NURS 6501 Module 1 Assignment: Case Study AnalysisNURS 6501 Module 1 Assignment: Case Study Analysis

NURS 6501 Module 1 Assignment: Case Study Analysis

NURS 6501 Module 1 Assignment: Case Study Analysis

Week 1: Cellular Processes and the Genetic Environment

One of the more common biology analogies refers to cells as the “building blocks” of life. This rightfully places an emphasis on understanding cells, cellular behavior, and the impact of the environment in which they function.

Such an understanding helps explain how healthy cell activity contributes to good health. Just as importantly, it helps explain how breakdowns in cellular behavior and alterations to cells lead to health issues.

This week, you examine cellular processes that are subject to alterations that can lead to disease. You evaluate the genetic environments within which these processes exist as well as the impact these environments have on disease.

Also Read:

Discussion: Alterations in Cellular Processes NURS 6501

Cellular Processes and the Genetic Environment Example

A disease process can be explained at molecular, cellular, histological, organ, and organ system levels. In this biological hierarchy, the cellular and molecular processes contribute significantly to the development of disease at the advanced macroscopic levels. The role of the immune system must be considered when describing disease processes because immunity is the custodian of biological wellness at the cellular level. This paper aims to describe the association between the cellular processes and the genetic environment in normal bio-physiological processes and their interactions with the immune system in disease states. 

Cellular Processes and Alterations Within Cellular Processes

Most cells in the human body communicate, grow and multiply in a well-organized fashion to contribute to the proper functioning of the tissues, organs, and organ systems. Cells communicate with each other through molecules and second messenger molecules within the cells. This communication enables the cells to respond to noxious stimuli and initiate death when programmed. Additionally, this communication also enables the cells to maintain a balanced internal and external homeostasis and regulate their growth. 

At the genetic level, these cells depend greatly on the master information and commands from the nucleic material from the nucleus and ribosomes to control cellular processes. How the cells react and normal and abnormal communication and growth depend on their genetic makeup. The role of mitochondria is vital in maintaining growth, metabolism, and cell death (Birsoy & Sancak, 2019). Cell division and energy production utilization require normal mitochondrial functioning

Impact of The Genetic Environment on Disease

Genetic and epigenetic processes within the cell control the cellular processes. The cellular nucleus transcribes genetic information into the DNA through replication, after which the ribosomes will use this information to make proteins for intracellular and intercellular communication, growth, and multiplication. Therefore, alteration in the processes of gene transcription, DNA translation, and protein synthesis can cause ineffective communication, uncontrolled growth and multiplication, or even cell death. This can be explained by the impact of gene mutations on cancers and autoimmune diseases (Kumar et al., 2021). These genetic alterations and mutations can arise from the external environment through chemicals that interfere with the gene patterns, leading to wrong communication and disordered growth.

Roles Genetics Plays in Disease Processes

Genetics plays an important role in the disease process because it will determine how the cell prepares for defense against disease or responds when these disease states occur. Faulty genetic sequences can be transcribed and translated to pathogenic proteins. The role of genetics in disease processes can be multifaceted in that genetic mutations, genetic susceptibility, and variations in genetic expressions can be implicated in various diseases. Ultimately, it all narrows down the gene transcription and translations to control communication growth and response to disease.

Cells and Disease

The basic units of life are the cells; thus, they are fundamental in disease states. At the cellular level, abnormalities in communications and signaling, disordered growth patterns, disruption of normal cellular metabolisms and respiration, and inadequate defense against noxious stimuli and damage are pathogenetic processes that lead to disease (McCance & Huether, 2019). The involvement of more cells leads to tissue pathology, which leads to organ damage and systemic disease when the damage advances. The central role in this cascade is attributed to the cells’ abilities to control and maintain their normal physiologic processes, as described earlier.

Altered Physiology

Derangements in the aforementioned processes lead to altered physiology. Cellular structure, gene expression, protein activity, and cell metabolism constitute the key physiological processes that maintain cellular and multisystem functioning (Birsoy & Sancak, 2019). Damage to cellular physical structure leads to poor communication and cellular response to the damage that constitutes the disease process. Faulty gene expression can lead to uncooled cell growth, as seen with cancers and benign neoplasms (Mbemi et al., 2020). Altered cell metabolisms lead to cell death through programmed (apoptosis) and non-programmed (necrosis) cell death deaths. 

