Sample Answer for NURS 6512 Assignment: Assessment Tools and Diagnostic Tests Included After Question
When seeking to identify a patient’s health condition, advanced practice nurses can use a diverse selection of diagnostic tests and assessment tools; however, different factors affect the validity and reliability of the results produced by these tests or tools. Nurses must be aware of these factors in order to select the most appropriate test or tool and to accurately interpret the results.
Not only do these diagnostic tests affect adults, body measurements can provide a general picture of whether a child is receiving adequate nutrition or is at risk for health issues. These data, however, are just one aspect to be considered. Lifestyle, family history, and culture—among other factors—are also relevant. That said, gathering and communicating this information can be a delicate process.
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For this Assignment, you will consider the validity and reliability of different assessment tools and diagnostic tests. You will explore issues such as sensitivity, specificity, and positive and negative predictive values. You will also consider examples of children with various weight issues. You will explore how you could effectively gather information and encourage parents and caregivers to be proactive about their children’s health and weight.
To Prepare
- Review this week’s Learning Resources and consider factors that impact the validity and reliability of various assessment tools and diagnostic tests. You also will review examples of pediatric patients and their families as it relates to BMI.
- By Day 1 of this week, you will be assigned to one of the following Assignment options by your Instructor: Adult Assessment Tools or Diagnostic Tests (option 1), or Child Health Case (Option 2). Note: Please see the “Course Announcements” section of the classroom for your assignments from your Instructor.
- Search the Walden Library and credible sources for resources explaining the tool or test you were assigned. What is its purpose, how is it conducted, and what information does it gather?
NURS 6512 Assignment Assessment Tools and Diagnostic Tests - Also, as you search the Walden library and credible sources, consider what the literature discusses regarding the validity, reliability, sensitivity, specificity, predictive values, ethical dilemmas, and controversies related to the test or tool.
- If you are assigned Assignment Option 2 (Child), consider what health issues and risks may be relevant to the child in the health example.
- Based on the risks you identified, consider what further information you would need to gain a full understanding of the child’s health. Think about how you could gather this information in a sensitive fashion.
- Consider how you could encourage parents or caregivers to be proactive toward the child’s health.
The Assignment
Assignment (3–4 pages, not including title and reference pages):
Assignment Option 1: Adult Assessment Tools or Diagnostic Tests:
Include the following:
- A description of how the assessment tool or diagnostic test you were assigned is used in healthcare.
- What is its purpose?
- How is it conducted?
- What information does it gather?
- Based on your research, evaluate the test or the tool’s validity and reliability, and explain any issues with sensitivity, reliability, and predictive values. Include references in appropriate APA formatting.
Assignment Option 2: Child Health Case:
Include the following:
- An explanation of the health issues and risks that are relevant to the child you were assigned.
- Describe additional information you would need in order to further assess his or her weight-related health.
- Identify and describe any risks and consider what further information you would need to gain a full understanding of the child’s health. Think about how you could gather this information in a sensitive fashion.
- Taking into account the parents’ and caregivers’ potential sensitivities, list at least three specific questions you would ask about the child to gather more information.
- Provide at least two strategies you could employ to encourage the parents or caregivers to be proactive about their child’s health and weight.
By Day 6 of Week 3
Submit your Assignment.
Submission and Grading Information
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A Sample Answer For the Assignment: NURS 6512 Assignment: Assessment Tools and Diagnostic Tests
Title: NURS 6512 Assignment: Assessment Tools and Diagnostic Tests
The rationale for conducting any screening exam is to identify the early stages of a pathologic disorder. Screening allows providers to take early treatment interventions before the clinical signs or symptoms of the condition are prevalent, thus reducing the risk of morbidity or mortality. Prostate cancer is the second leading cancer in men, after non-melanoma skin cancer and the fourth leading cause of cancer mortality in males globally (Fenton et al., 2018). Cancer of the prostate is screened either through a digital rectal exam (DRE) or prostate-specific antigen (PSA) test (Fenton et al., 2018). This paper seeks to discuss the PSA test, including its purpose, how it is conducted, the information it obtains, and its validity and reliability
Purpose of PSA Test
The primary purpose of the PSA test is to screen for prostate cancer. PSA test has proved to be superior to DRE and transrectal prostatic ultrasonography in the early detection of prostate cancer (Fenton et al., 2018). The serum level of PSA is generally elevated in persons with prostate cancer. In addition to screening for prostate cancer, it is used to monitor a person’s response to prostate cancer treatment. It is also used to determine the progress of the prostate tumor (Fenton et al., 2018). Furthermore, the PSA test is used to identify male patients who are candidates for prostate biopsy. The Food and Drug Administration (FDA) approved the use of the PSA test in examining the progress of prostate cancer in males who had been previously diagnosed (Kovac et al., 2020). Males with prostate symptoms take on a PSA test alongside a DRE to help in determining the nature of the underlying problem. Men above 45 years are recommended to have a screening for prostate cancer (Kovac et al., 2020). However, the current guidelines recommend against serum PSA screening in asymptomatic males over 70 years.
