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Clinical simulationPharmacotherapeutics

Herzing NU 636 Unit 4 Assignment Shadow Health DCE: HTN and DM

Hypertension and diabetes are set together for a reason. They damage the same organs and their drug decisions overlap, so treating them as two separate exams misses the assignment.

Editorial process

Last reviewed · August 25, 2026

01

Two conditions that share organs and share decisions

The pairing is the assignment. Hypertension and type 2 diabetes damage the same target organs, so the focused examination has to cover the kidney, the eye, the peripheral nerves and the vasculature rather than confining itself to blood pressure, and the history has to reach the same places: visual change, numbness or burning in the feet, chest symptoms, erectile dysfunction, claudication. A simulated encounter rewards asking, so ask. A simulated encounter rewards asking, so ask about the feet, the eyes and the chest even when nothing is volunteered. The commonest reason these encounters score poorly is not clinical error at all but incomplete subjective data, because the simulation records only what the student thought to elicit and an unasked question is scored as a gap rather than as a normal finding. Encounters lose marks for gaps in the history far more often than for errors in the examination.

The pharmacology is where the two conditions converge again and where advanced practice reasoning shows. An ACE inhibitor or angiotensin receptor blocker is the antihypertensive that also addresses albuminuria, which is a decision about both conditions at once; metformin's use depends on renal function, so the same laboratory value governs two different drug choices; thiazides and beta blockers interact with glycaemic control; and some glucose-lowering agents lower blood pressure and cardiovascular risk in their own right. Write the plan so the reader can see those connections being made rather than two parallel lists. Then be explicit about the numbers you are treating to and where the target comes from, since blood pressure and glycated haemoglobin targets are individualised by age, comorbidity and hypoglycaemia risk, and the education section should name what the patient monitors at home and what brings them back sooner than the next appointment.

Likely learning objectives

  • Extend a focused exam across the organs both conditions damage.
  • Recognise incomplete subjective data as the usual scoring failure.
  • Choose drugs that address both conditions where the evidence allows.
  • State individualised targets and where they come from.

Assignment instructions

Read the full question

Review every instruction before using the planning guidance that follows.

Return to your Shadow Health Advanced Pharmacology course. Complete the DCE Focused Exam. Location: Shadow Health – Advanced Pharmacology. Points: 40 points are available; points earned are calculated by taking the % score you achieved on the simulation activity and multiplying that by 40 [e.g. if you score an 73% on your simulation activity your faculty person will multiply .73 times 40 and you will earn 29.2 points]. As you can see it is in your best interest to repeat your simulation activities if you are not satisfied with your % score on your initial attempt. There is no limit on the number of times you can repeat the simulation activity. Be sure to submit the ‘Lab pass’ that demonstrates the highest score. Shadow Health Support: Contact Shadow Health with any questions or technical issues regarding Shadow Health before contacting your instructor. If at any time you have any questions or encounter any technical issues regarding the Digital Clinical Experience, please contact the Shadow Health support specialists by visiting the Learner Support Page at http://support.shadowhealth.com (Links to an external site.) for contact information and hours.

Course-wide instructions that accompany this question

ADDITIONAL INSTRUCTIONS FOR THE CLASS Discussion Questions (DQ) Initial responses to the DQ should address all components of the questions asked, include a minimum of one scholarly source, and be at least 250 words. Successful responses are substantive (i.e., add something new to the discussion, engage others in the discussion, well-developed idea) and include at least one scholarly source. Herzing NU 636 Unit 4 Assignment Shadow Health DCE HTN and DM One or two sentence responses, simple statements of agreement or “good post,” and responses that are off-topic will not count as substantive. Substantive responses should be at least 150 words. I encourage you to incorporate the readings from the week (as applicable) into your responses. Weekly Participation Your initial responses to the mandatory DQ do not count toward participation and are graded separately. In addition to the DQ responses, you must post at least one reply to peers (or me) on three separate days, for a total of three replies. Participation posts do not require a scholarly source/citation (unless you cite someone else’s work). Part of your weekly participation includes viewing the weekly announcement and attesting to watching it in the comments. These announcements are made to ensure you understand everything that is due during the week. APA Format and Writing Quality Familiarize yourself with APA format and practice using it correctly. It is used for most writing assignments for your degree. Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for APA paper templates, citation examples, tips, etc. Points will be deducted for poor use of APA format or absence of APA format (if required). Cite all sources of information! When in doubt, cite the source. Paraphrasing also requires a citation. I highly recommend using the APA Publication Manual, 6th edition. Use of Direct Quotes I discourage overutilization of direct quotes in DQs and assignments at the Masters’ level and deduct points accordingly. As Masters’ level students, it is important that you be able to critically analyze and interpret information from journal articles and other resources. Simply restating someone else’s words does not demonstrate an understanding of the content or critical analysis of the content. It is best to paraphrase content and cite your source. LopesWrite Policy For assignments that need to be submitted to LopesWrite, please be sure you have received your report and Similarity Index (SI) percentage BEFORE you do a “final submit” to me. Once you have received your report, please review it. This report will show you grammatical, punctuation, and spelling errors that can easily be fixed. Take the extra few minutes to review instead of getting counted off for these mistakes. Review your similarities. Did you forget to cite something? Did you not paraphrase well enough? Is your paper made up of someone else’s thoughts more than your own? Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for tips on improving your paper and SI score. Late Policy The university’s policy on late assignments is 10% penalty PER DAY LATE. This also applies to late DQ replies. Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances. If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect. I do not accept assignments that are two or more weeks late unless we have worked out an extension. As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading. Communication Communication is so very important. There are multiple ways to communicate with me: Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class. Individual Forum: This is a private forum to ask me questions or send me messages. This will be checked at least once every 24 hours.

