[ANSWERED] Patient is a 24-year-old female administrative assistant who comes to the emergency department with a chief complaint of severe right-sided headache
Patient is a 24-year-old female administrative assistant who comes to the emergency department with a chief complaint of severe right-sided headache Case Study Analysis An understanding of the neurological and musculoskeletal systems is a critically important component of disease and disorder diagnosis and treatment. This importance is magnified by the impact that that these two systems can have on each other. A variety of factors and circumstances affecting the emergence and severity of issues in one system can also have a role in the performance of the other. Effective analysis often requires an understanding that goes beyond these systems and their mutual impact. For example, patient characteristics such as, racial and ethnic variables can play a role. An understanding of the symptoms of alterations in neurological and musculoskeletal systems is a critical step in diagnosis and treatment. For APRNs this understanding can also help educate patients and guide them through their treatment plans. In this Assignment, you examine a case study and analyze the symptoms presented. You identify the elements that may be factors in the diagnosis, and you explain the implications to patient health. To prepare: By Day 1 of this week, you will be assigned to a specific case study scenario for this Case Study Assignment. In your Case Study Analysis related to the scenario provided, explain the following: Both the neurological and musculoskeletal pathophysiologic processes that would account for the patient presenting these symptoms. Any racial/ethnic variables that may impact physiological functioning. How these processes interact to affect the patient. Case Study Scenario Patient is a 24-year-old female administrative assistant who comes to the emergency department with a chief complaint of severe right-sided headache. She states that this is the sixth time in the last 2 months she has had this headache. She says the headaches last 2–3 days and have impacted her ability to concentrate at work. She complains of nausea and has vomited three times in the last 3 hours. She states, “the light hurts my eyes.” She rates her pain as a 10/10 at this time. Ibuprofen and acetaminophen ease her symptoms somewhat but do not totally relieve them. No other current complaints. Rubric Detail Excellent Good Fair Poor Develop a 1- to 2-page case study analysis, examining the patient symptoms presented in the case study. Be sure to address the following: Explain both the neurological and musculoskeletal pathophysiologic processes of why the patient presents these symptoms. 28 (28%) – 30 (30%) The response accurately and thoroughly describes the patient symptoms. The response includes accurate, clear, and detailed explanations of both the neurological and musculoskeletal pathophysiologic processes of patients who present these symptoms and is supported by evidence and/or research, as appropriate, to support the explanation. 25 (25%) – 27 (27%) The response describes the patient symptoms. The response includes accurate, explanations of both the neurological and musculoskeletal pathophysiologic processes of patients who present these symptoms and is supported by evidence and/or research, as appropriate, to support the explanation. 23 (23%) – 24 (24%) The response describes the patient symptoms in a manner that is vague or inaccurate. The response includes explanations of both the neurological and musculoskeletal pathophysiologic processes of patients who present these symptoms and is supported by explanations that are vague or based on inappropriate evidence/research. 0 (0%) – 22 (22%) The response describes the patient symptoms in a manner that is vague and inaccurate, or the description is missing. The response does not include explanations of both the neurological and musculoskeletal pathophysiologic processes of patients who present these symptoms, or the explanations are vague or based on inappropriate evidence/research. Explain how the highlighted processes interact to affect the patient. 28 (28%) – 30 (30%) The response includes an accurate, complete, detailed, and specific explanation of how the highlighted processes interact to affect the patient and is supported by evidence and/or research, as appropriate, to support the explanation. 25 (25%) – 27 (27%) The response includes an accurate explanation of how the highlighted processes interact to affect the patient and is supported by evidence and/or research, as appropriate, to support the explanation. 23 (23%) – 24 (24%) The response includes a vague or inaccurate explanation of how the highlighted processes interact to affect the patient, with explanations that are based on inappropriate evidence/research. 0 (0%) – 22 (22%) The response includes a vague or inaccurate explanation of how the highlighted processes interact to affect the patient, with explanations that are based on inappropriate or missing evidence/research. Explain any racial/ethnic variables that may impact physiological functioning. 23 (23%) – 25 (25%) The response includes an accurate, complete, detailed, and specific explanation of racial/ethnic variables that may impact physiological functioning and is supported by evidence and/or research, as appropriate, to support the explanation. 20 (20%) – 22 (22%) The response includes an accurate explanation of racial/ethnic variables that may impact physiological functioning and is supported by evidence and/or research, as appropriate, to support the explanation. 18 (18%) – 19 (19%) The response includes a vague or inaccurate explanation of racial/ethnic variables that may impact physiological functioning, and/or explanations that are based on inappropriate evidence/research. 0 (0%) – 17 (17%) The response includes a vague or inaccurate explanation of racial/ethnic variables that may impact physiological functioning, or the explanations are based on inappropriate or no evidence/research. 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. The 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. The purpose, introduction, and conclusion of the assignment are vague or off topic. 0 (0%) – 3 (3%) Paragraphs and sentences follow writing standards
