Central Venous Catheter Infection

Evidence Summary Worksheet

Directions: Please type your answers directly into the worksheet.

Describe the practice problem in your own words with reference to the identified population, setting and magnitude of the problem in measurable terms:Central venous catheters are life-sparing and the larger part of patients in the hospital intensive care units have them put in request to get medication and fluids. In any case, the utilization of these can bring about genuine bloodstream diseases. bloodstream diseases related with the insertion and maintenance of central venous catheters (CVC) are among the most unsafe inconveniences that can happen. These inconveniences decline patients’ health, prolong hospital stay and increase the cost of care

Type the complete APA reference for the systematic review article you chose from the list provided, It must be relevant to the practice issue you described above.Merrill, K. C., Sumner, S., Linford, L., Taylor, C., & Macintosh, C. (2014). Major article: Impact of universal disinfectant cap implementation on central line-associated bloodstream infections.AJIC: American Journal of Infection Control, 421724-1277. Doi:10.1016/j.ajic.2014.09.008

Identify the objectives of the article.ApplyAntiseptic barrier caps on needleless connector hubs on central venous catheters decrease CLABSI rates.Provide a statement of the questions being addressed in the work and how they relate to your practice issue:Experimental research studies the cause and effect of the intervention. The intervention, or independent variable, is the use of antiseptic caps. The cause and effect would be to determine if the use of the caps vs. no caps, decrease CLABSI rates.

Summarize (in your own words) the interventions the author(s) suggest to improve patient outcomes.Hospitals shared administration group created and actualized a pilot protocol that incorporated a hand hygiene awareness campaign addition unique posted cautions and prompt immediate accessibility for those patients with central lines.Summarize the main findings by the authors of your systematic review including the strength of evidence for each main outcome. Consider the relevance to your project proposal for the Milestone 2 project paper.Measures must be implemented systematically for success in preventing these infections. Useful steps include instructing all personnel who manage catheters with interactive educational programs, practicing cutaneous antisepsis, following aseptic insertion technique, and using antibiotic- and antiseptic-impregnated catheters.

.Outline evidence-based solutions that you will consider for your project.Appropriate support of CVCs incorporates sanitization of catheter hubs, connectors, and injection ports and changing dressings over the site each two days for gauze dressings or each seven days for semipermeable dressings. A dressing should also be changed if it becomes damp, loose, or visibly soiled.Health care personnel must guarantee that a patient’s CVC is expelled or replaced at the fitting time and in a sheltered way. Such considerations incorporate day by day review of line need, changing administration system components, and CVC exchanges over a guidewire.Discuss any limitations to the studies performed that you believe impacts your ability to utilize the research in your project.Since PICC lines are still considered a central line, we use the caps on those lines as well. I pulled up a few articles that brought up the issue of peripheral IVs, and I believe this will be something that will be further researched in the future. In fact, we recently just changed our policy regarding PIVs. We used to rotate PIV sites every 4 days, but studies have recently showed that changing the site no longer has any benefit. I contemplated doing my research on that, but research is so new, I was worried that I would not have enough information.

You are to create a Design for Change proposal inclusive of your Practice Issue and Evidence Summary worksheet from your Capstone Project Milestone 1. Your plan is to convince your management team of a nursing problem you have uncovered and you feel is significant enough to change the way something is currently practiced. In the event you are not currently working as a nurse, please use a hypothetical clinical situation you experienced in nursing school, or nursing education issue you identified in your nursing program.

Course Outcomes

This assignment enables the student to meet the following course outcomes.

· CO1: Applies the theories and principles of nursing and related disciplines to individuals, families, aggregates, and communities from entry to the healthcare system through long-term planning. (PO #1)

· CO2: Proposes leadership and collaboration strategies for use with consumers and other healthcare providers in managing care and/or delegating responsibilities for health promotion, illness prevention, health restoration and maintenance, and rehabilitative activities. (PO #2)

Directions

1. Create a proposal for your Design for Change Capstone Project. Open the NR451_Milestone2_Design_Proposal_ template in Course Resources to create your paper. You will include the information from Milestone 1, your practice issue and evidence summary worksheets, as you compose this proposal. Your plan is to convince your management team of a practice problem you have uncovered that is significant enough to change current practice.

2. The format for this proposal will be a paper following the Publication manual of APA 6^th edition.

3. The paper is to be four- to six-pages excluding the Title page and Reference page.

4. As you organize your information and evidence, include the following topics.

a. Introduction:Write an introduction but do not use “Introduction” as a heading in accordance with the rules put forth in the Publication manual of the American Psychological Association(2010, p. 63). Introduce the reader to the plan with evidence-based problem identification and solution.

b. Change Model Overview:Overview of the ACE Star model (the model we have been discussing this session); define the scope of the EBP; identify the stakeholders, and determine the responsibility of the team members.

c. Evidence: Conduct internal and external searches of evidence; integrate and summarize the evidence summary worksheet from Milestone 1; develop a recommendation for change.

d. Translation: develop a hypothetical action plan; include measurable outcomes, reporting to stakeholders; identify next steps and disseminate the findings.

e. Conclusion:Provide a clear and concise summary, inclusive of the problem issue, the five points of the ACE Star change model; and ways to maintain the change plan.

5. Citations and References must be included to support the information within each topic area. Refer to the APA manual, Chapter 7, for examples of proper reference format. In-text citations are to be noted for all information contained in your paper that is not your original idea or thought. Ask yourself, “How do I know this?” and then cite the source. Scholarly sources are expected, which means using peer-reviewed journals and credible websites.

6. Tables and Figures may be added as appropriate to the project. They should be embedded within the body of the paper (see your APA manual for how to format and cite). Creating tables and figures offers visual aids to the reader and enhances understanding of your literature review and design for change.

The template

Title

Your Name

Chamberlain College of Nursing

NR451 RN Capstone Course

Term and Year

Your title here

This paragraph(s) is to introduce the paper. State the problem and potential solutions backed by evidence. Briefly, introduce the nursing focused plan. Remember this is a scholarly APA assignment so you cannot use first person. Remember also that you will keep all the bolded headings and just remove the non-bolded content when you start your paper.

Change Model Overview

In this first paragraph, provide an overview of the ACE Star model Evidence-Based Practice Process.Feel free to state why nurses should use this model as a guide to facilitate change. Under each of the second level headers listed below, you now link your identified topic to the ACE Star model EBP Process.

Define the Scope of the EBP

Restate your practice issue. Why is this a problem? Give basic statistics and information to back the scope of the problem at your facility/work area. How does this problem impact healthcare on a broader scale?

Stakeholders

You will be the leader of the team since this is your project. Who will you also include in your team? Make sure you choose relevant stakeholders. You should have no more than eight members. Do not list your team members by name but instead by position (pharmacists, charge nurse, etc.).

Determine Responsibility of Team Members

Why are the members chosen important to your project? What are their roles?

Evidence

Conduct internal/ external search for evidence. What type of evidence did you find in addition to you Evidence Summary? EBP guidelines? Quality improvement data? Position statements? Clinical Practice Guidelines? Briefly discuss the strength of this research. This is not where you describe the results of your studies. This is done in the following steps.

Summarize the Evidence

In this section, you need to synthesize the information from the systematic review article. What are some of the evidence-based interventions you discovered in your Evidence Summary that do you plan to use? Be sure and cite all of your references, in proper APA format, from any and all articles into this one paragraph.

Develop Recommendations for Change Based on Evidence

What is your recommendation based on the research? Ideally, you will have found enough support in your evidence to proceed with implementing your pilot program.

Translation

Action Plan

You have not implemented your project yet, therefore, this section will be hypothetical. Develop your plan for implementation. What are the specific steps you will take to implement your pilot study? What is the timeline for your plan? Make sure you include a plan for evaluation of outcomes and method to report the results.

