COLLEGE OF NURSING

Master of Science in Nursing

Distance Learning Programs

NURS8020C
Health Assessment for Advanced Nursing
Practice

Christine Colella DNP, CS, CNP

Summer 2016
May 9, 2016 August 6, 2016

Syllabus
Course Information
Course Number: NURS 8020C

Course Name: Health Assessment for Advanced Nursing Practice

 NURS8020: Health Assessment for Advanced Nursing Practice
Course Credits: 3

Corequsities/Pre-requisites: N/A

Course Description

This course provides opportunities for students to develop the knowledge and skills
necessary for the performance of both a comprehensive and focused health
assessment. This course addresses health assessment across the life span to
include pediatric, adult, and geriatric content. Data to collect when eliciting a health
history, principles of performing a physical assessment, diagnostic study
interpretations (EKG, X-rays) and examination techniques will be stressed in the
didactic portion of the course. Critical thinking is emphasized as the basis for
synthesis of knowledge regarding the performance of a health assessment. During a
concurrent laboratory experience, students will obtain health histories, perform
physical assessments and identify potential diagnostic tests for alterations in health
patterns in specific client systems. Emphasis will be placed on the differentiation of
normal and abnormal findings.

Textbooks and Resources

Required

Bickley, L (2013) 11th ed. Bates guide to physical examination & history taking.

Lippincott, New York. ISBN-10: 1609137620 ISBN-13: 978-1-60913-762-5

Shadow Health: We will be using Shadow Health a computer software program

that you will buy like a book. We will use this program in this class.
***To register and purchase access, please visit app.shadowhealth.com and
click "Register for a Student Account." Your pin is May2016-9571-9036-
7846-2776 and select your course section to enroll under Colella. Once you
are in your lab groups you will be moved to the appropriate group.

The Shadow Health Digital Clinical Experience (DCE) provides a dynamic, immersive
experience designed to improve your skills and clinical reasoning through the
examination of a digital standardized patient, Tina Jones.
Tina Jones, your digital standardized patient, is a 28-year-old woman who has come to
receive treatment for an infected foot wound, fever, and decreased appetite.
Although a digital patient, Tina Jones breathes, speaks, and has a complex medical
and psychosocial history. We will be accessing and completing Shadow Health
assignments throughout the course. Each assignment represents one piece of Tinas
comprehensive assessment within the same 8am hour at Shadow General. By
breaking Tinas assessment into individual assignments, you are able to apply your
knowledge and practice your skills to each system in greater depth.
If at any time you have any questions or encounter any technical issues, Shadow Health has
a dedicated team of helpful and knowledgeable Learner Support specialists who will
patiently assist you. Please visit the Learner Support page at
http://support.shadowhealth.com for contact information and hours. You may email
the Learner Support team directly at support@shadowhealth.com at any time.

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Recommended

American Psychological Association (2010). Publication manual of the American

Psychological

Association (6th ed.). Washington, DC: Author

th
Bickley, L. (2009). Companion guide to Bates' guide (6 ed.). New York: Lippincott.
th
Fishbach, F. (2008). A manual of laboratory and diagnostic tests (8 ed.).

Philadelphia: Lippincott Williams & Wilkins.

Or any adequate current lab test book

Course Objectives
Upon completion of this course, the student will be able to:

1. Develop a systematic approach to the collection and

documentation of data for the health history and physical
assessment.
2. Demonstrate skills and techniques required to gather the data
needed for a complete history & physical
3. Demonstrate critical thinking to differentiate normal from
abnormal findings in specific client systems across the lifespan.
4. Document findings gathered from a complete history and
physical examination performed on an identified patient.
5. Clinical decision making for selecting appropriate tests or
procedures, and interpretation of diagnostic test results is
addressed EKG interpretation and X-ray

This course meets: MSN Essential I_Background for Practice

MSN Essential III_Quality Improvement and Safety
MSN Essential V_Informatics
MSN Essential VIII_Clinical Prevention
MSN Essential IX_MSN Practice
MSN Essential X_ Interpretation of diagnostic test

Health Assessment Evaluator

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It is recommended but not mandatory that you utilize an Advance Practice Nurse
(APN) or a physician (MD or DO) to observe each module assessment which will
allow for feedback and further prepare you for your future profession.
For the Mid-term lab evaluation you will need to record yourself performing the
HEENT exam. For the video component, you will need to follow the steps below. The
video must be 15 minutes or less in length and we must be able to see you
professionally dressed and professionally interact with your patient utilizing the
otoscope/opthamlascope/tuning fork etc you do not need to gather the history on
video just the physical. The rubric for this experience will be found in the lab folder
for week 7. Please see rubric for this assignment

