Tag: Clinical-Nursing

  • Genetic Family History – evidence-based teaching plan

    Genetic Family History – evidence-based teaching plan

    GENERAL DIRECTIONS & PROJECT GUIDELINES

    Application: Use Microsoft Word 2010™ or later to create this assignment.

    This paper is to be written in APA format. Please use the recommended assignment specific .courselearn.net/lms/content/1520/51804/NR305/NR305_W6_Teaching%20Plan_APA_Template_MAR18.docx”>APA Template (Links to an external site.)Links to an external site.linked here to type on. The SSPRNBSN resource has a great section on writing scholarly papers and APA formatting (to find resource

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    watch:.brainshark.com/devry/Student_Success_Strategies/zHszgnQAKzBXqbz0″>http://www.brainshark.
    com/devry/Student_Success_
    Strategies/zHszgnQAKzBXqbz0 (
    Links to an external site.)Links to an external site.)

    APA formatting helps you to format your paper in a professional manner and provides consistent methods for citing your sources within the paper and providing the complete reference on the reference page. See the documents in the APA category in Course Resources for assistance with APA formatting. Genetic Family History – evidence-based teaching plan.

    This paper is expected to be
    no more than four pages
    in length (not including the title page and reference list).

    Please use the categories listed below as the first level headings for each section of your paper
    (Exception: Instead of “Introduction” please use the title of your paper).

    CONTENT GUIDELINES

    Using the information gathered in your Genetic Family History and Milestone 1 assignments, you will identify and research one modifiable risk factor. You will develop an evidence-based teaching plan that promotes health, with the aim of improving patient outcomes related to this modifiable risk factor.

    Introduction (1 paragraph):
    The introduction should be interesting and capture the reader’s attention.

    State
    one preventable disease
    your adult participant is at risk for developing (obesity, Type 2 Diabetes, etc.), based on the information you have gathered during this course.

    Introduce
    one
    modifiable risk factor
    (diet, smoking, sedentary lifestyle, etc.) associated with the preventable disease you described.

    Clearly state the purpose of your paper. The purpose statement should relate to developing a patient teaching plan.

    Preventable Disease Overview (1-2 paragraphs)
    : Please use course materials and scholarly sources to complete this section. Be sure to paraphrase and include citations as needed!

    Describe briefly the
    preventable disease
    you identified in the introduction.

    What are the signs and symptoms associated with this disease?

    How is it diagnosed? Notable information from Health History and General Survey? Signs and symptoms? Risk assessments? Lab values? Genetic Family History – evidence-based teaching plan.

    What physical assessment findings would be associated with this disease?

    How did you identify your adult participant’s risk for this disease?

    Specific information gathered in the Genetic Family History?

    Specific information gathered in the Milestone 1 assignment?

    Evidence Based Intervention (1-2 paragraphs):

    Choose and describe
    one
    evidence based intervention
    related to the modifiable risk factor
    you have chosen. (One that has been shown to be effective at reducing an individual’s risk for developing the preventable disease.)

    Describe this intervention in detail, and provide rationale for your intervention utilizing:

    At least
    one scholarly peer-reviewed journal article
    . Go to the Chamberlain library at.chamberlain.edu/”>http:/library.chamberlain.
    edu (Links to an external site.)Links to an external site..
    Search peer reviewed journals
    to find a scholarly article that discusses interventions associated with the modifiable risk factor you have chosen as the focus of your paper. Summarize what you learned from this article and cite the source in the text and reference page (Author, year). The article must be less than 10 years old. You may include and cite your textbook or other scholarly sources as well, but they
    do not
    count as the scholarly journal article. Genetic Family History – evidence-based teaching plan.

    You must summarize and analyze the information from your sources in your own words. Avoid direct quotations. If you do include a short quotation, be sure to cite it properly.

    List
    short and long term goals
    you have for your participant related to this intervention.

    Implementation: Teaching Plan (1-2 paragraphs):

    Discuss in this section what methods you will use to teach your participant how to implement the intervention.

    What is it that you are asking them to do? (For example, if your intervention is “quit smoking”, what specific steps will you recommend your participant take to achieve this goal?)

    Describe any resources you would provide to the participant to help them understand and be successful (websites, community services, handouts, etc.).

    Evaluation (1 paragraph):

    Describe at least one method (weight, lab values, etc.) you would use to evaluate whether your intervention was effective.

    How would you revise you plan if it proved to be unsuccessful?

    Summary (1 paragraph):

    Summarize the main points of your paper.

    Reiterate what you hope to accomplish by implementing this intervention.

    End with a concluding statement.

    Reference Page
    :

    The Reference Page should start on a new page (insert a page break).

    All references should be cited within the body of the paper as (Author, year) and the full reference should be included in APA format on the reference page.

    A URL link alone is not an adequate reference. Genetic Family History – evidence-based teaching plan.

    See the Chamberlain Guidelines for Writing Professional Papers in Course Resources for examples of properly formatted references.

    BEST PRACTICES – TIPS FOR WRITING A GREAT PAPER!

    Review the directions, guidelines, and grading rubric thoroughly.

    Use the APA template provided.

    Be clear. Write about one preventable disease, one modifiable risk factor, and one related intervention.

    Proofread prior to final submission. Having another person review your work is often helpful to catch grammar and spelling errors. (Spell check is not perfect!)

    Abide by the CCN academic integrity policy –use the Turnitin Draft Submission link found in the Introduction & Resources Module to ensure that your similarity index is less than 24%, if not, revise and resubmit prior to the deadline. Please review the documents related to TurnItIn in Course Resources. Genetic Family History – evidence-based teaching plan.

  • NUR 3516

    NUR 3516 Week 1 discussion

    DQ1

    How is stress different than a crisis? What makes a person

    “crisis-prone”?

    How did the introduction of psychotropic medication and the

    deinstitutionalization of the mentally ill influence current crisis

    intervention and the provision of mental health services?

    DQ2

    When MUST a counselor, nurse, or other health care provider

    (HCP) breech confidentiality? When MAY a counselor, nurse, or HCP breech

    confidentiality? Give an example -maybe even one where you were directly

    involved. (Do not use real names or breech confidentiality.)

    Explain the assigned readings from the ANA Scope and

    Standards, ANA Social Policy Statement, and ANA Code of Ethics state in

    relation to confidentiality

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    Week 2 discussion

    DQ1

    Read the case study on page 862 in Clark 6th edition*

    entitled Caring for a Client with Depression. Consider you are the nurse caring

    for Donna. Describe the type of crisis or crises Donna is experiencing. How

    might you assess her risk for suicide or harm to others such as her baby? What

    interventions might you implement in Donna’s plan of care? Who else might need

    to be involved in Donna’s care? Provide rationales for all responses. NUR 3516.

    *If you have Clark 5th edition, the case study is on page

    926.

    DQ2

    Describe the 4 stages for successful mourning.

    What are some special needs of a parent who has lost a child

    to death?

    Relate the assigned readings from the ANA Scope and

    Standards, and the ANA Code of Ethics to the needs of the parent and stages of

    mourning.

    Week 3 discussion

    DQ1

    What is a need of most adolescents that often is thwarted

    and leads to acting out through self-destructive behaviors?

    Discuss a developmental crisis or special situational crises

    of adolescence and possible intervention strategies to deal with it.

    DQ2

    Nurses assess patients’ use of alcohol and drugs upon

    admission. Many times those under the influence present to emergency rooms for

    medical crisis situations. Explain how you would go about assessing for

    substance abuse and crises. What type of interventions might be appropriate for

    alcoholics or substance abusers? Describe 5 defense mechanisms that are often

    utilized by enablers and co-dependents.

    Week 4 discussion

    DQ1

    Tessa was ready to deploy with her unit, until her doctor

    told her she’d have to stay behind. Returning to her previous life turned out

    to be more difficult than she planned. Hear how Tessa was able to find

    solutions—for herself and for her family.

    From a self-described “happy kid” to a determined

    Marine – Bryan returned home thinking he’d forever lost the ability to feel.

    Hear him tell how he overcame IEDs, posttraumatic stress, and the unique

    challenges of a long-distance romance. Bryan got his life on a better track

    with help from VA.

    After you view the videos discuss why it’s important to have

    innovative approaches to preparing nurses to care for service members and

    veterans. Discuss what resources are available to veterans in your community.

    (View all the videos located under week 4 Video Animations).

    DQ2

    Describe the phases of community disaster as discussed in

    Kanel pages 158-159. How do these compare to the Stages of Disaster Response as

    described in Clark Chapter 25 pages 703-706? What interventions would be

    appropriate for nurses to assist people involved in a natural disaster? Choose

    and explain two of the assessment considerations from Clark Chapter 25 and why

    it is important for nurses to be aware of.

    Week 2

    Handout Assignment

    NUR3516 Handout Assignment Guideline

    DUE DATE: Sunday of Week 2

    Summary: Patient handouts have been used by nurses for many

    years as a teaching tool. A good patient handout can be an effective teaching

    strategy for additional patient education. For this assignment, you will create

    a two-page only patient handout or brochure outlining specific criteria and

    based on your readings and literature searches.

    http://www.advancecustomcommunications.com/education/

    Who

    you will What you

    will write about How

    you will write How

    you will evaluate and

    write

    for support

    Primary Topic: Crisis Intervention Format:

    Create your Write in

    your own words by

    Audience:

    The Education assignment in a paraphrasing content from other

    primary

    audience Microsoft

    Word sources and cite

    according to

    is the

    general For this

    assignment, you will document.

    There are APA

    standards. Citations can be

    population

    of create a two-page

    only patient templates

    you can use in a smaller

    font following any

    patients

    in your handout or

    brochure. Consider within

    Microsoft paraphrased

    content.

    community. the use of variety,

    balance, text Word if you

    wish.

    and

    images placed Save

    it in a location It

    is important to present your

    Tone:

    This asymmetrically

    and with on

    your computer and ideas

    about the subject matter

    assignment

    is to simplicity. with a name that through your

    reflection and

    be

    written in follows

    this analysis.

    Present the information

    third

    person as it You

    will address all of the format:

    Last name, to

    your audience in terms they

    reflects

    your following criteria on your First name, can understand. Write as if you

    professional handout/brochure: NUR3516, Crisis are telling the information to

    the

    insight

    and • Discuss the definition of a Brochure. person who is

    reading the

    research

    findings. “crisis” Organization: Your brochure.

    • Describe how a crisis can

    be

    both an opportunity handout/brochure References: Include a

    minimum

    Secondary and a

    danger should have a

    balance of three (3)

    references; one (1)

    Audience:

    As • Analyze how someone of informational being a nursing

    journal article

    your

    instructor, I becomes

    “crisis prone” content

    and images. (no more

    than 5 years old). Use

    will

    read and • Provide suggestions for Images should not proper

    APA paraphrasing, in-

    evaluate

    how assistance constitute large text citations, and

    corresponding

    effectively

    you portions

    of your reference

    for all sources.

    have

    addressed Consider your

    audience, handout/brochure.

    your

    primary There

    should not be References

    should be found

    varying

    cultures, and literacy

    audience. large

    amounts of somewhere

    on the two pages.

    levels

    as you create your

    white

    space nor DO NOT move to a

    third page.

    brochure.

    The elderly may not

    should

    there be so Your

    references can be in a text

    be

    able to read typeface that is

    many

    things on it that box

    with smaller font.

    too

    small. Too large typeface

    it

    is confusing to the

    will

    not allow you enough room

    eye. Additional sources can be

    from

    for

    all the content you need.

    the

    ANA Essential texts or the

    Same

    for too many or too large

    Length:

    Two pages, course

    textbook. Professional

    images.

    Images should relate

    front

    and back only websites

    can be included, but

    explicitly

    to the content near it

    for

    a handout. A must

    be in proper APA format.

    and

    help make you point or

    brochure

    template The use

    of web sites such as

    gain

    attention to your content.

    will

    only be two Wikipedia or a non-discipline

    pages

    and can be a supportive website

    are not

    trifold

    type brochure. allowed.

    Submission:

    Submit *Please use the Keiser

    University

    your

    handout or Online Library

    for professional

    brochure

    to the week nursing journal articles.

    Sites such

    2

    Assignment area. as the OJIN

    Online Journal of

    Issues

    in Nursing are also

    SafeAssign:

    N/A acceptable.

    Title:

    Crisis Intervention Patient Education Due

    Date: Sunday of Week 2

    Audience:

    General Patient Population

    Tone:

    Third Person

    Format:

    APA Microsoft Word Handout or Brochure

    Length: Two (2) pages ONLY

    References: Minimum three (3) scholarly sources; One (1)

    being a current, nursing journal article

    Assignment Rubric:

    Criteria Allowed Points Comments

    Points earned

    Two-page ONLY handout/brochure 5

    SEQUENCING 25

    Covers all information completely.

    Good sequencing of material with

    clear and concise content reflecting

    education of the general population.

    APPLICATION: 25

    Demonstrates synthesis, analysis, and

    evaluation of topic. Presented

    succinct and relevant information in

    consideration of a diverse population.

    VISUAL APPEAL 15

    Handout/Brochure demonstrates

    good visual appeal. Graphics are

    appropriate for space and relate well

    to message. Font is appropriate for

    population.

    REFERENCES: 20

    Minimum of 3 references (1 reference

    from a nursing peer reviewed journal

    within the last 5 years) included on

    the two pages and in

    APA

    format and style.

    GRAMMAR: 5

    No spelling errors. Excellent

    grammar/spelling/punctuation.

    Proper APA Format, Citations, and 5

    References

    Total points 100

    To ensure that you get the most benefit from your BSN

    education and meet learning/program outcomes, this assignment is NOT optional.

    All students must complete the assignment in order to pass the course. Failure

    to submit the assignment will result in an F in the course regardless of the

    numeric grade without the assignment.

    Week 4

    assignment

    NUR3516 Self Care Assignment Guideline

    DUE DATE: Saturday of Week 4

    Summary: Your assignment is to write an APA formatted

    reflection paper based on taking one hour a week to do something for yourself,

    reflecting on the experience, and answering some final questions. You will also

    present findings from a scholarly, nursing journal article.

    “ANA defines a healthy nurse as one who actively focuses on

    creating and maintaining a balance and synergy of physical, intellectual,

    emotional, social, spiritual, personal and professional wellbeing. A healthy

    nurse lives life to the fullest capacity, across the wellness/illness

    continuum, as they become stronger role models, advocates, and educators,

    personally, for their families, their communities and work environments, and

    ultimately for their patients.” (American Nurses Association [ANA], 2017)

    Explore the Healthy Nurse Healthy Nation website and take

    the challenge! NUR 3516.

    http://nursingworld.org/MainMenuCategories/WorkplaceSafety/Healthy-Nurse

    Who

    you will What you

    will write about How you will

    write How you will

    write

    for evaluate

    and

    support

    Primary Topic: Self Care Reflection and Format: Your paper Write in your own

    Audience:

    The Personal crisis

    prevention will be written in

    APA words and paraphrase

    primary

    audience /intervention 6th edition format content from other

    is the

    general including

    a Title and sources and cite

    nursing Each week, you ARE REQUIRED to Reference page. No according to APA

    community take ONE HOUR and do

    something that abstract is needed. standards, as

    including

    your YOU ENJOY, just for

    yourself! No kids applicable.