Process, Outcomes Evaluation and Reporting

What are the desired outcomes? How will they be measured? How will you report the results to the key stakeholders?

Identify Next Steps

How will you implement the plan on a larger scale? Will this be applicable to other units or the facility as a whole? What will you do to ensure that the implementation becomes permanent?

Disseminate Findings

How will you communicate your findings internally (within your organization) and externally (to others outside of your organization)?

Conclusion

Provide a clear and concise summary. Review the key aspects of the problem as well as the change model. Be sure to include important aspects of the five points of the ACE Star change model EBP process and ways to maintain the change plan.

4.   Which one of the following statements accurately represents the practice known as unbundling?

   A. Combination codes are assigned separately in ICD-10-CM.   B. Codes that should be grouped into one code are broken into separate codes to maximize physician reimbursement.   C. ICD-10-PCS codes are broken into separate codes for congruent assignment.   D. Codes listed as separate procedures are assigned individually. 

5.   Placing a catheter into the aorta or directly into an artery or vein is called

   A. brachiocephalic manipulation.   B. third order placement.   C. selective catheter placement.   D. nonselective catheter placement. 

6.   What ICD-10-CM code would be assigned for a patient with acute tubule-interstitial nephritis?

   A. L50.0   B. Z02.6   C. N10   D. B96.2 

7.   The suffix -sis means

   A. inflammation.   B. drooping.   C. condition.   D. process. 

8.   The concept of meaningful use pertains to

   A. medical office protocol and document organization.   B. electronic health record implementation.   C. resource management in the inpatient setting.   D. categorization of patient information. 

9.   In what CPT code range is Surgical Pathology found?

   A. 88400–80499   B. 88000–80299   C. 88300–88309   D. 88515–88598 

10.   According to the CMS National Physician Fee Schedule, what is the conversion factor for basic life support mileage?

   A. $32.4726   B. $34.5741   C. $28.8457   D. $36.0666 

11.   A patient who was involved in a motor vehicle accident is taken to the hospital by ambulance and admitted to the hospital in critical care. The physician sees the patient for 74 minutes in critical care. The physician leaves to attend to other patients in the ICU and the NICU of the same hospital. Five hours later, the physician returns to the patient and continues to treat the patient in critical care for an additional 30 minutes. The patient spends a total of 104 minutes in critical care. What codes are assigned?

   A. 99291, 99292   B. 99292, 99293   C. 99291, 99291   D. 99292, 99292, 99293 

12.   The prefix endo- means

   A. beneath.   B. outside of.   C. adjacent to.   D. within. 

13.   What is the CPT code for a three-view x-ray of the mandible?

   A. 70200   B. 70100   C. 70150   D. 70240 

14.   Rules of evidence control the

   A. amount of evidence that may be admitted during a civil trial.   B. processes and procedures for question and answer sessions.   C. documents that can be considered during jury trial.   D. length of criminal court proceedings, but not civil court proceedings. 

15.   The ampulla, isthmus, interstitium, and fimbria are examples of

   A. implantation sites of ectopic pregnancy.   B. incision sites for pacemaker insertion.   C. membranes in the abdomen.   D. bones in the ankle. 

16.   Code J9165 is assigned for intravenous diethylstilbestrol diphosphate. According to the code description, what dosage was administered?

   A. 20 mg   B. 50 mg   C. Up to 0.5 mg   D. 250 mg 

17.   Members of the uniformed services, their families and survivors, and retired members and their families qualify for

   A. TRICARE.   B. OIG Recovery.   C. Medicare.   D. Medicaid. 

18.   A patient comes to the emergency room complaining of abdominal pain. She was previously diagnosed with type I diabetes. She also complains of watery eyes, congestion, pressure in the sinuses, and difficulty breathing. Her final diagnoses are right lower quadrant abdominal pain, type I diabetes, acute sinusitis, and asthma. What CPT and ICD-10-CM codes are assigned?

   A. 99222, R18.91, E16.9, J01.91, J45.919   B. 99221, R17.41, E17.9, J01.90, J45.909   C. 99221, R10.31, E10.9, J01.90, J45.909   D. 99223, R14.31, E15.9, J01.90, J45.929 

19.   Under HIPAA, health care facilities must

   A. follow up with patients who repeatedly miss scheduled appointments for mandatory services.   B. keep records of patients who refill prescriptions more than once within a three-month timeframe.   C. maintain a clean, safe working environment.   D. choose a privacy officer in accordance with HIPAA policies and procedures. 

20.   What is the ICD-10-CM code for unspecified acute pericarditis?

   A. I30.89   B. I30.9   C. I30   D. I30.79 

21.   What is the full code description for 25515?

   A. Open treatment of radial shaft fracture, includes internal fixation, when performed   B. Closed treatment of ulnar shaft fracture; without manipulation   C. Closed treatment of radial shaft fracture; without manipulation   D. Open treatment of radial shaft fracture, includes internal fixation, when performed, and open treatment of distal radioulnar joint dislocation (Galeazzi fracture/dislocation), includes internal fixation, when performed, includes repair of triangular fibrocartilage complex 

22.   Which of the following anatomical locations would contain the diaphysis?

   A. Metatarsal   B. Diaphragm   C. Septum   D. Tibia 

23.   A patient recently became eligible for health insurance through her employer. Her health insurance is considered to be an 80-20 policy. Under the terms of an 80-20 policy, the insurer pays 80 percent and the insured pays 20 percent of expenses. This 80-20 policy is an example of

   A. coinsurance.   B. prospective payment.   C. capitation.   D. case management. 

24.   The Outpatient Prospective Payment System (OPPS) pays

   A. an established rate for outpatient services in specific hospitals.   B. a percentage of the national average for the same surgery performed in a different geographic location.   C. 65% of the schedule C rate for all surgeries.   D. subsidies to contain health care costs in rural facilities.  

25.   The study of disease is called

   A. physiology.   B. pathology.   C. urology.   D. neurology. 

26.   Superficial injuries such as abrasions or contusions are

   A. not coded when associated with more severe injuries of the same site.   B. queried to determine if the injuries are confined to the same site.   C. coded when associated with more severe injuries of the same site.   D. coded only when debridement is performed. 

27.   Another name for XXY syndrome is

   A. Turner’s syndrome.   B. Cooley’s anemia.   C. Klinefelter syndrome.   D. Huntington’s chorea. 

28.   The method that physicians use to bill for each service or visit individually rather than on a pre-paid basis is called

   A. fee-for-service.   B. capitation.   C. pre-paid care.   D. managed care. 

29.   A physician has a meeting with a pharmaceutical sales representative. During the course of the conversation, the physician reveals the diagnosis and past family, medical, and social history of a patient currently being treated with one of the medications that the sales representative is selling. In this situation, the doctor could be sued for

   A. invasion of privacy.   B. malfeasance.   C. undue harm and fraud.   D. malice. 

30.   A patient is prescribed a medication that narrows the blood vessels and raises her blood pressure. The medication is most likely a

   A. tranquilizer.   B. cardiogenic.   C. vasoconstrictor.   D. cardiotonic 

31.   Physicians typically refer to anatomical locations using directional terms, which are often

   A. paired in opposites.   B. used primarily by chiropractors.   C. used to describe surgical incisions.   D. referenced horizontally.  

32.   The study of tissue disease using macroscopic or microscopic analysis is called

   A. immunology.   B. histopathology.   C. cytopathology.   D. microbiology. 

33.   A physician obtains cells from the bone marrow cavity using a needle and a syringe. How would this procedure be coded?

