course materials

1. NURS 6630N Week 4: Therapy for Patients With Major Depressive
Disorder (MDD)
NURS 6630N Week 4: Therapy for Patients With Major Depressive Disorder (MDD)NURS
6630N Week 4: Therapy for Patients With Major Depressive Disorder
(MDD)Permalink: https:// /nurs-6630n-week-…ressive-disorder/Mood disorders can
impact every facet of a human being’s life, making the most basic activities difficult for
patients and their families. This was the case for 13-year-old Jeanette, who was struggling at
home and at school. For more than 8 years, Jeanette suffered from temper tantrums,
impulsiveness, inappropriate behavior, difficulty in judgment, and sleep issues. NURS
6630N Week 4: Therapy for Patients With Major Depressive DisorderAs a PNP working
with pediatric patients, you must be able to assess whether these symptoms are caused by
psychological, social, or underlying growth and development issues. You must then be able
recommend appropriate therapies.This week, as you examine antidepressant therapies, you
explore the assessment and treatment of three populations: pediatrics, adults, and
geriatrics. The focus of your assessment tool, a decision tree, will specifically center on one
of the most vulnerable populations, pediatrics. Please remember, you must also consider
the ethical and legal implications of these therapies. You will also complete a Quiz on the
concepts addressed throughout this module.Learning ObjectivesStudents will:Assess
patient factors and history to develop personalized plans of antidepressant therapy across
the lifespanAnalyze factors that influence pharmacokinetic and pharmacodynamic
processes in pediatric, adult, and geriatric patients requiring antidepressant
therapySynthesize knowledge of providing care to pediatric, adult, and geriatric patients
presenting for antidepressant therapyAnalyze ethical and legal implications related to
prescribing antidepressant therapy to patients across the lifespanLearning Resources –
NURS 6630N Week 4: Therapy for Patients With Major Depressive DisorderRequired
Readings (click to expand/reduce)Baek, J. H., Nierenberg, A. A., & Fava, M. (2016).
Pharmacological approaches to treatment-resistant depression. In T. A. Stern, M. Favo, T. E.
Wilens, & J. F. Rosenbaum. (Eds.), Massachusetts General Hospital psychopharmacology and
neurotherapeutics (pp. 44–47). Elsevier.Fava, M., & Papakostas, G. I. (2016).
Antidepressants. In T. A. Stern, M. Favo, T. E. Wilens, & J. F. Rosenbaum. (Eds.),
Massachusetts General Hospital psychopharmacology and neurotherapeutics (pp. 27–43).
Elsevier.American Psychiatric Association. (2013). Diagnostic and statistical manual of
mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596Howland,

2. R. H. (2008a). Sequenced Treatment Alternatives to Relieve Depression (STAR*D). Part 1:
Study design. Journal of Psychosocial Nursing and Mental Health Services, 46(9), 21–24.
https://doi.org/10.3928/02793695-20080901-06Howland, R. H. (2008b). Sequenced
Treatment Alternatives to Relieve Depression (STAR*D). Part 2: Study outcomes. Journal of
Psychosocial Nursing and Mental Health Services, 46(10), 21–24.
https://doi.org/10.3928/02793695-20081001-05Lorberg, B., Davico, C., Martsenkovskyi,
D., & Vitiello, B. (2019). Principles in using psychotropic medication in children and
adolescents. In J. M. Rey & A. Martin (Eds.), IACAPAP e-textbook of child and adolescent
mental health. https://iacapap.org/content/uploads/A.7-Psychopharmacology-
2019.1.pdfMagellan Health. (2013). Appropriate use of psychotropic drugs in children and
adolescents: A clinical monograph.
http://www.magellanhealth.com/media/445492/magellan-psychotropicdrugs-
0203141.pdfPoznanski, E. O., & Mokros, H. B. (1996). Child depression rating scale—
Revised. Western Psychological Services.Rao, U. (2013). Biomarkers in pediatric depression.
