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assessment

NUR2092 WRITE-UP—HEALTH HISTORY
Classroom Assignment Week Two

Date __________________________ Examiner ______________________

1. Biographic Data Name _______________________________________________ Phone________________________ Address____________________________________________________________________________ Birthdate ________________________________ Birthplace _________________________________ Age __________ Gender __________ Marital Status ______________ Occupation _______________ Race/ethnic origin __________________________________ Employer ________________________

2. Source and Reliability

3. Reason for Seeking Care

4. Present Health or History of Present Illness

Past Health

Describe general health ______________________________________________________________ Childhood illnesses __________________________________________________________________ Accidents or injuries (include age) ______________________________________________________ Serious or chronic illnesses (include age) ________________________________________________ Hospitalizations (what for? location?) ____________________________________________________ Operations (name procedure, age) ______________________________________________________
Obstetric history: Gravida ____________ Term ____________ Preterm ____________ (# Pregnancies)
(# Term pregnancies) (# Preterm pregnancies)
Ab/incomplete _____________________ Children living _____________________ (# Abortions or miscarriages) _____

Course of pregnancy__________________________________________________________________ (Date delivery, length of pregnancy, length of labor, baby’s weight and sex, vaginal delivery or cesarean section, complications, baby’s condition)
Immunizations_____________________________________________________________________

Last examination date: Physical ________________

Dental ________________ Vision ________________ Allergies _________________________________ Reaction __________________________________

Current medications _________________________________________________________________ _

6. Family History—Specify Which Relative(s)

Heart disease___________________________ High blood pressure______________________ Stroke_________________________________ Diabetes_______________________________

Blood disorders_________________________ Breast or ovarian cancer___________________

Cancer (other)__________________________ Sickle cell______________________________ Arthritis_______________________________
Allergies_______________________________ Asthma _______________________________ Obesity________________________________ Alcoholism or drug addiction ______________

Mental illness ___________________________ Suicide ________________________________

Seizure disorder ________________________ Kidney disease __________________________ Tuberculosis _____

Review of Systems (Circle/highlight both past health problems that have been resolved and current problems, including date of onset.)

General Overall Health State: Present weight (gain or loss, period of time, by diet or other factors), fatigue, weakness or malaise, fever, chills, sweats or night sweats

Skin: History of skin disease (eczema, psoriasis, hives), pigment or color change, change in mole, excessive dryness or moisture, pruritus, excessive bruising, rash or lesion

Hair: Recent loss, change in texture

Nails: Change in shape, color, or brittleness

Health Promotion: Amount of sun exposure, method of self-care for skin and hair

Head: Any unusually frequent or severe headache, any head injury, dizziness (syncope), or vertigo

Eyes: Difficulty with vision (decreased acuity, blurring, blind spots), eye pain, diplopia (double vision), redness or swelling, watering or discharge, glaucoma or cataracts

Health Promotion Eyes: Wears glasses or contacts, last vision check or glaucoma test, how coping with loss of vision, if any

Ears: Earaches, infections, discharge and its characteristics, tinnitus, or vertigo

Health Promotion Ears: Hearing loss, hearing aid use, how loss affects daily life, any exposure to environmental noise, method of cleaning ears

Nose and Sinuses: Discharge and its characteristics, any unusually frequent or severe colds, sinus pain, nasal obstruction, nosebleeds, allergies or hay fever, or change in sense of smell

Mouth and Throat: Mouth pain, frequent sore throat, bleeding gums, toothache, lesion in mouth or tongue, dysphagia, hoarseness or voice change, tonsillectomy, altered taste

Health Promotion/Mouth & Throat: Pattern of daily dental care, use of prostheses (dentures, bridge), and last dental checkup

Neck: Pain, limitation of motion, lumps or swelling, enlarged or tender nodes, goiter

Breast: Pain, lump, nipple discharge, rash, history of breast disease, any surgery on breasts Axilla: Tenderness, lump or swelling, rash

Health Promotion Breast: Performs breast self-examination, including frequency and method used, last mammogram and results

Respiratory System: History of lung disease (asthma, emphysema, bronchitis, pneumonia, tuberculosis), chest pain with breathing, wheezing or noisy breathing, shortness of breath, how much activity produces shortness of breath, cough, sputum (color, amount), hemoptysis, toxin or pollution exposure Health Promotion Respiratory: Last chest x-ray examination

Cardiovascular System: Precordial or retrosternal pain, palpitation, cyanosis, dyspnea on exertion (specify amount of exertion it takes to produce dyspnea), orthopnea, paroxysmal nocturnal dyspnea, nocturia, edema, history of heart murmur, hypertension, coronary artery disease, anemia

Health Promotion Cardiovascular: Date of last ECG or other heart tests and results

Peripheral Vascular System: Coldness, numbness and tingling, swelling of legs (time of day, activity), discoloration in hands or feet (bluish red, pallor, mottling, associated with position, especially around feet and ankles), varicose veins or complications, intermittent claudication, thrombophlebitis, ulcers Health Promotion Peripheral Vascular: If work involves long-term sitting or standing, avoid crossing legs at the knees; wear support hose.

Gastrointestinal System: Appetite, food intolerance, dysphagia, heartburn, indigestion, pain (associated with eating), other abdominal pain, pyrosis (esophageal and stomach burning sensation with sour eructation), nausea and vomiting (character), vomiting blood, history of abdominal disease (ulcer, liver or gallbladder, jaundice, appendicitis, colitis), flatulence, frequency of bowel movement, any recent change, stool characteristics, constipation or diarrhea, black stools, rectal bleeding, rectal conditions, hemorrhoids, fistula)

Health Promotion Gastrointestinal: Use of antacids or laxatives

Urinary System: Frequency, urgency, nocturia (the number of times awakens at night to urinate, recent change), dysuria, polyuria or oliguria, hesitancy or straining, narrowed stream, urine color (cloudy or presence of hematuria), incontinence, history of urinary disease (kidney disease, kidney stones, urinary tract infections, prostate); pain in flank, groin, suprapubic region, or low back

Health Promotion Urinary: Measures to avoid or treat urinary tract infections, use of Kegel exercises

Male Genital System: Penis or testicular pain, sores or lesions, penile discharge, lumps, hernia

Health Promotion Male Genital: Perform testicular self-examination? How frequently?

