| Course | NU673 PMHNP Diagnosis and Management Across the Lifespan I |
|---|---|
| Unit | Unit 1 |
| Paper type | Discussion board post with two replies |
| Length | About 570 words, 3 pages double-spaced |
| Format | APA 7 discussion post |
| School | Purdue University Global |
| Program | MSN |
| Updated | September 2026 |
Free sample paper for NU673 Unit 1
Not Anxiety Yet: Four Medical Explanations to Test First in an Irritable, Underweight 17-Year-Old Swimmer With a Racing Heart
NU673 · Unit 1 Discussion Board Post
Posted by [Student Name]
The patient is composite; values are bracketed.
Initial Post
The patient I am thinking about is [Ella], a [17]-year-old who swims for a club team, training [18] hours a week. Since August she has lost [4] kg, sleeps poorly, snaps at her family and says her heart "races" when she is lying in bed. Her last period was [four] months ago. Her mother asked for "something for her anxiety." Anxiety may turn out to be part of the answer, but the combination of weight loss, a fast heart at rest and missed periods has several medical explanations that should be tested first. Here are the four I would put at the top, with the finding that would settle each.
1. Hyperthyroidism. Weight loss despite eating, palpitations, poor sleep and irritability are classic. Deciding finding: a suppressed TSH with raised free T4; if present, antibody testing follows the American Thyroid Association guidance (Ross et al., 2016).
2. Relative energy deficiency in sport. The IOC consensus describes a syndrome in which too little energy intake for the amount of training impairs many body systems, including menstrual function, bone health, metabolism and mood (Mountjoy et al., 2018). A teenage endurance athlete with weight loss and four months without a period fits closely. Deciding finding: a careful dietary and training history, and a resting heart rate. Note that low energy availability often produces a slow resting heart rate in athletes, so her racing heart would point elsewhere, perhaps to a stimulant or an arrhythmia.
3. Stimulant or supplement use. Many teen athletes use pre-workout powders or energy drinks with large doses of caffeine, and some use diet pills. Deciding finding: a direct, private question about every supplement and drink, and a look at the labels.
4. An arrhythmia. A racing heart at rest could be supraventricular tachycardia. Deciding finding: an ECG, and if the episodes are brief, an event monitor.
Every one of these explanations would make an anxiety prescription at best useless and at worst harmful, so the workup comes before the diagnosis. I would also screen gently for disordered eating, since restriction may drive the weight loss and anxiety may drive both, and speak with her alone for part of the visit.
What would you add to the list, and in what order would you test?
Reply to a Classmate Who Put Anxiety First
You suggested starting an SSRI while the tests are pending, since her distress is real. I agree her distress is real, and I would offer support and follow-up this week. But an SSRI would not help a thyroid storm or an energy deficit, and early side effects such as jitteriness or appetite change could muddy the picture. A few days for blood tests and an ECG seems a small cost.
Reply to a Classmate Who Asked About Her Period
You asked whether the missed periods could simply be from swimming. That is possible, and it is exactly what the IOC consensus warns against normalizing: menstrual disruption in athletes is often a sign of low energy availability and carries risks to bone health (Mountjoy et al., 2018). I would ask about her periods and her eating in the same private conversation.
References
Mountjoy, M., Sundgot-Borgen, J. K., Burke, L. M., Ackerman, K. E., Blauwet, C., Constantini, N., Lebrun, C., Lundy, B., Melin, A. K., Meyer, N. L., Sherman, R. T., Tenforde, A. S., Klungland Torstveit, M., & Budgett, R. (2018). IOC consensus statement on relative energy deficiency in sport (RED-S): 2018 update. British Journal of Sports Medicine, 52(11), 687-697. https://doi.org/10.1136/bjsports-2018-099193
Ross, D. S., Burch, H. B., Cooper, D. S., Greenlee, M. C., Laurberg, P., Maia, A. L., Rivkees, S. A., Samuels, M., Sosa, J. A., Stan, M. N., & Walter, M. A. (2016). 2016 American Thyroid Association guidelines for diagnosis and management of hyperthyroidism and other causes of thyrotoxicosis. Thyroid, 26(10), 1343-1421. https://doi.org/10.1089/thy.2016.0229
The Purdue Global NU673 Unit 1 instructions
The first NU673 discussion usually presents a patient whose symptoms look psychiatric and asks which medical conditions must be ruled out before a psychiatric diagnosis is made. Prompts ask for three to five plausible medical explanations, the history, examination or test that would confirm or exclude each, and a statement of what you would do while results are pending. A post of 400 to 550 words and two replies is common, with sources for each condition. Graders reward explanations chosen because the case points to them, not a generic list. The post should be honest about what can be done for the patient's distress now, without starting a treatment that could mask or complicate the workup.
