| Course | NS310 Nutritional Assessment |
|---|---|
| Unit | Unit 2 |
| Paper type | Screening tool comparison |
| Length | About 1,160 words, 7 pages double-spaced |
| Format | APA 7 student paper |
| School | Purdue University Global |
| Program | BS in Nutrition Science |
| Updated | October 2026 |
Free sample paper for NS310 Unit 2
Low Risk on One Screen, At Risk on the Other: A Unit 2 Comparison of MUST and the MNA-SF for a Woman Ten Weeks After Hip Surgery
[Student Name]
Purdue University Global
NS310: Nutritional Assessment
Unit 2 Screening Tool Comparison
[Instructor Name]
[Date]
The woman, the senior meal program and her measurements are composite; the screening tools, validation studies and ESPEN guidance cited are real.
The Two Tools Side by Side
Both tools are short screens meant to sort people into risk groups so that a fuller assessment can be targeted. They differ in who they were designed for and in what they count.
The Malnutrition Universal Screening Tool, known as MUST, was developed for adults in any setting: hospital, care home or community. It has three scored steps. Body mass index scores 0 at 20 or above, 1 from 18.5 to 20, and 2 below 18.5. Unplanned weight loss over the past three to six months scores 0 below 5 percent, 1 from 5 to 10 percent and 2 above 10 percent. An acute disease effect scores 2 if the person is acutely ill and has had, or is likely to have, no nutritional intake for more than five days. Totals of 0, 1, and 2 or more mean low, medium and high risk, and each band carries management guidance. A study in hospital inpatients and outpatients found MUST quick to use and in good agreement with other tools (Stratton et al., 2004).
The Mini Nutritional Assessment Short Form, or MNA-SF, was built for older adults from the full Mini Nutritional Assessment (Rubenstein et al., 2001). It has six items: a decline in food intake over three months, weight loss over three months, mobility, recent stress or acute illness within the last three months, neuropsychological problems, and body mass index. Scores run to 14; 12 to 14 is normal, 8 to 11 at risk and 7 or below malnourished. A revised version allows calf circumference in place of body mass index when weight or height cannot be measured (Kaiser et al., 2009).
ESPEN's screening guidance of 2002 recommended MUST for adults in the community and the MNA for older people (Kondrup et al., 2003). The guidance itself anticipates that the two might disagree in an older adult living at home.
The Woman and Her Measurements
She is 162 cm tall and weighs 63.0 kg on the program's scale, giving a body mass index of 24.0. Her chart from the orthopedic clinic recorded 65.0 kg before surgery three months ago, a loss of 2.0 kg, or 3.1 percent. She was in the hospital for three days and ate small amounts throughout. She now walks with a cane, rides the program's van three days a week and lives with her sister. Since surgery she has been eating "about half" of her usual dinner, because she tires while cooking and the pain medicine dulls her appetite. She shows no signs of memory problems or low mood.
Scoring MUST
1. Body mass index 24.0: score 0.
2. Weight loss of 3.1 percent in three months: below 5 percent, score 0.
3. Acute disease effect: she is not acutely ill now and was never without intake for five days, score 0.
Total: 0, low risk. MUST's guidance for low risk in the community is routine care, with screening repeated at set intervals.
Scoring the MNA-SF
1. Food intake: a moderate decrease over three months, score 1.
2. Weight loss: between 1 and 3 kg, score 2.
3. Mobility: goes out, score 2.
4. Stress or acute illness within the last three months: yes, the surgery, score 0.
5. Neuropsychological problems: none, score 2.
6. Body mass index 23 or above: score 3.
Total: 10 of 14, at risk.
Where the Totals Part Company
The disagreement comes from three items the MNA-SF counts and MUST does not.
The first is intake. The MNA-SF scores a moderate fall in eating over three months directly. MUST asks about intake only within its acute disease step, and only when intake has been absent for more than five days. Her half-portions do not register.
The second is the recent acute event. The MNA-SF scores any acute illness or stress within the last three months, so her hip surgery costs her two points. MUST considers only current acute illness with a long gap in eating.
The third is the weight threshold. The MNA-SF gives credit for small losses, scoring 1 to 3 kg as a middle category. MUST does not count weight loss until it reaches 5 percent. Her 2.0 kg loss, which matters for a woman in her seventies recovering from surgery, sits below MUST's floor.
The two screens are not contradicting each other; they are answering different questions, MUST asking whether weight and body mass have already fallen and the MNA-SF asking whether the conditions that lead to that fall are present.
Neither score is wrong. MUST correctly reports that her weight and body mass are still in a safe range. The MNA-SF correctly reports that she is eating less after an acute event and losing a little weight, which is how decline in older adults often begins.
Which Tool Suits the Program
The program serves people 60 and older living in their own homes, many of them alone or recovering from illness. Its staff are not clinicians, and it can refer to a registered dietitian at the area agency on aging. For that setting I would choose the MNA-SF, for three reasons.
1. It was designed and validated for older adults, which is the program's entire population (Kaiser et al., 2009).
2. It detects risk earlier, before weight has fallen far, which matters because the program sees people regularly and can act early.
3. It allows calf circumference when a standing weight is hard to get, which is common among participants with walkers or wheelchairs.
The choice has costs. The MNA-SF will flag more people as at risk, and some of them will turn out to be well nourished on fuller assessment, adding to the dietitian's workload. It also relies on self-report for intake and stress, which some participants may understate. MUST's weight steps are more objective, and I would keep them as a cross-check: recording weight at each screen lets the program see the trend that MUST measures.
What Happens Next for Her
Under the MNA-SF result, she would be referred for a full assessment and offered the program's home-delivered dinners on the days she does not attend. Her weight would be recorded monthly. If her intake recovers as her hip heals, a repeat screen in three months should show it.
Limits of This Comparison
This is one woman scored by one person. Agreement between the tools across a whole program would need many screens and a reference assessment to judge which tool sorted people correctly. Her intake was self-reported, and her presurgery weight came from a different scale.
References
Kaiser, M. J., Bauer, J. M., Ramsch, C., Uter, W., Guigoz, Y., Cederholm, T., Thomas, D. R., Anthony, P., Charlton, K. E., Maggio, M., Tsai, A. C., Grathwohl, D., Vellas, B., & Sieber, C. C. (2009). Validation of the Mini Nutritional Assessment short-form (MNA-SF): A practical tool for identification of nutritional status. The Journal of Nutrition, Health and Aging, 13(9), 782-788. https://doi.org/10.1007/s12603-009-0214-7
Kondrup, J., Allison, S. P., Elia, M., Vellas, B., & Plauth, M. (2003). ESPEN guidelines for nutrition screening 2002. Clinical Nutrition, 22(4), 415-421. https://doi.org/10.1016/S0261-5614(03)00098-0
Rubenstein, L. Z., Harker, J. O., Salva, A., Guigoz, Y., & Vellas, B. (2001). Screening for undernutrition in geriatric practice: Developing the short-form Mini-Nutritional Assessment (MNA-SF). The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 56(6), M366-M372. https://doi.org/10.1093/gerona/56.6.M366
Stratton, R. J., Hackston, A., Longmore, D., Dixon, R., Price, S., Stroud, M., King, C., & Elia, M. (2004). Malnutrition in hospital outpatients and inpatients: Prevalence, concurrent validity and ease of use of the 'malnutrition universal screening tool' ('MUST') for adults. British Journal of Nutrition, 92(5), 799-808. https://doi.org/10.1079/BJN20041258
What the NS310 Unit 2 assignment asks for
The Unit 2 assignment asks students to compare two or more nutrition screening tools, usually by applying them to a case or a volunteer. Prompts typically ask for each tool's design, the scores obtained, an explanation of any difference and a recommendation for a setting. Describe each tool from its official form, including intended population and cutoffs. Score every item and show the arithmetic. If the totals differ, trace the difference to specific items. Use validation studies to support claims about each tool's performance. Judge the tools against the setting's population and staff, not in the abstract. Name the costs of your recommendation as well as its benefits. Most comparisons run four to five pages.
How this NS310 Unit 2 example is built
The paper opens by describing MUST's three steps and the MNA-SF's six items, with scores and cutoffs for each. Validation studies for both tools and the 2002 ESPEN guidance are cited. The woman's measurements follow: a BMI of 24.0, a 2.0 kg loss over three months and half-portions at dinner since surgery. Every MUST step and every MNA-SF item is scored on its own line. A section explains the gap item by item. Its highlighted line recasts the split as each screen answering its own question. Three numbered reasons support choosing the MNA-SF for the program. The paper then sets out what happens next for her and closes with limits.
NS310 Unit 2 rubric: what earns full points
Expect marks for describing the tools correctly, correct scoring, quality of the explanation and a justified recommendation. Showing every item's score lets a grader check the arithmetic, which often earns credit on its own. Points go to tracing a disagreement to specific items rather than calling one tool better. Using validation studies to support claims shows research skill. The recommendation should fit the setting's population and resources. Naming the drawbacks of the chosen tool shows balance. APA style and organization are also assessed. Papers that describe tools without applying them to a person usually score lower. Explaining why neither score is wrong often lifts a paper.
Common NS310 Unit 2 mistakes, and how to avoid them
These comparisons often describe the tools from secondary sources, with errors in cutoffs or items. Another weakness is reporting totals without showing how each was reached. Some papers declare one tool more accurate based on a single case. The setting is often ignored, so the recommendation could apply anywhere. Validation evidence is mentioned without saying what population it came from. Costs of the chosen tool, such as more false positives, are rarely discussed. A few papers misapply MUST's weight-loss percentage. If your two screens disagree and you cannot see why, line up the items side by side and look for what one counts and the other skips. A writer can draft the comparison from that side-by-side view.
Get an NS310 Unit 2 example written to your instructions
Your NS310 Unit 2 prompt may pair different screens, the MST, NRS-2002 or SGA among them, or supply a case of its own. Send the tool names, any case details, and the rubric. Expect every item scored, any disagreement explained and a choice argued for the setting: a free first custom sample, back in 24-48 hours. The paper above is an original model document written by our desk, not a submitted student paper and not an official Purdue University Global document.
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NS310 Unit 2 questions, answered
Where can the official versions of these tools be found?
The MNA forms and user guide are published through the Nestle Nutrition Institute, and MUST with its explanatory booklet by the British Association for Parenteral and Enteral Nutrition. Use those versions rather than reproductions in secondary sources, because item wording and cut-points are sometimes altered in summaries. The example cites both originals directly.
What if both tools give the same result?
The comparison still has work to do. Agreement on one person says little about agreement in general, so the analysis shifts to design differences, practicality in the setting and published validation. The example's disagreement makes a vivid case, but a paper where both screens agree can argue fit just as well by explaining which items would diverge for a different client.
Where can I find a free NS310 Unit 2 sample paper?
This page has a complete Unit 2 comparison of MUST and the MNA-SF for a woman recovering from hip surgery, with every item scored and a recommendation for a senior meal program.
Why can MUST and the MNA-SF disagree?
They count different things. The MNA-SF scores reduced intake, recent acute illness and small weight losses, while MUST waits for 5 percent weight loss, a low BMI or more than five days without eating.
Which screening tool is best for older adults living at home?
The MNA-SF was designed and validated for older adults and detects risk before weight falls far. ESPEN guidance recommended the MNA for older people and MUST for adults in the community generally.