NURS6521 Week 6 Quiz latest 2018

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Question

Week 6 quiz

Question 1

A 65-year-old woman has an advanced form of rheumatoid arthritis. Her treatment includes a regular dosage of methotrexate. The nurse will advise her to take which of the following vitamin supplements while taking the drug?

A) Vitamin A
B) Vitamin B
C) Vitamin C
D) Vitamin D

Question 2

To minimize the risk of adverse effects of glucagon when given to an unconscious diabetic patient, as the patient regains consciousness, the nurse should

A) administer calcium supplements.
B) position the patient in the side-lying position.
C) administer carbohydrates.
D) monitor for nausea and vomiting.

Question 3

A female patient with a diagnosis of type 1 diabetes mellitus has been experiencing increasing neuropathic pain in recent months, a symptom that has not responded appreciably to conventional analgesics. The patient’s care provider has begun treatment with gabapentin (Neurontin). How is the addition of this drug likely to influence the management of the patient’s existing drug regimen?

A) The patient may be required to temporarily hold her other medications until a stable serum level of gabapentin is achieved.
B) It is unlikely to influence the patient’s other medications because gabapentin does not interact with other drugs.
C) Gabapentin is contraindicated with the use of exogenous insulin.
D) The patient’s medication-related risk for renal failure must be assessed prior to the use of gabapentin.

Question 4

A nurse is caring for a patient who has been diagnosed with hypothyroidism. Levothyroxine (Synthroid) has been prescribed. Before the drug therapy is started, the nurse will assess for which of the following?

A) History of taking anticoagulant drugs
B) Allergy to seafood
C) Hirsutism
D) The patient’s age

Question 5

A nurse is caring for a male patient who has a spinal cord injury due to a motorcycle accident. He has been taking dantrolene (Dantrium) for 2 weeks. The nurse will monitor which of the following?

A) Prothrombin time and partial thromboplastin time
B) Urine specific gravity
C) Alanine aminotransferase and total bilirubin levels
D) Follicle-stimulating hormone levels

Question 6

A nurse is assessing a patient who has come to the emergency department complaining of back spasms. The patient states that he has a history of opioid addiction and does not want to take any drug that “puts me at risk of becoming physically dependent.” Which of the following medications would the nurse question, if ordered?

A) Methocarbamol (Robaxin)
B) Orphenadrine (Norflex)
C) Cyclobenzaprine (Flexeril)
D) Metaxalone (Skelaxin)

Question 7

A 40-year-old woman with a diagnosis of fibromyalgia has been prescribed cyclobenzaprine (Flexeril) as an adjunct to her existing drug regimen. What nursing diagnosis should the nurse prioritize when updating the nursing care plan for this patient?

A) Risk for Injury related to CNS depressant effects
B) Diarrhea related to anticholinergic effects
C) Altered Nutrition, Less than Body Requirements, related to appetite suppression
D) Impaired Swallowing related to increased muscle tone

Question 8

A nurse is working with a 57-year-old man who is a former intravenous drug abuser. He has been prescribed a weekly dosage of methotrexate for his rheumatoid arthritis. Which of the following will the nurse include in her teaching plan for this patient?

A) Avoid high-fat foods
B) Drink plenty of water every day
C) Take the tablets before bedtime
D) Avoid red meat

Question 9

Following an assessment by her primary care provider, a 70-year-old resident of an assisted living facility has begun taking daily oral doses of levothyroxine. Which of the following assessment findings should prompt the nurse to withhold a scheduled dose of levothyroxine?

A) The resident has not eaten breakfast because of a recent loss of appetite
B) The resident’s apical heart rate is 112 beats/minute with a regular rhythm
C) The resident had a fall during the night while transferring from her bed to her bathroom
D) The resident received her annual influenza vaccination the previous day

Question 10

A nurse is caring for a 61-year-old man who has had a severe attack of gout while in the hospital for food poisoning. The nurse administers colchicine intravenously in order to

A) avoid aggravating the gastrointestinal tract.
B) ensure quick distribution of the drug.
C) prevent the risk of infection or bleeding.
D) minimize the risk of depressed bone marrow function.

Question 11

A patient receives 25 units of NPH insulin at 7.AM. At what time of day should the nurse advise the patient to be most alert for a potential hypoglycemic reaction?

A) After breakfast
B) Before lunch
C) Late afternoon
D) Bedtime

Question 12

A male patient is to begin glyburide (Diabeta) for type 2 diabetes. Before the drug therapy begins, a priority action by the nurse will be to assess the patient’s

A) blood pressure.
B) potassium level.
C) use of alcohol.
D) use of salt in his diet.

Question 13

A male patient with a diagnosis of relapsing-remitting multiple sclerosis is in the clinic to discuss with the nurse the possibility of self-administration of glatiramer. During the patient education session for self-administration, the nurse will emphasize

A) the need to rotate the injection site of the drug.
B) the need to avoid crushing the tablet.
C) the need to place the tablet under the tongue.
D) the need to use only the thigh muscle for the drug injection site.

Question 14

A diabetic patient being treated for obesity tells the nurse that he is having adverse effects from his drug therapy. The patient has been taking dextroamphetamine for 2 weeks as adjunct therapy. Which of the following adverse effects would need the nurse’s immediate attention?

A) Decreased libido
B) Increased blood glucose
C) Dry eyes
D) Jittery feeling

Question 15

A patient with diabetes has had a cough for 1 week and has been prescribed a cough syrup (an expectorant). What special instructions should the nurse include in the patient teaching for this situation?

