Spring 2018

NURS 4315-002 Care of the Adult II: Theoretical Foundations

All students are responsible for checking their UTHSCSA Livemail account regularly (i.e., daily or several times every week) to obtain Official University Communication regarding their courses, program and student status.

Welcome to NURS. 4315!

Please note the following:

Date: October 18, 2018
First Class Day from 1300-1600  Objectives and readings for the class will be posted one week prior to class.


Please note 4316 Adult II Clinical begins before 4315


Faculty: Team Taught

Course Coordinator

Isabell Stoltz MN, RN, CCNS

Assistant Professor/ Clinical 

UT Nursing 

Email: stoltzi@uthscsa.edu

Office: 2.504

Phone: 210-567-3850

Office Hours: See Starfish 


This course addresses holistic care of the acutely and critically ill adult experiencing complex health alterations within acute care settings.


3 semester hours (3 hours theory)


Completion of Care of the Adult I: Theoretical Foundations and Care of the Adult I: Clinical Application


At the completion of the baccalaureate program the student will demonstrate the following:

  1. Incorporate knowledge, skills, and attitudes from the liberal arts and sciences in professional nursing education and practice.
  2. Apply knowledge and skills of organizational and systems leadership, quality improvement and patient safety in promoting safe, high-quality care for diverse patients across healthcare systems and environments.
  3. Analyze and apply evidence from research and other information sources as a basis for nursing practice.
  4. Incorporate knowledge and skills in using information systems and a range of patient-care technologies to facilitate delivery of quality patient care.
  5. Advocate for financial and regulatory healthcare policies, processes, and environments that improve the nature and functioning of the healthcare delivery system and nursing practice.
  6. Collaborate and communicate effectively with healthcare professionals to promote positive working relationships, improve patient health outcomes, and deliver quality, safe patient care.
  7. Promote individual and population health by assessing factors that influence individual and population health and apply principles and culturally appropriate health promotion and disease-prevention strategies. Demonstrate consistent application of the core values of the discipline of nursing and the professional standards of moral, ethical, and legal conduct.
  8. Demonstrate consistent application of the core values of the discipline of nursing and the professional standards of moral, ethical, and legal conduct.
  9. Integrate the knowledge, skills, and attitudes expected of baccalaureate prepared nurses by providing professional nursing care to diverse patients and populations across the lifespan, healthcare settings, and healthcare environments.


  1. Integrate knowledge from liberal arts, sciences, and nursing to plan complex disease management for adults with acute and life-threatening illnesses. (Essential I, IX)
  2. Synthesize evidence, clinical judgment, interprofessional perspectives, and patient preferences in assessing, planning, and evaluating quality nursing care of acutely and critically ill adults. (Essential II, VII, IX)
  3. Evaluate the psychosocial impact of acute and life-threatening illness on adults and multigenerational families. (Essential I, IX)
  4. Examine end-of-life and palliative care issues, such as symptom management, support of rituals, and respect for patient and family preferences. (Essential IX)
  5. Evaluate effective communication strategies when interacting with the patient, the patient’s support systems, and within the interprofessional healthcare team. (Essential II, IV, IX)
  6. Integrate age, culture, spirituality, patient preferences, and health literacy to plan teaching for acutely and critically ill adult patients and their families. (Essential IX)
  7. Examine patient care technologies that support safe and quality nursing care of acutely and critically ill adult patients. (Essential IV)


A = 4 points (90-100)
B = 3 points (80-89)
C = 2 points (75-79)
D = 1 point (66-74)
F = 0 points (65 or below)


Successful completion of NURS 4315 requires the achievement of objectives for the course.

Grade Percentages:

70% - Exams
15% - ATI Medical Surgical Content Mastery Exam
15% - Assignments/graded activities

100% - Total

NOTE: Completing the Adult Medical-Surgical ATI proctored exam is mandatory for all students in this course. Please refer to ATI section below.


1.    Each course exam will have questions of equal weight and will be timed.

2.    To reinforce learning, promote understanding of content, and maintain the integrity of exams, the following policies apply:

a.     Students who wish to review missed exam items must make an appointment with the clinical faculty member (time frame to schedule the review will be announced prior to the exam). 

b.     Group test reviews will not be done.

3.    A blueprint of each examination will be available at least two weeks prior to the scheduled date of the exam. Scheduled time for each exam may vary based on the number of items on the exam.

Class Cancellation: If class is canceled for any reason, the student is expected to complete the readings and class objectives for that day(s). The content will still be included on course examinations.

