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  • How to Write Nursing Essay Topic Sentences

    How to Write Nursing Essay Topic Sentences Overview

    The best way to understand the role of the topic sentence in paragraph development is to imagine that any given paragraph is a miniature essay that has its own thesis, support, and conclusion. The parts of a paragraph easily correspond to the parts of an essay:

    Essay Level

    Paragraph Level

    Thesis statement

    Topic sentence

    Body paragraphs

    Supporting details, explanation, analysis

    Conclusion

    Wrap-up sentence(s)

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    Just as an effective essay starts off with an introduction that presents the paper’s thesis statement and indicates the specific claim or argument that the essay will develop, each paragraph should begin with a topic sentence that indicates the focus of that paragraph, alerting the reader to the particular subtopic that the paragraph will provide evidence to support. How to Write Nursing Essay Topic Sentences.

    A strong topic sentence should be placed at or near the beginning of a paragraph. In addition, this sentence should focus on a specific issue, avoid the use of direct quotations, and leave room for support and analysis within the body of the paragraph. Read on to learn more about creating an effective topic sentence.

    How to Write Nursing Essay Topic Sentences Placement

    The topic sentence does not have to be the first sentence in the paragraph; however, it should come early in the paragraph in order to orient the reader to the paragraph’s focus right away. Occasionally a writer may place a transition sentence before the topic sentence, to create continuity between topics.

    Topic Sentence to begin paragraph:

    In the novel Sula
    , Morrison uses the physical bonds of female friendship to propel her characters into self-awareness.

    Transition Sentence + Topic Sentence to begin paragraph:

    However, Morrison does not only use the emotional and spiritual bonds between her female characters to initiate their coming-of-age. In addition, the author uses the physical bonds of female friendship to propel her adolescent protagonists into self-awareness. How to Write Nursing Essay Topic Sentences.

    Specificity

    Your topic sentence should be more narrowly focused than your thesis sentence, and you will want to make sure the claim you are making can be supported, argued, and analyzed within the body of your paragraph.

    Example:
     In the novel 
    Sula
    , Morrison uses the physical bonds of female friendship to propel her characters into self-awareness. How to Write Nursing Essay Topic Sentences.

    In this topic sentence, the essayist is arguing that physical bonds of friendship, specifically, make the female characters more self-aware. Because this idea can be refuted or supported by readers (based on how successfully the essayist persuades his or her readers with examples and analysis from the novel), and because the claim is narrow enough to address within a single paragraph, the above sentence is a successful topic sentence.

    Direct Quotations (Are Best Avoided)

    Although it might be tempting to begin a paragraph with a compelling quotation, as a general rule, 
    topic sentences should state the main idea of the paragraph in your own words.
     Direct quotations have a place later in the paragraph, where they may be incorporated to support the topic sentence. How to Write Nursing Essay Topic Sentences.

    Needs Improvement:
     As Morrison (1982) conveyed, the girls’ “friendship let them use each other to grow on…they found in each other’s eyes the intimacy they were looking for” (p. 52).

    Better:
     In the novel 
    Sula
    , Morrison uses the physical bonds of female friendship to propel her characters into self-awareness. Pointing to the connection of eyes meeting and bodies growing together, Morrison makes coming-of-age an interactive physical process between the adolescent protagonists. Specifically, Morrison describes how Sula and Nel have used “each other to grow on…they found in each other’s eyes the intimacy they were looking for” (p. 52). How to Write Nursing Essay Topic Sentences.

    In this second paragraph, the topic sentence appears first, immediately orienting readers to the main focus (or topic) of the paragraph. The quotation is used later in the paragraph as a form of evidence or support for the topic sentence.

    Extra Tips ON How to Write Nursing Essay Topic Sentences

    If you are finding it challenging to create effective topic sentences, you might consider 
    outlining
     before beginning to write a paper. The points and subpoints of an outline can then become the topic sentences for the paper’s paragraphs.

    Additionally, because the topic sentence functions similarly at the paragraph level to the thesis at the essay level, you may also find it helpful to check out our 
    thesis statement construction
     information. Our resource on paragraphs has helpful information about the scope of a paragraph, as well. Writers often think of paragraphs as units of length, but the paragraph measures something more abstract than inches of paper: it measures 
    ideas
    . Each paragraph in an academic paper acts as a concrete unit of the 
    central argument. 
    Every paragraph advances a new claim, building on the claims that have come before, until the writer conclusively establishes the position of the entire paper. How to Write Nursing Essay Topic Sentences.

  • Online APA Nursing Essay Assignment Paper Example

    Online APA Nursing Essay Assignment Paper Example

     

    Title of the Paper in Full Goes Here

    Student Name Here

    Institution

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    Abstract

    Abstracts are not required for the papers in this course.

     

    Title of the Paper in Full Goes Here

    APA format and college-level writing can be difficult for many students returning to school after several years away from academia. An example title page precedes this introduction.  An abstract is not required for the short papers undergraduates write. The references page shows some sample references for sources such as websites, textbooks, journals, and online journals. Below follows some advice for writing your paper and adhering to APA standards.

    Your introductory paragraph and every paragraph that follows should have a minimum of three sentences, with an average of four to five and no more than seven sentences. The last sentence of your opening paragraph should be the
    thesis statement
    , which summarizes the purpose of the assignment and how you intend to address it. The sentences preceding your thesis statement should simply provide background that contextualizes your thesis for readers.

    Each paragraph should begin with a
    topic sentence
    , which summarizes the paragraph’s main argument or idea. Also, the last sentence (or lead-out) of each paragraph should be a transition statement that connects what you discussed in that paragraph and what is to come in the next one. In the middle of each paragraph, you should cover something with your own thoughts, and in a separate sentence, provide a sentence paraphrased from a source with an in-text citation at the end. The source may back up your opinion, or give an alternative viewpoint, or even simply provide some background. See the Writing Center’s
    webpage on paragraphs
    for further advice. online apa nursing essay assignment paper example.

    Try to avoid direct quotes when possible, so that they comprise no more than 10% of your paper. Your in-text citation should list in parentheses an author’s last name (or website name—not the website address), year, and when appropriate, a page number. This citation should be identical to how the corresponding reference list citation begins, minus the author initials. If no date is given for a source, you can write “n.d.” in place of the year (it stands for “no date”). This sentence does not come from a source, but I will end it with an in-text citation so you can see an example (Allaboutapples, Inc., n.d.). According to APA style, every sentence that uses information from a source needs a citation. In other words, if you have more than two sentences of information from one source, you must use an in-text citation or parenthetical citation in each sentence (for more information on citing within a paragraph, see this
    sample
    or
    this
    one). While there are exceptions to this rule, undergraduates typically interpret these rules incorrectly and find themselves plagiarizing unintentionally, so it is best to err on the side of caution.

    Many websites that information comes from are suspect in terms of factual and unbiased  information. In a nutshell, never use Wikipedia, About.com, Answers.com, or similar websites. Though some .com sites are acceptable, most undergraduates have trouble identifying whether they can be trusted, so an easy guideline to follow is to avoid them. Websites ending in .gov, .net, .edu, .org, and so forth are typically more trustworthy than a .com source. online apa nursing essay assignment paper example.

    The body of your paper should have a couple of paragraphs or more. Your conclusion paragraph should briefly summarize the main points of your paper and place the paper in the context of social change. While your conclusion should not introduce new topics, you may suggest a direction for future research. Generally, you should not write anything in the conclusion that would require you to cite a source; instead, the conclusion should represent only your own thoughts and analysis.

    Make sure you follow directions, and do download the grading rubric from Doc Sharing that breaks down how an assignment is graded. A one-page essay means a FULL one page of writing and does not  include elements such as references, tables or figures, or the title page.  Using two sources does not mean simply providing two in-text citations for the same source; the sources themselves must be different. For more than one page within the same website, you must have different in-text citations and reference entries. online apa nursing essay assignment paper example. The example below illustrates this:

    United States Department of Agriculture. (2008a). Food and you. Retrieved October 13, 2008, from http://www.usda.gov/foodandyou

    United States Department of Agriculture. (2008b). Never eat hay. Retrieved October 13, 2008, from http://www.usda.gov/nevereathay

    United States Department of Agriculture. (2008c). Why do we eat. Retrieved October 13, 2008, from http://www.usda.gov/whyweeat

    Notice how the references appear in in alphabetical order by the title of the webpage and then by a lower-case letter next to the year. This formatting allows readers to distinguish which citation corresponds with which source and reference list entry. online apa nursing essay assignment paper example.

    When citing sources from the internet, follow this APA citation format:

    Author, A. (date). Title of document [Format description]. Retrieved from http://URL

    Note that the author may be an individual or a group or organization. Also, the format description is mostly used for blog posts or other nonwebsite material, so feel free to omit it if you are just referring to a website.

    As an example, say that you are attempting to cite
    this webpage
    . As you will see in the bottom of this webpage, the author is “National Council of Teachers of English,” and the publication year is the last copyright year in the given range (so, since the range is “1998-2012,” you would use 2012 as the date in your citation). Also, the title of the webpage is the text appearing in the top of the web browser, or “NCTE/IRA Standards for the English Language Arts,” as illustrated in this
    screenshot
    . online apa nursing essay assignment paper example. Finally, the URL for this page is http://www.ncte.org/standards/ncte-ira. With this information in mind, note how this citation should appear:

    National Council of Teachers of English. (2012). NCTE/IRA standards for the English language arts. Retrieved from http://www.ncte.org/standards/ncte-ira

    For more information on citing web sources, see this
    APA Style post
    . Lastly, if you have any questions about writing a paper or properly citing sources, feel free to contact the Writing Center. online apa nursing essay assignment paper example.

     

     

    References

    Allaboutapples, Inc..com. (n.d.). Varieties. Retrieved January 10, 2011, from http://www.allaboutapples.com/varieties/

    Hansel, G., & Gretel, D. (1973).
    Candied houses and unfriendly occupants.
    Thousand Oaks, CA: Fairy Tale Publishing.

    Laureate Education, Inc. (Producer). (2010).
    Name of program
    [Video webcast]. Retrieved from http://www.courseurl.com

    Rumstead, D. (2009). The essentials: Sandwiches and sleep.
    Journals of Famous Loafers
    ,
    5
    , 565-582. doi:12.2847/CEDG.39.2.51-71. online apa nursing essay assignment paper example.