A) Wash hands before and after taking the medicine
B) Keep track of any gastrointestinal tract infections
C) Monitor glucose levels closely
D) Note the time the medicine is taken each day

Question 16

A 13-year-old patient has juvenile arthritis. He has recently had oral surgery and was told by the surgeon to take aspirin for the pain. The nurse will monitor for which of the following?

A) Bronchoconstriction
B) Hepatotoxicity
C) Aplastic anemia
D) Agranulocytosis

Question 17

A nurse has been invited to speak to a support group for persons with movement disorders and their families. Which of the following statements by the nurse addresses the chronic nature of these diseases and the relevant drug therapies?

A) “Drug therapy can consist of one or more drugs to eliminate the symptoms of these diseases.”
B) “Drugs do not cure these disorders; they instead enhance quality of life.”
C) “Persons of all cultures are treated similarly and respond in similar ways to treatment.”
D) “Drugs used to treat these disorders always pose a risk of severe liver and kidney dysfunction.”

Question 18

A patient in need of myocardial infarction prophylaxis has been prescribed sulfinpyrazone for gout. Which of the following will the nurse monitor the patient most closely for?

A) Hypothermia
B) Hypotension
C) Renal dysfunction
D) Bleeding

Question 19

A nurse is developing a care plan for a patient who has multiple sclerosis. An expected outcome for the patient who is receiving glatiramer would be a decrease in

A) chest pain.
B) fatigue.
C) breathing difficulties.
D) heart palpitations.

Question 20

A 32-year-old female patient is taking tizanidine (Zanaflex) for spasticity related to her multiple sclerosis. The nurse will inform the patient and her husband that the adverse effect that poses the greatest safety risk to the patient is

A) constipation.
B) dry mouth.
C) fatigue.
D) hypotension.

Question 21

A 34-year-old male patient is prescribed methimazole (MMI).The nurse will advise him to report which of the following immediately?

A) Vertigo
B) Intolerance to cold
C) Loss of appetite
D) Epigastric distress

Question 22

A 43-year-old woman was diagnosed with multiple sclerosis 2 years ago and has experienced a recent exacerbation of her symptoms, including muscle spasticity. Consequently, she has been prescribed Dantrolene (Dantrium).In light of this new addition to her drug regimen, what teaching point should the woman’s nurse provide?

A) “This will likely relieve your muscle spasms but you’ll probably develop a certain amount of dependence on the drug over time.”
B) “We’ll need to closely monitor your blood sugar levels for the next week.”
C) “There’s a small risk that you might experience some hallucinations in the first few days that you begin taking this drug.”
D) “You might find that this drug exacerbates some of your muscle weakness while it relieves your spasticity.”

Question 23

A patient with type 1 diabetes has been admitted to the hospital for orthopedic surgery and the care team anticipates some disruptions to the patient’s blood glucose levels in the days following surgery. Which of the following insulin regimens is most likely to achieve adequate glycemic control?

A) Small doses of long-acting insulin administered four to five times daily
B) Doses of basal insulin twice daily with regular insulin before each meal
C) Large doses of rapid-acting insulin combined with long-acting insulin each morning and evening
D) Divided doses of intermediate-acting insulin every 2 hours, around the clock

Question 24

During long-term desmopressin therapy in a 48-year-old woman, it will be most important for the nurse to assess which of the following?

A) The patient’s environment
B) The patient’s diet
C) The condition of the patient’s skin
D) The condition of the patient’s nasal passages

Question 25

A 49-year-old woman has been diagnosed with myalgia. The physician has recommended aspirin. The patient is concerned that the aspirin will upset her stomach. The nurse will encourage the patient to

A) crush the tablet before swallowing.
B) swallow the tablet whole.
C) swallow the tablet with milk or food.
D) avoid drinking milk for 3 hours after swallowing the tablet.

Question 26

A nurse will instruct a patient taking allopurinol to take each dose

A) at night.
B) first thing in the morning.
C) after a meal.
D) before a meal.

Question 27

The nurse is conducting a medication reconciliation of a new resident of a long-term care facility. The nurse notes that the resident takes allopurinol on a daily basis for the treatment of gout. What is the primary purpose of this drug?

A) To balance urate concentration and prevent gout attacks
B) To promote the remodeling of damaged synovium
C) To potentiate the metabolism of dietary purines
D) To achieve pain relief in joints affected by gout

Question 28

A nurse is teaching a patient about his newly prescribed drug, colchicine, for gout. The nurse will instruct the patient to avoid which of the following foods?

A) Green beans
B) Shrimp
C) Eggs
D) Milk

Question 29

A nurse is instructing a patient who was recently diagnosed with multiple sclerosis about dantrolene (Dantrium). The patient is a 38-year-old-male and the foreman for a construction company. In order to minimize one important adverse effect of the drug, the nurse will give the patient which of the following instructions?

A) Eat a high-protein diet
B) Decrease the dosage if any adverse effect is experienced
C) Wear appropriate clothing and sunscreen whenever he is in direct sunlight
D) Have a complete blood cell count done weekly

Question 30

A 33-year-old man has developed acute gouty arthritis. He has been prescribed colchicine. When developing a care plan for this patient, which factor will be most important for the nurse to consider?

