| Course | DNRS 6800 Advanced Pediatric Development and Behavior |
|---|---|
| Week | Week 8 |
| Paper type | Referral letter |
| Length | About 310 words, 3 pages |
| Format | Letter, APA 7 citations |
| School | Walden University |
| Program | Doctor of Nursing Practice (DNP) |
| Updated | October 2026 |
Free sample paper for DNRS 6800 Week 8
Referral Letter
To: Pediatric Sleep Medicine Clinic, Regional Children's Hospital
From: Family Nurse Practitioner, Riverside Family Health Center
Date: Month Day, Year
Re: 6-year-old boy, snoring with witnessed pauses and daytime hyperactivity: request for polysomnography and advice on ENT referral
Dear Colleague,
I am writing to ask whether Eli, a 6-year-old boy, has obstructive sleep apnea and, if so, whether referral for adenotonsillectomy is the right next step.
Findings. His parents report loud snoring on most nights for about 8 months, pauses in breathing followed by gasps that his mother has watched and timed at up to 10 seconds, and restless sleep with sweating. Over the same period his first-grade teacher has reported that he is fidgety, impulsive, and has trouble staying in his seat, which is new this year. On examination his tonsils are enlarged, grade 3, and he breathes through his mouth at rest; his growth is normal. His Pediatric Sleep Questionnaire score is above the screening threshold for sleep-disordered breathing (Chervin et al., 2000).
What has been tried. A 6-week trial of a nasal steroid spray for possible allergic rhinitis produced no change in snoring. We have deliberately not started any evaluation for attention-deficit/hyperactivity disorder, because sleep-disordered breathing can produce the same behaviors in children and should be assessed first (Marcus et al., 2012).
My question. Would you arrange polysomnography for Eli, and, based on the result, advise whether he should be referred to pediatric ENT for adenotonsillectomy? Current guidelines recommend polysomnography before surgery for children with sleep-disordered breathing in certain circumstances and when the need for surgery is uncertain (Mitchell et al., 2019), and I would value your judgment on whether his findings warrant it before an ENT consultation.
His parents have given written consent for this referral and for sharing his records. His most recent visit note and the sleep questionnaire are attached. I can be reached directly at the clinic's provider line, and I would be grateful for a copy of the study report and your recommendations.
Sincerely,
Family Nurse Practitioner
References
Chervin, R. D., Hedger, K., Dillon, J. E., & Pituch, K. J. (2000). Pediatric Sleep Questionnaire (PSQ): Validity and reliability of scales for sleep-disordered breathing, snoring, sleepiness, and behavioral problems. Sleep Medicine, 1(1), 21-32. https://doi.org/10.1016/S1389-9457(99)00009-X
Marcus, C. L., Brooks, L. J., Draper, K. A., Gozal, D., Halbower, A. C., Jones, J., Schechter, M. S., Sheldon, S. H., Spruyt, K., Ward, S. D., Lehmann, C., & Shiffman, R. N. (2012). Diagnosis and management of childhood obstructive sleep apnea syndrome. Pediatrics, 130(3), 576-584. https://doi.org/10.1542/peds.2012-1671
Mitchell, R. B., Archer, S. M., Ishman, S. L., Rosenfeld, R. M., Coles, S., Finestone, S. A., Friedman, N. R., Giordano, T., Hildrew, D. M., Kim, T. W., Lloyd, R. M., Parikh, S. R., Shulman, S. T., Walner, D. L., Walsh, S. A., & Nnacheta, L. C. (2019). Clinical practice guideline: Tonsillectomy in children (update). Otolaryngology-Head and Neck Surgery, 160(1 Suppl.), S1-S42. https://doi.org/10.1177/0194599818801757
The Walden DNRS 6800 Week 8 instructions
The eighth week often asks for a referral letter to a specialist for a child with a developmental, behavioral or medical concern. Expect the prompt to require a clear referral question, relevant history and findings, what has already been done, and what you are asking the specialist to do. DNRS 6800 instructors grade professional form: addressee, subject line, length, tone and signature block. Most letters run one to two pages. Citations are often minimal or listed after the signature, though some sections require them in APA 7. Patient identifiers should be fictional. The letter should be readable in a minute by a busy clinician. Keep the tone collegial, since the receiving clinician owes you nothing. State the urgency honestly, neither inflating nor downplaying it. Include how the family can be reached and whether they have agreed to the referral.
How the DNRS 6800 Week 8 example is put together
The letter carries a proper heading block, a named addressee and a subject line that already contains the child's age and the concern. Its first sentence says why the letter exists. A findings paragraph follows, three to five sentences, giving only what the receiving clinician needs to prioritize the appointment: what was observed, over what period, and what the screening produced. What has already been tried gets its own short paragraph so the specialist does not repeat it. Then the question, written as a question, naming exactly what is being asked of the receiver rather than handing over the whole child. A closing line records consent obtained and gives a direct contact route. Everything about the family is composite.
DNRS 6800 Week 8 rubric: what earns full marks
Referral letters are graded on professional form as much as content, and the rows that catch students are the ones a paper never has: addressee accuracy, subject line, consent statement, contact route. The example carries all four. The heaviest content row asks whether the referral question is specific, since a letter asking a specialist to evaluate and advise transfers the thinking rather than sharing it. Marks are lost to length, because a two page referral is a referral nobody finishes, and to tone, where students slip into advocacy and start arguing for the child instead of describing the child. Another common loss is a findings paragraph written in course vocabulary rather than the clinical shorthand the receiving reader actually uses.
DNRS 6800 Week 8 help from the desk
Referral letters lose points on form a paper never needs: a missing subject line, a vague addressee, no date of birth or no clear question. Check each element. Another common mistake is writing the history as a long narrative when the reader needs the facts that support the question. Writers also ask the specialist to "evaluate and treat" without saying what they want answered. Name the question, such as whether sleep-disordered breathing explains the daytime behavior. Avoid speculating about diagnoses the specialist will decide. Keep the tone collegial and brief. Include what the family understands about the referral. Writers also forget to attach or mention the screening tool result, which gives the specialist a quick sense of severity. Note the questionnaire and its score in one line. Another common miss is leaving out the growth and tonsil findings from the examination, which a sleep service wants first. Close with a clear signature block and contact line.
Get a DNRS 6800 Week 8 example written to your instructions
Give the desk your Week 8 prompt, the rubric, and the specialty your section wants the letter addressed to. A finished letter comes back to that specification, free for the first sample and inside 24-48 hours, formatted as correspondence rather than as an essay so the professional conventions are visible.
More DNRS 6800 papers and DNP samples
- DNRS 6800 Week 1: Discussion Post
- DNRS 6800 Week 2: Observation Write-Up
- DNRS 6800 Week 3: Milestone Analysis
- DNRS 6800 Week 4: Behavior Log Analysis
- DNRS 6800 Week 5: Discussion Post
- DNRS 6800 Week 6: Case Formulation
- DNRS 6800 Week 7: Family Interview Write-Up
- DNRS 6800 Week 9: Discussion Post
- DNRS 6800 Week 10: Parent Guidance Plan
- DNRS 6800 Week 11: Reflection
- NURS 8002 Week 8: Translation evidence summary
- DNRS 6630 Week 8: Literature Appraisal
- NURS 8003 Week 8: Discussion post
- DNRS 6211 Week 8: Payer Mix Analysis
DNRS 6800 Week 8 questions, answered
Does the letter go to a real clinic?
No. The example addresses a plausible specialty and a fictional receiving clinician, and the child and family are composite. Nothing in it identifies a person, a practice or a placement site. If your prompt names a specific referral pathway, the desk writes to that pathway using the same conventions and keeps every party in the document invented.
How long should a referral letter be?
One page. The example holds to it, and the discipline of one page is part of what is being assessed even where the rubric does not name a limit. If your prompt sets a longer requirement, the extra length usually belongs in the findings paragraph, not in the opening, and the question at the end stays a single sentence regardless.
What makes a referral question specific enough?
It names what you want back. Asking whether an expressive language delay is present and whether services are indicated gives the receiver a task with an endpoint. Asking for evaluation and recommendations does not, and it is the most common version students submit. The example shows the difference by asking one answerable thing rather than three general ones.
Where can I find a free DNRS 6800 Week 8 sample paper?
The snoring and behavior referral letter is laid out here in full, including the referral question, the supporting findings and the closing block, with notes on form.
Which screening tool appears in the DNRS 6800 Week 8 letter?
The Pediatric Sleep Questionnaire, whose result supports the referral question about sleep-disordered breathing.