| Course | PA 502 Evidence Based Medicine |
|---|---|
| Week | 2 |
| Paper type | Bedside question brief |
| Length | About 710 words, 5 pages |
| Format | APA 7 student paper |
| School | Chamberlain University |
| Program | Master of Physician Assistant Studies (MPAS) |
| Updated | October 2026 |
Free sample paper for PA 502 Week 2
Bedside Question Brief: Would a Systolic Target Below 120 Help a 76-Year-Old With Treated Hypertension and Kidney Disease More Than It Harms?
Student Name
Chamberlain University
PA 502: Evidence Based Medicine
Instructor Name
Month Day, Year
Bedside Question Brief: Would a Systolic Target Below 120 Help a 76-Year-Old With Treated Hypertension and Kidney Disease More Than It Harms?
The Question
For a treated hypertensive patient of 76 with an eGFR of 52, with neither diabetes nor a past stroke, does a systolic blood pressure target below 120 mm Hg, compared with below 140 mm Hg, reduce major cardiovascular events and death over about three years, and how many more serious adverse events, such as fainting, low blood pressure and acute kidney injury, does it cause?
Where the Question Came From
The question came from the patient, during a routine visit on my family medicine rotation, after a neighbor reported that his doctor wanted his systolic pressure under 120. The patient's office reading was 146/82, taken by me with the patient talking, and the patient's home readings over the previous month averaged about 138 systolic. The patient takes two antihypertensive medicines, an ACE inhibitor and a calcium channel blocker, lives alone, walks daily and had one fall eight months ago after tripping on a curb. My preceptor's answer in the room was that under 140 was fine at the patient's age. One raised question came from the patient and one from me: is my preceptor's answer supported, or is it habit?
Minutes, Counted Honestly
I have about 30 minutes for this question before the patient's follow-up visit in four weeks, if I want an answer ready. That is enough to find and read the abstract and key tables of one or two trials and one guideline, not enough for a systematic review. I will look first for a randomized trial that compared these two targets in people like this patient, then for any analysis of older participants in that trial, and then for what major guidelines say, since they may disagree.
The Shape of the Answer, Declared Early
Before reading anything, I am stating what a useful answer would look like. It would be two numbers over a stated period: how many people like this patient need to be treated to the lower target to prevent one major cardiovascular event, and how many would need to be treated for one to have a serious adverse event. If the trial reports those events as counts with denominators, I can calculate both. A useful answer would also say whether the trial measured blood pressure the way we do in clinic, since a target only means something if the measurement matches.
What Would Change Either Way
The answer matters only if it could change what we do. If the lower target prevents substantially more events than it causes harm in people like this patient, the next step would be to discuss adding or increasing a medicine and checking kidney function and standing blood pressure soon after. If the benefit is small, or the harms fall heavily on older people with kidney disease, the next step would be to keep the current target and tell the patient why. If the answer is uncertain, the next step would be a shared decision based on what the patient values most, such as avoiding a stroke or avoiding dizziness and falls. Each result leads to a different visit, so the question is worth the 30 minutes.
What I Already Suspect
I suspect the main trial will favor the lower target overall, since it was stopped early for benefit (SPRINT Research Group, 2015), and I suspect at least one guideline recommends a higher target for adults over 60 (Qaseem et al., 2017). I am writing these suspicions down so that I can check whether the evidence changes them, rather than reading only for confirmation.
What I Will Not Try to Answer
This brief does not ask which drug to add, how to measure blood pressure at home or whether the patient's kidney disease needs separate treatment. Each is a fair question, but each would need its own search, and trying to answer all of them in 30 minutes would answer none.
