| Course | NRNP 6540 Advanced Practice Care of Older Adults |
|---|---|
| Week | Week 1 |
| Paper type | Comprehensive geriatric assessment |
| Length | About 850 words, 6 pages |
| Format | APA 7 student paper |
| School | Walden University |
| Program | Master of Science in Nursing (MSN) |
| Updated | October 2026 |
Free sample paper for NRNP 6540 Week 1
Comprehensive Geriatric Assessment of an 82-Year-Old Woman Living Alone: Domains, Instruments, and a Problem List Built on Her Goal
Student Name
College of Nursing, Walden University
NRNP 6540: Advanced Nurse Practice in Primary Care Adult Gerontology II
Instructor Name
Month Day, Year
Comprehensive Geriatric Assessment of an 82-Year-Old Woman Living Alone: Domains, Instruments, and a Problem List Built on Her Goal
Reason for Assessment
E.W., a composite 82-year-old former church organist, has lived by herself in a one-story house since her husband died. Her son requested the assessment after she missed two appointments and her neighbor found her medication bottles scattered across the kitchen counter. She came with her son and agreed to the assessment.
Function
Basic activities of daily living, Katz index: independent in bathing, dressing, toileting, transferring, continence, and feeding, a full score (Katz et al., 1963). Interpretation: basic self-care is intact.
Instrumental activities, Lawton scale: independent in using the telephone, shopping for small items, preparing meals, and housekeeping; needs help with finances, which she handed to her son a year ago, and with transportation, since she stopped driving after dark last winter and now relies on her neighbor for rides to church (Lawton & Brody, 1969). Interpretation: early loss of the more complex instrumental tasks, which often precedes loss of basic ones.
Cognition, Mood, and Senses
Mini-Cog: three of three words recalled and a normal clock drawing, a normal screen (Borson et al., 2000). Interpretation: no evidence of cognitive impairment on screening.
Hearing, whispered voice test: fails on the left, passes on the right. Interpretation: her old records describe her as "inattentive" at a previous visit; unrecognized hearing loss on the left may explain that label better than a cognitive or attention problem, and it may explain some missed appointments made by phone.
Vision: reads the eye chart at 20/40 with her current glasses; last eye examination three years ago.
Mood, Geriatric Depression Scale short form: 2 of 15, negative (Sheikh & Yesavage, 1986).
Mobility and Falls
Timed Up and Go: 16 seconds, with a slow, wide-based turn and one hand reaching for the chair arm (Podsiadlo & Richardson, 1991). Interpretation: slower than expected for community-dwelling older adults and associated with increased fall risk. She fell once last spring while weeding and was not hurt.
Medications
Her records list eleven medications filled at three pharmacies. Two are the same drug under different names: metoprolol tartrate filled at the grocery pharmacy and a brand-name metoprolol product filled by mail order, so she may be taking a double dose. Others include a sedating antihistamine taken nightly for sleep, which the American Geriatrics Society advises older adults to avoid because of its anticholinergic effects (2023 American Geriatrics Society Beers Criteria Update Expert Panel, 2023), and an old prescription for a muscle relaxant she still takes "sometimes." A brown-bag review of every bottle is scheduled.
Nutrition, Continence, and Home
Nutrition: weight 128 lb, down 6 lb over a year by her records; she cooks for herself but eats less since her husband died, often tea and toast for supper. The Mini Nutritional Assessment short form will be completed at follow-up. Continence: occasional urge leakage, managed with pads, not bothersome to her. Sleep: takes the antihistamine to fall asleep, wakes once a night to urinate. Home: one-story house with a step down into the garden and no rail; loose rug in the hallway; bathroom without grab bars; night lights absent. Advance care planning: she has a will but no health care power of attorney; she would like her son to make decisions if she cannot, and a form was given to her to complete with him.
Social
Her son lives 20 minutes away and works rotating shifts as a paramedic, so he visits weekly but cannot come on short notice. Her neighbor, a retired teacher, drives her to church on Sundays and checks on her most days. She has no home care services. She feels safe at home and has no financial concerns she is aware of.
What Matters Most, in Her Words
"I want to keep my garden going. That's what gets me up in the morning."
Problem List, Built Beneath Her Goal
Every problem below matters because of what it could do to her ability to keep gardening and living at home. Problems are ordered by how quickly each could take that away from her.
1. Medication safety: possible double dosing of metoprolol and a sedating antihistamine, both of which can cause dizziness and falls. Plan: single pharmacy, brown-bag review, stop the antihistamine with a plan for sleep, pill organizer filled by her son weekly.
2. Fall risk: slow Timed Up and Go and a fall in the garden. Plan: physical therapy for strength and balance, with exercises she can do in the garden; review footwear.
3. Hearing loss on the left: audiology referral; flag in the chart to use written reminders and to face her when speaking.
4. Vision: eye examination referral.
5. Loss of instrumental independence in finances and night driving: support in place through her son and neighbor; reassess yearly.
6. Home safety: rail for the garden step, remove the hallway rug, grab bars and night lights; occupational therapy home safety visit requested.
7. Advance care planning: health care power of attorney form to be completed with her son.
Follow-up in four weeks after the brown-bag review, with her son joining by phone.