   A. 36575   B. 37328   C. 38220   D. 35092 

34.   What is Medicare Part D?

   A. The component of Medicare Part A that covers outpatient surgeries   B. Add-on coverage for prescription drugs provided through insurance companies approved by Medicare   C. Supplemental coverage for war veterans and their dependents   D. Add-on coverage for dental procedures 

35.   A female patient is seen for her annual gynecological examination. During the examination, the physician performs a test to detect cervical cancer. This test is called a/an

   A. immunoassay test.   B. Pap smear.   C. carcinoembryonic antigen test.   D. mycobacterial culture. 

36.   A physician is called to the intensive care unit for a patient with second-degree burns sustained on 55% of his body while cooking in the kitchen where he works. The physician sees the patient in the critical care unit for two hours, leaves the unit, and returns later the same day to provide an additional hour of critical care. What ICD-10-CM and CPT codes would be assigned?

   A. L91.8, 99291 × 2, 99292 × 4   B. R53.81, 99291, 99293 × 5   C. Z30.09, 99293, 99294 × 2   D. T31.50, 99291, 99292 × 4 

37.   A change in the tissues and cells within a specific area on or in the body is called a

   A. lesion.   B. cyst.   C. neoplasm.   D. tumor. 

38.   Information about a patient can becan be released for research under the terms of HIPAA, only if

   A. the patient signs an authorization immediately upon admission.   B. the research is critical for technological development.   C. the patient has authorized the release and only a limited amount of information is released.   D. researchers obtain authorization from the admitting physician. 

39.   A patient is diagnosed with breast cancer and undergoes a partial mastectomy. What CPT code would be assigned?

   A. 19305   B. 19307   C. 19304   D. 19301 

40.   To conform to the HIPAA Privacy Rule, which of the following safeguards must be maintained in health care facilities?

   A. Immunization and injection safeguards   B. Reasonable administrative, technical, and physical safeguards   C. ICD-7 provisional safeguards   D. Hazardous waste protection safeguards 

41.   A patient sustains a fracture of the femur while playing football in a nearby park. What ICD-10-CM code would be assigned?

   A. S72.001A   B. S72.009A   C. S72.003A   D. S49.006A 

42.   According to the guidelines for medical records outlined in the Health Insurance Portability and Accountability Act (HIPAA), patients

   A. have the right to have errors reviewed by a hospital administrator.   B. have the right to correct errors in identification data only.   C. have the right to have errors in their medical records corrected.   D. do not have the right to have errors corrected, as the data has been previously verified by the physician.  

43.   Modifier -23 indicates that

   A. two surgeons performed a procedure.   B. a procedure was performed bilaterally.   C. a physician reviewed and interpreted a radiology procedure.   D. the patient received general anesthesia for a procedure that would ordinarily be performed with local or no anesthesia. 

44.   The Health Insurance Portability and Accountability Act (HIPAA) was created for the purpose of

   A. streamlining claims processing and reducing paperwork through electronic transmission.   B. stabilizing administrative costs and productivity.   C. decreasing employee turnover and reducing the volume of new hire paperwork.   D. modifying legal and ethical issues surrounding medical records retention. 

45.   A patient is seen in the emergency room complaining of abdominal pain in the left lower quadrant. It’s determined that the patient is experiencing inflammation of the pancreas, which is also called

   A. pancreaticoduodonal arcade.   B. pancreatitis.   C. pancreatolysis.   D. pancreatonia. 

46.   A 55-year-old patient was injured while working as a carpenter on a construction site. While framing the roof of a two-story house, he fell and hit his head. He was diagnosed with a concussion to the left side of his head, and underwent a right frontal parietal craniotomy with removal of a subdural hematoma. During the patient’s period of recovery, he was given a medication that resulted in a rash on his abdomen. The physician conducted an expanded problem focused history and exam, with straightforward medical decision making. What CPT code(s) should be assigned?

   A. 99251   B. 99252   C. 99292, 99291   D. 99253 

47.   Taking certain steps to protect PHI from being accidentally released to individuals who don’t need to know the information is called the

   A. minimum necessary standard.   B. privacy management statute.   C. health information guardianship guideline.   D. information provision standard. 

48.   The main term represents the most basic aspect of a disease or condition. For example, the main term of a diagnosis involving a broken arm is

   A. broken.   B. break.   C. fracture.   D. arm. 

49.   Performing a daily check for viruses and malware is one of the

   A. requirements of the Help Desk.   B. routine aspects of software maintenance.   C. sensible guidelines for Internet use in health care facilities.   D. functions of HIM encoders. 

50.   A coder overhears a confidential statement made outside of the court, and then, when called to testify, repeats the statement as being truth. This is an example of

   A. cross-examination.   B. hearsay.   C. speculation.   D. a direct quote. 

51.   A patient receives two venous pressure clamps for hemodialysis. What HCPCS Level II code is assigned?

   A. A4751   B. A4751 × 2   C. A4918 × 2   D. A4918  

52.   The process of removing tissue for histopathology is called

   A. shaving.   B. debridement.   C. excision.   D. biopsy. 

53.   A coder would assign modifier -53 to report

   A. dental procedures.   B. repeat procedures.   C. anesthesia administration.   D. procedures cancelled due to the patient’s condition. 

54.   Alternative dispute resolution (ADR) allows

   A. resolving medical malpractice suits by submitting pretrial depositions.   B. lawyer-to-lawyer mediation during trial recess.   C. mediating disputes with a judge in the presence of the bailiff.   D. litigants to resolve disputes prior to or after the start of litigation. 

55.   Code range 99231–99233 pertains to

   A. initial hospital care.   B. subsequent hospital care.   C. consultation services.   D. hospital discharge services. 

56.   A patient comes to the emergency room complaining of abdominal pain, nausea, and intractable vomiting. Unable to pinpoint the source of the patient’s complaints, the physician decides to admit the patient to the hospital. After conducting a complete history and examination, the patient’s final diagnosis is determined to be chronic duodenal ulcer. The patient remains hospitalized for three days. The physician sees the patient on the day of discharge. What ICD-10 and CPT codes are assigned?

   A. 99234, N17.9   B. 99223, I48.91   C. 99238, K26.7   D. 99291, D63.1 

57.   The specific guidelines that constitute a valid release of information under the HIPAA Privacy Rule are described as

   A. OIG specifications.   B. E/M levels.   C. considerations in relation to risk management.   D. core elements. 

58.   The suffix –centesis means

   A. abnormal condition.   B. calculus or stone.   C. a surgical puncture for fluid removal.   D. separation, breakdown, destruction. 

59.   The code for an ESWL would be found in the

   A. Urinary and Male Genital Systems of CPT.   B. Chemotherapy section of HCPCS.   C. Digestive System of CPT.   D. Cardiovascular System of CPT. 

60.   A female patient is diagnosed with breast cancer of the lower-inner quadrant of the right breast. The patient undergoes a modified radical mastectomy of the right breast in an attempt to circumvent the spread of the cancer to any secondary anatomical sites. The procedure was performed in three stages. In addition to the radical mastectomy, the physician also performed a right breast biopsy to treat the breast tumor in the lower-inner quadrant. What ICD-10-CM and CPT codes are assigned?

   A. 19307-58-RT, 19101-59-RT, C50.311   B. 15852-58, Z48.01   C. 11602, 15240, C50.312   D. 19307-RT, 19101-RT, C50.211 

61.   A patient comes to the ambulatory surgery center for a fusion of the cervical spine. Prior to the beginning of the surgery, the patient suffers an allergic reaction to the anesthesia shortly after it’s administered. Because of this reaction, the surgery is not performed. What code would be assigned as the first-listed diagnosis?