Alterations in the Immune System

When the immune cells fail to distinguish between the pathogen and host cells, it may attack the host cells, leading to autoimmune disorders. The immune system can also respond aggressively or inappropriately to harmless antigens, leading to inflammation such as those seen in allergic processes. During inflammation, bystander cells can be destroyed in this normal body response to noxious stimuli. Altered cellular physiology and genetics can lead to deficiency in mounting immune responses such as inflammation or communication through cytokines and cell surface molecules.

Racial Variables

Races and ethnicities determine a person’s way of life, including marriages and, thus, inheritance of genes. Therefore, bad or mutated genes can be passed from one generation to the next in cases of intra-ethnic marriages. Races and ethnicities also determine a person’s health behavior and beliefs about illness. This affects their health-seeking behaviors and disease perceptions, thus poor health choices and low literacy levels. A race can be situated in a unit geographical area exposed to similar environmental factors such as air and water pollution and radiation that affect their genetic information leading to various illnesses.

Impact of Patient Characteristics on Disorders

Patient characteristics that can impact disorders and physiology include but are not limited to race, age, sex, and weight. As people age, their body physiology deteriorates as they enter advanced elderly states (McCance & Huether, 2019). Slow response to external disease stimulus contributes to the advancement of some diseases. Sometimes, the sex determines the occurrence of some disorders due to variations in biochemical makeup and qualities between the male and female sexes. Obesity is a key determinant for various chronic illnesses, especially cardiovascular diseases.

Association of Genes in the Development of Disease

. The famous saying that genes load the gun but the lifestyle and environment pull the trigger justifies the role of genetics in disease processes. The genetic makeup of a person makes them genetically susceptible to some illnesses (Tukker et al., 2021). Familial illnesses such as sickle cell anemia, familial hypercholesterolemia, and Tay Sachs disease, among others, rely on genetic inheritance patterns that make the biological offspring of affected people more susceptible to these diseases.

Immunosuppression and Its Body Systems Impact

Reduction in the body’s immune system’s capacity to fight off pathogens results in various disease processes. Radiation, infections, and certain genetic expressions can cause immunosuppression. Immunosuppression leads to increased incidence and recurrence of infections, decreased capacity to prevent neoplastic changes, and delayed healing processes and tissues. The immune system plays a critical role in fighting off neoplastic cells such as melanoma, lymphoma, and other malignancies (Kumar et al., 2021). Opportunistic diseases rely on immune system suppression by HIV viruses.

Conclusion

This paper has covered a variety of topics, including the role of genetics in disease development, the impact of patient characteristics on disorders and altered physiology, and the process of immunosuppression and its effects on the body. The evaluation of cellular processes and alterations has also been discussed. Understanding the complex relationships between genetics, disease, and the immune system is important in understanding disease processes and interventions to prevent these diseases. 

NURS 6501 Module 1 Assignment: Case Study Analysis References

Birsoy, K., & Sancak, Y. (2019). The role of metabolism in cellular processes. Molecular Biology of the Cell, 30(6), 733. https://doi.org/10.1091/mbc.E19-01-0004

Kumar, V., Abbas, A. K., & Aster, J. C. (2021). Robbins Basic Pathology (V. Kumar, A. K. Abbas, & J. C. Aster, Eds.; 10th ed.). Elsevier – Health Sciences Division.

Mbemi, A., Khanna, S., Njiki, S., Yedjou, C. G., & Tchounwou, P. B. (2020). Impact of gene-environment interactions on cancer development. International Journal of Environmental Research and Public Health, 17(21), 8089. https://doi.org/10.3390/ijerph17218089

McCance, K. L., & Huether, S. E. (2019). Pathophysiology: The biologic basis for disease in adults and children (8th ed.). Mosby.

