| Course | DNP 637 Management of Complex and Chronic Health Problems in Children, Adults and Families |
|---|---|
| Module | Module 2 |
| Paper type | Case study discussion post with two peer replies |
| Length | About 630 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 637 Module 2
Case Study Discussion Board 2: She Asked About PrEP at Her Hormone Visit
A Question at the Hormone Visit: PrEP Eligibility, Regimen Choice and Feminizing Hormones for a 26-Year-Old Transgender Woman
The Case and My Assigned Question
Alexis is a 26-year-old transgender woman (she/her) seen for routine follow-up of gender-affirming hormone therapy: oral estradiol 4 mg daily and spironolactone 100 mg twice daily. She asks about PrEP. She has receptive anal sex with cisgender male partners, uses condoms inconsistently and was treated for rectal gonorrhea four months ago. She has no symptoms today and reports no condomless sex in the past three days. My assigned question: Is she a candidate for PrEP, what testing is needed before starting, which regimen would you recommend and how does her hormone therapy affect the choice?
Initial Post
Eligibility
Alexis is a clear candidate. The CDC guideline recommends that all sexually active adults be informed about PrEP and that it be offered to people with indications such as a bacterial sexually transmitted infection in the past six months or inconsistent condom use with partners of unknown HIV status (Centers for Disease Control and Prevention, 2021). She has both. The USPSTF gives PrEP for people at increased risk a grade A recommendation, which means most insurance plans must cover it without cost sharing (US Preventive Services Task Force, 2023).
Baseline Testing
Before starting, I would confirm that she does not already have HIV with a laboratory antigen/antibody test and ask about symptoms of acute infection. Because she reports no exposure in the past 72 hours, PEP is not needed. Other baseline tests include serum creatinine with estimated creatinine clearance, hepatitis B surface antigen, antibody and core antibody (stopping tenofovir can trigger a flare in someone with hepatitis B), hepatitis C antibody, syphilis serology and gonorrhea and chlamydia testing at every exposed site, including rectal and pharyngeal swabs (Centers for Disease Control and Prevention, 2021). Spironolactone can raise potassium, so I would review her most recent electrolytes at the same draw.
Regimen Choice
She has three options. Daily emtricitabine/tenofovir disoproxil fumarate is effective and available as a generic. Daily emtricitabine/tenofovir alafenamide is approved for people at risk through sex, excluding receptive vaginal sex, which fits her current exposure. Long-acting injectable cabotegravir, given at months 0 and 1 and then every two months, outperformed daily oral PrEP in HPTN 083, which enrolled cisgender men and transgender women with male partners, largely because adherence to pills was the weak point (Landovitz et al., 2021). I would present all three and let her choose; if she expects trouble with daily pills, the injection is the stronger option.
Hormone Therapy
Many transgender women worry that PrEP will weaken their hormones. The evidence does not show a clinically meaningful drop in estradiol, and while feminizing hormones may modestly lower tenofovir levels, daily dosing keeps levels in the protective range. For that reason, CDC advises against the on-demand "2-1-1" schedule for transgender women. Telling her this directly may matter more to her adherence than any other point.
Reply to a Classmate (On PEP)
Jordan, your question on PEP is a good companion to mine. If Alexis had reported condomless sex two days ago, the plan would change: start a 28-day PEP regimen today, since it must begin within 72 hours, and then move directly to PrEP once PEP is finished and a repeat HIV test is negative. Would you start the injectable option at that point or begin with oral PrEP first?
Reply to a Classmate (On Organ-Based Screening)
Sam, I agree that screening should follow the organs a patient has, not the gender marker in the chart. An organ inventory, asked respectfully and recorded once, lets us order the right STI sites now and the right cancer screening later, such as prostate screening for transgender women at the usual ages (Coleman et al., 2022).
