| Course | NU653 AGACNP Acute Care Diagnosis and Management Clinical II |
|---|---|
| Unit | Unit 5 |
| Paper type | Seminar reflection |
| Length | About 810 words, 5 pages double-spaced |
| Format | APA 7 student paper |
| School | Purdue University Global |
| Program | MSN |
| Updated | September 2026 |
Free sample paper for NU653 Unit 5
The Scans Are Normal, Which Is Good News: A Seminar Reflection on How a Functional Weakness Diagnosis Was Received
[Student Name]
Purdue University Global
NU653: AGACNP Acute Care Diagnosis and Management Clinical II
Unit 5 Seminar Reflection
[Instructor Name]
[Date]
The patient and the seminar are composite; days and findings are bracketed, and classmates are described by role.
The Case as I Presented It
Ms. [A.] is a [36]-year-old office manager who arrived as a stroke alert with sudden weakness of her left arm and leg. Her MRI with diffusion imaging was normal, as were her CT angiogram and blood tests. On day [two], her left leg was weak when she tried to lift it, but when she lifted her right leg against my hand, her left hip pressed firmly down into the bed. That is a positive Hoover sign, and with the rest of her examination it supported a diagnosis of functional weakness.
At the bedside I said: "The scans are normal, which is good news." She looked at me and asked, "Does that mean nobody believes my arm is weak?" I told her we believed her and that we would talk more with the neurology team. I presented this exchange at the seminar because her question stayed with me.
What My Classmates Said
The first response was about the word normal. A classmate who works in neurology said that to a patient whose arm will not move, a normal scan can sound like a verdict that nothing is wrong. What I meant as reassurance she may have heard as dismissal. I resisted this at first. The scans were normal, and it seemed dishonest to say otherwise.
The second response was about the Hoover sign. Another classmate pointed out that I had found a positive sign, something present rather than something absent, and had not told her about it. The neurological assessment can itself be part of treatment when the clinician shows the patient the positive signs and explains what they mean (Stone, 2016). A patient who sees her hip press down when she is not trying to move the leg has evidence that her nervous system can move it, and that the problem is in how movement is controlled rather than in damage.
The third response was about naming. The facilitator asked what diagnosis Ms. [A.] had actually been given. The honest answer was none; she had been told what she did not have. Functional neurological disorder is a common, recognized condition diagnosed on positive clinical features, not by excluding everything else, and current reviews describe explaining the diagnosis clearly as the first step of treatment (Espay et al., 2018).
What Changed in My Thinking
I had treated the conversation as a report of test results. She needed an explanation of what she had, and I gave her an explanation of what she did not have. The scans being normal was good news about stroke, but it said nothing about why her arm would not work, and that was her question.
My resistance to the first point came from thinking that avoiding the word normal would mean hiding the truth. The seminar showed me that the problem was not the word but its place in the sentence. The scans can be described accurately after the diagnosis has been named and the positive findings shown. Current thinking on functional disorders describes them as real problems of brain function, with identifiable mechanisms, and not as diagnoses of exclusion (Hallett et al., 2022). Saying that is not a softer version of the truth; it is the truth. I also noticed why I had reached for the scans first. They were the part of the case I was most certain about, and leading with certainty felt safer than leading with a diagnosis I had only recently learned to make. That was about my comfort, not hers.
What I Will Do Next Time
The conversation I would have now starts with the diagnosis: "You have a condition called functional weakness. It is common and it is real. Your nervous system is not damaged, but it is having trouble sending the signal to move your arm and leg." Then the positive sign: "Let me show you something I found." Then the scans, as evidence that there is no stroke or damage, which is good news in that specific sense. Then what happens next: physiotherapy that uses the finding that her leg can move automatically, and a follow-up with neurology.
I went back to Ms. [A.] on day [three] with the neurology nurse practitioner and had a version of that conversation. She asked whether it would get better, and the answer, with treatment, was that many people improve. What I take from the seminar is that the order of a sentence can decide whether a patient feels believed.
