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ASSIGNMENT
SPECIAL CONSIDERATIONS FOR PATIENT POPULATIONS PAPER
To complete this Assignment, you will choose a case study for a patient population for special consideration during prescribing practices. You will consider the specific patient and determine the appropriate medication to prescribe, based on the patient specifics and medication attributes in various case studies. You will construct a 4- to 5-page paper in which you determine the medication, the dosing, necessary patient education, and potential side effects. You will also indicate why the other medications would not be appropriate, as well as any necessary labs or diagnostics that might be needed. You will develop a plan to enhance medication adherence for the nonadherent patient.
Special Considerations for Patient Population Cases:
Patient 1: 82-year-old male presenting with cognitive decline. He had always been a very active individual. Over the past year, he has become less active in the community. Previously, he played cribbage weekly with friends at the local senior center but has been struggling with the math involved with the game and no longer attends the weekly card game. He had also volunteered as a crossing guard for the local public school. He quit doing that after he took the wrong turn to get home and drove around the town feeling lost. He acknowledges he is “sensitive” to this and can be irritable towards his children when they bring up these concerns. He was diagnosed with mild neurocognitive disorder after completing neuropsychological testing. Of the following medications, which would be the most appropriate to prescribe? Explain why you chose this medication. What would be the dosing schedule for this patient? Provide education to the patient and review risks, benefits, and potential side effects of the medication. In addition, explain why the other medications listed are not appropriate for this patient. Med List: lorazepam, olanzapine, memantine
Patient 2: 76-year-old female who recently moved from her home to an assisted living. After 1 week of moving in, she has become extremely confused. Staff have attempted to re-orient her, and she struggles to focus on what they are saying. She is only oriented to self. She has become very agitated and has even thrown breakable objects in her room. Her family is concerned stating she is “out of it.” The PCP ordered labs and UA. Labs are unremarkable outside of mild leukocytosis and positive dipstick analysis for nitrite and red blood cells. Med List: valproate, alprazolam, trimethoprim
Patient 3: A 33-year-old female that is 6 weeks postpartum. She presents with depressed mood, sadness, easily emotional, difficulties with sleep even when the infant is sleeping. She has lost weight and has a poor appetite. You note psychomotor retardation. She has limited interests in hobbies or bonding with the infant. Her partner is concerned and reports she is typically active and “bubbly” and enjoys the outdoors. She is diagnosed with major depressive disorder, with postpartum onset. She denies suicidal ideation, homicidal ideation, or infanticidal ideation. No psychotic symptoms are present. She is nursing the infant and wants to continue this hoping it will assist with bonding with the infant. Med List: lithium, paroxetine, sertraline
Patient 4: 10-year-old male who comes in with his father. He has been diagnosed with generalized anxiety disorder. He has constant worries that he cannot control. He feels nervous and tense. He is easily irritable. He struggles to settle down or relax. He is also quite fidgety and restless. He and his father are interested in medications to manage these symptoms. Med List: quetiapine, duloxetine, fluoxetine
Patient 5: 27-year-old male with a diagnosis of schizophrenia. He has been hospitalized three (3) times in the past 1 year due to symptoms. When symptomatic, he becomes disorganized and paranoid. He will respond to auditory hallucinations. He will scream out at night after seeing a shadow in his room. He has delusions that the CIA is poisoning food and will not eat for multiple days. He has unintentionally hurt his mother after “slapping” food out of her hand, as he did not want her to ingest the “poisoned food.” Symptoms are treated very well with paliperidone, but he struggles to remember to take it. Med List: paliperidone palmitate, clozapine, lamotrigine
RESOURCES
Turner, L. (2022, July 21). How to write a prescription: 7 steps for safety. https://www.studentdoctor.net/2018/08/15/how-to-wr…
Drugs.comLinks to an external site.. (2023). https://www.drugs.com/
Note: Please use the following resource to check the most up-to-date box warnings, FDA approvals and indications, recommendations for follow-up evaluations, changes, etc.
TO PREPARE:
Review the Learning Resources.
Carefully review your assigned vulnerable population patient.
Carefully review the medication list to determine the best medication to prescribe.
Consider the implications, impact, advantages, and disadvantages of the listed medications.
THE ASSIGNMENT (4–5 PAGES)
Construct a paper concerning your assigned vulnerable population patient case. In your paper include the following:
Determine which medication would be most appropriate to prescribe from the assigned vulnerable population patient case medication choices.
