NRNP 6665 Assessing, Diagnosing, and Treating Adults with Mood Disorders Essay

NRNP 6665 Assessing, Diagnosing, and Treating Adults with Mood Disorders Essay

NRNP 6665 Assessing, Diagnosing, and Treating Adults with Mood Disorders  Sample Essay

Subjective:

CC (chief complaint): “I have been taking medications and stopping them. I do not think I need them. I feel like the medication squashes who I am.

HPI: Petunia Park, a 26-year-old female patient, arrives at the psychiatric clinic today for an evaluation of her mental health. She claims she has been taking drugs on and off since she does not believe she needs them. She believes they are suffocating her. Petunia claims that she suffers from depression 4-5 times a year, which prevents her from working at her aunt’s bookstore. She claims to have days when she doesn’t want to get out of bed and feels drained of energy and ambition. Furthermore, her inventiveness fades, making her feel worthless. These occasions come after five days of intense activity, during which she was typically up and composing music, writing, and painting. Several people claim she is depressed, but she thinks she is merely exhausted. Petunia experiences creative spurts for around a week before she smashes. She somehow avoids taking medication when she feels inspired because she feels constricted. She has a lot of energy during these times, may spend 4-5 days without sleeping, completes a lot of tasks, speaks a lot, and seems chaotic. She also explores her thoughts and body with sexual activities while feeling wonderful. She claims that while she is creative, she is frequently too busy to eat, but when she is crashing, she eats anything. Furthermore, she sleeps for about three hours per week during creative moments and 12-16 hours per day when collapsed. She occasionally hears voices praising her for her greatness and brilliance while she is having trouble falling asleep.

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Past Psychiatric History:

• General Statement: The patient’s mental health history is ordinary. She had been diagnosed with the bipolar illness when she was a child.
• Caregivers (if applicable): The patient presently resides with her lone mother, who has been raising her since her father passed away when she was 5 years old.
• Hospitalizations: Denies any hospitalization history.
• Medication trials: Although taking mood stabilizers, the patient has been disobedient because, in her words, they “squash who she is.”
• Psychotherapy or Previous Psychiatric Diagnosis: Denies any previous or ongoing counseling for her mental illness.

Substance Current Use: She consumes one pack of tobacco every day and quit drinking alcohol when she was 19 years old. She once tried marijuana but gave it up because of paranoia.

Medical History: History of Hypothyroidism.

 

• Current Medications: Polycystic ovaries are treated with hormone tablets, while hypothyroidism is treated with levothyroxine.
• Allergies: No known dietary or medication allergies.

• Reproductive Hx: Positive history of Polycystic Ovaries.

ROS:

• GENERAL: During crash episodes, there is a decrease in energy and an increase in hunger. Increased energy and a loss of appetite during periods of creativity. Denies having a fever, chills, or feeling weak.
• HEENT: denies hazy vision, earache, hearing loss, rhinorrhea, sneezing, or swallowing problems.
• SKIN: Refuses to accept discoloration, rashes, blisters, or ulcers.
• CARDIOVASCULAR: Refuses to acknowledge chest pain, dyspnea, palpitations, or edema.
• RESPIRATORY: Refuses to acknowledge SOB, cough, chest discomfort, or sputum production.
• GASTROINTESTINAL: Refuses to acknowledge nausea/vomiting, abdominal cramps, or abnormal bowel habits.
• GENITOURINARY: Abnormal PV discharge, dysuria, or urine urgency/frequency are all negative.
• NEUROLOGICAL: Disallows dizziness, headache, weariness, or loss of consciousness.
• MUSCULOSKELETAL: Prevents mobility restrictions.
• HEMATOLOGIC: Prevents bleeding and bruising.
• LYMPHATICS: Denies the presence of swollen lymph nodes.
• ENDOCRINOLOGICAL: Hypothyroidism. Polydipsia, polyphagia, and polyuria are all denied.

Objective:

Vital Signs: T- 98.9 P- 97 R 22 150/88 Ht 5’5 Wt. 135lbs

HEENT: Atraumatic and normocephalic head. Pupils are circular, equal, and light-reactive. On the tympanic membrane, there is no erythema or effusion. There was no discharge or edema in the ear canals. In anterior cervical lymphadenopathy, the neck is supple. There is no edema or exudates in the throat. Tonsils are not inflamed.

Chest/lungs: Auscultation of the chest and lungs reveals clean breathing sounds.