How this NU673 Unit 1 example is built
The post introduces the swimmer's training load, weight loss, racing heart and four months without a period, and states the mother's request. Four numbered explanations follow, each with its deciding finding: thyroid tests read against the ATA guidance, a dietary and training history for energy deficiency drawn from the IOC consensus, a private question about supplements, and an ECG or event monitor. The energy deficiency entry notes that a slow resting heart would be expected, so her racing heart points elsewhere. A highlighted sentence explains why the workup comes first. The first reply answers a classmate who would start an SSRI now; the second explains why missed periods in an athlete should not be normalized.
NU673 Unit 1 rubric: what earns full points
The rubric for this opening post usually weighs the quality of the medical differential, the link between each condition and a deciding test, the use of evidence, clinical reasoning about timing, and peer engagement. The differential earns full points when every condition is supported by something in the case. The testing row rewards naming the specific finding that would confirm or exclude each condition. Evidence points go to guidelines or consensus statements matched to each entry. Reasoning about timing is judged on whether the post explains why treatment should wait for results. Engagement credit depends on replies that add a clinical point or source rather than agreement alone.
NU673 Unit 1 help: mistakes that cost points
The most common error is listing medical conditions from a textbook table without linking them to the patient. Another is naming a condition but not the test that would settle it. Students often forget to ask adolescents privately about supplements, diet and periods, which can change the differential. Some posts start medication while tests are pending. Others treat missed periods in athletes as harmless. Many ignore eating disorders, which can coexist with medical and anxiety problems. And a post that only lists possibilities, without an order of testing, leaves the reader unsure what to do first when the mother is asking for help today.
Get an NU673 Unit 1 example written to your instructions
Which presentation does the Unit 1 board in your NU673 section describe? Paste it, add the rubric, and mention any required sources. Written to those instructions, the free first post names the medical explanations that presentation makes plausible and the finding that would rule each in or out, then closes on a reply to a classmate; allow 24-48h. 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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NU673 Unit 1 questions, answered
How many medical conditions should the post cover?
Usually three to five, chosen because the presentation makes them plausible rather than because they appear on a standard list. Each needs a reason for inclusion and a test or finding that would settle it. A post covering fewer conditions in depth tends to earn more than one listing ten with no reasoning attached.
Can the post conclude that the problem is psychiatric?
It can say that a psychiatric diagnosis remains likely, but the opening board in this course usually asks what must be excluded first. The stronger conclusion is conditional: if the named tests are unremarkable, an anxiety or mood disorder becomes the leading explanation. That framing shows the diagnosis will rest on evidence rather than on first impression.
Where can I find a free NU673 Unit 1 sample paper?
The complete NU673 Unit 1 discussion post and its two replies appear on this page, with the four medical explanations, the finding that would settle each and the reasons for waiting before treatment, plus two references. A post for a different presentation can be written to your prompt.
Why is relative energy deficiency in sport on the list in NU673 Unit 1?
A teenage endurance athlete training 18 hours a week, with weight loss and four months without a period, fits the IOC description of low energy availability affecting menstrual function, bone health, metabolism and mood. A careful diet and training history would test it.
What should happen while tests are pending in NU673 Unit 1?
The post offers support and follow-up the same week, a private conversation with the teenager, and quick tests such as thyroid function and an ECG, rather than starting an anxiety medication that would not treat a medical cause and could muddy the picture.