Explain your rationale for choosing this medication. Explain why the other medications listed are not appropriate for this patient.
Explain the dosing schedule for the specific patient including the therapeutic endpoint.
Provide necessary education to the patient to review risks, benefits, and potential side effects of the medication.
Describe any necessary labs or additional diagnostics needed prior to prescribing this medication.
Explain how you might monitor efficacy or side effects of the medication.
Include any additional collaboration or education to others that would be necessary for this patient. Consider family members, home health care, primary care providers, etc.
What would you need to include in your assessment for a patient who may become nonadherent with your prescribing plan for your scenario? What are alternative treatment solutions based upon how you assessed? Describe your new treatment plan.
This Assignment requires a minimum of five (5) peer-reviewed, evidence-based scholarly references outside of course resources.
Note: You will need to include the APA style formatting.
Reminder: The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The Walden Writing Center Sample PaperLinks to an external site. provides an example of those required elements. All papers submitted must use this formatting.
Assignment2_Rubric
Criteria
Describes the selected mediation and explains the selection, dosing, and necessary patient education.
Ans:
The response comprehensively and clearly describes the selected medication, dosing, and patient education information. The response includes relevant, specific, and appropriate examples that fully support the selection, dosing, and patient education information.
Criteria
This criterion is linked to a Learning OutcomeDescribes any necessary labs or diagnostics needed prior to prescribing, as well as how side effects and efficacy will be monitored.
Ans:
The response comprehensively and clearly describes needed labs and other diagnostics. The response comprehensively and clearly describes monitoring of efficacy and side effects. The response includes relevant, specific, and appropriate examples that fully support the descriptions.
Criteria
20
Explains why the other medications are not appropriate
Ans:
The response comprehensively and fully details why other medications are not appropriate. The response includes relevant, specific, and appropriate examples that fully support the explanation.
Criteria
This criterion is linked to a Learning OutcomeProvides any additional collaboration or education necessary for the patient
Ans:
The response accurately and clearly provides all additional necessary information. The response includes relevant, specific, and appropriate examples the information.
Criteria
Written Expression and Formatting—Paragraph Development and Organization: Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction is provided which delineates all required criteria. Writes succinctly 4–5 page paper.
Ans:
Paragraphs and sentences follow writing standards for flow, continuity, and clarity. A clear and comprehensive purpose statement, introduction, and conclusion is provided, which delineates all required criteria. Writes succinctly 4–5 page paper.
Criteria
5
Written Expression and Formatting—English writing standards:
Correct grammar, mechanics, and proper punctuation
Ans:
Uses correct grammar, spelling, and punctuation with no errors.
Criteria
5
Written Expression and Formatting: The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, parenthetical/in-text citations, and reference list.5
Written Expression and Formatting: The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, parenthetical/in-text citations, and reference list.
Ans:
Uses correct APA format with no errors.

AP® Seminar
Free-Response Questions
Set 1
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AP® Seminar 2023 Free-Response Questions
AP SEMINAR
Part A
Suggested time — 30 minutes
Directions: Read the following passage and then respond to prompts A1, A2, and A3 .
A1. Identify the author’s argument, main idea, or thesis. (3 points)
A2. Explain the author’s line of reasoning by identifying the claims used to build the argument and the connections between them. (6 points)
A3. Evaluate the effectiveness of the evidence the author uses to support the claims made in the argument. (6 points)
From “Why full-day kindergarten is failing our children.”
By Charlie Gillis (Maclean’s, October 31, 2013)
When German educator Friedrich Fröebel opened the world’s first kindergartens in the mid-1800s, he frequently found himself at odds with suspicious government officials. Prussia, for example, banned his schools in 1851, characterizing them as hotbeds of socialist subversion and radicalism.
How things have changed. Today, most governments want more kindergarten, not less. Even the traditional half day programs aren’t enough. Five-year-olds in British Columbia, Quebec, New Brunswick, Nova Scotia and Prince Edward Island all attend full-day kindergarten. Ontario is currently in the fourth year of a five-year rollout for full-day junior and senior kindergarten, meaning kids as young as three attend school all day, five days a week. In those provinces without full-day programs, demands are heard regularly.
Yet despite the popularity of full-day kindergarten, particularly among working parents and teachers’ unions, the actual benefit it provides to the children themselves is still hotly debated.
