Promoting Health Care Quality

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Project Overview

Complete instructions are provided in this week’s Learning Resources.

In this course, you develop a comprehensive Course Project: Promoting Health Care Quality. To initiate this project, this week you examine the systems and structures of an organization with which you are familiar. This analysis will serve as a foundation for developing a plan to address a quality improvement issue.

Section 1: Organizational Systems and Structures Evaluation

When a problem related to health care quality and patient safety arises, there can be an inclination to focus on a specific event rather than to examine the larger context surrounding it. Analyzing the systems and structures within an organization provides a foundation for generating a fuller understanding of how and why the event occurred and for developing strategies to address the underlying issues. Perhaps more importantly, such an analysis can be used to proactively identify potential challenges and improve organizational systems and structures in order to promote positive outcomes.

In the first section of your Course Project, you analyze the systems and structures of a health care organization with which you are familiar.

To prepare:

Identify a health care organization with which you are familiar; one that you will be able to sufficiently analyze to complete the full scope of the Course Project. (Refer to the Course Project Overview as needed.) This may be the same organization that you addressed in this week’s Discussion.

Select two or more of the following frameworks:

Learning organizations

Complex adaptive systems (CAS)

Clinical microsystems

Good to great

The 5 Ps

You may use the same frameworks that you addressed in this week’s Discussion.

Check below link

(https://www.homeworkmarket.com/content/nurs-6231-healthcare-systems-and-quality-outcomes-discussion-3-grading-rubic-and-media-attac)

With these frameworks in mind, analyze the systems and structures of the organization. Be sure to research and consider:

Mission, vision, and values

Strategic plan, goals, and objectives, if possible

Key operational processes and patterns

Information technology use

Organizational priorities and investments, as indicated by financial data

As you continue your evaluation of a health care organization, it is essential to pay attention to culture. Organizational culture provides the context in which all interactions and processes occur, and is therefore central to any effort to enact change.

In addition, consider the ideas and information exchanged in this week’s Discussion. Continue to analyze essential elements of organizational culture and evaluate the influence of culture on the ability to achieve goals within your selected organization.

Use the below link also (https://www.homeworkmarket.com/content/nurs-6231-healthcare-systems-and-quality-outcomes-discussion-4-grading-rubic-and-media-attac)

Write a 3- to 5-page paper in which you:

Provide a description of the organization you selected

Present your analysis of the organization with attention to:

Its mission, vision, values

Strategic plan, goals, and objectives

Key operational processes and patterns

Information technology use

Organizational priorities and investments, as indicated by financial data

The essential elements of the organization’s culture

The influence of culture on meeting organizational goals

You will write a 3- to 5-page paper. Use the Week 3: Organizational Systems and Structures, Part 1 in the course Project Overview PDF for instructions.

Use the discussion Link for respources

Organizational Values Presentation

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Prepare a 10-minute presentation (10-15 slides, not including title or reference slide) on organizational culture and values.

  1. Describe how alignment between the values of an organization and the values of the nurse impact nurse engagement and patient outcomes.
  2. Discuss how an individual can use effective communication techniques to overcome workplace challenges, encourage collaboration across groups, and promote effective problem solving.
  3. Identify a specific instance from your own professional experience in which the values of the organization and the values of the individual nurses did or did not align. Describe the impact this had on nurse engagement and patient outcomes.

While APA style format is not required for the body of this assignment, solid academic writing is expected and in-text citations and references should be presented using APA documentation guidelines.