    Sinatra, F. (2008). Zing! Went the strings of my heart.
    Making Good Songs Great, 18
    (3), 31-22. Retrieved from http://articlesextollingrecordingsofyore.192/fs.com

    Smasfaldi, H., Wareumph, I., Aeoli, Q., Rickies, F., Furoush, P., Aaegrade, V., … Fiiel, B. (2005).
    The art of correcting surname mispronunciation.
    New York, NY: Supportive Publisher Press. Retrieved from http://www.onewaytociteelectronicbooksperAPA7.02.com. online apa nursing essay assignment paper example.

    White, S., & Red, R. (2001).
    Stop and smell the what now? Floral arranging for beginners
    (Research Report No. 40-921). Retrieved from University of Wooded Glen, Center for Aesthetic Improvements in Fairy Tales website: http://www.uwg.caift/~40_921.pdf. online apa nursing essay assignment paper example. online apa nursing essay assignment paper example.

  • Walden nursing APA paper referencing guide

    Walden nursing APA paper referencing guide

     
    Title of Your Paper, Centered, and Using Both Upper and Lowercase Letters

    Your Name Here

    Walden University

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    Instructor’s Name

    Course Title and Number

    Date

     

    Center the Title of Your Paper Here

    This formatting should be used as a template for all your assignments here at Walden, unless you have been directed to format your essay differently by your instructor. If you read this essay carefully and print a copy for your use, it will be a great help as you create your assignments. Because bachelor’s level students do not write extensive research papers, the appropriate requirements for your assignments will differ from those for graduate students. Most of your written assignments will take the form of essays with opening and closing paragraphs, a clear purpose that is accomplished in the course of the essay, and logically organized paragraphs that develop your ideas. Please note that the best introductory paragraphs identify a specific topic or problem, highlight what has been said or done concerning this topic, and offer a new and significant argument or perspective about the topic. As you construct your introductory paragraph, remember to engage the reader and to express the purpose you hope to fulfill in the paper. In addition, the introduction should offer thesis statement, which is usually the last sentence of your introductory paragraph. A strong thesis is like a roadmap for your readers, presenting the route you are planning to take in order to hit all of the highlights of your topic. For more help on how to create a focused thesis statement, make sure to check out
    here
    . Walden nursing APA paper referencing guide.

    This template generally follows APA formatting, but the exceptions are significant. A number of features appropriate for a long manuscript or for a dissertation are not necessary for relatively brief assignments. For example, you do not need to provide an abstract or Table of Contents for every assignment unless your instructor indicates otherwise. Also, note that the sixth edition of the APA manual allows for first person singular, meaning that you may to yourself, the singular author of the essay, using the pronouns
    I
    ,
    me
    , and
    my
    . However, you may not use the first person plural (
    we
    ,
    us
    ,
    our
    ) unless you are referring to yourself and a group of authors who are writing the assignment. Walden nursing APA paper referencing guide.

    Throughout your paper, consider the way a paragraph looks on the page. The indentation and length of a paragraph convey a message to the reader, suggesting a brief or extensively developed unity of an idea. Two naturally emphatic places in any paragraph are the opening sentence and the closing sentence. The opening sentence of a paragraph is often called the topic sentence, which should provide a mini-roadmap for what you plan on discussing in the paragraph. For a more comprehensive explanation of how to write effective topic sentences, make sure to review the 
     information on topic sentences
    . Take advantage of the positions of both the opening and closing sentences in a paragraph; use them for emphasis and for guiding your reader.

    Specifically, the opening sentence, or topic sentence, of any paragraph provides a natural opportunity to direct the reader from one idea to another. The sentence may function as a combination topic and transition device, suggesting to the reader where this particular section is headed. You may also use single words or phrases to connect your ideas to one another. Think of transitional expressions such as the following as glue or signposts:
    also, in addition, moreover, therefore, similarly, in contrast, although,
    or
    however.
    As the author, you have the responsibility to demonstrate for the reader the relationship between one idea and another so that the reader never has to guess at the logical organization of your ideas. Notice that I am writing about organization, and this sentence becomes a bridge to the next paragraph. Walden nursing APA paper referencing guide.

    Another way that you might wish to indicate organization to your reader is the use of headings. However, in many of your assignments, no headings are required.  If your paper exceeds five pages, or if you think that headings will help to convey the organization and clarity of a particularly complex paper, then consult the
      headings information
    for the correct formatting of the various levels of headings. Remember that headings alone will not accomplish what your writing should accomplish. In other words, your heading may announce “Conclusion,” but if a number of paragraphs introducing new ideas follow that heading, it is rather like a false advertisement and will confuse the reader. Walden nursing APA paper referencing guide.

    At Walden, your writing is expected to reflect standard edited English. In other words, it should appear as grammatically correct, formal, written English intended for silent reading. Scholarly readers do not usually speak in (or listen to) standard edited English; in their oral dialect, they naturally use contractions, slang, repetition, and all kinds of interpersonal oral signals to one another. In a rather formal writing context, however, none of those elements of speech are particularly useful or appropriate. In particular, APA style does not allow for the use of contractions (e.g., write
    it is
    instead of
    it’s
    ) or informal slang (i.e., use
    office assistant
    instead of
    office boy
    and
    students
    or
    learners
    instead of
    kids
    ). The writing that you are submitting for a grade is more formal than you may be accustomed to. Take the time to read your writing aloud or consult a grammar source regarding some stylistic elements you might have forgotten over the years; to avoid contractions, bullets, and the use of bold type; and to be sure that your sentences are clear to your reader. Write in your authentic voice but in your most intelligent and interesting voice as well. Imagine what questions your reader might ask you, and then provide your reader with well-developed, detailed, specific ideas rather than vague generalizations. Walden nursing APA paper referencing guide.

    One essential way to develop your ideas is to ground them in the course materials you have been reading or in additional evidence-based sources that you discover in the course of your studies. When you refer to the author of a required reading or to a statement by an expert on a video, you are offering a context for your idea that stems from the published research by experts in your field. For example, if you are writing about how Beach (1999) approached organizational change and you allude to his explanation of institutionalizing change in his book
    Leadership and the Art of Change
    , you are demonstrating your scholarship, which is an expected behavior of an exemplary Walden student. Conversely, if your thinking remains vague and general and you do not ground your ideas in references, your ideas are likely to be underdeveloped and taken as your opinion. Let your readers know that you have read (or viewed) and learned from the writings of theorists and scholars by either paraphrasing their ideas or quoting their language and following either the quote or a paraphrase with an in-text citation. For example, you can directly quote a source using the format illustrated by the following sentence (note that you use past tense to report research): Knowles (1998), an authority on adult learning theory, described students as “motivated to learn to the extent that they perceive that learning will help them perform tasks or deal with problems that they confront in their life situations” (p. 67). The reader may be so intrigued with this allusion to Knowles’s idea that he or she may wish to follow up by consulting the same reference. If you want to quote material that is 40 or more words in length, you would create a block quote, such as this quotation from the sixth edition of the
    Publication Manual of the American Psychological Association
    (2010), which states: Walden nursing APA paper referencing guide.

    Readers will better understand your ideas if you aim for continuity in words, concepts, and thematic development from the opening sentence to the conclusion. Continuity can be achieved in several ways. For instance, punctuation marks contribute to continuity by showing relationships between ideas. They cue the reader to the pauses, inflections, subordination, and pacing normally heard in speech. (p. 65)

    Note that the block quotation as shown above is double-spaced. When you end your quotation, make sure the next paragraph transitions from that information, so your reader can follow you. You might also want to include other theorists’ ideas to substantiate the above information. Note that if you are citing a course video, you should not directly quote from it because a video does not have page numbers. However, you can easily paraphrase the information and cite the publisher of the video in a parenthatical citation, like this: (Laureate Education, Inc., 2009). Also remember to include complete reference information for the cited source in the reference list, for your reader to further investigate if he or she chooses. Walden nursing APA paper referencing guide.

    Additionally, you may choose to cite a fellow student’s discussion post or other shared course work to substantiate your own perspective. Citing other students is a way to use all resources available to you, and it demonstrates your willingness to give credit to your online colleagues. For example, in a critical analysis of a source, you might remark that a fellow student named Alex Jones identified an author’s study as “interesting but lacking in practical application to the classroom” (Jones, 2012) to indicate how your views harmonized with those of other classmates.

    Now, glance back over this essay to note that it is a well-developed piece of writing and not merely a five-paragraph, perfunctory essay. Notice the transitional expressions that allow your mind to move smoothly from one idea to the next. Not all paragraphs are the same length, suggesting that the author is able to develop ideas in various ways. Try to determine what single topic unifies each paragraph. Ask yourself, “What question does this paragraph attempt to answer?” Sometimes it is helpful to write out one to two words that highlight the main idea beside each paragraph. After you have done this for each paragraph, then you should review each sentence of the paragraph to make sure it reflects this main idea. All of your sentences should not look or sound alike, either; some are brief and direct, while others are more complex and flowing. For tips on varying sentence structure,
    see this resource
    . With practice and time, you can create an assignment that not only looks professional but also conveys your ideas powerfully. Walden nursing APA paper referencing guide.

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    Some program tools can assist you in creating documents with a professional appearance. The MS Word Troubleshooting site can be a helpful resource. If you have MS Word 2007, go to
    File
    and then
    Word Options
    down at the bottom of the box. Then click on
    Proofing
    and select the various components from the
    Grammar and Style
    settings. Then click OK. To check your documents go to
    Review
    and then select
    ABC spelling
    . When a green squiggle line (indicating potential grammatical error) or a red squiggle line (indicating potential spelling error) appears, right click on the line, and you will get a message about the possible error. If you would like a more complete review of grammar usage, Grammarly, an automated grammar checker, is another program to explore.

    Finally, just before submitting your work to your instructor, ask yourself, “Have I fully addressed the complete assignment?” Then in your concluding paragraph, end your essay, rather like the last gesture of tying the ribbon on a present. Some writers close an essay with a concise summary of key ideas, as in the following sentence: “In this essay, I have examined the key requirements for the written assignments undergraduate students write in the Walden bachelor’s program.” Others like to offer an idea that takes the reader beyond the implications of this particular treatment of the topic. For more information on writing an effective conclusion, make sure to check out the
    resource on conclusions
    . However you choose to close your essay, do close the door firmly, thereby giving the reader a satisfying sense of completion. Walden nursing APA paper referencing guide.

    Walden APA paper referencing guide

    References

    American Psychological Association. (2010).
    Publication manual of the American Psychological Association
    (6
    th
    ed.). Washington DC: Author.

    Beach, L. R. (2006).
    Leadership and the art of change: A practical guide to organizational transformation
    . Thousand Oaks, CA: Sage Publication.

