Order ID 53563633773 Type Essay Writer Level Masters Style APA Sources/References 4 Perfect Number of Pages to Order 5-10 Pages Description/Paper Instructions
SUBJECTIVE
Michelle, a 17‐year‐old Caucasian female, presents to a primary care practice where she has been a patient since 5 years of age. She is accompanied by her maternal aunt. Michelle is usually accompanied by her mother. She is up to date with her immunizations including HPV series. Her last visit was 10 months ago for strep pharyngitis. She was very quiet and less interactive at that visit but when asked if anything was bothering her said “just my throat.”
Michelle tells you she is here today because she identifies “more as a boy,” saying “I’ve felt this way for about 2 years but was afraid to tell anybody before. I’m not afraid now and have told my mother and my aunt. I’m tired of lying by not saying anything and want to do things differently. My mom said I should come and talk to you because we like and trust you.” Michelle’s aunt ver-ifies this, saying, “My sister is still a little freaked out about this but wants what is best for Michelle. That’s why she asked me to come with her today.” Michelle’s mom would also like her to have a physical check‐up, since she hasn’t been seen for almost a year. Michelle’s aunt leaves the exam room to allow her privacy.
Past medical/surgical history: Michelle has a positive medical history for strep pharyngitis, which resolved with antibiotics. She has no chronic illnesses, surgery, or hospitalizations.
Menstrual history: She began menarche at age 11 with a regular 28‐day cycle and moderate bleeding. She expresses a desire to “not have my period.”
Family history: Maternal family history is positive for grandmother with COPD, grandfather with hypertension. Mother and 9‐year‐old sister have no health issues. Paternal history is unknown. Father has problems with substance abuse.
Social history: Michelle lives with her mother and younger sister in a rural, farming area. Her father is known but has little contact with the family. Michelle is a sophomore at the public high school. Her mother works full‐time at a local manufacturing plant. Michelle has a close relation-ship with her mother and maternal aunt. She denies alcohol and tobacco use, does admit to “smoking weed once but I hated it.” She denies depression but admits previous anxiety about her lifestyle choice. She reports her anxiety is “pretty much gone” since she has “come out” to her mother and aunt. She admits being attracted to other girls but denies any sexual experiences. She
has recently told a few other students about identifying as a boy, noting “it’s hard to be different in this area.”
Medications: No regular medications.
Allergies: Seasonal (spring) allergies. NKDA.
OBJECTIVE
General: Alert, pleasant adolescent; well groomed with good hygiene. Cooperative with good eye contact.
Vital signs: Height: 63.5 inches; weight: 112 pounds; BMI 19.5 (43rd percentile); B/P: 108/70; HR:
72; RR: 15.
Cardiac: RRR; S1‐S2 normal; no murmur, rub, or gallop.
Respiratory: Normal respiratory effort; lungs clear to auscultation bilaterally.
Abdominal: Soft, nondistended, nontender, with positive bowel sounds x 4 quadrants.
Breasts: Tanner stage IV.
PHQ‐9: Negative.
CRITICAL THINKING
What concerns should be addressed at this visit?
_____Sexual identity
_____Anxiety/Depression
_____Desire for amenorrhea
What case‐specific questions should be asked addressing Michelle’s desire for amenorrhea?
Are any referrals needed?
What complications exist related to the rural setting?
Are there implications for future medical care?
What psychosocial challenges present with “coming out”?