Depression & Anxiety, 30(9), 787–791. https://doi.org/10.1002/da.22171Yasuda, S. U.,
Zhang, L. & Huang, S.-M. (2008). The role of ethnicity in variability in response to drugs:
Focus on clinical pharmacology studies. Clinical Pharmacology & Therapeutics, 84(3), 417–
423.
https://web.archive.org/web/20170809004704/https://www.fda.gov/downloads/Drugs/
ScienceResearch/…/UCM085502.pdfMedication Resources (click to expand/reduce)IBM
Corporation. (2020). IBM
Micromedex.https://www.micromedexsolutions.com/micromedex2/librarian/deeplinkacc
ess?source=deepLink&institution=SZMC%5ESZMC%5ET43537Note: To access the
following medications, use the IBM Micromedex resource. Type the name of each
medication in the keyword search bar. Be sure to read all sections on the left navigation bar
related to each medication’s result page, as this information will be helpful for your review
in preparation for your Assignments.Review the following
medications: amitriptylinebupropioncitalopramclomipraminedesipraminedesvenlafaxined
oxepinduloxetineescitalopramfluoxetinefluvoxamine
imipramineketaminemirtazapinenortriptylineparoxetineselegilinesertralinetrazodo
nevenlafaxinevilazodonevortioxetine Required Media (click to expand/reduce)Case Study:
An African American Child Suffering from DepressionNote: This case study will serve as the
foundation for this week’s Assignment.Optional Resources (click to expand/reduce)El
Marroun, H., White, T., Verhulst, F., & Tiemeier, H. (2014). Maternal use of antidepressant or
anxiolytic medication during pregnancy and childhood neurodevelopmental outcomes: A
systematic review. European Child & Adolescent Psychiatry, 23(10), 973–992.
https://doi.org/10.1007/s00787-014-0558-3Gordon, M. S., & Melvin, G. A. (2014). Do
antidepressants make children and adolescents suicidal? Journal of Pediatrics and Child
Health, 50(11), 847–854. https://doi.org/10.1111/jpc.12655Seedat, S. (2014).
Controversies in the use of antidepressants in children and adolescents: A decade since the
storm and where do we stand now? Journal of Child & Adolescent Mental Health, 26(2),iii–v.
https://doi.org/10.2989/17280583.2014.938497Assignment: Assessing and Treating
Pediatric Patients With Mood DisordersWhen pediatric patients present with mood

3. disorders, the process of assessing, diagnosing, and treating them can be quite complex.
Children not only present with different signs and symptoms than adult patients with the
same disorders, they also metabolize medications much differently. Yet, there may be times
when the same psychopharmacologic treatments may be used in both pediatric and adult
cases with major depressive disorders. As a result, psychiatric nurse practitioners must
exercise caution when prescribing psychotropic medications to these patients. For this
Assignment, as you examine the patient case study in this week’s Learning Resources,
consider how you might assess and treat pediatric patients presenting with mood
disorders.To prepare for this Assignment:Review this week’s Learning Resources, including
the Medication Resources indicated for this week.Reflect on the psychopharmacologic
treatments you might recommend for the assessment and treatment of pediatric patients
requiring antidepressant therapy.The Assignment: 5 pagesExamine Case Study: An African
American Child Suffering From Depression. You will be asked to make three decisions
concerning the medication to prescribe to this patient. Be sure to consider factors that
might impact the patient’s pharmacokinetic and pharmacodynamic processes.At each
decision point, you should evaluate all options before selecting your decision and moving
throughout the exercise. Before you make your decision, make sure that you have
researched each option and that you evaluate the decision that you will select. Be sure to
research each option using the primary literature.Introduction to the case (1 page)Briefly
explain and summarize the case for this Assignment. Be sure to include the specific patient
factors that may impact your decision making when prescribing medication for this
patient.Decision #1 (1 page)Which decision did you select?Why did you select this decision?
Be specific and your response with clinically relevant and patient-specific resources,
including the primary literature.Why did you not select the other two options provided in
the exercise? Be specific and your response with clinically relevant and patient-specific
resources, including the primary literature.What were you hoping to achieve by making this
decision? your response with evidence and references to the Learning Resources
(including the primary literature).Explain how ethical considerations may impact your
treatment plan and communication with patients. Be specific and provide examples. NURS
6630N Week 4: Therapy for Patients With Major Depressive DisorderDecision #2 (1
page)Why did you select this decision? Be specific and your response with clinically
relevant and patient-specific resources, including the primary literature.Why did you not
select the other two options provided in the exercise? Be specific and your response with
clinically relevant and patient-specific resources, including the primary literature.What
were you hoping to achieve by making this decision? your response with evidence and
references to the Learning Resources (including the primary literature).Explain how ethical
considerations may impact your treatment plan and communication with patients. Be
specific and provide examples.Decision #3 (1 page)Why did you select this decision? Be
specific and your response with clinically relevant and patient-specific resources,
including the primary literature.Why did you not select the other two options provided in
the exercise? Be specific and your response with clinically relevant and patient-specific
resources, including the primary literature.What were you hoping to achieve by making this
decision? your response with evidence and references to the Learning Resources

4. (including the primary literature).Explain how ethical considerations may impact your
treatment plan and communication with patients. Be specific and provide
examples.Conclusion (1 page)Summarize your recommendations on the treatment options
you selected for this patient. Be sure to justify your recommendations and your response
with clinically relevant and patient-specific resources, including the primary
literature.Note: your rationale with a minimum of five academic resources. While you may
use the course text to your rationale, it will not count toward the resource requirement.