   A. The observation code   B. The reason that the surgery was scheduled to be performed   C. The allergy code   D. The anesthesia administration 

62.   Anti-inflammatory drugs applied to the skin to relieve skin disorders are called

   A. topical corticosteroids.   B. antiseptics.   C. keratolytics.   D. astringents. 

63.   The _______ nerve sends visual data to the occipital lobe of the brain.

   A. abducens   B. trochlear   C. optic   D. oculomotor 

64.   The root word OBSTETR/O means

   A. pregnancy.   B. cesarean.   C. midwife.   D. birth. 

65.   The root word ENTER/O means

   A. tooth.   B. stomach.   C. intestine.   D. secretion.  

66.   What code would be assigned for gastropathy?

   A. K29.7   B. K41.31   C. K31.9   D. K41.2 

67.   A patient comes to the physician’s office complaining of neck irritation. The physician examines her neck and notes that she has a 15 cm neck scar. Upon further examination, the physician notes that the neck scar requires extensive debridement and retention sutures. The physician performs a dermabrasion to treat the neck scar and then closes the complex wound with the sutures. What ICD-10 and CPT codes are assigned?

   A. 13132, 13133 × 2, L90.5   B. 13132, 13133 × 3, H81.09, L92.9   C. 13133-51, 13131-79, L60.0   D. 13132, L76.82 

68.   The bulbourethral gland is found in the _______ system.

   A. neurological   B. cardiovascular   C. male genital   D. female genital 

69.   A tethered health record allows patients to

   A. restructure insurance copayments.   B. use a secure portal to access their own records.   C. compare their health records to the records of patients with similar diagnoses.   D. amend the diagnoses listed in the health record. 

70.   A patient is diagnosed with lymphocytic lymphoma. Another patient is seen several weeks later and is diagnosed with histiocytic lymphoma. Both of these diagnoses are examples of _______ lymphoma.

   A. basic   B. Hodgkin’s   C. non-Hodgkin’s   D. Burkitt’s 

71.   A patient receives a blood glucose monitor. What HCPCS Level II code would be assigned?

   A. E0976   B. E0607   C. E0562   D. E4752 

72.   A good compliance program in the health care setting includes

   A. HHS surveillance.   B. regular tracking and monitoring of coding activities.   C. meetings with compliance officers.   D. regular audit consultations with trustees of the AAPC. 

73.   A patient with numerous symptoms is seen in the laboratory for a general health panel to gauge her overall physical well-being. What CPT code would be assigned for a general health panel?

   A. 80051   B. 82136   C. 84135   D. 80050 

74.   Code 71030-TC indicates a/an

   A. complete chest x-ray, four views, technical component only.   B. incomplete chest x-ray, two views, technical and professional component.   C. complete chest x-ray, two views, technical component only.   D. incomplete chest x-ray, three views, technical and professional component 

75.   If patients choose to obtain copies of their medical records, under the terms of HIPAA, providers can

   A. also fulfill requests for prescription data.   B. reschedule office visits to allow time to update medical records.   C. complete employee paperwork.   D. charge a reasonable fee for providing copies of those records. 

76.   A patient comes to the clinic complaining of fever, diarrhea, nausea, and vomiting. The patient is diagnosed with salmonella meningitis. What ICD-10-CM code would be assigned?

   A. A23.24   B. A02.21   C. A05.26   D. A07.21 

77.   A patient comes to the emergency room complaining of right knee pain. He states that he was playing baseball the previous evening and accidentally fell when sliding into first base. The physician obtains an expanded problem focused history and examination, as well as a two-view x-ray of the right knee. The physician reviews the x-ray, as well as the notes in the medical record, and renders a diagnosis of osteoarthritis of the knee. The physician performs a patellofemoral arthroplasty to repair the knee. What ICD-10-CM and CPT codes are assigned?

   A. 27477, M17.12   B. 27506-RT, N17.11   C. 27477-RT, D17.39   D. 27447-RT, M17.11 

78.   Provision of security against a hurt, loss, or damage with specific cash payments is called

   A. copayment.   B. protection.   C. indemnity.   D. secured loss. 

79.   HCPCS modifier –E2 indicates that the patient had a surgical procedure performed on the

   A. lower left eyelid.   B. upper left eyelid.   C. upper right eyelid.   D. lower right eyelid. 

80.   When is code 58120 assigned?

   A. The code is assigned for permanent pacemaker insertion.   B. The code has been deleted and cannot be assigned.   C. The code is assigned for a patient undergoing dilatation and curettage.   D. The code is assigned as an add-on code.  

81.   Epithelial tissue that secretes its products directly into the bloodstream is made of

   A. extracellular matrix.   B. endocrine gland cells.   C. endoplasmic reticulum.   D. columnar epithelial cells. 

82.   Which of the following modifiers would be assigned for a moribund patient?

   A. P4   B. P1   C. P5   D. P3 

83.   The anatomical location of the calyx is the

   A. spine.   B. brain.   C. arm.   D. kidney. 

84.   Which one of the following requirements is outlined in the guidelines established in HIPAA’s Privacy Rule?

   A. Hospital administrators must encrypt data within older data files.   B. Physicians must not disclose patient information to consulting physicians.   C. Patients must receive notice if their information will be used or disclosed to third parties.   D. Managers must secure medical records immediately following patient admission. 

85.   The I-10 helps coders classify patient

   A. morbidity and mortality.   B. management information.   C. evaluation files.   D. reimbursement data. 

86.   During a routine examination, a male patient is diagnosed with an elevated PSA. The physician performs a biopsy of the prostate with a rectal ultrasound to pinpoint the source of the problem. Which CPT and ICD-10-CM codes would be assigned?

   A. 55725, 76000-26, R93.6   B. 55700, 76872-26, R97.2   C. 55734, 73200-26, R97.2   D. 55720, 74000-26, R97.3 

87.   Health care practitioners must maintain records of privacy policy practices and procedures for

   A. 20 years.   B. 10 months.   C. 2 years.   D. 6 years. 

88.   A patient comes to the emergency department of a rural hospital. He complaints of problems sleeping, foot swelling, and insomnia. After a detailed review of the patient’s history and a detailed examination, the patient is diagnosed with chronic renal insufficiency, nephrotic syndrome, and anemia, based on the values listed in his blood test. The patient undergoes a biopsy of the left and right kidneys under physician guidance. A CT scan is also used for guidance and needle placement. A follow-up CT scan with physician review and interpretation is also performed. What ICD-10 and CPT codes are assigned?

   A. 50500-73, 51200-LT, C79.2, C61   B. 50200-RT-LT, 50310-RT, 51252-26, E46, N18.9, N04.9   C. 51000, 50310-59-LT, J90, Z90.12, E85.4   D. 50200-50, 50200-59-RT, 77012.26, N18.9, N04.9, D64.9 

89.   Data stored in a health care facility must

   A. comply with HIPAA rules and must be maintained securely.   B. adhere to OIG policies and procedures.   C. be organized in accordance with state standards for electronic data interchange.   D. conform to the physician’s expectations for data storage. 

90.   Health care practitioners who submit fraudulent bills to increase reimbursement may

   A. be blacklisted according to geographic location.   B. be listed in the Coding Directory of Fraudulent Billing published annually by the Department of Health and Human Services.   C. be reported to the Office of the Attorney General.   D. face financial penalties or, in some cases, imprisonment. 

91.   Which of the following anesthesia modifiers indicates a normal, healthy patient?

   A. P3   B. P1   C. P4   D. P2 

92.   When coding burns, coders should

   A. classify all burns as acute burns.   B. assign separate codes for each burn site.   C. assign the code for third-degree burns.   D. assign the code for chronic burns. 

93.   A 65-year-old patient is admitted to the hospital for 48 hours to receive treatment from her physician. This patient would be covered under

   A. Medicare Part D.   B. Medicare Part A.   C. Medicare Part B.   D. Medicare Part C.  

94.   A patient comes to the clinic complaining of ongoing headaches. The headaches began one week prior and have persisted ever since. A lumbar spinal tap is performed to pinpoint the source of the patient’s headaches. What CPT and ICD-10-CM codes are assigned?