A) Dietary habits
B) Work environment
C) Typical daily fluid intake
D) Ethnicity

Home visit with Sallie Mae Fisher

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Report Issue

 

observe the simulated “Home Visit With Sallie Mae Fisher” video (http://lc.gcumedia.com/zwebassets/courseMaterialPages/nrs410v_vp01Alt.php).

Refer to “Sallie Mae Fisher’s Health History and Discharge Orders” for specifics related to the case study used to inform the assignment.

Using “Home Visit With Sallie Mae Fisher” and “Sallie Mae Fisher’s Health History and Discharge Orders,” complete the following components of this assignment:

Essay Portion

After viewing the home visit, write an essay of 500-750-words in which you do the following:

  1. Identify,      prioritize, and describe at least four problems.( problems identify are as follows

Mrs. Fisher’s number one problem is dehydration. In the video her vital signs are: Heart rate 58, blood pressure 90/56, respiratory rate 24 and temperature 97.8F (GCU, 2017). Her physical assessment reveals poor skin turgor, tenting, dry mucus membranes, hypoactive bowel sounds, no bowel movement for three days and a 14 pound weight loss in one week (GCU, 2017). She admits to “not having an appetite.” She is taking Lasix, a diuretic further contributing to her fluid loss.  All of these finding are consistent with dehydration. Dehydration can lead to a kidney injury, seizures and hypovolemic shock (Mayo Clinic, 2017).

The next problem is an unsafe living environment. In in video we see a loose rug on the floor, prescriptions on the table and mail on the couch. This lack of organization and Mrs. Fisher’s age put at risk for a fall. The Center for Disease Control and Prevention (CDC) states, “One out of five falls in an older adult causes a serious injury such as broken bones or a head injury” (CDC, 2017).

Then we look at her lack of understanding surround her discharge. She is supposed to be on home oxygen but didn’t have it delivered because she thinks she will, “Be in the poor house” due to cost of her medications and medical supplies. The final problem is her depression. Mrs. Fisher explains her husband died. She now lives alone and, “doesn’t even care, is so lonesome and misses him so” (GCU, 2017).

  1. Provide      substantiating evidence (assessment data) for each problem identified.
  2. Identify      and describe at least four medical and/or nursing interventions.
  3. Discuss      your rationale for the interventions identified.

Prepare this step of the assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

Scripted Dialogue Portion

Utilizing the information learned from the home visit, health histories, and discharge orders, write a scripted dialogue in which you provide Sallie Mae with education that describes her problems and the interventions identified to improve her condition. Consider Sallie Mae’s physiological, psychosocial, educational, and spiritual needs when developing your dialogue.

Your dialogue should resemble a script. The following is an example of a few sentences from a scripted dialogue:

Nurse: “Good morning, Salle Mae, my name is ______ and I will be your nurse today. I understand you are experiencing problems with ________.”

APA format is not required for this part of the assignment, but solid academic writing is expected.

Refer to “Home Visit With Sallie Mae Fisher Grading Criteria.”

Entire Assignment

You are required to submit this assignment to Turnitin. Refer to the directions in the Student Success Center. Only Word documents can be submitted to Turnitin.

Cardiovascular Alterations

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Cardiovascular Alterations

At least once a year, the media report on a seemingly healthy teenage athlete collapsing during a sports game and dying of heart complications. These incidents continue to outline the importance of physical exams and health screenings for teenagers, especially those who play sports. During these health screenings, examiners check for cardiovascular alterations such as heart murmurs because they can be a sign of an underlying heart disorder. Since many heart alterations rarely have symptoms, they are easy to miss if health professionals are not specifically looking for them. Once cardiovascular alterations are identified in patients, it is important to refer them to specialists who can further investigate the cause.

Consider the following scenario:

A 16-year-old male presents for a sports participation examination. He has no significant medical history and no family history suggestive of risk for premature cardiac death. The patient is examined while sitting slightly recumbent on the exam table and the advanced practice nurse appreciates a grade II/VI systolic murmur heard loudest at the apex of the heart. Other physical findings are within normal limits, the patient denies any cardiovascular symptoms, and a neuromuscular examination is within normal limits. He is cleared with no activity restriction. Later in the season he collapses on the field and dies.

To Prepare

Review the scenario provided, as well as Chapter 25 in the Huether and McCance text. Consider how you would diagnose and prescribe treatment for the patient.

Select one of the following patient factors: genetics, ethnicity, or behavior. Reflect on how the factor you selected might impact diagnosis and prescription of treatment for the patient in the scenario.

Post a description of how you would diagnose and prescribe treatment for the patient in the scenario. Then explain how the factor you selected might impact the diagnosis and prescription of treatment for that patient.

Required Readings

** Huether, S. E., & McCance, K. L. (2017). Understanding pathophysiology (6th ed.). St. Louis, MO: Mosby.

Chapter 23, “Structure and Function of the Cardiovascular and Lymphatic Systems”

This chapter examines the circulatory system, heart, systemic circulation, and lymphatic system to establish a foundation for normal cardiovascular function. It focuses on the structure and function of various parts of the circulatory system to illustrate normal blood flow.

Chapter 24, “Alterations of Cardiovascular Function”

This chapter presents the pathophysiology, clinical manifestations, evaluation, and treatment of various cardiovascular disorders. It focuses on diseases of the veins and arteries, disorders of the heart wall, heart disease, and shock.

Chapter 25, “Alterations of Cardiovascular Function in Children”

This chapter examines cardiovascular disorders that affect children. It distinguishes congenital heart disease from acquired cardiovascular disorders.