[ANSWERED 2022] In this assignment you will propose a quality improvement initiative from your place of employment that could easily be implemented if approved. Assume you are presenting this program to the board for approval of funding
In this assignment you will propose a quality improvement initiative from your place of employment that could easily be implemented if approved In this assignment you will propose a quality improvement initiative from your place of employment that could easily be implemented if approved. Assume you are presenting this program to the board for approval of funding. Write an executive summary (750-1,000 words) to present to the board, from which the board will make its decision to fund your program or project. Include the following: The purpose of the quality improvement initiative. The target population or audience. The benefits of the quality improvement initiative. The interprofessional collaboration that would be required to implement the quality improvement initiative. The cost or budget justification. The basis upon which the quality improvement initiative will be evaluated. Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required. This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion. You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance Expert Answer and Explanation Quality Improvement Initiative A quality improvement initiative focuses on monitoring, analyzing, and improving the quality practices to improve healthcare outcomes in the healthcare organization. Beran et al. (2018) said that hospitals could gather and examine data in critical areas to effectively select a project that can meet their quality requirements. Therefore, this paper proposes a pharmacist-provided Medication Therapy Management (MTM) program to an organization’s board of directors for funding. Purpose of the quality improvement initiative The primary purpose of pharmacist-provided Medication Therapy Management (MTM) project is to improve patients’ outcomes and reduce healthcare costs (Beran et al., 2018). The target population or audience The pharmacist-provided or led MTM project will target the Medicare population. The population constitutes of individuals ages 65 and above, irrespective of their income, health status, medical history, and people with long-term disability (Beran et al., 2018). These persons use a lot of medicines because of their chronic conditions, including depression, heart diseases, influenza, respiratory infections, and diabetes. The benefits of the quality improvement initiative The two essential advantages of the MTM project include empowering of patients and provide service value. Empowering of patients Pharmacist-provided Medication Therapy Management (MTM) encourages patients to participate in their healthcare actively. This is an approach of empowering patients to be responsible and be knowledgeable about their medication use and health (Henderson, Brooks, Richey & Thompson, 2019). MTM services enable an active partnership among pharmacists, patients, physicians, and other healthcare professionals or providers for the attainment of optimum medication treatment outcomes. Henderson, Brooks, Richey, and Thompson (2019) concluded that various patients have attested that pharmacist-provided MTM services have a positive impact on their care in most states in the United States. Provision of services value Pharmacist-led Medication Therapy Management (MTM) services contribute to patients’ safety, appropriateness care, and effective use of drugs. These are the three ways in which this initiative will provide service value to patients. The methods are highlighted below. One, MTM project improves the quality of patient outcomes and care. For example, MTM services usually save lives at risk. Two, the MTM program reduces healthcare spending. Spivey et al., 2019 explained that MTM services have the potential of lowering medical expenditure linked with physician visits or emergency care visits or hospitalizations. Three, MTM project also reduce medication-associated adverse events by improving patient safety (Spivey et al., 2019). Moreover, there are various pieces of evidence indicating that improved healthcare outcomes and better management of healthcare spending result from pharmacist-provided MTM services in both the private and public health sector. For example, the Iowa Medicaid Pharmaceutical Case Management (PCM) Program. This is an MTM project that was established in 2000 to target high risks patients who use more than four medicines. The program has improved prescribing of appropriate drugs and a significant reduction in the utilization of high-risk medications. Another example, The Diabetes Ten City Challenge. This is an MTM health benefit project instituted by groups of employers in ten communities. The initiative has resulted in savings of