Female Genital System: Menstrual history (age at menarche, last menstrual period, cycle and duration, any amenorrhea or menorrhagia, premenstrual pain or dysmenorrhea, intermenstrual spotting), vaginal itching, discharge and its characteristics, age at menopause, menopausal signs or symptoms, postmenopausal bleeding.

Health Promotion Female Genital: Last gynecologic checkup, last Pap test and results

Sexual Health: Presently in a relationship involving intercourse? Are aspects of sex satisfactory to you and partner, any dyspareunia (for female), any changes in erection or ejaculation (for male), use of contraceptive, is contraceptive method satisfactory? Use of condoms, how frequently? Aware of any contact with partner who has sexually transmitted infection (gonorrhea, herpes, chlamydia, venereal warts, HIV/AIDS, syphilis)?

Musculoskeletal System: History of arthritis or gout. In the joints: pain, stiff-ness, swelling (location, migratory nature), deformity, limitation of motion, noise with joint motion. In the muscles: any pain, cramps, weakness, gait prob-lems or problems with coordinated activities. In the back: any pain (location and radiation to extremities), stiffness, limitation of motion, or history of back pain or disk disease.

Health Promotion Musculoskeletal: How much walking per day? What is the effect of limited range of motion on daily activities, such as on grooming, feeding, toileting, dressing? Any mobility aids used?

Neurologic System: History of seizure disorder, stroke, fainting, blackouts. In motor function: weakness, tic or tremor, paralysis, coordination problems. In sensory function: numbness and tingling (paresthesia). In cognitive function: memory disorder (recent or distant, disorientation). In mental status: any nervousness, mood change, depression, or any history of mental health dysfunction or hallucinations.

Hematologic System: Bleeding tendency of skin or mucous membranes, excessive bruising, lymph node swelling, exposure to toxic agents or radiation, blood transfusion and reactions.
Endocrine System: History of diabetes or diabetic symptoms (polyuria, polydipsia, polyphagia), history of thyroid disease, intolerance to heat or cold, change in skin pigmentation or texture, excessive sweating, relationship between appetite and weight, abnormal hair distribution, nervousness, tremors, need for hormone therapy.

Functional Assessment (Including Activities of Daily Living)

Self-Esteem, Self-Concept: Education (last grade completed, other significant training) ______________

Financial status (income adequate for lifestyle and/or health concerns) __________

Value-belief system (religious practices and perception of personal strengths) ___________

Self-care behaviors ______________________

Activity and Exercise: Daily profile, usual pattern of a typical day ________________________________

Independent or needs assistance with ADLs, feeding, bathing, hygiene, dressing, toileting, bed-to-chair transfer, walking, standing, climbing stairs _________________________________

Leisure activities ________________________________________

Exercise pattern (type, amount per day or week, method of warm-up session, method of monitoring

Sleep and Rest: Sleep patterns, daytime naps, any sleep aids used ___________________

Nutrition and Elimination: Record 24-hour diet recall. _______________________________________ _____________________________________________________________________________________

Is this menu pattern typical of most days? ___________________________________________________

Who buys food? ____________________________

Who prepares food? __________________________

Finances adequate for food? __________________________________

Who is present at mealtimes? __________________________________

Interpersonal Relationships and Resources: Describe own role in family _________________________

How getting along with family, friends, co-workers, classmates ______________________

Get support with a problem from? ______________________________________________

How much daily time spent alone? _______________________________________________________ Is this pleasurable or isolating? ___________________________________________________________

Coping and Stress Management: Describe stresses in life now __________________________________ _____________________________________________________________________________________ Change(s) in past year ______________________________________________

Methods used to relieve stress _______________________

Are these methods helpful? ___________________________

Personal Habits:

Daily intake caffeine (coffee, tea, colas) ______________________________________

Smoke cigarettes? ____________________________ Number packs per day ______________

Daily use for how many years __________________ Age started ___________

Ever tried to quit? ____________________________ How did it go? _____________________________

Drink alcohol? ____________________ Date of last alcohol use _______

Amount of alcohol that episode __________________________________________________________

Out of last 30 days, on how many days had alcohol? ____________________________________

Ever told had a drinking problem? ________________________________________________________ Any use of street drugs? ___________Marijuana? _________________________________

Cocaine? __________________________________ Crack cocaine? ______________________________ Amphetamines? _____________________________ Heroin? __________________

Prescription painkillers? _____________________ Barbiturates? _______________________________ LSD? _____________________________________

Ever been in treatment for drugs or alcohol? ________________________________________________

Environment and Hazards: Housing and neighborhood (type of structure, live alone, know neighbors) _____________________________________________________________________________________

Safety of area _________________________________________________________________________ Adequate heat and utilities ____________________________________________________________

Access to transportation ____________________________________________________________

Involvement in community services _______________________________________________________ Hazards at workplace or home ___________________________________________________________ Use of seatbelts ____________________________________________________________________

Travel to or residence in other countries ___________________________________________________ Military service in other countries ________________________________________________________ Self-care behaviors _____________________________________________________________________ Intimate Partner Violence: How are things at home? Do you feel safe? __________________

Ever been emotionally or physically abused by your partner or someone important to you___-

Ever been hit, slapped, kicked, pushed, or shoved or otherwise physically hurt by your partner or ex-partner? _____________________________________________________________________________________ Partner ever force you into having sex? ____________________________________________________ Are you afraid of your partner or ex-partner? ________________________________

Occupational Health:

Please describe your job. ______________________________________________

Work with any health hazards (e.g., asbestos, inhalants, chemicals, repetitive motion)? ___________________________________________________________________________________

Any equipment at work designed to reduce your exposure?

