DNP 625 Module 2 Neurological Vignette Discussion Example

Course	DNP 625 Management of Common Health Problems in Adult-Gerontology Theory
Module	Module 2
Paper type	Clinical vignette discussion post and replies
Length	About 492 words
Format	Discussion post with APA 7 citations
School	Arizona State University
Program	Doctor of Nursing Practice
Updated	October 2026

Free sample paper for DNP 625 Module 2

Clinical Vignette Discussion Board 2: Legs That Will Not Settle at Night

The Urge to Move at Night: Evaluating and Treating Restless Legs Syndrome in an Older Woman

The Vignette (Summary)

Mrs. L., 66, has had uncomfortable, crawling sensations in both calves for a year. They begin in the evening when she sits to watch television, ease when she walks and keep her awake. She takes sertraline for depression and an over-the-counter antihistamine to help her sleep. Her husband says she snores.

Assigned Question: Evaluation and Management

Her history meets the essential features of restless legs syndrome (RLS) in the international consensus criteria (Allen et al., 2014): an urge to move the legs, usually with unpleasant sensations, that begins or worsens at rest, is relieved by movement and is worse in the evening or at night. I would rule out mimics such as leg cramps, positional discomfort and peripheral neuropathy through the history and a focused neurologic and vascular examination.

Iron comes first. The American Academy of Sleep Medicine's 2025 guideline asks clinicians to check serum iron studies, including ferritin and transferrin saturation, in everyone with clinically significant RLS, ideally in the morning without recent iron intake, and notes that adults may benefit from iron replacement when ferritin is at or below 75 ng/mL or transferrin saturation is below 20%, thresholds higher than those used for the general population (Winkelman et al., 2025).

The next step is removing what makes RLS worse. The guideline lists alcohol, caffeine, sedating antihistamines, serotonergic and antidopaminergic medicines and untreated obstructive sleep apnea (Winkelman et al., 2025). Mrs. L. has three possible contributors: the antihistamine, the sertraline and possible sleep apnea given her snoring. I would stop the antihistamine, discuss with her whether an antidepressant less likely to worsen RLS is appropriate, and screen for sleep apnea.

If symptoms remain, medication choice has changed. The guideline now favors alpha-2-delta ligands, such as gabapentin and pregabalin, and recommends against the standard use of dopamine agonists because of augmentation, a worsening of symptoms over time with treatment (Winkelman et al., 2025). Doses in older adults should be started low with attention to dizziness and falls.

I would refer to neurology or sleep medicine if the diagnosis is uncertain, symptoms persist despite these steps, or she has augmentation from prior treatment.

What this page is doingThe answer follows the guideline's own order, iron studies, then aggravating factors, then medication, and applies each step to this patient's specific medicines and snoring, which is the clinical reasoning a vignette board rewards.

Reply to a Classmate (Assigned Question: Pharmacology)

You explained augmentation well, and an international task force has described the same pattern and how to prevent it (Garcia-Borreguero et al., 2016): symptoms start earlier in the day, spread to the arms and become more intense on a dopamine agonist. That helps explain why the newer guideline steered away from these drugs as first choices. Did you find advice on how to taper a patient already on one?

Reply to a Classmate (Assigned Question: Differential Diagnosis)

Your differential included obstructive sleep apnea as a cause of poor sleep. In this case it may be both a mimic and a trigger. Treating the apnea might improve her sleep and her leg symptoms at once.

References

Allen, R. P., Picchietti, D. L., Garcia-Borreguero, D., Ondo, W. G., Walters, A. S., Winkelman, J. W., Zucconi, M., Ferri, R., Trenkwalder, C., & Lee, H. B. (2014). Restless legs syndrome/Willis-Ekbom disease diagnostic criteria: Updated International Restless Legs Syndrome Study Group (IRLSSG) consensus criteria. History, rationale, description, and significance. Sleep Medicine, 15(8), 860-873. https://doi.org/10.1016/j.sleep.2014.03.025

Garcia-Borreguero, D., Silber, M. H., Winkelman, J. W., Högl, B., Bainbridge, J., Buchfuhrer, M., Hadjigeorgiou, G., Inoue, Y., Manconi, M., Oertel, W., Ondo, W., Winkelmann, J., & Allen, R. P. (2016). Guidelines for the first-line treatment of restless legs syndrome/Willis-Ekbom disease, prevention and treatment of dopaminergic augmentation: A combined task force of the IRLSSG, EURLSSG, and the RLS-foundation. Sleep Medicine, 21, 1-11. https://doi.org/10.1016/j.sleep.2016.01.017

