Assessing and Diagnosing Patients With Anxiety Disorders, PTSD, and OCD

This article covers NRNP 6635 Assignment: Assessing and Diagnosing Patients With Anxiety Disorders, PTSD, and OCD.

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NRNP 6635 Assignment: Assessing and Diagnosing Patients With Anxiety Disorders, PTSD, and OCD

Assignment: Assessing and Diagnosing Patients With Anxiety Disorders, PTSD, and OCD NRNP 6635

Purpose: The purpose of this assignment is to perform a comprehensive psychiatric evaluation and formulate three differential diagnosis using DSM 5 diagnostic criteria and critical thinking process in ruling out the primary diagnosis.

Subjective:

CC (chief complaint): Unable to “handle” negative situations, “afraid to sleep”, “don’t want to go anywhere” including “restaurants, or shopping, or even to baseball parks”, afraid to sit in traffic, flashbacks from combat triggered by loud noices, smell.

HPI: Sergeant P.F. is a 27 years old who presents for a psychiatric evaluation after an incident that occurred three nights ago at a county fair where the client “took off running”, trying “to find cover” when the fireworks that “sounded like combat fire” started without warning. Sergeant P.F. joined the military soon after high school. He served for eight years that included three long tours of duty in warzones. He separated from active duty in Marines (Field Artillery) less than a year ago. During his service he had witnessed two of his buddies burn when their Humvee was blown and the smell of diesel fuel, chopper smell, or burned hair triggers his flashback from warzones. He reports feeling “afraid” to go bed or to close his eyes due to fear of nightmares. Loud noises such as car backfiring or circular saw cutting into wood startle him and take him “right back in the middle of enemy fire.” He reports stopped traffic scares him and he breaks “in a sweat”, “start shaking”, and can’t catch a breath thinking someone could roll an IED under them. He is unable to “hanle” negative situations including argument between his fiancé and her mother. He states that sometimes he feels like his “mind just sinks back into itself, like I can’t see or hear or move”, feeling “numb all over”, and losing “track of time”. Thinks he was “going to go crazy”. Sometimes “stomach muscles get tight” and feel “nauseated”.

Past Psychiatric History:

  • General Statement: Client is a 27 years old male who grew up poor with a father who has been a “sloppy drunk”, joined military soon after high school, and has been experiencing anxiety, nightmares, and panic attacks since return/separation from active less than a year ago. He states he has not talked to anyone else about his situation because he doesn’t “want to remember”.
  • Caregivers (if applicable): Not applicable.
  • Hospitalizations: No hx of psychiatric or substance use treatment. (It is important for the provider to ask if client has had any mental health treatment, inpatient psychiatric hospitalizations, partial hospitalization or intensive outpatient treatment in the past including while in service).
  • Medication trials: Provider should ask if client is currently taking any medications or has tried medications in the past. If yes, ask about dosage, response to medication, side effects or any other issues, and reason for stopping medication.
  • Psychotherapy or Previous Psychiatric Diagnosis: Provider should ask if client received any psychotherapy in the past, what type, what for, and for how long. Provider should ask if patient has ever been diagnosed with any mental/psychiatric illness such as depression and anxiety.

Substance Current Use and History: Denies past or current use of any drugs and avoids alcohol. (Provider should ask client if he currently uses or has in the past used cigarette, vape, alcohol, street/illicit/recreational drugs; type, amount, frequency, length or duration, age of first use, and last use).

Family Psychiatric/Substance Use History:

Father: “sloppy drunk”, still drinking

Paternal grandfather (Veteran): depression

Provider should ask if anyone in the family including siblings, aunts, uncles, grandparents has been diagnosed with a mental illness and if anyone else besides father uses alcohol or other recreational drugs including abuse of prescribed medications.

Psychosocial History: Client comes from a poor family. He was born to an alcoholic father who suffers with DM, liver disease, HTN. Mother is well, but takes care of dad. Client has one younger and one older sister and a paternal grandfather who is a veteran and sufferes with depression. Client joined the military soon after high school and served for eight years. He eHe lives with fiancé and is currently working as a furniture saleman.

Medical History:

  • Medical diagnosis: Asthma – service connected, seasonal allergies
  • Current Medications: None
  • Allergies: No known medication allergy. Provider should ask about food and latex allergy
  • Reproductive Hx: Provider should ask about sexuality and sexual orientation, whether client is sexualy active, partner (male or female), use of condoms or contraceptives.

