Question 1. Question : When examining an infant, the nurse practitioner should examine which area first?

Ear

Nose

Throat

Abdomen

Question 2. Question : When preparing to examine a 6-year-old child, which action is most appropriate?

Start with the thorax, abdomen, and genitalia before examining the head.

Avoid talking about the equipment being used because it may increase the child’s anxiety.

Keep in mind that a child this age will have a sense of modesty.

Have the child undress from the waist up.

Question 3. Question : The nurse practitioner is assessing a patient’s skin during an office visit. What is the best technique to use to best assess the patient’s skin temperature?

Use the fingertips because they’re more sensitive to small changes in temperature.

Use the dorsal surface of the hand because the skin is thinner than on the palms.

Use the ulnar portion of the hand because there is increased blood supply that enhances temperature sensitivity.

Use the palmar surface of the hand because it is most sensitive to temperature variations because of increased nerve supply in this area.

Question 4. Question : Percussion notes heard during the abdominal assessment may include:

flatness, resonance, and dullness.

resonance, dullness, and tympany.

tympany, hyperresonance, and dullness.

resonance, hyperresonance, and flatness.

Question 5. Question : The nurse practitioner is assessing a patient for possible peptic ulcer disease and knows that which condition often causes this problem?

Hypertension

Streptococcus infections

History of constipation and frequent laxative use

Frequent use of nonsteroidal anti-inflammatory drugs

Question 1. Question : A patient complains of shortness of breath for the past few days. On examination, you note late inspiratory crackles in the lower third of the chest that were not present a week ago. What is the most likely explanation for these?

Asthma

COPD

Bronchiectasis

Heart failure

Question 2. Question : A sixty-year-old baker presents to your clinic, complaining of increasing shortness of breath and nonproductive cough over the last month. She feels like she can’t do as much activity as she used to do without becoming tired. She even has to sleep upright in her recliner at night to be able to breathe comfortably. She denies any chest pain, nausea, or sweating. Her past medical history is significant for high blood pressure and coronary artery disease. She had a hysterectomy in her 40s for heavy vaginal bleeding. She is married and is retiring from the local bakery soon. She denies any tobacco, alcohol, or drug use. Her mother died of a stroke, and her father died from prostate cancer.She denies any  recent upper respiratory illness, and she has had no other symptoms. On examination, she is in no acute distress. Her blood pressure is 160/100, and her pulse is 100. She is afebrile, and her respiratory rate is 16. With auscultation, she has distant air sounds and she has late inspiratory crackles in both lower lobes. On cardiac examination, the S1 and S2 are distant and an S3 is heard over the apex.

Pneumonia

COPD

Pleural pain

Left-sided heart failure

Question 3. Question : A patient with long-standing COPD was told by another practitioner that his liver was enlarged and this needed to be assessed. Which of the following would be reasonable to do next?

Percuss the lower border of the liver.

Measure the span of the liver.

Order a hepatitis panel.

Obtain an ultrasound of the liver.

Question 4. Question : A fifty-five-year-old smoker complains of chest pain and gestures with a closed fist over her sternum to describe it. Which of the following diagnoses should be considered because of her gesture?

Bronchitis

Costochondritis

Pericarditis

Angina pectoris

Question 5. Question : When crackles, wheezes, or rhonchi clear with a cough, which of the following is a likely etiology?

Bronchitis

Simple asthma

Cystic fibrosis

Heart failure

Question 6. Question : Is the following information subjective or objective? Mr. Mazz has shortness of breath that has persisted for the past ten days; it is worse with activity and relieved by rest.

Subjective

Objective

Question 7. Question : All of the following are implicated in causing chronic cough except:

Chronic bronchitis

Allergic rhinitis

Acute viral upper respiratory infection

Gastroesophageal reflux disease

Question 8. Question : A mother brings her infant to you because of a “rattle” in his chest with breathing. Which of the following would you hear if there is a problem in the upper airway?

Different sounds from the nose and the chest

Asymmetric sounds

Inspiratory sounds

Sounds louder in the lower chest

Question 9. Question : Which of the following is consistent with good percussion technique?

Allow all of the fingers to touch the chest while performing percussion.

Maintain a stiff wrist and hand.

Leave the plexor finger on the pleximeter after each strike.

Strike the pleximeter over the distal interphalangeal joint

You are an RN working in an Urgent Care. Below is just a brief history of a client with information limited on purpose to encourage you to utilize your critical thinking skills.