This assignment uses a grading rubric.  should review the rubric prior to beginning the assignment to become familiar with the assignment criteria and expectations for successful completion of the assignment. IT IS MANDATORY TO FOLLOW THE RUBRIC

Here is thr rubric

Organizational Values Presentation (Benchmark Assessment) 

80.0 %Content 
26.0 %Describes how alignment between the values of an organization and the values of the nurse impact nurse engagement and patient outcomes.A description to how alignment between the values of an organization and the values of the nurse impact nurse engagement and patient outcomes is not provided.A description to how alignment between the values of an organization and the values of the nurse impact nurse engagement and patient outcomes is provided; however, relevant information is missing as indicated in the assignment instructions.A description to how alignment between the values of an organization and the values of the nurse impact nurse engagement and patient outcomes is provided and meets the basic criteria for the assignment as indicated in the assignment instructions.A description to how alignment between the values of an organization and the values of the nurse impact nurse engagement and patient outcomes is offered in detail.A description to how alignment between the values of an organization and the values of the nurse impact nurse engagement and patient outcomes is offered in detail, while demonstrating higher level thinking by incorporating prior learning or reflective thought.
26.0 %Discusses how an individual can use effective communication techniques to Overcome Workplace Challenges, Encourage Collaboration Across Groups, and Promote Effective Problem-Solving.A discussion to how an individual can use effective communication techniques to overcome workplace challenges, encourage collaboration across groups, and promote effective problem-solving is not provided.A discussion to how an individual can use effective communication techniques to overcome workplace challenges, encourage collaboration across groups, and promote effective problem-solving is not provided. is offered; however, relevant information is missing as indicated by the assignment instructions.A discussion to how an individual can use effective communication techniques to overcome workplace challenges, encourage collaboration across groups, and promote effective problem-solving is not provided. is offered and meets the basic criteria for the assignment as indicated by the assignment instructions.A discussion to how an individual can use effective communication techniques to overcome workplace challenges, encourage collaboration across groups, and promote effective problem-solving is offered in detail.A discussion to how an individual can use effective communication techniques to overcome workplace challenges, encourage collaboration across groups, and promote effective problem-solving is offered in detail, while demonstrating higher level thinking by incorporating prior learning or reflective thought.
28.0 %Identify a specific instance from your own professional experience in which the values of the organization and the values of individual nurses did or did not align. Describe the impact this had on nurse engagement and patient outcomes.Identification of a specific instance from your own professional experience in which the values of the organization and the values of the individual nurses did or did not align is not provided.Identification of a specific instance from your own professional experience in which the values of the organization and the values of the individual nurses did or did not align is offered; however, relevant information is missing such as a description of the impact this had on nurse engagement and patient outcomes.Identification of a specific instance from your own professional experience in which the values of the organization and the values of the individual nurses did or did not align meets the basic criteria for the assignment as indicated in the assignment instructions.An example from your professional experience is offered in detail.An example from your professional experience is offered in detail, while demonstrating higher level thinking by incorporating prior learning or reflective thought.
15.0 %Organization and Effectiveness 
5.0 %LayoutThe layout is cluttered, confusing, and does not use spacing, headings, and subheadings to enhance the readability. The text is extremely difficult to read with long blocks of text, small point size for fonts, and inappropriate contrasting colors. Poor use of headings, subheadings, indentations, or bold formatting is evident.The layout shows some structure, but appears cluttered and busy or distracting with large gaps of white space or a distracting background. Overall readability is difficult due to lengthy paragraphs, too many different fonts, dark or busy background, overuse of bold, or lack of appropriate indentations of text.The layout uses horizontal and vertical white space appropriately. Sometimes the fonts are easy to read, but in a few places the use of fonts, italics, bold, long paragraphs, color, or busy background detracts and does not enhance readability.The layout background and text complement each other and enable the content to be easily read. The fonts are easy to read and point size varies appropriately for headings and text.The layout is visually pleasing and contributes to the overall message with appropriate use of headings, subheadings, and white space. Text is appropriate in length for the target audience and to the point. The background and colors enhance the readability of the text.
15.0 %Organization and Effectiveness 
5.0 %Language Use and Audience Awareness (includes sentence construction, word choice, etc.)Inappropriate word choice and lack of variety in language use are evident. Writer appears to be unaware of audience. Use of ?primer prose? indicates writer either does not apply figures of speech or uses them inappropriately.Some distracting inconsistencies in language choice (register) and/or word choice are present. The writer exhibits some lack of control in using figures of speech appropriately.Language is appropriate to the targeted audience for the most part.The writer is clearly aware of audience, uses a variety of appropriate vocabulary for the targeted audience, and uses figures of speech to communicate clearly.The writer uses a variety of sentence constructions, figures of speech, and word choice in distinctive and creative ways that are appropriate to purpose, discipline, and scope.
15.0 %Organization and Effectiveness 
5.0 %Mechanics of Writing (includes spelling, punctuation, grammar, language use)Slide errors are pervasive enough that they impede communication of meaning.Frequent and repetitive mechanical errors distract the reader.Some mechanical errors or typos are present, but are not overly distracting to the reader.Slides are largely free of mechanical errors, although a few may be present.Writer is clearly in control of standard, written academic English.
5.0 %Format 
5.0 %Mechanics of Writing (includes spelling, punctuation, grammar, language use)Contains no title slide, no references section, and no correctly cited references within the body of the presentation.Title slide is incomplete or inaccurate. References section includes sources, but many citation errors. Citations are included within the body of the presentation but with many errors.Title slide has minor errors. References section includes sources, but they are not consistently cited correctly. Citations are included within the body of the presentation but with some errors.Title slide is complete. References section includes correctly cited sources with minimal errors. Correct citations are included within the body of the presentation.Title slide is complete. References section includes correctly cited sources. Correct citations are included within the body of the presentation.
100 %Total Weightage 