02

What the DCE focused exam requires

  1. 01Completion of the Shadow Health Digital Clinical Experience focused exam on hypertension and diabetes.
  2. 02A documented history covering both conditions and their complications.
  3. 03A focused physical examination appropriate to both.
  4. 04An assessment and plan addressing pharmacological management.
  5. 05Patient education appropriate to the findings.
  6. 06Documentation submitted in the required format.
03

History, examination, and the combined plan

01

History of present illness

Cover control, adherence, hypoglycaemia and symptoms of complications.

What the assessor is likely looking for

Complication screening inside the history.

02

Review of relevant systems

Ask about visual, neurological, cardiac and vascular symptoms.

What the assessor is likely looking for

Breadth appropriate to the shared target organs.

03

Focused examination

Perform cardiovascular, foot, neurological and relevant screening.

What the assessor is likely looking for

Examination matched to the conditions, not the chief complaint.

04

Assessment

State control status and complication risk for both conditions.

What the assessor is likely looking for

An assessment that integrates the two.

05

Pharmacological plan

Choose agents with the overlaps and renal constraints in view.

What the assessor is likely looking for

Drug choices justified across both conditions.

06

Targets and education

Set individualised targets and say what the patient monitors.

What the assessor is likely looking for

Targets justified and education actionable.

04

Where the management evidence sits

Recommended databases

  • NCBI Bookshelf
  • NIDDK
  • NHLBI
  • PubMed Central

Search sequence

  1. 1.Read current management guidance for each condition before the encounter.
  2. 2.Check renal function thresholds for the glucose-lowering agents you plan to use.
  3. 3.Look up albuminuria management for the shared drug decision.
  4. 4.Read on individualised glycaemic targets for the justification section.
05

Reference shortlist

These are authoritative starting points, not a ready-made bibliography. A qualified reviewer must confirm that each source fits the assignment and supports the claim beside which it is cited.

Anemia in Chronic Kidney Disease

National Institute of Diabetes and Digestive and Kidney Diseases · 2024

Review before citing

Kidney disease resources, for the renal function governing both drug decisions.

What Is Diabetes?

National Institute of Diabetes and Digestive and Kidney Diseases · 2023

Review before citing

Diabetes, for the complication set the examination must cover.

06

Before you submit

Common mistakes

  • Examining only the cardiovascular system.
  • Omitting foot, eye and renal assessment.
  • Writing two parallel plans that never reference each other.
  • Quoting a target without saying why it applies to this patient.
  • Leaving out what the patient should monitor and when to return.

Submission checklist

  • Does the history cover complications of both conditions?
  • Does the examination include feet, eyes and cardiovascular assessment?
  • Does the plan show drugs chosen for their effect on both conditions?
  • Are targets individualised and justified?
  • Does education name home monitoring and return criteria?

Use this guide to plan and review your own work. Follow your institution's rules and read Brinevia's academic-integrity policy.

Written by

Maren Caldwell

MSN, RN, CNE

Medical-surgical nursing, pharmacology and NCLEX preparation

Maren is a registered nurse with over 15 years of clinical and educational experience in medical-surgical nursing. She writes on NCLEX preparation, patient care fundamentals, pharmacology and evidence-based practice.

Reviewed by

Dr. Tessa Redmond

DNP, RN, CNE

Evidence-based practice and clinical education

Tessa is a doctorally-prepared nurse educator. She reviews Brinevia content for clinical accuracy and alignment with current evidence-based guidelines.

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