NRNP 6531 – Primary Care of Adults Across the Lifespan
Week 4 Assignment: i‑Human Case Study – Evaluating and Managing Cardiovascular Conditions (Darius Davis)

Unit and assessment context

Course: NRNP 6531 Primary Care of Adults Across the Lifespan (or equivalent advanced practice adult primary care unit).
Level: Graduate / NP program.
Assessment type: Clinical simulation case study (i‑Human) with structured rubric.
Timing: Week 4 – Evaluation and management of cardiovascular conditions.
Weighting: Typically 10–20% of course grade (adjust per local outline).

Case study overview

In this assignment you will complete the i‑Human case study for an adult patient presenting with chest pain and cardiovascular risk factors (Darius Davis). The simulation is designed to assess your ability to gather an organised history, conduct a focused cardiovascular examination, select appropriate diagnostic tests, formulate a clear differential diagnosis, and develop an evidence‑based management plan that incorporates health promotion and patient education.

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Learning outcomes

• • Apply advanced health assessment skills to evaluate an adult presenting with chest pain and suspected cardiovascular disease.
  • Use structured history frameworks (e.g. OLDCARTS/OLDCARDS) to organise subjective data for a focused cardiovascular encounter.

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• • Interpret key physical findings and diagnostic tests to support a primary cardiovascular diagnosis and appropriate differentials.

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• • Design a cost‑effective, guideline‑based management plan, including pharmacological and non‑pharmacological strategies, health promotion, and patient education.

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Assignment instructions

Step 1: Prepare

• • Review the Week 4 learning resources on cardiovascular assessment, common chest pain presentations, and current clinical guidelines for stable angina, acute coronary syndrome, and other relevant conditions.

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• Ensure you can access the i‑Human platform and locate the assigned case: Darius Davis (chest pain / cardiovascular condition) for NRNP 6531.

Step 2: Complete the i‑Human encounter

Within the i‑Human case, you are expected to:

• • Conduct a focused history using OLDCARTS or a similar framework to clarify onset, location, duration, character, aggravating and relieving factors, timing, and severity of the chest pain, along with associated symptoms and relevant risk factors.

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• • Perform an appropriate focused physical examination with emphasis on cardiovascular, respiratory, and relevant systems, documenting both normal and abnormal findings.
  • Select and interpret appropriate diagnostic tests (e.g. ECG, cardiac biomarkers, basic labs, imaging) without ordering unnecessary or contraindicated studies.

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• • Generate a differential diagnosis list (three to five conditions) for the chest pain, clearly identifying the most likely primary diagnosis and supporting your choice with specific findings from the case.

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• Develop a management plan that includes:
  1. 1. pharmacologic treatment aligned with current cardiovascular guidelines,
     2. non‑pharmacologic measures and lifestyle modification,
     3. indications for referral or escalation of care, and
     4. patient education and health promotion specific to cardiovascular risk reduction.

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Step 3: Submit within i‑Human

• • Complete all required components of the case (history, physical exam, tests, diagnosis, plan, and embedded clinical questions/exercises).
  • Ensure you have reached the final summary screen within i‑Human; your work will be graded based on the case performance analytics and the rubric below.

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• No separate Word document is required unless specified by your instructor; submission occurs inside the i‑Human platform.

Week 4 Assignment Rubric – i‑Human Case Study: Evaluating and Managing Cardiovascular Conditions (Darius Davis)

1. HPI statement (15%)

2. History (subjective data) – OLDCARTS and risk factors (10%)

3. Physical examination (10%)

4. Testing (diagnostics) (10%)

5. Differential diagnosis summary (20%)

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6. Plan for patient (30%)

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7. Exercises / embedded questions (5%)

Short sample answer

In the Darius Davis i‑Human case, the pattern of exertional chest pressure, relief with rest, and associated cardiovascular risk factors fits best with stable angina rather than acute coronary syndrome or non‑cardiac causes. A structured OLDCARTS history clarifies that his discomfort is predictable, triggered by physical exertion such as carrying heavy items, and resolves within minutes of stopping, which is typical for stable ischemia. The focused exam should emphasise vital signs, cardiac auscultation, peripheral pulses, and signs of heart failure, although many patients with stable angina have a normal exam at rest. Baseline ECG and fasting lipid profile are essential, and most guidelines recommend initiating or intensifying statin therapy, antiplatelet therapy, and blood pressure control to reduce long‑term cardiovascular risk. The management plan also needs to incorporate clear advice on smoking cessation, physical activity within safe limits, and weight management, since modest lifestyle changes can significantly reduce future cardiac events.

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For advanced practice nurses, cases like Darius Davis illustrate how simulation can sharpen pattern recognition while tying each decision to established evidence such as ACC/AHA guidelines for chronic coronary disease. Students who consciously link each subjective and objective finding to their differentials tend to build more coherent treatment plans and to avoid reflexive over‑testing or inappropriate prescribing. Over time, repeating this reasoning process in simulated chest pain cases strengthens clinical judgment for real patients, where missing subtle red flags or over‑looking risk factor modification could have measurable consequences for morbidity and mortality.

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Suggested recent references (APA 7th)

• Arnett, D. K., Blumenthal, R. S., Albert, M. A., Buroker, A. B., Goldberger, Z. D., Hahn, E. J., Himmelfarb, C. D., Khera, A., Lloyd‑Jones, D., McEvoy, J. W., Michos, E. D., Miedema, M. D., Munoz, D., Smith, S. C. Jr., Virani, S. S., Williams, K. A. Sr., Yeboah, J., & Ziaeian, B. (2019). 2019 ACC/AHA guideline on the primary prevention of cardiovascular disease. Journal of the American College of Cardiology, 74(10), e177–e232. https://doi.org/10.1016/j.jacc.2019.03.010
• Gulati, M., Levy, P. D., Mukherjee, D., Amsterdam, E., Bhatt, D. L., Birtcher, K. K., Blankstein, R., Boyd, J., Bullock‑Palmer, R. P., Conejo, T., Fleisher, L. A., Gentile, F., Greenwood, J. P., Kumbhani, D. J., Lane, K., Lindley, K. J., Mieres, J. H., Morris, P. B., & Shaw, L. J. (2021). 2021 AHA/ACC chest pain guideline. Circulation, 144(22), e368–e454. https://doi.org/10.1161/CIR.0000000000001029
• NICE. (2020). Chest pain of recent onset: Assessment and diagnosis (CG95). National Institute for Health and Care Excellence. https://www.nice.org.uk/guidance/cg95
• Rosenthal, L. D., & Burchum, J. R. (2021). Lehne’s pharmacology for nursing care (11th ed.). Elsevier.
• Walden University. (2024).