PREPARING THE SCHOLARLY PAPER PHASE 1

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  1. Carefully read these instructions and the Rubric.
  2. Download the Week 4 Scholarly Paper Phase 1 Template (Links to an external site.)Links to an external site.. Use of the assigned template is required. Rename that document as Your Last Name Scholarly Paper Phase 1.docx, for example Smith Scholarly Paper Phase 1. Save it to your own computer or drive in a location where you will be able to retrieve it later.
  3. Type your assignment directly on the saved template. You are required to complete the form using the productivity tools required by Chamberlain University, which is Microsoft Office Word 2013 (or later version), or Windows and Office 2011 (or later version) for MAC. You must save the file in the “.docx” format. Do NOT save as Word Pad. A later version of the productivity tool includes Office 365, which is available to Chamberlain students for FREE by downloading from the student portal at http://my.chamberlain.edu (Links to an external site.)Links to an external site. Click on the envelope at the top of the page. Remember that only Microsoft Word 2010 or a later version is acceptable. The document must be saved as a .docx. Save your work frequently as you type to prevent loss of your work.
  4. The only resource for your paper is the following assigned article: Article link (Links to an external site.)Links to an external site.
    Note: Logging in to the Chamberlain Library is needed to access this article. Use of the assigned article is required. You must click on the PDF Full Text link on the upper left portion of the page to download the correct version of this required article.
  5. Follow the instructions and specifics on the assigned required template and the rubric. You will demonstrate your scholarly writing abilities as well as APA abilities in references, citations, quotations, and paraphrasing.
  6. See rubric for length limitations for each section and other criteria.
  7. Information below explains how to complete the Article Summary section of the paper (see Rubric for details).
    1. Clearly summarize the major content of the assigned article using 175–200 words.
    2. Content must include main ideas from across the entire article.
    3. Specifics should be excellent.
    4. Content must be attributed to the correct source.
  8. For the Impact section (see rubric for details)
    1. clearly state how learning from the assigned article will impact your future practice;
    2. length must be 125–150 words;
    3. writing must be concise and clearly relate the assigned article contents to practice; and
    4. use first person in this section.
  9. Double check your work with the rubric prior to submission.
  10. Note: Assigned Template must be used for this assignment. The Assigned Template has been specially prepared to help you do well on this assignment. See #2 above. 
  11. Note: Assigned Article must be used for this assignment. Failure to do so may result in loss of points and/or Academic Integrity violation investigation.