Assignments/Graded Activities

1.       All course work must be completed on or before the due date. Late work will not be accepted.

2.      All course assignments must represent the student's own accomplishments. Group work may be allowed and in that case, each student must submit his/her own assignment. Disciplinary action will be taken in the event of scholastic dishonesty. Scholastic dishonesty includes such acts as cheating, plagiarism, and collusion.



  1. Examination items are the proprietary intellectual property of the university and are not to be shared by students. Sharing of exam items by students is considered cheating and is subject to disciplinary action. There are no legal test item banks available to students in the SON other than those provided with the ATI NCLEX –RN exam preparation materials.
  2. Exams are required.
  3. Students are expected to take examinations at the scheduled time.
  4. The student must notify the course coordinator prior to the scheduled exam time if they are unable to take the exam as scheduled.  Failure to make this notification in advance will result in a "zero" for that examination.
  5. If the excuse is accepted as reasonable and necessary, arrangements will be made for a make-up examination.
  6. Exam content is based on course, class, and clinical objectives.  Included are all required readings, lecture and discussion, related material in the course packet, media presented in or required for class, material handed out, and material on Canvas.
  7. Students should follow the School of Nursing dress code during exams. 
  8. Students must leave all food and drink, books, purses, and backpacks in an area designated by exam proctors.  If available, students are encouraged to leave personal items in lockers.  No hats, caps or head coverings may be worn during exams, with the exception of those required for religious purposes.
  9. When entering the classroom for an exam, students will show their School of Nursing badge to the proctor.  Proctors will ensure only the students eligible to take the exam receive access to the test and take the exam in an approved testing location.  During the exam, students will wear their badge on the upper chest area.
  10. Calculators, scratch paper and pencils are provided by the School of Nursing for exams.  Proctors will distribute the scratch paper after students have initiated the exam.
  11. If students arrive late, no extra time to complete the exam will be given.
  12. Each student is responsible for making sure that he or she has completed the exam before the exam is turned in to a proctor.  Under no circumstances will a student be allowed to retrieve his or her exam materials after turning them in to the test proctor.
  13. Students will be given the opportunity to review exams.  


  1. To pass the course, a student must have a weighted average of 75% on all graded activities.
  2. Students must make a "C" (75) or higher in all nursing courses to progress in the program.


The final grade will be calculated to two decimal places and rounded mathematically as follows:


Attendance in class is an expectation of each student.


  1. If written assignments are made in a course they are required.
  2. Students are expected to submit written work on the scheduled date and time.
  3. The student must notify the course coordinator prior to the scheduled due date and time if they are unable to submit the written work as scheduled. Failure to make this notification in advance will result in a "zero" for that written work.
  4. If the excuse is accepted as reasonable and necessary, arrangements will be made for an alternative due date and time.
  5. Each student is responsible for making sure that he or she has completed the written work prior to submission.
  6. Late work will be accepted with consequences as outlined per course syllabi.


The APA Publication Manual 6th edition is required for use in all nursing school programs. 

Assessment Technologies Institute®, LLC (ATI) RN CONTENT MASTERY SERIES®

UTHSCSA School of Nursing utilizes the ATI RN Content Mastery Series®, RN Comprehensive Predictor® practice and proctored exams, and the ATI Virtual "greenlight" program to assist students in preparing for the NCLEX-RN® exam. Through practice and proctored examinations, students are able to assess their own knowledge and receive feedback and direction for content review throughout the program of study.

The proctored exams are administered in specific courses in both undergraduate tracks.

In order for a student to take the course related proctored exam, students will take the non-proctored (Practice A and B) tests individually, as often as they wish with a minimum of a 24 hour wait period between attempts. The student should engage in a minimum of one hour focused review on missed topics and/or identify three critical points to remember. Achievement of a 90% or higher individual score is required prior to taking the proctored test. Students may be required to show documentation by submitting a printed copy of the individual student transcript to the faculty prior to testing. Non-proctored tests are pass/fail.

To strengthen the review method, if students did not achieve a 90% or greater on the practice exam, students should understand the rationales for each distracter. It is recommended that students review 5-15 questions at a time with ample time given to review each of the rationales. When the student logs in again, the exam will continue from where the student had stopped previously.

Content Mastery Exams will comprise 15% of the total course grade. The following provides guidelines for inclusion of the CME in the course grade.

