course materials

1. NURS 6512 – Assessment Tools and Diagnostic Tests
NURS 6512 – Assessment Tools and Diagnostic TestsNURS 6512 – Assessment Tools and
Diagnostic Tests DQ1Assessment Tools and Diagnostic TestsWhen seeking to identify a
patient’s health condition, advanced practice nurses can use a diverse selection of
diagnostic tests and assessment tools; however, different factors affect the validity and
reliability of the results produced by these tests or tools. Nurses must be aware of these
factors in order to select the most appropriate test or tool and to accurately interpret the
results.In this Discussion, you will consider the validity and reliability of different
assessment tools and diagnostic tests. You will explore issues such as sensitivity, specificity,
and positive and negative predictive values.ORDER COMPREHENSIVE SOLUTION PAPERS
ON NURS 6512 – Assessment Tools and Diagnostic TestsTo prepare:Review this week’s
Learning Resources, and consider the factors that impact the validity and reliability of
various assessment tools and diagnostic tests.Select one of the following assessment tools
or diagnostic tests to explore for the purposes of this Discussion:MammogramPhysical tests
for sore throat (inspecting the throat, palpating the head and neck lymph nodes, listening to
breath sounds)Prostate-specific antigen (PSA) testDix-Hallpike testBody-mass index (BMI)
using waist circumference for adultsSearch the Walden Library and credible sources for
resources explaining the tool or test you selected. What is its purpose, how is it conducted,
and what information does it gather?Examine the literature and resources you located for
information about the validity and reliability of the test or tool you selected. What issues
with sensitivity, specificity, and predictive values are related to the test or tool?Are there
any controversies or issues related to any of these tests or tools?Consider any ethical
dilemmas that could arise by using these tests or tools.By Day 3Post a description of how
the assessment tool or diagnostic test you selected is used in health care. Based on your
research, evaluate the test or the tool’s validity and reliability, and explain any issues with
sensitivity, reliability, and predictive values. Include references in appropriate APA
formatting.Read a selection of your colleagues’ responses.By Day 6Respond to at least one
of your colleagues who selected a different tool or test than you, using one or more of the
following approaches:Critique your colleague’s evaluation of the validity and reliability of
the tool or test selected.Suggest alternative or additional tools or tests that should be
considered when gathering information about specific conditions or
symptoms.DQ2Diversity and Health AssessmentsIn May 2012, Alice Randall wrote an
article for The New York Times on the cultural factors that encouraged black women to
maintain a weight above what is considered healthy. Randall explained—from her

2. observations and her personal experience as a black woman—that many African-American
communities and cultures consider women who are overweight to be more beautiful and
desirable than women at a healthier weight. As she put it, “Many black women are fat
because we want to be” (Randall, 2012).Randall’s statements sparked a great deal of
controversy and debate; however, they emphasize an underlying reality in the health care
field: different populations, cultures, and groups have diverse beliefs and practices that
impact their health. Nurses and health care professionals should be aware of this reality and
adapt their health assessment techniques and recommendations to accommodate
diversity.In this Discussion, you will consider different socioeconomic, spiritual, lifestyle,
and other cultural factors that should be taken into considerations when building a health
history for patients with diverse backgrounds.Case 1Subjective DataCC: “I came for my
annual physical exam, but do not want to be a burden to my daughter.”History of Present
Illness (HPI): At-risk 86-year-old Asian male – who is physically and financially dependent
on his daughter, a single mother who has little time or money for her father’s health
needs.PMH: hypertension (HTN), gastroesophageal reflux disease (GERD), b12 deficiency
and chronic prostatitisPSH: S/P cholecystectomyDrug Hx:Current Meds: Lisinopril 10mg
daily, Prilosec 20mg daily, B12 injections monthly, and cipro 100mg daily.Review of
Systems (ROS)General: + weight loss of 25 lbs over the past year; no recent fatigue, fever or
chills.Head, eyes, ears, nose & throat (HEENT): no changes in vision or hearing, no difficulty
chewing or swallowing.Neck: no pain or injuryRespiratory:CV:GI:GU: no urinary hesitancy
or change in urine streamIntegument: multiple bruises on his upper arms and
back.MS/Neuro: + falls x 2 within the last 6 months; no syncopal episodes or
dizzinessPsych:Objective DataPE: B/P 188/96; Pulse 89; RR 16; Temp 99.0; Ht 5,6; wt 110;
BMI 17.8HEENT: Atraumatic, normocephalic, PERRLA, EOMI, arcus senilus bilaterally,
conjunctiva and sclera clear, nares patent, ornasopharynx clear, edentulous.Lungs: CTA
AP&LCor: S1S2 without rub or gallopAbd: benign, normoactive bowel sounds x 4Ext: no
cyanosis, clubbing or edemaIntegument: multiple bruises in different stages of healing – on
his upper arms and back.Neuro: No obvious deformities, CN grossly intact II-XIICase
2Subjective DataCC: “I am here for my annual physical exam and have been having vaginal
discharge.”History of Present Illness (HPI): 32-year-old pregnant lesbian – her pregnancy
has been without complication thus far. She has been receiving prenatal care from an
obstetrician. She received sperm from a local sperm bank.Drug Hx:Current Medications:
prenatal vitamins and takes Tylenol over the counter for aches and pains on occasionFamily
Hx: She a strong family history of diabetes. Gravida 1; Para 0; Abortions 0.Review of
Systems (ROS)General: no fatigue, fever or chills.Head, eyes, ears, nose & throat
(HEENT):Neck: no pain or injuryRespiratory:CV:GI:GU:Integument: multiple piercings, and
tattoos. Old scars related to “cutting”.Neuro: no syncopal episodes or dizziness, no change in
memory or thinking patterns; no twitches or abnormal movementsObjective DataPE: B/P
128/76; Pulse 83; RR 16; Temp 99.0; Ht 5,6; wt 128; BMI 20.98HEENT: Atraumatic,
normocephalic, PERRLA, EOMI, conjunctiva and sclera clear; nares patent, ornasopharynx
clear, good dentition. Piercing in her right nostril and lower lip.Lungs: CTA AP&LCor: S1S2
without rub or gallopAbd: benign, normoactive bowel sounds x 4GU: external genitalia
intact, no lesions or masses. White copious discharge with an amine odor; no cervical

3. motion tenderness; adenxa intact.Ext: no cyanosis, clubbing or edemaIntegument: intact
without lesions masses or rashes.Neuro: No obvious deficits and CN grossly intact II-XIICase
3Subjective DataCC: “Annual physical exam”History of Present Illness (HPI): 23-year-old
Native American male comes in to see you because he has been having anxiety and wants
something to help him. He has been smoking “pot” and says he drinks to help him too. He
tells you he is afraid that he will not get into Heaven if he continues in this lifestyle.Drug
Hx:Current medication – deniedAllergies: no allergies to food or medications.Family
history: is very positive for diabetes, hypertension, and alcoholism.Review of Systems
(ROS)General: no recent weight gains of losses, fatigue, fever or chills.Head, eyes, ears, nose
& throat (HEENT):Neck:Respiratory:CV: no chest discomfort or
palpitationsGI:GU:Integument: history of eczema – not activeMS/Neuro: no syncopal
episodes or dizziness, no change in memory or thinking patterns; no twitches or abnormal
movementsPsych:Objective DataPE: B/P 158/90; Pulse 88; RR 18; Temp 99.2; Ht 5,7; wt
208; BMI 32.6General: 23 year old male appears well developed and well nourished. He is
anxious – pacing in the room and fidgeting, but in no acute distress.HEENT: Atraumatic,
normocephalic, PERRLA, EOMI, sclera with mild icterus, nares patent, ornasopharynx clear,
poor dentition – multiple carries.Lungs: CTA AP&LCor: S1S2, +II/VI holosystolic murmur;
without rub or gallopAbd: benign, normoactive bowel sounds x 4; Hepatomegaly 2cm below
the costal margin.Ext: no cyanosis, clubbing or edemaIntegument: intact without lesions
masses or rashes.Neuro: No obvious deficits and CN grossly intact II-XIITo prepare:Reflect
on your experiences as a nurse and on the information provided in this week’s Learning
Resources on diversity issues in health assessments.Select one of the three case studies.
Reflect on the provided patient information.Reflect on the specific socioeconomic, spiritual,
lifestyle, and other cultural factors related to the health of the patient you selected.Consider
how you would build a health history for the patient. What questions would you ask, and
how would you frame them to be sensitive to the patient’s background, lifestyle, and
culture? Develop five targeted questions you would ask the patient to build his or her health
history and to assess his or her health risks.Think about the challenges associated with
communicating with patients from a variety of specific populations. What strategies can you
as a nurse employ to be sensitive to different cultural factors while gathering the pertinent
information?By Day 3Post an explanation of the specific socioeconomic, spiritual, lifestyle,
and other cultural factors associated with the patient you selected. Explain the issues that
you would need to be sensitive to when interacting with the patient, and why. Provide at
least five targeted questions you would ask the patient to build his or her health history and
to assess his or her health risks.Read a selection of your colleagues’ responses.By Day
6Respond on or before Day 6 to at leastone of your colleagues who selected a different
patient than you, using one or more of the following approaches:Suggest additional
socioeconomic, spiritual, lifestyle, and other cultural factors related to the patient.Critique
your colleague’s targeted questions, and explain how the patient might interpret these
questions. Explain whether any of the questions would apply to your patient, and why.