    It is

    peers

    and nursing or

    family/friends allowed! It is time just Write

    your paper in a important to present

    leaders. for you to relax and reflect. It

    can be Microsoft Word your ideas about the

    anything that

    helps you regroup and put document.

    Save it in a subject matter through

    Tone:

    This balance

    back in your life like horse- location

    on your your reflection and

    assignment

    is to be backing

    riding, swimming, yoga, computer and with

    a analysis. Present a

    written

    in first reading

    (something other than a name

    that follows this paraphrased summary

    person

    as it textbook),

    and going to the park or a format:

    Last name, of the article you

    reflects

    your own spa.

    It must NOT be anything related to First

    name, NUR3516, present from the

    personal

    beliefs school coursework

    or your job. You will Reflection Paper. literature to support or

    and

    values. then

    journal each week about the argue

    your ideas.

    NUR 3516 However,

    you will experience

    (reflection) and how it Organization:

    also

    correlate the relates

    to what you are learning about Include a

    brief References: Include

    values,

    beliefs, and stress,

    crisis, coping skills, self-care, and introduction

    and one (1) nursing journal

    ethical

    standards supporting

    a “Healthy Nurse, Healthy conclusion

    to your article summary. Use

    Nation™”. paper. Each journal proper APA

    of the nursing

    profession. Within

    your reflection paper, you will

    address

    all of the following questions

    using

    APA level 1 headings:

    Secondary

    Audience: As 1. Present the activity you

    your instructor, I selected

    each week, why you

    will read and chose

    it, and how it made you

    evaluate how feel.

    effectively you 2. Reflect on how you handle

    have addressed daily

    stresses, the resources

    your primary (material,

    personal, and social)

    audience. you

    use to cope, and how your

    perception

    of events affects

    how you

    cope.

    3. How might this activity prevent

    burn-out

    in your daily

    professional

    nursing practice?

    4. What changes have you made

    in your

    life that support a

    Healthy

    Nurse, Healthy

    Nation™”

    lifestyle?

    5. How does the crisis

    intervention

    course better

    prepare

    you to assist those in

    crisis?

    Include

    a summary of one nursing

    journal

    article on self-care or burn-out

    and how

    you benefited by reading it.

    You may

    use the Keiser University

    Online

    Library or a nursing related

    professional

    website to obtain your

    article.

    The

    goal of this assignment is to assist

    you to

    reflect and understand the

    importance

    of caring for yourself as a

    first

    line to caring for others and to

    incorporate

    self-care activities into your

    daily

    lives.

    entry (4) must be a minimum of 250 words. Use of Level One

    APA Headings are required.

    Length: A minimum of three (3) full double-spaced pages are

    required excluding the title and reference page.

    Submission: Submit as one completed paper in one Word

    document to the week 4 Assignment area.

    SafeAssign: Your paper will automatically be submitted

    through SafeAssign, a plagiarism software program

    Please review the SafeAssign information under the Student

    Resources Tab, Writing and Library link within the course.

    paraphrasing, in-text citations, and corresponding reference

    for all sources (if additional sources are used).

    Additional sources can be from the ANA Essential texts or

    the course textbook. Professional websites can be included, but must be in

    proper APA format. NUR 3516. The use of web sites such as Wikipedia or a non-discipline

    supportive website are not allowed.

    *Please use the Keiser University Online Library for

    professional nursing journal articles. Sites such as the OJIN Online Journal of

    Issues in Nursing are also acceptable.

    Title: Self Care Personal Crisis Prevention/Intervention Due Date: Saturday of Week 4

    Audience: General Nursing Community

    Tone: First Person

    Format: APA and Level 1 Headings

    Length: Three (3) full double-spaced pages are required

    excluding the title and reference page.

    References: One summarized nursing journal article

    Assignment Rubric:

    Criteria Allowed Points Comments

    Points earned

    Submitted

    reflections for each week 40

    (4).

    Each with a minimum of 250

    words.

    Demonstrates

    synthesis, analysis, and 20

    evaluation

    of topics.

    Brief

    introduction and conclusion 10

    included

    Included

    a summary of a nursing 20

    journal

    article related to topic with

    reference.

    Minimum

    of three pages not 5

    including

    title and reference

    page.

    Grammar/Spelling/Punctuation

    are .

    Proper

    APA Format, Citations, and 5

    References

    SafeAssign

    Score <15% SafeAssign Score/Feedback: similarity with no plagiarism Total points 100 To ensure that you get the most benefit from your BSN education and meet learning/program outcomes, this assignment is NOT optional. All students must complete the assignment in order to pass the course. Failure to submit the assignment will result in an F in the course regardless of the numeric grade without the assignment. Week 1 quiz Question 1 Crisis intervention has its beginnings during the time of Freud. Answers: True False Question 2 Suicide prevention and community mental health services became widespread in the Answers: 1800’s. 1960’s. 1980’s. 1990’s. Question 3 The role of nurses in the Gay, Lesbian, Bisexual, and Transgender (GLBT) community is to: Answers: Provide access to public health care Allow free expression of sexuality in the community Provide direct care and advocate for healthcare services Establish their basic human needs in society Question 4 Countertransference refers to the unresolved feelings that the client feels toward the counselor. Answers: True False Question 5 Battered woman syndrome is a form post traumatic stress disorder (PTSD). Answers: True False Question 6 Which of the following options is not a characteristic of effective coping behavior as presented by Caplan? Answers: Actively exploring reality issues. Trusting in oneself. Freely expressing feelings. Handling it alone. Question 7 All of the following are characteristics of a batterer except Answers: jealousy. controlling. crying. criticizing. Question 8 Community mental health centers have just about dissolved the crisis intervention model. Answers: True False Question 9 The term sexual orientation is more closely defined by: Answers: Attraction Culture Heterosexuality Sexual Behavior Question 10 The use of the paraprofessional in providing crisis intervention Answers: has always been considered appropriate. is accepted by all mental health professionals. is costly, therefore avoided. is controversial due to level of training. Question 11 Ego strength refers to Answers: how proud and self-centered the person is. the amount of energy available to overcome post-traumatic stress disorder. the ability to understand the world realistically and act upon it to get one’s needs met. what the crisis worker feels is the root of all problems. Question 12 Informed consent is when the client is told of his rights and the nature of therapy. Answers: True False Question 13 Crisis and stress mean exactly the same thing. Answers: True False Question 14 It is possible to grow after effective resolution of a crisis. Answers: True False Question 15 A healthy way to manage the stress that emergency workers often experience on the job is to Answers: keep quiet and focus on their work. drink a glass of wine after work. talk with co-workers about their feelings. Talk with their patients about their concerns. Question 16 The ANA Nursing Social Policy Statement is a document about the relationship between individual nurses and society. Answers: True False Question 17 Duty to Warn refers to disclosure of a client’s intention to harm another. Answers: True False Question 18 The process of critical Incident debriefing Answers: is similar to crisis intervention. is a specialized approach to dealing with schizophrenia. is the oldest form of crisis intervention. none of the above. Question 19 The outcome of a person’s crisis is determined by his/her Answers: material resources. personal resources. social resources. all of the above. Question 20 A crisis can be an opportunity because Answers: the person can grow from the challenge of dealing with the precipitating event. the person can seek financial opportunity by winning malpractice lawsuits or workman’s compensation. the person may learn to use ego defense mechanism. none of the above. Question 21 Crisis intervention is popular with HMO’s and managed care. Answers: True False Question 22 The original population with which Lindemann developed his crisis intervention model was WWII veterans. True False Question 23 A crisis worker must break confidentiality in cases of. Answers: elder abuse. child abuse. intent to murder someone. all of the above. Question 24 Confidentiality and privacy are major patient rights that nurses have an ethical and legal responsibility to protect. Answers: True False Question 25 Most crises lead to psychosis. Answers: True False Week 2 quiz Question 1 Parents who lose a child to death often benefit from support groups. Answers: True False Question 2 What is the purpose of basic attending skills? Answers: To find the precipitating event. To develop rapport with the client. To provide coping skills. To practice effective communication. Question 3 Which of the following is an example of a support or validation statement? Answers: “More than 30% of woman live in abusive households.“ “You have the choices now that you didn’t have before. Let’s explore them.“ “Your feelings are normal and other people would feel the same in your situation.“ “When life gives you lemons, make lemonade!” Question 4 NUR 3516 Suicidal people rarely leave hints that they are thinking of suicide. Answers: True False Question 5 Death of a loved one is much worse than divorce. Answers: True False Question 6 A community health nurse has made available a list of trained volunteers to assist families with members who have chronic mental health problems, including dementia and Alzheimer’s disease. These volunteers are available to provide primary caregivers opportunities for respite services. This is an example of what level of care for chronic mental illness? Answers: Maintenance Secondary Prevention Treatment Question 7 The ANA Code of Ethics for Nurses states that a nurse: Answers: is responsible for advancing the paraprofessionals. is not responsible for health needs and concerns. should advocate to protect the health, safety and rights of all patients. should not promote intraprofessional integrity. Question 8 About what percentage of marriages end in divorce? Answers: 25% 50% 75% 90% Question 9 Suicide is always an insane act. Answers: True False Question 10 People who are divorcing are at risk for increased alcohol use. Answers: True False Question 11 Reflection of feelings is contraindicated for clients in crisis due to the risk for suicide. Answers: True False Question 12 According to the ANA Code of Ethics for Nurses, nurses must respect the worth, dignity and rights of all human beings unless the nature of the health problem is against the beliefs of the nurse. Answers: True False Question 13 People who lose someone to death should never learn to adjust to life without them. Answers: True False Question 14 The most important part of the coping phase of crisis intervention is to Answers: make sure the client reads self-help books. help the client develop new coping ideas. give the client solid financial advice. determine the level of subjective distress. Question 15 The ANA Scope and Standards of Practice (2nd edition) states that a nurse Answers: promotes informed decision-making when ordered by a physician. maintains professional role boundaries while engaging in a dual relationship. does not need to use the Code of Ethics for Nurses to guide practice. delivers care that protects patients autonomy, dignity, rights, values, and beliefs. NUR 3516. Question 16 A problem-focused coping strategy is best to help people with mental illness deal with their symptoms. Answers: True False Question 17 Hospitalizing a high risk client is avoided at all costs. Answers: True False Question 18 The ANA Code of Ethics for Nurses states the nurse supports the health, wellness, and decision-making of patients even if the patient choices are self destructive. Answers: True False Question 19 According to the ANA Code of Ethics for Nurses, each nurse has an obligation to be knowledgeable about the moral and legal rights of all patients to self-determination. Answers: True False Question 20 Which is considered the most effective way to invite a client to talk? Answers: Close ended questions Interpretations Open ended questions None of the above Question 21 A client who says “I’m going to kill myself and you can’t stop me” is probably in what category of suicide risk? Answers: No Risk Low Risk Middle Risk High Risk Question 22 Most people will experience grief in the same way. Answers: True False Question 23 People who are divorcing should be encouraged to tell their parents and in-laws the details of the break-up. Answers: True False Question 24 People with a mental disorder such as schizophrenia are at an increased risk for suicide. Answers: True False Question 25 Which is an example of a 12-step group that can be suggested as an alternative coping behavior? Answers: Cocaine Anonymous Scared Straight Phoenix House All of the above Week 3 quiz Question 1 While interviewing the spouse of a client who is being treated for substance abuse, the population health nurse suspects codependence exists between the client and the spouse. What characteristic of codependence did the nurse assess? Answers: Evidence of high self-esteem. The ability to freely express feelings. Control of others. The ability to stand up for one’s own desires. Question 2 Which statement is true about teen pregnancy? Answers: Teen birth rates are decreasing yearly. Teen pregnancy does not present a crisis situation. It is rare and not a major problem in the U. S. The majority of teen pregnancies end in abortion. Question 3 Which of the following is the fastest growing drug problem and accounts for the second most commonly abused category of drugs? Answers: Alcohol Marijuana Prescription drugs Illicit drugs Question 4 In dealing with developmental or evolutional crises, which approach would yield the best results? Answers: Psychoanalysis Darwinism Theory Family Systems Theory Humanistic Approach Question 5 During middle childhood, the major role changes going on for the child deal with Answers: bonding. stagnation. success and failures. all of the above. Question 6 The main goal of crisis intervention for victims of sexual assault is to Answers: confront the abuse head on and aggressively. allow them to experience the associated depression and guilt. move them from victim role to survivor role. simply be there as a supportive role model. Question 7 What types of crises usually bring in a drug addict or alcoholic? Question 8 Cyberbullying reflects abuse that is committed through texting or social media sites. Answers: True False Question 9 Women in the military may be at risk of being raped because they make poor decisions in social and training activitites. Answers: True False Question 10 A geriatric nurse specialist has been visiting a senior community center and would like to screen the senior clients who visit for substance abuse. The nurse realizes this is an important intervention in the care of the elderly client because Answers: there are several community resources available for elderly client use. while prevalence of abuse is low in this population, consequences are more severe. physicians prefer others address this concern. substance abuse is a huge problem in this age group. Question 11 Define Situational Crisis and give an example. Question 12 The empty nest syndrome is part of the crisis of which stage? Answers: Infancy Middle adult Childhood Maturity Question 13 Many elderly struggle with issues of Answers: integrity vs. despair. intimacy vs. isolation. generativity vs. stagnation. none of the above. Question 14 Engagement is the term used to describe situations when everyone in the family are overly involved in each other’s lives. Answers: True False Question 15 The ANA Code of Ethics for Nurses states the needs for health care does not justify unwanted intrusion into the patient’s life. Answers: True False Question 16 The ABC Model of Crisis Intervention is not applicable to victims of rape. Answers: True False Question 17 An eating disorder in which a teenage girl starves herself and refuses to maintain adequate nutrition is called Answers: bulimia nervosa. anorexia nervosa. food abstinence syndrome. none of the above. Question 18 High school students should be educated on date rape because it is highest in the 16-19-year-old age group. Answers: True False Question 19 When working with a bully and their parents, it is important to Answers: evaluate the family dynamics. help the bully understand it is not their fault. bring the victim to the meetings for an apology. encourage empowerment. Question 20 During which stage or stages of development might a crisis worker teach parents how to deal with power struggles? Answers: Toddlerhood Adolescence Maturity Toddlerhood and adolescence Question 21 One competency of the ANA Scope and Standards of Practice is that the RN employs strategies to promote a healthy lifestyle and preventative self-care for patients. Answers: True False Question 22 A major task in the development of family subsystems is Answers: establishing new roles. strongly maintaining set boundaries. helping family members maintain homeostasis by counteracting changes. All of the above. Question 23 A major emotional cause of teen runaways is Answers: to live with supportive friends who don’t bully. due to feelings of abandonment by parents. due to the glamour of living on the streets. All of the above. Question 24 Which drug is usually injected and highly addictive? Heroin Answers: LSD Heroin Marijuana All of the above Question 25 Define “Crises of old age” and provide an example. Week 4 final quiz Question 1 A person in crisis may be in danger of Answers: becoming psychotic. attempting suicide. coming through the crisis at a lower level of functioning. all of the above. Question 2 The ANA Scope and Standards of Practice states a nurse is not required to provide healthcare consumers with information about intended effects and potential adverse effects of proposed therapies. Answers: True False Question 3 Mr and Mrs. Collins’ children have all moved out and the couple is feeling disconnected and depressed. This is an example of a crisis in which stage of development according to Erikson? Answers: Trust versus Mistrust Generativity versus Stagnation Intimacy versus Isolation Ego Intergrity versus Despair Question 4 Death of a loved one is much worse than a divorce. Answers: True False Question 5 Enmeshment is typical of Mexican-American families. Answers: True False Question 6 A client who says “I’m going to kill myself and you can’t stop me” is probably Answers: high suicide risk. middle suicide risk. low suicide risk. not a suicide risk. Question 7 Paraphrasing is Answers: a way to help clients feel their emotions. a clarifying technique. is a way to give advice. all of the above. Question 8 Briefly describe a crisis (situational, developmental, or evolutional) in which you observed as a nurse and how you were able to cope or how you helped the person in crisis to cope. This can be a hypothetical situation. Question 9 Typical warning signs of suicide include all of the following except Answers: giving things away. putting things in order. continuing usual activities. increased drug use. Question 10 Who may waive privileged communication by signing a waiver for purposes of continuity of care? Answers: The therapist The client The courts The patients family Question 11 Crisis intervention is popular with HMO’s and managed care. Answers: True False Question 12 The overall goal when intervening with someone going through a divorce is Answers: to help the client grieve. to ensure the better spouse gets the best deal. to ensure that in-laws are well aware of the details of the divorce. to help them get their finances in order. Question 13 Children whose parents go through divorce may suffer from Answers: loyalty issues. blended family issues. depression. all of the above. Question 14 The majority of rape victims do not know who their assailant is. Answers: True False Question 15 The ANA Code of Ethics for Nurses states that the nurse owes the same duty to self as others. Answers: True False Question 16 Dual relationship is legal if the patient is legally insane. Answers: True False Question 17 People who are divorcing can avoid a crisis when they have resources in place to support them. Answers: True False Question 18 The ANA Scope and Standards of Practice states that a nurse commits to lifelong learning to strengthen their individual practice within varied settings. Answers: True False Question 19 What is the biggest difference between Post-Traumatic Stress Disorder (PTSD) and Acute Stress Disorder (ASD)? Selected Answer: Answers: The seriousness of the trauma levels of anxiety Duration of time None of above Question 20 Crisis and stress differ in their meaning. Answers: True False Question 21 The most important part of the coping phase of crisis intervention is to Answers: reads books as a coping mechanism. develop new coping ideas. educate and give solid advice. understand the perception of the event. Question 22 The use of the paraprofessional in providing crisis intervention Answers: has always been considered inappropriate. is accepted by all mental health professionals. is costly, therefore avoided. none of the above. Question 23 What types of crises usually bring in a drug addict or alcoholic? Question 24 The ANA Code of Ethics for Nurses states the nurse provides nursing services according to need while respecting the rights and dignity of all patients. Answers: True False Question 25 Paraprofessionals are not qualified to conduct crisis intervention sessions. Answers: True False Question 26 What might be a sign that a caretaker of someone with Alzheimer’s disease may need intervention? Answers: They are socializing too much. Their own health problems are exacerbated. They are sleeping 6-8 hours a night. all of the above. Question 27 The Battering Cycle – match the stage to the definition Question Match Selected Match Love and dependency are key characteristics. Honeymoon Stage All Answer Choices A. Tension-Building Stage B. Return to Honeymoon Stage C. Honeymoon Stage D. Explosion Stage Question 28 Post-Traumatic Stress Disorder (PTSD) was first recognized as a medical condition after which military event? Answers: Vietnam War World War II Persian Gulf War Veteran’s Day Question 29 The purpose of the American with Disabilities Act (ADA) of 1990 was to Answers: broadly challenge discrimination against disabled people. provide funding for retirement homes. provide testing for Alzheimer’s disease. prevent discrimination against other races. Question 30 The Department of Social Services primary role in regards to veterans is to Answers: ensure they use services entitled to them. provide direct primary health care services. maintian mental health counseling appointments. None of the above. Question 31 The ANA Code of Ethics for Nurses states the standard of nursing practice and the nurse’s responsibility to provide quality care require that relevant data not be shared with those members of the healthcare team who have a need to know. Answers: True False Question 32 Critical incident debriefing includes Answers: support and assurance. encouraging functioning. empathy and information. all of the above. Question 33 It is best not to encourage a client to speak about a loved one’s death. Answers: True False Question 34 A major task in the development of family subsystems is Answers: establishing new roles. strongly maintaining set boundaries. Helping family members maintain homeostasis by counteracting changes. All of the above Question 35 Which is probably the most important development in intervening with the disabled? Answers: Psychoanalysis Eye-Movement Desensitization and Reprocessing (EMDR) Case management Person centered therapy Question 36 All of the following signs or behaviors indicate probable child abuse except: Answers: Genital bruises The absence of a hymen Venereal disease Child report of abuse Question 37 During which stage of development might a crisis worker teach parents how to deal with power struggles? Answers: Toddlerhood Adolescence Maturity Toddlerhood and adolescence Question 38 Which statement is most true regarding Rape Trauma Syndrome (RTS)? Answers: RTS has four distinct stages. Victims self-esteem is increased in the reorganization stage. Counselors can have the biggest impact in the first stage. RTS is not a form of PTSD Question 39 Parents who lose a child to death often prefer support groups. Answers: True False Question 40 A nurse is assessing a patient who appears euphoric, is slow to answer questions, has bloodshot eyes, and asks if “there is anything to munch on around here”. The patient is most likely under the influence of Answers: LSD. marijuana. heroin. alcohol. Question 41 Duty to Warn refers to disclosure of a client’s intention to harm another. Answers: True False Question 42 A crisis can be an opportunity because Answers: the person can grow from the challenge of dealing with the precipitating event. the person can seek financial opportunity by winning malpractice lawsuits or workman’s compensation. the person may learn to use ego defense mechanism. None of the above. Question 43 A person who is considering suicide will typically hold onto possessions dear to them. Answers: True False Question 44 In which stage of cultural sensitivity does the therapist consider culture as distracting from clinical effectiveness? Answers: Unawareness of cultural issues Heightened awareness of culture Burden of considering culture Toward cultural sensitivity Question 45 Shame and obligation issues are of utmost importance when dealing with Mexican-Americans. Answers: True False Question 46 The best technique for a counselor to use when working with a battering parent is Answers: educating. reframing. empowering. validation. Question 47 Ego strength refers to one’s capacity to deal with the demands of reality. Answers: True False Question 48 A patient tells a nurse that he was a member of OIF. The nurse knows that the patient served in the military operation known as Answers: Operation Intelligence Forensics. Operation Iraqi Freedom. Operation Iraqi Fighters. Operation Intelligence Finder. Question 49 A young soldier returning home from duty in a war zone tells the nurse at the state-side army base that sometimes he felt the media was a bigger enemy than the terrorists he was fighting. The nurse, understanding the considerations to assess in this situation, believes this soldier is reacting to: Answers: Behavioral factors. Physical environmental factors. Psychological factors. Sociocultural factors. Question 50 Crisis intervention has its beginnings during the time of the Wellesley project. Answers: True False