** Hammer, G. G. , & McPhee, S. (2014). Pathophysiology of disease: An introduction to clinical medicine. (7th ed.) New York, NY: McGraw-Hill Education.

Chapter 11, “Cardiovascular Disorders: Vascular Disease”

This chapter begins with an overview of the vascular component of the cardiovascular system and how the cardiovascular system is normally regulated. It then describes three common vascular disorders: atherosclerosis, hypertension, and shock.

**American Heart Association. (2012). Retrieved from http://www.heart.org/HEARTORG/ 

**Million Hearts. (2012). Retrieved from http://millionhearts.hhs.gov/index.html 

**National Heart, Lung, and Blood Institute. (2012). Retrieved from http://www.nhlbi.nih.gov/

Instructor Requirements

As advanced practice nurses, we are scholars, nurse researchers and scientists. As such, please use Peer-Reviewed scholarly articles and websites designed for health professionals (not designed for patients) for your references. Students should be using the original citation in Up

to Date and go to that literature as a reference. The following are examples (not all inclusive) of resources/websites deemed inadmissible for scholarly reference:

1. Up to Date (must use original articles from Up to Date as a resource)

2. Wikipedia

3. Cdc.gov- non healthcare professionals section

4. Webmd.com

5. Mayoclinic.com

– This work should have  Introduction and  Conclusion

– It should have at least 3 current references

– APA format

– At least 2 pages, references page not included

Walden NURS6521 Week 6 Quiz 2017

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Question 1 A nurse is developing a care plan for a patient who has multiple sclerosis. An expected outcome for the patient who is receiving glatiramer would be a decrease in

A) chest pain
B) fatigue
C) breathing difficulties
D) heart palpitations

Question 2 A nurse is teaching a patient about his newly prescribed drug, colchicine, for gout. The nurse will instruct the patient to avoid which of the following foods?

A) Green beans
B) Shrimp
C) Eggs
D) Milk

Question 3 A patient with type 1 diabetes has been admitted to the hospital for orthopedic surgery and the care team anticipates some disruptions to the patient’s blood glucose levels in the days following surgery. Which of the following insulin regimens is most likely to achieve adequate glycemic control?

A) Small doses of long-acting insulin administered four to five times daily
B) Doses of basal insulin twice daily with regular insulin before each meal
C) Large doses of rapid-acting insulin combined with long-acting insulin each morning and evening
D) Divided doses of intermediate-acting insulin every 2 hours, around the clock

Question 4 A 65-year-old woman has an advanced form of rheumatoid arthritis. Her treatment includes a regular dosage of methotrexate. The nurse will advise her to take which of the following vitamin supplements while taking the drug?

A) Vitamin A
B) Vitamin B
C) Vitamin C
D) Vitamin D

Question 5 A 49-year-old woman has been diagnosed with myalgia. The physician has recommended aspirin. The patient is concerned that the aspirin will upset her stomach. The nurse will encourage the patient to

A) crush the tablet before swallowing
B) swallow the tablet whole
C) swallow the tablet with milk or food
D) avoid drinking milk for 3 hours after swallowing the tablet

Question 6 A nurse is working with a 57-year-old man who is a former intravenous drug abuser. He has been prescribed a weekly dosage of methotrexate for his rheumatoid arthritis. Which of the following will the nurse include in her teaching plan for this patient?

A) Avoid high-fat foods
B) Drink plenty of water every day
C) Take the tablets before bedtime
D) Avoid red meat

Question 7 A male patient with a diagnosis of relapsing-remitting multiple sclerosis is in the clinic to discuss with the nurse the possibility of self-administration of glatiramer. During the patient education session for self-administration, the nurse will emphasize

A) the need to rotate the injection site of the drug
B) the need to avoid crushing the tablet
C) the need to place the tablet under the tongue
D) the need to use only the thigh muscle for the drug injection site

Question 8 A patient in need of myocardial infarction prophylaxis has been prescribed sulfinpyrazone for gout. Which of the following will the nurse monitor the patient most closely for?

A) Hypothermia
B) Hypotension
C) Renal dysfunction
D) Bleeding

Question 9 A nurse will monitor which of the following when assigned to a patient taking allopurinol for chronic gout who visits the clinic every 2 months?

A) Liver function tests
B) Blood sugar levels
C) Blood pressure
D) Body temperature

Question 10 Which of the following would be the most important safety-related instruction for a nurse to give to a patient taking baclofen (Lioresal)?

A) Do not walk or drive after taking the drug
B) Discontinue the use of alcohol
C) Learn to self-administer the drug
D) Take a laxative when needed

Question 11 A diabetic patient being treated for obesity tells the nurse that he is having adverse effects from his drug therapy. The patient has been taking dextroamphetamine for 2 weeks as adjunct therapy. Which of the following adverse effects would need the nurse’s immediate attention?

A) Decreased libido
B) Increased blood glucose
C) Dry eyes
D) Jittery feeling

Question 12 A nurse is caring for a patient who has been diagnosed with hypothyroidism. Levothyroxine (Synthroid) has been prescribed.Before the drug therapy is started, the nurse will assess for which of the following?

A) History of taking anticoagulant drugs
B) Allergy to seafood
C) Hirsutism
D) The patient’s age

Question 13 A nurse is instructing a patient in the administration of regular insulin by the subcutaneous route. Which of the following strategies would the nurse suggest if the goal is to promote absorption of the regular insulin?

