Category: Nursing

Upskilling of the Healthcare Workforce: A Pertinent National Healthcare Issue Affecting Healthcare Organizations in the United States

[Student name]

[College/ Institution]

Upskilling of the Healthcare Workforce: A Pertinent National Healthcare Issue Affecting Healthcare Organizations in the United States

There are many national healthcare stressors or issues affecting and impacting healthcare organizations all over the United States. All of them require addressing, although some are more urgent than others. The healthcare issue chosen in this case and one of the most significant stressors at the moment is the issue of upskilling of healthcare professionals. In this context, these would be the nurses working within the healthcare organization. According to Ross (2019), upskilling is the process of retraining employees so that they can acquire new skills for them to continue practicing in their field with ease. Upskilling of the Healthcare Workforce: A Pertinent National Healthcare Issue Affecting Healthcare Organizations in the United States. Recent developments (particularly technological) within and around healthcare have necessitated the requirement that workers such as nurses possess skillsets that are upgraded. As a matter of fact, upskilling was identified as one of the six important healthcare issues in 2019 by PwC Health Research Institute (Ross, 2019). Currently, whole healthcare workforces are threatened with redundancy by technologies such as artificial intelligence (AI) if they do not upskill. This includes nurses, who have traditionally not been involved with technology in the course of delivering nursing care (Teague, 2019). Upskilling of the Healthcare Workforce: A Pertinent National Healthcare Issue Affecting Healthcare Organizations in the United States

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The impact to my healthcare organization of upskilling as a healthcare issue is immense. This is because emerging healthcare technologies are becoming more and more mandatory in diagnostics, therapeutics, and nursing care. Nurses are therefore finding themselves short of skills to deliver quality patient care. This makes the organization set aside resources to retrain and upgrade the skills of its nurses so that they can cope with the emerging technological changes. This, however, is an inevitably resource-intensive undertaking fir the organization. In my organization, for instance, the policy makers have already had to set aside funds for training of the nurses and other healthcare staff on the use of the recently introduced EHR. Upskilling of the Healthcare Workforce: A Pertinent National Healthcare Issue Affecting Healthcare Organizations in the United States Already, upskilling is happening in the healthcare sector with the now standard requirement for electronic health records or EHR. That said, the hallmark of upskilling in healthcare is predicted to be artificial intelligence-assisted telehealth interventions (Teague, 2019) Upskilling of the Healthcare Workforce: A Pertinent National Healthcare Issue Affecting Healthcare Organizations in the United States.

Some of the Areas of Concern

Healthcare organizations must invest in the abilities of their workforce if they are to have a competitive advantage over their peers. Not doing so will of course render the organization unable to compete effectively in an ever-changing healthcare marketplace. Upskilling of the Healthcare Workforce: A Pertinent National Healthcare Issue Affecting Healthcare Organizations in the United States. For instance, AI is more and more used in healthcare at the moment. What this means is that rising sophistication of emerging medical technologies is driving the need for upskilled health workers (Ross, 2019). The advent of digital therapeutics is the other area of concern. This is the treatment of disease using healthcare technologies to complement or replace traditional methods in disease management. The reality is that the clinical validation of these digital therapeutics products and connected medical devices is already being done by the Food and Drug Administration or FDA (Siwicki, 2019). This is an indicator of the urgency with which upskilling of healthcare staff like nurses should be treated. Upskilling of the Healthcare Workforce: A Pertinent National Healthcare Issue Affecting Healthcare Organizations in the United States

Two Articles on the Upskilling of Healthcare Workers as a Healthcare Issue of Concern

           
Rimmer (2018) has posited that doctors have to undergo additional training in order to be successful at using emerging healthcare technologies. This particular article addresses doctors as the healthcare workers of concern, but it has been chosen because the very same situation is true for the nurses. This article talks of a report that states that training is needed by doctors in areas such as artificial intelligence algorithms, genomics, and digital literacy. As mentioned above, that is the same treatment that nurse practitioners should also receive. The article goes ahead to stress that training is a must for healthcare staff in order to cope with emerging healthcare technologies.

Fralic (2013) on her part observes that the American healthcare system is undergoing change that is radical and monumental. She states, correctly, that with change there is need to re-strategise and re-organize to deliver quality healthcare. To do this, upskilling is a must to keep up with healthcare technologies. In other organizations in the healthcare sector, the same situation portends. They, too, are adopting the same approach of retraining to upskill nurses, doctors, and other health workers so that they can cope with the recent technological changes and continue to offer quality and safe patient care. Upskilling of the Healthcare Workforce: A Pertinent National Healthcare Issue Affecting Healthcare Organizations in the United States

Strategies to Address the Organizational Impact of Upskilling

Since the reality of upskilling in healthcare organizations is inevitable, it is essential to develop strategies that aim at addressing the organizational impact of this issue. Three strategies are especially helpful. First, the organization needs to introduce new technologies gradually to allow for adaptation and training. Second, upskilling should be made a policy initiative that features in the organization’s goals. Third and last, upskilling should be properly budgeted for like any other expense if it is to succeed (Fralic, 2013; Rimmer, 2018; Teague, 2019). Under no circumstances should upskilling be considered as an afterthought. These strategies impact my organization positively in that they are geared towards giving the organization a competitive advantage. On the negative side, however, budgeting means that this strategy will consume resources that the organization must set aside.

References

Fralic, M.F. (2013). Upskilling for new-era healthcare: Lessons from high impact readings.
Nurse Leader, 11
(4).
http://dx.doi.org/10.1016/j.mnl.2013.05.008

Rimmer, A. (2018). Upskill doctors to make the most of new medical technologies, report says.
BMJ,
361
(k2861). Doi: 10.1136/bmj.k2861 Upskilling of the Healthcare Workforce: A Pertinent National Healthcare Issue Affecting Healthcare Organizations in the United States

Ross, J.R. (2019).
Upskilling could be an ideal treatment for healthcare’s employment woes
. Retrieved 4 March 2020 from
https://www.cardiovascularbusiness.com/topics/healthcare-economics/upskilling-could-be-ideal-rx-healthcares-employment-woes

Siwicki, B. (2019). Here are 6 major issues facing healthcare in 2019, according to PwC.
Healthcare ITNews
. Retrieved 4 March 2020 from
https://www.healthcareitnews.com/news/here-are-6-major-issues-facing-healthcare-2019-according-pwc

Teague, T. (2019).
Will healthcare employees need to be upskilled or reskilled as technology advances?
Retrieved 4 March 2020 from

Will Healthcare Employees Need to be Upskilled or Reskilled as Technology Advances?

