Proposed Core Team of Change Champion


In Week 4, you examined the benefits of stakeholder involvement and the negative consequences that may arise if this is not sufficiently addressed during strategic planning.

This week you have been considering how to leverage the influence of change champions and facilitate team building to promote the successful implementation of a proposed change.

How would you create a core team of change champions for the change you are proposing through your Course Project?

To prepare:

Reflect on the results of your SWOT analysis (submitted in Week 7) and other elements of your strategic plan.

Think about how effective stakeholder involvement would promote the successful adoption and implementation of your proposed change.

Consider the following:

What strategies would help you to develop a core team to generate buy-in for this change?

Which stakeholders should be included in the process as change champions? How and when should they become involved?

Begin to write a 1- to 2-page description of your core team of change champions.

Section 6: Evaluation Plan

Creating an evaluation plan is a critical part of developing a strategic plan. How would evaluation allow you to determine the cost benefits and effectiveness of your proposed change?

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To prepare:

Reflect on the elements of your Course Project that you have developed thus far. Review the information on evaluation presented in the Learning Resources, and reflect on any insights you have gained from this week’s Discussion. (Week 11 Discussion)

How would you evaluate the implementation of your strategic plan? Develop an evaluation plan that includes a timeline for evaluation. Be sure to incorporate refreezing.

To complete:

Write a 1- to 3-page explanation of your evaluation plan. Include the timeline for evaluation, and explain how you will incorporate refreezing.

Note: This will be submitted as part of your Course Project this week.

Section 7: Executive Summary

As your development of a strategic plan comes to a conclusion, it is time to develop foundational pieces for your Course Project, including an executive summary.

An executive summary provides an overview of your proposed change and allows your target audience to become acquainted with the essential elements of the strategic plan. Your executive summary should be informative and persuasive, delineating the business case for your proposed change Proposed Core Team of Change Champion

To prepare:

Review the information in the Learning Resources related to developing an executive summary.

Craft an executive summary that appeals to your target audience and presents key information related to your strategic plan. Be sure to describe the unmet need you are addressing and convey the urgency or significance of this problem. Clearly state your proposed change and substantiate your recommendation.

To complete:

Write an executive summary for your strategic plan.

Note: This will be submitted as part of your Course Project this week.

Section 8: References

The inclusion of a reference list not only allows you to credit others’ work appropriately but also provides the information readers would need to read resources of interest to them and learn more about the underpinnings of your strategic plan.

To prepare:

Develop and/or refine the list of the resources cited in your strategic plan.

To complete:

Create your reference list to accompany your strategic plan.

Comprehensive Course Project: Developing a Strategic Plan

Over the past several weeks of this course, you have been developing elements of a strategic plan. As you prepare to submit your Course Project, reflect on what you have learned throughout this process. Also think about how you would like to convey the results of your analysis and planning to your target audience.

Your Course Project must include information related to each section of the Course Project assigned in Weeks 6–11; however, you have some flexibility in terms of how you present it. You may wish to compare strategic plans from various groups and organizations and then develop a format that best suits your plan Proposed Core Team of Change Champion. 

Note: Your comprehensive Course Project serves as your Portfolio Assignment for this course.

To complete:

Create a strategic plan that includes essential information related to the following:

Section 1: Summary of the Issue

Section 2: SWOT Analysis

Section 3: Balanced Scorecard

Section 4: Budgeting and Timeline Tools

Section 5: Proposed Core Team of Change Champions

Section 6: Evaluation Plan

Section 7: Executive Summary

Section 8: References

SECTION 1 – 2 – 3 – 4 are attached. 

PLEASE COMPLETE OTHER SECTIONS and need one comprehensive project submitted including each section. Proposed Core Team of Change Champion

PATIENT CARE DELIVERY MODELS

As the country focuses on the restructuring of the U.S. health care delivery system, nurses will continue to play an important role. It is expected that more and more nursing jobs will become available out in the community, and fewer will be available in acute care hospitals.

  1. Write an informal presentation (500-700 words) to educate nurses about how the practice of nursing is expected to grow and change. Include the concepts of continuity or continuum of care, accountable care organizations (ACO), medical homes, and nurse-managed health clinics.
  2. Share your presentation with nurse colleagues on your unit or department and ask them to offer their impressions of the anticipated changes to health care delivery and the new role of nurses in hospital settings, communities, clinics, and medical homes.

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  3. In 800-1,000 words summarize the feedback shared by three nurse colleagues and discuss whether their impressions are consistent with what you have researched about health reform.
  4. A minimum of three scholarly references are required for this assignment.

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. PATIENT CARE DELIVERY MODELS

INDIVIDUAL CLIENT HEALTH HISTORY AND EXAMINATION

In this assignment, you will be completing a health assessment on an older adult. To complete this assignment, do the following:

  1. Perform a health history on an older adult. Students who do not work in an acute setting may “practice” these skills with a patient, community member, neighbor, friend, colleague, or loved one. (If an older individual is not available, you may choose a younger individual).
  2. Complete a physical examination of the client using the “Health History and Examination” assignment resource. Use the “Functional Health Pattern Assessment” resource as a guideline to assist you in completing the template. INDIVIDUAL CLIENT HEALTH HISTORY AND EXAMINATION

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  3. Document findings of complete physical examination in Situation-Background-Assessment-Recommendation (SBAR) format. Refer to the sample SBAR Template located on the National Nurse Leadership Council website at https://www.ihs.gov/nnlc/includes/themes/newihstheme/display_objects/documents/resources/SBARTEMPLATE.pdf as a guide.
  4. Document the findings of the physical examination in the assessment worksheet.
  5. Using the “Health History and Examination” assignment resource, provide the physical examination findings summary with planned interventions for the client. Include any community services in the interventions.

APA format is not required, but solid academic writing is expected.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion. INDIVIDUAL CLIENT HEALTH HISTORY AND EXAMINATION

APPROACH TO CARE OF CANCER

Write a paper (1,250-1,750 words) describing the approach to care of cancer. In addition, include the following in your paper: APPROACH TO CARE OF CANCER

  1. Describe the diagnosis and staging of cancer.
  2. Describe at least three complications of cancer, the side effects of treatment, and methods to lessen physical and psychological effects.
  3. Prepare this assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

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

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RUBRICS

1
Unsatisfactory 0-72%
0.00%
2
Less Than Satisfactory 72-75%
75.00%
3
Satisfactory 76-79%
79.00%
4
Good 80-89%
89.00%
5
Excellent 90-100%
100.00%
80.0 %Content  
30.0 % Explanation of the Diagnosis and Staging of Cancers is Provided. An explanation of the diagnosis and staging of cancers is not provided. An explanation of the diagnosis and staging of cancers is provided but is missing relevant information. An explanation of the diagnosis and staging of cancers is provided that meets the assignment criteria. An explanation of the diagnosis and staging of cancers is provided that is offered in a detailed manner. An explanation of the diagnosis and staging of cancers is provided that is offered in a detailed manner, while demonstrating higher level or critical thinking.
20.0 % At Least Three Complications of Cancer are Identified With Comprehensive Discussion of Available Treatments. Less than three complications of cancer are identified. At least three complications of cancer are identified but lacking a comprehensive discussion of available treatments. At least three complications of cancer are identified with a comprehensive discussion of available treatments. More than three complications of cancer are identified with a comprehensive discussion of available treatments. More than three complications of cancer are identified with a comprehensive discussion of available treatments, while demonstrating higher level or critical thinking.
30.0 % Provides Recommendations to Address Physiological and Psychological Side Effects of Care. Recommendations to address physiological and psychological side effects of care are lacking. Recommendations to address physiological and psychological side effects of care are missing relevant information. Recommendations to address physiological and psychological side effects of care meet the assignment criteria. Recommendations to address physiological and psychological side effects of care are offered in a detailed manner. Recommendations to address physiological and psychological side effects of care are offered in a detailed manner, while demonstrating higher level or critical thinking.
15.0 %Organization and Effectiveness  
5.0 % Thesis Development and Purpose Paper lacks any discernible overall purpose or organizing claim. Thesis and/or main claim are insufficiently developed and/or vague; purpose is not clear. Thesis and/or main claim are apparent and appropriate to purpose. Thesis and/or main claim are clear and forecast the development of the paper. It is descriptive and reflective of the arguments and appropriate to the purpose. Thesis and/or main claim are comprehensive; contained within the thesis is the essence of the paper. Thesis statement makes the purpose of the paper clear.
5.0 % Paragraph Development and Transitions Paragraphs and transitions consistently lack unity and coherence. No apparent connections between paragraphs are established. Transitions are inappropriate to purpose and scope. Organization is disjointed. Some paragraphs and transitions may lack logical progression of ideas, unity, coherence, and/or cohesiveness. Some degree of organization is evident. Paragraphs are generally competent, but ideas may show some inconsistency in organization and/or in their relationships to each other. A logical progression of ideas between paragraphs is apparent. Paragraphs exhibit a unity, coherence, and cohesiveness. Topic sentences and concluding remarks are appropriate to purpose. There is a sophisticated construction of paragraphs and transitions. Ideas progress and relate to each other. Paragraph and transition construction guide the reader. Paragraph structure is seamless.
5.0 % Mechanics of Writing (includes spelling, punctuation, grammar, language use) Surface errors are pervasive enough that they impede communication of meaning. Inappropriate word choice and/or sentence construction are used. Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice (register), sentence structure, and/or word choice are present. Some mechanical errors or typos are present, but 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.
5.0 %Format  
2.0 % Paper Format (1- inch margins; 12-point-font; double-spaced; Times New Roman, Arial, or Courier) Template 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.
3.0 % Research Citations (In-text citations for paraphrasing and direct quotes, and reference page listing and formatting, as appropriate to assignment) No reference page is included. No citations are used. Reference page is present. Citations are inconsistently used. Reference page is included and lists sources used in the paper. Sources are appropriately documented, although some errors may be present. Reference page is present and fully inclusive of all cited sources. Documentation is appropriate and GCU style is usually correct. In-text citations and a reference page are complete. The documentation of cited sourc

BELIEFS OF A HEALTH CARE WORKER

What happens when a patient’s wishes contradict the beliefs of a health care worker’s?

To prepare for this Discussion, consider this week’s Learning Resources regarding conscientious objection and patient rights.

By Day 4

Post a comprehensive response to the following:

  • Do health care workers have the right to conscientiously object to providing care if it varies from their own personal moral and ethical belief system? Please explain by providing an example.
  • How would you apply the four ethical principles to your example?
  • How might your answer differ based on your chosen profession in health care? BELIEFS OF A HEALTH CARE WORKER

Read a selection of your colleagues’ postings.

________________________________________________________

RESOURCES

Judson, K., & Harrison, C. (2016). Law and ethics for the health professions. (7th ed.). New York: McGraw-Hill.

  • Chapter 3, “Working in Health Care”

This chapter looks at some of the practical ethical and legal issues encountered in the health care work environment.

Medical Law, Ethics, and Bioethics for the Health Professions

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  • Chapter 7, “Public Duties”

Health care professionals have ethical and legal responsibilities to their patients and their institutions. They also have public duties that require them to report certain situations to medical or legal authorities. This chapter examines these public duties in practice.

  • Chapter 12, “A Cultural Perspective for Health Professionals”

This chapter considers the growing role that cultural competency plays in health care.

Cantor, J. (2009). Conscientious Objection Gone Awry — Restoring Selfless Professionalism in Medicine. The New England Journal of Medicine. 360(15), p. 1484.

Note: Retrieved from the Walden Library databases.

Cantor, J. & Baum, K. (2004) The Limits of Conscientious Objection – May Pharmacists Refuse to Fill Prescriptions for Emergency Contraception? The New England Journal of Medicine. 351(19), 2008-2012.

Note: Retrieved from the Walden Library databases.

Required Media

Laureate Education (Producer). (2010). Ethical and legal issues in healthcare: Ethics in practice: Inside an ethics committee [Video file]. Retrieved from https://class.waldenu.edu BELIEFS OF A HEALTH CARE WORKER

Medical Illnesses

In completing the case study, students will be addressing the following learning objectives:

Identify common medical conditions that can have accompanying psychiatric complications or symptoms. Describe general nursing implications for clients experiencing psychiatric disorders that are intertwined with other nonpsychiatric illnesses.

1. Carla, a 27-year-old white single mother of two preschool-age children, is in the psychiatric hospital for treatment of anxiety and depression.   Carla has a cardiac condition that requires surgery.  Carla is concerned over the financial cost of the surgery and caretakers for her children while she is in the hospital and undergoing rehabilitation. Carla is also worried that she may be unable to continue in her present employment as a salesperson due to the physical demands of this position.  Carla’s case is representative of many patients with medical conditions who develop psychiatric symptoms. Medical Illnesses

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(Learning Objectives: 1, 2)

a. What are some prevalent medical conditions that can also be accompanied by psychiatric symptoms or complications?

b.What are some nursing implications for Carla that address both the psychiatric and nonpsychiatric illnesses?

Write a 1,000- to 1,400-word paper that addresses the following: Please include headers for each section below to ensure everything is explained in detail. 

  • Why is accountability important in the health care industry?
  • How is an employee’s accountability measured in the health care industry?
  • How does accountability apply to ethical considerations in leadership and management?
  • What does a checks-and-balances process look like in a successful organization?
  • How does accountability affect an organization’s working culture?
  • How can you maintain a positive working culture and avoid a working culture of blame?

Cite a minimum of 4 references.

Format your paper according to APA guidelines .Medical Illnesses

VEIN THROMBOSIS


Will using intermittent pneumatic compression device prevent deep vein thrombosis after orthopedic surgery ?

Person – Post  operative  orthopedic  patients  in  a  hospital.

Intervention –Does the use of intermittent pneumatic compression device prevent deep vein thrombosis.

Comparison – Standard treatment like, early ambulation, graduated elastic compression stocking, and anticoagulation therapy.

Outcome -The risk of getting DVT following orthopedic surgery will be reduced with the use of intermittent pneumatic compression device. VEIN THROMBOSIS

Time– 6 months

Please write an essay according to the guideline. Attaching the question below.

Locate a minimum of 15 peer-reviewed articles that describe the problem or issue and that support the proposed solution. Eight of the 15 articles must be research-based (e.g., a study which is qualitative, quantitative, descriptive, or longitudinal).

Hint: Begin your search for literature by utilizing the databases located in the GCU eLibrary. Contact your faculty member, the librarian, or library staff for additional researching tips and key word suggestions.

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Preview each of the 15 articles chosen by reading the article abstracts and summaries.

Hint: Article abstracts and summaries provide a concise description of the topic, research outcomes, and significance of findings.

Hint: Refer to “RefWorks” and “Module 1: Checklist.”

Perform a rapid appraisal of each article by answering the following questions (one to two sentences are sufficient to answer each question):

  1. How does each article describe the nature of the problem, issue, or deficit you have identified?
  2. Does each article provide statistical information to demonstrate the gravity of the issue, problem, or deficit?
  3. What are example(s) of morbidity, mortality, and rate of incidence or rate of occurrence in the general population?
  4. Does each article support your proposed change?

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

2 NRS 441v.11R.Module1_Checklist.docx1 NRS441v.10.0R RefWorks.docx. VEIN THROMBOSIS

Check list:

Instructions:

This checklist is designed to help students organize the weekly exercises/assignments to be completed as preparation for the final, capstone project proposal. This checklist will also serve as a communication tool between students and faculty. Comments, feedback and grading for modules 1-4 will be documented using this checklist.

Topic Task Completed Comments/Feedback      Points
Identifying aProblem  ·  Explains setting and/or context in which nursing problem is observed.     _____ / 10
  ·  Detailed description of problem, issue, or educational deficit provided.     _____ / 10
  ·  Impact of problem on work environment and patient outcomes described.      _____ / 5
  ·  Significance to nursing profession discussed.     _____ / 5
  ·  Solution to the problem identified.      _____ / 10
      Total _____ / 40
Developing a Question ·  Identified components of PICOT:  P – Population of Focus  I  –  Intervention  C –  Comparison  O –  Outcome  T-Time     _____ / 30
  ·  Developed PICO question/statement.      _____ / 10
  ·      Total _____ / 40
Selecting Sources of Literature ·  Rapid Appraisal Performed (see below) on a minimum of 15 peer-reviewed articles.     _____ / 100
  ·      Total _____ / 100
          

Rapid Appraisal

Perform a rapid appraisal of each article by answering the following questions (one to two sentences are sufficient to answer each question):

1)      How does each article describe the nature of the problem, issue, or deficit you have identified?

2)      Does each article provide statistical information to demonstrate the gravity of the issue, problem, or deficit?

3)      Example(s): morbidity, mortality, rate of incidence or rate of occurrence in the general population.

4)      Does each article support your proposed change? VEIN THROMBOSIS

HEALTH ANALYSIS

Analyze the health status of a specific minority group. Select a minority group that is represented in the United States (examples include: American Indian/Alaskan Native, Asian American, Black or African American, Hispanic or Latino, Native Hawaiian, or Pacific Islander.)

In an essay of 750-1,000 words, compare and contrast the health status of the minority group you have selected to the national average. Consider the cultural, socioeconomic, and sociopolitical barriers to health. How do race, ethnicity, socioeconomic status, and education influence health for the minority group you have selected? Address the following in your essay: HEALTH ANALYSIS

  1. What is the current health status of this minority group?
  2. How is health promotion defined by the group?
  3. What health disparities exist for this group?
  4. Describe at least one approach using the three levels of health promotion prevention (primary, secondary, and tertiary) that is likely to be the most effective given the unique needs of the minority group you have selected. Provide an explanation of why it might be the most effective choice.

Cite a minimum of three references in the paper.

You will find important health information regarding minority groups by exploring the following Centers for Disease Control and Prevention (CDC) links:

  1. Minority Health: http://www.cdc.gov/minorityhealth/index.html
  2. Racial and Ethnic Approaches to Community Health (REACH): http://www.cdc.gov/chronicdisease/resources/publications/aag/reach.htm
  3. Racial and Ethnic Minority Populations: http://www.samhsa.gov/specific-populations/racial-ethnic-minority

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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. Please refer to the directions in the Student Success Center HEALTH ANALYSIS

HEALTH EXAM

Question 1

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

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

Question 2

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

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

Question 3

In alcoholic cirrhosis, hepatocellular damage is caused by:

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

Question 4

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

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

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Question 5

Kwashiorkor is a severe dietary deficiency of:

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

Question 6

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

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

Question 7

Prolonged diarrhea is more serious in children than adults because:

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

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Question 8

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

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

Question 9

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

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

Question 10

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

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

Question 11

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

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

Question 12

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

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

Question 13

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

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

Question 14

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

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

Question 15

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

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

Question 16

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

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

Question 17

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

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

NURSING EXAM


Question 1 A patient asks the nurse practitioner about food sources such as soybeans and soy products. The nurse practitioner understands that these foods are considered

A) phytoestrogens.

B) monotherapy.

C) taboo.

D) inappropriate

Question 2 A 12-year-old boy is being discharged from the hospital after major surgery. The boy will be taking two medications at home for an extended period. The nurse who is discharging the patient should provide medication teaching specifically to

A) the mother regarding why the boy needs to take the medications.

B) both the boy and his mother regarding all medication issued NURSING EXAM.

C) the boy by telling him not to worry about the medications and to take them as directed

D) The mother and be sure to reinforce the need to force the medications, if her sondoes not want to take them

Question 3 A 15-year-old boy who has been taking dextroamphetamine for the treatment of ADHD has been experiencing a depressed mood and a sense of hopelessness. He confides in the school nurse that he has begun taking his stepfather’s antidepressant to improve his mood. After immediately phoning the boy’s stepfather, the nurse learns that the drug in question is phenelzine (Nardil), a monoamine oxidase inhibitor (MAOI). The nurse should recognize that this combination of drugs creates a serious risk of what health problem?

A) Cardiac dysrhythmia
B) Hypertensive crisis
C) Nephrotoxicity
D) Hypokalemia

Question 4 A child is admitted to the burn unit with second and third degree burns on both arms and part of his or her face. When administering topical medications to the burned areas, the nurse should

A) cool the medication prior to administration.
B) use sterile technique when applying the medication.
C) allow the child to apply the medication if possible.
D) use clean technique only when applying the medication.

Question 5 A patient is being seen in the emergency department for a sprained ankle and is given a drug to relieve pain. When a second dose of the pain medication is given, the patient develops redness of the skin, itching, and swelling at the site of injection of the drug. The most likely cause of this response is

A) a hepatotoxic response.
B) an idiosyncratic response.
C) a paradoxical response.
D) an allergic response.

Question 6 A 5-year-old boy needs an IM injection. The least painful and most effective injection site would be the

A) deltoid muscle.
B) rectus femoris muscle.
C) ventrogluteal muscle.
D) dorsogluteal muscle.

Question 7 A patient reports to a clinic with complaints of breast tenderness, a right lumpy breast, and no breast discharge. The breast tenderness occurs primarily during her menstrual cycle. The nurse practitioner probably suspects

A) breast cancer

B) PMS

C) pain in the heart

D) cancerous breast tenderness

Question 8 A 29-year-old woman who is morbidly obese has recently begun a comprehensive, medically-supervised program of weight reduction. Prior to adding dextroamphetamine (Dexedrine) to her regimen, the patient should be questioned about her intake of

A) alcohol.
B) trans fat.
C) caffeine.
D) grapefruit juice.

Question 9 A nurse is caring for a 10-year-old boy who complains of chronic headaches. His mother reports that she gives him Tylenol at least three times a day. Which of the following will the nurse work with the physician to evaluate?

A) Renal function
B) Hepatic function
C) Respiratory function
D) Cardiac function

Question 10 A 21-year-old female has a history of irregular menses. She recently became sexually active, and would like to begin taking oral contraceptives (OCs). The nurse practitioner recognizes that most likely this patient would benefit from taking which category of OCs.

A) Monophasic

B) Triphasic OC

C) Ortho Tri-Cyclen

D) Biphasic OC

Question 11 A nurse who provides care on a pediatric medicine unit has conducted a medication reconciliation of a recently-admitted patient. In light of the fact that the child takes methylphenidate (Ritalin), the nurse is justified in considering a history of what health problem?

A) Anxiety
B) Respiratory depression
C) Obesity
D) ADHD

Question 12 A nurse working in a cancer center is preparing to administer medication to a 5-year-old child. The nurse will calculate the drug dosage by using

A) body surface area.
B) weight.
C) age in months.
D) age in years.

Question 13 A 13-year-old female took a weight loss drug that activated the sympathetic nervous system. Which of the following assessment findings would the nurse expect?

A) Decreased myocardial contraction
B) Decreased heart rate
C) Increased cardiac conduction
D) Increased intranodal conduction time

Question 14 A 6-month-old child has developed skin irritation due to an allergic reaction. He has been prescribed a topical skin ointment. The nurse will consider which of the following before administering the drug?

A) That the infant’s skin has greater permeability than that of an adult
B) That there is less body surface area to be concerned about
C) That there is decreased absorption rates of topical drugs in infants
D) That there is a lower concentration of water in an infant’s body compared with an adult

Question 15 A nurse is providing patient education to a 13-year-old girl who was just diagnosed with type 1 diabetes mellitus. Which of the following statements by the patient will alert the nurse that special instructions regarding insulin are necessary?

A) “I walk two blocks to school every day.”
B) “I am on the middle school track team.”
C) “We live in a two-story house.”
D) “My mother is going to give me my insulin.”

Question 16 A nurse who provides care on a pediatric unit of a hospital is aware that the potential for harm as a result of drug errors is higher among infants and children than adults. This fact is primarily due to

A) the inability of infants and children and describe symptoms of adverse drug reactions.
B) increased body surface area relative to body volume in infants and children.
C) increased heart rate and subsequently rapid drug distribution among infants and children.
D) immature liver and kidney function in infants and children.

Question 17 A nurse practitioner orders 150 mg of oral fluconazole for a patient with vulvovaginal candidiasis. The patient should expect to take medication

A) for 20 days.

B) once a day.

C) every day until the infection is gone.

D) for 30 days.

Question 18 To which of the following patients would a medication nurse most likely administer caffeine as part of the treatment plan?

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A) A preterm neonate who has apnea
B) A 34-year-old woman with a diagnosis of gastric ulcerations
C) A school-age child with severe ADHD
D) A 52-year-old man with narcolepsy

Question 19 A nurse works at a weight management clinic. To which of the following overweight patients could the nurse safely administer dextroamphetamine? NURSING EXAM

A) A 38-year-old Caucasian woman with glaucoma
B) A 60-year-old African-American man who experiences angina
C) A 48-year-old Caucasian man who has adult-onset diabetes
D) A 28-year-old African-American woman with hyperthyroidism

Question 20 A 3-year-old boy has developed otitis media and requires antibiotics. In order to increase the chance that the boy will take his prescribed medication, the nurse should

A) teach the boy about the fact that he will feel much better after he takes his medications.
B) have the mother hold the child firmly and sooth him while the drugs are administered.
C) offer a choice between liquid and chewable medications, if possible.
D) insert a central intravenous line.

Question 21 The recommended treatment for trichomoniasis is

A) Flagyl.

B) Diflucan.

C) Meclizine.

D) Amoxicillan

Question 22 A school nurse has been teaching high school students about the risks associated with marijuana use. However, the nurse has been met with considerable skepticism on the part of students, most of whom believe that marijuana is a benign drug. Which of the following teaching points should the nurse provide?

A) “Most people don’t know that marijuana can be just as addictive as heroin or cocaine over time.”
B) “Marijuana can easily interact with other drugs and cause potentially fatal reactions.”
C) “Every year, thousands of Americans end up in emergency departments with marijuana overdoses.”
D) “Smoking marijuana is just as bad, or worse, for your lungs as smoking cigarettes.”

Question 23 A nurse is going to administer medication to an infant using a medicine dropper. The best method is to open the child’s mouth by gently squeezing the cheeks and placing the drops

A) at the back of the mouth.
B) in the buccal pouch.
C) under the tongue.
D) on top of the tongue.

Question 24 A nurse is obtaining baseline physical data from a 7-year-old patient who is to be started on dextroamphetamine for ADHD. After obtaining vital signs, height, and weight, the nurse will prepare the patient for an

A) electrocardiogram (ECG).
B) electromyelogram (EMG).
C) electroencephalogram (EEG).
D) electrophysiologic study (EPS).

Question 25 A 10-year-old boy is taking dextroamphetamine (Dexedrine) daily for ADHD. At each clinic visit, the nurse’s priority assessment would be

A) height and weight.
B) Vision.
C) body temperature.
D) blood pressure.

Question 26 A 7-year-old child has been taking tetracycline for a bacterial infection. The nurse will be sure to inform the parents that this drug could cause

A) orange-tinged urine.
B) staining of permanent teeth.
C) sleep deprivation.
D) deep muscle pain NURSING EXAM.

Question 27 A nurse is administering drugs to a 10-year-old child who has multiple health problems.The child is underweight and is on a special diet. Which of the following will the nurse consider when planning for the best absorption of the prescribed drugs? (Select all that apply.)

A) Age
B) Weight
C) Disease process
D) Diet
E) Route of administration

ACDE

Question 28 The clinical nurse educator who oversees the emergency department in a children’s hospital has launched an awareness program aimed at reducing drug errors. What measure addresses the most common cause of incorrect doses in the care of infants and children?

A) Having nurses check their math calculations with a colleague before administering a drug.
B) Ensuring that a full assessment takes place no more than 30 minutes before giving a drug.
C) Recording drug administration in both the nurse’s notes and the medication administration record (MAR)
D) Avoiding intravenous administration of drugs whenever possible.

Question 29 A 15-year-old boy has been diagnosed with bone cancer after several months of fatigue and pain. What question should the nurse include in an assessment when trying to minimize the potential for adverse drug reactions?

A) “Do you ever use alcohol or drugs?”
B) “How much do you weigh?”
C) “On a scale of zero to ten, what level of pain is acceptable to you?”
D) “Did Tylenol or other over-the-counter pain remedies ever relieve your pain?”

Question 30 A 35-year-old woman is on a weight-loss program and is to begin taking sibutramine (Meridia). After baseline physical data are obtained, the nurse will assess the patient’s childbearing potential. The nurse will inform the patient that during sibutramine therapy she should

A) abstain from sex.
B) obtain a pap smear .
C) use adequate contraception.
D) take a pregnancy test every month.

Question 31 A 16-year-old boy is prescribed cromolyn sodium nasal spray to treat a nasal allergy. To maximize the therapeutic effects of the drug, which of the following will the nurse include in instructions to the patient?

A) Take the drug on a full stomach
B) Avoid high noise levels
C) Take the drug for one full week before coming in contact with allergens
D) Drink plenty of fluids.

Question 32 A 19-year-old patient reports to a clinic with vaginal discharge with a foul odor. A microscopic exam reveals trichomonas vaginalis.The nurse practitioner is aware that

A) trichomoniasis is an incurable disease.

B) trichomoniasis discharge is typically thin and clear.

C) asymptomatic women are diagnosed with trichomoniasis by a routine pap smear.

D) it is unusual to have an odor with trichomoniasis

Question 33 A 2-year-old child is diagnosed with a minor ailment and is to be administered medications at home for 2 weeks. The child lives with his mother, grandmother, and four other children between the ages of 14 months and 7 years. The home health nurse is asked to assess the home environment to determine if it is appropriate for the child to take his medication at home. Which of the following will have the greatest impact on the nurse’s assessment?

A) The mother and grandmother’s understanding about the drugs
B) How clean the house is
C) The health status of the other children
D) Where the medications will be stored NURSING EXAM

Question 34 A nurse is having difficulty administering a bitter drug to a 5-year-old child. The nurse should

A) have the parent gently force the child’s mouth open.
B) give the drug in a pill form.
C) involve the child in a play therapy session, and then tell the child that the medicine is candy.
D) offer the child a flavored ice chip or ice pop prior to administering the drug.

Question 35 A 22-year-old woman has given birth to an infant who exhibits the signs and symptoms of maternal cocaine use during pregnancy.These signs and symptoms are a result of what pathophysiological effect of opioid use during pregnancy?

A) Changes in blood chemistry as a result of nephrotoxicity and hepatotoxicity
B) Impaired maternal nutrition as a result of drug use
C) Vasoconstriction leading to reduced placental blood flow
D) Hypoxia as a result of a prolonged second stage of labor

Question 36 A preterm neonate received caffeine for the treatment of apnea. The nurse should monitor the neonate for which of the following?

A) Bloody stools
B) Bradycardia
C) Constipation
D) Hypoglycemia

Question 37 A 30-year-old man with a BMI of 59 has recently been diagnosed with type 2 diabetes mellitus. In light of the man’s lack of success with weight loss programs in the past, his care provider has prescribed sibutramine (Meridia). What instructions should the nurse consequently provide to this patient?

A) “Take this drug once each day on an empty stomach.”
B) “It’s best to take a dose of sibutramine after each meal.”
C) “This drug will help you to lose weight without having to exercise or change your normal diet.”
D) “Take a dose when you feel like you are tempted to binge on food.”

Question 38 A nurse practitioner orders a single dose of 2 g Metronidazole orally. How many milligrams will the patient receive in one dose?

A) 1000 mg

B) 2000 mg

C) 3000 mg

D) 4000 mg

Question 39 A nurse is explaining to the parents of a 6-year-old child suffering from angina why nitroglycerin patches for chest pain would not be appropriate. Which of the following will the nurse include in an explanation?

A) A child has an erratic blood flow from an immature peripheral circulation, which increases drug absorption, causing an increase in adverse effects.
B) A child’s gastric pH is decreased, causing less of the drug to be absorbed from the subcutaneous skin, therefore producing more adverse effects.
C) A child has a greater body surface area, creating greater permeability resulting in an increase in absorption of topical agents, which may result in more adverse effects.
D) A child has a smaller body surface area, resulting in an increase in topical absorption, which can cause more adverse effects.

Question 40 An immunocompromised 7-year-old child was recently discharged home with a peripherally-inserted central line (PIC line) for home antibiotic therapy. He has now been brought to the emergency department by his mother and father with signs and symptoms of line sepsis.Upon questioning, the mother states that she has been removing the PIC dressing daily and washing the site with warm water and a cloth. What nursing diagnosis is most appropriate in this situation?

A) Caregiver Role Strain
B) Ineffective Family Therapeutic Regimen Management
C) Delayed Growth and Development
D) Knowledge Deficit NURSING EXAM