| Course | NU 631 Healthcare of Women across the Lifespan |
|---|---|
| Unit | Unit 5 |
| Paper type | Screening result management algorithm |
| Length | About 1,000 words, 6 pages |
| Format | APA 7 student paper |
| School | Herzing University |
| Program | MSN Family Nurse Practitioner |
| Updated | October 2026 |
Free sample paper for NU 631 Unit 5
Algorithm for an HPV-Positive ASC-US Cervical Screening Result in a 34-Year-Old Under the 2019 ASCCP Risk-Based Guidelines
Student Name
Department of Nursing, Herzing University
NU 631: Healthcare of Women across the Lifespan
Instructor Name
February 23, 2026
Algorithm for an HPV-Positive ASC-US Cervical Screening Result in a 34-Year-Old Under the 2019 ASCCP Risk-Based Guidelines
The Test, the Result, and the Guidance Applied
Ms. V., a composite 34-year-old, had routine cotesting, cytology together with high-risk human papillomavirus (HPV) testing, which is one of the recommended screening strategies for people aged 30 to 65 (US Preventive Services Task Force, 2018). The result is atypical squamous cells of undetermined significance (ASC-US) cytology with a positive HPV test for high-risk types other than 16 and 18. This algorithm applies the 2019 American Society for Colposcopy and Cervical Pathology (ASCCP) risk-based management consensus guidelines (Perkins et al., 2020), which replaced result-based pathways with management based on each patient's estimated risk of cervical intraepithelial neoplasia grade 3 or worse (CIN3+). The guidelines are intended to be used with the ASCCP risk tables or app, since risk depends on the current result combined with history.
Context That Changes the Pathway
History matters because a prior negative HPV test lowers risk and a prior abnormal result raises it. Ms. V. moved from another state; she believes her last screening was normal about five years ago, but the record could not be obtained after two requests. Under the guidelines, an undocumented history is treated as unknown. She is not pregnant, not immunocompromised, and has no history of treatment for cervical precancer. She would like to have another child in the next two years, which matters if treatment becomes necessary.
The Algorithm
Branch 1, today's result: HPV-positive ASC-US with unknown history. The estimated immediate risk of CIN3+ for this combination is about 4.4% (Egemen et al., 2020), which is above the 4% threshold at which colposcopy is recommended. Action: colposcopy within about three months. Expedited treatment without colposcopy is not an option at this risk level. For comparison, had her HPV test been positive for type 16 or 18, her risk would have been higher, colposcopy would be recommended regardless of cytology, and, with HPV 16 and a high-grade cytology result, expedited treatment would become an option; had her cytology been negative with HPV positive for other types and an unknown history, her immediate risk would have been below the colposcopy threshold and repeat testing in one year would have been recommended instead.
Branch 2, colposcopy findings. If the colposcopy is adequate and biopsies show no lesion or CIN1, go to Branch 3. If biopsies show CIN2, go to Branch 4. If biopsies show CIN3 or adenocarcinoma in situ, go to Branch 5. If colposcopy is inadequate or the transformation zone is not fully visible and a lesion is suspected, repeat colposcopy or perform an excisional procedure for diagnosis, based on the colposcopist's findings.
Branch 3, CIN1 or less after HPV-positive ASC-US. Action: repeat HPV-based testing in one year. If the one-year test is HPV negative, repeat in three years; if still negative, return to routine screening intervals. If the one-year test is HPV positive, return to colposcopy.
Branch 4, CIN2. Treatment by excision is generally preferred. Because Ms. V. wishes to become pregnant soon, observation with colposcopy and HPV-based testing every six months for up to two years is an acceptable alternative for CIN2, provided the colposcopy is adequate (Perkins et al., 2020). She would be counseled on both options, including the small increase in preterm birth risk after excision. If CIN2 persists for two years under observation, or progresses to CIN3, treatment is recommended.