 

Upskilling of the Healthcare Workforce: A Pertinent National Healthcare Issue Affecting Healthcare Organizations in the United States

[Student name]

[College/ Institution]

 

Upskilling of the Healthcare Workforce: A Pertinent National Healthcare Issue Affecting Healthcare Organizations in the United States

There are many national healthcare stressors or issues affecting and impacting healthcare organizations all over the United States. All of them require addressing, although some are more urgent than others. The healthcare issue chosen in this case and one of the most significant stressors at the moment is the issue of upskilling of healthcare professionals. In this context, these would be the nurses working within the healthcare organization. According to Ross (2019), upskilling is the process of retraining employees so that they can acquire new skills for them to continue practicing in their field with ease. Recent developments (particularly technological) within and around healthcare have necessitated the requirement that workers such as nurses possess skillsets that are upgraded. As a matter of fact, upskilling was identified as one of the six important healthcare issues in 2019 by PwC Health Research Institute (Ross, 2019). Currently, whole healthcare workforces are threatened with redundancy by technologies such as artificial intelligence (AI) if they do not upskill. This includes nurses, who have traditionally not been involved with technology in the course of delivering nursing care (Teague, 2019). Upskilling of the Healthcare Workforce: A Pertinent National Healthcare Issue Affecting Healthcare Organizations in the United States

The impact to my healthcare organization of upskilling as a healthcare issue is immense. This is because emerging healthcare technologies are becoming more and more mandatory in diagnostics, therapeutics, and nursing care. Nurses are therefore finding themselves short of skills to deliver quality patient care. This makes the organization set aside resources to retrain and upgrade the skills of its nurses so that they can cope with the emerging technological changes. This, however, is an inevitably resource-intensive undertaking fir the organization. In my organization, for instance, the policy makers have already had to set aside funds for training of the nurses and other healthcare staff on the use of the recently introduced EHR. Upskilling of the Healthcare Workforce: A Pertinent National Healthcare Issue Affecting Healthcare Organizations in the United States. Already, upskilling is happening in the healthcare sector with the now standard requirement for electronic health records or EHR Upskilling of the Healthcare Workforce: A Pertinent National Healthcare Issue Affecting Healthcare Organizations in the United States. That said, the hallmark of upskilling in healthcare is predicted to be artificial intelligence-assisted telehealth interventions (Teague, 2019).

Some of the Areas of Concern

Healthcare organizations must invest in the abilities of their workforce if they are to have a competitive advantage over their peers. Not doing so will of course render the organization unable to compete effectively in an ever-changing healthcare marketplace. For instance, AI is more and more used in healthcare at the moment. What this means is that rising sophistication of emerging medical technologies is driving the need for upskilled health workers (Ross, 2019). The advent of digital therapeutics is the other area of concern. This is the treatment of disease using healthcare technologies to complement or replace traditional methods in disease management. The reality is that the clinical validation of these digital therapeutics products and connected medical devices is already being done by the Food and Drug Administration or FDA (Siwicki, 2019). This is an indicator of the urgency with which upskilling of healthcare staff like nurses should be treated. Upskilling of the Healthcare Workforce: A Pertinent National Healthcare Issue Affecting Healthcare Organizations in the United States

Two Articles on the Upskilling of Healthcare Workers as a Healthcare Issue of Concern

           
Rimmer (2018) has posited that doctors have to undergo additional training in order to be successful at using emerging healthcare technologies. This particular article addresses doctors as the healthcare workers of concern, but it has been chosen because the very same situation is true for the nurses. This article talks of a report that states that training is needed by doctors in areas such as artificial intelligence algorithms, genomics, and digital literacy. As mentioned above, that is the same treatment that nurse practitioners should also receive. The article goes ahead to stress that training is a must for healthcare staff in order to cope with emerging healthcare technologies.

Fralic (2013) on her part observes that the American healthcare system is undergoing change that is radical and monumental. She states, correctly, that with change there is need to re-strategise and re-organize to deliver quality healthcare. To do this, upskilling is a must to keep up with healthcare technologies. In other organizations in the healthcare sector, the same situation portends. They, too, are adopting the same approach of retraining to upskill nurses, doctors, and other health workers so that they can cope with the recent technological changes and continue to offer quality and safe patient care. Upskilling of the Healthcare Workforce: A Pertinent National Healthcare Issue Affecting Healthcare Organizations in the United States.

Strategies to Address the Organizational Impact of Upskilling

Since the reality of upskilling in healthcare organizations is inevitable, it is essential to develop strategies that aim at addressing the organizational impact of this issue. Three strategies are especially helpful. First, the organization needs to introduce new technologies gradually to allow for adaptation and training. Second, upskilling should be made a policy initiative that features in the organization’s goals. Third and last, upskilling should be properly budgeted for like any other expense if it is to succeed (Fralic, 2013; Rimmer, 2018; Teague, 2019). Under no circumstances should upskilling be considered as an afterthought. These strategies impact my organization positively in that they are geared towards giving the organization a competitive advantage. On the negative side, however, budgeting means that this strategy will consume resources that the organization must set aside.

References

Fralic, M.F. (2013). Upskilling for new-era healthcare: Lessons from high impact readings.
Nurse Leader, 11
(4).
http://dx.doi.org/10.1016/j.mnl.2013.05.008

Rimmer, A. (2018). Upskill doctors to make the most of new medical technologies, report says.
BMJ,
361
(k2861). Doi: 10.1136/bmj.k2861 Upskilling of the Healthcare Workforce: A Pertinent National Healthcare Issue Affecting Healthcare Organizations in the United States

Ross, J.R. (2019).
Upskilling could be an ideal treatment for healthcare’s employment woes
. Retrieved 4 March 2020 from
https://www.cardiovascularbusiness.com/topics/healthcare-economics/upskilling-could-be-ideal-rx-healthcares-employment-woes

Siwicki, B. (2019). Here are 6 major issues facing healthcare in 2019, according to PwC.
Healthcare ITNews
. Retrieved 4 March 2020 from
https://www.healthcareitnews.com/news/here-are-6-major-issues-facing-healthcare-2019-according-pwc

Teague, T. (2019).
Will healthcare employees need to be upskilled or reskilled as technology advances?
Retrieved 4 March 2020 from

Will Healthcare Employees Need to be Upskilled or Reskilled as Technology Advances?

s  Upskilling of the Healthcare Workforce: A Pertinent National Healthcare Issue Affecting Healthcare Organizations in the United States

NR 509 Week 2 Quiz Review

What does dullness when percussing lung fields: Jarvis pg 427

Facial sensation controlled by which CN: Jarvis 283,

Know what two salivary glands are accessible during exam

What CN is being assessed when pt shrugs shoulders Jarvis 646

What muscles are being assessed when assessing CN 11 (spinal accessory nerve)

Concern for malignant nodules versus benign lymph nodule

Know what you’d do next if you palpated a submental lymph node: Jarvis pg 253

Define visual acuity

Know what to do if your patient can’t read the largest number on the Snellen chart: Jarvis 289

Example of good visual acuity : Jarvis 289 NR 509 Week 2 Quiz Review

Example of poor visual acuity: Jarvis 289

What is expected with corneal light reflex-

Know normal variances of sclera : Jarvis 283

Know how to check for Ptosis: Jarvis 292

What does ptosis indicate: Jarvis 292

Nasal fissure of pt with 
chronic 
allergies : Jarvis 271

Acute 
allergies : Jarvis p 363 
.

What is an abnormal palpation of sinuses: Jarvis 362

Normal palpation of sinuses

Know normal variations in gingival margin

Know what a dehydrated oral cavity will look like: Jarvis 387

What is tactile fremitus, how do you test for it and what does it indicate. Jarvis 425 NR 509 Week 2 Quiz Review

NURS 6050: Politics and the Patient Protection and Affordable Care Act

Welcome to NURS 6050: Policy and Advocacy for Improving Population Health

Politics and the Patient Protection and Affordable Care Act

Regardless of political affiliation, individuals often grow concerned when considering perceived competing interests of government and their impact on topics of interest to them. The realm of healthcare is no different. Some people feel that local, state, and federal policies and legislation can be either helped or hindered by interests other than the benefit to society. NURS 6050: Politics and the Patient Protection and Affordable Care Act.