Winkelman, J. W., Berkowski, J. A., DelRosso, L. M., Koo, B. B., Scharf, M. T., Sharon, D., Zak, R. S., Kazmi, U., Falck-Ytter, Y., Shelgikar, A. V., Trotti, L. M., & Walters, A. S. (2025). Treatment of restless legs syndrome and periodic limb movement disorder: An American Academy of Sleep Medicine clinical practice guideline. Journal of Clinical Sleep Medicine, 21(1), 137-152. https://doi.org/10.5664/jcsm.11390

Reading the DNP 625 Module 2 assignment instructions

The posted syllabus places the second Clinical Vignette Discussion Board in Week 10, the neurological system. As with the first board, a clinical case is posted, questions are divided among the discussion group, and each member posts an answer to an assigned question by the deadline and then engages through the week. Canvas holds the case, posting deadlines and rubric, and both boards together account for 15% of the grade. Expect to answer your assigned question with current guideline evidence applied to the patient in the vignette, especially details that change management, such as the patient's medications or other conditions. Keep to your question so classmates can cover theirs, and plan replies that connect the group's answers into a complete picture of the case.

Inside the DNP 625 Module 2 example

The post summarizes the vignette in a short paragraph, including the details that later matter: her antidepressant, her sleep aid and her husband's report of snoring. The answer then confirms the diagnosis against the essential features and names mimics to exclude. It follows the current guideline's order, iron studies with thresholds, aggravating factors applied to this patient's medications and possible sleep apnea, and then medication choice, noting the guideline's move away from dopamine agonists and the need for caution with doses in older adults. Referral triggers close the answer. Two replies link classmates' answers on pharmacology and differential diagnosis to the case. Each recommendation is tied to a detail in the vignette, so the answer reads as care for this patient rather than a summary of the guideline.

Reading the DNP 625 Module 2 grading rubric

Graders will probably look for an accurate, complete answer to the assigned question, use of the most current guideline, application to the specific patient, clinical reasoning, constructive replies and timely posting. Credit goes to answers that notice details in the vignette that change care, such as medications that worsen symptoms. Citing a recent guideline, and knowing what changed from older advice, shows up-to-date practice. Safety considerations for older adults, such as fall risk with sedating drugs, show gerontological focus. Replies that tie a classmate's answer back to the case advance the group's understanding. Brevity with substance suits a busy board. Mentioning when to refer shows awareness of the limits of primary care management.

DNP 625 Module 2 help with common mistakes

A frequent miss is recommending a dopamine agonist as first-line because older references did; check the newest guideline. Another is overlooking the patient's own medications as causes. Iron studies come before medication decisions, so mention them early. If you would like help preparing an answer for your own vignette question, send the case and your assigned question to the desk. Keep doses general unless your question asks for them. Read the full case even if your question covers one part, since other details may change your answer. If your vignette includes medications, look each one up for effects on the condition in question. Close with a referral plan, since faculty often ask about it.

Write yours, or have the desk draft it

This paper is an original model document written by our desk, not a submitted student paper and not an official Arizona State University document. Read it for the moves, then write your own to the instructions in your classroom. If you want one built to your exact prompt and rubric, the first custom sample is free and arrives in 24 to 48 hours.

More DNP 625 and Doctor of Nursing Practice sample papers

DNP 625 Module 2 questions, answered

Where can I find a free DNP 625 Module 2 sample paper?

A complete DNP 625 Clinical Vignette Discussion Board 2 sample on evaluating and treating restless legs syndrome in an older woman, with two replies, is on this page.

What tests are needed for restless legs syndrome?

Serum iron studies, including ferritin and transferrin saturation, are recommended for everyone with clinically significant restless legs syndrome.

What medicines make restless legs worse?

Sedating antihistamines, many antidepressants, antidopaminergic drugs, alcohol and caffeine can worsen symptoms, as can untreated sleep apnea.

Are dopamine agonists still first-line for restless legs?

The 2025 sleep medicine guideline recommends against their standard use because of augmentation and favors alpha-2-delta ligands instead.

When is the second DNP 625 vignette board?

The syllabus places it in Week 10, the neurological system week.

DNP 625 Module 2 Clinical Vignette Discussion Board 2: Neurological Example