Tag: Clinical-Nursing

NR 509 APEA EXAM – NEUROLOGY

Question 1:
 Sudden, brief, rapid jerks, involving the trunk or limbs may be consistent with:

Question 2:
 Which of the following neurological assessment findings indicate the need for further evaluation?

3:
 An example of proximal weakness is:

4: A female patient complains of weakness in her hand when opening a jar. This finding could be suggestive of which type of weakness pattern?

5: A patient presents with an altered level of consciousness. He/she is considered in a stuporous state if he/she: NR 509 APEA EXAM – NEUROLOGY.

6: One way to assess cerebellar function would be to have the patient:

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7: Hypesthesia refers to:

8: When conducting a neurologic exam, which one of the following assessments is not considered part of the mental status assessment?

detailed explanations…

9: A mother reports to the nurse practitioner that her teenager might be taking drugs because earlier today the teenager had a mild seizure and now has an unstable gait and is beginning to complain of shortness of breath. These symptoms might be consistent with a possible overdose of:

10: An ischemic stroke is:

11: By placing the patient in the supine position, the nurse practitioner raises the patient’s relaxed and straightened leg while flexing the leg at the hip, then dorsiflexes the foot. This maneuver is known as:

Question 12: The level of consciousness that refers to the patient that appears drowsy but can open his eyes, respond to questions, then fall back to sleep is ….

Question 13: When assessing coordination of muscle movement, four areas of the nervous system function in an integrated way. These areas include the motor, cerebellar, the vestibular, and the sensory systems. Which system coordinates a steady posture?

14: An older adult presenting with signs of undernourishment, slowed motor performance, and loss of muscle mass or weakness suggests: NR 509 APEA EXAM – NEUROLOGY.

15: Postural tremors appear when the affected part is:

16: A discriminative sensation that describes the ability to identify an object by feeling it is:

17: When evaluating a patient for weakness of the upper extremities, bilateral distal weakness is noted. This finding could be suggestive of:

18: When observing for thenar atrophy of the hands, a typical observation is:

19: Fasciculations in atrophic muscles suggest:

20: The part of the brain that controls most functions in the body and is responsible for breathing, heart rate, and articulate speech is the:

21: Assessing the neurological status of a child with a ventriculoperitoneal shunt should include:

22: What geriatric condition is characterized by normal alertness but progressive global deterioration of cognition in multiple domains?

23: An abnormal or unpleasant sense of touch is termed:

24: When eliciting deep tendon reflexes in the knee, the nurse practitioner notes an abnormal reflex in the right knee. This abnormality is probably consistent with a pathological lesion in which segmented level of the spine?

25: When evaluating a patient for weakness of the upper extremities, bilateral proximal limb weakness without sensory loss is noted. This finding could be suggestive of:

26: The term used to describe involuntary muscle spasms and twisting of the limbs is:

27: A 40-year-old male presents with complaints of headaches. History reveals headaches that occurred daily for about 4-6 weeks. He had relief for 6 months but now they are recurring. These are most likely:

28: Which of the following symptoms may be associated with a tumor of the eighth cranial nerve?

29: When trying to determine the level of consciousness in a patient whose level of consciousness is altered, a comatose patient:

30 : A female patient complaints of weakness in both arms when transferring the wet clothes from the washer and placing them in the dryer. This finding could be suggestive of which type of weakness pattern? NR 509 APEA EXAM – NEUROLOGY

31: Which developmental area is predominantly …..by lead poisoning?

32: A form of aphasia in which the person has word-finding difficulties for speaking and writing is …..

33: A patient presents with an altered level of consciousness. He/she is …..in an obtunded state if he/she:

34: With the patient lying supine, the nurse practitioner places her hands behind the patient’s head while flexing his neck forward until his chin touches his chest. Neck stiffness with resistance to flexion is noted. This is a positive:

35: Which of the following procedures should NOT be performed in a comatose patient?

36: The term used to describe a distortion of any sense, especially that of touch, is:

37: Winging of the scapula can be noted in patients with all of the following conditions except:

38: Resting tremors refer to those tremors that disappear:

39: A patient is instructed to stand, close both eyes, and extend both arms forward with the palms facing upward for 20-30 seconds. If the forearm drifts downward, this would indicate:

40: A progressive disorder of the nervous system that affects movement is known as:

41: While assessing the trigeminal nerve V (CN V) for sensory function, the patient reports a pain sensation on the right cheek. This finding could be consistent with a:

42: When assessing the cranial nerves, the nurse practitioner uses the tongue blade to gently stimulate the back of the throat on each side. A unilateral absence of the gag reflex is noted. This finding could be suggestive of a unilateral lesion in which cranial nerve?

43: On examination of the adult patient, symptoms of flexed posture, tremor, rigidity, and shuffling gait are …… These findings are consistent with: NR 509 APEA EXAM – NEUROLOGY

44: Brief, repetitive, stereotyped, coordinated movements occurring at irregular intervals are consistent with:

45: A sudden brief lapse of consciousness with momentary blinking, staring, or movements of the lips and hands but no falling is consistent with:

46: Physical exam of a well two-week-old infant reveals a little dimple with a small amount of hair just above the sacral area. This could be:

47: Persistent blinking after glabellar tap and difficulty walking heel-to- toe are common in:

48: An example of distal weakness is:

49: A teenager presents with signs of being gleeful, somewhat drowsy, and unable to focus. On examination , B/P 90/65, pupils constricted, and speech slurred. These symptoms are consistent with:

50: An 8-month-old with a significant head lag would suggest the need for:

51: Symptoms of a subdural hematoma include:

52: Assessment findings in an infant with increased intracranial pressure would include:

53: When evaluating the sensory system, testing the posterior columns tract would include assessing sensations of:

54: The term used to describe low back pain with nerve pain that radiates down the leg is:

55: A form of aphasia in which the speech is confluent, slow, with few words and laborious effort and inflection and articulation are impaired but words are meaningful, is …..