Consider for example that the number one job of a legislator is to be reelected. Cost can be measured in votes as well as dollars. Thus, it is important to consider the legislator’s perspective on either promoting or not promoting a certain initiative in the political landscape. NURS 6050: Politics and the Patient Protection and Affordable Care Act.

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To Prepare:

Review the Resources and reflect on efforts to repeal/replace the Affordable Care Act (ACA).

Consider who benefits the most when policy is developed and in the context of policy implementation.

Post an explanation for how you think the cost-benefit analysis in terms of legislators being reelected affected efforts to repeal/replace the ACA. NURS 6050: Politics and the Patient Protection and Affordable Care Act Then, explain how analyses of the votes views may affect decisions by legislative leaders in recommending or positioning national policies (e.g., Congress’ decisions impacting Medicare or Medicaid). Remember, the number one job of a legislator is to be re-elected. Please check your discussion grading rubric to ensure your responses meet the criteria. NURS 6050: Politics and the Patient Protection and Affordable Care Act.

NR 509 Week 2 Alternative Writing Assignment

Respiratory

Purpose

As a family nurse practitioner, you must possess excellent physical assessment skills. This alternative writing assignment mirrors the discussion content of the debriefing session and will allow the student to expand their knowledge of physical health assessment principles specific to the advanced practice role.

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The purposes of this assignment are to: (a) identify and articulate advanced assessment health history and physical examination techniques which are relevant to a focused body system (CO 1), (b) differentiate normal and abnormal findings with regard to a disease or condition that impacts the body system (CO 2), and (c) adapt advanced assessment skills if necessary to suit the needs of specific patient populations (CO 4). NR 509 Week 2 Alternative Writing Assignment

NOTE
: 
You are to complete this alternative writing assignment ONLY if you had not participated or do not plan to participate in a debriefing session for the given week.

Due Date: 
This alternative written assignment is due no later than the 
Sunday of the week in which you did not attend the weekly debriefing session
. For example, if you did not attend a debriefing session for Week 3, this written assignment is due on Week 4.

 

Requirements:

This paper will be graded on the quality of the information, inclusion of evidence-based scholarly resources, use of citations, use of Standard English grammar, and organization based on the required components (see the paper headings and content details below).

Submit to the appropriate location in Canvas 
of the week due
.

The length of the paper is to be 
no less than 
1,500 words
, excluding title page and reference list
.

Create this assignment using Microsoft (MS) Word. You can tell that the document is saved as a MS Word document because it will end in “.docx.” NR 509 Week 2 Alternative Writing Assignment

APA format (6
th
 edition) is required in this assignment, explicitly for in-text citations and the reference list. Use 12-point Times New Roman font with 1 inch margins and double spacing.

Organize the headings and content of your paper using the outline below
:

Identify and briefly discuss the body system selected for the topic of this paper

Discuss the physiology (structure and function) of the body system including details about the major organ systems (if applicable)

Discuss relevant health history questions (subjective data) pertaining to the body system

Discuss an overview of the objective data and expected normal physical examination findings for this body system NR 509 Week 2 Alternative Writing Assignment

Discuss special physical assessment examination techniques or procedures specific to assessing this body system

Discuss how you might adapt your physical assessment skills or techniques to accommodate each of the following specific populations:

Infant/pediatric

Pregnancy

Geriatric

Identify 
one
 major disease or disease process that may significantly impact this body system

Discuss the expected abnormal physical examination findings that may be associated with this disease or disease process

Summarize the key points NR 509 Week 2 Alternative Writing Assignment

 

Preparing the Paper:

Select a focused body system from the weekly lesson which corresponds with the week of the written assignment.

Carefully read and review the selected body system in your course textbooks.

Incorporate at least 
one
scholarly peer-reviewed journal article that relates to the body system. It may be useful to identify an article that relates to a disease that impacts the body system. NR 509 Week 2 Alternative Writing Assignment

The paper must clearly articulate the relevance of advanced physical assessment skills, techniques, application of advanced practice knowledge, and assessment modification (when necessary) to accommodate for specific patient populations.

Provide concluding statements that should summarize key points of the overall assignment content.

In-text citations and reference page(s) must be written. NR 509 Week 2 Alternative Writing Assignment

Week 2 Practicum Journal: Safe Prescribing

There is probably no greater responsibility that the psychiatric mental health nurse practitioner assumes than the responsibility of prescribing medications. While someone can be harmed by psychotherapy, the level and intensity of the harm generally does not come to the same level of harm that can occur from improper prescribing. The PMHNP must understand his/her responsibility both at a state and federal level when it comes to prescribing medications.

In this Practicum Journal Assignment, you will explore the legalities associated with prescribing controlled substances, as well as what a DEA number is, how to obtain one, and, most importantly, how to prescribe controlled substances in your state. Practicum Journal: Safe Prescribing

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Learning Objectives

Students will:

• Analyze roles of the Drug Enforcement Administration

• Analyze PMHNP responsibilities when issued a DEA number

• Analyze DEA number application procedures

• Analyze state requirements for safe prescribing and prescription monitoring

• Analyze PMHNP responsibilities for safe prescribing and prescription monitoring

• Analyze Schedule II-V drug levels

** Assigned in Week 2 and submitted in Week 4.

To prepare for this Practicum Journal: Practicum Journal: Safe Prescribing

• Review the Learning Resources.

In 2-3 pages:

• Describe the role of the Drug Enforcement Administration (DEA) as it pertains to the PMHNP.

• Explain your responsibilities when having a DEA number.

• Explain how you apply for a DEA number.

• Explain your state’s requirements for a safe prescribing and prescription monitoring program. Explain your responsibility as a PMHNP to follow these requirements. Practicum Journal: Safe Prescribing

• Provide an example of a drug you may prescribe from each of the Schedule II-V drug levels.

NR 509 Week 1 Quiz (25 Points) – Question and Answers

A patient tells the FNP that he is very nervous, that he is nauseated, and that he “feels hot”. This type of data would be:

The patient’s record, laboratory studies, objective data, and subjective data combine to form the:

The FNP is reviewing information about evidence-based practice. Which statement best reflects evidence-based practice?

A 59-year-old patient tells the FNP that he has ulcerative colitis. He has been having black stools for the last 24 hours. How would the FNP best document his reason for seeking care?

A 29-year-old woman tells the FNP that she has excruciating pain in her back. Which would be an appropriate response by the FNP to the woman statement?

In recording the childhood illnesses of a patient who denies having had any, which note by the FNP would be most accurate?

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If a female patient tells the FNP that she has had six pregnancies, with four live births at term and two spontaneous abortions. Her four children are still living. How would the FNP record this information?

Which of these statements represents subjective data the FNP obtained from the patient regarding the patient’s skin?

The FNP is obtaining a history for a 30-year-old male patient and is concerned about health promotion activities. Which of these questions would be appropriate to use to assess health promotion activities for this patient? NR 509 WEEK 1-7 QUIZ

Which statement indicates that the FNP understands the pain experienced by an elderly person?

The FNP is performing a vision examination. Which of these charts is most widely used for visual examination?

During a complete health assessment, how would the FNP test the patients hearing? nr 509 week 1 quiz

The FNP has just completed an examination of a patient’s extra-ocular muscles. When documenting the findings, the FNP should document the assessment of which cranial nerves?

A patient’s uvula rises midline when she says “ahh” and she has a positive gag reflex. The FNP has just tested which cranial nerve?

During an examination the FNP notices that a patient is unable to stick out his tongue. Which cranial nerve is involved with successful performance of this action?