   A. 62270, G44.1   B. 62270, G74.3   C. 62141, G46.8   D. 62272, G46.9 

95.   What code would be assigned for a tube pericardiostomy?

   A. 33210   B. 33026   C. 33015   D. 33050 

96.   What is the code description for 65101-LT?

   A. Removal of ocular implant performed laterally   B. Fine needle aspiration of orbital contents on the left third of the orbit   C. Biopsy of cornea performed on the lower third of the cornea   D. Enucleation of eye, without implant, performed on the left side of the body 

97.   Another name for diazepam is

   A. Flexeril.   B. Valium.   C. Norflex.   D. Myolastan.

98.   The gatekeeper concept refers to the operation of

   A. prospective payment organizations.   B. retrospective payment organizations.   C. ambulatory payment surgery centers.   D. health maintenance organizations. 

99.   The CPT code for thrombolysis is

   A. 93000.   B. 92975.   C. 92920.   D. 93797. 

100.   According to HIPAA, a patient’s information may be released for

   A. paternity testing.   B. research.   C. determining premiums based on a patient’s past medical history.   D. transferring electronic medical records to remote locations. 

101.   Which of the following statements is true of the Affordable Care Act?

   A. It includes a provision for military service members who served in Afghanistan.   B. It requires health care facilities to maintain health records for at least 10 years.   C. It makes it mandatory for patients to carry health insurance.   D. It offers parents supplementary coverage for dependents with chronic illness 

102.   A patient is seen in the physician’s office after the results of an earlier mammogram demonstrated microcalcification in the right breast as well as a breast lesion. The lesion is excised using needle localization. The patient’s final diagnosis is fibrosclerosis of the right breast. What CPT and ICD-10-CM codes are assigned?

   A. 19120-RT, L10.11   B. 19125-RT, N60.31   C. 19126-LT, M25.1   D. 19123-RT, H16.11 

103.   A coder would assign a Q code as a temporary code for

   A. holistic treatments for spinal procedures.   B. durable medical equipment only.   C. procedures or services only.   D. procedures, services, and supplies 

104.   Which of the following forms is used to bill outpatient charges?

   A. HCFA-1350 or CMS-650   B. HCFA-1400 or CMS-1540   C. AMA-14 or UCF-1250   D. CMS-1500 or UCF-1500. 

105.   During a routine examination, a patient indicates that she is taking an antihypertensive medication that causes her kidneys to excrete more urine. These antihypertensive medications are called

   A. calcium-channel blockers.   B. anticoagulants.   C. beta blockers.   D. diuretics.  

106.   A patient comes to the emergency room complaining of postnasal drip, frequent nosebleeds, headaches, and difficulty breathing. She is diagnosed with a deviated nasal septum, hypertrophy of the turbinate, and inflammation of the ethmoid sinuses. The physician performs an endoscopic ethmoidectomy of the left nasal sinus, septoplasty, and turbinate excision. What ICD-10-CM and CPT codes are assigned?

   A. 31255, 30520, 30130, J34.2, J34.3, J32.2   B. 31255-LT, 30520-51, 30130-51, J34.2, J34.3, J32.2   C. 31230, 30520, J34.2, J34.3, J32.2   D. 31230-51, 30520-LT, J34.2 

107.   A physician is analyzing specific organs in a particular region of the patient’s body. In her notes, she refers to the transverse or cross-sectional plane, which divides the body

   A. inferiorly.   B. vertically.   C. horizontally.   D. bilaterally. 

108.   A patient comes to the emergency room after having dinner at a restaurant, where she began to experience chest tightness during the meal. She is seen for a cardiology consultation in the outpatient setting for a diagnosis of chest tightness. Which CPT and ICD-10-CM codes would be assigned?

   A. 99245, R07.89   B. 99244, R07.59   C. 99242, R17.52   D. 99243, R25.96 

109.   Providers that receive reimbursement after health care services have been provided are being compensated under the _______ system.

   A. prospective payment   B. retrospective payment   C. capitation   D. UCR 

110.   The regulations in HIPAA apply to three groups of individual and corporate entities, each involved in electronic medical records transfer. These groups are collectively referred to as

   A. health care administrators.   B. covered entities.   C. provisional health care data collectors.   D. protected personnel. 

111.   The largest salivary glands are called the _______ glands.

   A. amylase   B. parotid   C. sublingual   D. submandibular 

112.   Which modifier indicates a staged or related procedure performed during the postoperative period?

   A. -59   B. -57   C. -58   D. -54 

113.   The voluntary program that’s financed through a combination of payments from general federal revenues and premiums paid by beneficiaries who elect to participate is called

   A. CHAMPVA.   B. Medicare Part B.   C. Medicaid.   D. TRICARE. 

114.   What is the full code description for 33536?

   A. Repair of postinfarction ventricular septal defect, with or without myocardial resection   B. Coronary artery bypass, using arterial graft(s); 4 or more coronary arterial grafts   C. Repair of double outlet right ventricle with intraventricular tunnel repair   D. Closure of atrioventricular valve (mitral or tricuspid) by suture or patch 

115.   Categorically needy and medically needy patients may qualify for

   A. Medicaid.   B. CHAMPVA.   C. Champus.   D. Medicare Advantage 

116.   ICD-10-CM code S50.351A indicates that the patient has a superficial foreign body of the right elbow. The A indicates that

   A. code S50.351A should be assigned to page 1 of the medical record, but not subsequent pages.   B. this is the patient’s first encounter.   C. this is the patient’s second encounter for the same original diagnosis.   D. code S50.351A should be sequenced before secondary codes. 

117.   The foramen ovale is found in which anatomical location?

   A. Fibula   B. Heart   C. Pancreas   D. Liver 

118.   A new patient is seen in a clinic for complaints of shortness of breath, fever, difficulty swallowing, runny nose, and cough. The physician performs a detailed history, detailed examination, and medical decision making of low complexity. The physician also obtains a chest x-ray and lab workup. Based on the results of the diagnostic tests, the physician renders a diagnosis of upper respiratory tract infection and lymphadenopathy. What ICD-10 and CPT codes are assigned?

   A. 99203, J06.9, R59.0   B. 99202, D63.1, J45.909   C. 99213, R06.82, F10.229   D. 99215, M19.011, R13.10 

119.   A patient has a disorder in which the bone marrow produces an overabundance of white blood cells. What is this disorder called?

   A. Leukemia   B. Hemophilia   C. Coagulation   D. Septicemia 

120.   A patient is diagnosed with acne. What ICD-10-CM code would be assigned?

   A. L74.2   B. L72.3   C. L70.0   D. L73.1  

121.   A coder assigns a HCPCS Level II code to a patient’s medical record. The code description reads as follows: Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape. Based on this description, which HCPCS Level II code was assigned?

   A. B4072   B. B4125   C. B4034   D. B4278 

122.   The Health Insurance Portability and Accountability Act (HIPAA) standards were developed to

   A. ensure that coders could easily access each medical record.   B. determine the structure of insurance carrier payments for health care practitioners.   C. protect patient confidentiality when health information is transferred electronically.   D. define XLTM standards for health records management. 

123.   Another name for third-party contractors who have access to medical information is

   A. business associates.   B. insurance administrators.   C. healthcare vendors.   D. covered entities. 

124.   Bones inside the nose are called

   A. maxillae.   B. turbinates.   C. ethmoids.   D. septal mucosa. 

125.   The atrioventricular (tricuspid) valve is located in the

   A. fibula.   B. lung.   C. heart.   D. brain. 

126.   Another term for disease evolution is

   A. exacerbation.   B. remission.   C. pathogenesis.   D. morphology. 

127.   The vitreous humor can be found in the

   A. ear.   B. tongue.   C. nose.   D. eye. 

128.   The codes for pacemakers and implantable defibrillators would be found in what section of CPT?

   A. 33202–33273   B. 33200–33205   C. 33437–33537   D. 33533–33799 

129.   The HIPAA Privacy Rule indicates that

   A. practitioners should disclose only the minimum amount of health information necessary for the purpose of the disclosure.   B. physicians may release medical information at their own discretion.   C. restrictions on information disclosure exist only for patients with life-threatening illnesses.   D. the level of information disclosure permitted is based on the nature of the procedure. 