    Clark, R. E. (1994). Media will never influence learning.
    Educational Technology Research and Development
    ,
    42
    (2), 21-29.
    This is an article found on hard copy. For information about how to cite an article you found online, use the next entry. Walden nursing APA paper referencing guide.

    Constantine, S. (2006). Correction in the countryside: Convict labour in rural Germany 1871-

    German History, 24
    (1), 39-61. doi:10.1191/0266355406gh362oa
    According to

    the Publication Manual of the American Psychological Association (6th ed.)

    guidelines for citing sources, cite the DOI number whenever one is available. The

    DOI stands for Digital Object Identifier, a number specific to this article that can

    help others locate the source. For a useful chart that explains how to locate a DOI, make sure to review this 
    DOI and URL Flowchart

    Intrigue, A., & Allure, P. (2006). An article without a DOI number.
    Journal of Citing Correctly
    ,

    99
    (3), 331-355. Retrieved from http://www.journalofcitingcorrectly.com   
    If a DOI

    number is not available, replace with the url of journal’s homepage. Walden nursing APA paper referencing guide.

    Jones, P., & Boozer, C. (2001). No DOI and no journal homepage?
    Old Journal That Does Not

    Have Its Own Homepage
    ,
    4
    (3), 34-44. Retrieved from

    Academic Search Premiere database.
    If a DOI number is not available and if—in a

    rare instance—the journal does not have its own homepage, provide the name of the

    database. Walden nursing APA paper referencing guide.

    Knowles, M. (1998).
    The adult learner
    . Woburn, MA: Butterworth-Heinemann.

    Laureate Education, Inc. (Producer). (2006). Introduction to scholarly writing: Purpose, audience, and evidence [DVD]. In
    Series Title
    . Baltimore, MD: Author.
    The title of the program goes before [DVD].  The title in italics is the name of the series.  There is no period after the title of the video before [DVD].

    Laureate Education, Inc. (Producer). (2010).
    Name of program
    [Video webcast]. Retrieved from http://www.courseurl.com.

    Malborne, C. (2006, June 29). Re: Environmental responsibility [Online discussion group]. Retrieved from http://laureate.ecollege.com/ec/crs/default.learn? CourseID=2321812&Survey=1&47=2565415&ClientNodeID=404183&coursenav=0&bhcd2=1149711503. Walden nursing APA paper referencing guide.

  • Sentence Structure in English Nursing Essay Writing

    Sentence Structure in English Nursing Essay Writing Basics

    Sentence structure
     refers to the physical nature of a sentence and how the elements of that sentence are presented. Just like word choice, writers should strive to vary their sentence structure to create rhythmic prose and keep their reader interested. Sentences that require a variation often repeat 
    subjects
    , 
    lengths
    , or 
    types
    .

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    Related information about varying sentence structures listed below can be found through later in this Sentence Structure in English Nursing Essay Writing post:

    Sentence Structure and Types of Sentences

    Run-On Sentences and Sentence Fragments

    Parallel Construction

    Relative, Restrictive, and Nonrestrictive Clauses

    Conjunctions

    Modifiers

    Commas

    Semicolons

    Read more on the above 8 topics herebelow.

    Varying Subject or Word Choice

    One of the easiest ways to spot text that requires variety is by noting how each sentence opens. Writers can often overuse the same word, like an author’s name, or a subject, like pronouns to refer to an author, when beginning sentences. This lack of subject variety can be distracting to a reader. Review the following paragraph’s sentence variety:

    My philosophy of education is derived from my personal experiences. I have been an educator for 4 years, and I have learned a lot from more experienced teachers in my district. I also work mainly with students from a low socioeconomic background; my background was quite different. I will discuss how all of these elements, along with scholarly texts, have impacted my educational philosophy. Sentence Structure in English Nursing Essay Writing.

    Notice how the writer of this paragraph starts each sentence and clause with a personal pronoun. While the writer does alternate between “I” and “my”, both pronouns refer to the same subject. This repetition of personal pronouns is most common when writing a Personal Development Plan (PDP) or other personal papers. To avoid this type of repetition, try adjusting the placement of prepositional phrases or dependent clauses so the subject does not open each sentence:

    My philosophy of education is derived from my personal experiences. Having been an educator for 4 years, I have learned a lot from more experienced teachers in my district. I also work mainly with students from a low socioeconomic background that is quite different from mine. In this paper, I will discuss how all of these elements, along with scholarly texts, have impacted my educational philosophy.

    Varying Sentence Length

    Another way to spot needed sentence variety is through the length of each sentence. Repeating longer sentences can inundate a reader and overshadow arguments, while frequently relying on shorter sentences can make an argument feel rushed or stunted. Sentence Structure in English Nursing Essay Writing.

    Overusing Long Sentences

    The company reported that yearly profit growth, which had steadily increased by more than 7% since 1989, had stabilized in 2009 with a 0% comp, and in 2010, the year they launched the OWN project, actually decreased from the previous year by 2%. This announcement stunned Wall Street analysts, but with the overall decrease in similar company profit growth worldwide, as reported by Author (Year) in his article detailing the company’s history, the company’s announcement aligns with industry trends and future industry predictions. Sentence Structure in English Nursing Essay Writing.

    Notice how this paragraph is comprised of just two sentences. While each clause does provide relevant information, the reader may have difficulty identifying the subject and purpose of the whole paragraph.

    Overusing Short Sentences

    In 2010, the company’s yearly profit growth decreased from the previous year by 2%. This was the year they launched the OWN project. The profit growth had steadily increased by more than 7% since 1989. (They stabilized in 2009.) This announcement stunned Wall Street analysts. However, it aligns with the decrease in similar company profit growth worldwide. It also supports future predictions for the industry (Author, Year).

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    Notice how this paragraph uses the same information as the previous one but breaks it into seven sentences. While the information is more digestible through these shorter sentences, the reader may not know what information is the most pertinent to the paragraph’s purpose. Sentence Structure in English Nursing Essay Writing.

    Alternating Sentence Length

    Alternating between lengths allows writers to use sentences strategically, emphasizing important points through short sentences and telling stories with longer ones:

    The company reported that profit growth stabilized in 2009, though it had steadily increased by more than 7% since 1989. In 2010, the year they launch the OWN project, company profit growth decreased from the previous year. This announcement stunned Wall Street analysts. According to Author (Year), however, this decrease is exemplar of a trend across similar company profit growth worldwide; it also supports future predictions for the industry.

    Varying Sentence Type

    One of the trickiest patterns to spot is that of repetitive sentence type. Just like subject and length, overusing a sentence type can hinder a reader’s engagement with a text. There are four types of sentences: simple, compound, complex, and compound-complex. Each sentence is defined by the use of independent and dependent clauses, conjunctions, and subordinators.

    Simple sentences:
     A simple sentence is an independent clause with no conjunction or dependent clause.

    Compound sentences:
     A compound sentence is two independent clauses joined by a conjunction (e.g., and, but, or, for, nor, yet, so). Sentence Structure in English Nursing Essay Writing.

    Complex sentences:
     A complex sentence contains one independent clause and at least one dependent clause. The clauses in a complex sentence are combined with conjunctions and subordinators, terms that help the dependent clauses relate to the independent clause. Subordinators can refer to the subject (who, which), the sequence/time (since, while), or the causal elements (because, if) of the independent clause.

    Compound-complex sentences:
     A compound-complex sentence contains multiple independent clauses and at least one dependent clause. These sentences will contain both conjunctions and subordinators.

    Understanding sentence type will help writers note areas that should be varied through the use of clauses, conjunctions, and subordinators.

    In her article, Author (Year) noted that the participants did not see a change in symptoms after the treatment. Even during the treatment, Author observed no change in the statements from the participants regarding their symptoms. Based on these findings, I will not use this article for my final project. Because my project will rely on articles that note symptom improvement, Author’s work is not applicable.

    Notice how the writer relies solely on complex sentences in this paragraph, even placing dependent clauses at the beginning of each sentence. Here is an example of merely adjusting the placement of these dependent clauses but not the sentence type:

    In her article, Author (Year) noted that the participants did not see a change in symptoms after the treatment. Author observed, even during treatment, no change in the statements from the participants regarding their symptoms. I will not use this article for my final project based on these findings. Because my project will rely on articles that note symptom improvement, Author’s work is not applicable. Sentence Structure in English Nursing Essay Writing.

    While this change in the placement of dependent clauses does avoid a repetitive rhythm to the paragraph, try combining sentences or using conjunctions to create compound or compound-complex sentences to vary sentence type:

    In her article, Author (Year) noted that the participants did not see a change in symptoms after the treatment. Author observed, even during treatment, no change in the statements from the participants regarding their symptoms, and based on these findings, I will not use this article for my final project. Because my project will rely on articles that note symptom improvement, Author’s work is not applicable.

    Making these slight adjustments to sentence type helps the reader engage with the narrative rather than focus on the structure of the text. Adjusting your sentence type during a final revision is a great way to create effective prose for any scholarly document. Sentence Structure in English Nursing Essay Writing.

    1. Sentence Structure and Types of Sentences

    Definitions and Examples of Basic Sentence Elements

    Key: 
    Yellow, bold
     = subject; 
    green underline
     = verb, 
    blue
    , italics
     = object, 
    pink, regular font
     = prepositional phrase

    Independent clause
    : An independent clause can stand alone as a sentence. It contains a subject and a verb and is a complete idea.

    I
     
    like
     
    spaghetti
    .

    He
     
    reads
    many books
    .

    Dependent clause
    : A dependent clause is not a complete sentence. It must be attached to an independent clause to become complete. This is also known as a subordinate clause.

    Although I like spaghetti,…

    Because he reads many books,…

    Subject
    : A person, animal, place, thing, or concept that does an action. Determine the subject in a sentence by asking the question “Who or what?”

    I
     like
    spaghetti.

    He
     reads
    many books.

    Verb
    : Expresses what the person, animal, place, thing, or concept does. Determine the verb in a sentence by asking the question “What was the action or what happened?” Sentence Structure in English Nursing Essay Writing.

    I
    like
     spaghetti.

    He
    reads
     many books.

    The movie
    is
    good. (The 
    be
     verb is also sometimes referred to as a copula or a linking verb. It links the subject, in this case 
    the movie
    , to the complement or the predicate of the sentence, in this case, 
    good
    .) Sentence Structure in English Nursing Essay Writing.

    Object
    : A person, animal, place, thing, or concept that receives the action. Determine the object in a sentence by asking the question “The subject did what?” or “To whom?/For whom?”

    I like 
    spaghetti
    .

    He reads 
    many books
    .