ROS:

  • GENERAL: The client is alert and oriented x 4, well groomed, dressed appropriately for the weather and occasion and appears in no acute distress.
  • HEENT: Provider should ask about head injury, vision/hearing change, use of contacts, eye glasses, or hearing aid/eartubes, change in taste or smell, drainage, problem swallowing.
  • SKIN: Provider should check for discoloration, scars, rashes, sores, or any other skin abnormalities.
  • CARDIOVASCULAR: Provider should assess for chest pain, palpitations, syncope or edema
  • RESPIRATORY: client reports difficulty catching a breath when triggered such as waiting in traffic at a stop light. Provider should assess for lung/breath sounds, shortness of breath, wheezing, or cough.
  • GASTROINTESTINAL: Client reports nausea with anxiety and flashbacks. Provider should assess for nausea/vomiting/diarrhea/constipation.
  • GENITOURINARY: Provider should assess for hematuria/incontinence/polyuria/pain on urination/flank pain/discharge
  • NEUROLOGICAL: provider should assess for head trauma/dizziness/seizure/lightheadedness/loss of coordination/tremors/tics/weakness/falls
  • MUSCULOSKELETAL: Provider should assess for muscle pain/joint pain/back pain/ muscle weakness/gout/arthritis
  • HEMATOLOGIC: provider should assess for anemia/easy bruising/unusual bleeding/blood related disorders
  • LYMPHATICS: provider should assess for plapable nodes/painful or swollen lymph nodes.
  • ENDOCRINOLOGIC: Provider should assess for diabetes/thyroid disorder/polyuria/polyphagia/polydipsia/ hormonal changes/intolerance to heat or cold.

Objective:

Physical exam:

T- 97.4

P – 84

R- 18

B/P – 134/88

Ht – 5’8”

Wt – 167 lbs

BMI – 25.4 (slightly overweight)

Diagnostic results: Provider should screen for depression and anxiety score. Also, should order blood test (CBC, CMP, TSH, UDS)

Assessment:

Mental Status Examination:

Appearance: Well kempt/well groomed. Provider should assess for any odor

Eye contact: fair

Speech: normal rate, rhythm, and volume

Behavior: calm and cooperative

Psychomotor: no involuntary movements

Mood: depressed, dysphoric, tearful

Affect: constricted, shallow, congruent with mood

Thought process: paranoid (some one could have “rolled IED under us”), organized, goal directed

Thought content: No delusions. Provider should ask for suicidal ideation/homicidal ideation/self-harm thoughts

Perception: no reaction to external stimuli noted. Provider should assess for audio-visual hallucination

Attention/concentration: sustained attention and concentration

Cognition: alert and oriented x 4

Memory: short-term and long-term memory grossly intact as eveidenced by recollection of events

Insight: fair

Judgment: fair

Fund of knowledge: average

Intelligence: average

Differential Diagnoses:

  1. Post Traumatic Stress Disorder (PTSD): DSM criteria/time and symptoms – Exposure to trauma. ≥1 for ≥1 month AND Instrusion: memories, dreams, flashbacks, exposure distress, physiological reactions. ≥1 for ≥1 month Avoidance: internal reminders, external reminders. ≥2 for ≥1 month AND Negative symptoms: impaired memory of trauma, negative self worth, pathological blame, negative emotions, dectreased participation, detachment, emotional numbness. ≥2 for ≥1 month Arousal: irritability or aggression, recklessness, hypervigilance, exaggerated startle, impaired concentration, sleep disturbance
  2. Anxiety Disorder – Panic disorder: DSM criteria/time – ≥4 AND symptoms – palpitations, sweating, trembling, shortness of breath, choing, chest pain, nausea, dizziness, chills, paresthesias, derealization, fear of insanity, fear of death. ≥1 month persistent concern or worry.
  3. Major depressive disorder – DSM criteria/time and symptoms – ≥1 for ≥2 weeks AND depressed mood, lost of interest in activities or pleasure

Reflections:

Client was in the military for eight years and did three long tours in the warzone, witnessing death of “buddies”, Humvee been blown, active duty in marines (artillery) prior to separation/leaving. This case study helped understand the trauma veterans go through while serving. According to Armour (2017), during their deployment veterans witness trauma that manifests into fear and anxiety. Frenkel (2017) describes that certain smells and sounds trigger flashbacks and reactions such as avoiding places and things, detachment from people, having nighmares. As mentioned in the interview, it takes a lot of courage especially for a veterans to share their story due to feeling like a wimp or a whiner. Therefore, it is very important to support and encourage veterans to seek help. It is important to educate them how to recognize signs and symptoms of increasing stress so they are able to seek the needed help for coping and symptom management (Friedman & Bernardy, 2017). It is also important to understand barriers faced by many veterans in seeking treatment for their mental health (Yang et al., 2017) so that proper and timely resources, services, support could be provided.

