WEEK 2: Cardiovascular System scenario Assignment
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Scenario 1
Errors, Correct Prescriptions, Classifications, and MOA
Metoprolol succinate ER 50 mg PO daily #30 1 RF
Error: Missing clear instructions (e.g., “once daily”). “ER” should be stated as “extended-release.”
Correct Prescription:
Metoprolol succinate ER 50 mg PO once daily. Dispense 30 tablets. Refills: 1.
Class: Beta-1 selective blocker.
MOA: Decreases heart rate and contractility by blocking beta-1 adrenergic receptors, lowering myocardial oxygen demand (Morris & Dunham, 2024).
Amiodarone 75 mg PO daily #30 1 RF
Error: Incorrect strength (not commercially available in 75 mg tablets). Standard doses are 100, 200, or 400 mg.
Correct Prescription:
Amiodarone 200 mg PO once daily. Dispense 30 tablets. Refills: 1.
Class: Class III antiarrhythmic.
MOA: Blocks potassium channels, prolonging repolarization and action potential duration (Gelman et al., 2024).
Amlodipine/hydrochlorothiazide (Lotrel) 5 mg/12.5 mg PO daily #30 3 RF
Error: Lotrel combines amlodipine and benazepril, not hydrochlorothiazide.
Correct Prescription:
Amlodipine/benazepril (Lotrel) 5/20 mg PO once daily. Dispense 30 capsules. Refills: 3.
Class: Calcium channel blocker + ACE inhibitor.
MOA: Amlodipine blocks calcium influx into vascular smooth muscle (Bulsara & Cassagnol, 2024); benazepril inhibits angiotensin-converting enzyme, reducing vasoconstriction and aldosterone effects (Dahal & Gupta, 2020).
Hydralazine/isosorbide mononitrate (BiDil) 37.5 mg/20 mg PO every 8 hours #90 1 RF
Error: Frequency incomplete. BiDil is dosed TID (every 8 hrs). #90 covers only one month.
Correct Prescription:
Hydralazine/isosorbide dinitrate (BiDil) 37.5/20 mg PO three times daily. Dispense 90 tablets. Refills: 1.
Class: Direct vasodilator + nitrate.
MOA: Hydralazine relaxes arterioles via smooth muscle relaxation; isosorbide dinitrate donates nitric oxide, causing venous dilation (Mavrakanas et al., 2022).
Clonidine patch (Catapres-TTS-1) 0.1 mg/day apply one patch to skin and replace every 3 days #10 patches 0 RF
Error: Patch is replaced every 7 days, not every 3 days.
Correct Prescription:
Clonidine patch (Catapres-TTS-1) 0.1 mg/day. Apply one patch weekly. Dispense 4 patches. Refills: 0.
Class: Central alpha-2 adrenergic agonist.
MOA: Reduces sympathetic outflow from the CNS, lowering blood pressure (Yasaei & Saadabadi, 2023).
Scenario 2
Verapamil and First-Pass Effect
Verapamil undergoes high first-pass metabolism, meaning a significant portion is metabolized by the liver before reaching systemic circulation. This is important to know because it will determine the route of administration. Oral bioavailability is low, approximately 20–35% because much of the absorbed dose is metabolized in the gut wall and liver before reaching systemic circulation (Herman & Santos, 2023). Since verapamil undergoes substantial first-pass metabolism, oral doses produce variable systemic levels. Clinicians must be cautious about interactions that affect CYP3A / hepatic blood flow or gut metabolism (grapefruit, CYP3A inhibitors), as these can raise verapamil concentrations and risk toxicity (excess bradycardia or hypotension).
First-pass effect: The process by which the liver metabolizes drugs taken orally, reducing systemic bioavailability.
Bioavailability: The proportion of a drug that reaches systemic circulation unchanged.
100% Bioavailability Route: Intravenous (IV).
To avoid first-pass metabolism: Verapamil can also be administered sublingually or intravenously.
Prescription Example:
Verapamil 80 mg PO three times daily. Dispense 90 tablets. Refills: 1.
Scenario 3
CYP Enzyme & Drug Identification
1) Where are the majority of cytochrome P450 (CYP) enzymes located?