FAQs: http://www.uc.edu/bblearn/Resources-
Training/Instructors.html (scroll down to the
documentation labeled 'Working with Video')
Video FAQs:
Screen Capture- http://www.kaltura.com/tiny/xs03l
Embedding a Video- http://www.kaltura.com/tiny/otnkj

Video Recording- http://www.kaltura.com/tiny/n8in4

It is MANDATORY to have a Nurse Practitioner or Physician present to

evaluate the Final Laboratory assessment, there is NO video component.
The evaluator will be responsible for evaluating your assessment skills as well as
completing a Student Evaluation Form. You should not use a CNS or PA as the
evaluator because performing comprehensive physical exams in not generally part
of their practice role.
Setting up a relationship with a preceptor now will be an advantage to you when
you move into the next part of the program and begin your clinical courses.
Please note that you are NOT allowed to use a family member as an evaluator.

Weekly patient
Each week you will need to practice the system assessment on a friendly
volunteer that you provide. You are not to use a patient in your workplace. This
person can be a friend, spouse, neighbor it would be preferable to have a different
one for each assignment. There are different chief complaints for each system and
your patient will have one of those and then can create their own history so you
can write it up.
Please note that performing breast and pelvic exams on a friendly
volunteer are not a part of this health assessment course. You will be
learning the techniques but are not responsible for performing the assessments.
You will still interview a friendly volunteer for the history section but you will then
write up a normal exam. You will be acquiring that skill in your Practicum courses
Learning Activities

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A variety of learning activities are designed to support the course objectives and
facilitate different learning styles. Learning activities for each module include the
following:
Readings
Please read the assigned chapters in the textbook, the articles listed are there as
supplemental information. There is no expectation that you read all the articles
provided but there is an expectation that you read the textbook and the power point
lectures. Specific reading assignments are listed on the Course Schedule and in the
specific Modules.

Multimedia
There are a variety of multimedia presentations available to assist students to
prepare for the exam and accommodate differing learning styles. The module
learning objectives and multimedia will provide an overview to assist students in
focusing their studies. Your text has a CD included as well. Under multimedia you
will find demonstrated physical assessments of the various systems through the
Bates series. Students should view the appropriate assessments for each module.
The Multimedia may include items such as: Lectures, Supplemental Lecture Notes,
Supplemental Pictures, and Videos/Animations, ShadowHealth
Writing Assignments, Projects, and Assessments:
Lab Assessments
You will be assigned (by week 2) to your lab faculty. The lab faculty are
practicing NPs and know what you need to be successful. The expectation is
that they will return your graded assignments to you within 4 days. They will
give you very important feedback it is expected that you review their
comments and make these adjustments on your next assessment. Please
take advantage of this wonderful information. Feedback should be
reflected in subsequent assignments, if it is not the grade will be
affected. So please review and learn from feedback.
The assignments are required in order to meet two needs: one is to practice
the assessment skill and secondly to practice the documentation of how to
write up a patient encounter. Both of these skills require practice and that is
why we utilize ShadowHealth. ShadowHealth is a software teaching strategy
that gives you the virtual lab time to see the assessment skill and practice
the write up to augment both the physical & the documentation components.
The Shadow Health work remains within that site the assignment that you
turn in each week for grading to your lab faculty is the write up that you
complete on your friendly volunteer.
Each week you will complete a focused assessment the templates for each of
these will be posted in the lab section of the weekly module and must be
used. There is a guide to help you include the important components of the
history and physical. This is guide and is not to be submitted but to be used
to assist you in the writing of the focused assessment.

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A major component is the writing of the HPI (history of the present illness)
your pretend patient will have a chief complaint (I have a cough for
exampleeach system has some Chief Compliant from which you may
choose) and then you will get the story for the HPI the actual exam is written
with what you really see/hear/feel it does not have to be made up to match
the HPI.
During the learning modules, you will conduct physical exams of the
corresponding body system specific to that module on an individual.
The individual that you use for the assessments can be a family member or
friend, but must be a "friendly volunteer.
You are NOT allowed to use a patient. This is a course in which you should be
able to spend sufficient time going through the process of obtaining a health
history and doing an adequate health assessment.
If the paper you turn in states the patient presents to the ER or if we suspect
that you used an actual patient your assignment may not be accepted!
You are to document the actual assessment findings noted during the
physical examination. So even though your "friendly volunteer" is making up
a story to go along with the chosen complaint, you are to document the
actual findings rather than expected findings with that diagnosis. If your
friendly volunteer actually has abnormal findings you should document as
such. However, make a specific note in regards to the abnormal findings at
the end of your document.
You must assess different people for the various modules. You may repeat
one friendly volunteer for the final lab exam, however you are not allowed
to use the same individual that you used for the module 1 comprehensive
health history.
You will chart the findings of the exam using the form found in the modules
here on the course site. There may be other examples of documents within
the course but use the document provided and then use the assignment link
within the module for your assignment.
You will chart subjective and objective data only, not the analysis and plan.
You are to use adults for the exams if you are in the adult nurse practitioner
curriculum. However, if you are in the family nurse practitioner curriculum,
you may use a pediatric patient for one of the assessments. However, make
certain you follow the documentation guidelines in the pediatric text book.
You may not use a child for the HEENT, neurological, or final exam.