References

Armour, C., Fried, E. I., Deserno, M., Tsai, J.,  Pietrzak, R. (2017). A network analysis of DSM-

5 posttraumatic stress disorder symptoms and correlates in U.S. military veterans.

     Journal of Anxiety Disorders, 45:49-59.

Frankel, A. S. (2017). Legal and ethical considerations in working with trauma survivors: Risk

management principles for clinicians. American Psychological Association.  547–558.

https://doi.org/10.1037/0000019-027

Friedman, M., Bernardy, N. C. (2017). Considering future pharmacotherapy for PTSD.

Neuroscience, 649:181-185.

Yang, S., Schneider, B., Wynn, G. H., & Howe, E., 3rd (2017). Ethical considerations in the

treatment of PTSD in military populations. Focus (American Psychiatric Publishing)15(4),

435–440.

“Fear,” according to the DSM-5, “is the emotional response to real or perceived imminent threat, whereas anxiety is anticipation of future threat” (APA, 2013). All anxiety disorders contain some degree of fear or anxiety symptoms (often in combination with avoidant behaviors), although their causes and severity differ. Trauma-related disorders may also, but not necessarily, contain fear and anxiety symptoms, but their primary distinguishing criterion is exposure to a traumatic event. Trauma can occur at any point in life. It might not surprise you to discover that traumatic events are likely to have a greater effect on children than on adults. Early-life traumatic experiences, such as childhood sexual abuse, may influence the physiology of the developing brain. Later in life, there is a chronic hyperarousal of the stress response, making the individual vulnerable to further stress and stress-related disease.

Photo Credit: Hill Street Studios / Blend Images / Getty Images

For this Assignment, you practice assessing and diagnosing patients with anxiety disorders, PTSD, and OCD. Review the DSM-5 criteria for the disorders within these classifications before you get started, as you will be asked to justify your differential diagnosis with DSM-5 criteria.

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Assessing and Diagnosing Patients With Anxiety Disorders, PTSD, and OCD
Assessing and Diagnosing Patients With Anxiety Disorders, PTSD, and OCD

To Prepare:

  • Review this week’s Learning Resources and consider the insights they provide about assessing and diagnosing anxiety, obsessive-compulsive, and trauma- and stressor-related disorders.
  • Download the Comprehensive Psychiatric Evaluation Template, which you will use to complete this Assignment. Also review the Comprehensive Psychiatric Evaluation Exemplar to see an example of a completed evaluation document.
  • By Day 1 of this week, select a specific video case study to use for this Assignment from the Video Case Selections choices in the Learning Resources. View your assigned video case and review the additional data for the case in the “Case History Reports” document, keeping the requirements of the evaluation template in mind.
  • Consider what history would be necessary to collect from this patient.
  • Consider what interview questions you would need to ask this patient.
  • Identify at least three possible differential diagnoses for the patient. Assignment: Assessing and Diagnosing Patients With Anxiety Disorders, PTSD, and OCD NRNP 6635
By Day 7 of Week 4

Complete and submit your Comprehensive Psychiatric Evaluation, including your differential diagnosis and critical-thinking process to formulate primary diagnosis.

Incorporate the following into your responses in the template:

  • Subjective: What details did the patient provide regarding their chief complaint and symptomology to derive your differential diagnosis? What is the duration and severity of their symptoms? How are their symptoms impacting their functioning in life?
  • Objective: What observations did you make during the psychiatric assessment?
  • Assessment: Discuss the patient’s mental status examination results. What were your differential diagnoses? Provide a minimum of three possible diagnoses with supporting evidence, listed in order from highest priority to lowest priority. Compare the DSM-5 diagnostic criteria for each differential diagnosis and explain what DSM-5 criteria rules out the differential diagnosis to find an accurate diagnosis. Explain the critical-thinking process that led you to the primary diagnosis you selected. Include pertinent positives and pertinent negatives for the specific patient case.
  • Reflection notes: What would you do differently with this client if you could conduct the session over? Also include in your reflection a discussion related to legal/ethical considerations (demonstrate critical thinking beyond confidentiality and consent for treatment!), health promotion and disease prevention taking into consideration patient factors (such as age, ethnic group, etc.), PMH, and other risk factors (e.g., socioeconomic, cultural background, etc.).

