NURS3020 Health
Assessment
WEEK 2
Assignment
Digital Clinical Experience: Health History
Throughout this course, you will participate in digital
clinical experiences using the online simulation tool Shadow Health. The Shadow
Health digital clinical experience provides a dynamic, immersive experience
designed to improve nursing skills and clinical reasoning through the
examination of digital standardized patients. Using Shadow Health you will
participate in single-system exams, focused exams, concept labs, and a
comprehensive assessment in the capstone assignment. Below you will find more
details about Shadow Health.
For registration
Shadow Health, Inc. (n.d.). Accessing Shadow Health.
Retrieved from /orders/player.vimeo.com/video/275921826
Review the video link above, then use the Shadow Health link
in the Blackboard menu to access Shadow Health and register following the steps
in the video. You will use the access code provided by the university bookstore
upon purchase of the Shadow Health access. If you should have issues please
contact Shadow Health Support. Review the sections below related to Technical
Requirements and the Shadow Health Support contact information.
Accessing Shadow Health from Shadow Health, Inc. on Vimeo
Technical requirements
Shadow Health Help Desk
Shadow Health. (n.d.). Shadow Health help desk. Retrieved
from /orders/support.shadowhealth.com/hc/en-us>
Note: Please use only Google Chrome with Shadow Health.
Shadow Health support
Shadow Health. (n.d.). Shadow Health help desk. Retrieved
from /orders/support.shadowhealth.com/hc/en-us
Note: If you have questions or encounter technical issues,
regarding the digital clinical experience (DCE), contact Shadow Health at the
link above. If unavailable, contact Walden Student Support.
Topic/Skill Shadow
Health Assignment
Week 1 Taking a Health
History DCE Orientation (15 min)
Conversation Concept Lab (50 min)
Health History (180 min)
Week 2 The General
Survey HEENT (120 min)
Skin, Hair, and Nails (120 min)
Week 3 Assessment of
the Heart, Lungs, and Peripheral Vascular System Respiratory Concept Lab (25 min)
Respiratory (90 min)
Cardiovascular Concept Lab (25 min)
Cardiovascular (90 min)
Week 4 Assessment of
the Abdomen Abdominal Concept Lab (25
min)
Abdominal (90 min)
Week 5 Cognition and
the Neurological and Musculoskeletal Systems Musculoskeletal
(90 min)
Neurological (90 min)
Week 6 Creating Nurse
Patient Synergy No Shadow Health exam due
Assignment submissions
Shadow Health. (n.d.). Shadow Health help desk. Retrieved
from /orders/support.shadowhealth.com/hc/en-us
Students may reopen an assignment attempt before the due
date. Directions on how to enable this option are provided in the above link.
(Note: As the Instructor, you may reopen an attempt for a student at any time.)
This link (above) provides instructions on reopening an
attempt click on “Tutorials” to learn more.
To Prepare
Review Chapters 1–6 in the course text.
Review the Shadow Health Student Orientation media and the
Useful Tips and Tricks document, provided in this week’s Resources.
Review “Applying the Ethics of Care to Your Nursing
Practice” and “Code of Ethics for Nurses,” provided in this week’s Resources.
Review this week’s Writing Resources and Program Success
Tools, and Health Assessment Nursing Documentation Tutorial provided in this
week’s Resources.
Review the Shadow Health Support Resources, provided in this
week’s Resources.
Review Health Assessment: Introduction and Health
Assessment: Taking a Health History, provided in this week’s Media.
Review the Week 1 Assignment 2 Rubric provided in the Course
Information Area or accessible through the link below for details on completing
the Assignment in Shadow Health.
By Day 7
Complete the following in Shadow Health:
Orientation (15 min)
Conversation Concept Lab Conversation (50 min)
Health History (180 min) including ROS
NURS3020 Health
Assessment
WEEK 2
Assignment
Digital Clinical Experience: Hair, Skin, Nails, and HEENT
To Prepare
Review this week’s Resources including the Health Assessment
Nursing Documentation Tutorial.
Review the Shadow Health Assignments Grading Rubric provided
in the Course Information area or accessible through the link below for details
on completing the Assignments in Shadow Health.
By Day 7
Complete the following in Shadow Health:
Single System Exams:
Skin and Nails (70–120min)
HEENT (90–120 min)

Walden_NURS3020_Week_1_Assignment_Latest_2019_JULY.docx (15.19 KB)

Walden NURS3020 Week 1 Assignment Latest NURS3020 Health Assessment WEEK 1 Assignment

Journal: Observe, Process, Reflect Pen and glasses The objective of the Journal Assignment is to
provide you with a private place to “think on the page,” a phrase used to
describe writing as a form of thinking. Some of us process our thoughts out
loud as we describe them to others. In an academic environment, you will be
asked to record your ideas in writing, or “think on the page,” to show the new
knowledge that you’ve acquired through reading and listening to the resources
and completing the assignments. The journal is not a formal type of writing,
and only you and your Instructor will see the journal entry. These entries are
meant to be free writing but should be revised before submitting.
As you write, think about the audience to whom you are
writing, and the difference between personal writing and scholarly writing.
Your journal writing falls into the category of personal writing, and should be
approached in that way. Think of the journal as an academic reflection space.
To Prepare
Review the Week 1 Assignment 1 Rubric provided in the Course
Information area or accessible through the link below.
Review the Syllabus provided in the course. Review material
concerning health histories and physical examinations.
Include the following in your Journal entry:
Think, reflect and record the feelings you have had as you
have prepared to take this course—which may initially seem like a refresher
course for most of you.
Examine and record your strengths and weaknesses concerning
collecting health histories and performing physical examinations.
Describe in your journal what you expect to learn in this
assessment course.
By Day 5
Submit a 150-word Journal entry addressing the three
elements of focus above and in the grading rubric. You may include any other
comments or thoughts unrelated to the listed areas. There are no right or wrong
answers and credit for the Assignment is earned by timely completion and
providing coherent thoughts about the areas of focus.
Please note that this Assignment is due Day 5 of Week 1.
Failure in submitting by Day 5 could result in automatically being dropped from
the course due to lack of participation.

Walden_NURS6650_final_exam_july_2019.docx (63.78 KB)