A patient is unable to shrug her shoulders against the FNP‘s resistant hands. What cranial nerve is involved with successful shoulder shrugging?

During an examination, the patient has just successfully completed the finger to nose and rapid alternating movements test and is able to run each heel down the opposite shin. The FNP would conclude that the patient’s___ function is intact

A five-year-old child is in the clinic for checkup. The FNP would expect him to:

When the FNP performs the confrontation test the FNP has assessed: nr 509 week 1 quiz

Which of these statements is true regarding the complete physical assessment?

…. recording of data from the history and physical examination?

… in assessment of general appearance? nr 509 week 1 quiz

The FNP is performing a review of symptoms. Which of these questions are appropriate as Health promotion questions to ask during this time? NR 509 WEEK 1-7 QUIZ

The FNP is incorporating a person’s spiritual values into the health history. Which of these questions illustrates the community portion of the FICA questions?

The FNP is preparing to complete a health assessment on a 16-year-old girl whose parents have brought her to the clinic. Which instruction would be appropriate for the parents before the interview begins?

 

NR 509 Week 2 Quiz (25 Points) – Question and Answers

A mother brings her two month old daughter in for an examination says “my daughter rolled over against the wall and now I have noticed that she has the spot soft on the top of her head, is there something terribly wrong?” The FNP‘s best response would be:

During percussion the FNP knows that a dull percussion note elicited over a lung lobe. This most likely results from:

The patient is unable to differentiate between sharp and dull stimulation to both sides of her face. The FNP suspects Damage to:

When examining the face, the FNP is aware that the two pairs of salivary gland‘s that are accessible to examination are the _____ glands

A patient comes to the clinic complaining of neck and shoulder pain and is unable to turn her head. The FNP suspects damage to cranial nerve ____ and proceeds with the examination by____

When examining a patient’s cranial nerve function, the FNP remembers that the muscles in the neck that are innervated by CN XI are the:

The patient’s laboratory data reveal an elevated thyroxine level. The FNP would proceed with an examination of the _____ gland

A patient says that she has recently noticed a lump in the front of her neck below her “Adams apple” that seems to be getting bigger. During the assessment, the finding that leaves the FNP to suspect that this may not be a cancerous thyroid nodule is that the lump:

The FNP notices that the patient’s submental lymph nodes are enlarged. In an effort to identify the cause of the node enlargement, the FNP would assess the patient’s:

The FNP is aware that the four areas in the body were lymph nodes accessible are the: nr 509 week 2 quiz

A 52-year-old patient describes the presence of occasional floaters or spots moving in front of his eyes. The FNP should know that floaters are usually not significant and are caused by:

The FNP is preparing to assess the visual acuity of a 16-year-old patient. How should the FNP proceed?

A patient’s vision is recorded as 20/30 when the Snellen eye chart is used. The FNP interprets these results to indicate that:

A patient is unable to read even the largest letters on the Snellen chart. The FNP should take which action next:

A patient’s vision is ……as 20/80 in each eye. The FNP interprets this finding to mean that nr 509 week 2 quiz

When performing the corneal light reflex assessment, the FNP notes that the light is …..at 2 o’clock in each eye. The FNP should

The FNP is performing the diagnostic positions test. Normal findings would be which of these results? nr 509 week 2 quiz

During an assessment of the sclera of an African-American patient, the FNP would consider which of these an expected finding?

A 60-year-old man is at the clinic for an examination. The FNP suspects that he has ptosis of one eye. How should the FNP check for this?

The FNP is doing an assessment on a 21-year-old patient and notices that his nasal mucosa appears pale gray and swollen. What would be the most appropriate question to ask the patient?

The FNP is palpating the sinus areas. If the findings are normal, then the patient should report which sensation?

During an oral assessment of a 30-year-old African-American patient, the FNP notices bluish lips and a dark line along the gingival margin. What would the FNP do in response to these findings

During an assessment of a 20-year-old patient with a three day history of nausea and vomiting the FNP notices dry mucous and deep vertical fissures on the tongue. These findings are reflective of:

The FNP is reviewing the technique of palpating for tactile fremitus with a new graduate. Which statement by the graduate FNP reflects a correct understanding of tactile fremitus?

The FNP student is reviewing physical assessment findings of the HEENT system associated with pregnancy. Which statement by the graduate FNP reflects a correct understanding of expected HEENT changes associated with pregnancy? During pregnancy:

 

NR 509 Week 3 Quiz (25 Points) – Question and Answers

A teenage girl has arrived complaining of pain in her left wrist. She was playing basketball when she fell and landed on her left hand. The FNP examined her hand and will expect a fracture if the girl complains:

A patient has been diagnosed with osteoporosis and asked the FNP “what is osteoporosis?” The FNP explains to the patient that osteoporosis is defined as:

Patient states, “I can hear a crunching or grating sound when I kneel”. She also states “that it is very difficult to get out of bed in the morning because of stiffness and pain in my joints”. The FNP should assess for signs of what problem?

When taking the history on a patient with a seizure disorder the FNP assesses whether the patient has an aura. Which of these would be the best question for obtaining this information?

The FNP is teaching a class on osteoporosis prevention to a group of post menopausal women. A participant shows that she needs more instruction when she states I will:

The FNP is performing a neurological assessment on a 41-year-old woman with a history of diabetes. When testing her ability to feel the vibrations of a tuning fork the FNP notices that the patient is unable to feel vibrations on the great toe or ankle bilaterally, but she is able to feel vibrations on both patella. Given this information what would the FNP suspect?

And 80-year-old woman is visiting the clinic for a check up. She states “I can’t walk as much as I used to”. The FNP is observing from motor dysfunction in her hip and should have her:

The FNP is testing the function of cranial nerve XI. Which of these best describes the response the FNP should expect if the nerve is intact? The patient:

A 50-year-old woman is in a clinic for weakness in her left arm and leg that she noticed for the past week. The FNP should perform which type of neurologic examination?

During the neurological assessment of a healthy 35-year-old patient the FNP asks him to relax his muscles completely. The FNP then moves each extremity through full range of motion. Which of these results would the FNP expect to find?

A woman who is 8 months pregnant comments that she has noticed a change in posture and is having lower back pain. The FNP tells her that during pregnancy women have a posture shift to compensate for the enlarging fetus. This shift and posture is known as

A patient is able to flex his right arm forward without difficulty or pain but is unable to abduct his arm because of pain and muscle spasm’s. The FNP should suspect:

A professional tennis player comes into the clinic complaining of a sore elbow. The FNP will assess for tenderness at the:

The FNP suspect that a patient has carpal tunnel syndrome and wants to perform the Phalens test. To perform this task the FNP should instruct the patient to:

During the history a patient tells the FNP that “it feels like the room is spinning around me”. The FNP would document this as: nr 509 week 3 quiz

The assessment of a 60-year-old patient has taken longer than anticipated. In testing his pain perception the FNP decides to complete the test as quickly as possible. When the FNP applies the sharp point of a pin on his arm several times he is only able to identify these as one very sharp prick. What would be the most accurate explanation for this?

An 85-year-old patient comments during his annual physical that “he seems to be getting shorter as he ages”. The FNP should explain that decrease height occurs with aging because:

A patient is complaining of pain in his joints that is worse in the morning, is better after he has moved around for a while, and then gets worse again if he sits for long periods of time. The FNP should assess for other signs of what problem?

