Read Chapter 6 & 7

APA FORMAT AND REFERENCE

1. Discuss the importance of effective communication in the personal relationship, the therapeutic relationship, and the relationship within the interprofessional health-care team.

2. What similarities and differences can you identify among the above interactions? 

3. Explain the concept of congruence between verbal and nonverbal communication.

4. There are many pitfalls to electronic communication. Identify a situation in which an electronic form of communication may result in a miscommunication. What other method of communication would have been more effective? 

5. How have you seen ISBAR used during your clinical experiences? 

6- Develop a hand-off report for yourself. Include items that you believe are pertinent for safe and effective nursing care. Refer to the information in the chapter for creating this report form. Using the information from the chapter, determine the effectiveness of the system currently in use on your unit for communicating shift-to-shift reports. 

7-Dr. Roberts comes into the nurses’ station demanding, “Where are Mr. Adams’s lab reports? I ordered these stat, and they’re not here! Who’s responsible for this patient?” How would you, as the nurse, respond? 

8-Explain the concept of accountability in delegation. What are the legal ramifications of accountability in delegation?

9. Dennie and Elias arrive in the unit for the 7:00 p.m. to 7:00 a.m. shift. Both nurses completed orientation 4 weeks ago. They find that they will be the only two RNs on the floor that night. There is a census of 48 clients. The remaining staff consists of two NAPs/UAPs and one LPN. What are the responsibilities of the RN, NAP/UAP, and LPN? Can Dennie and Elias effectively delegate client care tasks and care safely for all 48 clients? Use the Delegation Tree to make your decisions.

10. Discuss the differences between direct delegation and indirect delegation. 

1. You have to observe delegation procedures in your assigned unit:

A-What considerations does the RN take into account when delegating patient care? 

2-You have to look at the unit census and prioritize the patient care:

A- Give the rationale foryour choices.

3.Answer the following questions during your clinical experiences:

a. What specific tasks did your patients require that you might have been able to delegate?

b. How effective was your nurse/preceptor in delegating tasks to others? 

c. How did your nurse/preceptor ensure that the tasks were completed safely and appropriately?

No Plegarism please, 

Will need minimum of 250 words, APA Style, double spaced, times new romans, font 12, and and  (3 references – intext citations) per discussion topic. 

There are 2 discussions: Topic 1 & Topic 2 (They both require references please)  

Topic 1: Getting to Know You and Cultural Competence

First, provide a brief introduction of your professional background. (ME)

Next, review the Office of Minority Health, National CLAS Standards located in the Web Resources area.  (see  link:   

· The Office of Minority Health. The National CLAS Standards. Retrieved from http://minorityhealth.hhs.gov/omh/browse.aspx?lvl=2&lvlid=53 

1. Discuss your ethnic/cultural background (health perception and practices).   ( I am Hispanic) 
2. Choose a different culture or ethnic group and discuss potential cultural/linguistic needs. Consider your food preferences, rituals, health beliefs, and any religious orientations that may influence patient care.
3. Apply at least one CLAS Standard that supports the identified need and discuss the role of the advanced practice nurse in promoting culturally sensitive care.
4. Please list references in APA format.

Topic 2:  Healthy People 2020

Healthy People 2020’s commitment to promote health and prevent disease encourages individuals to make healthy lifestyle choices for themselves and their families. Conceptual models and theories play a major role in health promotion and disease prevention. In addition, epidemiological data, such as morbidity and mortality statistics, helps identify health problems common to a particular population.

Select one of the Healthy People 2020 initiatives and discuss available preventative health services (immunizations, health screenings, etc.) relevant to the initiative, as well as health promotion strategies to be implemented by the advanced practice nurse for a selected population/age/ethnic group (neonates, children, adults, pregnant female, older adult). Please consider theoretical concepts and epidemiological data while discussing health promotion strategies.

No Plegarism please,

Will need minimum of 250 words, APA Style, double spaced, times new romans, font 12, and and  (3 references – intext citations) per discussion topic. 

FNU Pathophysiology Quiz

Question 1 

A 70-year-old woman has received a diagnosis of chronic myelogenous leukemia (CML) after a clinical investigation sparked by the presence of leukocytosis in her routine blood work. What clinical course should her care provider tell her to expect? 

Answers: 

A. “It’s likely that this will give you chronic fatigue and malaise for the rest of your life, but that will probably be the extent of your symptoms.” 