• Question 1 When completing this exam, did you comply with Walden
University’s Code of Conduct including the expectations for academic integrity?
• Question 2 One member of a therapy group had been quiet for the first
several sessions. The member revealed to the other members feeling of
depression and emptiness. This week, the member was full of energy and talking
very quickly. The member became irritated with another member tried to
interrupt, started yelling, and then broke into a fit of laughter. Based on the
situation, what can the PMHNP determine about the member?
• Question 3 The PMHNP conducts a specialized individual interview with
a patient named Sandy. During this interview, Sandy expresses her want of the
other members to like her, and she has a deep dread for the first group
meeting. How does the PMHNP correctly interpret Sandy’s interpersonal
circumplex?
• Question 4 A PMHNP has been holding group therapy sessions for several
weeks and notices that a patient is timid and predictable in his or her
responses. When the patient does speak, he or she avoids saying anything to
contradict anyone in the group. Based on this information, what is an
appropriate question the PMHNP should ask herself?
• Question 5 When discussing the role of the consultant in the parenting
group session, Dr. Carlson explains that the consultant should use several
skills in order to help keep the group going and should enable group members to
become very engaged with one another. The consultant should use all of the
following skills to achieve this, except:
• Question 6 During an initial screening session, the PMHNP is
considering a patient for group therapy. The patient is recently divorced and
says he is lonely and depressed. What is the best referral by the PMHNP?
• Question 7 A PMHNP is leading a group therapy session for patients
with substance abuse problems. After a productive session in which all members
participated, the following week was not as productive. In order to help the
group members assume responsibility for evaluating the meeting, what is an
appropriate comment for the PMHNP to make?
• Question 8
Following the PMHNP’s
cancellation of a group session, he or she notices a decrease in compliance and
attendance within the group. What does the PMHNP identify as the group’s reason
for noncompliance?
A.
The group did not expect to have time off, so it may take up to a month to get
back into a routine.
B. The group members may believe that the
group is not important to the PMHNP.
C. The PMHNP’s absence gave the members a
reason to also be absent.
D. The group members feel let down, because
the PMHNP cancelled a meeting.
• Question 9 A client has attended five group therapy sessions yet has
not engaged verbally with others in the group. The PMHNP has identified the
client as a “silent member.” Which statement is true about silent members as
related to group therapy?
• Question 10 For several months, a patient in group therapy always
participated in conversation but only shared positive stories about her own
life. During the next session, she finally confessed that she has been
depressed and cutting herself. What is the best response by the PMHNP?
• Question 11 A 14-year-old girl named Laura and her parents are meeting
with a PMHNP. The parents explain why they are there by saying, “Laura has been
unhappy since she moved to a new school. She has been moody and often talks
back to us.” Laura sits quietly and looks uncomfortable. Which is the best
response by the PMHNP?
• Question 12 Members of a therapy group have been meeting for several
weeks. While a member named Margaret is talking about how her spouse ignores
her when she tries to tell him what to do, another member named Nicole
interrupts and says, “Maybe he thinks you are being bossy.” Margaret replies by
saying, “At least I’m not an alcoholic like you are!” What is an appropriate
response by the PMHNP?
• Question 13 Group participation is an important aspect of how successful
group therapy will be. The PMHNP recognizes that the gender of group
participants can play a role in the likelihood of group participation. Which
statement about gender and group composition does the PMHNP take into account?
• Question 14 A patient has had a problem with substance use and has been
receiving treatment for addiction. Which additional step might the PMHMP
suggest to help the patient maintain abstinence from drugs during and after
treatment?
• Question 15 Jane has been attending group therapy for the past year; she
and the therapist have determined that she has met her goals. Jane has been
arriving to group late or not coming to group at all. How does the PMHNP
correctly interpret Jane’s behavior?
• Question 16 Peter, a successful businessman, is introduced to the group
during the twelfth week. Following Peter’s introduction, Joseph, a long-term
member in the group, begins to lead the group and discuss all of the things
that he has personally accomplished. In what way does the PMHNP correctly interpret
Joseph’s behavior? D
• Question 17 When the counselor discussed assertiveness with the group
members, she began the session by providing definitions and asking group
members to line up consistent with where they feel they are currently in terms
of assertiveness. Why did she do this?
• Question 18
A 21-year-old client with
narcissistic traits is noted to continuously disrupt the group by speaking
while others are speaking. It becomes evident that the client is purposely
disrupting the group and decreasing the group’s productivity. What does the
PMHNP identify as a cause of the client’s behavior?
• Question 19 A narcissistic patient was unhappy that other members did not
seem concerned about his or her dating problems, which the patient spent half
the session talking about. The patient confronted the group by saying, “All of
you are rude and uncaring!” When group members ignored this comment, the
patient said, “And no one said anything nice about my new haircut either!” What
is an appropriate response by the PMHNP?
• Question 20
During a group session, a member
turns to the PMHNP and says, “I need some advice. My manager asked me to take
on an extra project, and now I’m overwhelmed. I don’t want to seem incompetent,
so I agreed to the extra work. What do you recommend I do?” What is the best
response by the PMHNP in order to shape group behavior?B
A.
“I am sorry to hear you feel overwhelmed, and I have several suggestions
that you might find helpful.”
B.
“Let’s ask the group what they think. Does anyone have feedback about this
situation?”
C. “Before I give recommendations, please
explain why turning down the project might make you seem incompetent.”?
• Question 21 In a group therapy session for patients with anxiety
problems, a patient named Eve was afraid to disclose to the other members that
she was a victim of sexual abuse. She kept the secret for months, although she
hinted at it to other members. During a meeting, another member tried to
pressure Eve to disclose her secret, but she was flustered and not ready to
share. What is an appropriate response by the PMHNP?
• Question 22
A PMHNP is leading a group
therapy session for patients with substance abuse problems. After one member
shares a problem, other members offer support, concern, and observations. The
PMHNP points out that the group is offering many truthful reactions and helpful
feedback. Which principle does this illustrate?
• Question 23 During an initial meeting, a PMHNP spends time speaking with
a patient who suffers from social anxiety. The therapist finds the patient
extremely loud and overbearing. The PMHNP’s negative feelings continue no
matter how hard he or she tries to feel differently toward the patient. What is
the most appropriate next step by the PMHNP?
• Question 24
The PMHNP recognizes that
hostility is unavoidable in a group and acknowledges that a frequent source of
hostility can be parataxic distortions. Which situation is likely to present a
parataxic distortion within the group?
• Question 25 During the “mid-group debrief” the clinical supervisor
focused on the following areas with the two counselors except:
• Question 26 Harold Wyman is a 74-year-old man who is trying to mend a
relationship with his adult daughter. Based on his intake assessment, the PMHNP
believes that the father has depression. The daughter and Harold meet with the
PMNHP, and the daughter explains that her father always appears mopey and
withdrawn and refuses to do anything about it. When asked, the father reports
feeling sad all the time. Which action will the PMNHP employ with Harold using
the interpersonal psychotherapy approach throughout the various sessions?
• Question 27 A patient who has been depressed is seeing a PMHNP for
individual therapy. The patient explains that he has been avoiding most social
activities for the past few months. He is divorced and has joint custody of his
10-year-old daughter. Based on this information, what recommendation by the
PMHNP would most benefit the patient?
• Question 28 The PMHNP explains during a discussion that subgrouping has
the potential to make group therapy more complicated and less rewarding. Tara,
a member of the group, angrily states, “Well, Jack and I have been meeting
outside of the group for weeks now.” What is the PMHNP’s most appropriate
response?
• Question 29
Members of group therapy have
been meeting for several weeks. The PMHNP often starts sentences with a thank
you or compliment such as, “Good observation.” The PMHNP notices that some of
the group members having been starting their statements with compliments. To
which principle can the PMHNP attribute this process?
• Question 30 Many key principles assist with composing intensive
interactional psychotherapy groups. When composing a psychotherapy group,
utilizing the intensive interactional approach, which key principle does the PMHNP
identify as being false?
• Question 31 Members of a therapy group have been meeting for several
months. During group therapy, a patient is bossy and controlling. During this week’s
session, she is confronted by another group member about her behavior and
replies, “This is not how I normally act. You are not my family and friends. I
don’t act the same way around them.” What can the PMHNP deduce from her
behavior?
• Question 32
The PMHNP is meeting with an
older married couple. The couple reports having concerns about becoming
dependent on their adult children someday, since several of their other friends
have had to move in with their kids. They make it clear to the PMHNP that they
aren’t keen on therapy or taking medicine but would be willing to try some
alternative therapies. What does the PMHNP suggest for evidence-based CAM modalities?
• Question 33 The PMHNP understands that conflicts within the psychotherapy
group can be troublesome for clients and have the potential to reduce the
effectiveness of the group process. As it pertains to group meetings, the PMHNP
understands which statement to be true about conflict?
• Question 34 During a group therapy session, a member comments that
another member named Ted had no compassion. Ted replies, “Why does it matter if
I care one way or another. I can’t solve their problems.” The other member
starts crying and blames Ted for this. He shrugs and answers, “I don’t
understand why you are crying.” Based on this information, what is the most
likely determination the PMHNP can make about Ted?
• Question 35
During a first group therapy
session, a member is outgoing and participates actively. Based on this
information, what is an appropriate prediction about this group member by the
PMHNP?
• Question 36
A PMHNP has a therapy group in
which many members have been dropping out over the past several weeks. Members
have complained that they do not feel part of the group. What is an appropriate
step for the PMHNP to take?
• Question 37
A PNHNP is holding a group
therapy session for a father and his 10-year-old son, whom the father explains
has been acting out lately. The son says, “He is always telling me what to do
and never listens when I have an idea.” Which solution would the PMHNP most
likely suggest as an approach to the problem?
A.
Role-playing exercises
B. Intrapersonal skills training
C. Psychological testing
D. Individual therapy
• Question 38
A patient has attended three
group therapy sessions and has remained silent throughout each. The patient
