Walden University Preventative Health and Assessing PPT

WEEK NINE CASE STUDY

Edwardo is a 21-year-old Mexican American male who is about to embark on a rigorous exercise program to lose weight. He works as IT support for an organization, a position that requires most of his shift to be seated in his chair with a headset, responding to IT requests online for the duration of his shift. He is a full-time graduate student in an IT program at the local university. He goes out with friends once weekly “for some fun and relief”, he drinks socially, one to two beers with his friends, does not smoke or use recreational drugs. He takes no medications, has not had a physical since he enrolled in his first college program and that consisted of completing a form. He played football in high school but has had no time for sports since enrolling in his first college program. He considers his studies the most essential aspect for his focus. His parents are healthy and invite him over once weekly for “one good meal” and he takes groceries offered by his mother home so that he has food in his apartment. His parents want to help him stay healthy since he has little time to grocery shop, and often gets a burger on the way home from classes. He sleeps well, feels “sluggish” sometimes, especially during his bus ride to and from work. This concerned him and so he has managed to find time to go to a gym for exercise. He hopes to feel better and lose at least 30 pounds by working out at the gym. He went to visit a personal trainer for the first session and is surprised to hear his trainer suggest that he go to his primary healthcare provider for a checkup first. He began thinking about his parents and their health habits. Both are working full-time and active and healthy, eat nutritious meals, which he enjoys when he has the time to visit, and they take no meds. He has no brothers or sisters. He is concerned that maybe he will not enjoy the health of his parents and maybe he is doing something wrong since he should have inherited good health from his parents. You learn this during your introductory conversation with him and now you must determine where to begin with this “healthy” young man and apparently, his trainer. You applaud his new plan for exercise and begin to discuss with him some health goals and objectives.

B/P 124/70 H/R 70 R 18 WT 200 pounds HT 70 inches

Based on the provided patient information, think about the health history you would need to collect from the patient.

Consider what physical exams and diagnostic tests would be appropriate to gather more information about the patient’s condition. Reflect on how the results would be used to make a diagnosis.

Identify three to five possible conditions that may be considered in a differential diagnosis or at risk for the patient or that you share with him he is at risk for having.

Consider clinical guidelines that might support each diagnosis.

Develop a realistic preventive health treatment plan for the patient that includes health promotion and patient education strategies for special populations. How would you categorize him as “special population”? Use social determinants of health, information that you gather during your assessment, to guide your realistic preventive health plan.

Determine if you will refer Edwardo back to his trainer for full approval of an exercise program or will you follow up with him first, or concurrently, or tell him that he should not enter an exercise program now (share your reasoning for your decision). This is primarily a PREVENTIVE health assessment. You will want to provide an evaluation, but no pathology must be found; however, a preventive health plan is a must. Social determinants of health must be considered. Referrals or none? Patient education. How would you plan to work with the trainer who provided this referral?

This is a different kind of case study, however, one you may encounter and one that is really important for you to be able to work through. Enjoy!

PREVENTATIVE HEALTH AND ASSESSING, DIAGNOSING, AND TREATING SPECIAL POPULATIONS

Certain groups of patients have concerns that may be specific to their particular population. Conditions related to men’s or women’s health, older adults, college students, LGBTQ individuals, athletes, those with particular cultural beliefs or concerns, or those undergoing palliative or end-of-life care would all fall under this category. Individuals may identify with more than one category.

For this Assignment, you practice assessing, diagnosing, and treating disorders seen in special population patients.

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 this week’s Learning Resources. Consider preventative health and assessing, diagnosing, and treating special populations.

Review the case study provided by your Instructor. Based on the provided patient information, think about the health history you would need to collect from the patient.

Consider what physical exams and diagnostic tests would be appropriate in order to gather more information about the patient’s condition. Reflect on how the results would be used to make a diagnosis.

Identify three to five possible conditions that may be considered in a differential diagnosis for the patient.

Consider each patient’s diagnosis. Think about clinical guidelines that might support this diagnosis.

Develop a preventative health treatment plan for the patient that includes health promotion and patient education strategies for special populations.

Complete:

Use the Focused SOAP Note Template to address the following:

Subjective: What details are provided regarding the patient’s personal and medical history?