130.   The abbreviation INH indicates what route of drug administration?

   A. Inhaled and intrathecal administration   B. Inhaled and intravenous administration   C. Intrathecal injection   D. Inhalant solution 

131.   A patient comes to the clinic complaining of nausea, vomiting, fever, dizziness, and intermittent confusion. The physician conducts a detailed history and examination and reviews the patient’s lab results. The patient is diagnosed with pyelonephritis and is scheduled for an ultrasound to review the state of the kidneys and other organs. What CPT and ICD-10-CM codes are assigned?

   A. 76775-TC, N15   B. 76775-26, N10   C. 73256-TC, M11   D. 71010-26, B12 

132.   What happens when HIPAA rules conflict with state law?

   A. Conflicting state rules are overridden by federal law.   B. The interpretation of HIPAA rules is left to the physician’s discretion.   C. State laws overrule federal law.   D. The Supreme Court’s decision becomes final in binding arbitration 

133.   Which of the following statements is true of the olfactory nerve?

   A. It’s susceptible to erosion due to Peyronie’s disease.   B. It’s located in the mitral valve and helps to circulate blood throughout the heart.   C. It conveys the fluid from lymph glands to other areas of the body.   D. It’s found in the nose and allows the senses to detect and distinguish odors. 

134.   The first step in EHR implementation is

   A. structuring the timeline for EHR implementation.   B. analyzing the content of the traditional medical record.   C. conducting an assessment of the goals, needs, and financial stability of the health care practice.   D. reviewing the list of established patients currently being seen in the practice. 

135.   The outcome of delivery code should be

   A. omitted from the maternal record for stillborn delivery.   B. assigned to the newborn record only.   C. assigned to the maternal record when a delivery occurs.   D. assigned to both the maternal and newborn records. 

136.   A patient is seen in the office for complaints of dizziness and insomnia. The physician records a chronological description of specific elements of the patient’s condition. This chronological description is called the

   A. history of present illness.   B. examination.   C. review of systems.   D. chief complaint. 

137.   What is the CPT code description for 64483?

   A. Injection(s) anesthetic agent and/or steroid, transforaminal epidural, with imaging guidance (fluoroscopy or CT); lumbar or sacral, single level   B. Injection, anesthetic agent, sphenopalatine ganglion   C. Injection(s) anesthetic agent and/or steroid, transforaminal epidural, with imaging guidance (fluoroscopy or CT); lumbar or sacral, multiple levels   D. Transforaminal epidural injection under ultrasound guidance 

138.   Releasing genetic information is forbidden under the terms of HIPAA because it may

   A. allow immediate family members to have access to a patient’s medical records.   B. require physicians to fulfill contractual obligations for treatments provided in ambulatory surgery centers.   C. indicate susceptibility to a future illness, without the patient actually being diagnosed with the condition.   D. not be successfully transmitted to all health care facilities.  

139.   Prescribing combination drugs that contain multiple medications to cut down on the number of pills
patients take on a daily basis

   A. compounds the drugs’ effectiveness.   B. increases the likelihood of compliance.   C. decreases the frequency of drug interactions.   D. supports good body function. 

140.   A patient who has paralysis of all four limbs is called

   A. quadriplegic.   B. paraplegic.   C. tetraplegic.   D. hemiplegic. 

141.   Which of the following is true about HIPAA national standards?

   A. The national standards apply to any electronic data interchange.   B. The national standards apply only to data exchange within a specified geographical region.   C. The national standards do not apply to surgical procedures in the inpatient setting.   D. The national standards do not apply to data exchanged within a claim clearinghouse. 

142.   A patient undergoes an appendectomy and later returns to the operating room for a related procedure the same day. Which modifier should be assigned to the CPT code?

   A. -51   B. -AA   C. -78   D. -76 

143.   The portion of health insurance that an insured pays before he or she is entitled to receive benefits from an insurance plan is called the

   A. deductible.   B. OPPS reimbursement.   C. capitation.   D. coinsurance. 

144.   A patient is seen in follow-up two weeks after undergoing cholecystectomy. During the follow-up examination, the physician notes that the abdominal wound has not yet healed. The patient undergoes a split-thickness autograft due to a nonhealing left lower abdominal wound that’s 10 square centimeters. Which CPT and ICD-10-CM codes would be assigned?

   A. 15350, L52.64   B. 15250, L34.74   C. 15200, L85.64   D. 15100, L76.82 

145.   The Female Genital System subsection covers which CPT code range?

   A. 56203–56303   B. 56607–56809   C. 56300–56499   D. 56405–58999 

146.   What ICD-10-CM code would be assigned for unilateral primary osteoarthritis of the right hip?

   A. M16.12   B. M16.30   C. M16.11   D. M16.10 

147.   Which of the following anatomical locations would contain the superior vena cava?

   A. Hip   B. Nose   C. Lungs   D. Heart 

148.   A patient receives an injection of nandrolone decanoate. What HCPCS Level II code would be assigned?

   A. J2323   B. J3530   C. J2320   D. J2300 

149.   The suffix –stasis means

   A. breakdown.   B. stopping and controlling.   C. kinetic.   D. flow. 

150.   A patient undergoes a sigmoidoscopy. The coder would assign CPT code

   A. 45852.   B. 45330.   C. 45397.   D. 45919. 

Week Two Assignment: Refinement of Nursing Issue into Research Assignment Guidelines
Purpose
This assignment provides the opportunity for the student to continue work on a previously identified area or phenomenon of interest. This work is expanded into selected elements of the evidence-based practice (EBP) process including development of the PICOT/PICo question and identification of evidence related to topic. This assignment becomes the framework for the project proposal due at the end of the course. Students begin writing the proposal with this assignment and add to this work throughout the course. NOTE that all faculty feedback and corrections are to be completed prior to resubmission of additional sections in the following weeks.
Course Outcomes
This assignment enables the student to meet the following course outcomes:
CO#1 Integrate evidence-based practice and research to support advancement of holistic nursing care in diverse healthcare settings. (PO 1, 2, 7, 9)
CO#2 Integrate knowledge related to evidence-based practice and person-centered care to improve healthcare outcomes. (PO 1, 2, 7, 9, 11)
CO#4 Develop knowledge related to research and evidence-based practice as a basis for designing and critiquing research studies. (PO 1, 2, 6, 9)
Due Date: Sunday 11:59 PM MT at the end of Week Two
Total Points Possible: 130 points
Requirements
Description of the Assignment
This assignment builds on the identification of a nursing issue from NR 500 and the application of a nursing theory to the selected issue from NR 501. For this course, the selected issue and nursing theory serve as the foundation to the identification of PICOT/PICo. Literature search strategy is also required.
Criteria for Content
1. Introduction and area or phenomenon of interest background. This section provides an opening to your MSN EBP scholarly project. It should contain the following elements:
Identification of key research findings that support the need for developing an EBP project on this area or phenomenon of interest
Identification and clarification of selected nursing issue; be specific
Rationale for selecting the specific issue
Identification of the sections of the assignment
2. Application to selected MSN Program Specialty Track: This section provides a comprehensive discussion of how the selected nursing issue impacts the student’s MSN specialty track.
Identification of MSN Program specialty track
Description of impact of selected nursing issue has upon advanced practice in your specialty track
3. Nursing issue and supportive evidence regarding the issue: This section provides a thorough discussion of the selected nursing issue. It also cites relevant supportive evidence that the selected issue occurs with frequency and has a serious impact upon advanced practice in the student’s selected specialty track. Included in this section will be:
Identification selected nursing issue
Identification of frequency of it occurrence
Identification of the stakeholders impacted by the issue
Rationale for selecting the identified nursing issue
Statement of the PICOT/PICo question at the end of this section based on the evidence
Identification of literature search strategy
4. Conclusion:
Provides a summary of the key elements of the assignment
Identifies expected outcomes for the project proposal
Provides a self-reflection by the student regarding what was learned from writing this assignment

