Nurs6052Quantitative Research Designs

Week 6 discussion
Validity in Quantitative Research Designs
Validity in research refers to
the extent researchers can be confident that the cause and effect they identify
in their research are in fact causal relationships. If there is low validity in
a study, it usually means that the research design is flawed and the results
will be of little or no value. Four different aspects of validity should be
considered when reviewing a research design: statistical conclusion validity,
internal validity, construct validity, and external validity. In this
Discussion, you consider the importance of each of these aspects in judging the
validity of quantitative research.
To prepare:
Review the information in Chapter
10 of the course text on rigor and validity.
Read the method section of one of
the following quasi-experimental studies (also located in this week’s Learning
Resources). Identify at least one potential concern that could be raised about
the study’s internal validity.
Metheny, N. A., Davis-Jackson,
J., & Stewart, B. J. (2010). Effectiveness of an aspiration risk-reduction
protocol. Nursing Research, 59(1), 18–25.
Padula, C. A., Hughes, C., &
Baumhover, L. (2009). Impact of a nurse-driven mobility protocol on functional
decline in hospitalized older adults. Journal of Nursing Care Quality, 24(4),
325–331.
Yuan, S., Chou, M., Hwu, L.,
Chang, Y., Hsu, W., & Kuo, H. (2009). An intervention program to promote
health-related physical fitness in nurses. Journal of Clinical Nursing, 18(10),
1,404–1,411.
Consider strategies that could be
used to strengthen the study’s internal validity and how this would impact the
three other types of validity.
Think about the consequences of
an advanced practice nurse neglecting to consider the validity of a research
study when reviewing the research for potential use in developing an
evidence-based practice.
By Day 3
Post the title of the study that
you selected and your analysis of the potential concerns that could be raised
about the study’s internal validity. Propose recommendations to strengthen the
internal validity and assess the effect your changes could have with regard to
the other three types of validity. Discuss the dangers of failing to consider
the validity of a research study.
Read a selection of your
colleagues’ responses.
By Day 6
Respond to at least two of your
colleagues in one or more of the following ways:
Ask a probing question,
substantiated with additional background information, and evidence.
Share an insight from having read
your colleagues’ postings, synthesizing the information to provide new
perspectives.
Offer and support an alternative
perspective using readings from the classroom or from your own review of the
literature in the Walden Library.
Validate an idea with your own
experience and additional sources.
Make a suggestion based on
additional evidence drawn from readings or after synthesizing multiple
postings.
Expand on your colleagues’
postings by providing additional insights or contrasting perspectives based on
readings and evidence.

Quantitative Research

Nurs6052 week 5 discussion latest

Week 5 discussion
Quantitative Research
Designs
In order to find the best information on a topic, not only
should you develop a question and search for resources, but you should also
know how to analyze the value of the resources that you identify. There are
different ways to evaluate resources, such as using the hierarchy of evidence,
which you explored in Week 4 of this course. Another way to evaluate resources
is to consider the appropriateness of the research design. Understanding how
research designs contribute to the quality of a study is essential for being
able to analyze resources when conducting a literature review or locating
evidence for practice.
In this Discussion, you consider the different research
designs and evaluate how these designs have been used to research a specific
topic. You also consider strategies for selecting an appropriate research design.
To prepare:
Review the information in the course texton quantitative
research designs. Focus on the information in Box 9.1, “Guidelines for
Critiquing Research Designs in Quantitative Studies” located on page 230 of the
course text.
Select a topic from the list below and search the Walden
Library to find two different quantitative research studies addressing that
issue:
Caregiver stress
Anxiety in children
Sleep apnea
Depression in college freshmen
Rural health care issues
Post-traumatic stress syndrome
Traumatic brain injury in veterans
Health effects of environmental contaminants
Bipolar disorder
End-of-life ethical issues
Alternative medicine
For each of the sources that you select, identify the type
of quantitative research design used, and evaluate whether it is the most
appropriate approach to the research.
Consider the ramifications of choosing an inappropriate
design for a research study.
By Day 3
Post the topic you selected, references for the two sources
you identified, and the quantitative research design used in each. Critique the
appropriateness of the design used and justify your comments with information
from the Learning Resources. Discuss the ramifications of choosing an
inappropriate design for a research study.
Read a selection of your colleagues’ responses.
By Day 6
Respond to at least two of your colleagues on two different
days in one or more of the following ways:
Ask a probing question, substantiated with additional
background information, and evidence.
Share an insight from having read your colleagues’ postings,
synthesizing the information to provide new perspectives.
Offer and support an alternative perspective using readings
from the classroom or from your own review of the literature in the Walden
Library.
Make a suggestion based on additional evidence drawn from
readings or after synthesizing multiple postings.

ADDITIONAL INSTRUCTIONS FOR THE CLASS

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• Discussion Questions (DQ)

Initial responses to the DQ should address all components of the questions asked, including a minimum of one scholarly source, and be at least 250 words. Successful responses are substantive (i.e., add something new to the discussion, engage others in the discussion, well-developed idea) and include at least one scholarly source. One or two-sentence responses, simple statements of agreement or “good post,” and responses that are off-topic will not count as substantive. Substantive responses should be at least 150 words. I encourage you to incorporate the readings from the week (as applicable) into your responses.

• Weekly Participation

Your initial responses to the mandatory DQ do not count toward participation and are graded separately. In addition to the DQ responses, you must post at least one reply to peers (or me) on three separate days, for a total of three replies. Participation posts do not require a scholarly source/citation (unless you cite someone else’s work). Part of your weekly participation includes viewing the weekly announcement and attesting to watching it in the comments. These announcements are made to ensure you understand everything that is due during the week.

• APA Format and Writing Quality

Familiarize yourself with the APA format and practice using it correctly. It is used for most writing assignments for your degree. Visit the Writing Center in the Student Success Center, under the Resources tab in Loud-cloud for APA paper templates, citation examples, tips, etc. Points will be deducted for poor use of APA format or absence of APA format (if required). Cite all sources of information! When in doubt, cite the source. Paraphrasing also requires a citation. I highly recommend using the APA Publication Manual, 6th edition.

• Use of Direct Quotes

I discourage over-utilization of direct quotes in DQs and assignments at the Master’s level and deduct points accordingly. As Masters’ level students, it is important that you be able to critically analyze and interpret information from journal articles and other resources. Simply restating someone else’s words does not demonstrate an understanding of the content or critical analysis of the content. It is best to paraphrase content and cite your source.

• LopesWrite Policy

For assignments that need to be submitted to Lopes Write, please be sure you have received your report and Similarity Index (SI) percentage BEFORE you do a “final submit” to me. Once you have received your report, please review it. This report will show you grammatical, punctuation, and spelling errors that can easily be fixed. Take the extra few minutes to review instead of getting counted off for these mistakes. Review your similarities. Did you forget to cite something? Did you not paraphrase well enough? Is your paper made up of someone else’s thoughts more than your own? Visit the Writing Center in the Student Success Center, under the Resources tab in Loud-cloud for tips on improving your paper and SI score.

• Late Policy

The university’s policy on late assignments is a 10% penalty PER DAY LATE. This also applies to late DQ replies. Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances. If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect. I do not accept assignments that are two or more weeks late unless we have worked out an extension. As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading.

• Communication

Communication is so very important. There are multiple ways to communicate with me: Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class. Individual Forum: This is a private forum to ask me questions or send me messages. This will be checked at least once every 24 hours.

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Nurs6052 Nursing Research

Week 1 discussion
Nursing Research and
Evidence-Based Practice
In your practice as a nurse, you may use procedures and
methods that did not necessarily originate in evidence, but instead were
derived from informal and unwritten conventions, traditions, and observations.
While these techniques may have merit, practices are constantly being updated
and contradicted by information from scholarly research studies and
professional guidelines. This new information serves as “evidence” for revising
practices to improve outcomes across health care.
Based on this evidence, you can formulate a question. In
this Discussion, you consider the use of evidence-based practice in your own
organization and formulate a question that you will need to answer for your
portfolio project. This is called a PICOT question. You will also investigate
strategies for overcoming barriers to implementing evidence-based practice
(EBP).
To prepare:
Consider a recent clinical experience in which you were
providing care for a patient.
Determine the extent to which the care that you provided was
based on evidence and research findings or supported only by your
organization’s standard procedures. How do you know if the tasks were based on
research?
What questions have you thought about in a particular area
of care such as a procedure or policy?
Review Chapter 2, pages 36—39 on “Asking Well worded
Clinical Questions” in Polit & Beck and consult the resource from the
Walden Student Center for Success: Clinical Question Anatomy & examples of
PICOT questions (found in this week’s Learning Resources). Formulate your
background questions and PICOT question.
Reflect on the barriers that might inhibit the
implementation of evidence-based practice in your clinical environment.
Review the article “Adopting Evidence-Based Practice in
Clinical Decision Making” in this week’s Learning Resources. Select one of the
barriers described that is evident in your organization and formulate a plan
for overcoming this barrier.
By Day 3
Post an evaluation of the use, or lack thereof, of EBP in a
recent clinical experience. Identify which aspects of the care delivered, if
any, were based on evidence and provide your rationale. List your background
questions and PICOT question about this nursing topic. Critique how the
policies, procedures, and culture in your organization may hinder or support
the adoption of evidence-based practices. Identify the barrier you selected
from the article and explain how this barrier could be overcome within your
organization.
Read a selection of your colleagues’ responses.
By Day 6
Respond to at least two of your colleagues on two different
days using one or more of the following approaches:
Ask a probing question, substantiated with additional
background information, and evidence.
Share an insight from having read your colleagues’ postings,
synthesizing the information to provide new perspectives.
Validate an idea with your own experience and additional
sources.
Make a suggestion based on additional evidence drawn from
readings or after synthesizing multiple postings.
Expand on your colleagues’ postings by providing additional
strategies for addressing barriers to EBP based on readings and evidence.

ADDITIONAL INSTRUCTIONS FOR THE CLASS

SCORE A+ WITH HELP FROM OUR PROFESSIONAL WRITERS: ORDER NOW FOR AN ORIGINAL PAPER ASSIGNMENT

We will process your orders through multiple stages and checks to ensure that what we are delivering to you, in the end, is something that is precise as you envisioned it. All of our essay writing service products are 100% original, ensuring that there is no plagiarism in them. The sources are well-researched and cited so it is interesting. Our goal is to help as many students as possible with their assignments, i.e. our prices are affordable and services premium.

• Discussion Questions (DQ)

Initial responses to the DQ should address all components of the questions asked, including a minimum of one scholarly source, and be at least 250 words. Successful responses are substantive (i.e., add something new to the discussion, engage others in the discussion, well-developed idea) and include at least one scholarly source. One or two-sentence responses, simple statements of agreement or “good post,” and responses that are off-topic will not count as substantive. Substantive responses should be at least 150 words. I encourage you to incorporate the readings from the week (as applicable) into your responses.

• Weekly Participation

Your initial responses to the mandatory DQ do not count toward participation and are graded separately. In addition to the DQ responses, you must post at least one reply to peers (or me) on three separate days, for a total of three replies. Participation posts do not require a scholarly source/citation (unless you cite someone else’s work). Part of your weekly participation includes viewing the weekly announcement and attesting to watching it in the comments. These announcements are made to ensure you understand everything that is due during the week.

• APA Format and Writing Quality

Familiarize yourself with the APA format and practice using it correctly. It is used for most writing assignments for your degree. Visit the Writing Center in the Student Success Center, under the Resources tab in Loud-cloud for APA paper templates, citation examples, tips, etc. Points will be deducted for poor use of APA format or absence of APA format (if required). Cite all sources of information! When in doubt, cite the source. Paraphrasing also requires a citation. I highly recommend using the APA Publication Manual, 6th edition.

• Use of Direct Quotes

I discourage over-utilization of direct quotes in DQs and assignments at the Master’s level and deduct points accordingly. As Masters’ level students, it is important that you be able to critically analyze and interpret information from journal articles and other resources. Simply restating someone else’s words does not demonstrate an understanding of the content or critical analysis of the content. It is best to paraphrase content and cite your source.

• LopesWrite Policy

For assignments that need to be submitted to Lopes Write, please be sure you have received your report and Similarity Index (SI) percentage BEFORE you do a “final submit” to me. Once you have received your report, please review it. This report will show you grammatical, punctuation, and spelling errors that can easily be fixed. Take the extra few minutes to review instead of getting counted off for these mistakes. Review your similarities. Did you forget to cite something? Did you not paraphrase well enough? Is your paper made up of someone else’s thoughts more than your own? Visit the Writing Center in the Student Success Center, under the Resources tab in Loud-cloud for tips on improving your paper and SI score.

• Late Policy

The university’s policy on late assignments is a 10% penalty PER DAY LATE. This also applies to late DQ replies. Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances. If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect. I do not accept assignments that are two or more weeks late unless we have worked out an extension. As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading.

• Communication

Communication is so very important. There are multiple ways to communicate with me: Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class. Individual Forum: This is a private forum to ask me questions or send me messages. This will be checked at least once every 24 hours.

• Guarantee

• Zero Plagiarism
• On-time delivery
• A-Grade Papers
• Free Revision
• 24/7 Support
• 100% Confidentiality
• Professional Writers

• Services Offered

• Custom paper writing
• Question and answers
• Essay paper writing
• Editing and proofreading
• Plagiarism removal services
• Multiple answer questions

We will process your orders through multiple stages and checks to ensure that what we are delivering to you, in the end, is something that is precise as you envisioned it. All of our essay writing service products are 100% original, ensuring that there is no plagiarism in them. The sources are well-researched and cited so it is interesting. Our goal is to help as many students as possible with their assignments, i.e. our prices are affordable and services premium.