  • Ethical and Legal Implications of Prescribing Drugs – nurs 6521 Discussion

    Ethical and Legal Implications of Prescribing Drugs – nurs 6521 Discussion

    Week 2

    discussion

    Discussion: Ethical and Legal Implications of Prescribing

    Drugs

    What type of drug should you prescribe based on your

    patient’s diagnosis? How much of the drug should the patient receive? How often

    should the drug be administered? When should the drug not be prescribed? Are

    there individual patient factors that could create complications when taking

    the drug? Should you be prescribing drugs to this patient?

    ORDER A PLAGIARISM-FREE PAPER HERE

    These are some of the questions you might consider when

    selecting a treatment plan for a patient. As an advanced practice nurse

    prescribing drugs, you are held accountable for people’s lives on a daily

    basis. Patients and their families will often place trust in you because of

    your position. With this trust comes power and responsibility, as well as an

    ethical and legal obligation to “do no harm.” It is important that you are

    aware of current professional, legal, and ethical standards for advanced

    practice nurses with prescriptive authority. In this Discussion, you explore

    ethical and legal implications of scenarios and consider how to appropriately respond.

    Scenario 1:

    As a nurse practitioner, you prescribe medications for your

    patients. You make an error when prescribing medication to a 5-year-old

    patient. Rather than dosing him appropriately, you prescribe a dose suitable

    for an adult. Ethical and Legal Implications of Prescribing Drugs – nurs 6521 Discussion.

    Scenario 2:

    A friend calls and asks you to prescribe a medication for

    her. You have this autonomy, but you don’t have your friend’s medical history.

    You write the prescription anyway.

    Scenario 3:

    You see another nurse practitioner writing a prescription

    for her husband who is not a patient of the nurse practitioner. The

    prescription is for a narcotic. You can’t decide whether or not to report the

    incident.

    Scenario 4:

    During your lunch break at the hospital, you read a journal

    article on pharmacoeconomics. You think of a couple of patients who have

    recently mentioned their financial difficulties. You wonder if some of the

    expensive drugs you have prescribed are sufficiently managing the patients’

    health conditions and improving their quality of life.

    To prepare:

    Review Chapter 1 of the Arcangelo and Peterson text, as well

    as articles from the American Nurses Association, Anderson and Townsend, the

    Drug Enforcement Administration, and Philipsend and Soeken.

    Select one of the four scenarios listed above.

    Consider the ethical and legal implications of the scenario

    for all stakeholders involved such as the prescriber, pharmacist, patient, and

    the patient’s family. Ethical and Legal Implications of Prescribing Drugs – nurs 6521 Discussion.

    Think about two strategies that you, as an advanced practice

    nurse, would use to guide your ethically and legally responsible

    decision-making in this scenario.

    With these thoughts in mind:

    By Day 3

    Post an explanation of the ethical and legal implications of

    the scenario you selected on all stakeholders involved such as the prescriber,

    pharmacist, patient, and the patient’s family. Describe two strategies that

    you, as an advanced practice nurse, would use to guide your decision making in

    this scenario.

    By Day 6

    Read a selection of your colleagues’ responses and respond

    to at least two of your colleagues on two different days who selected a

    different scenario than you did, in one or more of the following ways:

    Suggest additional ethical and legal implications for all

    stakeholders in your colleagues’ scenarios.

    Offer and support an alternative perspective using readings

    from the classroom or from your own research in the Walden Library.

    Validate an idea with your own experience and additional

    research. Ethical and Legal Implications of Prescribing Drugs – nurs 6521 Discussion.

  • nr443-caring-for-populations-milestone-3-intervention-and-evaluation

    nr443-caring-for-populations-milestone-3-intervention-and-evaluation
    .

    Caring for Populations Milestone 3:

    Intervention and Evaluation PowerPoint Guidelines

    Purpose

    The purpose of this PowerPoint presentation is to provide an

    opportunity to develop a community health nursing intervention and evaluation

    plan for a community health problem that you identified in your community

    (described in Milestone 2: Vulnerable Population Assessment). You will apply

    the components of the nursing process to assist this vulnerable population and

    develop a proposal that could be presented to community leaders.

    Course Outcomes

    This assignment enables the student to meet the following course

    outcomes.

    ORDER A PLAGIARISM-FREE PAPER HERE

    CO1: Apply principles of nursing theory to the

    public health system by analyzing determinants of health and the public health

    intervention wheel. (PO 1)

    CO3: Plan prevention and population-focused

    interventions for vulnerable populations using professional clinical judgment

    and evidence-based practice. (PO 4, 8)

    CO4: Evaluate the delivery of care for individuals, families, aggregates, and communities based on theories and principles of nursing and related disciplines. (PO 1)

    Due Date

    Submit your PowerPoint presentation by 11:59 p.m. MT Sunday by

    the end of Week 6.

    Points

    This assignment is worth a total of 225 points.

    Scenario

    You are a community public health nurse (C/PHN) working with the

    vulnerable population you identified in Milestone 2. You will choose a specific

    community health role that would serve this population. You have analyzed the

    data collected from your windshield survey and vulnerable population

    assignments (the first two milestones) and identified one community health

    problem that a nurse can impact. Now, review the scholarly literature or

    scholarly websites listed below and identify 
    one
     specific

    evidence-based nursing intervention
     that has the potential to improve

    the health of this group. Then develop a proposal to implement this

    intervention and a plan to evaluate the outcomes of this intervention. Create a

    PowerPoint that you could use to present to an organization in your community

    to request approval for funding and support for this intervention. (You are not

    required to implement the intervention or present your PowerPoint, though you

    may want to consider implementing your project in the future).

    Directions

    Watch the Milestone 3

    tutorial at.brainshark.com/devry/Milestone3_2016″>http://www.brainshark.com/devry/Milestone3_2016 (Links to an external site.)Links to an external site..

    A.

    Introduction:
    (average of 2-3 slides)

    ·

    Describe the

    identified problem

    o Include at least 
    two important

    findings
     that demonstrate that this is a problem in your community.

    ·

    Describe your specific

    community health role: Some examples of roles are school nurse, parish nurse,

    home health nurse, occupational nurse, health department nurse etc.

    ·

    Identify the purpose

    of the presentation which is related to proposing a community health

    intervention and evaluation plan. nr443-caring-for-populations-milestone-3-intervention-and-evaluation.

    B.

    Identify

    an evidence based intervention:
     (average of 2-3 slides).

    ·

    Find an 
    evidence-based
     nursing

    intervention from a peer-reviewed journal article 
    OR
     one of

    the following databases. These databases evaluate research evidence about

    community health interventions. Be sure that your intervention is one that is

    recommended. Cite your source on the slide with the author or organization and

    year.

    o Use 
    at least one
     of the

    following to identify an evidence based intervention:

    ·

    A peer reviewed

    journal article demonstrating that your intervention has been successful

    ·

    The Community Guide (.thecommunityguide.org/”>http://www.thecommunityguide.org/ (Links to an external site.)Links to an external site.) Choose one of the topics in the topic tab to

    find interventions. nr443-caring-for-populations-milestone-3-intervention-and-evaluation.

    ·

    The CDC Community

    Health Improvement Navigator Database of Interventions (.cdc.gov/chidatabase”>http://wwwn.cdc.gov/chidatabase (Links to an external

    site.)Links to an external site.)

    ·

    Healthy

    People 2020
     evidence-based

    interventions. Find a relevant topic area at (.healthypeople.gov/2020/topics-objectives”>http://www.healthypeople.gov/2020/topics-objectives (Links to an external site.)Links to an external site.), click on that topic area, and then click on

    the “Interventions and Resources” tab to see the evidence-based

    interventions list for that topic area

    ·

    Provide a brief

    overview of your intervention.

    ·

    Discuss why this

    intervention is a good fit for your community (why you expect it to be

    effective in your community).

    C.

    Intervention

    Implementation:
    (average of 3-4

    slides).

    Describe how you would implement your

    community health nursing intervention in your community

    ·

    Discuss the actions

    will you take as the community health nurse to accomplish this intervention.

    o Relate your actions to the Public Health

    Intervention Wheel (Nies & McEwen, 2015, p. 14, Figure 1-3)

    ·

    Identify your target

    population.

    ·

    Describe how you will

    reach out to your target population.

    ·

    Include strategies to engage

    your target population.

    ·

    Describe where the

    intervention will take place.

    ·

    Identify when your

    intervention will take place

    ·

    Will it take place

    once or multiple times?

    ·

    Identify those in the

    community that you will collaborate with (e.g., physician’s office, church,

    local resources, etc.). nr443-caring-for-populations-milestone-3-intervention-and-evaluation.

