Benchmark – Evidence-Based Practice Project—Paper on Diabetes

Identify a research or evidence-based article that focuses comprehensively on a specific intervention or new diagnostic tool for the treatment of diabetes in adults or children.

In a paper of 750-1,000 words, summarize the main idea of the research findings for a specific patient population. Research must include clinical findings that are current, thorough, and relevant to diabetes and the nursing practice.

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. Benchmark – Evidence-Based Practice Project—Paper on Diabetes

This assignment uses a grading rubric. Instructors will be using the rubric to grade the assignment; therefore, students should review the rubric prior to beginning the assignment to become familiar with the assignment criteria and expectations for successful completion of the assignment.

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

ORDER A FREE-PLAGIARISM PAPER HERE

125.0 Evidence-Based Practice Project—Intervention Presentation on Diabetes

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. Benchmark – Evidence-Based Practice Project—Paper on Diabetes

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 required to submit this assignment to Turnitin, Only Word documents can be submitted to Turnitin .Benchmark – Evidence-Based Practice Project—Paper on Diabetes

Ethical And Spiritual Decision Making In Health Care

Details:

In addition to the topic study materials, use the chart you completed and questions you answered in the Topic 3 about “Case Study: Healing and Autonomy” as the basis for your responses in this assignment.

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

1. In 200-250 words, respond to the following: Should the physician allow Mike to continue making decisions that seem to him to be irrational and harmful to James, or would that mean a disrespect of a patient’s autonomy? Explain your rationale .Ethical And Spiritual Decision Making In Health Care

ORDER A FREE-PLAGIARISM PAPER HERE

2. In 400-500 words, respond to the following: How ought the Christian think about sickness and health? How should a Christian think about medical intervention? What should Mike as a Christian do? How should he reason about trusting God and treating James in relation to what is truly honoring the principles of beneficence and nonmaleficence in James’s care?

3. In 200-250 words, respond to the following: How would a spiritual needs assessment help the physician assist Mike determine appropriate interventions for James and for his family or others involved in his care?

Remember to support your responses with the topic study materials.

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

This assignment uses a rubric. 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 LopesWrite. Refer to the LopesWrite Technical Support articles for assistance. Ethical And Spiritual Decision Making In Health Care

history of otitis media

Question

Question 1

2 / 2 pts

A patient who has diabetes reports intense discomfort when needing to void. A urinalysis is normal. To treat this, the primary care NP should consider prescribing: history of otitis media

flavoxate (Urispas).

bethanechol (Urecholine).

phenazopyridine (Pyridium).

oxybutynin chloride (Ditropan XL).

Question 2

2 / 2 pts

A patient reports difficulty returning to sleep after getting up to go to the bathroom every night. A physical examination and a sleep hygiene history are noncontributory. The primary care NP should prescribe:

zaleplon.

ZolpiMist.

ramelteon.

chloral hydrate.

Question 3

2 / 2 pts

A 5-year-old child who has no previous history of otitis media is seen in clinic with a temperature of 100° F. The primary care NP visualizes bilateral erythematous, nonbulging, intact tympanic membranes. The child is taking fluids well and is playing with toys in the examination room.The NP should: history of otitis media

prescribe azithromycin once daily for 5 days.

ORDER A FREE-PLAGIARISM PAPER HERE

prescribe amoxicillin twice daily for 10 days.

prescribe amoxicillin-clavulanate twice daily for 10 days.

initiate antibiotic therapy if the child’s condition worsens.

Question 4

2 / 2 pts

An 80-year-old patient with congestive heart failure has a viral upper respiratory infection. The patient asks the primary care NP about treating the fever, which is 38.5° C. The NP should:

recommend acetaminophen.

recommend high-dose acetaminophen.

tell the patient that antibiotics are needed with a fever that high.

tell the patient a fever less than 40° C does not need to be treated.

Question 5

2 / 2 pts

A patient who takes levodopa and carbidopa for Parkinson’s disease reports experiencing freezing episodes between doses. The primary care NP should consider using:

selegiline.

amantadine.

apomorphine.

modified-release levodopa.

Question 6

2 / 2 pts

A patient is being tapered from long-term therapy with prednisolone and reports weight loss and fatigue. The primary care NP should counsel this patient to: history of otitis media

consume foods high in vitamin D and calcium.

begin taking dexamethasone because it has longer effects.

expect these side effects to occur as the medication is tapered.

increase the dose of prednisolone to the most recent amount taken.

Question 7

2 / 2 pts

The primary care nurse practitioner (NP) sees a 50-year-old woman who reports frequent leakage of urine. The NP learns that this occurs when she laughs or sneezes. She also reports having an increased urge to void even when her bladder is not full. She is not taking any medications. The NP should:

perform a dipstick urinalysis.

prescribe desmopressin (DDAVP).

prescribe oxybutynin chloride (Ditropan XL).

teach exercises to strengthen the pelvic muscles.