Looking for a Similar Assignment? Order a custom-written, plagiarism-free paper

NURS6521 Full Course

NURS6521 Advanced Pharmacology Week 1 Forum Pharmacokinetics and Pharmacodynamics
As an advanced practice nurse assisting physicians in diagnosing and treating disorders, it is important to understand not only the impact of disorders on the body, but also the impact of drug treatments on the body. Pharmacokinetics and pharmacodynamics can describe the relationships between drugs and the body.
Pharmacokinetics describes what the body does to the drug through absorption, distribution, metabolism, and excretion, whereas pharmacodynamics describes what the drug does to the body.
Photo Credit: Getty Images/Ingram Publishing
When selecting drugs and determining dosages for patients, it is essential to consider individual patient factors that might impact the patient’s pharmacokinetic and pharmacodynamic processes. These patient factors include genetics, gender, ethnicity, age, behavior (i.e., diet, nutrition, smoking, alcohol, illicit drug abuse), and/or pathophysiological changes due to disease.
For this Discussion, you reflect on a case from your past clinical experiences and consider how a patient’s pharmacokinetic and pharmacodynamic processes may alter his or her response to a drug.
To Prepare
Review the Resources for this module and consider the principles of pharmacokinetics and pharmacodynamics.
Reflect on your experiences, observations, and/or clinical practices from the last 5 years and think about how pharmacokinetic and pharmacodynamic factors altered his or her anticipated response to a drug.
Consider factors that might have influenced the patient’s pharmacokinetic and pharmacodynamic processes, such as genetics (including pharmacogenetics), gender, ethnicity, age, behavior, and/or possible pathophysiological changes due to disease.
Think about a personalized plan of care based on these influencing factors and patient history in your case study.
By Day 3 of Week 1
Post a patient case description from your experiences, observations, and/or clinical practice from the last 5 years. Then, describe factors that might have influenced the pharmacokinetic and pharmacodynamic processes of the patient you identified. Finally, explain details of the personalized plan of care that you would develop based on influencing factors and patient history in your case. Be specific and provide examples.
By Day 6 of Week 1
Read a selection of your colleagues’ responses and respond to at least two of your colleagues on two different days by suggesting additional patient factors that might have interfered with the pharmacokinetic and pharmacodynamic processes of the patients they described. In addition, suggest how the personalized plan of care might change if the age of the patient were different and/or if the patient had a comorbid condition, such as renal failure, heart failure, or liver failure.

NURS6521 Advanced Pharmacology Week 5 Forum Diabetes and Drug Treatments
Each year, 1.5 million Americans are diagnosed with diabetes (American Diabetes Association, 2019). If left untreated, diabetic patients are at risk for several alterations, including heart disease, stroke, kidney failure, neuropathy, and blindness. There are various methods for treating diabetes, many of which include some form of drug therapy. The type of diabetes as well as the patient’s behavior factors will impact treatment recommendations.
For this Discussion, you compare types of diabetes, including drug treatments for type 1, type 2, gestational, and juvenile diabetes.
Reference: American Diabetes Association. (2019). Statistics about diabetes. Retrieved from http://diabetes.org/diabetes-basics/statistics/
To Prepare
Review the Resources for this module and reflect on differences between types of diabetes, including type 1, type 2, gestational, and juvenile diabetes.
Select one type of diabetes to focus on for this Discussion.
Consider one type of drug used to treat the type of diabetes you selected, including proper preparation and administration of this drug. Then, reflect on dietary considerations related to treatment.
Think about the short-term and long-term impact of the diabetes you selected on patients, including effects of drug treatments.
By Day 3 of Week 5
Post a brief explanation of the differences between the types of diabetes, including type 1, type 2, gestational, and juvenile diabetes. Describe one type of drug used to treat the type of diabetes you selected, including proper preparation and administration of this drug. Be sure to include dietary considerations related to treatment. Then, explain the short-term and long-term impact of this type of diabetes on patients. including effects of drug treatments. Be specific and provide examples.
By Day 6 of Week 5
Read a selection of your colleagues’ responses and respond to at least two of your colleagues on two different days who selected a different type of diabetes than you did. Provide recommendations for alternative drug treatments and patient education strategies for treatment and management.

NURS6521 Advanced Pharmacology Week 8 Forum Decision-Making When Treating Psychological Disorders
Psychological disorders, such as depression, bipolar, and anxiety disorders can present several complications for patients of all ages. These disorders affect patients physically and emotionally, potentially impacting judgment, school and/or job performance, and relationships with family and friends. Since these disorders have many drastic effects on patients’ lives, it is important for advanced practice nurses to effectively manage patient care. With patient factors and medical history in mind, it is the advanced practice nurse’s responsibility to ensure the safe and effective diagnosis, treatment, and education of patients with psychological disorders.
Photo Credit: Getty Images/iStockphoto
For this Discussion, you will select an interactive media piece to practice decision-making when treating patients with psychological disorders. You will recommend the most effective pharmacotherapeutic to treat the psychological disorder presented and examine the potential impacts of pharmacotherapeutics on a patient’s pathophysiology.
To Prepare
Review this week’s interactive media pieces and select one to focus on for this Discussion.
Reflect on the decision steps in the interactive media pieces, and consider the potential impacts of the administration of the associated pharmacotherapeutics on the patient’s pathophysiology.
By Day 3 of Week 8
Post a brief explanation of the psychological disorder presented and the decision steps you applied in completing the interactive media piece for the psychological disorder you selected. Then, explain how the administration of the associated pharmacotherapeutics you recommended may impact the patient’s pathophysiology. How might these potential impacts inform how you would suggest treatment plans for this patient? Be specific and provide examples.
By Day 6 of Week 8
Read a selection of your colleagues’ responses and respond to at least two of your colleagues on two different days who selected a different interactive media piece on a psychological disorder, and provide recommendations for alternative drug treatments to address the patient’s pathophysiology.

NURS6521 Advanced Pharmacology Week 9 Forum Women’s and Men’s Health, Infectious Disease, and Hematologic Disorders
As an advanced practice nurse, you will likely experience patient encounters with complex comorbidities. For example, consider a female patient who is pregnant who also presents with hypertension, diabetes, and has a recent tuberculosis infection. How might the underlying pathophysiology of these conditions affect the pharmacotherapeutics you might recommend to help address your patient’s health needs? What education strategies might you recommend for ensuring positive patient health outcomes?
For this Discussion, you will be assigned a patient case study and will consider how to address the patient’s current drug therapy plans. You will then suggest recommendations on how to revise these drug therapy plans to ensure effective, safe, and quality patient care for positive patient health outcomes
Photo Credit: Getty Images
To Prepare
Review the Resources for this module and reflect on the different health needs and body systems presented.
Your Instructor will assign you a complex case study to focus on for this Discussion.
Consider how you will practice critical decision-making for prescribing appropriate drugs and treatment to address the complex patient health needs in the patient case study you selected.
By Day 3 of Week 9
Post a brief description of your patient’s health needs from the patient case study you assigned. Be specific. Then, explain the type of treatment regimen you would recommend for treating your patient, including the choice or pharmacotherapeutics you would recommend, and explain why. Be sure to justify your response. Explain a patient education strategy you might recommend for assisting your patient with the management of their health needs. Be specific and provide examples.

NURS6521 Advanced Pharmacology Week 1 Assignment Ethical and Legal Implications of Prescribing Drugs
What type of drug should you prescribe based on your patient’s diagnosis? How much of the drug should the patient receive? How often should the drug be administered? When should the drug not be prescribed? Are there individual patient factors that could create complications when taking the drug? Should you be prescribing drugs to this patient? How might different state regulations affect prescribing this drug to this patient?
These are some of the questions you might consider when selecting a treatment plan for a patient.
Photo Credit: Getty Images/Caiaimage
As an advanced practice nurse prescribing drugs, you are held accountable for people’s lives every day. Patients and their families will often place trust in you because of your position. With this trust comes power, responsibility, and an ethical and legal obligation to “do no harm.” It is important that you are aware of current professional, legal, and ethical standards for advanced practice nurses with prescriptive authority. Additionally, it is important to ensure that the treatment plans and administration/prescribing of drugs is in accordance with the regulations of the state in which you practice. Understanding how these regulations may affect the prescribing of certain drugs in different states may have a significant impact on your patient’s treatment plan. In this Assignment, you explore ethical and legal implications of scenarios and consider how to appropriately respond.
To Prepare
Review the Resources for this module and consider the legal and ethical implications of prescribing prescription drugs, disclosure, and nondisclosure.
Review the scenario assigned by your Instructor for this Assignment.
Search specific laws and standards for prescribing prescription drugs and addressing medication errors for your state or region, and reflect on these as you review the scenario your instructor assigned.
Consider the ethical and legal implications of the scenario for all stakeholders involved, such as the prescriber, pharmacist, patient, and patient’s family.
Consider two strategies that you would use as an advanced practice nurse to guide your ethically and legally responsible decision-making in this scenario, including whether you would disclose any medication errors.
By Day 7 of Week 1
Write a 2- to 3-page paper that addresses the following:
Explain the ethical and legal implications of the scenario you selected on all stakeholders involved, such as the prescriber, pharmacist, patient, and patient’s family.
Describe strategies to address disclosure and nondisclosure as identified in your selected scenario. Be sure to reference laws specific to your state.
Explain two strategies that you would use as an advanced practice nurse to guide your decision-making in this scenario, including whether you would disclose your error. Be sure to justify your explanation.
Explain the process of writing prescriptions, including strategies to minimize medication errors.

NURS6521 Advanced Pharmacology Week 2 Assignment Pharmacotherapy for Cardiovascular Disorders
..heart disease remains the No. 1 killer in America; nearly half of all Americans have high blood pressure, high cholesterol, or smoke—some of the leading risk factors for heart disease…
—Murphy et al., 2018
Despite the high mortality rates associated with cardiovascular disorders, improved treatment options do exist that can help address those risk factors that afflict the majority of the population today.
Photo Credit: Getty Images/Science Photo Library RF
As an advanced practice nurse, you must recommend appropriate treatment options for patients with cardiovascular disorders. To ensure the safety and effectiveness of drug therapy, advanced practice nurses must consider aspects that might influence pharmacokinetic and pharmacodynamic processes such as medical history, other drugs currently prescribed, and individual patient factors.
Reference: Murphy, S. L., Xu, J., Kochanek, K. D., & Arias, E. (2018). Mortality in the United States, 2017. Retrieved from /orders/www.cdc.gov/nchs/products/databriefs/db328.htm
To Prepare
Review the Resources for this module and consider the impact of potential pharmacotherapeutics for cardiovascular disorders introduced in the media piece.
Review the case study assigned by your Instructor for this Assignment.
Select one the following factors: genetics, gender, ethnicity, age, or behavior factors.
Reflect on how the factor you selected might influence the patient’s pharmacokinetic and pharmacodynamic processes.
Consider how pharmacokinetic and pharmacodynamic processes changes might impact the patient’s recommended drug therapy.
Think about how you might improve the patient’s drug therapy plan based on the pharmacokinetic and pharmacodynamic changes. Reflect on whether you would modify the current drug treatment or provide an alternative treatment option for the patient.
By Day 7 of Week 2
Write a 2- to 3-page paper that addresses the following:
Explain how the factor you selected might influence the pharmacokinetic and pharmacodynamic processes in the patient from the case study you were assigned.
Describe how changes in the processes might impact the patient’s recommended drug therapy. Be specific and provide examples.
Explain how you might improve the patient’s drug therapy plan and explain why you would make these recommended improvements.

NURS6521 Advanced Pharmacology Week 3 Assignment Asthma and Stepwise Management
Asthma is a respiratory disorder that affects children and adults. Advanced practice nurses often provide treatment to patients with these disorders. Sometimes patients require immediate treatment, making it essential that you recognize and distinguish minor asthma symptoms from serious, life-threatening ones. Since triggers often induce symptoms and attacks, advanced practice nurses must also help patients identify triggers and recommend appropriate management options. Like many other disorders, various approaches to treating and managing care for asthmatic patients depend on individual patient factors.
Photo Credit: Getty Images
One method that supports the clinical decision-making of drug therapy plans for asthmatic patients is the stepwise approach, which you explore in this Assignment.
To Prepare
Reflect on drugs used to treat asthmatic patients, including long-term control and quick relief treatment options for patients. Consider these drugs’ impact on patients, including adults and children.
Consider how you might apply the stepwise approach to address a patient’s health needs in your practice.
Reflect on how stepwise management assists healthcare providers and patients in gaining and maintaining disease control.
By Day 7 of Week 3
Create a 5- to 6-slide PowerPoint presentation that can be used in a staff development meeting on presenting different approaches for implementing the stepwise approach for asthma treatment. Be sure to address the following:
Describe long-term control and quick relief treatment options for the asthma patient from your practice as well as the impact these drugs might have on your patient.
Explain the stepwise approach to asthma treatment and management for your patient.
Explain how stepwise management assists healthcare providers and patients in gaining and maintaining disease control. Be specific.

NURS6521 Advanced Pharmacology Week 4 Assignment Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders
Gastrointestinal (GI) and hepatobiliary disorders affect the structure and function of the GI tract. Many of these disorders often have similar symptoms, such as abdominal pain, cramping, constipation, nausea, bloating, and fatigue. Since multiple disorders can be tied to the same symptoms, it is important for advanced practice nurses to carefully evaluate patients and prescribe a treatment that targets the cause rather than the symptom.
Once the underlying cause is identified, an appropriate drug therapy plan can be recommended based on medical history and individual patient factors. In this Assignment, you examine a case study of a patient who presents with symptoms of a possible GI/hepatobiliary disorder, and you design an appropriate drug therapy plan.
To Prepare
Review the case study assigned by your Instructor for this Assignment
Reflect on the patient’s symptoms, medical history, and prescribed drugs.
Think about a possible diagnosis for the patient. Consider whether the patient has a disorder related to the gastrointestinal and hepatobiliary system or whether the symptoms result from a disorder from another system or other factors, such as pregnancy, drugs, or a psychological disorder.
Consider an appropriate drug therapy plan based on the patient’s history, diagnosis, and drugs currently prescribed.
By Day 7 of Week 4
Write a 1-page paper that addresses the following:
Explain your diagnosis for the patient, including your rationale for the diagnosis.
Describe an appropriate drug therapy plan based on the patient’s history, diagnosis, and drugs currently prescribed.
Justify why you would recommend this drug therapy plan for this patient. Be specific and provide examples.

NURS6521 Advanced Pharmacology Week 8 Assignment Decision Tree for Neurological and Musculoskeletal
For your Assignment, your Instructor will assign you one of the decision tree interactive media pieces provided in the Resources. As you examine the patient case studies in this module’s Resources, consider how you might assess and treat patients presenting symptoms of neurological and musculoskeletal disorders.
Photo Credit: Getty Images/Science Photo Library RF
To Prepare
Review the interactive media piece assigned by your Instructor.
Reflect on the patient’s symptoms and aspects of the disorder presented in the interactive media piece.
Consider how you might assess and treat patients presenting with the symptoms of the patient case study you were assigned.
You will be asked to make three decisions concerning the diagnosis and treatment for this patient. Reflect on potential co-morbid physical as well as patient factors that might impact the patient’s diagnosis and treatment.
By Day 7 of Week 8
Write a 1- to 2-page summary paper that addresses the following:
Briefly summarize the patient case study you were assigned, including the three decisions you made for the patient presented.
Based on the decisions you recommended for the patient case study, explain whether you believe the evidence-based literature supported the decisions provided. Be specific and provide examples. Be sure to support your response with evidence and references from outside resources.
What were you hoping to achieve with the decisions you recommended for the patient case study you were assigned? Support your response with evidence and references from outside resources.
Explain any difference between what you expected to achieve with each of the decisions and the results of the decision in the exercise. Describe whether they were different. Be specific and provide examples.