56: Symmetric weakness of the distal muscles of the legs suggests a: NR 509 APEA EXAM – NEUROLOGY

57: Symmetric weakness of the proximal muscles of the legs suggests a:

58: Dysarthria refers to:

59: Walking on the toes and heels may reveal:

60: When upper motor neuron systems are damaged above the crossover of its tracts in the medulla, motor impairment develops on the opposite side. This term is:

61: An infant with fetal alcohol syndrome would:

62: Involuntary movements of the body that are slower and more twisting and writhing than choreiform movements, and have a larger amplitude are suggestive of:

63: An example of symmetric weakness is:

64: Anesthesia refers to:

65: When assessing an elderly patient for delirium, the recommended instrument with the best supportive data is the:

66: An indication that there is a malfunction of a ventriculoperitoneal (VP) shunt in an older child would be the presence of a:

67: When assessing abdominal cutaneous reflexes, the nurse practitioner strokes the lower abdomen, the localized twitch is absent. This finding could be suggestive of a pathologic lesion in which segmented level of the spine?

68: While assessing the cranial nerves, the nurse practitioner touches the cornea lightly with a wisp of cotton. This maneuver assesses which cranial nerve? NR 509 APEA EXAM – NEUROLOGY

69: The level of consciousness that refers to the patient that arouses from sleep only after painful stimuli is ……

70: When evaluating the sensory system, testing the spinothalamic tracts would include assessing sensations of:

71: Hypalgesia refers to:

72: Which choice is least likely to be an example of asymmetric weakness?

73: When assessing coordination of muscle movement, four areas of the nervous system function in an integrated way. These areas include the motor, cerebellar, the vestibular, and the sensory systems. Which system coordinates head movements?

74: When comparing two sides of the body for symmetric sensation a symmetrical distal sensory loss would be suggestive of : nr 509 apea exam

75: A 80 year old male visits the nurse practitioner for an annual well exam. History reveals two falls in the prior 12 months and difficulty with balance. The next step the nurse practitioner should take is:

76: The principal muscles ……when closing the mouth are …..by which Cranial nerve?

77: The best method of detecting cognitive impairment or mental retardation at an early age is by:

78: When trying to determine the level of consciousness in a patient whose level of consciousness is ….., a lethargic patient: NR 509 APEA EXAM – NEUROLOGY

79: When eliciting deep tendon reflexes in the ankle, the nurse practitioner notes an abnormal reflex in the right ankle. This abnormality is probably consistent with a pathological lesion in which segmented level of the spine?

80: The term used to describe the absence or loss of control of voluntary muscle movements is:

81: With the adult patient lying supine, the nurse practitioner strokes the lateral aspect of the sole from the heel to the ball of the foot with the end of an applicator stick. Dorsiflexion of the big toe was ….. This is a positive:

82: The part of the peripheral nervous system that regulates muscle movement and response to the sensations of pain and touch is the:

83: The part of the brain that coordinates all movement and helps maintain the body upright in space is the: nr 509 apea exam

84: The part of the brain tissue that consists of neuronal axons that are …..with myelin is the:

85: A patient complains of experiencing symptoms of nausea, diaphoresis, and pallor triggered by a fearful or unpleasant event. These symptoms are most likely …..

86: The patient has his eyes ….and an area on his right leg is briefly …..by the nurse practitioner. The patient is i…..to open his eyes and point to the area that was …… This is an example of the discriminative sensation …….:

87: Hyperesthesia refers to:

88: A patient who is being …..for frequent headaches, mentions that the headache worsens with coughing, sneezing, or when changing positions. Increasing pain with these maneuvers may be suggestive of:

89: The term used to describe an abnormal tremor consisting of involuntary jerking movements, especially in the hands is: nr 509 apea exam

90: Which one of the following assesses pain, temperature, and sensation using the distal and proximal areas testing pattern?

91: The part of the brain that maintains homeostasis is the:

92: An example of tandem walking is having the patient:

93: The central nervous system extends from the medulla into the:

94: A patient is unable to identify the smell of an orange. This inability could reflect an abnormality in cranial nerves: NR 509 APEA EXAM – NEUROLOGY

95: When assessing the patient’s sense of position, instruct the patient to first stand with his feet together and eyes open, then instruct him to close both eyes for 30-60 seconds. If he loses his balance with his eyes closed, this is:

96: When evaluating the six cardinal directions of gaze, a loss of conjugate movements is ….when the patient looks to his left. This finding could be consistent with damage to which cranial nerve?

97: Dysarthria refers to:

98: Disorders of speech fall into three groups that affect all of the following except the:

99: Unilateral weakness in cranial nerve V (CN V) would be suggestive of a: nr 509 apea exam

100: The most common cause of viral encephalitis in children is:

101: The principal muscles ….when closing the mouth are …..by which Cranial nerve?

102: Intention tremors appear with movement and:

103: When assessing coordination of muscle movement, four areas of the nervous system function in an integrated way. These areas include the motor, cerebellar, the vestibular, and the sensory systems. Which system coordinates a steady posture?

104: Sudden, brief, rapid jerks, involving the trunk or limbs may be consistent with:  nr 509 apea exam

105: A patient experiences difficulty rising from a sitting position without arm support. This would be suggestive of:

106: Common physical findings in a young child with cerebral palsy include which one of the following?