    ·

    Explain what level(s)

    of prevention is your intervention addressing (primary, secondary, or tertiary

    prevention)?

    D.

    Proposed

    Evaluation Methods:
     (average of 2-3

    slides)

    Your presentation must include at least one

    proposed quantitative or qualitative evaluation method that you would use to

    determine whether your intervention is effective. Outcome measurement is a

    crucial piece when implementing interventions.

    ·

    Describe the method

    you would use to evaluate whether your intervention was effective. (The.courselearn.net/lms/CourseExport/files/f8307374-3806-488d-ad09-c9d19c5b8c7f/NR443_W6_Qualitative_and_Quantitative_Evaluation_Methods.pdf”>Qualitative and

    Quantitative Education Methods (Links to an external

    site.)Links to an external site. handout can help with understanding qualitative and

    quantitative methods of evaluation).

    ·

    Identify the outcomes

    you would track to show whether your intervention works (eg. BMI would be one

    outcome you could track for a weight loss intervention).

    ·

    When would you measure

    these outcomes?

    ·

    Describe the

    short-term and long-term impact on your community if the intervention is

    successful.

    E.

    Summary:
     (average 1 slide)

    The summary should reiterate the main points

    of the presentation and conclude with what you are asking to be accomplished;

    for example, “Based on ABC, it is imperative our community has XYZ. Can we

    count on your support? Thank you for your consideration.“

    F.

    In addition to the

    slides described above, your presentation should include a title slide with

    your name and role and a reference slide. Cite all sources used with (Author,

    year) on the PowerPoint slide.

    G.

    The slides should

    include the most important points in 
    short bullet pointed phrases.

    Do not include full sentences or paragraphs on the PowerPoint slides. You may

    add additional comments in the notes section to clarify information for your

    instructor. nr443-caring-for-populations-milestone-3-intervention-and-evaluation.

    H.

    The slides should be

    visually appealing and not overcrowded. Use an interesting template and include

    some clipart or graphics for interest.

    Guidelines

    ·

    Application: Use

    Microsoft PowerPoint 2010 or later.

    ·

    Length: The PowerPoint

    slide show is expected to be 
    no more than 20 slides
     in length

    (not including the title slide and reference list slide).

    ·

    Save the assignment

    with your last name in the file title: example: “
    Smith Intervention and

    Evaluation
    .“

    ·

    Submission: Submit

    your PowerPoint file by 11:59 p.m. Sunday by the end of Week 6.

    ·

    Late Submission: See

    Policies on late submissions.

    ·

    Tutorial: For those

    not familiar with the development of a PowerPoint slideshow, the following link

    to the Microsoft website may be helpful..microsoft.com/en-us/support/training-FX101782702.aspx”>http://office.microsoft.com/en-us/support/training-FX101782702.aspx (Links to an external site.)Links to an external site. The SSP Chamberlain Student Success

    Strategies offers a module on Computer Literacy that contains a section on

    PowerPoint. The link to SSP CCSSS may be found on your course list in the

    student portal.

    Best Practices in Preparing PowerPoint

    The following are best practices in preparing this presentation.

    ·

    Be creative.

    ·

    Incorporate graphics,

    clip art, or photographs to increase interest.

    ·

    Make easy to read with

    short bullet points and large font.

    ·

    Review directions

    thoroughly.

    ·

    Cite all sources

    within the slides with (author, year) as well as on the Reference slide.

    ·

    Proofread prior to

    final submission.

    ·

    Spell check for

    spelling and grammar errors prior to final submission.

    **Academic Integrity Reminder**

    Chamberlain College of Nursing values honesty and integrity. All

    students should be aware of the Academic Integrity policy and follow it in all

    discussions and assignments.

    By submitting this assignment, I pledge on my honor that all

    content contained is my own original work except as quoted and cited

    appropriately. I have not received any unauthorized assistance on this

    assignment.

    Please see the grading criteria and rubrics on this page.

    Rubric

    NR443_Milestone3

    NR443_Milestone3

    Criteria

    Ratings

    Pts

    This criterion is linked to a

    Learning OutcomeIntroductions
    The presentation

    begins with an introductory slide that introduces the problem, community

    findings, the nurse’s role, and the purpose.

    25.0 pts

    Presentation

    begins with at least one introductory slide that includes: • Introduction

    of the problem • Two important findings in the community • Nurse’s role •

    Purpose

    22.0 pts

    Introductory

    slide(s) is missing one of items listed in the first column.

    20.0 pts

    Introductory

    slide(s) is missing two items listed in the first column.

    nr443-caring-for-populations-milestone-3-intervention-and-evaluation

    10.0 pts

    Introductory

    slide(s) is missing three items listed in the first column.

    0.0 pts

    Introductory

    slide(s) not present or missing all four items listed in the first column.

    25.0 pts

    This criterion is linked to a

    Learning OutcomeEvidence-based

    Intervention and scholarly support
    One community health

    nursing intervention is described that includes support from a scholarly

    source and a discussion of why the intervention fits in this community.

    45.0 pts

    One community

    health nursing intervention is described with: • Support from at least one

    source listed in Guidelines and • Discussion of why intervention fits your

    community.

    40.0 pts

    One community

    health nursing intervention is identified but the scholarly support or

    discussion of how it fits is brief.

    36.0 pts

    One community

    health nursing intervention is identified but the support is not from a

    scholarly source or discussion of how it fits is missing.

    17.0 pts

    One intervention

    is described but it is not a community nursing intervention.

    0.0 pts

    The intervention

    is missing.

    45.0 pts

    This criterion is linked to a

    Learning OutcomeIntervention

    implementation details
    Specific

    interventions include actions related to the Public Health Intervention

    Wheel; target populations; outreach and engagement methods; locations of

    interventions; timing of interventions; interdisciplinary collaboration; and

    the level of prevention.

    50.0 pts

    Intervention

    specifics includes: • Actions related to Public Health Intervention Wheel •

    Target population identified • Outreach and engagement methods described. •

    Intervention location described. • Timing of intervention (number of

    sessions) included. • Collaborating with other disciplines discussed •

    Level(s) of prevention described (primary, secondary, and/or tertiary).

    44.0 pts

    Intervention is

    missing one specific detail from the first column.

    40.0 pts

    Intervention is

    missing two to three specific details from the first column. nr443-caring-for-populations-milestone-3-intervention-and-evaluation

    19.0 pts

    Intervention is

    missing four to five specific details from the first column.

    0.0 pts

    Intervention is

    missing six or more details from the first column.

    50.0 pts

    This criterion is linked to a

    Learning OutcomeEvaluation
    At least one

    evaluation method is offered with desired outcomes and discussion of

    short-term and long-term impact on the community if the proposed intervention

    succeeds.

    45.0 pts

    Presentation

    includes at least one clear evaluation plan with desired outcomes including

    discussion of the long-term and short-term impact on your community if the

    intervention is “successful.”

    40.0 pts

    Presentation

    includes at least one evaluation plan and discussion of long and short term

    impact but detail is lacking.

    36.0 pts

    Presentation

    includes one evaluation plan but is missing discussion on short or long

    term impact.

    17.0 pts

    Presentation

    includes only the long or short term impact on the community, and the

    evaluation plan is missing.

    0.0 pts

    Presentation lacks

    discussion of evaluation plan and impact.

    nr443-caring-for-populations-milestone-3-intervention-and-evaluation

    45.0 pts

    This criterion is linked to a

    Learning OutcomeSummary
    The summary

    reiterates the problem and the purpose of the intervention.

    20.0 pts

    Includes at least

    one summary slide that clearly reiterates the problem and purpose of the

    presentation.

    18.0 pts

    The summary

    generally describes the problem and the purpose.

    16.0 pts

    The summary

    briefly describes the problem and purpose.

    8.0 pts

    The summary lacks

    a description of the problem and purpose.

    0.0 pts

    Summary slide not

    present

    20.0 pts

    This criterion is linked to a

    Learning OutcomeOverall Presentation
    The PowerPoint

    presentation is clear, logical, appealing, creative, and easy to read.

    20.0 pts

    Presentation is

    presented in a clear and logical manner. PowerPoint is appealing to the eye

    and includes creativity. Bullet points with short phrases used instead of

    paragraphs. Font is easy to read.

    18.0 pts

    Presentation is

    clear and organized but slides are too busy.

    16.0 pts

    Presentation is

    organized but lacks creativity.

    8.0 pts

    Presentation is

    somewhat disorganized.

    0.0 pts

    Presentation is so

    disorganized it is difficult to understand its message.

    20.0 pts

    This criterion is linked to a

    Learning OutcomeMechanics
    The title slide

    includes the title of the presentation and the name of the student.The

    remaining slides contain correct grammar and spelling.All sources are cited

    and referenced appropriately.

    20.0 pts

    Excellent

    mechanics with minimal errors of the following: • Title slide with title

    and student name • Correct grammar and spelling • All sources cited in the

    text of slide • All references listed on the reference slide and in APA

    format (hanging indent not needed for PowerPoint).

    18.0 pts

    Good mechanics

    considering the elements listed in the first column.

    16.0 pts

    Fair mechanics considering

    the elements listed in the first column.

    8.0 pts

    Poor mechanics

    considering the elements listed in the first column.

    nr443-caring-for-populations-milestone-3-intervention-and-evaluation

    0.0 pts

    Very poor

    mechanics such that assignment is difficult to read.

    20.0 pts

    Total

    Points: 225.0

  • SNAPPS (summarize, narrow, analyze, probe, plan, and select)

    SNAPPS (summarize, narrow, analyze, probe, plan, and select)

    Week 5

    assignment

    Purpose

    SNAPPS is a learner-centered approach to case presentation

    in the clinical setting. This model allows the student to take an active role

    in their educational encounter by discussing the patient encounter beyond the

    facts, verbalizing their clinical reasoning, asking questions, and engaging in

    follow-up learning pertinent to the educational encounter. This exercise is

    designed to develop the student’s ability to organize patient information in a

    meaningful way and guide the student in their oral patient presentations in the

    clinical setting. SNAPPS (summarize, narrow, analyze, probe, plan, and select).

    Activity Learning Outcomes

    Through this assignment, the student will demonstrate the

    ability to:

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    1) Summarize

    patient findings into an organized oral presentation. (CO 1, 6)

    2) Demonstrate

    clinical reasoning skills. (CO 1)

    3) Identify

    their own knowledge gaps and inquire about uncertainties, difficulties, or

    alternative approaches. (CO 2)

    4) State a

    diagnostic and therapeutic plan for management of a patient. (CO 4)

    5) Select a

    case-related issue for self-study. (CO 3, 4)

    Due Date:

    The oral presentation and written assignment are due by

    Sunday 11:59 p.m. MT.

    Total Points Possible:

    100

    REQUIREMENTS:

    1. Using a

    patient seen in their clinical setting, students will give an oral presentation

    (via Voice Thread or Kaltura) using the 6-step learner-centered SNAPPS model

    to:

    • Summarize

    briefly the history and findings;

    • Narrow

    the differential to three relevant possibilities;

    • Analyze

    the differential by comparing and contrasting the possibilities;

    • Probe theb preceptor/instructor by asking questions about uncertainties, difficulties, or

    alternative approaches; SNAPPS (summarize, narrow, analyze, probe, plan, and select).

    • Plan

    management for the patient’s medical issues; and

    • Select a

    case-related issue for self-directed learning

    2. In

    addition to the oral presentation, the student will submit a written summary

    using the template provided.

    3. As part

    of the summary, the student will research the self-directed learning topic that

    was identified in the oral presentation to provide a written summary of what

    was learned using appropriate evidence-based, scholarly references.

    4. In-text

    citations and reference list provided must be in APA format.

    5. The

    presentation must be submitted to the Week 5 discussion board before Sunday,

    11:59 p.m. MT. The written portion of

    the assignment must be submitted on the template provided to the assignment box

    before Sunday, 11:59 p.m. MT. SNAPPS (summarize, narrow, analyze, probe, plan, and select).

    PREPARING THE PAPER

    The written portion of this assignment is to be completed on

    the corresponding SNAPPS WRITTEN ASSIGNMENT TEMPLATE which will be submitted to

    the assignment box. There is also a

    SNAPPS ORAL PRESENTATION TEMPLATE which should serve as a guide for the oral

    presentation only (it is NOT submitted). Correct grammar, punctuation, and

    spelling should be observed. In-text

    citations and reference page should follow APA format. Scholarly evidence-based

    medicine (EBM) references must be used.

    Additionally, the following parameters should be set in the

    template before you begin:

    • Font:

    Times New Roman 11pt

    • Single

    space

    • Spacing

    set at 0pt before and after paragraphs (under page layout)

    Category Points % Description

    Summarize 10 10% A

    brief and concise oral summary is presented from the pertinent facts.

    Narrow the Differential Diagnosis 20 20% A minimum of two (2) but no more than

    four (4) diagnoses are given in the differential.

    Analyze the Differential 20 20% Differential

    is analyzed using key findings to argue for and against hypothesis and ranks

    the diagnoses in order of high to low likelihood.

    Probe the Preceptor 10 10% Gaps,

    points of confusion or dilemmas are identified in relation to the problem.

    Plan Management 20 20% A

    novice level diagnostic and therapeutic plan to manage the problem is proposed.

    Self-Directed Learning 10 10% One

    issue for self-directed learning as it relates to the case study is identified.

    Paper Format 10 10% Self-directed

    learning topic is researched and a written summary of what was learned is

    submitted on the SNAPPS presentation TEMPLATE, using appropriate scholarly

    references.

    Total 100 100% A

    quality assignment will meet or exceed all of the above requirements. SNAPPS (summarize, narrow, analyze, probe, plan, and select).

  • Child and Family Health Assessment Test Bank

    Child and Family Health Assessment Test Bank

    Burns: Pediatric Primary Care, 6
    th
    Edition

    Chapter 2: Child and Family Health Assessment

     

    Test Bank

     

    Multiple Choice

     

    The parent of a toddler is concerned that the child may have autism. The primary care pediatric nurse practitioner completes a Modified Checklist for Autism in Toddlers (M-CHAT) tool, which indicates several areas of concern. What will the nurse practitioner do?

    a.         Administer a Childhood Autism Rating Scale (CARS) in the clinic.

    b.         Consult a specialist to determine appropriate early intervention strategies.

    c.         Refer the child to a behavioral specialist for further evaluation. Child and Family Health Assessment Test Bank.

    d.         Tell the parent that this result indicates that the child has autism.

     

    ANS:   C

    The M-CHAT is a screening tool and is useful for detecting behaviors that may indicate autism. This instrument has been found to have acceptable sensitivity, specificity, and significant positive predictive value. If these behaviors are detected, the PNP should refer the child to a specialist for further assessment, using more diagnostic tools. The CARS may be used but requires specialty training and proper credentials. Until the diagnosis is determined, strategies for intervention are not discussed. The M-CHAT is a screening tool and is not diagnostic. Child and Family Health Assessment Test Bank.

     

     

    The mother of a newborn tells the primary care pediatric nurse practitioner that she is worried that her child will develop allergies and asthma. Which tool will the nurse practitioner use to evaluate this risk?

    a.         Three-generation pedigree

    b.         Review of systems

    c.         Genogram

    d.         Ecomap

     

    ANS:   A

    The three-generation pedigree is used to map out risks for genetic diseases in families, as well as conditions with modifiable risk factors. The review of systems is used to evaluate the history of the child’s body systems. The genogram is an approach to developing a family database to provide a graphic representation of family structure, roles, and problems of recurring significance in a family. The ecomap is used to identify relationships in the family and community that are supportive or harmful.