Increased PSA levels are related to prostate cancer and benign prostatic hyperplasia (BPH). Nonetheless, PSA secretion increases with age, which is believed to be an evolutionary adaptation that bestows males with genetic fitness over other male counterparts (Fenton et al., 2018). Therefore, rises in PSA levels increase the occurrence of disorders such as BPH in the general population. Research has established that 86% of persons with BPH have an elevated serum PSA (Fenton et al., 2018). The United States Preventative Task Force (USPSTF) proposes selectively conducting PSA screening on a patient based on professional judgment and patient preference in men aged 55 to 69.
How PSA Test Is Conducted
A PSA test is performed by drawing a blood specimen from a vein in the arm. The blood specimen is centrifuged, which results in the serum being separated within 2-3 hours. An assay is then conducted in the subsequent 2-3 hours. However, if the assay is not performed within 2-3 hours, the serum should be frozen at temperatures below -20oC (Kovac et al., 2020). The test quantifies the level of PSA in the serum. Results are reported as nanograms of PSA per milliliter (ng/mL) of blood. No specific normal or abnormal serum PSA levels exist since the levels may differ over time in the same individual. The standard PSA reference range is 0.0-4.0 ng/mL. A PSA value equal to or more than 4.0 ng/mL necessitates further assessment for prostate cancer should be done (Kovac et al., 2020). The value has been demonstrated to maximize specificity at the expense of sensitivity for prostate cancer detection. Nonetheless, no PSA value assures the detection of prostate cancer.
Information Gathered From the PSA Test
The PSA test gathers information on the amount of prostate-specific antigen in the serum. The prostate-specific antigen is a serine protease enzyme secreted by the columnar epithelium of prostatic tissue. Upon secretion, it passes along the basal cell layer, endothelial cells, and capillary membranes into the systemic circulation (Kovac et al., 2020). The prostate gland is well-vascularized, and as a result, small amounts of PSA regularly pass into the bloodstream. PSA levels below 3 ng/ml are considered normal (Kovac et al., 2020). However, the PSA levels can surpass 3 ng/ml when the prostate gland changes or is irritated.
Validity and Reliability and Issues with Sensitivity, Reliability, and Predictive Values
The PSA test offers both false-positive and false-negative results. A false-positive result is established when the serum PSA level is above the standard range, but the patient has no prostate cancer (Ilic et al., 2018). A majority of patients with a high PSA level do not have prostate cancer. Furthermore, only approximately 25% of patients indicated for a prostate biopsy due to a high PSA level end up being diagnosed with prostate cancer after the biopsy. A false-negative result occurs when a patient’s PSA level is within the standard range, although they have prostate cancer (Ilic et al., 2018). Several factors can cause low secretion of PSA, such as dutasteride and finasteride drugs used to treat BPH. Conversely, high PSA levels can be found in conditions other than prostate cancer, including prostatitis and urinary tract infection. Besides, PSA levels can rise if pressure is exerted on the prostate or after ejaculation.
Reliability is a major issue when using the PSA test. It has been established that PSA levels vary to some degree across different laboratories. The reliability of the PSA test is limited because studies used to determine the standard range were carried out mainly in white males (Ilic et al., 2018). The sensitivity of PSA testing with a cutoff point of 4.0 ng/ml is 67.5-80%. This suggests that 20-30% of prostate cancers are not detected when only the PSA test is used for screening. In addition, the specificity of PSA tests of levels using cutoffs greater than 4.0 ng/ml is 60-70%, with a positive predictive value of 0.43 (Ilic et al., 2018). The sensitivity and specificity levels should guide the provider on the screening tests to recommend for different patients.
Conclusion
PSA testing is recommended in males above 45 years to promote early detection and lower the morbidity and mortality of prostate cancer. PSA is the best screening tool available for early prostate cancer diagnosis. It is used to screen for prostate cancer, monitor a patient’s response to prostate cancer treatment, and monitor the progress of the prostate tumor. PSA test is conducted by obtaining a blood specimen and performing an assay. The standard PSA range is 0.0-4.0 ng/mL, and values higher than that necessitate a further evaluation of prostate cancer. However, the PSA test is associated with false positives and negatives. Many patients with elevated PSA levels have no prostate cancer, and patients with normal PSA levels may have prostate cancer that goes unnoticed.
References
Fenton, J. J., Weyrich, M. S., Durbin, S., Liu, Y., Bang, H., & Melnikow, J. (2018). Prostate-specific antigen-based screening for prostate cancer: evidence report and systematic review for the US Preventive Services Task Force. Jama, 319(18), 1914-1931. https://doi.org/doi:10.1001/jama.2018.3712
Ilic, D., Djulbegovic, M., Jung, J. H., Hwang, E. C., Zhou, Q., Cleves, A., Agoritsas, T., & Dahm, P. (2018). Prostate cancer screening with prostate-specific antigen (PSA) test: a systematic review and meta-analysis. BMJ (Clinical research ed.), 362, k3519. https://doi.org/10.1136/bmj.k3519
Kovac, E., Carlsson, S. V., Lilja, H., Hugosson, J., Kattan, M. W., Holmberg, E., & Stephenson, A. J. (2020). Association of baseline prostate-specific antigen level with long-term diagnosis of clinically significant prostate cancer among patients aged 55 to 60 years: a secondary analysis of a cohort in the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial. JAMA network open, 3(1), e1919284-e1919284. https://doi.org/10.1001/jamanetworkopen.2019.19284
Grading Rubric
| Performance Category | 100% or highest level of performance
100% 16 points |
Very good or high level of performance
88% 14 points |
Acceptable level of performance
81% 13 points |
Inadequate demonstration of expectations
68% 11 points |
Deficient level of performance
56% 9 points
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Failing level
of performance 55% or less 0 points |
| Total Points Possible= 50 | 16 Points | 14 Points | 13 Points | 11 Points | 9 Points | 0 Points |
| Scholarliness
Demonstrates achievement of scholarly inquiry for professional and academic topics. |
Presentation of information was exceptional and included all of the following elements:
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Presentation of information was good, but was superficial in places and included all of the following elements:
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Presentation of information was minimally demonstrated in all of the following elements:
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Presentation of information is unsatisfactory in one of the following elements:
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Presentation of information is unsatisfactory in two of the following elements:
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Presentation of information is unsatisfactory in three or more of the following elements
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| 16 Points | 14 Points | 13 Points | 11 Points | 9 Points | 0 Points | |
| Application of Course Knowledge
Demonstrate the ability to analyze and apply principles, knowledge and information learned in the outside readings and relate them to real-life professional situations |
Presentation of information was exceptional and included all of the following elements:
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Presentation of information was good, but was superficial in places and included all of the following elements:
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Presentation of information was minimally demonstrated in the all of the following elements:
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Presentation of information is unsatisfactory in one of the following elements:
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Presentation of information is unsatisfactory in two of the following elements:
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Presentation of information is unsatisfactory in three of the following elements
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| 10 Points | 9 Points | 6 Points | 0 Points | |||
| Interactive Dialogue
Initial post should be a minimum of 300 words (references do not count toward word count) The peer and instructor responses must be a minimum of 150 words each (references do not count toward word count) Responses are substantive and relate to the topic. |
Demonstrated all of the following:
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Demonstrated 3 of the following:
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Demonstrated 2 of the following:
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Demonstrated 1 or less of the following:
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| 8 Points | 7 Points | 6 Points | 5 Points | 4 Points | 0 Points | |
| Grammar, Syntax, APA
Points deducted for improper grammar, syntax and APA style of writing. The source of information is the APA Manual 6th Edition Error is defined to be a unique APA error. Same type of error is only counted as one error. |
The following was present:
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The following was present:
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The following was present:
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The following was present:
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The following was present:
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| Participation
Requirements |
Demonstrated the following:
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| Due Date Requirements | Demonstrated all of the following:
A minimum of one peer and one instructor responses are to be posted within the course no later than Sunday, 11:59 pm MT. |
Demonstrates one or less of the following.
A minimum of one peer and one instructor responses are to be posted within the course no later than Sunday, 11:59 pm MT. |