107: A teenager is being ….for possible acute marijuana usage and appears intoxicated. Findings consistent with marijuana intoxication could include:

108: When eliciting deep tendon reflexes in the triceps, the nurse practitioner notes an abnormal reflex in the right triceps. This abnormality is probably consistent with a pathological lesion in which segmented level of the spine?

109: The central nervous system extends from the medulla into the: nr 509 apea exam

110: Which nerve runs from the spine through the neck, the axilla, and into the arm? NR 509 APEA EXAM – NEUROLOGY

LINGO software

Premier Consulting’s two consultants, Avery and Baker, can be scheduled to work for clients up to a maximum of 160 hours each over the next four  (4) weeks. A third consultant Campbell has some adminstrative assignments already planned and is availble for clieents up to a maximum of 140 hours over the next four (4) weeks. The company has four (4) clients with projects in process. The estimated hourly requirments for each of the clients over the four-week period as follows:

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CLIENT                         HOURS

A                                      180

B                                      75

C                                      100

D                                      85

Hourly rates vary form the consultant-client combinations and are based on several factors, including project type and consultants” experince. The rates( dollars per hour) for each consultants-client combination are as follows: LINGO software

 

CLIENT

CONSULTANTS                            A              B                    C                   D

AVERY                                        100             125               115              100

BAKER                                         120             135             115               120

CAMPBELL                                  155             150            140               130

 

a) Develop a network representation of the problem.

b) formulate the problem as linear program, with the optimal solution providing the hours each consultant should be scheduled for each client to maximize the consulting firm’s billings. What is the schedule and what is the total billing?

c)New information shows that Avery doesn’t have the experince to be scheduled for client B. If this consultingnassignment is not premitted, what impact does it have on total billings? What is the revised scheduled?

 

To solve problem using LINGO software.

Strategic Points Quantitative Study Extraction

In the prospectus, proposal, and dissertation there are 10 strategic points that need to be clear, simple, correct, and aligned to ensure the research is doable, valuable, and credible. These points, which provide a guide or vision for the research, are present in almost any research study. The ability to identify these points is one of the first skills required in the creation of a viable doctoral dissertation. In this assignment, you will identify and evaluate 10 strategic points in a published quantitative research study.

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General Requirements:

Use the following information to ensure successful completion of the assignment:

Review the Casteel dissertation.

Locate and download “Modified 10 Points Template.”

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

APA style is required for this assignment. Strategic Points Quantitative Study Extraction

You are required to submit this assignment to Turnitin.

Directions:

Using the “Modified 10 Points Template,” identify each of the 10 strategic points in this quantitative dissertation.

Complete the “Evaluation” section of the template by addressing the following questions (250-500 words) with regard to the 10 strategic points in the study:

 Discuss the key points in the literature review and how the author used this section to identify the gap or problem addressed in the study.

Describe the variables under study and how they are a key component in this quantitative research study. You are not expected to understand the differences between variables at this point, but should be able to identify how they inform the problem, purpose, research questions and data collection instruments.

Describe the problem and how it informed the research questions under study.

Describe the quantitative design used and why it is appropriate for the identified problem and research questions. Support your response with a peer-reviewed citation from a research source. Strategic Points Quantitative Study Extraction

Assess the appropriateness of the instruments used to collect data and answer the research questions as well as to address the stated problem.

Discuss how the problem statement informed the development of the purpose statement in this study. Strategic Points Quantitative Study Extraction

NRS-410V Module  1 Assess Your Knowledge Of Foundational Concepts

Anatomy

Backward effects of left-sided heart failure include:

A.    Pulmonary congestion

B.     Jugular vein distention

C.     Dependent edema in the legs

D.    Bounding pulses

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Anatomy

In performing a physical assessment, the nurse notes the patient has a “barrel” configuration to the chest. This is a consequence of:

A.    Reduced intrapleural pressures

B.     Bronchial airway expansion

C.     Increased vital capacity

D.    Increased residual lung volume

 

Anatomy

Ausculation of the chest reveals bilateral fine crackles in the bases bilaterally, indicating:

A.    Right-sided heart failure

B.     Left-sided heart failure

C.     Pneumonia

D.    Acute respiratory distress syndrome

 

Biology

The signs and symptoms of anemia are all related to what common pathophysiologic feature of the condition? NRS-410V

A.    Increased oxygen consumption by tissues

B.     Decreased blood oxygen content

C.     Vasodilation

D.    A shift in the oxyhemoglobin dissociation curve

 

Biology

In addition to hypertension, preeclampsia is characterized by:

A.    Nausea and vomiting

B.     Fatigue and lower back pain

C.     Protein in the urine and edema

D.    Retinal changes and rates in the lungs

 

Biology

Common manifestations of bacterial pneumonia include all of the following except:

A.    Fever

B.     Productive Cough

C.     Tachypnea

D.    Hyperinflation

 

Biology

Closed drainage systems work to re-expand a lung after pneumothorax by:

A.    Re-establishing the normal negative intrapleural pressure.

B.     Creating a positive pressure in the pleural space

C.     Removing excess fluid from the pleural space so that there is room for lung expansion.

D.    Pulling oxygen into distal air sacs to re-expand lung tissue

 

Biology

Patients with chronic renal failure usually exhibit:

A.    Bradycardia

B.     Hypokalemia

C.     Hypocalcemia

D.    Hematomas

 

NRS-410V Biology

The diet of a patient in end-stage kidney disease is restricted in all of the following except:

A.    Fluid

B.     Potassium

C.     Protein

D.    Calories

 

Anatomy

Which of the following is true of the biological functions of progesterone?

A.    Progesterone is the most important hormone associated with pregnancy.

B.     Progesterone directs male sexual characteristics.

C.     Levels of progesterone increases if the egg is not fertilized.

D.    Levels of progesterone remain stable if the egg is not fertilized.

 

Anatomy

Which of the following is true of the biological functions of testosterone?