    Prepositional Phrase
    : A phrase that begins with a preposition (i.e., in, at for, behind, until, after, of, during) and modifies a word in the sentence. A prepositional phrase answers one of many questions. Here are a few examples: “Where? When? In what way?”

    I like spaghetti 
    for dinner.

    He reads many books 
    in the library.

    English Sentence Structure

    The following statements are true about sentences in English:

    A new sentence begins with a capital letter.

    H
    e obtained his degree.

    A sentence ends with punctuation (a period, a question mark, or an exclamation point).

    He obtained his degree
    .

    A sentence contains a subject that is only given once.

    Smith
     he obtained his degree.

    Sentence Structure in English Nursing Essay Writing.

    A sentence contains a verb or a verb phrase.

    He 
    obtained
     his degree.

    A sentence follows Subject + Verb + Object word order.

    He 
    (subject) 
    obtained
     (verb) 
    his degree
     (object).

    A sentence must have a complete idea that stands alone. This is also called an independent clause.

    He obtained his degree.

    Simple Sentences

    A simple sentence contains a subject and a verb, and it may also have an object and modifiers. However, it contains only 
    one
     independent clause.

    Key: 
    Yellow, bold
    = subject; 
    green underline
     = verb, 
    blue, italics
     = object, 
    pink, regular font
     =prepositional phrase

    Here are a few examples:

    She
    read
    .

    She
    completed
     
    her literature review
    .

    He
     
    organized
     
    his sources
     
    by theme.

    They
     
    studied 
    APA rules
     
    for many hours.

    Compound Sentences

    A compound sentence contains at least 
    two 
    independent clauses.  These two independent clauses can be combined with a comma and a coordinating conjunction or with a semicolon.

    Key: independent clause = 
    yellow, bold
    ; 
    comma  or semicolon = pink, regular font; coordinating conjunction = 
    green, underlined

    Here are a few examples:

    She completed her literature review
    ,
     
    and
    she created her reference list
    .

    He organized his sources by theme
    ;
    then, he updated his reference list.

    They studied APA rules for many hours
    ,
     
    but
    they realized there was still much to learn
    .

    Using some compound sentences in writing allows for more sentence variety.

    Complex Sentences

    A complex sentence contains at least 
    one 
    independent clause and at least 
    one
     dependent clause. Dependent clauses can refer to the subject (
    who, which
    ) the sequence/time (
    since, while
    ), or the causal elements (
    because, if
    ) of the independent clause.

    If a sentence begins with a dependent clause, note the comma after this clause. If, on the other hand, the sentence begins with an independent clause, there is not a comma separating the two clauses.

    Key: independent clause = 
    yellow, bold
    ; 
    comma = 
    pink, regular font
    ; dependent clause = 
    blue, italics

    Here are a few examples:

    Although she completed her literature review
    ,
    she still needed to work on her methods section
    .

    Note the comma in this sentence because it begins with a dependent clause.

    Because he organized his sources by theme
    ,
    it was easier for his readers to follow
    .

    Note the comma in this sentence because it begins with a dependent clause.

    They studied APA rules for many hours
     
    as they were so interesting
    .

    Note that there is no comma in this sentence because it begins with an independent clause.

    Using some complex sentences in writing allows for more sentence variety.

    Compound-Complex Sentences

    Sentence types can also be combined. A compound-complex sentence contains at least 
    two
     independent clauses and at least 
    one
     dependent clause.

    Key: independent clause = 
    yellow, bold
    ; 
    comma  or semicolon = 
    pink, regular font
    ; coordinating conjunction = 
    green, underlined
    ; dependent clause = 
    blue, italics

    She completed her literature review
    ,
    but
     she still needs to work on her methods section 
    even though she finished her methods course last semester
    .

    Although he organized his sources by theme
    ,
    he decided to arrange them chronologically
    , 
    and
    he carefully followed the MEAL plan for organization.

    With pizza and soda at hand
    ,
    they studied APA rules for many hours
    ,
    and
    they decided that writing in APA made sense
    because it was clear, concise, and objective
    .

    Using some complex-compound sentences in writing allows for more sentence variety.

    Pay close attention to comma usage in complex-compound sentences so that the reader is easily able to follow the intended meaning.

    2. Run-On Sentences and Sentence Fragments

    Run-On Sentences

    A 
    run-on sentence 
    occurs when two or more independent clauses (also known as complete sentences) are connected improperly. Sentence Structure in English Nursing Essay Writing.

    Example
    : 
    I love to write papers. 
    I would write one every day if I had the time
    .

    There are two complete sentences in the above example:

    Sentence 1
    : 
    I love to write papers.

    Sentence 2
    : 
    I would write one every day if I had the time.

     

    One common type of run-on sentence is a 
    comma splice
    . A comma splice occurs when two independent clauses are joined with just a comma.

    Example of a comma splice:
     
    Participants could leave the study at any time
    , 
    they needed to indicate their preference.

    Sentence 1
    : 
    Participants could leave the study at any time
    .

    Sentence 2
    : 
    They needed to indicate their preference.

     

    Some comma splices occur when a writer attempts to use a transitional expression in the middle of a sentence.

    Example of a comma splice:
     
    The results of the study were inconclusive
    , 
    therefore
     more research needs to be done on the topic.

    Sentence 1
    : The results of the study were inconclusive

    Transitional expression
     (conjunctive adverb): 
    therefore

    Sentence 2:
     
    More research needs to be done on the topic

    To fix this type of comma splice, use a semicolon before the transitional expression and add a comma after it. See more examples of this on the semicolon page.

    Revision:
     
    The results of the study were inconclusive
    ; 
    therefore
    ,
     
    more research needs to be done on the topic.

    You can correct a run-on sentence by connecting or separating its parts correctly. There are several easy ways to connect independent clauses. Sentence Structure in English Nursing Essay Writing.

    Correcting Run-On Sentences

    A run-on sentence can be fixed by connecting its parts correctly. There are several ways to connect independent clauses.

    Use a period
    . The easiest way to fix a run-on is to split the sentence into smaller sentences using a period. This revision works especially well with longer sentences. Check, however, to make sure that this solution does not result in short, choppy sentences.

    Revision example
    : 
    I love to write papers
    . 
    I would write one every day if I had the time
    .

    Use a semicolon
    . Inserting a semicolon between independent clauses creates a grammatically correct sentence. Using a semicolon is a stylistic choice that establishes a close relationship between the two sentences.

    Revision example
    : 
    I love to write papers
    ; 
    I would write one every day if I had the time
    .

    Use a comma and a coordinating conjunction
    . A comma, paired with a coordinating conjunction (such as 
    and
    , 
    but
    , or 
    or
    ), corrects a run-on sentence. This method emphasizes the relationship between the two clauses.

    Revision example
    : 
    I love to write papers
    , 
    and
     
    I would write one every day if I had the time
    .

    Use a subordinating conjunction
    . Turn one of the independent clauses into a dependent clause. A subordinating conjunction (such as 
    because
    , 
    unless
    , and 
    although
    ) connects two clauses to create a complex sentence. This option works to cement the relationship between the two parts of the sentence and may improve the flow of the clauses.

    Example
    : 
    Because I love to write papers
    , 
    I would write one every day if I had the time
    .

    However you decide to revise for run-on sentences, remember that maintaining sentence variety helps to keep the writing clear and interesting for your readers.

    Sentence Fragments

    A 
    sentence fragment
     is a string of words that does not form a complete sentence; there is a  necessary component of a complete sentence missing. This missing component may be a subject (usually a noun) or a predicate (verb or verb phrase) and/or when the sentence does not express a complete idea. Sentence Structure in English Nursing Essay Writing.

    Here is an example of a fragment with a missing subject.

    Example of a fragment
    : Shows no improvement in any of the vital signs.

    The sentence above is a fragment since there is no subject (
    Who
     shows no improvement?). Fragments can be corrected by identifying the missing element and including it.

    Revision
    :
     
    The patient
     shows no improvement in any of the vital signs.

    Here is an example of a fragment with a missing predicate, or action:

    Example of a fragment
    : The doctors, who were using peer-reviewed research articles that contributed to the body of knowledge in their fields, which was obstetrics.

    Notice here that although the sentence is quite long, it still contains no action (What are the doctors 
    doing
    ?). Once identified, the sentence can be corrected easily.

    Revision:
     The doctors, who were using peer-reviewed research articles that contributed to the body of knowledge in their field, 
    improved their knowledge of 
    obstetrics.

     

    3. Parallel Construction

    Parallel Construction Basics

    Parallel ideas must be presented in 
    parallel grammatical form
    . Parallel grammatical form means that each part of a sentence uses the same grammatical structure.

    Examples of Parallel Construction

    Between
     and 
    And

    Incorrect
    :  We debated the difference between 
    the weather in Minnesota in the winter
     and 
    how hot it is in the summer
    .

    Correct
    :  We debated the difference between 
    the weather in Minnesota in the winter
     and 
    the weather in Minnesota in the summer.

    Both
     and 
    And

    Incorrect
    : The films were enjoyable 
    to watch
     and 
    discuss
    .

    Correct
    : The films were enjoyable 
    to watch
     and 
    to discuss
    .

    Neither
     and 
    Nor; Either
     and 
    Or

    Incorrect
    : Neither 
    the responses to the questionnaire
     nor 
    what we asked on the survey
     were answered.

    Correct
    : Neither 
    the responses to the questionnaire
     nor 
    the responses to the survey
     were answered.

    Not Only
     and 
    But Also

    Incorrect
    : It was surprising not only 
    that the house sold,
     but also 
    it sold well over the asking price.

    Correct
    : It was surprising not only 
    that the house sold
     but also that 
    it sold well over the asking price. 
    Sentence Structure in English Nursing Essay Writing.

    Parallel Construction in a Series

    Sentences with series, or lists, require particular attention to parallel construction.

    Example 1:

    Incorrect:
     This paper will address 
    No Child Left Behind, how to teach effectively, and instructing with multimedia aids
    .

    Correct:
     This paper will address No Child Left Behind 
    benchmarks
    , effective teaching 
    strategies
    , and multimedia instructional 
    aids
    .

    Now, the series has parallel elements (
    benchmarks
    , 
    strategies
    , and 
    aids
     are all plural nouns).

     

    Example 2:

    Incorrect:
     The students were unprepared, poorly behaved, and disrupted the class.

    Correct:
     The students were 
    underprepared
    , poorly 
    behaved
    , and 
    disruptive
    .

    Now, the series has parallel elements (
    underprepared
    , 
    behaved
    , and
     disruptive
     are all adjectives).

