10 ExemplarsExemplar I NR503 Population Health, Epidemiology & .docx

10 Exemplars
Exemplar I: NR503 Population Health, Epidemiology &
Statistical Principles Week 3
The prevalence of underweight, overweight and obesity in
children and adolescents from Ukraine
The main objective of this study was to determine the
prevalence of obesity, overweight and underweight in Ukrainian
children. The study took the format of a cross-sectional design
where a representative sample of 13,739 was taken for the
children. Measures taken from the children included body
weight and height and the Body Mass Index (BMI) obtained
from these. Results were interpreted based on standards of the
US Center for Disease Control (CDC) International Obesity
Taskforce (IOTF) and the World Health Organization
(WHO).Results indicated that 12.1% of children are
underweight, 17.6% overweight and 12.6% obese among
children aged 12 to 18 years. More of the young
populations are obese than the old in the country. The
prevalence of overweight and obesity among Ukrainian children
is higher than the average for Europe that stands at
30%. However, compared to the US, 18.5% obesity in children,
Ukraine children are less obese. Included in the article are
measures that would help reduce the prevalence of overweight
at a national level (Dereń et al., 2018).
This article is relatively relevant to an average reader in the US.
While it does not indicate the impact of the high rate of
overweight and obesity, it shows that the US leads the world in
cases of obesity and overweight. It has the capacity to influence
group decision making more than individual based
decisions. The article left out the most relevant information
such as factors that have contributed to the high rate of
overweight and obesity among children in Ukraine. Another
important information that would have been included in the
article are measures to control the overweight epidemic at an

individual level (Dietz et al., 2015). Another important
information would be methods to determine one’s weight status
to determine if they are safe or not.
References
Dereń, K., Nyankovskyy, S., Nyankovska, O., Łuszczki,
E., Wyszyńska, J., Sobolewski, M., & Mazur, A. (2018). The
prevalence of underweight, overweight and obesity in children
and adolescents from Ukraine. Scientific reports, 8(1),
3625.https://www.nature.com/articles/s41598-018-21773-
4 (Links to an external site.)
Dietz, W. H., Baur, L. A., Hall, K., Puhl, R. M., Taveras, E.
M., Uauy, R., & Kopelman, P. (2015). Management of obesity:
improvement of health-care training and systems for prevention
and care. The Lancet, 385(9986), 2521-
2533.https://www.sciencedirect.com/science/article/pii/S014067
3614617487
Chamberlain Program Outcomes
· PO #1: Provide high quality, safe, patient-centered care
grounded in holistic health principles (Holistic Health &
Patient-Centered Care)
AACN MSN Essentials
· Essential I: Background for Practice from Sciences and
Humanities
NONPF Core Competencies
· Scientific Foundation Competencies
· Technology and Information Literacy Competencies
I have learned a lot of understanding and knowledge of
epidemiological and statistical concepts. It is stated in the
course overview, “epidemiology is an important tool in the
Advanced Practice Nurse (APN) arsenal for providing effective
and fiscally responsible healthcare to individuals and
populations.” With that being said, this course has given me the
necessary tools and knowledge to meet the MSN Essential II
and NP Core Competencies #2. Program Outcome #4 is
regarding quality improvement and safety, the integration of

scholarship into practice, and promoting the health of
populations through prevention (AACN, 2011). I was able to
achieve Program Outcome #4 through the case studies presented
each week. Each case required a list of possible differentials to
include pathophysiology, etiology, and treatment options. Each
case required critical thinking and the use of current research.
Quality improvement and safety were promoted with evidenced-
based research offering current evidenced-based treatment
options to incorporate into daily practice. Exemplar II: NR 505
Advance Research Methods Week 5
The research PICO question;
P = How effective is the incorporation of massage therapy
compared to the sole use of opioids in the management of
chronic pain among the elderly with chronic non-cancer pain
seeking help in a primary healthcare setting?
I = Intervention—Massage therapy and opioid prescription
C = Control or Comparison--- what is the effectiveness of
massage therapy versus Opioid use for chronic pain.
O = Outcome --- The acceptable pain level will less than 3.
T = Time Frame – 3 months
The quantitative research approach that provides a summary of
data gathered to support generalizations will be used. This
approach allows for a broader study by taking a big number of
subjects allowing generalization of results and also allowing for
a greater level of accuracy and objectivity (Choy, 2014). For the
study design to provide summaries of data that support
generalizations, a few variables are tested on many cases using
highly rigid prescribed procedures to ensure validity and
reliability. Finally, keeping a distance from the subjects and
ensuring they are unknown to him/her, the research can avoid
personal bias (Choy, 2014). The research aims at studying the
effectiveness of incorporation of massage therapy in pain
management and the exclusive use of opioids, in primary health
care. Consequently, we need measurable numerical descriptions
of effectiveness rather than narratives and verbatim information

given by a qualitative research approach (Choy, 2014). This will
help create a highly precise relational model between the
method of pain management used and the level of pain control
achieved.
The experimental design where the researcher manipulates the
independent variable in some independent groups will be used
in the study. The primary use of the experimental research
design is to understand the causal relationship (Salazar, Crosby
& DiClemente, 2015). Another hallmark of the experimental
research design is the random selection of participants to be
included in the groups available in the research making the
treatment distributed among the participants (Harriss &
Atkinson, 2015). Due to the repeatability of the experimental
research design, results can be checked and verified for validity.
The experimental design also allows for many variations that
allow the researcher to tailor their experiment while still
maintaining the design validity. The relative freedom of an
experimental method may lead to results that are not applicable
in real life situation if the researcher engages in too many
hypotheticals (Harriss & Atkinson, 2015). Also, ethical
considerations are very vital when the experimental
methodology is applied in human subjects hence is not highly
popular in health research (Bromley, Mikesell, Jones &
Khodyakov, 2015).
Data quality is defined by validity, reliability, objectivity,
integrity, relevance and completeness. To ensure the integrity of
data, there will be a random selection of participants to avoid
researcher bias. Careful provision of the treatments by first
treating the administers will ensure the validity of data. To
ensure generalizability, a relatively large number of participants
will be recruited. Consistency in recording results will ensure
the completeness of data.
References
Bromley, E., Mikesell, L., Jones, F., & Khodyakov, D. (2015).
From subject to participant: Ethics and the evolving role of

community in health research. American Journal of Public
Health, 105(5), 900-908.
https://ajph.aphapublications.org/doi/abs/10.2105/AJPH.2014.3
02403
Harriss, D. J., & Atkinson, G. (2015). Ethical standards in sport
and exercise science research: 2016 update. Int J Sports
Med, 36(14), 1121-1124.
http://researchonline.ljmu.ac.uk/2784/1/IJSM_HARRISS-14-
15%20final%20draft.pdf
Salazar, L. F., Crosby, R. A., & DiClemente, R. J.
(2015). Research methods in health promotion. John Wiley &
Sons.
https://www.tandfonline.com/doi/abs/10.1080/03630242.2014.9
32893
Choy, L. T. (2014). The strengths and weaknesses of research
methodology: Comparison and complimentary between
qualitative and quantitative approaches. IOSR Journal of
Humanities and Social Science, 19(4), 99-104.
https://s3.amazonaws.com/academia.edu.documents/37208325/N
0194399104.pdf?AWSAccessKeyId=AKIAIWOWYYGZ2Y53U
L3A&Expires=1533581350&Signature=sTabQTLpQs%2BaUY6
qNpYu77TDT40%3D&response-content-
disposition=inline%3B%20filename%3DThe_Strengths_and_We
aknesses_of_Research.pdf
· PO #5: Advocates for positive health outcomes through
compassionate, evidence-based, collaborative advanced nursing
practice (Extraordinary nursing)
AACN MSN Essentials
· Essential VI: Health Policy and Advocacy
· Scientific Foundation Competencies
· Policy CompetenciesExemplar III: NR 507 Advanced
Pathophysiology Week 3
Sickle cell anemia is a disorder that causes the oxygen-

carrying red blood cells to misshapen, distort, become rigid and
at times take a crescent shape. It is a genetic disease in which in
the sixth amino acid of the beta globin chain, valine is replaced
by glutamic acid. The valine replacing glutamic acid has the
ability to fit in the hydrophobic pocket of
the hemoglobinmolecule causing the hemoglobin in red blood
cell to polymerize and form hemoglobin tetramers recognized
by long stiff fibers (Rivera, Veneziani, Ware & Platt,
2016). The sickle cell disease occurs when a child inherits the
sickle cell gene from both parents.
The hemoglobin polymerization is either triggered by acidosis
or hypoxia that causes the increased rigidity of red blood cells
making them become crescent-shaped. Further, the deformed
cell may cause vaso-occlusion in small blood vessels when they
adhere to the endothelium that slow blood flow in larger
vessels (Steinberg et al., 2014). Further, the deformed cells are
susceptible to hemolysis cause anemia. The sickle cell state is
an inflammation resulting from the abnormal activation of
granulocytes and monocytes precipitated by cold, stress,
extreme exercise acidosis, dehydration, and infections among
other factors.
One of the hallmark symptoms in the patient is the episodic pain
where she complains of abdominal pain and severe chest
pain. The second sign is the high temperature that the patient
reports to have had during her exercise. Jaundice is also an
indicator of sickle cell (Steinberg et al., 2014). The low blood
pressure and the history of sickle cells confirm that she has the
disorder.
Pain is the major sign of sickle cell anemia and is referredto as
crises. It normally develops when the crescent shapes red blood
cells block small blood vessels in the chest, joint, andabdomen.
Lasting for weeks and varying in intensity is the major indicator
that the pain is caused by sickle cell. Sickle
cell anemia increases individual susceptibility to infections that
can cause fevers in the patient. Long lasting sickle cells
episodes can cause a deficiency in nitrous oxide as hemoglobin

and arginase are released from lysed blood cells
and scavenge on it (Steinberg et al., 2014). The deficiency
in nitrous oxide may cause thrombosis
or pulmonary vasoconstriction hence blood pressure problems.
One important teaching to give the patient is on the importance
of prevention of infections through hygiene and avoiding
exposure to germs. They should be advised to take plenty of
water as dehydration increases risk. They should avoid
temperature extremes, do regular but not extreme physical
exercise and avoid the uncontrolled use of over the counter
drugs as they may affect their kidneys (Steinberg, 2016).
References
Rivera, C. P., Veneziani, A., Ware, R. E., & Platt, M. O. (2016).
Sickle cell anemia and pediatric strokes: computational fluid
dynamics analysis in the middle cerebral artery. Experimental
Biology and Medicine, 241(7), 755-
765.http://journals.sagepub.com/doi/abs/10.1177/153537021663
6722 (Links to an external site.)
Steinberg, M. H. (2016). Overview of sickle cell anemia
pathophysiology. In Sickle Cell Anemia (pp. 49-73). Springer,
Cham.https://link.springer.com/chapter/10.1007/978-3-319-
06713-1_3
Steinberg, M. H., Chui, D. H., Dover, G. J., Sebastiani, P., &
Alsultan, A. (2014). Fetal hemoglobin in sickle cell anemia: a
glass half full?. Blood, 123(4), 481-
485.https://onlinelibrary.wiley.com/doi/full/10.1002/ajh.23811
· PO #2: Create a caring environment for achieving quality
health outcomes (Care-Focused)
· PO #4: Integrate professional values through scholarship and
service in health care (Professional identity)
AACN MSN Essentials
· Essential VIII: Clinical Prevention and Population Health for
Improving Health