Heart: rate and rhythm are normal, with no murmurs or gallop.

Abdomen: The abdomen is firm, non-distended, and non-tender, with bowel sounds audible in all four quadrants.

Diagnostic results: There were no diagnostic tests ordered.

Assessment:

Mental Status Examination: The 26-year-old female patient appears healthy and dressed appropriately. She, on the other hand, appears depressed and uninterested in the interview. She is anxious, yet she walks steadily. Clear, regular volume/rate, and goal-directed speech. Her demeanor is decent yet uninteresting. Even though the procedure is still in place. Confirms auditory hallucinations but denies having visual hallucinations or delusions. Her short-term and long-term memories are both intact. Her perspective is correct. Confirms suicidal thoughts but denies ever trying suicide. Understanding is lacking. The patient’s capacity to identify the repercussions of her behavior is restricted.

Diagnostic Impression:

1. Bipolar Disorder:  This is a mood illness characterized by cycles of deep and profound sadness followed by moments of abnormally elevated or irritable mood known as mania (Vieta et al., 2018). Manic episodes last at least one week and are distinguished by significant mood disturbances such as euphoria, expansiveness, or anger. Petunia exhibits traits associated with the DSM-V criteria for Bipolar illness, such as bouts of creative bursts interspersed by moments of feeling crashed. A week-long manic episode is marked by a lack of desire for sleep, excessive activity levels, excessive goal-focused hobbies like painting and writing, risky pleasant sexual practices, and distractibility. Moreover, she has low energy, low drive, a loss of interest in her pursuits, and thoughts of worthlessness during her depressive episodes.
2. Schizophrenia: Positive signs of schizophrenia include delusions, hallucinations, incomprehensible language, and chaotic behavior. It also has negative symptoms including poor communication, a narrow emotional range, and a loss of interest and desire. Moreover, it is marked by mood symptoms, most notably a gloomy mood. A patient may only be diagnosed with schizophrenia if they exhibit at least two of the following symptoms for at least a month, according to the DSM-V diagnostic criteria: delusion, disordered speech, hallucinations, unpleasant symptoms, and catatonic conduct (McCutcheon et al., 2020). Based on the patient’s auditory hallucinations, in which she could hear voices speaking to her, schizophrenia is a differential diagnosis. Also, the fact that she is unmotivated, uninterested in her interests, and depressed are important indicators that suggest schizophrenia. However, the presence of manic and depressed symptoms disqualifies schizophrenia as a core diagnosis.
3. Major Depressive Disorder (MDD): A gloomy mood or a lack of interest or pleasure that lasts for at least two weeks are the main signs of MDD. Feeling down, empty, or hopeless most of the day and virtually every day is a sign of depression. The patient has symptoms that are indicative of MDD, such as a history of depressive episodes and a lack of interest. The MDD characteristics of lack of energy, lack of desire, tiredness, and feeling unworthy are also present along with the symptoms (Vieta et al., 2018). Yet, the patient’s manic and depressive episodes alternate, making MDD an implausible initial diagnosis.

Case Formulation and Treatment Plan:

• Petunia experiences manic and depressive periods, which are signs of bipolar illness. The course of treatment will combine both medicine and psychotherapy. The goal of treatment is to lessen how severe manic episodes are (Jelen & Young, 2020).

• Medication: Lamotrigine 25 mg at bedtime for the first two weeks, followed by 50 mg and eventually 100 mg. Recent FDA approval of lamotrigine for the treatment of bipolar patients as an option for PCOS-prone women (Kumar et al., 2021). Moreover, the medication lowers the chances of relapsing during manic or depressed periods. It causes moderate side effects including headaches and dizziness.
• Psychotherapy: Therapy with cognitive behavior (CBT). Using CBT, the client will learn about bipolar illness and acquire cognitive-behavioral coping mechanisms for dealing with the disease’s psychosocial stresses and difficulties (Gunjal et al., 2019).
• Health promotion: Physical activity must be performed by the patient to increase blood flow to the brain and prevent depressive episodes (Bonnn et al., 2019). It will also assist the patient’s well-being if they eat a balanced diet and get enough sleep. Smoking cessation is one of the additional methods for promoting health.
• Education: To prevent repeated instances of noncompliance, the patient must be informed about the potential adverse effects of the medication she is taking and how to manage them (Bonnin et al., 2019). To improve treatment results, she should also be educated on the significance of following the prescribed treatment plan and taking her medications on time.
• Follow-up: After four weeks, the patient will be checked on again.

