NP615 Primary Health Care III: Advanced Diagnostics 
and Urgent Care (Spring 2013)


Course Coordinator

Diane John, PhD, ARNP, FNP-BC

Course Faculty

Gwen Short, DNP, MPH, ARNP

Nancy Pesta Walsh, DNP, FNP

Course Credit



Course Description

This course refines critical thinking and diagnostic reasoning skills and provides students with an opportunity to demonstrate cognitive, affective and psychomotor skills necessary for accurate diagnosis of health status. Urgent treatment for common emergencies, their differential diagnoses and primary care management are also covered in this course.


PC612 and PC617

Course Objectives

Upon successful completion of NP615 the learner will be able to:


Method of Measurement/Evaluation
(1)  Distinguish normal findings on a 12 lead ECG (1) Quiz, Exam
(2)  Distinguish  normal from abnormal heart sounds across the lifespan (2)  Quiz, Exam
(3)  Analyze and identify indications for ordering radiographs, ultrasonography, magnetic resonance imagery and computerized tomography and related preparation required for appropriate diagnoses of urgent health needs. (3) Quiz, Exam
(4)  Recognize common emergencies, their differential diagnoses and primary care management (4)  Quiz, Forum case study assignments, and exams.
(5)  Prioritize a management plan for office emergencies including consultation, referral, and follow-up (5)  Quiz, Forum case study assignments, and exams.

Core Competencies

Essentials of Master’s Education for Advanced Practice Nursing: ACCN Graduate Core Curriculum Content


Course work should provide graduates with the knowledge and skills to:

Access current and relevant data needed to answer questions identified in one’s nursing practice;

Utilize new knowledge to analyze the outcomes of nursing interventions, to initiate change, and to improve practice;

Use computer hardware and appropriate software, and to understand statistics and research methods;

Utilize information systems for the storage and retrieval of data, consistent with the particular population focus;

Initiate a line of inquiry into comprehensive databases in order to utilize available research in the practice of nursing; and

Write and communicate effectively—identify a clinical problem, demonstrate an understanding of the research related to this problem, critically analyze the problem and current knowledge, and develop a strategy for the incorporation of the research into the treatment regimen.

Organization of the Health Care Delivery System

Course work should provide graduates with the knowledge and skills to:

Understand how various health care delivery systems are organized, including community and population-based systems;

Deliver health care services in a variety of delivery system, including acute and ambulatory care delivery systems, and managed and integrated care systems.

Health Care Financing

Course work should provide graduates with the knowledge and skills to:

Analyze and monitor the cost-effectiveness of clinical decisions and make recommendations for increasing the cost-effectiveness of care;

Make high quality cost-effective choices in the use of health care resources;


Course work should provide graduates with the knowledge and skills to:

Evaluate ethical methods of decision making and engage in an ethical decision-making process;

Identify areas in which a personal conflict of interest may arise; propose resolutions or actions to resolve the conflict.

Professional Role Development

Course work should provide graduates with the knowledge and skills to:

Communicate with other health care professionals; develop and work in collaborative and interdependent relationships;

Human Diversity and Social Issues

Course work should provide graduates with the knowledge and skills to:

Define, design and implement culturally competent health care;

Recognize the variants in health, including physiological variations, in a wide range of cultural, racial, ethnic, age and gender groups that may influence the assessment and plan of care.

Advanced Practice Nursing Core Curriculum

Advanced Health/Physical Assessment

Course work should provide graduates with the knowledge and skills to:

Demonstrate sound critical thinking and clinical decision making;

Develop a comprehensive data base, including complete functional assessment, health history, physical examination and appropriate diagnostic testing;

Relate assessment findings to underlying pathology or physiologic changes;

Establish a differential diagnosis based on the assessment data; and

Develop an effective and appropriate plan of care for the client, which takes into consideration life circumstance and cultural, ethnic and developmental variations.

Advanced Physiology and Pathophysiology

Course work should provide graduates with the knowledge and skills to:

Synthesize and apply current research-based knowledge regarding pathological changes in selected disease states;

Describe the developmental physiology, normal physiology, normal etiology, pathogenesis, and clinical manifestations of commonly found/seen altered health states.

