SCHOOL OF NURSING AND MIDWIFERY

NURS1001 — Foundations of Nursing Practice

Written Assessment Task 1: Clinical Nursing Case Study

Unit Code	NURS1001
Unit Title	Foundations of Nursing Practice
Assessment Title	Written Assessment Task 1: Clinical Nursing Case Study
Assessment Type	Individual Written Assignment
Weighting	35% of final unit grade
Word Count	1,500–2,000 words (excluding reference list and appendices)
Due Date	Week 7 — Sunday 11:59 PM AEST (refer to unit outline for exact date)
Submission	Online via the Learning Management System (LMS) — TurnItIn-enabled portal
Citation Style	APA 7th Edition
Learning Outcomes	ULO 1, 2, 3, 4

1. Purpose and Overview

This written assessment task gives you the opportunity to demonstrate your understanding of foundational nursing concepts through the analysis of a realistic clinical case study. You will apply theoretical knowledge related to patient admission, neurological assessment, clinical documentation, care planning, and evidence-based nursing practice to the scenario presented.

The case study is centred on Mrs. Soo Hui, a 46-year-old female patient admitted to a medical ward following a cerebrovascular accident (CVA). You are expected to work through each question below using correct clinical reasoning and current best-practice evidence. The assessment reflects real ward expectations placed on Enrolled Nurses (ENs) and beginning Registered Nurses (RNs) in Australian acute-care settings.

2. Clinical Case Study — Mrs. Soo Hui

Read the following case study carefully before answering the assessment questions.

2.1 Patient Presentation

Mrs. Soo Hui is a 46-year-old female (she/her pronouns) admitted to your medical ward at St. Elsewhere Hospital. Her neighbour found her on the ground outside her front door, unable to move or speak, following an episode of blurred vision, right-sided numbness, and a sharp pain in her head. She has been diagnosed with a left-sided ischaemic cerebrovascular accident (CVA) and was immediately commenced on anticoagulant therapy.

2.2 Social and Cultural Background

Born to Thai parents in Australia; identifies as Buddhist
Speaks both Thai and English
Lives with her husband, their two children (Ty, aged 13 years, and Grace, aged 5 years), and her elderly father (82 years, frail)

2.3 Past Medical History

Hypertension
Type 2 Diabetes Mellitus
Asthma
Depression
Hearing aid — left ear
Bifocal glasses (broken in fall)
Upper dental partial plate
Regular medications: Amlodipine, Metformin, Salbutamol

2.4 Admission Observations

Observation	Result	Observation	Result
Blood Pressure (BP)	150/90 mmHg	Blood Glucose Level (BGL)	8.4 mmol/L
Pulse Rate (PR)	85 bpm (regular)	Weight / Height	69 kg / 162 cm
Respiratory Rate (RR)	24 breaths/min	GCS Score	14/15
Temperature (T°)	36.9°C	PERL	Pupils equal, reactive to light
SpO₂	96% (room air)	Pain Score	7/10 (right hip & shoulder)

2.5 CVA-Related Clinical Findings

Dysphasia (speech impaired but comprehensible)
Dysphagia (difficulty swallowing — NBM order in place)
Right-sided facial droop
Right hemiparesis / mild right-sided hemiplegia
Large haematoma — right hip
5 cm skin tear — right elbow

2.6 Initial Medical Orders

Rest in bed (RIB)
Neurological observations every 2 hours
Nil by mouth (NBM) until Speech Therapist review
Physiotherapist review
Full assistance with hygiene
Indwelling catheter (IDC) in situ
Intravenous therapy via cannula — left forearm

2.7 Discharge Plan

Mrs. Hui will remain in the acute care ward for two (2) weeks before transfer to the Rehabilitation Unit for intensive physiotherapy and occupational therapy. The Discharge Planning team and Community Services have been contacted. Cultural and language support services are to be arranged in consultation with the social worker.

3. Assessment Questions

Answer all eight (8) questions below. Use APA 7th edition in-text citations where appropriate. Each answer should be concise, clinically accurate, and grounded in current evidence-based practice. Sub-questions are indicated by roman numerals.

Question 1 — Preparing the Ward Room (Approx. 150–200 words)

Explain how you would prepare the hospital room for Mrs. Hui’s admission to the ward. In your explanation, consider infection control principles, patient safety, cultural and sensory needs, and required equipment placement.

Question 2 — Admission Assessment Equipment (Approx. 100 words)

List and briefly justify four (4) pieces of equipment you would need to conduct an initial nursing assessment of Mrs. Hui on admission to the ward. For each item, explain why it is specifically relevant to her presentation.

Question 3 — Nursing Documentation (Approx. 150 words)

Identify and explain four (4) components of correct nursing documentation, including electronic health records (EHR) documentation. Refer to current Australian nursing standards where applicable.

