NRNP 6531 Week 1 Sore Throat SOAP Note Example

Course	NRNP 6531 Primary Care of Adults Across the Lifespan
Week	Week 1
Paper type	Episodic SOAP note
Length	About 860 words, 6 pages
Format	APA 7 student paper
School	Walden University
Program	MSN Family Nurse Practitioner (FNP)
Updated	October 2026

Free sample paper for NRNP 6531 Week 1

Episodic SOAP Note: Three Days of Sore Throat and Fever in a 27-Year-Old Warehouse Worker

Student Name

College of Nursing, Walden University

NRNP 6531: Primary Care of Adults Across the Lifespan

Instructor Name

Month Day, Year

What this page is doingThe title gives the complaint, its duration, the fever, and one social detail, the shared workplace, that matters for exposure. An episodic note is a single visit, and the title keeps that scope rather than naming a diagnosis before the reasoning is shown.

Episodic SOAP Note: Three Days of Sore Throat and Fever in a 27-Year-Old Warehouse Worker

Subjective

Chief complaint: "It feels like I'm swallowing glass."

History of present illness: L.P. is a 27-year-old woman, invented for this note, who works as a picker at a distribution warehouse. Her throat pain began abruptly three days ago on waking, and it has been constant since, rated 7 of 10, worse with swallowing. She measured a temperature of 101.8 F at home last night and has had chills. Two coworkers on her shift were out sick last week with sore throats; she does not know their diagnoses. She has taken ibuprofen 400 mg every eight hours, which takes the edge off for a few hours. She reports feeling more tired than usual for about a week, before the sore throat began, which she had put down to overtime shifts. Appetite is reduced because swallowing hurts, but she is drinking fluids.

Pertinent negatives: no cough, no runny nose, no hoarseness or muffled voice, no drooling, no difficulty opening her mouth, no ear pain, no rash, no abdominal pain, and no difficulty breathing. She has not had a sore throat treated in the past year.

Past medical history: none. Medications: ibuprofen as above; combined oral contraceptive. Allergies: penicillin caused a pruritic rash without swelling or breathing difficulty at age 8, as reported by her mother. Social history: lives with a roommate, does not smoke or vape, drinks alcohol occasionally, one male partner. Immunizations: current per her report.

What this page is doingThe history opens with the patient's own words and then turns them into onset, severity, and exposure. Pertinent negatives get their own line because each one lowers a specific diagnosis: no cough lowers viral illness, and no drooling, muffled voice, or trismus lowers peritonsillar abscess and epiglottitis. The week of fatigue is recorded because it keeps mononucleosis on the list.

Objective

Vital signs: temperature 101.2 F oral, heart rate 104, respirations 16, blood pressure 118/72, oxygen saturation 99 percent on room air.

General: uncomfortable but not toxic appearing; speaking in a normal voice; handling her secretions.

Head, eyes, ears, nose, throat: tympanic membranes clear bilaterally. Nasal mucosa without discharge. Oropharynx with bilateral tonsillar enlargement, erythema, and white exudate; the soft palate and uvula are midline and symmetric, with no palatal bulge; no trismus. A few petechiae on the soft palate.

Neck: tender, enlarged anterior cervical lymph nodes bilaterally, about 1.5 cm; no posterior cervical, axillary, or inguinal lymphadenopathy; no neck stiffness.

Abdomen: soft, nontender; no palpable spleen tip or hepatomegaly.

Skin: no rash.

Assessment

Applying the Centor criteria as reasoning rather than as a bare score: she has tonsillar exudate, tender anterior cervical nodes, a history of fever, and no cough, which meets all four criteria (Centor et al., 1981). In adults with this pattern, the probability of group A streptococcal infection is high enough that testing is warranted, while clinical features alone cannot confirm it; the score predicts likelihood but does not establish the diagnosis, and it does not distinguish streptococcal pharyngitis from mononucleosis, which can produce the same exam.