National Organization of Nurse Practitioner Faculties

Domains and Core Competencies of Nurse Practitioner Practice March 2006

Domain One: Management of Patient Health/Illness Status

Domain Two: The Nurse Practitioner-Patient Relationship

Domain Three: The Teaching-Coaching Function

Domain Four: Professional Role

Domain Five: Managing and Negotiating Health Care Delivery Systems

Domain Six: Monitoring and Ensuring the Quality of Health Care Practice

Domain Seven: Culturally-Sensitive Care

National Organization of Nurse Practitioner Faculties

Nurse Practitioner Primary Care Competencies In Specialty Areas April 2006

Family Nurse Practitioner Competencies

1. Health Promotion, Health Protection, Disease Prevention, and Treatment
1. Assessment of Health Status

2. Diagnosis of Health Status

3. Plan of Care and Implementation of Treatment

2. Nurse Practitioner-Patient Relationship

3. Teaching-Coaching Function

4. Professional Role

5. Managing and Negotiating Health Care Delivery Systems

6. Monitoring and Ensuring the Quality of Health Care Practice

7. Cultural Competence

Topical Outline and Time Frame


Reading, Assignments, Exams, etc.


Sign in to forum, choose a teaching PowerPoint topic posted in the forum, get organized, start readings post initial impression by end of week one


Continue with readings and start work on PowerPoint 


Read and study


Target week for Exam 1 


Read and study


Post your PowerPoint by end of week 6.  Review classmates' PowerPoints


Target week for Exam 2  


Read, study, and post evidenced based research topic summary


Read, study, target week for Exam 3


Read study, complete Lexicomp Online assignment


Read, study, target week for Exam 4, post final reflection by end of week 11

Complete all Exams by Friday 5:00 EST the last day of term.  

Please Note: Any exam submitted after 5:00 EST the last day of term this date will not be accepted without prior written approval from your grader.

Assignments and Grades

Grading Criteria

The final grade for this course will be based on the following:

Grade Scale

Percent of Final Grade

Initial impressions 5
Forum Assignment:  Teaching PowerPoint 15
Evidenced Based Practice -  summary of current literature  POEM (1 summary) 5
Practice Quizzes  0
Exam 1  20
Exam 2 15
Exam 3 15
Exam 4 15
Lexicomp Online Exercise 5
Ending Reflection 5



Exam Policy

Students must achieve both an 80% average of the exam total and an 80% course average in order to pass the course. There will be no rounding of exam scores or the exam total average.

NOTE:  This course uses the Remote Proctor camera and Securexam Browser for the Exams. We strongly suggest you complete the Secure Exams lesson in BT202, including taking the practice exams, before any exam is due to ensure that no problems arise. Also please review the guidelines for taking exams as stated in the Catalog ( and familiarize yourself with the Student FAQs ( Please note, your testing environment and actions should mimic an in-classroom exam setting.

Incomplete Grade

Students are strongly encouraged to complete the course within the term to maximize their likelihood of success not only in this course, but also in the courses they will take the next term that may suffer if they are finishing an incomplete. However, we recognize that students may have circumstances that necessitate requesting an incomplete grade. Therefore, we want to clearly define the expectations for this course regarding criteria for an incomplete grade.

According to the FNU Incomplete Grade Policy and Procedure, “an ‘Incomplete’ (I) grade may be assigned only if a majority of graded assignments and/or examinations, as appropriate, for a class have been satisfactorily completed.”

In NP 615, you must have completed two of the four exams and have posted your teaching PowerPoint and POEM summaries be eligible for an incomplete grade. If you will not be able to complete the assignment, you should withdraw from the course. You must also petition for incomplete within the time frame stipulated in the student handbook and calendar. Students who do not qualify for a grade of incomplete will fail the course.

Required Textbooks

Physical assessment book of your own choice, section on cardiac assessment and heart sounds.

Pharmacology book of your own choice.