B. “Unfortunately, your leukemia will likely enter a crisis mode within a few weeks if we don’t treat it immediately.” 

C. “You could remain the chronic stage of CML for several years before it accelerates and culminates in a crisis.” 

D. “You can expect your blood results, fatigue, and susceptibility to infection to gradually worsen over a few years.” 

Question 2 

Following an injury resulting in a small cut from a knife, the first cells to go to the area of the cut would be the 

Answers: 

A. erythrocytes. 

B. basophils. 

C. neutrophils. 

D. albumin. 

Question 3 

Which of the following diagnostic findings is likely to result in the most serious brain insult? 

Answers: 

A. Moderate decrease in brain tissue volume secondary to a brain tumor removal 

B. High intracellular concentration of glutamate 

C. Increased ICP accompanied by hyperventilation 

D. Mean arterial pressure (MAP) that equals intracranial pressure (ICP) 

Question 4 

Which of the following patients would be most likely to be experiencing an increase in renal erythropoietin production? 

Answers: 

A. A 70-year-old woman admitted with dehydration secondary to an overdose of her potassium-wasting diuretic 

B. A 21-year-old man with acute blood loss secondary to a motor vehicle accident 3 hours prior 

C. A 68-year-old man with a long-standing diagnosis of polycythemia vera 

D. A 71-year-old smoker admitted to hospital with exacerbation of his chronic obstructive pulmonary disease (COPD) 

Question 5 

A college student has been experiencing frequent headaches that he describes as throbbing and complaining of difficulty concentrating while studying. Upon cerebral angiography, he is found to have an arteriovenous malformation. Which of the following pathophysiological concepts is likely responsible for his symptoms? 

Answers: 

A. Localized ischemia with areas of necrosis noted on CT angiography 

B. High pressure and local hemorrhage of the venous system 

C. Hydrocephalus and protein in the cerebral spinal fluid 

D. Increased tissue perfusion at the site of the malformation 

Question 6 

A group of nursing students were studying for their pathophysiology exam by quizzing each other about disorders of WBCs and lymphoid tissue. When asked what the first chromosomal abnormality that identified cancer was, one student correctly answered Answers: 

A. interleukin cells. 

B. Philadelphia. 

C. PSA. 

D. BRCA-1. 

Question 7 

A 47-year-old woman was diagnosed with amyotrophic lateral sclerosis 3 years ago and has experienced a progressive onset and severity of complications. She has been admitted to a palliative care unit due to her poor prognosis? What assessments and interventions should the nursing staff of the unit prioritize in their care? 

Answers: 

A. Regular pain assessment and administration of opioid analgesics as needed 

B. Cardiac monitoring and administration of inotropic medications 

C. Assessment and documentation of cognitive changes, including confusion and restlessness 

D. Assessment of swallowing ability and respiratory status 

Question 8 

A 53-year-old man presents with inability to concentrate, itching in his fingers and toes, elevated blood pressure, and unexplained weight loss. He is diagnosed with primary polycythemia. What will be the primary goal of his treatment? 

Answers: 

A. To increase the amount of oxygen distributed by his red blood cells 

B. To reduce the viscosity of his blood 

C. To reduce the mean size of his red cells 

D. To control his hypertension 

Question 9 

During a late night study session, a pathophysiology student reaches out to turn the page of her textbook. Which of the following components of her nervous system contains the highest level of control of her arm and hand action? 

Answers: 

A. Thalamus 

B. Cerebellum 

C. Frontal lobe 

D. Basal ganglia 

Question 10 

The family members of an elderly patient are wondering why his “blood counts” are not rising after his last GI bleed. They state, “He has always bounced back after one of these episodes, but this time it isn’t happening. Do you know why?” The nurse will respond based on which of the following pathophysiological principles? 

Answers: 

A. “Don’t worry about it. We can always give him more blood.” 

B. “Due to stress, the red blood cells of older adults are not replaced as promptly as younger people.” 

C. “Everything slows down when you get older. You just have to wait and see what happens.” 

D. “The doctor may start looking for another cause of his anemia, maybe cancer of the bone.” 

Question 11 

A 44-year-old female patient presents to the emergency department with abnormal bleeding and abdominal pain that is later attributed to gallbladder disease. Which of the following diagnoses would the medical team be most justified in suspecting as a cause of the patient’s bleeding? 

Answers: 

A. Hemophilia B 

B. Vitamin K deficiency 

C. Excess calcium 

D. Idiopathic immune thrombocytopenic purpura (ITP) 

Question 12 

Your ESRD patient is receiving 2 units of packed red blood cells for anemia (Hgb of 8.2). Twenty minutes into the first transfusion, the nurse observes the patient has a flushed face, hives over upper body trunk, and is complaining of pain in lower back. His vital signs include pulse rate of 110 and BP drop to 95/56.What is the nurse’s priority action? Answers: 

A. Recheck the type of blood infusing with the chart documentation of patient’s blood type. B. Discontinue the transfusion and begin an infusion of normal saline. 