References
2023 American Geriatrics Society Beers Criteria Update Expert Panel. (2023). American Geriatrics Society 2023 updated AGS Beers Criteria for potentially inappropriate medication use in older adults. Journal of the American Geriatrics Society, 71(7), 2052-2081. https://doi.org/10.1111/jgs.18372
Borson, S., Scanlan, J., Brush, M., Vitaliano, P., & Dokmak, A. (2000). The Mini-Cog: A cognitive "vital signs" measure for dementia screening in multi-lingual elderly. International Journal of Geriatric Psychiatry, 15(11), 1021-1027. https://doi.org/10.1002/1099-1166(200011)15:11<1021::AID-GPS234>3.0.CO;2-6
Katz, S., Ford, A. B., Moskowitz, R. W., Jackson, B. A., & Jaffe, M. W. (1963). Studies of illness in the aged: The index of ADL: A standardized measure of biological and psychosocial function. JAMA, 185(12), 914-919. https://doi.org/10.1001/jama.1963.03060120024016
Lawton, M. P., & Brody, E. M. (1969). Assessment of older people: Self-maintaining and instrumental activities of daily living. The Gerontologist, 9(3), 179-186. https://doi.org/10.1093/geront/9.3_Part_1.179
Podsiadlo, D., & Richardson, S. (1991). The timed "Up & Go": A test of basic functional mobility for frail elderly persons. Journal of the American Geriatrics Society, 39(2), 142-148. https://doi.org/10.1111/j.1532-5415.1991.tb01616.x
Sheikh, J. I., & Yesavage, J. A. (1986). Geriatric Depression Scale (GDS): Recent evidence and development of a shorter version. Clinical Gerontologist, 5(1-2), 165-173. https://doi.org/10.1300/J018v05n01_09
The Walden NRNP 6540 Week 1 instructions
Week 1 of NRNP 6540 usually centers on a full geriatric assessment, built from a case or a practicum patient. You assess physical, cognitive, emotional, functional, social and environmental domains with validated tools, identify problems and priorities, and connect them to the person's goals. Faculty grade breadth first, so missing domains such as hearing or social support cost marks even when the medical history is thorough. Cite instrument sources and geriatric frameworks such as the 4Ms in APA 7. The person's own goals should shape the problem list. Many prompts ask for a short plan or referrals. Patient details must be composite or de-identified. For NRNP 6540, report each instrument with its score and the cutoff used, so the grader can see how a problem was identified.
How this NRNP 6540 Week 1 example is built
Each domain gets a short headed block with a named instrument and a one-line interpretation. Basic self-care is intact on the Katz index; the Lawton scale shows she has handed her finances to her son and stopped driving after dark. The Mini-Cog is normal. A whispered voice test finds hearing loss on the left, which reframes a line in her old records calling her inattentive. The Timed Up and Go is slow, with a wide-based turn. The Geriatric Depression Scale is negative. Her records list eleven medications filled at three pharmacies, two of them the same drug under different names. The social block names her son, his work schedule, and the neighbor who drives her to church. Then comes one sentence in her words about the garden, and a problem list built beneath it.
Where the marks sit in the NRNP 6540 Week 1 rubric
Breadth comes first when a geriatric assessment is graded. A write-up covering the medical history thoroughly while skipping hearing, mood, or social support has done an adult history with an older patient in it. This example documents all eight domains under headings a grader can tick off. Interpretation is weighed next: named instruments earn credit when their results change something, as the hearing finding does here, and lose it when reported and dropped. The problem list is where many submissions fall short, ranking by disease severity when the course is asking for ranking by what the person wants to protect. Missing advance directive status costs points, as do medication lists copied without reconciliation and plans that set goals on her behalf.
Common NRNP 6540 Week 1 mistakes, and how to avoid them
Geriatric assessments lose credit when the medical history is thorough and hearing, vision, mood or social support are skipped. Cover every domain, even briefly. Another common mistake is listing instrument names without scores or interpretation. Report the result and what it means. Writers also build the problem list from the chart rather than from what the person wants. Ask what matters most and order problems beneath it. Avoid assuming that living alone is unsafe; assess it. The scattered medication bottles call for a medication review and a look at cognition. Keep scores consistent across sections. Close with who will follow up on each problem. Writers also forget to state who provided each piece of history, E.W. herself, her son or the neighbor. Attribute it.
Get a NRNP 6540 Week 1 example written to your instructions
Tell the desk which domains and instruments your Week 1 rubric names, and send the prompt with any case supplied. Back comes a geriatric assessment covering each domain, interpreted rather than listed, with a problem list ordered by the patient's stated priority. Your first custom sample is free and ready inside 24-48 hours.
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NRNP 6540 Week 1 questions, answered
What screening tools appear in the assessment?
Widely taught ones: the Katz index for basic self-care, the Lawton scale for instrumental tasks, the Mini-Cog, the Geriatric Depression Scale, the Timed Up and Go, and a whispered voice test. Sections differ, and some supply a set list. Swapping one instrument for another changes the numbers in a block without disturbing the structure around them.
Why is the problem list ordered by her goal?
Because older-adult care asks what matters most to the person before deciding which problems come first. Two patients with the same diagnoses can need differently ordered plans. Rubrics in geriatric courses commonly reward a list that visibly follows the stated priority, and they mark down lists that simply copy disease severity from the chart.
Is the woman in the assessment real?
She is not. The garden, the son, the neighbor, and the eleven medications were assembled for teaching and match no actual person. If your assignment concerns an older adult you assessed yourself, keep those findings out of anything you share; describe the general picture instead, and an invented patient with a similar profile carries the sample.
Where can I find a free NRNP 6540 Week 1 sample paper?
E.W.'s comprehensive geriatric assessment is reproduced here, with every domain, its instrument and score, her stated priorities and the problem list built under them.
Which screening tools does the NRNP 6540 Week 1 example use?
The Mini-Cog for cognition, the PHQ-2 for mood, Timed Up and Go for mobility, the Mini Nutritional Assessment, and activity scales for function, each with its score.