Objective: What observations did you make during the physical assessment? Include pertinent positive and negative physical exam findings. Describe whether the patient presented with any morbidities or psychosocial issues.

Assessment: Explain your differential diagnoses, providing a minimum of three. List them from highest priority to lowest priority and include their CPT and ICD-10 codes for the diagnosis. What would your primary diagnosis be and why?

Plan: Explain your plan for diagnostics and primary diagnosis. What would your plan be for treatment and management? Include pharmacologic and non-pharmacologic treatments, alternative therapies, and follow-up parameters as well as a rationale for this treatment and management plan.

Reflection notes: Describe your “aha!” moments from analyzing this case.

Focused SOAP Note Template
Patient Information:
Initials, Age, Sex, Race
S.
CC (chief complaint): A brief statement identifying why the patient is here, stated in the
patient’s own words (for instance “headache” not “bad headache for 3 days”). For a
patient with dementia or other cognitive deficits, this statement can be obtained from a
family member.
HPI: This is the symptom analysis section of your note. Thorough documentation in this
section is essential for patient care, coding, and billing analysis. Paint a picture of what
is wrong with the patient. Use LOCATES Mnemonic to complete your HPI. You need to
start EVERY HPI with age, race, and gender (e.g., 34-year-old AA male). You must
include the seven attributes of each principal symptom in paragraph form not a list. If
the CC was “headache,” the LOCATES for the HPI might look like the following
example:
Location: head
Onset: 3 days ago
Character: Pounding, pressure around the eyes and temples
Associated signs and symptoms: Nausea, vomiting, photophobia, phonophobia
Timing: After being on the computer all day at work
Exacerbating/relieving factors: Light bothers eyes; Aleve makes it tolerable but
not completely better
Severity: 7/10 pain scale
Current Medications: Include dosage, frequency, length of time used, and reason for
use. Also include OTC or homeopathic products.
Allergies: Include medication, food, and environmental allergies separately. Provide a
description of what the allergy is (e.g., angioedema, anaphylaxis). This will help
determine a true reaction vs. intolerance.
© 2020 Walden University
Page 1 of 4
PMHx: Include immunization status (note date of last tetanus for all adults), past major
illnesses and surgeries. Depending on the CC, more info is sometimes needed.
Soc and Substance Hx: Include occupation and major hobbies, family status, tobacco
and alcohol use (previous and current use), and any other pertinent data. Always add
some health promo question here such as whether they use seat belts all the time or
whether they have working smoke detectors in the house, living environment, text/cell
phone use while driving, and support system.
Fam Hx: Identify illnesses with possible genetic predisposition, and contagious or
chronic illnesses. Reason for death of any deceased first-degree relatives should be
included. Include parents, grandparents, siblings, and children. Include grandchildren if
pertinent.
Surgical Hx: Prior surgical procedures.
Mental Hx: Diagnosis and treatment. Current concerns: (Anxiety and/or depression).
History of self-harm practices and/or suicidal or homicidal ideation.