Windshield Survey

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Conduct a windshield survey to identify a population and its primary health concern. Develop a 3–5-page report that explains demographic changes for a population and describes the health disparities and social determinants of health that can affect the population. 

**Central Florida United States community**

Requirements

  • Conduct the windshield survey, using the template attached.
  • Use the template as a guide to write a report for your team. If possible, look at other written documents used within your organization. How are they formatted? Follow that format as closely as possible, making sure you still use APA guidelines for your in-text references, citations, and reference page.

Based on your observations and notes from your survey experience, write a report that includes the following:

  • Describe, briefly, the neighborhood or community you observed (overall condition, types of spaces and businesses, evidence of services, and so forth).
  • Describe a vulnerable or diverse population you observed living within the neighborhood or community.

Now you will need to do some research on the population you described:

  • Explain how the demographics for the population have changed over the past 5–10 years. Note: This information should be readily available through the United States Census Bureau, similar state Web sites, the Bureau of Labor Statistics, or other professional sites. Be sure your information is current.
  • Describe the most prevalent health risks for the population. For example, if your population is senior citizens, then the health risks might be diabetes and loss of mobility. Include statistics on the health risks, such as frequency of occurrence in the population and number of deaths per year in the population.
  • Identify the health disparities and social determinants of health that can affect the population. In other words, what will you need to overcome to develop a successful health promotion and disease prevention program for the population?

Your completed assessment should be 3–5 pages in length, not including the title page and reference page. Support your information with references to at least three professional, scholarly, or government resources, and follow current APA guidelines for your in-text citations and references.

Additional Requirements

  • Include a title page and reference page. The completed assessment should be 3–5 pages in length, not including the title page and reference page.
  • Reference at least three current scholarly, professional, or government resources.
  • Use current APA format for citations and references.
  • Use Times New Roman font, 12 point.
  • Double spaced

Attached is an example of a well graded paper as well as an example of a windshield survey to use as a reference.

Disability Culture Plunge Portfolio

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For this assignment you are required to develop a portfolio that showcases your experience through a disability culture plunge (You can find a list of activity and event options on Blackboard). A culture plunge can be defined as exposure to a culture that is different from our own and in this class specifically, the culture of disability. For some of you, you may already identify as being familiar with disability culture. If so, you will need to explore an arena of disability culture that you are not as familiar with. For many of you though, this may be your first time interacting or being involved with the disability community, and we are very excited to read about your experience!  It is normal for you to feel nervous, intimidated, and fearful about this assignment, but we hope that this assignment is a valuable and memorable experience that transcends beyond your time at university. 

What is required for this portfolio?

1. Student Self-Scored Checklist 

2. About the Organization/Activity/Event/Person

This portion of the assignment includes background information about the Organization: 

a. Name, Location, Date of Culture Plunge, website (if applicable)

b. Contact information (i.e., website, email, and name of contact person if applicable)

c. A brief 300-word description of what you did during your time and the types of disabilities that were represented at the event. 

3. Photos of the event/activity. Please include a caption with each photo. 

4. Reflection: 

Please answer all 4 reflection questions to receive full 10 points. No less than one page, double spaced, 12 pt. font response. Indicate A, B, C or D for each part of this response. 

a. What were some assumptions you had before participating in your disability culture plunge activity? Your assumptions can be positive, negative or both. 

b. What was something new you learned during your culture plunge?

c. How did this experience change your views about people with disabilities?

d. How might you see yourself contributing to the lives of people with disabilities in the future?