You will be graded on 9 module lab assessments. (Health History, Breast,

Respiratory, Cardiac, Abdomen, Skin, Male/female, Neuro,
Musculoskeletal)

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You will receive one grade for each MODULE'S lab assessment. The lab
assessments will be averaged and become comprise 10% of your grade. Each
module will be graded on organization, completeness, proper use of
terminology, and neatness
The only time you are responsible for doing a full history is week 1 (but no
physical exam) and for your final all the other modules are a focused
assessment. The difference in a complete versus focused health history,
review of systems, and assessment is covered in the textbook and lectures.
Submit your lab assessments using the Assignment tool in Blackboard.
Assignments have a due date and you are expected to submit them through
the appropriate module link. No assignments will be accepted by e-mail. If
you are late with a submission, you must notify your lab faculty member
PRIOR to the due date if you need an extension in order to qualify the
assignment for acceptance. You will still be able to submit through the
Blackboard link even if the assignment is late. However, if you do not
notify your assigned faculty member prior to the due date you will
receive zero points!
You will be expected to do the ShadowHealth assignment for the specific modules they offer
which are Health History, Respiratory Assessment and concept, Cardiac
Assessment and concept, Abdomen assessment and concept, HEENT, Neuro,
Musculoskeletal, Mental Health and one more depending on your population
focus.. 12 in total
Each week the shadow health column in your my grades will increase so
after the completion of the first module it will show 1/12 that means you
completed the first one and as you do more it is reflected as 6/12, 8/12 until
the final one 12/12
the completion of all of the assigned modules will be 5% of your grade. Your
faculty person may also suggest redoing or doing remedial work with this
program for your documentation.
Refer to the Course Schedule and Weekly Assignments for due dates.
Purpose and Guidelines for the Lab Assignment
The purpose of each lab assignment is for you to gain experience addressing the
chief complaint, history of present illness, past medical history, review of systems
and of course the exam.
When doing your system assessments, try to find a volunteer with a history
that relates to the system being examined. For instance, in the cardiac
module they could have hypertension. In the skin assessment, they could be
seen for a rash, or a suspicious lesion. We have provided a list of chief
complaints in each module, from which they can chose to make up a story.
Do not use a generalized complaint such as fatigue or dizziness that could
encompass a number of systems.

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With any complaint you need to document the seven attributes of a
symptom. So if your patient complains of numerous items, you need to fully
explore each area. For example, your patient's chief complaint is a sore
throat, but then while conducting the interview they admit to a cough. You
must now clarify the seven attributes of the both the symptom of a sore
throat and the cough. You will be better served to keep things relatively
simple to learn the process of documenting a focused assessment.
We have found that students often do a better job by listing items in the
health history rather than combining information in paragraph form. You will
generally use a paragraph for the history of present illness, however for the
remaining items in the health history you may want to try listing the
components. Long narrative descriptions make it easier for you to omit
important details as well as more difficult for the reader to locate pertinent
information. This is just a suggestion to improve your technique and to help
prevent you from losing points.
As a student you are expected to document the information fully.
So do not ever defer an exam.
Do not say that something is up-to-date, within normal limits or normal.
These terms are considered an opinion and add no value to the assessment
b/c they are vague
o The patient's idea of up to date is not necessarily the same as the
providers
o One person's interpretation of normal may be quite different from
another person's interpretation
o Just remember to fully document your findings during the examination.
Midterm Lab Assessment see above for the video information
You will complete an HEENT exam on a friendly volunteer. You will gather the
history and then perform the physical capturing it as a video. The individual must be
a willing participant. There will be a site for uploading the video and then you will
also submit the documentation using the assigned link.
Final Lab Assessment
The final requires a NP or MD to evaluate your performance
You will complete a full assessment on a friend, family member, (excluding breast/
pelvic/genitalia) using the form found in Module 12 on the course site.
The individual should be a willing participant that you bring to the place where
the evaluator will be watching your work.
You should not be using a patient in the evaluator's practice. The
assessments are confidential and will only be shared with your facilitator and
preceptor for evaluation purposes.
Your evaluator should complete the assessment/evaluation checklist (found on the
course website under Module 12.)

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You will need to submit your written documentation along with the evaluation form
via the assignment link in BB
You must complete both the midterm video and the final lab
assessment (with the evaluation forms) to pass the course. We
must have contact information for the evaluators practice setting.
Refer to the Course Schedule for due dates.
There are 5 exams: Please see schedule for opening & closing times.
The exams are open for 4 days if there is a situation that arises that you are
unable to take the exam in the allotted time you MUST contact Dr. Colella. If
the exam has closed there is no option and you will fail that exam. If notified
while it is open other arrangements may be possible. The number of
questions stated below are approximate they may change during the
semester.
Exam 1 covers Week 1 History & week 2 Prevention Guidelines there
approximately 30 questions & you will have 50 minutes
Exam 2 covers Week 3:Breasts & Axilla, Week 4: Chest & lungs, and week 5:
Cardiac there are approximately 50 questions and 75 minutes
Exam 3 covers week 6: Abdomen, Week 7: HEENT, and Week 8: Skin..there
are approximately 60 questions and 90 minutes
Exam 4 covers Week 9: Male/Female, Week 10: Neuro, Week 11:
Musculoskeletal there are approximately 70 questions and you have 105
minutes
Exam 5 is comprehensive there are approximately 80 questions and
you have 2 hours via Examity**
Students in an online/hybrid program should expect to be immersed in technology. As a result, it
is imperative that students proactively prepare for this technology immersion by adhering to
CON technology requirements (http://nursing.uc.edu/centers/cater/technology-resources/online-
technology-requirements.html) and checking to ensure that all systems are functioning prior to
major exams and due dates. Students should also prepare for technology failure by having a
back-up plan, using technology support services, and communicating with faculty.

Because technology failure and security issues are inherent in a technology-immersed

environment, the faculty and staff of the CON have taken steps to ensure that processes are in
place to protect the quality of assessments. All students are expected to participate in these
processes, which may include, but are not limited to, authentication, validation, video recording,
and proctoring of examinations. Adherence to these processes will help to protect the integrity of
the CON graduate programs, faculty, and student outcomes. Maintaining these high standards
benefits our graduates, as their future patients and employers can continue to have confidence in
the quality of their credentials.

The CON has contracted with Examity to provide online proctoring for this course, enabling
you to take exams remotely from a location of your choosing during the scheduled testing
window. Detailed instructions on using Examity will be provided to you by your

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instructor. Once you receive those instructions, please login as soon as possible to set up your
Examity profile.

Please check ahead of time that the PC with which you plan to take your exam meets the
following Examity technical requirements:

Webcam and microphone (either built-in or external is fine)

Connection to a network with sufficient internet speed: at least 10-15 Mbps upload and
download speed. You may test your internet speed at http://www.speedtest.net or
www.bandwidthplace.com

NOTE: If your PC does not meet these requirements, you may be unable to complete your exam
and asked to reschedule.

If you have any questions or concerns, feel free to contact Examitys technical support team at
support@examity.com or (855)-392-6489.
There will a test review done by the faculty after the closing and review
of the exam. There will be an announcement posted as to when the
review will be available. You will not be able to access your exam for
review.
Please be very cautious with your time. It is YOUR responsibility to
keep up with your time, so please set a timer or closely monitor your
time. Five (5) points will be deducted for each minute exceeding the
minute limit. You do not want to fail the course because you exceeded
the time on a test.
The kaltura video review will be done after all students have taken the
exam. If you have questions regarding the test after all grades have
been posted, please contact Dr. Colella with your questions.
** Your final exam (only) for this course will be taken remotely (online) and
proctored by a service called Examity. Detailed instructions on using
Examity will be provided in Blackboard.

Please check ahead of time that the computer with which you plan to take
your exam meets the following Examity technical requirements:

Webcam and microphone (either built-in or external is fine)

Connection to a network with sufficient internet speed: at least 700KBPS
upload and download speed. You may test your internet speed at
http://www.speedtest.net

NOTE: If your computer does not meet these requirements, you may be
unable to complete your exam and will be asked to reschedule.