Reflections: The patient information given is very helpful in making a bipolar illness diagnosis. According to Bonnn et al. (2019), the doctor performed a fantastic job of gathering data that paints a clear picture of the patient’s symptoms, including manic and depressed episodes. To establish the severity of the ailment, more details are still required. To further evaluate the patient’s MDD symptoms, I would thus administer the Patient Health Questionnaire (PHQ-9) to them. To validate the bipolar disorder diagnosis, I would also administer the Mood Disorder Questionnaire (MDQ) (Talen & Edberg, 2020). The treatment strategy should be guided by the ethical principles of beneficence and nonmaleficence to guarantee that the treatments chosen will promote the best results and are not linked to negative consequences (Jelen & Young, 2020). To encourage autonomy, the patient should be involved in the design of the therapy.

References

Bonnín, C. D. M., Reinares, M., Martínez-Arán, A., Jiménez, E., Sánchez-Moreno, J., Solé, B., … & Vieta, E. (2019). Improving functioning, quality of life, and well-being in patients with bipolar disorder. International Journal of Neuropsychopharmacology, 22(8), 467-477. https://doi.org/10.1093/ijnp/pyz018

Gunjal, A., Tajane, M., & Londhe, R. (2019). Formulation and evaluation of lamotrigine 25 mg immediate-release tablet. Journal of Drug Delivery and Therapeutics, 9(4-s), 295-297. https://doi.org/10.22270/jddt.v9i4-s.3321

Jelen, L. A., & Young, A. H. (2020). The treatment of bipolar depression: current status and future perspectives. Current Behavioral Neuroscience Reports, 7(1), 1-14. https://doi.org/10.1007/s40473-020-00200-x

Kumar, R., Nuñez, N. A., Prokop, L. J., Veldic, M., Betcher, H., & Singh, B. (2021). Association of Optimal Lamotrigine Serum Levels and Therapeutic Efficacy in Mood Disorders: A Systematic Review. Journal of clinical psychopharmacology, 41(6), 681-686. DOI: 10.1097/JCP.0000000000001475

McCutcheon, R. A., Marques, T. R., & Howes, O. D. (2020). Schizophrenia—an overview. JAMA Psychiatry, 77(2), 201-210. doi:10.1001/jamapsychiatry.2019.3360

Talen, M. R., & Edberg, D. L. (2020). What is the most effective screening tool for bipolar disorder in primary care? Evidence-Based Practice, 23(3), 16-17. https://doi.org/10.1097/EBP.0000000000000543

Vieta, E., Berk, M., Schulze, T. G., Carvalho, A. F., Suppes, T., Calabrese, J. R., … & Miskowiak, K. W. (2018). Grande. Bipolar disorders. Nat Rev Dis Primers, 4, 18008. https://doi.org/10.1038/nrdp.2018.8

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It is important for the PMHNP to have a comprehensive understanding of mood disorders in order to assess and accurately formulate a diagnosis and treatment plan for patients presenting with these disorders. Mood disorders may be diagnosed when a patient’s emotional state meets the diagnostic criteria for severity, functional impact, and length of time. Those with a mood disorder may find that their emotions interfere with work, relationships, or other parts of their lives that impact daily functioning. Mood disorders may also lead to substance abuse or suicidal thoughts or behaviors, and although they are not likely to go away on their own, they can be managed with an effective treatment plan and understanding of how to manage symptoms.

In this Assignment you will assess, diagnose, and devise a treatment plan for a patient in a case study who is presenting with a mood disorder.

RESOURCES

 

Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.

WEEKLY RESOURCES

LEARNING RESOURCES

Required Readings

• Sadock, B. J., Sadock, V. A., & Ruiz, P. (2015). Kaplan & Sadock’s synopsis of psychiatry (11th ed.). Wolters Kluwer.
  • Chapter 8, “Mood Disorders”
• Zakhari, R. (2020). The psychiatric-mental health nurse practitioner certification review manual. Springer.
  • Chapter 11, “Mood Disorders”
• Document: Focused SOAP Note TemplateDownload Focused SOAP Note Template
• Document: Focused SOAP Note ExemplarDownload Focused SOAP Note Exemplar

Required Media

• CrashCourse. (2014, September 8). Depressive and bipolar disorders: Crash course psychology #30Links to an external site. [Video]. YouTube. https://youtu.be/ZwMlHkWKDwM https://www.youtube.com/watch?v=ZwMlHkWKDwM&t=1sLinks to an external site.
• Walden University. (2021). Case study: Petunia Park. Walden University Blackboard. https://waldenu.instructure.com