You should be utilizing the primary and secondary literature.Reminder : The College of
Nursing requires that all papers submitted include a title page, introduction, summary, and
references. The Sample Paper provided at the Walden Writing Center provides an example
of those required elements (available at
https://academicguides.waldenu.edu/writingcenter/templates/general#s-lg-box-
20293632).All papers submitted must use this formatting.By Day 7Submit your
Assignment.NURS 6630N Week 4: Therapy for Patients With Major Depressive Disorder
Rubric DetailSelect Grid View or List View to change the rubric’s
layout.Name: NURS_6630_Week4_Assignment_RubricGrid ViewList View ExcellentPoint
range: 90–100 GoodPoint range: 80–89 FairPoint range: 70–79 PoorPoint
range: 0–69Introduction to the case (1 page)Briefly explain and summarize the case for this
Assignment. Be sure to include the specific patient factors that may impact your decision
making when prescribing medication for this patient. NURS 6630N Week 4: Therapy for
Patients With Major Depressive Disorder 9 (9%) – 10 (10%)The response accurately,
clearly, and fully summarizes in detail the case for the Assignment.The response accurately
and clearly explains in detail the specific patient factors that impact decision making when
prescribing medication for this patient. 8 (8%) – 8 (8%)The response accurately
summarizes the case for the Assignment.The response accurately explains the specific
patient factors that impact decision making with prescribing medication for this patient.
7 (7%) – 7 (7%)The response inaccurately or vaguely summarizes the case for the
Assignment.The response inaccurately or vaguely explains the specific patient factors that
impact decision making with prescribing medication for this patient. 0 (0%) – 6 (6%)The
response inaccurately and vaguely summarizes the case for the Assignment, or is
missing.The response inaccurately and vaguely explains the specific patient factors that
impact decision making with prescribing medication for this patient.Decision #1 (1–2
pages)• Which decision did you select?• Why did you select this decision? Be specific and
your response with clinically relevant and patient-specific resources, including the primary
literature.• Why did you not select the other two options provided in the exercise? Be
specific and your response with clinically relevant and patient-specific resources,
including the primary literature.• What were you hoping to achieve by making this
decision? your response with evidence and references to the Learning Resources
(including the primary literature).• Explain how ethical considerations may impact your
treatment plan and communication with patients. Be specific and provide examples.
18 (18%) – 20 (20%)The response accurately and clearly explains in detail the
decision selected.The response accurately and clearly explains in detail why the decision
was selected, with specific clinically relevant resources that fully the decision selected.The

5. response accurately and clearly explains in detail why the other two responses were not
selected, with specific clinically relevant resources that fully the response.The response
accurately and clearly explains in detail the outcome the student was hoping to achieve with
the selected decision, with specific clinically relevant resources that fully the response.The
response accurately and clearly explains in detail how ethical considerations impact the
treatment plan and communication with patients.Examples provided fully the decisions
and responses provided. 16 (16%) – 17 (17%)The response accurately explains the
decision selected.The response explains why the decision was selected, with specific
clinically relevant resources that the decision selected.The response accurately explains
why the other two responses were not selected, with specific clinically relevant resources
that the response.The response accurately explains the outcome the student was hoping to
achieve with the selected decision, with specific clinically relevant resources that the
response.The response accurately explains how ethical considerations impact the treatment
plan and communication with patients.Examples provided the decisions and responses
provided. NURS 6630N Week 4: Therapy for Patients With Major Depressive Disorder
14 (14%) – 15 (15%)The response inaccurately or vaguely explains the decision
selected.The response inaccurately or vaguely explains why the decision was selected, with
specific clinically relevant resources that inaccurately or vaguely the decision selected.