1. Group A streptococcal pharyngitis. For: abrupt onset, fever, tonsillar exudate, tender anterior nodes, palatal petechiae, absence of cough and coryza, and workplace exposure. Against: nothing in the history or examination argues against it. This is the leading diagnosis.

2. Infectious mononucleosis. For: a week of fatigue preceding the sore throat, exudative tonsillitis, and her age. Against: no posterior cervical lymphadenopathy and no palpable splenomegaly, which are more typical of Epstein-Barr virus infection. Kept second because of the fatigue.

3. Viral pharyngitis. For: the most common cause of sore throat in adults. Against: absence of cough, rhinorrhea, and hoarseness, which usually accompany viral illness.

4. Peritonsillar abscess. For: severe pain and fever. Against: the soft palate is symmetric with a midline uvula and no trismus or muffled voice, the findings that argue most strongly against an abscess. Listed because missing it would be dangerous.

What this page is doingThe Centor tally sits inside a sentence that says what it predicts and what it cannot, rather than appearing as a bare number. The four diagnoses are ranked, each with findings for and against, and the dangerous one is kept on the list with the specific examination findings that make it unlikely.

Plan

Diagnostics: rapid antigen detection test for group A streptococcus, supported by her score. Current guidance recommends testing rather than treating on clinical grounds, and in adults a negative rapid test does not routinely require a backup throat culture because streptococcal pharyngitis and its complications are less common in adults (Shulman et al., 2012). If the rapid test is negative, a heterophile antibody test for mononucleosis is sent, given the preceding fatigue.

Treatment if the rapid test is positive: because her penicillin reaction was a childhood rash without features of immediate hypersensitivity, cephalexin 500 mg by mouth twice daily for 10 days is prescribed, a first-generation cephalosporin recommended for patients with non-anaphylactic penicillin allergy (Shulman et al., 2012). If the rapid test is negative, no antibiotic is prescribed.

Symptom care: ibuprofen with food, up to 600 mg a dose and no more often than every six hours, or acetaminophen, warm saltwater gargles, and fluids.

Education: if positive, she is contagious until she has taken the antibiotic for at least 12 hours and should stay home from work until then. If mononucleosis is diagnosed, she should avoid contact sports and heavy lifting at work for at least three to four weeks because of the risk of splenic rupture, a real concern for a warehouse job. Return or emergency warning signs: difficulty swallowing saliva, drooling, a muffled voice, trouble opening her mouth, one-sided throat swelling, or difficulty breathing.

Follow-up: a call with test results today; a return visit if not improving within 48 to 72 hours of treatment, or sooner with any warning sign (Dains et al., 2020).

References

Centor, R. M., Witherspoon, J. M., Dalton, H. P., Brody, C. E., & Link, K. (1981). The diagnosis of strep throat in adults in the emergency room. Medical Decision Making, 1(3), 239-246. https://doi.org/10.1177/0272989X8100100304

Dains, J. E., Baumann, L. C., & Scheibel, P. (2020). Advanced health assessment and clinical diagnosis in primary care (6th ed.). Elsevier.

Shulman, S. T., Bisno, A. L., Clegg, H. W., Gerber, M. A., Kaplan, E. L., Lee, G., Martin, J. M., & Van Beneden, C. (2012). Clinical practice guideline for the diagnosis and management of group A streptococcal pharyngitis: 2012 update by the Infectious Diseases Society of America. Clinical Infectious Diseases, 55(10), e86-e102. https://doi.org/10.1093/cid/cis629

The Walden NRNP 6531 Week 1 instructions

The first week of NRNP 6531 usually asks for an episodic SOAP note on an acute complaint, often from a case scenario or your practicum. You document the subjective history, a focused examination, a differential diagnosis with at least three possibilities ranked and justified, and a plan covering testing, treatment, education and follow-up. Faculty expect clinical decision tools where they exist. The note typically runs a few pages with APA 7 citations for guidelines and the assessment text. Patient details should be fictional or de-identified. Many instructors want pertinent negatives recorded in the history. Read the template your section provides, since headings and required elements vary. Expect the note to cover pertinent positives and negatives for each item on the differential. Some sections also want a brief statement on antibiotic stewardship.