has, however, been listening to the other members. When the therapist makes eye
contact with the patient, he or she forces a smile but has clenched fists. What
is the most appropriate response by the PMHNP to help the patient? A
A.
“Your clenched fists indicate that you might be tense or angry about
something.”
B. “If you do not feel comfortable
speaking, I think it would be best if you just listen.”
C. “Today, we are all going to focus on
what you want to get out of group therapy.”?
D. “Since it is our fourth therapy
session, I expect everyone to join in the conversation.”
• Question 39 A member in group therapy named Tom asked others for
suggestions to a problem he was having. He did not think a suggestion by a
member named Steve would work, and for the rest of session, the group took
sides arguing why the idea would work or would not work. The session ended with
Tom agreeing to try the suggestion and report back to the group the following
week. Based on this session, what is an appropriate step by the PMHNP?B
• Question 40
A patient named Tyrone was
nervous sharing personal information with the group. To compensate, he makes
comments on other members’ problems as if he were the therapist. Another member
of the group asked him, “Do you think you’re better than everyone here?” What
might the PMHNP help Tyrone gain from this exchange?
• Question 41
A patient in group therapy
discloses her concern about feeling suicidal again in the future. Using the
principle of universality, what is an appropriate step by the PMHNP?
• Question 42 In the parent consultation session, the parent discusses her
son “Blake” who has changed since his 13th birthday. Dr. Carlson discusses the
power conflict that the parent appears to be getting into with her son. When
they discuss approaches they can use to help Blake experience increased
responsibility, Dr. Carlson explains that the parent must make a commitment
with her son by agreeing to:
• Question 43
A patient in group therapy,
Monique, describes another member, Anna, as bossy and selfish; however, the
PMHNP does not notice this behavior at all. In addition, other members have
expressed how thoughtful and caring Anna is to them. Based on this information,
what is an appropriate observation by the PMHNP?
• Question 44
During a group therapy session,
a member shares that she often feels lonely and depressed. She has been turning
down invitations to spend time with friends lately, because she does not want
to leave the house. What is an appropriate step for the PMHNP to take?
• Question 45
The social microcosm theory is a
theory that relates to group composition. In accordance with this theory, the
PMHNP is aware that the group must consist of which of the following?
• Question 46
A client is observed discussing
many problems and complaints during group therapy. However, when other group
members attempt to offer advice, the client does not accept it. Based on this
observation, what can the PMHNP determine about the client?
• Question 47
The PMHNP is meeting with an
adult woman and her father, who is 85 years old. The father stays quiet most of
the session. The daughter explains he is mad at her for “bringing him to a see
a shrink.” The daughter reports that things have been tense in the house since
her father moved in. The father has a history of depression, though he does not
take any medication for it. In addition, lately the father seems to never
sleep. “I hear him rummaging around in the kitchen, the garage, the living
room, at all hours of the night. Sometimes he’ll nap during the day, but not
much. This is putting a strain on my marriage, because my husband can’t sleep
with all of this going on.” Which therapeutic approach does the PMHNP identify
as most appropriate for the 85-year-old father?
• Question 48
A patient in group therapy named
Ted shares personal information for the first time. He seems nervous but
continues to talk. How might the PMHNP use nonverbal positive reinforcement to
support Ted’s feeling more comfortable?
• Question 49
A 36-year-old client attends
group therapy regularly but is consistently tardy. The client explains that job
and family obligations interfere with attendance to the group. What is the most
appropriate intervention by the PMHNP?
• Question 50
A
group member who suffers from depression and anxiety says during the session,
“I don’t see how any of this is going to help. I am still too anxious to leave
the house and do the things I want to do.” What is an appropriate response by
the PMHNP?
• Question 51 A PMHNP is putting together a heterogeneous, interactional
therapy group. During an initial screening, a patient explains that he is
unemployed because he keeps getting fired from new jobs after several months.
The therapist asks, “Why do you think those companies let you go?” The
patient’s reply is, “Those companies are all terrible. They don’t know how to
treat employees.” After asking the patient if he thought about his role in
getting fired, the patient says, “Why should I? I am not part of the problem.”
Based on this information, what is an appropriate observation by the PMHNP?
• Question 52
One group member is identified
by the PMHNP as the monopolist of the group. Which behavior does the PMHNP believe
this member is most likely to display?
• Question 53 The PMHNP provides cognitive behavioral therapy (CBT) to an
older adult patient with depression. The patient’s 41-year-old daughter and
32-year-old son attend one of his sessions with the PMHNP so that they can
learn more about how to help their father. What does the PMHNP say to the
daughter and son about the goals of their father’s CBT?
• Question 54
In a group therapy session for
adolescents, a 15-year-old patient says he has trouble making conversation with
people he does not know well. Based on the principle of development of
socializing techniques, what explicit approach might the PMHNP take?
• Question 55 A PMHNP is treating a 7-year-old child exhibiting signs of
aggression and attention problems. Before suggesting an intervention using a
common elements approach, what may the PMHNP consider?
• Question 56 A PMHNP is meeting with the mother of a 10-year-old boy named
Malik, who has been depressed since his parents’ divorce. The mother explains
that her goal for treatment is to help Malik feel better so he can become his
“usual outgoing self.” She insists that she does not want him on medication.
Which is the best response by the PMHNP?
• Question 57 A PNHNP is holding a group therapy session. Today, several
members have expressed fears about being unlovable. Based on this information,
what is an appropriate step by the PMHNP to raise the members’ self-esteem?
• Question 58 During an initial meeting, a patient who has been discussing
suicide says to the PMHNP, “I’m so depressed that I don’t want to leave my
house. All I want to do is stay in bed.”
What
type of therapy would the PMHNP most likely recommend to this patient?
• Question 59 During his second group therapy session, a member, who was
quiet the previous week, becomes very judgmental. He criticizes another member by
saying, “Mary, you are always late because you don’t respect our group.” Then
he adds, “In fact, all of you are disrespectful and uncaring.” What is an appropriate
step by the PMHNP?
• Question 60 A PMHNP notices that adolescents in a therapy group have not
been getting along. They are divided into two main groups and each
automatically dislikes members of the other group. What is an appropriate step
for the PMHNP to take?
• Question 61 A PMHNP is treating an 8-year-old child who was at a cousin’s
house during a domestic violence situation. Using a common factors model, the
PMHNP wants to pay attention to cultivating the relationship with the parents
and child. After the child talks about how nervous he or she has been since
witnessing the trauma, what is an appropriate response by the PMHNP?
• Question 62
A client diagnosed with
depression has begun to feel despair and expresses a desire to leave the group
because he or she does not believe it is helpful. Which action by the PMHNP
will most likely contribute to the client staying in the group?
• Question 63
A PMHNP is treating a patient in
individual therapy and thinks the patient may be a good candidate for group
therapy. The patient is motivated to start group therapy, which meets twice a
month. Then the patient adds, “I can come to the first two meetings, but then
will be away on business for at least a month, maybe longer. But then I can
come to the at least one meeting before my next trip.” Based on this
information, what is the most likely recommendation by the PMHNP? B
• Question 64
During therapy, a patient named
Maria states she is unhappy that other members did not express missing her
while she was away the previous week. She confronted the PMHNP by saying,
“Nobody here cares about this stupid group!” What might the PMHNP say to increase
group cohesiveness?
• Question 65
A PMHNP is meeting with parents and their 10-year-old child. The child is having trouble paying attention at
school and has been getting easily frustrated at home when doing homework,
which often results in everyone arguing. What step might the PMHNP take as part
of a family-centered, solution-oriented approach?
• Question 66
A PMHNP is creating a therapy group and is including a patient with borderline personality disorder. Which
action would most likely reduce the patient’s chance of separation anxiety?
• Question 67
When forming a group for
therapy, which action would the PMHNP likely take as a predictor for group
behavior?
• Question 68
The PMHNP is working with an older adult woman and her adult children. The children report that the mother was diagnosed with dementia, and they are all concerned about her welfare. The
plan is for the mother to move in with one of the children, but they are still
worried about how the mother will manage during the day when she is left alone.
What does the PMHNP identify as the
focus of the family therapy?
• Question 69
Gregory is a middle-aged veteran participant in a group led by the PMHNP. Since Gregory has been attending group, he frequently interrupts others and seems to take much of the group time
for himself. The PMHNP identifies Gregory as a monopolist and confronts him.
She explains that she does not want him to talk less; instead, she actually
encourages him to talk more. What is the likely cause of the PMHNP’s
explanation?
• Question 70
Two PMHNPs are in charge of a therapy group that has experienced several maladaptive interpersonal dramas lately. One of the patients has been described by other members as
argumentative. After a particularly awkward session, one of the therapists
feels that his own interpersonal distortion of the session may be clouding his
observation. What is an appropriate step by that PMHNP?
• Question 71
A patient in group therapy for
people dealing with panic disorder is describing a recent panic attack. He
says, “During this attack, I felt like I was dying.” What is an appropriate
response by the PMHNP using didactic instruction?
• Question 72
The PMHNP is meeting with a
married couple. The husband is 81 years old, and the wife is 78 years old. They
tell the PMHNP that many of their friends have passed away over the last couple
of years, and it’s making them feel sentimental about their lives and the fact
that they are getting older. Hearing this, the PMHNP uses a life review
approach with the couple. What action will the PMHNP employ?
• Question 73
During the first group meeting,
a client states, “I am here because I am very shy. I don’t mesh well with
others and I rarely get invitations to go anywhere.” Which statement about the
client’s reason for seeking help and treatment best applies?
• Question 74
According to Dr. Carlson, since
Adler talked about how the social setting in which we live influences our
lives, the best way parents can change their children’s behavior is to change:
• Question 75
Self-disclosure is a very
important part of group therapy. Which of the following conditions does the
PMHNP identify in his or her own life as a possible hindrance to
self-disclosure?
• Question 76 The leader begins a group meeting by doing the “names
activity.” At the completion of the activity, the leader explains that the
activity is useful for all of the following reasons, except:

NURS 6050 Week 4 assignment: Legislation Comparison Grid and Testimony/Advocacy Statement Example

Assignment: Legislation Comparison Grid and Testimony/Advocacy Statement
As a nurse, how often have you thought to yourself, If I had anything to do about it, things would work a little differently? Increasingly, nurses are beginning to realize that they do, in fact, have a role and a voice.

Many nurses encounter daily experiences that motivate them to take on an advocacy role in hopes of impacting policies, laws, or regulations that impact healthcare issues of interest. Of course, doing so means entering the less familiar world of policy and politics. While many nurses do not initially feel prepared to operate in this space effectively, the reward is the opportunity to shape and influence future health policy.

To Prepare:

Select a bill that has been proposed (not one that has been enacted) using the congressional websites provided in the Learning Resources.
The Assignment: (1- to 2-page Comparison Grid; 1- to 2-page Legislation Testimony/Advocacy Statement)

Part 1: Legislation Comparison Grid

Based on the health-related bill (proposed, not enacted) you selected, complete the Legislation Comparison Grid Template. Be sure to address the following:

Determine the legislative intent of the bill you have reviewed.
Identify the proponents/opponents of the bill.

NURS 6050 Week 4 assignment: Legislation Comparison Grid and Testimony/Advocacy Statement Example
Identify the target populations addressed by the bill.
Where in the process is the bill currently? Is it in hearings or committees?
Is it receiving press coverage?
Part 2: Legislation Testimony/Advocacy Statement

Based on the health-related bill you selected, develop a 1- to 2-page Legislation Testimony/Advocacy Statement that addresses the following:

Advocate a position for the bill you selected and write testimony in support of your position.
Describe how you would address the opponent to your position. Be specific and provide examples.
Recommend at least one amendment to the bill in support of your position.

NURS 6050 Week 4 assignment: Legislation Comparison Grid and Testimony/Advocacy Statement Example 1

Part 1. Legislative comparison grid

Part 2. Legislation testimony/advocacy statement

There is a need for the legislation to be reauthorized in its current form as the Autism CARES Act of 2019. That is because it seeks to increase the federal investment across the government departments concerned with addressing the increasing needs of persons with autism spectrum disorder. Should the Bill fail to be reauthorized by the 30^th September 2019 deadline, then efforts to address autism spectrum disorders are likely to hindered and past gains reversed. In fact, failing to reauthorized the Bill would deny the Interagency Autism Coordinating Committee the authority to coordinate federal efforts targeted at autism. This would increase the possibility of efforts being duplicated and resources wasted. Besides that, autism is a present concern since 1.67% of children are suffering from the disorder, a significant population and yet management efforts are hindered by a dearth of information that would be best addressed through research. NURS 6050 Week 4 assignment: Legislation Comparison Grid and Testimony/Advocacy Statement Example. Through passing the bill, significant advances would be reported in three areas. Firstly, research efforts would be coordinated through supporting research funded by the National Institute of Health. Secondly, streamlining data and surveillance through building infrastructure at CDC to monitor autism.

Finally, supporting training efforts to address the reported shortages of personnel who address screening, diagnosis and treatment efforts (Autism Society, 2019). Although the Bill seeks to improve autism management, there is a legitimate concern that it would increase federal spending on health and the federal deficit. This objection is in reference to Section 3 Part e of the Bill that amends appropriations authorization to increase funding for federal programs. This concern can be addressed through making two amendments to the Bill. The first amendment is to eliminate the part that seeks to increasing federal funding for autism management (repeal authorizations of appropriations) so that the federal deficit concerns are eliminated (Saba & McCormick, 2015). The second amendment is to mobilize funding from non-governmental and private donors who support a similar heath agenda. This would ensure that although federal funding is not used, the autism management activities identified by the Bill are not discontinued and they continue to receive funding (Feldstein, 2006). Overall, the Autism CARES Act of 2019 has much value, and could be improved to receive greater support if federal funding is reduced and alternative non-government funding is sourced. NURS 6050 Week 4 assignment: Legislation Comparison Grid and Testimony/Advocacy Statement Example.

References

Autism Society (2019). Autism CARES Act Reauthorization (2019). Retrieved from /orders/www.autism-society.org/public-policy/autism-cares-act-reauthorization-2019/

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

Saba, V. & McCormick, K. (2015). Essentials of nursing informatics (6^th ed.). New York, NY: McGraw-Hill. NURS 6050 Week 4 assignment: Legislation Comparison Grid and Testimony/Advocacy Statement Example

Walden_nur6003_week_6_discussion_july_2019.docx (52.78 KB)

Using the Walden Library Where can you find evidence to inform your thoughts and scholarly writing? Throughout your degree program, you will use research literature to explore ideas, guide your thinking, and gain new insights. As you search the research literature, it is important to use resources that are peer-reviewed and from scholarly journals. You may already have some favorite
online resources and databases that you use or have found useful in the past.
For this Discussion, you explore databases available through the Walden Library.
To Prepare:
Review the information presented in the Learning Resources
for using the Walden Library, searching the databases, and evaluating online
resources.
Begin searching for a peer-reviewed article that pertains to
your practice area and interests you.
By Day 3 of Week 6
Post the following:
Using proper APA formatting, cite the peer-reviewed article
you selected that pertains to your practice area and is of particular interest
to you and identify the database that you used to search for the article.
Explain any difficulties you experienced while searching for this article.
Would this database be useful to your colleagues? Explain why or why not. Would
you recommend this database? Explain why or why not.
By Day 6 of Week 6
Respond to at least two of your colleagues’ posts by
offering suggestions/strategies for working with this database from your own
experience, or offering ideas for using alternative resources.
Attachments area

NURS3020 Health
Assessment
WEEK 3
Assignment
Digital Clinical Experience: Respiratory, Cardiac and
Peripheral Vascular Systems
To Prepare
Review this week’s Resources.
Review the Shadow Health Assignments Grading Rubric provided
in the Course Information area or accessible through the link below for details
on completing the Assignments in Shadow Health.
By Day 7
Complete the following in Shadow Health:
Respiratory Concept Lab (25 min)
Respiratory Exam (90 min)
Cardiovascular Concept Lab (25 min)
Cardiovascular Exam (90 min)

NURS3020 Health
Assessment
WEEK 4
Assignment
Digital Clinical Experience: Abdomen
To Prepare
Review this week’s Resources.
Review the Shadow Health Assignments Grading Rubric provided
in the Course Information area or accessible through the link below for details
on completing the Assignment in Shadow Health.
By Day 7
Complete the following in Shadow Health:
Abdominal Concept Lab (25 min)
Abdominal Exam (90 min)