A.    Testosterone is not secreted by the ovaries.

B.     Testosterone is needed for development of female secondary sexual characteristics.

C.     Testosterone stimulates ovulation.

D.    Testosterone is needed for development of male secondary sexual characteristics.

 

Anatomy

Which of the following is true of the biological functions of estrone?

A.    Estrone is required for proper development of male secondary sexual characteristics.

B.     Level of estrogen degreases if the egg is not fertilized.

C.     Estrone is required for proper development of female secondary sexual

characteristics.

D.    Estrone affects only the reproductive organs.

 

Biology

What is the function of hemoglobin?

A.    Hemoglobin is the protein in red blood cells that is responsible for carrying oxygen to the cells of the body.

B.     Hemoglobin is a lipid in red blood cells that is responsible for carrying oxygen to the cells of the body.

C.     Hemoglobin is a protein in white blood cells that is responsible for carrying oxygen to the cells of the body.

D.    Hemoglobin is a protein in red blood cells that is not responsible for carrying carbon dioxide to the cells of the body.

 

NRS-410V Biology

Why is heat an effective means of sterilization?

 

A.    Heat is an effective means of sterilization because it destroys the proteins of microbial life forms, including fungi, bacteria, and viruses.

B.     Heat is an effective means of sterilization because it destroys the proteins of anaerobic microbial life forms, including fungi, bacteria, and viruses.

C.     Heat is an effective means of sterilization because it destroys the lipids of microbial life forms, including fungi, bacteria, and viruses.

D.    Both (B) and (C).

 

Chemistry
:

List the enzymes whose levels are elevated in the blood serum following an MI.

A.    CPK, LDH, AST, and SGOT

B.     LDH, AST, and SGOT

C.     CRE, AST, and ALT

D.    None of the above

 

Chemistry

What is the physiological function of gluconeogenesis?

A.    Gluconeogenesis is production of glucose from noncarbohydrate molecules in times when blood glucose levels are low. This ensures proper function of brain and red blood cells, which only use glucose as fuel.

B.     Gluconeogenesis is production of glucose from noncarbohydrate molecules in times when blood glucose levels are high. This ensures proper function of brain and white blood cells, which only use glucose as fuel.

C.     Gluconeogenesis is production of glucose from carbohydrate molecules in times when blood glucose levels are low. This ensures proper function of brain and red blood cells, which only use glucose as fuel.

D.    None of the above

 

Chemistry

What effect does glycogen metabolism have on glucose levels?

A.    Glycogen metabolism traps glucose within liver cells and increases storage of glucose in the form of glycogen. These processes decrease blood glucose levels.

B.     Glycogen metabolism traps glucose within liver cells and increases storage of glucose in the form of glycogen. These processes increase blood glucose levels.

C.     Glycogen metabolism releases glucose within liver cells and increases storage of glucose in the form of glycogen. These processes decrease blood glucose levels.

D.    None of the above

 

NRS-410V Chemistry

Carbon monoxide binds tightly to the heme groups of hemoglobin and myoglobin. How does this affinity reflect the toxicity of carbon monoxide?

A.    Since carbon monoxide binds the heme groups of hemoglobin, it is easily removed or replaced by oxygen. As a result, the effects of oxygen enhancement result in what divers call the “bends.”

B.     Because carbon monoxide binds the heme groups of hemoglobin, it is easily removed or replaced by oxygen. As a result, the effects of oxygen deprivation result in suffocation.

C.     Because carbon monoxide binds tightly to the heme groups of hemoglobin, it is not easily removed or replaced by oxygen. As a result, the effects of oxygen deprivation result in suffocation.

D.    None of the above

 

Pathophysiology

Which of the following may be a reason to order an ABG on a patient?

A.    The patient suddenly develops shortness of breath

B.     An asthmatic is starting to show signs of tiring

C.     A diabetic has developed Kussmaul’s respirations

D.    All of the above

 

Pharmacology

How do sulfa drugs selectively kill bacteria while causing no harm to humans?

A.    Folic acid is a vitamin required for the synthesis of a coenzyme needed to make the amino acid methionine and the purine and pyrimidine nitrogenious bases for DNA and RNA and folic acid is produced by humans.

B.     Sulfa drug binds to the enzyme, no product is formed, folic acid is made and the biosynthesis of methionine and nitrogenous bases increases.

C.     Humans are not harmed because they do not synthesize their own folic acid. It is obtained in the diet.

D.    None of the above

 

NRS-410V Pharmacology

What occurs when glycogen metabolism is stimulated by insulin?

A.    Insulin stimulates glycogen synthase, the first enzyme in glycogen synthesis.

B.     Insulin stimulates glycogen synthase, the first enzyme in glycogen synthesis. It also stimulates removal of glucose from the bloodstream into cells and phosphorylation of glucose by the enzyme glucokinase.

C.     Insulin stimulates glycogen synthase, the first enzyme in glycogen synthesis. It also stimulates uptake of glucose from the bloodstream into cells and phosphorylation of glucose by the enzyme glucokinase.