Question 4 — Anthropometric Measurements on Admission (Approx. 100–150 words)

Explain why it is important to measure and record a patient’s weight and height on admission to hospital. In your answer, discuss at least three (3) clinical purposes served by these measurements in relation to Mrs. Hui’s care.

Question 5 — ISBAR Clinical Handover (Approx. 200–250 words)

You are required to provide a verbal bedside clinical handover for Mrs. Hui to the Enrolled Nurse and Registered Nurse commencing the next shift. Using the ISBAR framework, complete each section below with the relevant information from the case study.

I	Identity — Introduce yourself, your role, and the patient
S	Situation — Current status and reason for admission
B	Background — Relevant history, comorbidities, medications
A	Assessment — Current clinical findings and concerns
R	Recommendation — Actions required and follow-up needed

Question 6 — Cerebrovascular Accident: Pathophysiology and Clinical Presentation

Answer the following sub-questions in relation to Mrs. Hui’s diagnosis.

Explain the two (2) types of cerebrovascular accident (CVA), identifying where in the brain each occurs and the underlying cause of each type. (Approx. 150–200 words)
Identify four (4) clinical indications of a left-sided CVA and relate each finding to Mrs. Hui’s specific presentation. (Approx. 100 words)

Identify all co-morbidities documented for Mrs. Hui and briefly explain how each may complicate her acute care management. (Approx. 150 words)

Question 7 — Depression in Middle Adulthood (Approx. 150–200 words)

Mrs. Hui is 46 years of age and has a documented history of depression. Discuss how depression can affect a person during middle adulthood, with reference to physical, psychological, social, and functional impacts. Relate your discussion to Mrs. Hui’s current situation and her family responsibilities where relevant.

Question 8 — Nursing Care Plans (Approx. 400–500 words)

The Registered Nurse has identified four (4) nursing diagnoses for Mrs. Hui based on the nursing process. As the Enrolled Nurse contributing to the care planning process, complete the following for each of the four (4) care plans:

Two (2) evidence-based nursing implementations for each care plan
One (1) rationale and one (1) assessment/evaluation criterion for each implementation

The four (4) nursing diagnoses to address are:

Acute pain related to tissue injury secondary to fall and hemiplegia
Impaired swallowing related to neuromuscular dysfunction secondary to CVA
Impaired verbal communication related to dysphasia
Risk for impaired skin integrity related to reduced mobility and haematoma

4. Submission Requirements and Academic Conventions

Submit one (1) Microsoft Word document (.docx) or PDF via the LMS TurnItIn portal by the due date.
Use APA 7th edition for all in-text citations and the reference list.
A minimum of six (6) peer-reviewed sources published between 2019 and 2026 must be used.
Do not exceed the maximum word count. The word count includes in-text citations but excludes the reference list, title page, and appendices.
Use 12-point Arial or Times New Roman font, 1.5 line spacing, and 2.5 cm page margins.
Number all pages. Include your student ID, unit code, and assessment title on the title page.
Late submissions without an approved extension will attract a 10% per day penalty as per university policy.
Academic integrity: All work must be your own. Refer to the University Academic Integrity Policy before submission. AI-generated content submitted as original student work is considered a breach of academic integrity.

5. Marking Rubric / Assessment Criteria

Total: 100 marks (weighted to 35% of final unit grade). Each criterion is assessed across five (5) performance levels.

Assessment Criterion	Marks	HD (85–100%)	D (75–84%)	C (65–74%)	P (50–64%)	F (<50%)
Clinical Knowledge and Pathophysiology (Q1, Q6)	30	Demonstrates detailed, accurate knowledge of CVA pathophysiology and admission care with strong use of current evidence.	Demonstrates sound knowledge with minor inaccuracies. Evidence used effectively.	Demonstrates adequate knowledge. Some gaps in clinical reasoning or evidence.	Basic knowledge evident. Limited depth in clinical reasoning or evidence.	Inaccurate or insufficient clinical knowledge. Little to no evidence used.
Assessment and Clinical Handover (Q2, Q3, Q4, Q5)	25	ISBAR is complete, accurate, and clinically precise. Documentation principles correctly identified and contextualised.	ISBAR is mostly complete with minor omissions. Documentation principles identified.	ISBAR partially complete. Documentation principles listed with limited context.	ISBAR incomplete with notable omissions. Basic documentation principles listed.	ISBAR absent or substantially incorrect. Documentation not addressed.
Nursing Care Planning (Q8)	25	Four care plans demonstrate sophisticated clinical reasoning. Implementations are specific, evidence-based, and measurable.	Care plans are clearly reasoned. Most implementations are evidence-based with appropriate rationales.	Care plans are adequate. Implementations are general. Rationales partially developed.	Care plans are present but lack depth. Implementations are vague or not evidence-based.	Care plans incomplete or absent. Implementations lacking clinical accuracy.
Psychosocial and Holistic Care (Q7)	10	Insightful, well-evidenced discussion of depression in middle adulthood contextualised to Mrs. Hui’s circumstances.	Sound discussion with evidence. Contextualised to the patient with some depth.	Adequate discussion. Limited contextualisation to Mrs. Hui.	Basic discussion of depression. Little patient context.	Superficial or inaccurate discussion. Patient not considered.
Academic Writing and Referencing (APA 7th)	10	Flawless academic writing. APA 7th used accurately. Minimum 6 current peer-reviewed sources.	Clear writing with minor errors. APA mostly accurate. 6 appropriate sources.	Adequate writing. Some APA errors. Sources adequate but not all peer-reviewed.	Writing lacks clarity. Significant APA errors. Fewer than 6 sources.	Poor writing with major errors. Referencing absent or incorrect.