QUESTION 4: Walden NURS6630 Final Exam July NURS6630 Final Exam: Walden University
Why does the PMHNP avoid
prescribing clozapine (Clozaril) as a first-line treatment to the patient with
psychosis and aggression?
A. There is too high a risk
of serious adverse side effects.
B. It can exaggerate the
psychotic symptoms.
C. Clozapine (Clozaril)
should not be used as high-dose monotherapy.
D. There is no
documentation that clozapine (Clozaril) is effective for patients who are
violent.
QUESTION 5
The PMHNP is caring for a
patient on risperidone (Risperdal). Which action made by the PMHNP exhibits
proper care for this patient?
A. Explaining to the
patient that there are no risks of EPS
B. Prescribing the patient
12 mg/dail
C. Titrating the dose by
increasing it every 5–7 days
D. Writing a prescription for a higher dose of
oral risperidone (Risperdal) to achieve high D2 receptor occupancy
QUESTION 6: Walden NURS6630 Final Exam July NURS6630 Final Exam: Walden University
The PMHNP wants to
prescribe Mr. Barber a mood stabilizer that will target aggressive and
impulsive symptoms by decreasing dopaminergic neurotransmission. Which mood
stabilizer will the PMHNP select?
A. Lithium (Lithane)
B. Phenytoin (Dilantin)
C. Valproate (Depakote)
D. Topiramate (Topamax)

QUESTION 7: Walden NURS6630 Final Exam July NURS6630 Final Exam: Walden University
The parents of a 7-year-old
patient with ADHD are concerned about the effects of stimulants on their child.
The parents prefer to start pharmacological treatment with a non-stimulant.
Which medication will the PMHNP will most likely prescribe?
A. Strattera
B. Concerta
C. Daytrana
D. Adderall
QUESTION 8
8 The PMHNP understands
that slow-dose extended release stimulants are most appropriate for which
patient with ADHD?
A. 8-year-old patient
B. 24-year-old patient
C. 55-year-old patient
D. 82-year-old patient
QUESTION 9
A patient is prescribed
D-methylphenidate, 10-mg extended-release capsules. What should the PMHNP
include when discussing the side effects with the patient?
A. The formulation can have
delayed actions when taken with food.
B. Sedation can be a common
side effect of the drug.
C. The medication can
affect your blood pressure.
D. This drug does not cause
any dependency.
QUESTION 10
The PMHNP is teaching
parents about their child’s new prescription for Ritalin. What will the PMHNP
include in the teaching?
A. The second dose should
be taken at lunch.
B. There are no risks for
insomnia.
C. There is only one daily
dose, to be taken in the morning.
D. There will be continued
effects into the evening.
QUESTION 11: Walden NURS6630 Final Exam July NURS6630 Final Exam: Walden University
A young patient is
prescribed Vyvanse. During the follow-up appointment, which comment made by the
patient makes the PMHNP think that the dosing is being done incorrectly?
A. “I take my pill at
breakfast.”
B. “I am unable to fall
asleep at night.”
C. “I feel okay all day
long.”
D. “I am not taking my pill
at lunch.”
QUESTION 12
A 14-year-old patient is
prescribed Strattera and asks when the medicine should be taken. What does the
PMHNP understand regarding the drug’s dosing profile?
A. The patient should take
the medication at lunch.
B. The patient will have
one or two doses a day.
C. The patient will take a
pill every 17 hours.
D. The dosing should be
done in the morning and at night.
QUESTION 13: Walden NURS6630 Final Exam July NURS6630 Final Exam: Walden University
The PMHNP is meeting with
the parents of an 8-year-old patient who is receiving an initial prescription
for D-amphetamine. The PMHNP demonstrates appropriate prescribing practices
when she prescribes the following dose:
A. The child will be
prescribed 2.5 mg.
B. The child will be
prescribed a 10-mg tablet.
C. The child’s dose will
increase by 2.5 mg every other week.
D. The child will take
10–40 mg, daily.
QUESTION 14
A patient is being
prescribed bupropion and is concerned about the side effects. What will the
PMHNP tell the patient regarding bupropion?
A. Weight gain is not
unusual.
B. Sedation may be common.
C. It can cause cardiac
arrhythmias.
D. It may amplify fatigue.
QUESTION 15: Walden NURS6630 Final Exam July NURS6630 Final Exam: Walden University
Which patient will receive
a lower dose of guanfacine?
A. Patient who has
congestive heart failure
B. Patient who has
cerebrovascular disease
C. Patient who is pregnant
D. Patient with kidney
disease
QUESTION 16
An 18-year-old female with
a history of frequent headaches and a mood disorder is prescribed topiramate
(Topamax), 25 mg by mouth daily. The PMHNP understands that this medication is
effective in treating which condition(s) in this patient?
A. Migraines
B. Bipolar disorder and
depression
C. Pregnancy-induced
depression
D. Upper back pain
QUESTION 17
The PMHNP is treating a
patient for fibromyalgia and is considering prescribing milnacipran (Savella).
When prescribing this medication, which action is the PMHNP likely to choose?
A. Monitor liver function
every 6 months for a year and then yearly thereafter.
B. Monitor monthly weight.
C. Split the daily dose into two doses after
the first day.
D. Monitor for occult blood
in the stool.
QUESTION 18
The PMHNP is assessing a
patient she has been treating with the diagnosis of chronic pain. During the
assessment, the patient states that he has recently been having trouble getting
to sleep and staying asleep. Based on this information, what action is the
PMHNP most likely to take?
A. Order hydroxyzine
(Vistaril), 50 mg PRN or as needed
B. Order zolpidem (Ambien),
5mg at bedtime
C. Order melatonin, 5mg at
bedtime
D. Order quetiapine
(Seroquel), 150 mg at bedtime
QUESTION 19
The PMHNP is assessing a
female patient who has been taking lamotrigine (Lamictal) for migraine
prophylaxis. After discovering that the patient has reached the maximum dose of
this medication, the PMHNP decides to change the patient’s medication to
zonisamide (Zonegran). In addition to evaluating this patient’s day-to-day
activities, what should the PMHNP ensure that this patient understands?
A. Monthly blood levels
must be drawn.
B. ECG monitoring must be
done once every 3 months.
C. White blood cell count
must be monitored weekly.
D. This medication has
unwanted side effects such as sedation, lack of coordination, and drowsiness.
QUESTION 20
A patient recovering from
shingles presents with tenderness and sensitivity to the upper back. He states
it is bothersome to put a shirt on most days. This patient has end stage renal
disease (ESRD) and is scheduled to have hemodialysis tomorrow but states that
he does not know how he can lie in a recliner for 3 hours feeling this
uncomfortable. What will be the PMHNP’s priority?
A. Order herpes simplex
virus (HSV) antibody testing
B. Order a blood urea
nitrogen (BUN) and creatinine STAT
C. Prescribe lidocaine 5%
D. Prescribe hydromorphone
(Dilaudid) 2mg
QUESTION 21
The PMHNP prescribed a
patient lamotrigine (Lamictal), 25 mg by mouth daily, for nerve pain 6 months
ago. The patient suddenly presents to the office with the complaint that the
medication is no longer working and complains of increased pain. What action
will the PMHNP most likely take?
A. Increase the dose of
lamotrigine (Lamictal) to 25 mg twice daily.
B. Ask if the patient has
been taking the medication as prescribed.
C. Order gabapentin
(Neurontin), 100 mg three times a day, because lamotrigine (Lamictal) is no
longer working for this patient.
D. Order a complete blood
count (CBC) to assess for an infection.
QUESTION 22
An elderly woman with a
history of Alzheimer’s disease, coronary artery disease, and myocardial
infarction had a fall at home 3 months ago that resulted in her receiving an
open reduction internal fixation. While assessing this patient, the PMHNP is
made aware that the patient continues to experience mild to moderate pain. What
is the PMHNP most likely to do?
A. Order an X-ray because
it is possible that she dislocated her hip.
B. Order ibuprofen (Motrin) because she may need long-term treatment and
chronic pain is not uncommon.
C. Order naproxen
(Naprosyn) because she may have arthritis and chronic pain is not uncommon.
D. Order Morphine and
physical therapy.
QUESTION 23
The PMHNP is assessing a
49-year-old male with a history of depression, post-traumatic stress disorder
(PTSD), alcoholism with malnutrition, diabetes mellitus type 2, and
hypertension. His physical assessment is unremarkable with the exception of
peripheral edema bilaterally to his lower extremities and a chief complaint of
pain with numbness and tingling to each leg 5/10. The PMHNP starts this patient
on a low dose of doxepin (Sinequan). What is the next action that must be taken
by the PMHNP?
A. Orders liver function
tests.
B. Educate the patient on
avoiding grapefruits when taking this medication.
C. Encourage this patient
to keep fluids to 1500 ml/day until the swelling subsides.
D. Order a BUN/Creatinine
test.
QUESTION 24
The PMHNP is evaluating a
30-year-old female patient who states that she notices pain and a drastic
change in mood before the start of her menstrual cycle. The patient states that
she has tried diet and lifestyle changes but nothing has worked. What will the
PMHNP most likely do? A. Prescribe Estrin FE 24 birth control
B. Prescribe ibuprofen
(Motrin), 800 mg every 8 hours as needed for pain
C. Prescribe desvenlafaxine
(Pristiq), 50 mg daily
D. Prescribe risperidone
(Risperdal), 2 mg TID
QUESTION 25
A patient with chronic back
pain has been prescribed a serotonin-norepinephrine reuptake inhibitor (SNRI).
How does the PMHNP describe the action of SNRIs on the inhibition of pain to
the patient?
A. “The SNRI can increase
noradrenergic neurotransmission in the descending spinal pathway to the dorsal
horn.”
B. “The SNRI can decrease
noradrenergic neurotransmission in the descending spinal pathway to the dorsal
horn.”
C. “The SNRI can reduce
brain atrophy by slowing the gray matter loss in the dorsolateral prefrontal
cortex.”
D. “The SNRI can increase
neurotransmission to descending neurons.”
QUESTION 26
A patient with fibromyalgia
and major depression needs to be treated for symptoms of pain. Which is the
PMHNP most likely to prescribe for this patient?
Venlafaxine (Effexor)
Duloxetine (Cymbalta)
Clozapine (Clozaril)
Phenytoin (Dilantin)
QUESTION 27
The PMHNP prescribes
gabapentin (Neurontin) for a patient’s chronic pain. How does the PMHNP
anticipate the drug to work?
A. It will bind to the
alpha-2-delta ligand subunit of voltage-sensitive calcium channels.
B. It will induce synaptic
changes, including sprouting.
C. It will act on the
presynaptic neuron to trigger sodium influx.
D. It will inhibit activity
of dorsal horn neurons to suppress body input from reaching the brain.
QUESTION 28
Mrs. Rosen is a 49-year-old
patient who is experiencing fibro-fog. What does the PMHNP prescribe for Mrs.
Rosen to improve this condition?
A. Venlafaxine (Effexor)
B. Armodafinil (Nuvigil)
C. Bupropion (Wellbutrin)
D. All of the above
QUESTION 29
The PMHNP is caring for a
patient with fibromyalgia. Which second-line treatment does the PMHNP select
that may be effective for managing this patient’s pain?
A. Methylphenidate (Ritalin)
B. Viloxazine (Vivalan)
C. Imipramine (Tofranil)
D. Bupropion (Wellbutrin
QUESTION 30
The PMHNP is attempting to
treat a patient’s chronic pain by having the agent bind the open channel
conformation of VSCCs to block those channels with a “use-dependent” form of
inhibition. Which agent will the PMHNP most likely select?
A. Pregabalin (Lyrica)
B. Duloxetine (Cymbalta)
C. Modafinil (Provigil)
D. Atomoxetine (Strattera)
QUESTION 31
A patient with irritable
bowel syndrome reports chronic stomach pain. The PMHNP wants to prescribe the
patient an agent that will cause irrelevant nociceptive inputs from the pain to
be ignored and no longer perceived as painful. Which drug will the PMHNP
prescribe?
A. Pregabalin (Lyrica)
B. Gabapentin (Neurontin)
C. Duloxetine (Cymbalta)
D. B and C
QUESTION 32
The PMHNP wants to use a
symptom-based approach to treating a patient with fibromyalgia. How does the
PMHNP go about treating this patient?
A. Prescribing the patient
an agent that ignores the painful symptoms by initiating a reaction known as
“fibro-fog”
B. Targeting the patient’s
symptoms with anticonvulsants that inhibit gray matter loss in the dorsolateral
prefrontal cortex
C. Matching the patient’s
symptoms with the malfunctioning brain circuits and neurotransmitters that
might mediate those symptoms D. None of the above
QUESTION 33
The PMHNP is working with
the student to care for a patient with diabetic peripheral neuropathic pain.
The student asks the PMHNP why SSRIs are not consistently useful in treating
this particular patient’s pain. What is the best response by the PMHNP?
A. “SSRIs only increase
norepinephrine levels.”
B. “SSRIs only increase
serotonin levels.”
C. “SSRIs increase
serotonin and norepinephrine levels.”
D. “SSRIs do not increase
serotonin or norepinephrine levels.”
QUESTION 34
A patient with gambling
disorder and no other psychiatric comorbidities is being treated with
pharmacological agents. Which drug is the PMHNP most likely to prescribe?
A. Antipsychotics
B. Lithium
C. SSRI
D. Naltrexone
QUESTION 35
Kevin is an adolescent who
has been diagnosed with kleptomania. His parents are interested in seeking
pharmacological treatment. What does the PMHNP tell the parents regarding his
treatment options?
A. “Naltrexone may be an
appropriate option to discuss.”
B. “There are many medicine
options that treat kleptomania.”
C. “Kevin may need to be
prescribed antipsychotics to treat this illness.”
D. “Lithium has proven
effective for treating kleptomania.”
QUESTION 36
Which statement best
describes a pharmacological approach to treating patients for impulsive
aggression?
A. Anticonvulsant mood
stabilizers can eradicate limbic irritability.
B. Atypical antipsychotics
can increase subcortical dopaminergic stimulation.
C. Stimulants can be used
to decrease frontal inhibition.
D. Opioid antagonists can
be used to reduce drive.
QUESTION 37
A patient with hypersexual
disorder is being assessed for possible pharmacologic treatment. Why does the
PMHNP prescribe an antiandrogen for this patient?
A. It will prevent feelings
of euphoria.
B. It will amplify impulse
control.
C. It will block
testosterone.
D. It will redirect the
patient to think about other things.
QUESTION 38
Mrs. Kenner is concerned
that her teenage daughter spends too much time on the Internet. She inquires
about possible treatments for her daughter’s addiction. Which response by the
PMHNP demonstrates understanding of pharmacologic approaches for compulsive disorders?