NURS 6630N Week 4: Therapy for Patients With Major Depressive DisorderThe response
inaccurately or vaguely explains why the other two responses were not selected, with
specific clinically relevant resources that inaccurately or vaguely the response.The
response inaccurately or vaguely explains the outcome the student was hoping to achieve
with the selected decision, with specific clinically relevant resources that inaccurately or
vaguely the response.The response inaccurately or vaguely explains how ethical
considerations impact the treatment plan and communication with patients.Examples
provided may the decisions and responses provided. 0 (0%) – 13 (13%)The
response inaccurately and vaguely explains the decision selected.The response inaccurately
and vaguely explains why the decision was selected, with specific clinically relevant
resources that do not the decision selected, or is missing.The response inaccurately and
vaguely explains why the other two responses were not selected, with specific clinically
relevant resources that do not the decision selected, or is missing.The response
inaccurately and vaguely explains the outcome the student was hoping to achieve with the
selected decision, with specific clinically relevant resources that do not the response, or is
missing.The response inaccurately and vaguely explains how ethical considerations impact
the treatment plan and communication with patients, or is missing.Examples provided do
not the decisions and responses provided, or is missing.Decision #2 (1–2 pages)• Which
decision did you select?• Why did you select this decision? Be specific and your response
with clinically relevant and patient-specific resources, including the primary literature.•
Why did you not select the other two options provided in the exercise? Be specific and
your response with clinically relevant and patient-specific resources, including the primary
literature.• What were you hoping to achieve by making this decision? your response with
evidence and references to the Learning Resources (including the primary literature).•
Explain how ethical considerations may impact your treatment plan and communication

6. with patients. Be specific and provide examples. 18 (18%) – 20 (20%)The response
accurately and clearly explains in detail the decision selected.The response accurately and
clearly explains in detail why the decision was selected, with specific clinically relevant
resources that fully the decision selected.The response accurately and clearly explains in
detail why the other two responses were not selected, with specific clinically relevant
resources that fully the response.The response accurately and clearly explains in detail the
outcome the student was hoping to achieve with the selected decision, with specific
clinically relevant resources that fully the response.The response accurately and clearly
explains in detail how ethical considerations impact the treatment plan and communication
with patients.Examples provided fully the decisions and responses provided.
16 (16%) – 17 (17%)The response accurately explains the decision selected.The
response explains why the decision was selected, with specific clinically relevant resources
that the decision selected.The response accurately explains why the other two responses
were not selected, with specific clinically relevant resources that the response.The
response accurately explains the outcome the student was hoping to achieve with the
selected decision, with specific clinically relevant resources that the response.The
response accurately explains how ethical considerations impact the treatment plan and
communication with patients.Examples provided the decisions and responses provided.
NURS 6630N Week 4: Therapy for Patients With Major Depressive Disorder 14 (14%) –
15 (15%)The response inaccurately or vaguely explains the decision selected.The response
inaccurately or vaguely explains why the decision was selected, with specific clinically
relevant resources that inaccurately or vaguely the decision selected.The response
inaccurately or vaguely explains why the other two responses were not selected, with
specific clinically relevant resources that inaccurately or vaguely the response.The
response inaccurately or vaguely explains the outcome the student was hoping to achieve
with the selected decision, with specific clinically relevant resources that inaccurately or
vaguely the response.The response inaccurately or vaguely explains how ethical
considerations impact the treatment plan and communication with patients.Examples
provided may the decisions and responses provided. 0 (0%) – 13 (13%)The
response inaccurately and vaguely explains in detail the decision selected.The response
inaccurately and vaguely explains why the decision was selected, with specific clinically
relevant resources that do not the decision selected, or is missing.The response
inaccurately and vaguely explains why the other two responses were not selected, with
specific clinically relevant resources that do not the decision selected, or is missing.The
response inaccurately and vaguely explains the outcome the student was hoping to achieve
with the selected decision, with specific clinically relevant resources that do not the
response, or is missing.The response inaccurately and vaguely explains how ethical
considerations impact the treatment plan and communication with patients, or is
missing.Examples provided do not the decisions and responses provided, or is
missing.Decision #3 (1–2 pages)• Which decision did you select?• Why did you select this
decision? Be specific and your response with clinically relevant and patient-specific
resources, including the primary literature.• Why did you not select the other two options
provided in the exercise? Be specific and your response with clinically relevant and

7. patient-specific resources, including the primary literature.• What were you hoping to