     

    4. Relative, Restrictive, and Nonrestrictive Clauses

    Relative Clauses and Relative Pronouns

    Relative Clause

    This is a clause that generally modifies a noun or a noun phrase and is often introduced by a relative pronoun (
    which, that, who, whom, whose
    ). A relative clause connects ideas by using pronouns that relate to something previously mentioned and allows the writer to combine two independent clauses into one sentence. A relative clause is also known as an adjective clause. There are two types of relative clauses: restrictive and nonrestrictive.

    Here are a few examples:

    The book 
    that she read
     was important for her literature review. (restrictive)

    The participants 
    who were interviewed
     volunteered to be part of the study. (restrictive)

    Walden University, 
    which is entirely online
    , has main administrative offices in Baltimore and Minneapolis. (nonrestrictive)

    Relative Pronouns

    Referring to a human

    Referring to something other than a human

    Possessive

    Restrictive

    who, whom, that*

    which, that**

    whose

    Nonrestrictive (with commas)

    who, whom

    which

    whose

    *In APA, per Section 3.22, use 
    who 
    or
     whom 
    instead of 
    that 
    when referring to a human.

    **Although both 
    which
     and 
    that
     are grammatically correct in restrictive clauses, APA prefers 
    that
     for restrictive clauses. See APA Section 3.22 for more information on this. Sentence Structure in English Nursing Essay Writing.

    Use relative clauses to create more sentence variety.

    Restrictive Clauses

    Restrictive Clause

    A restrictive clause restricts or defines the meaning of a noun or noun phrase and provides necessary information about the noun in the sentence.  It is 
    not separated from the rest of the sentence by commas
    . Restrictive clauses are more common in writing than nonrestrictive clauses. A restrictive clause is also sometimes referred to as an essential clause or phrase. Sentence Structure in English Nursing Essay Writing.

    Here are a few examples:

    The student 
    who sits in the back of the room
     asks a lot of questions.

    The results 
    that I obtained
     may invoke positive social change.

    The journalist 
    whose story I read yesterday
     has won prizes for her work.

    When the relative pronoun functions as the object of the sentence, it can (and usually is) omitted from the relative clause. Sentence Structure in English Nursing Essay Writing.

    Here are a few examples:

    The results 
    that 
    I obtained
     may invoke positive social change.

    The article 
    that 
    I requested
     did not arrive on time.

    The participants 
    who
     I interviewed
     met me at the local library.

    Nonrestrictive Clauses

    Nonrestrictive Clause

    A nonrestrictive clause adds additional information to a sentence. It is usually a proper noun or a common noun that refers to a unique person, thing, or event. It 
    uses commas
     to show that the information is additional. The commas almost act like parentheses within the sentence. If the information between the commas is omitted, readers will still understand the overall meaning of the sentence. A nonrestrictive clause is also known as a nonessential clause or phrase. Sentence Structure in English Nursing Essay Writing.

    Here are a few examples:

    I want to thank my father
    , Mark Smith,
     for all of his love and support.

    With the nonrestrictive clause omitted: I want to thank my father for all of his love and support.

    The hypothesis
    , which I tested throughout the research,
     was rejected. Sentence Structure in English Nursing Essay Writing.

    With the nonrestrictive clause omitted: The hypothesis was rejected.

    I have found the article
    , which I have been looking for
    .

    With the nonrestrictive clause omitted: I have found the article.

    While 
    that
     is sometimes used in restrictive clauses, it is not allowed in nonrestrictive clauses.

    CORRECT: Minneapolis
    , which has a population of about 400,000, 
    is the largest city in Minnesota.

    INCORRECT:
    Minneapolis
    , that has a population of about 400,000,
     is the largest city in Minnesota.

    CORRECT: I had to fix my printer
    , which I bought less than a year ago.

    INCORRECT:
    I had to fix my printer, 
    that I bought less than a year ago
    .

    ORDER A CUSTOM-WRITTEN PAPER NOW

    A relative pronoun cannot be deleted in a nonrestrictive clause.

    CORRECT: Minneapolis
    , which has a population of about 400,000, 
    is the largest city in Minnesota.

    INCORRECT:
    Minneapolis
    , has a population of about 400,000,
     is the largest city in Minnesota. Sentence Structure in English Nursing Essay Writing.

    CORRECT: I had to fix my printer
    , which I bought less than a year ago.

    INCORRECT:
    I had to fix my printer, 
    I bought less than a year ago
    .

    Reduced Relative Clauses

    In academic writing, relative clauses are often reduced for a more concise style. This also creates more sentence variety. When reducing a relative clause, it is necessary to delete the relative pronoun and either delete or change the verb. Here are some examples:

    Gun control is a controversial issue 
    that is
     
    about
     personal rights. (
    be
     + prepositional phrase)

    The steps 
    that were
    followed 
    were explained in the Methods section. (passive)

    Other researchers 
    who are
     exploring
     the same topic have discovered similar solutions. (progressive verb tense) Sentence Structure in English Nursing Essay Writing.

    Participants 
    who were
     available
     to meet in my office completed their interview there. (
    be
     + 
    able 
    adjective)

    Some of the subjects lived in urban areas 
    that had
     
    with
     high crime rates. (
    have
     as a main verb is replaced by 
    with
    )

    In this paper, I reviewed many research articles 
    that addressed
     
    addressing
     the topic of gun control. (linking verbs or verbs describing facts can be changed to 
    –ing
     clauses)

    The changes 
    that are
    to be implemented
     with the new curriculum revisions are outlined in the handout. (
    to
    clauses)

     

    5. Conjunctions

    Basics of Conjunctions

    Conjunctions
     are parts of speech that connect words, phrases, clauses, or sentences. There are three kinds of conjunctions: 
    coordinating
    , 
    paired
    , and 
    subordinating
    .

    For more information about conjunctions, also see Compound Sentences, Varying Sentence Structure, and Comma Basics. Sentence Structure in English Nursing Essay Writing.

    Coordinating Conjunctions

    Coordinating conjunctions
     connect words or phrases that serve the same grammatical purpose in a sentence. There are seven main coordinating conjunctions in English, which form the acronym FANBOYS:

    F: 
    for
    : The teachers were frustrated, 
    for
     the school had cut funding for all enrichment programs.*

    A: 
    and
    : In this course, I will write a literature review, a case study, 
    and
     a final paper.**

    N: 
    nor
    : The students did not complete their homework, 
    nor
     did they pass the test.

    B: 
    but
    : The study is several years old 
    but
     still valuable to this study.

    O: 
    or
    : At the end of the class, the students can choose to write an essay 
    or
     take a test.

    Y: 
    yet
    : The patient complained of chronic pain, 
    yet
     she refused treatment.

    S: 
    so
    : I have only been a nurse for one year, 
    so
     I have little experience with paper charting.

    * 
    For
     is rarely used as a conjunction in modern English.

    ** When the conjunctions 
    and
     and 
    or
     connect three or more words or phrases, use a serial comma to separate items in the series.

    Transitional words such as 
    however
     and 
    therefore
     can also function as conjunctions:

    The authors agreed on the prevalence of the problem; 
    however
    , they disagreed on the problem’s cause.

    Several employees complained about the new policies, and 
    therefore
    , the manager held an all-staff meeting to address their concerns. Sentence Structure in English Nursing Essay Writing.

    Paired Conjunctions

    Paired conjunctions
     consist of two words or phrases that help make a point or establish alternatives. While paired conjunctions can be helpful in structuring a sentence, they can also make sentences wordier than necessary, so use these conjunctions sparingly.

    both…and

    The project will require significant investments of 
    both
     time 
    and
     money.

    Both
     the students 
    and
     the teachers were satisfied with the pilot program.

    Note: When two subjects are connected by both…and, use a plural verb (such as are or were).

    not only…but also

    Students who did not complete the assignment received 
    not only
     a poor grade 
    but also
     a warning from the teacher.

    Not only
     did the student include full sentences from the source without using quotation marks, 
    but
     he 
    also 
    failed to properly cite paraphrased material.

    either…or

    Either
     the students were unprepared 
    or
     the assessment was poorly written.

    Participants in the survey could 
    either
     choose from a list of possible answers 
    or
     write in their own responses.

    neither…nor

    Students who did not complete the project received 
    neither
     praise 
    nor
     rewards.

    The staff 
    neither
     followed the new policy 
    nor
     asked for clarification.

    Subordinating Conjunctions

    Subordinating conjunctions
     join a subordinate clause to a main clause and establishes a relationship between the two. There are many subordinating clauses, but here are some of the most common:

    after

    although

    as much as/as soon as/as long as

    as though

    because

    before

    how

    if

    in order to/in order that

    once

    since

    than

    that

    though

    unless

    until

    when/whenever

    where/wherever

    whether

    while

    There are two ways to structure a sentence using a subordinating conjunction:

    Main clause + subordinate clause

    The teacher administered the test after giving instructions.

    The author must avoid bias if she wants to maintain a scholarly tone.

    I will turn in this assignment at midnight whether or not I complete it.

    Subordinate clause + , + main clause

    After giving instructions, the teacher administered the test.

    Sentence Structure in English Nursing Essay Writing

    If she wants to maintain a scholarly tone, the author must avoid bias.

    Whether or not I complete this assignment, I will turn it in at midnight.

    That
     as a Conjunction for Noun Clauses

    That
     has a few different functions in English. This can lead to confusion because some instances of 
    that
     are more optional than others in academic writing.

    One important use of 
    that
     is for embedding (inserting) a certain type of dependent clause called a noun clause into an independent clause. Frequently, such 
    that-
    clauses serve as the direct object of a reporting verb (such as found, reported, posited, argued, claimed, maintained, and hypothesized) to introduce a paraphrase, summary, or quotation. Sentence Structure in English Nursing Essay Writing.

     

    Key: 
    Yellow, bold
     = subject; 
    green, underline
     
    = verb;
     
    blue, italics
     = object

     

    For example,

    Smith (2015)
     
    reported
     
    that more research was necessary
    .

    Smith (2015)
     = subject

    reported
     = verb

    that more research was necessary
     = dependent clause, direct object of the verb 
    reported

    The authors
     
    hypothesized
     
    that there would be significant results
    .

    The authors
     = subject

    hypothesized
     
    = verb

    that there would be significant results
     
    = dependent clause, direct object of the verb 
    hypothesized

    Jones (2014)
     
    asserted
     
    that confidentiality was maintained throughout the study
    .

    Jones (2014)
     = subject

    asserted
     = verb

    that confidentiality was maintained throughout the study
     = dependent clause, direct object of the verb 
    asserted

    Rephrasing these sentences into questions and answers is one way to see that the 
    that
    -clauses are acting as direct objects.