Any work programs designed to monitor your exposure? _________________________________

Any health problems that you think are related to your job? _____________________________

What do you like or dislike about your job? _________________________________________________

Perception of Own Health:

How do you define health? ________________________________________

View of own health now ________________________________________________________________

What are your concerns? ________________________________________________________________

What do you expect will happen to your health in future? _______________________

Your health goals ______________________________________________________________________

Your expectations of nurses, physicians ___________________________________________________

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Table of Contents

Physical Examination and Health Assessment

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Physical Examination and Health Assessment
Carolyn Jarvis

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  • Cover imagecover
  • Title Pageiii
  • Table of Contentsxix
  • Chapter OrganizationIFC2

  • Copyrightiv
  • Dedicationv
  • About the Authorvii
  • Contributorsix
  • Reviewersxi
  • Prefacexiii
  • Acknowledgmentsxvii
  • Unit 1 Assessment of the Whole Personxviii

    • Chapter 1 Evidence-Based Assessment1

    • Chapter 2 Cultural Assessment11

    • Chapter 3 The Interview23

    • Chapter 4 The Complete Health History45

    • Chapter 5 Mental Status Assessment63

    • Chapter 6 Substance Use Assessment85

    • Chapter 7 Domestic and Family Violence Assessment99

  • Unit 2 Approach to the Clinical Setting112

  • Unit 3 Physical Examination196

  • Unit 4 Integration: Putting It All Together766

  • Illustration Credits837
  • Index845
  • Assessment Terms: English and SpanishIBC2
  • Assessment Terms: English and SpanishIBC3

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Assessment

Respond to at least two of your colleagues on 2 different days who were assigned different case studies than you. Analyze the possible conditions from your colleagues’ differential diagnoses. Determine which of the conditions you would reject and why. Identify the most likely condition, and justify your reasoning.

Post 1

Sendy Jean Baptiste 

Ankle pain



COLLAPSE

Top of Form

Patient Information:

GP 46 yo black female


S.

CC Ankle pain

HPI: A 46-year-old female reports pain in both of her ankles, but she is more concerned about her right ankle. She was playing soccer over the weekend and heard a “pop.” She is able to bear weight, but it is uncomfortable. 

           Location: both ankles

Onset: 3 days ago

Character: pressure, aching.

Associated signs and symptoms: pain,

Timing: while playing soccer over the weekend, she heard a pop.

Exacerbating/ relieving factors: Acetaminophen makes the pain better from 7/10 to 4/10

Severity: 4/10 pain scale

Current Medications: Acetaminophen 650 mg OTC for the past 3 days. Daily multivitamins OTC

Allergies: NKA

PMHx: sprained right ankle last July 2021, UTD on immunizations, covid vaccine #1 7/19/2021 Pfizer; Covid vaccine #2 9/01/2021 Pfizer

Soc Hx: Single with 3 children 2 boys (twins) 18 yo and a girl 16 yo. High school PE class trainer. Denies smoking, drinks a glass of wine occasionally. Loves playing sports and loves to travel with family.

Fam Hx: Dad decease in a car accident 12 years ago, mom has a history of HTN and hyperlipidemia, both paternal grandfather and paternal grandmother died of cancer. The maternal grandmother has a history of hypertension and hyperlipidemia, the maternal grandfather has a history of CAD, rheumatoid arthritis. All of her children are healthy with no medical issues.

GENERAL:  Denies weight loss, fever, chills, reports weakness and fatigue.

HEENT:  Eyes: Denies visual loss, blurred vision, double vision, or yellow sclerae. Ears, Nose, Throat Denies hearing loss, sneezing, congestion, runny nose, or sore throat.

SKIN:  Denies rash or itching.

CARDIOVASCULAR:  Denies chest pain, chest pressure, or chest discomfort. No palpitations or edema.

RESPIRATORY:  Denies shortness of breath, cough, or sputum.

GASTROINTESTINAL:  Denies anorexia, nausea, vomiting, or diarrhea. No abdominal pain or blood.

GENITOURINARY:  Denies burning on urination. Pregnancy. Last menstrual period unknown.

NEUROLOGICAL:  Denies headache, dizziness, syncope, paralysis, ataxia, numbness, or tingling in the extremities. No change in bowel or bladder control.

MUSCULOSKELETAL:  Ankle pain (both), denies back pain.

HEMATOLOGIC:  Denies anemia, bleeding, or bruising.

LYMPHATICS:  Denies enlarged nodes. No history of splenectomy.

PSYCHIATRIC:  Denies history of depression or anxiety.

ENDOCRINOLOGIC:  Denies reports of sweating, cold, or heat intolerance. No polyuria or polydipsia.

ALLERGIES:  Denies history of asthma, hives, eczema, or rhinitis.


O.

VS: BP 106/82; P 64; R 18; T 96.9; 02 100% Wt 152lbs; Ht 76”

General: Right ankle swollen, unable to walk straight, capillary refill within 3 seconds, no abnormal findings in the left ankle.

 

HEENT: No redness to eyes, Nose clear, symmetric, pink/reddish mucosa. Throat pink, and moist.

SKIN: No signs of rash

CARDIOVASCULAR: no murmurs or abnormal heart sounds auscultated.

RESPIRATORY: No respiratory distress, lungs are clear.

GASTROINTESTINAL: Bowel sounds normoactive, no guarding.

GENITOURINARY: Urine clear and yellow.

NEUROLOGICAL: Cranial nerves present, no sensitivity to light.

MUSCULOSKELETAL: abnormal gait noted due to right ankle injury.

LYMPHATICS: no swelling lymph nodes palpated.

Diagnostic results: X-rays. Doctors use X-rays to rule out a foot fracture or an ankle dislocation. X-rays can also detect arthritis of the foot and the ankle, which can cause pain and swelling.

Anterior drawer test: To assess for ankle instability.

Talar tilt test (or inversion stress maneuver): To assess the integrity of the calcaneofibular ligament

Ottawa Ankle Rules: The Ottawa ankle rules are used to predict whether an x-ray is indicated for a patient presenting with ankle pain. Location of the pain over the malleoli and the ability to bear weight is important in this determination Lau et al. (2018).


A

.

Differential Diagnoses

Ankle Sprain:

According to Dains, J. E., Baumann, L. C., & Scheibel, P. (2019), ankle sprain (Inversion or Eversion) The most common mechanism of ankle injury is an inversion force that stresses the lateral ligamentous support of the joint. The lateral ligaments are of greater length than the medial ligaments and are more predisposed to injury. An audible pop or tear implies a rupture or tear of the ligament. Swelling of the ankle within minutes of injury indicates bleeding and soft tissue trauma. Patients with a ligamentous injury will generally be able to walk and bear weight on the injured foot even though it may be uncomfortable. Examine the injured joint by palpating the course and attachment points of the ligaments and perform joint ROM to test for ligamentous integrity.