C. Slow the rate of the blood infusion to 50 mL/hour. 

D. Document the assessment as the only action. 

Question 13 

A 5th grade elementary student asks the school nurse how much blood is in an entire body. The nurse should respond that the average grown-up adult has 

Answers: 

A. 2 to 4 cups of blood in his or her body. 

B. 5 to 6 L of blood throughout his or her body. 

C. 3 pints of blood in total. 

D. 3 to 4 quarts of blood in his or her body. 

Question 14 

The geriatrician providing care for a 74-year-old man with diagnosis of Parkinson disease has recently changed the client’s medication regimen. What is the most likely focus of the pharmacologic treatment of the man’s health problem? 

Answers: 

A. Preventing demyelination of the efferent cerebellar pathways 

B. Preventing axonal degradation of motor neurons 

C. Maximizing acetylcholine release from synaptic vesicles at neuromuscular junctions 

D. Increasing the functional ability of the underactive dopaminergic system 

Question 15 

A student makes the statement to a colleague, “Blood plasma is essentially just a carrier for the formed elements like red blood cells and white blood cells.”What would be the most accurate response to this statement? 

Answers: 

A. “Not really. Plasma also contributes to the processes of protein synthesis and hematopoiesis.” 

B. “Actually, plasma plays a significant role in nutrient and waste transport.” 

C. “Actually, plasma is integral to the proper function of the liver and maintenance of acid–base balance.” 

D. “That’s not really true. Plasma is crucial in the immune and inflammatory responses.” 

Question 16 

Several months ago, a 20-year-old male suffered a spinal cord injury brought about by a snowboard trick gone wrong. The lasting effects of his injury include a flaccid bowel and bladder and the inability to obtain an erection. While sensation has been completely preserved in his legs and feet, his motor function is significantly impaired. What type of incomplete spinal cord injury has the man most likely experienced? 

Answers: 

A. Central cord syndrome 

B. Conus medullaris syndrome 

C. Brown-Séquard syndrome 

D. Anterior cord syndrome 

Question 17 

A client with a gastrointestinal bleed secondary to alcohol abuse and a hemoglobin level of 5.8 g/dL has been ordered a transfusion of packed red blood cells. The client possesses type B antibodies but lacks type D antigens on his red cells. Transfusion of which of the following blood types would be least likely to produce a transfusion reaction?

Answers: 

A. A– 

B. A 

C. B– 

D. B 

Question 18 

Which of the following clients’ signs and symptoms would allow a clinician to be most justified in ruling out stroke as a cause? An adult 

Answers: 

A. has vomited and complained of a severe headache. 

B. states that his left arm and leg are numb, and gait is consequently unsteady. 

C. has experienced a sudden loss of balance and slurred speech. 

D. has had a gradual onset of weakness, headache, and visual disturbances over the last 2 days. 

Question 19 

Amniocentesis has suggested that a couple’s first child will be born with sickle cell disease. The parents are unfamiliar with the health problem, and their caregiver is explaining the complexities. Which of the following statements by the parents would suggest a need for further teaching or clarification? 

Answers: 

A. “Our baby’s red cells are prone to early destruction because of his or her weak membranes.” 

B. “Our son or daughter likely won’t show the effects of sickling until he or she is school-aged because of the different hemoglobin in babies.”

C. “Not all of his or her red cells will be sickled, but low oxygen levels can cause them to become so.” 

D. “Sickled cells can block his or her blood vessels, especially in the abdomen, chest, and bones.” 

Question 20 

During science class, a student asks, “What’s the difference between plasma and serum in the blood?” The nurse responds that the primary difference between plasma and serum is that plasma contains 

Answers: 

A. hydrogen ions. 

B. heparin. 

C. white blood cells. 

D. fibrinogen. 

Question 21 

During a flu shot clinic, one of the questions the student nurse asks relates to whether the patient has had Guillain-Barré syndrome in his medical history. The patient asks, “What is that?” How should the nursing student reply? 

Answers: 

A. “A type of paralysis that affects movement on both sides of the body that may even involve the respiratory muscles” 

B. “Influenza-like illness where you had fever and chills for 2 to 3 days after your last flu shot” 

C. “A degenerative disease where you have trouble walking without the help of a cane or walker” 

D. “Swelling of your arm where you got your flu shot, and maybe your eyes and lips had some swelling as well” 

Question 22 

A 22-year-old female college student is shocked to receive a diagnosis of myasthenia gravis. What are the etiology and most likely treatment for her health problem? 

