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wk7assignment.docx

Learning Resources: Please plan accordingly throughout the week to review all learning resources that include but not limited to the lecturio resources and all required reading. There is much information provided but all is relevant that you will need not only for the successful completion of this course but also as you begin your practice as a Nurse Practitioner. As well, there are many required media videos for you to view this week and they are very informative.

Week 7 Assignment: Please use the following Case Studies to complete your Assignment for this week that is Due by Day 7.

Directions: For each of the scenarios below, answer the questions below using clinical practice guideline where applicable. Explain the problem and explain how you would address the problem. If prescribing a new drug, write out a complete medication order just as you would if you were completing a prescription. Use at least 3 sources for each scenario and cite sources using APA format.

SCENARIO 1

What are the errors in the following prescriptions (1 per prescription)? Rewrite each prescription correctly. What is each medication’s classification and mechanism of action (MOA)?

· fentanyl transdermal patch 12 mcg/hr Apply 1 patch to skin every 72 hours #10 patches 1 RF

· Skyrizi 600 mg/10 mL IV infused over 1 hour at weeks 0, 4, 8 and 12 for Crohn’s disease #1 vial 3 RF

· allopurinol 300 mg PO QID #120 0 RF

· adalimumab (Humira) 120 mg SQ inject every other week #2 syringes 1 RF

· bupropion XL 150 mg PO BID for smoking cessation #60 1 RF

SCENARIO 2

Zolpidem has a half-life of 3 hours. If a patient takes 10 mg at 21:00, what will the blood level be at 06:00? Name 3 antidepressants/antipsychotics you might prescribe for patients with co-existing depression and insomnia. What is their MOA? Include complete medication orders and patient monitoring for each of the 3 medications.

SCENARIO 3

Match the following patients to the most appropriate antidepressant for their symptom cluster. Each medication option is used once. Include MOA, medication side effects, and a medication order for at least 1 of the patients.

Patient	Presentation
1	fibromyalgia, insomnia, no depression
2	diabetic neuropathy, fatigue, depression
3	postherpetic neuralgia, poor appetite, insomnia
4	chronic musculoskeletal pain, anxiety, hot flashes
5	fibromyalgia, no mood disorder, prefers non-sedating

Medication options:

A. amitriptyline

B. duloxetine

C. mirtazapine

D. venlafaxine

E. milnacipran

SCENARIO 4

OH is an 9-year-old male brought in by his father due to concerns about behavior and school performance. His teacher reports that OH is frequently out of his seat, talks excessively, blurts out answers, and has difficulty completing tasks and following directions. At home, he often loses homework, seems forgetful, and struggles to stay focused on activities like reading. Growth and development are age-appropriate. He sleeps about 9 hours per night but still wakes up feeling tired. There are no signs of anxiety, depression, or other mood disorders. What is the most likely diagnosis? What is an appropriate first-line medication (include complete medication order)? What monitoring parameters should be considered during treatment?

· Required Resourses: Rosenthal, L. D., & Burchum, J. R. (2025). Lehne’s pharmacotherapeutics for advanced practice nurses and physician assistants (3rd ed.). Elsevier.

· Chapter 24, “Opioid Analgesics, Opioid Antagonists, and Nonopioid Centrally Acting Analgesics” (pp. 180–191)

· Chapter 32, “Substance Use Disorders I: Basic Considerations” (pp. 252–257)

· Chapter 33, “Substance Use Disorders II: Alcohol” (pp. 257–264)

· Chapter 34, “Substance Use Disorders III: Nicotine and Smoking” (pp. 264–269)

· Chapter 35, “Substance Use Disorders IV: Major Drugs of Abuse Other Than Alcohol and Nicotine” (pp. 269–280)

· Chapter 59, “Cyclooxygenase Inhibitors: Nonsteroidal Antiinflammatory Drugs and Acetaminophen” (pp. 500–509)

· Chapter 61, “Drug Therapy of Rheumatoid Arthritis” (pp. 519–533)

· Chapter 62, “Drug Therapy for Gout” (pp. 534–539)

· Review the information provided and answer questions posed in the case study

· When recommending a medication, write out a complete prescription for the medication

· Whenever possible, use clinical practice guidelines in developing your answers when possible

· Include at least three references to support your answer and cite them in APA format.