A) Rotate injection sites by using the arm one day, the stomach the next day, and the thigh the day after and then repeating the cycle
B) Select one injection site for regular insulin injections and use it exclusively
C) Administer the medication 30 to 60 minutes after a meal
D) Select one anatomic area for regular insulin injections and then use serial locations within that area.

Question 14 A nurse is caring for a male patient who has a spinal cord injury due to a motorcycle accident. He has been taking dantrolene (Dantrium) for 2 weeks. The nurse will monitor which of the following?

A) Prothrombin time and partial thromboplastin time
B) Urine specific gravity
C) Alanine aminotransferase and total bilirubin levels
D) Follicle-stimulating hormone levels

Question 15 The nurse is conducting a medication reconciliation of a new resident of a long-term care facility. The nurse notes that the resident takes allopurinol on a daily basis for the treatment of gout.What is the primary purpose of this drug?

A) To balance urate concentration and prevent gout attacks
B) To promote the remodeling of damaged synovium
C) To potentiate the metabolism of dietary purines
D) To achieve pain relief in joints affected by gout

Question 16 A 33-year-old man has developed acute gouty arthritis. He has been prescribed colchicine. When developing a care plan for this patient, which factor will be most important for the nurse to consider?

A) Dietary habits
B) Work environment
C) Typical daily fluid intake
D) Ethnicity

Question 17 During long-term desmopressin therapy in a 48-year-old woman, it will be most important for the nurse to assess which of the following?

A) The patient’s environment
B) The patient’s diet
C) The condition of the patient’s skin
D) The condition of the patient’s nasal passages

Question 18 A patient is taking gabapentin (Neurontin) for spasticity associated with multiple sclerosis. Which of the following should be the priority for monitoring?

A) Hepatic function
B) Cardiac function
C) Respiratory function
D) Renal function

Question 19 Following an assessment by her primary care provider, a 70-year-old resident of an assisted living facility has begun taking daily oral doses of levothyroxine. Which of the following assessment findings should prompt the nurse to withhold a scheduled dose of levothyroxine?

A) The resident has not eaten breakfast because of a recent loss of appetite
B) The resident’s apical heart rate is 112 beats/minute with a regular rhythm
C) The resident had a fall during the night while transferring from her bed to her bathroom
D) The resident received her annual influenza vaccination the previous day

Question 20 To minimize the risk of adverse effects of glucagon when given to an unconscious diabetic patient, as the patient regains consciousness, the nurse should

A) administer calcium supplements
B) position the patient in the side-lying position
C) administer carbohydrates
D) monitor for nausea and vomiting

Question 21 A 34-year-old male patient is prescribed methimazole (MMI). The nurse will advise him to report which of the following immediately?

A) Vertigo
B) Intolerance to cold
C) Loss of appetite
D) Epigastric distress

Question 22 A male patient is to begin glyburide (Diabeta) for type 2 diabetes. Before the drug therapy begins, a priority action by the nurse will be to assess the patient’s

A) blood pressure
B) potassium level
C) use of alcohol
D) use of salt in his diet

Question 23 A 43-year-old woman was diagnosed with multiple sclerosis 2 years ago and has experienced a recent exacerbation of her symptoms, including muscle spasticity. Consequently, she has been prescribed Dantrolene (Dantrium). In light of this new addition to her drug regimen, what teaching point should the woman’s nurse provide?

A) “This will likely relieve your muscle spasms but you’ll probably develop a certain amount of dependence on the drug over time.”
B) “We’ll need to closely monitor your blood sugar levels for the next week.”
C) “There’s a small risk that you might experience some hallucinations in the first few days that you begin taking this drug.”
D) “You might find that this drug exacerbates some of your muscle weakness while it relieves your spasticity.”

Question 24 A nurse is instructing a patient who was recently diagnosed with multiple sclerosis about dantrolene (Dantrium). The patient is a 38-year-old-male and the foreman for a construction company. In order to minimize one important adverse effect of the drug, the nurse will give the patient which of the following instructions?

A) Eat a high-protein diet
B) Decrease the dosage if any adverse effect is experienced
C) Wear appropriate clothing and sunscreen whenever he is in direct sunlight
D) Have a complete blood cell count done weekly

Question 25 A 40-year-old woman with a diagnosis of fibromyalgia has been prescribed cyclobenzaprine (Flexeril) as an adjunct to her existing drug regimen. What nursing diagnosis should the nurse prioritize when updating the nursing care plan for this patient?

A) Risk for Injury related to CNS depressant effects
B) Diarrhea related to anticholinergic effects
C) Altered Nutrition, Less than Body Requirements, related to appetite suppression
D) Impaired Swallowing related to increased muscle tone

Question 26 A 70-year-old woman who is on long-term ibuprofen therapy for osteoarthritis has returned to the clinic for her regular 6-month visit. In the last couple of months, she has been having increasing periods of abdominal pain. The nurse suspects that this pain may be related to

A) anemia
B) peptic ulcer disease or gastritis
C) interstitial nephritis
D) constipation

Question 27 A 13-year-old patient has juvenile arthritis. He has recently had oral surgery and was told by the surgeon to take aspirin for the pain. The nurse will monitor for which of the following?

