences.
Satisfactory Not Yet Satisfactory
2. Briefly describe the key features of the mental health legislation applicable to your State or
Territory under the following headings:
Objectives (in 60 90 words)
To provide legal ground for the reform of mental health in South Australia
To establish noteworthy changes in the practice of mental healthcare so that the
mental health services are aligned with national and global best practice
To increase the accountability of mental healthcare among practitioners
To strengthen the involvement between the consumer of mental health services
and the caregiver so that quality outcomes can be achieved for the consumer and
their family
To provide the best quality of care that is safe and multidisciplinary
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Involuntary admission (in 50-80 words)
According to the Mental Health Act of 2009, an order for involuntary treatment and
admission is permissible if the individual has been diagnosed with mental illness
with an authorized medical practitioner. The grounds of involuntary admission are
further based on the possibility of the individual with the mental illness to come to
harm and if the individual has no capability of making a sound decision
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Consumer rights (provide any five rights)
The consumers have the right to participate in their own treatment and planning of
The consumers have the right to be informed of their rights including
circumstances and documentation copies of involuntary orders
Consumers have the right to be given information in a way that they understand
Consumers have the right to privacy and decision on what information can be
given to whom
Consumers have the right to ask for support from other people during interviews
with mental health professionals
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Involuntary review processes/ involuntary assessment (60 90 words)
The assessment must be done an authorized medical practitioner from an order
made by a different practitioner
The assessment must occur within 24 hours after the order is made
If it is not workable for the assessment to be done within this allocated period, then
the assessment must be done as soon as it is feasible thereafter
After the assessment, the medical practitioner may confirm the order for level 1
community treatment that the patient has a mental illness and may be harmed or
harm others and has a limited capacity to make sound decisions.
Satisfactory Not Yet Satisfactory
Seclusion and restraint (in 90-120 words)
According to the Mental Act 2009, medical personnel are allowed to seclude a
restrain a patient to maintain order and safety at the medical center and prevent
harm or trouble to others.
Medical staff may further seclude and restrain a patient during the administration
of treatment that is beneficial for the patient and one that is in compliance with the
Mental Health Act.
The patient may also be restrained during transfer from the healthcare facility to
another center in order to maintain security and prevent harm to the patient or
other individuals.
Satisfactory Not Yet Satisfactory
Admission procedures (in 90-120 words)
Before admission, it has to be proved that the individual is mentally ill by an
authorized medical practitioner. On admission, the patient is required to be given a
copy of the treatment order, a statement of their rights and any other necessary
information for the patient. Should the patient be unable to read during admission,
the practitioners are required to find an understandable way to convey the
information to the patient. On admission, the director of treatment needs to
arrange for a copy of the treatment order and statement of rights to be given to a
guardian, relative caregiver or friend of the patient as soon as it is feasible.
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Community treatment orders (in 70-100 words)
The Act provides for two community treatment orders including level 1 community
treatment order and level 2 community treatment orders. The level 1 community
treatment order is given when there is reasonable evidence of mental illness
certified by an authorized mental health professional. In this treatment,
consideration needs to be given for the possibility of the person receiving
treatment to be individually protected as well as protect others on a voluntary
basis. The level 2 community treatment order on the other hand is based on
tribunal that determines whether an individual is mentally ill and provides
instruction on the care of the individual
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Role of the mental health practitioner
To deliver care to mentally ill patients according to the Mental Health Act 2009
To examine patients and diagnose mental illness in patients
To authorize treatment for mentally ill patients
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Consent (in 60-90 words)
According to the Mental Health Act 2009, a community treatment level 1 or level 2
orders may be given with or without the consent of the patient. In the
administration of Electroconvulsive therapy, the mental health practitioner
requires written consent of the patient unless it cannot be practically given or the
patient is in urgent need of the therapy. Neurosurgery and other prescribed
psychiatric treatments also require consent from the patient and if consent is not
obtained then the administrator of the treatment is liable to legal action.
Satisfactory Not Yet Satisfactory
Confidentiality (in 40-70 words)
The Act requires that information regarding the administration of mental health
care not be disclosed by any party unless the person that was treated allows it.