CYP enzymes are predominantly expressed in the liver (hepatocytes, smooth endoplasmic reticulum) and are also significantly present in the small intestinal mucosa (enterocytes), where they contribute to first-pass metabolism. Other tissues (kidney, lung, brain) express lower amounts. The highest total CYP mass is in the liver, making it the primary site of drug metabolism.
2) Pill identification (imprint ATO 40, oval white)
Using the Medscape pill identifier (Medscape, 2024), imprint ATO 40 corresponds to Atorvastatin 40 mg (white oval tablet).
3) What CYP enzyme metabolizes this medication?
Atorvastatin is primarily metabolized by CYP3A4 (hepatic CYP3A4 pathway) (McIver & Siddique, 2020). This matters because drugs that inhibit or induce CYP3A4 will significantly change atorvastatin plasma concentrations.
4) How can this information be applied to medication-therapy management (MTM)?
Screen for interacting drugs : Avoid co-prescription with potent CYP3A4 inhibitors (e.g., clarithromycin, itraconazole, some HIV protease inhibitors) or adjust dose/switch statin (consider pravastatin or rosuvastatin, which have less CYP3A4 dependence) to reduce the risk of statin-associated myopathy or rhabdomyolysis (Sizar et al., 2024).
Counsel patients about grapefruit/grapefruit juice (inhibits intestinal CYP3A4 and can raise atorvastatin levels) (McIver & Siddique, 2020).
Monitoring : check baseline lipid panel, then recheck LDL-C 4–12 weeks after initiation or dose change to assess response; monitor for muscle symptoms and check CK if symptomatic; monitor LFTs as clinically indicated. (Follow ACC/AHA lipid monitoring recommendations.) (Grundy, 2019).
5) Sample prescription (complete order):
Atorvastatin 40 mg (ATO 40) — Take one (1) tablet by mouth once daily at bedtime. Dispense #30 (30-day supply). Refills: 2. Special instructions: Baseline fasting lipid panel prior to initiation; repeat LDL-C 4–12 weeks after start or dose change and then every 3–12 months; avoid grapefruit juice; notify provider for unexplained muscle pain/weakness.
6) What are the goal cholesterol levels and CAD risk factors?
For patients with clinical ASCVD or very high risk, aim for LDL-C < 70 mg/dL and consider high-intensity statin or nonstatin therapy if the threshold is not met. For secondary prevention and many high-risk primary prevention patients, LDL percent reduction goals and clinician-patient discussion guide intensity (Grundy, 2019). Other lipid targets: HDL desirable >40 mg/dL (men) / >50 mg/dL (women); triglycerides <150 mg/dL (desirable) (Grundy, 2019). Common CAD risk factors: Hypertension, diabetes mellitus, dyslipidemia (elevated LDL), cigarette smoking, age (men ≥45 y; women ≥55 y), family history of premature CAD, obesity, physical inactivity, chronic kidney disease, chronic inflammatory conditions, and specific biomarkers (e.g., elevated hsCRP), all used in ASCVD risk assessment (Grundy, 2019). Scenario 4 Case Analysis (RT, 54 years old) Current BP: 135/90, consistent with Stage 1 Hypertension (Whelton et al., 2018). Goal BP: <130/80 mmHg for patients with diabetes (ElSayed et al., 2023). Current meds: Metformin, ibuprofen, duloxetine. Concern: Long-term NSAID use (ibuprofen) can elevate BP and increase cardiovascular risk (Buciuman et al., 2025). Recommend discontinuing or limiting. Treatment Plan: Start an ACE inhibitor for BP control and renal protection in diabetes. Recommend stopping ibuprofen; suggest acetaminophen as safer for chronic pain. Start lisinopril (ACE inhibitor): Lisinopril 10 mg: Take one (1) tablet by mouth once daily. Dispense #30 (30-day supply). Refills: 2. Special instructions: Check serum creatinine and potassium 1–2 weeks after initiation or dose change; hold and notify provider for lightheadedness, angioedema, cough, or significant rise in creatinine (>30% increase). Take at the same time daily (bedtime may reduce first-dose dizziness).