NURS6521 Advanced Pharmacology Week 11 Assignment Off-Label Drug Use in Pediatrics
The unapproved use of approved drugs, also called off-label use, with children is quite common. This is because pediatric dosage guidelines are typically unavailable since very few drugs have been specifically researched and tested with children.
When treating children, prescribers often adjust dosages approved for adults to accommodate a child’s weight. However, children are not just “smaller” adults. Adults and children process and respond to drugs differently in their absorption, distribution, metabolism, and excretion.
Children even respond differently during stages from infancy to adolescence. This poses potential safety concerns when prescribing drugs to pediatric patients. As an advanced practice nurse, you have to be aware of the safety implications of the off-label use of drugs with this patient group.
To Prepare
Review the interactive media piece in this week’s Resources and reflect on the types of drugs used to treat pediatric patients with mood disorders.
Reflect on situations in which children should be prescribed drugs for off-label use.
Think about strategies to make the off-label use and dosage of drugs safer for children from infancy to adolescence. Consider specific off-label drugs that you think require extra care and attention when used in pediatrics.
By Day 5 of Week 11
Write a 1-page narrative in APA format that addresses the following:
Explain the circumstances under which children should be prescribed drugs for off-label use. Be specific and provide examples.
Describe strategies to make the off-label use and dosage of drugs safer for children from infancy to adolescence. Include descriptions and names of off-label drugs that require extra care and attention when used in pediatrics.

NURS6521 Advanced Pharmacology Week 7 Exam
Question 1A patient taking Metformin (Glucophage) is scheduled for a cardiac cath. The patient asks why he can’t take his metformin the day of the test. What is the most appropriate reply?
Answers:
Metformin interacts with the dye used in the test.  You can take the Metformin starting the day after the test.
You can develop lactic acidosis if you take metformin and are given dye.  You should have a serum creatinine drawn before restarting the medication.
The combination of metformin and the dye stimulates the liver to release insulin causing hypoglycemia.  You can restart the metformin 48 hours after the test.
Dye is a cytochrome system inducer that affects metformin.   You should wait 3 days before restarting the metform so you don’t develop a toxic level of the drug.
Question 2
A child is prescribed an inhaled corticosteroid agent to decrease respiratory inflammation related to exposure to an animal. The patient’s parent administers a higher than prescribe dose of the medication for 5 days. What should the APRN monitor the child for?
Answers:
tachycardia
adrenal insufficiency
hypokalemia
hypoglycemia
Question 3
Mr. Lacuna is an 83-year-old resident of a long-term care facility diagnosed with moderate Alzheimer’s disease. Mr. Lacuna’s physician recently prescribed oral rivastigmine, but he could not tolerate the drug due to its gastrointestinal effects. As a result, he has been ordered the transdermal patch form of the medication. When administering this form of rivastigmine, the nurse should
Answers:
teach Mr. Lacuna about the importance of rotating sites when he applies the patch.
teach Mr. Lacuna’s family to apply a second patch if they notice an acute exacerbation of his confusion.
apply the patch to Mr. Lacuna’s back to reduce the chance that he will remove it.
apply the patch to a mucous membrane to facilitate complete absorption.
Question 4
A 53-year-old man has been treated for severe asthma for several years with prednisone. Recently, his physician initiated alternate-day therapy for him. The patient tells the nurse that he would rather take the medication every day to prevent confusion. Which of the following would be the best response by the nurse?
Answers:
“This schedule will be more convenient for you.”
“This schedule will enable you to lose weight.”
“This schedule will decrease the cost of your medication.”
“This schedule allows rest periods so that adverse effects are decreased but the anti-inflammatory effects continue.”
Question 5
John is a newly diagnosed diabetic that contacts the office  with complaints of severe nausea and vomiting.  What instructions should the APRN provide related to his insulin doses?
Answers:
I will call in a prescription for metformin for you to take in place of your insulin.
Monitor your blood sugar every 4  hours and take regular insulin based on the blood sugar reading.
Stop your insulin while you are not eating and restart it at half strength when you can keep liquids down.
There is no need to change your insulin dosage while sick.  Continue your regular doses
Question 6During a clinic visit, a patient complains of having frequent muscle cramps in her legs. The nurse’s assessment reveals that the patient has been taking over-the-counter laxatives for the past 7 years. The nurse informed the patient that prolonged use of laxatives
Answers:
may cause nutrient deficiencies.
may counter the therapeutic effect of other drugs.
causes acidic urine and urinary tract infections.
inhibits the biotransformation of drugs.
Question 7
Which of the following statements best defines how a chemical becomes termed a drug?
Answers:
To become a drug, a chemical must have a proven therapeutic value or efficacy without severe toxicity or damaging properties.
A chemical becomes a drug when it is introduced into the body to cause a change.
A chemical is considered a drug when the Food and Drug Administration (FDA) approves its release to be marketed.
A chemical must have demonstrated therapeutic value to become a drug.
Question 8 The Nurse Practitioner’s assessment of a community-dwelling adult suggests that the client may have drug allergies that have not been previously documented. What statement by the client would confirm this?
Answers:
“I tend to get sick in the stomach when I take antibiotics.”
“I’ve been told that aspirin might have caused my stomach bleed a few years back.”
“I broke out in hives and got terribly itchy when I started a new prescription last year.”
“When I fell last year, the doctor said that it might have been because of my blood pressure pills.”
Question 9
A Nurse Practitioner is teaching an older adult patient about polypharmacy. Which of the following statements best describe this term?
Answers:
Taking more than one drug when the patient deems it necessary
Taking several drugs simultaneously
Increasing the dosage of a drug by the patient
Taking one drug one day and another drug the next day
Question 10
A 33-year-old woman has irritable bowel syndrome (IBS). The physician has prescribed simethicone (Mylicon) for her discomfort. Which of the following will the nurse monitor most closely during the patient’s drug therapy?
Answers:
Drug toxicity
Anorexia
Increased abdominal pain and vomiting
Increased urine output
Question 11
Decongestants are recommended to use in which of the following patients?
Answers:
patients with otitis media
patients with coronary artery disease
patients taking monoamine oxidase inhibitors
patients with hypertension
Question 12
A 70-year-old woman with a history of atrial fibrillation takes digoxin and verapamil to control her health problem. Verapamil achieves a therapeutic effect by
Answers:
blocking adrenergic receptors and producing antisympathetic effects.
inhibiting the movement of calcium ions across the cardiac muscle cell membrane.
decreasing sodium and potassium conduction.
weakening diastolic depolarization and the action potential duration.
Question 13
Mrs. Houston is a 78-year-old woman who resides in an assisted living facility. Her doctor prescribed digoxin at her last visit to the clinic and she has approached the nurse who makes regular visits to the assisted-living facility about this new drug. What teaching point should the nurse emphasize to Mrs. Houston?
Answers:
The importance of having required laboratory work performed on time
The need to take the medication at the same time each day regardless of her heart rate
The  technique for using a home blood pressure cuff
Timing household activities to coincide with the administration times of her digoxin
Question 14
The Nurse Practitioner is treating a patient taking frequent doses of antacids for his heartburn and taking an enteric coded aspirin.  What instructions should be provided to the patient?
Answers:
The aspirin is less effective when taken with an antacid so you need to increase the dose.
There is no effect of the antacid on the aspirin so they can be taken when it is convenient for you
The antacid destroys the aspirin so you should stop taking any antacids
The medications should be taken at least 2 hours apart.
Question 15
A patient has recently been prescribed a drug that treats his hypertension by blocking the sympathetic receptors in his sympathetic nervous system. This action is characteristic of
Answers:
an adrenergic antagonist.
an adrenergic agonist.
cardiotonic.
A neurotransmitter.
Question 16
Given her recent high blood pressure readings, a patient has been started on a thiazide diuretic and metoprolol (Lopressor), a beta-adrenergic blocker. What is the most likely rationale for using two medications to address the patient’s hypertension?
Answers:
The adverse effects of each drug may cancel each other out.
Using two drugs for a health problem tends to increase patient compliance with the drug regimen.
Using lower doses of two separate drugs may lessen the risk of adverse reactions.
Using the two drugs to treat a health problem may create a synergistic effect.
Question 17
An elderly postsurgical patient has developed postoperative pneumonia in the days following abdominal surgery and is being treated with a number of medications. Which of the following medications that the nurse will administer has the slowest absorption?
Answers:
A sublingual benzodiazepine that has been prescribed to help the patient sleep
An intravenous (IV) antibiotic that is being administered by IV piggyback at 150 mL/hour
An oral antidepressant that the patient has been taking daily for several years
An intramuscular (IM) injection of an opioid analgesic
Question 18
A 79-year-old patient in a long-term care facility is to receive an intravenous fat emulsion. Which of the following lab values would be a priority for the nurse to assess before administration?
Answers:
Blood glucose levels
Serum potassium levels
Serum sodium levels
Triglyceride levels
Question 19
A woman has a long history of seasonal allergies that are typically accompanied by rhinorrhea, red eyes, and frequent sneezing. Sneezes are a result of
Answers:
a CNS reflex that is initiated by receptors in the nasal cavities.
a reflex that is caused when irritants come into contact with cilia.
elevated CO2 levels that are detected by chemoreceptors in the large vessels.
stimulation of goblet cells and mast cells by the presence of microorganisms.
Question 20
A Nurse Practitioner is providing discharge planning for a 45-year-old woman who has a prescription for oral albuterol. The Nurse Practitioner will question the patient about her intake of which of the following?
Alcohol
Answers:
Coffee
Alcohol
Salt
Vitamin C

NURS6521 Advanced Pharmacology Week 11 Exam
Question 1
A male patient has been brought to the emergency department during an episode of status epilepticus. Diazepam is to be administered intravenously. The APRN will be sure to
Question 2
Which of the following would the nurse include in a teaching plan about the signs and symptoms of thrombophlebitis and thromboembolism that should be reported by a patient taking estrogen?
Question 3
A patient is being seen in the emergency department for a sprained ankle and is given a drug to relieve pain. When a second dose of the pain medication is given, the patient develops redness of the skin, itching, and swelling at the site of injection of the drug. The most likely cause of this response is
Question 4
A 7-year-old child has tonsillitis and is prescribed penicillin V, which is to be administered at home. The nurse will instruct the parents to administer the drug
Question 5
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 APRN is responsible for facilitating this new aspect of the patient’s drug regimen. This will involve the administration of
Question 6
A postmenopausal patient is prescribed bisphosphonates to treat osteoporosis. The nurse will instruct the patient to take the drug
Question 7
When planning care for a patient who is receiving filgrastim (Neupogen) for a nonmyeloid malignancy, the nurse should formulate which of the following patient outcomes? (Select all that apply.)
Question 8
A 15-year-old boy who has been taking dextroamphetamine for the treatment of ADHD has been experiencing a depressed mood and a sense of hopelessness. He confides in the school nurse that he has begun taking his stepfather’s antidepressant to improve his mood. After immediately phoning the boy’s stepfather, the nurse learns that the drug in question is phenelzine (Nardil), a monoamine oxidase inhibitor (MAOI). The nurse should recognize that this combination of drugs creates a serious risk of what health problem?
Question 9
An elderly woman is slated for a hemiarthroplasty (hip replacement surgery) after falling and breaking her hip on the stairs outside her home. The woman’s pain in the time since her injury has been severe, and her care team has been treating it with morphine. Which administration schedules are most likely to control the patient’s pain?
Question 10
A patient is taking flavoxate hydrochloride (Urispas) to help control an overactive bladder. On a follow-up visit to the clinic, the nurse will question the patient about which of the following?
Question 11
Alendronate (Fosamax) is prescribed for a 67-year-old postmenopausal woman. In order to help prevent gastrointestinal distress, the nurse will advise the patient to
Question 12
A Nurse Practitioner is caring for a 10-year-old boy who complains of chronic headaches. His mother reports that she gives him Tylenol at least three times a day. Which of the following will the nurse work with the physician to evaluate?
Question 13
A 45-year-old woman with acute leukemia is going to begin chemotherapy with vincristine. The nurse is aware that vincristine must always be administered
Question 14
A 68-year-old man is being treated for benign prostatic hypertrophy (BPH) and began treatment with finasteride (Proscar) 3 months ago. When planning the care of this patient, what desired outcome should the nurse prioritize?
Question 15
A 45-year-old female patient is prescribed ciprofloxacin to treat a bronchial infection. A nursing assessment revealed that she started taking daily vitamin supplements about 2 years ago. To maximize the therapeutic effects of ciprofloxacin therapy, the nurse should advise the patient to
Question 16
A Nurse Practitioner is obtaining baseline physical data from a 7-year-old patient who is to be started on dextroamphetamine for ADHD. After obtaining vital signs, height, and weight, the nurse will prepare the patient for an
Question 17
The nurse recognizes that the potential for teratogenic drug effects is not static throughout the prenatal and postnatal periods. The potential for teratogenic effects is highest during
Question 18
A patient has been admitted to the hospital’s critical care unit with bacterial septicemia that has failed to respond to initial antibiotic treatment. The patient’s most recent blood cultures reveal the presence of methicillin-resistant Staphylococcus aureus (MRSA) in the patient’s blood. The nurse will anticipate that this patient will likely require intravenous administration of what antibiotic?
Question 19
A nurse practitioner has administered filgrastim to a diverse group of patients in recent months. Which patients should the nurse observe for extremely elevated white blood cell counts following administration of the drug?
Question 20
A patient is taking etoposide for a testicular tumor refractory to treatment. The nursing assessment reveals that he is also taking warfarin. The nurse must carefully monitor for which of the following?