Question 8

2 / 2 pts

A 7-year-old patient who has severe asthma takes oral prednisone daily. At a well-child examination, the primary care NP notes a decrease in the child’s linear growth rate. The NP should consult the child’s asthma specialist about:

gradually tapering the child off the prednisone.

a referral for possible growth hormone therapy.

giving a double dose of prednisone every other day.

dividing the prednisone dose into twice-daily dosing. history of otitis media

Question 9

2 / 2 pts

A patient who is taking isoniazid and rifampin for latent TB is seen by the primary care NP for a routine follow-up visit. The patient reports having nausea, vomiting, and a decreased appetite. The NP should:

ask about alcohol intake.

suggest taking the medications with food.

reassure the patient that these side effects are common.

order liver and renal function tests and serum glucose.

Question 10

2 / 2 pts

A primary care NP sees a child with asthma to evaluate the child’s response to the prescribed therapy. The child uses an ICS twice daily and an albuterol metered-dose inhaler as needed. The child’s symptoms are well controlled. The NP notes slowing of the child’s linear growth on a standardized growth chart. The NP should change this child’s medication regimen to a:

combination ICS/LABA inhaler twice daily.

short-acting 2-agonist (SABA) with oral corticosteroids when symptomatic.

combination ipratropium/albuterol inhaler twice daily.

SABA as needed plus a leukotriene modifier once daily.

Question 11

2 / 2 pts

A patient is newly diagnosed with Alzheimer’s disease stage 6 on the Global Deterioration Scale. The primary care NP should prescribe:

donepezil (Aricept).history of otitis media

rivastigmine (Exelon).

memantine (Namenda).

galantamine (Razadyne).

Question 12

2 / 2 pts

The primary care NP sees a 12-month-old infant who needs the MMR, Varivax, influenza, and hepatitis A vaccines. The child’s mother tells the NP that she is pregnant. The NP should:

administer all of these vaccines today.

give the hepatitis A and influenza vaccines.

give the Varivax, hepatitis A, and influenza vaccines.

withhold all of these vaccines until after the baby is born.

Question 13

2 / 2 pts

A parent brings a 5-year-old child to a clinic for a hospital follow-up appointment. The child is taking a medication at a dose equal to an adult dose.The parent reports that the medication is not producing the desired effects. The NP should:

order renal function tests.

prescribe another medication to treat this child’s symptoms.

discontinue the drug and observe the child for toxic side effects.

obtain a serum drug level and consider increasing the drug dose.

Question 14

2 / 2 pts

An NP orders an inhaled corticosteroid 2 puffs twice daily and an albuterol metered-dose inhaler 2 puffs every 4 hours as needed for cough or wheezing for a 65-year-old patient with recent onset of reactive airways disease who reports symptoms occurring every 1 or 2 weeks. At a follow-up appointment several months later, the patient reports no change in frequency of symptoms. The NP’s initial action should be to:

order spirometry to evaluate pulmonary function.

prescribe a systemic corticosteroid to help with symptoms.

ask the patient to describe how the medications are taken each day.

give the patient detailed information about the use of metered-dose inhalers.history of otitis media

Question 15

2 / 2 pts

A patient is diagnosed with a condition that causes chronic pain. The primary care NP prescribes an opioid analgesic and should instruct the patient to:

wait until the pain is at a moderate level before taking the medication.

take the medication at regular intervals and not just when pain is present.

start the medication at higher doses initially and taper down gradually.

take the minimum amount needed even when pain is severe to avoid dependency.

Question 16

2 / 2 pts

A patient tells the primary care NP that he has difficulty getting and maintaining an erection. The NP’s initial response should be to:

prescribe sildenafil (Viagra).

perform a medication history.

evaluate his cardiovascular status.

order a papaverine injection test to screen for erectile dysfunction.

Question 17

2 / 2 pts

A 55-year-old patient develops Parkinson’s disease characterized by unilateral tremors only. The primary care NP will refer the patient to a neurologist and should expect initial treatment to be:

levodopa.

carbidopa.

pramipexole.

carbidopa/levodopa.

Question 18

2 / 2 pts

A patient who has migraine headaches without an aura reports difficulty treating the migraines in time because they come on so suddenly. The patient has been using over-the-counter NSAIDs. The primary care NP should prescribe:

frovatriptan (Frova).

sumatriptan (Imitrex).

cyproheptadine (Periactin).

dihydroergotamine (D.H.E. 45).

Question 19

2 / 2 pts

A woman tells a primary care NP that she is considering getting pregnant. During a health history, the NP learns that the patient has seasonal allergies, asthma, and epilepsy, all of which are well controlled with a second-generation antihistamine daily, an inhaled steroid daily with albuterol as needed, and an antiepileptic medication daily. The NP should counsel this patient to:

take her asthma medications only when she is having an acute exacerbation.

avoid using antihistamine medications during her first trimester of pregnancy.

discontinue her seizure medications at least 6 months before becoming pregnant.

use only oral corticosteroids and not inhaled steroids while pregnant for improved asthma control.

Question 20

2 / 2 pts

A patient who has partial seizures has been taking phenytoin (Dilantin). The patient has recently developed thrombocytopenia. The primary care nurse practitioner (NP) should contact the patient’s neurologist to discuss changing the patient’s medication to:

topiramate (Topamax).

levetiracetam (Keppra).

zonisamide (Zonegran).

carbamazepine (Tegretol).