Tukker, A. M., Royal CD, Bowman, A. B., & McAllister, K. A. (2021). The Impact of Environmental Factors on Monogenic Mendelian Diseases. Toxicological Sciences?: An Official Journal of the Society of Toxicology, 181(1). https://doi.org/10.1093/toxsci/kfab022

Alterations in Cellular Processes Discussion Responses

Response 1

Hello. I agree with your discussion. It was a splendid analysis of the case study. I would add a few perspectives to your analysis. The fact that the patient has protein malnutrition is undeniable. In my view, his protein malnutrition could have arisen from different etiologies – some acquired while some causes could have a genetic component to them (McCance & Huether, 2018). Firstly, she has poor intake from lack of dentures leading to inadequate absorption of protein.

Secondly, she has a malabsorption syndrome that leads to poor absorption of proteins, thus protein malnutrition. This situation could have arisen from genetic conditions such as hereditary folate malabsorption, inflammatory bowel disease (IBS), and intestinal lymphangiectasia (Zuvarox & Belletieri, 2021). The genetic background of the patient’s clinical condition would result from the inheritable diseases in this patient’s list of possible etiologies.

References

McCance, K. L., & Heather, S. E. (2018). Pathophysiology: The biologic basis for disease in adults and children (8th ed.). Mosby. https://shop.elsevier.com/books/pathophysiology/mccance/978-0-323-40281-1

Zuvarox, T., & Belletieri, C. (2021). Malabsorption Syndromes. In StatPearls [Internet]. StatPearls Publishing. https://pubmed.ncbi.nlm.nih.gov/31971746/

NURS 6501 Module 1 Assignment: Case Study Analysis Response 2

Hello. You have posted an elaborate discussion there. Alongside an anaphylactic reaction, the patient also had an underlying infectious process going on. His disease complication is iatrogenic and would be foreseen of food and drug allergies history would reveal the presence of penicillin allergies. Anaphylactic reactions, as you have mentioned, are type 1 hypersensitivity reactions. I agree that the pathophysiology of his presentation was based on an anaphylactic reaction leading to edema.

These symptoms would most likely be triggered by increased permeability in inflammatory reaction, causing fluid leakage into third spaces. Genetics would have a role in his pathogenetic process, and atopy best explains the role of genetics in his symptoms’ development (American Academy of Allergy, Asthma, and Immunology, 2020). An interplay between environmental, personal characteristics, and genetics would also be possible in pathophysiology (McCance & Huether, 2018). Infections are environmental in this case.

NURS 6501 Module 1 Assignment: Case Study Analysis References

American Academy of Allergy, Asthma, and Immunology. (2020, July 23). Too much of an allergy-related gene makes anaphylaxis worse. Aaaai.Org. https://www.aaaai.org/Tools-for-the-Public/Latest-Research-Summaries/The-Journal-of-Allergy-and-Clinical-Immunology/2020/gene

McCance, K. L., & Huether, S. E. (2018). Pathophysiology: The biologic basis for disease in adults and children (8th ed.). Mosby. https://shop.elsevier.com/books/pathophysiology/mccance/978-0-323-40281-1

Learning Resources

Required Readings (click to expand/reduce)

McCance, K. L. & Huether, S. E. (2019). Pathophysiology: The biologic basis for disease in adults and children (8th ed.). St. Louis, MO: Mosby/Elsevier.

• Chapter 1: Cellular Biology; Summary Review
• Chapter 2: Altered Cellular and Tissue Biology: Environmental Agents (pp. 46-61; begin again with Manifestations of Cellular Injury pp. 83-97); Summary Review
• Chapter 3: The Cellular Environment: Fluids and Electrolytes, Acids, and Bases
• Chapter 4: Genes and Genetic Diseases (stop at Elements of formal genetics); Summary Review
• Chapter 5: Genes, Environment-Lifestyle, and Common Diseases (stop at Genetics of common diseases); Summary Review
• Chapter 7: Innate Immunity: Inflammation and Wound Healing
• Chapter 8: Adaptive Immunity (stop at Generation of clonal diversity); Summary Review
• Chapter 9: Alterations in Immunity and Inflammation (stop at Deficiencies in immunity); Summary Review
• Chapter 10: Infection (pp. 289–303; stop at Infectious parasites and protozoans); (start at HIV); Summary Review
• Chapter 11: Stress and Disease (stop at Stress, illness & coping); Summary Review
• Chapter 12: Cancer Biology (stop at Resistance to destruction); Summary Review
• Chapter 13: Cancer Epidemiology (stop at Environmental-Lifestyle factors); Summary Review