Branch 5, CIN3 or adenocarcinoma in situ. Action: excisional treatment. Observation is not recommended for CIN3.
Branch 6, after any treatment for CIN2 or worse. Action: HPV-based testing at six months. If negative, repeat annually until three consecutive negative tests, then every three years for at least 25 years, even if that extends beyond age 65. A positive test after treatment returns her to colposcopy.
What She Is Told at Each Point
Today: "Your screening test found a type of HPV that can cause changes in the cells of the cervix, along with a mild change on the Pap test. This is common and usually clears on its own, but the combination means we should take a closer look with a test called colposcopy, which uses a magnifying scope and may involve taking small samples. This is not a cancer diagnosis." After colposcopy: each result is explained with what happens next and why, using the branch that applies. If treatment is recommended, the procedure, its purpose, and its effect on future pregnancy are explained in writing as well as in person.
Tracking and Non-Attendance
Loss to follow-up after an abnormal result is the largest real-world failure of this pathway. Her result is entered in the clinic's abnormal result tracking log with the due date for colposcopy. The colposcopy appointment is booked before she leaves the clinic. If she does not attend, the clinic makes three contact attempts by phone and text over two weeks, then sends a letter by mail and a portal message explaining the importance of follow-up. If there is no response after 30 days, the case is reviewed by the clinician and documented. Barriers are asked about directly at each contact, including transportation, time off work, child care, cost, and fear of the procedure, and addressed where possible, for example with an early-morning appointment or a financial counselor referral.
Referral
Referral to a colposcopist within the practice's women's health service. The referral states the result, her unknown history, her pregnancy plans, and the question: colposcopy with biopsy as indicated, with management according to the 2019 guidelines.
Why Risk-Based Management Matters Here
Under older, result-based algorithms, HPV-positive ASC-US led to colposcopy for everyone. The 2019 guidelines produce the same recommendation for Ms. V., but for a different reason: her estimated risk, not the result category alone. Had her previous negative HPV test been documented, her risk might have been lower and the recommendation might have differed. That is why obtaining her prior records remains part of the plan, and why the clinic will continue to request them before her colposcopy.
References
Egemen, D., Cheung, L. C., Chen, X., Demarco, M., Perkins, R. B., Kinney, W., Poitras, N., Befano, B., Locke, A., Guido, R. S., Wiser, A. L., Gage, J. C., Katki, H. A., Wentzensen, N., Castle, P. E., Schiffman, M., & Lorey, T. S. (2020). Risk estimates supporting the 2019 ASCCP risk-based management consensus guidelines. Journal of Lower Genital Tract Disease, 24(2), 132-143. https://doi.org/10.1097/LGT.0000000000000529
Perkins, R. B., Guido, R. S., Castle, P. E., Chelmow, D., Einstein, M. H., Garcia, F., Huh, W. K., Kim, J. J., Moscicki, A.-B., Nayar, R., Saraiya, M., Sawaya, G. F., Wentzensen, N., & Schiffman, M. (2020). 2019 ASCCP risk-based management consensus guidelines for abnormal cervical cancer screening tests and cancer precursors. Journal of Lower Genital Tract Disease, 24(2), 102-131. https://doi.org/10.1097/LGT.0000000000000525
US Preventive Services Task Force. (2018). Screening for cervical cancer: US Preventive Services Task Force recommendation statement. JAMA, 320(7), 674-686. https://doi.org/10.1001/jama.2018.10897
The Herzing NU 631 Unit 5 instructions
The Unit 5 assignment asks you to manage an abnormal screening result by building or applying an algorithm from current guidelines. Expect to state the test, the result and the exact guideline version used. History that changes risk, such as prior results, should be addressed. The algorithm should show each branch, the risk estimate or rule behind it and the next step, with follow-up intervals. Many sections ask what the patient is told at each point, in plain language. Tracking results and handling patients who do not return are commonly required. Referral content should be specific. Cite the guideline and its risk tables in APA 7, since version matters for this kind of assignment. Use an invented patient, and present the algorithm as a flowchart or numbered branches as your section prefers.