Preparing the Assignment
Criteria for Format and Special Instructions
The paper (excluding the title page and reference page) should be at least 5, but no more than 8 pages. Points will be lost for not meeting these length requirements.
Title page, running head, body of paper, and reference page must follow APA guidelines as found in the 6th edition of the manual. This includes the use of headings for each section of the paper except for the introduction where no heading is used.
A minimum of 6 (six) appropriate scholarly references must be used. Required textbook for this course, dictionary and Chamberlain College of Nursing lesson information may NOT be used as scholarly references for this assignment. For additional assistance regarding scholarly nursing references, please see “What is a scholarly source” located in the Course Resources found within Modules. Be aware that information from .com websites may be incorrect and should be avoided. References are current – within a 5-year time frame unless a valid rationale is provided and the instructor has approved them prior to submission of the assignment.
Ideas and information from scholarly, peer reviewed, nursing sources must be cited and referenced correctly.
Rules of grammar, spelling, word usage, and punctuation are followed and consistent with formal, scientific writing.
REMOVE to prevent inflated originality scores: This assignment must be submitted to TurnItIn™, as required by the TurnItIn™ policy. A Similarity Index of “blue” or “green” must be obtained. A score in the blue or green range indicates a similarity of less than 24%, which is the benchmark for CCN graduate nursing students. Any other level of similarity index level requires the student to revise the assignment before the due date and time. To allow sufficient time for revision, early submission of the assignment to TurnItIn™ is highly encouraged. The final submission will be graded by faculty. If a TurnItIn™ report indicates that plagiarism has occurred, the Academic Integrity policy will be followed.
Directions and Assignment Criteria

Assignment Criteria Points % Description
Introduction and area or phenomenon of interest background 20 15 Required content includes:
Identification of key research findings that support the need for developing an EBP project on this area or phenomenon of interest
Identification and clarification of selected nursing issue; be specific
Rationale for selecting the specific issue
Identification of the sections of the assignment
Application to selected MSN Program Specialty Track

20 15 The required content for this section includes:
Identification of MSN Program specialty track
Description of impact of selected nursing issue has upon advanced practice in your specialty track
Nursing issue and supportive evidence regarding the issue
40 31 The required content for this section includes:
Identification selected nursing issue
Identification of frequency of it occurrence
Identification of the stakeholders impacted by the issue
Rationale for selecting the identified nursing issue
State the PICOT/PICo question at the end of this section based on the evidence
Conclusion 20 15 The required content is:
Provides a summary of key elements from paper
Identifies expected outcomes for the project proposal based on the PICOT/PICo
Provides a self-reflection by the student regarding what was learned from writing this assignment
Paper Specifications 7 5 Paper meets length requirements of 8 to 10 pages.
Minimum of 6 (six) appropriate scholarly nursing references
A dictionary, required textbook for this course and Chamberlain College of Nursing lesson information, may NOT be used as scholarly references for this assignment.
References are current – within a 5-year time frame unless a valid rationale is provided and the instructor has approved them prior to assignment submission.
APA Format (6th edition) 10 8 Title page, running head, body of paper, and reference page must follow APA guidelines as found in the 6th edition of the manual. This includes the use of headings for each section of the paper except for the introduction where no heading is used.
One deduction for each type of APA style error
Citations in Text 5 4 Ideas and information that come from published resources must be cited and referenced correctly.
Writing Mechanics 8 7 Rules of grammar, spelling, word usage, and punctuation are followed and consistent with formal written work as found in the 6th edition of the APA manual.
Total   130 100 %

Grading Rubric

Assignment Criteria Exceptional
(100%)
Outstanding or highest level of performance Exceeds
(88%)
Very good or high level of performance Meets
(80%)
Competent or satisfactory level of performance Needs Improvement
(38%)
Poor or failing level of performance Developing
(0)
Unsatisfactory level of performance
Content
Possible Points = 107 Points
Introduction & area or phenomenon of interest background 20 Points 18 Points 16 Points 8 Points 0 Points
Presentation of information was exceptional and included all of the following elements:
Identification of key research findings that support the need for developing an EBP project on this area or phenomenon of interest

Identification and clarification of selected nursing issue

Rationale for selecting the specific issue

Identification of the sections of the assignment Presentation of information was good, but was superficial in places and included all of the following elements:
Identification of key research findings that support the need for developing an EBP project on this area or phenomenon of interest
Identification and clarification of selected nursing issue
Rationale for selecting the specific issue
Identification of the sections of the assignment Presentation of information was minimally demonstrated in the all of the following elements:
Identification of key research findings that support the need for developing an EBP project on this area or phenomenon of interest
Identification and clarification of selected nursing issue
Rationale for selecting the specific issue
Identification of the sections of the assignment Presentation of information in one or two of the following elements fails to meet expectations:
Identification of key research findings that support the need for developing an EBP project on this area or phenomenon of interest
Identification and clarification of selected nursing issue
Rationale for selecting the specific issue
Identification of the sections of the assignment
Presentation of information is unsatisfactory in three or more of the following elements:
Identification of key research findings that support the need for developing an EBP project on this area or phenomenon of interest
Identification and clarification of selected nursing issue
Rationale for selecting the specific issue
Identification of the sections of the assignment

