Health History and Screening of an Adolescent or Young Adult Client

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Details:

In this assignment, you will be completing a comprehensive health screening and history on a young adult. To complete this assignment, do the following:

Select an adolescent or young adult client on whom to perform a health screening and history. Students who do not work in an acute setting may “practice” these skills with a patient, community member, neighbor, friend, colleague, or loved one.

Complete the “Health History and Screening of an Adolescent or Young Adult Client” worksheet.

Complete the assignment as outlined on the worksheet, including:

  1. Biographical data
  2. Past health history
  3. Family history: Obstetrics history (if applicable) and well young adult behavioral health history screening
  4. Review of systems
  5. All components of the health history
  6. Three nursing diagnoses for this client based on the health history and screening (one actual nursing diagnosis, one wellness nursing diagnosis, and one “risk for” nursing diagnosis)
  7. Rationale for the choice of each nursing diagnosis.
  8. A wellness plan for the adolescent/young adult client, using the three nursing diagnoses you have identified.

Format the write-up in a manner that is easily read, computer-generated, neat, and without spelling errors. Use correct acronyms or abbreviations when indicated.

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.

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 not required to submit this assignment to Turnitin.

NRS-434VN-R-HealthScreeningandHistoryAdolescentAssignment-Student.docx  

Process of retrieval, appraisal, and synthesis of evidence in collaboration with other members of the healthcare team to improve patient outcomes

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https://learn.westcoastuniversity.edu/bbcswebdav/institution/Concourse/WCU_BSN_Docs/BaccEssentials08.pdf

Reflection Assignment #3: Meeting Essential III

This week, reflect on your perception of healthcare delivery models and the nurse’s role in public health programs as it has evolved over the course of your RN-BSN program at WCU. Identify specific healthcare delivery models you support, and compare and contrast public health programs you are familiar with. How does your academic work support evidence of meeting the following?

Essential III: Scholarship for Evidence-Based Practice

Outcome #2: Demonstrate an understanding of the basic elements of the research process and models for applying evidence to clinical practice.

Outcome #5: Participate in the process of retrieval, appraisal, and synthesis of evidence in collaboration with other members of the healthcare team to improve patient outcomes.

Outcome #6: Integrate evidence, clinical judgment, interprofessional perspectives, and patient preferences in planning, implementing, and evaluating outcomes of care.

Outcome #7: Collaborate in the collection, documentation, and dissemination of evidence.

Review your past academic work, evaluate your effectiveness at meeting this program essential, and ponder the impact that this proficiency will have on your future.

Identify how you met the essential by referring to the assignment(s) specifically in your response. Additionally, reflect on and make connections between your academic experience and real-world applications. 

Your reflection should be 2 pages, and APA formatted. Reference and cite any sources you use.

Rubrics:

The writer clearly and effectively responds to the assignment. The writer thoughtfully and eloquently evaluates his/her effectiveness at meeting the program essential(s), and ponders the future as it relates to this accomplishment. The writer makes clear and meaningful connections between academics and real-world applications. The student is aptly able to describe growth and development in becoming a professional nurse. There is one clear, well- focused topic. Main ideas are clear and are well supported by detailed and accurate information. The student showcases relevant assignment(s) and course work that support the essentials and outcomes indicated. The student directly references relevant assignments/ course work in his/her reflection. The introduction is engaging, states the main topic, and provides an overview of the paper. Information is relevant and presented in a logical order. The conclusion is strong and definitive. Reflection has a logical progression of thought and information. The assignment consistently follows current APA format and is free from errors in formatting, citations, and references. No grammatical, spelling, or punctuation errors. All sources are cited and referenced correctly.

Relevant “health behavior(s)” that contributes to increasing and/or decreasing risk factor for contracting the disease

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*****DUE IN 8-10 HOURS!!

Watch this video https://www.youtube.com/watch?v=BFZ1TEDJlqI

Read this scenario: 

You have been hired as Assistant Manager of a Home Health Care Agency. The agency offers a wide range of skilled medical services such as nursing care, physical therapy, occupational therapy from qualified medical professionals. The agency also provides home health aide services including assistance with activities of daily living, such as bathing and eating.

Your supervisor told you that she recently received a call from an advocate whom an employee consulted via the Employee Assistance Program because the employee felt that she had been treated unfairly after contracting an illness. She explained that a few months ago, one of your agency’s home health aides, Sara, became ill. Sara had been coughing for approximately six weeks, lost weight without trying, had no appetite, was having difficulty sleeping, and had an intermittent fever. She became concerned and went to see a healthcare professional who diagnosed her with active tuberculosis (TB).

Sara missed a lot of time from work while completing treatment for TB. Her physician cleared her to return to work after she was no longer contagious. Upon returning to work, Sara felt isolated because her boss and co-workers refused to spend time with her. She heard that someone from the agency’s Human Resources Department told her co-workers her diagnosis. The stressful circumstances at work became even worse when another home health aide started to display the same symptoms Sara had.

Your supervisor has asked you to review the entire situation and how it was handled by the agency.

Now, in a complete 600-800 words paper, address the following questions: (DO NOT WRITE QUESTIONS IN THE PAPER)

  1. Identify relevant “health behavior(s)” that contributes to increasing and/or decreasing risk factor for contracting the disease.
  2. Identify and describe a surveillance system that monitors disease or health-related risk factors in the United States.
  3. Was risk communication essential for Sara’s co-workers? Why or why not?
  4. Describe the key components in developing crisis and emergency risk communication messages.

Your paper must include:

  • · 100% originality
  • · 600-800 words count excluding title and reference page
  • · Proper introduction and conclusion
  • · 3 credible references cited in APA

How will a negative manager affect the overall group dynamic as opposed to a positive leader who wants to see the team develop

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You are in charge of developing a team-building activity to improve collaboration and increased communication for your team members. You are the newly promoted manager. Your department is closing for the day so you have four hours together in a team environment.

Review the following details of team members:

  • Rosanna (46) and Mary (20) are two staff members who do not get along. Rosanna is quiet and a loner. Mary is outspoken, and talks about her personal life to friends.
  • Cindy, (35), and Lolita, (40), are part-time staff. They are stressed due to economy. They interact with full time staff, but full time staff think they complain too much and shouldn’t because they are part time
  • Chip is a twenty-three-year-old maintenance worker who works part-time job at night, in addition to full-time role. He is often tired.
  • Samir is fifty-five, works full-time, and cannot wait until retirement.
  • Sarah (52) is a negative department manager who complains. She is a strong informal leader and has influence over the group.
  • Jerry is twenty-four and in graduate school. He has a positive attitude and is not motivated because no one likes to work together.

You need to divide the team into three groups. Remember this is a team-building activity.

  • How will you make the determination which members to put together?
  • Should members, who have a negative attitude, be placed with members who are positive? Why or why not?
  • How will a negative manager affect the overall group dynamic as opposed to a positive leader who wants to see the team develop?
  • How influential can an informal leader be among team members?
  • What barriers to effective teamwork can you anticipate and how will it be addressed?

Submission Details:

  • Your presentation should consist of 12–15 professional color Microsoft PowerPoint slides (not including the title and reference slide) along with detailed speaker notes to include examples to support each slide.
  • Support your responses with examples.
  • Cite any sources in APA format
  • Present the additional information in the Notes section.

Disorders of Fluid and Electrolyte Balance

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 No Plagiarism please, assignment will be checked with Turnitin. 

Will need 4 full pages,  double spaced all throughout the page for the case study, APA Style, Times New Roman, font 12, Title Page and a Reference page. 

 Make sure all of the topics in the case study have been answered 

Cite at least 3 References; journal articles, textbooks, or evidenced-based websites to support the content. 

All sources must be within five years (2012-2017).

Case Study 3:  Disorders of Fluid and Electrolyte Balance

Amanda is an 18-year-old with anorexia nervosa. She was recently admitted to an eating disorders clinic with a BMI of 13.9, and although she was a voluntary patient, she was reluctant about the treatment. She was convinced she was overweight because her clothes felt tight on her. She complained that even her hands and feet “were fat.” One of her nurses explained that a protein in her blood was low. The nurse further explained that, as difficult as it may be to believe, eating a normal healthy diet would make the “fat hands and feet” go away. 

What protein do you suspect the nurse was referring to? How would a deficiency in this protein contribute to edema?

What is the difference between the physiology of pitting and nonpitting edema? 

Because of her weakened condition, Amanda was moved around the ward in a wheelchair when she was not on bed rest. How does this affect her edematous tissues? 

Public policies, licensure, and accreditation standards for health care professionals and organizations

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Measures of Quality

 Health care quality is a nationally recognized topic that is addressed through public policies, licensure, and accreditation standards for health care professionals and organizations. Throughout history, numerous organizations have been involved in developing health care quality and safety initiatives.
 

The Joint Commission and Centers for Medicare and Medicaid Services (CMS) developed quality and safety indicators for various health care systems. These indicators seek to establish accountability for health care organizations through a reporting system, which is available to the public. For this Discussion, explore various accrediting organizations and specific measures that pertain to quality. In your research on accrediting organizations, consider how these quality measures affect quality outcomes, support ethical principles, and influence the delivery of clinical services.
 

To prepare:

  • Select one specific quality indicator      from the Week 2 Discussion and compare it with those outlined in this      week’s Learning Resources (In week 2 discussion, I spoke about nosocomial      infections and pain management as quality indicators).
  • Review the accrediting body standards      that pertain to your organization focusing on those standards that require      your organization to define its quality management program.
  • Consider regulatory requirements at      the state or national level that affect quality outcomes in your      organization.
  • Ask yourself: How do the Centers for      Medicare and Medicaid Services (CMS) restricted reimbursements affect      quality management or improvement efforts at my organization? How do these      standards and regulations influence or support ethical principles and      influence patient care and nursing practice?

By tomorrow Wednesday 12/13/17, write a minimum of 550 words in APA format with at least 3 references from the list below that addresses the level one & two headings as numbered and lettered below:

post a cohesive scholarly response that addresses the following:

1) Choose any measurement and explain the extent to which your chosen measure is affected by CMS driven incentives and disincentives. 

2) From a systems perspective, discuss how this measure affects:

a. Quality outcomes 

b. Supports ethical principles 

c. Influences patient care and nursing practice.

Required Readings

Joshi, M.S., Ransom, E.R., Nash, D.B., & Ransom, S.B., (Eds.). (2014). The Healthcare Quality Book, 3rd ed. Chicago, IL: Health Administration Press.

Chapter 5: “Data Collection”

Chapter 6: “Statistical Tools for QI”

Park, J., Konetzka, R. T., & Werner, R. M. (2011). Performing well on nursing home report cards: Does it pay off? Health Services Research, 46(2), 531–554. doi:10.1111/j.1475-6773.2010.01197.x

The study in this article evaluates whether or not nursing homes benefit from improvements in quality measures. Four financial outcomes are measured before and after the improvements are enacted. The study shows that the nursing homes that improved quality measures benefitted financially.

Suchy, K. (2010). A lack of standardization: The basis for the ethical issues surrounding quality and performance reports. Journal of Healthcare Management, 55(4), 241–251.

Because performance reports are easily found online, this article supports creating ethical guidelines for the performance reports of the health care industry. It compares nearly ten different organizations that provide performance reporting, and then it proposes an ethical framework and principles for public quality reporting.

Wachter, R. M., & Pronovost, P. J. (2009). Balancing “no blame” with accountability in patient safety. New England Journal of Medicine, 361(14), 1401–1406.

This article addresses the issue of individual accountability in health care organizations. It suggests moving from a culture within health care that does not place blame on individuals to a culture where individuals become more accountable.

Centers for Medicare & Medicaid Services. (n.d.). Quality initiatives: Overview. Retrieved from http://www.cms.gov/QualityInitiativesGenInfo/

Created by the U.S. Department of Health & Human Services, this website overviews quality initiatives that affect the health care industry. It also provides information and downloadable PDFs on the Post-Acute Care Reform Plan and Development of Quality Indicators for Impatient Rehabilitation Facilities (IRF).

Required Media

Video: Laureate Education, Inc. (Executive Producer). (2011). Organizational and systems leadership for quality improvement: External quality improvement. Baltimore: Author.

Note: The approximate length of this media piece is 10 minutes.

The presenters in this video discuss various external organizations involved in quality, and examine the enforcement of standards by governmental agencies versus voluntary organizations. This program also addresses the publication of quality information and why organizations should do their own reporting in addition to mandated reporting. Licensing, credentialing, and certification are discussed as they relate to the social compact that health care providers have for quality and safety.

Development of a medical emergency requiring blood transfusion to prevent death or serious compromise of the patient’s wellbeing

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Read the Case Law and answer the questions.

Instructions:

  1. Read the Case Law – Werth vs. Taylor (See Below)
  2. Then, answer the questions below.
    1. Did this case turn out the way you thought it would? Why or why not?
    2. How could Cindy have assured herself that she would not receive any blood no matter what happened?
    3. Would it have made any difference in the outcome of the case if the anesthesiologist had interviewed Cindy before the procedure and told her that her life could be in danger if she refused blood during both procedures?
    4. What kind of consent is it when there is an emergency situation and the physician/healthcare worker needs to act or the patient may lose their life?
  3. Your paper should be:
    • One (1) page
    • Typed according to APA style for margins, formatting and spacing standards
    • Typed into a Microsoft Word document, save the file, and then upload the file
    • CASE LAW
    • Case Law Werth vs. Taylor 475 N.W.2d 426, 427 (Mich. Ct. App. 1991) Cindy Werth was expecting twins. Because she was a Jehovah’s Witness and had a firm belief in the religion’s teaching “that it is a sin to receive blood transfusions”, Cindy signed a “Refusal to Permit Blood Transfusions” form as part of her hospital preregistration. After delivery, Cindy had complications and was experiencing uterine bleeding. She was advised to undergo a dilatation and curettage and agreed. Again, she discussed her refusal to allow a blood transfusion with her obstetrician/gynecologist (OB/Gyn). After being placed under anesthesia and despite the specialist’s efforts during surgery, Cindy continued to bleed and was experiencing, among other things, premature ventricular activity and a significant decrease in blood pressure. The anesthesiologist (Dr. Michael Taylor) determined that Cindy needed a blood transfusion to sustain her life. Cindy’s OB/Gyn expressed Cindy’s refusal of blood transfusions, but the anesthesiologist proceeded anyway stating that it was medically necessary. The Werth’s filed a malpractice suit, alleging that Dr. Taylor committed battery by performing the transfusion without Cindy’s consent. Dr. Taylor moved for a summary disposition “because Cindy’s refusal was not conscious, competent, contemporaneous and fully informed.” The trial court found that Cindy’s refusals of a transfusion were made when she contemplated “merely routine elective surgery” and not life-threatening circumstances, and that, “it could not be said that she made the decision to refuse a blood transfusion while in a competent state and while fully aware that death would result from such refusal.” The record apparently reflected “the unexpected development of a medical emergency requiring blood transfusion to prevent death or serious compromise of the patient’s wellbeing.” 

Signs or symptoms indicate an inflammatory etiology to musculoskeletal pain

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NR 511 Week 4 Midterm Exam Version 2

Question 1: Women are at the highest risk for developing postpartum depression for up to how long after childbirth?

2 weeks

1 month

3 months

6 months

Question 2: CPT coding offers the uniformed language used for reporting medical services and procedures performed by physician and nonphysician practitioners. Clinicians are paid based on calculated resource costs that are calculated based on practice components.

a. Clinician education loans
b. Clinician practice liability and malpractice expense
c. Clinician reported cost reduction efforts
d. Clinician volume of patients treated

Question 3: Janet is a 30-year-old woman who has been recently diagnosed with a herniated disc at the level of L5-S1. She is currently in the emergency room with suspicion of cauda equina compression.
Which of the following is a sign or symptom of cauda equina compression?
a. Gastrocnemius weakness
b. A reduced or absent ankle reflex
c. Numbness in the lateral foot
d. Paresthesia of the perineum and buttocks

Question 4: A 58-year-old woman who had a total abdominal hysterectomy at the age of 45 is diagnosed with atrophic vaginitis. Which of the following is the most appropriate treatment?
a. Conjugated estrogen 0.625 mg/day oral
b. Estradiol 7.5 mcg/24 hr vaginal ring
c. Medroxyprogesterone 10 mg/day oral
d. Conjugated estrogen 0.3 mg + medroxyprogesterone 1.5 mg/day oral

Question 5: Which of the following is a specific test for multiple sclerosis (MS)?

a. Magnetic resonance imaging (MRI)
b. Computed tomography (CT) scan
c. A lumbar puncture
d. There is no specific test.

Question 6: Most adult poisonings are:

a. intentional and self-inflicted.
b. accidental.
c. caused by someone wishing to do harm to the person.
d. not attributed to any reason.

Question 7: A 60-year-old man presents with an enlarged scrotum. The clinician uses a penlight to transilluminate the scrotum. In a patient with a hydrocele, what would the clinician expect to find?

a. The scrotum will be dark.
b. The scrotum will appear light pink or yellow.
c. The scrotum will appear milky white.
d. The internal structures will be clearly visible.

Question 8: Which clinical feature is the first to be affected in increased intracranial pressure (ICP)?What is the normal number for the Glascow Coma Scale?

a. 7

b. 9

c. 10
d. 15

Question 9: S presents in the clinic with pain, tenderness, erythema, and swelling of his left great toe. The clinician suspects acute gout. Which of the following should the clinician suspect in the initial test results for this patient?

a. Elevated uric acid level
b. Elevated blood urea nitrogen (BUN)
c. Decreased urine pH
d. Decreased C-reactive protein (CRP)

Question 10: Which solution should be used when irrigating lacerated tissue over a wound on the arm?

a. Dilute povidone-iodine solution
b. Hydrogen peroxide (H2O2)
c. Saline solution infused with an antibiotic
d. Saline irrigation or soapy water

Question 11: Which ethical principle reflects respect for all persons and their self-determination?

a. Autonomy

b. Beneficence

c. Justice
d. Veracity

Question 12: During a digital rectal exam (DRE) on a 75-year-old man, the clinician suspects the patient has prostate cancer. What physical finding should make the clinician suspicious?

a. An enlarged rubbery gland

b. A hard irregular gland

c. A tender gland
d. A boggy gland

Question 13: How often should the clinician examine the feet of a person with diabetes?

a. Once a year
b. Every 6 months
c. Every 3 months
d. Every visit

Question 14: Which of the following medications is the treatment of choice for trichomonas? (Points: 2)

a. Metranidazole

b. Ceftriaxone

c. Diflucan
d. Doxycycline

Question 15: Immunizations are an example of which type of prevention? (Points: 2)

a. Primary
b. Secondary
c. Tertiary

Question 16: What is the treatment of choice for a patient diagnosed with testicular cancer?

a. Radical orchidectomy

b. Lumpectomy

c. Radiation implants
d. All of the above

Question 17: George, aged 59, complains of a flulike illness, including fever, chills, and myalgia after returning from visiting his grandchildren in New England. He reports having discovered a rash or red spot that grew in size on his right leg. What disease are you considering?

a. A viral syndromes
b. Lyme disease
c. Rocky Mountain spotted fever
d. Relapsing fever

Question 18: A 24-year-old woman presents to the clinic with dysuria, dyspareunia, and a mucopurulent vaginal discharge. Her boyfriend was recently treated for nongonococcal urethritis. What sexually transmitted disease (STD) has she most probably been exposed to?
a. Gonorrhea
b. Human papillomavirus (HPV)
c. Chlamydia
d. Trichomonas

Question 19: What is usually the first sign or symptom that a patient would present with that would make you suspect herpes zoster?

a. A stabbing type of pain on one small area of the body
b. A vesicular skin lesion on one side of the body
c. A pain that is worse upon awakening
d. A lesion on the exterior ear canal

Question 20: Which drug commonly prescribed for burns is active against a wide spectrum of microbial pathogens and is the most frequently used agent for partial- and full-thickness thermal injuries?
a. Clotrimazole cream (Lotrimen)
b. Mafenide acetate (Sulfamylon)
c. Silver nitrate
d. Silver sulfadiazine (Silvadene)

Question 21: Which of the following is a role of the advanced practice nurse in palliative cancer care?

a. Detecting cancer in asymptomatic patients or those with specific symptoms
b. Arranging for follow-up care, including psychosocial and spiritual support
c. Identifying and managing complications of care
d. All of the above

Question 22: Which type of burn injury results in destruction of epidermis with most of the dermis, yet the epidermal cells lining hair follicles and sweat glands remain intact?

a. Superficial burns
b. Superficial partial-thickness burns
c. Deep partial-thickness burns
d. Full-thickness burns

Question 23: The criteria for diagnosing generalized anxiety disorder in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (text revision) (DSM-IV-TR) state that excessive worry or apprehension must be present more days than not for at least:

a. 1 month.
b. 3 months.
c. 6 months.
d. 12 months.

Question 24: In the United States, what is the second most common connective tissue disease and the most destructive to the joints?

a. Osteoarthritis
b. Systemic lupus erythematosus (SLE)
c. Rheumatoid arthritis (RA)
d. Sjogren’s syndrome

Question 25: A sunscreen with a sun-protection factor (SPF) of at least what number will block most harmful ultraviolet (UV) radiation?

a. 4

b. 8

c. 10
d. 15

Question 26: The hallmark of an absence seizure is:

a. No activity at all.
b. A blank stare.
c. Urine is usually voided involuntarily.
d. The attack usually lasts several minutes.

Question 27: The effectiveness of benzodiazepines in treating anxiety disorders suggests that which of the following neurotransmitters plays a role in anxiety?

a. Acetylcholine
b. Gamma-aminobutyric acid (GABA)
c. Dopamine
d. Serotonin

Question 28: Which characteristic of delirium helps to distinguish delirium from dementia?

a. Abrupt onset
b. Impaired attention
c. Affective changes
d. Delusions

Question 29: A 26-year-old woman is seen with complaints of irregular vaginal bleeding. Which of the following tests should be the first priority?

a. Pregnancy test

b. Pelvic ultrasound

c. Endometrial biopsy
d. Platelet count

Question 30: The clinician should question the patient with suspected gout about use of which of these medications that may be a risk factor?

a. Low-dose aspirin

b. Thiazide diuretics

c. Ethambutol
d. All of the above

Question 31: A bulla is:

a. A vesicle larger than 1 cm in diameter.
b. An elevated solid mass with a hard texture, and the shape and borders can be regular or irregular.
c. A superficial elevated lesion filled with purulent fluid.
d. Thinning of the skin (epidermis and dermis) that appears white or translucent.

Question 32: Sam is a 25-year-old man who has been diagnosed with low back strain based on his history of localized low back pain and muscle spasm along with a normal neurological examination.
As the clinician, you explain to Sam that low back pain is a diagnosis of exclusion. Which of the following symptoms would alert the clinician to the more serious finding of a herniated nucleus pulposus or ruptured disc?
a. Morning stiffness and limited mobility of the lumbar spine
b. Unilateral radicular pain symptoms that extend below the knee and are equal to or greater than the back pain
c. Fever, chills, and elevated erythrocyte sedimentation rate
d. Pathologic fractures, severe night pain, weight loss, and fatigue

Question 33: Which of the following statements is true concerning the musculoskeletal exam?

a. The uninvolved side should be examined initially and compared to the involved side.
b. The part of the body that is causing the patient pain should be examined first.
c. The patient should not be asked to perform active range-of-motion (ROM) exercises whenever possible to avoid causing pain.
d. Radiographs should always be obtained prior to examination so as not to cause further injury to the patient.

Question 34: The current goal of treatment for a patient with HIV infection is which of the following?

a. Viral suppression of HIV to undetectable levels in the peripheral blood
b. Compete eradication of the virus
c. Encouraging the person to have no contact with uninfected individuals
d. Complete abstinence

Question 35: Which of the following classes of drugs should be used as first-line therapy for treatment of delirium?
a. Benzodiazepines
b. Antipsychotics
c. Anticonvulsants
d. Antidepressants

Question 36: After removing a tack from a type 2 diabetic’s heel and evaluating the site for infection, what is the best plan for this patient?

a. Suggest she use a heating pad to improve circulation
b. Refer to a podiatrist for a foot care treatment plan
c. Send her for acupuncture treatments
d. All of the above

Question 37: Which of the following statements is true concerning the management of the client with a herniated disc?

a. Muscle relaxants and narcotics can be used to control moderate pain but should be discontinued after 3 weeks of use.
b. An epidural injection is helpful in reducing leg pain that has persisted for at least 3 weeks after the herniation occurred.
c. Intolerable pain for more than a 3-month period is an indication for surgical intervention.
d. All of the above

Question 38: Which patient is more likely to have a cluster headache?

a. A female in her reproductive years
b. A 40-year-old African American male
c. A 55-year-old female who drinks 10 cups of coffee daily
d. A 45-year-old male awakened at night

Question 39: The main mechanism for avoiding a lawsuit involves:

a. Good liability insurance
b. A collaborating physician
c. Good documentation
d. Open communication skills

Question 40: A 45-year-old woman is seen in the clinic with complaints of a vaginal discharge. The clinician identifies clue cells on the vaginal smear. Which of the following diagnoses is associated with this finding?

a. Trichomonas
b. Bacterial vaginosis
c. Human papillomavirus (HPV)
d. Herpes simplex virus (HSV)

Question 41: Which of the following laboratory findings should the clinician expect in a patient with untreated Graves’ disease?

a. Elevated thyroid-stimulating hormone (TSH)
b. Elevated T4
c. Elevated TRH
d. All of the above

Question 42: A 23-year-old sexually active woman presents for her first Pap smear. Her history includes nulligravida, age at first intercourse 14, and more than 10 sexual partners. Which of the following conditions should the clinician be particularly alert for during her exam?

a. Human papillomavirus (HPV)
b. Endometrial hyperplasia
c. Vagismus
d. Polycystic ovarian syndrome

Question 43: When may confidentiality be overridden?  

a. When personal information is available on the computer
b. When a clinician needs to share information with a billing company
c. When an insurance company wants to know the results of a breast cancer gene test
d. When a patient has a communicable disease

Question 44: A patient is diagnosed with hypothyroidism. Which of the following electrocardiogram (ECG) changes should the clinician expect as a manifestation of the disease?

a. Sinus bradycardia

b. Atrial fibrillation

c. Supraventricular tachycardia
d. U waves

Question 45: The most cost-effective screening test to determine HIV status is which of the following?

a. Western Blot
b. Enzyme-linked immunosorbent assay (ELISA)
c. Venereal Disease Research Laboratory (VDRL) test
d. Viral load

Question 46: After 6 months of synthroid therapy, the clinician should expect which of the following in the repeat thyroid studies?

a. Elevated thyroid-stimulating hormone (TSH)
b. Normal TSH
c. Low TSH
d. Undetectable TSH

Question 47: The vegetarian patient with gout asks the clinician about food that he should avoid. The clinician should advise the patient to avoid which of the following foods?

a. Rice
b. Carrots
c. Spinach
d. Potatoes

Question 48: A 64-year-old man with type 2 diabetes presents to the clinic with the complaint of “my feet feel like they are on fire.” He has a loss of vibratory sense, +1 Achilles reflex, and a tack embedded in his left heel. Which of the following would be an appropriate treatment?

a. Tricyclic antidepressants
b. Capsacin cream
c. Vitamin B12 injections
d. Insulin

Question 49 : In the consensus model for Advanced Practice Registered Nurse (APRN) regulation, the “C” of LACE represents?

a. Commitment

b. Consensus

c. Certification
d. Collaboration

Question 50: Which of the following signs or symptoms indicate an inflammatory etiology to musculoskeletal pain?

a. Decreased C-reactive protein
b. Hyperalbuminemia
c. Morning stiffness
d. Weight gain

Renaissance and Baroque Sculpture in Italy

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Question 1: Renaissance and Baroque Sculpture in Italy

The biblical hero David was a popular subject for sculpture and painting throughout the Renaissance and into the Baroque period. By studying, comparing, and contrasting sculptures of David created in the fifteenth, sixteenth, and seventeenth centuries, you can begin to see the stylistic changes that occurred across these centuries. In a minimum of 3 well-developed paragraphs, compare and contrast the following 3 sculptures of David:

  1. Early Renaissance: Donatello. David. 1446-1460.
  2. High Renaissance: Michelangelo. David. 1501-1504.
  3. Baroque. Gianlorenzo Bernini. David. 1623.

In your comparison, discuss:

  • What specific visual similarities do you observe in these three sculptures?
  • What specific differences do you see? Consider the representation of the figure, additional objects portrayed, and the role of the viewer for each sculpture
  • How has the attitude of David changed between these three representations?
  • How is each sculpture representative of the time period and style in which it was created?

Be sure to explain your ideas clearly and support them by discussing specific works of art that you have read about this week, talking about how they illustrate and support your ideas.

Question 2: Dutch Baroque Painting

As we learned this week, Dutch Baroque art showed the influence of Protestantism and the middle-class merchants and traders who served as patrons. Dutch Baroque artists created portraits, still lifes, landscapes, and genre scenes of domestic life.

In a minimum of 2 well developed paragraphs, discuss how the following paintings reflect the social and historical context of sixteenth-century Holland. Consider the influence of religion, commerce, social structure, and/or patrons of the art in your response. Offer specific examples of how the subject of each painting reflects the society and culture in which it was created.

  1. Frans Hals, Officers of the Haarlem Militia Company of Saint Adrian, c. 1627
  2. Rembrandt van Rijn, The Anatomy Lesson of Dr. Tulp, 1632
  3. Johannes Vermeer, Woman Holding a Balance, c. 1664

Be sure to explain your ideas clearly and support them by discussing specific works of art that you have read about this week, talking about how they illustrate and support your ideas.

Respond to both questions as thoroughly as possible, making sure to use information from the readings and the lectures. All responses should be in complete sentence form, using proper spelling and grammar.

The role of vascular endothelial growth factor

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NR 507 Week No. 1 Quiz

1. Which statement about vaccines is true? (Points : 2)

2. Which statement is true about fungal infections? (Points : 2)

3. What is the role of reverse transcriptase in HIV infection? (Points : 2)

4. What of the following remains a significant cause of morbidity and mortality worldwide? (Points : 2)

5. Once they have penetrated the first line of defense, which microorganisms do neutrophils actively attack, engulf, and destroy by phagocytosis? (Points : 2)

6. After sexual transmission of HIV, a person can be infected yet seronegative for _____ months. (Points : 2)

7. Deficiencies in which element can produce depression of both B- and T-cell function? (Points : 2)

8. Hypersensitivity is best defined as a(n) (Points : 2)

9. A person with type O blood is likely to have high titers of anti-___ antibodies. (Points : 2)

10. What mechanism occurs in Raynaud phenomenon that classifies it as a type III hypersensitivity reaction? (Points : 2)

11. During an IgE-mediated hypersensitivity reaction, what causes bronchospasm? (Points : 2)

12. In a type II hypersensitivity reaction, when soluble antigens from infectious agents enter circulation, tissue damage is a result of (Points : 2)

13. In which primary immune deficiency is there a partial to complete absence of T-cell immunity? (Points : 2)

14. Which cytokines initiate the production of corticotropin-releasing hormone (CRH)? (Points : 2)

15. What effect does estrogen have on lymphocytes? (Points : 2)

16. Which hormone increases the formation of glucose from amino 

17. During a stress response, increased anxiety, vigilance, and arousal is prompted by (Points : 2)

18. Which cytokine is involved in producing cachexia syndrome? (Points : 2)

19. Which of the viruses below are oncogenic DNA viruses? (Points : 2)

20. By what process does the ras gene convert from a proto-oncogene to an oncogene? (Points : 2)

21. What is the role of vascular endothelial growth factor (VEGF), basic fibroblast growth factor (bFGF), and transforming growth factor-alpha (TGF-) in cell metastasis? (Points : 2)

22. Many cancers create a mutation of ras. What is ras? (Points : 2)

23. In chronic myeloid leukemia (CML), a piece of chromosome 9 fuses to a piece of chromosome 22. This is an example of which mutation of normal genes to oncogenes? (Points : 2)

24. Tobacco smoking is associated with cancers of all of the following except (Points : 2)

25. What percentage of children with cancer can be cured? (Points : 2)

NR 507 Week 2 No. Quiz 

1. At the arterial end of capillaries, fluid moves from the intravascular space into the interstitial space because the (Points : 2)

2. Physiologic pH is maintained around 7.4 because bicarbonate (HCO3) and carbonic acid (H2CO3) exist in a ratio of (Points : 2)

3. When thirst is experienced, how are osmoreceptors activated? (Points : 2)

4. Chvostek sign and Trousseau sign indicate (Points : 2)

5. Which are indications of dehydration? (Points : 2)

6. In hyperkalemia, cardiac rhythm changes are a direct result of (Points : 2)

7. Water movement between the intracellular fluid compartment and the extracellular compartment is primarily a function of (Points : 2)

8. In tuberculosis, the body walls off the bacilli in a tubercle by stimulating (Points : 2)

9. Pulmonary edema usually begins at a pulmonary capillary wedge pressure or left atrial pressure of _____ mm Hg. (Points : 2)

10. Which inflammatory mediators are produced in asthma? (Points : 2)

11. The most successful treatment for chronic asthma begins with (Points : 2)

12. Which pleural abnormality involves a site of pleural rupture that act as a one-way valve, permitting air to enter on inspiration but preventing its escape by closing during expiration? (Points : 2)

13. _____ is a fulminant form of respiratory failure characterized by acute lung inflammation and diffuse alveolocapillary injury. (Points : 2)

14. In ARDS, alveoli and respiratory bronchioles fill with fluid as a result of the (Points : 2)

15. Clinical manifestations that include unexplained weight loss, dyspnea on exertion, use of accessory muscles, and tachypnea with prolonged expiration are indicative of (Points : 2)

16. Clinical manifestations of pulmonary hypertension include (Points : 2)

17. Dyspnea is not a result of (Points : 2)

18. High altitudes may produce hypoxemia through (Points : 2)

19. Chest wall compliance in infants is _____ in adults. (Points : 2)

20. What is the primary cause of RDS of the newborn? (Points : 2)

21. An accurate description of childhood asthma is that it is a(n) (Points : 2)

22. Cystic fibrosis (CF) is caused by a(n) (Points : 2)

23. Which of the following statements about the advances in the treatment of RDS of the newborn is incorrect? (Points : 2)

24. Which of the following types of croup is most common? (Points : 2)

25. Which immunoglobulin is present in childhood asthma? (Points : 2)

NR 507 Week No. 3 Quiz

1. The underlying disorder of _____ anemia is defective secretion of intrinsic factor, which is essential for the absorption of vitamin B12.(Points : 2)

2. What is the pathophysiologic process of aplastic anemia? (Points : 2)

3. The body compensates for anemia by (Points : 2)

4. A woman complains of chronic gastritis, fatigue, weight loss, and tingling in her fingers. Laboratory findings show low hemoglobin and hematocrit levels, and a high mean corpuscular volume. These findings are consistent with _____ anemia. (Points : 2)

5. In hemolytic anemia, jaundice occurs only when (Points : 2)

6. Symptoms of polycythemia vera are mainly the result of (Points : 2)

7. Which proinflammatory cytokines are responsible for the development and maintenance of DIC? (Points : 2)

8. Which of the following is a description consistent with acute lymphocytic leukemia (ALL)? (Points : 2)

9. Heparin-induced thrombocytopenia (HIT) is described as a(n) (Points : 2)

10. Which of the following is a description consistent with chronic lymphocytic leukemia (CLL)? (Points : 2)

11. Hemolytic disease of the newborn can occur if the mother is (Points : 2)

12. Polycythemia occurs in a fetus because (Points : 2)

13. The type of anemia that occurs as a result of thalassemia is (Points : 2)

14. The sickle cell trait differs from sickle cell disease in that the child with sickle cell trait (Points : 2)

15. Hemophilia B is caused by clotting factor _____ deficiency. (Points : 2)

16. What is the name of the disorder in which levels of bilirubin remain excessively high in the newborn and are deposited in the brain?(Points : 2)

17. An individual who is demonstrating elevated levels of troponin, creatine kinase (CK), and lactic dehydrogenase (LDH) is exhibiting indicators associated with: (Points : 2)

18. What alteration occurs in injured endothelial cells that contributes to atherosclerosis? (Points : 2)

19. Which of the following is manufactured by the liver and primarily contains cholesterol and protein? (Points : 2)

20. Cardiac cells can withstand ischemic conditions and still return to a viable state for how many minutes? (Points : 2)

21. When does systemic vascular resistance in infants begin to rise? (Points : 2)

22. An infant has a loud, harsh, holosystolic murmur and systolic thrill that can be detected at the left lower sternal border that radiates to the neck. These clinical findings are consistent with which congenital heart defect? (Points : 2)

23. Which congenital heart defects occur in trisomy 13, trisomy 18, and Down syndrome? (Points : 2)

24. The foramen ovale is covered by a flap that creates a check valve allowing blood to flow unidirectionally from the _____ to the _____.(Points : 2)

25. Which heart defect produces a systolic ejection murmur at the right upper sternal border that transmits to the neck and left lower sternal border with an occasional ejection click? (Points : 2)

NR 507 Week No. 5 Quiz

1. Aldosterone synthesis and secretion are primarily regulated by the (Points : 2)

2. A surgical individual just arrived on the unit from the postanesthesia care unit. This person’s respirations are 4 per minute and shallow. As the nurse calls for assistance, the person suddenly feels jittery and breathing quickens. Which of the following feedback loops is operating for the nurse in this situation? (Points : 2)

3. What effect does aldosterone have on fluid and electrolyte imbalances? (Points : 2)

4. What effect does hyperphosphatemia have on other electrolytes? (Points : 2)

5. Where is oxytocin synthesized? (Points : 2)

6. Which mineral is needed for the synthesis of thyroid hormones? (Points : 2)

7. The portion of the pituitary that secretes oxytocin is the _____ pituitary. (Points : 2)

8. When insulin binds its receptors on muscle cells, an increase in glucose uptake by the muscle cells is the result. This is an example of a _____ effect by a hormone. (Points : 2)

9. Which of the following hormones acts on its target cell via a second messenger? (Points : 2)

10. Target cells for parathyroid hormone (PTH) are located in the (Points : 2)

11. Which hormone is involved in the regulation of serum calcium levels? (Points : 2)

12. A person who has experienced physiologic stresses will have increased levels of which hormone? (Points : 2)

13. The first lab test that indicates type 1 diabetes is causing the development of diabetic nephropathy is (Points : 2)

14. A deficiency of which of the following may result in hypothyroidism? (Points : 2)

15. Diagnosing a thyroid carcinoma is best done with (Points : 2)

16. The effects of syndrome of inappropriate antidiuretic hormone (SIADH) include solute (Points : 2)

17. Which of the following clinical manifestations is not common to both diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar nonketotic syndrome (HHNKS)? (Points : 2)

18. The signs of thyroid crisis resulting from Graves disease include (Points : 2)

19. What causes the microvascular complications of clients with diabetes mellitus? (Points : 2)

20. A man with a closed head injury has a urine output of 6 to 8 L/day. Electrolytes are within normal limits, but his antidiuretic hormone (ADH) level is low. Although he has had no intake for 4 hours, there is no change in his polyuria. These are indications of (Points : 2)

21. Amenorrhea, galactorrhea, hirsutism, and osteopenia are each caused by a (Points : 2)

22. The most common cause of hypoparathyroidism is (Points : 2)

23. The level of thyroid-stimulating hormone (TSH) in Graves disease is usually (Points : 2)

24. The most probable cause of low serum calcium following a thyroidectomy is (Points : 2)

25. Hyperpituitarism is generally caused by (Points : 2)

NR 507 Week No. 6 Quiz

1. Considering the pathophysiology of osteoporosis, which cytokines and hormones decrease receptor activator of RANKL expression?(Points : 2)

2. Rhabdomyolysis is characterized by (Points : 2)

3. Which type of osteoporosis would a person develop after having the left leg in a cast for 8 weeks to treat a compound displaced fracture of the tibia and fibula? (Points : 2)

4. Considering the pathophysiology of osteoporosis, what are the effects of extracellular signal regulated kinases (ERKs) and receptor activator of RANKL on osteoblasts and osteoclasts? (Points : 2)

5. What is the diagnosis of a person who has tennis elbow characterized by tissue degeneration or irritation of the extensor carpi brevis tendon? (Points : 2)

6. Which statement is false about giant cell tumors? (Points : 2)

7. What pattern of bone destruction is described as not well defined and not easily separated from normal bone? (Points : 2)

8. The pain experienced in Legg-Calvé-Perthes disease is referred to as involving (Points : 2)

9. In osteomyelitis, bacteria gain access to the subperiosteal space in the metaphysis, which is considered the “path of least resistance.” What factor makes this route for bacteria the path of least resistance? (Points : 2)

10. Molecular analysis has demonstrated that osteosarcoma is associated with (Points : 2)

11. Ewing sarcoma arises from (Points : 2) 

12. Which serum laboratory test is elevated in all forms of osteogenesis imperfecta? (Points : 2)

13. The _____ is cartilage that retains the ability to form and calcify new cartilage and deposit bone until the skeleton matures. (Points : 2)

14. Osteochondrosis is caused by a(n) (Points : 2)

15. An insufficient dietary intake of vitamin _____ can lead to rickets in children. (Points : 2)

16. In latex allergies, which immunoglobulin is associated with an immediate reaction? (Points : 2)

17. Chickenpox may be followed years later by (Points : 2)

18. Cutaneous vasculitis develops from the deposit of _____ in small blood vessels as a toxic response allergen. (Points : 2)

19. Which malignancy is characterized by slow-growing lesions that usually have depressed centers and rolled borders and are frequently located on the face and neck? (Points : 2)

20. Scleroderma is more common in women and is associated with a(n) (Points : 2)

21. Thrush is a superficial infection that commonly occurs in children and is caused by (Points : 2)

22. What is the cause of chickenpox? (Points : 2)

23. Which vascular anomaly is a congenital malformation of dermal capillaries that does not fade with age? (Points : 2)

24. What is a common source of tinea corporis? (Points : 2)

25. Which contagious disease creates a primary skin lesion that is a pinpointed macule, papule, or wheal with hemorrhagic puncture site?(Points : 2)

NR 510 Week No. 7 Quiz

1. Which dyskinesia involves involuntary movements of the face, trunk, and extremities? (Points : 2)

2. Uncal herniation occurs when (Points : 2)

3. Cerebral edema is an increase in the fluid content of the (Points : 2)

4. The body compensates to a rise in intracranial pressure by first displacing (Points : 2)

5. In Parkinson disease (PD), the basal ganglia influences the hypothalamic function to produce which grouping of clinical manifestations?(Points : 2)

6. The most critical aspect in diagnosing a seizure disorder and establishing its cause is (Points : 2)

7. Subarachnoid hemorrhage causes communicating hydrocephalus by obstructing (Points : 2)

8. Dilated and sluggish pupils, widening pulse pressure, and bradycardia are clinical findings evident of which stage of intracranial hypertension? (Points : 2)

9. Microinfarcts resulting in pure motor or pure sensory deficits are the result of which type of stroke? (Points : 2)

10. A right hemisphere embolic cerebrovascular accident has resulted in left-sided paralysis and reduced sensation of the left foot and leg. The vessel most likely affected by the emboli is the right _____ artery. (Points : 2)

11. In children most intracranial tumors are located (Points : 2)

12. Which clinical finding is considered a diagnostic indicator for an arteriovenous malformation (AVM)? (Points : 2)

13. Which electrolyte imbalance contributes to lithium toxicity? (Points : 2)

14. A decrease in receptor binding for which neurotransmitter is found in depressed individuals? (Points : 2)

15. Which neurotransmitter receptors are blocked by antipsychotic drugs? (Points : 2)

16. Spina bifida occulta is characterized by a(n) (Points : 2)

17. The form of cerebral palsy that results in gait disturbances and instability is (Points : 2)

18. The life-threatening problems associated with myelomeningocele include (Points : 2)

19. Intussusception causes intestinal obstruction by (Points : 2)

20. Which statement is false regarding the pathophysiology of acute pancreatitis? (Points : 2)

21. The most common manifestation of portal hypertension induced splenomegaly is (Points : 2)

22. Congenital aganglionic megacolon (Hirschsprung disease) involves inadequate motility of the colon caused by neural malformation of the _____ nervous system. (Points : 2)

23. Which disorder is characterized by an increase in the percentages in T cells and complement together with IgA and IgM antigliadin antibodies found in jejunum fluid? (Points : 2)

24. Incomplete fusion of the nasomedial or intermaxillary process during the fourth week of embryonic development causes (Points : 2)

25. Prolonged diarrhea is more severe in children than in adults because (Points : 2)