· Independent Practice Competencies
· Policy Competencies
· The purpose of the MSN program is to equip students with
skills to integrate findings from different fields including
nursing, public health, genetics, nursing, biopsychological
fields to improve the quality of care delivered in diverse
settings. This course improves the ability of nursing
professionals to use available knowledge in these fields to
respond to the specific needs of patients under their care.
Throughout the course, I have learned and practised different
aspects that not only makes me able to respond to the needs of
the given patient but also create a holistic approach to dealing
with health challenges in the community.
· Among the most important aspects that we went through in
class are Evidence-Based Practice (EBP) and the utility of
research knowledge in patient care. EBP involves the explicit,
judicious and conscientious use of the most current research
findings to make decisions on patient care (Solomons, Spross &
Lamb, 2017). It involves the integration of patient values,
clinical expertise accumulated through experience and most
appropriate evidence from research to make decisions about
patient care. I have acquired the skills and knowledge necessary
to allow me to assess patients, ask clinical questions, acquire
evidence and appraise it before applying and evaluating it in the
clinical setting. While EBP gives an opportunity to reduce cost
and time used in care among other benefits, the most important
is the allowance for tailor making care to make it patient
centered.
· Through EBP, the specific needs of individual patients are
integrated with their values and desired outcomes. This is
patient-centred Care and leads to improved healthcare quality
and reduced hospital stay. Patient-centred healthcare involves
encouraging the active collaboration in making decisions among
the different stakeholders of patient care including family to
ensure customized care is provided (Elwyn et al., 2014).

Patient-centred goals are hence aligned with the vision, mission
and quality improvement goals of healthcare. Patient-centred
care focuses on both the emotional and physical comfort of
patients (Hack et al., 2017). Chief Benefit of this integration
includes improved healthcare outcomes and reduced stay in
hospitals.
· Nursing not only involves the integration of different fields in
EBD to provide both patient-centred care and enhance the
health of the society. In this course, different fields including
genetics, psychology, social science, biology and others were
used as the basis for understanding different conditions and
create solutions. This integration improves the quality of
healthcare delivered by the nurse to increase health quality in
the society.
·
· References
· Elwyn, G., Dehlendorf, C., Epstein, R. M., Marrin, K., White,
J., & Frosch, D. L. (2014). Shared decision making and
motivational interviewing: achieving patient-centered care
across the spectrum of health care problems. The Annals of
Family Medicine, 12(3), 270-275.
http://www.annfammed.org/content/12/3/270.short (Links to an
external site.)
· Hack, S. M., Muralidharan, A., Brown, C. H., Lucksted, A. A.,
& Patterson, J. (2017). Provider behaviors or consumer
participation: How should we measure person-centered
care?. International Journal of Person Centered Medicine, 7(1),
14-20.
http://ijpcm.org/index.php/IJPCM/article/view/602 (Links to an
external site.)
· Solomons, N. M., Spross, J. A., & Lamb, G. (2017). Influence
of Nurse Social Networks on Evidence-Based Practice (EBP):
Results of an Exploratory Study.
https://sigma.nursingrepository.org/handle/10755/622234
Exemplar IV: NR 508 Advanced Pharmacology Week 5
For Maria who is at risk of developing diabetes mellitus, there

are several treatment goals to help regulate and reduce the
chances of occurrence. Maria is at the pre-diabetes stage of the
disease and risks getting the disease with symptoms that may
impede her quality of life. The first goals are to lower the
fasting plasma glucose from 179mg/dl to the normal range of
less than 110 mg/dl to 90mg/dl. The second is to lower the
HgbA1C percentage from 7.4% to normal ranges of 4% to 5.6%.
The third goal is to reduce the TSH levels to 5.5 and below.
The final goal is to reduce Maria’s weight to lower the chances
of getting diabetes and the consequences that come with it.
Maria should get the first line of diabetes management drugs.
Metformin is the first line of diabetes medicine and is often
given to first time users. Metformin is an antihyperglycemic
agent that improves the patient’s tolerance to glucose through
several ways that lower basal and postprandial plasma glucose
(Chaudhury et al., 2017). First, metformin decreases intestinal
absorption of glucose hence making the amount reaching the
bloodstream from the intestines low (Lipska et al., 2015). It
also reduces hepatic glucose production hence lowers the
amount of glucose coming from the liver by glycogen
breakdown. Thirdly, metformin increases cell insulin
sensitivity by increasing peripheral uptake and utilization
(Chaudhury et al., 2017). It further does not cause
hypoglycaemia. The patient would also be given sulfonylureas
which act by increasing the production of insulin (Chaudhury et
al., 2017).
For patients using metformin, several points of teaching are
important to regulate blood sugar and ensure no negative
impacts. The first point is on the dosage of the drug where the
patient should adhere to the amount and frequency of the drug
prescribed by the doctor (Chaudhury et al., 2017). Secondly,
there is a need to teach the patients on when to take medicine in
relations to their food intake and exercise regime. The
thirdpoint, the patient should be taught on the possibility of side
effects including those related to the alimentary canal such as
indigestion, bloating, diarrhea and stomach pain. Other

symptoms that may develop are headache, chest pain, rash and
muscle pain(Chaudhury et al., 2017). Finally, there is a need to
teach what to do in case of overdose and the consequent
poisoning of the individuals.
If Maria was having an initial HbgA1C of 10.2mg/dl and fasting
glucose of 305 mg/dl, there would be a need to change the drug
to insulin. Insulin will break down the excess sugar in the blood
and lower it hence reduce the possibility of negative
consequences (Chaudhury et al., 2017).
References
Chaudhury, A., Duvoor, C., Dendi, R., Sena, V., Kraleti, S.,
Chada, A., ... & Kuriakose, K. (2017). Clinical review of
antidiabetic drugs: Implications for type 2 diabetes mellitus
management. Frontiers in endocrinology, 8,
6.https://www.frontiersin.org/articles/10.3389/fendo.2017.0000
6/full (Links to an external site.)
Lipska, K. J., Ross, J. S., Miao, Y., Shah, N. D., Lee, S. J., &
Steinman, M. A. (2015). Potential overtreatment of diabetes
mellitus in older adults with tight glycemiccontrol. JAMA
internal medicine, 175(3), 356-
362.https://jamanetwork.com/journals/jamainternalmedicine/full
article/2089233?utm_source=Silverchair%20Information%20S
· PO #5: Advocates for positive health outcomes through
practice (Extraordinary nursing).
AACN MSN Essentials
· Essential VII: Interprofessional Collaboration for Improving
Patient and
Population Health Outcomes.

Health Delivery Systems CompetenciesExemplar V: NR 509
Advanced Physical Assessments Week 4
The Cardiovascular System
Introduction
Also known as the circulatory system, the cardiovascular system
is responsible for the transportation of blood containing
nutrients and other substances including electrolytes, hormones,
carbon dioxide and blood cells throughout the body. The
circulatory system includes different components and is linked
to the lymph transporting lymphatic system (Feher, 2017). Due
to its importance as part of the body, the cardiovascular system
needs to be thoroughly taken care of through substantive
assessment not only during periods when people are unwell but
also when health to ensure normal functioning.
Structure and Function
In general, the cardiovascular system can be described as being
composed on the heart, blood vessels, and blood. The heart that
is located in the chest is the system that pumps blood through a
blood vessel to all the [parts of the body. The heart is made of
cardiac muscles that aid in the movement that result in the
pumping of blood throughout the body. The pumping of blood is
an involuntary action aided by the pacemaker (Feher, 2017).
Moreover, the heart is divided into four chambers, two atrium,
and two ventricles. While atrium receives blood from the body
parts, ventricles pump blood out.
Blood vessels carry blood from the heart to all the parts of the
body and back. Arteries are blood vessels that carry blood from
the heart to body parts while veins carry blood from all body
parts back into the heart. Due to the low pressure of blood in
veins compared to arteries, the former have valves that prevent
backflow of blood. Among the most important major blood
vessels include the pulmonary artery and vein that take oxygen
from the lungs, the hepatic artery and vein that take nutrients
from the alimentary canal and the coronary artery and vein that
circulate blood to heart muscles (Feher, 2017). Joining arteries
and veins are microscopic blood vessels called capillaries that

supply blood to tissues and cells.
Blood is the fluid that is pumped through blood vessels by the
heart and carries oxygen, nutrients, cells, electrolytes and waste
substances throughout the body. The major components of blood
are plasma and blood cells. Plasma is 92% water and is the fluid
within which ions, hormones, glucose, proteins, blood cells, and
carbon dioxide are found (Hillegass, 2016). On the other hand,
the blood cells are different and specialized for certain
functions. Red blood cells have hemoglobin to carry oxygen.
White blood cells fight disease-causing pathogens and platelets
aid in clotting.
Subjective data
Collections of subjective data on the circulatory system include
asking for common symptoms. These include the presence of
chest pain, its location, intensity, type, duration, radiation,
when it occurs and with and without exertion (Hillegass, 2016).
Also associated symptoms such as sweating, nausea, anxiety,
and shortness of breath should also be considered. Assessment
on the shortness of breath including whether it occurs when
bending, after waking up, while site, or when one cough (King,
2017). Other symptoms that should be considered include
irregular heartbeats, pain, numbness and tingling sensation on
extremities. Skin changes to pallor, hair loss, visible veins,
lower leg ulceration, and cold skin, should also be assessed.
Apart from symptoms, one should also ask for other risk factors
including personal history of heart disease, diet and weight
history, use of alcohol, illicit drugs, and smoking. Also the
history of type 2 diabetes and a family history of heart diseases
should be assessed. Information on usual daily activities such as
long standing or sitting duration, bleeding disorders should also
be gathered (King, 2017). History of other related diseases
including diabetes and hypertension should also be considered.
Objective Data
The collection of objective data on the cardiovascular system
involves the measurement of vital signs. The first is blood
pressure measurement where normal rates should be between