This September, on the first day of the school year, the Ontario government claimed conclusive evidence of full day kindergarten’s advantages was finally at hand, thanks to a pair of academic studies it commissioned. “In every area, students improved their readiness for Grade 1 and accelerated their development,” a provincial news release declared. Education Minister Liz Sandals called the results, which tracked students in both half- and full day kindergarten over two years, “nothing short of incredible.”
This news was immediately hailed by supporters of the concept. Charles Pascal, the driving force behind Ontario’s full-day program, said “it shows the program is truly a life-changer.” In a front-page story, the Globe and Mail dubbed it a “landmark study.”
And yet there was no study to read, landmark or otherwise. The hype and excitement came from a few bullet points selectively released by the province. The actual reports were nowhere to be seen. The reason for this reticence is now apparent.
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AP® Seminar 2023 Free-Response Questions
With the complete reports finally available online, it appears that Ontario’s $1.5-billion-a-year full-day kindergarten experiment is a grave disappointment, from both pedagogical and financial perspectives.
The provincial studies did find that children attending schools marked by low income and/or poor test scores showed improvement in some categories after participating in full-day kindergarten. This corresponds with previous research, particularly by Nobel laureate economist James Heckman, which suggested that early intervention can improve school readiness for disadvantaged children. For everyone else, however, the Ontario results ranged from negligible to abysmal.
Not only did most children not receive a distinct advantage from spending all week at school, the results for many were lower than if they’d stayed in the old half-day system.
“To be clear, some children appear to have done worse with [full-day kindergarten],” the report states. The biggest failings were in the categories of emotional maturity, communication skills and general knowledge. This aligns with complaints that full-day programs impede the social and emotional development of some children by removing them from familial care too early.
Special-needs kids did particularly poorly. “The children with special educational needs showed superior outcomes on the measures of social competence and emotional maturity in non-[full-day kindergarten] programs,” the researchers found, calling for more investigation into this troubling result. It’s a far cry from declaring the whole thing “life-changing” or “nothing short of incredible.”
It is worth noting that even those gains identified for some kids are likely to be temporary, a phenomenon that’s been identified in numerous other studies. McMaster University economist Philip DeCicca told Maclean’s earlier this year that any positive academic effects arising from full-day kindergarten are largely gone by the end of Grade 1. Similarly, a study published last year on California’s school system1 found that, after three years, “there were no significant differences in students who attended the all-day kindergarten program and students who attended a traditional kindergarten program.” …. . .
While children from poor or disadvantaged families may derive short-term benefits from extra attention in kindergarten, it defies common sense and financial reality to provide this to all families on a universal basis. The tax system or local authorities are much better suited to targeting children at risk, and at far less cost.
All the above suggests taxpayers in provinces that have so far managed to avoid the full-day-kindergarten craze ought to consider themselves quite lucky. Earlier this year, for example, Alberta announced it was putting its plans for province-wide full-day kindergarten on hold due to budgetary constraints. Wise move.
“Why full-day kindergarten is failing our children.” by Charlie Gillis, from Maclean’s. © 2013, Maclean’s.
1 Charles Milligan, “Full-Day Kindergarten Effects on Later Academic Success.” SAGE Open, 2012.
END OF PART A
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AP® Seminar 2023 Free-Response Questions
Part B
Suggested time — 1 hour and 30 minutes
Directions: Read the four sources carefully, focusing on a theme or issue that connects them and the different perspective each represents. Then, write a logically organized, well-reasoned, and well-written argument that presents your own perspective on the theme or issue you identified. You must incorporate at least two of the sources provided and link the claims in your argument to supporting evidence. You may also use the other provided sources or draw upon your own knowledge. In your response, refer to the provided sources as Source A, Source B, Source C, or Source D, or by the author’s name.
Source A
From “Can Simulated Nature Support Mental Health? Comparing Short, Single-Doses of 360-Degree Nature Videos in Virtual Reality With the Outdoors”
By Matthew H. E. M. Browning, Katherine J. Mimnaugh, Carena J. van Riper, Heidemarie K. Laurent, and Steven M. LaValle (Frontiers in Psychology, January 15, 2020)
Not everyone has access to natural environments. This is a public health concern because nature promotes human health and well-being by mitigating adverse environmental stressors and providing salutogenic1 experiences. Nearly two-thirds of Americans live in cities and may have less access to safe green spaces than other citizens. Americans spend over a million days every two years in hospitals where most windows look onto grayspace rather than greenspace. Over nine million adults in the United States and Europe live in assisted care facilities that have limited nearby nature. Approximately 40 million Americans are physically disabled and may struggle to go outdoors. Even people with access to nature do not always feel comfortable going outside or have sufficient time to do so. These circumstances warrant the development of technologies that facilitate more frequent interactions with the natural world.
