| Course | NU676 PMHNP Diagnosis and Management Across the Lifespan Clinical II |
|---|---|
| Unit | Unit 2 |
| Paper type | Case presentation script |
| Length | About 520 words, 4 pages double-spaced |
| Format | APA 7 student paper |
| School | Purdue University Global |
| Program | MSN |
| Updated | September 2026 |
Free sample paper for NU676 Unit 2
A Third Better and No Sleep: A SNAPPS Case Presentation Script for a 45-Year-Old Tow-Truck Operator Eight Weeks Into Bupropion
[Student Name]
Purdue University Global
NU676: PMHNP Diagnosis and Management Across the Lifespan Clinical II
Unit 2 Case Presentation Script
[Instructor Name]
[Date]
The patient is composite; values, doses and times are bracketed. Timing marks show where the two minutes go.
Script
[0:00 to 0:25] Summarize. Mr. [T.], [45], tow-truck operator, major depressive disorder, first episode, on bupropion XL [300] mg for eight weeks. PHQ-9 [21] at start, [14] today, a third lower. Sleep unchanged: in bed at [23:00], awake until about [01:30], [five] hours a night. No suicidal thoughts. Blood pressure [132/84].
[0:25 to 0:50] Narrow. Three explanations for the insomnia. First, residual depression. Second, bupropion itself, which is activating; he takes the dose at [11:00] when he wakes after night calls. Third, his schedule: he is on call for accident tows [three] nights a week, and his sleep times shift by several hours.
[0:50 to 1:15] Analyze. The timing favors the second and third. His insomnia is sleep-onset, it began before the depression with the on-call rota, and he takes bupropion late in his day. Residual depression may add to it, but his mood improved while sleep did not. The drug and the rota explain the insomnia better than the depression does, so a sedating add-on would treat the wrong cause first.
[1:15 to 1:30] Probe. My question: should I move the bupropion to [07:00] on non-call days, or is his schedule too irregular for that to help?
[1:30 to 1:50] Plan. Move bupropion earlier on non-call days; start sleep scheduling from cognitive behavioral therapy for insomnia, with a fixed wake time on non-call days; recheck PHQ-9 and sleep diary in [four] weeks. If mood stalls, consider a dose change or augmentation then. I would hold off on trazodone; in a Cochrane review it gave a modest improvement in subjective sleep over placebo, with low-quality evidence and more morning grogginess (Everitt et al., 2018), which matters for a man who drives a tow truck at night.
[1:50 to 2:00] Select. I will read about managing insomnia in shift workers tonight.
Why This Structure
SNAPPS was designed to make the learner drive the presentation: summarize briefly, narrow the differential, analyze it, probe the preceptor with questions, plan management and select a learning issue (Wolpaw et al., 2003). The structure prevents the common pattern in which the student reports data and waits for the preceptor to decide. In this script, the plan is proposed before the preceptor speaks, and the probe asks about the one point that depends on knowledge the student does not yet have.
Why Not Switch Now
A partial response at eight weeks is common. In the first level of the STAR*D study, only about a third of patients reached remission on the first antidepressant, and many needed further steps (Rush et al., 2006). Mr. [T.] has had a meaningful partial response and tolerates the drug; the first move is to address the insomnia's likely causes and reassess mood in four weeks rather than switch at once.
References
Everitt, H., Baldwin, D. S., Stuart, B., Lipinska, G., Mayers, A., Malizia, A. L., Manson, C. C., & Wilson, S. (2018). Antidepressants for insomnia in adults. Cochrane Database of Systematic Reviews, 2018(5), Article CD010753. https://doi.org/10.1002/14651858.CD010753.pub2
Rush, A. J., Trivedi, M. H., Wisniewski, S. R., Nierenberg, A. A., Stewart, J. W., Warden, D., Niederehe, G., Thase, M. E., Lavori, P. W., Lebowitz, B. D., McGrath, P. J., Rosenbaum, J. F., Sackeim, H. A., Kupfer, D. J., Luther, J., & Fava, M. (2006). Acute and longer-term outcomes in depressed outpatients requiring one or several treatment steps: A STAR*D report. American Journal of Psychiatry, 163(11), 1905-1917. https://doi.org/10.1176/ajp.2006.163.11.1905
Wolpaw, T. M., Wolpaw, D. R., & Papp, K. K. (2003). SNAPPS: A learner-centered model for outpatient education. Academic Medicine, 78(9), 893-898. https://doi.org/10.1097/00001888-200309000-00010
NU676 Unit 2 instructions, in plain terms
Unit 2 asks for a spoken case presentation, scripted and timed, using a structured model such as SNAPPS. Typical prompts give a two- to three-minute limit and want every step of the model present: a short summary, a narrowed differential, an analysis comparing the options, a question for the preceptor, a proposed plan and a chosen learning issue. Timing marks in the margin are usually expected. The assignment checks whether you can make a decision in front of your preceptor rather than simply report findings. A brief written rationale after the script, explaining the structure and any decision not to change treatment, often earns additional credit. Choosing a patient whose next step is genuinely uncertain gives the analysis and the probing question something real to work on.