Justiz-Vaillant, A. A., & Zito, P. M. (2019). Immediate hypersensitivity reactions. In StatPearls. Treasure Island, FL: StatPearls Publishing. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK513315/

Credit Line: Immediate Hypersensitivity Reactions – StatPearls – NCBI Bookshelf. (2019, June 18). Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK513315/. Used with permission of Stat Pearls

Required Media (click to expand/reduce)

Module 1 Overview with Dr. Tara Harris 

Dr. Tara Harris reviews the structure of Module 1 as well as the expectations for the module. Consider how you will manage your time as you review your media and Learning Resources throughout the module to prepare for your Discussion and Assignment. (4m)

Immunity and Inflammation

Khan Academy (2010, February 24). Inflammatory response | Human anatomy and physiology | Health & medicine [Video file]. Retrieved from https://www.youtube.com/watch?v=FXSuEIMrPQk  

Note: The approximate length of the media program is 14 minutes.

Soo, P. (2018, July 28). Pathophysiology Ch 10 alterations in immune function [Video file]. Retrieved from https://www.youtube.com/watch?v=Jz0wx1-jTds   

Note: The approximate length of the media program is 37 minutes.

Acid-Base Balance #1

MedCram. (2012, April 28). Medical acid base balance, disorders & ABGs explained clearly [Video file]. Retrieved from https://www.youtube.com/watch?v=4wMEMhvrQxE 

Note: The approximate length of the media program is 13 minutes.

Acid-Base Balance #2

MedCram. (2012, April 29). Medical acid base balance, disorders & ABGs explained clearly | 2 of 8 [Video file]. Retrieved from https://www.youtube.com/watch?v=GmEeKVTpOKI  

Note: The approximate length of the media program is 15 minutes.

Hyponatremia

MedCram. (2017, December 23). Hyponatremia explained clearly (remastered) – Electrolyte imbalances [Video file]. Retrieved from https://www.youtube.com/watch?v=bLajK5Vy55M 

Note: The approximate length of the media program is 15 minutes.

Online Media from?Pathophysiology: The Biologic Basis for Disease in Adults and Children

In addition to this week’s media, it is highly recommended that you access and view the resources included with the course text, Pathophysiology: The Biologic Basis for Disease in Adults and Children. Focus on the videos and animations in Chapters 3, 7, and 8 that relate to alterations in immunity, hyponatremia, and acid/base balance.

Note: To access the online resources included with the text, you need to complete the FREE online registration that is located at https://evolve.elsevier.com/cs/store?role=student

To Register to View the Content

1. Go to https://evolve.elsevier.com/cs/store?role=student
2. Enter the name of the textbook, Pathophysiology: The Biologic Basis for Disease in Adults and Children, or ISBN 9780323654395 (name of text without the edition number) in the Search textbox.
3. Complete the registration process.

To View the Content for This Text

1. Go to https://evolve.elsevier.com/
2. Click on Student Site.
3. Type in your username and password.
4. Click on the Login button.
5. Click on the plus sign icon for Resources on the left side of the screen.
6. Click on the name of the textbook for this course.
7. Expand the menu on the left to locate all the chapters.
8. Navigate to the desired content (checklists, videos, animations, etc.).

Note: Clicking on the URLs in the APA citations for the Resources from the textbook will not link directly to the desired online content. Use the online menu to navigate to the desired content.

Discussion: Alterations in Cellular Processes

Photo Credit: Getty Images

At its core, pathology is the study of disease. Diseases occur for many reasons. But some, such as cystic fibrosis and Parkinson’s Disease, occur because of alterations that prevent cells from functioning normally.

Understanding of signals and symptoms of alterations in cellular processes is a critical step in diagnosis and treatment of many diseases. For the Advanced Practice Registered Nurse (APRN), this understanding can also help educate patients and guide them through their treatment plans.

For this Discussion, you examine a case study and explain the disease that is suggested. You examine the symptoms reported and explain the cells that are involved and potential alterations and impacts.

To prepare:

• By Day 1 of this week, you will be assigned to a specific scenario for this Discussion. Please see the “Course Announcements” section of the classroom for your assignment from your Instructor.