Stop/modify current meds:
Ibuprofen 600 mg PO TID : Discontinue for chronic use; recommend acetaminophen prescription as below: Acetaminophen (Tylenol) 500 mg PO (by mouth) Every 6 hours as needed for pain. Do not exceed 3,000 mg per 24 hours (to avoid hepatotoxicity). Dispense #60 tablets (10-day supply). Refills : 1
Metformin 500 mg PO BID: continue (for glycemic control). Monitor renal function per usual practice, but metformin generally continued unless eGFR falls below guideline cutoffs (Corcoran & Jacobs, 2023).
Duloxetine 60 mg PO daily: Continue if clinically indicated (e.g., neuropathic pain), but advise BP monitoring because duloxetine can increase blood pressure in some patients. If BP remains uncontrolled or if duloxetine is judged contributory, consider alternative analgesic strategies in coordination with the patient.
Monitoring & Education:
Monitor BP at home 2–3 times per week.
Labs: Serum creatinine and potassium in 1–2 weeks.
Educate the patient on a low-sodium DASH diet, weight management, smoking cessation, and physical activity.
References
Buciuman, C. A., Dobrea, C. M., Butuca, A., Frum, A., Gligor, F. G., Gligor, O., Vicaș, L. G., & Morgovan, C. (2025). Exploring the cardiovascular safety profile of ibuprofen: Insights from EudraVigilance database. Pharmaceuticals , 18 (7), 1045. https://doi.org/10.3390/ph18071045
Bulsara, K. G., & Cassagnol, M. (2024, April 21). Amlodipine . National Library of Medicine. https://www.ncbi.nlm.nih.gov/books/NBK519508/
Corcoran, C., & Jacobs, T. F. (2023, August 17). Metformin . National Library of Medicine; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK518983/
Dahal, S. S., & Gupta, M. (2020). Benazepril . PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK549885/
ElSayed, N. A., Aleppo, G., Bannuru, R. R., Bruemmer, D., Collins, B., Das, S. R., Ekhlaspour, L., Hilliard, M. E., Johnson, E. L., Khunti, K., Kosiborod, M., Lingvay, I., Matfin, G., McCoy, R. G., Mary Lou Perry, Pilla, S. J., Polsky, S., Prahalad, P., Pratley, R. E., & Segal, A. R. (2023). 10. Cardiovascular disease and risk management: Standards of care in diabetes—2024. Diabetes Care , 47 (Supplement_1), S179–S218. https://doi.org/10.2337/dc24-s010
Gelman, I., Sharma, N., Mckeeman, O., Lee, P., Campagna, N., Tomei, N., Baranchuk, A., Zhang, S., & El-Diasty, M. (2024). The ion channel basis of pharmacological effects of amiodarone on myocardial electrophysiological properties, a comprehensive review. Biomedicine & Pharmacotherapy = Biomedecine & Pharmacotherapie , 174 , 116513. https://doi.org/10.1016/j.biopha.2024.116513
Grundy, S. M. (2019). 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Blood Cholesterol. Circulation , 139 (25). https://doi.org/10.1161/cir.0000000000000625
Herman, T. F., & Santos, C. (2023, November 3). First pass effect . PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK551679/
Mavrakanas, T. A., Soomro, Q. H., & Charytan, D. M. (2022). Hydralazine–Isosorbide dinitrate use in patients with end-stage kidney disease on dialysis. Kidney International Reports , 7 (6), 1332–1340. https://doi.org/10.1016/j.ekir.2022.03.032
McIver, L. A., & Siddique, M. S. (2020, September 25). Atorvastatin . Nih.gov; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK430779/
Medscape. (2024). Pill identifier (drug & pill finder) – Medscape reference . Reference.medscape.com. https://reference.medscape.com/pill-identifier
Morris, J., & Dunham, A. (2024). Metoprolol . Nih; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK532923/
Sizar, O., Khare, S., Jamil, R. T., & Talati, R. (2024). Statin medications . PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK430940/
Whelton, P. K., Carey, R. M., Aronow, W. S., Casey, D. E., Collins, K. J., Dennison Himmelfarb, C., DePalma, S. M., Gidding, S., Jamerson, K. A., Jones, D. W., MacLaughlin, E. J., Muntner, P., Ovbiagele, B., Smith, S. C., Spencer, C. C., Stafford, R. S., Taler, S. J., Thomas, R. J., Williams, K. A., & Williamson, J. D. (2018). 2017 acc/aha/aapa/abc/acpm/ags/apha/ash/aspc/nma/pcna guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: A report of the american college of cardiology/american heart association task force on clinical practice guidelines. Hypertension , 71 (6). https://doi.org/10.1161/hyp.0000000000000065
Yasaei, R., & Saadabadi, A. (2023, July 17). Clonidine . Nih.gov; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK459124/
NURS-6521 Week 2: Assignment Case Studies
Scenario 1
What are the errors in the following prescriptions (1 per prescription)? Rewrite each prescription correctly. What is each medication classification? What is the mechanism of action (MOA)?