References
Qaseem, A., Wilt, T. J., Rich, R., Humphrey, L. L., Frost, J., & Forciea, M. A. (2017). Pharmacologic treatment of hypertension in adults aged 60 years or older to higher versus lower blood pressure targets: A clinical practice guideline from the American College of Physicians and the American Academy of Family Physicians. Annals of Internal Medicine, 166(6), 430-437. https://doi.org/10.7326/M16-1785
SPRINT Research Group. (2015). A randomized trial of intensive versus standard blood-pressure control. New England Journal of Medicine, 373(22), 2103-2116. https://doi.org/10.1056/NEJMoa1511939
What the PA 502 Week 2 assignment asks for
Week two asks for a short brief built around one clinical question you could answer in the time you actually have. Put the question at the top in a single sentence, tight enough that a reader can tell an answer from an evasion. Record where the question came from and who raised it. Estimate honestly how much time you can spend and what kind of evidence that time allows. Say before you search what a useful answer would look like, such as a number needed to treat over a stated period. Explain what each possible answer would change in practice, since a question whose answers lead to the same next step is not worth the time. Note the questions you are deliberately leaving out.
Inside the PA 502 Week 2 example
The brief's question names the patient group, the two targets, the outcomes and a three-year horizon. Its origin section gives the office reading of 146 taken while the patient talked, home readings near 138, two medicines, living alone, daily walks and one trip-and-fall, along with the preceptor's answer. The time section allows 30 minutes for a trial, any older subgroup and a guideline. The answer's shape is two numbers, to treat and to harm, plus a check on measurement. Each possible answer leads to a different visit plan. The student records suspicions that the trial favored the lower target and that a guideline disagreed, and leaves out drug choice and home monitoring.
Where the points sit in the PA 502 Week 2 rubric
The failure that costs most here is a question wide enough to need a textbook, where managing a whole condition is offered as though an afternoon could settle it. Next is a brief in which every possible answer leads to the same next step, so the document turns out to have no reason to exist. Briefs that hide the time available, never say what a useful answer would look like or skip where the question came from also lose points. Strong briefs state one tight question at the top, give its origin, count the minutes honestly, declare the answer's shape in advance, explain what each answer would change and set aside related questions on purpose. Writing down suspicions before searching is a mark of honest work and is often rewarded.
PA 502 Week 2 help from the desk
Narrowing a question to one you can answer in a short time is the main skill this brief tests, and most first drafts are too broad. If you share the clinical situation and how much time you really have, we can help you tighten the question to one sentence, decide what kind of evidence you can reach and state in advance what a useful answer would look like. Spelling out what each possible answer would change is a step we can work through together. The question and the clinical details stay yours. Where a section supplies a brief template, the custom sample keeps its blocks in order with the question still at the top.
Get a PA-502 Week 2 example written to your instructions
Send your assignment instructions or rubric and a line or two about the question you want the brief built around, and a custom PA-502 Week 2 bedside question brief is written to your section's requirements and returned inside 24-48h. The first one is free, and nothing is reused from a template.
More PA 502 papers and MPAS samples
- PA 502 Week 1: Clinical Question Post
- PA 502 Week 3: NNT Calculation
- PA 502 Week 4: Surrogate Outcome Critique
- PA 502 Week 5: Applicability Write-up
- PA 502 Week 6: Guideline Comparison
- PA 502 Week 7: Decision Aid Draft
- PA 502 Week 8: Journal Club Brief
- PA 501 Week 2: Origins of the Profession Essay
PA 502 Week 2 questions, answered
Is this the same document as a formal question worksheet?
It overlaps and the object differs. A worksheet is graded on whether the elements are present and correctly labeled. This brief is graded on whether the question is worth the time it would take to answer, which is why the consequences block carries so much of the mark. Send your section wording and the example is built to whichever of the two yours is marking.
Can the brief use a question I have no way of answering?
Yes, and some sections ask for exactly that, since a question that turns out to be unanswered in the published work is a real result. What the brief still has to show is that the question was well formed before anybody went looking. Say what would have settled it, and note that the answer does not appear to exist yet.
How specific does the alternative have to be?
Specific enough that somebody else could set the two options side by side. Usual care is not an alternative until the brief says what it consists of in the clinic under discussion, including the option of doing nothing at all. This is where most early briefs give ground, because the treatment gets three sentences and the other option gets a phrase.
Where can I find a free PA 502 Week 2 sample paper?
You can read the full PA 502 Week 2 bedside question brief on a blood pressure target for a 76-year-old on this page.
What does the PA 502 Week 2 sample say a useful answer would be?
Two numbers over a stated period, the number needed to treat and the number needed to harm, plus a check that the trial measured blood pressure as the clinic does.