Diabetes And Blood Pressure Teaching Plan Related To Obesity

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This is an individual assignment. In 1,500-2,000 words, describe the teaching experience and discuss your observations. The written portion of this assignment should include:

  1. Summary of teaching plan
  2. Epidemiological rationale for topic
  3. Evaluation of teaching experience
  4. Community response to teaching
  5. Areas of strengths and areas of improvement

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

Please respond to the following: “Brand Design Model”

  • Evaluate the value of assigning appropriate brand identities to represent health care goods, services, and institutions. Provide support for your rationale.
  • Assess the value of Calder and Reagan’s Brand Design Model as a device for systematically guiding health care marketers through the process of formulating brands. Explain one (1) reason why a SWOT analysis is needed to help health care organizations understand competitor brands. Provide two (2) examples from a health care organization with which you are familiar that support the value of Calder and Reagan’s Brand Design Model.

Based on the summary of research findings identified from the Evidence-Based Project—Paper on Diabetes that describes a new diagnostic tool or intervention for the treatment of diabetes in adults or children, complete the following components of this assignment:

Develop a PowerPoint presentation (a title slide, 6-12 slides, and a reference slide; no larger than 2 MB) that includes the following:

  1. A      brief summary of the research conducted in the Evidence-Based Project –      Paper on Diabetes.
  2. A      descriptive and reflective discussion of how the new tool or intervention      may be integrated into practice that is supported by sound research.

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

You are not required to submit this assignment to Turnitin, unless otherwise directed by your instructor. If so directed, refer to the Student Success Center for directions. Only Word documents can be submitted to Turnitin.

  • rubricEvidencebasedpractice.docx

The Ethics And Legalities Of Medication Error Disclosure

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American writer Nikki Giovanni once said: “Mistakes are a fact of life. It is the response to the error that counts” (Goodreads, 2012). Whenever you make an error when writing a prescription, you must consider the ethical and legal implications of your error—no matter how seemingly insignificant it might be. You may fear the possible consequences and feel pressured not to disclose the error. Regardless, you need to consider the potential implications of non-disclosure. How you respond to the prescription error will affect you, the patient, and the health care facility where you practice. In this Assignment, you examine ethical and legal implications of disclosure and nondisclosure of personal error.

Consider the following scenario:

· You are working as an advanced practice nurse at a community health clinic. You make an error when prescribing a drug to a patient. You do not think the patient would know that you made the error, and it certainly was not intentional.

To prepare:

· Consider the ethical implications of disclosure and nondisclosure.

· Research federal and state laws for advanced practice nurses. Reflect on the legal implications of disclosure and nondisclosure for you and the health clinic.

· Consider what you would do as the advanced practice nurse in this scenario including whether or not you would disclose your error.

· Review the Institute for Safe Medication Practices website in the Learning Resources. Consider the process of writing prescriptions. Think about strategies to avoid medication errors.

Write a 2- to 3- page paper that addresses the following:

· Explain the ethical and legal implications of disclosure and nondisclosure. Be sure to reference laws specific to your state.

· Describe what you would do as the advanced practice nurse in this scenario including whether or not you would disclose your error. Provide your rationale.

· Explain the process of writing prescriptions including strategies to minimize medication errors.

– This work should have Introduction and conclusion

– This work should have at 4 to 6 current references 

– Use at least 3 references from class Learning Resources

The following Resources are not acceptable:

1. Wikipedia

2. Cdc.gov- nonhealthcare professionals section

3. Webmd.com

4. Mayoclinic.com

Required Readings

**Arcangelo, V. P., Peterson, A. M., Wilbur, V., & Reinhold, J. A. (Eds.). (2017). Pharmacotherapeutics for advanced practice: A practical approach (4th ed.). Ambler, PA: Lippincott Williams & Wilkins.

  • Chapter 1, “Issues for the           Practitioner in Drug Therapy” (pp. 3–14)
              This chapter introduces issues relating to      drug therapy such as adverse      drug events and      medication adherence. It also explores drug safety, the           practitioner’s role and responsibilities in      prescribing, and prescription      writing.
  • Chapter 59, “The Economics           of Pharmacotherapeutics” (pp. 1009-1018)
              This chapter analyzes the costs of drug      therapy to health care systems and      society      and explores practice guideline compliance and current issues in           medical care.
  • Chapter 60, “Integrative      Approaches to      Pharmacotherapy—A Look at      Complex Cases” (pp. 1021-1036)
              This chapter examines issues in individual      patient cases. It explores      concepts relating      to evaluation, drug selection, patient education, and           alternative treatment options.