120/80mmhg and 140/90 mmHg (King, 2017). The second is the
pulse rate, and quality was normal for a person at rest should be
between 60 and 100 beats per minutes. The respiratory rate
should also be measured with an adult expected to have 12 to 20
breaths per minute. Secondly, the general appearance of the
patient should be checked. First, the mucous membrane should
be checked for pallor as normal should be pink to red.
Extremities should be checked for clubbing or cyanosis. The
patient should also be observed for pulsation, and retractions
while sited or lying down (King, 2017). Examination of blood
vessels in the neck to ensure that the corticoid artery has a local
and brisk pulsation. The internal jugular vein should also be
soft and with undulating pulses.
Special Examination Techniques
Auscultation is one technique used to examine the heart using a
stethoscope. The assessment should occur with the patient sited,
lying on the back with head lifted and lying on the left. The
examiner should listen to all the four sounds including the lab,
dib, ventricle gallop and the fourth (King, 2017). The examiner
should also listen to murmurs that occur when there is a
turbulent blood flow that can either be caused by defects in the
chambers of the valve and changes in blood viscosity.
Adapting the Examination
Infant/ Pediatric
The heart and blood vessels of children are not fully developed
and which makes the assessment different from that of adults.
First, due to the fact that the child’s body has a low surface for
the heart to pump blood, the pressure and rates are lower than
those of a normal adult (King, 2017). In conduction
auscultation, the examiner must consider the third heart sound
as normal since their cardiac output is high while it in adults is
vertical gallop.
Pregnant Women
Pregnancy increases the work of the heart as a woman has to
pump more blood to replenish the increased nutritional and
waste disposal needs of the body. Moreover, hormone changes

may result in increased blood pressure and other changes in the
cardiovascular system that may result in changes in the physical
examination (Hillegass, 2016). Moreover, to protect the mother
and her unborn child, frequent physical examinations are
recommended including measuring blood pressure and
conduction auscultation. For a pregnant woman, the breast may
be large. The breast must be displaced to the left when checking
for displacement.
Geriatric
There are age-related cardiac changes such as reduced arterial
compliance and the diastolic dysfunction of the left ventricle.
Also, one should check for nausea/vomiting, dyspnea and
diaphoresis in the elderly suspected with myocardial infarction.
Further, systolic blood pressure increase with age as the rigidity
of blood vessel walls increases. Other factors that may increase
with age include respiratory rate. Body temperature, on the
other hand, tends to reduce with age. These should be
considered during physical examination to ensure the quality of
data collected and escape misdiagnosis (Hillegass, 2016). Also,
knowing other medical conditions that may affect readings.
Heart Failure
Also known as congestive heart failure, this is a condition that
comes when the heart muscles do not pump blood sufficiently as
it should. The condition is caused by different factors including
the narrowing or blocking of blood vessels, high blood pressure
and accumulation of plague on blood vessels (Karlström et al.,
2016). These factors involve making the heart too weak and
stiff making it difficult to pump blood out. The disease can be
chronic or acute depending on the cause (Inamdar & Inamdar,
2016). The symptoms of heart failure include fatigue and
weakness, swelling especially on the legs, ankles, and feet,
shortness of breath, reduced the ability to work of exercise,
wheezing and persistent cough. Other signs of the disease
include the decrease in alertness and chest pain in case the heart
failure is caused by a heart attack (Hillegass, 2016). While heart
failure has no cure, those affected normally lead enjoyable lives

by management using drugs and lifestyle changes.
Objective data for Heart Failure
The first objective data collected for people with heart failure is
auscultation. The presence of the third heart sound, ventricular
gallop, indicate that the heart is struggling to pump blood and
hence positive for heart failure (Yancy et al., 2017). There …
Running Head: APN CAPSTONE PORTFOLIO PART 2
APN CAPSTONE PORTFOLIO PART 2 2
APN Capstone Portfolio Part 2
Name
Course
Instructor
Institution
Date
Table of Contents
APN Capstone Portfolio Part 2 1
Background 4
Exemplar #1: NR503 Population Health, Epidemiology &
Statistical Principles 5
Chamberlain Program Outcomes 7
AACN MSN Essentials 7
NONPF Core Competencies 7
Connect 8
Reflection 8

References 8
Exemplar #2: NR505 Advance Research Methods: Evidence-
Based Practice) 9
(Week 4; Research Literature, Design Approach and Sampling
Guidelines) 9
MSN Essentials 10
NONPF Competencies 11
Connection 11
Reflection 11
References 12
Exemplar #3: NR507 Advanced Pathophysiology 12
Connect 15
Reflection 15
References 16
Exemplar #4: NR508 Advanced Pharmacology 16
Connect 18
Reflection 18
References 19
Exemplar #5: NR509 Advanced Physical Assessments 20
Connect 22
Reflection 22
References 22
Exemplar #6: NR510: Leadership and Role of the Advanced
Practice Nurse 23

Connect 25
Reflection 25
Reference 26
Exemplar #7: NR 511 Differential Diagnoses and Primary Care
27
Connect 29
Reflection 29
References 30
Exemplar #8: NR601 Primary Care of the Maturing and Ageing
Family 30
Connect 32
Reflection 33
References 33
Exemplar #9: NR 602 Primary Care of the Childbearing and
Childbearing Family34
Connect 36
Reflection 36
References 37
Exemplar #10: NR 602 Advanced Clinical Care and Practice
Across the Lifespan Practinum 37
Connect 40
Reflection 40
References 41

References 42
Appendix 1: Tabulation of achieved program 0utcome, MSN
Essentials and NONPF Competencies 45
Background
On account of the intense and comprehensive nursing education
program that I have undergone at Chamberlain College of
Nursing, resulting into an award of Masters of Science in
Nursing, here is a compilation of a reflection through the
journey. The reflection entails the Program Outcomes, Master’s
Education Essentials and the Core Competencies of the National
Organization of Nurse Practitioners Faculties with the
abbreviations as PO, MSN Essentials, and NONPF. Further, this
documentation also covers ten exemplars with an assessment on
views of the right argument that all of the above requirements
have been covered.
Exemplar #1: NR503 Population Health, Epidemiology &
Statistical Principles
In #Week 6 of this course we conducted an Evaluation of
Epidemiological Problem. This assignment enabled the students
to meet different course outcomes. The assignment required
defining key terms in community health, epidemiology, and
population-based research. We also gained the knowledge and
skills to compare study designs used for obtaining population
health information from observation, surveillance, community,
and control trial-based research. The assignment also enabled us

to commonly used measures of health risk and identify
appropriate outcome measures and study designs applicable to
epidemiological subfields, for instance chronic disease,
infectious disease, reproductive health, environmental
exposures, and genetics. We were able to identify important
sources of epidemiological data and evaluate a public health
problem as regards to place, person, magnitude, and person.
The task was to discuss HIV/AIDS and give its background
information. The assignment was able to realize that HIV/AIDS
is both an infectious disease and an epidemic disease. Learning
that, since its onset, HIV/AIDS has claimed over 35 million
lives was very scaring. HIV is considered infectious because it
causes a severe impairment of the immune system, which then
leads to AIDS (Moyer, 2015). With a weak immune system,
AIDS patients become susceptible to other cancers, diseases and
infections – often called opportunistic infections since their
causal organisms only take advantage of the weakened immune
system (Maartens, Celum & Lewin, 2014).
I was able to learn about the worrying prevalence statistics of
AIDS with 23,304 people estimated to be living with HIV in
Houston Texas (Maartens, et al., 2014). I also established the
current surveillance techniques and strategies of HIV in the US
and a clear descriptive epidemiological analysis. Finally, I was
able to understand the screening and diagnosis methods of HIV.
I was then able to develop and action plan for dealing with the
disease or infection when I finished my MSN. Chamberlain
Program Outcomes
This assignment enabled me to meet course outcome PO #1:
Provide high quality, safe, patient-centered care grounded in
holistic health principles (Holistic Health & Patient-Centered
Care).The course was able to realize Program Outcome #1 by
calculating HIV prevalence in Houston Texas and breaking it
down to address particular interests of the populations. The
assignment discussed the surveillance methods for HIV, which
is one of the techniques that support community intervention
plan. I was able to successfully suggest an intervention plan of

increasing health awareness on HIV to help in its
prevention.AACN MSN Essentials
This assignment met the AACN MSN Essential I: Background
for Practice from Sciences and Humanities. This MSN Essential
captures the importance of obtaining an understanding of a
disease and using an informed background for practice to
manage its prevalence. As demonstrated in the assignment, in
identifying HIV’s prevalence and designing an intervention for
Houston Texas, I relied on nursing scientific findings to
advocate for quality and improved health outcomes. NONPF
Core Competencies
The NONPF that I was able to demonstrate with this assignment
were Practice Inquiry, Scientific Foundation and Technology
and Information Literacy Competencies. I was able to think
critically while compiling data on HIV and being able to apply
evidence-based practice to design the intervention plan. I also
included research outcomes for practice improvement and
improving patient outcomes. I also had to include knowledge
from other disciplines as a way of practice inquiry. Using
spreadsheet application demonstrated technology and
information competency. Connect
The concepts that I can connect with from the exemplar are
screening and surveillance. In nursing context, screening is used
to refer to a test conducted to determine a health condition prior
to manifestation of symptoms. Screening helps to detect
diseases and conditions in their early periods to improve
treatment outcomes. This makes screening an essential part of
preventive care (Moyer, 2015).
On the other hand, disease surveillance refers to information-
oriented activity encompassing gathering, analyzing and
interpreting relevant health data from varied and different
sources (Houston Health Department. 2015). This requires the
use of informatics and technology to enhance surveillance and
enable real time analysis. Surveillance leads to effective disease
management and enhances preventive measures (Moyer,
2015).Reflection

