Nursing Process Dealing With Spiritual Distress

  Week 9/Module 9 Written AssignmentThere are many religions and spiritual sects in our world today. Many are apparent in our own United States due to the immigration of different cultural and ethnic groups of unique peoples. Along with the more orthodox ritual practices, there are many ALTERNATIVE therapies spirituality encompasses.  Prayer is NOT an alternative therapy, unless it is the ONLYtherapy being used to affect a change in wellness for the client.
Find one scholarly article about one ALTERNATIVE THERAPY(meditation, yoga, naturopathy, mindfulness, etc.), NOT A MAINSTREAM RELIGION, using the Rasmussen Library, consulting with the Nursing Librarian to better inform your literature search.
Write a one-page paper meeting the following criteria:

  • 1. Write an introduction or background section introducing the alternative spiritual therapy you selected. 1-2 paragraphs.
  • 2. Discuss how you think this complimentary method will or will not enhance the spirituality of your patient. 1-2 paragraphs.
  • 3. Discuss how you as a nurse could support your client in practicing this alternative spiritual therapy. 1-2 paragraphs.
  • 4.Follow correct APA formatting for your paper (title page, body, reference page), in-text citing and citing your reference at the end of the paper, and use correct sentence structure, spelling, and punctuation.

Module 09 Written Assignment – Nursing Process Dealing With Spiritual DistressScoring Rubric:Criteria Points1. Found a scholarly article on an alternative spiritual therapy __ 5.02. Write an introduction or background section describing the alternative spiritual therapy you selected. 1-2 paragraphs __5.03. Discuss how you think this complimentary method will or will not enhance the spirituality of your patient. 1-2 paragraphs ___5.04. Discuss how you as a nurse could support your client in practicing this alternative spiritual therapy _ 5.05. Followed APA format for in-text citing and reference citing, along with correct use of sentence structure, spelling, and punctuation __5.0Total Points  

How often should drug levels be monitored when a seizure medication has controlled the seizures

Question 1 2 / 2 points

Which statement about confusion is true?

Question options:

a) Confusion is a disease process.

b) Confusion is always temporary.

c) Age is a reliable predictor of confusion.

d) Polypharmacy is a major contributor to confusion in older adults.

Question 2 0 / 2 points

Sondra’s peripheral vestibular disease causes dizziness and vertigo. Which of the following medications will help to decrease edema in the labyrinth of the ear?

Question options:

a) Meclizine

b) Diphenhydramine

c) Diamox

d) Promethazine

Question 3 2 / 2 points

The hallmark of an absence seizure is:

Question options:

a) No activity at all

b) A blank stare

c) Urine is usually voided involuntarily

d) The attack usually lasts several minutes

Question 4 2 / 2 points

How often should drug levels be monitored when a seizure medication has controlled the seizures, and the drug level is adequate?

Question options:

a) Every 3 months

b) Every 6 months

c) Annually

d) Whenever there is a problem

Question 5 2 / 2 points

Which of the following persons fits the classic description of a patient with multiple sclerosis (MS)?

Question options:

a) A teenage male

b) A 65-year-old male

c) A 25-year-old female

d) A 60-year-old female

Question 6 2 / 2 points

Which of the following is a specific test to MS?

Question options:

a) Magnetic resonance imaging (MRI)

b) Computed tomography (CT) scan

c) A lumbar puncture

d) There is no specific test.

Question 7 2 / 2 points

Which drug for Alzheimer’s disease should be administered beginning at the time of diagnosis?

Question options:

a) Cholinesterase inhibitors

b) Anxiolytics

c) Antidepressants

d) Atypical antipsychotics

Question 8 2 / 2 points

Which hematoma occurs along the temporal cranial wall and results from tears in the middle meningeal artery?

Question options:

a) Epidural hematoma

b) Subdural hematoma

c) Subarachnoid hematoma

d) Intraparenchymal hemorrhage

Question 9 2 / 2 points

Which cranial nerve is affected in a patient with a cerebrovascular accident who has difficulty chewing?

Question options:

a) CN V

b) CN VII

c) CN IX

d) CN X

Question 10 2 / 2 points

Which statement best describes a carotid bruit?

Question options:

a) It is felt with the middle three fingers over the carotid artery.

b) A bruit becomes audible when the lumen is narrowed to 1 mm or less.

c) A low-pitched bruit is a medical emergency.

d) The higher the pitch of the bruit, the higher the degree of stenosis.

Question 11 2 / 2 points

Which patient is more likely to have a cluster headache?

Question options:

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 12 2 / 2 points

Inattention and a sleep-wake cycle disturbance are the hallmark symptoms of?

Question options:

a) Dementia

b) Alzheimer’s disease

c) Parkinson’s disease

d) Delirium

Question 13 2 / 2 points

Which type of meningitis is more benign, self-limiting, and caused primarily by a virus?

Question options:

a) Purulent meningitis

b) Chronic meningitis

c) Aseptic meningitis

d) Herpes meningitis

Question 14 2 / 2 points

Which is the most sensitive neuroimaging test to evaluate patients with encephalitis?

Question options:

a) MRI

b) CT

c) Electroencephalogram (EEG)

d) An initial lumbar puncture

Question 15 2 / 2 points

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

Question options:

a) A stabbing 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 16 1 / 1 point

Gabby, aged 22, has Bell’s palsy on the right side of her face. Her mouth is distorted, and she is concerned about permanent paralysis and pain. What do you tell her?

Question options:

a) “Most patients have complete recovery in 3 to 6 months.”

b) “Unfortunately, you’ll probably have a small amount of residual damage.”

c) “Don’t worry, I’ll take care of everything.”

d) “You may have a few more episodes over the course of your lifetime but no permanent damage.”

Question 17 2 / 2 points

Sam, aged 65, is started on L-dopa for his Parkinson’s disease (PD). He asks why this is necessary. You tell him:

Question options:

a) “L-dopa is neuroprotective.”

b) “The primary goal of therapy is to replace depleted stores of dopamine.”

c) “This is the only drug that can provide symptomatic benefit.”

d) “This is the initial monotherapy drug.”

Question 18 2 / 2 points

Which of the following signs is seen in a patient with more advanced PD?

Question options:

a) Resting tremor

b) Bradykinesia

c) Rigidity

d) Postural instability

Question 19 2 / 2 points

Which of the following is the most commonly experienced symptom of migraine?

Question options:

a) Light sensitivity

b) Pulsatile pain

c) Sound sensitivity

d) Experiencing an aura

Question 20 2 / 2 points

Which of the following characteristics differentiates peripheral vertigo from central vertigo?

Question options:

a) The duration of central vertigo is shorter than that of peripheral vertigo.

b) There is an auditory-associated symptom with peripheral vertigo and a visual-associated symptom with central vertigo.

c) Central vertigo is positional, and peripheral vertigo is not.

d) The onset of central vertigo is more sudden than that of peripheral vertigo.

Question 21 2 / 2 points

Carotid endarterectomy should be considered only for symptomatic patients with greater than what percentage of stenosis?

Question options:

a) Greater than 25%

b) Greater than 50%

c) Greater than 75%

d) Only for 100% occlusion

Question 22 2 / 2 points

What antiplatelet agent is most widely used for secondary prevention of stroke?

Question options:

a) Aspirin

b) Ticlopidine

c) Clopidogrel

d) Aspirin and clopidogrel

Question 23 2 / 2 points

Which adjunctive diagnostic test should be used in the work-up of a patient with suspected Creutzfeldt-Jakob disease or transient epileptic amnesia?

Question options:

a) MRI

b) CT

c) Cerebrospinal fluid analysis

d) EEG

Question 24 2 / 2 points

Which herbal preparation may cause delirium and should be avoided in an elderly patient?

Question options:

a) Sam-e

b) Saint John’s Wort

c) Melatonin

d) Saw Palmetto

Question 25 0 / 2 points

Which of the following activities is part of the functional activities questionnaire?

Question options:

a) Asking the patient to unravel a Rubik’s cube

b) Determining if the patient can drive on the highway

c) Asking the patient about a news event from the current week

d) Seeing if the patient can keep his or her home clean

Question 26 2 / 2 points

About 90% of all headaches are?

Question options:

a) Tension

b) Migraine

c) Cluster

d) Without pathological cause

Question 27 2 / 2 points

Which statement is true regarding driving and patients with a seizure disorder?

Question options:

a) Once diagnosed with a seizure disorder, patients must never drive again.

b) After being seizure free for 6 months, patients may drive.

c) Each state has different laws governing driving for individuals with a seizure disorder.

d) These persons may drive but never alone.

Question 28 2 / 2 points

Julie has relapsing-remitting muscular sclerosis. She has not had a good response to interferon. Which medication might help given intravenously once a month?

Question options:

a) Glatiramer acetate

b) Natalizumab

c) Fingolimod

d) Glucocorticoids

Question 29 2 / 2 points

The ‘freezing phenomenon’ is a cardinal feature of?

Question options:

a) Parkinson’s disease

b) Alzheimer’s disease

c) A CVA

d) Bell’s palsy

Question 30 2 / 2 points

A ratchet-like rhythmic contraction, especially in the hand, during passive stretching is known as?

Question options:

a) Spinothalamic dysfunction

b) Ratcheting

c) Cogwheeling

d) Hand tremors

Question 31 2 / 2 points

Clinical features of insidious onset, slow progression, and a lack of other findings to explain the symptoms are fairly diagnostic of which condition?

Question options:

a) Guillain-Barré syndrome

b) Parkinson’s disease

c) Alzheimer’s disease

d) Huntington’s disease

Question 32 1 / 1 point

Which condition is characterized by the impaired ability to learn new information along with either a cognitive disturbance in language, function, or perception?

Question options:

a) Guillain-Barré syndrome

b) Parkinson’s disease

c) Alzheimer’s disease

d) Delirium

Question 33 2 / 2 points

A score of 20 to 25 on this test indicates early-stage Alzheimer’s disease:

Question options:

a) SLUMS

b) MoCA

c) FAST

d) MMSE

Question 34 2 / 2 points

Intravenous thrombolytic therapy following an ischemic CVA should be given within how many hours of symptom onset?

Question options:

a) 1 hour

b) 3 hours

c) 6 hours

d) 12 hours

Question 35 2 / 2 points

When administered at the beginning of an attack, oxygen therapy may help this kind of headache?

Question options:

a) Tension

b) Migraine

c) Cluster

d) Stress

Question 36 2 / 2 points

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

Question options:

a) Acetylcholine

b) Gamma-aminobutyric acid (GABA)

c) Dopamine

d) Serotonin

Question 37 2 / 2 points

The criteria for diagnosing generalized anxiety disorder in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, 5th edition (text revision) state that excessive worry or apprehension must be present more days than not for at least:

Question options:

a) 1 month

b) 3 months

c) 6 months

d) 12 months

Question 38 1 / 1 point

A patient presents to the clinician after experiencing four episodes in the last month of sweating, palpitations, chest pain, nausea, and shaking. Each episode lasted about 10 minutes. The patient is now becoming very fearful of future events and has been reluctant to leave the house. The clinician suspects panic disorder but wants to rule out any possible medical causes. Which of the following medical conditions can mimic the symptoms of a panic attack?

Question options:

a) Pheochromocytoma

b) Hyperthyroidism

c) Cardiac arrhythmias

d) All of the above

Question 39 2 / 2 points

Which of the following is considered first-line treatment for panic disorders?

Question options:

a) Benzodiazepines

b) Selective serotonin reuptake inhibitors (SSRIs)

c) Tricyclic antidepressants

d) Cognitive behavioral therapy

Question 40 1 / 1 point

Which of the following symptoms is not part of the diagnostic criteria for post-traumatic stress disorder (PTSD)?

Question options:

a) Hypersomnolence

b) Blunted feelings

c) Loss of interest in significant activities

d) Intrusive recurrent recollections of the event

Question 41 2 / 2 points

Which of the following neuroendocrine abnormalities is implicated in depression?

Question options:

a) Decrease in adrenal size

b) Increased cortisol and corticotrophin-releasing hormone

c) An exaggerated response of thyrotropin (TRH) to infusion of thyroid-releasing hormone

d) Increased inhibitory response of glucocorticoids to dexamethasone

Question 42 2 / 2 points

The clinician has chosen to prescribe an SSRI instead of a tricyclic antidepressant (TCA) for a patient fitting the diagnostic criteria for depression. Which of the following is not true concerning SSRIs in comparison to tricyclic antidepressants?

Question options:

a) SSRIs are more effective than TCAs.

b) SSRIs take less time to work than TCAs.

c) SSRIs have a more favorable side-effect profile than TCAs.

d) SSRIs are not lethal in overdose.

Question 43 2 / 2 points

After discontinuing fluoxetine, how long must a person wait before starting a monoamine oxidase inhibitor?

Question options:

a) 2 weeks

b) 3 weeks

c) 4 weeks

d) 5 weeks

Question 44 2 / 2 points

It is important to educate patients with depression and their family members about reporting signs of increasing depression and suicidal thoughts. This is especially true during which time period?

Question options:

a) Before the initiation of treatment

b) 1 to 2 weeks after the initiation of treatment

c) When switching to a different medication

d) 1 to 2 weeks after tapering off medications

Question 45 2 / 2 points

A patient is experiencing extrapyramidal side effects from his antipsychotic medications. The clinician would most likely take which of the following approaches to treating these side effects?

Question options:

a) Give the patient a “drug holiday” until the symptoms resolve and then restart the medication.

b) Switch the patient to a different antipsychotic.

c) Treat the patient with anticholinergics.

d) Treat the patient with anticonvulsants.

Question 46 1 / 1 point

According to Kübler-Ross, the stages of grief occur in which order?

Question options:

a) Anger, denial, depression, bargaining, acceptance

b) Anger, denial, bargaining, acceptance, depression

c) Denial, anger, depression, bargaining, acceptance

d) Denial, anger, bargaining, depression, acceptance

Question 47 1 / 1 point

The clinician is educating a patient about the effects of marijuana. The patient stated she has been smoking for years and believes the use does not interfere with her life. What is a significant long-term sequelae of marijuana use that the clinician should educate this patient about?

Question options:

a) Memory impairment

b) Sexual dysfunction

c) Dry mouth

d) There are no long-term consequences of marijuana use.

Question 48 2 / 2 points

Cocaine acts as a stimulant by blocking the reuptake of which neurotransmitter?

Question options:

a) GABA

b) Acetylcholine

c) Dopamine

d) Serotonin

Question 49 2 / 2 points

What blood alcohol level corresponds with the signs of stupor and confusion?

Question options:

a) 0.05

b) 0.1

c) 0.2

d) 0.3

Question 50 2 / 2 points

Rapid eye movement (REM) sleep occurs how frequently during non-REM sleep?

Question options:

a) Every 30 minutes

b) Every 60 minutes

c) Every 90 minutes

d) Every 180 minutes

Question 51 2 / 2 points

Which of the following is a laboratory finding commonly found in patients with anorexia nervosa?

Question options:

a) Hypercholesterolemia

b) Hypermagnesmia

c) Leukocytosis

d) Decreased TRH

Question 52 2 / 2 points

Which of the following is the only drug for bulimia approved by the U.S. Food and Drug Administration?

Question options:

a) Sertraline

b) Fluoxetine

c) Citoprolam

d) Imipramine

Question 53 2 / 2 points

Which of the following would be important to monitor in a child receiving methylphenidate for treatment of attention deficit-hyperactivity disorder (ADHD)?

Question options:

a) Liver function

b) Vision

c) Growth parameters

d) Renal function

Question 54 2 / 2 points

It is important for the clinician to discuss the long-term effects of sexual assault with survivors. Which of the following is the most common long-term effect of sexual assault?

Question options:

a) Depression

b) Obsessive-compulsive disorder

c) Substance abuse

d) PTSD

Question 55 2 / 2 points

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

Question options:

a) 2 weeks

b) 1 month

c) 3 months

d) 6 months

Question 56 2 / 2 points

Which is the most prevalent psychiatric condition in the United States?

Question options:

a) Depression

b) Anxiety

c) Substance-related addictions

d) Gambling

Question 57 1 / 1 point

What is recorded as clinical category two of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, 5th edition (text revision)?

Question options:

a) Clinical disorder or focus of clinical attention

b) Personality or environmental problems

c) Environmental and psychosocial stressors

d) Global assessment of functioning

Question 58 2 / 2 points

Which of the following may be used to evaluate a person’s suicide risk?

Question options:

a) CAGE

b) SANE

c) SAD PERSONAS

d) DIGFAST

Question 59 2 / 2 points

Assessing for adherence with prescribed medications and developing a plan for what to do if they are stopped is a major treatment issue for which of the following diagnostic groups?

Question options:

a) ADHD

b) Bipolar

c) Depression

d) Anxiety

Question 60 1 / 1 point

Bipolar disorder requires differential diagnosis from all of the following except?

Question options:

a) Substance abuse and medication effects

b) Medical and neurological disorders

c) Cluster B personality disorders and depression

d) Obsessive-compulsive disorder

Question 61 1 / 1 point

The use of benzodiazepines in the patient with generalized anxiety disorder and comorbid depression can exacerbate depressive symptoms.

Question options:

a) True

b) False

Question 62 1 / 1 point

Depressive episodes associated with bipolar disorder are treated the same as major depressive disorder.

Question options:

a) True

b) False

Question 63 1 / 1 point

Women in abusive relationships have a greater chance of being killed by their batterers when they leave the relationship than women who stay.

Question options:

a) True

b) False

Question 64 1 / 1 point

Adults must show childhood onset of symptoms to receive a diagnosis of ADHD.

Question options:

a) True

b) False

Question 65 1 / 1 point

Parkinson’s disease and dementing illnesses may commonly manifest depressive symptoms.

Question options:

a) True

b) False

Question 66 1 / 1 point

The best predictor of suicide risk is a history of suicide attempts.

Question options:

a) True

b) False

Question 67 1 / 1 point

A no-suicide contract can prevent a suicide attempt.

Question options:

a) True

b) False

Question 68 1 / 1 point

Depression is the most chronic disabling and economically catastrophic medical disorder of the severe mental illnesses.

Question options:

a) True

b) False

Question 69 1 / 1 point

Clozapine (Clozaril) requires laboratory monitoring at specified frequencies with results reported to a national registry.

Question options:

a) True

b) False

Question 70 1 / 1 point

When combined with certain other medications, serotonin-specific antidepressants can have significant liver P450-interaction effects.

Question options:

a) True

b) False

Question 71 1 / 1 point

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 examination?

Question options:

a) Human papillomavirus (HPV)

b) Endometrial hyperplasia

c) Vagismus

d) Polycystic ovarian syndrome

Question 72 2 / 2 points

A 20-year-old woman is seen in the clinic because her boyfriend was found to have gonorrhea. Which of the following is the treatment of choice for gonorrhea?

Question options:

a) Ceftriaxone

b) Doxycycline

c) Acyclovir

d) Metronidazole

Question 73 1 / 1 point

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 has she most probably been exposed to?

Question options:

a) Gonorrhea

b) HPV

c) Chlamydia

d) Trichomonas

Question 74 1 / 1 point

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?

Question options:

a) Trichomonas

b) Bacterial vaginosis

c) HPV

d) Herpes simplex virus

Question 75 2 / 2 points

Which of the following medications is the treatment of choice for trichomonas?

Question options:

a) Metronidazole

b) Ceftriaxone

c) Diflucan

d) Doxycycline

Question 76 1 / 1 point

A 36-year-old woman is seen with complaints of vaginal itching, burning, and discharge. On potassium hydroxide (KOH) wet mount of vaginal discharge, the clinician notices hyphae. Which of the following treatments would be appropriate?

Question options:

a) Fluconazole

b) Estrogen vaginal cream

c) Metronidazole

d) Doxycycline

Question 77 2 / 2 points

Mandy presents with a cauliflower-like wart in her anogenital region. You suspect it was sexually transmitted and document this as a:

Question options:

a) Filiform/digitate wart

b) Dysplastic cervical lesion

c) Condyloma acuminata

d) Koilocytosis

Question 78 0 / 2 points

During a DRE on a 75-year-old man, the clinician suspects the patient has prostate cancer. What physical finding should make the clinician suspicious?

Question options:

a) An enlarged rubbery gland

b) A hard irregular gland

c) A tender gland

d) A boggy gland

Question 79 2 / 2 points

Of the following types of cellulitis, which is a streptococcal infection of the superficial layers of the skin that does not involve the subcutaneous layers?

Question options:

a) Necrotizing fasciitis

b) Periorbital cellulitis

c) Erysipelas

d) “Flesh-eating” cellulitis

Question 80 2 / 2 points

The forced vital capacity is decreased in:

Question options:

a) Asthma

b) Chronic bronchitis

c) Emphysema

d) Restrictive disease

Question 81 2 / 2 points

The most common cause of CAP is?

Question options:

a) Streptococcus pneumoniae

b) Klebsiella pneumoniae

c) Legionella pneumoniae

d) Pseudomonas aeruginosa

Question 82 2 / 2 points

Which of the following is a possible consequence of sleep apnea?

Question options:

a) Asthma

b) Increased white blood cells

c) Insulin resistance

d) Hyperactivity

Question 83 2 / 2 points

The majority of HSV-1 and HSV-2 infections are asymptomatic so that only which elevated antibody titer shows evidence of previous infection?

Question options:

a) IgA

b) IgE

c) IgG

d) IgM

Question 84 2 / 2 points

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?

Question options:

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 85 0 / 2 points

During a DRE on a 75-year-old man, the clinician suspects the patient has prostate cancer. What physical finding should make the clinician suspicious?

Question options:

a) An enlarged rubbery gland

b) A hard irregular gland

c) A tender gland

d) A boggy gland

Question 86 2 / 2 points

A 78-year-old man is diagnosed with C2 prostate cancer, and he asks the clinician what that means. In order to answer the patient, the clinician must have which of these understandings of the Jewett rating system?

Question options:

a) The cancer involves the seminal vesicles.

b) There is metastatic disease to regional lymph nodes.

c) The cancer is confined to the capsule.

d) There is metastasis to distant organs.

Question 87 1 / 1 point

A 58-year-old patient has been receiving leuprolide as treatment for prostate cancer. The clinician should instruct the patient about which of these side effects?

Question options:

a) Risk of osteoporosis

b) May have hot flushes

c) May have impotence

d) All of the above

Question 88 1 / 1 point

A 22-year-old male is seen in the clinic because he found a hard lump in his testicle when performing testicular self-examination (TSE).Which of the following should be included in the list of differential diagnoses?

Question options:

a) Testicular cancer

b) Inguinal hernia

c) Varicocele

d) All of the above

Question 89 1 / 1 point

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

Question options:

a) Radical orchidectomy

b) Lumpectomy

c) Radiation implants

d) All of the above

Question 90 1 / 1 point

A patient with testicular cancer is being followed after completing treatment 1 year ago. He has been symptom-free with no evidence of disease. How often should he have a CT scan?

Question options:

a) Every month

b) Every 3 to 4 months

c) Every 6 to 12 months

d) Every year

Question 91 2 / 2 points

Simon presents with alopecia areata with well-circumscribed patches of hair loss on the crown of his head. How do you respond when he asks you the cause?

Question options:

a) “You must be under a lot of stress lately.”

b) “It is hereditary. Did your father experience this also?”

c) “The cause is unknown, but we suspect it is due to an immunologic mechanism.”

d) “We’ll have to do some tests.”

Question 92 2 / 2 points

Which of the following is “a linear crack extending from the epidermis to the dermis?”

Question options:

a) An ulcer

b) A fissure

c) Lichenification

d) An excoriation

Question 93 2 / 2 points

A bulla is:

Question options:

a) A vesicle larger than 1 cm in diameter

b) An elevated solid mass with a hard texture; 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 94 1 / 1 point

A 70-year-old female has fallen 2 weeks ago and developed immediate pain in her left wrist. She thought she just bruised it but is worried because it has not improved. She has used Tylenol® and ice at home, and that has helped slightly. You examine her and find she has moderate swelling and ecchymosis but no overtly obvious deformity. Her ROM is uncomfortable and severely diminished due to the pain. No crepitus is heard or felt. Her fingers are warm; her pulse is strong; and capillary refill is less than 2 seconds.What should you do?

Question options:

a) Make an immediate referral for an orthopedic evaluation without further assessment.

b) Tell her that it takes time for these bruises to improve, so she should be patient.

c) Obtain a wrist x-ray and place her wrist in a splint or prescribe a splint.

d) Send her to the emergency room for reduction of this obvious wrist fracture.

Question 95 1 / 1 point

Osteoarthritis is primarily a noninflammatory condition.

Question options:

a) True

b) False

Question 96 1 / 1 point

The presence of a positive rheumatoid factor is always indicative of rheumatoid arthritis.

Question options:

a) True

b) False

Question 97 2 / 2 points

Which of the following medications can cause hyperglycemia?

Question options:

a) Prednisone

b) Metformin

c) Synthroid

d) Cephalexin

Question 98 2 / 2 points

Which of the following is diagnostic for diabetes mellitus?

Question options:

a) A1C 7.0 on one occasion

b) Fasting blood sugar (FBS) of 100 mg/dL on two occasions

c) Random glucose of 200 mg/dL on two occasions

d) Two-hour post-load plasma glucose of 300 mg/dL on one occasion

Question 99 2 / 2 points

Which of the following medications for type 2 diabetes mellitus should not be prescribed during pregnancy?

Question options:

a) Insulin

b) Metformin

c) Glucotrol

d) Precose

Question 100 1 / 1 point

A 35-year-old woman presents with symptoms of hypoglycemia.There is no history of diabetes mellitus. Which of the following should be included in the differential diagnosis?

Question options:

a) Anxiety disorder

b) Pheochromocytoma

c) Psychosis

d) All of the above

How often should drug levels be monitored when a seizure medication has controlled the seizures

Question 1 2 / 2 points

Which statement about confusion is true?

Question options:

a) Confusion is a disease process.

b) Confusion is always temporary.

c) Age is a reliable predictor of confusion.

d) Polypharmacy is a major contributor to confusion in older adults.

Question 2 0 / 2 points

Sondra’s peripheral vestibular disease causes dizziness and vertigo. Which of the following medications will help to decrease edema in the labyrinth of the ear?

Question options:

a) Meclizine

b) Diphenhydramine

c) Diamox

d) Promethazine

Question 3 2 / 2 points

The hallmark of an absence seizure is:

Question options:

a) No activity at all

b) A blank stare

c) Urine is usually voided involuntarily

d) The attack usually lasts several minutes

Question 4 2 / 2 points

How often should drug levels be monitored when a seizure medication has controlled the seizures, and the drug level is adequate?

Question options:

a) Every 3 months

b) Every 6 months

c) Annually

d) Whenever there is a problem

Question 5 2 / 2 points

Which of the following persons fits the classic description of a patient with multiple sclerosis (MS)?

Question options:

a) A teenage male

b) A 65-year-old male

c) A 25-year-old female

d) A 60-year-old female

Question 6 2 / 2 points

Which of the following is a specific test to MS?

Question options:

a) Magnetic resonance imaging (MRI)

b) Computed tomography (CT) scan

c) A lumbar puncture

d) There is no specific test.

Question 7 2 / 2 points

Which drug for Alzheimer’s disease should be administered beginning at the time of diagnosis?

Question options:

a) Cholinesterase inhibitors

b) Anxiolytics

c) Antidepressants

d) Atypical antipsychotics

Question 8 2 / 2 points

Which hematoma occurs along the temporal cranial wall and results from tears in the middle meningeal artery?

Question options:

a) Epidural hematoma

b) Subdural hematoma

c) Subarachnoid hematoma

d) Intraparenchymal hemorrhage

Question 9 2 / 2 points

Which cranial nerve is affected in a patient with a cerebrovascular accident who has difficulty chewing?

Question options:

a) CN V

b) CN VII

c) CN IX

d) CN X

Question 10 2 / 2 points

Which statement best describes a carotid bruit?

Question options:

a) It is felt with the middle three fingers over the carotid artery.

b) A bruit becomes audible when the lumen is narrowed to 1 mm or less.

c) A low-pitched bruit is a medical emergency.

d) The higher the pitch of the bruit, the higher the degree of stenosis.

Question 11 2 / 2 points

Which patient is more likely to have a cluster headache?

Question options:

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 12 2 / 2 points

Inattention and a sleep-wake cycle disturbance are the hallmark symptoms of?

Question options:

a) Dementia

b) Alzheimer’s disease

c) Parkinson’s disease

d) Delirium

Question 13 2 / 2 points

Which type of meningitis is more benign, self-limiting, and caused primarily by a virus?

Question options:

a) Purulent meningitis

b) Chronic meningitis

c) Aseptic meningitis

d) Herpes meningitis

Question 14 2 / 2 points

Which is the most sensitive neuroimaging test to evaluate patients with encephalitis?

Question options:

a) MRI

b) CT

c) Electroencephalogram (EEG)

d) An initial lumbar puncture

Question 15 2 / 2 points

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

Question options:

a) A stabbing 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 16 1 / 1 point

Gabby, aged 22, has Bell’s palsy on the right side of her face. Her mouth is distorted, and she is concerned about permanent paralysis and pain. What do you tell her?

Question options:

a) “Most patients have complete recovery in 3 to 6 months.”

b) “Unfortunately, you’ll probably have a small amount of residual damage.”

c) “Don’t worry, I’ll take care of everything.”

d) “You may have a few more episodes over the course of your lifetime but no permanent damage.”

Question 17 2 / 2 points

Sam, aged 65, is started on L-dopa for his Parkinson’s disease (PD). He asks why this is necessary. You tell him:

Question options:

a) “L-dopa is neuroprotective.”

b) “The primary goal of therapy is to replace depleted stores of dopamine.”

c) “This is the only drug that can provide symptomatic benefit.”

d) “This is the initial monotherapy drug.”

Question 18 2 / 2 points

Which of the following signs is seen in a patient with more advanced PD?

Question options:

a) Resting tremor

b) Bradykinesia

c) Rigidity

d) Postural instability

Question 19 2 / 2 points

Which of the following is the most commonly experienced symptom of migraine?

Question options:

a) Light sensitivity

b) Pulsatile pain

c) Sound sensitivity

d) Experiencing an aura

Question 20 2 / 2 points

Which of the following characteristics differentiates peripheral vertigo from central vertigo?

Question options:

a) The duration of central vertigo is shorter than that of peripheral vertigo.

b) There is an auditory-associated symptom with peripheral vertigo and a visual-associated symptom with central vertigo.

c) Central vertigo is positional, and peripheral vertigo is not.

d) The onset of central vertigo is more sudden than that of peripheral vertigo.

Question 21 2 / 2 points

Carotid endarterectomy should be considered only for symptomatic patients with greater than what percentage of stenosis?

Question options:

a) Greater than 25%

b) Greater than 50%

c) Greater than 75%

d) Only for 100% occlusion

Question 22 2 / 2 points

What antiplatelet agent is most widely used for secondary prevention of stroke?

Question options:

a) Aspirin

b) Ticlopidine

c) Clopidogrel

d) Aspirin and clopidogrel

Question 23 2 / 2 points

Which adjunctive diagnostic test should be used in the work-up of a patient with suspected Creutzfeldt-Jakob disease or transient epileptic amnesia?

Question options:

a) MRI

b) CT

c) Cerebrospinal fluid analysis

d) EEG

Question 24 2 / 2 points

Which herbal preparation may cause delirium and should be avoided in an elderly patient?

Question options:

a) Sam-e

b) Saint John’s Wort

c) Melatonin

d) Saw Palmetto

Question 25 0 / 2 points

Which of the following activities is part of the functional activities questionnaire?

Question options:

a) Asking the patient to unravel a Rubik’s cube

b) Determining if the patient can drive on the highway

c) Asking the patient about a news event from the current week

d) Seeing if the patient can keep his or her home clean

Question 26 2 / 2 points

About 90% of all headaches are?

Question options:

a) Tension

b) Migraine

c) Cluster

d) Without pathological cause

Question 27 2 / 2 points

Which statement is true regarding driving and patients with a seizure disorder?

Question options:

a) Once diagnosed with a seizure disorder, patients must never drive again.

b) After being seizure free for 6 months, patients may drive.

c) Each state has different laws governing driving for individuals with a seizure disorder.

d) These persons may drive but never alone.

Question 28 2 / 2 points

Julie has relapsing-remitting muscular sclerosis. She has not had a good response to interferon. Which medication might help given intravenously once a month?

Question options:

a) Glatiramer acetate

b) Natalizumab

c) Fingolimod

d) Glucocorticoids

Question 29 2 / 2 points

The ‘freezing phenomenon’ is a cardinal feature of?

Question options:

a) Parkinson’s disease

b) Alzheimer’s disease

c) A CVA

d) Bell’s palsy

Question 30 2 / 2 points

A ratchet-like rhythmic contraction, especially in the hand, during passive stretching is known as?

Question options:

a) Spinothalamic dysfunction

b) Ratcheting

c) Cogwheeling

d) Hand tremors

Question 31 2 / 2 points

Clinical features of insidious onset, slow progression, and a lack of other findings to explain the symptoms are fairly diagnostic of which condition?

Question options:

a) Guillain-Barré syndrome

b) Parkinson’s disease

c) Alzheimer’s disease

d) Huntington’s disease

Question 32 1 / 1 point

Which condition is characterized by the impaired ability to learn new information along with either a cognitive disturbance in language, function, or perception?

Question options:

a) Guillain-Barré syndrome

b) Parkinson’s disease

c) Alzheimer’s disease

d) Delirium

Question 33 2 / 2 points

A score of 20 to 25 on this test indicates early-stage Alzheimer’s disease:

Question options:

a) SLUMS

b) MoCA

c) FAST

d) MMSE

Question 34 2 / 2 points

Intravenous thrombolytic therapy following an ischemic CVA should be given within how many hours of symptom onset?

Question options:

a) 1 hour

b) 3 hours

c) 6 hours

d) 12 hours

Question 35 2 / 2 points

When administered at the beginning of an attack, oxygen therapy may help this kind of headache?

Question options:

a) Tension

b) Migraine

c) Cluster

d) Stress

Question 36 2 / 2 points

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

Question options:

a) Acetylcholine

b) Gamma-aminobutyric acid (GABA)

c) Dopamine

d) Serotonin

Question 37 2 / 2 points

The criteria for diagnosing generalized anxiety disorder in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, 5th edition (text revision) state that excessive worry or apprehension must be present more days than not for at least:

Question options:

a) 1 month

b) 3 months

c) 6 months

d) 12 months

Question 38 1 / 1 point

A patient presents to the clinician after experiencing four episodes in the last month of sweating, palpitations, chest pain, nausea, and shaking. Each episode lasted about 10 minutes. The patient is now becoming very fearful of future events and has been reluctant to leave the house. The clinician suspects panic disorder but wants to rule out any possible medical causes. Which of the following medical conditions can mimic the symptoms of a panic attack?

Question options:

a) Pheochromocytoma

b) Hyperthyroidism

c) Cardiac arrhythmias

d) All of the above

Question 39 2 / 2 points

Which of the following is considered first-line treatment for panic disorders?

Question options:

a) Benzodiazepines

b) Selective serotonin reuptake inhibitors (SSRIs)

c) Tricyclic antidepressants

d) Cognitive behavioral therapy

Question 40 1 / 1 point

Which of the following symptoms is not part of the diagnostic criteria for post-traumatic stress disorder (PTSD)?

Question options:

a) Hypersomnolence

b) Blunted feelings

c) Loss of interest in significant activities

d) Intrusive recurrent recollections of the event

Question 41 2 / 2 points

Which of the following neuroendocrine abnormalities is implicated in depression?

Question options:

a) Decrease in adrenal size

b) Increased cortisol and corticotrophin-releasing hormone

c) An exaggerated response of thyrotropin (TRH) to infusion of thyroid-releasing hormone

d) Increased inhibitory response of glucocorticoids to dexamethasone

Question 42 2 / 2 points

The clinician has chosen to prescribe an SSRI instead of a tricyclic antidepressant (TCA) for a patient fitting the diagnostic criteria for depression. Which of the following is not true concerning SSRIs in comparison to tricyclic antidepressants?

Question options:

a) SSRIs are more effective than TCAs.

b) SSRIs take less time to work than TCAs.

c) SSRIs have a more favorable side-effect profile than TCAs.

d) SSRIs are not lethal in overdose.

Question 43 2 / 2 points

After discontinuing fluoxetine, how long must a person wait before starting a monoamine oxidase inhibitor?

Question options:

a) 2 weeks

b) 3 weeks

c) 4 weeks

d) 5 weeks

Question 44 2 / 2 points

It is important to educate patients with depression and their family members about reporting signs of increasing depression and suicidal thoughts. This is especially true during which time period?

Question options:

a) Before the initiation of treatment

b) 1 to 2 weeks after the initiation of treatment

c) When switching to a different medication

d) 1 to 2 weeks after tapering off medications

Question 45 2 / 2 points

A patient is experiencing extrapyramidal side effects from his antipsychotic medications. The clinician would most likely take which of the following approaches to treating these side effects?

Question options:

a) Give the patient a “drug holiday” until the symptoms resolve and then restart the medication.

b) Switch the patient to a different antipsychotic.

c) Treat the patient with anticholinergics.

d) Treat the patient with anticonvulsants.

Question 46 1 / 1 point

According to Kübler-Ross, the stages of grief occur in which order?

Question options:

a) Anger, denial, depression, bargaining, acceptance

b) Anger, denial, bargaining, acceptance, depression

c) Denial, anger, depression, bargaining, acceptance

d) Denial, anger, bargaining, depression, acceptance

Question 47 1 / 1 point

The clinician is educating a patient about the effects of marijuana. The patient stated she has been smoking for years and believes the use does not interfere with her life. What is a significant long-term sequelae of marijuana use that the clinician should educate this patient about?

Question options:

a) Memory impairment

b) Sexual dysfunction

c) Dry mouth

d) There are no long-term consequences of marijuana use.

Question 48 2 / 2 points

Cocaine acts as a stimulant by blocking the reuptake of which neurotransmitter?

Question options:

a) GABA

b) Acetylcholine

c) Dopamine

d) Serotonin

Question 49 2 / 2 points

What blood alcohol level corresponds with the signs of stupor and confusion?

Question options:

a) 0.05

b) 0.1

c) 0.2

d) 0.3

Question 50 2 / 2 points

Rapid eye movement (REM) sleep occurs how frequently during non-REM sleep?

Question options:

a) Every 30 minutes

b) Every 60 minutes

c) Every 90 minutes

d) Every 180 minutes

Question 51 2 / 2 points

Which of the following is a laboratory finding commonly found in patients with anorexia nervosa?

Question options:

a) Hypercholesterolemia

b) Hypermagnesmia

c) Leukocytosis

d) Decreased TRH

Question 52 2 / 2 points

Which of the following is the only drug for bulimia approved by the U.S. Food and Drug Administration?

Question options:

a) Sertraline

b) Fluoxetine

c) Citoprolam

d) Imipramine

Question 53 2 / 2 points

Which of the following would be important to monitor in a child receiving methylphenidate for treatment of attention deficit-hyperactivity disorder (ADHD)?

Question options:

a) Liver function

b) Vision

c) Growth parameters

d) Renal function

Question 54 2 / 2 points

It is important for the clinician to discuss the long-term effects of sexual assault with survivors. Which of the following is the most common long-term effect of sexual assault?

Question options:

a) Depression

b) Obsessive-compulsive disorder

c) Substance abuse

d) PTSD

Question 55 2 / 2 points

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

Question options:

a) 2 weeks

b) 1 month

c) 3 months

d) 6 months

Question 56 2 / 2 points

Which is the most prevalent psychiatric condition in the United States?

Question options:

a) Depression

b) Anxiety

c) Substance-related addictions

d) Gambling

Question 57 1 / 1 point

What is recorded as clinical category two of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, 5th edition (text revision)?

Question options:

a) Clinical disorder or focus of clinical attention

b) Personality or environmental problems

c) Environmental and psychosocial stressors

d) Global assessment of functioning

Question 58 2 / 2 points

Which of the following may be used to evaluate a person’s suicide risk?

Question options:

a) CAGE

b) SANE

c) SAD PERSONAS

d) DIGFAST

Question 59 2 / 2 points

Assessing for adherence with prescribed medications and developing a plan for what to do if they are stopped is a major treatment issue for which of the following diagnostic groups?

Question options:

a) ADHD

b) Bipolar

c) Depression

d) Anxiety

Question 60 1 / 1 point

Bipolar disorder requires differential diagnosis from all of the following except?

Question options:

a) Substance abuse and medication effects

b) Medical and neurological disorders

c) Cluster B personality disorders and depression

d) Obsessive-compulsive disorder

Question 61 1 / 1 point

The use of benzodiazepines in the patient with generalized anxiety disorder and comorbid depression can exacerbate depressive symptoms.

Question options:

a) True

b) False

Question 62 1 / 1 point

Depressive episodes associated with bipolar disorder are treated the same as major depressive disorder.

Question options:

a) True

b) False

Question 63 1 / 1 point

Women in abusive relationships have a greater chance of being killed by their batterers when they leave the relationship than women who stay.

Question options:

a) True

b) False

Question 64 1 / 1 point

Adults must show childhood onset of symptoms to receive a diagnosis of ADHD.

Question options:

a) True

b) False

Question 65 1 / 1 point

Parkinson’s disease and dementing illnesses may commonly manifest depressive symptoms.

Question options:

a) True

b) False

Question 66 1 / 1 point

The best predictor of suicide risk is a history of suicide attempts.

Question options:

a) True

b) False

Question 67 1 / 1 point

A no-suicide contract can prevent a suicide attempt.

Question options:

a) True

b) False

Question 68 1 / 1 point

Depression is the most chronic disabling and economically catastrophic medical disorder of the severe mental illnesses.

Question options:

a) True

b) False

Question 69 1 / 1 point

Clozapine (Clozaril) requires laboratory monitoring at specified frequencies with results reported to a national registry.

Question options:

a) True

b) False

Question 70 1 / 1 point

When combined with certain other medications, serotonin-specific antidepressants can have significant liver P450-interaction effects.

Question options:

a) True

b) False

Question 71 1 / 1 point

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 examination?

Question options:

a) Human papillomavirus (HPV)

b) Endometrial hyperplasia

c) Vagismus

d) Polycystic ovarian syndrome

Question 72 2 / 2 points

A 20-year-old woman is seen in the clinic because her boyfriend was found to have gonorrhea. Which of the following is the treatment of choice for gonorrhea?

Question options:

a) Ceftriaxone

b) Doxycycline

c) Acyclovir

d) Metronidazole

Question 73 1 / 1 point

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 has she most probably been exposed to?

Question options:

a) Gonorrhea

b) HPV

c) Chlamydia

d) Trichomonas

Question 74 1 / 1 point

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?

Question options:

a) Trichomonas

b) Bacterial vaginosis

c) HPV

d) Herpes simplex virus

Question 75 2 / 2 points

Which of the following medications is the treatment of choice for trichomonas?

Question options:

a) Metronidazole

b) Ceftriaxone

c) Diflucan

d) Doxycycline

Question 76 1 / 1 point

A 36-year-old woman is seen with complaints of vaginal itching, burning, and discharge. On potassium hydroxide (KOH) wet mount of vaginal discharge, the clinician notices hyphae. Which of the following treatments would be appropriate?

Question options:

a) Fluconazole

b) Estrogen vaginal cream

c) Metronidazole

d) Doxycycline

Question 77 2 / 2 points

Mandy presents with a cauliflower-like wart in her anogenital region. You suspect it was sexually transmitted and document this as a:

Question options:

a) Filiform/digitate wart

b) Dysplastic cervical lesion

c) Condyloma acuminata

d) Koilocytosis

Question 78 0 / 2 points

During a DRE on a 75-year-old man, the clinician suspects the patient has prostate cancer. What physical finding should make the clinician suspicious?

Question options:

a) An enlarged rubbery gland

b) A hard irregular gland

c) A tender gland

d) A boggy gland

Question 79 2 / 2 points

Of the following types of cellulitis, which is a streptococcal infection of the superficial layers of the skin that does not involve the subcutaneous layers?

Question options:

a) Necrotizing fasciitis

b) Periorbital cellulitis

c) Erysipelas

d) “Flesh-eating” cellulitis

Question 80 2 / 2 points

The forced vital capacity is decreased in:

Question options:

a) Asthma

b) Chronic bronchitis

c) Emphysema

d) Restrictive disease

Question 81 2 / 2 points

The most common cause of CAP is?

Question options:

a) Streptococcus pneumoniae

b) Klebsiella pneumoniae

c) Legionella pneumoniae

d) Pseudomonas aeruginosa

Question 82 2 / 2 points

Which of the following is a possible consequence of sleep apnea?

Question options:

a) Asthma

b) Increased white blood cells

c) Insulin resistance

d) Hyperactivity

Question 83 2 / 2 points

The majority of HSV-1 and HSV-2 infections are asymptomatic so that only which elevated antibody titer shows evidence of previous infection?

Question options:

a) IgA

b) IgE

c) IgG

d) IgM

Question 84 2 / 2 points

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?

Question options:

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 85 0 / 2 points

During a DRE on a 75-year-old man, the clinician suspects the patient has prostate cancer. What physical finding should make the clinician suspicious?

Question options:

a) An enlarged rubbery gland

b) A hard irregular gland

c) A tender gland

d) A boggy gland

Question 86 2 / 2 points

A 78-year-old man is diagnosed with C2 prostate cancer, and he asks the clinician what that means. In order to answer the patient, the clinician must have which of these understandings of the Jewett rating system?

Question options:

a) The cancer involves the seminal vesicles.

b) There is metastatic disease to regional lymph nodes.

c) The cancer is confined to the capsule.

d) There is metastasis to distant organs.

Question 87 1 / 1 point

A 58-year-old patient has been receiving leuprolide as treatment for prostate cancer. The clinician should instruct the patient about which of these side effects?

Question options:

a) Risk of osteoporosis

b) May have hot flushes

c) May have impotence

d) All of the above

Question 88 1 / 1 point

A 22-year-old male is seen in the clinic because he found a hard lump in his testicle when performing testicular self-examination (TSE).Which of the following should be included in the list of differential diagnoses?

Question options:

a) Testicular cancer

b) Inguinal hernia

c) Varicocele

d) All of the above

Question 89 1 / 1 point

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

Question options:

a) Radical orchidectomy

b) Lumpectomy

c) Radiation implants

d) All of the above

Question 90 1 / 1 point

A patient with testicular cancer is being followed after completing treatment 1 year ago. He has been symptom-free with no evidence of disease. How often should he have a CT scan?

Question options:

a) Every month

b) Every 3 to 4 months

c) Every 6 to 12 months

d) Every year

Question 91 2 / 2 points

Simon presents with alopecia areata with well-circumscribed patches of hair loss on the crown of his head. How do you respond when he asks you the cause?

Question options:

a) “You must be under a lot of stress lately.”

b) “It is hereditary. Did your father experience this also?”

c) “The cause is unknown, but we suspect it is due to an immunologic mechanism.”

d) “We’ll have to do some tests.”

Question 92 2 / 2 points

Which of the following is “a linear crack extending from the epidermis to the dermis?”

Question options:

a) An ulcer

b) A fissure

c) Lichenification

d) An excoriation

Question 93 2 / 2 points

A bulla is:

Question options:

a) A vesicle larger than 1 cm in diameter

b) An elevated solid mass with a hard texture; 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 94 1 / 1 point

A 70-year-old female has fallen 2 weeks ago and developed immediate pain in her left wrist. She thought she just bruised it but is worried because it has not improved. She has used Tylenol® and ice at home, and that has helped slightly. You examine her and find she has moderate swelling and ecchymosis but no overtly obvious deformity. Her ROM is uncomfortable and severely diminished due to the pain. No crepitus is heard or felt. Her fingers are warm; her pulse is strong; and capillary refill is less than 2 seconds.What should you do?

Question options:

a) Make an immediate referral for an orthopedic evaluation without further assessment.

b) Tell her that it takes time for these bruises to improve, so she should be patient.

c) Obtain a wrist x-ray and place her wrist in a splint or prescribe a splint.

d) Send her to the emergency room for reduction of this obvious wrist fracture.

Question 95 1 / 1 point

Osteoarthritis is primarily a noninflammatory condition.

Question options:

a) True

b) False

Question 96 1 / 1 point

The presence of a positive rheumatoid factor is always indicative of rheumatoid arthritis.

Question options:

a) True

b) False

Question 97 2 / 2 points

Which of the following medications can cause hyperglycemia?

Question options:

a) Prednisone

b) Metformin

c) Synthroid

d) Cephalexin

Question 98 2 / 2 points

Which of the following is diagnostic for diabetes mellitus?

Question options:

a) A1C 7.0 on one occasion

b) Fasting blood sugar (FBS) of 100 mg/dL on two occasions

c) Random glucose of 200 mg/dL on two occasions

d) Two-hour post-load plasma glucose of 300 mg/dL on one occasion

Question 99 2 / 2 points

Which of the following medications for type 2 diabetes mellitus should not be prescribed during pregnancy?

Question options:

a) Insulin

b) Metformin

c) Glucotrol

d) Precose

Question 100 1 / 1 point

A 35-year-old woman presents with symptoms of hypoglycemia.There is no history of diabetes mellitus. Which of the following should be included in the differential diagnosis?

Question options:

a) Anxiety disorder

b) Pheochromocytoma

c) Psychosis

d) All of the above

Types of Hazards in Nursing

Module 10 Written Assignment – Types of Hazards in Nursing

Scoring Rubric:

Criteria

Points

Answer the following in 1-2 pages:

  1. Discuss and define each of the three hazards
  2. Give examples of each hazard
  3. Explain and give specific examples to when, where, why, and how nurses may potentially be exposed to these hazards
  4. Give examples in which the patient may be exposed to these hazards

5

In 3-4 pages (including your title page and your reference page), address the following grading criteria: 

  1. Discuss and define each of the three nursing hazards (physical, chemical and biological) covered in your reading.
  2. Give a specific example for each hazard how nurses may potentially be exposed to that hazard
  3. Give examples in which the patient may be exposed to these hazards.
  4. Explain how these potential exposures can be reduced or eliminated.
  5. Write your paper in APA format (title page, body, reference page).
  6.  Use APA formatting for in-text citations and references. 
  7. Be aware of your grammar and use of writing mechanics (typos, paragraphs, font, etc.).

What is the most influential accomplishment in nursing theory from the 1950's and 1960's

VIEW THE STEP-BY-STEP SOLUTION TO:

Please create a Power Point to answer the following. Case study Ann, a community nurse, made an afternoon home visit with Susan and her father.

Please create a Power Point to answer the following… Case study Ann, a community nurse, made an afternoon home visit with Susan and her father. After the death of her mother, Susan had growing concerns about her father living alone. “I worry about my father all the time. He is becoming more forgetful and he has trouble seeing. Mom used to take care of him. I am not sleeping and I am irritable around him. Yesterday I shouted at him because he wouldn’t let me help him with his laundry. I felt terrible! I am at my wits’ end! My brothers and sisters do not want to put dad in a nursing home but they are not willing to help out. As usual, they have left me with all the responsibility. I work part time and have two small children to care for.” Susan’s father, Sam, sat quietly with tears filling his eyes. He was well nourished and well-groomed but would not make eye contact. Nurse Ann noticed that the house was clean and orderly. A tray in front of the TV had the remains of a ham sandwich and glass of ice tea. Mail was piled up, unopened on a small table near the front door. There was only one car in the driveway and the yard was in need of attention. What questions does Orlando’s theory guide the nurse to consider in caring for Susan and Sam?Develop a family plan of care from the perspective of Orlando. Explore the 1950 and 60’s in the United States: Explore was happening in the United States during this time (culture, social, economics, struggles)What did nursing look like during this times (what are their job like, responsibilities, dress, autonomy, respect)What is the most influential accomplishment in nursing theory from the 1950’s and 1960’s? Power Point should include at least 3 outside references and the textbook. It should include title and reference slides and be 14-20 slides

Politics And The Patient Protection And Affordable Care Act

The suppliers of legislative benefits are legislators, and their primary goal is to be re-elected. Thus, legislators need to maximize their chances for re-election, which requires political support. Legislators are assumed to be rational and to make cost-benefit calculations when faced with demands for legislation. However, the legislator’s cost-benefit calculations are not the cost-benefits to society of enacting particular legislation. Instead, the benefits are the additional political support the legislator would receive from supporting legislation and the lost political support they would incur as a result of their action. When the benefit to legislators (positive political support) exceeds their costs (negative political support) they will support legislation. (page 27)

Source: Feldstein, P. (2006). The politics of health legislation: An economic perspective (3rd ed.). Chicago, IL: Health Administration Press. 

To Prepare:

  • Review the Resources and reflect on efforts to repeal/replace the Affordable Care Act (ACA).
  • Consider who benefits the most when policy is developed and in the context of policy implementation.

Post an explanation for how you think the cost-benefit analysis in the statement from page 27 of Feldstein (2006) affected efforts to repeal/replace the ACA. Then, explain how analyses such as the one portrayed by the Feldstein statement may affect decisions by legislative leaders in recommending or positioning national policies (e.g., Congress’ decisions impacting Medicare or Medicaid).  APA citation, 3 references

The use of specific medication classifications in specific health conditions and in consideration of medication side/adverse effects

Medication Teaching Plan Assignment Guidelines

Purpose

The purpose of this assignment is for the student to synthesize pharmacological knowledge (i.e., core drug

knowledge, core patient variables, and nursing implications) of pharmacotherapeutic agents into a useful

teaching and learning tool for nurses and patients.

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

· CO1 Apply the concepts of pharmacotherapeutics, pharmacokinetics, pharmacodynamics, and pharmacogenomics to the use of specific medication classifications in specific health conditions and in consideration of medication side/adverse effects, nursing implications, and medication teaching. (POs 1, 2, and 3)

· CO2 Apply principles of health promotion, as well as illness and injury prevention, to promote safety and effectiveness of commonly used pharmacologic therapy across the lifespan, taking into consideration sociocultural, genetic/genomic, developmental, and gender implications. (POs 3 and 8)

· CO3 Utilize the nursing process in understanding the effects of drug therapy on health outcomes across the lifespan within the framework of a diverse population of individuals, families, and communities. (PO 4)

Due Date

Refer to Course Calendar for details. The Late Assignment Policy applies to this assignment.

Total Points Possible

100 Points

Requirements

1. Choose a pharmacological agent that has been on the market less than 5 years.

2. Research the literature and obtain two to three resources for current, evidence-based information related to the pharmacological agent. You must submit your resources with the assignment. Identify the following key/relevant drug information that will be used to develop a medication teaching brochure:

· Drug Class

· Mechanism of Action

· Drug Administration and Dosage

· Drug/food Interactions

· Lab effects/Interference

3. Design a brochure to be used as a patient teaching tool containing the identified relevant/key

information outlined above and the following important information:

· Nursing Management

· Patient Education Considerations

· Patient Assessment

· Potential Side Effects/Adverse Effects/Toxicities

· Special considerations

Preparing the Assignment

1. After selecting your pharmacotherapeutic agent, use the Chamberlain online library or other database to research the key/relevant drug information.

2. Create your teaching brochure using MS Word or PowerPoint. Microsoft Word has built-in and online templates for brochures. You may choose one of these for your format. The brochure should be printed on one page, two-sided.

3. Include appropriate images, graphics, bulleted items, and subtitles in your brochure. Choose images that illustrate your points and do not serve as mere decorations.

4. Use no higher than seventh-grade reading level, except for required medical terminology. Microsoft Word will calculate a Flesch Kincaid Grade Level for you. Go to Review > Spelling and Grammar. When the check is complete, Word will give you the statistics. You may need to save your file with a new name and temporarily delete required medical terms and then run the Flesch Kincaid statistics again to get to the seventh-grade reading level.

5. Complete a separate document that contains the following information:

· Your name, date and class

· A short paragraph describing the intended audience and use for your teaching brochure. For example, is this for teaching a pediatric patient who is newly diagnosed with asthma about the new drug? Is it designed to teach an older adult about a new cholesterol drug?

· A reference page in APA format

The brochure is not a paper that follows APA format so please use your creativity when developing the

brochure. Consider your audience when choosing font, style and graphics.

6. Submit the brochure and the one-page document to the assignment by the due date.

Directions and Assignment Criteria

CategoryPoints%Description
Brochure: Key/Relevant Drug Information3030%Brochure contains following key/relevant drug information· Drug Class· Mechanism of Action· Drug Administration and Dosage· Drug Interactions· Lab effects/interference· Special Considerations· Potential Side Effects/Adverse Effects/Toxicities
Brochure: Patient Education Considerations3535%Brochure contains the following patient education information· Nursing Management· Patient Education Considerations· Patient Assessment· Potential Side Effects/Adverse Effects/Toxicities· Special considerations
Brochure: Visual Effects/Creativity1010%Brochure meets all of the following· Developed per the required standard· Appropriate for the intended audience· Flesch Kincaid reading level is not higher than seventh grade· Graphics do not distract from the purpose of the brochure· Visually appealing
One Page Paper1515%One page paper is clearly written and contains the following information:· Name· Date· Class· A short paragraph describing the intended audience and use for the teaching brochure.· A reference page
APA format55%Reference page is present and follows APA format. At least two sources are used and submitted with work
Writing Mechanics55%Writing follows rules of grammar, spelling, word usage, punctuation, and other aspects of formal written work as found in the 6th edition of the APA manual
Total 100100%

NR293Pharmacology for Nursing PracticeNR293 Medication Teaching Plan Assignment Guidelines.docx Revised 03/13/2018 WS/SCM1

Grading Rubric

Category
Brochure: Key/Relevant Drug Information30 Points25 Points20 Points15 points0 Points
Presentation of information on brochure is accurate and includes all of the following elements:· Drug Class· Mechanism of Action· Drug Administration and Dosage· Drug Interactions· Lab effects/interference· Special Considerations· Potential Side Effects/Adverse Effects/ToxicitiesPresentation of informationon brochure is accurate and includes six (6) of the following elements:· Drug Class· Mechanism of Action· Drug Administration and Dosage· Drug Interactions· Lab effects/interference· Special Considerations· Potential Side Effects/Adverse Effects/ToxicitiesPresentation of information on brochureis accurate andincludes five (5) of the following elements:· Drug Class· Mechanism of Action· Drug Administration and Dosage· Drug Interactions· Lab effects/interference· Special Considerations· Potential Side Effects/Adverse Effects/ToxicitiesPresentation of informationon brochure is accurate and includes four (4)of the following elements:· Drug Class· Mechanism of Action· Drug Administration and Dosage· Drug Interactions· Lab effects/interference· Special Considerations· Potential Side Effects/Adverse Effects/ToxicitiesPresentation of informationon brochure includes less than four (4) of the following elements:· Drug Class· Mechanism of Action· Drug Administration and Dosage· Drug Interactions· Lab effects/interference· Special Considerations· Potential Side Effects/Adverse Effects/Toxicities
Brochure: Patient Education Considerations35 points25 Points15 Points10 Points0 Points
Presentation of informationon brochure is accurate and includes all of the following elements:· Nursing Management· Patient Education Considerations· Patient Assessment· Potential Side Effects/Adverse Effects/Toxicities· Special considerationsPresentation of informationon brochure is accurate and includes four(4) of the following elements:· Nursing Management· Patient Education Considerations· Patient Assessment· Potential Side Effects/Adverse Effects/Toxicities· Special considerationsPresentation of informationon brochure is accurate and includes three (3)of the following elements:· Nursing Management· Patient Education Considerations· Patient Assessment· Potential Side Effects/Adverse Effects/Toxicities· Special considerationsPresentation of informationon brochure is accurate and includes two (2) of the following elements:· Nursing Management· Patient Education Considerations· Patient Assessment· Potential Side Effects/Adverse Effects/Toxicities· Special considerationsPresentation of informationon brochure includes less than two (2) of the following elements:· Nursing Management· Patient Education Considerations· Patient Assessment· Potential Side Effects/Adverse Effects/Toxicities· Special Considerations·
Brochure: Visual Effects/Creativity10 Points8 Points6 Points4 Points0 Points
Presentation of informationon brochureincludes all of the following elements:· Developed per the required standard· Appropriate for the intended audience· Flesch Kincaid reading level is not higher than seventh grade· Graphics do not distract from the purpose of the brochure· Visually appealingPresentation of informationon brochure includes four (4) of the following elements:· Developed per the required standard· Appropriate for the intended audience· Flesch Kincaid reading level is not higher than seventh grade· Graphics do not distract from the purpose of the brochure· Visually appealingPresentation of informationon brochure includes three (3) of the following elements:· Developed per the required standard· Appropriate for the intended audience· Flesch Kincaid reading level is not higher than seventh grade· Graphics do not distract from the purpose of the brochure· Visually appealingPresentation of informationon brochure includes two (2) of the following elements:· Developed per the required standard· Appropriate for the intended audience· Flesch Kincaid reading level is not higher than seventh grade· Graphics do not distract from the purpose of the brochure· Visually appealingPresentation of information on brochureincludes less than two(2) of the following elements:· Developed per the required standard· Appropriate for the intended audience· Flesch Kincaid reading level is not higher than seventh grade· Graphics do not distract from the purpose of the brochure· Visually appealing
One page paper15 Points12 Points9 Points6 Points0 Points
Presentation of information in the paperis clearly written andincludes all of the following elements:· Name· Date· Class· A short paragraph describing the intended audience and use for the teaching brochure.· A reference pagePresentation of informationin the paper is clearly written and includes four (4)of the following elements:· Name· Date· Class· A short paragraph describing the intended audience and use for the teaching brochure.· A reference pagePresentation of informationin the paper is clearly written and includes three (3)of the following elements:· Name· Date· Class· A short paragraph describing the intended audience and use for the teaching brochure.· A reference pagePresentation of informationin the paper is clearly written andincludes two (2) of the following elements:· Name· Date· Class· A short paragraph describing the intended audience and use for the teaching brochure.· A reference pagePresentation of informationin the paperincludes less than two (2) of the following elements:· Name· Date· Class· A short paragraph describing the intended audience and use for the teaching brochure.· A reference page
APA Format5 Points4 Points0 Point
APA guidelines, as per the 6th edition of the manual, are demonstrated for allthe following:· Reference page is present and follows APA format· At least two sources are used and submitted with workAPA guidelines, as per the 6th edition of the manual, are demonstrated for one (1) of the following:· Reference page is present and follows APA format· At least two sources are used and submitted with workAPA guidelines, as per the 6th edition of the manual, are demonstrated for none of the following:· Reference page is present and follows APA format· At least two sources are used and submitted with work
Writing Mechanics5 Points4 Points3 Points1 Point0 Point
0–2 errors or exceptions to the rules of grammar, spelling, word usage, punctuation, and other aspects of formal written work as found in the 6th edition of the APA manual3–4 errors or exceptions to the rules of grammar, spelling, word usage, punctuation, and other aspects of formal written work as found in the 6th edition of the APA manual5–6 errors or exceptions to the rules of grammar, spelling, word usage, punctuation, and other aspects of formal written work as found in the 6th edition of the APA manual7–8 errors or exceptions to the rules of grammar, spelling, word usage, punctuation, and other aspects of formal written work as found in the 6th edition of the APA manual9 or greater errors or exceptions to the rules of grammar, spelling, word usage, punctuation, and other aspects of formal written work as found in the 6th edition of the APA manual
Total Points Possible = 100 points Student’s Score ______/100 Points
Comments:
NR293 Medication Teaching Plan Assignment Guidelines.docx Revised 03/13/2018 WS/SCM7

Maladaptive Responses to Immune Disorders

Discussion 1: Maladaptive Responses to Immune Disorders

Maladaptive responses to disorders are compensatory mechanisms that ultimately have adverse health effects for patients. For instance, a patient’s allergic reaction to peanuts might lead to anaphylactic shock, or a patient struggling with depression might develop a substance abuse problem. To properly diagnose and treat patients, advanced practice nurses must understand both the pathophysiology of disorders and potential maladaptive responses that some disorders cause.

Consider Immune Disorders such as HIV, Psoriasis, Inflammatory Bowel Disease, and Systemic Lupus E. What are resulting Maladaptive Responses for patients with these disorders?

To Prepare

1-Review Chapter 6 and Chapter 8 in the Huether and McCance text.

2 –Reflect on the Concept of Maladaptive Responses to Disorders.

3- Select TWO of the following immune disorders: HIV, Psoriasis, Inflammatory Bowel Disease, or Systemic Lupus E (SLE).

4-Identify the Pathophysiology of Each Disorder you selected.

5- Consider the Compensatory Mechanisms that the Disorders Trigger. Then

6-Compare the Resulting Maladaptive and Physiological Responses of the TWO Disorders.

7-Select ONE of the following factors: Genetics, Gender, Ethnicity, Age, or Behavior.

8- Reflect on HOW the factor might Impact your selected Immune Disorders.

By Day 3

Post a Brief Description of the Pathophysiology of your selected Immune Disorders.

Explain HOW the Maladaptive and Physiological responses of the TWO Disorders Differ.

Finally, Explain HOW the factor you selected might impact the Pathophysiology of Each Disorder.

Critical appraisal that demonstrates comprehension of two qualitative research studies

Write a critical appraisal that demonstrates comprehension of two qualitative research studies. Use the “Research Critique Guidelines – Part 1” document to organize your essay. Successful completion of this assignment requires that you provide rationale, include examples, and reference content from the studies in your responses.

Use the practice problem and two qualitative, peer-reviewed research article you identified in the Topic 1 assignment to complete this assignment.

Qualitative data has been described as voluminous and sometimes overwhelming to the researcher. Discuss two strategies that would help a researcher manage and organize the data.

Qualitative data is looking at the “why” behind the behaviors in question. This type of research often means asking people to disclose personal information to you about their experiences and feelings. This is not the type of collecting that is analyzed into statistical data sets. This is data that is expressed feelings and experiences so creating transcripts of interviews conducted is an effective way to manage the information. Recording how the participant was feeling and the experiences described is the goal of the researcher. This will mean recording what is really said instead of interpreting the information and making conclusions and summaries of the information. Having a transcript of the conversation will provide a basis to make notes on and glean information from later. Care needs to be taken to protect the participants identities in the transcripts.

Another way to manage the data collected is to code the data based on similarities. Once a researcher has several transcripts to review, they can begin coding and identifying the areas of similarity between interviews. Coding is used enough that researchers have developed software systems that help them organize their transcripts. Items can be highlighted in various colors to represent the different coded areas. By grouping the information the researcher can see larger patterns in responses and begin to form hypotheses about the problem.

Sutton, J., & Austin, Z. (2015). Qualitative Research: Data Collection, Analysis, and Management. The Canadian journal of hospital pharmacy, 68(3), 226–231.

The collection and management of data for a qualitative nursing study entails not only a sufficient amount of time, but also a high level of flexibility, fluidity, and creativity (Green and Johnson, 2018). The process evolves as the study is carried out as it adapts to the dynamic characteristics of the identified participants. While it involves an in-depth discussion of personal thoughts and feelings with the participants, the researcher takes precautions to ensure that the study remains objective and unbiased by maintaining professional boundaries and adhering to professional standards of practice (Green and Johnson, 2018)

Green and Johnson identified at least four methodologies that can help researchers manage and organize the data for a qualitative study. Among these methodologies include conducting interviews which can either be structured and unstructured. Structured interviews involve a set of standardized questions that are predetermined based on the goals of the study. Unstructured interviews involve questions that are not prearranged but are spontaneous and are developed during the course of the interview depending on the interviewee’s responses. Although they are designed to be more informal and free-flowing, unstructured interviews involve probing questions to gather the thoughts of the interviewee about the subject matter. In both types of interviews, transcripts of conversations are needed (Green and Johnson, 2018). The other methodology is through a focus group where a group of people are assembled for a free-flowing discussion. Members of the focus groups are usually selected based on a criteria determined prior to the selection of members. The interviewer functions as the moderator who prepares a set of questions that will be explored during the discussion. Transcripts of conversations are also documented or recorded.  

Reference

Green, S. and Johnson, J., 2018. Research Ethics and Evaluation of Qualitative Research. Nursing Research: Understanding Methods for Best Practice. Retrieved from https://lc.gcumedia.com/nrs433v/nursing-research-understanding-methods-for-best-practice/v1.1/#/chapter/2

In a 1,000–1,250 word essay, summarize two qualitative studies, explain the ways in which the findings might be used in nursing practice, and address ethical considerations associated with the conduct of the study.

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 LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.

AttachmentsNRS-433V-RS2-ResearchCritiqueGuidelinesPart I.docx

Rough Draft Qualitative Research Critique and Ethical Considerations – Rubric

No of Criteria: 10 Achievement Levels: 5CriteriaAchievement LevelsDescriptionPercentageUnsatisfactory0.00 %Less than Satisfactory75.00 %Satisfactory83.00 %Good94.00 %Excellent100.00 %Content75.0     Background of Study 15.0Background of study including problem, significance to nursing, purpose, objective, and research questions is incomplete.Background of study including problem, significance to nursing, purpose, objective, and research questions is included but lacks relevant details and explanation.Background of study including problem, significance to nursing, purpose, objective, and research questions is partially complete and includes some relevant details and explanation. Background of study including problem, significance to nursing, purpose, objective, and research questions is complete and includes relevant details and explanation.Background of study including problem, significance to nursing, purpose, objective, and research questions is thorough with substantial relevant details and extensive explanation. Method of Study15.0Discussion of method of study including discussion of conceptual/theoretical framework is incomplete.Discussion of method of study including discussion of conceptual/theoretical framework is included but lacks relevant details and explanation.Discussion of method of study including discussion of conceptual/theoretical framework is partially complete and includes some relevant details and explanation.Discussion of method of study including discussion of conceptual/theoretical framework is complete and includes relevant details and explanation.Discussion of method of study including discussion of conceptual/theoretical framework is thorough with substantial relevant details and extensive explanation.Results of Study15.0Discussion of study results including findings and implications for nursing practice is incomplete.Discussion of study results including findings and implications for nursing practice is included but lacks relevant details and explanation.Discussion of study results including findings and implications for nursing practice is partially complete and includes some relevant details and explanation.Discussion of study results including findings and implications for nursing practice is complete and includes relevant details and explanation. Discussion of study results including findings and implications for nursing practice is thorough with substantial relevant details and extensive explanation.Ethical Considerations15.0Discussion of ethical considerations associated with the conduct of nursing research is incomplete.Discussion of ethical considerations associated with the conduct of nursing research is included but lacks relevant details and explanation.Discussion of ethical considerations associated with the conduct of nursing research is partially complete and includes some relevant details and explanation.Discussion of ethical considerations associated with the conduct of nursing research is complete and includes relevant details and explanation.Discussion of ethical considerations associated with the conduct of nursing research is thorough with substantial relevant details and extensive explanation.Conclusion15.0Conclusion does not summarize a critical appraisal and applicability of findings.Conclusion is vague and does not discuss importance to nursing. Conclusion summarizes utility of the research and importance to nursing practice.Conclusion summarizes utility of the research from the critical appraisal and the findings importance to nursing practice.Conclusion summarizes utility of the research from the critical appraisal, knowledge learned, and the importance of the findings to nursing practice.Organization and Effectiveness15.0     Thesis Development and Purpose5.0Paper lacks any discernible overall purpose or organizing claim.Thesis is insufficiently developed or vague. Purpose is not clear.Thesis is apparent and appropriate to purpose.Thesis is clear and forecasts the development of the paper. Thesis is descriptive and reflective of the arguments and appropriate to the purpose.Thesis is comprehensive and contains the essence of the paper. Thesis statement makes the purpose of the paper clear.Argument Logic and Construction5.0Statement of purpose is not justified by the conclusion. The conclusion does not support the claim made. Argument is incoherent and uses noncredible sources.Sufficient justification of claims is lacking. Argument lacks consistent unity. There are obvious flaws in the logic. Some sources have questionable credibility.Argument is orderly, but may have a few inconsistencies. The argument presents minimal justification of claims. Argument logically, but not thoroughly, supports the purpose. Sources used are credible. Introduction and conclusion bracket the thesis. Argument shows logical progressions. Techniques of argumentation are evident. There is a smooth progression of claims from introduction to conclusion. Most sources are authoritative.Argument is clear and convincing and presents a persuasive claim in a distinctive and compelling manner. All sources are authoritative.Mechanics of Writing (includes spelling, punctuation, grammar, language use)5.0Surface errors are pervasive enough that they impede communication of meaning. Inappropriate word choice or sentence construction is used.Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice (register), sentence structure, or word choice are present.Some mechanical errors or typos are present, but they are not overly distracting to the reader. Correct sentence structure and audience-appropriate language are used. Prose is largely free of mechanical errors, although a few may be present. A variety of sentence structures and effective figures of speech are used. Writer is clearly in command of standard, written, academic English.Format10.0     Paper Format (use of appropriate style for the major and assignment)5.0Template is not used appropriately or documentation format is rarely followed correctly.Template is used, but some elements are missing or mistaken; lack of control with formatting is apparent.Template is used, and formatting is correct, although some minor errors may be present. Template is fully used; There are virtually no errors in formatting style.All format elements are correct. Documentation of Sources (citations, footnotes, references, bibliography, etc., as appropriate to assignment and style)5.0Sources are not documented.Documentation of sources is inconsistent or incorrect, as appropriate to assignment and style, with numerous formatting errors.Sources are documented, as appropriate to assignment and style, although some formatting errors may be present.Sources are documented, as appropriate to assignment and style, and format is mostly correct. Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error.Total Percentage  100

Working with staff who cannot cooperate effectively can negatively influence your ability to spend time with patients

You are a family nurse practitioner working in an outpatient primary care office of a large hospital system. The practice has been operating for over 15 years, and many of the administrative and clinical staff were hired when the practice opened. You have been in the practice for less than 3 months. In that short amount of time, you have witnessed several of the clinical staff engaging in heated arguments with each other, sometimes in patient areas. You overhear an argument occurring today between two staff. You pick up a patient’s chart and notice a very low blood pressure that the medical assistant failed to notify you about. When you confront the MA, she states that she was going to report the vital signs to you when she became engaged in the heated argument you overheard and forgot to notify you.

Unfortunately, this pattern of behavior is not unusual in this practice. Working with staff who cannot cooperate effectively can negatively influence your ability to spend time with patients, can impede the flow of patients through the office, and could impact patient safety.

Discussion Question:

What are the potential ethical and legal implications for each of the following practice members?:

  • Medical assistants
  • Nurse Practitioner
  • Medical Director
  • Practice

What strategies would you implement to prevent further episodes of potentially dangerous patient outcomes?

What leadership qualities would you apply to effect a positive change in the practice?  Be thinking about the culture of the practice.

Provide rationales and evidence to support your decisions