 

Medication Review

Depression		Premenstrual dysphoric disorder	Seasonal affective disorder (MDD with Seasonal Variation)
agomelatine amitriptyline amoxapine aripiprazole (adjunct) brexpiprazole (adjunct)bupropion citalopram clomipramine cyamemazine desipramine desvenlafaxine dothiepindoxepin duloxetine escitalopram fluoxetine fluvoxamine iloperidone imipramine isocarboxazid ketamine lithium (adjunct) l-methylfolate (adjunct)	lofepramine maprotiline mianserin milnacipran mirtazapine moclobemide nefazodone nortriptyline paroxetine phenelzine protriptyline quetiapine (adjunct) reboxetine selegiline sertindole sertraline sulpiride tianeptine tranylcypromine trazodone trimipramine venlafaxine vilazodone vortioxetine	citalopram desvenlafaxine duloxetin eescitalopram fluoxetin eparoxetine pepexev sarafe, sertraline venlafaxine	Bupropion HCL extended-release

 

Bipolar depression	Bipolar disorder (mixed Mania/Depression		Bipolar maintenance	Mania
lithium (used with lurasidone) lurasidone olanzapine-fluoxetine combination (symbyax) quetiapine valproate (divalproex) (used with lurasidone)	aripiprazole asenapine carbamazepine	olanzapine ziprasidone	aripiprazole lamotrigine lithium olanzapine	aripiprazole asenapine carbamazepine lithium olanzapine quetiapine risperidone valproate (divalproex) ziprasidone

TO PREPARE

• Review this week’s Learning Resources. Consider the insights they provide about assessing, diagnosing, and treating mood disorders.
• Review the Focused SOAP Note template, which you will use to complete this Assignment. There is also a Focused SOAP Note Exemplar provided as a guide for Assignment expectations.
• Review the video, Case Study: Petunia Park. You will use this case as the basis of this Assignment. In this video, a Walden faculty member is assessing a mock patient. The patient will be represented onscreen as an avatar.
• Consider what history would be necessary to collect from this patient.
• Consider what interview questions you would need to ask this patient.
• Consider patient diagnostics missing from the video:Provider Review outside of interview:

  Temp 98.2  Pulse  90 Respiration 18  B/P  138/88

  Laboratory Data Available: Urine drug and alcohol screen negative.  CBC within normal ranges, CMP within normal ranges. Lipid panel within normal ranges. Prolactin Level 8; TSH 6.3 (H)

THE ASSIGNMENT

Develop a Focused SOAP Note, including your differential diagnosis and critical-thinking process to formulate a primary diagnosis. Incorporate the following into your responses in the template:

• Subjective: What details did the patient provide regarding their chief complaint and symptomatology to derive your differential diagnosis? What is the duration and severity of their symptoms? How are their symptoms impacting their functioning in life?
• Objective: What observations did you make during the psychiatric assessment? 
• Assessment: Discuss the patient’s mental status examination results. What were your differential diagnoses? Provide a minimum of three possible diagnoses with supporting evidence, listed in order from highest to lowest priority. Compare the DSM-5-TR diagnostic criteria for each differential diagnosis and explain what DSM-5 criteria rules out the differential diagnosis to find an accurate diagnosis. Explain the critical-thinking process that led you to the primary diagnosis you selected. Include pertinent positives and pertinent negatives for the specific patient case.
• Plan: What is your plan for psychotherapy? What is your plan for treatment and management, including alternative therapies? Include pharmacologic and nonpharmacologic treatments, alternative therapies, and follow-up parameters as well as a rationale for this treatment and management plan. Also incorporate one health promotion activity and one patient education strategy.
• Reflection notes: Reflect on this case. Discuss what you learned and what you might do differently. Also include in your reflection a discussion related to legal/ethical considerations (demonstrate critical thinking beyond confidentiality and consent for treatment!), social determinates of health, health promotion, and disease prevention that takes into consideration patient factors (such as age, ethnic group, etc.), PMH, and other risk factors (e.g., socioeconomic, cultural background, etc.).

BY DAY 7 OF WEEK 4

Submit your Focused SOAP Note.

SUBMISSION INFORMATION

Before submitting your final assignment, you can check your draft for authenticity. To check your draft, access the Turnitin Drafts from the Start Here area.