Submission and Grading Information

To submit your completed Assignment for review and grading, do the following:

  • Please save your Assignment using the naming convention “WK4Assgn+last name+first initial.(extension)” as the name.
  • Click the Week 4 Assignment Rubric to review the Grading Criteria for the Assignment.
  • Click the Week 4 Assignment link. You will also be able to “View Rubric” for grading criteria from this area.
  • Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK4Assgn+last name+first initial.(extension)” and click Open.
  • If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
  • Click on the Submit button to complete your submission.
Grading Criteria

To access your rubric:

Week 4 Assignment Rubric

Check Your Assignment Draft for Authenticity

To check your Assignment draft for authenticity:

Submit your Week 4 Assignment draft and review the originality report.

Submit Your Assignment by Day 7 of Week 4

Next week, you will continue to practice your assessment and diagnosis skills, focusing on disruptive, impulse-control, conduct, dissociative, and somatic symptom-related disorders.

Midterm Exam

You should also begin studying for your midterm exam, which is completed in Week 6. This will be a 100-question, multiple-choice exam covering all topics in Week 1–Week 6 of the course. The exams in your MSN program are designed to test your knowledge in preparation for your certification exam and to simulate the certification exam environment. Accordingly, no outside resources, including books, notes, websites, or any other type of resource, may be used to help you complete the exams in your courses.

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Photo Credit: [Vergeles_Andrey]/[iStock / Getty Images Plus]/Getty Images

Next Week

To go to the next week:

Week 5

Week 4: Anxiety Disorders, PTSD, and OCD

Your own experiences might tell you that expectations from family, friends, and work—as well as your own expectations regarding achievement, success, and happiness—can create stress. Stressors are a normal part of life, and stress traditionally has been viewed as an adaptive function with a set of physiological responses to a stressor. In a situation where stress is perceived, the organism is physiologically prepared to attack or flee from the threat. Those with effective fight or flight responses tended to survive long enough to reproduce, so we are descended from those who are genetically hardwired for self-protection. When you experience stress, your biology, emotions, social support, motivation, environment, attitude, immune function, and wellness all feel the ripple effect.

This stress response is an adaptive response the human body has to threats; however, stress can also be difficult to handle and—depending upon the nature and intensity of the stress—can result in anxiety disorders, obsessive-compulsive disorders, or trauma- and stressor-related disorders. This week, you will focus on these disorders and explore strategies to accurately assess and diagnose them.

Learning Objectives

Students will:

  • Apply concepts, theories, and principles related to patient interviewing, diagnostic reasoning, and recording patient information
  • Formulate differential diagnoses using DSM-5 criteria for patients with anxiety disorders, PTSD, and OCD across the lifespan

Learning Resources

Required Readings (click to expand/reduce)

American Psychiatric Association. (2013). Anxiety disorders. In Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: Author. doi:10.1176/appi.books.9780890425596.dsm05

Assignment: Assessing and Diagnosing Patients With Anxiety Disorders, PTSD, and OCD NRNP 6635 American Psychiatric Association. (2013). Obsessive compulsive and related disorders. In Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: Author. doi:10.1176/appi.books.9780890425596.dsm06

American Psychiatric Association. (2013). Trauma- and stressor-related disorders. In Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: Author. doi:10.1176/appi.books.9780890425596.dsm07

Sadock, B. J., Sadock, V. A., and Ruiz, P. (2015). Kaplan & Sadock’s synopsis of psychiatry (11th ed.). Wolters Kluwer.

  • Chapter 9, Anxiety Disorders
  • Chapter 10, Obsessive-Compulsive and Related Disorders
  • Chapter 11, Trauma- and Stressor-Related Disorders
  • Chapter 31.11 Trauma-Stressor Related Disorders in Children
  • Chapter 31.13 Anxiety Disorders in Infancy, Childhood, and Adolescence
  • Chapter 31.14 Obsessive-Compulsive Disorder in Childhood and Adolescence

Document: Comprehensive Psychiatric Evaluation Template

Document: Comprehensive Psychiatric Evaluation Exemplar

Required Media (click to expand/reduce)

Classroom Productions. (Producer). (2015). Anxiety disorders [Video]. Walden University.

Classroom Productions. (Producer). (2012). The neurobiology of anxiety [Video]. Walden University.

Classroom Productions. (Producer). (2015). Obsessive-compulsive disorders [Video]. Walden University.