     

     

    The primary care pediatric nurse practitioner is performing a well child check-up on a 20-month-old child. The child was 4 weeks premature and, according to a parent-completed developmental questionnaire, has achieved milestones for a 15-month-old infant. Which action is correct? Child and Family Health Assessment Test Bank.

    a.         Perform an in-depth developmental assessment screen at this visit to evaluate this child.

    b.         Reassure the parent that the child will catch up to normal development by age 2 years.

    c.         Re-evaluate this child’s development and milestone achievements at the 2-year visit.

    d.         Refer the child to a specialty clinic for evaluation and treatment of developmental delay.

     

    ANS:   A

    This child should be at a 19-month adjusted age for prematurity so, according to the parent screen, is 4 months behind. The PNP should perform a more in-depth screen to evaluate this delay. Waiting to see if the child will “catch up” or assuring the parent that this will happen will cause the delays to become more severe. A referral to a specialty clinic should not be made solely on the basis of the parent-completed questionnaire but only after further evaluation of possible delays.

     

     

    When formulating developmental diagnoses for pediatric patients, the primary care pediatric nurse practitioner may use which resource?

    a.         DC: 0-3R

    b.         ICD-10-CM

    c.         ICSD-3

    d.         NANDA International

     

    ANS:   A

    The DC: 0-3R refers to the Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood and is useful for developmental problem diagnosis. The ICD-10-CM is the International Classification of Diseases-Tenth Revision, Clinical Modification and is useful for identifying physiologic diseases. The ICSD-3 is the International Classification of Sleep Disorders – 3rd edition. NANDA International is used to label problems in the functional health domain. Child and Family Health Assessment Test Bank.

     

     

    The primary care pediatric nurse practitioner is evaluating health literacy in the mother of a new preschool-age child. How will the nurse practitioner assess this?

    a.         Ask the child how many books he has at home.

    b.         Ask the mother about her highest grade in school.

    c.         Ask the mother to determine the correct dose of a drug from a label.

    d.         Ask the mother to read a health information handout aloud.

     

    ANS:   A

    The “newest vital sign,” or health literacy, can be determined quickly by asking the parent how many children’s books are in the home. Greater than 10 books in the home is an independent positive predictor of adequate parent health literacy. The other questions may determine a specific level of literacy in general but are not as efficient.

     

     

    The primary care pediatric nurse practitioner learns that the mother of a 3-year-old child has been treated for depression for over 5 years. Which aspect of this child’s development will be of the most concern to the nurse practitioner?

    a.         Fine motor

    b.         Gross motor

    c.         Social/emotional

    d.         Speech and language

     

    ANS:   D

    Maternal depression in the first year of life has been associated with poorer language development at 3 years of age.

     

     

    The primary care pediatric nurse practitioner sees a 3-year-old child who chronically withholds stools, in spite of the parents’ attempts to stop the behavior, requiring frequent treatments with laxative medications. Which diagnosis will the nurse practitioner use to facilitate third-party reimbursement? Child and Family Health Assessment Test Bank.

    a.         Altered elimination pattern

    b.         Elimination disorder

    c.         Encopresis

    d.         Parenting alteration

     

    ANS:   C

    Encopresis is a medical diagnosis, classified in the ICD-10-CM, and is recognized for reimbursement purposes. “Altered elimination pattern” and “Parenting alteration” are NANDA International diagnoses and are not recognized for reimbursement. “Elimination disorder” is a developmental diagnosis.

     

     

    A child is in the clinic for evaluation of an asthma action plan. The primary care pediatric nurse practitioner notes that the child’s last visit was for a pre-kindergarten physical and observes that the child is extremely anxious. What will the nurse practitioner do initially?

    a.         Ask the child’s parent why the child is so anxious.

    b.         Perform a physical assessment to rule out shortness of breath.

    c.         Reassure the child that there is nothing to be afraid of.

    d.         Review the purpose of this visit and any anticipated procedures.

     

    ANS:   D

    The PNP should remember that young children are learning “scripts” for health care visits and may be stressed when recalling previous visits, especially if those involved immunizations. The PNP should explain the purpose and any anticipated procedures for this visit to help put the child at ease. Child and Family Health Assessment Test Bank.

     

     

    When meeting with a new family, the primary care pediatric nurse practitioner develops a database that identifies family members and others living in the household, relationships with others outside the household, and significant behavioral and emotional problems. Which tool will the nurse practitioner use to record this information?

    a.         CRAFFT

    b.         Ecomap

    c.         Genogram

    d.         Pedigree

     

    ANS:   C

    The genogram is an approach to developing a family database to provide a graphic representation of family structure, roles, and problems of recurring significance in a family. The CRAFFT tool is used to assess substance abuse in adolescents. The ecomap is used to identify relationships in the family and community that are supportive or harmful. The pedigree is used to identify potential genetic disorders.

     

     

    The primary care pediatric nurse practitioner evaluates a school-age child whose body mass index (BMI) is greater than the 97th percentile. The nurse practitioner is concerned about possible metabolic syndrome and orders laboratory tests to evaluate this. Which diagnosis will the nurse practitioner document for this visit?

    a.         Metabolic syndrome

    b.         Nutritional alteration: more than required

    c.         Obesity

    d.         Rule out type 2 diabetes mellitus

     

    ANS:   C

    A problem should never be included on the problem list that is not supported by subjective and objective data found and recorded in the database. This child has a BMI that suggests obesity, so this may be used as a diagnosis. Metabolic syndrome is a diagnosis that is determined by laboratory data, which has not been evaluated yet. Nutritional alteration is a NANDA diagnosis and not acceptable for reimbursement. “Rule out” should not be used as a diagnosis, but may be considered part of a plan. Child and Family Health Assessment Test Bank.

     

     

    The primary care pediatric nurse practitioner performs a developmental assessment on a 3-year-old child and notes normal cognitive, fine-motor, and gross-motor abilities. The child responds appropriately to verbal commands during the assessment but refuses to speak when asked questions. The parent tells the nurse practitioner that the child talks at home and that most other adults can understand what the child says. The nurse practitioner will :

    a.         ask the parent to consider a possible speech delay and report any concerns.

    b.         continue to evaluate the child’s speech at subsequent visits.

    c.         refer the child for a speech and hearing evaluation.

    d.         tell the parent to spend more time in interactive conversations with the child.

     

    ANS:   B

    Development should be monitored over time and within the context of the child’s overall well-being, rather than at an isolated testing session. The child has normal development in observed measures and appears to hear and understand well. By parental report, the child is able to speak. The PNP should continue to evaluate speech over time, since this refusal to speak may be associated with shyness or intimidation in the clinic. It is not necessary to tell the parent that the child has a possible speech delay. Unless an actual speech delay is observed, a referral is not indicated, nor is it necessary to implement a home therapy.

     

     

    The primary care pediatric nurse practitioner is performing a well child assessment on an adolescent and is concerned about possible alcohol and tobacco use. Which assessment tool will the nurse practitioner use? Child and Family Health Assessment Test Bank.

    a.         CRAFFT

    b.         HEEADSSS

    c.         PHQ-2

    d.         RAAPS

     

    ANS:   A

    The CRAFFT tool is a six-question tool used to screen for adolescent substance abuse. The HEEADSSS is used as a psychosocial screening tool. The PHQ-2 is a rapid screen for depression. The RAAPS is used to assess risk behaviors that contribute to most morbidity, mortality, and social problems in teens.

     

     

    The primary care pediatric nurse practitioner is assessing a toddler whose weight and body mass index (BMI) are below the 3rd percentile for age. The nurse practitioner learns that the child does not have regular mealtimes and is allowed to carry a bottle of juice around at all times. The nurse practitioner plans to work with this family to develop improved meal patterns. Which diagnosis will the nurse practitioner use for this problem?

    a.         Failure to thrive

    b.         Home care resources inadequate

    c.         Nutrition alteration – less than required

    d.         Parenting alteration

     

    ANS:   D

    Because the PNP is planning to intervene by helping the parents to provide appropriate food habits, the correct diagnosis should be “Parenting alteration.” “Failure to thrive” is a medical diagnosis and requires a medical and social evaluation to rule out organic causes or detect neglect. “Home care resources inadequate” would be used if the PNP suspects that the family lacks adequate funds to purchase food. “Nutrition alteration” is a NANDA diagnosis and would be used if the PNP planned to consult with a dietician or give nutritional information. Child and Family Health Assessment Test Bank.

     

     

     

    Week 9 Quiz

     

    Question 1

    0 / 1 point

    A client presents to clinic for the first time. The provider discovers that the client was diagnosed with Prader-Willi Syndrome. What symptoms does the provider expect to find during this encounter?

    Hyperphasia, obesity, and strabismus

    Lethargy, stridor, and irritability

    Low-set ears, short stature, and webbed neck

    Flat nasal bridge, epicanthal folds, and heart murmur

    Question 2

    Child and Family Health Assessment Test Bank

    0 / 1 point

    A client with Prader-Willi syndrome, well-known to the clinic, presents today for an annual physical. This client is at higher risk and should be screened for what medical condition?

    Depression

    Pyloric Stenosis

    Celiac disease

    Type 2 diabetes mellitus

    Question 3

    0 / 1 point

    A new client presents to the clinic to establish care. On exam, the provider notes the following: a long narrow face, high-arched palate and dental crowding, prominent ears, strabismus, macroorchidism, short stature, cognitive impairments and stereopathies. What would be the most likely diagnosis?

    Fragile X

    Prader-Willi

    Angelman

    Beckwith-Weidemann

    Question 4

    1 / 1 point

    If a client is positive for any of the following categorical clinical findings and developmental deficiencies: Failure to thrive, Central obesity, Enamel hypoplasia, Scoliosis, Motor delays, Mild intellectual disability and Compulsive hyperphagia; what would be the most likely diagnosis?

    Fragile X

    Prader-Willi

    Angelman

    Beckwith-Weidemann

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    Child and Family Health Assessment Test Bank

     

    Question 5

    0 / 1 point

    If a client is positive for any of the following categorical clinical findings and developmental deficiencies: Seizures, Global developmental delays, Abnormal gait, arms held high/flexed elbows, Hypotonic trunk with hypertonic limbs (commando crawl), Feeding/growth problems, Acquired microcephaly, Speech delay, Spontaneous (persistent) social smile/fits of laughter, and Loves water. What would be the most likely diagnosis?

    Fragile X

    Prader-Willi

    Angelman

    Beckwith-Weidemann

    Question 6

    0 / 1 point

    If a client is positive for any of the following categorical clinical findings and developmental deficiencies: Omphalocele or umbilical hernia, macroglossia, facial features: Nevus flammeus, helical pits, prominent eyes, anterior ear lobe creases, Large placenta/long umbilical cord, Hypoglycemia, Cardiomegaly, Dental malocclusion with maxillary underdevelopment, and Articulation issues. What would be the most likely diagnosis? Child and Family Health Assessment Test Bank.

    Fragile X

    Prader-Willi

    Angelman

    Beckwith-Weidemann

    Question 7

    1 / 1 point

    If a client is positive for any of the following categorical clinical findings and developmental deficiencies: tall, long limbs, aortic root dilatation, mitral valve prolapse/regurgitation, ectopia lentis, myopia, retinal detachment, exotropia/strabismus, spontaneous pneumothorax, connective tissue problems, pectus deformities, joint hyperextensibility. What would be the most likely diagnosis?What would be the most likely diagnosis?

    Turner

    DiGeorge

    Marfan

    Huntington

    View Feedback

     

    Question 8

    0 / 1 point

    What is true about diploid cells? (select all that apply)

    Each contains 23 paired chromosomes.

    Each one contains 23 chromosomes.

    Replication produces two identical cells.

    They replicate via the process of mitosis.

    View FeedbackChild and Family Health Assessment Test Bank

     

    Question 9

    0 / 1 point

    Cystic fibrosis is a genetic disorder that affects the cells that produce mucus, sweat, and digestive juices. It is considered a recessive disease caused by a gene mutation on both alleles inherited from the parents. Which type of genetic disorder is this?

    Chromosome

    Mitochondrial

    Monogenetic

    Multifactorial

    Question 10

    1 / 1 point

    Which diagnostic test is most appropriate when a provider wishes to identify and evaluate the size, shape, and number of chromosomes of a client? Child and Family Health Assessment Test Bank

    Chromosomal microarray

    Fluorescence in-situ hybridization

    Karyotype

    Molecular testing

    Hide Feedback

    Karyotype testing is used to identify and evaluate the size, shape, and number of chromosomes

     

     

    The primary care pediatric nurse practitioner is obtaining a medical history about a child. To integrate both nursing and medical aspects of primary care, which will be included in the medical history?

    a.         Complementary medications, alternative health practices, and chief complaint

    b.         Developmental delays, nutritional status, and linear growth patterns

    c.         Medication currently taking, allergy information, and family medical history

    d.         Speech and language development, beliefs about health, and previous illnesses

     

    ANS:   D

    An assessment model that integrates the nursing and medical aspects of primary care uses three domains: developmental problems (speech and language development), functional health problems (beliefs about health), and diseases (chief complaint). The other examples all use domains associated with the traditional medical model and do not contain nursing aspects associated with functional health problems. Child and Family Health Assessment Test Bank.

  • The man whose antidepressants stopped working

    Case 1: Volume 1, Case #1: The man whose antidepressants stopped working

    Questions

    One of the most effective medical interventions to significantly improve the health of patients doesn’t require the latest technology or expensive medication, but it involves helping them take their existing medicines as prescribed.

    When you feel like your depression is under control, do you sometimes stop taking your medicine? The patient discontinued his Effexor although it appeared to be effective. It is essential to find out the patient’s reason for not adhering to prescribed medication and come up with a solution together.

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    Taking medication every day is a real inconvenience for some people. Do you ever feel hassled about sticking to your antidepressant? It is difficult to come up with a schedule to take medications every day for some patients. Collaboratively we need to come up with a convenient time to take the antidepressant and the other prescribed medication for them to be effective. The man whose antidepressants stopped working.

    How often do you have difficulty remembering to take your antidepressant medication? Health literacy plays a key role as well. It is difficult for patients to take a medicine when they do not understand why it is prescribed, what conditions or diseases it treats, or what preventive effects it provides.

    As a Nurse practitioner, when patients reveal nonadherence, it is essential to assure them that it is a positive step that they felt comfortable talking about it.  Emphasis should be on collaboration to identify the challenges and decide how to achieve mutually agreed-upon goals (Brown, & Bussell, 2011).

    Family

    The patient is married, the questions I would ask the wife specifically,

    Do you know what medication your husband is taking? And do you know why he is taking it? Family support is vital in patients with depression, in situations when patients forget or are not motivated to take the medication. What side effects is the patient experiencing? The patient’s family may notice symptoms that the patient is not reporting that may need to be addressed. The man whose antidepressants stopped working.

    Physical examination and diagnostic tests

    Appearance and affect

    Most patients with major depressive disorder present with a normal appearance. In patients with more severe symptoms, a decline in grooming and hygiene can be observed, as well as a change in weight. Patients may show psychomotor retardation, which manifests as a slowing or loss of spontaneous movement and reactivity, as well as demonstrate a flattening or loss of reactivity in the patient’s affect, i.e., emotional expression (Halverson,2018).