A. “Compulsive Internet use
can be treated similarly to how we treat people with substance use disorders.”
B. “Internet addiction is
treated with drugs that help block the tension/arousal state your daughter
experiences.”
C. “When it comes to Internet
addiction, we prefer to treat patients with pharmaceuticals rather than
psychosocial methods.”
D. “There are no
evidence-based treatments for Internet addiction, but there are behavioral
therapies your daughter can try.”
QUESTION 39
Mr. Peterson is meeting
with the PMHNP to discuss healthier dietary habits. With a BMI of 33, Mr.
Peterson is obese and needs to modify his food intake. “Sometimes I think I’m
addicted to food the way some people are addicted to drugs,” he says. Which
statement best describes the neurobiological parallels between food and drug
addiction?
A. There is decreased
activation of the prefrontal cortex.
B. There is increased
sensation of the reactive reward system.
C. There is reduced
activation of regions that process palatability.
D. There are amplified
reward circuits that activate upon consumption.
QUESTION 40
The PMHNP is caring for a
patient who reports excessive arousal at nighttime. What could the PMHNP use
for a time-limited duration to shift the patient’s brain from a hyperactive
state to a sleep state?
A. Histamine 2 receptor
antagonist
B. Benzodiazepines
C. Stimulants
D. Caffeine