    What did Smith (2015) report?

    Answer: 
    that 
    more research was necessary

    What did the authors hypothesize?

    Answer: 
    that
     there would be significant results

    What did Jones (2014) assert?

    Answer: 
    that
     confidentiality was maintained throughout the study

    In formal written English, for clarity, most academic writers choose to keep 
    that 
    when it introduces a noun clause (Caplan, 2012). Leaving out 
    that
     can cause the reader to misread (at first anyway) the subject of the dependent clause as being the object of the reporting verb (Jamieson, 2012).

    For example, if readers see the sentence, 
    Smith (2015) reported more research was necessary
     (without 
    that
    ), they may understand “more research” as the thing Smith reported and then have to backtrack and reread upon seeing “was necessary.” Sentence Structure in English Nursing Essay Writing.

    Any structure that leads to misinterpretation, even temporarily, can be an unwanted distraction from the writer’s message.

    In spoken English, however, 
    that
     may be dropped in such sentences. (Intonation patterns—rising and falling pitch—give the listener clues that may not be present in writing.)

     

    Reference

    Caplan, N. (2012). 
    Grammar choices for graduate and professional writers
    . Ann Arbor, MI: University of Michigan Press. Sentence Structure in English Nursing Essay Writing.

    6. Modifiers

    Modifier Basics

    A 
    modifier
     is a word, phrase, or clause that modifies—that is, gives information about—another word in the same sentence. For example, in the following sentence, the word 
    burger
     is modified by the word 
    vegetarian
    :

    Example:
     I’m going to the Saturn Café for a 
    vegetarian
     burger.

    The modifier 
    vegetarian
     gives extra information about what kind of burger it is.

    A modifier can be an 
    adjective
     (a word that modifies a noun, like 
    burger
    ), but it can also be an 
    adverb
     (a word that modifies a verb):

    Example: 
    The student 
    carefully
     proofread her draft.

    The adverb 
    carefully
     is the modifier in this example—it modifies the verb 
    proofread
    , giving important details about how the proofreading was conducted.

    A modifier can even be 
    a phrase or clause
    , as in the following example:

    Example:
     She studied 
    in the library
    .

    Here, the phrase 
    in the library
     gives us extra information about the verb, 
    studied.

     

    Modifiers can also be used for sentence variety. See this page on varying sentence structure for more information.

    Misplaced Modifiers

    When a modifier is ambiguously or illogically modifying a word, we consider it a 
    misplaced modifier
    . See APA 3.21 for more explanation and examples.

    Example:
     Dolger discovered an ancient Mayan civilization 
    using astronavigation
    .

    The modifier, 
    using astronavigation
    , is unclear in this sentence. Does it modify 
    Dolger
     or 
    civilization
    ? A reader will wonder, “Was Dolger using astronavigation? Or was the civilization he discovered using astronavigation?”

    Revision 1:
     Using astronavigation
    , Dolger discovered an ancient Mayan civilization.

    This modifier placement makes it clear that 
    Dolger
     is the one using astronavigation.

    Revision 2:
     Dolger discovered an ancient Mayan civilization that used astronavigation.

    This modifier placement makes it clear that the 
    civilization
     used astronavigation.

    Dangling Modifiers

    When a modifier is not modifying a specific word, we call it a 
    dangling modifier.
     See APA 3.21 for more explanation and examples.

    Example: After consulting a selection of current publications
    , research in this area has been sparse.

    In this example, it is not clear who is consulting the selection of current publications. In other words, there is no referent in the sentence.

    Revision 1: After consulting a selection of current publications, I
     determined that the research in this area has been sparse. Sentence Structure in English Nursing Essay Writing.

    Now the subject in the sentence “I” matches the modifier “after consulting a selection of current publications.”

    Revision 2: According to the selection of current publications, research
     in this area has been sparse.

    Now the modifier “according to the selection of current publications” matches the subject “research.”

    7. Commas

    Comma Basics

    Commas
     are punctuation marks with a variety of uses. The following constructions require commas:

    Serialized lists.
     In 
    a list with three or more elements
    , use commas to separate all of the elements of the series.

    Example
    : 
    This KAM consists of Breadth, Depth, and Application.

    This punctuation rule is also followed for parallel construction in a series.

    Nonessential clauses.
     Use commas to set off clauses that contain information that is 
    nonessential
     to the sentence’s meaning.

    Example:
     Walden University, established in 1970, offers many degree programs.

    Note that without the middle clause (
    established in 1970
    ), the sentence still makes sense (
    Walden University offers many degree programs
    ). Therefore, the clause is nonessential. For more information, view the page on relative, restrictive, and nonrestrictive clauses.

    Compound sentences.
     Use a comma to separate two independent clauses connected by a coordinating conjunction. A coordinating conjunction is a connecting word such as 
    and, but
    , or 
    or. 
    For more information, view the page on sentence structure and types of sentences. Sentence Structure in English Nursing Essay Writing.

    Example
    : Smith (2001) conducted the research, and Heller (2008) commented on the results.

    After a dependent introductory clause, phrase, or word
    . Use a comma after a dependent introductory clause, phrase, or word.

    Example of introductory clause: 
    If you are using this sentence structure, place a comma after the dependent clause.

    Example of introductory phrase:
     Before completing the interviews, I must obtain Walden University approval.

    Example of introductory word
    : 
    Therefore, I created three research questions.

    Example of introductory word
    :
     However, further research is needed.

    Dates.
     Use a comma to set off the year in exact dates.

    Example:
     The hospital’s pursuit of Magnet status was successful (R. Jones, personal communication, 
    September 18, 2009
    ).

    Citations.
     Use commas to set off the elements of a citation.

    Example:
     The research was “inconclusive in its implications” (
    Sanders, 2009, p. 45
    ).

    Introducing quotations (not seamless). 
    Use a comma when an independent clause introduces a quotation but is not seamlessly integrated into it.

    Example:
     Freud (1900) 
    claimed,
     “the dreamer…assumes that the dream–even if it does not come from another world–has at all events transported the dreamer into another world” (p. 5).

     

    Visit varying sentence structures for more information on comma usage.

    In addition, refer to APA Section 4.03 for more about commas. Sentence Structure in English Nursing Essay Writing.

    Common Comma Errors

    The following constructions do not require commas:

    Months.
     Do not use a comma when referring to a month within a particular year.

    Example:
     I conducted the study in 
    June 2003
    .

    Complex sentences.
     Do not use a comma in a sentence that joins an independent clause and a dependent clause with a conjunction (
    and
    , 
    or
    , 
    but
    ).

    Example:
     Smith (2001) found that results were consistent but also suggested further investigation.

    Introducing quotations (seamless).
     Do not use a comma when an independent clause seamlessly introduces a quotation.

    Example:
     Freud (1900) claimed 
    that “the 
    dreamer…assumes that the dream–even if it does not come from another world–has at all events transported the dreamer into another world” (p. 5).

    Comma splices.
     A comma splice occurs when two independent clauses (complete sentences) are separated by just a comma.

    Example:
     Jessica and I went to the movies, we had a good time.

    There are many ways to correct the sentence above. Review the information on run-on sentences for examples of correctly joining independent clauses.

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    8. Semicolons

    Semicolon Basics

    Semicolons
     are punctuation marks used to separate parts of sentences. Use a semicolon in the following instances.

    Two independent clauses.
     Use a semicolon when separating two independent clauses that are not joined by a conjunction. Sentence Structure in English Nursing Essay Writing.

    Example:
     Jones (2014) argued that intelligence was fixed; Smith (2011) argued that ability could be fluid.

    To join two independent clauses with a conjunctive adverb 
    (such as 
    however, therefore, consequently, nevertheless, furthermore, moreover
    ). Note that there is a semicolon before the conjunctive adverb and a comma after it.

    Example
    : This structure joins two independent clauses; moreover, it creates cohesion in the text by showing how one idea relates to another.

    Example
    : I had difficulty obtaining a large number of participants; however, I still reached saturation in the interviews. Sentence Structure in English Nursing Essay Writing.

    Series.
     Use a semicolon to separate elements in a series that already contains commas.

    Example:
     Amy ordered three pizzas: one with pepperoni, sausage, mushroom; one with bacon, ham, and green peppers; and one with tomatoes, olives, and red peppers.

    Example:
     Many have claimed that the sky is blue (Hawking, Goldberg, & Rita, 1994; Lima, 2003; Steinberg & Jordan, 2001).

    For more information about semicolons, read on the following:

    Sentence Structures and Types of Sentences

    Run-Ons and Sentence Fragments

    Varying Sentence Structures

    In addition, refer to APA section 4.04 for more information about semicolon usage and Sentence Structure in English Nursing Essay Writing.

  • Decision Tree Assignment

    Decision Tree Assignment

    Here is a general framework for what I am looking for on the decision tree assignments.

    Provide an 
    introduction to the disease state
     discussed in the case. I am looking for a high-level summary that briefly describes the key aspects of that disease state. I do not want several pages of information related to the diagnosis of the disease state.

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    Provide a 
    high-level summary of the important pieces of information from the case-study
     that is presented. I do not want the entire case study presented. The goal is that you would be able to give your essay to someone that does not know anything about the assignment and for that individual to be able to understand the purpose of your essay. Again….focus on the important pieces of information that will help you make your decision.

    You also want to mention the 
    purpose of the assignment
    . This can be brief.

    Decision Point 1, 2, and 3.

    At each decision point, 
    list the options that are presented and describe your rationale for choosing the option you chose
    .

    I 
    do not want general answers
    ….”I chose sertraline because sertraline is an SSRI and SSRIs are approved for depression/anxiety”. I want VERY SPECIFIC reasons you chose the option you chose. These reasons must be backed by good evidence. Feel free to include studies comparing agents, side effects, dosing, patient considerations, therapeutic practice guidelines, comorbid conditions, etc….  You will also need to 
    explain your rationale for not choosing the other two options.
      This is very important in your learning. Please remember that you will have MANY more medications to chose from than three in clinical practice. When you make your choice, you also need to describe your 
    goals of treatment
    . What do you want to achieve by initiating the therapy you picked. Again….be specific. Defend your choices like you are in a courtroom. Decision Tree Assignment.

    After each decision, you will be presented with the outcome of that decision. You need to 
    discuss how that outcome was what you expected or if it was different than what you expected and why.

    You will do the above for all three decision points.

    You need to use evidence to support your rationale. [Support your rationale with a minimum of three academic resources. While you may use the course text to support your rationale, it will not count toward the resource requirement. Credible reference material only will be accepted. Sites such as WebMD and drugs.com (among others) will not be counted.]