about $918 per worker in total healthcare expenses for the past years and a 50% reduction in employees’ absenteeism (Spivey et al., 2019). Therefore, the value of pharmacist-provided Medication Therapy Management in clinical, humanistic, and economical is real as its results are outstanding and replicable. The interpersonal collaboration required for the implementation of the quality improvement initiative Enhancement of patient-centered medical care and patient outcomes, a comprehensive team-based will be necessary for the implementation of this project. In MTM project implementation, pharmacists will be prerequisite to boost medicines use that can help to improve patient outcomes. According to the American College of Clinical Pharmacy et al. (2015), for organizations to deliver pharmacist-provided Medical Therapy Management, pharmacists are required to work together with doctors or physicians effectively. Physicians are also required to collaborate with nurses. Nurses are needed to work in partnership with patients (American College of Clinical Pharmacy et al., 2015). The three collaborations are vital for the implementation of pharmacist-led MTM. The cost or budget justification The table below presents different costs needed for the implementation of pharmacist-provided Medication Therapy Management (MTM) program at the organization. Cost category Cost in USD in million % of total Type of cost (USD) Personnel 19. 21 41.32 Variable Material and Supplies 9.25 19.90 Variable Equipment 7.45 16.02 Fixed Non-salary direct 10.1 21.72 Fixed Overhead 0.48 1.03 Fixed Total 46. 49 100% Source (Author, 2019). From the table above it can be deduced that the project requires a total of US$46.49 million. Variable costs in this program are will be caused by the changing cause quality and quantity of the service that the health organization will deliver (Berry, Eizenberg & Waldfogel, 2016). Fixed costs are also expenditures that dependent on the level of services that the organization will offer to its clients. The basis upon which the
[ANSWERED 2023] Lab Assignment Assessing the Abdomen
Lab Assignment Assessing the Abdomen A male went to the emergency room for severe midepigastric abdominal pain. He was diagnosed with AAA ; however, as a precaution, the doctor ordered a CTA scan. Because of a high potential for misdiagnosis, determining the precise cause of abdominal pain can be time consuming and challenging. By analyzing case studies of abnormal abdominal findings, nurses can prepare themselves to better diagnose conditions in the abdomen. In this Lab Assignment, you will analyze an Episodic note case study that describes abnormal findings in patients seen in a clinical setting. You will consider what history should be collected from the patients as well as which physical exams and diagnostic tests should be conducted. You will also formulate a differential diagnosis with several possible To Prepare Review the Episodic note case study your instructor provides you for this week’s Assignment. Please see the “Course Announcements” section of the classroom for your Episodic note case study. With regard to the Episodic note case study provided: Review this week’s Learning Resources, and consider the insights they provide about the case study. Consider what history would be necessary to collect from the patient in the case study. Consider what physical exams and diagnostic tests would be appropriate to gather more information about the patient’s condition. How would the results be used to make a diagnosis? Identify at least five possible conditions that may be considered in a differential diagnosis for the patient. The Assignment Analyze the subjective portion of the note. List additional information that should be included in the documentation. Analyze the objective portion of the note. List additional information that should be included in the documentation. Is the assessment supported by the subjective and objective information? Why or why not? What diagnostic tests would be appropriate for this case, and how would the results be used to make a diagnosis? Would you reject/accept the current diagnosis? Why or why not? Identify three possible conditions that may be considered as a differential diagnosis for this patient. Explain your reasoning using at least three different references from current evidence-based literature. Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Seidel’s guide to physical examination: An interprofessional approach (9th ed.). St. Louis, MO: Elsevier Mosby. Chapter 6, “Vital Signs and Pain Assessment”This chapter describes the experience of pain and its causes. The authors also describe the process of pain assessment. Chapter 18, “Abdomen”In this chapter, the authors summarize the anatomy and physiology of the abdomen. The authors also explain how to conduct an assessment of the abdomen. Dains, J. E., Baumann, L. C., & Scheibel, P. (2019). Advanced health assessment and clinical diagnosis in primary care (6th ed.). St. Louis, MO: Elsevier Mosby. Credit Line: Advanced Health Assessment and Clinical Diagnosis in Primary Care, 6th Edition by Dains, J.E., Baumann, L. C., & Scheibel, P. Copyright 2019 by Mosby. Reprinted by permission of Mosby via the Copyright Clearance Center. Chapter 3, “Abdominal Pain” This chapter outlines how to collect a focused history on abdominal pain. This is followed by what to look for in a physical examination in order to make an accurate diagnosis. Chapter 10, “Constipation” The focus of this chapter is on identifying the causes of constipation through taking a focused