Answers: 

A. Excess acetylcholinesterase production; treatment with thymectomy 

B. A decline in functioning acetylcholine receptors; treatment with corticosteroids and intravenous immunoglobulins 

C. Cerebellar lesions; surgical and immunosuppressive treatment 

D. Autoimmune destruction of skeletal muscle cells; treatment with intensive physical therapy and anabolic steroids 

Question 23 

A baseball player was hit in the head with a bat during practice. In the emergency department, the physician tells the family that he has a “coup”injury. How will the nurse explain this to the family so they can understand? 

Answers: 

A. “It’s like squeezing an orange so tight that the juice runs out of the top.” 

B. “When the bat hit his head, his neck jerked backward causing injury to the spine.” 

C. “Your son has a contusion of the brain at the site where the bat hit his head.” 

D. “Your son has a huge laceration inside his brain where the bat hit his skull.” 

Question 24 

Which of the following glycoproteins is responsible for treating such diseases as bone marrow failure following chemotherapy and hematopoietic neoplasms such as leukemia? Answers: 

A. Growth factors and cytokines 

B. T lymphocytes and natural killer cells 

C. Neutrophils and eosinophils 

D. Natural killer cells and granulocytes 

Question 25 

While being on subcutaneous heparin injections for deep vein thrombosis during her latter pregnancy, a patient begins to experience major side effects. Her OB-GYN physician has called in a specialist who thinks that the patient is experiencing heparin-induced thrombocytopenia. The nurse should anticipate which of the following orders? 

Answers: 

A. Immediately discontinue the heparin therapy 

B. Switch to Coumadin 2.5 mg once/day 

C. Decrease the dose of heparin from 5000 units b.i.d to 3000 units b.i.d 

D. Infuse FFP stat 

Question 26 

Which of the following individuals would most likely experience global ischemia to his or her brain? 

Answers: 

A. A woman who is being brought to hospital by ambulance following suspected carbon monoxide poisoning related to a faulty portable heater 

B. A male client who has just had an ischemic stroke confirmed by CT of his head 

C. A woman who has been admitted to the emergency department with a suspected intracranial bleed 

D. A man who has entered cardiogenic shock following a severe myocardial infarction 

Question 27 

A new mother and father are upset that their 2-day-old infant is requiring phototherapy for hyperbilirubinemia. The pediatrician who has followed the infant since birth is explaining the multiplicity of factors that can contribute to high serum bilirubin levels in neonates. Which of the following factors would the physician be most likely to rule out as a contributor? 

Answers: 

A. Transitioning of hemoglobin F (HbF) to hemoglobin A (HbA) 

B. Hepatic immaturity of the infant 

C. Hypoxia 

D. The fact that the infant is being breast-fed 

Question 28 

A 14-year-old boy has been diagnosed with infectious mononucleosis. Which of the following pathophysiological phenomena is most responsible for his symptoms? 

Answers: 

A. Viruses are killing some of his B cells and becoming incorporated into the genome of others. 

B. The Epstein-Barr virus (EBV) is lysing many of the boy’s neutrophils. 

C. The virus responsible for mononucleosis inhibits the maturation of myeloblasts into promyelocytes. 

D. The EBV inhibits the maturation of white cells within his peripheral lymph nodes. 

Question 29 

A 16-year-old female has been brought to her primary care physician by her mother due to the girl’s persistent sore throat and malaise. Which of the following facts revealed in the girl’s history and examination would lead the physician to rule out infectious mononucleosis? 

Answers: 

A. Chest auscultation reveals crackles in her lower lung fields bilaterally. 

B. Her liver and spleen are both enlarged. 

C. Blood work reveals an increased white blood cell count. 

D. The girl has a temperature of 38.1°C (100.6°F) and has enlarged lymph nodes. 

Question 30 

A 30-year-old woman who has given birth 12 hours prior is displaying signs and symptoms of disseminated intravascular coagulation (DIC). The client’s husband is confused as to why a disease of coagulation can result in bleeding. Which of the nurse’s following statements best characterizes DIC? 

Answers: 

A. “The same hormones and bacteria that cause clotting also cause bleeding.” 

B. “Massive clotting causes irritation, friction, and bleeding in the small blood vessels.” 

C. “So much clotting takes place that there are no available clotting components left, and bleeding ensues.” 

D. “Excessive activation of clotting causes an overload of vital organs, resulting in bleeding.” 

Question 31 

A 20-year-old has been diagnosed with an astrocytic brain tumor located in the brain stem. Which of the following statements by the oncologist treating the client is most accurate? 