metaprolol succinate ER 50 mg PO daily #30 1 RF
amiodarone 75 mg PO daily #30 1 RF
amlodipine/hydrochlorothiazide (Lotrel) 5 mg/12.5 mg PO daily #30 3RF
hydralazine/isosorbide mononitrate (BiDil) 37.5 mg/20 mg PO every 8 hours #90 1 RF
clonidine patch (Catapres-TTS-1) 0.1 mg/day apply one patch to skin and replace every 3 days #10 patches 0 RF
SCENARIO 2
Does verapamil have a high or low first pass effect ? Please discuss why this is important to know and how it relates to bioavailability . Define these two terms. What route has 100% bioavailability? In addition to parenterally, how can verapamil be given to counter the first pass effect? Write a sample prescription for this medication.
SCENARIO 3
Where are the majority of cytochrome P450 (CYP) enzymes located ? Using the Medscape pill identifier, enter the following characteristics to identify the medication AND strength. What CYP enzyme metabolizes this medication? How can this information be applied to medication therapy management ? Write a sample prescription for the identified medication and strength. What are goal cholesterol levels and (Coronary Artery Disease) CAD risk factors ?
Imprint (ATO 40) Shape (Oval) Color (White) Form (Tablet) Scoring (None)
SCENARIO 4
RT is a 54-year-old female presenting with blood pressure today of 135/90 HR 80 RR 15. Her last visit to the clinic 3 months ago shows a BP of 134/88. She is currently taking metformin 500 mg PO BID with meals, ibuprofen 600 mg PO TID for back pain, and duloxetine 60 mg PO daily. What is her goal blood pressure? What medication would you prescribe and how would you improve her treatment (include complete medication order)? What patient monitoring and education would you provide?
Assignment: Case Studies
Case studies are a useful way for you to apply your knowledge of pharmacokinetics and pharmacodynamic aspects of pharmacology to specific patient cases and health histories.
For this Assignment, you evaluate drug treatment plans for patients with various disorders and justify drug therapy plans based on patient history and diagnosis.
Resources
Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.
WEEKLY RESOURCES
To Prepare:
Review the case study posted in “Announcements” by your Instructor for this Assignment
Review the information provided and answer questions posed in the case study
When recommending a medication, write out a complete prescription for the medication
Whenever possible, use clinical practice guidelines in developing your answers when possible
Include at least three references to support your answer and cite them in APA format.
NURS-6521 Week 2: Assignment Case Studies
By Day 7 of Week 1
Submit the Assignment.
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Rubric
NURS_6521_Week2_Assignment_Rubric
NURS_6521_Week2_Assignment_Rubric
Criteria
Ratings
Pts
This criterion is linked to a Learning Outcome Scenario 1: Appropriate medication is prescribed or changed. Rationale provided and includes current literature to support decision. All aspects of the patient history are considered in making the medication selection.
15 to > 11.0 pts Excellent Medication selected is appropriate and considers all of the unique patient characteristics. Rationale for selection is clear, complete, and appropriate.
11 to > 7.0 pts Good Medication selected might be appropriate but conflicts with the unique patient characteristics. Rationale for selection is clear but lacks discussion about potential prescribing issues.
7 to > 3.0 pts Fair Medication selected is not appropriate for this patient unique characteristics. Rationale provided is not correct or is flawed in applying the medication to this patient.
3 to > 0 pts Poor Medication selected is inappropriate or would not be provided based on patient unique characteristics.
15 pts
This criterion is linked to a Learning Outcome Scenario 1: Written medication orders include all 5 aspects required for a valid order. The order is complete, accurate, and appropriate.
3 pts Complete Written medication orders includes all 5 aspects required for a valid order. The order is complete, accurate, and appropriate.