achieve by making this decision? your response with evidence and references to the
Learning Resources (including the primary literature).• Explain how ethical considerations
may impact your treatment plan and communication with patients. Be specific and provide
examples. 18 (18%) – 20 (20%)The response accurately and clearly explains in detail
the decision selected.The response accurately and clearly explains in detail why the
decision was selected, with specific clinically relevant resources that fully the decision
selected.The response accurately and clearly explains in detail why the other two responses
were not selected, with specific clinically relevant resources that fully the response.The
response accurately and clearly explains in detail the outcome the student was hoping to
achieve with the selected decision, with specific clinically relevant resources that fully the
response.The response accurately and clearly explains in detail how ethical considerations
impact the treatment plan and communication with patients.Examples provided fully the
decisions and responses provided. 16 (16%) – 17 (17%)The response accurately
explains the decision selected.The response explains why the decision was selected, with
specific clinically relevant resources that the decision selected.The response accurately
explains why the other two responses were not selected, with specific clinically relevant
resources that the response.The response accurately explains the outcome the student
was hoping to achieve with the selected decision, with specific clinically relevant resources
that the response.The response accurately explains how ethical considerations impact the
treatment plan and communication with patients.Examples provided the decisions and
responses provided. NURS 6630N Week 4: Therapy for Patients With Major Depressive
Disorder 14 (14%) – 15 (15%)The response inaccurately or vaguely explains the
decision selected.The response inaccurately or vaguely explains why the decision was
selected, with specific clinically relevant resources that inaccurately or vaguely the
decision selected.The response inaccurately or vaguely explains why the other two
responses were not selected, with specific clinically relevant resources that inaccurately or
vaguely the response.The response inaccurately or vaguely explains the outcome the
student was hoping to achieve with the selected decision, with specific clinically relevant
resources that inaccurately or vaguely the response.The response inaccurately or vaguely
explains how ethical considerations impact the treatment plan and communication with
patients.Examples provided may the decisions and responses provided. 0 (0%) –
13 (13%)The response inaccurately and vaguely explains in detail the decision selected.The
response inaccurately and vaguely explains why the decision was selected, with specific
clinically relevant resources that do not the decision selected, or is missing.The response
inaccurately and vaguely explains why the other two responses were not selected, with
specific clinically relevant resources that do not the decision selected, or is missing.The
response inaccurately and vaguely explains the outcome the student was hoping to achieve
with the selected decision, with specific clinically relevant resources that do not the
response, or is missing.The response inaccurately and vaguely explains how ethical
considerations impact the treatment plan and communication with patients, or is
missing.Examples provided do not the decisions and responses provided, or is
missing.Conclusion (1 page)• Summarize your recommendations on the treatment options

8. you selected for this patient. Be sure to justify your recommendations and your response
with clinically relevant and patient-specific resources, including the primary literature.
14 (14%) – 15 (15%)The response accurately and clearly summarizes in detail the
recommendations on the treatment options selected for this patient.The response
accurately and clearly explains a justification for the recommendations provided, including
clinically relevant resources that fully the recommendations provided. 12 (12%) –
13 (13%)The response accurately summarizes the recommendations on the treatment
options selected for this patient.The response accurately explains a justification for the
recommendation provided, including clinically relevant resources that the
recommendations provided. 11 (11%) – 11 (11%)The response inaccurately or vaguely
summarizes the recommendations on the treatment options selected for this patient.The
response inaccurately or vaguely explains a justification for the recommendations provided,
including clinically relevant resources that inaccurately or vaguely the recommendations
provided. 0 (0%) – 10 (10%)The response inaccurately and vaguely summarizes the
recommendations on the treatment options selected for this patient, or is missing.The
response inaccurately and vaguely explains a justification for the recommendations
provided, including clinically relevant resources that do not the recommendations
provided, or is missing.Written Expression and Formatting – Paragraph Development and
Organization:Paragraphs make clear points that well-developed ideas, flow logically, and
demonstrate continuity of ideas. Sentences are carefully focused—neither long and
rambling nor short and lacking substance. A clear and comprehensive purpose statement
and introduction are provided that delineate all required criteria. 5 (5%) –
5 (5%)Paragraphs and sentences follow writing standards for flow, continuity, and clarity.A
clear and comprehensive purpose statement, introduction, and conclusion are provided that
delineate all required criteria. 4 (4%) – 4 (4%)Paragraphs and sentences follow writing
standards for flow, continuity, and clarity 80% of the time.Purpose, introduction, and
conclusion of the assignment are stated, yet they are brief and not descriptive.