Answers: 

A. “Our treatment plan will depend on whether your tumor is malignant or benign.” 

B. “This is likely a result of a combination of heredity and lifestyle.” 

C. “The major risk that you face is metastases to your lungs, liver, or bones.” 

D. “Your prognosis will depend on whether we can surgically resect your tumor.” 

Question 32 

A patient diagnosed with low-risk chronic lymphocytic leukemia (CLL) has recently developed thrombocytopenia. One of the medications utilized to treat this would be Answers: 

A. cisplatin, a chemotherapeutic. 

B. vincristine, a Vinca alkaloid. 

C. dexamethasone, a corticosteroid. 

D. doxorubicin, a cytotoxic antibiotic. 

Question 33 

Two nursing students are attempting to differentiate between the presentations of immune thrombocytopenic purpura (ITP) and thrombotic thrombocytopenic purpura (TTP). Which of the students’ following statements best captures an aspect of the two health problems? Answers: 

A. “ITP can be either inherited or acquired, and if it’s acquired, it involves an enzyme deficiency.” 

B. “Both of them involve low platelet counts, but in TTP, there can be more, not less, hemostasis. 

C. “TTP can be treated with plasmapheresis, but ITP is best addressed with transfusion of fresh frozen plasma.” 

D. “Both diseases can result from inadequate production of thrombopoietin by megakaryocytes.” 

Question 34 

A physician is explaining to a 40-year-old male patient the importance of completing his course of antibiotics for the treatment of tuberculosis. The physician explains the damage that could occur to lung tissue by Mycobacterium tuberculosis. Which of the following phenomena would underlie the physician’s explanation? 

Answers: 

A. Tissue destruction results from neutrophil deactivation. 

B. Neutrophils are ineffective against the Mycobacterium tuberculosis antigens. 

C. Macrophages form a capsule around the Mycobacterium tuberculosis bacteria, resulting in immune granulomas. 

D. Nonspecific macrophage activity leads to pulmonary tissue destruction and resulting hemoptysis. 

Question 35 

A teenager, exposed to West Nile virus a few weeks ago while camping with friends, is admitted with headache, fever, and nuchal rigidity. The teenager is also displaying some lethargy and disorientation. The nurse knows which of the following medical diagnoses listed below may be associated with these clinical manifestations?

Answers: 

A. Encephalitis 

B. Lyme disease 

C. Rocky Mountain spotted fever 

D. Spinal infection 

Question 36 

A patient has been diagnosed with anemia. The physician suspects an immune hemolytic anemia and orders a Coombs test. The patient asks the nurse what this test will tell the doctor. The nurse replies, 

Answers: 

A. “They are looking for the presence of antibody or complement on the surface of the RBC.” 

B. “They will look at your RBCs under a microscope to see if they have an irregular shape (poikilocytosis).” 

C. “They will wash your RBCs and then mix the cells with a reagent to see if they clump together.” 

D. “They will be looking to see if you have enough ferritin in your blood.” 

Question 37 

A 29-year-old construction worker got a sliver under his fingernail 4 days ago. The affected finger is now reddened, painful, swollen, and warm to touch. Which of the following hematological processes is most likely occurring in the bone marrow in response to the infection? 

Answers: 

A. Phagocytosis by myelocytes 

B. Increased segmented neutrophil production 

C. High circulatory levels of myeloblasts 

D. Proliferation of immature neutrophils 

Question 38 

A surgeon is explaining to the parents of a 6-year-old boy the rationale for the suggestion of removing the boy’s spleen. Which of the following teaching points would be most accurate? 

Answers: 

A.“We think that his spleen is inhibiting the production of platelets by his bone marrow.” 

B.“We believe that your son’s spleen is causing the destruction of many of his blood platelets, putting him at a bleeding risk.” 

C.“Your son’s spleen is holding on to too many of his platelets, so they’re not available for clotting.” 

D.“Your son’s spleen is inappropriately filtering out the platelets from his blood and keeping them from normal circulation.” 

Question 39 A nurse practitioner is providing care for a client with low levels of the plasma protein gamma globulin. The nurse would recognize that the client is at risk of developing which of the following health problems? 

Answers: 

A. Anemia 

B. Blood clots 

C. Jaundice 

D. Infections 

Question 40 

A 32-year-old woman presents at her neighborhood health clinic complaining of weakness and a feeling of abdominal fullness. She reports that 6 months earlier she noticed that she had difficulty in maintaining the high level of energy she has relied on during her aerobic workouts over the past few years. Because she felt that she was in overall good health, but knew that women often need additional iron, she added a multiple vitamin with iron and some meat and leafy greens to her diet. She followed her plan carefully but had no increase in energy. Upon examination, her spleen is noted to be enlarged. Which of the following is most likely to be the cause? 