Classroom Productions. (Producer). (2015). Trauma, PTSD, and Trauma-Informed Care [Video]. Walden University.

As you continue, thestudycorp.com has the top and most qualified writers to help with any of your assignments. All you need to do is place an order with us.

Assessing and Diagnosing Patients With Anxiety Disorders, PTSD, and OCD
Assessing and Diagnosing Patients With Anxiety Disorders, PTSD, and OCD

MedEasy. (2017). Anxiety, OCD, PTSD and related psychiatric disorders | USMLE & COMLEX [Video]. YouTube. https://www.youtube.com/watch?v=-BwzQF9DTlY

Video Case Selections for Assignment (click to expand/reduce)

Select oneof the following videos to use for your Assignment this week. Then, access the document “Case History Reports” and review the additional data about the patient in the specific video number you selected.

Symptom Media. (Producer). (2017). Training title 15 [Video]. https://video-alexanderstreet-com.ezp.waldenulibrary.org/watch/training-title-15

Symptom Media. (Producer). (2016). Training title 21 [Video]. https://video-alexanderstreet-com.ezp.waldenulibrary.org/watch/training-title-21

Symptom Media. (Producer). (2016). Training title 37 [Video]. https://video-alexanderstreet-com.ezp.waldenulibrary.org/watch/training-title-37

Symptom Media. (Producer). (2016). Training title 40 [Video]. https://video-alexanderstreet-com.ezp.waldenulibrary.org/watch/training-title-40

Symptom Media. (Producer). (2017). Training title 55 [Video]. https://video-alexanderstreet-com.ezp.waldenulibrary.org/watch/training-title-55

Symptom Media. (Producer). (2017). Training title 85 [Video]. https://video-alexanderstreet-com.ezp.waldenulibrary.org/watch/training-title-85

Symptom Media. (Producer). (2018). Training title 95 [Video]. https://video-alexanderstreet-com.ezp.waldenulibrary.org/watch/training-title-95

Document: Case History Reports

Rubric Detail

Select Grid View or List View to change the rubric’s layout.

Name: NRNP_6635_Week4_Assignment_Rubric
Grid View
List View
Excellent Good Fair Poor
Create documentation in the Comprehensive Psychiatric Evaluation Template about the patient you selected.

In the Subjective section, provide:
• Chief complaint
• History of present illness (HPI)
• Past psychiatric history
• Medication trials and current medications
• Psychotherapy or previous psychiatric diagnosis
• Pertinent substance use, family psychiatric/substance use, social, and medical history
• Allergies
• ROS
18 (18%) – 20 (20%)
The response throughly and accurately describes the patient’s subjective complaint, history of present illness, past psychiatric history, medication trials and current medications, psychotherapy or previous psychiatric diagnosis, pertinent histories, allergies, and review of all systems that would inform a differential diagnosis.
16 (16%) – 17 (17%)
The response accurately describes the patient’s subjective complaint, history of present illness, past psychiatric history, medication trials and current medications, psychotherapy or previous psychiatric diagnosis, pertinent histories, allergies, and review of all systems that would inform a differential diagnosis.
14 (14%) – 15 (15%)
The response describes the patient’s subjective complaint, history of present illness, past psychiatric history, medication trials and current medications, psychotherapy or previous psychiatric diagnosis, pertinent histories, allergies, and review of all systems that would inform a differential diagnosis, but is somewhat vague or contains minor innacuracies.
0 (0%) – 13 (13%)
The response provides an incomplete or inaccurate description of the patient’s subjective complaint, history of present illness, past psychiatric history, medication trials and current medications, psychotherapy or previous psychiatric diagnosis, pertinent histories, allergies, and review of all systems that would inform a differential diagnosis. Or, subjective documentation is missing.
In the Objective section, provide:
• Physical exam documentation of systems pertinent to the chief complaint, HPI, and history
• Diagnostic results, including any labs, imaging, or other assessments needed to develop the differential diagnoses.
18 (18%) – 20 (20%)
The response thoroughly and accurately documents the patient’s physical exam for pertinent systems. Diagnostic tests and their results are thoroughly and accurately documented.
16 (16%) – 17 (17%)
The response accurately documents the patient’s physical exam for pertinent systems. Diagnostic tests and their results are accurately documented.
14 (14%) – 15 (15%)
Documentation of the patient’s physical exam is somewhat vague or contains minor innacuracies. Diagnostic tests and their results are documented but contain minor innacuracies.
0 (0%) – 13 (13%)
The response provides incomplete or inaccurate documentation of the patient’s physical exam. Systems may have been unnecessarily reviewed, or, objective documentation is missing.