D.    All of the above

 

Pharmacology

What is the medical application of cortisone? Cortisone is used to treat:

A.    Rheumatoid arthritis, asthma, gastrointestinal disorders, and a variety of skin conditions.

B.     Kidney disease, high blood pressure, and osteoporosis.

C.     Muscle disorders, tuberculosis, and thyroid disorder.

D.    All of the above

 

Anatomy

Oxygen saturation is likely to be lowest when an asthmatic with a diagnosis of pneumonia is positioned:

A.    In a high Fowler position

B.     Lying on the left side

C.     Lying on the right side

D.    Lying supine with the head of the bed flat

Chemistry

Laboratory test results indicative of thrombocytopenia, in addition to a low platelet count, would be:

A.    Increased PT

B.     Prolonged bleeding time and poor clot retraction.

C.     Increased aPTT

D.    Decreased RBC count.

 

Pharmacology

The purposes of epinephrine injection include all of the following except:

A.    Stabilizing mast cell membranes.

B.     Relaxing bronchial smooth muscle.

C.     Supporting arterial blood pressure.

D.    Blocking histamine receptors.

 

NRS-410V Pharmacology

Therapeutic interventions focused on increasing the oxygen supplied to the heart and decreasing the heart’s demand for oxygen include:

A.    Antiplatelet drugs

B.     Anticoagulants

C.     Morphine sulphate

D.    Thrombolytic drugs

 

Pharmacology

An intervention that would contribute toward the healing of a peptic ulcer is:

A.    Steroid administration

B.     Blocking or neutralizing of acid secretion

C.     Surgical removal of the ulcer

D.    Intravenous nutritional support

 

Pharmacology

Aspirin and NSAIDs are causative factors for the development of peptic ulcer disease because they:

A.    Increase acid secretion

B.     Allow proliferation of H. pylori

C.     Damage the mucosal barrier

D.    Alter platelet aggregation

 

Pharmacology

Your patient is interested in trying medication to improve low mood/depression. All of the following medications might be appropriate except:

A.    Selective serotonin reuptake inhibitors

B.     Amitriptyline

C.     Serotonin and norepinephrine reuptake inhibitors

 

D.    Benzodiazepines

NRS-410V

Prescriptive and non-prescriptive drug therapies

Discussion: Mr. Smith brings his 4-year-old to your office with chief complaints of right ear pain, sneezing, mild cough, and low-grade fever of 100 degrees for the last 72 hours. Today, the child is alert, cooperative, and well hydrated. You note a mildly erythemic throat with no exudate, both ears mild pink tympanic membrane with good movement, lungs clear. You diagnose an acute upper respiratory infection, probably viral in nature. Mr. Smith is states that the family is planning a trip out of town starting tomorrow and would like an antibiotic just in case.

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Create a communication plan for Mr. Smith and/or families for both prescriptive and non-prescriptive drug therapies. Describe what you would tell Mr. Smith and the child. Provide resources that Mr. Smith could access which would provide information concerning your decision.

This is a full APA paper with citation will upload the grading rubric

prescriptive and non-prescriptive drug therapies

Natonstate Insurance and RR Communication Case Studies

Below are two case study due by Saturday. I need 2 copies of each case study. It should be done in APA format. I have attached the sample APA format document.

RR Communication Case Study

Read the RR Communications Case Study on pages 156-159 in the textbook. Answer Discussion Questions 1-3 at the end of the Case Study. Your responses must be complete, detailed and in APA format. See the sample assignment for expected format and length. The grading rubric is included below. 4-5 pages

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Textbook:

Read the Nationstate Case Study on pages 160-164 in the textbook. Answer Discussion Questions 1-2 at the end of the Case Study. Your responses must be complete, detailed and in APA format. See the sample assignment for expected format and length. The grading rubric is included below. 4-5 pages

Textbook: Natonstate Insurance and RR Communication Case Studies

MN553 Practice Quiz Question

Question 1 1 / 1 point

Up to 21% of Asians are ultra-rapid 2D6 metabolizers, leading to:

Question options:

A need to monitor drugs metabolized by 2D6 for toxicity

Increased dosages needed of drugs metabolized by 2D6, such as the selective serotonin reuptake inhibitors

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Decreased conversion of codeine to morphine by CYP 2D6

The need for lowered dosages of drugs, such as beta blockers

Question 2 1 / 1 point

Rifampin is a nonspecific CYP450 inducer that may:

Question options:

Lead to toxic levels of rifampin and must be monitored closely

Cause toxic levels of drugs, such as oral contraceptives, when coadministered

Induce the metabolism of drugs, such as oral contraceptives, leading to therapeutic failure

Cause nonspecific changes in drug metabolism

Question 3 1 / 1 point

Inhibition of P-glycoprotein by a drug such as quinidine may lead to:

Question options:

Decreased therapeutic levels of quinidine

Increased therapeutic levels of quinidine

Decreased levels of a coadministered drug, such as digoxin, that requires P-glycoprotein for absorption and elimination

Increased levels of a coadministered drug, such as digoxin, that requires P-glycoprotein for absorption and elimination

MN553 Practice Quiz Question 4 1 / 1 point

Warfarin resistance may be seen in patients with VCORC1 mutation, leading to:

Question options:

Toxic levels of warfarin building up

Decreased response to warfarin

Increased risk for significant drug interactions with warfarin

Less risk of drug interactions with warfarin

Question 5 1 / 1 point

Pharmacogenetic testing is required by the U.S. Food and Drug Administration prior to prescribing:

Question options:

Erythromycin

Digoxin

Cetuximab

Rifampin

Question 6 1 / 1 point

Carbamazepine has a Black Box Warning recommending testing for the HLA-B*1502 allele in patients with Asian ancestry prior to starting therapy due to:

Question options:

Decreased effectiveness of carbamazepine in treating seizures in Asian patients with the HLA-B*1502 allele

Increased risk for drug interactions in Asian patients with the HLA-B*1502 allele

Increased risk for Stevens-Johnson syndrome in Asian patients with HLA-B*1502 Allele

Patients who have the HLA-B*1502 allele being more likely to have a resistance to carbamazepine

Question 7 1 / 1 point

A genetic variation in how the metabolite of the cancer drug irinotecan SN-38 is inactivated by the body may lead to:

Question options:

Decreased effectiveness of irinotecan in the treatment of cancer

Increased adverse drug reactions, such as neutropenia

Delayed metabolism of the prodrug irinotecan into the active metabolite SN-38

Increased concerns for irinotecan being carcinogenic

Question 8 1 / 1 point

A good history of herb and supplement use is critical before prescribing because approximately ____ % of patients in the United States are using herbal products.