Rubric:

Scenario 1: Appropriate medication is prescribed or changed. Rationale provided and includes current literature to support decision. All aspects of the patient history are considered in making the medication selection.	15 to >11.0 ptsExcellentMedication selected is appropriate and considers all of the unique patient characteristics. Rationale for selection is clear, complete, and appropriate. 11 to >7.0 ptsGoodMedication selected might be appropriate but conflicts with the unique patient characteristics. Rationale for selection is clear but lacks discussion about potential prescribing issues. 7 to >3.0 ptsFairMedication selected is not appropriate for this patient unique characteristics. Rationale provided is not correct or is flawed in applying the medication to this patient. 3 to >0 ptsPoorMedication selected is inappropriate or would not be provided based on patient unique characteristics.	15 pts
This criterion is linked to a Learning OutcomeScenario 1: Written medication orders include all 5 aspects required for a valid order. The order is complete, accurate, and appropriate.	3 ptsCompleteWritten medication orders includes all 5 aspects required for a valid order. The order is complete, accurate, and appropriate. 0 ptsPoorThe prescription is incomplete. Aspects of a complete order are missing. The order is either incomplete, inaccurate, or inappropriate.	3 pts
This criterion is linked to a Learning OutcomeScenario 1: References for the scenario are within past 5 years and include the appropriate clinical practice guideline if applicable.	4 ptsExcellentReferences for the scenario are within past 5 years and include the appropriate clinical practice guideline if applicable. Correct APA format is used. 3 ptsGoodReferences for the scenario are within past 5 years but do not include the appropriate clinical practice guideline if applicable. Contains a few (1 or 2) APA format errors. 2 ptsFairReferences for the scenario are not from within the past 5 years or do not reflect the content of this scenario and do not include the appropriate clinical practice guideline if applicable. Contains several (3 or 4) APA format errors. 0 ptsPoorNo references are included. References do not reflect the content of this scenario. Appropriate clinical practice guideline is not include. Contains many (≥ 5) APA format errors.	4 pts
This criterion is linked to a Learning OutcomeScenario 1: Written Expression and Formatting - English writing standards: Correct grammar, mechanics, and proper punctuation	3 ptsExcellentUses correct grammar, spelling, and punctuation with no errors. 2 ptsGoodContains a few (1 or 2) grammar, spelling, and punctuation errors. 1 ptsFairContains several (3 or 4) grammar, spelling, and punctuation errors. 0 ptsPoorContains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.	3 pts
This criterion is linked to a Learning OutcomeScenario 2: Appropriate medication is prescribed or changed. Rationale provided and includes current literature to support decision. All aspects of the patient history are considered in making the medication selection.	15 to >11.0 ptsExcellentMedication selected is appropriate and considers all of the unique patient characteristics. Rationale for selection is clear, complete, and appropriate. 11 to >7.0 ptsGoodMedication selected might be appropriate but conflicts with the unique patient characteristics. Rationale for selection is clear but lacks discussion about potential prescribing issues. 7 to >3.0 ptsFairMedication selected is not appropriate for this patient unique characteristics. Rationale provided is not correct or is flawed in applying the medication to this patient. 3 to >0 ptsPoorMedication selected is inappropriate or would not be provided based on patient unique characteristics.	15 pts
This criterion is linked to a Learning OutcomeScenario 2: Written medication orders include all 5 aspects required for a valid order. The order is complete, accurate, and appropriate.	3 ptsCompleteWritten medication orders includes all 5 aspects required for a valid order. The order is complete, accurate, and appropriate. 0 ptsPoorThe prescription is incomplete. Aspects of a complete order are missing. The order is either incomplete, inaccurate, or inappropriate.	3 pts
This criterion is linked to a Learning OutcomeScenario 2: References for the scenario are within past 5 years and include the appropriate clinical practice guideline if applicable.	4 ptsExcellentReferences for the scenario are within past 5 years and include the appropriate clinical practice guideline if applicable. Correct APA format is used. 3 ptsGoodReferences for the scenario are within past 5 years but do not include the appropriate clinical practice guideline if applicable. Contains a few (1 or 2) APA format errors. 2 ptsFairReferences for the scenario are not from within the past 5 years or do not reflect the content of this scenario and do not include the appropriate clinical practice guideline if applicable. Contains several (3 or 4) APA format errors. 0 ptsPoorNo references are included. References do not reflect the content of this scenario. Appropriate clinical practice guideline is not include. Contains many (≥ 5) APA format errors.	4 pts
This criterion is linked to a Learning OutcomeScenario 2: Written Expression and Formatting - English writing standards: Correct grammar, mechanics, and proper punctuation	3 ptsExcellentUses correct grammar, spelling, and punctuation with no errors. 2 ptsGoodContains a few (1 or 2) grammar, spelling, and punctuation errors. 1 ptsFairContains several (3 or 4) grammar, spelling, and punctuation errors. 0 ptsPoorContains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.	3 pts