A) Bronchoconstriction
B) Hepatotoxicity
C) Aplastic anemia
D) Agranulocytosis

Question 28 A nurse is caring for a 61-year-old man who has had a severe attack of gout while in the hospital for food poisoning. The nurse administers colchicine intravenously in order to

A) avoid aggravating the gastrointestinal tract
B) ensure quick distribution of the drug
C) prevent the risk of infection or bleeding
D) minimize the risk of depressed bone marrow function

Question 29 A 66-year-old woman has experienced a significant decline in her quality of life as a result of worsening rheumatoid arthritis. Her physician has prescribed etanercept and the nurse is responsible for facilitating this new aspect of the patient’s drug regimen. This will involve the administration of

A) daily, outpatient intravenous therapy
B) daily, oral administration
C) weekly subcutaneous injections
D) weekly administration of an enteric coated tablet

Question 30 A clinic nurse is following a 9-year-old boy who is taking somatropin. Which of the following will the nurse monitor periodically?

A) Antidiuretic hormone (ADH) levels
B) Height
C) Dehydration
D) Water retention

Advanced Coding: E/M, Medicine, and Anesthesia

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1.   Anesthesia administered to a normal, healthy patient undergoing an esophageal procedure is coded as

A. 00500-P1.   B. 00502-P1.   C. 00500-P2.   D. 00506-P1.

 

2.   A new patient comes into the doctor’s office for her annual gynecological exam. During the course of the exam, she undergoes a screening cervical cytopathology smear, which is performed by an automated system under the supervision of a physician. What HCPCS code is assigned?

A. G0185   B. G7869   C. G7452   D. G0147

 

3.   A new patient is seen for a home visit that involves a comprehensive history, examination, and medical decision making of high complexity. What code should be assigned?

A. 99349   B. 99345   C. 99342   D. 99350

 

4.   A prolonged evaluation and management service before and/or after direct patient care for one hour is coded as

A. 99359.   B. 99358.   C. 99361.   D. 99360.

 

5.   A 57-year-old patient is admitted to the hospital for a hip arthroscopy procedure. The patient is a normal healthy patient with no systemic disease. What anesthesia CPT code should be assigned?

A. 01242-P2   B. 01202-P1   C. 01202-P3   D. 01202-P5

 

6.   Anesthesia for procedures performed on the larynx and trachea in an 11-month-old child would be assigned to code

A. 00620.   B. 00625.   C. 00326.   D. 00532.

 

7.   A patient returns for a follow-up office visit regarding the repair of her fractured knee. The office visit consists of a detailed history, detailed examination, and medical decision making of moderate complexity. What CPT code is assigned?

A. 99213   B. 99212   C. 99211   D. 99214

 

8.   Intramuscular nonhormonal antineoplastic chemotherapy administration would be assigned to code

A. 96402.   B. 96405.   C. 96406.   D. 96401.

 

9.   Home infusion with specialty drug administration during a 6-hour visit would be assigned what codes?

A. 99606, 99607 ×3   B. 99601, 99602 ×4   C. 99604, 99605 ×2   D. 99603, 99604 ×2

 

10.   A patient is seen for a psychiatric diagnostic evaluation. The physician obtains a complete history of the patient’s mental status and does a complete biological and psychosocial assessment along with a complete physical examination. The physician’s final diagnosis is recurrent episode of severe major depressive disorder, without any psychotic behavior involved. The patient also has a history of psychological trauma. What codes are assigned?

A. F33.2, Z91.49   B. F33.1, Z91.47   C. F34.2, Z91.49   D. F36.2, Z91.46

 

11.   A 17-year-old patient is diagnosed with a severe form of nutritional anemia. What ICD-10-CM code should be assigned?

A. D45.9   B. D53.9   C. D74.9   D. D65.9

 

12.   A 32-year-old patient receives anesthesia for spinal surgery. The anesthesia is complicated by utilization of controlled hypotension. What add-on anesthesia code would be assigned?

A. 99174   B. 92117   C. 99100   D. 99135

 

13.   Nursing facility discharge day management of 19.5 minutes would be assigned to code

A. 99317.   B. 99319.   C. 99316.   D. 99315.

 

14.   A patient is admitted to the hospital for leukemia. She has a comprehensive history, comprehensive examination, and medical decision making of high complexity. What CPT code should be assigned?

A. 99202   B. 99223   C. 99213   D. 99251

 

15.   A service that is rarely provided, unusual, variable, or new may require a

A. physician’s authorization.   B. patient’s authorization.   C. staged or related procedure.   D. special report.

 

16.   A new patient is seen for a prescription refill. During the visit, the physician obtains a problem focused history, problem focused examination, and medical decision making is straightforward. What CPT code should be assigned for this service?

A. 99214   B. 99215   C. 99213   D. 99201

 

17.   A 7-year-old child is brought to the clinic due to recurrent ear infections. The physician performs a bilateral tympanostomy under general anesthesia. What CPT code should be assigned?

A. 69436-50   B. 69536-50   C. 69426-50   D. 69736-50

 

18.   Code 00906 is assigned for

A. an angioscopy.   B. anesthesia for surgery performed on the bony pelvis.   C. an osteotomy.   D. anesthesia provided for a vulvectomy.

 

19.   A 25-year-old patient receives a Hepatitis A vaccination. The vaccine is administered intramuscularly in the clinic. What CPT codes should be assigned?

A. 90632, 90471   B. 90541, 90489   C. 90637, 90472   D. 90672, 90451

 

20.   A dark adaptation examination with interpretation and report is assigned to code

A. 92326.   B. 92284.   C. 92287.   D. 92325.

Assignment: Practicum – Week 1 Journal Entry

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  Assignment: Practicum – Week 1 Journal Entry

 

As a future advanced practice nurse, it is important that you can connect your classroom experience to your practicum experience. By applying the concepts, you study in the classroom to clinical settings, you enhance your professional competency. Each week, you complete an Assignment that prompts you to reflect on your practicum experiences and relate them to the material presented in the classroom. This week, you begin documenting your practicum experiences in your Practicum Journal.