Question options:

10

5

38

70

Question 9 1 / 1 point

A potential harmful effect on patients who take some herbal medication is:

Question options:

Constipation

Lead poisoning

Diarrhea

Life-threatening rash

MN553 Practice Quiz Question 10 1 / 1 point

A thorough understanding of herbs is critical to patient safety. An example is the use of cinnamon to treat type II diabetes. It is important the patient uses Ceylon cinnamon, as the commercially available cassia cinnamon contains:

Question options:

Coumadin, which may lead to bleeding problems

Coumarin, which can cause liver and kidney damage

Cinnamic aldehyde, which is toxic to the kidney

Cinnamate eugenol, which is toxic to the liver

Question 11 1 / 1 point

Traditional Chinese medicine utilizes yin (cooling) versus yang (warming) in assessing and treating disease. Menopause is considered a time of imbalance, therefore the Chinese herbalist would prescribe:

Question options:

Herbs which are yang in nature

Herbs that are yin in nature

Ginger

Golden seal

Question 12 1 / 1 point

According to traditional Chinese medicine, if a person who has a fever is given a herb that is yang in nature, such as golden seal, the patient’s illness will:

Question options:

Get worse

Get better

Not be adequately treated

Need additional herbs to treat the yang

Question 13 1 / 1 point

In Ayurvedic medicine, treatment is based on the patient’s dominant dosha, which is referred to as the person’s:

Question options:

Vata

Pitta

Kapha

Prakriti

Question 14 1 / 1 point

When melatonin is used to induce sleep, the recommendation is that the patient:

Question options:

Take 10 mg 30 minutes before bed nightly

Take 1 to 5 mg 30 minutes before bed nightly

Not take melatonin more than three nights a week

Combine melatonin with zolpidem (Ambien) for the greatest impact on sleep

Question 15 1 / 1 point

In the United States, over-the-counter drugs are regulated by:

Question options:

No one. There is no oversight for over-the-counter medications.

The U.S. Food and Drug Administration Center for Drug Evaluation and Research

The U.S. Drug Enforcement Administration

MedWatch

Question 16 1 / 1 point

As drugs near the end of their patent, pharmaceutical companies may apply for the drug to change to over-the-counter status in order to:

Question options:

Get a new patent for the over-the-counter form of the drug

Lower the costs because most prescription benefit plans do not cover generics

Market the drug to a whole new population, as they are able to market to patients instead of just providers

Continue to make large profits from their blockbuster brand-name drug

MN553 Practice Quiz Question 17 1 / 1 point

The ailment that generates the greatest over-the-counter annual drug sales is:

Question options:

Constipation

Cough and colds

Heartburn

Acute and chronic pain

Question 18 1 / 1 point

Common over-the-counter pain relievers such as acetaminophen or ibuprofen:

Question options:

Are always safer for the patient than prescription pain medication

Are harmful if taken in higher than recommended amounts

Have minimal interaction with prescription medications

Should never be given to children unless recommended by their provider

Question 19 1 / 1 point

When obtaining a drug history from Harold, he gives you a complete list of his prescription medications. He denies taking any other drugs, but you find that he occasionally takes aspirin for his arthritis flare ups. This is an example of:

Question options:

His appropriately only telling you about his regularly prescribed medications

His hiding information regarding his inappropriate use of aspirin from you

A common misconception that intermittently taken over-the counter medications are not an important part of his drug history

A common misuse of over-the-counter aspirin

Question 20 1 / 1 point

Michael asks you about why some drugs are over-the-counter and some are prescription. You explain that in order for a drug to be approved for over-the-counter use the drug must:

Question options:

Be safe and labeled for appropriate use

Have a low potential for abuse or misuse

Be taken for a condition the patient can reliably self-diagnose

All of the above

MN553 Practice Quiz

NR 509 APEA EXAM – HEENT

Question 1:
 The function of the auditory ossicles is to:

Question 2:
 A 35-year-old patient complains of vertigo accompanied by nausea and vomiting. Examination reveals bilateral diplopia and an unsteady gait. These symptoms could be suggestive of:

3. A 60-year-old was concerned about a yellowish colored lesion above her right eyelid. Findings revealed a slightly raised yellowish, well circumscribed plaque along the nasal area of her right eyelid. This finding is most consistent with:

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4. Assessment of a patient’s visual acuity resulted in 20/200 using the Snellen eye chart. This means that:

APEA HEENT

5. Findings following assessment of a person’s left eye gaze include impaired movements when attempting to look upward, downward, or inward. This condition is most consistent with: a conjugate gaze.

6. Findings following assessment of a person’s eye gaze include both eyes moving in the same direction simultaneously. This condition is most consistent with: a conjugate gaze.

7. A patient was diagnosed as being farsighted. The term for this condition is:

8.  buildup of excess fluid around the periphery of the eye orbits is known as:

9. hat connects the middle ear to the nasopharynx? NR 509 APEA EXAM – HEENT.