    Don’t forget to include information related to the 
    ethical considerations
     and how they might impact your treatment plan and communication with your clients. Decision Tree Assignment.

    In summary: What needs to be in your essay.

    Introduction regarding disease state

    High-level summary of patient case

    Purpose of the essay statement

    Decision 1

    What options were listed

    What option did you choose?

    Why did you select that option?

    Why didn’t you select the other two options?

    What was your goal of treatment

    Was the outcome what you expected? Why?

    Decision 2

    What options were listed

    What option did you choose?

    Why did you select that option?

    Why didn’t you select the other two options?

    What was your goal of treatment

    Was the outcome what you expected? Why?

    Decision 3

    What options were listed

    What option did you choose?

    Why did you select that option?

    Why didn’t you select the other two options?

    What was your goal of treatment

    Was the outcome what you expected? Why?

    Conclusion with Ethical considerations

    ***Do not use the start over button and complete several different times. That is not the point. If you do use the START OVER button, I do not want your paper to reflect this. I have had students do it multiple times and address incorrect outcomes in their paper.
    Decision Tree
    Assignment. I have also had students submit a paper that defends using all three options presented at decision point number one. You will need to click the option to move to the next screen which will provide you with the outcome and the options for the next decision point.  You will receive a ZERO on the assignment if you do not follow the instructions correctly. I had a handful of students last semester complete the assignment incorrectly.  Please ask questions if you do not understand. Decision Tree Assignment.

  • Aricept (donepezil) 5 mg nursing decision tree essay

    Aricept (donepezil) 5 mg nursing decision tree essay

    : Begin Aricept (donepezil) 5 mg orally at BEDTIME

    RESULTS OF DECISION POINT ONE

     Client returns to clinic in four weeks

     The client is accompanied by his son who reports that his father is “no better” from this medication

     He reports that his father is still disinterested in attending religious services/activities, and continues to exhibit disinhibited behaviors

     You continue to note confabulation and decide to administer the MMSE again. Mr. Akkad again scores 18 out of 30 with primary deficits in orientation, registration, attention & calculation, and recall

    Decision Point Two

    Aricept (donepezil) 5 mg nursing decision tree essay

     

    Increase Aricept to 10 mg orally at BEDTIME

     

    RESULTS OF DECISION POINT TWO

     Client returns to clinic in four weeks

     Client’s son reports that the client is tolerating the medication well, but is still concerned that his father is no better. Aricept (donepezil) 5 mg nursing decision tree essay

     He states that his father is attending religious services with the family, which the son and the rest of the family is happy about. He reports that his father is still easily amused by things he once found serious

    Decision Point Three

     

    Continue Aricept 10 mg orally at BEDTIME

     

    Guidance to Student

    At this point, it would be prudent for the PMHNP to continue Aricept at 10 mg orally at bedtime. Recall that this medication can take several months before stabilization of deterioration is noted. At this point, the client is attending religious services with the family, which has made the family happy. Disinhibition may improve in a few weeks, or it may not improve at all. This is a counseling point that the PMHNP should review with the son.

    There is no evidence that Aricept given at doses greater than 10 mg per day has any therapeutic benefit. It can, however, cause side effects. Increasing to 15 and 20 mg per day would not be appropriate.

    There is nothing in the clinical presentation to suggest that the Aricept should be discontinued. Whereas it may be appropriate to add Namenda to the current drug profile, there is no need to discontinue Aricept. In fact, NMDA receptor antagonist therapy is often used with cholinesterase inhibitors in combination therapy to treat Alzheimer’s disease. The key to using both medications is slow titration upward toward therapeutic doses to minimize negative side effects.

    Finally, it is important to note that changes in the MMSE should be evaluated over the course of months, not weeks. The absence of change in the MMSE after 4 weeks of treatment should not be a source of concern.

  • Exelon (rivastigmine) 1.5 mg decision tree essay

    Exelon (rivastigmine) 1.5 mg decision tree essay

    Decision Point One

    Begin Exelon (rivastigmine) 1.5 mg orally BID with an increase to 3 mg orally BID in 2 weeks

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    RESULTS OF DECISION POINT ONE

     Client returns to clinic in four weeks

     The client is accompanied by his son who reports that his father is “no better” from this medication. He reports that his father is still disinterested in attending religious services/activities, and continues to exhibit disinhibited behaviors

     You continue to note confabulation and decide to administer the MMSE again. Exelon (rivastigmine) 1.5 mg decision tree essay.Mr. Akkad again scores 18 out of 30 with primary deficits in orientation, registration, attention & calculation, and recall

    Decision Point Two

     

    Increase Exelon to 4.5 mg orally BID

     

    RESULTS OF DECISION POINT TWO

     Client returns to clinic in four weeks

     Client’s son reports that the client is tolerating the medication well, but is still concerned that his father is no better

     He states that his father is attending religious services with the family, which the son and the rest of the family is happy about. He reports that his father is still easily amused by things he once found serious

    Exelon (rivastigmine) 1.5 mg decision tree essay

    Decision Point Three

     

    Increase Exelon to 6 mg orally BID

     

    Guidance to Student

    At this point, the client is reporting no side effects and is participating in an important part of family life (religious services). This could speak to the fact that the medication may have improved some symptoms. The PMHNP needs to counsel the client’s son on the trajectory of presumptive Alzheimer’s disease in that it is irreversible, and while cholinesterase inhibitors can stabilize symptoms, this process can take months. Also, these medications are incapable of reversing the degenerative process. Some improvements in problematic behaviors (such as disinhibition) may be seen, but not in all clients. Exelon (rivastigmine) 1.5 mg decision tree essay.

    At this point, the PMHNP could maintain the current dose until the next visit in 4 weeks, or the PMHNP could increase it to 6 mg orally BID and see how the client is doing in 4 more weeks. Augmentation with Namenda is another possibility, but the PMHNP should maximize the dose of the cholinesterase inhibitor before adding augmenting agents. However, some experts argue that combination therapy should be used from the onset of treatment. Exelon (rivastigmine) 1.5 mg decision tree essay.

    Finally, it is important to note that changes in the MMSE should be evaluated over the course of months, not weeks. The absence of change in the MMSE after 4 weeks of treatment should not be a source of concern. Exelon (rivastigmine) 1.5 mg decision tree essay.

  • Razadyne (galantamine) 4 mg decision tree essay

    Razadyne (galantamine) 4 mg decision tree essay

    Decision Point One

    Begin Razadyne (galantamine) 4 mg orally BID

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    RESULTS OF DECISION POINT ONE

     Client returns to clinic in four weeks

     The client is accompanied by his son who reports that his father is “no better” from this medication

     He reports that his father is still disinterested in attending religious services/activities, and continues to exhibit disinhibited behaviors

     You continue to note confabulation and decide to administer the MMSE again. Mr. Akkad again scores 18 out of 30 with primary deficits in orientation, registration, attention & calculation, and recall

    Razadyne (galantamine) 4 mg decision tree essay

    Decision Point Two

     

    Increase Razadyne to 24 mg extended release daily

     

    RESULTS OF DECISION POINT TWO

     Client returns to clinic in four weeks

     The client’s son accompanies the client to his appointment today. The client is in a wheelchair and is somewhat agitated. Razadyne (galantamine) 4 mg decision tree essay.

     You are informed by the son that his father has not taken his medication since he got out of the hospital. Apparently, about 7 days after starting the Galantamine extended release, the client began having seizures which resulted in a fall and fractured hip. The son reports that his father is agitated with everyone and is asking for help in treating his agitation

    Decision Point Three

     

    Restart Razadyne extended release 24 mg

     

    Guidance to Student

    Razadyne extended release 24 mg is a “target” dose—not a starting dose. Side effects of Razadyne include GI side effects as well as dizziness. Rare side effects include seizures. If no other medications were added to the client’s medication regimen and no other physical issues were present (e.g., metabolic derangements), then the high dose of Razadyne in this client would most likely be responsible for his seizures, which resulted in the fall and the hip fracture. This would represent malpractice. If the PMHNP were to consider restarting Razadyne, it should be restarted at a proper starting dose, as side effects are often dose dependent. Razadyne (galantamine) 4 mg decision tree essay.

    Risperdal would not be appropriate to treat agitation in this client as the FDA has issued a black box warning against the treatment of agitation in dementia with antipsychotic medications. Although they can still be used despite black box warnings, the PMHNP should conduct a comprehensive assessment of this client to see if a physical issue is causing the agitation. A hip fracture is often associated with pain, and untreated pain may be the cause of the client’s agitation. Therefore, assessment for pain would be the correct choice in this scenario.

    Never use psychotropic drugs to treat behaviors until physical causes of the behavior have been ruled out (e.g., pain, infection, constipation). Razadyne (galantamine) 4 mg decision tree essay.

    Finally, it is important to note that changes in the MMSE should be evaluated over the course of months, not weeks. The absence of change in the MMSE after 4 weeks of treatment should not be a source of concern. Razadyne (galantamine) 4 mg decision tree essay.

  • Case Study: An Elderly Iranian Man With Alzheimer’s Disease

    Case Study: An Elderly Iranian Man With Alzheimer’s Disease

    Examine 
    Case Study: An Elderly Iranian Man With Alzheimer’s Disease
    . You will be asked to make three decisions concerning the medication to prescribe to this client. Be sure to consider factors that might impact the client’s pharmacokinetic and pharmacodynamic processes.

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    At each decision point stop to complete the following:

    Decision #1

    Which decision did you select?

    Why did you select this decision? Support your response with evidence and references to the Learning Resources.

    What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.

    Explain any difference between what you expected to achieve with Decision #1 and the results of the decision. Why were they different? Case Study: An Elderly Iranian Man With Alzheimer’s Disease.

    Decision #2

    Why did you select this decision? Support your response with evidence and references to the Learning Resources.

    What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources. Case Study: An Elderly Iranian Man With Alzheimer’s Disease.

    Explain any difference between what you expected to achieve with Decision #2 and the results of the decision. Why were they different?

    Decision #3

    Why did you select this decision? Support your response with evidence and references to the Learning Resources.

    What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.

    Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different?

    Also include how ethical considerations might impact your treatment plan and communication with clients. Case Study: An Elderly Iranian Man With Alzheimer’s Disease.

    Note
    : Support your rationale with a minimum of three academic resources. While you may use the course text to support your rationale, it will not count toward the resource requirement.

    Decision Tree Assignment

    Here is a general framework for what I am looking for on the decision tree assignments.