1. To submit your completed assignment, save your Assignment as WK1Assgn+last name+first initial.
2. Then, click on Start Assignment near the top of the page.
3. Next, click on Upload File and select Submit Assignment for review.

 

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Rubric

NRNP_6665_Week4_Assignment_Rubric

Criteria	Ratings	Pts
This criterion is linked to a Learning OutcomeCreate documentation in the Focused SOAP Note Template about the patient in the case study. In the Subjective section, provide: • Chief complaint• History of present illness (HPI)• Past psychiatric history• Medication trials and current medications• Psychotherapy or previous psychiatric diagnosis• Pertinent substance use, family psychiatric/substance use, social, and medical history• Allergies• ROS	15 to >13.0 ptsExcellent The response throughly and accurately describes the patient’s subjective complaint, history of present illness, past psychiatric history, medication trials and current medications, psychotherapy or previous psychiatric diagnosis, pertinent histories, allergies, and review of all systems that would inform a differential diagnosis. 13 to >11.0 ptsGood The response accurately describes the patient’s subjective complaint, history of present illness, past psychiatric history, medication trials and current medications, psychotherapy or previous psychiatric diagnosis, pertinent histories, allergies, and review of all systems that would inform a differential diagnosis. 11 to >10.0 ptsFair The response describes the patient’s subjective complaint, history of present illness, past psychiatric history, medication trials and current medications, psychotherapy or previous psychiatric diagnosis, pertinent histories, allergies, and review of all systems that would inform a differential diagnosis but is somewhat vague or contains minor innacuracies. 10 to >0 ptsPoor The response provides an incomplete or inaccurate description of the patient’s subjective complaint, history of present illness, past psychiatric history, medication trials and current medications, psychotherapy or previous psychiatric diagnosis, pertinent histories, allergies, and review of all systems that would inform a differential diagnosis. Or the subjective documentation is missing.	15 pts
This criterion is linked to a Learning OutcomeIn the Objective section, provide:• Review of Systems (ROS) documentation and relate if pertinent to the chief complaint, HPI, and history• Diagnostic results, including any labs, imaging, or other assessments needed to develop the differential diagnoses	15 to >13.0 ptsExcellent The response thoroughly and accurately documents the patient’s ROS for pertinent systems. Diagnostic tests and their results are thoroughly and accurately documented. 13 to >11.0 ptsGood The response accurately documents the patient’s ROS for pertinent systems. Diagnostic tests and their results are accurately documented. 11 to >10.0 ptsFair Documentation of the patient’s ROS is somewhat vague or contains minor innacuracies. Diagnostic tests and their results are documented but contain minor inaccuracies. 10 to >0 ptsPoor The response provides incomplete or inaccurate documentation of the patient’s ROS. Systems may have been unnecessarily reviewed. Or the objective documentation is missing.	15 pts
This criterion is linked to a Learning OutcomeIn the Assessment section, provide:• Results of the mental status examination, presented in paragraph form• At least three differentials with supporting evidence. List them from top priority to least priority. Compare the DSM-5 diagnostic criteria for each differential diagnosis and explain what DSM-5 criteria rules out the differential diagnosis to find an accurate diagnosis. Explain the critical-thinking process that led you to the primary diagnosis you selected. Include pertinent positives and pertinent negatives for the specific patient case.	20 to >17.0 ptsExcellent The response thoroughly and accurately documents the results of the mental status exam. Response lists at least three distinctly different and detailed possible disorders in order of priority for a differential diagnosis of the patient in the assigned case study, and it provides a thorough, accurate, and detailed justification for each of the disorders selected. 17 to >15.0 ptsGood The response accurately documents the results of the mental status exam. Response lists at least three distinctly different and detailed possible disorders in order of priority for a differential diagnosis of the patient in the assigned case study, and it provides an accurate justification for each of the disorders selected. 15 to >13.0 ptsFair The response documents the results of the mental status exam with some vagueness or innacuracy. Response lists at least three different possible disorders for a differential diagnosis of the patient and provides a justification for each, but may contain some vagueness or innacuracy. 13 to >0 ptsPoor The response provides an incomplete or inaccurate description of the results of the mental status exam and explanation of the differential diagnoses. Or the assessment documentation is missing.	20 pts