Sprains cause minimal to moderate pain, increasing 1 to 2 days after the trauma when the inflammatory process begins. A complete disruption that severs the sensory nerve fibers within the structure will cause little pain, whereas a partial injury irritates sensory fibers, and may produce intense pain.

Achilles tendon rupture:

The Achilles tendon is a strong fibrous cord that connects the back of the calf to the heel. Overstretching this tendon can lead to partial or complete (rupture) tear. It is often an injury in recreational sports. Patients will report a jumping, falling, or stepping injury and hearing a pop followed by a sharp pain in the ankle and difficulty ambulating. The patient will not be able to stand on the toes with the affected limb. Ankle swelling may be present.

Ankle injury:

According to Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019), ankle injuries are defined by the kind of tissue — bone, ligament, or tendon — that’s damaged. The ankle is where three bones meet — the tibia and fibula of your lower leg with the talus of your foot. These bones are held together at the ankle joint by ligaments, which are strong elastic bands of connective tissue that keep the bones in place while allowing normal ankle motion. Tendons attach muscles to the bones to do the work of making the ankle and foot move and help keep the joints stable.

Calcaneus Fracture: A fracture of the calcaneus, or heel bone, can be a painful and disabling injury. This type of fracture commonly occurs during a high-energy event.

Subtalar Dislocation: Subtalar dislocation is the disruption of the articulation of both the talocalcaneal and the talonavicular joints with an intact ankle joint mortis.


P.
  

This section is not required for the assignments in this course (NURS 6512) but will be required for future courses.

References

Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Seidel’s guide to physical examination: An interprofessional approach (9th ed.). St. Louis, MO: Elsevier Mosby.

Dains, J. E., Baumann, L. C., & Scheibel, P. (2019). Advanced health assessment and clinical diagnosis in primary care (6th ed.). St. Louis, MO: Elsevier Mosby.

Lau, B. C., Moore, L. K., & Thuillier, D. U. (2018). Evaluation and management of lateral ankle pain following injury. JBJS Reviews, 6(8), e7-e7. https://doi.org/10.2106/jbjs.rvw.17.00143

Sullivan, D. D. (2019). Guide to clinical documentation (3rd ed.). Philadelphia, PA: F. A. Davis.

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Post 2

Justin Wilt 

Review of case study 3



COLLAPSE

Top of Form

Patient Information:

AB, 15 yo., Caucasian male


S.

CC- “Dull ache in both knees, and sometimes a clicking in the knees.”

HPI: The patient is a 15 yo Caucasian male presenting to the clinic with report of dull pain, which he reports to be a 5/10, in both knees. There is also a click in one or both knees and a catching sensation under the patella. The patient reports difficulty walking and concentrating when the pain and the sounds occur. The symptoms usually express themselves after walking long distances or sometimes standing too long before sitting down, which usually occur in the daytime. The patient takes either 650 mg Tylenol or 500 mg ibuprofen for the pain, depending on which is available. He feels that Tylenol and ibuprofen dull the pain but do not totally alleviate the pain.

Current Medications: Ibuprofen 500 mg and Tylenol 650 mg PRN.

Allergies: NKA

Past medical hx (PMH): No previous medical history to report,

Past surgical hx (PSH)- Patient reports a history of torn rotator cuff.

Soc hx: Patient does not use tobacco products, alcohol, or illicit drugs. He is the starting 140-pound wrestler on his high school team. He lives with his biological parents and has a younger sister (12 yo). He occasionally works for local farmers doing jobs such as bailing hay, mowing, and feeding livestock. He enjoys going to the local mall with his friends to hang out  and skate in the parking lot.

Immunizations- COVID vaccination (Moderna) 10.23/2021, current flu shots.

Fam hx: Father: 38 yo with a history of Osgood-Schlatter disease; Mother: 36 yo with no previous medical history; Sister: 12 yo with no previous medical history; Maternal grandmother obesity, HTN; Maternal grandfather HTN, obesity, knee replacement age 58; Paternal grandmother died of cancer age 63; Paternal grandfather HTN.

ROS:

General:  Patient reports no fatigue, cough, fever, or chills. Denies problems sleeping. He has not had any recent weight loss or appetite change.

HEENT: Patient denies headaches, dizziness, or confusion. Patient denies problems hearing, tinnitus, or discharge. Patient denies issues with vision or itching, dryness, or pain in the eye.  Patient denies epistaxis, pain, or trouble breathing through his nose. Patient denies soreness in throat, difficulty swallowing, or problems talking. Patient has no pain in the mouth, problems chewing, or changes in taste. Patient denies neck pain, stiffness, or limited ROM.

Cardiovascular:  Denies palpitations, chest pain, SOB, or irregular heartbeat.

Respiratory:  Patient denies cough, difficulty breathing, SOB, or dyspnea upon exertion.

Gastrointestinal: Denies N/V. No changes in bowel movement.

Musculoskeletal: Expresses normal ROM.

Psychiatric: Patient has no history or present diagnosis of psychiatric disorders. Denies depression, anxiety, SI or HI.

 

Physical exam:

Vital Signs:

Blood pressure: 118/76

spO2: 100% room air

HR: 62 bpm

Resp. rate: 14

Temp.: 36.8 Celsius

 

HEENT- Patient does not have headaches or altered sensorium. Eyes are clear, moist conjunctiva, no diplopia, does not wear glasses. Ears equilateral, no hearing loss, tinnitus, or abnormalities. Mouth has no lesions, gum abnormalities, tooth decay, or bleeding. Throat is pink, no swelling, and no pain reported.

 

Respiratory- No crackles, rhonchi, or stridor heard during auscultation. Even, unlabored breathing.

 

Cardiovascular- No murmurs, rubs, gallups, or abnormal heart rhythm detected during auscultation.

Gastrointestinal- Normal bowel sounds heard in all quadrants during auscultationKidneys and spleen not palpable.

 

Skin- No lesions, wounds, or lacerations found during assessment. Warm, dry, and intact.

Musculoskeletal- No swelling, pain, or stiffness in the joints. Normal ROM. 

 

Neurological- No neuropathy and neuro checks are normal. Alert and oriented X4. Speaks well.

Diagnostic tests- valgus and varus test (medial and lateral ligament), posterior drawer test (posterior crucial ligament), Lachman test (anterior crucial ligament, anterior drawer test (anterior crucial ligament), pivot shift test (anterior crucial ligament), McMurray test (menisci), arthrometric testing, x-ray, and CT scan.


A

.

Meniscal injury- damage to the knee cartilage that provide cushion between the tibia from the femur. Pain, swelling, and locking of the knee joint are hallmarks of this injury. Usually resolved by rest, ice, pain relievers and sometimes surgery (Kraus et al., 2012).

Medial collateral ligament injury- damage to the ligament locate on the inner side of the knee that usually sounds like a pop. Swelling, pain, and a feeling that the knee may “give way” are hallmarks of this injury. Usually resolved by rest, ice, compression, and elevation (RICE) (Hoetzel et al., 2014).

Anterior crucial ligament injury- tissue that connects the femur to the tibia at the knee. Pain and swelling usually followed by inability to move normally or make sudden twists or turns. If it is a full tear surgical intervention is imminent, otherwise physical therapy may be an option (Kraus et al., 2012).

Osgood-Schlatter disease- affects children with growth spurts, especially active children playing sports. There is usually a painful lump below the kneecap that usually resolves on its own (Jones et al., 2000).

Sinding-Larsen-Johansson syndrome- swelling and irritation of the growth plate at the bottom of the knee characterized by swelling, tenderness around the kneecap, or pain that increases with activity or squatting. Usually treated with ice, OTC medication, or physical therapy (Hoetzel et al., 2014).


P.
  

This section is not required for the assignments in this course (NURS 6512) but will be required for future courses.

 

References

Ball, J.W., Dains, J.E., Flynn, J.A., Solomon, B.S., & Stewart, R.W. (2019). Head and neck: Key

points. In Seidel’s guide to physical examination: An interprofessional approach (9th ed.).

St. Louis, MO: Elsevier Mosby.

Hoetzel, J., Preiss, A., Heitmann, M.A., & Frosch, K.H. (2014). Knee injuries in children and

adolescents. European Journal of Trauma and Emergency Surgery, 40(1), 23-36.

Jones, D., Louw, Q., & Grimmer, K., (2000). Recreational and sporting injury to the adolescent

knee and ankle: Prevalence and causes. Australian Journal of Physiotherapy, 46(3),

179-88.

Kraus, T., Svehlik, M., Singer, G., Schalamon, J., Zwick, E., & Linhart, W. (2012). The

epidemiology of knee injuries in children and adolescents. Archives of orthopaedic and

trauma surgery, 132(6), 773-779.

Bottom of Form

Assessment

Top of Form


Directions:

Explain the positive and negative aspects of the living arrangements for the elderly listed below. Be sure to thoroughly evaluate each option.

1. Living in own home

2. Living with their children

3. Assisted living facility

4. Nursing home with intermediate care

5. Nursing home with skilled nursing care and make recommendations for healthy and disabled elderly

Review the posts made by your classmates and reply to at least two that explored ideas different from your list. Reply to those posts indicating which aspect(s) of their reasoning you found most compelling.

Due dates for your initial and response posts can be found by checking the Course Syllabus and Course Calendar.

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DISCUSSION

Assessment

Katherine Esparra Santiago

16 hours ago, at 9:33 PM

Top of Form

1. Living in own home

There are pros and cons when it comes to elderly people living in their own homes. Financially, it may be beneficial to stay in your own home, feeling comfortable, and even safer given that in a nursing home you are exposed to other people with illnesses. On the negative side, as you get older you begin to lose your memory of things, which can be very dangerous. According to Lucy Lediaev, ” A significant number of seniors notice a decline in memory that may affect their ability to safely carry out household chores. Failure to turn off stoves, heaters, irons, and other appliances that can cause house fires is more common in the elderly.”. Another con would be having someone at all times in case of an accident.

2. Living with their children

The advantages of the elderly living with their children are they won’t feel lonely, they will have someone to monitor them in case of an emergency, and it is also financially better. The disadvantage would be less personal time from both parts and not feeling as comfortable as you would in your own home.

3. Assisted living facility

Living in assisted living has its benefits. The elderly can socialize more and enjoy the company of others while also doing the things you like doing. Living in assisted living also provides physical benefits such as exercising and eating a good diet. It is also beneficial for the family as it gives peace of mind. Although it does have its great benefits, it also has its disadvantages such as negligent care due to the facility being under staff or many rules that restrict you from doing things you like or want to do. This can become very stressful for the patient and the family.

4. Nursing home with intermediate care

A nursing home with intermediate care would be very beneficial to the elderly who have chronic medical conditions that require 24-hour care. This is great, especially for families who unfortunately are not able to dedicate too much of their time to care for their loved ones. This has the same disadvantages as living in assisted living. There may be rules you have to follow and negligence as well.

5. Nursing home with skilled nursing care and make recommendations for healthy and disabled elderly

A nursing home with these benefits could be a huge advantage to the elderly that need this type of extensive care. Especially having access to doctors, nurses, and medication at all times. The disadvantages would be the same as being anywhere other than home. The feeling of loneliness and feeling uncomfortable can cause the elderly to feel stressed or even depressed.

References

Lucy Lediaev. Love to know, Disadvantages of Elderly People Living Alone.https://seniors.lovetoknow.com/disadvantages-elderly-people-living-alone. Accessed 8 March 2022

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Reply

Assessment

Sara Karsten

3/8/22, 11:19 AM

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1. Living in own home:

2. Pros: Berk (2017) states that the individual has the atmosphere of intimacy and loving care in which the ill person is unlikely to feel abandoned or humiliated by physical decline. The elderly’s loved ones get to spend more time together.

3. Cons: Demands of caretakers are higher. Requires a skilled professional to assist with activities of daily living. Most homes are poorly equipped to handle the medical and comfort-care needs of the elderly.

4. Living with their children:

5. Pros: Costs are lower than the elderly living in their own home. Family gets to spend more time with their elderly. If the elderly is physically/mentally capable, they may offer childcare support.

6. Cons: Berk (2017) states that the home will need to be modified to account for hazards, such as dimly lit areas, grab bars and non-slip rugs, and ramps. The main caregiver may become stressed and can suffer from the physical and mental toll of being the caregiver.

7. Assisted living facility:

8. Pros: Elderly receives help with everyday living activities, their rooms can be decorated to make them feel at home, offers plenty of socialization with peers of the same age, offers plenty of scheduled activities to keep residents entertained, less expensive than nursing home.