10. The fleshly projection of the earlobe is known as the:

11.Then examining the pupils, the left pupil is noted to be fixed and dilated to light and near accommodation. This condition may be suggestive of:

12. A deposit of uric acid crystals appearing as hard nodules on the helix or antihelix is termed:

13. n the outer ear, anterior and parallel to the helix, is a curved prominence known as the:

14. On examination of the pupils, both are round but the right pupil appears larger than the left and reacts much slower to light. This condition may be indicative of:

15. A six-year-old complains that something is in her left eye. There is a red raised area of the left lid. There is redness and tenderness of the eye and tearing. These findings are consistent with:

16. Ophthalmoscopic examination of the retina reveals AV tapering. This appears as if the: vein “winds” down on either side of the artery.

17.  A patient presents with complaints of burning, itching, tearing, and some pain in the eye. Findings reveal red, scaly, greasy flakes and thickened, crusted lid margins. This would be suggestive of:

18. Ophthalmoscopic examination of the fundus reveals small, rounded, slightly irregular red spots embedded in the retina. These findings are consistent with: NR 509 APEA EXAM – HEENT.

19. Redness, bleeding, pain, and swelling of the gums is most likely nr 509 apea exam

20. Ophthalmoscopic examination of the retina reveals a normal arteriovenous crossing. This appears as if the:

21. Otosclerosis is an example of a(n):

22.  Which of the following findings in a preschooler would indicate the need for further evaluation?

23. A 50- year-old patient complains of being unable to read the hymnal at church. This describes:

24. The gradual loss of vision with a change in color and size of the optic disc is referred to as:

25. In order to examine the tongue, ask the patient to stick out his tongue and with the examiner’s right hand nr 509 apea exam

26. A 30-year-old patient presents with complaints of seeing double in the right eye. Examination reveals diplopia in the right eye when the left eye is …… This may be suggestive of a:

27. One cause of nasal septum perforation may be:

28. A 30-year-old patient presents with a moderate “aching” in his right eye. Findings reveal a small and irregular shaped right pupil.

29. Sudden bilateral and painless visual loss is rare but can be associated with all the following except:

30. On ophthalmoscopic examination, optic atrophy appears: NR 509 APEA EXAM – HEENT.

31. Ophthalmoscopic examination of the retina reveals AV banking. This appears as if the: vein tapes down on either side of the artery.

32. Causes of sensorineural hearing loss include all of the following except nr 509 apea exam

33. What visual acuity constitutes legal blindness?

34. An example of a cause of conductive hearing loss in children would be:

35. Miosis is a term used to describe:

36.  If a patient complains of seeing flashing lights across the field of vision, this could be: NR 509 APEA EXAM – HEENT

Toulmin Outline: Are Children Overmedicated in ADHD and ADD:

Using the TOULMIN OUTLINE, write a paper that discusses your position on whether or not children are over-medicated in regards to ADD and ADHD.

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Toulmin Outline: Are Children Overmedicated in ADHD and ADD

NB: This is a sample introduction

There exists increased public concern, especially among health research specialists that many American children receive early and often unnecessary exposure to ADD and ADHD medication. The diagnosis discourses of ADD and ADHD are intrinsically problematic, simply because the diagnosis seeks such symptoms as impulsivity, hyperactivity and distractibility, traits that, in children, tend to be consistent with normal developmental behavior. However, upon diagnosis, the implication is always that the child is characteristically impulsive, hyperactive or distractible. That this approach to diagnosing ADD and ADHD in children is flawed relates to the ocean of misdiagnosis reported across the globe, hence the need to determine where to draw the line between medical disorder and developmentally normal behavior. Toulmin Outline: Are Children Overmedicated in ADHD and ADD.

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A study by Visser (2013) established that in 2011, about 11 percent of children aged between 4 and 17 years had received positive diagnosis of ADHD, primarily through parental reporting, most of which were on related ADHD drugs. The study also cites earlier findings that indicate that about 7.5 percent of U.S. children below age 17 are on medication related to emotional or behavioral difficulties with a another study contending that the number of children on psychostimulants has increased five-fold between the periods 1988-1994 and 2007-2010. That these diagnoses and the subsequent administration of ADD and ADHDF related drugs proceed from parental diagnosis as opposed to physician diagnosis is particularly of greater concern. Toulmin Outline: Are Children Overmedicated in ADHD and ADD.

NR 509 APEA EXAM – WOMEN’S HEALTH

Question 1:
 When palpating the cervix during the bimanual exam, cervical motion tenderness (chandelier sign) is noted. This tenderness could be suggestive of:

Question 2:
 In a female diagnosed with a first-degree uterine prolapse, the cervix:

3: Daughters of women who took Diethylstilbestrol (DES) during pregnancy are at a high risk for developing all of the following abnormalities except:

4: A female patient presents with a profuse, yellowish, green vaginal discharge that is malodorous. This vaginal discharge is most consistent with:

5: The most common causes of sexual problems in females are …..

6: Chronic pelvic pain refers to pain that does not respond to therapy and:

7: In female patients with dyspareunia, superficial pain is most likely related to all of the following except: NR 509 APEA EXAM – WOMEN’S HEALTH.

8: If urethritis or inflammation of the paraurethral glands is suspected in a female patient, the index finger should be inserted into the vagina and:

9: Upon examination of the vagina, a swollen red ring is noted around the urethral opening. This finding is most consistent with a:

10: When performing a bimanual vaginal exam, a solid, nodular-like lesion is palpated over the right ovary. This finding is most consistent with:

11: Indications for performing a rectovaginal exam include all of the following except to:

12: Examination of a female patient’s right breast reveals a retraction of the nipple and areola. This finding is consistent with: NR 509 APEA EXAM – WOMEN’S HEALTH.