Question 21

2 / 2 pts

A patient is taking dicloxacillin (Dynapen) 500 mg every 6 hours to treat a severe penicillinase-resistant infection. At a 1-week follow-up appointment, the patient reports nausea, vomiting, and epigastric discomfort. The primary care NP should:

change the medication to a cephalosporin.

decrease the dose to 250 mg every 6 hours.

reassure the patient that these are normal adverse effects of this drug.

order blood cultures, a white blood cell (WBC) count with differential, and liver function tests (LFTs).

Question 22

2 / 2 pts

A 75-year-old patient who lives alone will begin taking a narcotic analgesic for pain. To help ensure patient safety, the NP prescribing this medication should:

assess this patient’s usual sleeping patterns.

ask the patient about problems with constipation.

obtain a baseline creatinine clearance test before the first dose.

perform a thorough evaluation of cognitive and motor abilities.

Question 23

2 / 2 pts

A patient has been taking intramuscular (IM) meperidine 75 mg every 6 hours for 3 days after surgery. When the patient is discharged from the hospital, the primary care NP should expect the patient to receive a prescription for _____ mg orally every _____ hours.

hydrocodone 30; 6

hydrocodone 75; 6

meperidine 300;12

meperidine 75; 6

Question 24

2 / 2 pts

A patient who is obese and has hypertension is taking a thiazide diuretic and develops gouty arthritis, which is treated with probenecid. At a follow-up visit, the patient’s serum uric acid level is 7 mg/dL, and the patient denies any current symptoms. The primary care NP should discontinue the probenecid and:

prescribe colchicine.

prescribe febuxostat.

tell the patient to use an NSAID if symptoms recur.

counsel the patient to report recurrence of symptoms.

Question 25

2 / 2 pts

A mother brings her a college-age son to the primary care NP and asks the NP to talk to him about alcohol use. He reports binge drinking on occasion and drinking only beer on weekends. The NP notes diaphoresis, tachycardia, and an easy startle reflex. The NP should:

admit him to the hospital for detoxification.

ask him how much he had to drink last night.

prescribe lorazepam (Ativan) to help with symptoms.

suggest that he talk to a counselor about alcohol abuse.

Question 26

2 / 2 pts

A primary care NP sees a patient who has fever, flank pain, and dysuria. The patient has a history of recurrent urinary tract infections (UTIs) and completed a course of trimethoprim-sulfamethoxazole (TMP/SMX) the week before. A urine test is positive for leukocyte esterase. The NP sends the urine for culture and should treat this patient empirically with:

gemifloxacin.

ciprofloxacin.

azithromycin.

TMP/SMX.

Question 27

2 / 2 pts

A patient who takes carbamazepine (Tegretol) has been seizure-free for 2 years and asks the primary care NP about stopping the medication. The NP should:

order an electroencephalogram (EEG).history of otitis media

prescribe a tapering regimen of the drug.

inform the patient that antiepileptic drug (AED) therapy is lifelong.

tell the patient to stop the drug and use only as needed.

Question 28

2 / 2 pts

A primary care NP has been working with a young woman who wants to quit smoking before she begins having children. She has made several attempts to quit using nicotine replacement therapy and is feeling discouraged. She does not want to take medication at this time. The NP should:

discuss the effects of smoking on fetal development.

ask her to write down any factors that triggered her relapses.

give her information about the long-term effects of smoking.

convince her that taking medication will be essential in her case.

Question 29

2 / 2 pts

A primary care NP prescribes a nonselective NSAID for a patient who has osteoarthritis. The patient expresses concerns about possible side effects of this medication. When counseling the patient about the medication, the NP should tell this patient:

to avoid taking antacids while taking the NSAID.

to take each dose of the NSAID with a full glass of water.

that a few glasses of wine each day are allowed while taking the NSAID.

to decrease the dose of the NSAID if GI symptoms occur.

Question 30

2 / 2 pts

A patient has been taking a COX-2 selective NSAID to treat pain associated with a recent onset of RA. The patient tells the primary care NP that the pain and joint swelling are becoming worse. The patient does not have synovitis or extraarticular manifestations of the disease. The NP will refer the patient to a rheumatologist and should expect the specialist to prescribe:

methotrexate.

corticosteroids.

opioid analgesics.

hydroxychloroquine.

Question 31

2 / 2 pts

A patient has been taking an opioid analgesic for 2 weeks after a minor outpatient procedure. At a follow-up clinic visit, the patient tells the primary care NP that he took extra doses for the past 2 days because of increased pain and wants an early refill of the medication. The NP should suspect:

dependence.

drug addiction.

possible misuse.

increasing pain.

Question 32

2 / 2 pts

An elderly patient with dementia exhibits hostility and uncooperativeness. The primary care NP prescribes clozapine (Clozaril) and should counsel the family about:

a decreased risk of extrapyramidal symptoms.

improved cognitive function.

the need for long-term use of the medication.

a possible increased risk of heart disease and stroke.