The information may however be disclosed based on a requirement by the law, by
request of the person whom the information is about or their guardian.
Satisfactory Not Yet
3. Briefly describe the following three (3) principles of recovery in the mental health context in
a consumer point of view.
Recovery is self directed
The choices made belong to an individual alone. The path to recovery is
therefore achieved through individual control and making of proper choices
Recovery empowers
The individual is the only person that can turn their decisions into actions and
as such empower themselves
Recovery includes support from others
Recovery is strongly based on positive relationships with others which give an
opportunity for the individual to help other and find purpose for themselves
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4. Identify six (6) principles of recovery-oriented mental health practice.
Individuality of the mental health consumer- this includes giving power to the individual to
be the centre of care
Genuine choices- this involves reaching a point where duty of care and motivation of the
individual to take constructive risk is balanced
Attitudes and rights- involves effective communication between the individual and their
Dignity and esteem
Collaboration and communication- involves acknowledging individuality of the mental
health consumer and their expertise of their own life and working with the individual
Assessment of recovery- involves measuring the results using different parameters such
as wellness, social relationships, living arrangements and employment
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5. Briefly describe the role of evidence based practice in the context of recovery in mental
health (in 90-120 words).
The role of evidence-based practice in mental health is to provide quality assessment of
mental health that is according to the needs of the patients and their families. Furthermore,
evidence-based practice enables patients, families and caregivers to meet the goals of the
intervention methods as is most recent and clinically relevant. Based on evidence-based
practice, caregivers, patients and their families are able to make informed choices on
health interventions concerning their conditions. Evidence-based practice ultimately
provides the opportunity for the patient and their families to choose from a range of
intervention options and decide on the most suitable method for the condition.
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6. Briefly describe the purpose of the ‘National framework for recovery-orientated mental
health services’ published by the Department of Health (Australian Government) (in 50-80
The purpose of the framework is to assist mental health personnel in different health
settings to align their mental health practices with the principles of recovery. Furthermore,
the framework supports the review of skills associated with professionals in the workplace
and increases the value of the experience of the workforce with all stakeholders involved in
the mental health setting. Additionally, the framework seeks to develop service models that
are effective in the provision care for people with mental health concerns.
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7. Briefly describe the application of Barker's Tidal Model of Mental Health Recovery in your
mental health nursing practice (in 90-120 words).
Barker’s Tidal Model has been adopted in the hospital within the patient care
plan with a special focus on assisting the individual patient make their own way
to recovery. Based on the Model, the psychiatric unit has trained its nurses to
lead patients towards believing that recovery is certainly possible and that
change cannot be avoided. The patients get to learn that they ultimately know
what is best for them and that they have the resources needed to assist them
make the journey to recovery. The patients furthermore recover on the basis
that they are the teachers and the helpers are the students. The helper is
additionally required to be curious and study what is needed to help the
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8. Briefly describe any three (3) examples each of social, psychological, cognitive and
physical factors associated with mental health conditions.
Age- early childhood exposure to stress may lead to the possibility of mental
Gender- women are susceptible to mental disorders particularly when they are
burdened with illiteracy, domestic violence, and inability to provide for their
Social class- the social class of an individual may influence their mental health
particularly when an individual comes from a lower social class and feels that
they are disadvantaged because of it
Psychologically related trauma including emotional or physical trauma may
cause a mental disorder
Neglect and rejection may also cause mental illness as the individual feels stress
from being unwanted
Early loss such as that of a parent may cause mental illness
Short attention spans have been related to disorders such as depression
Inability to recall information is also related to mental disorders
Inability to think critically, organize information and solve problems is also
associated with mental illness
Exercises improve both physical and mental health. Lack of exercise may lead to
physical problems that increase stress on an individual
Habits such as smoking are linked to stress and the inclination further cause’s
deterioration of physical health which may affect the individuals mental health
Dietary observations keep an individual’s physical health in check. Different
people may binge eat based on stress while others lack appetite as a result of
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9. Provide two (2) examples of the impact of stigma, discrimination, culture and belief
systems on a person with a mental health condition.