RUBRIC
QUALITY OF RESPONSE NO RESPONSE POOR / UNSATISFACTORY SATISFACTORY GOOD EXCELLENT Content (worth a maximum of 50% of the total points) Zero points: Student failed to submit the final paper. 20 points out of 50: The essay illustrates poor understanding of the relevant material by failing to address or incorrectly addressing the relevant content; failing to identify or inaccurately explaining/defining key concepts/ideas; ignoring or incorrectly explaining key points/claims and the reasoning behind them; and/or incorrectly or inappropriately using terminology; and elements of the response are lacking. 30 points out of 50: The essay illustrates a rudimentary understanding of the relevant material by mentioning but not full explaining the relevant content; identifying some of the key concepts/ideas though failing to fully or accurately explain many of them; using terminology, though sometimes inaccurately or inappropriately; and/or incorporating some key claims/points but failing to explain the reasoning behind them or doing so inaccurately. Elements of the required response may also be lacking. 40 points out of 50: The essay illustrates solid understanding of the relevant material by correctly addressing most of the relevant content; identifying and explaining most of the key concepts/ideas; using correct terminology; explaining the reasoning behind most of the key points/claims; and/or where necessary or useful, substantiating some points with accurate examples. The answer is complete. 50 points: The essay illustrates exemplary understanding of the relevant material by thoroughly and correctly addressing the relevant content; identifying and explaining all of the key concepts/ideas; using correct terminology explaining the reasoning behind key points/claims and substantiating, as necessary/useful, points with several accurate and illuminating examples. No aspects of the required answer are missing. Use of Sources (worth a maximum of 20% of the total points). Zero points: Student failed to include citations and/or references. Or the student failed to submit a final paper. 5 out 20 points: Sources are seldom cited to support statements and/or format of citations are not recognizable as APA 6th Edition format. There are major errors in the formation of the references and citations. And/or there is a major reliance on highly questionable. The Student fails to provide an adequate synthesis of research collected for the paper. 10 out 20 points: References to scholarly sources are occasionally given; many statements seem unsubstantiated. Frequent errors in APA 6th Edition format, leaving the reader confused about the source of the information. There are significant errors of the formation in the references and citations. And/or there is a significant use of highly questionable sources. 15 out 20 points: Credible Scholarly sources are used effectively support claims and are, for the most part, clear and fairly represented. APA 6th Edition is used with only a few minor errors. There are minor errors in reference and/or citations. And/or there is some use of questionable sources. 20 points: Credible scholarly sources are used to give compelling evidence to support claims and are clearly and fairly represented. APA 6th Edition format is used accurately and consistently. The student uses above the maximum required references in the development of the assignment. Grammar (worth maximum of 20% of total points) Zero points: Student failed to submit the final paper. 5 points out of 20: The paper does not communicate ideas/points clearly due to inappropriate use of terminology and vague language; thoughts and sentences are disjointed or incomprehensible; organization lacking; and/or numerous grammatical, spelling/punctuation errors 10 points out 20: The paper is often unclear and difficult to follow due to some inappropriate terminology and/or vague language; ideas may be fragmented, wandering and/or repetitive; poor organization; and/or some grammatical, spelling, punctuation errors 15 points out of 20: The paper is mostly clear as a result of appropriate use of terminology and minimal vagueness; no tangents and no repetition; fairly good organization; almost perfect grammar, spelling, punctuation, and word usage. 20 points: The paper is clear, concise, and a pleasure to read as a result of appropriate and precise use of terminology; total coherence of thoughts and presentation and logical organization; and the essay is error free. Structure of the Paper (worth 10% of total points) Zero points: Student failed to submit the final paper. 3 points out of 10: Student needs to develop better formatting skills. The paper omits significant structural elements required for and APA 6th edition paper. Formatting of the paper has major flaws. The paper does not conform to APA 6th edition requirements whatsoever. 5 points out of 10: Appearance of final paper demonstrates the student’s limited ability to format the paper. There are significant errors in formatting and/or the total omission of major components of an APA 6th edition paper. They can include the omission of the cover page, abstract, and page numbers. Additionally the page has major formatting issues with spacing or paragraph formation. Font size might not conform to size requirements. The student also significantly writes too large or too short of and paper 7 points out of 10: Research paper presents an above-average use of formatting skills. The paper has slight errors within the paper. This can include small errors or omissions with the cover page, abstract, page number, and headers. There could be also slight formatting issues with the document spacing or the font Additionally the paper might slightly exceed or undershoot the specific number of required written pages for the assignment. 10 points: Student provides a high-caliber, formatted paper. This includes an APA 6th edition cover page, abstract, page number, headers and is double spaced in 12’ Times Roman Font. Additionally, the paper conforms to the specific number of required written pages and neither goes over or under the specified length of the paper. GET THIS PROJECT NOW BY CLICKING ON THIS LINK TO PLACE THE ORDER
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