13: To assess pelvic floor muscle strength during the bimanual vaginal exam, have the patient squeeze around the inserted fingers for as long as possible. To consider full strength, snug compression should last for:

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14: Upon examination of the vagina, a tense, hot, very tender abscess with labial swelling is noted. This finding is most consistent with a:

15: A female patient has a history of a retroverted uterus. This condition refers to:

16: Upon examination of the vagina, the entire anterior vaginal wall, together with the bladder and urethra create a bulge. This condition is most consistent with a:

17: Urethritis in a female patient may arise from all of the following organisms except:

18: To palpate the uterus during a bimanual exam, the examiner would lubricate the index and middle fingers of one hand and insert them into the vagina. The other hand would be placed on the abdomen: NR 509 APEA EXAM – WOMEN’S HEALTH.

19: When do the ovaries become non-palpable after menopause?

20: When performing a rectal exam on a female, a hard nodular rectal “shelf” is palpable at the tip of the examiner’s finger. This finding is suggestive of:

21: A twenty-year-old female complains of a milky discharge bilaterally from her breasts. This suggests:

22: A woman complains of infrequent menses with intervals greater than 35 days. This condition is …..

23: The most common cause of acute pelvic pain in women is:

24: When performing a vaginal exam with a speculum, the use of the upper blade as a retractor could expose a:

25: When preparing to perform a pelvic exam in an older female, vaginal atrophy is noted. Due to this finding, the speculum:

26: Upon examination of the cervix, a yellow drainage is visible around the cervical os. This finding is most likely suggestive of: NR 509 APEA EXAM – WOMEN’S HEALTH.

27: When examining the cervix, a bright, red, soft and fragile lesion is noted on the cervical surface. This finding is consistent with:

28: During examination of the vagina, a bulge in the upper two-thirds of the anterior vaginal wall is noted. This symptom is most consistent with a:

29: The most common type of hernia in women is the:

30: A female patient presents with a gray, thin, malodorous (fishy) vaginal discharge. These symptoms are most consistent with:

31: When performing a bimanual vaginal exam, a smooth and rather compressible non-tender lesion is palpated over the right ovary. This finding is most consistent with:

32: When performing the bimanual vaginal exam, a nodule on the anterior uterine surface could suggest a (an):

33: Cessation of the menses for 12 months is ….

34: A woman complains of experiencing uterine bleeding between expected menstrual cycles. This condition is …..

35: A 45-year old female presents to the nurse practitioner with complaints of postcoital bleeding (greater than spotting) unrelated to the menstrual cycle. What is the most likely cause?

36: When performing the bimanual vaginal exam, uterine enlargement is …… This enlargement could suggest: NR 509 APEA EXAM – WOMEN’S HEALTH.

37: In which of the following situations would it be difficult for the examiner to palpate an ovary during the bimanual vaginal exam?

38: Causes of post menopausal bleeding typically include all of the following except:

39: A 35-year-old female presents with complaints of swelling of her right breast. Findings reveal edema of the lower portion of her right breast. The skin appears thickened with enlarged pores. This condition is consistent with:

40: The shiny, pink area located around the cervical os is ….as nr 509 apea exam

41: During a speculum exam of the cervix the speculum is maintain in an open position by:

42: A female patient presents with a white and curd-like thin vaginal discharge. This discharge is most consistent with:

Question 43:
 Upon examination of the vagina, a bulge is …..in the lower posterior wall of the vagina. This finding is most consistent with a:

Question 44:
 Upon examination of the cervix, an irregular cauliflower-like growth was ….around the cervical os. This finding is most suggestive of:

45: Upon examination of the vagina, a small, red, benign tumor is …..at the posterior part of the urethral meatus. This finding is most consistent with a:

46: To palpate an indirect inguinal hernia in a woman, have her stand and palpate in the labia majora and:

47: An ulcerated vulvar lesion in an elderly woman may indicate nr 509 apea exam

48: Pelvic floor muscle weakness may be due to all of the following except:

49: In a female diagnosed with a third-degree uterine prolapse, the cervix:

50: A woman complains of abnormally heavy and prolonged menstrual periods that occur at regular intervals. This condition is most likely:

51: In a female diagnosed with a second-degree uterine prolapse, the cervix:

52: A woman complains of experiencing frequent menses with intervals of fewer than 21 days. This condition is …..

53: If performed correctly and in a timely fashion, which one of the following is most definitive for the diagnosis of breast cancer? NR 509 APEA EXAM – WOMEN’S HEALTH.

54: Retraction of the nipple and areola suggest:

55: The vaginal mucosa lies in transverse folds ……

56: The most important risk factor for cervical cancer is nr 509 apea exam

57: When performing a bimanual exam of the vagina, the examiner should lubricate the index and middle fingers of a gloved hand. From a standing position, the fingers should be ….into the vagina while exerting pressure primarily:

58: Fixed flattening of the nipple suggests:

59: Chronic pelvic pain may be secondary to all of the above except:

60: When discussing the female anatomy, the introitus is also ….as the nr 509 apea exam

61: When performing a breast exam, a mobile mass becomes fixed when the arm relaxes. This suggests that the mass is:

62: To palpate the right ovary when performing the bimanual vaginal exam, the abdominal hand should be on the right lower quadrant and the pelvic hand needs to be:

63: When performing an examination of the external genitalia of a female patient, a small, firm, round cystic nodule in the labia is …… This lesion is most consistent with:

64: Primary dysmenorrhea results from:

65: The deep red area located around the cervical os is ….as nr 509 apea exam

66: When examining the cervix, a translucent nodule is …..on the cervical surface. This finding is consistent with:

67: To palpate the left ovary when performing the bimanual vaginal exam, the abdominal hand should be on the left lower quadrant and the pelvic hand needs to be:

68: When performing a vaginal exam with a speculum, the use of the lower blade as a retractor during bearing down could expose an anterior wall defect such as a: NR 509 APEA EXAM – WOMEN’S HEALTH