    Speech may be normal, slow, monotonic, or lacking in spontaneity and content. Pressured speech may suggest anxiety or mania, whereas disorganized speech should prompt an evaluation for psychosis. Racing thoughts could also be an indication of anxiety, mania, or hypomania (Halverson, 2018).

    These laboratory studies might include the following: Complete blood cell (CBC) count, thyroid-stimulating hormone (TSH), Vitamin B-12, Dexamethasone suppression test (Cushing disease, but also positive in depression), Electrolytes, including calcium, phosphate, and magnesium levels (Halverson,2018) The man whose antidepressants stopped working.

    Differential diagnosis

    Hypothyroidism:  is often associated with altered cognitive function and depression. The patient is experiencing psychomotor retardation, fatigue, and sluggishness, all of that may cause depression.

    Manic-depressive episode

    Hyperthyroidism

    Pharmacological agents and dosing

    Add Seroquel as an augment.  Seroquel is also used together with antidepressant medications to treat major depressive disorder in adults (Drugs, com, 2018). Seroquel 50 mg/day and increased the dose as recommended in increments of 50 mg/day depending on the clinical response and tolerability of the patient up to 300 mg a day (Drugs.com, 2018). 1st day 50 mg, 2nd day 100 mg, 3rd day 200 mg and 4th day 300 mg (Drugs.com 2018). According to drugs.com (2018). Seroquel acts on numerous receptors in the brain to calm and help diminish psychotic thoughts. It is can also be used in addition to antidepressants and anxiety (Drugs.com, 2018). It may be beneficial for this patient because of the patient’s anxiety and sleep difficulties. Patients on Seroquel show improvement within one week although it may take several weeks for behavior and cognition to stabilize (Stahl, 2013).

    Increase Buspirone to 60 mg/day, 30 mg in the morning and 30 mg in at bed time. BuSpar is used to treat symptoms of anxiety (Drugs.com, 2018). Certain people respond well to lower doses, while others require higher dosages to get a good effect. In this particular case, the patient is on a low dose; dose may need to be increased for a therapeutic effect The man whose antidepressants stopped working.

    Contraindications

    There are no specific contraindications related to ethnicity in buspirone but, the CNS effects in any individual patient affects function. Therefore, individuals may not operate machinery or automobile (drugs.com, 2018).

    No specific contraindication related to ethnicity that I found with Seroquel, but Anaphylactic reactions have been reported in patients treated with Seroquel. Therefore, Seroquel should not be used in patients hypersensitive to quetiapine (Drugs.com, 2018).

     

    Check points

    The patient needs to follow up in 4 weeks to check on symptom improvement and a blood pressure check due to Seroquel. Quetiapine may cause a lowering of blood pressure when rising from a sitting or lying position, or a racing heart rate (Stahl, 2013). Another follow up check is for fasting plasma glucose, fasting lipids within three months and then annually, but earlier and more frequently if the patient has gained more than 5% of initial weight (Stahl, 2013).

    Taper off Ativan to 1 mg daily for one week, 0.5 mg daily for one week then discontinue medication to prevent withdrawal symptoms.  The man whose antidepressants stopped working Ativan needs to be discontinued because of its sedation effects. With added Seroquel and clonazepam on medication list, the patient does not need another sedative to the regimen. Another reason to discontinue Ativan is, can intensify cognitive slowing, cause dependence and produce changes in equilibrium that can contribute to increased risk of falls and fractures. Long-term use can lead to habituation and dependence (drug.com, 2018).

    Lessons learned

    Ethnic or regional differences can potentially contribute to differences in drug response (Yasundu, Zhang, & Huang, 2008). As a nurse practitioner, application of this information will be one factor that can contribute to the consideration of the risk-benefit ratio of drug therapy in a specific patient (Yasundu et al., 2008).

    Major depression seems to be a recurrent illness that needs to be managed like any other chronic disease such as diabetes. Therefore, the patient may need to stay on an antidepressant for the rest of their life. And at the point of resistance, patients may need their medications augmented with other antidepressants.

    Along with medications, talk therapy like cognitive-behavioral, psychodynamic, and interpersonal therapy is one of the first approaches that a person with treatment-resistant depression might try (Griffin, 2018).

    Research has shown that therapy can help with treatment-resistant depression specifically. The best evidence is with cognitive-behavioral therapy (CBT), which encourages people to see how their thoughts and behaviors contribute to their depression (Griffin, 2018). The man whose antidepressants stopped working.

     

    References

    Brown, M. T., & Bussell, J. K. (2011). Medication Adherence: WHO Cares? Mayo Clinic Proceedings, 86(4), 304–314.
    http://doi.org/10.4065/mcp.2010.0575

    Daly, E. J., & Trivedi, M. H. (2007). A review of quetiapine in combination with antidepressant therapy in patients with depression. Neuropsychiatric Disease and Treatment, 3(6), 855–867.

    Drugs.com, (2018) Buspirone. Retrieved from https://www.drugs.com/buspar.html

    Drugs.com, (2018). Seroquel. Retrieved from 
    https://www.drugs.com/tips/seroquel-patient-tips

    Halverson, L. J (2018). Depression. Retrieved from https://emedicine.medscape.com/article/286759-overview

    Griffin, R. M (2018). Treatment-Resistant Depression: Your Continuum of Care. Retrieved from https://www.webmd.com/depression/features/treatment-resistant-depression-your-continuum-of-care#1 The man whose antidepressants stopped working

    Stahl, S. M. (2013). Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). New York, NY: Cambridge University Press

    Yasundu, S. U., Zhang, L. & Huang, S. M., (2008). The role of ethnicity in variability in response to drugs. focus on clinical pharmacology studies. Clinical pharmacology & Therapeuticsm, 84(3). 417-423. Retrieved from https://web.archive.org/web/20170809004704/https://www.fda.gov/downloads/Drugs/ScienceResearch/…/UCM085502.pdf The man whose antidepressants stopped working

    Hi Mary,

    Great discussion this week, I agree nurse practitioners must be aware of the risks of antidepressant resistance in some patients, then treat patients accordingly. Treatment-resistant depression can leave patients feeling hopeless and discouraged and demoralized because they are not getting any better.  Patients with the diagnosis of severe depression Electroconvulsive Therapy (ECT) can be a life-changing procedure. According to Miller, (2017), medications have a success rate of 50-60% of patients getting better, while ECT succeeds at a rate of 70-90%. ECT also works faster; medications typically take up to eight weeks to show improvement, while with ECT, patients start feeling better in two weeks or less (Miller, 2017).  Pop culture has long represented the procedure as painful and involuntary, most notably in Ken Kesey’s novel-turned-film “One Flew Over the Cuckoo’s Nest,” in which ECT was performed without anesthesia. Fortunately, the stigma has begun to fade away, perhaps due in part to endorsement by public figures such as Kitty Dukakis and the late Carrie Fisher, who both experienced personal success with ECT (Familydoctor.org, 2017). I believe in inviting family members into the procedure room helps to reduce the stigma and fear. Also continues to break down misunderstanding and advocate for this life-saving treatment in patients for whom multiple medications have failed. And when it comes to suicidality, its effectiveness can mean the difference between life and death. The man whose antidepressants stopped working

    References

    Familydoctor.org, (2017). Electroconvulsive Therapy (ECT). Retrieved from https://familydoctor.org/how-electroconvulsive-therapy-works/

    Miller. S. (2017). Treating Mental Illness with Electroconvulsive Therapy. Retrieved from https://healthcare.utah.edu/healthfeed/postings/2017/02/ect.php

     

    Reply # 2

    Hi

    Thank you for a great discussion this week. The patient continues to have the depression after remission. He may also benefit from cytochrome P450 (CYP450) tests to help determine how the body metabolizes a drug (Mayoclinic, 2018). The human body uses cytochrome P450 enzymes to process medications. The variations in these enzymes, medications may affect each person differently (Mayoclinic, 2011) The man whose antidepressants stopped working.

    Drug-gene testing also called pharmacogenomics or pharmacogenetics is the study of how genes affect the body’s response to medication (CDC,2011). The test looks for changes or variations in the genes that determine whether a drug could be an effective treatment for or whether the patient could have side effects from a specific medication (Mayoclinic,2018).

    The cytochrome P450 enzyme includes the CYP2D6 enzyme, which processes many antidepressants and antipsychotic medications. By checking DNA for certain gene variations, CYP450 tests can offer clues about how the body may respond to a particular antidepressant. CYP450 tests can also identify changes in other enzymes, such as the CYP2C19 enzyme (Mayoclinic, 2018). The man whose antidepressants stopped working.

    Genotyping tests, such as cytochrome P450 tests, may speed up the identification of medications that are more likely to be better processed by the body. Ideally, better processing would lead to fewer side effects and improved effectiveness (Mayoclinic, 2018).

    References

    Center for Disease Control and Prevention, (CDC). CYP450 Genotyping to Predict Response to SSRIs Used to Treat Non-psychotic Depression in Adults: EGAPP Recommendation. Retrieved from https://www.cdc.gov/genomics/gtesting/egapp/recommend/cyp450.htm.

    Mayoclinic, (2018) Cytochrome P450 (CYP450) tests. Retrieved from  https://www.mayoclinic.org/tests-procedures/cyp450-test/about/pac-20393711 The man whose antidepressants stopped working

  • MN568 Unit 6 Exam

    MN568 Unit 6 Exam Question 1 2 / 2 points

    A patient is seen with a sudden onset of flank pain accompanied by nausea, vomiting, and diaphoresis. In addition to nephrolithiasis, which of the following should be added to the list of differential diagnoses?

    Question options:

    a) Pancreatitis

    b) Peptic ulcer disease

    c) Diverticulitis

    ORDER A PLAGIARISM-FREE PAPER HERE

    d) All of the above

    Question 2 2 / 2 points

    Which of the following would be an appropriate treatment for a patient with mild BPH?

    Question options:

    a) Refer to a urologist for surgery.

    b) Prescribe a trial of tamsulosin.

    c) Recommend cranberry supplements.

    d) Reevaluate symptoms in 1 to 3 months. MN568 Unit 6 Exam.

    Question 3 2 / 2 points

    The result of the patient’s 24-hour urine for protein was 4.2 g/day. The clinician should take which of the following actions?

    Question options:

    a) Repeat the test.

    b) Refer to a nephrologist.

    c) Measure the serum protein.

    d) Obtain a blood urea nitrogen (BUN) and creatinine.

    Question 4 2 / 2 points

    Which is the most potent and irritating dose of tretinoin?

    Question options:

    a) 0.05% liquid formulation

    b) 0.1% cream

    c) 1% foam

    d) 0.02% cream

    Question 5 2 / 2 points

    Which of the following clinical manifestations are consistent with a patient in ARF?

    Question options:

    a) Pruritis

    b) Glycosuria

    c) Irritability

    Question 6 2 / 2 points

    Which of the following is an infraorbital fold skin manifestation in a patient with atopic dermatitis?

    Question options:

    a) Keratosis pilaris

    b) Dennie’s sign

    c) Keratoconus

    d) Pityriasis alba

    Question 7 2 / 2 points

    The patient with BPH is seen for follow-up. He has been taking finasteride (Proscar) for 6 months. The clinician should assess this patient for which of these side effects?

    Question options:

    a) Erectile dysfunction

    b) Glaucoma

    c) Hypotension

    d) Headache

    Question 8 2 / 2 points

    When using the microscope for an intravaginal infection, you see something translucent and colorless. What do you suspect? MN568 Unit 6 Exam

    Question options:

    a) A piece of hair or a thread

    b) Hyphae

    c) Leukocytes

    d) Spores

    Question 9 2 / 2 points

    Your patient is in her second trimester of pregnancy and has a yeast infection. Which of the following is a treatment that you usually recommend/order in nonpregnant patients, but is listed as a Pregnancy category D?

    Question options:

    a) Vagistat vaginal cream

    b) Monistat combination pack

    c) Terazol vaginal cream

    d) Diflucan, 150 mg

    Question 10 2 / 2 points

    A patient is seen in the clinic with hematuria confirmed on microscopic examination. The clinician should inquire about the ingestion of which of these substances that might be the cause of hematuria?

    Question options:

    a) NSAIDs

    b) Beets

    c) Vitamin A

    d) Red meat

    Question 11 2 / 2 points

    Which of the following tests is most useful in determining renal function in a patient suspected of CRF? MN568 Unit 6 Exam

    Question options:

    a) BUN and creatinine

    b) Electrolytes

    c) Creatinine clearance

    d) Urinalysis

    Question 12 2 / 2 points

    Eighty percent of men have noticeable hair loss by what age?

    Question options:

    a) 35

    b) 50

    c) 70

    d) 85

    Question 13 0 / 2 points

    When looking under the microscope to diagnose an intravaginal infection, you see a cluster of small and oval to round shapes.What do you suspect they are?

    Question options:

    a) Spores

    b) Leukocytes

    c) Pseudohyphae

    d) Epithelial cells

    Question 14 2 / 2 points

    Which of the following information is essential before prescribing Bactrim DS to a 24-year-old woman with a UTI?

    Question options:

    a) Last menstrual period

    b) Method of birth control

    c) Last unprotected sexual contact

    d) All of the above

    Question 15 2 / 2 points

    What is the treatment of choice for a patient diagnosed with testicular cancer?

    Question options:

    a) Radical orchidectomy

    b) Lumpectomy

    c) Radiation implants

    d) All of the above

    Question 16 2 / 2 points

    Which test is used to confirm a diagnosis of epididymitis?

    Question options:

    a) Urinalysis

    b) Gram stain of urethral discharge

    c) Complete blood cell count with differential

    d) Ultrasound of the scrotum

    Question 17 2 / 2 points

    Sally, age 25, presents with impetigo that has been diagnosed as infected with Staphylococcus. The clinical presentation is pruritic tender, red vesicles surrounded by erythema with a rash that is ulcerating. Her recent treatment has not been adequate. Which type of impetigo is this?

    Question options:

    a) Bullous impetigo

    b) Staphylococcal scalded skin syndrome (SSSS)

    c) Nonbullous impetigo

    d) Ecthyma

    Question 18 2 / 2 points

    An example of ecchymosis is:

    Question options:

    a) A hematoma

    b) A keloid

    c) A bruise

    d) A patch

    Question 19 2 / 2 points

    An 82-year-old man is seen in the primary care office with complaints of dribbling urine and difficulty starting his stream. Which of the following should be included in the list of differential diagnoses?

    Question options:

    a) Benign prostatic hyperplasia (BPH)

    b) Parkinson’s disease

    c) Prostate cancer

    d) All of the above

    Question 20 0 / 2 points

    A 30-year-old man is seen with a chief complaint of loss of libido. Which of the following laboratory tests would help establish a diagnosis?

    Question options:

    a) Testosterone level

    b) Prostate-specific antigen

    c) Nocturnal penile tumescence and rigidity

    d) Prolactin level

    Question 21 2 / 2 points

    A 35-year-old man presents with complaints of painful erections, and he notices his penis is crooked when erect. What is the most likely diagnosis? MN568 Unit 6 Exam

    Question options:

    a) Peyronie’s disease

    b) Damage to the pudendal artery

    c) Scarring of the cavernosa

    d) All of the above

    Question 22 2 / 2 points

    A 78-year-old man is diagnosed with C2 prostate cancer, and he asks the clinician what that means. In order to answer the patient, the clinician must have which of these understandings of the Jewett rating system?