One inexpensive and convenient way to provide access to nature is 360-degree videos in virtual reality (VR). VR has been defined as “inducing targeted behavior in an organism using artificial sensory stimulation, while the organism has little or no awareness of interference” (LaValle, 2017). …. . . [R]ecent advances make it easier for people to acquire and use this technology for therapeutic uses.
At least some of the benefits of nature exposure can be obtained through the visual and auditory exposure provided by all-in-one VR headsets. …. . . [Multiple theories] explain how visual exposure to natural landscapes capture people’s fascination and match human evolutionary history or personal experiences and familiarity. Numerous studies now show that 360-degree nature videos are therapeutic and improve mood within 6, 9, or 15 min. In addition to improvements in mood, cognitive functioning and physiological stress levels also show some benefit from brief 360-degree videos of nature.
Nearly 200 studies have examined the human health and cognitive functioning benefits conferred by viewing still images, videos, and other simulations of nature. …. . . Simulations include replications of fictional or existing environments shown in any location (not just the laboratory) that evoke a sense of presence: the psychological presence of “being there.”
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AP® Seminar 2023 Free-Response Questions
The literature is not clear on whether simulations of nature serve as substitutes for real nature experienced in the outdoors. On one hand, some participants have reported no difference in energy or stress after exposure to outdoor nature versus exposure to nature videos on TV. On the other hand, real views of nature seen from windows have reduced physiological markers of stress more than virtual views of nature seen from wall-mounted TVs. VR may provide stronger beneficial effects of nature simulations than TV videos because of VR’s high level of immersion. Immersion reflects the extent to which someone perceives themselves enveloped by, included in, and interacting with an environment. Compared to less immersive technologies, VR simulations are more realistic, provide greater therapeutic benefits, and elicit more feelings of awe that are central to attention restoration theory.
Ultimately, further understanding of whether simulations of nature serve as substitutes for nature is warranted, including consideration of confounding factors.
“Can Simulated Nature Support Mental Health? Comparing Short, Single-Doses of 360-Degree Nature Videos in Virtual Reality With the Outdoors” by Matthew H. E. M. Browning, Katherine J. Mimnaugh, Carena J. van Riper, Heidemarie K. Laurent, and Steven M. LaValle, from Frontiers in Psychology. © 2020, Frontiers in Psychology.
1 able to cause human health and well-being
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Source B
“The Lake Isle of Innisfree”
By William Butler Yeats (National Observer, 1890)
I will arise and go now, and go to Innisfree,
And a small cabin build there, of clay and wattles made; Nine bean-rows will I have there, a hive for the honey-bee And live alone in the bee-loud glade.
And I shall have some peace there, for peace comes dropping slow, Dropping from the veils of the morning to where the cricket sings; There midnight’s all a glimmer, and noon a purple glow, And evening full of the linnet’s wings.
I will arise and go now, for always night and day
I hear lake water lapping with low sounds by the shore; While I stand on the roadway, or on the pavements grey, I hear it in the deep heart’s core.
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Source C
From “Transport-related CO2 Emissions of the Tourism Sector—Modelling Results”By Zurab Pololikashvili and Young Tae Kim (World Tourism Organization and International Transport Forum, 2019)
Today, tourism is one of the most important economic sectors driving growth and development. It represents 10% of global GDP and 10% of global employment and is forecast to continue growing steadily. While this evolution offers vast opportunities, it also comes with great responsibilities, notably with regards to environmental impacts and climate change.
The tourism sector contributes to climate change. According to the 2008 publication from UNWTO and UN Environment entitled Climate Change and Tourism—Responding to Global Challenges, the tourism sector contributed approximately 5% of all man-made CO2 emissions in 2005, with transport representing the largest component, i.e., 75% of the overall emissions of the sector (see figure 1.1).
