Illnesses, Diagnosis And Decision-making

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Question 1 A 42-year-old man is being treated for a peptic ulcer with ranitidine (Zantac) taken PO at bedtime. Even though few adverse effects are associated with this drug, one common adverse effect that can be severe is

A) headache

B) irritability

C) dry mouth

D) heart palpitations

Question 2 A patient on 5-FU calls the clinic and reports that he has between five and seven loose bowel movements daily. The nurse will instruct the patient to

A) treat the diarrhea with OTC medications

B) avoid protein-rich foods

C) avoid grapefruit and grapefruit juice

D) notify the clinic if the stools are black or if there is evidence of blood

Question 3 A patient has been prescribed a histamine-2 (H2) receptor antagonist for the treatment of GERD. Why are H2RAs more effective than H1 receptor antagonists in the treatment of diseases of the upper GI tract?

A) H2RAs have a longer duration of action and fewer adverse effects than H1RAs

B) The parietal cells of the stomach have H2 receptors but not H1 receptors

C) H2RAs may be administered orally and in an outpatient environment but H1RAs require intravenous administration

D) H2 receptors in the upper GI tract outnumber H1 receptors by a factor of 2:1

Question 4 To maximize the therapeutic effect of diphenoxylate HCl with atropine sulfate, the nurse will instruct the patient to take the medication

A) once a day

B) twice a day

C) every 2 hours

D) four times a day

Question 5 A 22-year-old male college senior has lived with a diagnosis of Crohn’s disease for several years and has undergone several courses of treatment with limited benefit. Which of the following targeted therapies has the potential to alleviate the symptoms of Crohn’s disease?

A) Tositumomab plus 131I (Bexxar)

B) Muromonab-CD3 (Orthoclone OKT3)

C) Infliximab (Remicade)

D) Eculizumab (Soliris)

Question 6 A patient has been prescribed rabeprazole (Aciphex). It will be important for the nurse to assess the patient’s drug history to determine if the patient is taking which of the following drugs?

A) Levodopa

B) Morphine

C) Digoxin

D) Dicyclomine hydrochloride

Question 7 An adult patient who has been diagnosed with a rectal tumor is scheduled to begin treatment with cisplatin. The nurse has conducted patient teaching about the possibility of nausea and vomiting. In order to reduce the patient’s risk of severe nausea, the nurse should

A) place the patient on a low-residue diet

B) ensure that the patient is NPO from midnight prior to receiving the drug

C) administer a combination of antiemetics prior to the administration of the drug

D) encourage the patient to request antiemetics if the nausea becomes unbearable

Question 8 It is determined that a patient, who is in a hepatic coma, needs a laxative. Lactulose is prescribed. Which of the following should the nurse monitor to assess the efficacy of the lactulose therapy?

A) Water levels in the colon

B) Oncotic pressure in the colon

C) Blood ammonia levels

D) Relief from symptoms

Question 9 A 60-year-old man has scheduled a follow-up appointment with his primary care provider stating that the omeprazole (Prilosec) which he was recently prescribed is ineffective. The patient states,“I take it as soon as I feel heartburn coming on, but it doesn’t seem to help at all.” How should the nurse best respond to this patient’s statement?

A) “It could be that Prilosec isn’t the right drug for you, so it would be best to talk this over with your care provider.”

B) “Prilosec won’t really decrease the sensation of heartburn, but it is still minimizing the damage to your throat and stomach that can be caused by the problem.”

C) “Prilosec will help your heartburn but it’s not designed to provide immediate relief of specific episodes of heartburn.”

D) “A better strategy is to take a dose of Prilosec 15 to 30 minutes before meals or drinks that cause you to get heartburn.”

Question 10 A 33-year-old woman has irritable bowel syndrome (IBS). The physician has prescribed simethicone (Mylicon) for her discomfort.Which of the following will the nurse monitor most closely during the patient’s drug therapy?

A) Drug toxicity

B) Anorexia

C) Increased abdominal pain and vomiting

D) Increased urine output

Question 11 Mr. Tan is a 69-year-old man who prides himself in maintaining an active lifestyle and a healthy diet that includes adequate fluid intake. However, Mr. Tan states that he has experienced occasional constipation in recent months. What remedy should be the nurse’s first suggestion?

A) Bismuth subsalicylate

B) A bulk-forming (fiber) laxative

C) A stimulant laxative

D) A hyperosmotic laxative

Question 12 A 29-year-old woman has been prescribed alosetron (Lotronex) for irritable bowel syndrome. Before starting the drug therapy, the nurse will advise the patient about which of the following adverse effect(s)?

A) Constipation

B) Breathlessness and hypotension

C) Hyperthyroidism

D) Impaired cardiac function

Question 13 A 29-year-old female patient has been prescribed orlistat (Xenical) for morbid obesity. The nurse is providing patient education concerning the drug. An important instruction to the patient would be to

A) omit the dose if the meal does not contain fat

B) take orlistat and multivitamins together

C) take orlistat in one dose at breakfast

D) omit the dose if the meal does not contain protein

Question 14 Prior to administering a dose of 5-FU to a patient with pancreatic cancer, the nurse is conducting the necessary drug research. The nurse is aware that 5-FU is a cell cycle–specific chemotherapeutic agent. Which of the following statements best describes cell cycle–specific drugs?

A) They follow a specific sequence of cytotoxic events in order to achieve cell death

B) They affect cancerous cells during a particular phase of cellular reproduction

C) They achieve a synergistic effect when administered in combination with cell cycle–nonspecific drugs

D) They affect cancerous cells and normal body cells in a similar manner

Question 15 A patient with a long history of alcohol abuse has been admitted to an acute medical unit with signs and symptoms of hepatic encephalopathy. His current medication orders include QID doses of oral lactulose. What desired outcomes should the nurse associate with this drug order?

A) Patient will have three to four loose bowel movements each day

B) Patient will express relief from constipation

C) Patient will have formed bowel movements that do not contain frank or occult blood

D) Patient will express an understanding of his current bowel regimen

Question 16 A nurse is assessing a female patient who is taking diphenoxylate HCl with atropine sulfate. Which of the following would lead the nurse to suspect that she is experiencing an allergic reaction?

A) Numbness of extremities

B) Headache and lethargy

C) Toxic megacolon

D) Urticaria

Question 17 A 73-year-old woman has scheduled an appointment with her nurse practitioner to discuss her recurrent constipation. The woman states that she experiences constipation despite the fact that she takes docusate on a daily basis and performs cleansing enemas several times weekly.How should the nurse best respond to this patient’s statements?

A) “Because we become more prone to constipation as we age, you’ll likely need to increase the number of stool softeners you take.”

B) “I’ll refer you to a specialist because it could be that you have a disease affecting your bowels or stomach.”

C) “Taking too many laxatives can make your bowels dependent on them, making you more susceptible to constipation.”

D) “Try using a different over-the-counter laxative and see that if you resolves your problem.”

Question 18 A patient develops diarrhea secondary to antibiotic therapy. He is to receive two tablets of diphenoxylate HCl with atropine sulfate (Lomotil) orally as needed for each loose stool. The nurse should inform him that he may experience

A) dizziness

B) bradycardia

C) muscle aches

D) increase in appetite

Question 19 A patient who takes aluminum hydroxide with magnesium hydroxide (Mylanta) frequently for upset stomach, heartburn, and sour stomach is seen regularly in the clinic. The nurse should assess which of the following?

A) Blood glucose level

B) Serum phosphate level

C) Urine specific gravity

D) Aspartate transaminase levels

Question 20 A teenage boy has undergone a diagnostic workup following several months of persistent, bloody diarrhea that appears to lack an infectious etiology. The boy has also experienced intermittent abdominal pain and has lost almost 15 pounds this year. Which of the following medications is most likely to treat this boy’s diagnosis?

A) Lubiprostone

B) Mesalamine

C) Docusate

D) Bismuth subsalicylate

Question 21 Mesalamine (Asacol) is prescribed for a 22-year-old woman with Crohn disease. The nurse will discuss with the patient the possibility for which of the following adverse effects related to the new drug therapy?

A) Hair loss

B) Metallic taste

C) Fatigue

D) Increased appetite

Question 22 A 58-year-old man is prescribed dicyclomine (Bentyl) for irritable bowel syndrome. In which of the following conditions is dicyclomine therapy contraindicated?

A) Hypertension

B) Diabetes mellitus

C) Glaucoma

D) Rheumatoid arthritis

Question 23 A nurse is planning care for a 59-year-old woman who is on ranitidine therapy. The nurse is concerned for the patient’s safety.Which of the following would be an appropriate nursing diagnosis?

A) Diarrhea related to adverse effects of drug therapy

B) Acute Pain related to adverse drug effects, headache

C) Risk for Injury related to drug-induced somnolence, dizziness, confusion, or hallucinations

D) Potential Complication: Electrolyte Imbalance related to hypophosphatemia, secondary to drug therapy

Question 24 A 57-year-old man is to begin 5-FU therapy for colon cancer. It will be most important for the nurse to monitor which of the following during the first 72 hours of the initial treatment cycle?

A) Myelosuppression

B) Cardiac events

C) White blood cell nadir

D) Nausea and vomiting

Question 25 A patient is taking cholestyramine. The nurse will assess for which of the following common adverse effects of the drug?

A) Abdominal pain

B) Headache

C) Constipation

D) Indigestion

Question 26 A patient comes to the clinic asking for help to quit drinking alcohol. She has a 21-year history of heavy drinking and is worried about developing cirrhosis of the liver. The patient agrees to take disulfiram (Antabuse). The nurse will teach the patient that the combination of alcohol and Antabuse will cause which of the following?

A) Bradycardia

B) Diarrhea

C) Nausea

D) Slight headache

Question 27 A 52-year-old man is suffering from a deficiency of exocrine pancreatic secretions and is prescribed pancrelipase (Pancrease MT). Before the medication therapy begins, the nurse will assess for allergies related to

A) ragweed

B) pollen

C) pork

D) shellfish

Question 28 A nurse is providing discharge instructions to a patient who will be taking fludrocortisone at home. The nurse will encourage the patient to eat a diet that is

A) low in sodium and potassium

B) low in sodium, high in potassium

C) high in iron

D) low in proteins

Question 29 A nurse is aware that diphenoxylate HCl with atropine sulfate is an effective adjunct in the treatment of diarrhea. For which of the following patients could the administration of this drug be potentially harmful?

A) An 80-year-old man who has diarrhea secondary to Clostridium difficile infection

B) A woman who has experienced severe diarrhea associated with influenza

C) A man who has experienced diarrhea shortly after beginning tube feeding through a nasogastric tube

D) A 60-year-old woman who tends to get diarrhea during periods of intense stress

Question 30 A clinic nurse is planning care for a 68-year-old man who has been on omeprazole (Prilosec) therapy for heartburn for some time. Regarding the patient’s safety, which of the following would be a priority nursing action?

A) Teach the patient to take omeprazole 1 hour before meals

B) Emphasize that the drug should not be crushed or chewed

C) Coordinate bone density testing for the patient

D) Monitor the patient for the development of diarrhea

Question 31 A nurse is overseeing the care of a young man whose ulcerative colitis is being treated with oral prednisone. Which of the following actions should the nurse take in order to minimize the potential for adverse drug effects and risks associated with prednisone treatment?

A) Avoid OTC antacids for the duration of treatment

B) Advocate for intravenous, rather than oral, administration

C) Teach the patient strategies for dealing with headaches

D) Carefully assess the patient for infections

Question 32 A woman with numerous chronic health problems has been diagnosed with a benign gastric ulcer has begun treatment with ranitidine (Zantac). Which of the following teaching points should the nurse provide to this patient?

A) “Quitting smoking will significantly increase the chance that this drug will heal your ulcer.”

B) “This drug will help to eliminate the bacteria in your stomach that caused your ulcer.”

C) “You should eat several small meals each day rather than three larger meals.”

D) “Take each dose of ranitidine with an antacid of your choice.”

Question 33 A patient has GERD and is taking ranitidine (Zantac). She continues to have gastric discomfort and asks whether she can take an antacid. Which of the following is an appropriate response by the nurse?

A) “Sure, you may take an antacid with ranitidine.”

B) “No, the two drugs will work against each other.”

C) “Yes, but be sure to wait at least 2 hours to take the antacid after you take the ranitidine.”

D) “I wouldn’t advise it. You may experience severe constipation.”

Question 34 A woman with an inflammatory skin disorder has begun taking prednisone in an effort to control the signs and symptoms of her disease. The nurse who is providing care for this patient should prioritize which of the following potential nursing diagnoses in the organization of the patient’s care?

A) Fluid Volume Excess

B) Constipation

C) Acute Confusion

D) Impaired Gas Exchange

Question 35 Following an endoscopy, a 66-year-old man has been diagnosed with a duodenal ulcer resulting from Helicobacter pylori infection. Which of the following medications will likely be used in an attempt to eradicate the patient’s H. pylori infection? (Select all that apply.)is situation?

A) A PPI

B) Antibiotics

C) Cisapride (Propulsid)

D) Aluminum hydroxide

Picot Statement And Literature

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While the implementation plan prepares students to apply their research to the problem or issue they have identified for their capstone change proposal project, the literature review enables students to map out and move into the active planning and development stages of the project.

A literature review analyzes how current research supports the PICOT, as well as identifies what is known and what is not known in the evidence. Students will use the information from the earlier PICOT Statement Paper and Literature Evaluation Table assignments to develop a 750-1,000 word review that includes the following sections:

Title page

Introduction section

A comparison of research questions

A comparison of sample populations

A comparison of the limitations of the study

A conclusion section, incorporating recommendations for further research

Prepare APA style

Medical Case Study

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Report Issue
I need this in next 12 hours.

Case Study ► Peter Smith is a 73-year-old male with mild Type 2 diabetes. He states that he has needed to urinate more frequently during the last 2 weeks, and he feels a burning sensation when he urinates. He has also been very tired lately. Based on the vital signs you measured and Peter’s current complaints, the physician ordered a fasting blood glucose and a urinalysis.

What is the likely diagnosis for Mr. Smith?

Why did the physician order both a urinalysis and a blood glucose test?

Why might Mr. Smith’s vital signs show that his temperature is slightly elevated?

Based on the laboratory test results, the physician prescribed an antibiotic for Mr. Smith. What can you advise Mr. Smith to do in addition to taking the antibiotic as prescribed?

Benchmark – Human Experience Across The Health-Illness Continuum

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The benchmark assesses the following competency:

Benchmark: 5.1. Understand the human experience across the health-illness continuum.

Research the health-illness continuum and its relevance to patient care. In a 750-1,000 word paper, discuss the relevance of the continuum to patient care and present a perspective of your current state of health in relation to the wellness spectrum. Include the following:

Examine the health-illness continuum and discuss why this perspective is important to consider in relation to health and the human experience when caring for patients.

Reflect on your overall state of health. Discuss what behaviors support or detract from your health and well-being. Explain where you currently fall on the health-illness continuum.

Discuss the options and resources available to you to help you move toward wellness on the health-illness spectrum. Describe how these would assist in moving you toward wellness (managing a chronic disease, recovering from an illness, self-actualization, etc.).

Prepare this assignment according to the guidelines found in the APA Style Guide. An abstract or thesis is required.

PICOT Statement

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Review the Topic Materials and the work completed in NRS-433V to formulate a PICOT statement for your capstone project.

A PICOT starts with a designated patient population in a particular clinical area and identifies clinical problems or issues that arise from clinical care. The intervention should be an independent, specified nursing change intervention. The intervention cannot require a provider prescription. Include a comparison to a patient population not currently receiving the intervention, and specify the time frame needed to implement the change process.

Formulate a PICOT statement using the PICOT format provided in the assigned readings. The PICOT statement will provide a framework for your capstone project.

In a paper of 500-750 words, clearly identify the clinical problem and how it can result in a positive patient outcome.

Make sure to address the following on the PICOT statement:

Evidence-Based Solution

Nursing Intervention

Patient Care

Health Care Agency

Nursing Practice

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

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

You are required to submit this assignment to Turnitin

Diagnosis And Management Of Respiratory, Cardiovascular, And Genetic Disorders

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Case Studies 1–3

Respiratory disorders such as pneumonia and asthma are among the leading causes of hospitalization in pediatric patients (U.S. Department of Health and Human Services, 2011). With such severe implications associated with many respiratory disorders, advanced practice nurses must be able to quickly identify symptoms, diagnose patients, and recommend appropriate treatment. For this Discussion, consider potential diagnoses and treatments for the patients in the following three case studies.

Case Study 1:

A 14-month-old female presents with a 4-day history of nasal congestion and congested cough. This morning, the mother noted that her daughter was breathing quickly and “it sounds like she has rice cereal popping in her throat.” Oral intake is decreased. Physical examination reveals the following: respiratory rate is 58, lung sounds are diminished in the bases, she has pronounced intercostal and subcostal retractions, expiratory wheezes are heard in all lung fields, and her tympanic membranes are normal. There is moderate, thick, clear rhinorrhea and postnasal drip. Her capillary refill is less than 3 seconds, and she is alert and smiling. Her RSV rapid antigen test is positive.

Case Study 2:

Brian is a 14-year-old known asthmatic with a 2-day history of worsening cough and shortness of breath. He reports using a short-acting beta agonist every 3 hours over the previous 24 hours. He has a long-acting inhaled corticosteroid, but the prescription ran out, and he forgot to get it refilled. He says he came today because he woke up at 2 a.m. coughing and couldn’t stop, thus preventing him from going back to sleep. Over-the-counter cough suppressants don’t help. He denies cigarette smoking, but his clothing smells like smoke. His respiratory rate is 18 and he has prolonged expiration and expiratory wheezes in all lung fields. There are no signs of dyspnea. All other exam findings are normal.

Case Study 3:

A father presents his 9-year-old with a 3-day history of cough. Dad states that his son is coughing up yellow mucus. The boy is afebrile and is sleeping through the night, but the father’s sleep is disturbed listening to his son coughing. Dad says he thinks his son has bronchitis and is requesting treatment. Physical examination reveals the following: respiratory rate is 18, lungs are clear to auscultation, patient is able to take deep breaths without coughing, there is no cervical adenopathy, nasal turbinates are slightly enlarged, and there is moderate clear rhinorrhea.

Case Studies 4–6

Assessing, diagnosing, and treating pediatric patients for many cardiovascular and genetic disorders can be challenging. As an advanced practice nurse who facilitates care for patients presenting with these types of disorders, you must be familiar with current evidence-based clinical guidelines. Because of the clinical implications, you have to know when to treat patients with these disorders and when to refer them for specialized care. In this Discussion, you examine the following case studies and consider appropriate treatment and management plans.

Case Study 4:

Miguel is a 15-year-old male who presents for a sports physical. He is a healthy adolescent with no complaints. He plays basketball. He is 6 feet 5 inches tall and weighs 198 pounds. You note long arms and long thin fingers. He has joint laxity in his wrists, shoulders, and elbows.

Case Study 5:

Trina is a 9-year-old female who weighs 110 pounds. Vital signs are as follows: BP 122/79, P 98, R 20. Her mother reports she is a picky eater and refuses to eat fruits and vegetables. Her physical activity includes soccer practice for 1 hour a week with one game each weekend from September through November. Family history is negative for myocardial infarction, but both parents take medication for dyslipidemia.

Case Study 6:

You see a 2-month-old for a well-child visit. She is breastfed and nurses every 2 to 3 hours during the day, but her mother reports she is not nursing as vigorously as before. She sleeps one 4-hour block at night. Birth weight was 7 pounds 5 ounces. Weight gain over the last 2 weeks reveals gain of 5 ounces per week. Physical examination reveals the following: HEENT exam is benign, lung sounds are clear, a new III/VI systolic ejection murmur is noted along the left lower sternal border, cap refill is brisk, skin is pink and moist, and abdominal exam is benign.

To prepare:

Review “Respiratory Disorders,” “Cardiovascular Disorders,” and “Genetic Disorders” in the Burns et al. text.

Review and select one of the six provided case studies. Analyze the patient information.

Consider a differential diagnosis for the patient in the case study you selected. Think about the most likely diagnosis for the patient.

Think about a treatment and management plan for the patient. Be sure to consider appropriate dosages for any recommended pharmacologic and/or non-pharmacologic treatments.

Consider strategies for educating patients and families on the treatment and management of the respiratory disorder.

By Day 3

Post an explanation of the differential diagnosis for the patient in the case study you selected. Explain which is the most likely diagnosis for the patient and why. Include an explanation of unique characteristics of the disorder you identified as the primary diagnosis. Then, explain a treatment and management plan for the patient, including appropriate dosages for any recommended treatments. Finally, explain strategies for educating patients and families on the treatment and management of the respiratory, cardiovascular, and/or genetic disorder.

The Health Care System

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Why is understanding the health care system at the local level important to consider when planning an EBP implementation? Conduct research and solicit anecdotal evidence from your course mentor that you will take into consideration for your own change project. ( PATIENTS WITH CANCER)

Environmental Factors And Health Promotion Pamphlet: Accident Prevention And Safety Promotion For Parents And Caregivers Of Infant

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To prepare for this assignment view the following brief video from the American Medical Association titled, “Health Literacy and Patient Safety: Help Patients Understand.”

Part I: Pamphlet

Develop a pamphlet to inform parents and caregivers about environmental factors that can affect the health of infants.

Use the “Pamphlet Template” document to help you create your pamphlet. Include the following:

Select an environmental factor that poses a threat to the health or safety of infants.

Explain how the environmental factor you selected can potentially affect the health or safety of infants.

Offer recommendations on accident prevention and safety promotion as they relate to the selected environmental factor and the health or safety of infants.

Offer examples, interventions, and suggestions from evidence-based research. A minimum of three scholarly resources are required.

Provide readers with two community resources, a national resource, and a Web-based resource. Include a brief description and contact information for each resource.

In developing your pamphlet, take into consideration the healthcare literacy level of your target audience.

Part II: Pamphlet Sharing Experience

Share the pamphlet you have developed with a parent of an infant child. The parent may be a person from your neighborhood, a parent of an infant from a child-care center in your community, or a parent from another organization, such as a church group with which you have an affiliation.

Provide a written summary of the teaching / learning interaction. Include in your summary:

Demographical information of the parent and child (age, gender, ethnicity, educational level).

Description of parent response to teaching.

Assessment of parent understanding.

Your impressions of the experience; what went well, what can be improved.

Submit Part I and Part II of the Accident Prevention and Safety Promotion for Parents and Caregivers of Infants assignment by the end of Topic 1.

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 required to submit this assignment to LopesWrite. Please refer to the directions in the Student Success Center.

Medical Coding

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QUESTION 1

  1. For the statement “ovarian androgen hormone hypersecretion” the main term to reference in the Index is __.

[removed]

a.

ovarian

[removed]

b.

androgen

[removed]

c.

hormone

[removed]

d.

hypersecretion

QUESTION 2

  1. For the statement “oligospermia due to efferent duct obstruction” the main term to reference in the Index is __.

[removed]

a.

oligospermia

[removed]

b.

efferent

[removed]

c.

duct

[removed]

d.

obstruction

QUESTION 3

  1. For the statement “acute antitubular basement membrane nephritis” the main term to reference in the Index is __.

[removed]

a.

antitibular

[removed]

b.

basement

[removed]

c.

membrane

[removed]

d.

nephritis

QUESTION 4

  1. For the statement “adhesive shoulder joint capsulitis” the main term to reference in the Index is _.

[removed]

a.

adhesive

[removed]

b.

shoulder

[removed]

c.

joint

[removed]

d.

capsulitis

QUESTION 5

  1. Acute adenoviral follicular conjunctivitis is reported with code(s) _.

[removed]

a.

B30

[removed]

b.

B30.1

[removed]

c.

B30.1, H10.9

[removed]

d.

B30.9

QUESTION 6

  1. Viral endocarditis is reported with code(s) __.

[removed]

a.

B33.21, I38

[removed]

b.

B33.24, I38

[removed]

c.

B33.24

[removed]

d.

B33.21

QUESTION 7

  1. Mast cell leukemia in remission is reported with code _.

[removed]

a.

C94.3

[removed]

b.

C94.30

[removed]

c.

C94.31

[removed]

d.

C94.32

QUESTION 8

  1. Evans syndrome is reported with code __.

[removed]

a.

D69

[removed]

b.

D69.4

[removed]

c.

D69.41

[removed]

d.

D69.49

QUESTION 9

  1. Medullary hypoplasia is reported with code _.

[removed]

a.

D61.9

[removed]

b.

D61.1

[removed]

c.

D62

[removed]

d.

D63.8

QUESTION 10

  1. Tommy Jones was hospitalized, and the discharge diagnosis recorded for his case is meningitis due to Lyme disease. The correct code(s) for this case is/are __.

[removed]

a.

A69.20

[removed]

b.

A69.20, G03.9

[removed]

c.

G03.9

[removed]

d.

A69.21

QUESTION 11

  1. Malignant neoplasm of the tail of the pancreas is reported with code __.

[removed]

a.

C24.9

[removed]

b.

C25

[removed]

c.

C25.2

[removed]

d.

C26.9

QUESTION 12

  1. Sally was admitted with a mass on her left ovary. After work-up it was determined that the mass was a benign neoplasm. The correct code for the principal diagnosis is __.

[removed]

a.

R19.01

[removed]

b.

D26.0

[removed]

c.

D27.1

[removed]

d.

R19.00

QUESTION 13

  1. Tuberculosis cerebral arteritis is reported with code _.

[removed]

a.

I77.6

[removed]

b.

A18.89

[removed]

c.

M31.6

[removed]

d.

A18.85

QUESTION 14

  1. Scarlet fever with otitis media is reported with code __.

[removed]

a.

A38.9

[removed]

b.

A38.1

[removed]

c.

A38.0

[removed]

d.

A38.8

  1. Tom Jones is being seen today by Dr. Smith for gonococcal tenosynovitis. The correct code for this case is _.

[removed]

a.

A54.49

[removed]

b.

M65.9

[removed]

c.

A54.42

[removed]

d.

A54.4

QUESTION 16

  1. Tim Hill has been experiencing diarrhea for a number of weeks with weight loss. Testing has determined that he has a beef tapeworm infection. Code(s) ____________ would be reported for this case.

[removed]

a.

R19.7

[removed]

b.

R19.7, B68.1

[removed]

c.

B68.1

[removed]

d.

B71.9

QUESTION 17

  1. The code used to report a benign neoplam of ureteric orifice of bladder is __.

[removed]

a.

D30.3

[removed]

b.

C67.6

[removed]

c.

C67.5

[removed]

d.

D30

QUESTION 18

  1. A benign neoplasm of the hepatic flexure is coded with code __.

[removed]

a.

C18.3

[removed]

b.

D12.3

[removed]

c.

D12

[removed]

d.

D12.9

QUESTION 19

  1. Janet is an 84 year old complaining of being tired and weak for the last week. She drove herself to the emergency department. The provided ordered blood work-up that revealed mast cell leukemia. The diagnostic code to report for this encounter is _.

[removed]

a.

C94.32

[removed]

b.

C94.31

[removed]

c.

C94

[removed]

d.

C94.30

QUESTION 20

  1. Linda has been tired and complains of feeling weak for the last two to three months. Blood work shows that she has folic acid deficiency anemia. The code(s) for this case are _.

[removed]

a.

R53.1

[removed]

b.

R53.1, D52.9

[removed]

c.

D52.9

[removed]

d.

D52.0

Diagnosing And Managing Gynecologic Conditions

/in /by

Discussion: Diagnosing and Managing Gynecologic Conditions

Gynecologic conditions can be difficult to diagnose for a variety of reasons, including overlapping symptoms, lack of patient knowledge, or even patient fear or embarrassment about sharing information. Your role provides you the opportunity to develop a relationship of trust and understanding with these patients so that you can gather the appropriate details related to medical history and current symptoms. When caring for this patient population, it is important to make these women an integral part of the process and work collaboratively with them to diagnose and develop treatment and management plans that will meet their individual needs. For this Discussion, consider diagnosis, treatment, and management strategies for the patients in the following four case studies:

Case Study 1:

A 32-year-old African American female is concerned about increasing dysmenorrhea over the past three years. In the past year, this was associated with painful intercourse. She has been in a monogamous relationship with one male partner for the past five years. They tried to have children without success. Menarche was at age 10; menstrual cycles are 21 days apart and last for 6–7 days. The first day of her last menstrual period was 10 days ago and was normal. She denies vaginal itching or discharge. On gynecologic exam there was no swelling, external lesions, or erythema, urethral swelling, or vaginal discharge. Cervix is pink without lesions or discharge. Uterus was small, retroverted, and non-tender. Adnexa were small and non-tender. Nodules are noted along the cul de sac.

Case Study 2:

A 42-year-old African American female is in the clinic for a routine gynecologic exam. When asked, she admits to noticing bleeding in between her menstrual periods for the past several months. She has been pregnant three times and has three children. She is sexually active with one male sex partner in a monogamous relationship. During her bimanual exam, you note an irregular intrauterine non-tender mass about 4 cm in diameter. The mass is palpable abdominally. The remainder of her gynecologic exam was normal.

Case Study 3:

A 48-year-old Caucasian female is in the clinic concerned about prolonged menstrual bleeding for three weeks now. Her prior menstrual periods have been irregular for the past eight months, lasting no more than three days each. There have been one to two months when she had no menstrual cycles at all. She reports occasional hot flushes and mood swings.

Case Study 4:

A 16-year-old Caucasian female comes to the clinic concerned because she has not had a menstrual period for three months. She’s a junior in high school and active in sports. She has lost about 10 lbs. in the past two months. She is currently 5 ft. 4 in. and weighs 100 lbs.

To prepare:

Review Chapter 26 of the Schuiling and Likis text and Chapter 7 of the Tharpe et al. text.

Review and select one of the four provided case studies. Analyze the patient information.

Consider a differential diagnosis for the patient in the case study you selected. Think about the most likely diagnosis for the patient.

Think about a treatment and management plan for the patient. Be sure to consider appropriate dosages for any recommended pharmacologic and/or nonpharmacologic treatments.

Consider strategies for educating patients on the treatment and management of the sexually transmitted infection you identified as your primary diagnosis.

By Day 3

Post an explanation of the differential diagnosis for the patient in the case study you selected. Provide a minimum of three possible diagnoses and list them from highest priority to lowest priority. Explain which is the most likely diagnosis for the patient and why. Then, explain a treatment and management plan for the patient, including appropriate dosages for any recommended treatments. Finally, explain strategies for educating patients on the disorder.