Question 33

2 / 2 pts

A patient who was hospitalized for an infection was treated with an aminoglycoside antibiotic. The patient asks the primary care nurse practitioner (NP) why outpatient treatment wasn’t an option. The NP should tell the patient that aminoglycoside antibiotics:

are more likely to be toxic.

cause serious adverse effects.

carry more risk for serious allergic reactions.

must be given intramuscularly or intravenously.

Question 34

2 / 2 pts

A woman who is pregnant tells an NP that she has been taking sertraline for depression for several years but is worried about the effects of this drug on her fetus. The NP will consult with this patient’s psychiatrist and will recommend that she:

stop taking the sertraline now.

continue taking the antidepressant.

change to a monoamine oxidase inhibitor (MAOI).

discontinue the sertraline a week before delivery.

Question 35

2 / 2 pts

A patient who has HIV is being treated with Emtriva. The patient develops hepatitis B. The primary care NP should contact the patient’s infectious disease specialist to discuss:

adding zidovudine.

changing to Truvada.

changing to tenofovir.

ordering Combivir and tenofovir.

Question 36

2 / 2 pts

A patient who was in a motor vehicle accident has been treated for lower back muscle spasms with metaxalone (Skelaxin) for 1 week and reports decreased but persistent pain. A computed tomography scan is normal. The primary care NP should:

suggest ice and rest.

order physical therapy.

prescribe diazepam (Valium).

add an opioid analgesic medication.

Question 37

2 / 2 pts

A primary care NP sees a patient who has dysuria, fever, and urinary frequency. The NP orders a urine dipstick, which is positive for nitrates and leukocyte esterase, and sends the urine to the laboratory for a culture. The patient is allergic to sulfa drugs. The NP should:

order cefaclor (Ceclor).

prescribe cefixime (Suprax).

administer intramuscular ceftriaxone (Rocephin).

wait for culture results before ordering an antibiotic.

Question 38

2 / 2 pts

A patient comes to the clinic several days after an outpatient surgical procedure complaining of swelling and pain at the surgical site. The primary care NP notes a small area of erythema but no abscess or induration. The NP should:

prescribe TMP-SMX.

prescribe topical mupirocin four times daily.

suggest that the patient apply warm soaks three times daily.

refer the patient to the surgeon for further evaluation.

Question 39

2 / 2 pts

A patient who has genital herpes has frequent outbreaks. The patient asks the primary care NP why it is necessary to take oral acyclovir all the time and not just for acute outbreaks. The NP should explain that oral acyclovir may:

prevent the virus from developing resistance.

cause episodes to be shorter and less frequent.

actually eradicate the virus and cure the disease.

reduce the chance of transmitting the virus to others.

Question 40

2 / 2 pts

A patient is taking isoniazid, pyrazinamide, rifampin, and streptomycin to treat TB. The primary care NP should routinely perform:

serum glucose and liver function tests (LFTs).

bone marrow density and ophthalmologic tests.

ophthalmologic, hearing, and serum glucose tests.

color vision, serum glucose, and LFTs.

Question 41

2 / 2 pts

A primary care NP sees a patient who was recently hospitalized for infection and treated with gentamicin for 10 days. The patient tells the NP that the drug was discontinued early because “my blood level was too high.” The NP should order:

a serial audiometric test.

a serum blood urea nitrogen (BUN) and creatinine.

a urinalysis and complete blood count.

serum calcium, magnesium, and sodium.

Question 42

2 / 2 pts

A 40-year-old woman asks the primary care NP what she can do to minimize her risk of osteoporosis. She takes 800 mg of calcium and drinks 2 cups of skim milk each day. The NP should recommend that she:

decrease dietary fat.

limit her caffeine intake.

consume a high-protein diet.

drink diet instead of sugary sodas.

Question 43

2 / 2 pts

A patient has a sore throat with fever. The primary care NP observes erythematous 4+ tonsils with white exudate. A rapid antigen strep test is negative, and a culture is pending. The NP orders amoxicillin as empiric treatment. The patient calls the next day to report a rash. The NP should suspect:

penicillin drug allergy.

a viral cause for the patient’s symptoms.

a serum sickness reaction to the penicillin.

scarlatiniform rash from the streptococcal infection.

Question 44

2 / 2 pts

A patient is taking sulfisoxazole. The patient calls the primary care NP to report abdominal pain, nausea, and insomnia. The NP should:

change to TMP/SMX.

tell the patient to stop taking the drug immediately.

reassure the patient that these are minor adverse effects of this drug.

order a CBC with differential, platelets, and a stool culture.

Question 45

2 / 2 pts

A patient is in the clinic with acute symptoms of anxiety. The patient is restless and has not slept in 3 days. The primary care NP observes that the patient is irritable and has moderate muscle tension. The patient’s spouse reports that similar symptoms have occurred before in varying degrees for several years. The NP should refer the patient to a psychologist and should prescribe which drug for short-term use?