Violence Hx: Concern or issues about safety (personal, home, community, sexual
(current & historical)
Reproductive Hx: Menstrual history (date of LMP), Pregnant (yes or no),
Nursing/lactating (yes or no), contraceptive use (method used), types of intercourse:
oral, anal, vaginal, other, any sexual concerns
ROS: Cover all body systems that may help you include or rule out a differential
diagnosis You should list each system as follows: General: Head: EENT: etc. You
should list these in bullet format and document the systems in order from head to toe.
Example of Complete ROS:
GENERAL: No weight loss, fever, chills, weakness, or fatigue.
HEENT: Eyes: No visual loss, blurred vision, double vision, or yellow sclerae. Ears,
Nose, Throat: No hearing loss, sneezing, congestion, runny nose, or sore throat.
SKIN: No rash or itching.
CARDIOVASCULAR: No chest pain, chest pressure, or chest discomfort. No
palpitations or edema.
RESPIRATORY: No shortness of breath, cough, or sputum.
GASTROINTESTINAL: No anorexia, nausea, vomiting, or diarrhea. No abdominal pain
or blood.
© 2020 Walden University
Page 2 of 4
GENITOURINARY: Burning on urination. Pregnancy. Last menstrual period
(MM/DD/YYYY).
NEUROLOGICAL: No headache, dizziness, syncope, paralysis, ataxia, numbness, or
tingling in the extremities. No change in bowel or bladder control.
MUSCULOSKELETAL: No muscle, back pain, joint pain, or stiffness.
HEMATOLOGIC: No anemia, bleeding, or bruising.
LYMPHATICS: No enlarged nodes. No history of splenectomy.
PSYCHIATRIC: No history of depression or anxiety.
ENDOCRINOLOGIC: No reports of sweating, cold, or heat intolerance. No polyuria or
polydipsia.
ALLERGIES: No history of asthma, hives, eczema, or rhinitis.
O.
Physical exam: From head to toe, include what you see, hear, and feel when doing
your physical exam. You only need to examine the systems that are pertinent to the CC,
HPI, and History. Do not use “WNL” or “normal.” You must describe what you see.
Always document in head-to-toe format i.e., General: Head: EENT: etc.
Diagnostic results: Include any labs, X-rays, or other diagnostics that are needed to
develop the differential diagnoses (support with evidenced and guidelines).
A.
Differential Diagnoses: You must have at least three differentials with supporting
evidence. Explain what rules each differential in or out and justify your primary
diagnosis selection. Include pertinent positives and pertinent negatives for the specific
patient case.
P.
Includes documentation of diagnostic studies that will be obtained, referrals to other
health care providers, therapeutic interventions, education, disposition of the patient,
and any planned follow-up visits. Each diagnosis or condition documented in the
assessment should be addressed in the plan. The details of the plan should follow an
orderly manner.
© 2020 Walden University
Page 3 of 4
Also included in this section is the reflection. Reflect on this case and discuss
whether or not you agree with your preceptor’s treatment of the patient and why or why
not. What did you learn from this case? What would you do differently?
Also include in your reflection, a discussion related to health promotion and disease
prevention taking into consideration patient factors (such as age, ethnic group, etc.),
PMH, and other risk factors (e.g., socioeconomic, cultural background, etc.).
References
You are required to include at least three evidence-based, peer-reviewed journal