NURS6521 Advanced Pharmacology

Walden NURS6521 Week 11 Exam Latest

NURS6521 Advanced Pharmacology
Week 11 Exam
Question 1
A male patient has been brought to the emergency department during an episode of status epilepticus. Diazepam is to be administered intravenously. The APRN will be sure to
Question 2
Which of the following would the nurse include in a teaching plan about the signs and symptoms of thrombophlebitis and thromboembolism that should be reported by a patient taking estrogen?
Question 3
A patient is being seen in the emergency department for a sprained ankle and is given a drug to relieve pain. When a second dose of the pain medication is given, the patient develops redness of the skin, itching, and swelling at the site of injection of the drug. The most likely cause of this response is
Question 4
A 7-year-old child has tonsillitis and is prescribed penicillin V, which is to be administered at home. The nurse will instruct the parents to administer the drug
Question 5
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 APRN is responsible for facilitating this new aspect of the patient’s drug regimen. This will involve the administration of
Question 6
A postmenopausal patient is prescribed bisphosphonates to treat osteoporosis. The nurse will instruct the patient to take the drug
Question 7
When planning care for a patient who is receiving filgrastim (Neupogen) for a nonmyeloid malignancy, the nurse should formulate which of the following patient outcomes? (Select all that apply.)
Question 8
A 15-year-old boy who has been taking dextroamphetamine for the treatment of ADHD has been experiencing a depressed mood and a sense of hopelessness. He confides in the school nurse that he has begun taking his stepfather’s antidepressant to improve his mood. After immediately phoning the boy’s stepfather, the nurse learns that the drug in question is phenelzine (Nardil), a monoamine oxidase inhibitor (MAOI). The nurse should recognize that this combination of drugs creates a serious risk of what health problem?
Question 9
An elderly woman is slated for a hemiarthroplasty (hip replacement surgery) after falling and breaking her hip on the stairs outside her home. The woman’s pain in the time since her injury has been severe, and her care team has been treating it with morphine. Which of the following administration schedules is most likely to control the patient’s pain?
Question 10
A patient is taking flavoxate hydrochloride (Urispas) to help control an overactive bladder. On a follow-up visit to the clinic, the nurse will question the patient about which of the following?
Question 11
Alendronate (Fosamax) is prescribed for a 67-year-old postmenopausal woman. In order to help prevent gastrointestinal distress, the nurse will advise the patient to
Question 12
A Nurse Practitioner is caring for a 10-year-old boy who complains of chronic headaches. His mother reports that she gives him Tylenol at least three times a day. Which of the following will the nurse work with the physician to evaluate?
Question 13
A 45-year-old woman with acute leukemia is going to begin chemotherapy with vincristine. The nurse is aware that vincristine must always be administered
Question 14
A 68-year-old man is being treated for benign prostatic hypertrophy (BPH) and began treatment with finasteride (Proscar) 3 months ago. When planning the care of this patient, what desired outcome should the nurse prioritize?
Question 15
A 45-year-old female patient is prescribed ciprofloxacin to treat a bronchial infection. A nursing assessment revealed that she started taking daily vitamin supplements about 2 years ago. To maximize the therapeutic effects of the ciprofloxacin therapy, the nurse should advise the patient to
Question 16
A Nurse Practitioner is obtaining baseline physical data from a 7-year-old patient who is to be started on dextroamphetamine for ADHD. After obtaining vital signs, height, and weight, the nurse will prepare the patient for an
Question 17
The nurse recognizes that the potential for teratogenic drug effects is not static throughout the prenatal and postnatal periods. The potential for teratogenic effects is highest during
Question 18
A patient has been admitted to the critical care unit of the hospital with bacterial septicemia that has failed to respond to initial antibiotic treatment. The patient’s most recent blood cultures reveal the presence of methicillin-resistant Staphylococcus aureus (MRSA) in the patient’s blood. The nurse will anticipate that this patient will likely require intravenous administration of what antibiotic?
Question 19
A nurse practitioner has administered filgrastim to a diverse group of patients in recent months. Which of the following patients should the nurse observe for extremely elevated white blood cell counts following administration of the drug?
Question 20
A patient is taking etoposide for a testicular tumor refractory to treatment. The nursing assessment reveals that he is also taking warfarin. The nurse must carefully monitor for which of the following?
Question 21
A Nurse Practitioner is having difficulty administering a bitter drug to a 5-year-old child. The nurse should
Question 22
An immunocompromised 7-year-old child was recently discharged home with a peripherally-inserted central line (PIC line) for home antibiotic therapy. He has now been brought to the emergency department by his mother and father with signs and symptoms of line sepsis. Upon questioning, the mother states that she has been removing the PIC dressing daily and washing the site with warm water and a cloth. What nursing diagnosis is most appropriate in this situation?
Question 23
A 15-year-old patient has meningitis caused by Haemophilusinfluenzae. She is being treated with chloramphenicol. The most important nursing action for this patient would be to monitor
Question 24
A Nurse Practitioner is performing patient education for a woman who has just been prescribed a bisphosphonate. Which of the following diagnostic and history findings would have prompted the woman’s care provider to prescribe a bisphosphonate?
Question 25
A 29-year-old woman who is morbidly obese has recently begun a comprehensive, medically-supervised program of weight reduction. Prior to adding dextroamphetamine (Dexedrine) to her regimen, the patient should be questioned about her intake of
Question 26
A female patient is taking filgrastim (Neupogen) to decrease the incidence of infection. The nurse notices a small increase in the neutrophil count 2 days after starting therapy. The nurse’s evaluation of the increase is that
Question 27
A woman is receiving magnesium sulfate for intrapartumeclampsia. The patient is perspiring and her blood pressure is 88/50. The serum magnesium level is 10 mg/dL. The nurse will interpret these manifestations as
Question 28
After 6 months of unsuccessfully trying to conceive, a 31-year-old woman and her husband have sought a referral to a fertility specialist in order to explore their options. A nurse at the clinic should recognize that the woman may benefit from
Question 29
The clinical nurse educator who oversees the emergency department in a children’s hospital has launched an awareness program aimed at reducing drug errors. What measure addresses the most common cause of incorrect doses in the care of infants and children?
Question 30
A 30-year-old African-American woman tested positive for TB and is prescribed isoniazid. The nurse will plan the patient’s care to include close monitoring of the drug therapy because
Question 31
A 71-year-old man has just been prescribed finasteride (Proscar). Which of the following complaints by this patient most likely indicated a need for this drug?
Question 32
A Nurse Practitioner will monitor which of the following when assigned to a patient taking allopurinol for chronic gout who visits the clinic every 2 months?
Question 33
A Nurse Practitioner will instruct a patient taking allopurinol to take each dose
Question 34
Mr. Singh is a 66-year-old man who is receiving chemotherapy for the treatment of lung cancer that has metastasized to his liver. In an effort to prevent infection, Mr. Singh has been prescribed filgrastim (Neupogen). Which of the nurse’s following assessment questions most directly addresses a common adverse effect of filgrastim?
Question 35
A Nurse Practitioner who provides care on a pediatric medicine unit has conducted a medication reconciliation of a recently-admitted patient. In light of the fact that the child takes methylphenidate (Ritalin), the nurse is justified in considering a history of what health problem?
Question 36
A Nurse Practitioner is caring for a 64-year-old female patient who is receiving IV heparin and reports bleeding from her gums. The nurse checks the patient’s laboratory test results and finds that she has a very high aPTT. The nurse anticipates that which of the following drugs may be ordered?
Question 37
A Nurse Practitioner is working with a 16-year-old pregnant teen and assessing for behavior that may put the baby at risk. The most important assessment the nurse can make is
Question 38
A 65-year-old woman has an advanced form of rheumatoid arthritis. Her treatment includes a regular dosage of methotrexate. The APRN will advise her to take which of the following vitamin supplements while taking the drug?
Question 39
A patient has completed 4 weeks of treatment with epoetinalfa. Which of the following assessment findings would most strongly indicate that treatment has been effective?
Question 40
A 19-year-old patient reports to a clinic with vaginal discharge with a foul odor. A microscopic exam reveals trichomonasvaginalis. The nurse practitioner is aware that
Question 41
Morphine has been prescribed for a 28-year-old man with severe pain due to a back injury. The nurse will advise the patient to avoid
Question 42
A 20-year-old female patient is receiving topical clindamycin for acne vulgaris. She develops a rash and urticaria along with severe itching where the medication is applied. The nurse will formulate which of the following nursing diagnoses for the patient?
Question 43
A patient is to begin taking tobramycin (Nebcin) for a nosocomial infection. Which of the following assessments should the nurse prioritize?
Question 44
A child is admitted to the burn unit with second and third degree burns on both arms and part of his or her face. When administering topical medications to the burned areas, the nurse should
Question 45
A 56-year-old woman will soon begin treatment of her overactive bladder with tolterodine (Detrol). What patient teaching should the nurse provide to this woman?
Question 46
On the advice of her sister, a 52-year-old woman has visited her nurse practitioner to discuss the potential benefits of hormone replacement therapy in controlling the symptoms of menopause. Which of the following responses by the nurse is most appropriate?
Question 47
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?
Question 48
A 29-year-old pregnant patient is extremely upset about having to take medication for a pre-existing medical condition. She is consumed with fear that her baby will be born with a physical deformity or a congenital anomaly but knows that she has to take the medication. She talks constantly about this and is unable to sleep most nights. Which of the following is the most appropriate nursing diagnosis for this patient is?
Question 49
A Nurse Practitioner is instructing a 19-year-old female patient on the use of fluconazole for candida vaginitis. A teaching priority will be to
Question 50
A Nurse Practitioner works at a weight management clinic. To which of the following overweight patients could the nurse safely administer dextroamphetamine?
Question 51
A pregnant patient asks the Nurse Practitioner what over-the-counter medication she can take for recurring headaches. The nurse should recommend
Question 52
A patient with chronic heart failure has begun treatment with epoetinalfa, which she will receive in her own home from a home health nurse. The nurse should teach the patient to supplement this treatment with a diet that is high in
Question 53
A patient is receiving radiotherapy for an overactive thyroid gland and asks whether her milk is safe for her baby. If her treatment cannot be discontinued, what should the nurse recommend?
Question 54
Alprostadil (Caverject), a drug used to treat erectile dysfunction, has been prescribed to a 42-year-old patient. When providing education to the patient and his wife, the nurse should inform the wife about which of the following adverse effects?
Question 55
A 73-year-old woman has osteoporosis and is prescribed alendronate. She takes calcium and vitamin D supplements, drinks lots of water, and has just quit smoking. The nurse should advise the patient to also
Question 56
A patient will soon begin targeted therapy as a component of her treatment plan for chronic leukemia. The nurse is conducting health education about this new aspect of the patient’s drug regimen and the patient has asked about the potential side effects of treatment. How should the nurse best respond?
Question 57
An oncology nurse is reviewing the pathophysiology of cancer and is discussing with a colleague the factors that contribute to the success or failure of a patient’s chemotherapy. Which of the following cancerous cells is most susceptible to the effects of chemotherapeutic drugs?
Question 58A patient with non-Hodgkin’s lymphoma (NHL) will be starting a course of doxorubicin shortly. When planning this patient’s care, what nursing diagnosis should the nurse prioritize?
Question 59
A Nurse Practitioner is assigned to a patient who is at 32 weeks’ gestation and is receiving terbutaline (Brethine) IV for 24 hours to control preterm labor. Which of the following nursing actions will the nurse take to decrease the risk of hypotension and promote circulation to the fetus?
Question 60Which of the following would a Nurse Practitioner assess for in a patient who is taking polymyxin B systemically?
Question 61A Nurse Practitioner is caring for a patient who is on amphotericin B. On morning rounds the patient reports weakness, numbness, and a tingling sensation in his feet. What would be a priority action by the nurse?
Question 62 A patient has been admitted to the critical care unit with a diagnosis of peritonitis that has necessitated treatment with gentamicin. As a result, the care team should be cautious when concurrently administering other medications that may cause
Question 63A male patient is taking finasteride for BPH. Which of the following will the nurse evaluate at each clinic visit?
Question 64A male patient has been on long-term bicalutamide (Casodex) therapy. In order to assess adverse effects of the drug therapy, the nurse will closely monitor which of the following?
Question 65Which of the following patients will be at the greatest risk for anemia and would be the most likely candidate for epoetinalfa therapy?
Question 66A 30-year-old woman who is in the first trimester of pregnancy has presented to her primary care provider with a 4-day history of a reddened, itchy left eye that is crusted with purulent exudate. The clinician suspects a bacterial, rather than viral, etiology. How will the patient’s pregnancy affect the potential use of ciprofloxacin to treat her conjunctivitis?
Question 67 A 59-year-old man with a recent history of erectile dysfunction has been assessed and prescribed sildenafil (Viagra). When providing patient education to this man, the nurse should tell him which of the following?
Question 68A Nurse Practitioner is caring for a patient who is at 28 weeks’ gestation and is receiving terbutaline (Brethine) to control preterm labor. Which of the following assessment parameters should the nurse prioritize?
Question 69Laboratory testing has confirmed that a patient has chloroquine-resistant malaria and the patient’s physician has prescribed quinine along with an adjunctive drug. The nurse should question the physician’s order if the patient has a history of
Question 70A 36-year-old woman with a history of dysmenorrhea has begun treatment with progesterone, which she will be receiving by the intramuscular route. The nurse participating in the woman’s care should prioritize which of the following potential nursing diagnoses?
Question 71 The Nurse Practitioner has established peripheral IV access and begun an infusion of magnesium sulfate on a 29-year-old antepartum patient who is 35 weeks pregnant. Which of the following assessment findings most likely prompted the patient’s physician to order magnesium sulfate for this patient?
Question 72A patient is taking rifampin (Rifadin) for active TB. When discussing this drug with the patient, the nurse should stress that
Question 73A 36-year-old patient comes to the clinic and tells the nurse practitioner that she suspects that she is pregnant. During the initial assessment, the nurse practitioner learns that the patient is currently taking medications for diabetes, hypertension, and a seizure disorder. The nurse would be most concerned about which of the following medications?
Question 74A Nurse Practitioner is assessing a patient who has chronic lymphoblastic myelogenous leukemia. The treatment plan includes hydroxyurea (Hydrea). The nurse will assess the patient for which of the following?
Question 75A Nurse Practitioner is reviewing the prepregnancy medication regimen of a patient who has just had a positive pregnancy test. The nurse should be aware of which of the following changes in pharmacokinetics that accompanies pregnancy?
Question 76A Nurse Practitioner is discussing with a 58-year-old male patient the causes of erectile dysfunction in men over 50 years of age. Which of the following will the nurse inform the patient is the primary physical cause of erectile dysfunction of men in this age group?
Question 77A 38-year-old pregnant patient admits to the Nurse Practitioner that she is an alcoholic and has been consuming alcohol during her pregnancy. The nurse knows that using alcohol during pregnancy may result in a child who presents with
Question 78 The nurse practitioner orders Amoxicillin 500 mg tid? What is the total amount of medication patient will take per day?
Question 79 A patient has been prescribed oral tetracycline. The nurse will instruct the patient to take the drug
Question 80A 46-year-old man is receiving a quinupristin/dalfopristin IV infusion for a life-threatening infection. Which of the following would be most important for the nurse to monitor?
Question 81A 6-month-old child has developed skin irritation due to an allergic reaction. He has been prescribed a topical skin ointment. The nurse will consider which of the following before administering the drug?
Question 82A 3-year-old boy has developed otitis media and requires antibiotics. In order to increase the chance that the boy will take his prescribed medication, the nurse should
Question 83 A 51-year-old female patient has been receiving doxorubicin (Adriamycin) for metastatic breast cancer. Her medical record indicates she has cardiomyopathy and a cumulative dose of 300 mg/m2 of doxorubicin. Which of the following measures would help limit the severity of the cardiomyopathy in this patient?
Question 84A 20-year-old woman has been prescribed estrogen. As with all women taking estrogen, the nurse will carefully monitor the patient for which of the following?
Question 85A Nurse Practitioner is explaining to a pregnant 21-year-old college student why she cannot continue to take ibuprofen (Advil) for her headaches. The nurse draws a picture depicting drug molecules crossing the placental membrane and entering into the fetal circulation. The nurse tells the patient that the main reason this happens is because
Question 86 A Nurse Practitioner who provides care on a pediatric unit of a hospital is aware that the potential for harm as a result of drug errors is higher among infants and children than adults. This fact is primarily due to
Question 87A patient is receiving cefazolin in combination with anticoagulants. To minimize the adverse effects during therapy, the nurse will
Question 88 A Nurse Practitioner is explaining to the parents of a 6-year-old child suffering from angina why nitroglycerin patches for chest pain would not be appropriate. Which of the following will the nurse include in an explanation?
Question 89 A 20-year-old woman will soon begin taking oral contraceptives for the first time. What advice should the nurse provide to this patient?
Question 90 A 9-year-old boy was bought to his primary care provider by his mother with signs and symptoms of hookworm infection and will be sent home with a prescription for mebendazole. When provided patient and family education, the nurse should teach the mother with which of the following measures to avoid reinfection following treatment?
Question 91Intravenous carmustine has been prescribed for a patient with cancer. The nurse should help relieve the discomfort of pain and burning during the infusion by
Question 92 A 5-year-old boy needs an IM injection. The least painful and most effective injection site would be the
Question 93 A woman who is in the second trimester of her first pregnancy has been experiencing frequent headaches and has sought advice from her nurse practitioner about safe treatment options. What analgesic can the nurse most safely recommend?
Question 94 An older adult woman has been diagnosed with acute lymphoblastic leukemia (ALL) and her care team has identified potential benefits of imatinib. Which of the following characteristics of this patient’s current health status may preclude the use of imatinib?
Question 95 A man has a demonstrated history of androgen deficiency and the consequences of this health problem include an inability to maintain an erection. Which of the following medications would best address this patient’s erectile dysfunction (ED)?
Question 96A patient with a recent diagnosis of chronic myelogenous leukemia (CML) is discussing treatment options with his care team. What aspect of the patient’s condition would contraindicate the use of cyclophosphamide for the treatment of leukemia?
Question 97A Nurse Practitioner is explaining the use of acyclovir therapy to a 72-year-old man. Nephrotoxicity is discussed as a major adverse effect in older patients. To minimize the risk of the patient developing this adverse effect, the nurse will advise him to
Question 98Sulconazole has been prescribed for a patient with tineapedis. The nurse will instruct the patient to use the topical agent
Question 99An oncology nurse is aware of the risks for injury that exist around the preparation, transportation, and administration of chemotherapeutic agents. In order to reduce these risks of injury, the nurse should take which of the following actions?
Question 100 Mr. Lepp is a 63-year-old man who was diagnosed with colon cancer several weeks ago and who is scheduled to begin chemotherapy. He reports to the nurse that he read about the need for erythropoietin in an online forum for cancer patients and wants to explore the use of epoetinalfa with his oncologist. Which of the following facts should underlie the nurse’s response to Mr. Lepp?
Question 101 When completing this exam, did you comply with Walden University’s Code of Conduct including the expectations for academic integrity?