3.5 (3.5%) – 3.5 (3.5%)Paragraphs and sentences follow writing standards for flow,
continuity, and clarity 60%–79% of the time.Purpose, introduction, and conclusion of the
assignment is vague or off topic. 0 (0%) – 3 (3%)Paragraphs and sentences follow
writing standards for flow, continuity, and clarity < 60% of the time.No purpose statement,
introduction, or conclusion were provided.Written Expression and Formatting – English
writing standards:Correct grammar, mechanics, and proper punctuation 5 (5%) –
5 (5%)Uses correct grammar, spelling, and punctuation with no errors. 4 (4%) –
4 (4%)Contains a few (1 or 2) grammar, spelling, and punctuation errors. 3.5 (3.5%) –
3.5 (3.5%)Contains several (3 or 4) grammar, spelling, and punctuation errors.
0 (0%) – 3 (3%)Contains many (? 5) grammar, spelling, and punctuation errors that
interfere with the reader’s understanding.Written Expression and Formatting – The paper
follows correct APA format for title page, headings, font, spacing, margins, indentations,
page numbers, parenthetical/in-text citations, and reference list. 5 (5%) – 5 (5%)Uses
correct APA format with no errors. 4 (4%) – 4 (4%)Contains a few (1 or 2) APA format
errors. 3.5 (3.5%) – 3.5 (3.5%)Contains several (3 or 4) APA format errors. 0 (0%) –
3 (3%)Contains many (? 5) APA format errors. NURS 6630N Week 4: Therapy for Patients

9. With Major Depressive DisorderTotal Points:
100Name: NURS_6630_Week4_Assignment_RubricRubric DetailSelect Grid View or List
View to change the rubric’s layout.Name: NURS_6630_Week4_Assignment_RubricGrid
ViewList ViewExcellentPoint range: 90–100 GoodPoint range: 80–89 FairPoint range: 70–
79 PoorPoint range: 0–69Introduction to the case (1 page)Briefly explain and summarize
the case for this Assignment. Be sure to include the specific patient factors that may impact
your decision making when prescribing medication for this patient. NURS 6630N Week 4:
Therapy for Patients With Major Depressive Disorder9 (9%) – 10 (10%)The response
accurately, clearly, and fully summarizes in detail the case for the Assignment.The response
accurately and clearly explains in detail the specific patient factors that impact decision
making when prescribing medication for this patient.8 (8%) – 8 (8%)The response
accurately summarizes the case for the Assignment.The response accurately explains the
specific patient factors that impact decision making with prescribing medication for this
patient.7 (7%) – 7 (7%)The response inaccurately or vaguely summarizes the case for the
Assignment.The response inaccurately or vaguely explains the specific patient factors that
impact decision making with prescribing medication for this patient.0 (0%) – 6 (6%)The
response inaccurately and vaguely summarizes the case for the Assignment, or is
missing.The response inaccurately and vaguely explains the specific patient factors that
impact decision making with prescribing medication for this patient.Decision #1 (1–2
pages)• Which decision did you select?• Why did you select this decision? Be specific and
your response with clinically relevant and patient-specific resources, including the primary
literature.• Why did you not select the other two options provided in the exercise? Be
specific and your response with clinically relevant and patient-specific resources,
including the primary literature.• What were you hoping to achieve by making this
decision? your response with evidence and references to the Learning Resources
(including the primary literature).• Explain how ethical considerations may impact your
treatment plan and communication with patients. Be specific and provide examples.18
(18%) – 20 (20%)The response accurately and clearly explains in detail the decision
selected.The response accurately and clearly explains in detail why the decision was
selected, with specific clinically relevant resources that fully the decision selected.The
response accurately and clearly explains in detail why the other two responses were not
selected, with specific clinically relevant resources that fully the response.The response
accurately and clearly explains in detail the outcome the student was hoping to achieve with
the selected decision, with specific clinically relevant resources that fully the response.The
response accurately and clearly explains in detail how ethical considerations impact the
treatment plan and communication with patients.Examples provided fully the decisions
and responses provided.16 (16%) – 17 (17%)The response accurately explains the decision
selected.The response explains why the decision was selected, with specific clinically
relevant resources that the decision selected.The response accurately explains why the
other two responses were not selected, with specific clinically relevant resources that the
response.The response accurately explains the outcome the student was hoping to achieve
with the selected decision, with specific clinically relevant resources that the response.The
response accurately explains how ethical considerations impact the treatment plan and

10. communication with patients.Examples provided the decisions and responses provided.14
(14%) – 15 (15%)The response inaccurately or vaguely explains the decision selected.The r