When the FNP asks a 68-year-old patient to stand with feet together and arms at his side with his eyes closed he starts to sway and moves his feet farther apart. The FNP would document this finding as:

During an assessment of the cranial nerves the FNP finds the following asymmetry when the patient smiles or frowns, uneven lifting of eyebrows, sagging of lower eyelids, and escape of air when the FNP presses against the right path cheek. This would indicate dysfunction of which of these cranial nerves? nr 509 week 3 quiz

The FNP is teaching a class on osteoporosis prevention to a group of postmenopausal women which of these actions is the best way to prevent or delay bone loss in this group?

In obtaining a history on a 74 year old patient the FNP notes that he drinks alcohol daily and that he has noticed a tremor in his hands that affects his ability to hold thing. With this information what should the FNP‘s response be?

During a history of a 78-year-old man his wife states that “he occasionally has problems with short-term memory loss and confusion. He can’t even remember how to button his shirt”. In doing the assessment of his sensory system which action of the FNP‘s is most appropriate?

While obtaining a history of a 3 month old infant from the mother the FNP asks about the infants ability to suck and grass the mothers finger. What is the FNP assessing? nr 509 week 3 quiz

The FNP is doing an assessment on a 29-year-old woman who visits the clinic complaining of always dropping things and falling down. While testing rapid alternating movements the FNP notices that the woman is unable to pat both her knees. Her response is very slow and she misses frequently. What should the FNP suspect?

 

NR 509 Week 4 Quiz (25 Points)

A 35-year-old man is seen in the clinic for an infection in his left foot. Which of these findings should the FNP expect to see during an assessment of this patient?

The direction of blood flow through the heart is best described by which of these

In assessing the carotid artery’s of an older patient with cardiovascular disease, the FNP would

When listening to heart sounds the FNP knows that the valve closures that can be heard best at the base of the heart are

The sack that surrounds and protects the heart is called the

When assessing a newborn infant who is five minutes old the FNP knows that which of these statements would be true?

The FNP is performing an assessment on an adult. The adults vital signs are normal and capillary refill is five seconds. What should the FNP do next?

During an assessment of an older adult the FNP should expect to notice which finding as normal physiologic change associated with aging process?

The mother of a three month old infant states that her baby has not been gaining weight. With further questioning the FNP finds that the infant falls asleep after nursing and wakes up after a short amount of time hungry again. What other information with the FNP want to have?

In assessing a patient’s major risk factors for heart disease which would the FNP want to include when taking a history?

The FNP is assessing the pulses of a patient who has been admitted for untreated hyperthyroidism. The FNP should expect to find a____pulse NR 509 WEEK 1-7 QUIZ

A patient complains of leg pain that wakes him at night. … states that he has been having problems with his legs. He has pain in his legs when they are … and disappears when he dangles them. He recently noticed a sore on the inner aspect of his right ankle. On the basis of this history information the FNP interprets that the patient is most likely experiencing

During an assessment the FNP uses the profile sign to detect nr 509 week 4 quiz

 … these statements describes the closure of the valves in a normal cardiac cycle?

When performing a peripheral vascular assessment on a patient the FNP is unable to palpate the ulnar pulses. The patient skin is warm and capillary refill is normal. The FNP should next

A 67-year-old patient states that he “recently began have pain in his left calf when climbing the 10 stairs to his apartment”. This pain is relieved by sitting for about two minutes then he’s able to resume activities. The FNP interprets this patient is most likely experiencing

In assessing a 70-year-old man the FNP finds the following blood pressure 140/100 mmHg, heart rate 104 and slightly irregular, split S2. nr 509 week 4 quiz  Which of these findings can … explained by expected hemodynamic changes related to age?

The FNP is examining the lymphatic system of a healthy three year old child. Which finding should the FNP expect?

The FNP is preparing to perform modified Allen test. Which is an appropriate reason for this test?

A 25-year-old woman is in her fifth month of pregnancy has a blood pressure of 100/70 mmHg. In reviewing her previous exam the FNP notes that her blood pressure in her second month was 124/80 mmHg. When evaluating this change what does the FNP know to be true?

Findings from an assessment of a 70-year-old patient with swelling in his ankles include jugular venous pusations, 5 cm above the sternal angle when the head of his bed is … 45°. The FNP knows that this finding indicate:

The component of the conduction system referred to as the pacemaker of the heart is the nr 509 week 4 quiz

The FNP is reviewing anatomy and physiology of the heart. Which statement best describes what is … by atrial kick?

A 45-year-old man is in the clinic for a routine physical. During history the patient states he has been having difficulty sleeping. I’ll be sleeping great and then I wake up and feel like I can’t catch my breath. The FNP‘s best response to this would be NR 509 WEEK 1-7 QUIZ

When assessing a patient the FNP notes that the left femoral pulse as diminished 1+/4+. What should the FNP do next?

 

NR 509 Week 5 Quiz (25 Points) – Question and Answers

An older patient has been diagnosed with pernicious anemia. The FNP knows that this condition could be related to

The FNP is examining a patient who tells the FNP “I sure sweat a lot especially on my face and feet but it doesn’t have an odor”. The FNP knows that this could be related to

During an abdominal assessment the FNP elicits tenderness on light palpation in the right lower quadrant. The FNP interprets that this finding could indicate a disorder which of these structures?

An Inuit visiting Nevada from anchorage has come to the clinic in July during the hottest part of the day. It so happens that the clinics air conditioning is broken and the temperature is very hot. The FNP knows that which of these statements is true about the Inuit sweating tendencies?

The FNP notices that a patient has black, tarry stool and recalls that a possible cause would be

The FNP knows that during an abdominal assessment deep palpation is used to determine

The FNP is assessing the abdomen of an aging adult. Which of these statements regarding an aging adult and abdominal assessment is true?

During examination the FNP finds that a patient has excessive dryness of the skin. The best term to describe this condition is

A FNP notices that a patient has ascites, which indicates the presence of nr 509 week 5 quiz

The FNP is performing percussion during an abdominal assessment. Percussion notes during the abdominal assessment may include

The FNP is caring for a black child who has been diagnosed with marasmus. The FNP would expect to find the

The FNP just noted from a patient’s medical record that the patient has a lesion that is confluent in nature. On examination the FNP would expect to find

The FNP is assessing the abdomen of a pregnant woman who is complaining of having acid indigestion all the time. The FNP knows that esophageal reflux during pregnancy can cause

The patient has abdominal borborygmi. The FNP knows that this term refers to nr 509 week 5 quiz

A patient has a terrible itch for several months that he has been scratching continuously. On examination the FNP might expect to find NR 509 WEEK 1-7 QUIZ

During aging process, the hair can look gray or white and begin to feel thin and fine. The FNP knows that this occurs because of a decrease in number of functioning

The FNP notices that a patient has a solid, elevated, circumscribed lesion that is less than 1 cm in diameter. When documenting this finding the FNP would report this as a

During an abdominal assessment the FNP would consider which of these findings as normal?

A 52 -year-old Woman has a papule on her nose that has a rounded pearly border and a central red ulcer. She said she first noticed it several months ago and that it is slowly growing larger. The FNP suspects which condition?

The FNP is listening to bowel sounds. Which of these statements is true about bowel sounds?

The FNP is watching a new graduate FNP perform auscultation of a patient abdomen. Which statement by the new graduate shows a correct understanding of the reason auscultation proceeds percussion and palpitation of the abdomen?

A patient is complaining of a sharp pain along the costovertebral angles. The FNP knows that this symptom is most often indicative of

The patient is ….of having inflammation of the gallbladder or cholecystitis. The FNP should conduct which of these techniques to assess for this condition?