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Advanced Pharmacology

Walden NURS6521 Week 7 Exam Latest

NURS6521 Advanced Pharmacology
Week 7 Exam
Question 1A patient taking Metformin (Glucophage) is scheduled for a cardiac cath. The patient asks why he can’t take his metformin the day of the test. What is the most appropriate reply?
Answers:
Metformin interacts with the dye used in the test.  You can take the Metformin starting the day after the test.
You can develop lactic acidosis if you take metformin and are given dye.  You should have a serum creatinine drawn before restarting the medication.
The combination of metformin and the dye stimulates the liver to release insulin causing hypoglycemia.  You can restart the metformin 48 hours after the test.
Dye is a cytochrome system inducer that affects metformin.   You should wait 3 days before restarting the metform so you don’t develop a toxic level of the drug.
Question 2
A child is prescribed an inhaled corticosteroid agent to decrease respiratory inflammation related to exposure to an animal. The patient’s parent administers a higher than prescribe dose of the medication for 5 days. What should the APRN monitor the child for?
Answers:
tachycardia
adrenal insufficiency
hypokalemia
hypoglycemia
Question 3
Mr. Lacuna is an 83-year-old resident of a long-term care facility who has a diagnosis of moderate Alzheimer disease. Mr. Lacuna’s physician recently prescribed oral rivastigmine, but he was unable to tolerate the drug due to its gastrointestinal effects. As a result, he has been ordered the transdermal patch form of the medication. When administering this form of rivastigmine, the nurse should
Answers:
teach Mr. Lacuna about the importance of rotating sites when he applies the patch.
teach Mr. Lacuna’s family to apply a second patch if they notice an acute exacerbation of his confusion.
apply the patch to Mr. Lacuna’s back to reduce the chance that he will remove it.
apply the patch to a mucous membrane to facilitate complete absorption.
Question 4
A 53-year-old man has been treated for severe asthma for several years with prednisone. Recently, his physician initiated alternate-day therapy for him. The patient tells the nurse that he would rather take the medication every day to prevent confusion. Which of the following would be the best response by the nurse?
Answers:
“This schedule will be more convenient for you.”
“This schedule will enable you to lose weight.”
“This schedule will decrease the cost of your medication.”
“This schedule allows rest periods so that adverse effects are decreased but the anti-inflammatory effects continue.”
Question 5
John is a newly diagnosed diabetic that contacts the office  with complaints of severe nausea and vomiting.  What instructions should the APRN provide related to his insulin doses?
Answers:
I will call in a prescription for metformin for you to take in place of your insulin.
Monitor your blood sugar every 4  hours and take regular insulin based on the blood sugar reading.
Stop your insulin while you are not eating and restart it at half strength when you can keep liquids down.
There is no need to change your insulin dosage while sick.  Continue your regular doses
Question 6During a clinic visit, a patient complains of having frequent muscle cramps in her legs. The nurse’s assessment reveals that the patient has been taking over-the-counter laxatives for the past 7 years. The nurse informed the patient that prolonged use of laxatives
Answers:
may cause nutrient deficiencies.
may counter the therapeutic effect of other drugs.
causes acidic urine and urinary tract infections.
inhibits biotransformation of drugs.
Question 7
Which of the following statements best defines how a chemical becomes termed a drug?
Answers:
A chemical must have a proven therapeutic value or efficacy without severe toxicity or damaging properties to become a drug.
A chemical becomes a drug when it is introduced into the body to cause a change.
A chemical is considered a drug when the Food and Drug Administration (FDA) approves its release to be marketed.
A chemical must have demonstrated therapeutic value to become a drug.
Question 8 The Nurse Practitioner’s assessment of a community-dwelling adult suggests that the client may have drug allergies that have not been previously documented. What statement by the client would confirm this?
Answers:
“I tend to get sick in the stomach when I take antibiotics.”
“I’ve been told that aspirin might have caused my stomach bleed a few years back.”
“I broke out in hives and got terribly itchy when I started a new prescription last year.”
“When I fell last year, the doctor said that it might have been because of my blood pressure pills.”
Question 9
A Nurse Practitioner is teaching an older adult patient about polypharmacy. Which of the following statements best describe this term?
Answers:
Taking more than one drug when the patient deems it necessary
Taking several drugs simultaneously
Increasing the dosage of a drug by the patient
Taking one drug one day and another drug the next day
Question 10
A 33-year-old woman has irritable bowel syndrome (IBS). The physician has prescribed simethicone (Mylicon) for her discomfort. Which of the following will the nurse monitor most closely during the patient’s drug therapy?
Answers:
Drug toxicity
Anorexia
Increased abdominal pain and vomiting
Increased urine output
Question 11
Decongestants are recommended to use in which of the following patients?
Answers:
patients with otitis media
patients with coronary artery disease
patients taking monoamine oxidase inhibitors
patients with hypertension
Question 12
A 70-year-old woman with a history of atrial fibrillation takes digoxin and verapamil to control her health problem. Verapamil achieves a therapeutic effect by
Answers:
blocking adrenergic receptors and producing antisympathetic effects.
inhibiting the movement of calcium ions across the cardiac muscle cell membrane.
decreasing sodium and potassium conduction.
weakening diastolic depolarization and the action potential duration.
Question 13
Mrs. Houston is a 78-year-old woman who resides in an assisted living facility. Her doctor prescribed digoxin at her last visit to the clinic and she has approached the nurse who makes regular visits to the assisted-living facility about this new drug. What teaching point should the nurse emphasize to Mrs. Houston?
Answers:
The importance of having required laboratory work performed on time
The need to take the medication at the same time each day regardless of her heart rate
The  technique for using a home blood pressure cuff
Timing household activities to coincide with the administration times of her digoxin
Question 14
The Nurse Practitioner is treating a patient that takes frequent doses of antacids for his heartburn and is also taking an enteric coded aspirin.  What instructions should be provided to the patient?
Answers:
The aspirin is less effective when taken with an antacid so you need to increase the dose.
There is no effect of the antacid on the aspirin so they can be taken when it is convenient for you
The antacid destroys the aspirin so you should stop taking any antacids
The medications should be taken at least 2 hours apart.
Question 15
A patient has recently been prescribed a drug that treats his hypertension by blocking the sympathetic receptors in his sympathetic nervous system. This action is characteristic of
Answers:
an adrenergic antagonist.
an adrenergic agonist.
acardiotonic.
a neurotransmitter.
Question 16
In light of her recent high blood pressure readings, a patient has been started on a thiazide diuretic and metoprolol (Lopressor), which is a beta-adrenergic blocker. What is the most likely rationale for using two medications to address the patient’s hypertension?
Answers:
The adverse effects of each drug may cancel each other out.
Using two drugs for a health problem tends to increase patient compliance with the drug regimen.
Using lower doses of two separate drugs may lessen the risk of adverse reactions.
Using the two drugs to treat a health problem may create a synergistic effect.
Question 17
An elderly postsurgical patient has developed postoperative pneumonia in the days following abdominal surgery and is being treated with a number of medications. Which of the following medications that the nurse will administer has the slowest absorption?
Answers:
A sublingual benzodiazepine that has been prescribed to help the patient sleep
An intravenous (IV) antibiotic that is being administered by IV piggyback at 150 mL/hour
An oral antidepressant that the patient has been taking daily for several years
An intramuscular (IM) injection of an opioid analgesic
Question 18
A 79-year-old patient in a long-term care facility is to receive an intravenous fat emulsion. Which of the following lab values would be a priority for the nurse to assess before administration?
Answers:
Blood glucose levels
Serum potassium levels
Serum sodium levels
Triglyceride levels
Question 19
A woman has a long history of seasonal allergies that are typically accompanied by rhinorrhea, red eyes, and frequent sneezing. Sneezes are a result of
Answers:
a CNS reflex that is initiated by receptors in the nasal cavities.
a reflex that is caused when irritants come into contact with cilia.
elevated CO2 levels that are detected by chemoreceptors in the large vessels.
stimulation of goblet cells and mast cells by the presence of microorganisms.
Question 20
A Nurse Practitioner is providing discharge planning for a 45-year-old woman who has a prescription for oral albuterol. The Nurse Practitioner will question the patient about her intake of which of the following?
Alcohol
Answers:
Coffee
Alcohol
Salt
Vitamin C
Question 21
The nurse practitioner orders Amoxicillin 500 mg tid? What is the total amount of medication patient will take per day?
Answers:
500 mg
1000 mg
1500 mg
150 mg
Question 22
A Nurse Practitioner is caring for a 78-year-old patient with renal insufficiency and chronic heart failure who is receiving rapid infusions of high-dose furosemide. It will be a priority for the Nurse Practitioner to monitor for
Answers:
hepatic encephalopathy.
ototoxicity.
vascular thrombosis.
dehydration.
Question 23A 72-year-old man is prescribed theophylline for symptomatic relief of bronchial asthma. Which of the following findings would alert the nurse to the need for close monitoring?
Answers:
Enlarged prostate gland
Need for additional bronchodilation
Signs of an active lung infection
Hypersensitivity to povidone
Question 24
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?
Answers:
Small doses of long-acting insulin administered four to five times daily
Doses of basal insulin twice daily with regular insulin before each meal
Large doses of rapid-acting insulin combined with long-acting insulin each morning and evening
Divided doses of intermediate-acting insulin every 2 hours, around the clock
Question 25A patient with seasonal allergies is exasperated by her recent nasal congestion and has expressed her desire to treat it by using pseudoephedrine. The nurse should inform the patient that
Answers:
under the Combat Methamphetamine Abuse Act, pseudoephedrine now requires a prescription.
drugs containing pseudoephedrine are available without a prescription but are kept off pharmacy shelves.
she must be prepared to show identification when buying a drug that contains pseudoephedrine.
pseudoephedrine is being phased out of the marketplace in order to combat illegal use.
Question 26
Mr. Penny, age 67, was diagnosed with chronic angina several months ago and has been unable to experience adequate relief of his symptoms. As a result, his physician has prescribed ranolazine (Ranexa). Which of the following statements is true regarding the use of ranolazine for the treatment of this patient’s angina?
Answers:
Ranolazine confers protection from myocardial infarction but does not relieve symptoms of angina.
Amlodipine will now be contraindicated in the treatment of Mr. Penny’s angina.
Mr. Penny will need to be taught to monitor his blood pressure and heart rate.
Mr. Penny requires concurrent treatment with a beta blocker, nitrate, or a calcium channel blocker.
Question 27
A Nurse Practitioner is caring for a patient who has recently moved from Vermont to south Florida. The patient has been on the same antihypertensive drug for 6 years and has had stable blood pressures and no adverse effects. Since her move, however, she reports “dizzy spells and weakness” and feels that the drug is no longer effective. The Nurse Practitioner suspects that the change in the effectiveness of the drug is related to
Answers:
the impact of the placebo effect on the patient’s response.
the accumulative effect of the drug if it has been taken for many years.
the impact of the warmer climate on the patient’s physical state.
problems with patient compliance with the drug regimen due to the move.
Question 28
Which of the following patients is most likely to benefit from the administration of an adrenergic agonist?
Answers:
A man who is in cardiogenic shock following a myocardial infarction
A man who has a diagnosis of primary hypertension
A woman who has been admitted with a suspected ischemic stroke
A woman who is in labor and may require a caesarean section