articles or evidenced-based guidelines which relate to this case to support your
diagnostics and differentials diagnoses. Be sure to use correct APA 7th edition
formatting.
© 2020 Walden University
Page 4 of 4
NRNP_6565_Week9_Assignment_Rubric
NRNP_6565_Week9_Assignment_Rubric
Criteria
This criterion is linked to a
Learning OutcomeCreate
documentation in the
Focused SOAP Note
Template about the patient
in the case study to which
you were assigned. In the
Subjective section, provide:
• Chief complaint• History
of present illness (HPI)•
Current medications•
Allergies• Patient medical
history (PMHx) • Review of
systems
Ratings
10
to
>8.0
pts
Exce
llent
90%
–
100
%
The
resp
onse
thro
ughl
y
and
accu
ratel
y
desc
ribe
s
the
pati
ent’
s
subj
ectiv
e
com
plai
nt,
hist
ory
of
pres
ent
illne
ss,
curr
8 to
>7.0
pts
Goo
d
80%
–
89%
The
resp
onse
accu
ratel
y
desc
ribe
s
the
pati
ent’
s
subj
ectiv
e
com
plai
nt,
hist
ory
of
pres
ent
illne
ss,
curr
ent
med
icati
ons,
aller
gies,
7 to
>6.0
pts
Fair
70%
–
79%
The
resp
onse
desc
ribe
s
the
pati
ent’
s
subj
ectiv
e
com
plai
nt,
hist
ory
of
pres
ent
illne
ss,
curr
ent
med
icati
ons,
aller
gies,
med
ical
hist
ory,
Pts
6 to
>0
pts
Poo
r
0%–
69%
The
resp
onse
prov
ides
an
inco
mpl
ete
or
inac
cura
te
desc
ripti
on
of
the
pati
ent’
s
subj
ectiv
e
com
plai
nt,
hist
ory
of
pres
ent
illne
ss,
10 pts
ent
med
icati
ons,
aller
gies,
med
ical
hist
ory,
and
revi
ew
of
all
syst
ems
that
wou
ld
infor
ma
diffe
renti
al
diag
nosi
s.
med
ical
hist
ory,
and
revi
ew
of
all
syst
ems
that
wou
ld
infor
ma
diffe
renti
al
diag
nosi
s.
and
revi
ew
of
all
syst
ems
that
wou
ld
infor
ma
diffe
renti
al
diag
nosi
s,
but
it is
som
ewh
at
vagu
e or
cont
ains
min
or
inna
cura
cies.
curr
ent
med
icati
ons,
aller
gies,
med
ical
hist
ory,
and
revi
ew
of
all
syst
ems
that
wou
ld
infor
ma
diffe
renti
al
diag
nosi
s.
Or,
subj
ectiv
e
doc
ume
ntati
on is
miss
ing.
This criterion is linked to a
Learning OutcomeIn the
Objective section, provide: •
Physical exam
documentation of systems
pertinent to the chief
complaint, HPI, and history•
Diagnostic results, including
any labs, imaging, or other
assessments needed to
develop the differential
diagnoses
10
to
>8.0
pts
Exce
llent
90%
–
100
%
The
resp
onse
thor
oug
hly
and
accu
ratel
y
doc
ume
nts
the
pati
ent’
s
phys
ical
exa
m
for
perti
nent
syst
ems.
Diag
nost
ic
test
s
and
their
resu
lts
are
8 to
>7.0
pts
Goo
d
80%
–
89%
The
resp
onse
accu
ratel
y
doc
ume
nts
the
pati
ent’
s
phys
ical
exa
m
for
perti
nent
syst
ems.
Diag
nost
ic
test
s
and
their
resu
lts
are
accu
ratel
y
doc
ume
7 to
>6.0
pts
Fair
70%
–
79%
Doc
ume
ntati
on
of
the
pati
ent’
s
phys
ical
exa
m is
som
ewh
at
vagu
e or
cont
ains
min
or
inna
cura
cies.
Diag
nost
ic
test
s
and
their
resu
lts
are
doc
ume
nted
but
6 to
>0
pts
Poo
r
0%–
69%
The
resp
onse
prov
ides
inco
mpl
ete
or
inac
cura
te
doc
ume
ntati
on
of
the
pati
ent’
s
phys
ical
exa
m.
Syst
ems
may
hav
e
bee
n
unn
eces
saril
y
revi
ewe
d, or
10 pts
This criterion is linked to a
Learning OutcomeIn the
Assessment section,
provide: • At least three
differentials with supporting
evidence. Explain what rules
each differential in or out
and justify your primary
diagnosis selection. Include
pertinent positives and
pertinent negatives for the
specific patient case.
thor
oug
hly
and
accu
ratel
y
doc
ume
nted
.
nted
.
cont
ain
min
or
inna
cura
cies.
obje
ctive
doc
ume
ntati
on is
miss