Alprazolam

Buspirone

Melatonin

Zolpidem

Question 46 history of otitis media

2 / 2 pts

A woman who takes oral contraceptive pills develops vaginal candidiasis. The primary care NP prescribes a single dose of fluconazole. When counseling the patient about this drug, the NP should tell her:

that the drug is safe if she were to become pregnant.

that she may consume alcohol while taking this medication.

to use a backup contraceptive method for the next 2 months.

that she may need a lower dose of fluconazole because she takes oral contraceptive pills.

Question 47

2 / 2 pts

A patient in the clinic reports taking a handful of acetaminophen extra-strength tablets about 12 hours prior. The patient has nausea, vomiting, malaise, and drowsiness. The patient’s aspartate aminotransferase and alanine aminotransferase are mildly elevated. The primary care NP should:

expect the patient to sustain permanent liver damage.

reassure the patient that these symptoms are reversible.

tell the patient that acetylcysteine cannot be given this late.

administer activated charcoal to remove acetaminophen from the body.

Question 48

2 / 2 pts

An NP sees a preschooler in clinic for the first time. When obtaining a medication history, the NP notes that the child is taking a medication for which safety and effectiveness in children has not been established in drug information literature. The NP should:

discontinue the medication.

order serum drug levels to evaluate toxicity.

report the prescribing provider to the Food and Drug Administration (FDA).

ask the parent about the drug’s use and side effects.

Question 49

2 / 2 pts

A patient who has Parkinson’s disease who takes levodopa and carbidopa reports having drooling episodes that are increasing in frequency. The primary care NP should order:

benztropine.

amantadine.

apomorphine.

modified-release levodopa.

Question 50

2 / 2 pts

The primary care NP sees a 6-month-old infant for a routine physical examination and notes that the infant has a runny nose and a cough. The parents report a 2-day history of a temperature of 99° F to 100° F and two to three loose stools per day. Other family members have similar symptoms. The infant has had two sets of immunizations at 2 and 4 months of age. The NP should:

administer the 6-month immunizations at this visit today.

schedule an appointment in 2 weeks for 6-month immunizations.

administer DTaP, Hib, IPV, hepatitis B, and PCV13 today and RV in 2 weeks.

withhold all immunizations until the infant’s temperature returns to normal and the cough is gone.

Question 51

2 / 2 pts

A patient who was recently hospitalized and treated with gentamicin tells the primary care NP, “My kidney function test was abnormal and they stopped the medication.” The patient is worried about long-term effects. The NP should:

monitor renal function for several months.

reassure the patient that complete recovery should occur.

refer the patient to a nephrologist for follow-up evaluation.

monitor serum electrolytes and serum creatinine and BUN.

Question 52

2 / 2 pts

A patient has begun treatment for HIV. The primary care NP should monitor the patient’s complete blood count (CBC) at least every _____ months.

1 to 3

3 to 6

6 to 9

9 to 12

Question 53

2 / 2 pts

A patient who was recently diagnosed with COPD comes to the clinic for a follow-up evaluation after beginning therapy with a SABA as needed for dyspnea. The patient reports occasional mild exertional dyspnea but is able to sleep well. The patient’s FEV1 in the clinic is 85% of predicted, and oxygen saturation is 96%. The primary care NP should recommend:

a combination LABA/ICS twice daily.

influenza and pneumococcal vaccines.

ipratropium bromide (Atrovent) twice daily.

home oxygen therapy as needed for dyspnea.

Question 54

2 / 2 pts

A patient who takes 150 mg of clozapine (Clozaril) twice daily calls the primary care NP at 10:00 AM one day to report forgetting to take the 8:00 AM dose. The NP should counsel the patient to:

take the missed dose now.

take 75 mg of clozapine now.

wait and take the evening dose at the usual time.

take the evening dose 2 hours earlier than usual.

Question 55

2 / 2 pts

A patient has been taking fluoxetine 20 mg every morning for 5 days and calls the primary care NP to report decreased appetite, nausea, and insomnia. The NP should:

suggest taking a sedative at bedtime.

change the medication to bupropion.

add trazodone to the patient’s regimen.

reassure the patient that these effects will subside.

Question 56

2 / 2 pts

A female patient presents with grayish, odorous vaginal discharge. The primary care NP performs a gynecologic examination and notes vulvar and vaginal erythema. Testing of the discharge reveals a pH of 5.2 and a fishy odor when mixed with a solution of 10% potassium hydroxide. The NP should:

order topical fluconazole.

order metronidazole 500 mg twice daily for 7 days.

withhold treatment until culture results are available.

prescribe a clotrimazole vaginal suppository for 7 days.

Question 57

2 / 2 pts

An 80-year-old patient has a diagnosis of glaucoma, and the ophthalmologist has prescribed timolol (Timoptic) and pilocarpine eye drops. The primary care NP should counsel this patient:

that systemic side effects of these medications may be severe.

that the combination of these two drugs may cause drowsiness.

to begin an exercise program to improve cardiovascular health.

that a higher dose of one or both of these medications may be needed.

Question 58 history of otitis media

2 / 2 pts

An 18-month-old child who attends day care has head lice and has been treated with permethrin 1% (Nix). The parent brings the child to the clinic 1 week later, and the primary care NP notes live bugs on the child’s scalp. The NP should order:

lindane.

malathion.

ivermectin.

permethrin 5%.