Answers: 

A. CLL 

B. Accelerated CML 

C. Infectious mononucleosis 

D. Stage A Hodgkin disease 

Question 41 

A nurse is providing care for several patients on an acute medical unit of a hospital.Which of the following patients would be most likely to benefit from hematopoietic growth factors? 

Answers: 

A. A 61-year-old female patient with end-stage renal cancer 

B. A 55-year-old obese male patient with peripheral neuropathy secondary to diabetes 

C. A 51-year-old female patient with liver failure secondary to hepatitis 

D. A 44-year-old man with a newly diagnosed brain tumor 

Question 42 

Misinterpreting her physician’s instructions, a 69-year-old woman with a history of peripheral artery disease has been taking two 325 mg tablets of aspirin daily. How has this most likely affected her hemostatic status? 

Answers: 

A. The binding of an antibody to platelet factor IV produces immune complexes. 

B. The patient’s prostaglandin (TXA2) levels are abnormally high. 

C. Irreversible acetylation of platelet cyclooxygenase activity has occurred. 

D. She is at risk of developing secondary immune thrombocytopenic purpura (ITP). 

Question 43 Which of the following teaching points would be most appropriate with a client who has a recent diagnosis of von Willebrand disease? 

Answers: 

A. “Make sure that you avoid taking aspirin.” 

B. “Your disease affects your platelet function rather than clot formation.” 

C. “Clotting factor VIII can help your body compensate for the difficulty in clotting.” 

D. “It’s important that you avoid trauma.” 

Question 44 

A nurse at a long-term care facility provides care for an 85-year-old man who has had recent transient ischemic attacks (TIAs). Which of the following statements best identifies future complications associated with TIAs? TIAs 

Answers: 

A. are caused by small bleeds that can be a warning sign of an impending stroke. 

B. are a relatively benign sign that necessitates monitoring but not treatment. 

C. are an accumulation of small deficits that may eventually equal the effects of a full CVA. D. resolve rapidly but may place the client at an increased risk for stroke. 

Question 45 

Following a motor vehicle accident 3 months prior, a 20-year-old female who has been in a coma since her accident has now had her condition declared a persistent vegetative state. How can her care providers most accurately explain an aspect of her situation to her parents? 

Answers: 

A. “If you or the care team notices any spontaneous eye opening, then we will change our treatment plan.” 

B. “Your daughter has lost all her cognitive functions as well as all her basic reflexes.” 

C. “Though she still goes through a cycle of sleeping and waking, her condition is unlikely to change.” 

D. “Your daughter’s condition is an unfortunate combination with total loss of consciousness but continuation of all other normal brain functions.” 

Question 46 

A couple who is expecting their first child has been advised by friends to consider harvesting umbilical cord blood in order to have a future source of stem cells. The couple has approached their caregiver with this request and is seeking clarification of exactly why stem cells are valuable and what they might expect to gain from harvesting it. How can their caregiver best respond to the couple’s enquiry? Stem cells can 

Answers: 

A. “be used as source of reserve cells for the entire blood production system.” 

B. “help treat some cancers and anemias, but they must come from your child himself or herself.” 

C. “be used to regenerate damaged organs should the need ever arise.” 

D. “help correct autoimmune diseases and some congenital defects.” 

Question 47 A surgeon is explaining to the parents of a 6-year-old boy the rationale for the suggestion of removing the boy’s spleen. Which of the following teaching points would be most accurate? 

Answers: 

A. “Ferritin is a protein–iron complex that allows your red blood cells to make use of the iron that you consume in your diet.” 

B. “Ferritin is the activated and usable form of iron that your red blood cells can use to transport oxygen.” 

C. “Ferritin is the form of iron that is transported in your blood plasma to red blood cells that need it.” 

D. “Ferritin is a stored form of iron that indirectly shows me whether you would benefit from iron pills.” 

Question 48 

A 13-year-old African American boy comes to the ER complaining of fatigue and a rapid heartbeat. In conversation with the father, it becomes apparent to you that the boy has grown 2 inches in the previous 5 months. What is the first problem the health care team would attempt to rule out? 

Answers: 

A. Aplastic anemia 

B. Sickle cell anemia 

C. Thalassemia 

D. Iron deficiency anemia 

Question 49 

In which of the following patients, would diagnostic investigations least likely reveal increased thrombopoietin production? 

Answers: 

A. A 55-year-old man with dehydration secondary to Crohn disease 

B. An 81-year-old woman with diagnoses of rheumatoid arthritis and failure to thrive 

C. A 66-year-old woman with a diagnosis of lung cancer with bone metastases 

D. A 21-year-old woman awaiting bone marrow transplant for myelogenous leukemia 

Question 50 

A hospital laboratory technologist is analyzing the complete blood count (CBC) of a patient. Which of the following statements best reflects an aspect of the platelets that would constitute part of the CBC? 

Answers: 

A. New platelets are released from the bone marrow into circulation. 

B. The half-life of a platelet is typically around 8 to 12 days. 

C. Platelets originate with granulocyte colony–forming units (CFU). 

D. The α-granules of platelets contribute primarily to vasoconstriction.

Epidemiology and Population Health

Reflect on your nursing practice for a moment. If you could wipe out one illness, what would it be? How would that impact not just an individual patient, but your entire patient population? What would be the long-term benefits of eliminating that one illness?

The eradication of smallpox by 1979 provides an excellent example of this scenario. This eradication came about as a result of global collaborative efforts involving many countries and organizations, as well as the application of epidemiologic methods. In spite of high initial financial costs, it is estimated that millions of dollars continue to be saved around the world each year as a result of the eradication of this disease.

The eradication of smallpox illustrates the rich history of epidemiology and demonstrates the cost/benefits and implications of improving health at the population level. The application of epidemiologic methods and principles to other critical population health issues continues to play an essential role in improving health and health outcomes.

For this Discussion, you will identify a current population health problem, and you will examine how, and if, the problem is being addressed through the application of epidemiologic principles. You will also discuss the cost-effectiveness of dealing with the problem at the population level.

To prepare:

• Review      the Learning Resources, focusing on the smallpox epidemic of the 1960s and      1970s and how health organizations applied principles of epidemiology to      eradicate this disease. (See attached file)
• In      light of this example, consider the cost effectiveness of addressing      smallpox at the population level.
• Using      the Learning Resources, research a current population health problem      (local or global). Select one on which to focus for this Discussion.
• Think      about how principles of epidemiology are being applied—or could be      applied—to address the problem.
• What      lessons from the use of epidemiology in the eradication of smallpox might      be applicable to this selected problem? What are the financial benefits of      addressing this issue at the population level as opposed to the individual      level?

By tomorrow Wednesday 02/28/18 by 12pm, write a minimum of 550 words in APA format with a minimum of THREE scholarly references from the list of required readings below. Include the level one headers as numbered below:

Post a cohesive response that addresses the following:

1) Briefly summarize your selected population health problem and describe how principles of epidemiology are being applied—or could be applied—to address the problem.

2) Are there any lessons learned from the use of epidemiology in the eradication of smallpox that can be applied to your selected problem?

3) Evaluate the cost effectiveness of addressing this health problem at the population level versus the individual level.

Required Readings

Friis, R. H., & Sellers, T. A. (2014). Epidemiology for public health practice (5th ed.). Sudbury, MA: Jones & Bartlett.

Chapter 1, “History and Scope of Epidemiology”

Chapter 2, “Practical Applications of Epidemiology” (pages 49–80 only)

Epidemiology is defined and introduced in Chapter 1. This chapter also presents an interesting historical overview that explains the emergence of the field. The assigned section of Chapter 2 addresses several uses of epidemiology.

Nash, D. B., Fabius, R. J., Skoufalos, A., Clarke, J. L. & Horowitz, M. R. (2016). Population health: Creating a culture of wellness (2nd ed). Burlington, MA: Jones & Bartlett Learning.

Building Cultures of Health and Wellness (xxvii)

In the “Population Health Mandate” section of the course text, the authors provide an introduction to population health, noting that it has three core components: health outcomes, health 

determinants, and policies.

Chapter 2, “The Spectrum of Care”

In Chapter 2, the authors examine the purposes of the population health approach. Two key themes are introduced in this chapter: 1) population health as it relates to the challenges of quality and cost in health care, and 2) population health as an approach to not only reducing the burden of chronic illness but also to promoting wellness and increasing prevention.

Chapter 8, “Behavioral Economics”

In Chapter 8, the authors examine effect of social and cognitive function on an individual’s economic decisions. Reinforced by legislation, behavioral economics can be applied in population health to influence and change health outcomes. Compelling examples of incremental improvements (e.g., corporate wellness programs) are provided throughout the chapter.

Larkin, H. (2010). Managing population health. Hospitals & Health Networks, 84(10), 28–32. 

This article uses examples from a diabetes pilot program to demonstrate the value of population health management. The author discusses how the application of individual patient interventions can positively affect the entire target population, as well as improve the cost effectiveness of management programs.

Center for Global Development. (n.d.). Case 1: Eradicating smallpox. Retrieved March 5, 2012, from http://www.cgdev.org/doc/millions/MS_case_1.pdf

This reading presents the eradication of smallpox in the form of a case study. Many lessons can be learned from the successful global effort to eliminate smallpox.

Centers for Disease Control and Prevention. (2011). Morbidity and mortality weekly report. Retrieved from http://www.cdc.gov/mmwr/

The Morbidity and Mortality Weekly Report (MMWR) is a weekly epidemiological report distributed by the U.S. Centers for Disease Control and Prevention (CDC) to provide, according to the MMWR website, “timely, reliable, authoritative, accurate, objective, and useful public health information and recommendations.” It is one of the most important sources of timely public health data published anywhere.

World Health Organization. (2001). Smallpox. Retrieved from http://www.who.int/topics/smallpox/en/

The World Health Organization provides a succinct overview of the eradication of small pox and its impact on population health.

Note: Explore population health issues presented at the websites below as you prepare for this week’s Discussion and Assignment:

American Public Health Association. (2011). Retrieved from http://www.apha.org/

Centers for Disease Control and Prevention. (2011). Retrieved from http://www.cdc.gov/

Food and Agricultural Organization of the United Nations. (2011). Retrieved from http://www.fao.org/index_en.htm

U.S. Food and Drug Administration. (2011). Retrieved from http://www.fda.gov/

Healthy People 2020. (2011). Global health. Retrieved from http://healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicid=16

U.S. Food and Drug Administration. (2011). Public health focus. Retrieved from http://www.fda.gov/NewsEvents/PublicHealthFocus/default.htm

Required Media

Laureate Education (Producer). (2012). Epidemiology and population health: Introduction to epidemiology and population health [Video file]. Baltimore, MD: Author.

Note: The approximate length of this media piece is 6 minutes.

In this week’s program, “Introduction to Epidemiology and Population Health,” Dr. Hull and Dr. Frerich introduce foundational concepts related to epidemiology, noting that this scientific arena focuses on the study of human populations rather than individuals.

Laureate Education (Producer). (2012). Epidemiology and population health: Epidemiology in nursing practice [Video file]. Baltimore, MD: Author.

Note: The approximate length of this media piece is 4 minutes.

In “Epidemiology in Nursing Practice,” Dr. Rebecca Lee, Dr. Donna Shambley-Ebron, and Dr. Missie Willmarth discuss how epidemiology is utilized in nursing practice and, in particular, why it is salient for DNP-prepared nurses.

Optional Resources

Long, D. A., & Sheehan, P. (2010). A case study of population health improvement at a Midwest regional hospital employer. Population Health Management, 13(3), 163–173.

Oudin, Åström D., Bertfil, F., & Joacim R. (2011). Heat wave impact on morbidity and mortality in the elderly population: A review of recent studies. Occupational and Environmental Medicine, 69(2), 99–105.

Excite. (2004). An introduction to epidemiology. Retrieved from http://www.cdc.gov/excite/classroom/intro_epi.htm

In this unit, you were introduced to electronic orders, problem lists, lab results, and body mass index. For this assignment, you will get to demonstrate the skills you have learned by completing exercises using the Quippe software in the MyHealthProfessionsLab located in Blackboard.

First, use the instructions for “Exercise 6G: Discharging a Patient with Deep Vein Thrombosis” on page 245 of your textbook and “Exercise 7H: Patient with Upper Abdominal Chest Pain” on page 298 of your textbook to complete these exercises in the MyHealthProfessionsLab. Note: You do not have to complete step 4 in Exercise 6G or step 7 in Exercise 7H because you are not actually submitting the work in the lab.

After completing the exercises, compose a reflection paper about your experience that applies what you have learned in this unit. In your paper, be sure to include the following:

How was your overall experience using the software to document the patient encounter? Did you experience any issues while using the software?

Were you able to successfully complete the hospital discharge instructions? What do you feel was most beneficial about this exercise?

How do you feel that using problems lists can help you determine the education needed for a patient? What specific skills do you feel you have mastered? What skills do you need to improve?

Why are electronic orders and results important? How will you use them in your career?

Your reflection paper must be at least two pages in length. You are not required to use any outside resources, but if you choose to incorporate information from outside resources including your textbook, you must cite and reference them in APA format.

Information about accessing the grading rubric for this assignment is provided below.