How the NRNP 6531 Week 1 example is put together

The history opens with the patient's own phrase, like swallowing glass, then fills in onset, fever, and exposure at a shared workplace. Pertinent negatives get their own line: no cough, no drooling, no change in voice, no trouble opening the mouth. The exam block records tonsillar exudate, tender anterior neck nodes, and a symmetric soft palate, which is the finding that argues against an abscess. Centor criteria are tallied inside a sentence of reasoning rather than dropped in as a bare number. Four diagnoses follow in ranked order, each carrying the findings for and against it, with mononucleosis kept on the list because of the fatigue she mentions. The plan states which test the score supports, what a negative result would change, and the warning signs that would bring her back.

NRNP 6531 Week 1 rubric: what earns full marks

Graders in a primary care course tend to read the assessment before anything else, and a note that names strep throat with nothing beneath it has skipped the skill the week exists to test. This example keeps four diagnoses in view and says why each sits where it does. Points also depend on linkage: every item on the differential must point back to a finding already recorded, so an exam that never mentions the palate cannot support setting an abscess aside. Plans lose credit when an antibiotic appears with no testing rationale, when education is one generic sentence, and when follow-up is missing entirely. A smaller deduction lands on sources older than current guidance, and on a note that abandons its headings halfway down and drifts into narrative.

NRNP 6531 Week 1 help: mistakes that cost marks

The assessment is where graders look first, and a note that names strep throat with nothing beneath it has skipped the reasoning. Rank the differential and give each item a reason. Another common gap is leaving out pertinent negatives such as the absence of cough, which drives the Centor score. Writers also treat with antibiotics before testing, against the guideline. Tie the plan to the score. Avoid copying a template examination that includes systems you did not examine. Include red flags such as trismus or drooling that would change the plan. Check that the guideline you cite is the version still in force. Students sometimes forget to address work: a warehouse worker may need a note about returning once afebrile and on treatment for a day. Close the plan with clear follow-up instructions and when to return sooner.

Get a NRNP 6531 Week 1 example written to your instructions

Send the Week 1 instructions and rubric from your classroom, plus the complaint your section assigned, and the desk writes an episodic note to that case with the differential ranked. Your first custom sample is free and returns inside 24-48 hours. If your template adds a review of systems table, say so and it is filled in.

More NRNP 6531 papers and FNP samples

NRNP 6531 Week 1 questions, answered

How many diagnoses belong in the differential?

The example ranks four, which is a common expectation for an episodic note at this level, but rubrics differ and some ask for three with one marked as the working diagnosis. The count is not what earns credit. Each entry needs findings for and against it, and the order has to follow from the data recorded above, so a grader can check the ranking instead of taking it on trust.

Is the patient in the note a real case?

No. The twenty-seven-year-old was invented for this page, put together from a presentation common enough to teach from, and nothing in the history or exam comes from an actual encounter. If your assignment is built on a patient you saw, keep that record where it belongs and describe the complaint in general terms; the sample is written around an invented person with the same shape.

Does the plan need to name a specific medication?

Rubrics in this course commonly ask for pharmacologic and non-pharmacologic elements, and the example names a first-line drug class, notes the allergy history that governs the choice, and cites the guideline behind it. It stops short of presenting dosing as instruction. Your prompt may want more detail, in which case the finished sample matches the level of specificity your rubric describes.

Where can I find a free NRNP 6531 Week 1 sample paper?

The sore throat episodic note is laid out here with each SOAP section, the Centor calculation and the ranked differential, plus margin notes for the FNP student.

How is the Centor score used in NRNP 6531 Week 1?

It counts fever, tonsillar exudate, tender anterior nodes and absent cough. The example uses the score to decide on rapid strep testing before any antibiotic.