Question 59

2 / 2 pts

An adult patient who has a viral upper respiratory infection asks the primary care nurse practitioner (NP) about taking acetaminophen for fever and muscle aches. To help ensure against possible drug toxicity, the NP should first:

determine the patient’s height and weight.

ask the patient how high the temperature has been.

tell the patient to take 325 mg initially and increase as needed.

ask the patient about any other over-the-counter (OTC) cold medications being used.

Question 60

2 / 2 pts

The primary care NP follows a patient who is being treated for RA with methotrexate. The patient asks the NP why the medication does not seem to alleviate pain. The NP tells the patient that:

an immunomodulator may be needed to control pain.

a higher dose of methotrexate may be needed to achieve pain control.

if methotrexate does not control pain, an opioid analgesic may be necessary.

methotrexate is used to slow disease progression and preserve joint function.

Question 61

2 / 2 pts

A patient has a UTI and will begin treatment with an antibiotic. The patient reports moderate to severe suprapubic pain. The primary care NP should prescribe:

ibuprofen as needed.

bethanechol (Urecholine).

phenazopyridine (Pyridium).

increased oral fluid intake to dilute urine.

Question 62

2 / 2 pts

The parent of an 8-year-old child recently diagnosed with AD/HD verbalizes concerns about giving the child stimulants. The primary care NP should recommend:

modafinil (Provigil).

guanfacine (Intuniv).

bupropion (Wellbutrin).

atomoxetine (Strattera).

Question 63

2 / 2 pts

The primary care NP is performing a medication reconciliation on a patient who takes digoxin for congestive heart failure and learns that the patient uses ibuprofen as needed for joint pain. The NP should counsel this patient to:

use naproxen (Naprosyn) instead of ibuprofen.

increase the dose of digoxin while taking the ibuprofen.

use an increased dose of ibuprofen while taking the digoxin.

take potassium supplements to minimize the effects of the ibuprofen.

Question 64

2 / 2 pts

A patient who takes valproic acid for a seizure disorder is preparing to have surgery. The primary care NP should order:

coagulation studies.

a complete blood count.

an EEG.

a creatinine clearance test.

Question 65

2 / 2 pts

A patient who has Alzheimer’s disease is taking 10 mg of donepezil daily and reports difficulty sleeping. The primary care NP should recommend:

decreasing the dose to 5 mg.

increasing the dose to 15 mg.

taking the drug in the morning.

taking the drug in the evening.

Question 66

2 / 2 pts

A child has been taking methylphenidate 5 mg at 8 AM, 12 PM, and 4 PM for 30 days after a new diagnosis of AD/HD and comes to the clinic for evaluation. The child’s mother reports that the child exhibits some nervousness and insomnia but is doing much better in school. The primary care NP should suggest:

discontinuing the 4 PM dose.

increasing the dose to 10 mg each time.

giving 10 mg at 8 AM and 5 mg at noon.

changing the dosing to 15 mg twice daily.

Question 67

2 / 2 pts

A 60-year-old woman is in the clinic for an annual well-woman examination. She has been taking alendronate (Fosamax) 10 mg daily for 4 years.Her last bone density test yielded a T-score of 2.0. Her urine NTx level today is 22. She walks daily. Her fracture risk is low. The primary care NP should recommend that she:

take a 1- to 2-year drug holiday.

change to 70 mg of alendronate weekly.

decrease the alendronate dose to 5 mg daily.

change to ibandronate (Boniva) 3 mg IV every 3 months.

Question 68

2 / 2 pts

The primary care nurse practitioner (NP) is seeing a patient who reports chronic lower back pain. The patient reports having difficulty sleeping despite taking ibuprofen at bedtime each night. The NP should prescribe:

diazepam (Valium).

metaxalone (Skelaxin).

methocarbamol (Robaxin).

cyclobenzaprine (Flexeril).

Question 69

2 / 2 pts

A patient reports smoking two or more packs of cigarettes per day and expresses a desire to quit smoking. The primary care NP learns that the patient smokes heavily during breaks at work and during the evening but with no established schedule. The NP should recommend:

bupropion (Wellbutrin).

nicotine replacement gum or nasal spray.

a high-dose 24-hour nicotine patch.

intensive smoking cessation counseling.

Question 70

2 / 2 pts

A patient is seen in the clinic with a 1-week history of frequent watery stools. The primary care NP learns that a family member had gastroenteritis a week prior. The patient was treated for a UTI with a sulfonamide antibiotic 2 months prior. The NP should suspect:

Clostridium difficile–associated disease (CDAD).

viral gastroenteritis.

serum sickness reaction.

recurrence of the UTI.

Question 71

2 / 2 pts

A female patient has vaginal candidiasis and has taken a single dose of fluconazole without resolution of the infection. The primary care NP obtains a culture and should order:

oral ketoconazole.

griseofulvin for 4 weeks.

another dose of fluconazole.

topical miconazole (Monistat).