                   Content Mastery Examinations Requirements


 1st ATI Exam  (15% of Course Points)

2nd ATI Exam      (15% of Course Points)


100% of points  

85% of points


90% of points

80% of points    


*0% of points, develop focused review** and must retake exam

0% of points

Less than Level 1

*0% of points, develop focused review** and must retake exam

0% of points

*Level 1 and below: An individualized student success plan will be developed and implemented in conjunction with faculty to help student attain content mastery.

* Focused review consists of printing out the specific proctored “report” and using either the available ATI templates or a plain piece of paper to handwrite all of the missed items under “Topics to Review” and label each missed item with the topic descriptors. This handwritten remediation will be stapled with the student’s proctored “report”. 

The RN Comprehensive Predictor will be given in Nurs 4420 (traditional BSN program) or Nurs 4423 accelerated BSN program).


Students are expected to be above reproach in all scholastic activities. Students who engage in scholastic dishonesty are subject to disciplinary penalties, including the possibility of failure in the course and dismissal from the university. "Scholastic dishonesty includes but is not limited to cheating, plagiarism, collusion, and submission for credit of any work or materials that are attributable in whole or in part to another person, taking an examination for another person, any act designed to give unfair advantage to a student or the attempt to commit such acts." Regents Rules and Regulations, Part One, Chapter VI, Section 3, Subsection 3.2, Subdivision 3.22.


Students who are nurses or are preparing to enter the profession of nursing are expected to treat others with respect and compassion. “The principle of respect for persons extends to all individuals with whom the nurse interacts. The nurse maintains compassionate and caring relationships with colleagues and others with a commitment to the fair treatment of individuals, to integrity-preserving compromise and to resolving conflict. This standard of conduct precludes any and all prejudicial actions, any form of harassment or threatening behavior, or disregard for the effects of one’s actions on others” (American Nurses Association Code for Nurses, Interpretive Statement 1.5).

The students, faculty, Department Chairs, Associate Deans, and the Dean of the School of Nursing of the University Texas Health Science Center San Antonio subscribe to the highest standards of conduct. Our aim is professional behavior beyond reproach. Failure to abide by the signed code of professional conduct may lead to suspension and/or permanent dismissal from the UTHSCSA SON. In particular, we subscribe to the provisions of the Code of Ethics for Nurses (http://bit.ly/1mtD5p2) and the following points of conduct.



Any student seeking reasonable accommodations through the Americans with Disabilities Act (ADA) should contact either the Associate Dean for Admissions and Student Services within the first week of the semester or schedule a meeting with the UTHSCSA ADA Compliance Office so that appropriate accommodations may be arranged. A request for accommodations (Form ADA-100: http://uthscsa.edu/eeo/form100-Faculty-student-resident.pdf) must be completed and submitted to the Executive Director of the ADA Compliance Office before accommodations can be provided. Additional information can be provided in the Student Success Center, Room 1.118 or through the ADA Compliance Office website: http://uthscsa.edu/eeo/request.asp.


Assessment Technologies Institute (ATI) Materials (students should already have the Med-Surg)

Lewis, S.M., Bucher, L., I. C., & Heitkemper, M. M. (2017).Medical surgical nursing: Assessment and management of clinical problems. St.Louis: MO: Mosby.(10th edition). ISBN 9780323328524

Students should already have this textbook


Lewis, S.M., Collier, I. C., & Heitkemper, M. M. (2017). Study Guide for Medical Surgical Nursing: Assessment and management of clinical problems. St.Louis: MO: Mosby.(9th edition). ISBN 9780323328524


1.       Stress response

2.      ICU Environment

3.      End-of-Life Care

4.      Organ Donation

5.       Diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic syndrome (HHS)

6.      Acute Coronary Syndrome, Heart Failure, Cardiomyopathy, Cardiac Surgery & Cardiogenic Shock

7.      Dysrhythmias

8.      Hypertensive Crisis

9.      Abdominal Aortic Aneurysm (AAA)

10.   Arterial Blood Gases (ABG’s)

11.   Acute neurologic conditions

12.   ARDS, pulmonary edema, pulmonary embolism, pneumothorax, chest tubes, mechanical ventilation

13.   Burns

14.   Oncologic emergencies

15.   Inflammation (SIRS/DIC/MODS) Sepsis/septic shock

16.   Acute kidney injury

17.   Liver failure

18.   Acute abdomen

19.   Pancreatitis

20.  Trauma

CALENDAR - 1st Day Only

Please check the schedule for recent updates on Class Dates & Room.

Date: October 18, 2018
First Class Day from 1300-1600. Objectives and readings for the class will be posted one week prior to class.


Please note 4316 Adult II Clinical begins before 4315

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