9. Cons: Reluctance to leave their family home, may not want to abide by facilities policies, may have to share a room, extensive medical care is not available like it would be at a nursing home, monthly costs can be in the thousands and are generally not paid for by Medicaid programs, visitation hours may be limited.

10. Nursing home with intermediate care:

11. Pros: Support under medical direction is provided 24 hours a day, the goal is to enable patients to return home and regain the functions of daily living, provide for greater independence, which increases their quality of life,

12. Cons: More expensive than living at home or with family, since meals are prepared for the residents, elderly have no control over what is offered, ICF’s typically have a larger staff and have higher staff turnover rates, caregiver may be a different person, scheduled visiting hours means less time to socialize with family.

13. Nursing home with skilled nursing care:

14. Pros: a SNF is a short-term rehabilitation center so access to physical or occupational therapy is more readily available, staff is available 24 hours a day, two-person assists are available if needed, a good facility will coordinate medical services, may have access to facilities such as a gym, socialization opportunities.

15. Cons: Medicare programs may only cover a certain amount of days and there may be a copay, visiting hours may limit family socialization, if the elderly has memory loss, the rehabilitation efforts may be difficult.

16. Make recommendations for healthy and disabled elderly:

For a healthy elderly person, I would recommend living at home to maintain their level of comfort. For a disabled elderly person, I would recommend living in an assisted living facility.

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Assessment

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Directions:

Explain the positive and negative aspects of the living arrangements for the elderly listed below. Be sure to thoroughly evaluate each option.

1. Living in own home

2. Living with their children

3. Assisted living facility

4. Nursing home with intermediate care

5. Nursing home with skilled nursing care and make recommendations for healthy and disabled elderly

Review the posts made by your classmates and reply to at least two that explored ideas different from your list. Reply to those posts indicating which aspect(s) of their reasoning you found most compelling.

Due dates for your initial and response posts can be found by checking the Course Syllabus and Course Calendar.

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Assessment

Module 05 Assignment – Menopause

Module 05 Assignment – Menopause

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Module 05 Content

1.

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In a 3-page paper, written in APA format using proper spelling/grammar, research the topic of menopause and address the following:

1. Explain perimenopause, surgical menopause, stress menopause, and postmenopause.

2. Describe the signs of menopause.

3. Which other life changes (e.g., physical, psychosocial, and cognitive) may influence a women’s experience during menopause?

4. Which women are at the highest risk for osteoporosis?

5. Describe the traditional and alternative therapies for the conditions associated with menopause.

6. Suggest appropriate health, nutrition, and exercise guidelines for middle-aged and older adults.

Be sure to include APA citations for any resources you used as references.

Rasmussen’s Library and Learning Services team has developed a variety of Guides to help support students’ academic endeavors. For this assignment, the Writing Guide and APA Guide may both be helpful. Also consider submitting each assignment to the online Writing Lab for feedback on your draft prior to submitting it for grading. You will find links to these Guides as well as other writing resources and services on the Resources tab.

Submit your completed assignment to the drop box below. Please check the Course Calendar for specific due dates.

Save your assignment as a Microsoft Word document. (Mac users, please remember to append the “.docx” extension to the filename.) The name of the file should be your first initial and last name, followed by an underscore and the name of the assignment, and an underscore and the date. An example is shown below:

Jstudent_exampleproblem_101504

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Week 5 Assignment Rubric.docx

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Submission

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Assessment

Module 05 Content

1.

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Depression in later life is usually diagnosed on the basis of two clusters of symptoms: feelings and physical changes. In a 3-page paper, written in APA format using proper spelling/grammar, research the topic of depression in the elderly and address the following:

1. How would one know if an elderly relative had clinical depression or was sad because of specific life changes and losses?

2. What are the consequences of depression in the elderly?

3. Which behaviors would indicate a person going through depression needs therapy?

4. What kind of therapy would a professional recommend and why?

Be sure to include APA citations for any resources you used as references.

Rasmussen’s Library and Learning Services team has developed a variety of Guides to help support students’ academic endeavors. For this assignment, the Writing Guide and APA Guide may both be helpful. Also consider submitting each assignment to the online Writing Lab for feedback on your draft prior to submitting it for grading. You will find links to these Guides as well as other writing resources and services on the Resources tab.

Submit your completed assignment to the drop box below. Please check the Course Calendar for specific due dates.

Save your assignment as a Microsoft Word document. (Mac users, please remember to append the “.docx” extension to the filename.) The name of the file should be your first initial and last name, followed by an underscore and the name of the assignment, and an underscore and the date. An example is shown below:

Jstudent_exampleproblem_101504

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Assessment

Work with your preceptor to perform a needs assessment of the organization and community for your practicum. Review the needs assessment to identify possible project topics. In preparation for the capstone change project proposal, compile a list of three to five possible topics for your project 

Assessment

 a short reflection summarizing what you learned from the assessment and how you will leverage the results in mapping your career plans. 

Assessment

Focus 2 Portfolio

Texas A&M University San Antonio

Shawn Simon

03/18/2022

My Career Planning Involvement
Completion Date March 9, 2022

Self Assessment Score
3.83

Self Assessment is the first and most important step in career planning and is
used to identify occupations and major study areas compatible with your
personal attributes. Your high self assessment score indicates that you are
very involved in examining your interests, values, personality, and skills. It is
important that you stay actively involved in self assessment because finding a
satisfying career path begins with knowing yourself.

Career Exploration Score
3.83

Career Exploration is important because learning about types of jobs,
educational requirements, and job functions will help you to identify
occupations that appeal to you. Your high score indicates that you are very
involved in career exploration. It is important that you continue your high
involvement in career exploration because it will help you narrow down your
options and map out your career goals. Exploration should be ongoing
because new career paths are constantly unfolding, traditional ones are
changing and shifts may be taking place in skills and educational
requirements.

Career Planning Satisfaction Score
3.50

Career Planning Satisfaction measures the extent to which you are satisfied
with the results of your career planning activities and your ability to resolve
problems that can interfere with your decision making. Your medium score
suggests you may be experiencing some problems with your career planning.
If you think you are not able to resolve problems of concern on your own, you
should discuss them with a career counselor.