Question 72

2 / 2 pts

A patient reports difficulty falling asleep and staying asleep every night and has difficulty staying awake during the commute to work every day.The NP should:

suggest the patient try diphenhydramine first.

perform a thorough history and physical examination.

teach about avoiding caffeine and good sleep hygiene.

suggest melatonin and consider prescribing Ambien if this is not effective.

Question 73

2 / 2 pts

A patient who is newly diagnosed with schizophrenia is overweight and has a positive family history for type 2 diabetes mellitus. The primary care NP should consider initiating antipsychotic therapy with:

ziprasidone (Geodon).

olanzapine (Zyprexa).

risperidone (Risperdal).

chlorpromazine (Thorazine).

Question 74

2 / 2 pts

A patient asks an NP about using an oral over-the-counter decongestant medication for nasal congestion associated with a viral upper respiratory illness. The NP learns that this patient uses loratadine (Claritin), a ?-adrenergic blocker, and an intranasal corticosteroid. The NP would be concerned about which adverse effects?

Liver toxicity

Excessive drowsiness

Rebound congestion

Tremor, restlessness, and insomnia

Question 75

2 / 2 pts

A patient has been taking paroxetine (Paxil) for major depressive symptoms for 8 months. The patient tells the primary care NP that these symptoms improved after 2 months of therapy. The patient is experiencing weight gain and sexual dysfunction and wants to know if the medication can be discontinued. The NP should:

change to a tricyclic antidepressant medication.

begin to taper the paroxetine and instruct the patient to call if symptoms increase.

tell the patient to stop taking the medication and to call if symptoms get worse.

continue the medication for several months and consider adding bupropion (Wellbutrin). history of otitis media

Walden NURS6501 Week 8 Quiz latest 2017

Question 1

A 40-year-old female presents complaining of pain near the midline in the epigastrium. Assuming the pain is caused by a stimulus acting on an abdominal organ, the pain felt is classified as: biliary atresia

a. Visceral
b. Somatic
c. Parietal
d. Referred

Question 2

An 8-week-old male was recently diagnosed with cystic fibrosis. Which of the following digestive alterations would be expected?

a. Insufficient bile production
b. Gastric atrophy
c. Hypersecretion of stomach acid
d. Nutrient malabsorption

Question 3

In alcoholic cirrhosis, hepatocellular damage is caused by:

a. acetaldehyde accumulation.
b. bile toxicity.
c. acidosis.
d. fatty infiltrations. biliary atresia

Question 4

Where does the nurse expect the obstruction to be in a patient with extrahepatic portal hypertension?

a. Sinusoids
b. Bile ducts
c. Hepatic portal vein
d. Hepatic artery

Question 5

Kwashiorkor is a severe dietary deficiency of:

a. fat-soluble vitamins.
b. carbohydrates.
c. protein.
d. calcium and magnesium.

Question 6

A 27-year-old male presents with fever, GI bleeding, hepatomegaly, and transient joint pain. He reports that as a child he received blood transfusions following a motor vehicle accident. He also indicates he was vaccinated against hepatitis B. Which of the following types of hepatitis does the clinician think he most likely has?

a. A
b. B
c. C
d. D

Question 7

Prolonged diarrhea is more serious in children than adults because:

a. children have lower adipose reserves.
b. fluid reserves are lower in children.
c. children have a lower metabolic rate.
d. children are more resistant to antimicrobial therapy.

Question 8

A 40-year-old male develops an intestinal obstruction related to protrusion of the intestine through the inguinal ring. This condition is referred to as:

a. Intussusception
b. A volvulus
c. A hernia
d. Adhesions

Question 9

A 60-year-old male presents with GI bleeding and abdominal pain. He reports that he takes NSAIDs daily to prevent heart attack. Tests reveal that he has a peptic ulcer. The most likely cause of this disease is:

a. Increasing subepithelial bicarbonate production
b. Accelerating the H+ (proton) pump in parietal cells
c. Inhibiting mucosal prostaglandin synthesis
d. Stimulating a shunt of mucosal blood flow

Question 10

Acute pancreatitis often manifests with pain to which of the following regions?

a. Right lower quadrant
b. Right upper quadrant
c. Epigastric
d. Suprapubic

Question 11

A 60-year-old male is diagnosed with cancer of the esophagus. Which of the following factors most likely contributed to his disease? biliary atresia

a. Reflux esophagitis
b. Intestinal parasites
c. Ingestion of salty foods
d. Frequent use of antacids

Question 12

The primary complication of enterocolitis associated with Hirschsprung disease is related to which finding?

a. Fecal impaction
b. Pancreatic insufficiency
c. Hyperactive peristalsis
d. Ileal atresia

Question 13

The most common cause of chronic vascular insufficiency among the elderly is:

a. Anemia
b. Aneurysm
c. Lack of nutrition in gut lumen
d. Atherosclerosis

Question 14

The most common clinical manifestation of portal hypertension is _____ bleeding.

a. rectal
b. duodenal
c. esophageal
d. intestinal

Question 15

A 54-year-old male is diagnosed with peptic ulcer disease.This condition is most likely caused by:

a. Hereditary hormonal imbalances with high gastrin levels
b. Breaks in the mucosa and presence of corrosive secretions
c. Decreased vagal activity and vascular engorgement
d. Gastric erosions related to high ammonia levels and bile reflux