0 pts Poor The prescription is incomplete. Aspects of a complete order are missing. The order is either incomplete, inaccurate, or inappropriate.
3 pts
This criterion is linked to a Learning Outcome Scenario 1: References for the scenario are within past 5 years and include the appropriate clinical practice guideline if applicable.
4 pts Excellent References for the scenario are within past 5 years and include the appropriate clinical practice guideline if applicable. Correct APA format is used.
3 pts Good References for the scenario are within past 5 years but do not include the appropriate clinical practice guideline if applicable. Contains a few (1 or 2) APA format errors.
2 pts Fair References for the scenario are not from within the past 5 years or do not reflect the content of this scenario and do not include the appropriate clinical practice guideline if applicable. Contains several (3 or 4) APA format errors.
0 pts Poor No references are included. References do not reflect the content of this scenario. Appropriate clinical practice guideline is not include. Contains many (≥ 5) APA format errors.
4 pts
This criterion is linked to a Learning Outcome Scenario 1: Written Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation
3 pts Excellent Uses correct grammar, spelling, and punctuation with no errors.
2 pts Good Contains a few (1 or 2) grammar, spelling, and punctuation errors.
1 pts Fair Contains several (3 or 4) grammar, spelling, and punctuation errors.
0 pts Poor Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.
3 pts
This criterion is linked to a Learning Outcome Scenario 2: Appropriate medication is prescribed or changed. Rationale provided and includes current literature to support decision. All aspects of the patient history are considered in making the medication selection.
15 to > 11.0 pts Excellent Medication selected is appropriate and considers all of the unique patient characteristics. Rationale for selection is clear, complete, and appropriate.
11 to > 7.0 pts Good Medication selected might be appropriate but conflicts with the unique patient characteristics. Rationale for selection is clear but lacks discussion about potential prescribing issues.
7 to > 3.0 pts Fair Medication selected is not appropriate for this patient unique characteristics. Rationale provided is not correct or is flawed in applying the medication to this patient.
3 to > 0 pts Poor Medication selected is inappropriate or would not be provided based on patient unique characteristics.
15 pts
This criterion is linked to a Learning Outcome Scenario 2: Written medication orders include all 5 aspects required for a valid order. The order is complete, accurate, and appropriate.
3 pts Complete Written medication orders includes all 5 aspects required for a valid order. The order is complete, accurate, and appropriate.
0 pts Poor The prescription is incomplete. Aspects of a complete order are missing. The order is either incomplete, inaccurate, or inappropriate.
3 pts
This criterion is linked to a Learning Outcome Scenario 2: References for the scenario are within past 5 years and include the appropriate clinical practice guideline if applicable.
4 pts Excellent References for the scenario are within past 5 years and include the appropriate clinical practice guideline if applicable. Correct APA format is used.
3 pts Good References for the scenario are within past 5 years but do not include the appropriate clinical practice guideline if applicable. Contains a few (1 or 2) APA format errors.
2 pts Fair References for the scenario are not from within the past 5 years or do not reflect the content of this scenario and do not include the appropriate clinical practice guideline if applicable. Contains several (3 or 4) APA format errors.
0 pts Poor No references are included. References do not reflect the content of this scenario. Appropriate clinical practice guideline is not include. Contains many (≥ 5) APA format errors.
4 pts
This criterion is linked to a Learning Outcome Scenario 2: Written Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation
3 pts Excellent Uses correct grammar, spelling, and punctuation with no errors.
2 pts Good Contains a few (1 or 2) grammar, spelling, and punctuation errors.
1 pts Fair Contains several (3 or 4) grammar, spelling, and punctuation errors.
0 pts Poor Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.
3 pts
This criterion is linked to a Learning Outcome Scenario 3: Appropriate medication is prescribed or changed. Rationale provided and includes current literature to support decision. All aspects of the patient history are considered in making the medication selection.
15 to > 11.0 pts Excellent Medication selected is appropriate and considers all of the unique patient characteristics. Rationale for selection is clear, complete, and appropriate.
11 to > 7.0 pts Good Medication selected might be appropriate but conflicts with the unique patient characteristics. Rationale for selection is clear but lacks discussion about potential prescribing issues.