Question 29The parents of a 7-year-old boy who has just been diagnosed with allergic asthma are being taught about their son’s medication regimen by the nurse. The nurse is currently teaching the parent’s about the appropriate use of a “rescue drug” for acute exacerbations of their son’s asthma. What drug should the nurse suggests the parents to use in these situations?
Answers:
Theophylline
Albuterol
Beclomethasone
Acetylcysteine
Question 30A patient with unstable angina pectoris who is NOT controlled with a nitrate would likely benefit most from the addition of:
Answers:
1. Sodium channel blocker
2. Beta blocker
3. Cardiac glycoside
4. Either 1 or 2
Question 31A 62-year-old woman has been prescribed a fentanyl transdermal patch for chronic cancer pain. The patient asks the nurse how long it will take for her to experience pain relief. The nurse will instruct the patient that she should feel pain relief in approximately
Answers:
6 hours.
12 hours.
24 hours.
32 hours.
Question 32A patient with bronchial asthma is prescribed a sustained-release preparation of theophylline. To help minimize the adverse effects of the drug, which of the following should the nurse suggest?
Answers:
Take it on an empty stomach, 1 hour before or 2 hours after meals
Take it with a meal
Take it with foods containing xanthines, such as caffeine
Increase the drug dosage up to 50%
Question 33A patient is taking gabapentin (Neurontin) for spasticity associated with multiple sclerosis. Which of the following should be the priority for monitoring?
Answers:
Hepatic function
Cardiac function
Respiratory function
Renal function
Question 34A 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?
Answers:
Hypothermia
Hypotension
Renal dysfunction
Bleeding
Question 35A patient has GERD and is taking ranitidine (Zantac). She continues to have gastric discomfort and asks whether she can take an antacid. Which of the following is an appropriate response by the nurse?
Answers:
“Sure, you may take an antacid with ranitidine.”
“No, the two drugs will work against each other.”
“Yes, but be sure to wait at least 2 hours to take the antacid after you take the ranitidine.”
“I wouldn’t advise it. You may experience severe constipation.”
Question 36A patient who takes aluminum hydroxide with magnesium hydroxide (Mylanta) frequently for upset stomach, heartburn, and sour stomach is seen regularly in the clinic. The nurse should assess which of the following?
Answers:
Blood glucose level
Serum phosphate level
Urine specific gravity
Aspartate transaminase levels
Question 37A 67-year-old man is admitted to the hospital with pneumonia. He reports to the nurse that he has chronic arthritis and circulation problems. Further assessment by the nurse reveals that the patient has a history of mild hypertension. He explains that he owns a business and lives alone. The nurse determines that he is within the normal weight range for his height and age but has a fondness for spicy foods and sweets. Which of the mentioned patient variables will have the greatest impact on the effectiveness of the patient’s drug therapy?
Answers:
Vascular impairment
Mild hypertension
Dietary habits
Chronic arthritis
Question 38An older adult who lives in a long-term care facility has recently begun taking losartan (Cozaar) for the treatment of hypertension. The nurse who provides care for this resident should recognize that this change in the resident’s medication regimen make create a risk for
Answers:
constipation.
falls.
xerostomia (dry mouth).
depression.
Question 39The APRN is caring for a patient taking a calcium channel blockers for hypertension.  The APRN should monitor the patient for what common side effects of this medication?
Answers:
peripheral edema, constipation, dizziness
hyperkalemia, dry cough, angioedema
bronchospasm, dry cough, angioedema
peripheral edema, dry cough, hypokalemia
Question 40A home health Nurse Practitioner is performing a home visit to an elderly client who has early-stage dementia. The Nurse Practitioner observes that some of the client’s pill bottles are empty, even though the client is not due for refills for 2 weeks. What nursing diagnosis should the Nurse Practitioner prioritize when planning this client’s care?
Answers:
Impaired Home Maintenance Management
Ineffective Coping
Knowledge Deficit
Ineffective Therapeutic Regimen Management
Question 41A Nurse Practitioner is discussing with a patient the efficacy of a drug that his physician has suggested, and he begin taking. Efficacy of a drug means which of the following?
Answers:
The amount of the drug that must be given to produce a particular response
How well a drug produces its desired effect
A drug’s strength of attraction for a receptor site
A drug’s ability to stimulate its receptor
Question 42You are seeing a 55 year old patient recently diagnosed with a bleeding ulcer. What should be the initial treatment choice for this patient?
Answers:
Sucralfate (Carafate)
A Proton Pump Inhibitor
An H2 Receptor Blocker
Lifestyle Modifications including smoking cessation
Question 43The APRN’s ability to prescribe controlled substances is regulated by:
Answers:
FDA
DEA
State Law
All of the above
Question 44
The lower respiratory system utilizes a number of different mechanisms that confer protection and maintain homeostasis. Which of the following physiological processes protects the lower respiratory system?
Answers:
Goblet cells throughout the lower airways produce phagocytes that trap particles and microorganisms.
The carina, where the trachea bifurcates into two bronchi, closes off the lower airway in response to noxious stimuli.
The alveoli produce positive pressure in order to expel particles that have been inhaled.
Cilia sweep foreign material and mucus upward toward the trachea and larynx where they can then be swallowed.
Question 45Which of the following serves to protect the public by ensuring the purity of a drug and its contents?
Answers:
American Pharmaceutical Association
United States Adopted Names Council
Nursing drug guides
Federal legislation
Question 46
A female patient has been taking zafirlukast for a week and is experiencing diarrhea. The nurse should instruct her to do which of the following?
Answers:
Take nonnarcotic analgesics
Schedule blood tests
Drink plenty of fluids
Take the drug with food
Question 47A 45-year-old man who is a construction worker has been diagnosed with hyperlipidemia and has been prescribed lovastatin. The nurse will advise the patient to
Answers:
use over-the-counter (OTC) drugs to treat any muscle cramps or pain.
drink moderate amounts of alcohol.
avoid prolonged exposure to sunlight.
change to another similar drug if lovastatin proves to be ineffective.
Question 48A 70-year-old woman has experienced peripheral edema and decreasing stamina in recent months and has sought care from her primary care provider. The patient’s subsequent diagnostic workup has resulted in a diagnosis of chronic heart failure. The woman has been prescribed digoxin and the nurse has begun patient education. What should the nurse teach the patient about her new medication?
Answers:
“By reducing the amount of fluid that your body contains, digoxin will make it easier for your heart to pump.”
“This will lessen the workload of your heart by reducing your blood pressure.”
“Most patients see their heart failure resolve in 2 to 4 months after they begin taking digoxin.”
“This drug won’t cure your disease, but it will help you be able to exercise more and be more comfortable.”
Question 49A 48-year-old woman who works as an office manager is prescribed metoclopramide (Reglan) for diabetic gastroparesis. The nurse will be sure to assess the patient for
Answers:
tachycardia.
depression.
hypotension.
anemia.
Question 50
A normal maintenance dose for digoxin is 0.125 to 0.5 mg/day. In which of the following patients would the nurse most likely administer a lower-than-normal maintenance dose of digoxin?
Answers:
A 25-year-old male with congestive heart failure and atrial fibrillation
A 32-year-old female with cardiomegaly
A 79-year-old male with cardiomegaly
A 42-year-old female with a third heart sound
Question 51
The most effective therapy for a patient  who is H. pylori positive with a gastric ulcer is:
Answers:
Cephalexin, Bismuth, Omeprazole, and Ranitidine
Bismuth, Metronidazole, Omeprazole, and Tetracycline
Amoxicillin, Cefzil, and omeprazole
Amoxicillin, Metronidazole, and Bismuth
Question 52
A patient has been prescribed a drug that can be self-administered at home. Which of the following would be the most important information for the nurse to relate to the patient concerning self-administration of a drug?
Answers:
Where to purchase the medication
The cost of the drug
The therapeutic effects and possible adverse effects
The pharmacokinetics of the drug
Question 53A 66-year-old woman has a complex medical history that includes poorly-controlled type 1 diabetes, renal failure as a result of diabetic nephropathy and chronic heart failure (CHF). Her care provider has recently added spironolactone (Aldactone) to the woman’s medication regimen. The nurse should consequently assess for signs and symptoms of
Answers:
atrial fibrillation.
thrombophlebitis.
hyperkalemia.
leukocytosis.
Question 54
In order to promote therapeutic drug effects, the Nurse Practitioner should always encourage patients to
Answers:
take their medication with meals.
take their medication at the prescribed times.
increase medication dosages if necessary.
use alternative therapy to increase the effects of their medications.
Question 55
A patient has been prescribed zolpidem (Ambien) for short-term treatment of insomnia. Which of the following will the nurse include in a teaching plan for this patient? (Select all that apply.)
Answers:
The drug should not be used for longer than 1 month.
It should be taken 1 hour to 90 minutes before going to bed.
The drug does not cause sleepiness in the morning.
One of the most common adverse effects of the drug is headache.
It is available in both quick-onset and continuous-release oral forms.
Question 56
A Nurse Practitioner who provides care on an acute medicine unit has frequently recommended the use of nicotine replacement gum for patients who express a willingness to quit smoking during their admission or following their discharge. For which of the following patients would nicotine gum be contraindicated?
Answers:
A patient who received treatment for kidney failure due to an overdose of acetaminophen
A patient whose pulmonary embolism was treated with a heparin infusion
A patient with a history of angina who experienced a non-ST wave myocardial infarction
A patient whose stage III pressure ulcer required intravenous antibiotics and a vacuum dressing
Question 57
Which of the following is TRUE about long acting beta agonist use in asthma patients?
Answers:
It is useful in exercise induced asthma
It is effective to use in acute exacerbations
It may be used as solo treatment in step 2 of asthma treatment
It can be combined with an inhaled corticosteroid to improve asthma control
Question 58
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
Answers:
crush the tablet before swallowing.
swallow the tablet whole.
swallow the tablet with milk or food.
avoid drinking milk for 3 hours after swallowing the tablet.
Question 59A 72-year-old female patient is prescribed ipratropium aerosol for pulmonary emphysema. The nurse will instruct her to “test spray” the new metered-dose inhaler (MDI) three times before using it to prevent which of the following?
Answers:
Anaphylactoid reaction
Asymptomatic elevated hepatic enzymes levels
Paradoxic acute bronchospasm
Symptomatic hepatitis with hyperbilirubinemia
Question 60A 68-year-old man complains of a chronic, nonproductive cough. He states that he has to have relief, that he has been coughing every 2 to 3 minutes, and he is worn out. Dextromethorphan is prescribed for him. Before he leaves the clinic he asks how long it will take for the medicine to work. The nurse will advise him that he should experience therapeutic effects in
Answers:
5 minutes.
10 minutes.
15 to 30 minutes.
60 minutes.
Question 61
A Nurse Practitioner has been following a male patient who is taking hydralazine, clonidine, and a diuretic for hypertension. After 2 weeks of medication therapy, the patient begins to complain of numbness and tingling in his hands and feet. The Nurse Practitioner suspects that these signs or symptoms are
Answers:
a result of new onset diabetes.
an adverse effect of the diuretic.
signs of peripheral neuritis.
an idiosyncratic reaction to clonidine.
Question 62
A 77-year-old patient has a long-standing history of hypertension, a health problem that is being treated with metoprolol and a thiazide diuretic. Before administering the 8 AM dose of these medications, what assessments should the nurse perform and document? (Select all that apply.)
Answers:
Respiratory rate
Oxygen saturation
Temperature
Heart rate
Blood pressure
Question 63Topical inhaled alpha adrenergic blocking agents or nasal vasoconstricting decongestants should not be used chronically (>5 days) because they can cause
Answers:
rebound insomnia
rebound coughing
rebound rhinitis/congestion
None of the above
Question 64
A patient is taking cholestyramine. The Nurse Practitioner will assess for which of the following common adverse effects of the drug?
Answers:
Abdominal pain
 