A newborn infant is in the clinic for a well baby check. The FNP observes the infant for possibility of fluid loss because of which these factors?

During an assessment of a newborn infant, the FNP recalls that pyloric stenosis would be manifested by nr 509 week 5 quiz

 

NR 509 Week 6 Quiz (25 Points) – Question and Answers

A woman has come to the clinic to seek help with a substance-abuse problem. She admits to using cocaine just before arrival. Which of these assessment findings would the FNP expect to find when examining the woman?

A 63-year-old Chinese American man enters the office with complaints of chest pain, shortness of breath, and palpitations. Which statement most accurately reflect the FNPs best course of action?

The FNP is planning to assess new memory with the patient. The best way for the FNP to do this would be

During the health history the FNP asks a female patient “how many alcoholic drinks do you have a week?” Which answer by the patient would indicate at risk drinking?

Symptoms such as pain are often influenced by a person’s cultural heritage. Which of the following is a true statement regarding pain? NR 509 WEEK 1-7 QUIZ

The FNP suspect abuse when a 10-year-old child is taken to the urgent care center for leg injury. nr 509 week 6 quiz The best way to document the history and physical findings is to

During a mental status assessment, which question by the FNP would best assess a persons judgment?

The FNP is performing a mental status assessment on a five-year-old girl. Her parents are undergoing a bitter divorce and are worried about the effect it is having on their daughter. Which action or statement might leave FNP to be concerned about the girls mental status?

During mental status examination, the FNP wants to assess a patient’s affect. The FNP should ask the patient which question?

During an examination FNP notices a patterned injury on a patients back. Which of these would cause such an injury?

The FNP is aware that intimate partner violence screening should occur with which situation?

Which statement is best for the FNP to use when preparing to administer the abuse assessment screen?

The FNP is conducting a class on alcohol and the effects of alcohol on the body. How many standard drinks (each containing 12 g alcohol) Per day are associated with increased deaths from cirrhosis, cancers of the mouth, esophagus and injuries in men?

A woman who has just discovered that she is pregnant is in the clinic for her first obstetric visit. She asked the FNP how many drinks a day safe for my baby? The FNP‘s best response is

The FNP is performing the Denver II screen test on a 12 month old infant during a routine well child visit. The FNP should tell the infants parents that the Denver II

Which term refers to a one produced by tearing or splitting of body tissue usually from blunt impact of a bony surface NR 509 WEEK 1-7 QUIZ

When reviewing the use of alcohol by older adults the FNP notes that the older adults have several characteristics that can increase the risk of alcohol use which would increase the bioavailability of alcohol in the blood for longer periods of time in the older adult?

The FNP is reviewing concepts of cultural aspects of pain. Which statement is true regarding pain?

The FNP is planning to assess a child using behavioral checklist. This tool is most appropriate for a(an)

The FNP is … orientation in a 79-year-old patient. Which of these responses would leave the FNP to conclude that the patient is … ?

As a mandatory reporter of elder abuse, which of these must be present before an FNP notifies the authorities?

A 30-year-old female patient is describing feelings of hopelessness and depression. She has attempted self-mutilation and has a history of prior suicide attempts. She describes difficulty sleeping at night and has lost 10 pounds in the past month. Which of these statements or questions is the FNP‘s best response in this situation? nr 509 week 6 quiz

For persons age 12 years and older which of these illicit substances was one of the most commonly used?

Which of these individuals would the FNP consider at highest risk for suicide attempt?

The FNP is assessing a patient who has … admitted for cirrhosis of the liver secondary to chronic alcohol use. nr 509 week 6 quiz During the physical assessment the FNP looks for cardiac problems that are … with chronic heavy use of alcohol such as

NR 509 Week 7 Quiz – Question and Answers

During an examination of an aging male the FNP recognizes that normal changes to expect would be:

During a health history, a 22-year-old woman asks “can I get that vaccine for HPV? I have gentle warts and I’d like them to go away!” What is the FNP‘s best response?

During a speculum inspection of the vagina the FNP would expect to see what at the end of the vaginal canal?

A 62-year-old man is experiencing fever, chills, malaise, urinary frequency and urgency. He also reports urethral discharge and a dull aching pain in the perineal and rectal area. The symptoms are most consistent with which of the following?

When performing a genital examination on a 25-year-old man the FNP notices deeply pigmented, wrinkled scrotal skin with large sebaceous follicles. On the basis of this information the FNP would:

The mother of a 10-year-old boy asks the FNP to discuss the recognition of puberty. The FNP should reply by saying:

The uterus is usually positioned tilting forward and superior to the bladder. This position is known as

A male patient with possible fertility problems asks the FNP where sperm is produced. The FNP knows that sperm production occurs in

A 15-year-old boy is seen in the clinic for complaints of dull pain and pulling in the scrotal area. On examination the FNP palpates a soft, irregular mass posterior to and above the testes on the left. This mass collapses when the patient is supine in refills when he is up right. This description is consistent with:

In performing an assessment of a woman’s axillary lymph system the FNP should assess which of these nodes?

A patient contacts the office and tells the FNP that she is … about her 10-year-old daughter having breast cancer. She describes a unilateral enlargement of the right breast with associated tenderness. She is … because the left breast is not enlarged. What would be the FNP‘s best response?

An 11-year-old girl is in the clinic for a sports physical. The FNP notices that she has begun to develop breasts, and during the conversation the girl reveals that she is worried about her development. … use which of these techniques to best assist the young girl in understanding the expected sequence for development? The FNP should: NR 509 WEEK 1-7 QUIZ

A 54-year-old woman who has just completed menopause is in the clinic today for yearly physical examination. Which of these statements should the FNP include in patient education? A post menopausal woman:

A 62-year-old man states that his doctor told him that he has an inguinal hernia. He asks the FNP to explain what a hernia is….. :

When performing a genital assessment on a middle-age man, the FNP notices multiple soft, moist, painless papules in the shape of cauliflower like patches scattered across the shaft of the penis. These lesions are characteristics of:

If a patient reports a recent breast infection, then the FNP should expect to find_____node enlargement

A 9-year-old girl is in the clinic for a sports physical. After some initial shyness she finally ….“am I normal? I don’t seem to need a bra yet, but I have some friends who do. What if I never get breasts?” The FNP‘s best response would be:

Which of these statements about the testes this true?

During an examination FNP observes a female patients vestibule and expect to see the

A 14-year-old girl is anxious about not having reached menarche. When taking history, the FNP should ascertain which of the following? The age:

A woman who is 22 weeks pregnant has a vaginal infection. She tells the FNP that she is afraid that the infection will hurt the fetus. The FNP knows that which of these statements is true?

In performing a breast examination the FNP knows that it is especially important to examine the upper outer quadrant of the breast. The reason for this is that the upper outer quadrant

An accessory glandular structure for the male genital organs is the

 …. true regarding the penis?

__ 8 weeks pregnant is in the clinic for a check up. The FNP reads on her chart that her cervix is … and looks cyanotic. The FNP knows that the woman is exhibiting____sign and _____sign NR 509 WEEK 1-7 QUIZ

NR 509 Week 1 Quiz (25 Points) – Question and Answers

A patient tells the FNP that he is very nervous, that he is nauseated, and that he “feels hot”. This type of data would be:

The patient’s record, laboratory studies, objective data, and subjective data combine to form the:

The FNP is reviewing information about evidence-based practice. Which statement best reflects evidence-based practice?