QUESTION 41
The PMHNP is caring for a
patient who experiences too much overstimulation and anxiety during daytime
hours. The patient agrees to a pharmacological treatment but states, “I don’t
want to feel sedated or drowsy from the medicine.” Which decision made by the
PMHNP demonstrates proper knowledge of this patient’s symptoms and appropriate
treatment options?
A. Avoiding prescribing the
patient a drug that blocks H1 receptors
B. Prescribing the patient
a drug that acts on H2 receptors
C. Stopping the patient
from taking medicine that unblocks H1 receptors
D.None of the above
QUESTION 42
The PMHNP is performing a
quality assurance peer review of the chart of another PMHNP. Upon review, the
PMHNP reviews the chart of an older adult patient in long-term care facility
who has chronic insomnia. The chart indicates that the patient has been
receiving hypnotics on a nightly basis. What does the PMHNP find problematic
about this documentation?
A. Older adult patients are
contraindicated to take hypnotics.
B. Hypnotics have prolonged
half-lives that can cause drug accumulation in the elderly.
C. Hypnotics have short
half-lives that render themselves ineffective for older adults.
D. Hypnotics are not
effective for “symptomatically masking” chronic insomnia in the elderly.
QUESTION 43
The PMHNP is caring for a
patient with chronic insomnia who is worried about pharmacological treatment
because the patient does not want to experience dependence. Which
pharmacological treatment approach will the PMHNP likely select for this
patient for a limited duration, while searching and correcting the underlying
pathology associated with the insomnia?
A. Serotonergic hypnotics
B. Antihistamines
C. Benzodiazepine hypnotics

D. Non-benzodiazepine
hypnotics
QUESTION 44
The PMHNP is caring for a
patient with chronic insomnia who would benefit from taking hypnotics. The
PMHNP wants to prescribe the patient a drug with an ultra-short half-life (1–3
hours). Which drug will the PMHNP prescribe?
A. Flurazepam (Dalmane)
B. Estazolam (ProSom)
C. Triazolam (Halcion)
D. Zolpidem CR (Ambien)
QUESTION 45
The PMHNP is attempting to
treat a patient’s chronic insomnia and wishes to start with an initial
prescription that has a half-life of approximately 1–2 hours. What is the most
appropriate prescription for the PMHNP to make?
A. Triazolam (Halcion)
B. Quazepam (Doral)
C. Temazepam (Restoril)
D. Flurazepam (Dalmane)
QUESTION 46
A patient with chronic
insomnia asks the PMHNP if they can first try an over-the-counter (OTC)
medication before one that needs to be prescribed to help the patient sleep.
Which is the best response by the PMHNP?
A. “There are no
over-the-counter medications that will help you sleep.”
B. “You can choose from one
of the five benzo hypnotics that are approved in the United States.”
C. “You will need to ask
the pharmacist for a non-benzodiazepine medicine.”
D. “You can get melatonin
over the counter, which will help with sleep onset.”
QUESTION 47
A patient with chronic
insomnia and depression is taking trazodone (Oleptro) but complains of feeling
drowsy during the day. What can the PMHNP do to reduce the drug’s daytime
sedating effects?
A. Prescribe the patient an
antihistamine to reverse the sedating effects B. Increasing the patient’s dose
and administer it first thing in the morning C. Give the medicine at night and
lower the dose D. None of the above
QUESTION 48
The PMHNP is teaching a
patient with a sleep disorder about taking diphenhydramine (Benadryl). The
patient is concerned about the side effects of the drug. What can the PMHNP
teach the patient about this treatment approach?
A. “It can cause diarrhea.”

B. “It can cause blurred
vision.”
C. “It can cause increased
salivation.”
D. “It can cause heightened
cognitive effects.”
QUESTION 49
Parents of a 12-year-old
boy want to consider attention deficit hyperactivity disorder (ADHD) medication
for their son. Which medication would the PMHNP start?
Methylphenidate Amphetamine
salts Atomoxetine All of the above could potentially treat their son’s
symptoms.
QUESTION 50
An adult patient presents with a history of
alcohol addiction and attention deficit hyperactivity disorder (ADHD). Given
these comorbidities, the PMHNP determines which of the following medications
may be the best treatment option?
A. Methylphenidate
(Ritalin, Concerta)
B. Amphetamine
C. Atomoxetine (Strattera)
D. Fluoxetine (Prozac)
QUESTION 51
An 8-year-old patient
presents with severe hyperactivity, described as “ants in his pants.” Based on
self-report from the patient, his parents, and his teacher; attention deficit
hyperactivity disorder (ADHD) is suspected. What medication is the PMNHP most
likely to prescribe?
A. Methylphenidate
(Ritalin, Concerta)
B. Clonidine (Catapres)
C. Bupropion (Wellbutrin)
D. Desipramine (Norpramin)
QUESTION 52
A 9-year-old female patient
presents with symptoms of both attention deficit hyperactivity disorder (ADHD)
and oppositional defiant disorder. In evaluating her symptoms, the PMHNP
determines that which of the following medications may be beneficial in augmenting
stimulant medication?
A. Bupropion (Wellbutrin)
B. Methylphenidate
(Ritalin, Concerta)
C. Guanfacine ER (Intuniv)
D. Atomoxetine (Strattera)

QUESTION 53
A PMHNP supervisor is
discussing with a nursing student how stimulants and noradrenergic agents
assist with ADHD symptoms. What is the appropriate response?
A. They both increase
signal strength output dopamine (DA) and norepinephrine (NE).
B. Dopamine (DA) and
norepinephrine (NE) are increased in the prefrontal cortex.
C. Noradrenergic agents correct
reductions in dopamine (DA) in the reward pathway leading to increased ability
to maintain attention to repetitive or boring tasks and resist distractions.
D. All of the above.
QUESTION 54
A 43-year-old male patient
is seeking clarification about treating attention deficit hyperactivity
disorder (ADHD) in adults and how it differs from treating children, since his
son is on medication to treat ADHD. The PMHNP conveys a major difference is which
of the following?
A. Stimulant prescription
is more common in adults.
B. Comorbid conditions are
more common in children, impacting the use of stimulants in children.
C. Atomoxetine (Strattera)
use is not advised in children.
D. Comorbidities are more
common in adults, impacting the prescription of additional agents.
QUESTION 55
A 26-year-old female
patient with nicotine dependence and a history of anxiety presents with
symptoms of attention deficit hyperactivity disorder (ADHD). Based on the
assessment, what does the PMHNP consider?
A. ADHD is often not the
focus of treatment in adults with comorbid conditions.
B. ADHD should always be
treated first when comorbid conditions exist.
C. Nicotine has no reported
impact on ADHD symptoms.
D. Symptoms are often easy
to treat with stimulants, given the lack of comorbidity with other conditions.
QUESTION 56
Which of the following is a
true statement regarding the use of stimulants to treat attention deficit
hyperactivity disorder (ADHD)?
A. In adults with both ADHD
and anxiety, treating the anxiety with selective serotonin reuptake inhibitors
(SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), or
benzodiazepines and the ADHD with stimulants is most effective in treating both
conditions.
B. Signal strength output
is increased by dialing up the release of dopamine (DA) and norepinephrine
(NE).
C. In conditions where
excessive DA activation is present, such as psychosis or mania, comorbid ADHD
should never be treated with stimulants.
D. High dose and pulsatile
delivery of stimulants that are short acting are preferred to treat ADHD.