    Provide an 
    introduction to the disease state
     discussed in the case. I am looking for a high-level summary that briefly describes the key aspects of that disease state. I do not want several pages of information related to the diagnosis of the disease state. Case Study: An Elderly Iranian Man With Alzheimer’s Disease.

    Provide a 
    high-level summary of the important pieces of information from the case-study
     that is presented. I do not want the entire case study presented. The goal is that you would be able to give your essay to someone that does not know anything about the assignment and for that individual to be able to understand the purpose of your essay. Again….focus on the important pieces of information that will help you make your decision. Case Study: An Elderly Iranian Man With Alzheimer’s Disease.

    You also want to mention the 
    purpose of the assignment
    . This can be brief.

    Decision Point 1, 2, and 3.

    At each decision point, 
    list the options that are presented and describe your rationale for choosing the option you chose
    .

    I 
    do not want general answers
    ….”I chose sertraline because sertraline is an SSRI and SSRIs are approved for depression/anxiety”. I want VERY SPECIFIC reasons you chose the option you chose. These reasons must be backed by good evidence. Feel free to include studies comparing agents, side effects, dosing, patient considerations, therapeutic practice guidelines, comorbid conditions, etc….  You will also need to 
    explain your rationale for not choosing the other two options.
      This is very important in your learning. Please remember that you will have MANY more medications to chose from than three in clinical practice. When you make your choice, you also need to describe your 
    goals of treatment
    . What do you want to achieve by initiating the therapy you picked. Again….be specific. Defend your choices like you are in a courtroom.

    After each decision, you will be presented with the outcome of that decision. You need to 
    discuss how that outcome was what you expected or if it was different than what you expected and why.

    You will do the above for all three decision points.

    You need to use evidence to support your rationale. [Support your rationale with a minimum of three academic resources. While you may use the course text to support your rationale, it will not count toward the resource requirement. Credible reference material only will be accepted. Sites such as WebMD and drugs.com (among others) will not be counted.] Case Study: An Elderly Iranian Man With Alzheimer’s Disease.

    Don’t forget to include information related to the 
    ethical considerations
     and how they might impact your treatment plan and communication with your clients. Case Study: An Elderly Iranian Man With Alzheimer’s Disease.

    In summary: What needs to be in your essay.

    Introduction regarding disease state

    High-level summary of patient case

    Purpose of the essay statement

    Decision 1

    What options were listed

    What option did you choose?

    Why did you select that option?

    Why didn’t you select the other two options?

    What was your goal of treatment

    Was the outcome what you expected? Why?

    Case Study: An Elderly Iranian Man With Alzheimer’s Disease

    Decision 2

    What options were listed

    What option did you choose?

    Why did you select that option?

    Why didn’t you select the other two options?

    What was your goal of treatment

    Was the outcome what you expected? Why?

    Decision 3

    What options were listed

    What option did you choose?

    Why did you select that option?

    Why didn’t you select the other two options?

    What was your goal of treatment

    Was the outcome what you expected? Why?

    Conclusion with Ethical considerations

    ***Do not use the start over button and complete several different times. That is not the point. If you do use the START OVER button, I do not want your paper to reflect this. I have had students do it multiple times and address incorrect outcomes in their paper. I have also had students submit a paper that defends using all three options presented at decision point number one. You will need to click the option to move to the next screen which will provide you with the outcome and the options for the next decision point.  You will receive a ZERO on the assignment if you do not follow the instructions correctly. I had a handful of students last semester complete the assignment incorrectly.  Please ask questions if you do not understand. Case Study: An Elderly Iranian Man With Alzheimer’s Disease.

    Alzheimer’s Disease

    76-year-old Iranian Male

    BACKGROUND

    Mr. Akkad is a 76 year old Iranian male who is brought to your office by his eldest son for “strange behavior.” Mr. Akkad was seen by his family physician who ruled out any organic basis for Mr. Akkad’s behavior. All laboratory and diagnostic imaging tests (including CT-scan of the head) were normal.

    According to his son, he has been demonstrating some strange thoughts and behaviors for the past two years, but things seem to be getting worse. Per the client’s son, the family noticed that Mr. Akkad’s personality began to change a few years ago. He began to lose interest in religious activities with the family and became more “critical” of everyone. They also noticed that things he used to take seriously had become a source of “amusement” and “ridicule.” Case Study: An Elderly Iranian Man With Alzheimer’s Disease.

    Over the course of the past two years, the family has noticed that Mr. Akkad has been forgetting things. His son also reports that sometimes he has difficult “finding the right words” in a conversation and then will shift to an entirely different line of conversation.

     

    SUBJECTIVE

    During the clinical interview, Mr. Akkad is pleasant, cooperative and seems to enjoy speaking with you. You notice some confabulation during various aspects of memory testing, so the PMHNP performs a Mini-Mental State Exam. Mr. Akkad scores 18 out of 30 with primary deficits in orientation, registration, attention & calculation, and recall. The score suggests moderate dementia.

     

    MENTAL STATUS EXAM

    Mr. Akkad is 76 year old Iranian male who is cooperative with today’s clinical interview. His eye contact is poor. Speech is clear, coherent, but tangential at times. He makes no unusual motor movements and demonstrates no tic. Self-reported mood is euthymic. Affect however is restricted. He denies visual or auditory hallucinations. No delusional or paranoid thought processes noted. He is alert and oriented to person, partially oriented to place, but is disoriented to time and event [he reports that he thought he was coming to lunch but “wound up here”- referring to your office, at which point he begins to laugh]. Insight and judgment are impaired. Impulse control is also impaired as evidenced by Mr. Akkad’s standing up during the clinical interview and walking towards the door. When the PMHNP asked where he was going, he stated that he did not know. Mr. Akkad denies suicidal or homicidal ideation. Case Study: An Elderly Iranian Man With Alzheimer’s Disease.

    Diagnosis: Major neurocognitive disorder due to Alzheimer’s disease (presumptive)

     

    RESOURCES

    Folstein, M. F., Folstein, S. E., & McHugh, P. R. (2002). Mini-Mental State Examination (MMSE). Lutz, FL: Psychological Assessment Resources. Case Study: An Elderly Iranian Man With Alzheimer’s Disease.

     

    Decision Point One

    Select what the PMHNP should do:

    Begin Exelon (rivastigmine) 1.5 mg orally BID with an increase to 3 mg orally BID in 2 weeks

    : Begin Aricept (donepezil) 5 mg orally at BEDTIME

    Begin Razadyne (galantamine) 4 mg orally BID

    Case Study: An Elderly Iranian Man With Alzheimer’s Disease

  • Anorexia Nervosa Essay

    Anorexia Nervosa Essay

    Anorexia nervosa is a serious eating disorder that results in unhealthy, often dangerous weight loss. While it is most common among adolescent women, anorexia can affect women and men of all ages and is characterized by a refusal to maintain a healthy body weight, an intense fear of gaining weight, and a distorted body image… Anorexia Nervosa Essay

    ORDER A PLAGIARISM-FREE PAPER HERE

    Anorexia nervosa is a life threatening eating disorder defined by a refusal to maintain fifteen percent of a normal body weight through self-starvation (NAMI 1). Ninety-five percent of anorexics are women between the ages of twelve and eighteen… Anorexia Nervosa Essay.

    Anorexia Nervosa is one of the most commonly known and yet least recognized eating disorders. Anorexia is a mental illness, which affects both boys and girls within normal weight ranges who think they are overweight. The early stages of Anorexia are often difficult to detect. A person should know what to look for as far as early symptoms and know what steps to take to help, but the most important thing would be to try to figure out what underlying problems could be responsible for the condition. Anorexia Nervosa Essay.

    Anorexia begins with feelings of self-confidence and higher self esteem as the result of a more “attractive” appearance making the person feel as if they are more capable of handling social interaction (Anorexia, Dying to Be Thin p.1-13). As the anorexia progresses, his/her preoccupation with staying thin, which he or she believes gave his/her feelings of success, caused his/her to concentrate even more on his/her weight (Anorexia, Dying to Be Thin p.1-13). Eventually, the anorexic’s body will start to deteriorate, his/her self-esteem will diminish, and he or she will begin to remove themselves from social interaction (Anorexia, Dying to Be Thin p.1-13). Communication with his/her family or friends will also be reduced or strained (Anorexia, Dying to Be Thin p.1-13)… Anorexia Nervosa Essay.

    Every generation has a set of values that they believe make a person beautiful. In the 1940’s and 50’s it was considered beautiful to be a voluptuous woman. A woman with a large chest and full hips was the ideal woman, such as Marylyn Monroe. The difference between then and now is, young women could escape this image if need be. Today it is impossible to ignore the stick thin super models on bill boards, TV, and in magazines. The influence of society on teenagers is so much that men actually expect a woman to be that stick thin model or they are considered “fat”, “tubby”, etc… Anorexia Nervosa Essay.

    Attempting to comprehend why society demands a high standard for a slender appearance is bewildering. Some individuals take extreme measures to acquire this desired look, assuming that if they achieve this look the pain within will disappear. For most men and women suffering from anorexia there are deeper, more complex emotional/mental issues to be resolved. Anorexia is common destructive eating disorder that individuals can develop overtime by giving into their deranged thoughts and perceptions. My research paper will describe in detail the actions and behaviors that someone who is suffering from Anorexia Nervosa demonstrates. I will be discussing the social attitudes towards the illness from the past to the present. Furthermore, I will give information on different ways to treat Anorexia Nervosa and also preventative measure that can be taken… Anorexia Nervosa Essay.

    …Many of anorexics died before they could get a well treatment. Anorexics that are in a very underweight condition, must be treated carefully, or hospitalized. After anorexics get the medical treatment, they need to get psychological counseling in order for them learn about healthy foods and lifestyle. The psychological counseling may includes nutritional counseling, individual counseling and group counseling. Nutritional counseling will teaches anorexics to count calories of body needed in comfortable method. And to help with weight gain, doctors usually use liquid food supplements. Anorexics may also need some therapies such as cognitive-behavioral therapy or known as CBT in the individual counseling. CBT teachers will help anorexics to change their attitudes and behaviors about eating. Group counseling is also needed for anorexics, to share their experiences and to encourage their friends (who also experience anorexia) to recover. Family therapy is very helpful, especially for teen with anorexics. Parents and siblings could support the anorexics during treatment emotionally and physically. Another effort to help anorexics recover is by letting them expressing their feelings and doing something enjoyable for them for instance doing their hobbies. Then, doing relaxation is also important. By having yoga, massage and the traditional Chinese relaxation exercises will build a healthy relationship with their body. Anorexia Nervosa Essay.