Headache
Constipation
Indigestion
Question 65
In which of the following patients would a Nurse Practitioner expect to experience alterations in drug metabolism?
Answers:
A 35-year-old woman with cervical cancer
A 41-year-old man with kidney stones
A 50-year-old man with cirrhosis of the liver
A 62-year-old woman in acute renal failure
Question 66
A 46-year-old white American has been prescribed a drug that binds to acid glycoproteins. The nurse understands that white Americans usually receive
Answers:
a higher-than-normal dose of drugs that bind to acid glycoproteins.
a lower-than-normal dose of drugs that bind to acid glycoproteins.
the recommended normal dose of drugs that bind to acid glycoproteins.
one half the recommended dose of drugs that bind to acid glycoproteins.
Question 67
A 20-year-old woman calls the clinic at 5 PM and reports to the Nurse Practitioner that she forgot to take her morning dose of fexofenadine (Allegra). She usually takes her evening dose at 8 PM. She wants to know what she should do. The Nurse Practitioner will instruct her to
Answers:
double her evening dose.
skip the evening dose and start back in the morning.
forget about the morning dose and take the evening dose.
take the morning dose now and the evening dose at the regular time.
Question 68
A patient with a recent diagnosis of acute renal failure has a long-standing seizure disorder which has been successfully controlled for several years with antiseizure medications. The nurse should recognize that the patient’s compromised renal function will likely
Answers:
increase the half-life of medications that are metabolized by the kidneys.
decrease the first-pass effect of medications that the patient is given.
necessitate intravenous, rather than oral, medications.
make the antiseizure medications less effective than in the past.
Question 69
A 79-year-old woman who takes several medications for a variety of chronic health problems has been prescribed an oral antiplatelet aggregator that is to be taken once daily. The nurse has encouraged the woman to take the pill at the same time of day that she takes some of her other medications. What is the most likely rationale for the nurse’s advice?
Answers:
Integrating the new drug into the patient’s existing schedule promotes adherence.
Combining a new drug with one or more existing drugs mitigates the risk of adverse effects.
Taking several drugs at one time maximizes recovery time for the liver and kidneys.
Rapid drug clearance fostered when a patient is able to minimize the number of drug administration times.
Question 70
A clinic Nurse Practitioner is planning care for a 68-year-old man who has been on omeprazole (Prilosec) therapy for heartburn for some time. Regarding the patient’s safety, which of the following would be a priority nursing action?
Answers:
Teach the patient to take omeprazole 1 hour before meals.
Emphasize that the drug should not be crushed or chewed.
Coordinate bone density testing for the patient.
Monitor the patient for the development of diarrhea.
Question 71
An expected outcome for a patient who has just taken sublingual nitroglycerin should be
Answers:
increased heart rate and decreased blood pressure.
decreased heart rate and decreased blood pressure.
increased heart rate and increased blood pressure.
decreased heart rate and increased blood pressure.
Question 72
A Nurse Practitioner is providing care for a patient who suffered extensive burns to his extremities during a recent industrial accident. Topical lidocaine gel has been ordered to be applied to the surfaces of all his burns in order to achieve adequate pain control. When considering this order, the Nurse Practitioner should be aware that
Answers:
intravenouslidocaine may be preferable to topical application.
lidocaine must be potentiated with another anesthetic in order to achieve pain control.
pain relief is unlikely to be achieved due to the destruction of nerve endings in the burn site.
there is a risk of systemic absorption of the lidocaine through the patient’s traumatized skin.
Question 73
A 22-year-old male college senior has lived with a diagnosis of Crohn’s disease for several years and has undergone several courses of treatment with limited benefit. Which of the following targeted therapies has the potential to alleviate the symptoms of Crohn’s disease?
Answers:
Tositumomab plus 131I (Bexxar)
Muromonab-CD3 (Orthoclone OKT3)
Infliximab (Remicade)
Eculizumab (Soliris)
Question 74
A Nurse Practitioner is caring for a patient who is diabetic and has been diagnosed with hypertension. An angiotensin-converting enzyme inhibitor, captopril, has been prescribed for her. Which of the following should the Nurse Practitioner assess before beginning drug therapy?
Answers:
Serum calcium levels
Serum potassium levels
Blood glucose levels
Serum magnesium levels
Question 75
A 60-year-old African-American man lives with a number of chronic health problems. Genetic factors are likely to influence his etiology and/or treatment of
Answers:
hypertension.
low bone density.
a seizure disorder.
cardiac arrhythmias.
Question 76
A 70-year-old man with diabetes mellitus is taking metoprolol (Lopressor) to manage his hypertension. The nurse would be sure to instruct the patient to
Answers:
take his pulse at least four times a day.
weigh himself once a week at the same time of the day.
avoid smoke-filled rooms.
understand the signs and symptoms of hypoglycemia.
Question 77
A Nurse Practitioner explains to a patient that nitroglycerin patches should be applied in the morning and removed in the evening. This medication schedule reduces the potential for
Answers:
adverse effects.
nitrate dependence.
nitrate tolerance.
toxic effects.
Question 78
A patient receives 25 units of NPH insulin at 7.AM. At what time of day should the nurse advise the patient to be most alert for a potential hypoglycemic reaction?
Answers:
After breakfast
Before lunch
Late afternoon
Bedtime
Question 79
A Nurse Practitioner is a member of a research team that is exploring unique differences in responses to drugs that each individual possesses, based on genetic make-up. This area of study is called
Answers:
pharmacotherapeutics.
pharmacodynamics.
pharmacoeconomics.
pharmacogenomics.
 
Question 80
A Nurse Practitioner is caring for a patient who is taking digoxin and a loop diuretic. Which of the following would be most important for the Nurse Practitioner to monitor?
Answers:
Electrocardiogram results
Potassium levels
Sodium levels
Liver enzymes
Question 81
To maximize the therapeutic effect of diphenoxylateHCl with atropine sulfate, the nurse will instruct the patient to take the medication
Answers:
once a day.
twice a day.
every 2 hours.
four times a day.
Question 82
A man who smokes one pack of cigarettes daily has been diagnosed with chronic bronchitis. He has been prescribed theophylline by his family doctor. What effect will the patient’s smoking status have on the therapeutic use of theophylline?
Answers:
Theophylline may be contraindicated due to the risk of an anaphylactoid reaction
The patient may require higher doses of theophylline than a nonsmoker
The patient may require administration of an inhaled bronchodilator before each dose of theophylline
The patient will require serial blood testing to ensure a safe serum level of theophylline
Question 83
A 60-year-old man has scheduled a follow-up appointment with his primary care provider stating that the omeprazole (Prilosec) which he was recently prescribed is ineffective. The patient states, “I take it as soon as I feel heartburn coming on, but it doesn’t seem to help at all.” How should the nurse best respond to this patient’s statement?
Answers:
“It could be that Prilosec isn’t the right drug for you, so it would be best to talk this over with your care provider.”
“Prilosec won’t really decrease the sensation of heartburn, but it is still minimizing the damage to your throat and stomach that can be caused by the problem.”
“Prilosec will help your heartburn but it’s not designed to provide immediate relief of specific episodes of heartburn.”
“A better strategy is to take a dose of Prilosec 15 to 30 minutes before meals or drinks that cause you to get heartburn.”
Question 84
A 34-year-old male patient is prescribed methimazole (MMI). The Nurse Practitioner will advise him to report which of the following immediately?
Answers:
Vertigo
Intolerance to cold
Loss of appetite
Epigastric distress
Question 85
A Nurse Practitioner is providing patient education to a 35-year-old man who has been prescribed clonidine (Catapres) as part of step 2 antihypertensive therapy. The Nurse Practitioner should anticipate that the drug will be administered
Answers:
intravenously.
subcutaneously.
transdermally.
orally.
Question 86
It is determined that a patient, who is in a hepatic coma, needs a laxative. Lactulose is prescribed. Which of the following should the nurse monitor to assess the efficacy of the lactulose therapy?
Answers:
Water levels in the colon
Oncotic pressure in the colon
Blood ammonia levels
Relief from symptoms
Question 87A diabetic patient being treated for obesity tells the Nurse Practitioner 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 Practitioner’s immediate attention?
 
Answers:
Decreased libido
Increased blood glucose
Dry eyes
Jittery feeling
Question 88
A resident of a long-term care facility receives 12.5 mg metoprolol (Lopressor) at 8 AM and 8 PM daily. Before administering this drug, the nurse should perform and document what assessments?
Answers:
Oxygen saturation and respiratory rate
Heart rate and blood pressure
Level of consciousness and pain level
Temperature and respiratory rate
Question 89
A 35 year old patient presents with a concern of two high blood pressures at local health fairs in the past month. The patient has a history of Type 2 Diabetes, Chronic Constipation, and Obesity. Today her pressure is 145/93. You will:
Answers:
Begin hydrochlorothiazide 12.5 mg daily.
Begin furosemide 20 mg daily.
Ask the patient to monitor their BP’s at home and reduce their sodium intake only.
Begin amlodipine 10 mg daily.
Question 90Which statement is FALSE regarding the treatment of hyperthyroidism?
Answers:
Propylthiouracil (PTU) reduces peripheral conversion of T4 to the more potent T3
Since methimazole (Tapazole) is stronger than Propylthiouracil (PTU), Methimazole should be initiated at 15 mg/day compared to 300 mg/day for Propylthiouracil for treatment of mild disease
Long-acting beta-blocking agents are given as adjunctive therapy until Propulthiouracil (PTU) or methimazole (Tapazole) restores the patient to euthyroid
Methimazole (Tapazole) is the drug of choice for pregnant or lactating females.
Question 91A 58-year-old man is prescribed dicyclomine (Bentyl) for irritable bowel syndrome. In which of the following conditions is dicyclomine therapy contraindicated?
Answers:
Hypertension
Diabetes mellitus
Glaucoma
Rheumatoid arthritis
Question 92
Mr. Tan is a 69-year-old man who prides himself in maintaining an active lifestyle and a healthy diet that includes adequate fluid intake. However, Mr. Tan states that he has experienced occasional constipation in recent months. What remedy should be the nurse’s first suggestion?
Answers:
Bismuth subsalicylate
A bulk-forming (fiber) laxative
A stimulant laxative
A hyperosmotic laxative
Question 93
A mother brings her 4-year-old child, who is vomiting and has a temperature of 103°F into the emergency department (ED). The ED physician orders acetaminophen (Tylenol) for the fever. The best form of Tylenol to give the child, considering her presentation, would be
Answers:
liquid.
lozenge.
tablet.
suppository.
Question 94
A Nurse Practitioner is caring for a male patient who has a diagnosis of coronary artery disease (CAD). His drug therapy includes lovastatin. Because the patient has a history of severe renal disease, the nurse will assess for which of the following?
Answers:
Decrease in plasma concentration of lovastatin
Increase in the statin tolerance level
Decrease in LDL
Increase in plasma concentration of lovastatin
 
Question 95
A 24-year-old factory worker has been prescribed guaifenesin for the first time. Which of the following will be a priority assessment by the nurse before the patient’s first dose?
Answers:
The amount of salt intake
The amount of alcohol consumption
The amount of fatty foods eaten daily
The number of cigarettes smoked per day
Question 96 A patient has been prescribed a Scheduled 5 drug, an example of this drug is
Answers:
Antianxiety
Narcotic Analgesics
Barbituates
Antitussives
Question 97 A high school student was diagnosed with asthma when he was in elementary school and has become accustomed to carrying and using his “puffers”. In recent months, he has become more involved in sports and has developed a habit of administering albuterol up to 10 times daily. The nurse should teach the student that overuse of albuterol can lead to
Answers:
permanent liver damage.
rebound bronchoconstriction.
community-acquired pneumonia.
severe anticholinergic effects.
Question 98 Drugs have a high potential for abuse. There is no routine therapeutic use for these drugs and they are not available for regular use. They may be obtained for “investigational use only” by applying to the U.S. Drug Enforcement Agency. Examples include heroin and LSD. Which scheduled drug is this?
Answers:
Schedule 1
Schedule 2
Schedule 3
Schedule 4
Question 99 A patient has a history of tonic-clonic seizures that have been successfully treated with phenytoin (Dilantin) for several years. Phenytoin achieves a therapeutic effect by
Answers:
decreasing the influx of sodium into neurons.
increasing the levels of available glutamate.
simultaneously potentiating the effects of GABA and inhibiting reuptake.
by slowing the function of calcium channels within the neurological system.
Question 100  A 29-year-old female patient has been prescribed orlistat (Xenical) for morbid obesity. The nurse is providing patient education concerning the drug. An important instruction to the patient would be to
Answers:
omit the dose if the meal does not contain fat.
takeorlistat and multivitamins together.
takeorlistat in one dose at breakfast.
omit the dose if the meal does not contain protein.
Question 101 When completing this exam, did you comply with Walden University’s Code of Conduct including the expectations for academic integrity?
Answers:
Yes
No

ADDITIONAL INSTRUCTIONS FOR THE CLASS

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Implications of Prescribing Drugs

NURS6521 Advanced Pharmacology Week 1 Assignment Ethical and Legal Implications of Prescribing Drugs
What type of drug should you prescribe based on your patient’s diagnosis? How much of the drug should the patient receive? How often should the drug be administered? When should the drug not be prescribed? Are there individual patient factors that could create complications when taking the drug? Should you be prescribing drugs to this patient? How might different state regulations affect prescribing this drug to this patient?
These are some of the questions you might consider when selecting a treatment plan for a patient.
Photo Credit: Getty Images/Caiaimage
As an advanced practice nurse prescribing drugs, you are held accountable for people’s daily lives. Patients and their families will often place trust in you because of your position. With this trust comes power, responsibility, and an ethical and legal obligation to “do no harm.” It is important that you are aware of current professional, legal, and ethical standards for advanced practice nurses with prescriptive authority. Additionally, it is important to ensure that the treatment plans and administration/prescribing of drugs follow the regulations of the state where you practice. Understanding how these regulations may affect the prescribing of certain drugs in different states may significantly impact your patient’s treatment plan. In this Assignment, you explore the ethical and legal implications of scenarios and consider how to respond appropriately.
To Prepare
Review the Resources for this module and consider the legal and ethical implications of prescribing prescription drugs, disclosure, and nondisclosure.
Review the scenario assigned by your Instructor for this Assignment.
Search specific laws and standards for prescribing prescription drugs and addressing medication errors for your state or region, and reflect on these as you review the scenario your instructor assigned.
Consider the ethical and legal implications of the scenario for all stakeholders involved, such as the prescriber, pharmacist, patient, and patient’s family.
Consider two strategies that you would use as an advanced practice nurse to guide your ethically and legally responsible decision-making in this scenario, including whether you would disclose any medication errors.
By Day 7 of Week 1
Write a 2- to 3-page paper that addresses the following:
Explain the ethical and legal implications of the scenario you selected on all stakeholders involved, such as the prescriber, pharmacist, patient, and patient’s family.
Describe strategies to address disclosure and nondisclosure as identified in the scenario you selected. Be sure to reference laws specific to your state.
Explain two strategies that you, as an advanced practice nurse, would use to guide your decision-making in this scenario, including whether you would disclose your error. Be sure to justify your explanation.
Explain the process of writing prescriptions, including strategies to minimize medication errors.