My Academic Strengths
Completion Date March 11, 2022

“I do very well” in the following: Performing Arts (Dance, Drama, Music); Physical Education; Physical

Sciences (Chemistry, Geology, Physics, Astronomy); Social Sciences
(Psychology, Philosophy, Religion); Skilled Trades/Vocational;

“I do alright” in the following: Art (Fine, Visual, Studio, Design); Business (Management, Marketing,
Economics); English and Language Arts; Family and Consumer Science
(Food Science, Hospitality, Child Care); Life Science (Biology, Environmental
Sciences, Ecology); Social Studies (History, Global Studies,
Government); Technology (Computer Science, Web Design, Media
Technology);

“I don’t do well” in the following: Engineering; Foreign Languages; Literature; Mathematics;

Am I Career Ready
Completion Date March 11, 2022

CRITICAL THINKING Moderately Developed
Participate in research projects.
Practice making step by step plans to solve problems.
Brainstorm various ways you could solve a problem.
Ask yourself, “What’s missing here?” when analyzing a situation.
Ask questions. Avoid accepting ideas as fact.
Practice gathering information that will help you solve problems.
Monitor your emotions during decision making.
Participate in class discussions and debates.
Join a club that engages in problem solving activities such as debate, robotics, chess, entrepreneurial club, etc.

COMMUNICATION Moderately Developed
Take a variety of writing classes such as Technical Writing and Creative Writing.
Proofread your papers to avoid errors.
Practice your interviewing skills. Complete a mock interview in the Career Center.
Get your professional job and graduate school documents reviewed in the Career Center.
Ask for feedback about your writing and public speaking.
Take a speech or public speaking class.
Record your voice. Eliminate “filler words” such as “um” and “like.”
Review and clean up your social media accounts–employers will check these.
Video tape or watch yourself in a mirror yourself speaking on a topic then watch it to assess your verbal and
non-verbal strengths and areas for improvement.

TEAMWORK Very Highly Developed
Work with your teammates to develop guidelines of each team member’s responsibilities.
Practice being respectful of people’s viewpoints even if you do not agree with them.
Respectfully and professionally address any issues regarding team members’ contributions and work load.

TECHNOLOGY Moderately Developed
Use online tutorials to expand knowledge of software used in your industry/career area.
Use an online calendar such as Microsoft or Google to keep up with all appointments, meetings, classes, tests,
and due dates.
Learn how to use Microsoft Excel effectively.
Create a LinkedIn profile and use LinkedIn regularly. Seek out social media responsibilities in a student
organization.
Take a computer & digital literacy class or Intro to computer Information systems class.
Look for opportunities in internships and jobs that use new technology.
Put your digital resume on LinkedIn and explore the information LinkedIn sends back to you based on your likes
and interests.
Practice using technology tools to develop presentations, communicate on-line and coordinate group projects.
Research what tools & technologies are important for your specific field of study.

LEADERSHIP Very Highly Developed
Take on leadership responsibilities in a club, work, internship or student group.
Seek a leadership role in a student organization.
Take a Leadership class.
Run for a campus office or become an officer of a campus club or organization.
Understand your preferred leadership style.
Seek opportunities to learn from people you see as leaders and use those lessons to hone your own leadership.
Assess yourself on a team. Identify ways you can be a better leader by understanding those around you.

PROFESSIONALISM Very Highly Developed

CAREER & SELF-DEVELOPMENT Moderately Developed

EQUITY & INCLUSION Very Highly Developed

Work Interest Assessment
Completion Date March 9, 2022

Social
The Helpers

Prefer to work with others with the team approach to problem solving.
Enjoy teaching, caring for others, volunteering, mediating disputes, meeting
new people, and working in groups.
Highly verbal, express themselves well, and get along well in groups.
Describe themselves as cooperative, friendly, and understanding.

Investigative
The Thinkers

Have a strong desire to understand cause and effect and solve puzzles and
problems.
Often work in jobs that are scientific in nature. Their work often involves the
analysis of data, using formulas, graphs and numbers.
Enjoy using computers, solving math problems, interpreting formulas, and
thinking abstractly.
Prefer to work independently with minimum supervision.

Enterprising
The Persuaders

Enjoy selling and promoting, having power and status, giving talks and
speeches, and leading groups.
Enjoy influencing others and being in a leadership position.
Often use their skills to influence others.
Often enjoy discussing politics and competitive activities. Self-confident,
talkative and energetic.

Values Assessment
Completion Date March 9, 2022

Personality Assessment
Completion Date March 9, 2022

Your Personality Type You focus your attention on practical issues and look at the realities of a situation.

S Social
The Helpers

I Investigative
The Thinkers

E Enterprising
The Persuaders

Helping Others
Being involved in helping other people in a direct way either individually or in a small group.

Independence
Being able to decide on how to get something done without significant direction from someone else.

Stability
Having a routine job where the duties are very predictable and not likely to change over a long period of
time.

Your Personality Type You focus your attention on practical issues and look at the realities of a situation.
You make decisions using logic as opposed to your feelings.
You are enthusiastic about new activities that offer you real-life, hands-on experiences.
You are flexible, spontaneous, and like to keep your options open.
You like to start new projects, and have a knack for coming up with solutions that
satisfy everyone who is involved.

Choosing Your Career:

People with your personality type are most attracted to occupations that deal with practical matters, require action,
problem solving and flexibility. Examples of such occupations can be found in fields such as engineering, applied
technologies, business administration, law enforcement, production and construction.

Skills Assessment
Completion Date March 9, 2022

Leisure Interest Assessment
Completion Date March 9, 2022

Reality
The Doers

Prefer hands-on activities, and tend to focus on things in the physical world.
Enjoy working with tools or machines, and often gravitate to toward careers
that can be performed outdoors.
Often described as being frank, genuine, humble, practical, natural, and
persistent

Sharing
The Helpers

Enjoy helping and advising people.
Tend to be concerned about peoples’ welfare.
Promote learning and personal development and are very interested in human
relationships.
Often described as being helpful, responsible, warm, cooperative, idealistic,
sociable, tactful, friendly, kind, sympathetic, generous, patient, and
understanding.