Brown, E. M., Leung, T. S., Collis, W. B., & Salmon, A. P. (2008). Heart sounds made easy (2nd ed.). St. Louis: Elsevier. ISBN 9780443069079

Buttaro, T. M., Trybulski, J., Bailey, P. P., & Sandberg-Cook, J. (2013). Primary care: A collaborative practice (4th ed).  St. Louis: Elsevier. ISBN 978-0-323-04742-5

Buttaravoli, P., Leffler, S. (2012). Minor emergencies (3rd ed.) Philadelphia, PA: Mosby Elsevier. ISBN: 9780323079099

Colyar, M. & Ehrhardt, C. (2004). Ambulatory care procedures for the nurse practitioner (2nd ed.). Philadelphia: F.A. Davis. ISBN 0-8-36-1123-4 

Ferri, F. (2010). Ferri’s best test: A practical guide to clinical laboratory medicine and diagnostic imaging (2nd ed). Philadelphia: Elsevier. ISBN 978-0-323-05759-2

Required Hardware for Exams - Securexam Remote Proctor (RP2) ISBN: 9783331141918 (Note:  It is HIGHLY Recommended that you purchase the Secure Remote Proctor camera from the Frontier University Bookstore due to problems that have occurred when purchasing incorrect models elsewhere.

Required Technology

In this course you will also be required to use Lexicomp Online and Essential Evidence Plus. Both are located in the school library under Find Journal Articles.

Honor Code Policy

There are unique opportunities in the adult-learner, self-paced, distance model of education to demonstrate the highest standards of ethical behavior and conduct. There are also unique opportunities to violate these standards. FNU regards academic honesty and scholarly integrity to be essential to the education of our students; violations are not tolerated. No student shall claim credit for another’s work or accomplishments or use another’s ideas in a written paper or presentation without appropriate citations and references. Students may be dismissed for violation of FNU standards of conduct.

Violations of the expected standards of conduct include, but are not limited to, the following:

Cheating: Cheating is the attempt to gain improper advantage in an academic evaluation. Among the forms that this kind of dishonesty can take are: obtaining a copy of an examination before it is officially available, learning an examination question from another student before taking the examination, or consulting an unauthorized source during an examination. These sources could include electronic sources, paper sources, or human sources. Submitting part or all of work done by another student as one’s own work is also cheating. This also includes sharing your own work with other students in any form (via email, posting on the internet, etc.).

Plagiarism: Plagiarism is the representation of another person’s ideas or writing as one’s own. The most obvious form of this kind of dishonesty is the presentation of another person’s ideas as something one has written. Paraphrasing another’s writing without proper acknowledgment may also be considered plagiarism. See the Plagiarism Definition for further information and clarification. ( FNU Catalog)

Unprofessional Conduct: Including lying, misrepresenting the truth, and falsifying records.

Criminal Conduct: Such as stealing, drunkenness, or illegal drug use while on the Hyden Campus or in a clinical site.

It is the student’s responsibility to behave in an honorable and ethical manner.

It is also the student’s responsibility to report any suspected violation to a Student Council Representative.

Any student or faculty member may bring suspected honor code violations to the attention of the Associate Dean.
( FNU Catalog)

Plagiarism Definition

Plagiarism and breaches of academic standards are infractions of academic integrity, prohibited by the FNU Honor Code.

Plagiarism Includes:

1. Submitting a paper, examination, or assignment written by another.

2. Word-for-word copying (including cutting and pasting) portions of another’s writing from the World Wide Web, from hard copy text, from personal communication, without enclosing the copied passage in quotation marks and acknowledging the source in the appropriate APA reference format.

3. The use of a unique term or concept taken from another source without acknowledging that source.

4. The paraphrasing or abbreviated restating of someone else’s ideas without acknowledging that person.

5. Changing a few words in someone else’s sentence does not make it your own, even if the reference is provided at the end of the sentence. Either use quotes or synthesize the information and write your own completely new sentence with appropriate referencing.

6. Falsely citing a reference that was never actually consulted, or making up a citation. Functioning web links in assignments are important for this reason.

7. Falsely reporting data that was never actually collected or which showed contrary results.

9. Unacknowledged multiple authors or collaboration on a project or paper.