Application to selected MSN Program Specialty Track
20 Points 18 Points 16 Points 8 Points 0 Points
Presentation of information was exceptional and included all of the following elements:
Identification of MSN Specialty track
Description of impact of selected nursing issue has upon advanced practice in your specialty track Presentation of information was good, but was superficial in places and included all of the following elements:
Identification of MSN Specialty track
Description of impact of selected nursing issue has upon advanced practice in your specialty track Presentation of information was minimally demonstrated in the all of the following elements:
Identification of MSN Specialty track
Description of impact of selected nursing issue has upon advanced practice in your specialty track Presentation of information in one or two of the following elements fails to meet expectations:
Identification of MSN Specialty track
Description of impact of selected nursing issue has upon advanced practice in your specialty track Presentation of information is unsatisfactory in three or more of the following elements:
Identification of MSN Specialty track
Description of impact of selected nursing issue has upon advanced practice in your specialty track
Nursing issue and supportive evidence regarding the issue
40 Points 35 Points 32 Points 15 Points 0 Points
Presentation of information was exceptional and included all of the following elements:
Identification selected nursing issue
Identification of frequency of its occurrence
Identification of the stakeholders impacted by the issue
Rationale for selecting the identified nursing issue Presentation of information was good, but was superficial in places and included all of the following elements:
Identification selected nursing issue
Identification of frequency of its occurrence
Identification of the stakeholders impacted by the issue
Rationale for selecting the identified nursing issue Presentation of information was minimally demonstrated in the all of the following elements:
Identification selected nursing issue
Identification of frequency of its occurrence
Identification of the stakeholders impacted by the issue
Rationale for selecting the identified nursing issue Presentation of information in one or two of the following elements fails to meet expectations:
Identification selected nursing issue
Identification of frequency of its occurrence
Identification of the stakeholders impacted by the issue
Rationale for selecting the identified nursing issue
Presentation of information is unsatisfactory in three or more of the following elements:
Identification selected nursing issue
Identification of frequency of its occurrence
Identification of the stakeholders impacted by the issue
Rationale for selecting the identified nursing issue
Conclusion 20 Points 18 Points 16 Points 8 Points 0 Points
Presentation of information was exceptional and included all of the following elements:
Provides a summary of key elements from paper
Identifies expected outcomes for the project proposal based on the PICOT/PICo
Provides a self-reflection by the student regarding what was learned from writing this assignment. Presentation of information was good, but was superficial in places and included all of the following elements:
Provides a summary of key elements from paper
Identifies expected outcomes for the project proposal based on the PICOT/PICo
Provides a self-reflection by the student regarding what was learned from writing this assignment. Presentation of information was minimally demonstrated in the all of the following elements:
Provides a summary of key elements from paper
Identifies expected outcomes for the project proposal based on the PICOT/PICo
Provides a self-reflection by the student regarding what was learned from writing this assignment. Presentation of
information in one of the following elements fails to meet expectations:
Provides a summary of key elements from paper
Identifies expected outcomes for the project proposal based on the PICOT/PICo
Provides a self-reflection by the student regarding what was learned from writing this assignment.
Presentation of information is unsatisfactory in two of the following elements:
Provides a summary of key elements from paper
Identifies expected outcomes for the project proposal based on the PICOT/PICo
Provides a self-reflection by the student regarding what was learned from writing this assignment.
Paper Specifications 7 Points 6 Points 5 Points 2Points 0 Points
This section included all of the following:
Paper meet length requirements of 5 to 8 page.
Minimum of 6 (six) scholarly nursing references
Dictionary, required textbook for this course and Chamberlain College of Nursing lesson information, were NOT used as scholarly references.
All references are current – within a 5-year time frame unless a valid rationale was provided and the instructor approved them. This section included three of the following:
Paper meet length requirements of 5 to 8 page.
Minimum of 6 (six) scholarly nursing references
Dictionary, required textbook for this course and Chamberlain College of Nursing lesson information, were NOT used as scholarly references.
All references are current – within a 5-year time frame unless a valid rationale was provided and the instructor approved them. This section included only two of the following:
Paper meet length requirements of 5 to 8 page.
Minimum of 6 (six) scholarly nursing references
Dictionary, required textbook for this course and Chamberlain College of Nursing lesson information, were NOT used as scholarly references.
All references are current – within a 5-year time frame unless a valid rationale was provided and the instructor approved them. This section included only one of the following:
Paper meet length requirements of 5 to 8 page.
Minimum of 6 (six) scholarly nursing references
Dictionary, required textbook for this course and Chamberlain College of Nursing lesson information, were NOT used as scholarly references.
All references are current – within a 5-year time frame unless a valid rationale was provided and the instructor approved them. This section included none of the following:
Paper meet length requirements of 5 to 8 page.
Minimum of 6 (six) scholarly nursing references
Dictionary, required textbook for this course and Chamberlain College of Nursing lesson information, were NOT used as scholarly references.
All references are current – within a 5-year time frame unless a valid rationale was provided and the instructor approved them.
Content Subtotal ________of 107 points
Format
Possible Points = 23 Points
APA Style 10 Points 9 Points 8 Points 4 Points 0 Points
APA guidelines, as per the 6th edition of the manual, are demonstrated for the
title page,
running head,
body of paper (including citations and headings), and
reference page

One deduction for each type of APA format error
0 to 1 APA error was present
APA guidelines, as per the 6th edition of the manual, are demonstrated for the
title page,
running head,
body of paper (including citations and headings), and
reference page

One deduction for each type of APA format error
2 – 3 APA errors were present APA guidelines, as per the 6th edition of the manual, are demonstrated for the
title page,
running head,
body of paper (including citations and headings), and
reference page

One deduction for each type of APA format error
4 – 5 APA were are present APA guidelines, as per the 6th edition of the manual, are demonstrated for the
title page,
running head,
body of paper (including citations and headings), and
reference page

One deduction for each type of APA format error
6 – 7 APA were are present APA guidelines, as per the 6th edition of the manual, are demonstrated for the
title page,
running head,
body of paper (including citations and headings), and
reference page

One deduction for each type of APA format error
8 or greater APA errors were present
Citations 5 Points 4 Points 3 Points 2 Points 0 Points
There were 0-1 errors in the crediting of ideas, and information that contributed to knowledge
Permission to use references older than 5 years was obtained from faculty. There were 2-3 errors in the crediting of ideas, and information that contributed to knowledge

Permission to use references older than 5 years was NOT obtained from faculty. There were 4-5 errors in the crediting of ideas, and information that contributed to knowledge

There were 6-7 errors in the crediting of ideas, and information that contributed to knowledge There were 8 or greater errors in the crediting of ideas, and information that contributed to knowledge
Writing Mechanics 8 Points 7 Points 6 Points 3 Points 0 Points
1–2 errors or exceptions to the rules of grammar, spelling, word usage, punctuation and other aspects of formal written work as found in the 6th edition of the APA manual 3 – 4 errors or exceptions to the rules of grammar, spelling, word usage, punctuation and other aspects of formal written work as found in the 6th edition of the APA manual 5 – 6 errors or exceptions to the rules of grammar, spelling, word usage, punctuation and other aspects of formal written work as found in the 6th edition of the APA manual
7 – 8 errors or exceptions to the rules of grammar, spelling, word usage, punctuation and other aspects of formal written work as found in the 6th edition of the APA manual
9 or greater errors or exceptions to the rules of grammar, spelling, word usage, punctuation and other aspects of formal written work as found in the 6th edition of the APA manual

Format Subtotal _____of 23 points
Total Points _____of 130 points

n this week’s activity you will have an opportunity to play a clinician and diagnose fictitious individuals with mental disorders. Please answer the questions below;

• Susan, a college student, is anxious whenever she must speak. Her anxiety motivates her to prepare meticulously and rehearse material again and again. Is Susan’s reaction normal, or does she have an anxiety disorder? Explain the criteria you used in arriving at your answer.
•  In recent years, several best-selling books have argued that most emotional problems can be traced to an unhappy or traumatic childhood (an abusive or dysfunctional family, “toxic” parents, suppression of the “inner child”). What are two possible benefits of focusing on childhood as the time when emotional problems originate, and what are two possible drawbacks? 
• Some mental health professionals (though not most psychologists) think that PMS should be classified as a mental disorder. Drawing on evidence from Chapter 5 of your textbook and information in Chapter 11, write a paragraph giving some arguments against this position.

This assignment must be submitted in “doc” or “ docx.” format. Additionally, it must be typed, double spaced, Times New Roman font (size 12), one inch margins on all sides. Type the question followed by your answer to the question. A title page is to be included. The title page is to contain the title of the assignment, your name, the instructor’s name, the course title, and the date.All assignments must be submitted in “Blackboard by by clicking on the Assignment link under the appropriate weekly unit and clicking on Browse to attach your work as a .doc or .docx. 

Practicum – Week 5 Journal Entry

                                      Learning Objectives

Students will:

· Develop diagnoses for clients receiving psychotherapy*

· Evaluate the efficacy of therapeutic approaches for clients*

· Analyze legal and ethical implications of counseling clients with psychiatric 

  disorders*

                                             The Assignment 

Select a client whom you observed or counseled that suffers from a disorder related to trauma. Then, address the following in your Practicum Journal:

· Describe the client (without violating HIPAA regulations) and identify any 

  pertinent history or medical information, including prescribed medications.

· Using the DSM-5, explain and justify your diagnosis for this client.

· Explain whether any of the therapeutic approaches in this week’s Learning 

 Resources would be effective with this client. Include expected outcomes based  

 on these therapeutic approaches. Support your approach with evidence-based  

 literature.

· Explain any legal and/or ethical implications related to counseling this client.

                                                  Learning Resources

Required Readings

Wheeler, K. (Ed.). (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      13, “Stabilization for Trauma and Dissociation” (pp. 469–508)

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

Required Media

Laureate Education (Producer). (2012a). Academic year in residence: Thompson family case study [Multimedia file]. Baltimore, MD: Author. 

Ochberg, F. (2012). Psychotherapy for chronic PTSD [Video file]. Mill Valley, CA: Psychotherapy.net.

· NOTE: PLEASE SEE AND PAY ATTENTION TO 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 IN MENTAL 

 HEALTH NURSING.