**Crigger, N., & Holcomb, L. (2008). Improving nurse practitioner practice through rational prescribing. The Journal for Nurse Practitioners, 4(2), 120–125.

Note: Retrieved from the Walden Library databases.

This article explores issues relating to prescription drugs, specifically the frequency in which drugs are prescribed to patients. It also examines factors to consider before beginning drug therapy plans with patients.

**Philipsen, N. C., & Soeken, D. (2011). Preparing to blow the whistle: A survival guide for nurses. The Journal for Nurse Practitioners, 7(9), 740–746.

Note: Retrieved from the Walden Library databases.

This article examines issues that nurses encounter when reporting errors in medical settings. It also outlines the role of ethics and the responsibility of nurses to notify all individuals who are impacted by a me

Current Scenario of Health Insurance Plans

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Currently, in the United States, an individual is not required to  purchase a health insurance plan. However, according to Section 1501 of  the PPACA, beginning in 2014, “Individuals will be required to maintain  minimum essential coverage beginning in 2014. Failure to maintain  coverage will result in a penalty of $95 in 2014, $350 in 2015, $750 in  2016 and indexed thereafter.”

Currently, employers are not required to provide health insurance  coverage to their employees. However, in 2014, the employers’  responsibility in health insurance coverage will change, according to  the PPACA. This is the latest update in a long line of US health care  reform efforts.

Using South University Online Library or the Internet, search on the  topic of latest health care reforms. On the basis of your research and  your understanding of the topic, answer the following questions:

  • Track the progress of health care reform efforts in the US history  starting with the early 1900s detailing the role of Presidents’  attempting to pass health care reform.
  • Give your views on the AALL’s efforts to pass National Health Reform.
  • What are the issues of culture, politics, and special interests in  the United States that have made health care reform difficult to  achieve?
  • Of these three issues, which issue do you find to be the most difficult to overcome? Why?
  • What is path dependency? What has this been an issue in health reform? How can the power of inertia be overcome?
  • What are the advantages and disadvantages of PPACA that was passed in 2010?

Reimbursement Issues for Nurse Practitioners

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Understanding the complex process of accurate coding and billing is essential to a sustainable practice. As NPs, we are ultimately responsible for ensuring all coding and billing is accurate for each patient seen. For this Discussion, 

1. you will search the health care literature and 2. 

2. summarize a peer-reviewed journal article published within the last five years.

To prepare:

·  3,  Select one of the following topics that u like to discuss

o  

o Applying for Medicare and Medicaid Provider Numbers

o Application process for National Provider Identifier Number

o Incident to billing

o Coding-Evaluation & Management

o Fraudulent billing

o Billing Self-Pay patients

o Managed Care Organizations

· 4. Conduct a search and select a peer-reviewed journal article published within the last five years related to the topic you selected.

Note: For this Discussion, all students are to avoid all written work, which reviews or outlines coding and billing at previous or current worksites as well as previous or current practicum sites.

5. Post a brief summary of the article you selected.

6.  Include the key reimbursement issue addressed and how they would impact the NP in a collaborative practice versus and independent practice. 

7. Discuss an ethical or legal implication(s) associated with your article.

      NOTE:

WRITE 1 PAGE

SAME AS BEFORE

DUE 1.09.2018

NO PLAGIARIS,

Use References provided

Required Readings

Buppert, C. (2018). Nurse practitioner’s business  practice and legal guide (6th ed.). Sudbury, MA: Bartlett & Jones  Learning.
Chapter 9, “Reimbursement for Nurse Practitioner Services” (pp. 311-325)

Optional Resources

Buppert, C. (2018). Nurse practitioner’s business  practice and legal guide (6th ed.). Sudbury, MA: Bartlett & Jones  Learning.

