Mr.Williams, a 62-year-old patient, presents for a physical examination. You suspect a vitamin D deficiency. Which of the following assessment findings might lead the examiner to suspect vitamin D deficiency

Mr.Williams, a 62-year-old patient, presents for a physical examination. You suspect a vitamin D deficiency. Which of the following assessment findings might lead the examiner to suspect vitamin D deficiency? 

Question

Question 1

Mr.Williams, a 62-year-old patient, presents for a physical examination. You suspect a vitamin D deficiency. Which of the following assessment findings might lead the examiner to suspect vitamin D deficiency? 

a. Spinal curvature and bowed legs

b. Night blindness and dry eyes

c. Neuropathy and seizures

d. Nausea and insomnia

Question 2

A college student comes to the student health center complaining of difficulty in concentrating during class and while studying. The diet that would contribute to this problem is one that contains mostly: 

a.fruit and vegetables.

b.lean meat and fish.

c.sandwiches and diet drinks.

d.pasta and chicken.

e.cereal and breads.

Question 3

In counseling a client regarding nutrition education, you explain that linoleic acid, a major fatty acid, is thought to be essential for: 

a. glycogen storage in the liver.
b. normal growth and development.
c. myocardial cell function.
d. building and maintaining tissues.

Question 4

Monitoring a patient’s waist-to-hip ratio provides data concerning: 

a. daily caloric requirements.
b. lung capacity.
c. stomach cancer risk.
d. cardiovascular disease risk.

Question 5

Mr.Jones is a 45-year-old patient who presents for a physical examination. On examination, you note costochondral beading, an enlarged skull, and bowed legs and diagnose him with rickets. A deficiency of which fat-soluble micronutrient can result in rickets? 

a. Vitamin A
b. Vitamin E
c. Vitamin D
d. Vitamin K

Question 6

A 17-year-old girl presents to the clinic for a sports physical. Physical examination findings reveal bradycardia, multiple erosions of tooth enamel, and scars on her knuckles. She appears healthy otherwise. You should ask her if she: 

a. binges and vomits.
b. has regular menstrual periods.
c. has constipation frequently.
d. is cold intolerant.

Question 7

Mr.Miles is a 45-year-old man who is being evaluated for obesity. Advising Mr.Miles to reduce which macronutrient will produce the greatest calorie reduction per gram? 

a. Carbohydrate
b. Protein
c. Fat
d. All provide the same number of calories per gram.

Question 8

Macronutrients are so named because they: 

a. have high molecular weights.
b. form long chemical chains.
c. tend to increase waist measurements.
d. are required in large amounts. 

Question 9

Bulging of an amber tympanic membrane without mobility is usually associated with: 

a. middle ear effusion.
b. healed tympanic membrane perforation.
c. impacted cerumen in the canal.
d. repeated and prolonged crying cycles.

Question 10

An infant’s auditory canal, compared with an adult’s, is: 

a. short, narrow, and straight.
b. short and curved upward.
c. long, narrow, and curved forward.
d. short and curved downward.

Question 11

An ear auricle with a low-set or unusual angle may indicate chromosomal aberration or: 

a. digestive disorders.
b. skeletal anomalies.
c. renal disorders.
d. heart defects.

Question 12

A 6-month-old who can hear well can be expected to: 

a. exhibit the Moro reflex.
b. stop breathing in response to sudden noise.
c. turn his or her head toward the source of sound.
d. imitate simple words.

Question 13

A hairy tongue with yellowish brown to black elongated papillae on the dorsum: 

a. is indicative of oral cancer.
b. is sometimes seen following antibiotic therapy.
c. usually indicates vitamin deficiency.
d. usually indicates anemia.

Question 14

A 5-year-old child presents with nasal congestion and a headache. To assess for sinus tenderness, you should palpate over the: 

a. sphenoid and frontal sinuses.
b. maxillary and frontal sinuses.
c. maxillary sinuses only.
d. sphenoid sinuses only.

Question 15

A smooth red tongue with a slick appearance may indicate: 

a. niacin or vitamin B12 deficiency.
b. oral cancer.
c. recent use of antibiotics.
d. fungal infection.

Question 16

A newborn whose serum bilirubin level is greater than 20 mg/100 mL has a risk of later: 

a. hearing loss.
b. sinusitis.
c. tooth decay.
d. meningitis.

Question 17

A clinical syndrome of failing memory and impairment of other intellectual functions, usually related to obvious structural diseases of the brain, describes: 

a. delirium.
b. dementia.
c. depression.
d. anxiety.

Question 18

Flight of ideas or loosening of associations is associated with: 

a. aphasia.
b. dysphonia.
c. multiple sclerosis.
d. psychiatric disorders.

Question 19

An older adult is administered the Set Test and scores a 14. The nurse interprets this score as indicative of: 

a. depression.
b. cognitive impairment.
c. delirium.
d. dementia.

Question 20

Assessing orientation to person, place, and time helps determine: 

a. ability to understand analogies.
b. abstract reasoning.
c. attention span.
d. state of consciousness.

Question 21

Appropriateness of logic, sequence, cohesion, and relevance to topics are markers for the assessment of: 

a. mood and feelings.
b. attention span.
c. thought process and content.
d. abstract reasoning.

Question 22

A 69-year-old truck driver presents with a sudden loss of the ability to understand spoken language. This indicates a lesion in the: 

a. temporal lobe.
b. Broca area.
c. frontal cortex.
d. cerebellum.

Question 23

An aversion to touch or being held, along with delayed or absent language development, is characteristic of: 

a. attention-deficit/hyperactivity disorder.
b. autism.
c. dementia.
d. mental retardation.

Question 24

Facial muscle or tongue weakness may result in: 

a. aphasia.
b. impaired comprehension.
c. neologisms.
d. echolalia.

Question 25

Adolescents most likely to smoke, abuse substances, perform poorly in school, and be depressed are those who are: 

a. from dual-income families.
b. from families that emphasize strong reli-gious beliefs.
c. from deprived socioeconomic groups.
d. unsupervised after school.

Question 26

An aspect of traditional Western medicine that may be troublesome to many Hispanics, Native Americans, Asians, and Arabs is Western medicine’s attempts to: 

a. use a holistic approach that views a par-ticular medical problem as part of a bigger picture.
b. determine a specific cause for every prob-lem in a precise way.
c. establish harmony between a person and the entire cosmos.
d. restore balance in an individual’s life.

Question 27

An image of any group that rejects its potential for originality or individuality is known as a(n): 

a. acculturation.
b. norm.
c. stereotype.
d. ethnos.

Question 28

A 22-year-old female nurse is interviewing an 86-year-old male patient. The patient avoids eye contact and answers questions only by saying, “Yeah,” “No,”or “I guess so.” Which of the following is appropriate for the interviewer to say or ask? 

a.“Why are you so depressed?”

b.“It’s hard for me to gather useful information because your answers are so short.”

c.“Are you uncomfortable talking with me?”

d.“Does your religion make it hard for you to answer my questions?”

Question 29

An example of a cold food is: 

a. chocolate.

b. hard liquor.

c. oil.

d. onions.

e. a dairy product

Question 30

An example of a cold condition would be: 

a. a fever.
b. a rash.
c. tuberculosis.
d. an ulcer.

Question 31

As the health care provider, you are informing a patient that he or she has a terminal illness. This discussion is most likely to be discouraged in which cultural group? 

a. Navajo Native Americans
b. Dominant Americans
c. First-generation African descendants
d. First-generation European descendants

Question 32

A flat, nonpalpable lesion is described as a macule if the diameter is: 

a. larger than 1 cm.
b. smaller than 1 cm.
c. 3 cm exactly.
d. too irregular to measure.

Question 33

A 17-year-old student complains of a “rash for 3 days.” You note pale, erythematous oval plaques over the trunk. They have fine scales and are arranged in a fernlike pattern, with parallel alignment. What is the nurse’s next action? 

a. Teach infectious control measures.
b. Inquire about another recent skin lesion.
c. Inspect the palms and the soles.
d. Inform the patient that this will resolve within a week.

Question 34

A 5-year-old child presents with discrete vesicles on an erythematous base (dew drops on a rose petal appearance) that began near her scalp and are spreading to the trunk. The child has a low-grade fever and feels tired. What is the nurse’s next action? 

a. Teach infectious control measures.
b. Inquire about other patterns of physical abuse.
c. Inspect the buccal mucosa for Koplik spots.
d. Inform the parent that this will resolve within a couple of days.

Question 35

Age spots are also called: 

a. seborrheic keratoses.
b. solar lentigines.
c. cutaneous horns.
d. acrochordon.

Question 36

A single transverse line seen in the palm of a small child may imply: 

a. Down syndrome.
b. Turner syndrome.
c. systemic sclerosis.
d. profound dehydration.

Question 37

A 29-year-old white woman appears jaundiced. Liver disease as a cause has been excluded. What history questions should the nurse ask? 

a. Whether she had unprotected sex
b. Whether she has a history of diabetes mellitus
c. Whether she had unusual bleeding prob-lems
d. Whether she eats a lot of yellow and orange vegetables

Question 38

A slightly elevated brownish papule with indistinct borders is a typical characteristic of a(n) _____ nevus. 

Compound 

Question 39

A Dennie-Morgan fold is probably caused by: 

a. birth trauma.
b. high fever.
c. excess adipose tissue.
d. chronic rubbing.

Question 40

A cause for alarm during chest assessment of a newborn is: 

a. crackles.
b. rhonchi.
c. gurgles from the gastrointestinal tract.
d. stridor.

Question 41

A pregnant woman is expected to develop: 

a. tachypnea and decreased tidal volume.
b. deep breathing but not more frequent breathing.
c. dyspnea and increased functional residual capacity.
d. bradypnea and increased tidal volume.

Question 42

A musical squeaking noise heard on auscultation of the lungs is called: 

a. a friction rub.
b. rales.
c. rhonchi.
d. wheezing.

Question 43

A 44-year-old male patient who complains of a cough has presented to the emergency department. He admits to smoking one pack per day. During your inspection of his chest, the most appropriate lighting source to highlight chest movement is: 

a. bright tangential lighting.

b. daylight from a window.

c. flashlight in a dark room.

d. fluorescent ceiling lights

Question 44

A 29-year-old patient presents with a new complaint of productive cough, with purulent sputum. He also complains of right lower quadrant abdominal pain. You suspect pneumonia in which lobe? 

a. Right lower
b. Right upper
c. Left upper
d. Left lower

Question 45

Bone spicule pigmentation is a hallmark of: 

a. chorioretinal pigmentosa.
b. cytomegalovirus infection.
c. lipemia retinalis.
d. retinitis pigmentosa.

Question 46

A pterygium is more common in people heavily exposed to: 

a. high altitudes.
b. tuberculosis.
c. ultraviolet light.
d. cigarette smoke.

Question 47

A condition that typically develops by the age of 45 years is: 

a. presbyopia.
b. hyperopia.
c. myopia.
d. astigmatism.

Question 48

An increased level of lysozyme in the tears will occur normally during which life stage? 

a. Adolescence
b. Childhood
c. Infancy
d. Pregnancy

Question 49

Ask the patient to look directly at the light of the ophthalmoscope when you are ready to examine the: 

a. retina.
b. optic disc.
c. retinal vessels.
d. macula.

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Question 50

Changes seen in proliferative diabetic retinopathy are the result of: 

a. anoxic stimulation.
b. macular damage.
c. papilledema.
d. minute hemorrhages.

Question 51

A condition in which the eyelids do not completely meet to cover the globe is called: 

a. glaucoma.
b. lagophthalmos.
c. exophthalmos.
d. hordeolum.

Question 52

An abnormal growth of conjunctiva extending over the cornea from the limbus is known as: 

a. a cataract.
b. erythematous.
c. glaucoma.
d. a pterygium.

Question 53

A 36-year-old woman complains that she has had crushing chest pain for the past 2 days. She seems nervous as she speaks to you. An appropriate response is to: 

a. continue to collect information regarding the chief complaint in an unhurried man-ner.
b. finish the interview as rapidly as possible.
c. ask the patient to take a deep breath and calm down.
d. ask the patient if she wants to wait until another day to talk to you.

Question 54

Constitutional symptoms in the ROS refer to: 

a. height, weight, and body mass index.
b. fever, chills, fatigue, and malaise.
c. hearing loss, tinnitus, and diplopia.
d. rashes, skin turgor, and temperature.

Question 55

A tool used to screen adolescents for alcoholism is the: 

a. CAGE.
b. CRAFFT.
c. PACES.
d. HITS.

Question 56

A guideline for history taking is for caregivers to: 

a. ask direct questions before open-ended questions so that data move from simple to complex.
b. ask for a complete history at once so that data are not forgotten between meetings.
c. make notes sparingly so that the patient can be observed during the history taking.
d. write detailed information as stated by patients so that their priorities are reflect-ed.

Question 57

A pedigree diagram is drafted for the purpose of obtaining: 

a. sexual orientation and history.
b. growth and developmental status.
c. genetic and familial health problems.
d. ethnic and cultural backgrounds.

Question 58

A brief statement of the reason the patient is seeking health care is called the: 

a. medical history.
b. chief complaint.
c. assessment.
d. diagnosis.

Question 59

Behaviors that diffuse anxiety during the interview include: 

a. avoiding wearing uniforms or laboratory coats.
b. providing forthright answers to questions.
c. providing all necessary information before the patient has to ask for it.
d. completing the interview as quickly as possible.

Question 60

After you ask a patient about her family history, she says, “Tell me about your family now.” Which response is generally most appropriate? 

a. Ignore the patient’s comment and contin-ue with the interview.
b. Give a brief, undetailed answer.
c. Ask the patient why she needs to know.
d. Tell the patient that you do not discuss your family with patients.

Question 61

If only two blood pressure values are recorded, they are the _______________ sounds. blank(s) with correct word

first systolic and second diastolic

Question 62

A normal adult’s pulse pressure should range from _____ to _____ mm Hg.  Fill in the blank(s) with correct word

30; 40

Question 63

Body language that leads you to suspect that a person is in pain is: 

a. talkative, verbose speech.
b. fretful hand movements.
c. focused, fixed eye stares.
d. marked salivation.

Question 64

During respiration, the internal intercostals: 

a. increase the force of muscular contraction.
b. decrease the lateral diameter during expi-ration.
c. decrease the intrathoracic space.
d. increase elastic recoil during expiration.

Question 65

Hypertension in the adult is generally defined as pressure in excess of: 

a. 120 mm Hg plus the patient’s age.
b. 140 mm Hg.
c. 160 mm Hg.
d. 200 mm Hg.

Question 66

If a sufficiently large cuff is unavailable to fit an obese arm, which technique may be used to assess blood pressure? 

a. Wrap a standard cuff around the deltoid area and place the stethoscope over the radial artery.
b. Wrap a standard cuff around the forearm and place the stethoscope over the radial artery.
c. Wrap a standard cuff around the thigh and place the stethoscope on the dorsalis pedis.
d. Wrap a pediatric cuff around the ankle and place the stethoscope on the popliteal artery.

Question 67

In a syndrome in which regional pain extends beyond this specific peripheral nerve injury, you would notice which of the following: (Select all that apply.

a. Allodynia
b. Sleep disturbance
c. Blood flow changes
d. Numbness
e. Edema

Question 68

A blood pressure cuff bladder should be long enough to: 

a. cover 20% to 25% of the arm circumfe-rence.
b. cover 45% to 50% of the arm circumfe-rence.
c. cover 75% to 80% of the arm circumfe-rence.
d. completely encircle the arm.

Question 69

A variant of the percussion hammer is the neurologic hammer, which is equipped with which of the following? 

a. Brush and needle
b. Tuning fork and cotton swab
c. Penlight and goniometer
d. Ruler and bell

Question 70

Auscultation should be carried out last, except when examining the: 

a. neck area.
b. heart.
c. lungs.
d. abdomen.

Question 71

A rubber or plastic ring should be around the bell endpiece of a stethoscope to: 

a. prevent the transmission of static electric-ity.
b. prevent cold metal from touching the pa-tient.
c. prevent the sharp edge of the stethoscope from damaging the patient’s skin.
d. ensure secure contact with the body sur-face.

Question 72

During percussion, a dull tone is expected to be heard over: 

a. healthy lung tissue.
b. emphysemic lungs.
c. the liver.
d. most of the abdomen.

Question 73

According to the guidelines for Standard Precautions, the caregiver’s hands should be washed: 

a. only after touching body fluids with un-gloved hands and between patient con-tacts.
b. only after touching blood products with ungloved hands and after caring for infec-tious patients.
c. only after working with patients who are thought to be infectious.
d. after touching any body fluids or conta-minated items, regardless of whether gloves are worn.

Question 74

During auscultation, you can limit your perceptual field best by: 

a. asking patients to describe their symp-toms.
b. closing your eyes.
c. performing auscultation before percussion.
d. using an aneroid manometer.

Question 75

A patient in the emergency department has a concussion. You suspect the patient may also have a retinal hemorrhage. You are using the ophthalmoscope to examine the retina of this patient. Which aperture of the ophthalmoscope is most appropriate for this patient? 

a. Grid
b. Red-free filter
c. Slit lamp
d. Small aperture

Question 76

A scale used to assess patients’ weight should be calibrated: 

a. only by the manufacturer.
b. by a qualified technician at regularly scheduled intervals.
c. each time it is used.
d. when necessary, with the patient standing on the scale.

Question 77

At what age does peak height growth velocity occur in boys? 

a. 10 years
b. 12 years
c. years
d. years

Question 78

An 11-year-old boy is brought in for an annual physical examination by his mother.You suspect _______________ when you measure his arm span at 65 inches and his height at 60 inches. Fill in the blank(s) with correct word

Marfan syndrome

Question 79

A pregnant woman of normal prepregnancy weight should be expected to gain how much weight per week during the second and third trimesters of pregnancy? 

a. 1 pound
b. pounds
c. 2 pounds
d. pounds

Question 80

A prominent forehead, large nose, large jaw, and elongation of the facial bones and extremities are signs of: 

a. infantile hydrocephalus.
b. acromegaly.
c. Cushing syndrome.
d. achondroplasia.

Question 81

A marker for nutritional status is the: 

a. head circumference.
b. waist-to-hip ratio.
c. standing height.
d. triceps skinfold thickness.

Question 82

A woman with a normal prepregnancy body mass index (BMI) should gain approximately _____ pounds during pregnancy. Fill in the blank(s) with correct word

30

Question 83

After 50 years of age, stature: 

a. becomes fixed.
b. begins a barely perceptible secondary in-crease.
c. increases at a rate of 0.5 cm/ year.
d. declines.

Question 84

A Mexican American mother brings her 12-year-old daughter to the clinic because this child is not maturing as quickly as her classmates. You examine the daughter and determine that her growth and physical findings are within normal limits. You should explain to the family that: 

a. Mexican Americans may develop more slowly than other ethnic groups.
b. more tests should be conducted because the family appears so worried.
c. the daughter should drink more juices and eat more fruit.
d. there is a serious problem with the daugh-ter’s development.

Question 85

A 29-year-old woman presents to the urgent care center with a history of a severe headache of 2 hours’ duration. She describes it as bandlike and constricting.In interviewing the woman about her complaint, you would ask: 

a. whether she has experienced increased tearfulness.
b. the date of her last menstrual period.
c. whether these headaches started in child-hood.
d. whether she is particularly stressed or overworked.

Question 86

An inconsequential finding on the head of an adult is a palpable: 

a. embryonic remnant.
b. posterior fontanel.
c. sagittal suture ridge.
d. skull indentation.

Question 87

Closure of the anterior skull fontanel should occur by ______________.  Fill in the blank(s) with correct word

24 months of age

Question 88

During a head and neck assessment of a neonate, it is important to screen for: 

a. the presence of torticollis.
b. signs and symptoms of cerebral palsy.
c. uneven movement of the eyes.
d. unilateral movement of the tongue.

Question 89

A stethoscope is used in a head and neck examination to assess: 

a. intracranial fluid.
b. pulsating fontanels.
c. skull bone development.
d. thyroid vascular sounds.

Question 90

During a physical examination of a 30-year-old Chinese man, you notice a slight asymmetry of his face. The cranial nerve examination is normal. Your best action is to: 

a. ask the patient if this characteristic runs in his family.
b. perform monofilament testing on the face.
c. consult with the physician regarding the laboratory tests needed.
d. record the finding in the patient’s chart.

Question 91

A bruit, or blowing sound, over the skull or temporal region of an adult indicates a: 

a. degenerative change.
b. hyperthyroid storm.
c. skull fracture.
d. vascular anomaly.

Question 92

Coarse, dry, and brittle hair is associated with which metabolic disorder? 

a. Hypothyroidism
b. Diabetes mellitus
c. Addison disease
d. Cushing syndrome

Question 93

A red streak that follows the course of the lymphatic collecting duct is a finding associated with: 

a. Hodgkin disease.
b. lymphangitis.
c. lymphedema.
d. lymphoma.

Question 94

As adults age, their ability to resist infection is reduced because of the lymphatic nodes becoming more: 

a. fibrotic.
b. mucoid.
c. porous.
d. profuse.

Question 95

Equipment for examining the lymphatic system includes a: 

a. caliper.
b. centimeter ruler.
c. goniometer.
d. syringe and needle.

Question 96

Cells that line the lymph node sinuses perform the specific function of: 

a. fat absorption.
b. fetal immunization.
c. hematopoiesis.
d. phagocytosis.

Question 97

An organ that is essential to the development of protective immune function in the infant but has little or no demonstrated function in the adult is the: 

a. spleen.
b. liver.
c. thymus.
d. pancreas.

Question 98

A congenital defect in the immune system of a 2-week-old infant may be suspected if: 

a. there are small femoral nodes palpable.
b. the umbilical cord has not yet dropped off.
c. the tonsils are visible.
d. the thymus is visible on a chest radio-graph.

Question 99

Hodgkin disease is most common in ______________________. Fill in the blank(s) with correct word

late adolescence and young adulthood

Question 100

Enlarged inguinal nodes are likely to be associated with: 

a. genital herpes.
b. pelvic inflammatory disease.
c. uterine cancer.
d. testicular cancer.

The Joint Commission resource found in topic materials, which provides some guidelines for creating spiritual assessment tools for evaluating the spiritual needs of patients

 Details:

This assignment requires you to interview one person and requires an analysis of your interview experience.

Part I: Interview

Select a patient, a family member, or a friend to interview. Be sure to focus on the interviewee’s experience as a patient, regardless of whom you choose to interview.

Review The Joint Commission resource found in topic materials, which provides some guidelines for creating spiritual assessment tools for evaluating the spiritual needs of patients. Using this resource and any other guidelines/examples that you can find, create your own tool for assessing the spiritual needs of patients.

Your spiritual needs assessment survey must include a minimum of five questions that can be answered during the interview. During the interview, document the interviewee’s responses.

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The transcript should include the questions asked and the answers provided. Be sure to record the responses during the interview by taking detailed notes. Omit specific names and other personal information through which the interviewee can be determined.

Part II: Analysis

Write a 500-750 word analysis of your interview experience. Be sure to exclude specific names and other personal information from the interview. Instead, provide demographics such as sex, age, ethnicity, and religion. Include the following in your response:

  1. What went well?
  2. Were there any barriers or challenges that inhibited your ability to complete the assessment tool? How would you address these in the future or change your assessment to better address these challenges?
  3. How can this tool assist you in providing appropriate interventions to meet the needs of your patient?
  4. Did you discover that illness and stress amplified the spiritual concern and needs of your interviewee? Explain your answer with examples.

Submit both the transcript of the interview and the analysis of your results. This should be submitted as one document. The interview transcript does not figure into the word count.

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.

This benchmark assignment assesses the following competencies:

CONHCP Program Competencies for the RN-BSN:

5.2: Assess for the spiritual needs and provide appropriate interventions for individuals, families, and groups.

Steps on Becoming a Grassroots Lobbyist/Advocate for Health Care Policy

First Steps on Becoming a Grassroots Lobbyist/Advocate for Health Care Policy  

This assignment has two parts, numbered below. Write each question as a new topic area, then follow with a paragraph or two to answer the question. You may find it necessary to search for answers to the questions outside of the assigned reading. Be sure to use APA guidelines for writing style, spelling and grammar, and citation of sources.  

Tasks: 

1.Imagine that you are going to make a visit to your representative in Congress. Develop a one-page document that supports your position on the AHCA that you would leave with your representative or his or her aide when you make your visit. This one-pager, also called a “leave behind,” should state your position clearly in bullet points and give your reasons why your position is preferred. This “leave behind” should have 1 inch margins and utilize 14-point font throughout. If you were making this visit in person, you would present your “leave behind” to the person with whom you speak during your visit. Include a second page that describes your rationale for the position in your “leave behind” page supported by at least two journal articles.

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2.Write a two-page brief to describe the scenario surrounding your legislative visit. Understanding the political affiliation of your representative, include answers to the following: 

•Was your member in support or in opposition to the AHCA? 

•State three points that you would cover in support or opposition to your representative’s position. 

•How does your nursing experience influence the advocacy position that you take on the AHCA?

perspective on the importance of “finding balance” between the roles of healthcare delivery providers

  •   Unit 1 Assignment 1 (U1A1)
       
    (Individual)
    “Finding Balance”
    Week 1
    100 points
     
    Introduce yourself to your classmates and to me.  Write using first person, such as—Hello class, my name is ME, and I want to tell you a little bit about myself and why I am interested in healthcare administration…
    Within the context of your intro, share your perspective on the importance of “finding balance” between the roles of healthcare delivery providers, such as nurses and assorted clinicians in a hospital environment next to the business/financial component that drives variables such as costs, length of stay, discharge protocols, admit/surgical denials, and any others.  Further consider that there is (or should be) a synergy among/between patient care providers and bean counters, yet it requires money to keep the beds open and salaries paid—just as it takes the care provided by trained professionals on the units.  How effective is writing “policy” on matters such as these?

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    This first assignment should be at least two pages in length, double spaced, 12 points font, and the title page is not part of the page count.  If you cite, be sure to include your sources within the essay, and at the end in a separate Reference List.  However, because this assignment is more of an opportunity to opine, sources are not mandatory.

     

    Evaluation Criteria
    You will be evaluated on your ability to complete the following tasks according to points designated:
     
    1. Introduce yourself…………………………………………………………………………………………………………………………….10 points 
    2. Identify and analyze a problem………………………………………………………………..…………………………   20 points 
    3. Outline and analyze proposed solutions……………………………………………………………………………………20 points 
    4. Explain the background of the issue including its history and previous attempts to address the problem…………….20 points 
    5. Name any inherent values that need to be assessed…………………………………………………… …………………..10 points 
    6. Determine the resources, both financial and human, needed to bring the issue forward and to reach a resolution…10 points 
    7. Describe a plan of action or policy based on your conclusions………………………………………………………….   10 points 

Lab Assignment: SS Disability Process PowerPoint /Assignment: Elevator Speech

Lab Assignment: SS Disability Process PowerPoint

1.  Using the SSDR website, (Links to an external site.)Links to an external site. you are to prepare a 6-8 slide PowerPoint presentation outlining the steps in the disability process. You must include detailed speaker notes.

Name your presentation “SS Disability Process “

Assignment: Elevator Speech

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2.  For the C3P Elevator Speech assignment, you will complete one of the following as directed by your instructor:

  • Option 1: Perform an Internet search and identify one company where you would like to work. Then write a short profile of the company, including its main products, its competitors, and who manages the company. Next, list the qualities you think this employer is looking for in an employee.
  • Option 2: Examine the company profiles of three employers in your local market (provided by your instructor). Reflect on the qualities these potential employers may be looking for in an employee. List qualities you already have and any you may need to work on.
  • note: I am study to be medical billing and coding. I live in San Antonio, Texas. I have no experiment in this field.

Serious Illness or Neurologic Impairment with Back Pain

this dq is due for tomorrow 08/18/18

You are working with Dr. Lee today. She hands you a triage note from the nurse regarding your next patient, Mr. Payne:

Forty-five-year-old white male truck driver complaining of two weeks of sharp, stabbing back pain. The pain was better after a couple of days but then got worse after playing softball with his daughter. This morning his pain is so bad that he had trouble getting out of bed.

Dr. Lee provides you some background information about low back pain.

TEACHING POINT

Low Back Pain Prevalence, Cost, & Duration

Low back pain (LBP) is the fifth most common reason for all doctor visits. In the U.S., lifetime prevalence of LBP is 60% to 80%. The direct and indirect costs for treatment of LBP are estimated to be $100 billion annually. Fortunately, most LBP resolves in two to four weeks.

Dr. Lee continues: “There are many causes for LBP. For presenting symptoms that have a broad differential diagnosis, I find it helpful to think of systems of etiologies in which diseases or conditions can be categorized.”

TEACHING POINT

Common Causes of Back Pain

Musculoskeletal (MSK) and Non-MSK Causes of Back Pain

MSK Causes

Axial:

  • Degenerative disc disease
  • Facet arthritis
  • Sacroiliitis
  • Ankylosing spondylitis
  • Discitis
  • Paraspinal muscular issues
  • SI dysfunction

Radicular:

  • Disc prolapse
  • Spinal stenosis

Trauma:

  • Lumbar strain
  • Compression fracture

Non-MSK Causes

Neoplastic:

  • Lymphoma/leukemia
  • Metastatic disease
  • Multiple myeloma
  • Osteosarcoma

Inflammatory:

  • Rheumatoid Arthritis

Visceral:

  • Endometriosis
  • Prostatitis
  • Renal lithiasis

Infection:

  • Discitis
  • Herpes zoster
  • Osteomyelitis
  • Pyelonephritis
  • Spinal or epidural abscess

Vascular:

  • Aortic aneurysm

Endocrine:

  • Hyperparathyroidism
  • Osteomalacia
  • Osteoporosis
  • Paget disease

Dr. Lee suggests, “Now, let’s look a bit more at the risk factors for mechanical low back pain that you can review with Mr. Payne during your history.”

Dr. Lee continues, “The major task in treating back pain is to Now that you have a diagnosis of disc herniation with radiculopathy for Mr. Payne, let’s discuss what would you like to do for him distinguish the common causes for back pain (95% of cases) from the 5% with serious underlying diseases or neurologic impairments that are potentially treatable.”

TEACHING POINT

Risk Factors for Low Back Pain

  • Prolonged sitting, with truck driving having the highest rate of LBP, followed by desk jobs
  • Deconditioning
  • Sub-optimal lifting and carrying habits
  • Repetitive bending and lifting
  • Spondylolysis, disc-space narrowing, spinal instability, and spina bifida occulta
  • Obesity
  • Education status: low education is associated with prolonged illness
  • Psycho-social factors: anxiety, depression stressors in life
  • Occupation: Job dissatisfaction, increased manual demands, and compensation claims

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TEACHING POINT

Red Flags For Serious Illness or Neurologic Impairment with Back Pain

  • Fever
  • Unexplained weight loss
  • Pain at night
  • Bowel or bladder incontinence
  • Neurologic symptoms
  • Saddle anesthesia
HISTORY

You and Dr. Lee take a few minutes to review Mr. Payne’s chart:

Vital signs:

  • Temperature: 98.6° Fahrenheit
  • Heart rate: 80 beats/minute
  • Respiratory rate: 12 breaths/minute
  • Blood pressure: 130/82 mmHg
  • Weight: 170 pounds
  • Body Mass Index: 24 kg/m2

Past Medical History: Diabetes, well controlled. Hypertension, fair control. Hyperlipidemia, fair control.

Past Surgical History: None

Social History: Works as a truck driver, which involves lifting 20-35 lbs 4 hours of the day, married with 2 daughters,

Habits: Quit smoking two years ago, drinks 1 to 2 beers occasionally on the weekends, no history of IV drug use.

Medication:

  • metformin 500mg 2 twice daily
  • glyburide 5mg 2 twice daily
  • amlodipine 2.5 mg daily
  • lisinopril 40 mg daily
  • simavastin 40 mg daily

Allergies: No known drug allergies

After introducing yourself to Mr. Payne, you sit down across from him and begin your history, focusing on the key elements.

“Can you tell me about your back pain?”

“As I told the nurse, the pain started two weeks ago after I lifted a box at work. Right away, I got this sharp pain on the left side of my back. The box wasn’t even that heavy.

“I talked to the nurse at work; she said to ice it and to take ibuprofen. It got better after three days. But, I was playing softball with my daughter last weekend, and the pain came back. This time it was worse than before. This week, the pain is so bad I can hardly get out of bed. I get a sharp pain in my back which goes down my left leg to my ankle.”

“On a scale of 0 to 10, 10 being the worst, how severe is the pain?”

“It’s probably a 7.”

“Have you found anything that improves the pain?”

“Ibuprofen and Naproxen worked at first, but they are not helping much anymore.”Serious Illness or Neurologic Impairment with Back Pain

“What about positions that make things better or worse?”

“The pain is worse with any movement of my back or sitting for a long time. It is better when I lie down.”

“Have you had back pain before?”

“Yes, I have back pain from time to time. But I’m usually better after 2 to 3 days. This is the worst pain I have ever had.”

You complete your history with a review of systems and discover:

Review of Systems

Mr. Payne does not have numbness or weakness in his legs. The pain is better when he lies down. He denies urinary frequency, dysuria, problems with bowel or bladder control, fever or chills, nausea or vomiting, or weight loss. He denies any specific trauma, except for when he lifted a 10-pound box at work. He denies unrelenting night pain.

You excuse yourself from Mr. Payne to discuss your findings with Dr. Lee.

Dr. Lee walks through the steps for completing a neurologic exam in a patient with back pain.

Back Exam – Standing:

Mr. Payne has normal curvature, tenderness on palpation on the left lumbar paraspinous muscle with increase tone. Full range of motion, but has pain with movement. His gait is normal. He can walk on his heels and toes. He can do deep knee bends.

Back Exam – Seated:

Mr. Payne denies feeling pain when checked for CVA tenderness. He has no pain in his right leg with the modified version of SLR. While he does not exhibit a true tripod sign, he does complain of pain when his left leg is raised. Mr. Payne’s reflexes are 2+ and equal at the knees and 1+ at both ankles. The motor exam reveals no weakness of the muscles of the lower extremities. His sensory exam is normal.

Pulmonary Exam: His lungs are clear.

Cardiovascular Exam: His cardiac exam demonstrates a regular rhythm, no murmur or gallop.

Mr. Payne’s abdominal exam is negative. His straight leg raising is positive at 75 degrees on the left and negative on the right. His FABER test is negative and sacroiliac joint is nontender. His motor exam reveals no weakness of the muscles of the lower extremities.

After finishing your exam together, you and Dr. Lee excuse yourselves from the exam room for a moment.

Dr. Lee reminds you that disc herniation, a condition which is self-limited and usually resolves in two to four weeks, remains a working diagnosis for Mr. Payne. She says, “Let’s take a few minutes, though, to discuss some conditions we still don’t want to miss.”

Now that you have a diagnosis of disc herniation with radiculopathy for Mr. Payne, let’s discuss what would you like to do for him

You and Dr. Lee now return to Mr. Payne’s exam room to talk about treatment options with him. Dr. Lee tells Mr. Payne to avoid strenuous activities but to remain active. Dr. Lee increases the dosage of naproxen to 500 mg BID to take with food. Since his pain is intense (7/10), he is given a prescription for acetaminophen with codeine to take at night, when his pain is severe. Mr. Payne declines a muscle relaxant because they usually make him drowsy. He would like to be referred to physical therapy as it was helpful in the past.

Three weeks later, Mr. Payne returns for his follow-up appointment and you discover the following:

Pertinent History

Mr. Payne has had little relief with the treatment prescribed. He is frustrated that he has been in pain for more than a month. His pain has been progressively worse. It radiates down the lateral part of his left leg and side of his left foot. This pain is worse than the back pain. He does not have any problems with bowel or bladder control and there is no weakness of his leg.

Pertinent Exam Findings

Vital signs: stable

Neurologic: Normal gait, but moves slowly due to pain; range of motion is full, with pain on flexion; SLR is positive at 45 degree on the left; motor strength intact; reflexes 2+ bilaterally at the knees, absent at the left ankle, 1+ at the right ankle.

Dr. Lee agrees with your diagnosis of radiculopathy of S1 nerve root with progression. She orders an MRI and sets up an appointment to see Mr. Payne after the MRI.

ne week later, Mr. Payne returns for follow-up. You review the results of the MRI report.

MRI report:

  1. Moderate-size, herniated disc at L5-S1 with associated marked impingement on the left S1 nerve root and mild to moderate impingement on the right S1 nerve root. There is mild central canal stenosis.
  2. Annular tear with a small central disc herniation at L4-5 causing mild central canal stenosis.

You review the findings with Dr. Lee. She agrees with your diagnosis of radiculopathy of S1 nerve root due to a large herniated disc at L5-S1.

You call Mr. Payne two weeks later to see how he is doing. He reports that he is doing quite a bit better. He went to an osteopathic physician who did some manual therapy and started him on a strict walking program. He is very encouraged and plans on losing weight through exercise and diet.

  • Discuss the Mr. Payne’s history that would be pertinent to his genitourinary problem. Include chief complaint, HPI, Social, Family and Past medical history that would be important to know.
  • Describe the physical exam and diagnostic tools to be used for Mr. Payne. Are there any additional you would have liked to be included that were not? 
  • Please list 3 differential diagnoses for Mr. Payne and explain why you chose them.  What was your final diagnosis and how did you make the determination?
  • What plan of care will Mr. Payne be given at this visit, include drug therapy and treatments; what is the patient education and follow-up? Serious Illness or Neurologic Impairment with Back Pain

Case Study: Social Media In Education And Healthcare

Assignment Details:

Perform the following tasks:

· Complete the reading assignment and the interactive lesson before attempting this assignment.

· Read the case study located in the Assignment Worksheet section below and answer the questions that follow 

· Ensure that your responses are free of spelling and grammar errors. 

· Cite all sources used to support your responses in APA format. Case Study: Social Media In Education And Healthcare

Assignment Worksheet

Ø Case Study

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Read the following case study and answer the questions that follow:

Grace Speak is a fourth-year student at Best University. She and her fellow classmates are working hard in their final courses and preparing for exams. Inspired by the teamwork that the healthcare profession espouses, Grace gets an idea for a study group. She thinks it will really help to share case experiences, course notes, and study tips. Unfortunately, several members of her peer group live out of town, which makes it difficult for them to participate fully. Grace is torn, as she does not want to exclude them from the study group. When she voices her concerns to a classmate, her friend suggests using social media tools as the primary medium for sharing information.

Questions 

1. Two required elements that a single social media site must have to meet the needs of her study group are the ability to share ideas and experiences (chat), and share information (store documents). Research several social media sites that meet both of the required elements for Grace’s group. Select one social media tool, include its website, and explain your rationale for selecting that tool.

Selected Social Media Tool (and website)

[Write your response here.] Case Study: Social Media In Education And Healthcare

Rationale

[Write your response here.]

2. Grace discovers that not all of the members of the group use the social media tool she selected. In your own words, create a set of simple instructions that other members of the group could follow to ensure full group participation. 

[Write your response here.]

3. Grace decides to establish a set of “ground rules” from the outset when she forms the study group. Create a set of “ground rules” that will help to create a group with full participation by all members and that will not place members of the group at risk, for either privacy or academic (plagiarism) concerns. Provide your reasoning for the “ground rules” you established.

Ground Rules

[Write your response here.]

Rationale

[Write your response here.]

4. In a specific week, the assignment is particularly challenging. One of the students in the study group offers to post the “answers” he received from a student who completed this same assignment last year from the same instructor. Grace knows that one of her close friends in the study group is at risk of failing if she does not do well on this assignment. Describe how Grace might handle this situation to reduce the academic risk of plagiarism for herself, her friend, and other members of the study group.

[Write your response here.] Case Study: Social Media In Education And Healthcare

Interrelationship Between Theory, Knowledge, And Research And EBP


The Interrelationship Between Theory, Knowledge, and Research and Evidence-Based Practice

Fawcett and Garity (2009) present an overview of the relationship between theory, knowledge, research, nursing research, and evidence-based practice (see attached file). As you prepare for this Discussion, reflect on your own specialty area and consider how the authors’ definitions of evidence-based practice and of research align with your understanding of these concepts based on your professional experiences and your experiences as a doctoral student embarking on your EBP Project.

To prepare:

  • Reflect on Fawcett and Garity’s definitions      of knowledge, theory, research and evidence-based      practice presented in the Learning Resources. How do these      definitions align with your understanding of the concepts? Interrelationship Between Theory, Knowledge, And Research And EBP
  • How does this interrelationship support or      guide your EBP Project?

By Wednesday 9/19/18 by 1:00 am please write a minimum of 550 words essay in APA format with at least 3 scholarly references from the list of required resources below. Include the level 1 headings as numbered below:

Post a cohesive scholarly response that addresses the following:

1) How do Fawcett and Garity’s (see attached file)definitions align with your understanding of knowledge, theory, research and evidence-based practice? Support your response with evidence from the literature (quote the literature below in the required readings).

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2) Discuss the interrelationship between theory, knowledge, research and evidence-based practice.

3) How does this interrelationship support or guide your EBP Project?

Required Readings

Terry, A. J. (2018). Clinical research for the Doctor of Nursing practice (3rd ed.). Burlington, MA: Jones & Bartlett Learning.

With your EBP project in mind, select and read the chapter that best fits your proposed methodologies: (I can attach the following chapters, let me know if you don’t have them and need me to attach them)

  • Chapter      6, “Designing a Clinically-Based Quantitative Capstone Research Project”
  • Chapter      7, “Designing a Clinically-Based Qualitative Capstone Research Project”
  • Chapter      8, “Designing a Clinically-Based Mixed Method Capstone Research Project”

Fawcett, J., & Garity, J. (2009). Chapter 1: Research and evidence-based nursing practice. In Evaluating Research for Evidence-Based Nursing, (pp. 3-20). Philadelphia, PA: F. A. Davis.

Adams, J.M., & Natarajan, S. (2016). Understanding influence within the context of nursing: Development of the Adams influence model using practice, research, and theory. Advances in Nursing Science, 39(3), E40-E56. 

Djulbergovic, B. (2014). A framework to bridge the gaps between evidence-based medicine, health outcomes, and improvement and implementation science. Journal of Oncology Practice, 10(3), 200-202. 

Hutchinson, A.M., Bioeth, M., Wilkinson, J.E., Kent, B., & Harrison, M.B. (2012). Using the promoting action on research implementation in health services framework to guide research use in the practice setting. Worldviews on Evidence-Based Nursing, First Quarter, 59-61.

Leung, K., Trevena, L., & Waters, D. (2014). Systematic review of instruments for measuring nurses’ knowledge, skills and attitudes for evidence-based practice. Journal of Advanced Nursing 70(10), 2181–2195.

Leung, K., Trevena, L., & Waters, D. (2016). Development of a competency framework for evidence-based practice in nursing. Nurse Education Today, 39, 189-196. 

PIICOT Question

In patients in extended intensive care within an urban acute care facility in Eastern United States, how does early mobilization as recommended by National Institute of Health and Care Excellence clinical guidelines on rehabilitation of patients after critical illness impact early transfers from intensive care as measured 6 months post-implementation when compared to the current standard of care including minimal mobilization of patients?

P: Adult patients 

I: in extended intensive care within an urban acute care facility

I: increased mobilization of the patients 

C: minimal mobilization of the patients

O: early transfers of the patients from intensive care

T: 6 months

Due tomorrow 09/19/18 by 1:00 am. Thanks! Interrelationship Between Theory, Knowledge, And Research And EBP

Impact of the mission and vision of the healthcare organization’s strategic plan

Continue analyzing the situation that your case study’s healthcare organization faces. In this milestone, you will continue to evaluate the impact of the mission and vision of the healthcare organization’s strategic plan. You will also consider how the organization’s strengths, weaknesses, opportunities, and threats affect the environmental factors that confront the healthcare organization.

Develop a SWOT analysis of the healthcare organization. Be sure to address the following:

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  1. Briefly summarize your case study.
  2. To what extent do the organization’s policies address this issue? Be sure to justify your response.
  3. To what extent does the organization’s strategic planning around this issue align with its organizational mission and vision? Use evidence and examples to justify your reasoning.
  4. What do you feel are the organization’s strengths, weaknesses, opportunities, and threats (SWOT) with regard to this issue? Be sure to substantiate your claims with evidence and specific examples.
  5. Based on the SWOT analysis you performed, what environmental factors are at play in terms of this issue and what is their impact on the delivery of care within the organization? In other words, identify any new policies or new trends that will affect your day-to-day operation.

The Presence And Effects Of Alteration In The Homeostatic State Secondary To Gender, Genetic, Ethnic And Temporal Variables

Evaluate the presence and effects of alteration in the homeostatic state secondary to gender, genetic, ethnic and temporal variables

Select one of the case studies below, and include in your discussion an evaluation of the presence and effects of alteration in the homeostatic state secondary to gender, genetic, ethnic, and temporal variables.

Requirements:

  1. Make sure all of the topics in the case study have been addressed.
  2. Cite at least three sources; journal articles, textbooks or evidenced-based websites to support the content.
  3. All sources must be within 5 years.
  4. Do not use .com, Wikipedia, or up-to-date, etc., for your sources.
  5. 4 pages APA not including Title page and reference page The Presence And Effects Of Alteration In The Homeostatic State Secondary To Gender, Genetic, Ethnic And Temporal Variables

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Case Study 1

Structure and Function of the Respiratory System

Brad is 45 years old and has been working as a coal cutter in a mine for the last 25 years. He likes the job because it pays well and the same mine had employed his father. Like many of his colleagues, Brad has had problems with a chronic cough. He has avoided his annual checkups for fear that he will be told he has “black lung,” or coal worker’s pneumoconiosis. The disease causes fibrosis, decreased diffusing capacity, and permanent small airway dilation. In later stages, pulmonary capillaries, alveoli, and airways are destroyed.

  1. How can the disease described above create a mismatch between ventilation and perfusion? Use your understanding of alveolar dead space and physiologic shunt to explain your answer.
  2. Individuals with chronic obstructive pulmonary disease have more difficulty exhaling than inhaling. Why is this so?
  3. In general terms, what mechanisms in lung disease can affect diffusing capacity across alveolar membranes? Use the Fick law to explain your answer.

Case Study 2

Respiratory Tract Infections, Neoplasms, and Childhood Disorders

Patricia was called at work by a woman at the local daycare center. She told Patricia to come and pick up her son because he was not feeling well. Her son, three-and-a-half-year-old Marshall, had been feeling tired and achy when he woke up. While at daycare, his cheeks had become red and he was warm to touch. He did not want to play with his friends, and by the time Patricia arrived, he was crying. Later that afternoon, Marshall’s condition worsened. He had fever, chills, a sore throat, runny nose, and a dry hacking cough. Suspecting Marshall had influenza, Patricia wrapped him up and took him to the community health care clinic.

  1. Why did Marshall’s presentation lead Patricia to think he had influenza and not a cold? Why is it important to medically evaluate and diagnose a potential influenza infection?
  2. Describe the pathophysiology of the influenza virus. Outline the properties of influenza A antigens that allow them to exert their effects in the host.
  3. Marshall may be at risk at contracting secondary bacterial pneumonia. Why is this so? Explain why cyanosis may be a feature associated with pneumonia. The Presence And Effects Of Alteration In The Homeostatic State Secondary To Gender, Genetic, Ethnic And Temporal Variables