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Assessing and Diagnosing Patients With Anxiety Disorders, PTSD, and OCD
Assessing and Diagnosing Patients With Anxiety Disorders, PTSD, and OCD


In the Assessment section, provide:
• Results of the mental status examination, presented in paragraph form.
• At least three differentials with supporting evidence. List them from top priority to least priority. Compare the DSM-5 diagnostic criteria for each differential diagnosis and explain what DSM-5 criteria rules out the differential diagnosis to find an accurate diagnosis. Explain the critical-thinking process that led you to the primary diagnosis you selected. Include pertinent positives and pertinent negatives for the specific patient case.
23 (23%) – 25 (25%)
The response thoroughly and accurately documents the results of the mental status exam.

Response lists at least three distinctly different and detailed possible disorders in order of priority for a differential diagnosis of the patient in the assigned case study, and it provides a thorough, accurate, and detailed justification for each of the disorders selected.
20 (20%) – 22 (22%)
The response accurately documents the results of the mental status exam.

Response lists at least three distinctly different and detailed possible disorders in order of priority for a differential diagnosis of the patient in the assigned case study, and it provides an accurate justification for each of the disorders selected.
18 (18%) – 19 (19%)
The response documents the results of the mental status exam with some vagueness or innacuracy.

Response lists at least three different possible disorders for a differential diagnosis of the patient and provides a justification for each, but may contain some vaguess or innacuracy.
0 (0%) – 17 (17%)
The response provides an incomplete or inaccurate description of the results of the mental status exam and explanation of the differential diagnoses. Or, assessment documentation is missing.
Reflect on this case. Discuss what you learned and what you might do differently. Also include in your reflection a discussion related to legal/ethical considerations (demonstrate critical thinking beyond confidentiality and consent for treatment!), health promotion and disease prevention taking into consideration patient factors (such as age, ethnic group, etc.), PMH, and other risk factors (e.g., socioeconomic, cultural background, etc.).
9 (9%) – 10 (10%)
Reflections are thorough, thoughtful, and demonstrate critical thinking.
8 (8%) – 8 (8%)
Reflections demonstrate critical thinking.
7 (7%) – 7 (7%)
Reflections are somewhat general or do not demonstrate critical thinking.
0 (0%) – 6 (6%)
Reflections are incomplete, inaccurate, or missing.
Provide at least three evidence-based, peer-reviewed journal articles or evidenced-based guidelines that relate to this case to support your diagnostics and differential diagnoses. Be sure they are current (no more than 5 years old).
14 (14%) – 15 (15%)
The response provides at least three current, evidence-based resources from the literature to support the assessment and diagnosis of the patient in the assigned case study. The resources reflect the latest clinical guidelines and provide strong justification for decision making.
12 (12%) – 13 (13%)
The response provides at least three current, evidence-based resources from the literature that appropriately support the assessment and diagnosis of the patient in the assigned case study.
11 (11%) – 11 (11%)
Three evidence-based resources are provided to support assessment and diagnosis of the patient in the assigned case study, but they may only provide vague or weak justification.
0 (0%) – 10 (10%)
Two or fewer resources are provided to support assessment and diagnosis decisions. The resources may not be current or evidence based.
Written Expression and Formatting—Paragraph development and organization:
Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction are provided that delineate all required criteria.
5 (5%) – 5 (5%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity.

A clear and comprehensive purpose statement, introduction, and conclusion are provided that delineate all required criteria.
4 (4%) – 4 (4%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time.

Purpose, introduction, and conclusion of the assignment are stated, yet they are brief and not descriptive.
3.5 (3.5%) – 3.5 (3.5%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time.

Purpose, introduction, and conclusion of the assignment is vague or off topic.
0 (0%) – 3 (3%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity less than 60% of the time.

No purpose statement, introduction, or conclusion were provided.
Written Expression and Formatting—English writing standards:
Correct grammar, mechanics, and punctuation
5 (5%) – 5 (5%)
Uses correct grammar, spelling, and punctuation with no errors
4 (4%) – 4 (4%)
Contains a few (one or two) grammar, spelling, and punctuation errors
3 (3%) – 3 (3%)
Contains several (three or four) grammar, spelling, and punctuation errors
0 (0%) – 2 (2%)
Contains many (≥ five) grammar, spelling, and punctuation errors that interfere with the reader’s understanding
Total Points: 100
Name: NRNP_6635_Week4_Assignment_Rubric

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