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If you have any questions or concerns, feel free to contact Examitys
technical support team at support@examity.com or (855)-392-6489.
For each test there will be There a practice test that contains a few
questions so that you can get an idea of how the questions will look. You do
not receive any points or credit for the practice test. The practice
tests will be open for the week prior to the real test and close
before the real test opens to eliminate any confusion.
*** If you have problems accessing or submitting any quiz please contact the
Blackboard Help Desk by phone at (513) 556-1602 or email
(blackboard@uc.edu). Also, immediately notify the Course Faculty Dr. Colella
by email Christine.colella@uc.edu

Evaluation (Evaluation Methods, Grading Policy, Grading Scale)

Grading Policy

Method for Calculation of Course Grade

Test 110%

Test 210%

Test 310%

Test 410%

Test 5 20% comprehensive

Lab weekly write-ups 10% (each assignment is graded and then the
average becomes 10% of your grade)

ShadowHealth 5% (you will get a point for each one you complete this
then becomes 5% of your grade)

Lab Mid-term: 10%

Lab Final: 15%

Grading: 94-100 A
90-93 A-
87-89 B+
84-86 B
80-83 B-
77-79 C+ (NOT PASSING requires repeating the course
>77 F

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All College of Nursing masters degree students must earn a B- grade or better for
the MSN degree core and advanced nurse practice nurse program core courses.
Students earning grades below a "B-", in any course, will have to repeat the course.
Please note that the University of Cincinnati Graduate School requires that masters
degree students maintain a grade point average (GPA) of at least 3.0 to remain in
good standing and obtain a masters degree at the University of Cincinnati.

Course Policies
It is your responsibility to check the announcement page and your e-mail frequently
for any changes or announcements. It would be advisable to check at least daily.

E-MAIL
All e-mail correspondence is to be conducted through your University of Cincinnati
e-mail account and must be respectful and professional.

SYLLABUS
The syllabus is subject to change. An announcement will be posted in the event of a
change.

LATE WORK
Lab Assessments and Final Lab Assessments
Students with extenuating circumstances need to contact the Course Faculty for
assignment extensions prior to the due date.

Exams
Zero points (0 points) will be earned for exams not completed by the due date if
faculty is not notified prior to the due date.
The final will be done within Examity (see information above)
ASSESSMENT POLICIES AND PROCEDURES
Adhere to the following requirements to successfully complete all assessments
during this course.
No books, notes, or collaborating with students or others during testing is
permitted, unless otherwise specified.
The questions will be multiple choice, true or false, or matching.
Any problem accessing or submitting a quiz/test contact the Blackboard help
desk at (513) 556-1602 or email (blackboard@uc.ed). Please also notify your

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assigned faculty member as soon as possible in the event that any problems
occur.
Each assessment has an allotted test time. Five points will be deducted for
every minute exceeding the allotted test time.
Use the latest version of the internet browser Mozilla Firefox to ensure correct
display of the Blackboard test timer. Make certain you are using high speed
internet access during testing. DO NOT use Wifi.
The test will not turn off automatically if you exceed the time limit.
A test not completed by due date will receive 0 points.

Academic Integrity: the University of Cincinnati Rules, including the

Student Code of Conduct, and documented policies of the department,
college, and university related to academic integrity will be enforced. Any
violation of these regulations, including acts of plagiarism or cheating will be
dealt with on an individual basis according to the severity of the misconduct.
Academic integrity violations include, but are not limited to the
following: presenting someone elses work as you own, plagiarizing
information from a text or article for an assignment, using someone elses
assignment to complete your own work, copying, or attempting to copy test
questions (either for personal use or distribution), communicating test
information by any means (verbal or written), or working on a test with
assistance from another person. In addition, any attempt to utilize the text
or notes during an EXAMITY proctored test will be judged as cheating and
you will receive a zero for the test and face possible disciplinary action.
Cheating threatens the integrity of exams and the graduate program.
Disciplinary action can be up to and including dismissal from the program.

SPECIAL NEEDS
If you have any special needs related to your participation in this course, including
identified visual impairment, hearing impairment, physical impairment,
communication disorder, and/or a specific learning disability that may influence
your performance in this course, you should notify the Course Faculty to arrange for
reasonable provisions to ensure an equitable opportunity to meet all the
requirements of this course. At the discretion of the Course Faculty some
accommodations may require prior approval by Disability Services.

GRADE DISPUTE
Any question or dispute over the earned points for a quiz, assignment, discussion,
or extra credit should be addressed by first appealing in writing to the Course
Faculty. An appeal of a negative decision may then be made to the Program
Director, who will follow the grade dispute policy of the University.

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NETIQUETTE
Communication using Web-based tools has created the need for a protocol called
"netiquette" that encourages efficient and effective communication while
discouraging abuse of e-mail, chat sessions, and message boards. There is a link on
the Blackboard page for this please review.

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