By Day 3 of Week 1

Post an explanation of the disease highlighted in the scenario you were provided. Include the following in your explanation:

• The role genetics plays in the disease.
• Why the patient is presenting with the specific symptoms described.
• The physiologic response to the stimulus presented in the scenario and why you think this response occurred.
• The cells that are involved in this process.
• How another characteristic (e.g., gender, genetics) would change your response.

Read a selection of your colleagues’ responses.

By Day 6 of Week 1

Respond to at least two of your colleagues on 2 different days and respectfully agree or disagree with your colleague’s assessment and explain your reasoning. In your explanation, include why their explanations make physiological sense or why they do not

Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link and then select “Create Thread” to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on Submit!

NURS 6501 Week 2: Altered Physiology

With a place squarely in the spotlight for patients diagnosed with all manner of disease, APRNs must demonstrate not only support and compassion, but expertise to guide patients’ understanding of diagnoses and treatment plans.

This expertise goes beyond an understanding of disease and sciences, such as cellular pathophysiology. APRNs must become experts in their patients, understanding their medical backgrounds, pertinent characteristics, and other variables that can be factors in their diagnoses and treatments.

This week, you examine alterations in the immune system and the resultant disease processes. You consider patient characteristics, including racial and ethnic variables, and the impact they have on altered physiology.

Learning Objectives

Students will:

• Evaluate cellular processes and alterations within cellular processes
• Analyze alterations in the immune system that result in disease processes
• Identify racial/ethnic variables that may impact physiological functioning
• Evaluate the impact of patient characteristics on disorders and altered physiology

Learning Resources

Required Readings (click to expand/reduce)

McCance, K. L. & Huether, S. E. (2019). Pathophysiology: The biologic basis for disease in adults and children (8th ed.). St. Louis, MO: Mosby/Elsevier.

• Chapter 1: Cellular Biology; Summary Review
• Chapter 2: Altered Cellular and Tissue Biology: Environmental Agents(pp. 46-61; begin again with Manifestations of Cellular Injury pp. 83-97); Summary Review
• Chapter 3: The Cellular Environment: Fluids and Electrolytes, Acids, and Bases,
• Chapter 4: Genes and Genetic Diseases (stop at Elements of formal genetics); Summary Review
• Chapter 5: Genes, Environment-Lifestyle, and Common Diseases (stop at Genetics of common diseases); Summary Review
• Chapter 7: Innate Immunity: Inflammation and Wound Healing
• Chapter 8: Adaptive Immunity (stop at Generation of clonal diversity); Summary Review
• Chapter 9: Alterations in Immunity and Inflammation (stop at Deficiencies in immunity); Summary Review
• Chapter 10: Infection (stop at Infectious parasites and protozoans); (start at HIV); Summary Review
• Chapter 11: Stress and Disease (stop at Stress, illness & coping); Summary Review
• Chapter 12: Cancer Biology (stop at Resistance to destruction); Summary Review
• Chapter 13: Cancer Epidemiology (stop at Environmental-Lifestyle factors); Summary Review

Note: You previously read these chapters in Week 1 and you are encouraged to review once again for this week.

Justiz-Vaillant, A. A., & Zito, P. M. (2019). Immediate hypersensitivity reactions. In StatPearls. Treasure Island, FL: StatPearls Publishing. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK513315/

?Credit Line: Immediate Hypersensitivity Reactions – StatPearls – NCBI Bookshelf. (2019, June 18). Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK513315/. Used with permission of Stat Pearls.
Note: This article was presented in the Week 1 resources. If you read it previously you are encouraged to review it this week.

Required Media (click to expand/reduce)

Immunity and Inflammation

Khan Academy (2010, February 24). Inflammatory response | Human anatomy and physiology  | Health & medicine [Video file]. Retrieved from https://www.youtube.com/watch?v=FXSuEIMrPQk  

Note: The approximate length of the media program is 14 minutes.

Soo, P. (2018, July 28). Pathophysiology Ch 10 alterations in immune function [Video file]. Retrieved from https://www.youtube.com/watch?v=Jz0wx1-jTds   

Note: The approximate length of the media program is 37 minutes.