Learning Objectives

Students will:

· Analyze nursing and counseling theories to guide practice in psychotherapy*

· Develop goals and objectives for personal practicum experiences*

· Create timelines for practicum activities*

In preparation for this course’s practicum experience, address the following in your Practicum Journal:

· Review the media Clinical Interview: Intake, Assessment, & Therapeutic Alliance in your Learning Resources.

· Select one nursing theory and one counseling theory to best guide your practice in psychotherapy.

Note: For guidance on nursing and counseling theories, refer to the Wheeler textbook in this week’s Learning Resources.

· Explain why you selected these theories. Support your approach with evidence-based literature.

· Develop at least three goals and at least three objectives for the practicum experience in this course.

· Create a timeline of practicum activities based on your practicum requirements.

Note: Be sure to use the Practicum Journal Template, located in this week’s Learning Resources.

Required Readings

Wheeler, K. (Eds.). (2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice (2nd ed.). New York, NY: Springer Publishing Company.

  • Chapter 1, “The Nurse Psychotherapist and a      Framework for Practice” (pp. 3–52)

Required Media

Sommers-Flanagan, J., & Sommers-Flanagan, R. (2012). Clinical interview: Intake, assessment, & therapeutic alliance [Video file]. Mill Valley, CA: Psychotherapy.net.

PLEASE SEE THE ATTACHED Practicum Journal Template AND JOURNAL SAMPLE (TIME LOG & JOURNAL ENTRIES) FOR WRITING THIS ASSIGNMENT…..ALSO FOR THE TIME LOG AND JOURNAL ENTRIES, JUST MAKE UP A REASONABLE INFORMATION AND CLIENT INFORMATION

Worldview Analysis and Personal Inventory

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Based on the required topic study materials, write a reflection about worldview and respond to following:

  1. In 250-300      words, explain the Christian perspective of the nature of spirituality and      ethics in contrast to the perspective of postmodern relativism within      health care.
  2. In 250-300      words, explain what scientism is and describe two of the main arguments      against it.
  3. In 750-1,000      words, answer each of the worldview questions according to your own      personal perspective and worldview: (a) What is ultimate reality? (b) What      is the nature of the universe? (c) What is a human being? (d) What is      knowledge? (e) What is your basis of ethics? (f) What is the purpose of      your existence?

Remember to support your reflection with the topic study materials. While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines.

Rubric 

· Explanation of the Christian perspective of the nature of spirituality and ethics in contrast to the perspective of postmodern relativism is clear, detailed, and demonstrates a deep understanding of the subject. Explanation is supported by topic study materials.

· Explanation of scientism is clear and accurate. Explanations of two main arguments against scientism are clear and insightful. Details are clearly supported by topic study materials.

· Each of the worldview questions is answered clearly and with deep personal insight.

· Thesis is comprehensive and contains the essence of the paper. Thesis statement makes the purpose of the paper clear.

· Writer is clearly in command of standard, written, academic English.

· Clear and convincing argument presents a persuasive claim in a distinctive and compelling manner. All sources are authoritative.

· All format elements are correct.

· Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error.

Benchmark – Human Experience Across the Health-Illness Continuum

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The benchmark assesses the following competency:

Benchmark: 5.1. Understand the human experience across the     health-illness continuum.

Research the health-illness continuum and its relevance to patient   care. In a 750-1,000 word paper, discuss the relevance of the   continuum to patient care and present a perspective of your current   state of health in relation to the wellness spectrum. Include the following:

  1. Examine the health-illness continuum and discuss why this     perspective is important to consider in relation to health and the     human experience when caring for patients.
  2. Reflect on your     overall state of health. Discuss what behaviors support or detract     from your health and well-being. Explain where you currently fall on     the health-illness continuum.
  3. Discuss the options and     resources available to you to help you move toward wellness on the     health-illness spectrum. Describe how these would assist in moving     you toward wellness (managing a chronic disease, recovering from an     illness, self-actualization, etc.).

Prepare this assignment according to the guidelines found in the APA   Style Guide. An abstract or thesis is required.

week 4 – Case Study on Death and Dying

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The practice of health care providers at all levels brings you into contact with people from a variety of faiths. This calls for knowledge and understanding of a diversity of faith expressions; for the purpose of this course, the focus will be on the Christian worldview.

Based on “Case Study: End of Life Decisions,” the Christian worldview, and the worldview questions presented in the required topic study materials you will complete an ethical analysis of George’s situation and his decision from the perspective of the Christian worldview.

Provide a 1,500-2,000-word ethical analysis while answering the following questions:

  1. How would George interpret his suffering in light of the Christian narrative, with an emphasis on the fallenness of the world?
  2. How would  George interpret his suffering in light of the Christian narrative, with an emphasis on the hope of resurrection?
  3. As George contemplates life with amyotrophic lateral sclerosis (ALS), how would the Christian worldview inform his view about the value of his life as a person?
  4. What sorts of values and considerations would the Christian worldview focus on in deliberating about whether or not George should opt for euthanasia?
  5. Given the above, what options would be morally justified in the Christian worldview for George and why?
  6. Based on your worldview, what decision would you make if you were in George’s situation?