This criterion is linked to a Learning OutcomeScenario 3: Appropriate medication is prescribed or changed. Rationale provided and includes current literature to support decision. All aspects of the patient history are considered in making the medication selection.	15 to >11.0 ptsExcellentMedication selected is appropriate and considers all of the unique patient characteristics. Rationale for selection is clear, complete, and appropriate. 11 to >7.0 ptsGoodMedication selected might be appropriate but conflicts with the unique patient characteristics. Rationale for selection is clear but lacks discussion about potential prescribing issues. 7 to >3.0 ptsFairMedication selected is not appropriate for this patient unique characteristics. Rationale provided is not correct or is flawed in applying the medication to this patient. 3 to >0 ptsPoorMedication selected is inappropriate or would not be provided based on patient unique characteristics.	15 pts
This criterion is linked to a Learning OutcomeScenario 3: Written medication orders include all 5 aspects required for a valid order. The order is complete, accurate, and appropriate.	3 ptsCompleteWritten medication orders includes all 5 aspects required for a valid order. The order is complete, accurate, and appropriate. 0 ptsPoorThe prescription is incomplete. Aspects of a complete order are missing. The order is either incomplete, inaccurate, or inappropriate.	3 pts
This criterion is linked to a Learning OutcomeScenario 3: References for the scenario are within past 5 years and include the appropriate clinical practice guideline if applicable.	4 ptsExcellentReferences for the scenario are within past 5 years and include the appropriate clinical practice guideline if applicable. Correct APA format is used. 3 ptsGoodReferences for the scenario are within past 5 years but do not include the appropriate clinical practice guideline if applicable. Contains a few (1 or 2) APA format errors. 2 ptsFairReferences for the scenario are not from within the past 5 years or do not reflect the content of this scenario and do not include the appropriate clinical practice guideline if applicable. Contains several (3 or 4) APA format errors. 0 ptsPoorNo references are included. References do not reflect the content of this scenario. Appropriate clinical practice guideline is not include. Contains many (≥ 5) APA format errors.	4 pts
This criterion is linked to a Learning OutcomeScenario 3: Written Expression and Formatting - English writing standards: Correct grammar, mechanics, and proper punctuation	3 ptsExcellentUses correct grammar, spelling, and punctuation with no errors. 2 ptsGoodContains a few (1 or 2) grammar, spelling, and punctuation errors. 1 ptsFairContains several (3 or 4) grammar, spelling, and punctuation errors. 0 ptsPoorContains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.	3 pts
This criterion is linked to a Learning OutcomeScenario 4: Appropriate medication is prescribed or changed. Rationale provided and includes current literature to support decision. All aspects of the patient history are considered in making the medication selection.	15 to >11.0 ptsExcellentMedication selected is appropriate and considers all of the unique patient characteristics. Rationale for selection is clear, complete, and appropriate. 11 to >7.0 ptsGoodMedication selected might be appropriate but conflicts with the unique patient characteristics. Rationale for selection is clear but lacks discussion about potential prescribing issues. 7 to >3.0 ptsFairMedication selected is not appropriate for this patient unique characteristics. Rationale provided is not correct or is flawed in applying the medication to this patient. 3 to >0 ptsPoorMedication selected is inappropriate or would not be provided based on patient unique characteristics.	15 pts
This criterion is linked to a Learning OutcomeScenario 4: Written medication orders include all 5 aspects required for a valid order. The order is complete, accurate, and appropriate.	3 ptsCompleteWritten medication orders includes all 5 aspects required for a valid order. The order is complete, accurate, and appropriate. 0 ptsPoorThe prescription is incomplete. Aspects of a complete order are missing. The order is either incomplete, inaccurate, or inappropriate.	3 pts
This criterion is linked to a Learning OutcomeScenario 4: References for the scenario are within past 5 years and include the appropriate clinical practice guideline if applicable.	4 ptsExcellentReferences for the scenario are within past 5 years and include the appropriate clinical practice guideline if applicable. Correct APA format is used. 3 ptsGoodReferences for the scenario are within past 5 years but do not include the appropriate clinical practice guideline if applicable. Contains a few (1 or 2) APA format errors. 2 ptsFairReferences for the scenario are not from within the past 5 years or do not reflect the content of this scenario and do not include the appropriate clinical practice guideline if applicable. Contains several (3 or 4) APA format errors. 0 ptsPoorNo references are included. References do not reflect the content of this scenario. Appropriate clinical practice guideline is not include. Contains many (≥ 5) APA format errors.	4 pts
This criterion is linked to a Learning OutcomeScenario 4: Written Expression and Formatting - English writing standards: Correct grammar, mechanics, and proper punctuation	3 ptsExcellentUses correct grammar, spelling, and punctuation with no errors. 2 ptsGoodContains a few (1 or 2) grammar, spelling, and punctuation errors. 1 ptsFairContains several (3 or 4) grammar, spelling, and punctuation errors. 0 ptsPoorContains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.	3 pts

Total Points: 100