A 59-year-old patient tells the FNP that he has ulcerative colitis. He has been having black stools for the last 24 hours. How would the FNP best document his reason for seeking care?

A 29-year-old woman tells the FNP that she has excruciating pain in her back. Which would be an appropriate response by the FNP to the woman statement?

In recording the childhood illnesses of a patient who denies having had any, which note by the FNP would be most accurate?

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If a female patient tells the FNP that she has had six pregnancies, with four live births at term and two spontaneous abortions. Her four children are still living. How would the FNP record this information?

Which of these statements represents subjective data the FNP obtained from the patient regarding the patient’s skin?

The FNP is obtaining a history for a 30-year-old male patient and is concerned about health promotion activities. Which of these questions would be appropriate to use to assess health promotion activities for this patient?

Which statement indicates that the FNP understands the pain experienced by an elderly person?

The FNP is performing a vision examination. Which of these charts is most widely used for visual examination?

During a complete health assessment, how would the FNP test the patients hearing? nr 509 week 1 quiz

The FNP has just completed an examination of a patient’s extra-ocular muscles. When documenting the findings, the FNP should document the assessment of which cranial nerves?

A patient’s uvula rises midline when she says “ahh” and she has a positive gag reflex. The FNP has just tested which cranial nerve? NR 509 WEEK 1 QUIZ

During an examination the FNP notices that a patient is unable to stick out his tongue. Which cranial nerve is involved with successful performance of this action?

A patient is unable to shrug her shoulders against the FNP‘s resistant hands. What cranial nerve is involved with successful shoulder shrugging?

During an examination, the patient has just successfully completed the finger to nose and rapid alternating movements test and is able to run each heel down the opposite shin. The FNP would conclude that the patient’s___ function is intact

A five-year-old child is in the clinic for checkup. The FNP would expect him to:

When the FNP performs the confrontation test the FNP has assessed: nr 509 week 1 quiz

Which of these statements is true regarding the complete physical assessment?

…. recording of data from the history and physical examination?

… in assessment of general appearance? nr 509 week 1 quiz

The FNP is performing a review of symptoms. Which of these questions are appropriate as Health promotion questions to ask during this time?

The FNP is incorporating a person’s spiritual values into the health history. Which of these questions illustrates the community portion of the FICA questions?

The FNP is preparing to complete a health assessment on a 16-year-old girl whose parents have brought her to the clinic. Which instruction would be appropriate for the parents before the interview begins? NR 509 WEEK 1 QUIZ

NR 509 Week 4 Quiz Advanced Physical Assessment

1. A 35-year-old man is seen in the clinic for an infection in his left foot. Which of these findings should the FNP expect to see during an assessment of this patient?

a. Hard and fixed cervical nodes

b. Enlarged and tender inguinal nodes

c. Bilateral enlargement of the popliteal nodes

d. Pelletlike nodes in the supraclavicular region

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2. The direction of blood flow through the heart is best described by which of these

a. Vena cava right atrium right ventricle lungs pulmonary artery left atrium left ventricle

b. Right atrium right ventricle pulmonary artery lungs pulmonary vein left atrium left ventricle

c. Aorta right atrium right ventricle lungs pulmonary vein left atrium left ventricle vena cava

d. Right atrium right ventricle pulmonary vein lungs pulmonary artery left atrium left ventricle

3. In assessing the carotid arteries of an older patient with cardiovascular disease, the FNP would

a. Palpate the artery in the upper one third of the neck. NR 509 Week 4 Quiz Advanced Physical Assessment

b. Listen with the bell of the stethoscope to assess for bruits.

c. Simultaneously palpate both arteries to compare amplitude.

d. Instruct the patient to take slow deep breaths during auscultation.

4. When listening to heart sounds the FNP knows that the valve closures that can be heard best at the base of the heart are

a. mitral, tricuspid.

b. tricuspid, aortic.

c. aortic, pulmonic.

d. mitral, pulmonic.

5. The sack that surrounds and protects the heart is called the

a. pericardium.

b. myocardium.

c. endocardium.

d. pleural space.

6. When assessing a newborn infant who is five minutes old the FNP knows that which of these statements would be true?

a. The left ventricle is larger and weighs more than the right.

b. The circulation of a newborn is identical to that of an adult.

c. There is an opening in the atrial septum where blood can flow into the left side of the heart.

d. The foramen ovale closes just minutes before birth and the ductus arteriosus closes immediately after.

7. The FNP is performing an assessment on an adult. The adults vital signs are normal and capillary refill is five seconds. What should the FNP do next? NR 509 Week 4 Quiz Advanced Physical Assessment

a. ask the parent if the child has had frostbite in the past.

b. suspect that the child has a venous insufficiency problem.

c. consider this a delayed capillary refill time and investigate further.

d. consider this a normal capillary refill time that requires no further assessment.

8. During an assessment of an older adult the FNP should expect to notice which finding as normal physiologic change associated with aging process?

a. Hormonal changes causing vasodilation and a resulting drop in blood pressure

b. Progressive atrophy of the intramuscular calf veins, causing venous insufficiency

c. Peripheral blood vessels growing more rigid with age, producing a rise in systolic blood pressure

d. Narrowing of the inferior vena cava, causing low blood flow and increases in venous pressure resulting in varicosities

9. The mother of a three month old infant states that her baby has not been gaining weight. With further questioning the FNP finds that the infant falls asleep after nursing and wakes up after a short amount of time hungry again. What other information with the FNP want to have?

a. The position that baby sleeps in

b. Sibling history of eating disorders

c. Amount of background noise when eating

d. Presence of dyspnea or diaphoresis when sucking

10. In assessing a patient’s major risk factors for heart disease which would the FNP want to include when taking a history?

a. Family history, hypertension, stress, age

b. Personality type, high cholesterol, diabetes, smoking

c. Smoking, hypertension, obesity, diabetes, high cholesterol

d. Alcohol consumption, obesity, diabetes, stress, high cholesterol

11. The FNP is assessing… the pulses of a patient who has been admitted for untreated hyperthyroidism. The FNP should expect to find a—— pulse NR 509 Week 4 Quiz Advanced Physical Assessment

a. normal

b. absent

c. bounding

d. weak, thread

12. A patient complains of leg pain that wakes him at night. He states that he has been having problems with his legs. He has pain in his legs his legs when they are elevated, which disappears when he dangles them. He recently noticed a sore on the inner aspect of his right ankle. On the basis of this history information the FNP interprets that the patient is most likely experiencing

a. pain related to lymphatic abnormalities.

b. problems related to arterial insufficiency.

c. problems related to venous insufficiency.

d. pain related to musculoskeletal abnormalities.

13. During an assessment the FNP uses the profile sign to detect

a. Pitting edema. NR 509 Week 4 Quiz Advanced Physical Assessment

b. Early clubbing.

c. Symmetry of the fingers.

d. Insufficient capillary refill.

14. Which of these statements describes the closure of the valves in a normal cardiac cycle?

a. The aortic valve closes slightly before the tricuspid valve.

b. The pulmonic valve closes slightly before the aortic valve.

c. The tricuspid valve closes slightly later than the mitral valve.

d. Both the tricuspid and pulmonic valves close at the same time.

15. When performing a peripheral vascular assessment on a patient the FNP is unable to palpate the ulnar pulses. The patient skin is warm and capillary refill is normal. The FNP should next

a. check for the presence of claudication.

b. refer the individual for further evaluation.

c. consider this a normal finding and proceed with the peripheral vascular evaluation.

d. ask the patient if he or she has experienced any unusual cramping or tingling in the arm.