Stigma upon a person with a mental health condition may affect how their
confidence as well as their self esteem in a huge way. This leads to social
isolation and feelings of self discrimination
Discrimination against people with mental illnesses additionally affects their
esteem and may limit their capability to recover
Culture has important impacts on persons with mental illness as it affects their
understanding of mental illness and willingness to seek and retain treatment
Beliefs on the other hand also affect the opinion of the individual on mental
illness and their readiness to seek treatment. These beliefs additionally
influence attitudes towards treatment.
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10. Briefly describe any three (3) strategies for managing oral health issues in a person with
mental illness.
Strategies that can help with the management of oral health concerns among persons
with mental illness include the management of the diet of the individual. This involves
giving advice on nutritious foods that are not harmful to the teeth as well as assisting
them to acknowledge the benefits of nutritious foods to the teeth
Training and administration of oral hygiene is equally important as this manages the
routine of the individual in taking care of their teeth
Early dental referral may be applied especially among young individuals to ensure
that any potential dental concerns are avoided.
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11. Briefly describe how the following factors cause oral health issues in a person with mental
illness (in 40-70 words each).
a. Side effects of medication:
Side effects of medication affect oral health among mental health patients
such as reduction of salivary secretions which results into a dry mouth. The
occurrence of a dry mouth increases the potential of acquiring oral infections,
dental caries and periodontal diseases. Further effects as a result of the dry
mouth may include problems with speech and swallowing.
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b. Poor nutrition:
Most persons with mental health illnesses are affected by low esteem which results
to poor health decisions. Among these decisions may be the ingestion of unhealthy
foods such as too many sugary and carbonated drinks and foods that affect the dental
hygiene of the individuals. Failure to take foods that affect oral health positively also
contributes to oral health problems.
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c. Reduced motivation for self-care:
Lack of interest in self-care and low self esteem may result to irregular dental
attendance as well as routine oral hygiene. Depression has been associated with
reduced oral health care. As a result of this disinterest, oral hygiene is highly likely to
go down which brings about oral health concerns.
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12. Outline the broad classification of mental health conditions under the following
classification systems.
International Classification of Diseases
(ICD - 10)
Certain infectious and parasitic
Diseases of the blood and blood
forming organs
Endocrine, nutritional and metabolic
Mental and behavioral diseases
Diseases of the nervous system
Diseases of the eye and adnexa
Diseases of tehe ar and mastoid
Diseases of the circulatory system
Diseases of the respiratory system
Diseases of the digestive system
Diseases of the skin and subcutaneous
Diseases of the musculoskeletal
system and connective tissue
Diseases of the genitourinary system
Pregnancy childbirth and the
Certain conditions originating in the
perinatal period
Congenital malformations,
deformations and chromosomal
Symptoms, signs and abnormal clinical
and laboratory findings, not elsewhere
Injury, poisoning and certain other
consequences of external causes
External causes of morbidity and
Factors influencing health status and
contact with health services
Codes for special purposes
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13. Complete the following table describing the treatment and management of identified
common mental health conditions.
Common mental
Psychotropic medications
which influence, emotions
behavior and the mind
Provision of reassurance to the patient,
schedule regular visits, enlist the help of
others to support the patient and encourage
patient participation in the management of
the condition
Anxiety disorders
Medication and / or
psychotherapy. Medication
mostly includes
Exercises, good nutrition, meditation,
adequate sleep and getting a support group
Use of antipsychotics
including Haloperidol,
Thiothixene, Thioridazine,
Fluphenazine and
Introduction of psychotherapy, support from
family and friends, encourage therapy
targeted towards conflict resolution, self
esteem improvement and self confidence
Organic disorders
Pain relieving medication,
bed rest, brain rest,
antibiotics for infections and
brain surgery in the most
severe of cases
Occupational therapy and physical therapy
Panic disorder
Cognitive behavioral therapy
and/ or use of
benzodiazepine to boost
Tailor treatment plan to the individual
patient, schedule routine checkups,
encourage patient to participate in treatment
Social phobia and
specific phobias such
as fear of animals
Exposure therapy and
cognitive therapy
Relaxation techniques, manage patients’
fears through exposing them to imagined
fears over time until the patient is able to
confront the problem
Cognitive behavioral
therapy including response
prevention and exposure,
medication such as
Schedule regular appointments with the
patient, combination of both medication
and therapeutic approaches
Post-traumatic stress
Cognitive behavioral
therapy, antidepressants
and anti anxiety medications
Emotional support, reassurance of victim,
encourage patient to participate in self
Use of and
Interpersonal psychotherapy, Cognitive
behavioral therapy, behavioral activation
and problem solving therapy
Bipolar disorder
Mood stabilizing medication
and psychotherapy
Inpatient management for severe cases,
find stress areas and attempt to minimize
them, monitor and support on the
medication, provide patient education and
therapeutic support
Anorexia nervosa
Medication may include
vitamin and calcium
Inpatient management for critically ill
patients, scheduled checkups with very
close monitoring, individual therapy and
refeeding strategy, encourage family
Borderline personality
Dialectic behavior therapy,
medication such as
Long terms monitoring, attention to the
experiences of the patient, emotional
regulation and patient participation in the
management process
Medical care including
antipsychotic treatments,
psychological therapy and
psychosocial inputs
Extreme care in the dispensation of
medication, management of the side
effects of drugs cognitive behavioral
therapy in stable patients, family
intervention and dietary management
Medication, psychotherapy
and environmental
Identification of the underlying cause of the
dementia, use of anti-dementia agents for
medication such as psychotropic drugs,
behavioral, emotional, cognition and
stimulation oriented therapies
Medication such as
antipsychotics and
benzodiazepine as well as
Identification of the underlying problem
and behavioral orientation therapy
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14. Briefly describe the values and philosophies that apply to mental health care (in 90-120
Inclusion where the individual wholly understands mental health and wellness while
breaking down barriers and promoting cooperation, respect and trust, resilience in the
promotion of mental health care and responsibility over mental health.
All the needs of the consumers of mental health care, their caregivers and their
families should be respected. The delivery of mental health service is dedicated
towards an approach to recovery. All persons should be included regardless of their
economic, cultural or social status. Delivery of service should furthermore consider all
diversities and comprehend the importance of the focus of care.
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15. Identify seven (7) of the signs and symptoms of the following mental health conditions.
Mental health conditions
Signs and symptoms
Post-traumatic stress
Recollection of trauma through flashbacks and
Avoidance of places, people or situations that trigger the
memory of the trauma
Difficulty in sleeping
Low concentration span
Easily irritated
Inability to remember the trauma
Self blame about the incident that caused the trauma
Anorexia Nervosa
Thin appearance
Abnormal blood counts
Loss of sleep
Abdominal pain
Low attention span
Poor memory
Withdrawal of an individual
Difficulty in reading or writing
Trouble with comprehending speech
Non comprehensible speech from the patient
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16. Briefly describe the biological and psychosocial effects of mental health conditions.
Biological effects of mental health conditions include use of toxic substances that
affect the body as a result of low self esteem. Biological effects also include poor
nutrition where the individual does not eat well based on lack of interest in self care.
Psychosocial effects of mental conditions include self discrimination where and
individual discriminates against himself based on what he thinks other think of him.
The stigma from mental conditions also causes reluctance to seek treatment as the
individuals do not want to face the social recrimination that comes with being ill.
Satisfactory Not Yet Satisfactory
Part B Case Study Questions:
Case study 1:
Mr Ahmed has obsessive compulsive disorder. Mr Ahmed stays with his younger brother. He is
a perfectionist and wants his house to be organised, neat and tidy. Both of them do not make
any unplanned changes in the arrangement of their house.
During a scheduled home visit, the social welfare worker moved a chair in the living area to be
close to a window. Mr Ahmed didn’t say anything, but his face was flushed and he started
grinding his teeth. He didn’t maintain eye contact with her and did not respond appropriately to
most of her questions. During the interview, the social welfare worker took a piece of paper
from the nearby printer rack and a pen from his computer table without asking him.