Subjective information: Miranda is a 26-year-old female who presents to the office with the complaint of diarrhea for 6 days. She states she has lost 8 pounds in one week. She is not currently taking any medications. She has tried over-the-counter remedies for the treatment of her diarrhea with minimal improvement. She is generally healthy with only a sinus and bladder infection on occasion.

Objective information: She does not have a temperature, BP is 102/60, Pulse is 98, and her bowel sounds are present in all quadrants and are hyperactive. Her abdomen is soft and mildly tender.

In a 2-3 page paper, answer the following questions. Include, at minimum, two peer reviewed sources (in-text citation), and provide a Reference page (not included in the page count) using APA Editorial format.

1. What is the pathogenesis of diarrhea?
2. Describe the different mechanisms of diarrhea (osmotic, secretory and motility).
3. With the limited information provided, what additional information would you like to obtain from her history and physical to help direct your care plan? Describe why obtaining this information would be helpful in leading you to a nursing diagnosis.
4. What infectious or inflammatory conditions could she be suffering from

Max Points: 150

Details:

It is important to identify and understand your own family culture in order to be able to understand and respect other cultures. Interview a family member, and an individual from another culture with which you are unfamiliar. Some examples of an individual from another culture to consider for the assignment include a neighbor, coworker, patient, or friend. Please inform the individuals of the purpose of this assignment and make sure you receive their consent.

Interviews:

Review the “Family Interview” template prior to the interview. Additional space is designated on the template for you to create three additional questions to ask both interviewees (family member and person from another culture). Additional questions should be relevant to the readings or discussion and should provide value to the interview by helping to understand culture.

Some of the questions may include:

1. Family beliefs: Have they changed over generations?
2. Educational and occupational status in the culture and in the family
3. Communication methods: verbal and nonverbal
4. Current family goals/priorities
5. Family member roles and organizational systems
6. Spiritual beliefs: current practice and death and dying
7. Alternative lifestyles
8. Work attitudes and structure

Written Paper:

Using the “Family Interview” template, interview your designated family member and the person from another culture. Be sure to write your responses in a way that will assist you in writing your paper. After the interview is completed, write a paper of 750-1,000 words that includes the following:

1. An introductory paragraph with the reasons for selecting the interviewees.
2. A summary of the responses from the interview template gathered from the interviewees.
3. A comparison and contrast of your findings between the two interviewees.
4. A reflective concluding paragraph on how family roles affect the cultural domains and relationships for each individual.

General Requirements:

Submit both the completed “Family Interview” template and the written paper” to the instructor.

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

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

You are required to submit this assignment to Turnitin. Please refer to the directions in the Student Success Center.

HLT-324V-RS-FamilyInterviewTemplate.docx

Introduction

Throughout your education, patient safety and improving the quality of patient care have been examined. Through numerous readings and media pieces, you have heard about Never Events. These are serious and costly medical errors that are preventable, such as wrong-side surgery, medication errors, and hospital-acquired infections. Each of these types of medical errors is preventable. The consequences of such errors are now financial as well as legal and emotional. The Centers for Medicare & Medicaid Services no longer reimburse for medical errors classified as Never Events.

As a nurse, how can you help to prevent these types of medical errors? What is your accountability for clinical outcomes? There are standards and core measures in place that guide nursing practice. In addition, the National Database of Nursing Quality Indicators (NDNQI) examines those components of clinical care that are specific to nursing. The NDNQI quantifies, or assesses, these nurse-sensitive components and provides specific feedback on how well nursing practice is being executed in those areas related to patient care.

This week, you will consider a series of articles that focus on strategies for ensuring safety and quality care for patients. You will also explore how successful, efficient teamwork between nurses, nursing leaders, physicians, and other medical personnel can help prevent many of the Never Events from occurring and decrease the likelihood of such events in the future.

Learning Objectives

Students will:

• Analyze the core measures and standards for nursing practice that promote patient safety and quality of care outcomes
• Analyze the impact of the nurse’s role in clinical outcomes for organizations
• Analyze nurse-specific challenges for influencing change in quality improvement
• Analyze the role of the nurse in supporting the organization’s strategic agenda in improving clinical outcomes

Photo Credit: PhotoAlto/Odilon Dimier / PhotoAlto Agency RF Collections / Getty Images

Learning Resources

Prior Knowledge

It is not uncommon for students to be required to complete group projects or to work as part of a team. While obtaining your RN credentials, or at some time in your work career, you have more than likely at some point been part of a unit or a collaborative team. Reflect on that experience of working with others to achieve a common goal. How did the actions of your team members impact your success as a team? Consider how this same philosophy applies within an organization. How might the actions of the individuals influence the success of the organization?

Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.