This criterion is linked to a Learning OutcomeIn the Plan section, provide:• Your plan for psychotherapy• Your plan for treatment and management, including alternative therapies. Include pharmacologic and nonpharmacologic treatments, alternative therapies, and follow-up parameters as well as a rationale for this treatment and management plan. • Incorporate one health promotion activity and one patient education strategy.	25 to >22.0 ptsExcellent The response provides an evidence-based, detailed, and appropriate plan for psychotherapy for the patient. The response provides an evidence-based, detailed, and appropriate plan for treatment and management, including pharmacologic and nonpharmacologic treatments, alternative therapies, and follow-up parameters. A strong rationale for the plan is provided that demonstrates critical thinking and content understanding. … The response includes at least one evidence-based health promotion activity and one evidence-based patient education strategy. 22 to >19.0 ptsGood The response provides an evidence-based and appropriate plan for psychotherapy for the patient. The response provides an evidence-based and appropriate plan for treatment and management, including pharmacologic and nonpharmacologic treatments, alternative therapies, and follow-up parameters. An adequate rationale for the plan is provided. … The response includes at least one health promotion activity and one patient education strategy. 19 to >17.0 ptsFair The response provides a somewhat vague or inaccurate plan for psychotherapy for the patient. The response provides a somewhat vague or inaccurate plan for treatment and management, including pharmacologic and nonpharmacologic treatments, alternative therapies, and follow-up parameters. The rationale for the plan is weak or general. … The response includes one health promotion activity and one patient education strategy, but it may contain some vagueness or innacuracy. 17 to >0 ptsPoor The response provides an incomplete or inaccurate plan for psychotherapy for the patient. The response provides an incomplete or inaccurate plan for treatment and management, including pharmacologic and nonpharmacologic treatments, alternative therapies, and follow-up parameters. The rationale for the plan is inaccurate or missing. … The health promotion and patient education strategies are incomplete or missing.	25 pts
This criterion is linked to a Learning Outcome• Reflect on this case. Discuss what you learned and what you might do differently. Also include in your reflection a discussion related to legal/ethical considerations (demonstrate critical thinking beyond confidentiality and consent for treatment!), social determinates of health, health promotion, and disease prevention that takes into consideration patient factors (such as age, ethnic group, etc.), PMH, and other risk factors (e.g., socioeconomic, cultural background, etc.).	5 to >4.0 ptsExcellent Reflections are thorough, thoughtful, and demonstrate critical thinking. 4 to >3.5 ptsGood Reflections demonstrate critical thinking. 3.5 to >3.0 ptsFair Reflections are somewhat general or do not demonstrate critical thinking. 3 to >0 ptsPoor Reflections are incomplete, inaccurate, or missing.	5 pts
This criterion is linked to a Learning OutcomeProvide at least three evidence-based, peer-reviewed journal articles or evidenced-based guidelines that relate to this case to support your diagnostics and differential diagnoses. Be sure they are current (no more than 5 years old).	10 to >8.0 ptsExcellent The response provides at least three current, evidence-based resources from the literature to support the assessment and diagnosis of the patient in the assigned case study. The resources reflect the latest clinical guidelines and provide strong justification for decision making. 8 to >7.0 ptsGood The response provides at least three current, evidence-based resources from the literature that appropriately support the assessment and diagnosis of the patient in the assigned case study. 7 to >6.0 ptsFair Three evidence-based resources are provided to support the assessment and diagnosis of the patient in the assigned case study, but they may only provide vague or weak justification. 6 to >0 ptsPoor Two or fewer resources are provided to support the assessment and diagnosis decisions. The resources may not be current or evidence based.	10 pts
This criterion is linked to a Learning OutcomeWritten Expression and Formatting – The paper follows correct APA format for parenthetical/in-text citations and reference list.	5 to >4.0 ptsExcellent Uses correct APA format with no errors 4 to >3.5 ptsGood Contains a few (one or two) APA format errors 3.5 to >3.0 ptsFair Contains several (three or four) APA format errors 3 to >0 ptsPoor Contains many (five or more) APA format errors	5 pts
This criterion is linked to a Learning OutcomeWritten Expression and Formatting – English Writing Standards: Correct grammar, mechanics, and punctuation	5 to >4.0 ptsExcellent Uses correct grammar, spelling, and punctuation with no errors 4 to >3.5 ptsGood Contains a few (one or two) grammar, spelling, and punctuation errors 3.5 to >3.0 ptsFair Contains several (three or four) grammar, spelling, and punctuation errors 3 to >0 ptsPoor Contains many (five or more) grammar, spelling, and punctuation errors that interfere with the reader’s understanding	5 pts
Total Points: 100