How this NU 631 Unit 5 example is built
The paper opens with the cotest result and names the guideline version and the risk tables behind it. The context section explains why an unknown history matters: a prior negative HPV test would lower risk, a prior abnormal result would raise it, and the plan uses the risk for unknown history. The algorithm is written as numbered branches, beginning with today's result and its immediate risk, which crosses the threshold for colposcopy. Later branches cover colposcopy findings and the surveillance intervals that follow each one. The patient communication section scripts what she hears today and after colposcopy, avoiding alarm while being clear. Tracking describes the clinic's abnormal result log and the calls and letters if she misses an appointment. The referral states her result, history, pregnancy plans and the clinical question.
NU 631 Unit 5 rubric: what full points look like
Herzing rubrics for a screening algorithm usually reward correct guideline application, risk-based reasoning, algorithm completeness, patient communication, follow-up systems and evidence. Guideline points require the current version applied accurately, with the result category named correctly. Risk-based reasoning is the center of the grade: the risk estimate must appear, along with and the threshold it crosses. Completeness is credited when each branch leads to a defined next step and interval. Communication points go to plain explanations at each stage. Follow-up system points depend on tracking and a plan for non-attendance. Evidence points require the guideline and risk tables properly referenced. The writing line rewards a readable layout, whether flowchart or numbered branches, that another clinician could follow.
Common NU 631 Unit 5 mistakes, and how to avoid them
Algorithm papers commonly lose points by using an older result-based pathway instead of the 2019 risk-based guidelines. Students also ignore how prior history changes risk. Branches often stop at colposcopy without saying what happens after each possible finding. Follow-up intervals are sometimes stated without the risk that justifies them. Patient communication is frequently missing or full of medical terms. Another common gap is ignoring tracking, though loss to follow-up is a major failure of screening programs. Referrals that only say "colposcopy" without the question are weak. Finally, cite the exact guideline version and year, since graders check it and the recommendations differ between versions.
Get a NU 631 Unit 5 example written to your instructions
Send the Unit 5 instructions and the rubric from your NU 631 classroom, plus the screening result your algorithm follows. We write a custom example that decides at every branch, cites the guidance version and plans for non-attendance, returned in 24 to 48 hours. The first custom sample is free.
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NU 631 Unit 5 questions, answered
Why is version citation so important here?
Because these pathways are revised and the revisions change management substantially. An algorithm following superseded guidance will confidently send patients to the wrong interval or the wrong procedure, which is worse than having no pathway because it looks authoritative. Name the body, the document and the year, and note if a newer version exists that you are aware of.
What does risk-based management mean in this context?
That the next step depends on the patient's estimated risk rather than on the current result alone. Prior results, prior treatment and other findings all feed into where she goes next, so two patients with identical current results can correctly follow different branches. An algorithm built only on the present result will handle some patients wrongly.
How much should the algorithm say about non-attendance?
Enough to constitute a plan. Who notices she has not returned, how many attempts are made and by what channel, when it escalates, and what is documented. Loss to follow-up after an abnormal screening result is where the serious harm in these pathways actually occurs, and a tracking plan is what separates a workable algorithm from a diagram.
Where can I find a free NU 631 Unit 5 sample paper?
This page presents the full NU 631 Unit 5 algorithm free, with the risk-based branches, plain-language explanations, tracking plan and referral. If your result is a different cytology or HPV combination, ask for a custom algorithm; it costs nothing and usually arrives within 48 hours.
What happens after an HPV-positive ASC-US Pap result?
Under the 2019 ASCCP risk-based guidelines, the immediate risk of CIN3+ for HPV-positive ASC-US with unknown history is about 4 percent, which crosses the threshold for colposcopy. Next steps after colposcopy depend on its findings.