This course was very insightful. It enables accomplishments of
Program Outcome #, which is to promote safe and high-quality
patient-driven care anchored in holistic health tenets. To
produce the document of HIV program, I had gone through
several scientific studies on HIV prevalence in Houston to
understand the disease’s status in the target population. I also
had to compare different studies to conclude on the prevalence
and determine the incident rate. Understanding the
epidemiological perspective of the disease enabled proper
identification of the intervention plan. I was also able to apply
evidence-based practice in the work.References
Houston Health Department. (2015). HIV Surveillance Program.
HIV Infection in Houston: An Epidemiologic Profile 2010-2014.
Houston, Texas; 2015.
Maartens, G., Celum, C., & Lewin, S. R. (2014). HIV infection:
epidemiology, pathogenesis, treatment, and prevention. The
Lancet, 384(9939), 258-271.
Moyer, V. A. (2015). Screening for HIV: US preventive
services task force recommendation statement. Annals of
internal medicine, 159(1), 51-60.Exemplar #2: NR505 Advance
Research Methods: Evidence-Based Practice)(Week 4; Research
Literature, Design Approach and Sampling Guidelines)
In NR505 the assignment was Research methods and evidence-
based practice. In week #4 of about Research Literature, Design
Approach and Sampling Guidelines. I chose obesity in children
and adolescents as the phenomenon of interest in the evidence-
based practice project. The selected nursing issue for the project
was prevention of adolescent and childhood obesity, with the
overall aim being to prevent obesity’s co-morbidities. Child and
teenage obesity has become a key problem in our society today.
I was able to discuss the literature support research of the
research, as well as identify the appropriate theoretical
framework, research design and methodology including
sampling method procedure.
Literature support generated three key pieces of information.
The reviewed CDC (2017) document recommended the need for

multi-disciplinary research to help develop proper behavioral
interventions to prevent childhood obesity. The CDC document
also gave a conclusive perspective of diet and exercise as the
proper initiatives for obesity control. In a longitudinal study,
Cunningham, Kramer & Narayan (2014) agreed with the CDC
recommendation and suggestions. Kliegman, et al (2016)
suggested the Nelson Textbook of Pediatrics as the key resource
for approaches that can help pediatric care including obesity.
Lobstein, et al (2015) study concluded an improved governance
of food markets and food supply can help address the challenge
of obesity. However, it would be impractical to govern food
markets and supply, thus instead education should be improved.
The theoretical framework suggested for the study was
Henderson’s Needs Theory. The argument was that although the
theory works well with inpatients, it can support the problem of
helping obesity patients (Ahtisham & Jacoline, 2015). The
suggested research approach and design of the study would be
qualitative study with a non-experimental (descriptive) inquiry-
based design based on the Grounded Theory (GT). The research,
as suggested, use interviews and existing documents as its
primary data collection tools. Chamberlain Program Outcomes
The assignment enabled realization of program outcome (PO)
#5: Advocates for positive health outcomes through
practice (Extraordinary nursing). This is because, evidence-
based practice is one of the ways through which nurses can
advocate for desirable health outcomes. The assignment enabled
the application of the ability to design an evidence-based
research. The process involves selecting an appropriate research
article, summarizing and reviewing its relevance and
information, research design, methodology, sampling and
presentation of research findings. MSN Essentials
This assignment met MSN Essential VI: Health Policy and
Advocacy. I was able to engage in advanced research method,
and research critique, to inform health advocacy and policy as
to attain MSN Essential VI. It is evident that an MSN prepared

nurse can apply research outcomes, become a change agent,
resolve a nursing practice issues, and help disseminate research
findings. I concluded that being able to translate findings of a
nursing research is an important.NONPF Competencies
To achieve the assignment outcome, I needed such NONPF
Competencies as policy, scientific foundation and health
delivery systems. Policy and health delivery systems
competencies enabled me to use health informatics for
determining the best guidelines for managing critical health
issues. Through scientific foundation I was able to critique
different study findings to generate appropriate information for
the research. Through health delivery systems competency I was
able to synthesize nursing practice methods that would improve
patient outcomes.Connection
I was able to connect with two concepts from this exemplar –
research gap and research limitations. Research gaps are the
areas with inadequate information, which constraints the
research’s effective conclusion. A research gap often leads to
recommendation of a new research to further the information.
One can conclude there’s a research gap only after a
comprehensive literature review.
Research Limitation are the research aspects that inhibit a
researcher from attaining the full potential of the research
outcomes. It is assumed that every research has a given
limitation level such as resources, scope or knowledge.
Limitations are the conditions, which an investigator cannot
fully manage and will constraint the research’s conclusions and
methodology.Reflection
I thank this course for giving me insight on conducting
scientific research and critique. Through program Outcome #5 I
am now able for advocating for the realization of a positive
health outcome through engaging evidence-based compassionate
and collaborative advanced nursing practices that are evidence-
based. Having gone through this course, it is evident that nurses
could experience challenges in research critiques and general
research conduct. Nurses should therefore exhibit NONPF Core

Competencies particularly the scientific foundation
competencies.References
Centers for Disease Control and Prevention. (2017). Childhood
Obesity Facts. Division of Population Health, National Center
for Chronic Disease Prevention and Health Promotion.
Kliegman, R. M., Schor, N. F., St Geme III, J. M., & Behrman,
R. E. (2016). Nelson Textbook of Pediatrics. Philadelphia:
Elsevier.
Lobstein, T., Jackson-Leach, R., Moodie, M. L., Hall, K. D.,
Gortmaker, S. L., Swinburn, B. A., . . . Mc Pherson, K. (2015).
Childhood and adolescent obesity: Part of a bigger picture. The
Lancet, 2510-2520.
National Collaborative on Childhood Obesity Research. (2012).
Childhood Obesity in the United States. NCCOR.
Exemplar #3: NR507 Advanced Pathophysiology
The NR507 Course of Advance Pathophysiology was key in
realizing the Chamberlin trained nurse practitioner’s program
outcomes, master’s essentials, and core competencies.
Pathophysiology focuses on the symptoms and function of
diseased organs, to enable diagnosis and effective patient care.
The different between pathophysiology and pathology, is that
pathology studies all aspects of a disease, and not just the
organic function. The question that NR507 sought to answer is
how the study of pathophysiology help nurses in their practice.
Nurse practitioners must have the right information coupled
with practice knowledge and skills to be able to achieve the best
evidence-based, comprehensive quality patient outcomes.
Pathophysiology entails Disease and etiology, signs and
symptoms, investigation and diagnosis, treatment and prognosis.
Pathophysiology puts together all of these steps. Nurse
practitioners are expected to have a clear understanding of the
process from the etiology and symptoms, through to medical
testing, investigation, diagnosis and finally prognosis. It is clear
that pathophysiology works closely with evidence-based
practice. Thus, nurse can conduct more effective treatments

through pathophysiology especially in such situations where
anxious, scared patients don’t really understand their
conditions. Nurses can educate the patients and calm them
down.
There are cases where, through pathophysiology, nurses can
help generate a valuable discovery for a patient’s healthcare
team. Acting – in their usual crucial role – as their patients’
advocates, it is possible that nurses could catch some
overlooked signs or and make them know to the doctor. The
course sheds the light of pathophysiology as a way of
facilitating the nurses’ knowledge to enable them to
comfortably walk their patients through the process of disease
etiology, testing, diagnosing, treating and prognosis. Nurses
become effective in their work when they clearly understand the
different ways biological processes and human organs behave in
the presence of a disease. This experience and practice skills is
gained through. effective research. Chamberlain Program
Outcomes
I found this course highly critical since it concerns
understanding a disease, correct diagnosis, treatment and its
prognosis for effective and quality patient care through proper
professional identity. Thus, this course met two program
outcomes. It met PO #2: Create a caring environment for
achieving quality health outcomes (Care-Focused) and PO #4:
Integrate professional values through scholarship and service in
health care (Professional identity). Pathophysiology ensures that
the patient’s care environment is perfect for achieving quality
treatment outcomes. AACN MSN Essentials
The course managed to achieve MSN Essential IV: Translating
and Integrating Scholarship into Practice and MSNEssential
VIII: Clinical Prevention and Population Health for Improving
Health. These two essentials are connected to PO #4, which this
course was also able to meet. An MSN prepared nurse must be
able to integrate broad, effective patient-centered, culturally
competent and organizational concepts to assess, manage and
deliver proper clinical care to the patient. As an MSN prepared

nurse, I can use pathophysiology to manage a patient and the
disease following through all the necessary steps learned
throughout the nursing course with appropriate understanding to
achieve quality health outcome for the patient.NONPF Core
Competencies
To effectively achieve this course, it was imperative to have
such NONPF competencies as quality, independent practice and
health delivery systems Competencies. To be able to apply
pathophysiology, an MSN trained nurse must exhibit
independent practice competencies. It is only through
independent practice that the nurse can bring to the doctor’s
attention certain aspects of the disease that were overlooked.
This competency is supported by quality-oriented practice and
having a clear knowledge of the health delivery systems.
Connect
The Autonomic Nervous System, controls the body’s internal
organs functions. It controls body muscles and is also an
integral part of the peripheral nervous system (Tappen, 2016).
The renal system is comprised of body organs, which filter out
excess fluid and other substances from the bloodstream. It is
responsible for the production, storage and elimination of urine
is done. The kidneys, being key part of the renal system, help to
excrete excess fluid waste. Further, the kidney filters waste and
extra blood from the blood system (Tappen, 2016).Reflection
One among the many useful and important courses in MSN, this
this NR507 Advanced Pathophysiology course sought to answer
the question of how the study of pathophysiology help nurses in
their practice. It is now clear to me that through this course the
nurse can conduct more effective treatments especially in such
situations where anxious, scared patients don’t really
understand their conditions. I even learned that there are cases
where, through pathophysiology, nurses can help generate a
valuable discovery for a patient’s healthcare team. This course
was important in realizing two program outcomes: PO #2:
Create a caring environment for achieving quality health
outcomes (Care-Focused) and PO #4: Integrate professional

values through scholarship and service in health care
(Professional identity). Understanding pathophysiology is an
important aspect of nurse evidence-based treatment.
References
American Association of Colleges of Nursing. The Essentials
of Masters Education for Nursing (2011). Retrieved from
http://www.aacn.nche.edu/education-
resources/MastersEssentials11.pdf
Robinson, B. K., & Dearmon, V. (2013). Evidence-based
nursing education: Effective use of instructional design and
simulated learning environments to enhance knowledge transfer
in undergraduate nursing students. Journal of Professional
Nursing, 29(4), 203-209. doi: 10.1016/j.profnurs.2012.04.022
Tappen, R. M. (2016). Advanced nursing research: From theory
to practice. Jones & Bartlett Publishers.Exemplar #4: NR508
Advanced Pharmacology
The focus of this course is on advanced knowledge base and
practice skills of pharmacology across in different clinical
settings. It discusses the principles of clinical pharmacology,
pharmacokinetics, therapeutics, and drug metabolism. Being a
dynamic science, advanced Pharmacology as explained in
NR508, built upon the previous knowledge to augment our
understanding of treatment complexities with pharmacological
interventions. The whole of this course expands knowledge of
the principles of pharmacology specific to the APN’s role. As a
student I was able to explore, analyze, evaluate, and apply
common drugs used for treatment of chronic diseases and some
self-limiting acute conditions and apply evidence-based practice
for prescriptive intervention.
In reflection, through this course, and as an MSN trained nurse,
I can now compile patients’ information to provide appropriate
evidence-based diagnosis and treatment. I can boast of better
understanding of the integration and application of appropriate
and quality care to patients while also focusing on
organizational standards, and considering distinct and dynamic
individual and family populations. I have learned this important

aspect of treatment through pharmacokinetics and giving
patients appropriate drug choices it is possible to achieve
quality treatment.
Through completion of NR 508, I can discuss the principles and
concepts of pharmacokinetics, pharmacotherapeutics and
pharmacodynamics. I can also now demonstrate an
understanding of the key drug classifications with regards to
rationale, risks, indications, and efficacy for the
pharmacotherapeutic agents regularly prescribed in acute and
primary care settings. I also gained the knowledge to evaluate
relevant and current research findings to come up with prudent
and quality pharmacological interventions. This course has also
enabled me to be able to design suitable pharmacologic
interventions. This class was one of those that are both
enlightening and challenging. I gained the knowledge necessary
to arrive at definitive patient diagnosis and establish an apt a
treatment plan. Chamberlain Program Outcomes
I believe this course me program outcome (PO) #5: Advocates
for positive health outcomes through compassionate, evidence-
based, collaborative advanced nursing practice (Extraordinary
nursing). It is important that nurses communicate effectively to
patients on the drugs given and treatment plan offered. It is
possible that NR508 MET PO #5 because it is the only outcome
that champions for desirable health outcomes through
compassionate and evidence-based encompassed with
collaboration AACN MSN Essentials
The course attained AACN MSN Essential VII:
Interprofessional Collaboration for Improving Patient and
Population Health Outcomes. MSN Essential VII addresses
interprofessional collaboration that enhances patient outcomes
and quality of population health. As an MSN prepared nurse, I
now understand that to attain quality care, it is important to
collaborate with other healthcare professionals so as manage
and coordinate the care. NONPF Core Competencies
Through this course (NR508) it is evident that one needs to
show Health Delivery Systems Competencies and practice

competencies. These two competencies impact the
operationalization of public health and community programs.
Using these competencies, a nurse can engage inquiry to come
up with appropriate diagnosis, treatment plan and drug
prescription. You also need to eb culturally competent to
deliver appropriate healthcare and work with others in the
healthcare field for effective patient outcomes. Connect
Through this course, can connect with two terms – allergy and
NSAIDs.In the context of pharmacology an allergy is used to
refer to the immune system’s response – unnecessary – to a
harmless foreign substance (Lilley, Shelly & Snyder,
2019).NSAIDs, on the other hand are non-steroidal anti-
inflammatory drugs, which work by obstructing prostaglandins.
prostaglandins are the chemicals that trigger the inflammation
and pain signal. NSAIDs then help to relieve the inflammation
from pain (Lilley, Shelly & Snyder, 2019).Reflection
This course has benefitted me a lot. Other than knowing the
essentials and specific applications of advanced pharmacology,
I managed to attain PO #5, which advocates for desirable health
outcomes through compassionate and evidence-based approach
to nursing practice while elevating collaboration. It is
understandable that you cannot work alone when you are a nurse
practitioner and that you have to engage other practitioners in
the healthcare field to attain quality healthcare outcomes. The
course is also aligned toMSN Essential VII, which addresses
interprofessional collaboration for enhanced patient outcomes.
Thus, while conducting evidence-based and compassionate care,
elevating interprofessional collaboration also leads to enhanced
patient outcomes. References
Chamberlain College of Nursing. (2016). Graduate Program
Outcomes. Retrieved from http://www.chamberlain.edu
Chamberlain College of Nursing. (2017). Pharmacokinetics,
Pharmacodynamics, Art of Pharmacotherapeutics, Reproductive
System Medications and Drug-OTC-Herbal Interactions. Week 1
lesson. Retrieved from http://www.chamberlain.edu
Lilley, L. L., Shelly Rainforth Collins, P., & Snyder, J. S.

(2019). Pharmacology and the nursing process. Mosby.
Exemplar #5: NR509 Advanced Physical Assessments
The name and expectation of the NR509 course is far much
different from time one needs to successfully complete the
course. I never expected that this course would involve that
much activity and time. There is much study and practical
application in this course than any other MSN course. I was
even overwhelmed with the amount of documentation and
information involved with the patients.
This course is best for those planning to undertaking
autonomous practice. An FNP is an example of an autonomous
practicing nurse. They have the knowledge for emergency
nursing, primary care, night-nurse practitioners, community
matrons, critical care, occupational therapists, physiotherapists,
and working in different pre-surgical clinics, and day surgery,
among other places. The course aims to enable one, as a
practitioner, to develop advanced physical assessment skills and
apply them in a clinical context, including when working as an
autonomous practitioner.
Immersion weekend – the lab component of NR-509: Advanced
Physical Assessment – gave me a great experience while also
being nerve wracking. Occurring in week 7 of NR-509, the
Immersion Weekend offered me an opportunity to demonstrate
competence and engage critical thinking in my health
assessment skills. The course has designed the Immersion
Weekend to teach us appropriate assessment techniques on
various general medical complaints, which help prepare us for
practicum experiences in NR-511. This means, one has to do
well in NR509 so as to understand NR511.
Even after all the preparations, study and documentations,
NR509 was still difficult to pass. I still had low scores in the

NR509 APEA exams in three areas – Neurology,
Gastroenterology, and Respiratory. I had to put a lot of work to
ensure that I performed well in these three areas so that I would
succeed in NR511. Also, to succeed in NR509, one has to be
well versed with the previous MSN courses that come before
509, and take keen consideration of pharmacology and
pathophysiology. Chamberlain Program Outcomes
The content and information of this course meets those of
Chamberlain MSN PO #1: Provide high quality, safe, patient-
centered care grounded in holistic health principles (Holistic
Health & Patient-Centered Care). Through this course I have
become keener on screening and diagnostics both of which
exemplify Program Outcome #1 for provision of safe, patient-
centered and high-quality care. Conducting advanced physical
assessments require not only clear and informed background in
nursing, but critical thinking and evidence-based practice.
AACN MSN Essentials
The course met the conditions for arriving at Essential IX:
Master’s-Level Nursing Practice. Clearly, advanced physical
assessments highly impact individuals’ healthcare outcomes. Its
achievement requires clear and well-defined background in
nursing which provokes the essentials of master’s level nursing
practice. It is a clear demonstration of advanced level of
understanding and comprehension of advanced nursing and its
relevant fields. NONPF Core Competencies
The course also needs a demonstration of NONPF Independent
Practice Core competencies. It gives an opportunity to work
autonomously exhibiting independent practice as a competency.
It also involved independently analyzing the given case studies
with stellar profession and distinguished care to provide
accurate diagnosis and establish quality outcome. A competent
MSN prepared nurse should distinguish between normal and
abnormal health results, which is supported by this course.
Connect
I can connect with two terms in this course – shadow-health and
gastroenterology. Gastroenterology, as a field of medicine, is

involved with interrogating, diagnosing, and suggesting
treatment that also encompasses listing preventive care for
gastrointestinal and hepatological tissues and organs (Tappen,
2016). Shadow health, on the other hand, is a software that
gives healthcare students a virtual learning opportunity through
simulations (Foronda et al., 2019). Thus, it enables students to
test their nursing knowledge and skills and hence build their
confidence.Reflection
The name and expectation of the NR509 course is far much
different from time one needs to successfully complete the
course. I never expected that this course would involve that
much activity and time. There is much study and practical
application in this course than any other MSN course. I was
even overwhelmed with the amount of documentation and
information involved with the patients. The sensitivity is on its
screening and diagnostic processes, which both inform the
treatment plan making any mistake – if any – at this stage costly
and fatal and costly. I discovered that conducting advanced
physical assessments needs stellar background in nursing
information and proper develop critical thinking. Students can
use Shadow Health and case studies to test their physical
assessment’s skills and knowledge.References
Codina, L. M. T. (2007). Adult nurse practitioner intensive
review: Fast facts & practice questions. New York: Springer
Pub. Co.
Foronda, C. L., Alfes, C. M., Dev, P., Kleinheksel, A. J.,
Nelson Jr, D. A., O'donnell, J. M., & Samosky, J. T. (2017).
Virtually nursing: Emerging technologies in nursing education.
Nurse educator, 42(1), 14-17.
to practice. Jones & Bartlett Publishers.Exemplar #6: NR510:
Leadership and Role of the Advanced Practice Nurse
This course was not only important but also practice assuring.
Id defined the leadership and role of an APNs practitioners in a
wide range of possible careers and employment opportunities.
Holding either MSN or a doctorate in nursing, APNs are

considered to be the most highly trained category of all
registered nurses. They conduct certain functions previously
reserved for medical doctors such as diagnosing condition,
requesting and/or interpreting laboratory tests, and prescribing
medications among others. They have a wide scope of practice
and lots of duties to perform either as practitioners or leaders.
APNs apply technical, cognitive and integrative abilities to
carry out their practice in ethical and safe approaches for
quality outcome of patients. APN must also have the capability
of peer and patient education, research and inquiry, mentorship
and accountability in interpreting and utilizing research to
advance and improve nursing practice. There are two main
themes identified in the role of an ANP – organization and
system‐focused leadership and Patient‐focused leadership.
These are the main leadership orientations of APNs as they seek
to contribute to and improve the clinical care environment for
patients and their families, other nurses including other
healthcare providers, and the entire healthcare system.
Being an APN requires a one to have an MSN. Other MSN’s
proceed to earn a doctoral degree to become Clinical Nurse
Specialists. With an MSN one also has to obtain a certification
after sitting an exam to become an APN. (“Advanced Practice
Nursing Fact Sheet”, 2017). It is also important to consider the
federal and state Licensure and Regulatory Requirements to
practice as an MSN trained APN. With an additional
certification, degree and license, being an MSN prepared APN
means having a higher responsibility. Further, a complex job
title, higher knowledge, more skills and authority give APN new
challenges and equal opportunities. Nevertheless, regardless of
having higher roles or authority, an APN must always keep in
mind that providing quality and safe healthcare is paramount.
This course meets the needs of program outcome (PO) #3:
Engage in lifelong personal and professional growth through
reflective practice and appreciation of cultural diversity
(Cultural Humility). Nurses are generally leaders both to

patients and to their lower ranking colleagues. By pursuing an
APN level nursing career, one is aligning with Program
Outcome #3 that urges continuous personal and professional
growth through reflective practice and appreciation of cultural
diversity.AACN MSN Essentials
This course realizes AACN MSN Essential II: Organizational
and Systems Leadership. APN’s are naturally leaders because of
their skill levels and associated responsibility, roles and
authority. Thus, they must demonstrate both organizational and
systems leadership to promote safe and quality care. They must
also engage critical thinking in their decision making and
engage systems-wide view.
The accurate and obvious competency that this course instill is
the Leadership Competency. As an MSN APN I have to build on
leadership competencies (Hickey & Brosnan, 2012). This is
because you will have more responsibilities, key roles and
authority, which put you in a leadership position. As a leader
you have to act on the best interest of all the stakeholders
involved in the care process including patients, junior
colleagues and other health sector practitioners. You must also
exercise effective communication skills and participate in
professional organizations to enhance your leadership
competences. Connect
Systems-wide view: seeks consider the organization’s entire
units or departments in a bid to accomplish a practical approach
to leadership. The systems-wide concept views an organization
from a cause-effect view which supports implementation of
corrective measures (Cherry & Jacob, 2016).
Nursing leadership is a dynamic concept of nursing that, simply
stated involves mentoring (or coaching) and building of
supportive relationships to maximize individual potential and
enhance professional growth. Mentorship involves a nurse
leader sharing their knowledge, behaviors, skills, and attitudes
with other nurses (Cherry & Jacob, 2016). Reflection
APNs are trained to be leaders and demonstrate leadership

competencies. This course not only teaches leadership but also
gives leadership opportunities for APNs in care environment.
While nursing leaders provide higher level leadership,
individual nurses are always engaged in leadership, for instance
when assigned students or nursing interns. This course is
aligned with Program Outcome #3, which urges nurses and
APNs to indulge in continuous personal and professional growth
while considering cultural diversity Reference
Advanced Practice Nursing Fact Sheet | 2017 NurseJournal.org.
(2017). Retrieved from http://nursejournal.org/advanced-
practice/advanced-practice-nursing-fact-sheet/
About Boards of Nursing | NCSBN. (2017). Retrieved from
https://www.ncsbn.org/about-boards-of-nursing.htm
Cherry, B., & Jacob, S. R. (2016). Contemporary nursing:
Issues, trends, & management. Elsevier Health Sciences.
Hickey, J. V., & Brosnan, C. A. (2012). Evaluation of health
care quality in advanced practice nursing. New York: Springer
Pub. Co.
Exemplar #7: NR 511 Differential Diagnoses and Primary Care
Through Differential Diagnosis and Primary Care nurse
practitioners systematically approach treatment symptoms and
signs with careful approach as they see them practice. NR 511
was the key test of my education and learning as an MSN
prepared nurse. Organized into categories different categories
such as mass, pain, bloody and non-bloody discharge, abnormal
laboratory results, and functional changes, this course offers a
clinical reference for diagnosis and taking appropriate steps in
ensuring that the patient gets appropriate diagnosis. I had the

opportunity to conduct my first FNP program clinical rotation.
As an MSN, you are prepared to handle different aspect of care
and diagnosis. In rotation, I realized that there is more that I
need to learn as far as diagnosis and primary care is concerned.
Primary care is intensive unlike ER, with the need for more
follow up and abroad treatment for quality outcome. There is
even more time needed to obtain lab results, hence diagnosis
and treatment plan must be based on advanced physical test and
the patient’s history.
There is also a key difference between primary care and ER
when it comes to medication and treatments. In primary care,
there are many protocols and many treatment options and
sometimes patients have numerous comorbidities that that must
be considered while choosing a plan of care. This often calls for
differential diagnosis to ensure that the treatment plan addresses
specific diseases and not comorbidities.
Primary care indulge different areas of clinical health and
rotation exposes you to different patients in terms of age,
gender, and disease infections. You have to be updated in
treatment methods and ensure that you have the correct
information going into treatment. As an MSN trained APN, you
are a leader and perceived to be more knowledgeable and with
more skills. Thus, it is only prudent to ensure that you follow
the right procedures and ensure quality outcome. Chamberlain
Program Outcomes
NR 511 met PO #1: Provide high quality, safe, patient-centered
care grounded in holistic health principles (Holistic Health &
Patient-Centered Care). The differential diagnosis and primary
course as it helps the MSN APN nurse determine the final
diagnosis of the patient and subsequent treatment plan. Thus, it
enables the realization of Program Outcome #1, which
advocates for safe, high-quality, patient centered healthcare that
is premised on holistic health principles. A critical element of
the patient’s safety is ensuring that the patient is given correct
of a medical condition or illness is a critical element of patient
safety and quality attributes of a healthcare system. The

treatment plan should be supported with an evidence-based
information.AACN MSN Essentials
The course helped in the realization of two AACN MSN
Essentials – Essential V: Informatics and Healthcare
TechnologiesandEssential IX: Master’s-Level Nursing Practice.
The realization of these essentials is demonstrated through the
achievement of PO #1. Differential diagnosis and Primary care
have a direct impact on patient’s healthcare outcomes as
addressed by Essential IX addresses. This is because any
nursing aspect that directly impacts healthcare outcomes
encompass MSN practice due to their requirement of detailed,
keener and more informed with high accountability demands.
This course managed to demonstrate the need for Quality
CompetenciesThrough this course, MSN-APN trained nurses
develop NONPF’s quality competencies to enable them
operationalize all the other important competencies. One can
achieve this trough applying the current and best research study
findings and results to clinical practice. Nurse practitioners
should also consider the complex relationships between quality,
safety, and cost in healthcare delivery. This competency has
many other aspects that an MSN-APN nurse must demonstrate.
Connect
Differential Diagnoses – when a patient has a condition that is
difficult to understand, clinicians and nurse practitioners use
differential diagnosis to distinguish one condition, disorder or
disease from others, especially when these conditions present
close or similar clinical features (Gorenstein & Comer, 2015).
This makes differential diagnosis a systematic diagnostic
method that can identify a particular disease where there is a
possibility of multiple alternatives.
Test sensitivity – In medical diagnosis, clinicians use test
sensitivity to describe a test’s ability “to correctly identify
those with the disease (true positive rate)” (Cummings et al.,
2015). This is the exact opposite of test specificity which
describe the test’s ability to correctly identify those without the

disease (true negative rate) (Cummings et al., 2015).Reflection
I can categorically say that this course was very critical in MSN
because it directly addresses the healthcare’s sensitive stages. It
informs the patient’s final diagnosis and all the subsequent
treatment plan that the nurse will give. By meeting the
requirements of PO #1 this course also directly advocates for f
safe, high-quality and patient-centered healthcare that is
premised on key holistic health principles. It emphasizes quality
outcome and patient safety, which are salient element of
healthcare provision. It also encourages evidence-based practice
for better outcome.
References
Cummings, J., Soomans, D., O'laughlin, J., Snapp, V., Jodoin,
A., Proco, H., ... & Rood, D. (2015). Sensitivity and specificity
of a nurse dysphagia screen in stroke patients. MedSurg
Nursing, 24(4), 219-224.
Gorenstein, E. & Comer, R. (2015). Case studies in abnormal
psychology. New York, NY: Worth Publishers, a Macmillan
Higher Education Company.
National Organization of Nurse Practitioner Facilities. (2013).
Nurse practitioner population focused competencies.
http://c.ymcdn.com/sites/www.nonpf.org/resource/resmgr/Comp
etencies/CompilationPopFocusComps2013.pdfExemplar #8:
NR601 Primary Care of the Maturing and Ageing Family
Part of nursing is being able to provide primary care from
pediatrics to the aged population. This course was an
opportunity to learn and practice about providing primary care
for the maturing and ageing population. This is a very delicate
population and one that needs intensive care. Primary care for
this category of this population is more intense during prognosis
and managing them after treatment (Boeckxstaens & De Graaf,
2011). As an MSN trained APN practitioner, it is important to
not only demonstrate leadership but also advocate for the well-
being of the patients after treatment.
During this course, I was able to learn that primary care doesn’t
mean a fixed organizational structure or style but a blend of

functional and variable characteristics to the needs – present
and emerging – of the older persons (Boeckxstaens & De Graaf,
2011). Clearly, multimorbidity, disability, dependence and
frailty play out often and differently in the aging persons;
making a key challenge for primary care to be able to provide
an adaptable response to these individuals’ needs. Indeed,
caring for the elderly needs involving them in the care decisions
since, contrary to what’s believed, the elderly consider their life
quality as high (Boeckxstaens & De Graaf, 2011). Furthermore,
providing care for the elderly requires coordination and
continuity with other specialist care programs.
The central theme of primary care for the old and ageing is
delivering seamless integrated care. I learned that instead of
disease management, primary care prefers case management
approach. This involves proactive geriatric assessment to know
the individual’s functional, medical, and social needs, including
isolation, and loneliness. We also need clinical or MSN practice
guidelines for multimorbidity to avoid costly uncoordinated and
multiple prescriptions. Importantly, primary care is a teamwork,
and coordinated healthcare provision, and nurses have a
significant role in ensuring quality care and alignment with
home (family) care and social services Chamberlain Program
Outcomes
This provisions and lessons in this course meet Chamberlain’s
PO #5: Advocates for positive health outcomes through
practice (Extraordinary nursing). For example, when I helped an
elderly patient get a referral by coordination and liaising her
service with the relevant office, I operationalized PO #5, which
advocates for positive outcomes through collaborative,
evidence-based and compassionate practice. The mere fact that
coordination and delivering of seamless integrated care in
primary care for the ageing is a fulfilment of the PO #5.AACN
MSN Essentials
This course realized the fulfillment of MSN Essential VII,
which advocates for Interprofessional Collaboration for

Improving Patient and Population Health Outcomes. This
essential is in line with PO #5 on the issue of coordinated and
integrated care delivery. As an MSN NP you need to be working
with different hospital/care departments to support the patient’s
and a referral quality result. It is important that a NP consult
and coordinate care with other health professionals as provided
in essential VII. NONPF Core Competencies
This course and the achievement of the practical outcomes that I
managed to achieve shoed the need for Ethics Competencies as
the NONPF core competencies. Dealing with elderly patients
needs not only need compassion but also ethics both in their
diagnosis and prognosis. I discovered that the elderly person’s
families need to be helped to understand the situation including
the patient’s prognosis. This is only possible when you infuse
ethical principles in decision making. Connect
Geriatrics: refers to the branch of social science or medicine
that deals with the health and care of old people (Zaccagnini &
White, 2015). This is basically what this course entailed.
Orthopaedic: is a special branch of medicine that deals with the
correction of the body’s deformities of bones and muscles. It
addresses the diagnosis, corrections, preventing, and treatment
of individuals with their skeletal deformities (Zaccagnini &
White, 2015). Most old people need to undergo orthopaedic
treatment. Reflection
In summary, I learned that the central theme of primary care for
the old and ageing is delivering seamless integrated care. I
learned that instead of disease management, primary care
prefers case management approach. This involves proactive
geriatric assessment to know the individual’s functional,
medical, and social needs, including isolation, and loneliness.
Nurses also need clinical or MSN practice guidelines for
multimorbidity to avoid costly uncoordinated and multiple
prescriptions. Importantly, primary care is a teamwork, and
coordinated healthcare provision, and nurses have a significant
role in ensuring quality care and alignment with home (family)
care and social services

Primary care for the old have complex demands. Fortunately,
nurses have adequate training to navigate through these complex
demands for positive and quality patient outcome. It also needs
ethics as a competency to be able to deal with the old and aging
population. Further, dealing with this population needs
interprofessional collaboration to enhance population and
patient health outcomes. References
Berry, S., Kiel, D. P., Schmader, K. E., & Sullivan, D. J.
(2017). Falls: Prevention in nursing care facilities and the
hospital setting. Uptodate. com.
Boeckxstaens, P., & De Graaf, P. (2011). Primary care and care
for older persons: position paper of the European Forum for
Primary Care. Quality in primary care, 19(6), 369.
Zaccagnini, M., & White, K. (2015). The doctor of nursing
practice essentials. Jones & Bartlett Learning
Exemplar #9: NR 602 Primary Care of the Childbearing and
Childbearing Family
This course course provides an NP student with the essential
knowledge, information and experience to be able to diagnose
and manage a childbearing/childrearing family and provide
them with primary care as well as manage their common health
problems. The course placed emphasis on assisting childrearing
families to maintain or reach the highest level of functioning
and health, focusing on health maintenance, health promotion. I
am glad that this course prepared me to meet the MSN PO #1,
MSN Essential VII, and the NP Core Competencies #8.
This course is focused on the primary care for low risk of a
childbearing woman and her newborn. It is important for an
FNP because it applies developmental theoretical perspective,
for achieving primary care for during childbearing in a family
practice setting. Also, the given clinical component gives the
opportunity fo the MSN-FNP’s to integrate the learned
theoretical content from their prior courses and use them in
clinical gynecologic and obstetrical family practice. It gives the
FNP-student nurse practitioner (SNP) skills needed for a quality
holistic, primary care of the woman obstetrical client in

ambulatory and family practice care.
This course also offers the practice and principles of care for
the childbearing woman and family throughout the ante- and
post-partum stages. The course explains this process through
different ethnicities, ages, and social circumstances and also
involves advanced physical assessment (NR509) and
management of both normal pregnancy and different pregnancy
complications. On top of the different pregnancy’s
physiological changes, the course also helps to examine the
psychological issues that are commonly encountered during the
pregnancy’s prenatal and post-partum care provision.
Furthermore, the builds on human development and growth to
focus on support knowledge of assessment and management of
chronic and acute health care problems that practitioners
encounter in primary care of family, and sometimes pediatric,
settings. It analyzes the medical problems and conditions of
expectant women, unborn and born infants, as well as children
and adolescents within the context of a FNP framework.
Program outcome #1 advocates forproviding high quality, safe,
patient-centered care grounded in holistic health principles
(summarized as holistic health & patient-centered care). The
significance of holistic care was first emphasized by Florence
Nightingale. Holistic care gives a patient satisfaction in the
provided healthcare, which is also their right (Andrus, 2014).
Through this course, and by meeting MSN PO #1 I am able to
address childbearing patients and families’ social, physical,
emotional, and spiritual needs, and support them in dealing with
their illnesses, to improve their lives.AACN MSN Essentials
The course achieved MSN Essential VII: Interprofessional
Collaboration for Improving Patient and Population Health
Outcomes. Achievement of this essential recognizes that an
APN MSN-prepared nurse, being a leader and member of
interprofessional teams, collaborates, consults, and
communicates with other professionals in the healthcare field to
coordinate and manage care (Andrus, 2014). As an MSN, you

coordinate and lead interdisciplinary care teams across different
care environment to improve health outcomes. This professional
identity is achieved through MSN Essential VII.NONPF Core
Competencies
This course demonstrates the Nurse Practitioner Core
Competency # 8: Ethics Competencies. This is because it
ensures integration of ethical principles in care decision
making, ensures evaluation of the ethical consequences of care
decisions. It also applies ethically sound solutions to complex
issues related to individuals, populations and systems of care.
As an FNP this course has prepared me to promote patient-
centered, comprehensive holistic care (Sohi, Champagne &
Shidler, 2015). Thus, I know that, ethically it is the patients’
right to choose the type of care they feel comfortable with and
can refuse care when they are not comfortable with a given
care. This means that the nurse – an MSN-APN prepared FNP –
has a responsibility to provide patients with enough information
about the treatment and care so that they can make informed
decision. Connect
Postnatal depression: is the form of depression, which a parent
can undergo after childbirth. The major victims are mothers but
it can also affect fathers. The signs of postnatal depression
include difficulty bonding with the new baby, insomnia or
intense irritability. If untreated it can go for a long time and can
lead to a major depression (Agrawal, 2015).
Postpartum hemorrhage entails excessive bleeding after
childbirth. The hemorrhage often takes place after the delivery
of the placenta. Its causes include uterine muscles’ loss of tone,
or a bleeding disorder or sometimes when the placenta fails to
be delivered completely or when it’s tone (Agrawal,
2015).Reflection
This is one of the courses that is suitable for an FNP because it
offers a lot of ways that help the FNP on addressing the social,
emotional, spiritual, and physiological needs of parents after
childbirth. In essence it helps to the student to operationalize
Program Outcome # 1, which urges nurses and care givers to

offer safe, high quality and patient-oriented care while
considering holistic healthcare tenets. Also, it provides for
collaboration and coordination while handling patients enhance
desired quality health outcomes. For example, through Essential
VII, this course helps you to learn to appreciate other
professionals in your team and appreciate the significance of
collaboration. References
Agrawal, P. (2015). Maternal mortality and morbidity in the
United States of America.
Andrus, V. L. (2014). Person-Centered Care: Enhancing Patient
(Person) Engagement. Beginnings, 34(1), 18-21.
Sohi, J., Champagne, M., & Shidler, S. (2015). Improving
health care professionals' collaboration to facilitate patient
participation in decisions regarding life-prolonging care: An
action research project. Journal of Interprofessional Care, 29(5),
409-414. Exemplar #10: NR 602 Advanced Clinical Care and
Practice Across the Lifespan Practinum
As an MSN-FNP this course is very essential for my practice.
This course has helped me achieve MSN-FNP Program
Outcome #4: professional identity (Integrate professional values
through scholarship and service in health care). This course
offered an opportunity for practical experience in nursing
scholarship. As described by the American Association of
Colleges of Nursing (2011), scholarship includes the activities,
which systematically advance the practice, research and
teaching of nursing through a rigorous inquiry. The course also
supports other MSN qualities such as leadership, advanced
practice, coordination, collaboration and authority in advocating
and providing quality care.
This enabled attainment of course MSN Essential
IV: Translating and Integrating Scholarship into Practice. This
essential recognizes that the MSN-prepared nurse must apply
research outcomes in the practice to make informed decisions
and solve practice problems through evidence-based practice.
The MSN-prepared nurse also works as a leader and change
agent in healthcare setting. Utilizing the guidelines of clinical

practice to recognize, plan, manage and treat diseases satisfies
this essential.
This course – being an important APN course – continues to
provide expanded the practical and theoretical knowledge of
diagnostic and disease management principles specific to the
MSN-FNP’s, for healthcare needs of all individuals across all
ages. It enables students to further their skills in diagnosis,
health promotion, prevention of illness, and general care
management of complex chronic and acute conditions, as well
as behavioral health. This course leads the student to develop
and maintain such care strategies as patient education, follow-
up, referral, and protocol development through an experience in
clinical practicum in an advanced practice setting.
This course solidifies the FNP’s clinical experience, which
involves developing knowledge and skills that supports
provision of quality healthcare outcome through best research
and evidence-based care. Achievement of the course leads to
attainment of numerous Nurse Practitioner Core Competencies,
key among them being competency # 7: Health Delivery System
Competencies. This cluster of competencies (#7) refer to the
design, planning, and implementation of community and public
health programs for quality healthcare outcome and encompass
such skills as effective communication, leadership, compassion,
coordination, research and evidence-based practice in care
provision (AACN, 2011). Chamberlain Program Outcomes
This course has helped me achieve MSN-FNP Program Outcome
#4: professional identity (Integrate professional values through
scholarship and service in health care). This program outcome
is especially important for aspiring FNPs in the clinical
practice. For example, I have learned to provide primary care to
patients of different ages, class and identities, which is
important in FNP practice. As an MSN-FNP prepared nurse
you’re expected to become a leader and have more skills in
different care settings that will make you stand out among other
practitioners. Thus, this course has offered important insights
on not only MSN requirements but also cultural diversity and

behavioral health concerns. AACN MSN Essentials
The meeting of PO #4 enabled attainment of MSN Essential IV:
Translating and Integrating Scholarship into Practice. Also,
MSN essential III: quality improvement and safety comes close
to this course. Expectedly, conducting advanced primary care to
different age groups of patients and conduction differential
diagnosis requires reliance on both Essential III and IV. As an
FNP, attaining MSN level of practice required covering
numerous theories, practical, simulations, laboratory sessions
and case studies and being able to apply them in real-world.
This course solidifies the FNP’s clinical experience, which
involves developing knowledge and skills that supports
provision (AACN, 2011).
Connect
Cryotherapy: is a form of therapy treatment that involves using
freezing temperatures. It is also known as cold therapy, and
used to cool body temperature and bring it down at the cellular
and tissue level for therapeutic benefits (Song et al., 2016). It is
a relatively new concept.
Immunization: often confused vaccination, and sometimes
referred to as inoculation. Vaccination involves administering a
vaccine (a mild form an infectious agent) in to your body
(usually by injection). Immunization is the result of
vaccination. The vaccine helps to stimulate the body’s immune
system so that the body can recognize the disease and gradually
build defenses against the pathogen to protect the body from

future infection (Wilder-Smith et al., 2017). Reflection
This course is an essential course for every MSN-FNP nurse
because it forms the core of nursing care. Through this course
one gets the opportunity to identify with all MSN Program
Outcomes especially PO #4, which requires a nurse practitioner
to incorporate scholarship and professional values in healthcare
service. This course solidifies the FNP’s clinical experience,
which involves developing knowledge and skills that supports
provision (AACN, 2011).
References
American Association of Colleges of Nursing (AACN). (2011).
Defining Scholarship for the Discipline of Nursing. Retrieved
from http://www.aacnnursing.org/News-Information/Position-
Statements-White-Papers/Defining-Scholarship.
Curtis, K., Fry, M., Shaban, R. Z., & Considine, J. (2016).
Translating research findings to clinical nursing
practice. Journal of Clinical Nursing, 26(5-6), 862-872.
Goroll, A., & Mulley, A. (2014). Primary care medicine: Office
evaluation and management of the adult patient (7th ed.). China:
Wolters Kluwer Health.
Wilder-Smith, A., Longini, I., Zuber, P. L., Bärnighausen, T.,
Edmunds, W. J., Dean, N., ... & Gessner, B. D. (2017). The
public health value of vaccines beyond efficacy: methods,
measures and outcomes. BMC medicine, 15(1), 138.

References
American Association of Colleges of Nursing (AACN). (2011).
Defining Scholarship for the Discipline of Nursing. Retrieved
from http://www.aacnnursing.org/News-Information/Position-
Statements-White-Papers/Defining-Scholarship.
Advanced Practice Nursing Fact Sheet | 2017 NurseJournal.org.
(2017). Retrieved from http://nursejournal.org/advanced-
practice/advanced-practice-nursing-fact-sheet/
About Boards of Nursing | NCSBN. (2017). Retrieved from
https://www.ncsbn.org/about-boards-of-nursing.htm
Agrawal, P. (2015). Maternal mortality and morbidity in the
United States of America.
Andrus, V. L. (2014). Person-Centered Care: Enhancing Patient
(Person) Engagement. Beginnings, 34(1), 18-21.
Berry, S., Kiel, D. P., Schmader, K. E., & Sullivan, D. J.
(2017). Falls: Prevention in nursing care facilities and the
hospital setting. Uptodate. com.
Boeckxstaens, P., & De Graaf, P. (2011). Primary care and care
for older persons: position paper of the European Forum for
Primary Care. Quality in primary care, 19(6), 369.
Centers for Disease Control and Prevention. (2017). Childhood
Obesity Facts. Division of Population Health, National Center
for Chronic Disease Prevention and Health Promotion.
Chamberlain College of Nursing. (2016). Graduate Program
Outcomes. Retrieved from http://www.chamberlain.edu
Chamberlain College of Nursing. (2017). Pharmacokinetics,
Pharmacodynamics, Art of Pharmacotherapeutics, Reproductive
System Medications and Drug-OTC-Herbal Interactions. Week 1
lesson. Retrieved from http://www.chamberlain.edu
Cherry, B., & Jacob, S. R. (2016). Contemporary nursing:
Issues, trends, & management. Elsevier Health Sciences.

Codina, L. M. T. (2007). Adult nurse practitioner intensive
review: Fast facts & practice questions. New York: Springer
Pub. Co.
Cummings, J., Soomans, D., O'laughlin, J., Snapp, V., Jodoin,
A., Proco, H., ... & Rood, D. (2015). Sensitivity and specificity
of a nurse dysphagia screen in stroke patients. MedSurg
Nursing, 24(4), 219-224.
Curtis, K., Fry, M., Shaban, R. Z., & Considine, J. (2016).
Translating research findings to clinical nursing practice.
Journal of Clinical Nursing, 26(5-6), 862-872.
Gorenstein, E. & Comer, R. (2015). Case studies in abnormal
psychology. New York, NY: Worth Publishers, a Macmillan
Higher Education Company.
Goroll, A., & Mulley, A. (2014). Primary care medicine: Office
evaluation and management of the adult patient (7th ed.). China:
Wolters Kluwer Health.
Foronda, C. L., Alfes, C. M., Dev, P., Kleinheksel, A. J.,
Nelson Jr, D. A., O'donnell, J. M., & Samosky, J. T. (2017).
Virtually nursing: Emerging technologies in nursing education.
Nurse educator, 42(1), 14-17.
Hickey, J. V., & Brosnan, C. A. (2012). Evaluation of health
care quality in advanced practice nursing. New York: Springer
Pub. Co.American Association of Colleges of Nursing. The
Essentials of Masters Education for Nursing (2011). Retrieved
from http://www.aacn.nche.edu/education-
resources/MastersEssentials11.pdf
Houston Health Department. (2015). HIV Surveillance Program.
HIV Infection in Houston: An Epidemiologic Profile 2010-2014.
Houston, Texas; 2015.
Kliegman, R. M., Schor, N. F., St Geme III, J. M., & Behrman,
R. E. (2016). Nelson Textbook of Pediatrics. Philadelphia:
Elsevier.
Lilley, L. L., Shelly Rainforth Collins, P., & Snyder, J. S.
(2019). Pharmacology and the nursing process. Mosby.
Lobstein, T., Jackson-Leach, R., Moodie, M. L., Hall, K. D.,
Gortmaker, S. L., Swinburn, B. A., . . . Mc Pherson, K. (2015).

Childhood and adolescent obesity: Part of a bigger picture. The
Lancet, 2510-2520.
Maartens, G., Celum, C., & Lewin, S. R. (2014). HIV infection:
epidemiology, pathogenesis, treatment, and prevention. The
Lancet, 384(9939), 258-271.
Moyer, V. A. (2015). Screening for HIV: US preventive
services task force recommendation statement. Annals of
internal medicine, 159(1), 51-60.
National Collaborative on Childhood Obesity Research. (2012).
Childhood Obesity in the United States. NCCOR.
National Organization of Nurse Practitioner Facilities. (2013).
Nurse practitioner population focused competencies.
http://c.ymcdn.com/sites/www.nonpf.org/resource/resmgr/Comp
etencies/CompilationPopFocusComps2013.pdf
Robinson, B. K., & Dearmon, V. (2013). Evidence-based
nursing education: Effective use of instructional design and
simulated learning environments to enhance knowledge transfer
in undergraduate nursing students. Journal of Professional
Nursing, 29(4), 203-209. doi: 10.1016/j.profnurs.2012.04.022
Sohi, J., Champagne, M., & Shidler, S. (2015). Improving
health care professionals' collaboration to facilitate patient
participation in decisions regarding life-prolonging care: An
action research project. Journal of Interprofessional Care, 29(5),
409-414.
to practice. Jones & Bartlett Publishers.
Wilder-Smith, A., Longini, I., Zuber, P. L., Bärnighausen, T.,
Edmunds, W. J., Dean, N., ... & Gessner, B. D. (2017). The
public health value of vaccines beyond efficacy: methods,
measures and outcomes. BMC medicine, 15(1), 138.
Zaccagnini, M., & White, K. (2015). The doctor of nursing
practice essentials. Jones & Bartlett Learning
Appendix 1: Tabulation of achieved program 0utcome, MSN
Essentials and NONPF Competencies

Exemplar# Title
Program outcome
MSN Essentials Met
NONPF Core Competencies Met
Exemplar I: NR503 Population Health, Epidemiology &
Statistical Principles
PO #1: Provide high quality, safe, patient-centred care grounded
in holistic health principles (Holistic Health & Patient-Cantered
Care)
Essential I: Background for Practice from Sciences and
Humanities
Scientific Foundation Competencies.
Technology and Information Literacy Competencies
Exemplar II: NR 505 Advance Research Methods Week 3
Essential VI: Health Policy and Advocacy
Scientific Foundation Competencies
Policy Competencies
Exemplar III: NR 507 Advanced Pathophysiology
PO #2: Create a caring environment for achieving quality health
outcomes (Care-Focused)
PO #4: Integrate professional values through scholarship and
Essential VIII: Clinical Prevention and Population Health for
Improving Health
Independent Practice Competencies.
Policy Competencies.
Exemplar IV: NR 508 Advanced Pharmacology
Essential VII: Interprofessional Collaboration for Improving

Patient and
Population Health Outcomes.
Health Delivery Systems Competencies
Exemplar V: NR 509 Advanced Physical Assessments
PO #1: Provide high quality, safe, patient-centered care
Patient-Centered Care).
Essential IX: Master’s-Level Nursing Practice
Independent Practice Competencies
Exemplar VI: NR510: Leadership and Role of the Advanced
Practice Nurse
PO #3: Engage in lifelong personal and professional growth
through reflective practice and appreciation of cultural diversity
(Cultural Humility))
Leadership Competencies
Exemplar VII NR 511 Differential Diagnoses and Primary Care
Essential V: Informatics and Healthcare Technologies
Quality Competencies
Exemplar VIII: NR 601 Primary Care of the Maturing and
Ageing Family
practice (Extraordinary nursing))
Patient and Population Health Outcomes
Ethics Competencies
Exemplar IX: NR 602 Primary Care of the Childbearing and
Childbearing Family

Patient and Population Health Outcomes.
Ethics Competencies
Exemplar X: NR 602 Advanced Clinical Care and Practice
Across the Lifespan of Practinum
PO #4: Integrate professional values through scholarship and
Essential III: Quality Improvement and Safety
Essential IV: Translating and Integrating Scholarship into
Practice
Health Delivery Systems Competencies
NR661 Professional Portfolio Part 2 Examples
The following are excerpts from prior students’ work to provide
examples of what we are looking for in
this assignment. These examples may not be replicated.
SAMPLE OF ONE EXEMPLAR (STUDENT A)

10 ExemplarsExemplar I NR503 Population Health, Epidemiology & .docx

10 ExemplarsExemplar I NR503 Population Health, Epidemiology & .docx

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