history, conducting physical examinations, and performing laboratory tests. Chapter 12, “Diarrhea” In this chapter, the authors focus on diagnosing the cause of diarrhea. The chapter includes questions to ask patients about the condition, things to look for in a physical exam, and suggested laboratory or diagnostic studies to perform. Chapter 29, “Rectal Pain, Itching, and Bleeding” This chapter focuses on how to diagnose rectal bleeding and pain. It includes a table containing possible diagnoses, the accompanying physical signs, and suggested diagnostic studies. Colyar, M. R. (2015). Advanced practice nursing procedures. Philadelphia, PA: F. A. Davis. Credit Line: Advanced practice nursing procedures, 1st Edition by Colyar, M. R. Copyright 2015 by F. A. Davis Company. Reprinted by permission of F. A. Davis Company via the Copyright Clearance Center. These sections below explain the procedural knowledge needed to perform gastrointestinal procedures. Chapter 107, “X-Ray Interpretation: Chest (pp. 480–487) Chapter 115, “X-Ray Interpretation of Abdomen” (pp. 514–520) Note: Download this Student Checklist and Abdomen Key Points to use during your practice abdominal examination. Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Abdomen: Student checklist. In Seidel’s guide to physical examination: An interprofessional approach (9th ed.). St. Louis, MO: Elsevier Mosby. Credit Line: Seidel’s Guide to Physical Examination, 9th Edition by Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. Copyright 2019 by Elsevier Health Sciences. Reprinted by permission of Elsevier Health Sciences via the Copyright Clearance Center. Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Abdomen: Key points. In Seidel’s guide to physical examination: An interprofessional approach (9th ed.). St. Louis, MO: Elsevier Mosby. Credit Line: Seidel’s Guide to Physical Examination, 9th Edition by Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. Copyright 2019 by Elsevier Health Sciences. Reprinted by permission of Elsevier Health Sciences via the Copyright Clearance Center. Optional Resource LeBlond, R. F., Brown, D. D., & DeGowin, R. L. (2014). DeGowin’s diagnostic examination (10th ed.). New York, NY: McGraw Hill Medical. Chapter 9, “The Abdomen, Perineum, Anus, and Rectosigmoid” (pp. 445–527)This chapter explores the health assessment processes for the abdomen, perineum, anus, and rectosigmoid. This chapter also examines the symptoms of many conditions in these areas. Chapter 10, “The Urinary System” (pp. 528–540)In this chapter, the authors provide an overview of the physiology of the urinary system. The chapter also lists symptoms and conditions of the urinary system. NURS_6512_Week_6_Assignment_1_Rubric NURS_6512_Week_6_Assignment_1_Rubric Criteria Ratings Pts This criterion is linked to a Learning Outcome With regard to the SOAP note case study provided, address the following:Analyze the subjective portion of the note. List additional information that should be included in the documentation. 12 to >9.0 pts Excellent The response clearly, accurately, and thoroughly analyzes the subjective portion of the SOAP
[ANSWERED 2023] Describe the national healthcare issue/stressor you selected and its impact on your organization
Describe the national healthcare issue/stressor you selected and its impact on your organization. Use organizational data to quantify the impact The Quadruple Aim provides broad categories of goals to pursue to maintain and improve healthcare. Within each goal are many issues that, if addressed successfully, may have a positive impact on outcomes. For example, healthcare leaders are being tasked to shift from an emphasis on disease management often provided in an acute care setting to health promotion and disease prevention delivered in primary care settings. Efforts in this area can have significant positive impacts by reducing the need for primary healthcare and by reducing the stress on the healthcare system. Changes in the industry only serve to stress what has always been true; namely, that the healthcare field has always faced significant challenges, and that goals to improve healthcare will always involve multiple stakeholders. This should not seem surprising given the circumstances. Indeed, when a growing population needs care, there are factors involved such as the demands of providing that care and the rising costs associated with healthcare. Generally, it is not surprising that the field of healthcare is an industry facing multifaceted issues that evolve over time. you reviewed some healthcare issues/stressors and selected one for further review. For this Assignment, you will consider in more detail the healthcare issue/stressor you selected. You will also review research that addresses the issue/stressor and write a white paper to your organization’s leadership that addresses the issue/stressor you selected. To Prepare: Review the national healthcare issues/stressors presented in the Resources and reflect on the national healthcare issue/stressor you selected for the study. Reflect on the feedback you received from your colleagues on your Discussion post for the national healthcare issue/stressor you selected. Identify and review two additional scholarly resources (not included in the Resources for this module) that focus on change strategies implemented by healthcare organizations to address your selected national healthcare issue/stressor. The Assignment (3-4 Pages): Analysis of a Pertinent Healthcare Issue Develop a 3- to 4-page paper, written to your organization’s leadership team, addressing your selected national healthcare issue/stressor and how it is impacting your work setting. Be sure to address the following: Describe the national healthcare issue/stressor you selected and its impact on your organization. Use organizational data to quantify the impact (if necessary, seek assistance from leadership or appropriate stakeholders in your organization). Provide a brief summary of the two articles you reviewed from outside resources on the national healthcare issue/stressor. Explain how the healthcare issue/stressor is being addressed in other organizations. Summarize the strategies used to address the organizational impact of national healthcare issues/stressors presented in the scholarly resources you selected. Explain how they may impact your organization both positively and negatively. Be specific and provide examples. APA citation 3 to 4 references within 5 years Grading Rubric Develop a 3- to 4-page paper, written to your organization’s leadership team, addressing the selected national healthcare issue/stressor and how it is impacting your work setting. Be sure to address the following: · Describe the national healthcare issue/stressor you selected and its impact on your organization. Use organizational data to quantify the impact (if necessary, seek assistance from leadership or appropriate stakeholders in your organization).— Excellent 23 (23%) – 25 (25%) The response accurately and thoroughly describes in detail the national healthcare issue/stressor selected and its impact on an organization. The response includes accurate, clear, and detailed data to quantify the impact of the national healthcare issue/stressor selected. Provide a brief summary of the two articles you reviewed from outside resources, on the national healthcare issue/stressor and explain how the healthcare issue/stressor is being addressed in other organizations.— Excellent 27 (27%) – 30 (30%) A complete, detailed, and specific synthesis of two outside resources reviewed on the national healthcare issue/stressor selected is provided. The response fully integrates at least 2 outside resources and 2 or 3 course-specific resources that fully support the summary provided. Summarize the strategies used to address the organizational impact of national healthcare issues/stressors presented in the scholarly resources you selected and explain how they may impact your organization both positively and negatively. Be specific and provide examples.— Excellent 27 (27%) – 30 (30%) A complete, detailed, and accurate summary of the strategies used to address the organizational impact of the national healthcare issue/stressor is provided. The response accurately and thoroughly explains in detail how the strategies may impact an organization both positively and negatively, with specific and accurate examples. 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 is provided which delineates all required criteria.— Excellent 5 (5%) – 5 (5%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity. A clear and comprehensive purpose statement, introduction, and conclusion is provided which delineates all required criteria. Written Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation— Excellent 5 (5%) – 5 (5%) Uses correct grammar, spelling, and punctuation with no errors. Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, parenthetical/in-text citations, and reference list.— Excellent 5 (5%) – 5 (5%) Uses correct APA format with no errors. EXPERT ANSWER Analysis of a Pertinent Healthcare Issue With the increasing number of people who are covered by the government-sponsored health insurance programs, a challenge has emerged on how to cater to the healthcare needs of the nation. The number of monetary investments has been on the increase but the manpower has failed to catch up to the increasing number of patients needing healthcare services. This especially has been the case with the increasing aged population who qualify for the Medicare and Medicaid programs (Blouin & Podjasek, 2019). This is an issue that has trickled down to the healthcare facilities including the organization I work for. Nurse staffing is considered an issue that has major significance in patient outcomes, including the quality of care delivered to patients. several studies have indicated the effects of nurse staffing on patient outcomes,
[ANSWERED 2023] Research the range of contemporary issues
Research the range of contemporary issues teenagers face today. In a 500-750-word paper, choose one issue (besides teen pregnancy) Research the range of contemporary issues teenagers face today. In a 500-750-word paper, choose one issue (besides teen pregnancy) and discuss its effect on adolescent behavior and overall well-being. Include the following in your submission: Describe the contemporary issue and explain what external stressors are associated with this issue. Outline assessment strategies to screen for this issue and external stressors during an assessment for an adolescent patient. Describe what additional assessment questions you would need to ask and define the ethical parameters regarding what you can and cannot share with the parent or guardian. Discuss support options for adolescents encountering external stressors. Include specific support options for the contemporary issue you presented. You are required to cite a minimum of three peer-reviewed sources to complete this assignment. Sources must be published within the last 5 years, appropriate for the assignment criteria, and relevant to nursing practice. Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion. You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance. Rubric Criteria Total90 points Criterion 1. Unsatisfactory 2. Insufficient 3. Approaching 4. Acceptable 5. Target Mechanics of Writing Includes spelling, capitalization, punctuation, grammar, language use, sentence structure, etc. 0 points Errors in grammar or syntax are pervasive and impede meaning. Incorrect language choice or sentence structure errors are found throughout. 4.05 points Frequent and repetitive mechanical errors are present. Inconsistencies in language choice or sentence structure are recurrent. 4.27 points Occasional mechanical errors are present. Language choice is generally appropriate. Varied sentence structure is attempted. 4.81 points Few mechanical errors are present. Suitable language choice and sentence structure are used. 5.4 points No mechanical errors are present. Appropriate language choice and sentence structure are used throughout. Thesis, Position, or Purpose Communicates reason for writing and demonstrates awareness of audience. 0 points The thesis, position, or purpose is not discernible. No awareness of the appropriate audience is evident. 4.73 points The thesis, position, or purpose is unfocused or confused. There is very little awareness of the intended audience. 4.98 points The thesis, position, or purpose is discernable in most aspects but is occasionally weak or unclear. There is limited awareness of the appropriate audience. 5.61 points The thesis, position, or purpose is adequately presented. An awareness of the appropriate audience is demonstrated. 6.3 points The thesis, position, or purpose is clearly communicated throughout and clearly directed to a specific audience. Development, Structure, and Conclusion Advances position or purpose throughout writing; conclusion aligns to and evolves from development. 0 points No advancement of the thesis, position, or purpose is evident. Connections between paragraphs are missing or inappropriate. No conclusion is offered. 4.73 points Writing lacks logical progression of the thesis, position, or purpose. Some organization is attempted, but ideas are disconnected. Conclusion is unclear and not supported by the overall development of the purpose. 4.98 points Limited advancement of thesis, position, or purpose is discernable. There are inconsistencies in organization or the relationship of ideas. Conclusion is simplistic and not fully aligned to the development of the purpose. 5.61 points The thesis, position, or purpose is advanced in most aspects. Ideas clearly build on each other. Conclusion aligns to the development of the purpose. 6.3 points The thesis, position, or purpose is logically advanced throughout. The progression of ideas is coherent and unified. A clear and logical conclusion aligns to the development of the purpose. Contemporary Issue and Associated External Stressors A description of the contemporary issue and explanation of what external stressors are associated with the issue are provided. 0 points A description of the contemporary issue and explanation of what external stressors are associated with the issue are omitted or inaccurate. 16.88 points A description of the contemporary issue and explanation of what external stressors are associated with the issue lack detail or are incomplete. 17.78 points A description of the contemporary issue and explanation of what external stressors are associated with the issue are present. 20.03 points A detailed description of the contemporary issue and explanation of what external stressors are associated with the issue are present. 22.5 points A thorough and accurate description of the contemporary issue and explanation of what external stressors are associated with the issue are present. Support Options for Adolescents Encountering External Stressors A discussion of support options for adolescents encountering external stressor and specific support options for the contemporary issue presented is provided. 0 points A discussion of support options for adolescents encountering external stressor and specific support options for the contemporary issue presented is omitted or inaccurate. 13.5 points A discussion of support options for adolescents encountering external stressor and specific support options for the contemporary issue presented lacks detail and is incomplete. 14.22 points A discussion of support options for adolescents encountering external stressor and specific support options for the contemporary issue is present. 16.02 points A detailed of includes support options for adolescents encountering external stressor and specific support options for the contemporary issue presented is present. 18 points A thorough and accurate discussion of support options for adolescents encountering external stressor and specific support options for the contemporary issue presented is present. Assessment Strategies to Screen for the Issue and External Stressors An outline includes assessment strategies to screen for the issue including external stressors during an assessment for an adolescent patient and a description of what additional assessment questions one would need to ask. A definition of the ethical parameters regarding what you can and cannot share with the parent or guardian is provided. 0 points An outline that includes assessment strategies to screen for the issue, including external stressors during an assessment for an adolescent patient and a description of what additional assessment questions one would need to ask, is omitted or inaccurate. A definition of the ethical parameters regarding what you can and cannot share with the parent or