6. Unit Learning Outcomes Addressed

ULO 1: Apply foundational nursing knowledge to assess and monitor a patient’s physical and psychosocial condition.
ULO 2: Demonstrate understanding of the principles underlying safe, person-centred nursing care, clinical documentation, and handover.
ULO 3: Identify and apply evidence-based nursing interventions appropriate to the patient’s diagnosed conditions and co-morbidities.
ULO 4: Communicate clinical information accurately and professionally using standard frameworks, including ISBAR and the nursing process.

7.

Note: The following passage is provided to guide your understanding of key clinical concepts relevant to this assessment. It is not a model answer and should not be reproduced in your submission.

Ischaemic cerebrovascular accident remains one of the leading causes of adult disability in Australia, accounting for roughly 80 per cent of all stroke presentations (Stroke Foundation, 2023). When the CVA is left-sided, nurses should anticipate right-sided motor and sensory deficits, including hemiparesis and facial droop, alongside communication impairments such as dysphasia, all of which are consistent with Mrs. Hui’s admission presentation. Accurate and timely documentation of these deficits using validated tools, including the Glasgow Coma Scale and NIHSS where applicable, forms the foundation of safe neurological monitoring as mandated by the Nursing and Midwifery Board of Australia. Clinical handover structured around ISBAR reduces the risk of information loss between shifts, with research confirming that structured handover frameworks significantly lower adverse event rates in acute care settings. The presence of type 2 diabetes and hypertension in a patient recovering from an ischaemic CVA demands close monitoring of blood glucose and blood pressure, given that dysglycaemia in the acute phase is independently associated with poorer neurological outcomes (Powers et al., 2019, https://doi.org/10.1161/STR.0000000000000211). Depression compounds rehabilitation outcomes by reducing patient motivation, disrupting sleep, and increasing the risk of post-stroke fatigue, making early psychological screening an essential component of holistic care for patients like Mrs. Hui. Multidisciplinary team involvement — including speech therapy for dysphagia, physiotherapy for mobility, and social work for family support — aligns with current Australian stroke care guidelines and should be documented and communicated at every clinical handover.

References

Powers, W. J., Rabinstein, A. A., Ackerson, T., Adeoye, O. M., Bambakidis, N. C., Becker, K., Biller, J., Brown, M., Demaerschalk, B. M., Hoh, B., Jauch, E. C., Kidwell, C. S., Leslie-Mazwi, T. M., Ovbiagele, B., Scott, P. A., Sheth, K. N., Southerland, A. M., Summers, D. V., & Tirschwell, D. L. (2019). Guidelines for the early management of patients with acute ischaemic stroke. Stroke, 50(12), e344–e418. https://doi.org/10.1161/STR.0000000000000211

Stroke Foundation. (2023). Clinical guidelines for stroke management. Stroke Foundation. https://informme.org.au/guidelines/living-clinical-guidelines-for-stroke-management

Australian Commission on Safety and Quality in Health Care. (2021). Standard 6: Communicating for safety. ACSQHC. https://www.safetyandquality.gov.au/standards/nsqhs-standards/communicating-safety-standard

Nursing and Midwifery Board of Australia. (2020). Enrolled nurse standards for practice. NMBA. https://www.nursingmidwiferyboard.gov.au/codes-guidelines-statements/professional-standards/enrolled-nurse-standards-for-practice.aspx

Mitchell, P. H., Veith, R. C., Becker, K. J., Buzaitis, A., Cain, K. C., Fruin, M., Tirschwell, D., & Teri, L. (2021). Brief psychosocial-behavioural intervention with antidepressant reduces post-stroke depression significantly more than usual care with antidepressant. Stroke, 40(9), 3073–3078. https://doi.org/10.1161/STROKEAHA.109.549808

Demaerschalk, B. M., Kleindorfer, D. O., Adeoye, O. M., Demchuk, A. M., Fugate, J. E., Grotta, J. C., Khalessi, A. A., Levy, E. I., Palesch, Y. Y., Prabhakaran, S., Saposnik, G., Saver, J. L., & Smith, E. E. (2022). Scientific rationale for the inclusion and exclusion criteria for intravenous alteplase in acute ischaemic stroke. Stroke, 47(2), 581–641. https://doi.org/10.1161/STR.0000000000000086