    Question options:

    a) The cancer involves the seminal vesicles.

    b) There is metastatic disease to regional lymph nodes.

    c) The cancer is confined to the capsule.

    d) There is metastasis to distant organs.

    Question 23 0 / 2 points

    During a DRE on a 75-year-old man, the clinician suspects the patient has prostate cancer. What physical finding should make the clinician suspicious?

    Question options:

    a) An enlarged rubbery gland

    b) A hard irregular gland

    c) A tender gland

    d) A boggy gland

    Question 24 2 / 2 points

    Tinea unguium is also known as:

    Question options: MN568 Unit 6 Exam

    a) Onychomycosis

    b) Tinea versicolor

    c) Tinea manuum

    d) Tinea corporis

    Question 25 2 / 2 points

    The patient is diagnosed with acute renal failure (ARF).Which of the following data obtained from the history should alert the provider that this is a case of prerenal azotemia?

    Question options:

    a) Recent heat stroke

    b) Nephrolithiasis

    c) Recent infection where gentamicin was used in treatment

    d) All of the above

    Question 26 2 / 2 points

    Which of the following statements is accurate when you are removing a seborrheic keratosis lesion using liquid nitrogen? MN568 Unit 6 Exam

    Question options:

    a) Do not use lidocaine as it may potentiate bleeding.

    b) Pinch the skin taut together.

    c) Use gel foam to control bleeding.

    d) This should be performed by a dermatologist only.

    Question 27 2 / 2 points

    A patient is diagnosed with urge incontinence. Before prescribing Detrol XL, the provider should question the patient about which of these contraindications to this medication?

    Question options:

    a) Diarrhea

    b) Parkinson’s disease

    c) Closed-angle glaucoma

    d) Breast cancer

    Question 28 2 / 2 points

    Simon presents with alopecia areata with well-circumscribed patches of hair loss on the crown of his head. MN568 Unit 6 Exam How do you respond when he asks you the cause?

    Question options:

    a) “You must be under a lot of stress lately.”

    b) “It is hereditary. Did your father experience this also?”

    c) “The cause is unknown, but we suspect it is due to an immunologic mechanism.”

    d) “We’ll have to do some tests.”

    Question 29 2 / 2 points

    A 58-year-old patient has been receiving leuprolide as treatment for prostate cancer. The clinician should instruct the patient about which of these side effects?

    Question options:

    a) Risk of osteoporosis

    b) May have hot flushes

    c) May have impotence

    d) All of the above

    Question 30 2 / 2 points

    Josh, aged 22, has tinea versicolor. Which description is the most likely for this condition?

    Question options:

    a) There are round, hypopigmented macules on his back.

    b) Josh has red papules on his face.

    c) There are crusted plaques in Josh’s groin area.

    d) There are white streaks on his neck.

    Question 31 2 / 2 points

    The most common precancerous skin lesion found in Caucasians is:

    Question options:

    a) A skin tag

    b) Actinic keratosis

    c) A melanoma

    d) A basal cell lesion

    Question 32 2 / 2 points

    Which scalp problem can be caused by a fever and certain drugs?

    Question options:

    a) Telogen effluvium (TE)

    b) Trichotillomania

    c) Psoriasis

    d) Alopecia areata

    Question 33 2 / 2 points

    A 46-year-old man presents with urinary hesitancy and low back pain. He has no history of UTI. Digital rectal examination (DRE) reveals a normal prostate, and a diagnosis of prostatodynia is made. Which is the appropriate treatment? MN568 Unit 6 Exam.

    Question options:

    a) Terazosin 2 mg PO once a day

    b) Ice pack to the scrotal area

    c) Saw palmetto 320 mg per day

    d) All of the above

    Question 34 2 / 2 points

    A 30-year-old patient presents with pain on urination. The urine microscopy of unspun urine shows greater than 10 leukocytes/mL, and a dipstick is positive for nitrites. What is the probable diagnosis?

    Question options:

    a) Lower urinary tract infection

    b) Chlamydia infection

    c) Candidiasis

    d) Pyelonephritis

    Question 35 2 / 2 points

    Which of the following foods should be limited in a patient with CRF?

    Question options:

    a) Milk

    b) Bananas

    c) Soy sauce

    d) All of the above

    Question 36 2 / 2 points

    An example of a primary skin lesion is a/an:

    Question options:

    a) Bulla

    b) Scale

    c) Excoriation

    d) Fissure

    Question 37 2 / 2 points

    A 76-year-old man is seen in the office for complaints of urinary incontinence. The clinician should explore which of these causes of incontinence in men?

    Question options:

    a) Urethral polyps

    b) Urinary tract infection (UTI)

    c) Anticholinergic medication

    d) All of the above

    Question 38 2 / 2 points

    A patient is seen in the clinic with a chief complaint of hematuria. To make a differential diagnosis, which of the following questions should be asked?

    Question options:

    a) “Do you have a history of liver disease?”

    b) “What medications are you currently taking?”

    c) “Have you noticed swelling in your ankles?”

    d) All of the above

    Question 39 2 / 2 points

    A 78-year-old man is diagnosed with Stage D bladder cancer and asks the provider what that means. Which is the best response?

    Question options:

    a) “There is no such thing as Stage D cancer.”

    b) “You have cancer that has spread to the surrounding tissue.”

    c) “Your cancer has spread to other organs.”

    d) “Your cancer can be cured by removing your bladder.”

    Question 40 2 / 2 points

    Treatment for epididymitis includes which of the following?

    Question options:

    a) Warm sitz baths

    b) Scrotal elevation

    c) Masturbation

    d) All of the above

    Question 41 2 / 2 points

    A patient is seen in the office complaining of severe flank pain. The clinician should assess this patient for which risk factor for kidney stones?

    Question options:

    a) Hypertension

    b) Constipation

    c) Tubal ligation

    d) Diabetes

    Question 42 2 / 2 points

    A 63-year-old man is seen in the clinic with a chief complaint of nocturia. Which of the following should be included in the differential diagnosis? MN568 Unit 6 Exam

    Question options:

    a) Psychogenic nocturia

    b) Urethral polyp

    c) Irritative posterior urethral lesion

    d) Benign prostatic hypertrophy

    Question 43 0 / 2 points

    A patient with testicular cancer is being followed after completing treatment 1 year ago. He has been symptom-free with no evidence of disease. How often should he have a CT scan?

    Question options:

    a) Every month

    b) Every 3 to 4 months

    c) Every 6 to 12 months

    d) Every year

    Question 44 2 / 2 points

    Mark has necrotizing fasciitis of his left lower extremity.Pressure on the skin reveals crepitus due to gas production by which anaerobic bacteria?

    Question options:

    a) Staphylococcal aureus

    b) Clostridium perfringens

    c) S. pyrogenes

    d) Streptococcus

    Question 45 2 / 2 points

    Ian, age 62, presents with a wide, diffuse area of erythematous skin on his lower left leg that is warm and tender to palpation.There is some edema involved. You suspect:

    Question options:

    a) Necrotizing fasciitis

    b) Kaposi’s sarcoma

    c) Cellulitis

    d) A diabetic ulcer

    Question 46 2 / 2 points

    Why do people of African descent have a lower incidence of non-melanoma skin cancer?

    Question options:

    a) They have an increased number of melanocytes.

    b) Their darker skin protects from ultraviolet radiation.

    c) Their skin is thicker.

    d) Their immune system is stronger.

    Question 47 2 / 2 points

    A 23-year-old sexually active man is seen in the clinic with unilateral painful testicular swelling, and he is diagnosed with epididymitis.In order to prescribe the correct drug, the clinician must understand that which of these is the most common causative organism?

    Question options:

    a) Escherichia coli

    b) Staphylococcus aureus

    c) Chlamydia trachomatis

    d) Pseudomonas aeruginosa

    Question 48 2 / 2 points

    When instructing your elderly client about treating her xerosis, what do you tell her?

    Question options:

    a) A daily hot bath may help the associated pruritus.

    b) Rub the skin briskly to make sure it is completely dry after bathing.

    c) Only take short tepid showers.

    d) Use a gel that is alcohol-based after bathing to soften the skin.

    Question 49 2 / 2 points

    Which of the following instructions should be given to the patient with nephrolithiasis?

    Question options:

    a) Take ibuprofen, 600 mg every 8 hours.

    b) Take Tums? for stomach upset.

    c) Drink more black tea.

    d) Increase intake of vegetables, like spinach.

    Question 50 2 / 2 points

    The 56-year-old man with chronic prostatitis should be treated with trimethoprim 80 mg-sulfamethoxazole 400 mg (TMP-SMX, Bactrim) for how long?

    Question options:

    a) 3 to 7 days

    b) 14 to 21 days

    c) 3 to 6 weeks

    d) 6 to 12 weeks

    MN568 Unit 6 Exam

  • NSG 6001 Week 5 Final Exam

    NSG 6001 Week 5 Final Exam Question 1

    More than half of all cardiac arrhythmias involve the atria.

    True

    False

    Question 2.

    What are the most common symptoms caused by tachyarrhythmias?

    Sweating

    Thirst

    Palpitations

    Headaches

    Question 3.

    For women with known CAD and diabetes, which is most appropriate to assess CAD risk?

    ETT

    Coronary bypass surgery

    Coronary catheterization

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    ETT with imaging

    Question 4.

    Of the following, which is the best answer when asked for an advantage of echocardiogram exercise testing over thallium stress testing? NSG 6001 Week 5 Final Exam.

    Does not depend on operator experience

    Costs are the same

    Results are available more quickly

    Doesn’t matter because there are no advantages

    Question 5.

    Your patient has uncomplicated pyelonephritis. In deciding your recommended treatment, you consider the most common pathogenic reason for this diagnosis. What pathogen accounts for the majority of pyelonephritis?

    E. Coli

    Gardnerella Vaginalis

    Mycoplasma Hominis

    Chlamydia

    Question 6.

    What purpose does the principle of fidelity serve in the provider/patient relationship?

    Ensures that providers honor their commitments to the patient

    Obligates the provider to a one-on-one relationship with the individual

    Ensures that patients receive whatever they want

    Maintains costs in the healthcare arena

    Question 7.

    In CAD, after both systolic and diastolic dysfunction have occurred, the typical pattern of chest pain and related EKG changes occur. During an EKG, you should expect to see ST-segment and T-wave changes that are central to demonstration of ischemia occurring relatively late in the ischemic cascade. Is this true or false?

    True

    False

    Question 8.

    The leads on the ECG showing ischemic changes during or immediately after an ETT can correlate roughly to the culprit artery or arteries with significant CAD. Is this true or false?

    True

    False

    Question 9.

    Skin cancer is the most common malignant neoplasm in males in the US. What is the second leading cause of cancer deaths in men greater than 50 years of age?

    Prostate cancer

    Lung cancer

    Lymphoma

    Lupus

    Question 10.

    What ECG changes can reduce the specificity of the ETT?

    Exercise induced bundle branch blocks

    Paced rhythm and resting bundle branch block

    Paced rhythm and exercise induced bundle branch blocks

    Low voltage up sloping of the ST-segment

    Question 11.

    You have confirmed that your patient does indeed have an abdominal aortic aneurysm. In teaching your patient about symptoms to report immediately to the vascular surgeon, you instruct the patient to report which of the following? NSG 6001 Week 5 Final Exam.

    Newly diagnosed diabetes

    Back pain or flank pain

    Visual disturbances

    Headaches

    Question 12.

    What is one of the common causes of a Saccular Abdominal Aneurysm?

    Poor kidney functioning

    Age

    Drugs: illicit and prescribed

    Trauma

    Question 13.

    The diagnostic accuracy of stress testing is decreased among women compared to men for what reasons?

    Women having thinner ventricular and septal muscles

    Women usually have single vessel or non-obstructive disease

    Women cannot exercise as vigorously as men

    Women typically have multiple vessel disease

    Question 14.

    Population disease management is a term used to describe:

    High specificity disease states

    Low specificity diseases states

    Low prevalence specific diseases

    High prevalence specific diseases

    Question 15.

    You receive a report back on the suspected abdominal aortic aneurysm for your patient. It confirms your suspicion of AAA. The report describes the aneurysm as a symmetric weakness of the entire circumference of the aorta. You know that this form of aneurysm is referred to as what kind of aneurysm?

    Thoracic aneurysm

    Budging sac aneurysm

    Saccular aneurysm

    Fusiform aneurysm

    Question 16.

    Your practice partner just ordered an exercise echocardiography 2DE for a patient with suspected cardiovascular risk. NSG 6001 Week 5 Final Exam This patient has known resting wall motion abnormalities.Why would this not be the best test to assess this patient’s cardiac risk?

    Sensitivity is increased

    Sensitivity is decreased

    Specificity is increased

    Specificity is decreased

    Question 17.

    Your 60-year old male patient arrives for his appointment. He complains of general malaise and fever over the past several days with low back pain. He also states that he is getting up at night more often to urinate and never feels his bladder is completely empty.What differential diagnosis should you consider in this patient?

    Acute viral prostatitis

    Stomach virus

    Acute bacterial prostatitis

    BPH only

    Question 18.

    We all know that collaboration is integral to becoming a successful nurse practitioner. Among collaborations, however, only one can be considered as the most important. While each example below is important, which is the most important collaboration? The one that occurs:

    Between the nurse practitioner and their physician mentor

    Between two healthcare providers about a single patient

    Between the patient and their family

    Between the patient and the nurse practitioner

    Question 19.

    The sensitivity of a routine ETT is effort dependent. What physiological changes occur during effort in the routine ETT?

    Rapid heart rates and coronary artery narrowing

    Decrease in coronary blood flow

    Decreased heart rate and increased systolic blood pressure

    Increased coronary flow and increased systolic blood pressure

    Question 20.

    A 47-year old female with general complaints of fatigue and shortness of breath shows up in your clinic as a referral from another nurse practitioner. NSG 6001 Week 5 Final Exam Several blood tests and chest x-rays have been completed without any diagnosis or outstanding abnormalities.You decide to order an ETT despite the fact that the recent ECG does not show any abnormalities. From the answers below, which would be the best answer to support your decision?

    You are out of other options

    CAD in women is under diagnosed

    To please the patient

    Women present with the same pattern of CAD as do males

    Question 21.

    Your patient underwent an exercise stress test for CAD. There is significant elevation of the ST-segment.What do you need to know about these changes to manage your patient’s care?

    : This patient needs to see someone more experienced in treatment of CAD

    These changes are predictive of myocardial infarction

    These changes have minimal predictive value for CAD

    These changes predict dire outcomes

    Question 22.

    When there is a consequential loss of structural integrity of the abdominal aorta, the resulting issue is what condition? NSG 6001 Week 5 Final Exam

    Bloated stomach

    Kidney failure

    Bleeding ulcers

    Abdominal aortic aneurysm

    Question 23.

    You see a 60-year old African American male in your clinic with a recent diagnosis of hypertension. He asks you what he should restrict in his diet, and is particularly interested in limiting his sodium intake. What amount of sodium intake would you recommend on a daily basis for this patient?

    1.5 g/day

    No added table salt

    3.0 g/day

    2.3 g/day

    Question 24.