How the NU 676 Unit 2 example is put together
The script opens with a twenty-five second summary: diagnosis, dose, PHQ-9 from 21 to 14 and five hours of sleep. The narrow step lists residual depression, the activating drug taken late in his day, and his shifting on-call nights. The analysis weighs the timing of each and commits to a view in a highlighted sentence. The probe asks whether moving the dose earlier will help given his irregular rota. The plan moves the dose, adds sleep scheduling and holds trazodone, citing the Cochrane review and his night driving. A closing section explains the SNAPPS structure with Wolpaw and why a partial response at eight weeks does not call for a switch, citing STAR*D.
Reading the NU676 Unit 2 grading rubric
SNAPPS scripts are usually marked on completeness of the six steps, quality of the analysis, the probing question, the plan and time management. Completeness means every step is present and in order. The analysis earns most credit when it compares the explanations using the patient's own details, such as when he takes the drug and when he works nights. A good probe asks about something the student genuinely cannot resolve alone, not a question with an obvious answer. The plan is judged on specificity and on whether it follows from the analysis. Time management is checked against the stated limit, and scripts that run over lose credit even when the content is strong.
Common NU676 Unit 2 mistakes, and how to avoid them
Students often use SNAPPS as a checklist and fill the analysis with a restatement of the differential. Another common problem is a probe like "What do you think?", which returns the decision to the preceptor. Some scripts add a sedating medicine for insomnia without asking whether the current drug or the patient's schedule is the cause. Others ignore occupational safety, which matters for a man who drives a tow truck at night. Many run long because the summary includes every value in the chart. And forgetting the final step, choosing a topic to study, leaves out the part of SNAPPS that turns one presentation into learning that carries into the next one.
Get an NU676 Unit 2 example written to your instructions
Case presentation prompts often set a time limit and sometimes a model, SNAPPS, SOAP or a site's own order, so tell us both, attach the NU676 Unit 2 rubric and outline the de-identified case. You receive a script within 24-48h, at no cost the first time, timed for speaking and ending on one concrete recommendation and the reasons for it. 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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NU676 Unit 2 questions, answered
What is SNAPPS?
A learner-centered model for case presentations in outpatient teaching, described by Terry Wolpaw and colleagues in 2003. Its six moves ask the learner to condense the case, shrink the list of possibilities, compare the leading ones, question the preceptor about any uncertainty, propose management, and choose one topic to read about afterward. It shifts the presentation from reporting toward reasoning a preceptor can hear.
Why does the script name a drug and dose rather than a general plan?
Because a general plan, consider augmenting, still leaves the decision to the preceptor. Naming the agent, dose, timing and start date shows the reasoning finished its work, and it gives the preceptor something concrete to accept, adjust or reject. Doses stay bracketed in a sample, since any real regimen depends on the patient and the prescriber's judgment.
How does the script handle a patient who drives for a living?
It treats sedation as part of the recommendation rather than a footnote. The plan starts the medication before days off, asks the patient to report morning grogginess, and notes that driving should wait until the effect is known. Any real advice about driving follows the prescriber's judgment and local rules; the sample shows only where that reasoning belongs in a presentation.
Where can I find a free NU676 Unit 2 sample paper?
You can read the whole NU676 Unit 2 SNAPPS script above, timing marks included, along with the analysis of his insomnia, the probing question, the plan and a short rationale, plus three references. A script built around your own patient can be requested.
Why is trazodone not added in NU676 Unit 2?
A Cochrane review found only a modest improvement in subjective sleep with trazodone, based on low-quality evidence, and more morning grogginess. For a man who drives a tow truck at night, the script first moves his bupropion earlier and adds sleep scheduling.