06475 Topic: Evaluation Method
Number of Pages: 1 (Double Spaced)
Number of sources: 2
Writing Style: APA
Type of document: Coursework
Academic Level:High School
Category: Nursing
Language Style: English (U.S.)
Order Instructions: ATTACHED
Midterm Exam: Primary Care of Adolescents and Children
Question 1
When completing this quiz, did you comply with Walden University’s Code of Conduct including the expectations for academic integrity?
· Question 2
Miguel, age 14, was hit in the eye with a baseball and developed eye pain, decreased visual acuity, and injection of the globe. Upon exam you note blood in the anterior chamber and confirm diagnosis of hyphema. What treatment do you recommend while Miguel is waiting to see the ophthalmologist
· Question 3
The father of a 3-year-old is concerned because the child stutters. What should your approach be?
· Question 4
A 2-day-old newbornwith conjunctivitis is likely due to
· Question 5
You see a 13-year-old who reports she is learning some basic geometry (areas, volume etc.). The ability to successfully master these concepts occurs during which Piaget developmental stage?
· Question 6
For adolescent girls, peak height velocity should occur by Tanner Stage (SMR):
· Question 7
Which is the correct order for introduction of solid foods to an infant?
· Question 8
I can walk well on tiptoes, my speech is 50% understandable, I know six body parts, but I cannot balance on one foot for 1 second. I am:
· Question 9
You receive a phone call from the mother of a 2-year-old. She states her child has sleep refusal. You suggest the child should be able to:
· Question 10
A 15-month-old boy says “mama” and “dada,” points and gestures if he wants things, and follows simple one-step commands. Your best response is which of the following?
· Question 11
At what age would a child be expected to remember a string of numbers and repeat them backwards?
· Question 12
A 13-month-old child is noted to be at the 25th percentile for weight, the 10th percentile for height, and less than the 5th percentile for head circumference. She was born at term. She was noted to have a small head at birth, to be developmentally delayed throughout her life, and to have required cataract surgery shortly after birth. She currently takes phenobarbital for seizures. Which of the following would most likely explain this child’s small size?
· Question 13
A child’s head circumference is routinely measured on each well visit until what age?
· Question 14
A 14-year-old female comes into the office for an urgent visit after taking 10 valium tablets. Following the initial emergent care and stailization, the most important part of the management is:
· Question 15
All of the following are consistent with peritonsillar abscess except:
b.
Trismus
· Question 16
Which of the following complication of strep pharyngitis cannot be prevented with antibiotics?
b.
Glomerulonephritis
· Question 17
A 4-year-old believes there is more juice in a tall, thin glass than a shorter, wider one. The child has not yet achieved which of the principles of Piaget?
b.
Conservation
· Question 18
Josh, age 13, has some enlargement of the scrotum and testes, a reddened scrotal sac, and some hair texture alteration. His penis is not enlarged. He is in Tanner stage
d.
II
· Question 19
A breastfed infant is expected to have a lower incidence of which of the following?
e.
Diarrhea
· Question 20
A 12-year-old male states he noticed an enlargement of his testes and scrotum. When counseling him about the next step in pubertal development, you state:
d.
The penis will grow in length and width.
· Question 21
You see a 7-year-old with complaints of “having accidents at night.” Physical exam and history are unremarkable. Urinalysis, urine culture, and specific gravity are normal. His parents ask about the best treatment for this problem. The best response is
a.
Fluid restriction and voiding prior to the night may be effective.
· Question 22
Chelsea, age 8, complains that she feels as if something is stuck in her ear. What action is contraindicated?
c.
Flushing the ear with water.
· Question 23
By what age should most children be able to sit well without support?
a.
9 months
· Question 24
A typically developing 8-year-old girl will have which of the following genital development?
a.
No pubic hair at all
· Question 25
John is diagnosed with allergic conjunctivitis. What type of discharge do you expect to see upon exam?
c.
Serous and clear
· Question 26
Which of the following vaccines is routinely recommended at 4 months of age?
a.
Diphtheria, tetanus, acellular pertussis (DTaP)
· Question 27
An 8-year-old female has an edematous, mildly erythematous right upper eyelid for 2 days with a fever of 102.9 (F). Which important eye assessment do you need to consider?
d.
Ocular mobility
· Question 28
Role-play with equipment during the course of the physical exam would be the most beneficial with which age group?
b.
Preschoolers
· Question 29
Conductive hearing loss can be caused by
c.
Serous otitis
· Question 30
You see a 30-month-old who speaks in mixed Spanish and English. The child’s vocabulary is normal but at the low end of the normal language spectrum. The parent is worried the child’s development will not be normal because she mixes up the two languages. You respond:
d.
“Your child’s speech is normal and bilingual children commonly intermix the words from both languages until about 3 years of age.”
· Question 31
Mark is in the exam room. You are concerned he may have epiglottitis. In what position do these patients prefer to sit?
d.
Sitting up and leaning forward
· Question 32
The mother of a 4-year-old tells you he likes to “play with himself” while playing and watching television. You advise the mother to
a.
Explain to the child that masturbation is something that should be done in private.
· Question 33
Parents bring their 6-month-old son to see you. He is symmetrically less than the 5th percentile for height, weight and head circumference. He was born at 30 weeks’ gestation and weighed 1000g. He was a planned pregnancy, and his mother’s prenatal course was uneventful until an automobile accident initiated the labor. He was ventilated for 3 days in the intensive care unit but otherwise did well without ongoing problems. He was discharged at 8 weeks of life. Which of the following is the most likely explanation for his small size?
e.
Normal ex-preemie infant growth
· Question 34
You assess a 15-year-old’s visual acuity and note her vision to be 20/50 in the right eye. She asks you what that means and you respond
d.
“You can see at 20 feet with your right eye what most people can see at 50 feet.”
· Question 35
During a “well-child” visit, the parents of a healthy 5-month-old offer a great amount of information. Which of the following bits of information is of most concern?
a.
Limited eye contact with parents.
· Question 36
You are performing an examination of a 3-year-old who is new to your office. Which finding requires immediate further evaluation?
d.
Heart rate increases during inspiration and decreases during expiration
· Question 37
A 9-year-old who weighs 70 pounds asks why she can’t sit in the front passenger seat of the family car. Your best response is
c.
The safest place for children under 12 years old and 100 pounds is in the backseat of the car.
· Question 38
Which of the following would not suggest an eating disorder with a purging component?
d.
Finger calluses
· Question 39
A fifteen-year-old female makes a statement to you during a well visit. Which of the following statements should not be kept confidential?
b.
“Sometimes I feel like ending my life.”
· Question 40
Sarah, age 15, presents with pain and pressure over her cheeks and discolored nasal discharge. You cannot transilluminate the sinuses. You suspect which common sinus to be affected?
d.
Maxillary sinus
· Question 41
A 6-month-old infant has been growing poorly. His parents have changed his formula three times without success. His examination is remarkable for a pale, emaciated child with little subcutaneous fat and anterior fontanelle fullness. His laboratory test results are notable for a hemolytic anemia and prolonged bleeding times. Which of the following is the most appropriate next step?
d.
Obtain a sweat chloride concentration
· Question 42
Medicaid provides health insurance coverage to
a.
Certain categories of people whose personal income falls below a certain percentage of the federal poverty level.
· Question 43
The mother of a 5-year-old informs you that her daughter cheats when playing board games. What is the best response?
b.
Tell the mother to spend time clarifying board game rules before starting games.
· Question 44
Which of the following substances is associated with pupillary constriction?
b.
Heroin
· Question 45
A 7-year-old has just been diagnosed with attention deficit hyperactivity disorder (ADHD). Her parents report that she is doing poorly in school and is disruptive in the classroom. They ask you what they can do. Your best response is:
a.
“Use a consistent approach with behavioral cues both at home and at school.”
· Question 46
Flourescein staining of the eye is used to detect a
c.
Corneal abrasion
· Question 47
0 out of 1 points
Luke, a 17-month-old, failed treatment with amoxicillin for otitis media. At the two-week recheck, his TM was still erythematous and you cannot see the landmarks. He has persistent nasal congestion, he is not sleeping at night, and he has a 101°F fever. What is the next best step for Luke?
a.
Ceftriaxone and an antihistamine
· Question 48
All of the following may predispose a patient to thrush except:
c.
Poor oral hygiene
· Question 49
Head and chest circumferences should be equal at:
c.
1 year of age
· Question 50
The diagnostic criteria for autism spectrum disorder include all of the following except
c.
Tolerance of flexibility with routines
· Question 51
Which of the following statements about bullying is true?
b.
It occurs most commonly during unstructured times (lunch, recess, etc.).
· Question 52
The most likely weight of a 1-year-old whose birth weight was 6-1/2 pounds would be:
a.
19 to 20 pounds
· Question 53
An eye that deviates in when covered but that returns to midline when uncovered is an
c.
esophoria
· Question 54
A 7-year-old boy with mental retardation was born at home at 26 weeks gestation to a 28-year-old mother who had received no prenatal care. An evaluation is likely to suggest his MR is related to which of the following?
e.
Complications of prematurity
· Question 55
The most common substance used in middle school is
a.
Alcohol
· Question 56
A 2-day-old infant has significant nasal and rectal bleeding. He was delivered by a midwife at home; the pregnancy was without complications. His Apgar scores were 9 at 1 minute and 9 at 5 minutes. He has breastfed well and has not required a health care professional visit since birth. Which of the following vitamin deficiencies might explain his condition?
a.
Vitamin K
· Question 57
Tammy, age 3, is at the office for her well-child visit. She has trouble removing her own shirt as requested. Her mother yanks off her shirt after smacking her wrist and saying, “you must do as you’re told quickly.” Which action is indicated?
d.
Observe Tammy for signs of child abuse.
· Question 58
A 4-month-old child has poor weight gain. Her current weight is less than the 5th percentile, height about the 10th percentile, and head circumference at the 50th percentile. The planned pregnancy resulted in a normal, spontaneous, vaginal delivery; mother and child were discharged after a 48-hour hospitalization. Feeding is via breast and bottle; the quantity seems sufficient. The child has had no illness. The examination is unremarkable except for the child’s small size. Screening laboratory shows the hemoglobin and hematocrit are 11 mg/dL and 33% respectively, with a platelet count of 198,000/mm3. Serum electrolyte levels are sodium 140, chloride 105, potassium 3.5, bicarbonate 17, blood urea nitrogen 15, and creatinine 0.3. Liver function tests are normal. Urinalysis reveals a pH of 8 with occasional epithelial cells but no white blood cells, bacteria, protein, ketones, or reducing substances. Which of the following is the most appropriate therapy for this child?
d.
Oral supplementation with bicarbonate
· Question 59
A teenage female who is overweight has moderate acne on the face and chest, and irregular menses. Elevation of which laboratory test provides the test evidence of polycystic ovarian syndrome?
a.
free testosterone
· Question 60
A 2-year-old boy has been slightly less than the 50th percentile for weight, height and head circumference, but in the last 6 months he has fallen to slightly less than the 25th percentile for weight. The pregnancy was normal, his development is as expected, and the family reports no psychosocial problems. The mother says that he is now a finicky eater (wants only macaroni and cheese at all meals), but she insists that he eat a variety of foods. The meals are marked by much frustration for everyone. His examination is normal. Which of the following is the best next step in his care? Midterm Exam: Primary Care of Adolescents and Children
c.
Reassurance and counseling for family about childhood normal developmental stage
· Question 61
I like to use my pincer grasp that involves the ablitily to pick up a small object such as a raisin or piece of cereal with the thumb and forefinger, and that is mastered around what age?
b.
9 months
· Question 62
An 11-year-old girl has dizziness, pupillary dilation, nausea, fever, techycardia, and facial flushing. She says she can “see” sound and “hear” colors. The agent likely to be responsible is which of the following?
d.
Lysergic acid diethylamide (LSD)
· Question 63
An 8-year-old female is brought into the office by her mother. She has complaints of fever and sore throat for the past 2 days. She denies difficulty swallowing but has loss of appetite and mild diarrhea. A few classmates have similar symptoms. A review of systems reveals clear nasal drainage, dry cough, and hoarseness. On exam she has a 101.5 temperature, 3+ erythematous tonsils, and anterior cervical lymphadenopathy. What is the likely diagnosis?
c.
Viral pharyngitis
· Question 64
Appropriate advice for a mother of a 2-week-old child here for a “well child” visit includes which of the following?
c.
Sleep in the supine position is recommended
· Question 65
0 out of 1 points
What is the most traumatic, yet common form and of child abuse seen in pediatric primary care?
d.
Soft tissue injuries
· Question 66
Which of the following is a priority nurse practitioner role to help children and adolescents to have healthy sexual development?
a.
Begin anticipatory guidance related to sexuality and normal pubertal development in the early school-age visits.
· Question 67
Appropriate anticipatory guidance for the parents of an 8-year-old girl includes
c.
Information that the child will start to value personal idols and role models.
· Question 68
Max, a 9-year-old boy, is a very active child with limited self-control. He is easily distracted and has difficulty staying on task. You determine that he should have a neurodevelopmental evaluation because he is showing signs of
d.
ADHD
· Question 69
Which of the following injuries is most likely to be caused by abuse of a toddler?
c.
A displaced posterior rib fracture.
· Question 70
Which of the following issues or concepts is relevant to the school-age child?
a.
Erikson’s initiative versus guilt
· Question 71
While assessing the skin of an infant, you note cafe-au-lait spots. Which disease should be ruled out?
c.
Neurofibromatosis
· Question 72
The first sign of the onset of female puberty is usually:
d.
Breast buds
· Question 73
A mother states that her 4-year-old son constantly grinds his teeth at night. You document this as:
d.
Bruxism
· Question 74
Which of the following characterizes middle adolescence (14 to 16 years old)?
c.
Intense peer group involvement, feelings of immortality, sexual experimentation
· Question 75
I can roll over, grasp a rattle, and reach for things and have begun feeding myself finger foods, but I can’t wave bye-bye yet. How old am I?
a.
6 months
· Question 76
You would be concerned about the language development of a child who:
b.
Stutters when excited or tired at the age of 7
· Question 77
Most children can independently get dressed by themselves by age:
d.
5 years
· Question 78
A differential diagnosis for child abuse would include all of the following except.
b.
Prader-Wlli syndrome
· Question 79
Which of the following eye findings would be considered an ophthalmic emergency?
b.
Unilateral vesicular lesions on the upper eyelid in a 3-week old.
· Question 80
A 2-year-old child weighs 34 lb. What type of car seat should the child use?
b.
A forward-facing car seat in the back of the vehicle.
· Question 81
An expected milestone of a 4-year-old is the ability to
c.
Copy a cross
· Question 82
Sam has an otitis media. He also presents with conjunctivitis. This is due to which organism?
a.
Haemophilus influenza
· Question 83
A 14-year old has ataxia. He is brought to the local emergency department, where he appears euphoric, emotionally labile, and disoriented. Many notice his abusive language. Which of the following agents is most likely responsible for his condition?
a.
Alcohol
· Question 84
What method can be safely used to remove cerumen in a 15-month-old child’s ear?
d.
Irrigation using warm water from a soft bulb syringe
· Question 85
The appropriate lab tests in assessment of cervical adenitis include all of the following except:
a.
Blood culture
· Question 86
Which of the following represents normal sequencing of development in a toddler?
b.
Feeds self, can undress self with help, washes hands, imitates housework.
· Question 87
You see a young child who has tripled her birth weight and looks for hidden objects. When given blocks, she places one in each hand. She has a fine pincer grasp. On the floor, she walks around holding objects and is trying to take independent steps. This child is most likely how old?
c.
12 months
· Question 88
During a domestic health assessment, the CDC recommends screening every refugee child for which of the following diseases?
d.
tuberculosis
· Question 89
A 4-month-old presents with both eyes turning inward. What is this called?
b.
Esotropia
· Question 90
A mother brings her 4-week-old infant into the office because she noticed small yellow-white glistening bumps on her infant’s gums. She says they look like teeth but is concerned that they may be cancer. You diagnose these bumps as
d.
Epstein’s pearls
· Question 91
The parents of a 7-year-old are concerned their son does not want to attend school. Which of the historical findings are not usually associated with the diagnosis of school phobia?
d.
Chronic medical illness
· Question 92
You are doing a kindergarten physical on a 5-year-old girl. Which of the following scenarios would suggest the child is not ready to start kindergarten in the fall?
d.
Counts to 4 and draws a person with three parts.
· Question 93
Which of the following children should be referred for a comprehensive developmental evaluation?
a.
A 3-year-old who consistently tracks at the 5th percentile for height and weight since birth.
· Question 94
Sarah, 7 years old, is in the office today. All of the following are acceptable management options for allergic rhinitis, except
b.
Nasal neosynephrine
· Question 95
You see a 3-year-old for a well-child visit. His mother informs you that potty training has been very easy because he “has an amazing internal clock. He falls asleep, gets hungry, and has bowel movements at the same time every day.” This describes which aspect of temperament?
a.
Rhythmicity
· Question 96
You see a healthy 18-month-old for a well-child visit. At the 12-month visit he received the diphtheria, tetanus, and acellular pertussis (DTaP) third dose; hepatitis B second dose; measles, mumps, and rubella (MMR) first dose; injected poliovirus (IPV) second dose; pneumococcal conjugate (PCV13) fourth dose; and Haemophilus influenzae type B (Hib) fourth dose. Which of the following do you order today?
c.
DTaP, varicella, hepatitis A, and hepatitis B
· Question 97
The results of the hemoglobin A1c test are LESS reliable in children with which of the following conditions? (Hint: select two)
Selected Answers:
a.
Cystic Fibrosis
b.
Sickle Cell Disease
· Question 98
You see a 5-month-old who is fussy, has interrupted sleep, and is drooling. You note large lower lateral incisor bulges. You recommend:
· Question 99
A 7-month-old male is found to have a spiral fracture of the femur that his father says he got by climbing onto a chair and then jumping off. Which of the following statements is true regarding this situation?
· Question 100
The nurse practitioner role was initially established to
· Question 101
Which of the following is a true contraindication of vaccinating a child?
NURS 6541 Midterm Exam / NURS 6541 Midterm Exam (Latest): Primary Care of Adolescents and Children: Walden University
· Question 1
1 out of 1 points
Medicaid provides health insurance coverage to
Selected Answer:
b.
Certain categories of people whose personal income falls below a certain percentage of the federal poverty level.
· Question 2
1 out of 1 points
A differential diagnosis for child abuse would include all of the following except.
Selected Answer:
c.
Prader-Wlli syndrome
· Question 3
1 out of 1 points
Which of the following injuries is most likely to be caused by abuse of a toddler?
Selected Answer:
d.
A displaced posterior rib fracture.
· Question 4
1 out of 1 points
You are doing a kindergarten physical on a 5-year-old girl. Which of the following scenarios would suggest the child is not ready to start kindergarten in the fall?
Selected Answer:
a.
Counts to 4 and draws a person with three parts.
· Question 5
1 out of 1 points
The first sign of the onset of female puberty is usually:
Selected Answer:
b.
Breast buds
· Question 6
1 out of 1 points
You see a 7-year-old with complaints of “having accidents at night.” Physical exam and history are unremarkable. Urinalysis, urine culture, and specific gravity are normal. His parents ask about the best treatment for this problem. The best response is
Selected Answer:
b.
Fluid restriction and voiding prior to the night may be effective.
· Question 7
1 out of 1 points
Which of the following statements about bullying is true?
Selected Answer:
d.
It occurs most commonly during unstructured times (lunch, recess, etc.).
· Question 8
1 out of 1 points
The mother of a 5-year-old informs you that her daughter cheats when playing board games. What is the best response?
Selected Answer:
b.
Tell the mother to spend time clarifying board game rules before starting games.
· Question 9
0 out of 1 points
Which of the following conditions requires urgent inpatient admission?
Selected Answer:
d.
Epiglottis
· Question 10
1 out of 1 points
All of the following are consistent with peritonsillar abscess except:
Selected Answer:
d.
Trismus
· Question 11
1 out of 1 points
The parents of a 7-year-old are concerned their son does not want to attend school. Which of the historical findings are not usually associated with the diagnosis of school phobia?
Selected Answer:
d.
Chronic medical illness
· Question 12
1 out of 1 points
You are performing an examination of a 3-year-old who is new to your office. Which finding requires immediate further evaluation?
Selected Answer:
c.
Heart rate increases during inspiration and decreases during expiration.
· Question 13
1 out of 1 points
A child’s head circumference is routinely measured on each well visit until what age?
Selected Answer:
a.
2 years
· Question 14
1 out of 1 points
Which of the following children has abnormal language development?
Selected Answer:
c.
Speech is 50% understandable at 36 months of age
· Question 15
1 out of 1 points
Please interpret the following labs for an adolescent. The adolescent has a history of obesity and acanthosis nigricans.
Test
Results
Fasting blood glucose
112 mg/dL
2 hour postprandial glucose
138 mg/dL
Selected Answer:
d.
Impaired fasting glucose, postprandial glucose within normal limits
· Question 16
1 out of 1 points
Which of the following issues or concepts is relevant to the school-age child?
Selected Answer:
c.
Erikson’s initiative versus guilt
· Question 17
1 out of 1 points
The diagnostic criteria for autism spectrum disorder include all of the following except
Selected Answer:
d.
Tolerance of flexibility with routines
· Question 18
1 out of 1 points
Conductive hearing loss can be caused by
Selected Answer:
d.
Serous otitis
· Question 19
1 out of 1 points
The most common substance used in middle school is
Selected Answer:
a.
Alcohol
· Question 20
1 out of 1 points
The results of the hemoglobin A1c test are LESS reliable in children with which of the following conditions? (Hint: select two)
Selected Answers:
a.
Cystic Fibrosis
b.
Sickle Cell Disease
· Question 21
1 out of 1 points
A teenage female who is overweight has moderate acne on the face and chest, and irregular menses. Elevation of which laboratory test provides the test evidence of polycystic ovarian syndrome?
Selected Answer:
d.
free testosterone
· Question 22
1 out of 1 points
Mark is in the exam room. You are concerned he may have epiglottitis. In what position do these patients prefer to sit?
Selected Answer:
a.
Sitting up and leaning forward
· Question 23
1 out of 1 points
You see a 30-month-old who speaks in mixed Spanish and English. The child’s vocabulary is normal but at the low end of the normal language spectrum. The parent is worried the child’s development will not be normal because she mixes up the two languages. You respond:
Selected Answer:
b.
“Your child’s speech is normal and bilingual children commonly intermix the words from both languages until about 3 years of age.”
· Question 24
1 out of 1 points
Which of the following characterizes middle adolescence (14 to 16 years old)?
Selected Answer:
b.
Intense peer group involvement, feelings of immortality, sexual experimentation
· Question 25
1 out of 1 points
You see a 4-year-old for a well-child visit. He has received four diphtheria, tetanus, and acellular pertussis vaccines (DTaP); three injected polio vaccines (IPV); one measles, mumps, and rubella vaccine (MMR); one varicella vaccine; and two hepatitis B (Hep B) vaccines. What do you order today?
Selected Answer:
c.
DTaP, IPV, MMR, and Varivax
· Question 26
1 out of 1 points
A 14-year old has ataxia. He is brought to the local emergency department, where he appears euphoric, emotionally labile, and a bit disoriented. He has nystagmus and hypersalivation. Many notice his abusive language. Which of the following agents is most likely responsible for his condition?
Selected Answer:
d.
Alcohol
· Question 27
1 out of 1 points
Parents bring their 6-month-old son to see you. He is symmetrically less than the 5th percentile for height, weight and head circumference. He was born at 30 weeks’ gestation and weighed 1000g. He was a planned pregnancy, and his mother’s prenatal course was uneventful until an automobile accident initiated the labor. He was ventilated for 3 days in the intensive care unit but otherwise did well without ongoing problems. He was discharged at 8 weeks of life. Which of the following is the most likely explanation for his small size?
Selected Answer:
b.
Normal ex-preemie infant growth
· Question 28
1 out of 1 points
A fifteen-year-old female makes a statement to you during a well visit. Which of the following statements should not be kept confidential?
Selected Answer:
c.
“Sometimes I feel like ending my life.”
· Question 29
1 out of 1 points
Most children can independently get dressed by themselves by age:
Selected Answer:
b.
5 years
· Question 30
1 out of 1 points
A 13-month-old child is noted to be at the 25th percentile for weight, the 10th percentile for height, and less than the 5th percentile for head circumference. She was born at term. She was noted to have a small head at birth, to be developmentally delayed throughout her life, and to have required cataract surgery shortly after birth. She currently takes phenobarbital for seizures. Which of the following would most likely explain this child’s small size?
Selected Answer:
e.
Congenital cytomegalovirus infection
· Question 31
1 out of 1 points
A 4-month-old child has poor weight gain. Her current weight is less than the 5th percentile, height about the 10th percentile, and head circumference at the 50th percentile. The planned pregnancy resulted in a normal, spontaneous, vaginal delivery; mother and child were discharged after a 48-hour hospitalization. Feeding is via breast and bottle; the quantity seems sufficient. The child has had no illness. The examination is unremarkable except for the child’s small size. Screening laboratory shows the hemoglobin and hematocrit are 11 mg/dL and 33% respectively, with a platelet count of 198,000/mm3. Serum electrolyte levels are sodium 140, chloride 105, potassium 3.5, bicarbonate 17, blood urea nitrogen 15, and creatinine 0.3. Liver function tests are normal. Urinalysis reveals a pH of 8 with occasional epithelial cells but no white blood cells, bacteria, protein, ketones, or reducing substances. Which of the following is the most appropriate therapy for this child?
Selected Answer:
d.
Oral supplementation with bicarbonate
· Question 32
1 out of 1 points
Chelsea, age 8, complains that she feels as if something is stuck in her ear. What action is contraindicated?
Selected Answer:
b.
Flushing the ear with water.
· Question 33
1 out of 1 points
Which of the following substances is associated with pupillary constriction?
Selected Answer:
c.
Heroin
· Question 34
1 out of 1 points
Which of the following children should be referred for a comprehensive developmental evaluation?
Selected Answer:
a.
A 3-year-old who consistently tracks at the 5th percentile for height and weight since birth.
· Question 35
0 out of 1 points
John is diagnosed with allergic conjunctivitis. What type of discharge do you expect to see upon exam?
Selected Answer:
c.
Serous and clear
· Question 36
1 out of 1 points
You diagnose a 16-year-old with acute otitis media and need to prescribe an antibiotic with beta-lactamase coverage. What do you choose?
Selected Answer:
d.
amoxicillin and potassium clavulanate (Augmentin)
· Question 37
1 out of 1 points
A new mom calls the NP on postpartum day 5. She reports her newborn wants to nurse for 30 minutes every 1-1/2 to 2 hours. Which of these is the best response?
Selected Answer:
d.
“This is a very healthy breastfeeding pattern. Be sure to rest when you can. You are doing a great job.”
· Question 38
1 out of 1 points
Which of the following represents normal sequencing of development in a toddler?
Selected Answer:
b.
Feeds self, can undress self with help, washes hands, imitates housework.
· Question 39
1 out of 1 points
By what age should most children be able to sit well without support?
Selected Answer:
a.
9 months
· Question 40
1 out of 1 points
A common feature of 2-year-old behavior is:
Selected Answer:
b.
Stranger anxiety
· Question 41
1 out of 1 points
You assess a 15-year-old’s visual acuity and note her vision to be 20/50 in the right eye. She asks you what that means and you respond
Selected Answer:
d.
“You can see at 20 feet with your right eye what most people can see at 50 feet.”
· Question 42
1 out of 1 points
Flourescein staining of the eye is used to detect a
Selected Answer:
b.
Corneal abrasion
· Question 43
1 out of 1 points
Blood pressure should be measured at well-child visits starting at age:
Selected Answer:
a.
3 years
· Question 44
1 out of 1 points
Sarah, 7 years old, is in the office today. All of the following are acceptable management options for allergic rhinitis, except
Selected Answer:
a.
Nasal neosynephrine
· Question 45
1 out of 1 points
During a “well-child” visit, the parents of a healthy 5-month-old offer a great amount of information. Which of the following bits of information is of most concern?
Selected Answer:
b. Limited eye contact with parents.
· Question 46
1 out of 1 points
At what age would a child be expected to remember a string of numbers and repeat them backwards?
Selected Answer:
a.
12 years
· Question 47
1 out of 1 points
During a domestic health assessment, the CDC recommends screening every refugee child for which of the following diseases?
Selected Answer:
b.
tuberculosis
· Question 48
1 out of 1 points
Which of the following signs may indicate a baby is not receiving sufficient breastmilk?
Selected Answer:
a.
Sleepiness, jaundice, and vomiting
· Question 49
1 out of 1 points
Which of the following eye findings would be considered an ophthalmic emergency?
Selected Answer:
d.
Unilateral vesicular lesions on the upper eyelid in a 3-week old.
· Question 50
1 out of 1 points
Which of the following statements regarding adolescent substance use is true?
Selected Answer:
c.
Tobacco is the most commonly abused substance during adolescence.
· Question 51
1 out of 1 points
Which of the following vaccines is routinely recommended at 4 months of age?
Selected Answer:
a.
Diphtheria, tetanus, acellular pertussis (DTaP)
· Question 52
1 out of 1 points
The nurse practitioner role was initially established to
Selected Answer:
c.
Improve access to care and partially solve physician shortage.
· Question 53
1 out of 1 points
Mark, a 10-year-old, has a lot of ear pain. He does not want anyone to touch it and is crying in pain. The ear canal is swollen and exudate is present. The TM is normal. Mark should be instructed to do which of the following?
Selected Answer:
b.
Keep ear dry until symptoms improve.
· Question 54
1 out of 1 points
A 4-year-old believes there is more juice in a tall, thin glass than a shorter, wider one. The child has not yet achieved which of the principles of Piaget?
Selected Answer:
b.
Conservation
· Question 55
1 out of 1 points
Early reflexive responses that are not related to survival include all but:
Selected Answer:
a.
Swimming
· Question 56
1 out of 1 points
You would be concerned about the language development of a child who:
Selected Answer:
b.
Stutters when excited or tired at the age of 7
· Question 57
1 out of 1 points
The appropriate lab tests in assessment of cervical adenitis include all of the following except:
Selected Answer:
a.
Blood culture
· Question 58
1 out of 1 points
A 4-month-old presents with both eyes turning inward. What is this called?
Selected Answer:
c.
Esotropia
· Question 59
1 out of 1 points
An 8-year-old female is brought into the office by her mother. She has complaints of fever and sore throat for the past 2 days. She denies difficulty swallowing but has loss of appetite and mild diarrhea. A few classmates have similar symptoms. A review of systems reveals clear nasal drainage, dry cough, and hoarseness. On exam she has a 101.5 temperature, 3+ erythematous tonsils, and anterior cervical lymphadenopathy. What is the likely diagnosis?
Selected Answer:
c.
Viral pharyngitis
· Question 60
1 out of 1 points
You see a 13-year-old who reports she is learning some basic geometry (areas, volume etc.). The ability to successfully master these concepts occurs during which Piaget developmental stage?
Selected Answer:
a.
Concrete operational
· Question 61
1 out of 1 points
An 8-year-old female has an edematous, mildly erythematous right upper eyelid for 2 days with a fever of 102.9 (F). Which important eye assessment do you need to consider?
Selected Answer:
a.
Ocular mobility
· Question 62
1 out of 1 points
Tammy, age 3, is at the office for her well-child visit. She has trouble removing her own shirt as requested. Her mother yanks off her shirt after smacking her wrist and saying, “you must do as you’re told quickly.” Which action is indicated?
Selected Answer:
a.
Observe Tammy for signs of child abuse.
· Question 63
1 out of 1 points
Which of the following is a true contraindication of vaccinating a child?
Selected Answer:
a.
Previous vaccination reaction that consisted of wheezing and hypotension
· Question 64
1 out of 1 points
The parent of a 2-year-old tells you her daughter recently started having breath-holding spells. She tells you the older sibling “did the same thing” and asks you for help. You advise her that after a breath-holding event:
Selected Answer:
c.
Act as if nothing abnormal happened.
· Question 65
1 out of 1 points
You see a healthy 18-month-old for a well-child visit. At the 12-month visit he received the diphtheria, tetanus, and acellular pertussis (DTaP) third dose; hepatitis B second dose; measles, mumps, and rubella (MMR) first dose; injected poliovirus (IPV) second dose; pneumococcal conjugate (PCV13) fourth dose; and Haemophilus influenzae type B (Hib) fourth dose. Which of the following do you order today?
Selected Answer:
c.
DTaP, varicella, hepatitis A, and hepatitis B
· Question 66
1 out of 1 points
A 7-year-old boy with mental retardation was born at home at 26 weeks gestation to a 28-year-old mother who had received no prenatal care. An evaluation is likely to suggest his MR is related to which of the following?
Selected Answer:
a.
Complications of prematurity
· Question 67
1 out of 1 points
Which is the correct order for introduction of solid foods to an infant?
Selected Answer:
d.
Cereal, vegetables, fruits, and meats
· Question 68
1 out of 1 points
Which of the following foreign body in the nose requires immediate removal?
Selected Answer:
c.
battery
· Question 69
1 out of 1 points
A Mantoux test in a child with no risk factors is considered positive with a reaction of:
Selected Answer:
c.
at least 15 mm induration
· Question 70
1 out of 1 points
Parents bring their 16-year-old daughter for a “well-child” checkup. She looks normal on examination. As part of your routine care you plan a urinalysis. The father pulls you aside and asks you to secretly run a UDS on his daughter. Which of the following is the most appropriate course of action?
Selected Answer:
b.
Explore the reasons for the request with the parents and the adolescent and perform a UDS with the adolescent’s permission if the history warrants.
· Question 71
1 out of 1 points
A 2-year-old boy has been slightly less than the 50th percentile for weight, height and head circumference, but in the last 6 months he has fallen to slightly less than the 25th percentile for weight. The pregnancy was normal, his development is as expected, and the family reports no psychosocial problems. The mother says that he is now a finicky eater (wants only macaroni and cheese at all meals), but she insists that he eat a variety of foods. The meals are marked by much frustration for everyone. His examination is normal. Which of the following is the best next step in his care?
Selected Answer:
e.
Reassurance and counseling for family about childhood normal developmental stage
· Question 72
1 out of 1 points
You receive a phone call from the mother of a 2-year-old. She states her child has sleep refusal. You suggest the child should be able to:
Selected Answer:
b.
Set his own bedtime based on his internal clock.
· Question 73
1 out of 1 points
All of the following may predispose a patient to thrush except:
Selected Answer:
c.
Poor oral hygiene
· Question 74
1 out of 1 points
Sarah, age 15, presents with pain and pressure over her cheeks and discolored nasal discharge. You cannot transilluminate the sinuses. You suspect which common sinus to be affected?
Selected Answer:
d.
Maxillary sinus
· Question 75
1 out of 1 points
I can walk well on tiptoes, my speech is 50% understandable, I know six body parts, but I cannot balance on one foot for 1 second. I am:
Selected Answer:
b.
2-1/2 years old (30 months)
· Question 76
1 out of 1 points
Which of the following screenings should adolescents have done annually?
Selected Answer:
d.
Psychosocial screening, blood pressure, body mass index
· Question 77
1 out of 1 points
A 6-month-old infant has been growing poorly. His parents have changed his formula three times without success. His examination is remarkable for a pale, emaciated child with little subcutaneous fat and anterior fontanelle fullness. His laboratory test results are notable for a hemolytic anemia and prolonged bleeding times. Which of the following is the most appropriate next step?
Selected Answer:
d.
Obtain a sweat chloride concentration
· Question 78
1 out of 1 points
You see a 3-year-old for a well-child visit. His mother informs you that potty training has been very easy because he “has an amazing internal clock. He falls asleep, gets hungry, and has bowel movements at the same time every day.” This describes which aspect of temperament?
Selected Answer:
a.
Rhythmicity
· Question 79
1 out of 1 points
A 12-year-old male states he noticed an enlargement of his testes and scrotum. When counseling him about the next step in pubertal development, you state:
Selected Answer:
c.
The penis will grow in length and width.
· Question 80
1 out of 1 points
A 14-year-old female comes into the office for an urgent visit after taking 10 valium tablets. Following the initial emergent care and stailization, the most important part of the management is:
Selected Answer:
c.
Assessing the family supports available to the child.
· Question 81
1 out of 1 points
A 2-year-old child weighs 34 lb. What type of car seat should the child use?
Selected Answer:
b.
A forward-facing car seat in the back of the vehicle.
· Question 82
1 out of 1 points
Which of the following is a priority nurse practitioner role to help children and adolescents to have healthy sexual development?
Selected Answer:
b.
Begin anticipatory guidance related to sexuality and normal pubertal development in the early school-age visits.
· Question 83
1 out of 1 points
Epiglottitis has decreased due to which immunization?
Selected Answer:
c.
Hib
· Question 84
1 out of 1 points
Role-play with equipment during the course of the physical exam would be the most beneficial with which age group?
Selected Answer:
a.
Preschoolers
· Question 85
1 out of 1 points
A 2-day-old newbornwith conjunctivitis is likely due to
Selected Answer:
a.
Gonorrhea
· Question 86
1 out of 1 points
A 9-year-old who weighs 70 pounds asks why she can’t sit in the front passenger seat of the family car. Your best response is
Selected Answer:
d.
The safest place for children under 12 years old and 100 pounds is in the backseat of the car.
· Question 87
1 out of 1 points
Which of the following would not suggest an eating disorder with a purging component?
Selected Answer:
b.
Finger calluses
· Question 88
1 out of 1 points
You see a 6-month-old for a well-child visit and the mother tells you the child’s grandmother recommends that she give the infant whole milk and eggs when he starts solids. What should you tell the mother?
Selected Answer:
d.
The baby should remain on infant formula and stage 2 and 3 baby foods for now.
· Question 89
1 out of 1 points
A 2-day-old infant has significant nasal and rectal bleeding. He was delivered by a midwife at home; the pregnancy was without complications. His Apgar scores were 9 at 1 minute and 9 at 5 minutes. He has breastfed well and has not required a health care professional visit since birth. Which of the following vitamin deficiencies might explain his condition?
Selected Answer:
a.
Vitamin K
· Question 90
1 out of 1 points
You see a 5-month-old who is fussy, has interrupted sleep, and is drooling. You note large lower lateral incisor bulges. You recommend:
Selected Answer:
e.
A and D
· Question 91
1 out of 1 points
The most likely weight of a 1-year-old whose birth weight was 6-1/2 pounds would be:
Selected Answer:
c.
19 to 20 pounds
· Question 92
1 out of 1 points
Head and chest circumferences should be equal at:
Selected Answer:
d.
1 years of age
· Question 93
1 out of 1 points
An 11-year-old girl has dizziness, pupillary dilation, nausea, fever, techycardia, and facial flushing. She says she can “see” sound and “hear” colors. The agent likely to be responsible is which of the following?
Selected Answer:
a.
Lysergic acid diethylamide (LSD)
· Question 94
1 out of 1 points
FIRST-LINE therapy for preschoolers (4-5 years of age) diagnosed with attention-deficit hyperactive disorder is:
Selected Answer:
c.
Behavior therapy
· Question 95
1 out of 1 points
Max, a 9-year-old boy, is a very active child with limited self-control. He is easily distracted and has difficulty staying on task. You determine that he should have a neurodevelopmental evaluation because he is showing signs of
Selected Answer:
a.
ADHD
· Question 96
1 out of 1 points
A 3-year-old (37 months) refuses to have bowel movements on the toilet. He is bladder trained. He goes and hides and squats when having bowel movements. Positive encouragement and praise is not working. You advise:
Selected Answer:
b.
Tell the parent this is normal; the child will eventually train himself, but it is difficult to wait.
· Question 97
1 out of 1 points
A typically developing 8-year-old girl will have which of the following genital development?
Selected Answer:
c.
No pubic hair at all
· Question 98
0 out of 1 points
Which of the following are important considerations when screening child refugees for tuberculosis? SELECT TWO (2)
Selected Answers:
c.
IGRA may be falsely positive in children who have autoimmune disorders.
d.
Mantoux TST should not be used in a child who has received a Bacille Calmette-Guerin vaccination.
· Question 99
1 out of 1 points
The mother of a 4-year-old tells you he likes to “play with himself” while playing and watching television. You advise the mother to
Selected Answer:
b.
Explain to the child that masturbation is something that should be done in private.
· Question 100
1 out of 1 points
A 7-year-old has just been diagnosed with attention deficit hyperactivity disorder (ADHD). Her parents report that she is doing poorly in school and is disruptive in the classroom. They ask you what they can do. Your best response is:
Selected Answer:
a.
“Use a consistent approach with behavioral cues both at home and at school.”
Week 6: Discussion: Healthcare Financing
Purpose
The purpose of this discussion is to explore the DNP-prepared nurse’s role in meeting the organization’s mission through effective planning, budgeting, and determining the allocation of resources.
ORDER A PLAGIARISM-FREE PAPER NOW
Instructions
This week, you will have an opportunity to estimate the resources needed for your practice change project and complete the budget for your practice change project. Reflect upon your readings and professional experience and complete the budget for your practice change project.
Common Health Conditions with Implications for Women
Select a patient that you examined during the last four weeks as a Nurse Practitioner. Select a female patient with common endocrine or musculoskeletal conditions, Evaluate differential diagnoses for common endocrine or musculoskeletal conditions you chose .With this patient in mind, address the following in a SOAP Note: Common Health Conditions with Implications for Women
Subjective: What details did the patient provide regarding or her personal and medical history?
Objective: What observations did you make during the physical assessment?
Assessment: What were your differential diagnoses? Provide a minimum of three possible diagnoses. List them from highest priority to lowest priority. What was your primary diagnosis and why? Common Health Conditions with Implications for Women
Plan: What was your plan for diagnostics and primary diagnosis? What was your plan for treatment and management, including alternative therapies? Include pharmacologic and nonpharmacologic treatments, alternative therapies, and follow-up appointment with the provider, as well as a rationale for this treatment and management plan.
Reflection notes: What would you do differently in a similar patient evaluation? And how can you relate this to your class and clinical readings.
References
Schuiling, K. D., & Likis, F. E. (2013). Women’s gynecologic health (2nd ed.). Burlington, MA: Jones and Bartlett Publishers. Common Health Conditions with Implications for Women
Chapter 22, “Urinary Tract Infection in Women” (pp. 535–546)
Tharpe, N. L., Farley, C., & Jordan, R. G. (2013). Clinical practice guidelines for midwifery & Women’s health (4th ed.). Burlington, MA: Jones & Bartlett Publishers.
Review: Chapter 8, “Primary Care in Women’s Health” (pp. 431–560)
Centers for Disease Control and Prevention. (2012b). Women’s health. Retrieved from http://www.cdc.gov/women/
National Institutes of Health. (2012). Office of Research on Women’s Health (ORWH). Retrieved from http://orwh.od.nih.gov/
U.S. Department of Health and Human Services. (2012a). Womenshealth.gov. Retrieved from http://www.womenshealth.gov/ Common Health Conditions with Implications for Women
Case Study And Moral Status
Based on “Case Study: Fetal Abnormality” and other required topic study materials, write a 750-1,000-word reflection that answers the following questions:
While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center.
This assignment uses a rubric.
You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.
Rubric
Explanation of the Christian view of the nature of human persons and the theory of moral status that it is compatible is clear, thorough, and explained with a deep understanding of the connection between them. Explanation is supported by topic study materials. 30%
The theory or theories that are used by each person to determine the moral status of the fetus is explained clearly and draws insightful relevant conclusions. Rationale for choices made is clearly supported by topic study materials and case study examples. 15%
Explanation of how the theory determines or influences each of their recommendations for action is clear, insightful, and demonstrates a deep understanding of the theory and its impact on recommendation for action. Explanation is supported by topic study materials. 15% Case Study And Moral Status
Evaluation of which theory is preferable within personal practice along with how that theory would influence personal recommendations for action is clear, relevant, and insightful. 10%
Thesis is comprehensive and contains the essence of the paper. Thesis statement makes the purpose of the paper clear.
Clear and convincing argument presents a persuasive claim in a distinctive and compelling manner. All sources are authoritative.
Writer is clearly in command of standard, written, academic English.
All format elements are correct.
Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error.
Here is a link to the Khan video on Moral Status. It will help explain the five theories discussed in the lecture:
https://www.khanacademy.org/partner-content/wi-phi/wiphi-value-theory/wiphi-ethics/v/moral-status Case Study And Moral Status
Personal Philosophy Of Nursing Paper
Use the questions in the table in chapter 3 on page 101 of your textbook as a guide as you write your personal philosophy of nursing. The paper should be three typewritten double spaced pages following APA style guidelines. The paper should address the following:
Grading criteria for the Personal Philosophy of Nursing Paper:
Introduction 10%
Definition of Nursing 20%
Assumptions and beliefs 20%
Definitions and examples of domains of nursing 30%
Summary 20%
Total 100% Personal Philosophy Of Nursing Paper
Case Studies Of Community Health
CASE # 1 About: History of Public Health and Public and Community Health Nursing
Michael works as a home health nurse in his suburban community. He visits 7-10 clients each day. On today’s visitations, Michael will provide care for four clients who are recovering from hip replacement surgery and three clients who are recovering from heart surgery, and he will provide intravenous (IV) antibiotics for a man with an infected wound.
Among this list of clients, Michael visits Mrs. T., an 87-year-old white woman who lives alone and is recovering from triple bypass surgery that she underwent a month ago. Michael’s goals are to check on her recovery progress, reload her medications in her weekly medication container, and administer an influenza vaccine. Case Studies Of Community Health
Upon entering Mrs. T.’s small house, Michael finds the house in disarray: clothes are scattered about, dirty dishes with crusted food line the kitchen counters, and no lights are on. Michael finds Mrs. T. lying in bed watching television. Mrs. T. complains to Michael of feeling too tired to do anything; she eats only what is already prepared (e.g., frozen dinners or snack foods like potato chips) because cooking requires too much effort. She spends most of her days lying in bed and has not bathed in a week.
Michael helps Mrs. T. out of bed and assists her with a bath. After the bath, Michael fixes Mrs. T. a quick lunch and refills her medication box while she eats. Michael encourages Mrs. T. to start getting some exercise by doing the household chores so that her heart can get stronger. “The stronger your heart is, the more energy you will have,” Michael tells Mrs. T. Michael also enlists several services for Mrs. T.: A home health aide will come to the house three times a week to help Mrs. T. bathe, and Meals-on-Wheels will bring her breakfast and lunch. Finally, Nurse Michael administers the influenza vaccine. Case Studies Of Community Health
During Nurse Michael’s visit the following week, Mrs. T. is showing improvement. She tells Michael, “I just love that little girl who comes to help me; she is just so sweet. And the Meals-on-Wheels program is a blessing, I now have more energy to keep this place clean the way I like it.”
Questions
CASE STUDY # 2 ABOUT CULTURAL DIVERSITY IN THE COMMUNITY
Nurse Betty is teaching a health-promotion class to a group of Hispanic migrant workers. Nurse Betty is white, and this is her first time interacting with people of Hispanic culture. Nurse Betty speaks a little Spanish, but not enough to teach the whole class in Spanish. Most of the migrant workers speak only Spanish. Nurse Betty understands that she needs to provide culturally competent care to make her health-promotion class most effective but is not sure where to start. Case Studies Of Community Health
Questions
CASE # 3: ABOUT ENVIROMMENTAL HEALTH
John J. is a school nurse at Jackson Elementary School, which was built in 1960. Nurse John has noticed that many students from Ms. Zee’s second grade class have come to the clinic complaining about coughing, sneezing, runny nose, and watery eyes. Nurse John has also observed that Steven Tea, the only asthmatic student in Ms. Zee’s class, has had more asthma attacks this year than he did last year. Because the rest of the school is not experiencing the same respiratory problems, Nurse John is concerned that something in Ms. Zee’s classroom is causing students to feel ill. Case Studies Of Community Health
Nurse John decides to visit Ms. Zee’s classroom. Upon entering the classroom, one of the few located in the school’s basement, John is struck by the powerful musty smell that inhabits the room. While talking to Ms. Zee, John learns that the classroom has “smelled bad for years,” and that students from previous years have complained about respiratory problems. Nurse John notes that Ms. Zee has stuffed a blanket at the base of the classroom’s small rectangular window near the ceiling because the window does not close completely.
John suspects that Ms. Zee’s classroom walls are contaminated with mold. Upon further research, Nurse John learns that if water gets between the exterior and the interior of a building’s wall, mold can grow in the moist environment. This situation can occur as the result of construction defects in the building (e.g., leaky windows). Nurse John also learns that people who are exposed to extensive mold growth may experience allergic reactions, such as hay fever-like allergy symptoms, and that people who already have a chronic respiratory disease, such as asthma, may experience difficulty breathing when exposed to mold. Nurse John is concerned about the possible mold contamination effect on his asthmatic student, Steven. Case Studies Of Community Health
Questions
CASE # 4: ABOUT INFECTIOUS DISEASE PREVENTION AND CONTROL
Hilary S. is a nurse health inspector at the county health department. Nurse Hilary visits businesses in the community that have the potential to spread infectious diseases to large and/or vulnerable populations. Today, Nurse Hilary will visit the We Love Kids daycare center and a nearby seafood restaurant.
The daycare center cares for children ages 1 month to 6 years. To enroll a child in daycare, parents must show proof that the child is up-to-date on all age-appropriate immunizations or must show proof of medical or religious exemption. Nurse Hilary finds the records in the office area and confirms that all children have received the necessary immunizations. She observes that employees use gloves when changing diapers, cleaning a baby’s spit-up, and tending to a scratched knee from a playground accident. Employees also wash their hands after each of these events, before and after giving a baby his bottle, and before entering the 1- to 6-month-old room after leaving the 2- to 3-year-old room. Nurse Hilary also notices a flyer posted in the employee break room that informs staff of the upcoming mandatory in-service that will be held to discuss the importance of checking bottles, especially those that contain breast milk, for the correct name before feeding a child. Case Studies Of Community Health
The seafood restaurant is a chain restaurant that has become less popular over the past couple of years. Many customers have complained about the quality of the food. Recently, 20 cases of severe diarrhea were reported to the health department by people who had just eaten at the restaurant. Nurse Hilary observes the cooks in the kitchen. The refrigerator and the freezer are kept at appropriate temperatures for storing food. Food is stored in airtight, plastic containers. Nurse Hilary watches as the cook who is preparing the chicken for broiling is also in charge of prepping the plates that are going out to the customers. Upon cutting into a piece of chicken about to go out to the dining room, Nurse Hilary notes that the center looks pink and undercooked. Pieces of wilted lettuce are scattered on the countertops. During her 2-hour visit, the main chef washes his hands twice, although he leaves the kitchen four times for a smoking break. Case Studies Of Community Health
Questions
CASE # 5: ABOUT FAMILY HEALTH RISK
The M. family consists of Mr. M. (Harry), Mrs. M. (Shirley), 18-year-old Annie, 15-year-old Michelle, 13-year-old Sean, and 7-year-old Bobby. Harry is the pastor of Faith Baptist Church, where he has served for the past 15 years. Shirley is a housemother and is the primary caretaker for the children.
For the past year, Shirley has felt tired and “rundown.” At her annual physical, Shirley describes her symptoms to her physician. After several tests, Shirley is diagnosed with stomach cancer. Shirley starts to cry and says, “How will I tell my family?”
Shirley’s primary physician refers the family to Trisha F., a mental health nurse specialist. Nurse Trisha calls the household and speaks to Shirley. Nurse Trisha tells Shirley that she was referred by the physician, and she can help Shirley cope with the diagnosis. Shirley confides in Trisha that it has been 2 weeks since she received the diagnosis, but she has yet to tell her husband and children. Shirley asks Trisha if she can help her tell her family and explain what it all means. Nurse Trisha makes an appointment to go to the M. household and facilitate the family meeting.
Questions
CASE # 6: ABOUT CHILD AND ADOLESCENT HEALTH
Glenda R. is a parish nurse for Holy Cross Catholic Church. The church’s youth group teacher has overheard several of the 13- and 14-year-old teenagers talking about dating and sexual behaviors. The youth group teacher invites the parish nurse to speak to the group about sex and abstinence. Nurse Glenda sends letters to the parents describing when she will speak to the group about these topics and what will be discussed. Parents who would like their child to attend this class are asked to fill out the permission form.
On the night of the class, 18 of the 20 youth group members arrive for the class with their consent forms in hand. The room is set up with chairs in a circle and a computer with projector next to Nurse Glenda’s chair. Using pictures on the computer, Nurse Glenda illustrates the basic anatomy of the reproductive system and discusses what should be expected during puberty. Most of the class time is then spent discussing reasons for abstinence, how to know when you are ready for sex, and how to say no if you are not. Case Studies Of Community Health
Questions
CASE # 7: ABOUT POVERTY AND HOMELESSNESS
The community of Finnytown has identified the need for a shelter to serve homeless women and children. Finnytown currently has a homeless shelter for men. Women and children can obtain health care services there but are not allowed to stay overnight. The Finnytown health care task force performed a community assessment that revealed that a higher number of homeless men than women reside in Finnytown, but the percentage of homeless women is steadily increasing. Results further showed that more women with children than men are living in poverty. The task force speculated that many women who are living in poverty are being overlooked and thus are becoming women without homes.
The task force and the community of Finnytown decide to open a homeless shelter for women and children. The new shelter will primarily serve women with children who are homeless or in poverty. Georgia B. is the community health nurse who is a member of the task force team. Nurse Georgia and other health care professionals are charged with planning health care services for women with children to be provided at the new homeless shelter. Case Studies Of Community Health
Questions
CASE # 8: ABOUT THE NURSE LEADER IN THE COMMUNITY
Ann T. is the state school nurse consultant. Nurse Ann provides guidance for school nurses across the state and organizes policy development for school nursing. Many of Nurse Ann’s hours are spent communicating by phone, face-to-face, or by e-mail with nurses and families who have questions regarding health services in the schools.
Terry L. contacts Nurse Ann. This is Terry’s first year as a school nurse, and she is working in a rural high school. She is worried about delegating medication administration to unlicensed personnel. “What exactly can be delegated, to whom, and how should I document it?” asks Nurse Terry.
Nurse Ann explains to Terry that some state laws specify who may delegate tasks, and the State Board of Nursing gives advice on which nursing tasks can be delegated. Nurse Ann tells Terry where on the Internet she can find these laws along with advisory opinions, and she e-mails copies to Terry. Nurse Ann shows Terry how to use the delegation decision tree and discusses some of Nurse Terry’s more challenging delegation issues. Nurse Terry must then use the materials to decide what she is comfortable delegating. Nurse Ann also gives Nurse Terry some sample training materials and documentation forms that other nurses in the state are currently using. Case Studies Of Community Health
Questions
CASE # 9: ABOUT FORENSIC NURSING IN THE COMMUNITY
Amanda J. is a forensic nurse who has been trained as a sexual assault nurse examiner (SANE). Amanda works part-time in the emergency room, where she occasionally examines victims of rape and sexual assault. Amanda also works part-time as a consultant for a local domestic-violence shelter for women and children. Every year Nurse Amanda helps to organize a Walk to Prevent Domestic Violence in her community. Proceeds raised from the walk go toward the domestic-violence shelter. Nurse Amanda provides literature about domestic violence at the walk as well as at other organizations in town. Case Studies Of Community Health
Questions
Case Study: Healing and Autonomy
Mike and Joanne are the parents of James and Samuel, identical twins born 8 years ago. James is currently suffering from acute glomerulonephritis, kidney failure. James was originally brought into the hospital for complications associated with a strep throat infection. The spread of the A streptococcus infection led to the subsequent kidney failure. James’s condition was acute enough to warrant immediate treatment. Usually cases of acute glomerulonephritis caused by strep infection tend to improve on their own or with an antibiotic. However, James also had elevated blood pressure and enough fluid buildup that required temporary dialysis to relieve Case Study: Healing and Autonomy.
The attending physician suggested immediate dialysis. After some time of discussion with Joanne, Mike informs the physician that they are going to forego the dialysis and place their faith in God. Mike and Joanne had been moved by a sermon their pastor had given a week ago, and also had witnessed a close friend regain mobility when she was prayed over at a healing service after a serious stroke. They thought it more prudent to take James immediately to a faith healing service instead of putting James through multiple rounds of dialysis. Yet, Mike and Joanne agreed to return to the hospital after the faith healing services later in the week, and in hopes that James would be healed by then Case Study: Healing and Autonomy.
Two days later the family returned and was forced to place James on dialysis, as his condition had deteriorated. Mike felt perplexed and tormented by his decision to not treat James earlier. Had he not enough faith? Was God punishing him or James? To make matters worse, James’s kidneys had deteriorated such that his dialysis was now not a temporary matter and was in need of a kidney transplant. Crushed and desperate, Mike and Joanne immediately offered to donate one of their own kidneys to James, but they were not compatible donors. Over the next few weeks, amidst daily rounds of dialysis, some of their close friends and church members also offered to donate a kidney to James. However, none of them were tissue matches Case Study: Healing and Autonomy.
James’s nephrologist called to schedule a private appointment with Mike and Joanne. James was stable, given the regular dialysis, but would require a kidney transplant within the year. Given the desperate situation, the nephrologist informed Mike and Joanne of a donor that was an ideal tissue match, but as of yet had not been considered—James’s brother Samuel.
Mike vacillates and struggles to decide whether he should have his other son Samuel lose a kidney or perhaps wait for God to do a miracle this time around. Perhaps this is where the real testing of his faith will come in? Mike reasons, “This time around it is a matter of life and death. What could require greater faith than that?” Case Study: Healing and Autonomy
The Patient Protection and Affordable Care Act focus on health promotion
Today, Health care delivery system has been increasingly expensive because of the shortage of health care professionals and costs of health care. Not only that, the costs of medical treatment been doubled with in ten years for each individual. The Affordable Care Act intends to resolve the health care problems in the United States and developing the resources to improve the health care delivery system (Abrams et al., 2015). In this situation, The Patient Protection and Affordable Care Act focus on health promotion and disease prevention for the people. The PPACA build the new models to deliver the care that would be essential to the patients and families in low costs. The PPACA plan is to lower the health costs with in ten years. “The major ways that these cost savings will be accomplished are promoting health and preventing disease, decreasing reliance on fee for service, providing cost-effective care, and using the electronic health record (EHR) across settings. Two of the delivery systems highlighted in PPACA are the “Patient Centered Medical Home” (PCMH) and the “Accountable Care Organization” (ACO)” (Hass, 2011).The Patient Protection and Affordable Care Act focus on health promotion
The PPACA established to deliver the care in health system by involving interdisciplinary care team because they can work together to provide most cost effective care and coordinate each other to achieve better outcomes. For example, Electronic health record information is available to entire health care team to share the information and evaluate the care if action needs to be taken. The interdisciplinary care team can monitor the patients if their chronic health problems need to be managed by educating or counseling them. The entire team members can document their notes and it will be easier to access their documentation to the rest of the team who is involved in patient’s care. Not only that, the results would be also available in timely manner to evaluate as well as it reduces the error on documentation. The EHR is reliable tools to use today and it is a great way to deliver the care to the patients to achieve better outcomes.
I NEED YOU TO COMMENT FROM THIS POST, 100 WORDS NEEDED AND A REFERENCE PLEASE The Patient Protection and Affordable Care Act focus on health promotion
Teenage Pregnancy Powerpoint
Topic: Teenage Pregnancy
Powerpoint presentation must be 20-25 slides, including the title slide and the references slide(s). You must use at least 5 scholarly sources within the last 5 years, all sources used, including the textbook and images, must be referenced and/or paraphrased; any quoted material must be placed in quotes, and must have accompanying APA style in-text citations.
PowerPoint Presentation: The speaker notes must contain a detailed script of your presentation, as if you were verbally presenting.
The PowerPoint should include:
