COURSE:
NR509: Advanced physical assessment
General Instructions
Some clients present specific challenges during the interview and physical examination. Nurse practitioners (NPs) must be able to identify behaviors that impede the assessment and consider strategies to communicate effectively with these clients. This week, you will create a scenario that could occur in NP practice in which a client displays a challenging behavior as assigned below.
Your topic is assigned based on the first letter of your first name. For example, if your first name is Grant then your assigned topic is communicating with a flirtatious client.
| The First Letter of Your First Name | Topic |
| A – D | Argumentative client |
| E – H | Flirtatious client |
| I – L | Talkative client |
| M – P | Client who displays racist or discriminatory behavior |
| Q – T | Adolescent client who is reluctant to answer questions |
| U – Z | Violent client |
Include the following sections (detailed criteria listed below and in the grading rubric):
- Application of Course Knowledge: Answer all questions/criteria with explanations and detail.
- Create a scenario depicting an interaction between an NP and a client. Describe the setting and type of encounter.
- Describe the client’s challenging behaviors related to the topic assigned.
- Examine the potential impact of the client’s behavior on the client-provider relationship.
- Analyze techniques to enhance communication with the client and address the client’s behavior.
- Create sample documentation for the encounter.
- Integration of Evidence: Integrate relevant scholarly sources as defined by program expectations.
- Cite a scholarly source in the initial post.
- Cite a scholarly source in one faculty response post.
- Cite a scholarly source in one peer post.
- Accurately analyze, synthesize, and/or apply principles from evidence with no more than one short quote (15 words or less) for the week.
- Include a minimum of two different scholarly sources per week. Cite all references and provide references for all citations.
- Engagement in Meaningful Dialogue: Engage peers and faculty by asking questions, and offering new insights, applications, perspectives, information, or implications for practice:
- Peer Response: Respond to at least one peer on a topic other than the initially assigned topic.
- Faculty Response: Respond to at least one faculty post.
- Communicate using respectful, collegial language and terminology appropriate to advanced nursing practice.
- Professionalism in Communication: Communicate with minimal errors in English grammar, spelling, syntax, and punctuation.
- Reference Citation: Use current APA format to format citations and references and is free of errors.
- Wednesday Participation Requirement: Provide a substantive response to the graded discussion topic (not a response to a peer or faculty), by Wednesday, 11:59 p.m. MT of each week.
- Total Participation Requirement: Provide at least three substantive posts (one to the initial question or topic, one to a student peer, and one to a faculty question) on two different days during the week.
Solution
a) Create a scenario depicting an interaction between an NP and a client. Describe the setting and type of encounter.
23-year-old female patient presents to the primary care clinic for a sick visit with her primary care provider. The patient’s general complaint is flu like symptoms for three weeks. The patient is presenting wanting a refill on a bottle of Omeprazole that has another patient’s name clearly labeled on the bottle stating that the medication has improved her symptoms. When the nurse practitioner tries to educate patient on the medication and the need for further testing the patient becomes argumentative and refuses any further care or advice from the provider and becomes verbally abusive and eventually leaves the clinic stating she will go elsewhere to get medications to treat her symptoms.
b) Describe the client’s challenging behaviors related to the topic assigned.
This patients argumentative and verbal escalation can make not only accessing this patient, but also caring for this patient very trying and difficult for the providers and………………………………………………….$5