  • Chapter 9, “Reimbursement for Nurse Practitioner Services” (pp. 311-325)

HUMAN HEALTH CARE EXAM

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Question 1. Which of the following is true of human papilloma virus (HPV) infection?

Pap smear is a relatively ineffective screening method.

It commonly resolves spontaneously in one to two years.

It is the second most common STI in the United States.

HPV infections cause a small but important number of cervical cancers.

Question 2. Question : Which of the following is the most effective pattern of palpation for breast cancer?

Beginning at the nipple, make an ever-enlarging spiral.

Divide the breast into quadrants and inspect each systematically.

Examine in lines resembling the back and forth pattern of mowing a lawn.

Beginning at the nipple, palpate vertically in a stripe pattern.

Question 3. Question : A 14-year-old junior high school student is brought in by his mother and father because he seems to be developing breasts. The mother is upset because she read on the Internet that smoking marijuana leads to breast enlargement in males. The young man adamantly denies using any tobacco, alcohol, or drugs. He has recently noticed changes in his penis, testicles, and pubic hair pattern. Otherwise, his past medical history is unremarkable. His parents are both in good health. He has two older brothers who never had this problem. On examination, you see a mildly overweight teenager with enlarged breast tissue that is slightly tender on both sides. Otherwise, his examination is normal. He is agreeable to taking a drug test. What is the most likely cause of his gynecomastia?

Breast cancer

Imbalance of hormones of puberty

Drug use

Question 4. Question : Which of the following represents metrorrhagia?

Fewer than 21 days between menses

Excessive flow

Infrequent bleeding

Bleeding between periods

Question 5. Question : What does a KOH (potassium hydroxide) prep help the nurse practitioner diagnose?

Herpes zoster infections

Yeast infections

Herpes simplex infections

Viral infections

Question 6. Question : Abby is a newly married woman who is unable to have intercourse because of vaginismus. Which of the following is true?

This is most likely due to lack of lubrication.

This is most likely due to atrophic vaginitis.

This is most likely due to pressure on an ovary.

Psychosocial reasons may cause this condition.

Question 7. Question : A 30-year-old man notices a firm, 2-cm mass under his areola. He has no other symptoms and no diagnosis of breast cancer in his first-degree relatives. What is the most likely diagnosis?

Breast tissue

Fibrocystic disease

Breast cancer

Lymph node

Question 8. Question : Which of the following is true regarding breast self-examination?

It has been shown to reduce mortality from breast cancer.

It is recommended unanimously by organizations making screening recommendations.

A high proportion of breast masses are detected by breast self-examination.

The undue fear caused by finding a mass justifies omitting instruction in breast self-examination.

Question 9. Question : A 23-year-old computer programmer comes to your office for an annual examination. She has recently become sexually active and wants to be placed on birth control. Her only complaint is that the skin in her armpits has become darker. She states it looks like dirt, and she scrubs her skin nightly with soap and water but the color stays. Her past medical symptoms consist of acne and mild obesity. Her periods have been irregular for 3 years. Her mother has type 2 diabetes, and her father has high blood pressure. The patient denies using tobacco but has four to five drinks on Friday and Saturday nights. She denies any illegal drug use. On examination, you see a mildly obese female who is breathing comfortably. Her vital signs are unremarkable. Looking under her axilla, you see dark, velvet-like skin. Her annual examination is otherwise unremarkable. What disorder of the breast or axilla is she most likely to have?

Peau d’orange

Acanthosis nigricans

Hidradenitis suppurativa

Question 10. Question : Which of the following is true of women who have had a unilateral mastectomy?

They no longer require breast examination.

They should be examined carefully along the surgical scar for masses.

Lymphedema of the ipsilateral arm usually suggests recurrence of breast cancer.

Women with breast reconstruction over their mastectomy site no longer require examination.