Figure 1.1: Contribution of various sub-sectors of tourism CO2 emissions, 2005
According to the previous UNWTO and UN Environment study on Climate Change and Tourism, in 2005, transport-related CO2 emissions from tourism totalled 982 million tonnes of CO2, including both overnight and same-day visitors. This represented about 18% of the total transport emissions and 3.7% of all man-made CO2 emissions (26,400 million tonnes).
In 2016, eleven years later, an estimated 20 billion tourist trips were taking place. This number translates into transport-related emissions from tourism of a total of 1,597 million tonnes of CO2, with 1,371 million tonnes of CO2 accounting for all overnight stays and same-day visitors accounting for 200 million tonnes.
In 2030, the total number of tourist trips is expected to reach 37.4 billion, of which 17.4 billion will be international and domestic overnight arrivals (1.8 billion international/15.6 billion domestic). Total transport related tourism emissions (excluding cruise) in 2030 are forecast to reach 1,998 million tonnes of CO2. This would represent 23% of the total expected transport emissions and 5.3% of the overall forecast man-made emissions (37,800 million tonnes) under IEA’s [International Energy Agency’s] current policies scenario/“baseline scenario”.
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AP® Seminar 2023 Free-Response Questions
All in all, from 2005 to 2016 the total transport-related emissions from tourism over the total man-made emissions grew from 3.7% to 5%, whereas from 2016 to 2030 this proportion is expected to increase to 5.3% (see figure 4.1).
Figure 4.1: Overall transport emissions and transport-related emissions from tourism, 2005, 2016 and 2030 (Mt of CO2)
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Source D
From “If You Travel to Escape Your Problems, What Happens When You’re Trapped in Place?” By Katka Lapelosova, (Fodor’s Travel, April 1, 2020)
Travel is a natural escape for most, but are there psychological implications of traveling to relieve—or avoid— your problems?
For most people, travel is a positive means of escape. It’s natural to want a break from routine, from work, from responsibilities, and the people who drive you crazy on a daily basis. [E]scaping somewhere that’s not your home is an exciting privilege that should be taken advantage of as often as possible.
“Travel and vacations are a means to reshift and reorganize identities,” states Karen Stein, a sociologist studying culture and travel and author of Getting Away from It All: Vacations and Identity. “We can use travel as a way to reexamine our priorities and devote our time and attention to identities and commitments that we, unwillingly, have to put in the background in our daily lives.”
But the psychological connections to this form of escapism can be more intense for others. Many avid travelers claim they travel to “discover” themselves by being open to new experiences. But in reality, are they just running away from underlying problems they don’t want to address?
“In psychology, escapism is generally defined as a desire or behavior to ignore, evade, or avoid reality,” says Dr. Carla Marie Manly, a clinical psychologist based in California. “During traumatic experiences, many individuals naturally ‘escape’ the situation mentally in order to avoid further distress and psychological harm.”
“When travel is motivated by a desire to escape reality,” she adds, “to embrace a nearly fictional experience that is free of the burdens of life the experience becomes escapist in quality.”
Most people know the travel-as-escape feeling in terms of fight-or-flight: the way we naturally (and physically) react when faced with conflict. Fight-or-flight involves a “carefully orchestrated yet near-instantaneous sequence of hormonal changes and physiological responses” which causes an individual to “fight the threat off” or “flee to safety.” I’m getting the hell out of here is actually a very normal message triggered for some dealing with intense emotions, situations, and experiences.
And being away from home presents challenges, which can often be a distraction from the issues individuals are escaping from. Learning a new language, figuring out how to get around a city, and other survival mechanisms, are sometimes exactly what travelers need.
According to Dr. Michael Brein, a psychologist with a specialty in travel, “Travel escapism that invites you to increase your feelings of self-esteem and self-confidence tends to ground you in the present and requires you to deal with virtually everything that is normally mindless back home.”
For these kinds of travelers, the power to control the outcomes of seemingly non-existent issues (such as successfully ordering pad thai from a street vendor in Bangkok) makes all the difference.
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AP® Seminar 2023 Free-Response Questions
Travel escapists need to be completely out of their comfort zone in order to do so. “The net result is that you are, in effect, a problem-solver,” adds Dr. Brein, “dealing successfully with virtually everything you normally take for granted.”
Copyright © Fodor’s Travel, a division of Internet Brands. All rights reserved. Fodor’s is a registered trademark of MH Sub I, LLC.
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STOP
END OF EXAM