7 to > 3.0 pts Fair Medication selected is not appropriate for this patient unique characteristics. Rationale provided is not correct or is flawed in applying the medication to this patient.
3 to > 0 pts Poor Medication selected is inappropriate or would not be provided based on patient unique characteristics.
15 pts
This criterion is linked to a Learning Outcome Scenario 3: Written medication orders include all 5 aspects required for a valid order. The order is complete, accurate, and appropriate.
3 pts Complete Written medication orders includes all 5 aspects required for a valid order. The order is complete, accurate, and appropriate.
0 pts Poor The prescription is incomplete. Aspects of a complete order are missing. The order is either incomplete, inaccurate, or inappropriate.
3 pts
This criterion is linked to a Learning Outcome Scenario 3: References for the scenario are within past 5 years and include the appropriate clinical practice guideline if applicable.
4 pts Excellent References for the scenario are within past 5 years and include the appropriate clinical practice guideline if applicable. Correct APA format is used.
3 pts Good References for the scenario are within past 5 years but do not include the appropriate clinical practice guideline if applicable. Contains a few (1 or 2) APA format errors.
2 pts Fair References for the scenario are not from within the past 5 years or do not reflect the content of this scenario and do not include the appropriate clinical practice guideline if applicable. Contains several (3 or 4) APA format errors.
0 pts Poor No references are included. References do not reflect the content of this scenario. Appropriate clinical practice guideline is not include. Contains many (≥ 5) APA format errors.
4 pts
This criterion is linked to a Learning Outcome Scenario 3: Written Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation
NURS-6521 Week 2: Assignment Case Studies
3 pts Excellent Uses correct grammar, spelling, and punctuation with no errors.
2 pts Good Contains a few (1 or 2) grammar, spelling, and punctuation errors.
1 pts Fair Contains several (3 or 4) grammar, spelling, and punctuation errors.
0 pts Poor Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.
3 pts
This criterion is linked to a Learning Outcome Scenario 4: Appropriate medication is prescribed or changed. Rationale provided and includes current literature to support decision. All aspects of the patient history are considered in making the medication selection.
15 to > 11.0 pts Excellent Medication selected is appropriate and considers all of the unique patient characteristics. Rationale for selection is clear, complete, and appropriate.
11 to > 7.0 pts Good Medication selected might be appropriate but conflicts with the unique patient characteristics. Rationale for selection is clear but lacks discussion about potential prescribing issues.
7 to > 3.0 pts Fair Medication selected is not appropriate for this patient unique characteristics. Rationale provided is not correct or is flawed in applying the medication to this patient.
3 to > 0 pts Poor Medication selected is inappropriate or would not be provided based on patient unique characteristics.
15 pts
This criterion is linked to a Learning Outcome Scenario 4: Written medication orders include all 5 aspects required for a valid order. The order is complete, accurate, and appropriate.
3 pts Complete Written medication orders includes all 5 aspects required for a valid order. The order is complete, accurate, and appropriate.
0 pts Poor The prescription is incomplete. Aspects of a complete order are missing. The order is either incomplete, inaccurate, or inappropriate.
3 pts
This criterion is linked to a Learning Outcome Scenario 4: References for the scenario are within past 5 years and include the appropriate clinical practice guideline if applicable.
4 pts Excellent References for the scenario are within past 5 years and include the appropriate clinical practice guideline if applicable. Correct APA format is used.
3 pts Good References for the scenario are within past 5 years but do not include the appropriate clinical practice guideline if applicable. Contains a few (1 or 2) APA format errors.
2 pts Fair References for the scenario are not from within the past 5 years or do not reflect the content of this scenario and do not include the appropriate clinical practice guideline if applicable. Contains several (3 or 4) APA format errors.
0 pts Poor No references are included. References do not reflect the content of this scenario. Appropriate clinical practice guideline is not include. Contains many (≥ 5) APA format errors.
4 pts
This criterion is linked to a Learning Outcome Scenario 4: Written Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation
3 pts Excellent Uses correct grammar, spelling, and punctuation with no errors.
2 pts Good Contains a few (1 or 2) grammar, spelling, and punctuation errors.
1 pts Fair Contains several (3 or 4) grammar, spelling, and punctuation errors.
0 pts Poor Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding. NURS-6521 Week 2: Assignment Case Studies
3 pts
Total Points: 100