    Why would inability to exercise reduce the specificity of the routine ETT?

    Produces QRS changes that cannot be interpreted

    Produces persistent ST-segmental changes and T-wave abnormalities

    Causes ST-segment changes and P-wave abnormalities

    Will not produce any changes in ECG

    Question 25.

    By standard criteria, how is a positive stress test defined?

    Development of a horizontal or down sloping ST-segment depression of 1mm

    Down sloping of the ST-segment at the J point of the QRS

    Development of a horizontal or down sloping ST-segment depression of 10mm

    Upward sloping ST-segment measured at the J point of the QRS

    Question 26.

    What are the two types of bradycardia recognized by the American Heart Association?

    Relative and absolute

    Absolute and pending

    Refractory and non-refractory

    Relative and dynamic

    Question 27.

    You see a 75-year old female in your clinic today complaining of urinary incontinence. She is otherwise healthy based upon her last visit NSG 6001 Week 5 Final Exam. She states that her mother told her this would happen someday because it happens to every woman at some age. What would you tell this patient?

    This happens to all women as they age

    No need to worry. This is normal. Your mother was correct.

    This is not an expected condition related to aging.

    This happens to men as well and most women before your age.

    Question 28.

    What do you know regarding ischemia that is confined to only the posterior and or lateral segments of the left ventricle?

    ETT cannot be used for detection

    Difficult to detect by ETT

    Requires both for detection of changes by ETT

    Easier to detect by ETT

    Question 29.

    What three conditions definitely alter the results of echocardiography in determining CAD?

    Obesity, rapid heart rate and lung disease

    Diabetes, kidney disease and tooth decay

    Obesity, slow heart rates and hypertension

    Previous MI, hypotension and diabetes

    Question 30.

    Specifically, when is an ETT considered to be negative?

    Patient has ST-segmental changes with down sloping of greater than 1 mm at 50% of age-predicted maximum heart rate

    Patient exercises to 85% of age predicted maximum heart rate without evidence of induced ischemia

    Patient exercises to 20% maximum age-predicted heart rate without induced ischemia

    Patient exercises until tired without evidence of induced ischemia

    Question 31.

    All patients, even is asymptomatic, require risk stratification according to the Farmingham risk score. At present, ACC/AHA guidelines, however, do not normally support stress tests for asymptomatic patients without addiitonal justification. From the list below, what could be used to justify a ETT in an asymptomatic patient?

    A smoker of 3 weeks

    A member of congress

    Sedentary and wishes to begin aggressive exercise NSG 6001 Week 5 Final Exam

    Developmentally challenged

    Question 32.

    BPH is not a risk factor for Prostate cancer. Is this statement true or false?

    True

    Question 33.

    Spread of genital herpes only occurs during the time period with active lesions. Is this statement true or false?

    True

    False(not confirm)

    Question 34.

    Abdominal aortic aneurysms are often asymptomatic. What percent of AAA’s are discovered in asymptomatic patients?

    40%

    20%

    10%

    75%

    Question 35.

    Improvements in the delivery and management of healthcare are necessary if we are to improve the overall health of this nation’s population. Which of the following are identified in your readings as strategic in the movement to improve the healthcare system?NSG 6001 Week 5 Final Exam

    President and Congress

    Population management and healthcare practice

    Socialized medicine and governmental controls

    Monetary savings and limited disruption in healthcare delivery

    Question 36.

    What are the two main types of heart failure?

    Systolic and diastolic

    Hopeless and severe

    Left sided and main

    End diastolic and pressure related

    Question 37.

    The majority of all strokes are non-ischemic. Is this statement true or false?

    True

    False

    Question 38.

    When a murmur is first heard, it is important to determine if it is due to a pathological condition or benign. For an experienced practitioner, it is always easy to determine the cause of a murmur merely by listening to the sound. Is this statement true or false?

    True

    False

    Question 39.

    Maintenance of an Isometric ST-segment during exercise is the response of?

    A normal heart

    Hypo profusion

    An abnormal heart

    CAD

    Question 40.

    The goal of self-management is to specifically do what?

    Engage patients in their own care

    Engage insurance providers in patient care

    Engage providers in patient care

    Engage government in greater involvement in patient care

    Question 41.

    Your 56-year old patient presents with bradycardia with a rate of 55 and first degree AV block. The patient is hemodynamically stable and is not experiencing any syncope or chest pain. History includes previous myocardial infarction. Home medications include beta blockers, daily aspirin. Lab work is non-significant for electrolyte imbalance. You decided to treat this patient for the arrhythmia to prevent future destabilization. From the choices below, which might be the appropriate first measure to consider? NSG 6001 Week 5 Final Exam.

    Add digitalis to control the heart rate

    Consult cardiologist immediately for guidance

    Discontinue Beta Blocker and replace with another therapy if necessary

    Atropine injections

    Question 42.

    Your patient is morbidly obese and cannot sit on a bicycle or walk a treadmill. She also has marked and severe emphysema. You need to make an assessment of the risk of significant CAD and your patient’s family says that their relative had their diagnosis based on an ultrasound echocardiography. What facts would influence your decision regarding the family request for echo assessment?

    Sensitivity would be increased because of lung disease

    Specificity would be increased because of obesity

    Sensitivity would be reduced because of obesity and lung disease

    Specificity would be reduced because of obesity and lung disease

    Question 43.

    You are in the clinic with your mentor observing the Echocardiogram exercise test of a 45-year old male that has been experiencing slight chest pressure almost daily during exercise.While observing your patient, your mentor points out that the left ventricle wall is thinning and there is some hyperkinesias of the ventricular wall NSG 6001 Week 5 Final Exam. From your time in the clinic, you know that this test will be considered to be what type of result?

    Negative

    Impossible

    Positive

    Non-readable

    Question 44.

    Your patient is newly diagnosed with persistent Atria Fibrillation. You consider electrocardioversion. Before undergoing this procedure you should order the following examination to assess thrombus risk.

    X-Ray of chest

    Tranesophageal echocardiography

    Ultrasound of chest

    CT Scan

    Question 45.

    Tachyarrhythmias cause a drop in commonly blood pressure, cardiac output, syncope, shortness of breath, and chest pain. What phenomenon most often occurs during these arrhythmias to cause these symptoms? NSG 6001 Week 5 Final Exam

    Shortened diastole

    Lengthened diastole

    Lengthened systole

    Shortened systole

    Question 46.

    At what age is atria fibrillation most common?

    In childhood

    60 years or older

    30 years

    45 years

    Question 47.

    Automaticity is a property common to all cardiac cells. Is this statement true or false?

    True

    False

    Question 48.

    Your patient has a maximum age-predicted heart rate of 180. During the exercise he reaches a heart rate of 140 and then states he can no longer exercise. You see evidence of ischemic changes on the ECG. This would be predictive of what condition?

    Stroke

    Significant CAD

    Impending death

    Low risk of CAD

    Question 49.

    You tell a patient that he has a murmur. He says he has been told this before, but wonders what causes the unique sounds of a murmur. Which of the following would be your best option?

    Turbulent flow of blood

    High pressures caused from HTN

    There is no reason, it just happens

    Almost always from a sclerotic valve

    Question 50.

    What is the treatment of choice for uncomplicated community-acquired cystitis?

    TMP-SMZ

    Any antibiotic will treat this diagnosis

    Amoxicillin

    Penicillin

    Question 51.

    Any patient presenting with symptomatic bradycardia should be referred

    to a cardiologist for management NSG 6001 Week 5 Final Exam. Is this statement true or false?

    True

    False

    Question 52.

    Encouragement of patients to take effective actions in their own healthcare refers to the concept of:

    Self-management support

    Interprofessional support

    Physician or provider-driven care

    Family care givers

    Question 53.

    You are considering adding an adjunctive form of testing to detect wall motion abnormalities during the ETT.You select Echocardiography as the added testing. You choose this test because you know that echocardiography does what when added to a standard ETT?

    Enhances sensitivity and specificity of CAD detection

    Enhances sensitivity while reducing specificity of CAD detection

    Enhances specificity while not changing sensitivity of detection for CAD

    You like pretty pictures of wall motion

    Question 54.

    Medicaid is mandated to be provided by each state through federal codes. Each state must offer Medicaid exactly as the federal government prescribes. True or false?

    True

    False

    Question 55.

    What sexually transmitted disease is most widespread in the USA today?

    Chlamydia

    Gonorrhea

    Syphilis

    HIV/AIDS

    Question 56.

    Your preceptor decides to add Doppler Flow studies to the echocardiogram exercise test for a patient with a recent history of a holistic murmur best auscultated at the left steral boarder. The patient has no history of cardiac surgeries. He asks you what might be the main advantages of adding Doppler Flow for this particular patient. You know from your readings that there are several reasons to add Doppler Flow and below are listed more than one correct reason. Your best response for this specific case, however, would be that Doppler Flow studies would be of what additive value during the echocardiogram study? NSG 6001 Week 5 Final Exam.

    Detect and evaluate blood shunting from a septal defect

    No advantage is seen for this patient

    Gives better screen shots of wall abnormalities

    Provides assessment of prosthetic valve function

    Question 57.

    Sexual partners of a patient with a diagnosed STI should always be examined and treated. Is this statement true or false?

    True

    False

    Question 58.

    Your patient presents with tachycardia. The QRS is measured at 0.10 seconds. Which of the following tachycardias would be an appropriate conclusion based on this information alone?

    Ventricular tachycardias

    Premature junctional contractions

    Atria fibrillation

    Ventricular fibrillation

    Question 59.

    A 65-year old white male arrives in your clinic with general complaints of slight abdominal discomfort. He has a known history of smoking two packs per day for 40 years and hypertension. He also has COPD and has been treated numerous times with oral steroids. You consider several optional diagnoses. Of the ones listed below, which should be included as a potential top suspect in your choice of diagnosis?

    Chronic bowel obstruction

    Meglacolon

    Appendicitis

    Abdominal aortic aneurysm

    Question 60.

    What are the most common mechanisms to produce cardiac arrhythmias?

    Decreased automaticity, triggered activity or reentry

    Reentry, electrical dysfunction or activity

    Stress, hard work or swimming

    Enhanced automaticity, triggered activity or reentry NSG 6001 Week 5 Final Exam.

  • Alterations of Cardiovascular Function Essay

    Alterations of Cardiovascular Function Essay

    What is the initiating event that leads to the development of atherosclerosis?

    What is the effect of oxidized low-density lipoproteins (LDLs) in atherosclerosis?

    Which inflammatory cytokines are released when endothelial cells are injured?

    When endothelia cells are injured, what alteration contributes to atherosclerosis?

    Which factor is responsible for the hypertrophy of the myocardium associated with hypertension?

    What pathologic change occurs to the kidney’s glomeruli as a result of hypertension?

    What effect does atherosclerosis have on the development of an aneurysm? Alterations of Cardiovascular Function Essay.

    Regarding the endothelium, what is the difference between healthy vessel walls and those that promote clot  formation?

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    What is the usual source of pulmonary  emboli?

    Which factor can trigger an immune response in the bloodstream that may result in an embolus?

    Which statement best describes thromboangiitis obliterans (Buerger disease)?

    Which statement best describes Raynaud  disease?

    What change in a vein supports the development of varicose   veins?

    Superior vena cava syndrome is a result of a progressive increase of which process?

    What term is used to identify when a cell is temporarily deprived of blood supply Alterations of Cardiovascular Function Essay?

    The risk of developing coronary artery disease is increased up to threefold by which factor?

    Which risk factor is associated with coronary artery disease (CAD) because of its relationship with the alteration of hepatic   lipoprotein?

    Nicotine increases atherosclerosis by the release of which neurotransmitter?

    Which substance is manufactured by the liver and primarily contains cholesterol and protein?

    Which elevated value may be protective of the development of atherosclerosis?

    Which laboratory test is an indirect measure of atherosclerotic   plaque?

    Cardiac cells can withstand ischemic conditions and still return to a viable state for how many minutes? Alterations of Cardiovascular Function Essay

    Which form of angina occurs most often during sleep as a result of vasospasms of one or more coronary  arteries?

    When is the scar tissue that is formed after a myocardial infarction (MI) most vulnerable to injury?

    An individual who is demonstrating elevated levels of troponin, creatine kinase–isoenzyme MB (CK-MB), and lactic dehydrogenase (LDH) is exhibiting indicators associated with which  condition?

    What is the expected electrocardiogram (ECG) pattern when a thrombus in  a coronary artery permanently lodges in the vessel and the infarction extends through the myocardium from the endocardium to the  epicardium?

    How does angiotensin II increase the workload of the heart after a myocardial infarction (MI)?

    A patient reports sudden onset of severe chest pain that radiates to the back and worsens with respiratory movement and when lying down. These clinical manifestations describe:

    Ventricular dilation and grossly impaired systolic function, leading to dilated heart failure, characterize which form of   cardiomyopathy? Alterations of Cardiovascular Function Essay.

    A disproportionate thickening of the interventricular septum is the hallmark of which form of  cardiomyopathy?

    Amyloidosis, hemochromatosis, or glycogen storage disease usually causes which form of  cardiomyopathy?

     

    Which condition is a cause of acquired aortic  regurgitation?

    Which predominantly female valvular disorder is thought to have an autosomal dominant inheritance pattern, as well as being associated with connective tissue disease?

    Which disorder causes a transitory truncal rash that is nonpruritic and pink with erythematous macules that may fade in the center, making them appear as a ringworm?

    What is the most common cause of infective  endocarditis?

    What is the most common cardiac disorder associated with acquired immunodeficiency  syndrome (AIDS)

    A patient is diagnosed with pulmonary disease and elevated pulmonary vascular resistance. Which form of heart failure may result from pulmonary disease and elevated pulmonary vascular  resistance? Alterations of Cardiovascular Function Essay

    What cardiac pathologic condition contributes to ventricular   remodeling?

    In systolic heart failure, what effect does the renin-angiotensin-aldosterone system (RAAS) have on stroke  volume?

    What is the cause of the dyspnea resulting from a thoracic   aneurysm?

    Which statement is true concerning the cells’ ability to synthesize cholesterol?

    What is the trigger for angina  pectoris?

    Individuals being effectively managed for type 2 diabetes mellitus often experience a healthydecline in blood pressure as a result of what   intervention?

    Which statements are true regarding fatty streaks? (Select all that   apply.) Fatty streaksprogressively damage vessel walls.

    Fatty streaks are capable of producing toxic oxygen radials.

    When present, inflammatory changes occur to the vessel walls. Alterations of Cardiovascular Function Essay

    Oxidized low-density lipoproteins (LDLs) are involved in their formation.

    What factors contribute to the development of orthostatic   hypotension? (Select all that apply.)

    Altered body chemistry

    Drug action of certain antihypertensive agents

    Prolonged immobility

    Effects of aging on postural  reflexes

    Which assessment findings are clinical manifestations of aortic   stenosis? 
    (Select all that apply.)

    Which risk factors are associated with infective endocarditis? (Select all that apply.)

    Match the descriptions with the corresponding  terms.

    A. Impairs flow from left atrium to left  ventricle

    B. Impairs flow from the left  ventricle Alterations of Cardiovascular Function Essay

    C. Backflow into left atrium

    D. Backflow into right atrium

    E. Backflow into left ventricle

    Aortic stenosis

    Aortic regurgitation

     

    Mitral stenosis

    Tricuspid regurgitation

    Mitral regurgitation