Mr Ahmed stood up and asked her not to touch any of his items without permission. The social
welfare worker commented ‘You are so arrogant. You must behave and respect people who
come in to support you’. He was angry at this response and asked the social welfare worker to
leave immediately. The social welfare worker continued talking while leaving in anger. Mr
Ahmed was furious and started mumbling and throwing papers and books from his shelf onto
the floor.
1. Briefly describe the triggers that might have caused Mr Ahmed to demonstrate this
Given that Mr. Ahmed is used to his routine, organization and absence of unplanned
changes, the sudden movement of a chair by the social worker and taking of piece of
paper and without asking for permission affected the routine; and as such the aggravated
behavior was triggered
Satisfactory Not Yet
2. What should have the social welfare worker done to deflect the triggers causing Mr Ahmed’s
challenging behaviour?
The social worker should have found out the condition of Mr. Ahmed before paying the
visit. She should have further been more attentive to the behavior of Mr. Ahmed. This
would have helped her in requesting to sit and asking if Mr. Ahmed was comfortable with
every move she made.
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3. How could have the social welfare worker have applied active listening skills in this situation
to avoid the challenging behaviour?
The social worker should have paid attention to the way Mr. Ahmed stopped responding
appropriately to his questions. She should further have been more attentive when Mr.
Ahmed asked her not to touch his things and asked the reason why he did not want that.
Satisfactory Not Yet
4. How could the social welfare worker have applied observation skills in this situation to avoid
the challenging behaviour?
The social worker should have seen Mr. Ahmed’s agitation as his face got flushed and he
started grinding his teeth. The social worker should have further noticed the behavior
aggravating from agitation to anger.
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5. What appropriate communication should the social welfare worker have used in this
situation to avoid the challenging behaviour once Mr Ahmed requested her not to touch any
of his items without permission?
The social worker should have apologized and returned the item then wait for
Mr. Ahmed to calm down and request for the item. She should further have
inquired why Mr. Ahmed felt irritated that his items were being touched.
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6. What expert assistance could Mr Ahmed seek in this situation to avoid similar occurrences?
Mr. Ahmed should seek medication particularly antidepressants to manage
aggressive feelings and also cognitive therapy and exposure therapy to get used to
the stimuli that causes his aggressive behavior
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7. What expert assistance could the social welfare worker seek in this situation to avoid similar
The social worker should get training on handling patients with mental health conditions
as putting the needs of the patient before all others during social assessments so as to
ensure the best recovery options for the individual
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Case study 2:
Assume that you are working in a mental health outpatient unit. Identify the mental health condition of two people
presented in your outpatient unit with the following clinical features.
Person 1: Presented with confusion, loss of concentration, laughing inappropriately, disturbed sleep, increased
sensitivity to light and unable to tell what is real from what is not.
Person 2: Presented with trembling hands and voice, blushing, hyperventilation, fear, anticipatory anxiety and
avoiding public places and crowds including seeing friends and family.
8. Correctly identify the mental health condition relating to the behaviour of person 1
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9. Correctly identify the mental health condition relating to the behaviour of person 2
Anxiety disorder
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Reference List
Alexander, L. (2016). Chapter 39 Mental health and mental illness. In. Koutoukidis, G,
Stainton, K & Hughson,J., Tabbners nursing care. (7
ed.). Chatswood, NSW: Churchill
American Psychiatric Association. (2013). Diagnostic and statistical manual of
mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
Government of South Australia - Attorney-General's Department. (n.d.). Mental Health Act
2009. Retrieved from
Nursing theory. (n.d.). Tidal Model. Retrieved from
The Department of Health. (2014). A National framework for recovery-oriented mental health
services: guide for practitioners and providers. Retrieved from
The Department of Health. (2013). National practice standards for the mental health workforce
2013. Retrieved from
WedMD. (2014). The ten principles of recovery. Retrieved from INFORMIT

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