16. A 67-year-old patient states that he “recently began have pain in his left calf when climbing the 10 stairs to his apartment”. This pain is relieved by sitting for about two minutes then he’s able to resume activities. The FNP interprets this patient is most likely experiencing NR 509 Week 4 Quiz Advanced Physical Assessment

a. Claudication.

b. Sore muscles.

c. Muscle cramps.

d. Venous insufficiency.

17. In assessing a 70-year-old man the FNP finds the following blood pressure 140/100 mmHg, heart rate 104 and slightly irregular, split S2. Which of these findings can… by expected hemodynamic changes related to age?

a. Increase in resting heart rate

b. Increase in systolic blood pressure

c. Decrease in diastolic blood pressure

d. Increase in diastolic blood pressure

18. The FNP is examining the lymphatic system of a healthy three year old child. Which finding should the FNP expect?

a. Excessive swelling of the lymph nodes

b. The presence of palpable lymph nodes

c. No nodes palpable because of the immature immune system of a child

d. Fewer numbers and a decrease in size of lymph nodes compared with those of an adult

19. The FNP is preparing to perform modified Allen test. Which is an appropriate reason for this test?

a. To measure the rate of lymphatic drainage NR 509 Week 4 Quiz Advanced Physical Assessment

b. To evaluate the adequacy of capillary patency before venous blood draws

c. To evaluate the adequacy of collateral circulation before cannulating the radial artery

d. To evaluate the venous refill rate that occurs after the ulnar and radial arteries are temporarily occluded

20. A 25-year-old woman is in her fifth month of pregnancy has a blood pressure of 100/70 mmHg. In reviewing her previous exam the FNP notes that her blood pressure in her second month was 124/80 mmHg. When evaluating this change what does the FNP know to be true?

a. This is the result of peripheral vasodilatation and is an expected change.

b. Because of increased cardiac output, the blood pressure should be higher this time.

c. This is not an expected finding because it would mean a decreased cardiac output.

d. This would mean a decrease in circulating blood volume, which is dangerous for the fetus

21. Findings from an assessment of a 70-year-old patient with swelling in his ankles include jugular venous pusations, 5 cm above the sternal angle when the head of his bed is eleveted 45°. The FNP knows that this finding indicate: NR 509 Week 4 Quiz Advanced Physical Assessment

a. Decreased fluid volume.

b. Increased cardiac output.

c. Narrowing of jugular veins.

d. Elevated pressure related to heart failure.

22. The component of the conduction system referred to as the pacemaker of the heart is the

a. Atrioventricular (AV) node.

b. Sinoatrial (SA) node.

c. Bundle of His.

d. Bundle branches.

23. The FNP is reviewing anatomy and physiology of the heart. Which statement best describes by atrial kick?

a. The atria contract during systole and attempt to push against closed valves.

b. Contraction of the atria at the beginning of diastole can be felt as a palpitation.

c. Atrial kick is the pressure exerted against the atria as the ventricles contract during systole.

d. The atria contract toward the end of diastole and push the remaining blood into the ventricles.

24. A 45-year-old man is in the clinic for a routine physical. During history the patient states he has been having difficulty sleeping. I’ll be sleeping great and then I wake up and feel like I can’t catch my breath. The FNP‘s best response to this would be

a. “When was your last electrocardiogram?”

b. “It’s probably because it’s been so hot at night.”

c. “Do you have any history of problems with your heart?”

d. “Have you had a recent sinus infection or upper respiratory infection?”

25. When assessing a patient the FNP notes that the left femoral pulse as diminished 1 /4 . What should the FNP do next? NR 509 Week 4 Quiz Advanced Physical Assessment

NR 509 Week 8 Summary Reflection

Purpose

In order to provide high quality healthcare to patients, the provider of care must possess the skills and competency indicative of a high quality medical provider. The rationale for measuring quality improvement is the belief that good performance reflects good-quality practice. A quality improvement strategy is defined as any intervention aimed at reducing the quality gap. Therefore, students must aim to achieve the skills and competencies indicative of high quality healthcare providers through the systematic implementation of a quality improvement strategy.

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Program Outcomes

This activity is guided by Program Outcome (PO) 1:

PO1. Provide high quality, safe, patient-centered care grounded in holistic health principles. (holistic health & patient-centered care) NR 509 Week 8 Summary Reflection

The purposes of this activity are to: (a) reflect upon providing high quality healthcare to patients, (b) identify knowledge deficits as determined by the 3P examination, (c) identify educational resources available through the Chamberlain University library, (d) create a self-driven quality improvement plan aimed at decreasing knowledge deficits and improving performance, and (e) share your improvement strategies with student peers.

Preparing for the Activity and Guidelines

Reflect upon PO1and provide 
two
 (2) or more examples of how you specifically achieved or had exposure to this outcome during this course.

Review the results of your 3P examination.

Identify 
three
 (3) content domains in which your performance was the lowest percentage as compared to the national average. If two or more domains share equal percentages, select the three lowest domains for this activity. In the 
example
 below, the student scored the lowest (17%) in the Endocrine and Urology domains and 33% in Cardiovascular. The student would select all three domains.

Access the 
NR509 Library 
using the web link below and select resources available through the Chamberlain University library to research topics and content areas related to the domains identified in Step 3. Explore the NR509 LibGuide Study Strategies box.  NR 509 Week 8 Summary Reflection

Create a self-guided quality improvement plan based on these resources. Include details such as:

Resource Names

Timeline for studying

Goals/Outcomes

Share your improvement plan with your peers in the Week 8 Summary Reflection Post in Canvas. NR 509 Week 8 Summary Reflection

Pre Brief

In this case study, you will complete the Plan My Exam activity to organize the exam procedures you will use into a sequence that moves smoothly from head to toe by mapping them to the region of the body where you will perform them. After you have planned your exam, you will enter the clinic room and conduct a Comprehensive Assessment by interviewing and examining your Digital Standardized Patient. When collecting information for the comprehensive assessment, be sure to include the following:

• Current Illnesses

• Past Illnesses

• Chronic Illnesses

• Past Medical History

• Injuries and Treatments

• Hospitalizations/Surgeries

• Environmental/Food/Drug Allergies

• Current Medications/Herbal Remedies/Health Supplements

• Past Medications

• Habits/Drug and Alcohol Use

• Family Medical History

• Psychosocial/Cultural/Spiritual History

• Sexual History

• Obstetric History

As you complete the case study this week, be cognizant of the time that it takes you to conduct the history and physical. In family practice, you are generally allocated a total of 15-minutes for an entire patient visit, which includes taking a history, performing a physical examination, and developing/implementing a treatment plan. You also need to incorporate health promotion into the visit when possible. Be certain to follow a systematic approach during your interview and inquire about each system on the ROS. During the physical exam, be sure to apply the examination skills that you have learned in this course to assess your virtual patient.

Ms. Tina Jones is a pleasant, 29-year-old African American single woman who presents for a pre-employment physical. She is the primary source of the history. Ms. Jones offers information freely and without contradiction. Speech is clear and coherent. She maintains eye contact throughout the interview. Reason for visit: Patient requests a complete health assessment for a pre-employment.

Results Included:

Experience Overview

Transcript

Subjective
 
Data
 
Collection

Objective
 
Data
 
Collection

Documentation
 
/
 
Electronic
 
Health
 
Record

Plan
 
My
 
Exam

Self –
 
Reflection