QUESTION 57
The PMHNP is providing a
workshop for pediatric nurses, and a question is posed about noradrenergic
agents to treat ADHD. Which of the following noradrenergic agents have
norepinephrine reuptake inhibitor (NRI) properties that can treat ADHD?
A. Desipramine (Norpramin)
B. Methylphenidate
(Ritalin, Concerta)
C. Atomoxetine (Strattera)
D. Both “A” & “C” E.
“C” only

QUESTION 58
A 71-year-old male patient
comes to an appointment with his 65-year-old wife. They are both having
concerns related to her memory and ability to recognize faces. The PMNHP is
considering prescribing memantine (Namenda) based on the following symptoms:
A. Amnesia, aphasia, apnea
B. Aphasia, apraxia,
diplopia
C. Amnesia, apraxia,
agnosia
D. Aphasia, agnosia,
arthralgia
QUESTION 59
The PMHNP evaluates a
patient presenting with symptoms of dementia. Before the PMHNP considers
treatment options, the patient must be assessed for other possible causes of
dementia. Which of the following answers addresses both possible other causes
of dementia and a rational treatment option for Dementia?
A. Possible other causes:
hypothyroidism, Cushing’s syndrome, multiple sclerosis Possible treatment
option: memantine
B. Possible other causes:
hypothyroidism, adrenal insufficiency, hyperparathyroidism Possible treatment
option: donepezil
C. Possible other causes:
hypothyroidism, adrenal insufficiency, niacin deficiency Possible treatment
option: risperidone
D. Possible other causes:
hypothyroidism, Cushing’s syndrome, lupus erythematosus Possible treatment
option: donepezil
QUESTION 60
A group of nursing students
seeks further clarification from the PMHNP on how cholinesterase inhibitors are
beneficial for Alzheimer’s disease patients. What is the appropriate response?
A. Acetylcholine (ACh)
destruction is inhibited by blocking the enzyme acetylcholinesterase.
B. Effectiveness of these agents occurs in all
stages of Alzheimer’s disease.
C. By increasing
acetylcholine, the decline in some patients may be less rapid.
D. Both “A” & “C.”
QUESTION 61
The PMHNP is assessing a
patient who presents with elevated levels of brain amyloid as noted by positron
emission tomography (PET). What other factors will the PMHNP consider before
prescribing medication for this patient, and what medication would the PMHNP want
to avoid given these other factors?
A. ApoE4 genotype and avoid
antihistamines if possible
B. Type 2 diabetes and
avoid olanzapine
C. Anxiety and avoid
methylphenidate
D. Both “A” & “B”
QUESTION 62
A 72-year-old male patient
is in the early stages of Alzheimer’s disease. The PMHNP determines that
improving memory is a key consideration in selecting a medication. Which of the
following would be an appropriate choice?
A. Rivastigmine (Exelon)
B. Donepezil (Aricept)
C. Galantamine (Razadyne)
D. All of the above
QUESTION 63
A 63-year-old patient
presents with the following symptoms. The PMHNP determines which set of
symptoms warrant prescribing a medication? Select the answer that is matched
with an appropriate treatment.
A. Reduced ability to
remember names is most problematic, and an appropriate treatment option is
memantine.
B. Impairment in the
ability to learn and retain new information is most problematic, and an
appropriate treatment option would be donepezil.
C. Reduced ability to find
the correct word is most problematic, and an appropriate treatment option would
be memantine.
D. Reduced ability to
remember where objects are most problematic, and an appropriate treatment
option would be donepezil.
QUESTION 64
A 75-year-old male patient
diagnosed with Alzheimer’s disease presents with agitation and aggressive
behavior. The PMHNP determines which of the following to be the best treatment
option?
A. Immunotherapy
B.
Donepezil (Aricept)
C.
Haloperidol (Haldol)
D. Citalopram (Celexa) or
Escitalopram (Lexapro)
QUESTION 65
The PMHNP has been asked to
provide an in-service training to include attention to the use of
antipsychotics to treat Alzheimer’s. What does the PMHNP convey to staff?
A. The use of
antipsychotics may cause increased cardiovascular events and mortality.
B. A good option in
treating agitation and psychosis in Alzheimer’s patients is haloperidol
(Haldol).
C. Antipsychotics are often
used as “chemical straightjackets” to over-tranquilize patients.
D. Both “A” & “C.”
QUESTION 66
An 80-year-old female
patient diagnosed with Stage II Alzheimer’s has a history of irritable bowel
syndrome. Which cholinergic drug may be the best choice for treatment given the
patient’s gastrointestinal problems?
A. Donepezil (Aricept)
B. Rivastigmine (Exelon)
C. Memantine (Namenda)
D. All of the above
QUESTION 67
The PMHNP understands that
bupropion (Wellbutrin) is an effective way to assist patients with smoking
cessation. Why is this medication effective for these patients?
A. Bupropion (Wellbutrin)
releases the dopamine that the patient would normally receive through smoking.
B. Bupropion (Wellbutrin)
assists patients with their cravings by changing the way that tobacco tastes.
C. Bupropion (Wellbutrin)
blocks dopamine reuptake, enabling more availability of dopamine.
D. Bupropion (Wellbutrin)
works on the mesolimbic neurons to increase the availability of dopamine.
QUESTION 68
Naltrexone (Revia), an
opioid antagonist, is a medication that is used for which of the following
conditions?
A. Alcoholism
B. Chronic pain
C. Abuse of inhalants
D. Mild to moderate heroin
withdrawal

QUESTION 69
A patient addicted to
heroin is receiving treatment for detoxification. He begins to experience
tachycardia, tremors, and diaphoresis. What medication will the PMHNP prescribe
for this patient?
A. Phenobarbital (Luminal)
B. Methadone (Dolophine)
C. Naloxone (Narcan)
D. Clonidine (Catapres)
QUESTION 70
A patient diagnosed with
obsessive compulsive disorder has been taking a high-dose SSRI and is
participating in therapy twice a week. He reports an inability to carry out
responsibilities due to consistent interferences of his obsessions and
compulsions. The PMHNP knows that the next step would be which of the
following?
A. Decrease his SSRI and
add buspirone (Buspar).
B. Decrease his SSRI and
add an MAOI.
C. Decrease his SSRI
steadily until it can be discontinued then try an antipsychotic to manage his
symptoms.
D. Keep his SSRI dosage the
same and add a low-dose TCA.
QUESTION 71
The PMHNP is assessing a
patient who will be receiving phentermine (Adipex-P)/topiramate (Topamax)
(Qsymia). Which of the following conditions/diseases will require further
evaluation before this medication can be prescribed?
A. Kidney disease stage II
B. Obesity
C. Cardiovascular disease
D. Diabetes type II
QUESTION 72
The PMHNP prescribes an
obese patient phentermine (Adipex-p)/topiramate ER (Topamax) (Qsymia), Why is
topiramate (Topamax) often prescribed with phentermine (Adipex-P)?
A. Phentermine (Adipex-P)
dose can be increased safely when taken with an anticonvulsant.
B. Phentermine (Adipex-P)
works by suppressing appetite while topiramate (Topamax) acts by inhibiting
appetite.
C. Topiramate (Topamax)
potentiates appetite suppression achieved by phentermine (Adipex-P).
D. Topiramate (Topamax)
helps prevent the unwanted side effects of phentermine (Adipex-P).
QUESTION 73
The PMHNP is assessing a
patient who has expressed suicidal intent and is now stating that he is hearing
voices and sees people chasing him. The PMHNP identifies these symptoms to be
associated with which of the following?
A. Barbiturate intoxication

B. Marijuana intoxication
C. “Bath salt” intoxication

D. Cocaine intoxication
QUESTION 74
The PMHNP is caring for a
patient who openly admitted to drinking a quart of vodka daily. Prior to
prescribing this patient disulfiram (Antabuse), it is important for the PMHNP
to:
A. Evaluate the patient’s
willingness to abstain from alcohol
B. Counsel the patient on
dietary restrictions
C. Obtain liver function
tests
D. Assess for addiction to
opioids
QUESTION 75 An opioid-naive
patient is taking MS Contin (morphine sulfate) to treat his pain that is
secondary to cancer. Under what circumstances would the PMHNP order naloxone
(Narcan) IM/SQ?
A. The patient’s speech is
slurred, and he is in and out of sleep.
B. The patient’s appetite
has decreased from eating 100% of his meal to 50% of his meal.
C. The patient complains of
not having a bowel movement for 4 days.
D. The patient’s vital
signs are 98.4F temp, 88 pulse, 104/62 blood pressure, and 8 respirations.
QUESTION 76
When completing this exam,
did you comply with Walden University’s Code of Conduct including the
expectations for academic integrity?
Yes
No

NURS3020 Health
Assessment
WEEK 5 Assignment
Digital Clinical Experience: Musculoskeletal and
Neurological Systems
To Prepare
Review this week’s Resources.
Review the Shadow Health Assignments Grading Rubric provided
in the Course Information area or accessible through the link below for details
on completing the Assignments in Shadow Health.
By Day 7
Complete the following in Shadow Health:
Musculoskeletal Exam (90 min)
Neurological Exam (90 min)