References
Espay, A. J., Aybek, S., Carson, A., Edwards, M. J., Goldstein, L. H., Hallett, M., LaFaver, K., LaFrance, W. C., Jr., Lang, A. E., Nicholson, T., Nielsen, G., Reuber, M., Voon, V., Stone, J., & Morgante, F. (2018). Current concepts in diagnosis and treatment of functional neurological disorders. JAMA Neurology, 75(9), 1132-1141. https://doi.org/10.1001/jamaneurol.2018.1264
Hallett, M., Aybek, S., Dworetzky, B. A., McWhirter, L., Staab, J. P., & Stone, J. (2022). Functional neurological disorder: New subtypes and shared mechanisms. The Lancet Neurology, 21(6), 537-550. https://doi.org/10.1016/S1474-4422(21)00422-1
Stone, J. (2016). Functional neurological disorders: The neurological assessment as treatment. Practical Neurology, 16(1), 7-17. https://doi.org/10.1136/practneurol-2015-001241
Reading the NU 653 Unit 5 instructions
The Unit 5 seminar reflection asks you to examine a clinical conversation or decision discussed in seminar and how your understanding of it changed. You describe the situation, report the discussion, analyze it with evidence, and state what you will do differently. The focus may be on communication rather than diagnosis, as it is here. Most sections set 650 to 900 words, written in the first person, with two or more sources. Your own resistance to feedback, if you felt it, belongs in the reflection. Keep classmates anonymous and the patient's details changed. Quoting the words that were actually said gives the reflection something concrete to examine.
How the NU 653 Unit 5 example is put together
The example keeps the clinical case to one paragraph, since the seminar was about how the diagnosis was received. The bedside sentence and the patient's question are quoted exactly. Each classmate response appears with its reasoning and a source: the assessment as treatment, the positive signs, and the recognition of functional disorder as a diagnosis made on positive features. The author's resistance to the first point is recorded. A section explains why the scans came first, as a matter of the clinician's comfort. The last section writes out a new version of the conversation and reports how the follow-up visit went. Its final lines report what she asked at the follow-up visit.
Reading the NU653 Unit 5 grading rubric
The Unit 5 rubric usually scores depth of reflection, integration of evidence, application to practice and writing. Depth earns full credit when the writer identifies a specific change in understanding and reports initial resistance honestly. Sources earn their place when they speak to the conversation itself, such as research on explaining functional diagnoses. Application is judged on whether the reflection produces a concrete change, like the rewritten conversation. Writing is judged on organization and a clear first-person voice. Reflections that stay with one exchange and examine it closely tend to score higher than broad ones. Quoting the actual words used, rather than summarizing them, lets the grader judge the conversation directly.
NU653 Unit 5 help: mistakes that cost points
A common mistake is turning a communication reflection into a clinical case report. Another is paraphrasing the bedside words instead of quoting them, which hides what actually happened. Students sometimes accept every classmate comment without examining it. Some reflections describe functional disorder as a diagnosis of exclusion, which current evidence does not support. Others end with a general promise to communicate better. And a reflection that leaves out the patient's own question misses the moment the seminar was really about. Keep the clinical detail short so the conversation stays at the center. And if the patient's question stayed with you, say why, since that is often where the learning began.
Get an NU653 Unit 5 example written to your instructions
Seminar sessions differ in case and focus, and some sections accept written work when the live meeting is missed. Describe the discussion, or the written prompt, and include the rubric. A first reflection costs nothing and arrives within 24-48h, anchored in one exchange from the case and the way the author's view of it moved. 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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NU653 Unit 5 questions, answered
Can the reflection quote something I actually said to a patient?
Your own words from the rotation are yours to use, provided they are de-identified and handled under your program's confidentiality rules. The sample's bedside sentence is invented to show how quoting one exact line can anchor a reflection. If you use a real exchange, alter whatever might point to the patient and center the writing on the communication, not the person.
Is functional neurological disorder a typical acute care topic?
It appears often in acute settings, because functional symptoms are among the common stroke mimics seen after a stroke alert. Your seminar may center on a different revised diagnosis, such as a cancer found during a pneumonia workup or a drug reaction mistaken for sepsis, and the sample follows whichever case your session used.
What if the patient received the revised diagnosis well?
Then the reflection examines why. A revision that lands smoothly still involves choices about timing, wording and who delivers it, and seminars sometimes study a success to identify what made it work. The sample's structure, one exchange quoted, the room's responses and the author's shift, works equally well for a case that went right.
Where can I find a free NU653 Unit 5 sample paper?
The full NU653 Unit 5 seminar reflection is on this page, with the quoted bedside sentence, three classmate responses, the author's change in view and the rewritten conversation. A free reflection on your own seminar can be written from your notes.
What is a Hoover sign in NU653 Unit 5?
When a patient with functional leg weakness lifts the strong leg against resistance, the weak hip presses down firmly into the bed. It shows the nervous system can move the leg automatically, and showing it to the patient can be part of treatment.