Remember to support your responses with the topic study materials.

Prepare this assignment according to the guidelines found in the APA Style Guide. An abstract is required.

This assignment uses a rubric.You are required to submit this assignment to LopesWrite.

1. Bioethics: A Primer for Christians

Read Chapters 6 and 12 in Bioethics: A Primer for Christians.

http://gcumedia.com/digital-resources/wm-b-eerdmans-publishing-co/2013/bioethics_a-primer-for-christians_ebook_3e.php
2. Called to Care: A Christian Worldview for Nursing

Read Chapters 10-12 in Called to Care: A Christian Worldview for Nursing.

http://gcumedia.com/digital-resources/intervarsity-press/2006/called-to-care_a-christian-worldview-for-nursing_ebook_2e.php

3. Defining Death: Medical, Legal and Ethical Issues in the Determination of Death

Read the Introduction and Chapters 1-3 of “Defining Death: Medical, Legal and Ethical Issues in the Determination of Death” by the President’s Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research (1984).

https://repository.library.georgetown.edu/bitstream/handle/10822/559345/defining_death.pdf?sequence=1

Rubric

  1. Analysis of how the man would interpret his suffering in light of the Christian narrative and the fallenness of the world is clear and demonstrates a deep understanding that is skillfully supported by topic study materials. 12%
  2. Analysis of how the man would interpret his suffering in light of the Christian narrative and the hope of resurrection is clear and demonstrates a deep understanding that is skillfully supported by topic study materials. 12%
  3. Analysis of how the Christian worldview of the man might inform his view about the value of his life as a person with ALS is clear and demonstrates a deep understanding that is skillfully supported by topic study materials.12%
  4. Evaluation of which values and considerations the Christian worldview focuses on when deliberating the option of euthanasia for the man is clear and demonstrates a deep understanding that is skillfully supported by topic study materials. 12%
  5. Evaluation of which options would be justified in the Christian worldview for the man is clear and demonstrates a deep understanding that is skillfully supported by topic study materials. 12%
  6. Reflection hypothesis of which personal choices would be make if faced with ALS based on personal worldview is clear, relevant, and insightful. 10%
  7. Thesis is comprehensive and contains the essence of the paper. Thesis statement makes the purpose of the paper clear. 7%
  8. Clear and convincing argument presents a persuasive claim in a distinctive and compelling manner. All sources are authoritative. 8%
  9. Writer is clearly in command of standard, written, academic English. 5%
  10. All format elements are correct.5%
  11. Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error. 5%
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In addition to the topic study materials, use the chart you completed and questions you answered in the Topic 3 about “Case Study: Healing and Autonomy” as the basis for your responses in this assignment.

Answer the following questions about a patient’s spiritual needs in light of the Christian worldview.

  1. In 200-250 words, respond to the following:      Should the physician allow Mike to continue making decisions that seem to      him to be irrational and harmful to James, or would that mean a disrespect      of a patient’s autonomy? Explain your rationale.
  2. In 400-450 words, respond to the following: How      ought the Christian think about sickness and health? How should a      Christian think about medical intervention? What should Mike as a      Christian do? How should he reason about trusting God and treating James      in relation to what is truly honoring the principles of beneficence and      nonmaleficence in James’s care?
  3. In 200-250 words, respond to the following: How      would a spiritual needs assessment help the physician assist Mike      determine appropriate interventions for James and for his family or others      involved in his care?

Remember to support your responses with the topic study materials.

While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center.

This assignment uses a rubric. You are required to submit this assignment to LopesWrite.

Rubric:

1. Decisions that need to be made by the physician and the father are analyzed from both perspectives with a deep understanding of the complexity of the principle of autonomy. Analysis is supported by the case study, topic study materials, or Topic 3 assignment responses. 20%

2. Decisions that need to be made by the physician and the father are analyzed with deep understanding of the complexity of the Christian perspective, as well as with the principles of beneficence and nonmaleficence. Analysis is supported by the case study, topic study materials, or Topic 3 assignment responses. 20%

3. How a spiritual needs assessment would help the physician assist the father determine appropriate interventions for his son, his family, or others involved in the care of his son is clearly analyzed with a deep understanding of the connection between a spiritual needs assessment and providing appropriate interventions. Analysis is supported by the case study, topic study materials, or Topic 3 assignment responses. 30%

4. Thesis is comprehensive and contains the essence of the paper. Thesis statement makes the purpose of the paper clear. 7%

5. Clear and convincing argument presents a persuasive claim in a distinctive and compelling manner. All sources are authoritative. 8%

6. Writer is clearly in command of standard, written, academic English. 5%

7. All format elements are correct. 5%

8. Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error. 5%

 

There are three different parts to this paper:

· Part one deals with Mike’s decision-making capabilities. 

· Part two deals with how to think issues related to sickness and health.

· Part three deals with a spiritual assessment.

Read “Doing a Culturally Sensitive Spiritual Assessment: Recognizing Spiritual Themes and Using the HOPE Questions,” by Anandarajah, from AMA Journal of Ethics(2005).

https://journalofethics.ama-assn.org/article/doing-culturally-sensitive-spiritual-assessment-recognizing-spiritual-themes-and-using-hope/2005-05

Read “End of Life and Sanctity of Life,” by Reichman, from American Medical Association Journal of Ethics, formerly Virtual Mentor (2005).

http://journalofethics.ama-assn.org/2005/05/ccas2-0505.html