Inquiring
The Thinkers

Like to be involved in activities that have to do with ideas and thinking and
search for facts and figure out problems mentally.
Like to observe, learn, investigate, analyze, evaluate, or solve problems.
Prefer working with ideas rather than with people or things.
Often described as being analytical, curious, methodical, rational, cautious,
independent, precise, reserved, complex, intellectual, and modest.

Helping
Actively looking for ways to help people.

Reasoning
Using logic to identify the strengths and weaknesses of alternative solutions, conclusions or approaches to
problems.

Social Perceptiveness
Being aware of the reactions of others, and understanding why they react the way they do.

R Reality
The Doers

S Sharing
The Helpers

I Inquiring
The Thinkers

Saved Majors

Major Your Rating
Social Work
Comments: Helping others and diving deep into the heart of an issue will always be my first passion.

Focus™ 2 Copyright 2022 Career Dimensions®, Inc. All Rights Reserved

Assessment

The individual Practice Assessment is a competency-guided assignment whereby the student critically describes the knowledge, values, skills, and cognitive and affective processes that comprise their competency at the generalist level of practice

Assessment

Applying the Four Principles: Case Study

Part 1: Chart (60 points)

Based on the “Healing and Autonomy” case study, fill out all the relevant boxes below. Provide the information by means of bullet points or a well-structured paragraph in the box. Gather as much data as possible.

Medical Indications

Beneficence and Nonmaleficence

Patient Preferences

Autonomy

Quality of Life

Beneficence, Nonmaleficence, Autonomy

Contextual Features

Justice and Fairness

©2020. Grand Canyon University. All Rights Reserved.

Part 2: Evaluation

Answer each of the following questions about how the four principles and four boxes approach would be applied:

1. In 200-250 words answer the following: According to the Christian worldview, how would each of the principles be specified and weighted in this case? Explain why. (45 points)

2. In 200-250 words answer the following: According to the Christian worldview, how might a Christian balance each of the four principles in this case? Explain why. (45 points)



References:

Assessment

SCRIP ASSESSMENT ASSIGNMENT INSTRUCTIONS
OVERVIEW
In this assignment, you will provide evidence to support personal practices that you, as a future
teacher, plan to use in demonstrating each of the SCRIP dispositions (Social Responsibility,
Commitment/Work Ethic, Reflection, Integrity, and Professionalism).  The focus of this
assignment is on the application of a biblical worldview integrated into educational philosophy
and ethical teaching practices.  
INSTRUCTIONS
 Using the SCRIP Assessment Template, write responses to demonstrate how you plan
to incorporate each of the five SCRIP dispositions in your teaching practice.
 Each paragraph is a minimum of 50 words.
 Submit the assignment in both Canvas and LiveText.
 No sources are required, but if you use any (including the Bible), be sure to follow
current APA formatting to citations and references.
Note: Your assignment will be checked for originality via the Turnitin plagiarism tool.

Assessment

Case Study: Healing and Autonomy

Mike and Joanne are the parents of James and Samuel, identical twins born 8 years ago. James is currently suffering from acute glomerulonephritis, kidney failure. James was originally brought into the hospital for complications associated with a strep throat infection. The spread of the A streptococcus infection led to the subsequent kidney failure. James’s condition was acute enough to warrant immediate treatment. Usually cases of acute glomerulonephritis caused by strep infection tend to improve on their own or with an antibiotic. However, James also had elevated blood pressure and enough fluid buildup that required temporary dialysis to relieve.

The attending physician suggested immediate dialysis. After some time of discussion with Joanne, Mike informs the physician that they are going to forego the dialysis and place their faith in God. Mike and Joanne had been moved by a sermon their pastor had given a week ago, and also had witnessed a close friend regain mobility when she was prayed over at a healing service after a serious stroke. They thought it more prudent to take James immediately to a faith healing service instead of putting James through multiple rounds of dialysis. Yet, Mike and Joanne agreed to return to the hospital after the faith healing services later in the week, and in hopes that James would be healed by then.

Two days later the family returned and was forced to place James on dialysis, as his condition had deteriorated. Mike felt perplexed and tormented by his decision to not treat James earlier. Had he not enough faith? Was God punishing him or James? To make matters worse, James’s kidneys had deteriorated such that his dialysis was now not a temporary matter and was in need of a kidney transplant. Crushed and desperate, Mike and Joanne immediately offered to donate one of their own kidneys to James, but they were not compatible donors. Over the next few weeks, amidst daily rounds of dialysis, some of their close friends and church members also offered to donate a kidney to James. However, none of them were tissue matches.

James’s nephrologist called to schedule a private appointment with Mike and Joanne. James was stable, given the regular dialysis, but would require a kidney transplant within the year. Given the desperate situation, the nephrologist informed Mike and Joanne of a donor that was an ideal tissue match, but as of yet had not been considered—James’s brother Samuel.

Mike vacillates and struggles to decide whether he should have his other son Samuel lose a kidney or perhaps wait for God to do a miracle this time around. Perhaps this is where the real testing of his faith will come in? Mike reasons, “This time around it is a matter of life and death. What could require greater faith than that?”

© 2020. Grand Canyon University. All Rights Reserved.

Assessment

This assignment will incorporate a common practical tool in helping clinicians begin to ethically analyze a case. Organizing the data in this way will help you apply the four principles and four boxes approach.

Assessment

 Download the Final Assessment Word document. Complete the answers and upload it here by the deadline for grading. Remember to cite your work, using proper APA formatting.

Assessment

EVSP331 – Public Lands Management – Final Assessment Week 8

Question 1. Discuss and compare the management strategies of the USFWS, highlighting the National Wildlife Refuge System. (20 points)

Question 2. Summarize the USFWS approach to planning in the Arctic National Wildlife Refuge. Do you agree or disagree with this approach? Why? (20 points)

Question 3. Explain how the Forest Reserves Act and the 1897 Organic Act have resulted in the National Park system we have today. Include a brief historical development timeline of US National Parks. (20 points)

Question 4. Summarize how the National Park System has addressed theof “social carrying capacity.” (20 points)

Question 5. Explain how the National Park Service employs multiple-use strategies in balancing preservation goals and resource use/visitor use. (20 points)

Assessment

Assessment Description

Review the evaluation frameworks discussed in your textbook. How do evaluation frameworks help guide a program evaluation? What are the key differences between these frameworks? Which framework would you choose to guide the evaluation of your program? Provide a rationale for your response.

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