Acid-Base Balance #1

MedCram. (2012, April 28). Medical acid base balance, disorders & ABGs explained clearly [Video file]. Retrieved from https://www.youtube.com/watch?v=4wMEMhvrQxE

Note: The approximate length of the media program is 13 minutes.

Acid-Base Balance #2

MedCram. (2012, April 29). Medical acid base balance, disorders & ABGs explained clearly | 2 of 8 [Video file]. Retrieved from https://www.youtube.com/watch?v=GmEeKVTpOKI  

Note: The approximate length of the media program is 15 minutes.

Hyponatremia

MedCram. (2017, December 23). Hyponatremia explained clearly [LK1] (remastered) – Electrolyte imbalances [Video file]. Retrieved from https://www.youtube.com/watch?v=bLajK5Vy55M

Note: The approximate length of the media program is 15 minutes.

Online Media from?Pathophysiology: The Biologic Basis for Disease in Adults and Children

In addition to this week’s media, it is highly recommended that you access and view the resources included with the course text, Pathophysiology: The Biologic Basis for Disease in Adults and Children. Focus on the videos and animations in Chapters 3, 7, and 8 that relate to alterations in immunity, hyponatremia, and acid/base balance.

Note: To access the online resources included with the text, you need to complete the FREE online registration that is located at https://evolve.elsevier.com/cs/store?role=student

To Register to View the Content

1. Go to https://evolve.elsevier.com/cs/store?role=student
2. Enter the name of the textbook, Pathophysiology: The Biologic Basis for Disease in Adults and Children, or ISBN 9780323654395 (name of text without the edition number) in the Search textbox.
3. Complete the registration process.

To View the Content for This Text

1. Go to https://evolve.elsevier.com/
2. Click on Student Site.
3. Type in your username and password.
4. Click on the Login button.
5. Click on the plus sign icon for Resources on the left side of the screen.
6. Click on the name of the textbook for this course.
7. Expand the menu on the left to locate all the chapters.
8. Navigate to the desired content (checklists, videos, animations, etc.).

Note: Clicking on the URLs in the APA citations for the Resources from the textbook will not link directly to the desired online content. Use the online menu to navigate to the desired content.

Case Study Analysis – Module 1 Assignment

An understanding of cells and cell behavior is a critically important component of disease diagnosis and treatment. But some diseases can be complex in nature, with a variety of factors and circumstances impacting their emergence and severity.

Effective disease analysis often requires an understanding that goes beyond isolated cell behavior. Genes, the environments in which cell processes operate, the impact of patient characteristics, and racial and ethnic variables all can have an important impact.

An understanding of the signals and symptoms of alterations in cellular processes is a critical step in the diagnosis and treatment of many diseases. 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 cell, gene, and/or process elements that may be factors in the diagnosis, and you explain the implications to patient health.

To prepare for NURS 6501 Module 1 Assignment: Case Study Analysis:

By Day 1 of this week, you will be assigned to a specific case study for this Case Study Assignment. Please see the “Course Announcements” section of the classroom for your assignment from your Instructor.

The Assignment (1- to 2-page case study analysis)

Develop a 1- to 2-page case study analysis in which you:

• Explain why you think the patient presented the symptoms described.
• Identify the genes that may be associated with the development of the disease.
• Explain the process of immunosuppression and the effect it has on body systems.

By Day 7 of Week 2

Submit your Case Study Analysis Assignment by Day 7 of Week 2.

Reminder: The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The sample paper provided at the Walden Writing Center provides an example of those required elements (available at https://academicguides.waldenu.edu/writingcenter/templates). All papers submitted must use this formatting.

NURS 6501 Module 1 Assignment: Case Study Analysis Rubric Detail 

Rubric Detail

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

Name: NURS 6501 Module 1 Case Study Assignment Rubric

Grid View
List View

• 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 why you think the patient presented the symptoms described.

28 (28%) – 30 (30%)

• The response accurately and thoroughly describes the patient symptoms.
• The response includes accurate, clear, and detailed reasons, with explanation for the symptoms 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 reasons, with explanation for the symptoms supported by evidence and/or research, as appropriate, to support the explanation.

23 (23%) – 24 (24%)

• The response describes the patient s

  ---

  Solution: