Bringing evidence-based practice to life.

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I NEED A POSITIVE COMMENT BASED IN THIS ARGUMENT..BETWEEN 100-120 WORDS

After discussion with your mentor, name one financial aspect, one quality aspect, and one clinical aspect that need to be taken into account in developing the evidence-based practice project. Explain how your proposal will, directly and indirectly, impact each of the aspects.

Speaking with the mentor, the financial aspect of the project would be hours spent trying to get nurses educated on the proposed guidelines for late preterm infants. Hours will be needed as well to get the basic checklist implemented into the computer in this particular area, which requires going to different committees and getting approvals needed. This takes more than one nurse or person to get this done. This requires more hours of pay, and that would be the financial aspect of the proposed project.

Now, the clinical aspect that has to be taken into account with developing the project would be how the nurses will accept the project. As lifelong learners, staff nurses continually encounter new knowledge of relevance to their patients. The conscientious nurse remains alert to clinical problems and encourages investigation into ways to improve patient outcomes(Di Lenoardi, 2014). The nurses need to be given research and data that proves this could help readmission of late preterm infants. If given this data, they would be involved in the process of implementing as well,

In 2001, the Institute of Medicine (IOM) recommended evidenced based practice to improve healthcare outcomes(Stephens, 2013). This project is to improve the quality outcome of late preterm infants and prevent their readmission to hospital.

All the aspects brought together will make a good impact on the project the author believes with the research and data given to the nurses, implementation and then follow up of results will show this is a great solution to help alleviate many readmissions nationwide as well. If this hospital shows that the guidelines are helping there, then they can show other colleagues in the nation that this helps and also will cut costs by preventing readmissions.

 

References

Di Lenoardi, B. C. (2014). Bringing evidence-based practice to life. Retrieved from https://lms.rn.com/getpdf.php/2145.pdf

Stephens, K. R. (2013, May 13). The impact of evidence-based practice in nursing and the next big ideas. The Online Journal of Issues in Nursing., 18. https://doi.org/10.3912/OJIN.Vol18No02Man04

ELIMINATION COMPLEXITIES

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Health History

Mr. C., a 32-year-old single male, is seeking information at the outpatient center regarding possible bariatric surgery for his obesity. He currently works at a catalog telephone center. He reports that he has always been heavy, even as a small child, gaining approximately 100 pounds in the last 2-3 years. Previous medical evaluations have not indicated any metabolic diseases, but he says he has sleep apnea and high blood pressure, which he tries to control by restricting dietary sodium. Mr. C. reports increasing shortness of breath with activity, swollen ankles, and pruritus over the last 6 months.

Objective Data:

1. Height: 68 inches; weight 134.5 kg

2. BP: 172/98, HR 88, RR 26

3. 3+ pitting edema bilateral feet and ankles

4. Fasting blood glucose: 146 mg/dL

5. Total cholesterol: 250 mg/dL

6. Triglycerides: 312 mg/dL

7. HDL: 30 mg/dL

8. Serum creatinine 1.8 mg/dL

9. BUN 32 mg/dl

Critical Thinking Essay

In 900-words, critically evaluate Mr. C.’s potential diagnosis and intervention(s). Include the following:

1. Describe the clinical manifestations present in Mr. C.

2. Describe the potential health risks for obesity that are of concern for Mr. C. Discuss whether bariatric surgery is an appropriate intervention.

3. Assess each of Mr. C.’s functional health patterns using the information given. Discuss at least five actual or potential problems can you identify from the functional health patterns and provide the rationale for each. (Functional health patterns include health-perception, health-management, nutritional, metabolic, elimination, activity-exercise, sleep-rest, cognitive-perceptual, self-perception/self-concept, role-relationship, sexuality/reproductive, coping-stress tolerance.)

4. Explain the staging of end-stage renal disease (ESRD) and contributing factors to consider.

5. Consider ESRD prevention and health promotion opportunities. Describe what type of patient education should be provided to Mr. C. for prevention of future events, health restoration, and avoidance of deterioration of renal status.

6. Explain the type of resources available for ESRD patients for nonacute care and the type of multidisciplinary approach that would be beneficial for these patients. Consider aspects such as devices, transportation, living conditions, return-to-employment issues.

You are required to cite to three sources to complete this assignment. Sources must be published within the last 5 years. Also, you must have an abstract and a conclusion with a minimum of 5 sentences to wrap up this case study.

The nurse will instruct the patient to avoid which of the following foods?

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Question 1 A nurse is developing a care plan for a patient who has multiple sclerosis. An expected outcome for the patient who is receiving glatiramer would be a decrease in

A) chest pain
B) fatigue
C) breathing difficulties
D) heart palpitations

Question 2 A nurse is teaching a patient about his newly prescribed drug, colchicine, for gout. The nurse will instruct the patient to avoid which of the following foods?

A) Green beans
B) Shrimp
C) Eggs
D) Milk

Question 3 A patient with type 1 diabetes has been admitted to the hospital for orthopedic surgery and the care team anticipates some disruptions to the patient’s blood glucose levels in the days following surgery. Which of the following insulin regimens is most likely to achieve adequate glycemic control?

A) Small doses of long-acting insulin administered four to five times daily
B) Doses of basal insulin twice daily with regular insulin before each meal
C) Large doses of rapid-acting insulin combined with long-acting insulin each morning and evening
D) Divided doses of intermediate-acting insulin every 2 hours, around the clock

Question 4 A 65-year-old woman has an advanced form of rheumatoid arthritis. Her treatment includes a regular dosage of methotrexate. The nurse will advise her to take which of the following vitamin supplements while taking the drug?

A) Vitamin A
B) Vitamin B
C) Vitamin C
D) Vitamin D

Question 5 A 49-year-old woman has been diagnosed with myalgia. The physician has recommended aspirin. The patient is concerned that the aspirin will upset her stomach. The nurse will encourage the patient to

A) crush the tablet before swallowing
B) swallow the tablet whole
C) swallow the tablet with milk or food
D) avoid drinking milk for 3 hours after swallowing the tablet

Question 6 A nurse is working with a 57-year-old man who is a former intravenous drug abuser. He has been prescribed a weekly dosage of methotrexate for his rheumatoid arthritis. Which of the following will the nurse include in her teaching plan for this patient?

A) Avoid high-fat foods
B) Drink plenty of water every day
C) Take the tablets before bedtime
D) Avoid red meat

Question 7 A male patient with a diagnosis of relapsing-remitting multiple sclerosis is in the clinic to discuss with the nurse the possibility of self-administration of glatiramer. During the patient education session for self-administration, the nurse will emphasize

A) the need to rotate the injection site of the drug
B) the need to avoid crushing the tablet
C) the need to place the tablet under the tongue
D) the need to use only the thigh muscle for the drug injection site

Question 8 A patient in need of myocardial infarction prophylaxis has been prescribed sulfinpyrazone for gout. Which of the following will the nurse monitor the patient most closely for?

A) Hypothermia
B) Hypotension
C) Renal dysfunction
D) Bleeding

Question 9 A nurse will monitor which of the following when assigned to a patient taking allopurinol for chronic gout who visits the clinic every 2 months?

A) Liver function tests
B) Blood sugar levels
C) Blood pressure
D) Body temperature

Question 10 Which of the following would be the most important safety-related instruction for a nurse to give to a patient taking baclofen (Lioresal)?

A) Do not walk or drive after taking the drug
B) Discontinue the use of alcohol
C) Learn to self-administer the drug
D) Take a laxative when needed

Question 11 A diabetic patient being treated for obesity tells the nurse that he is having adverse effects from his drug therapy. The patient has been taking dextroamphetamine for 2 weeks as adjunct therapy. Which of the following adverse effects would need the nurse’s immediate attention?

A) Decreased libido
B) Increased blood glucose
C) Dry eyes
D) Jittery feeling

Question 12 A nurse is caring for a patient who has been diagnosed with hypothyroidism. Levothyroxine (Synthroid) has been prescribed.Before the drug therapy is started, the nurse will assess for which of the following?

A) History of taking anticoagulant drugs
B) Allergy to seafood
C) Hirsutism
D) The patient’s age

Question 13 A nurse is instructing a patient in the administration of regular insulin by the subcutaneous route. Which of the following strategies would the nurse suggest if the goal is to promote absorption of the regular insulin?

A) Rotate injection sites by using the arm one day, the stomach the next day, and the thigh the day after and then repeating the cycle
B) Select one injection site for regular insulin injections and use it exclusively
C) Administer the medication 30 to 60 minutes after a meal
D) Select one anatomic area for regular insulin injections and then use serial locations within that area.

Question 14 A nurse is caring for a male patient who has a spinal cord injury due to a motorcycle accident. He has been taking dantrolene (Dantrium) for 2 weeks. The nurse will monitor which of the following?

A) Prothrombin time and partial thromboplastin time
B) Urine specific gravity
C) Alanine aminotransferase and total bilirubin levels
D) Follicle-stimulating hormone levels

Question 15 The nurse is conducting a medication reconciliation of a new resident of a long-term care facility. The nurse notes that the resident takes allopurinol on a daily basis for the treatment of gout.What is the primary purpose of this drug?

A) To balance urate concentration and prevent gout attacks
B) To promote the remodeling of damaged synovium
C) To potentiate the metabolism of dietary purines
D) To achieve pain relief in joints affected by gout

Question 16 A 33-year-old man has developed acute gouty arthritis. He has been prescribed colchicine. When developing a care plan for this patient, which factor will be most important for the nurse to consider?

A) Dietary habits
B) Work environment
C) Typical daily fluid intake
D) Ethnicity

Question 17 During long-term desmopressin therapy in a 48-year-old woman, it will be most important for the nurse to assess which of the following?

A) The patient’s environment
B) The patient’s diet
C) The condition of the patient’s skin
D) The condition of the patient’s nasal passages

Question 18 A patient is taking gabapentin (Neurontin) for spasticity associated with multiple sclerosis. Which of the following should be the priority for monitoring?

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

Question 19 Following an assessment by her primary care provider, a 70-year-old resident of an assisted living facility has begun taking daily oral doses of levothyroxine. Which of the following assessment findings should prompt the nurse to withhold a scheduled dose of levothyroxine?

A) The resident has not eaten breakfast because of a recent loss of appetite
B) The resident’s apical heart rate is 112 beats/minute with a regular rhythm
C) The resident had a fall during the night while transferring from her bed to her bathroom
D) The resident received her annual influenza vaccination the previous day

Question 20 To minimize the risk of adverse effects of glucagon when given to an unconscious diabetic patient, as the patient regains consciousness, the nurse should

A) administer calcium supplements
B) position the patient in the side-lying position
C) administer carbohydrates
D) monitor for nausea and vomiting

Question 21 A 34-year-old male patient is prescribed methimazole (MMI). The nurse will advise him to report which of the following immediately?

A) Vertigo
B) Intolerance to cold
C) Loss of appetite
D) Epigastric distress

Question 22 A male patient is to begin glyburide (Diabeta) for type 2 diabetes. Before the drug therapy begins, a priority action by the nurse will be to assess the patient’s

A) blood pressure
B) potassium level
C) use of alcohol
D) use of salt in his diet

Question 23 A 43-year-old woman was diagnosed with multiple sclerosis 2 years ago and has experienced a recent exacerbation of her symptoms, including muscle spasticity. Consequently, she has been prescribed Dantrolene (Dantrium). In light of this new addition to her drug regimen, what teaching point should the woman’s nurse provide?

A) “This will likely relieve your muscle spasms but you’ll probably develop a certain amount of dependence on the drug over time.”
B) “We’ll need to closely monitor your blood sugar levels for the next week.”
C) “There’s a small risk that you might experience some hallucinations in the first few days that you begin taking this drug.”
D) “You might find that this drug exacerbates some of your muscle weakness while it relieves your spasticity.”

Question 24 A nurse is instructing a patient who was recently diagnosed with multiple sclerosis about dantrolene (Dantrium). The patient is a 38-year-old-male and the foreman for a construction company. In order to minimize one important adverse effect of the drug, the nurse will give the patient which of the following instructions?

A) Eat a high-protein diet
B) Decrease the dosage if any adverse effect is experienced
C) Wear appropriate clothing and sunscreen whenever he is in direct sunlight
D) Have a complete blood cell count done weekly

Question 25 A 40-year-old woman with a diagnosis of fibromyalgia has been prescribed cyclobenzaprine (Flexeril) as an adjunct to her existing drug regimen. What nursing diagnosis should the nurse prioritize when updating the nursing care plan for this patient?

A) Risk for Injury related to CNS depressant effects
B) Diarrhea related to anticholinergic effects
C) Altered Nutrition, Less than Body Requirements, related to appetite suppression
D) Impaired Swallowing related to increased muscle tone

Question 26 A 70-year-old woman who is on long-term ibuprofen therapy for osteoarthritis has returned to the clinic for her regular 6-month visit. In the last couple of months, she has been having increasing periods of abdominal pain. The nurse suspects that this pain may be related to

A) anemia
B) peptic ulcer disease or gastritis
C) interstitial nephritis
D) constipation

Question 27 A 13-year-old patient has juvenile arthritis. He has recently had oral surgery and was told by the surgeon to take aspirin for the pain. The nurse will monitor for which of the following?

A) Bronchoconstriction
B) Hepatotoxicity
C) Aplastic anemia
D) Agranulocytosis

Question 28 A nurse is caring for a 61-year-old man who has had a severe attack of gout while in the hospital for food poisoning. The nurse administers colchicine intravenously in order to

A) avoid aggravating the gastrointestinal tract
B) ensure quick distribution of the drug
C) prevent the risk of infection or bleeding
D) minimize the risk of depressed bone marrow function

Question 29 A 66-year-old woman has experienced a significant decline in her quality of life as a result of worsening rheumatoid arthritis. Her physician has prescribed etanercept and the nurse is responsible for facilitating this new aspect of the patient’s drug regimen. This will involve the administration of

A) daily, outpatient intravenous therapy
B) daily, oral administration
C) weekly subcutaneous injections
D) weekly administration of an enteric coated tablet

Question 30 A clinic nurse is following a 9-year-old boy who is taking somatropin. Which of the following will the nurse monitor periodically?

A) Antidiuretic hormone (ADH) levels
B) Height
C) Dehydration
D) Water retention

Rate Yourself Using The Results From The “Nurse Manager Skills Inventory

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Details:
Rate yourself using the results from the “Nurse Manager Skills Inventory”:

http://www.aone.org/resources/nurse-manager-skills-inventory.pdf

Write a reflection of 750-1,000 words in which you identify your strengths and weaknesses related to the four content areas below:

  1. Personal and professional accountability
  2. Career planning
  3. Personal journey disciplines
  4. Reflective practice reference behaviors/tenets

Discuss how you will use your current leadership skill set to advocate for change in your workplace.

Identify one personal goal for your leadership growth and discuss your implementation plan to achieve that goal.

A minimum of Five scholarly references are required for this assignment. solid academic writing is expected, and in-text citations and references should be presented using APA documentation guidelines, an abstract is not required, CITE WEBSITE SOURCE

Rate Yourself Using The Results From The “Nurse Manager Skills Inventory”.

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 Details:
Rate yourself using the results from the “Nurse Manager Skills Inventory”:

http://www.aone.org/resources/nurse-manager-skills-inventory.pdf

Write a reflection of 750-1,000 words in which you identify your strengths and weaknesses related to the four content areas below:

  1. Personal and professional accountability
  2. Career planning
  3. Personal journey disciplines
  4. Reflective practice reference behaviors/tenets

Discuss how you will use your current leadership skill set to advocate for change in your workplace.

Identify one personal goal for your leadership growth and discuss your implementation plan to achieve that goal.

A minimum of Five scholarly references are required for this assignment. solid academic writing is expected, and in-text citations and references should be presented using APA documentation guidelines, an abstract is not required, CITE WEBSITE SOURCE

Family Health Assessment Part 2

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 Family Assessment Part II  View RubricDue Date: Feb 17, 2019 23:59:59       Max Points: 150  Details: Refer back to the interview and evaluation you conducted in the Topic 2 Family Health Assessment assignment. Identify the social determinates of health (SDOH) contributing to the family’s health status. In a 750-1,000-word paper, create a plan of action to incorporate health promotion strategies for this family. Include the following:

  1. Describe the SDOH that affect the family health status. What is the impact of these SDOH on the family? Discuss why these factors are prevalent for this family.
  2. Based on the information gathered through the family health assessment, recommend age-appropriate screenings for each family member. Provide support and rationale for your suggestions.
  3. Choose a health model to assist in creating a plan of action. Describe the model selected. Discuss the reasons why this health model is the best choice for this family. Provide rationale for your reasoning.
  4. Using the model, outline the steps for a family-centered health promotion. Include strategies for communication.

Cite at least three peer-reviewed or scholarly sources to complete this assignment. Sources should be published within the last 5 years and appropriate for the assignment criteria.Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion. You are required to submit this assignment to LopesWrite. Please refer to the directions in the Student Success Center.

Family Assessment Part II 1 Unsatisfactory 0.00%2 Less than Satisfactory 75.00%3 Satisfactory 79.00%4 Good 89.00%5 Excellent 100.00%80.0 %Content20.0 %SDOH Affecting Family and Family Health StatusSDOH affecting family health status, and the direct impact to the family, are not presented.SDOH affecting family health status are partially presented. SDOH listed are not relevant to the family. The direct impact to the family, and why the factors are prevalent to the family, are unclear. There are inaccuracies.Key SDOH affecting family health status are summarized. The SDOH identified are relevant to the family. The direct impact to the family, and why the factors are prevalent to the family, are generally discussed. More support or rationale is needed in some areas.The overall SDOH affecting family health status are accurately identified and described. The SDOH identified are relevant to the family. The direct impact to the family, and why the factors are prevalent to the family, are discussed. The SDOH directly affecting family health status are relevant, accurately identified and thoroughly described. The direct impact to the family, and why the factors are prevalent to the family, are discussed in detail. The discussion is well supported and illustrates insight into SDOH and their effect on family health status.20.0 %Age-Appropriate Screening RecommendationsAge-appropriate screenings are not presented.Screenings are presented for some family members. The screenings are not age appropriate. Screenings are not relevant to the information gathered through family health assessment. Screenings are presented for each family member. Screenings are generally age appropriate, but entirely not relevant based on the information gathered through family health assessment. More rationale and support is required.Screenings presented for each family member are age appropriate. Screenings are relevant and based on the information gathered through family health assessment. Some minor rationale or support is needed.Screenings presented for each family member are age appropriate and highly relevant. Screenings correlate to the information gathered through family health assessment. Strong rationale and support is presented.20.0 %Assessment of Health ModelA health model to assist in the creation of a plan of action is not presented. The model chosen is not a health model.A health model is selected to assist in creating a plan of action. The description of the model is incomplete. It is unclear why the chosen model is best for this family.A health model is selected and described. A summary of how the model will assist in creating a plan of action is presented. A general overview for why it is best for this family is provided. More rationale and support is required.A health model is selected and described. A discussion of how the model will assist in creating a plan of action is presented. Reasons for why it is best for this family are provided. Some rationale or support is needed.A health model is selected and thoroughly described. A detailed discussion of how the model will assist in creating a plan of action is presented. Reasons for why it is best for this family are clearly outlined. Strong rationale and support are provided to support reasoning.20.0 %Application of Health ModelFamily-centered health promotion using selected health model is omitted. Steps for a family-centered health promotion are partially presented. The health promotion is not based on the health model. Significant aspects are missing. There are major inaccuracies.The health model is used to create a general family-centered health promotion. The steps to achieve the desired outcome require more detail to illustrate a clear plan of action. A general plan for communication with the family is presented. More rationale and support is required.The health model is used to create a relevant family-centered health promotion. The steps to achieve the desired outcome are illustrated. Strategies for communication with the family are presented.The health model is used to create a relevant and viable family-centered health promotion. The steps to achieve the desired outcome are described in detail. Appropriate strategies for communication with the family are clearly presented. The health promotion is well-designed and demonstrates an ability to assimilate findings and appropriately apply theoretical knowledge to achieve desired outcomes.15.0 %Organization and Effectiveness 5.0 %Thesis Development and PurposePaper lacks any discernible overall purpose or organizing claim.Thesis is insufficiently developed or vague. Purpose is not clear.Thesis is apparent and appropriate to purpose.Thesis is clear and forecasts the development of the paper. Thesis is descriptive and reflective of the arguments and appropriate to the purpose.Thesis is comprehensive and contains the essence of the paper. Thesis statement makes the purpose of the paper clear.15.0 %Organization and Effectiveness 5.0 %Argument Logic and ConstructionStatement of purpose is not justified by the conclusion. The conclusion does not support the claim made. Argument is incoherent and uses noncredible sources.Sufficient justification of claims is lacking. Argument lacks consistent unity. There are obvious flaws in the logic. Some sources have questionable credibility.Argument is orderly, but may have a few inconsistencies. The argument presents minimal justification of claims. Argument logically, but not thoroughly, supports the purpose. Sources used are credible. Introduction and conclusion bracket the thesis. Argument shows logical progressions. Techniques of argumentation are evident. There is a smooth progression of claims from introduction to conclusion. Most sources are authoritative.Clear and convincing argument that presents a persuasive claim in a distinctive and compelling manner. All sources are authoritative.15.0 %Organization and Effectiveness 5.0 %Mechanics of Writing (includes spelling, punctuation, grammar, language use)Surface errors are pervasive enough that they impede communication of meaning. Inappropriate word choice or sentence construction is used.Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice (register), sentence structure, or word choice are present.Some mechanical errors or typos are present, but they are not overly distracting to the reader. Correct sentence structure and audience-appropriate language are used. Prose is largely free of mechanical errors, although a few may be present. A variety of sentence structures and effective figures of speech are used. Writer is clearly in command of standard, written, academic English.5.0 %Format2.0 %Paper Format (use of appropriate style for the major and assignment)Template is not used appropriately or documentation format is rarely followed correctly.Template is used, but some elements are missing or mistaken; lack of control with formatting is apparent.Template is used, and formatting is correct, although some minor errors may be present. Template is fully used; There are virtually no errors in formatting style.All format elements are correct. 3.0 %Documentation of Sources (citations, footnotes, references, bibliography, etc., as appropriate to assignment and style)Sources are not documented.Documentation of sources is inconsistent or incorrect, as appropriate to assignment and style, with numerous formatting errors.Sources are documented, as appropriate to assignment and style, although some formatting errors may be present.Sources are documented, as appropriate to assignment and style, and format is mostly correct. Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error.100 %Total Weightage

Benchmark – Policy Brief

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The benchmark assesses the following competencies:

1.4 Participate in health care policy development to influence nursing practice and health care.

Research public health issues on the “Climate Change” or “Topics and Issues” pages of the American Public Health Association (APHA) website. Investigate a public health issue related to an environmental issue within the U.S. health care delivery system and examine its effect on a specific population.

Write a 750-1,000-word policy brief that summarizes the issue, explains the effect on the population, and proposes a solution to the issue.

Follow this outline when writing the policy brief:

1. Describe the policy health issue. Include the following information: (a) what population is affected, (b) at what level does it occur (local, state, or national), and (c) evidence about the issues supported by resources.

2. Create a problem statement.

3. Provide suggestions for addressing the health issue caused by the current policy. Describe what steps are required to initiate policy change. Include necessary stakeholders (government officials, administrator) and budget or funding considerations, if applicable.

4. Discuss the impact on the health care delivery system.

Include four peer-reviewed sources and two other sources to support the policy brief.

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

NR 511 Week 4 Midterm Exam Version 5

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NR 511 Week 4 Midterm Exam Version 5

Question 1: How often should the clinician examine the feet of a person with diabetes?

a. Once a year
b. Every 6 months
c. Every 3 months
d. Every visit

Question 2: Which drug for Alzheimer’s disease should be administered beginning at the time of diagnosis?

a. Cholinesterase inhibitors
b. Anxiolytics
c. Antidepressants
d. Atypical antipsychotics

Question 3: Most adult poisonings are:

a. intentional and self-inflicted.
b. accidental.
c. caused by someone wishing to do harm to the person.
d. not attributed to any reason.

Question 4: A 58-year-old woman presents with a breast mass. Which of the following responses by the clinician would be most appropriate?

a. “It is probably just a cyst, because that is the most common breast mass.”
b. “We will order a mammogram and ultrasound to help establish a diagnosis.”
c. “We will go ahead and schedule you for a biopsy because that is the only way to know for sure.”
d. “Because your lump is painful, it is most likely not cancer.”

Question 5: Which of the following is a specific test for multiple sclerosis (MS)?

a. Magnetic resonance imaging (MRI)
b. Computed tomography (CT) scan
c. A lumbar puncture
d. There is no specific test.

Question 6: After removing a tack from a type 2 diabetic’s heel and evaluating the site for infection, what is the best plan for this patient?

a. Suggest she use a heating pad to improve circulation
b. Refer to a podiatrist for a foot care treatment plan
c. Send her for acupuncture treatments
d. All of the above

Question 7: Which characteristic of delirium helps to distinguish delirium from dementia?

a. Abrupt onset
b. Impaired attention
c. Affective changes
d. Delusions

Question 8: Which clinical feature is the first to be affected in increased intracranial pressure (ICP)?

a. Decrease in level of consciousness (LOC)
b. Headache
c. Nausea
d. Widening pulse pressure

Question 9: Jennifer is an 18-year-old girl who comes to the emergency room after a fall during a soccer game. Jennifer explains that she fell on her left side and kept her arm out straight to break her fall. She has been experiencing severe pain and limited range of motion in her left shoulder. The clinician has diagnosed Jennifer with a dislocated shoulder. Which of the following statements are true concerning shoulder dislocation?

a. Posterior dislocations are more common than anterior dislocations.
b. There is a risk of neurovascular and neurosensory trauma, so the clinician should check for distal pulses.
c. Recurrent dislocations are uncommon and would require a greater force to result in injury.
d. Surgery is most commonly the treatment of choice.

Question 10: Which of the following signs or symptoms indicate an inflammatory etiology to musculoskeletal pain?

a. Decreased C-reactive protein
b. Hyperalbuminemia
c. Morning stiffness
d. Weight gain

Question 11: The clinician sees a patient who is 5 feet tall and weighs 150 pounds. How would the clinician classify this patient?

a. Overweight

b. Mild obesity

c. Moderate obesity
d. Morbid obesity

Question 12: The vegetarian patient with gout asks the clinician about food that he should avoid. The clinician should advise the patient to avoid which of the following foods?

a. Rice
b. Carrots
c. Spinach
d. Potatoes

Question 13: A 23-year-old sexually active woman presents for her first Pap smear. Her history includes nulligravida, age at first intercourse 14, and more than 10 sexual partners. Which of the following conditions should the clinician be particularly alert for during her exam?

a. Human papillomavirus (HPV)
b. Endometrial hyperplasia
c. Vagismus
d. Polycystic ovarian syndrome

Question 14: Which of the following classes of drugs should be used as first-line therapy for treatment of delirium?

a. Benzodiazepines
b. Antipsychotics
c. Anticonvulsants
d. Antidepressants

Question 15: What is the treatment of choice for a patient diagnosed with testicular cancer?

a. Radical orchidectomy

b. Lumpectomy

c. Radiation implants
d. All of the above

Question 16: A 24-year-old woman presents to the clinic with dysuria, dyspareunia, and a mucopurulent vaginal discharge. Her boyfriend was recently treated for nongonococcal urethritis. What sexually transmitted disease (STD) has she most probably been exposed to?

a. Gonorrhea
b. Human papillomavirus (HPV)
c. Chlamydia
d. Trichomonas

Question 17: A 58-year-old woman who had a total abdominal hysterectomy at the age of 45 is diagnosed with atrophic vaginitis. Which of the following is the most appropriate treatment?

a. Conjugated estrogen 0.625 mg/day oral
b. Estradiol 7.5 mcg/24 hr vaginal ring
c. Medroxyprogesterone 10 mg/day oral
d. Conjugated estrogen 0.3 mg + medroxyprogesterone 1.5 mg/day oral

Question 18: When looking under the microscope to diagnose an intravaginal infection, you see a cluster of small and oval to round shapes. What do you suspect they are?

a. Spores

b. Leukocytes

c. Pseudohyphae
d. Epithelial cells

Question 19: Patients with a spontaneous pneumothorax should be counseled that up to what percentage may experience a reoccurrence at some point?

a. 10%

b. 20%

c. 30%
d. 50%

Question 20: John is a 16-year-old boy who presents to the emergency room after hurting his knee in a football game. He described twisting his knee and then being unable to extend it completely. John tells the clinician that he heard a pop when the injury occurred and has been experiencing localized pain. The clinician suspects a meniscal tear. Which test would be most appropriate to assess for the presence of a meniscal tear?

a. Valgus stress test
b. McMurray circumduction test
c. Lachman test
d. Varus stress test

Question 21: During a digital rectal exam (DRE) on a 75-year-old man, the clinician suspects the patient has prostate cancer. What physical finding should make the clinician suspicious?

a. An enlarged rubbery gland

b. A hard irregular gland

c. A tender gland
d. A boggy gland

Question 22: Janet is a 30-year-old woman who has been recently diagnosed with a herniated disc at the level of L5-S1. She is currently in the emergency room with suspicion of cauda equina compression. Which of the following is a sign or symptom of cauda equina compression?

a. Gastrocnemius weakness
b. A reduced or absent ankle reflex
c. Numbness in the lateral foot
d. Paresthesia of the perineum and buttocks

Question 23: The criteria for diagnosing generalized anxiety disorder in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (text revision) (DSM-IV-TR) state that excessive worry or apprehension must be present more days than not for at least:

a. 1 month.
b. 3 months.
c. 6 months.
d. 12 months.

Question 24: A patient is diagnosed with hypothyroidism. Which of the following electrocardiogram (ECG) changes should the clinician expect as a manifestation of the disease?

a. Sinus bradycardia

b. Atrial fibrillation

c. Supraventricular tachycardia
d. U waves

Question 25: Which type of burn injury results in destruction of epidermis with most of the dermis, yet the epidermal cells lining hair follicles and sweat glands remain intact?

a. Superficial burns
b. Superficial partial-thickness burns
c. Deep partial-thickness burns
d. Full-thickness burns

Question 26: Immunizations are an example of which type of prevention?

a. Primary
b. Secondary
c. Tertiary

Question 27: If a previously frostbitten area becomes frostbitten again after it has healed, what might occur?

a. Permanent tissue damage may occur, resulting in necrosis to that body part.
b. The area will be super sensitive.
c. The area is prone to a repeat frostbite.
d. The area is as susceptible as any other area.

Question 28: A 26-year-old woman is seen with complaints of irregular vaginal bleeding. Which of the following tests should be the first priority?

a. Pregnancy test

b. Pelvic ultrasound

c. Endometrial biopsy
d. Platelet count

Question 29: Julie, aged 50, has migraine headaches, frequent asthma attacks, coronary artery disease, and hypertension. Which of the following prophylactic medications would you order for her migraines?

a. Propranolol

c. Ergotamine
b. Timolol

d. Topiramate

Question 30: A 64-year-old man with type 2 diabetes presents to the clinic with the complaint of “my feet feel like they are on fire.” He has a loss of vibratory sense, +1 Achilles reflex, and a tack embedded in his left heel. Which of the following would be an appropriate treatment?

a. Tricyclic antidepressants
b. Capsacin cream
c. Vitamin B12 injections
d. Insulin

Assignment: Evidence-Based Practice And The Quadruple Aim

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Assignment: Evidence-Based Practice and the Quadruple Aim

Healthcare organizations continually seek to optimize healthcare performance. For years, this approach was a three-pronged one known as the Triple Aim, with efforts focused on improved population health, enhanced patient experience, and lower healthcare costs.

More recently, this approach has evolved to a Quadruple Aim by including a focus on improving the work life of healthcare providers. Each of these measures are impacted by decisions made at the organizational level, and organizations have increasingly turned to EBP to inform and justify these decisions.

To Prepare:

  • Read the articles by Sikka, Morath, & Leape (2015); Crabtree, Brennan, Davis, & Coyle (2016); and Kim et al. (2016) provided in the Resources.
  • Reflect on how EBP might impact (or not impact) the Quadruple Aim in healthcare.
  • Consider the impact that EBP may have on factors impacting these quadruple aim elements, such as preventable medical errors or healthcare delivery.

To Complete:

Write a brief analysis (no longer than 2 pages) of the connection between EBP and the Quadruple Aim.

Your analysis should address how EBP might (or might not) help reach the Quadruple Aim, including each of the four measures of:

  • Patient experience
  • Population health
  • Costs
  • Work life of healthcare providers

Rubrics:

Write a brief analysis of the connection between evidence-based practice and the Quadruple Aim. Your analysis should address how evidence-based practice might (or might not) help reach the Quadruple Aim, including each of the four measures of:

 ·   Patient experience
·   Population health
·   Costs
·   Work life of healthcare providers–

Levels of Achievement:  Excellent 77 (77%) – 85 (85%)    Good 68 (68%) – 76 (76%)    Fair 60 (60%) – 67 (67%)    Poor 0 (0%) – 59 (59%)

Written Expression and Formatting—Paragraph Development and Organization:
Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction is provided which delineates all required criteria.–

Levels of Achievement:  Excellent 5 (5%) – 5 (5%)    Good 4 (4%) – 4 (4%)    Fair 3.5 (3.5%) – 3.5 (3.5%)    Poor 0 (0%) – 3 (3%)

Written Expression and Formatting—English Writing Standards:
Correct grammar, mechanics, and proper punctuation.–

Levels of Achievement:  Excellent 5 (5%) – 5 (5%)    Good 4 (4%) – 4 (4%)    Fair 3.5 (3.5%) – 3.5 (3.5%)    Poor 0 (0%) – 3 (3%)

Written Expression and Formatting—The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running head, parenthetical/in-text citations, and reference list.–

Levels of Achievement:  Excellent 5 (5%) – 5 (5%)    Good 4 (4%) – 4 (4%)    Fair 3.5 (3.5%) – 3.5 (3.5%)    Poor 0 (0%) – 3 (3%)

Analyze the moral, ethical, and legal implications utilized in this situation

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  • Introduce the conceptual frameworks of the ethical constructs of ethics, moral, or legal standards and the purpose of the paper.
  • Consider  an ethical, moral, or legal dilemma that you have encountered in your work environment and describe it.
  • Analyze the moral, ethical, and legal implications utilized in this situation. Describe your role as a moral agent or advocate for this specific issue.
  • Consider your leadership styles identified by your self-assessment and determine if they act as a barrier or facilitation during this dilemma.