ing.
25
to
>22.
0
pts
Exce
llent
90%
–
100
%
The
resp
onse
lists
in
orde
r of
prio
rity
at
least
thre
e
disti
22
to
>19.
0
pts
Goo
d
80%
–
89%
The
resp
onse
lists
in
orde
r of
prio
rity
at
least
thre
e
diffe
rent
19
to
>17.
0
pts
Fair
70%
–
79%
The
resp
onse
lists
thre
e
poss
ible
con
ditio
ns
for a
diffe
renti
al
diag
17
to
>0
pts
Poo
r
0%–
69%
The
resp
onse
lists
two
or
few
er,
or is
miss
ing,
poss
ible
con
ditio
ns
for a
25 pts
nctl
y
diffe
rent
and
deta
iled
poss
ible
con
ditio
ns
for a
diffe
renti
al
diag
nosi
s of
the
pati
ent
in
the
assi
gne
d
case
stud
y,
and
it
prov
ides
a
thor
oug
h,
accu
rate,
and
deta
iled
justi
ficat
ion
poss
ible
con
ditio
ns
for a
diffe
renti
al
diag
nosi
s of
the
pati
ent
in
the
assi
gne
d
case
stud
y,
and
it
prov
ides
an
accu
rate
justi
ficat
ion
for
each
of
the
con
ditio
ns
sele
cted
.
nosi
s of
the
pati
ent
in
the
assi
gne
d
case
stud
y,
with
som
e
vagu
enes
s
and/
or
inac
cura
cy in
the
con
ditio
ns
and/
or
justi
ficat
ion
for
each
.
diffe
renti
al
diag
nosi
s of
the
pati
ent
in
the
assi
gne
d
case
stud
y,
with
inac
cura
te or
miss
ing
justi
ficat
ion
for
each
con
ditio
n
sele
cted
.
for
each
of
the
con
ditio
ns
sele
cted
.
This criterion is linked to a
Learning OutcomeIn the
Plan section, provide: • A
detailed treatment plan for
the patient that addresses
each diagnosis, as
applicable. Includes
documentation of diagnostic
studies that will be
obtained, referrals to other
healthcare providers,
therapeutic interventions,
education, disposition of the
patient, and any planned
follow up visits. • A
discussion related to health
promotion and disease
prevention taking into
consideration patient
factors, PMH, and other risk
factors. • Reflections on the
case describing insights or
lessons learned.
30
to
>26.
0
pts
Exce
llent
90%
–
100
%
The
resp
onse
thor
oug
hly
and
accu
ratel
y
outli
nes
a
trea
tme
nt
plan
for
the
pati
ent
that
addr
esse
s
each
diag
nosi
s
and
inclu
des
diag
nost
ic
26
to
>23.
0
pts
Goo
d
80%
–
89%
The
resp
onse
accu
ratel
y
outli
nes
a
trea
tme
nt
plan
for
the
pati
ent
that
addr
esse
s
each
diag
nosi
s
and
inclu
des
diag
nost
ic
stud
ies
nee
ed,
refe
23
to
>20.
0
pts
Fair
70%
–
79%
The
resp
onse
som
ewh
at
vagu
ely
or
inac
cura
tely
outli
nes
a
trea
tme
nt
plan
for
the
pati
ent.
The
disc
ussi
on
on
heal
th
pro
moti
on
and
dise
ase
prev
20
to
>0
pts
Poo
r
0%–
69%
The
resp
onse
does
not
addr
ess
all
diag
nose
s or
is
miss
ing
ele
men
ts of
the
trea
tme
nt
plan
.
The
disc
ussi
on
on
heal
th
pro
moti
on
and
dise
ase
prev
enti
30 pts
stud
ies
nee
ed,
refe
rrals
,
ther
ape
utic
inter
vent
ions,
pati
ent
edu
cati
on
and
disp
ositi
on,
and
plan
ned
follo
wup
visit
s. A
thor
oug
h
and
accu
rate
disc
ussi
on
of
heal
th
pro
moti
on
and
rrals
,
ther
ape
utic
inter
vent
ions,
pati
ent
edu
cati
on
and
disp
ositi
on,
and
plan
ned
follo
wup
visit
s.
An
accu
rate
disc
ussi
on
of
heal
th
pro
moti
on
and
dise
ase
prev
enti
on
relat
ed
to
enti
on
relat
ed
to
the
case
is
som
ewh
at
vagu
e or
cont
ains
inna
ccur
acie
s.
Refl
ecti
ons
on
the
case
dem
onst
rate
ade
quat
e
und
erst
andi
ng
of
cour
se
topi
cs.
on
relat
ed
to
the
case
is
vagu
e,
inna
ccur
ate,
or
miss
ing.
Refl
ecti
ons
on
the
case
are
vagu
e or
miss
ing.
dise
ase
prev
enti
on
relat
ed
to
the
case
is
prov
ided
.
Refl
ecti
ons
on
the
case
dem
onst
rate
stro
ng
criti
cal
thin
king
and
synt
hesi
s of
idea
s.
the
case
is
prov
ided
.
Refl
ecti
ons
on
the
case
dem
onst
rate
criti
cal
thin
king.
This criterion is linked to a
Learning OutcomeProvide at
least three evidence-based,
peer-reviewed journal
articles or evidenced-based
guidelines that relate to this
case to support your
diagnostics and differentials
diagnoses. Be sure they are
current (no more than 5
years old) and support the
treatment plan in following
current standards of care.
10
to
>8.0
pts
Exce
llent
90%
–
100
%
The
resp
onse
prov
ides
at
least
thre
e
curr
ent,
evid
ence
base
d
reso
urce
s
fro
m
the
liter
atur
e to
sup
port
the
trea
tme
nt
plan
for
the
pati
ent
8 to
>7.0
pts
Goo
d
80%
–
89%
The
resp
onse
prov
ides
at
least
thre
e
curr
ent,
evid
ence
base
d
reso
urce
s
fro
m
the
liter
atur
e to
sup
port
the
trea
tme
nt
plan
for
the
pati
ent
in
the
7 to
>6.0
pts
Fair
70%
–
79%
Thre
e
evid
ence
base
d
reso
urce
s are
prov
ided
to
sup
port
trea
tme
nt
deci
sion
s,
but
may
not
repr
esen
t the
lates
t in
stan
dard
s of
care
or
may
only
prov
ide
vagu
6 to
>0
pts
Poo
r
0%–
69%
Two
or
few
er
reso
urce
s are
prov
ided
to
sup
port
trea
tme
nt
deci
sion
s.
The
reso
urce
s
may
not
be
curr
ent
or
evid
ence
base
d or
do
not
sup
port
the
trea
tme
10 pts
in
the
assi
gne
d
case
stud
y.
Each
reso
urce
repr
esen
ts
the
lates
t in
stan
dard
s of
care
and
prov
ides
stro
ng
justi
ficat
ion
for
trea
tme
nt
deci
sion
s.
assi
gne
d
case
stud
y.
Each
reso
urce
repr
esen
ts
curr
ent
stan
dard
s of
care
and
sup
port
s
trea
tme
nt
deci
sion
s.
e or
wea
k
justi
ficat
ion
for
the
trea
tme
nt
plan
.
nt
plan
.
This criterion is linked to a
Learning OutcomeWritten
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 are provided
that delineate all required
criteria.
5 to
>4.0
pts
Exce
llent
90%
–
100
%
Para
grap
hs
and
sent
ence
s
follo
w
writi
ng
stan
dard
s for
flow
,
cont
inuit
y,
and
clari
ty.
A
clea
r
and
com
preh
ensi
ve
purp
ose
stat
eme
nt,
4 to
>3.0
pts
Goo
d
80%
–
89%
Para
grap
hs
and
sent
ence
s
follo
w
writi
ng
stan
dard
s for
flow
,
cont
inuit
y,
and
clari
ty
80%
of
the
time
.
Purp
ose,
intr
odu
ctio
n,
and
conc
3 to
>2.0
pts
Fair
70%
–
79%
Para
grap
hs
and
sent
ence
s
follo
w
writi
ng
stan
dard
s for
flow
,
cont
inuit
y,
and
clari
ty
60%
–
79%
of
the
time
.
Purp
ose,
intr
odu
ctio
n,
and
2 to
>0
pts
Poo
r
0%–
69%
Para
grap
hs
and
sent
ence
s
follo
w
writi
ng
stan
dard
s for
flow
,
cont
inuit
y,
and
clari
ty 4.0
pts
Exce
llent
90%
–
100
%
Uses
corr
ect
gra
mm
ar,
spell
ing,
and
pun
ctua
tion
with
no
erro
rs.
4 to
>3.0
pts
Goo
d
80%
–
89%
Cont
ains
1 or
2
gra
mm
ar,
spell
ing,
and
pun
ctua
tion
erro
rs.
3 to
>2.0
pts
Fair
70%
–
79%
Cont
ains
seve
ral
(3 or
4)
gra
mm
ar,
spell
ing,
and
pun
ctua
tion
erro
rs.
2 to
>0
pts
Poo
r
0%–
69%
Cont
ains
man
y (≥
5)
gra
mm
ar,
spell
ing,
and
pun
ctua
tion
erro
rs
that
inter
5 pts
fere
with
the
read
er’s
und
erst
andi
ng.
This criterion is linked to a
Learning OutcomeWritten
Expression and Formatting The paper follows correct
APA format for title page,
headings, font, spacing,
margins, indentations, page
numbers, running heads,
parenthetical/narrative intext citations, and reference
list.
Total Points: 100
5 to
>4.0
pts
Exce
llent
90%
–
100
%
Uses
corr
ect
APA
for
mat
with
no
erro
rs.
4 to
>3.0
pts
Goo
d
80%
–
89%
Cont
ains
1 or
2
APA
for
mat
erro
rs.
3 to
>2.0
pts
Fair
70%
–
79%
Cont
ains
seve
ral
(3 or
4)
APA
for
mat
erro
rs.
2 to
>0
pts
Poo
r
0%–
69%
Cont
ains
man
y (≥
5)
APA
for
mat
erro
rs.
5 pts

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