Question 16

The cardinal sign of pyloric stenosis caused by ulceration or tumors is:

a. Constipation
b. Diarrhea
c. Vomiting
d. Heartburn

Question 17

A 55-year-old male died in a motor vehicle accident. Autopsy revealed an enlarged liver caused by fatty infiltration, testicular atrophy, and mild jaundice secondary to cirrhosis. The most likely cause of his condition is:

a. Bacterial infection
b. Viral infection
c. Alcoholism
d. Drug overdose

Question 18

Manifestations associated with hepatic encephalopathy from chronic liver disease are the result of:

a. hyperbilirubinemia and jaundice.
b. fluid and electrolyte imbalances.
c. impaired ammonia metabolism.
d. decreased cerebral blood flow.

Question 19

The most common disorder associated with upper GI bleeding is:

a. diverticulosis.
b. hemorrhoids.
c. esophageal varices.
d. cancer.

Question 20

A 3-month-old female develops colicky pain, abdominal distention, and diarrhea after drinking cow’s milk. The best explanation for her symptoms is:

a. Deficiency of bile that stimulates digestive secretions and bowel motility
b. Excess of amylase, which increases the breakdown of starch and causes an osmotic diarrhea
c. Overgrowth of bacteria from undigested fat molecules, which leads to gas formation and de creased bowel motility
d. Excess of undigested lactose in her digestive tract, resulting in increased fluid movement into the digestive lumen and increased bowel motility

Question 21

A 55-year-old female has general symptoms of gallstones but is also jaundiced. IV cholangiography would most likely reveal that the gallstones are obstructing the:

a. Intrahepatic bile canaliculi
b. Gallbladder
c. Cystic duct
d. Common bile duct

Question 22

A 1-week-old female is brought to her pediatrician for abdominal distention and unstable temperature. Physical examination reveals bradycardia and apnea. Tests reveal hypoxic injury to the bowel resulting in bacterial invasion and perforation. This condition is referred to as:

a. Infective enteropathy
b. Necrotizing enterocolitis (NEC)
c. Mucoviscidosis
d. Ileus

Question 23

For the patient experiencing esophageal reflux, the nurse would expect which sphincter to be malfunctioning?

a. Pyloric
b. Lower esophageal
c. Upper esophageal biliary atresia
d. Gastric

Question 24

Cholecystitis is inflammation of the gallbladder wall usually caused by:

a. accumulation of bile in the hepatic duct.
b. obstruction of the cystic duct by a gall-stone.
c. accumulation of fat in the wall of the gallbladder.
d. viral infection of the gallbladder.

ORDER A FREE-PLAGIARISM PAPER HERE

Question 25

A 6-month-old male infant is brought to the ER after the sudden development of abdominal pain, irritability, and vomiting followed by passing of “currant jelly” stool. Ultrasound reveals intestinal obstruction in which the ileum collapsed through the ileocecal valve and invaginated into the large intestine. This type of obstruction is referred to as:

a. Prolapse
b. Pyloric stenosis
c. Intussusception
d. Imperforation

Question 26

A 22-year-old male underwent brain surgery to remove a tumor. Following surgery, he experienced a peptic ulcer. His ulcer is referred to as a(n) _____ ulcer.

a. Infectious
b. Cushing
c. Ischemic
d. Curling

Question 27

Chronic gastritis is classified according to the:

a. severity.
b. location of lesions.
c. patient’s age.
d. signs and symptoms.

Question 28

Reflux esophagitis is defined as a(n):

a. Immune response to gastroesophageal reflux
b. Inflammatory response to gastroesophageal reflux
c. Congenital anomaly
d. Secretory response to hiatal hernia

Question 29

The cardinal signs of small bowel obstruction are:

a. Vomiting and distention
b. Diarrhea and excessive thirst
c. Dehydration and epigastric pain
d. Abdominal pain and rectal bleeding

Question 30

The nurse assessing the patient with biliary atresia would expect to find which primary clinical manifestation?

a. Anemia
b. Jaundice
c. Hypobilirubinemia
d. Ascites

Question 31

A 20-year-old male was recently diagnosed with lactose intolerance. He eats an ice cream cone and develops diarrhea. His diarrhea can be classified as _____ diarrhea.

a. Motility
b. Hypotonic
c. Secretory
d. Osmotic

Question 32

Which of the following symptoms would help a health care provider distinguish between ulcerative colitis and Crohn disease?

a. Pattern of remission/exacerbations
b. Abdominal pain
c. Malabsorption
d. Diarrhea

Question 33

A 45-year-old male complains of heartburn after eating and difficulty swallowing. He probably has:

a. Pyloric stenosis
b. Hiatal hernia
c. Gastric cancer
d. Achalasia

Question 34

The exocrine portion of the pancreas contains:

a. alpha cells.
b. beta cells.
c. acinar cells.
d. islets of Langerhans. biliary atresia

Question 35

Outbreaks of hepatitis _____ often occur in young children attending day care centers and can be attributed to poor hand washing.

a. A
b. B
c. C
d. D