References
Centers for Disease Control and Prevention. (2021). Preexposure prophylaxis for the prevention of HIV infection in the United States: 2021 update: A clinical practice guideline. https://www.cdc.gov/hiv/pdf/risk/prep/cdc-hiv-prep-guidelines-2021.pdf
Coleman, E., Radix, A. E., Bouman, W. P., Brown, G. R., de Vries, A. L. C., Deutsch, M. B., Ettner, R., Fraser, L., Goodman, M., Green, J., Hancock, A. B., Johnson, T. W., Karasic, D. H., Knudson, G. A., Leibowitz, S. F., Meyer-Bahlburg, H. F. L., Monstrey, S. J., Motmans, J., Nahata, L., ... Arcelus, J. (2022). Standards of care for the health of transgender and gender diverse people, version 8. International Journal of Transgender Health, 23(Suppl. 1), S1-S259. https://doi.org/10.1080/26895269.2022.2100644
Landovitz, R. J., Donnell, D., Clement, M. E., Hanscom, B., Cottle, L., Coelho, L., Cabello, R., Chariyalertsak, S., Dunne, E. F., Frank, I., Gallardo-Cartagena, J. A., Gaur, A. H., Gonzales, P., Tran, H. V., Hinojosa, J. C., Kallas, E. G., Kelley, C. F., Losso, M. H., Madruga, J. V., ... Grinsztejn, B. (2021). Cabotegravir for HIV prevention in cisgender men and transgender women. New England Journal of Medicine, 385(7), 595-608. https://doi.org/10.1056/NEJMoa2101016
US Preventive Services Task Force. (2023). Preexposure prophylaxis to prevent acquisition of HIV: US Preventive Services Task Force recommendation statement. JAMA, 330(8), 736-745. https://doi.org/10.1001/jama.2023.14461
Reading the DNP 637 Module 2 assignment instructions
Case Study Discussion Board 2 falls in Week 14, when DNP 637 covers HIV, PrEP and PEP and gender inclusive care, the same week the APEA predictor exam reflection is due. The format repeats the first board: one shared case, a question for each group member, your answer posted first and then two or more replies to peers, all between Monday and Friday. Deadlines and the grading rubric are in Canvas, and this board shares a 10% slice of the grade with the Week 7 board. Expect the week's two topics to meet in the case, so a strong answer handles the clinical question and also the way care is delivered, including names, pronouns and anatomy-based decisions.
Inside the DNP 637 Module 2 example
Like the first board sample, this one restates the case briefly and quotes the assigned question before answering it. Four headings track the question's four parts. Eligibility cites the guideline's indications and the USPSTF grade, which also answers the cost question patients often ask. Baseline testing lists each test with a short reason, including the hepatitis B check that guards against a flare and STI testing at every exposed site. Regimen choice compares the three options and ties the injectable choice to adherence. The hormone section answers the patient's likely worry directly. The case uses the patient's name and pronouns throughout. Two replies take up PEP timing and organ-based screening, each adding one specific point and a question or citation.
Where the marks sit in the DNP 637 Module 2 rubric
Points on the case boards come from the Canvas rubric, and the two boards share 10% of the grade. Graders of nurse practitioner case boards look for a complete, accurate answer to the assigned question, reasoning anchored to the case, current guidelines cited correctly and replies that contribute something new. On a prevention question, an answer that names a regimen without baseline testing, follow-up intervals or the risk of starting PrEP in someone with undiagnosed HIV is incomplete. Respectful, inclusive language is part of clinical quality in this week's topic. Late posts lose 5% per day for up to seven days and then score zero, and a late initial post also leaves classmates without the answer their replies depend on.
DNP 637 Module 2 help from the desk
Common weaknesses include listing PrEP options without recommending one, skipping the HIV test before starting and forgetting hepatitis B, whose status changes how tenofovir is stopped. Another is giving one follow-up interval for every regimen; oral PrEP and the injection have different testing schedules. Keep the patient's name and pronouns consistent, and avoid language that treats gender identity as the risk factor; behaviors and exposures are what matter. Check whether a recent exposure calls for PEP first. Replies should add a fact or source, not agreement alone. No generative AI is allowed in this course, so build your answer from the guideline and the case. With your assigned question and the case details, the desk can help you outline a response.
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.
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DNP 637 Module 2 questions, answered
Where can I find a free DNP 637 Module 2 sample paper?
A full DNP 637 Module 2 sample is on this page: a Case Study Discussion Board 2 answer on PrEP for a transgender woman on estradiol, covering eligibility, testing, regimen choice and hormones.
What tests are needed before starting PrEP?
An HIV antigen/antibody test, creatinine clearance, hepatitis B and C serology, syphilis testing and gonorrhea and chlamydia testing at every exposed site, plus a check for recent exposure.
Does PrEP interact with feminizing hormone therapy?
Studies have not shown a meaningful drop in estradiol; hormones may modestly lower tenofovir levels, so daily dosing is advised and on-demand dosing is not recommended for transgender women.
What is the difference between PrEP and PEP?
PrEP is taken before possible exposure to prevent HIV; PEP is a 28-day course started within 72 hours after a possible exposure.
What topics does DNP 637 cover in Week 14?
Week 14 covers HIV, PrEP and PEP and gender inclusive care, with Case Study Discussion Board 2 and the APEA predictor exam reflection due.