NURS6521 Advanced Pharmacology Week 2 Assignment Pharmacotherapy for Cardiovascular Disorders
..heart disease remains the No. 1 killer in America; nearly half of all Americans have high blood pressure, high cholesterol, or smoke—some of the leading risk factors for heart disease…
—Murphy et al., 2018
Despite the high mortality rates associated with cardiovascular disorders, improved treatment options do exist that can help address those risk factors that afflict the majority of the population today.
Photo Credit: Getty Images/Science Photo Library RF
As an advanced practice nurse, you must recommend appropriate treatment options for patients with cardiovascular disorders. To ensure the safety and effectiveness of drug therapy, advanced practice nurses must consider aspects that might influence pharmacokinetic and pharmacodynamic processes such as medical history, other drugs currently prescribed, and individual patient factors.
Reference: Murphy, S. L., Xu, J., Kochanek, K. D., & Arias, E. (2018). Mortality in the United States, 2017. Retrieved from /orders/www.cdc.gov/nchs/products/databriefs/db328.htm
To Prepare
Review the Resources for this module and consider the impact of potential pharmacotherapeutics for cardiovascular disorders introduced in the media piece.
Review the case study assigned by your Instructor for this Assignment.
Select one the following factors: genetics, gender, ethnicity, age, or behavior factors.
Reflect on how the factor you selected might influence the patient’s pharmacokinetic and pharmacodynamic processes.
Consider how pharmacokinetic and pharmacodynamic processes changes might impact the patient’s recommended drug therapy.
Think about how you might improve the patient’s drug therapy plan based on the pharmacokinetic and pharmacodynamic changes. Reflect on whether you would modify the current drug treatment or provide an alternative treatment option for the patient.
By Day 7 of Week 2
Write a 2- to 3-page paper that addresses the following:
Explain how the factor you selected might influence the pharmacokinetic and pharmacodynamic processes in the patient from the case study you were assigned.
Describe how changes in the processes might impact the patient’s recommended drug therapy. Be specific and provide examples.
Explain how you might improve the patient’s drug therapy plan and explain why you would make these recommended improvements.

NURS6521 Advanced Pharmacology Week 3 Assignment Asthma and Stepwise Management
Asthma is a respiratory disorder that affects children and adults. Advanced practice nurses often provide treatment to patients with these disorders. Sometimes patients require immediate treatment, making it essential that you recognize and distinguish minor asthma symptoms from serious, life-threatening ones. Since triggers often induce symptoms and attacks, advanced practice nurses must also help patients identify triggers and recommend appropriate management options. Like many other disorders, various approaches to treating and managing care for asthmatic patients depend on individual patient factors.
Photo Credit: Getty Images
One method that supports the clinical decision-making of drug therapy plans for asthmatic patients is the stepwise approach, which you explore in this Assignment.
To Prepare
Reflect on drugs used to treat asthmatic patients, including long-term control and quick relief treatment options for patients. Consider these drugs’ impact on patients, including adults and children.
Consider how you might apply the stepwise approach to address a patient’s health needs in your practice.
Reflect on how stepwise management assists healthcare providers and patients in gaining and maintaining disease control.
By Day 7 of Week 3
Create a 5- to 6-slide PowerPoint presentation that can be used in a staff development meeting on presenting different approaches for implementing the stepwise approach for asthma treatment. Be sure to address the following:
Describe long-term control and quick relief treatment options for the asthma patient from your practice and the impact these drugs might have on your patient.
Explain the stepwise approach to asthma treatment and management for your patient.
Explain how stepwise management assists healthcare providers and patients in gaining and maintaining disease control. Be specific.
 
NURS6521 Advanced Pharmacology Week 4 Assignment Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders
Gastrointestinal (GI) and hepatobiliary disorders affect the structure and function of the GI tract. Many of these disorders often have similar symptoms, such as abdominal pain, cramping, constipation, nausea, bloating, and fatigue. Since multiple disorders can be tied to the same symptoms, it is important for advanced practice nurses to carefully evaluate patients and prescribe a treatment that targets the cause rather than the symptom.
Once the underlying cause is identified, an appropriate drug therapy plan can be recommended based on medical history and individual patient factors. In this Assignment, you examine a case study of a patient who presents with symptoms of a possible GI/hepatobiliary disorder, and you design an appropriate drug therapy plan.
To Prepare
Review the case study assigned by your Instructor for this Assignment
Reflect on the patient’s symptoms, medical history, and prescribed drugs.
Think about a possible diagnosis for the patient. Consider whether the patient has a disorder related to the gastrointestinal and hepatobiliary system or whether the symptoms result from a disorder from another system or other factors, such as pregnancy, drugs, or a psychological disorder.
Consider an appropriate drug therapy plan based on the patient’s history, diagnosis, and drugs currently prescribed.
By Day 7 of Week 4
Write a 1-page paper that addresses the following:
Explain your diagnosis for the patient, including your rationale for the diagnosis.
Describe an appropriate drug therapy plan based on the patient’s history, diagnosis, and drugs currently prescribed.
Justify why you would recommend this drug therapy plan for this patient. Be specific and provide examples.

NURS6521 Advanced Pharmacology Week 8 Assignment Decision Tree for Neurological and Musculoskeletal
For your Assignment, your Instructor will assign you one of the decision tree interactive media pieces provided in the Resources. As you examine the patient case studies in this module’s Resources, consider how you might assess and treat patients presenting symptoms of neurological and musculoskeletal disorders.
Photo Credit: Getty Images/Science Photo Library RF
To Prepare
Review the interactive media piece assigned by your Instructor.
Reflect on the patient’s symptoms and aspects of the disorder presented in the interactive media piece.
Consider how you might assess and treat patients presenting with the symptoms of the patient case study you were assigned.
You will be asked to make three decisions concerning the diagnosis and treatment for this patient. Reflect on potential co-morbid physical as well as patient factors that might impact the patient’s diagnosis and treatment.
By Day 7 of Week 8
Write a 1- to 2-page summary paper that addresses the following:
Briefly summarize the patient case study you were assigned, including the three decisions you made for the patient presented.
Based on the decisions you recommended for the patient case study, explain whether you believe the evidence-based literature supported the decisions provided. Be specific and provide examples. Be sure to support your response with evidence and references from outside resources.
What were you hoping to achieve with the decisions you recommended for the patient case study you were assigned? Support your response with evidence and references from outside resources.
Explain any difference between what you expected to achieve with each of the decisions and the results of the decision in the exercise. Describe whether they were different. Be specific and provide examples.

NURS6521 Advanced Pharmacology Week 11 Assignment Off-Label Drug Use in Pediatrics
The unapproved use of approved drugs, also called off-label use, with children is quite common. This is because pediatric dosage guidelines are typically unavailable since very few drugs have been specifically researched and tested with children.
When treating children, prescribers often adjust dosages approved for adults to accommodate a child’s weight. However, children are not just “smaller” adults. Adults and children process and respond to drugs differently in their absorption, distribution, metabolism, and excretion.
Children even respond differently during stages from infancy to adolescence. This poses potential safety concerns when prescribing drugs to pediatric patients. As an advanced practice nurse, you must be aware of the safety implications of the off-label use of drugs with this patient group.
To Prepare
Review the interactive media piece in this week’s Resources and reflect on the types of drugs used to treat pediatric patients with mood disorders.
Reflect on situations in which children should be prescribed drugs for off-label use.
Think about strategies to make the off-label use and dosage of drugs safer for children from infancy to adolescence. Consider specific off-label drugs that require extra care and attention when used in pediatrics.
By Day 5 of Week 11
Write a 1-page narrative in APA format that addresses the following:
Explain the circumstances under which children should be prescribed drugs for off-label use. Be specific and provide examples.
Describe strategies to make the off-label use and dosage of drugs safer for children from infancy to adolescence. Include descriptions and names of off-label drugs that require extra care and attention when used in pediatrics.

Advanced Health Assessment

Question

Walden NURS6512 Full Course Latest

NURS6512 Advanced Health Assessment and Diagnostic Reasoning Week 1 Discussion Building a Health History
Effective communication is vital to constructing an accurate and detailed patient history. Many factors, including age, gender, ethnicity, and environmental setting, influence a patient’s health or illness. As an advanced practice nurse, you must be aware of these factors and tailor your communication techniques accordingly. Doing so will not only help you establish rapport with your patients, but it will also enable you to gather the information needed to assess your patients’ health risks.
For this Discussion, you will take on the role of a clinician who is building a health history for a particular new patient assigned by your Instructor.
Photo Credit: Getty Images/Caiaimage
To prepare:
With the information presented in Chapter 1 of Ball et al. in mind, consider the following:
By Day 1 of this week, your instructor will assign you a new patient profile for this Discussion. Note: Please see the “Course Announcements” section of the classroom for your new patient profile assignment.
How would your communication and interview techniques for building a health history differ with each patient?
How might you target your questions for building a health history based on the patient’s social determinants of health?
What risk assessment instruments would be appropriate to use with each patient, or what questions would you ask each patient to assess his or her health risks?
Identify any potential health-related risks based on the patient’s age, gender, ethnicity, or environmental setting that should be considered.
Select one of the risk assessment instruments presented in Chapter 1 or Chapter 5 of Seidel’s Guide to Physical Examination text or another tool with which you are familiar, related to your selected patient.
Develop at least five targeted questions you would ask your selected patient to assess his or her health risks and begin building a health history.
By Day 3 of Week 1
Post a summary of the interview and a description of the communication techniques you would use with your assigned patient. Explain why you would use these techniques. Identify the risk assessment instrument you selected, and justify why it would be applicable to the selected patient. Provide at least five targeted questions you would ask the patient.

NURS6512 Advanced Health Assessment and Diagnostic Reasoning Week 2 Discussion Diversity and Health Assessments
In May 2012, Alice Randall wrote an article for The New York Times on the cultural factors that encouraged black women to maintain weight above what is considered healthy. Randall explained—from her observations and experience as a black woman—that many African-American communities and cultures consider women who are overweight to be more beautiful and desirable than women at a healthier weight. As she put it, “Many black women are fat because we want to be” (Randall, 2012).
Photo Credit: Getty Images
Randall’s statements sparked much controversy and debate; however, they emphasize an underlying reality in healthcare: different populations, cultures, and groups have diverse beliefs and practices that impact their health. Nurses and healthcare professionals should be aware of this reality and adapt their health assessment techniques and recommendations to accommodate diversity.
In this Discussion, you will consider different socioeconomic, spiritual, lifestyle, and other cultural factors that should be taken into consideration when building a health history for patients with diverse backgrounds. Your Instructor will assign a case study to you for this Discussion.
To prepare:
Reflect on your experiences as a nurse and on the information provided in this week’s Learning Resources on diversity issues in health assessments.
By Day 1 of this week, your instructor will assign you a case study. Note: Please see the “Course Announcements” section of the classroom for your case study assignment.
Reflect on the specific socioeconomic, spiritual, lifestyle, and other cultural factors related to the health of the patient assigned to you.
Consider how you would build a health history for the patient. What questions would you ask, and how would you frame them to be sensitive to the patient’s background, lifestyle, and culture? Develop five targeted questions you would ask the patient to build his or her health history and to assess his or her health risks.
Think about the challenges associated with communicating with patients from a variety of specific populations. What strategies can you as a nurse employ to be sensitive to different cultural factors while gathering the pertinent information?
By Day 3 of Week 2
Post an explanation of the specific socioeconomic, spiritual, lifestyle, and other cultural factors associated with the patient you were assigned. Explain the issues that you would need to be sensitive to when interacting with the patient, and why. Provide at least five targeted questions you would ask the patient to build his or her health history and to assess his or her health risks.

NURS6512 Advanced Health Assessment and Diagnostic Reasoning Week 8 Discussion Assessing Musculoskeletal Pain
The body is constantly sending signals about its health. One of the most easily recognized signals is pain. Musculoskeletal conditions comprise one of the leading causes of severe long-term pain in patients. The musculoskeletal system is an elaborate system of interconnected levers that provides the body with support and mobility. Because of the interconnectedness of the musculoskeletal system, identifying the causes of pain can be challenging. Accurately interpreting the cause of musculoskeletal pain requires an assessment process informed by patient history and physical exams.
In this Discussion, you will consider case studies that describe abnormal findings in patients seen in a clinical setting.
To prepare:
By Day 1 of this week, you will be assigned to one of the following specific case studies for this Discussion. Please see the “Course Announcements” section of the classroom for your assignment from your Instructor.
Your Discussion post should be in the Episodic/Focused SOAP Note format rather than the traditional narrative style Discussion posting format. Refer to Chapter 2 of the Sullivan text and the Episodic/Focused SOAP Template in the Week 5 Learning Resources for guidance. Remember that all Episodic/Focused SOAP notes have specific data included in every patient case.

Review the following case studies:

Case 1: Back Pain
Photo Credit: University of Virginia. (n.d.).Lumbar Spine Anatomy [Photograph].Retrieved from http://www.med-ed.virginia.edu/courses/rad/ext/5lumbar/01anatomy.html. Used with permission of University of Virginia.
A 42-year-old male reports pain in his lower back for the past month. The pain sometimes radiates to his left leg. In determining the cause of the back pain, based on your knowledge of anatomy, what nerve roots might be involved? How would you test for each of them? What other symptoms need to be explored? What are your differential diagnoses for acute low back pain? Consider the possible origins using the Agency for Healthcare Research and Quality (AHRQ) guidelines as a framework. What physical examination will you perform? What special maneuvers will you perform?

Case 2: Ankle Pain
Photo Credit: University of Virginia. (n.d.). Lateral view of ankle showing Boehler’s angle [Photograph]. Retrieved from http://www.med-ed.virginia.edu/courses/rad/ext/8ankle/01anatomy.html. Used with permission of University of Virginia.
A 46-year-old female reports pain in both of her ankles, but she is more concerned about her right ankle. She was playing soccer over the weekend and heard a “pop.” She is able to bear weight, but it is uncomfortable. In determining the cause of the ankle pain, based on your knowledge of anatomy, what foot structures are likely involved? What other symptoms need to be explored? What are your differential diagnoses for ankle pain? What physical examination will you perform? What special maneuvers will you perform? Should you apply the Ottawa ankle rules to determine if you need additional testing?

Case 3: Knee Pain
Photo Credit: University of Virginia. (n.d.).Normal Knee Anatomy [Photograph]. Retrieved from http://www.med-ed.virginia.edu/courses/rad/ext/7knee/01anatomy.html. Used with permission of the University of Virginia.
A 15-year-old male reports dull pain in both knees. Sometimes one or both knees click, and the patient describes a catching sensation under the patella. What additional history do you need to determine the causes of knee pain? What categories can you use to differentiate knee pain? What are your specific differential diagnoses for knee pain? What physical examination will you perform? What anatomic structures are you assessing as part of the physical examination? What special maneuvers will you perform?

Concerning the case study you were assigned:
Review this week’s Learning Resources, and consider the insights they provide about the case study.
Consider what history would be necessary to collect from the patient in the case study you were assigned.
Consider what physical exams and diagnostic tests would be appropriate to gather more information about the patient’s condition. How would the results be used to make a diagnosis?
Identify at least five possible conditions that may be considered in a differential diagnosis for the patient.
Note: Before you submit your initial post, replace the subject line (“Discussion – Week 8”) with “Review of Case Study ___.” Fill in the blank with the number of the case study you were assigned.
By Day 3 of Week 8
Post an episodic/focused note about the patient in the case study to which you were assigned using the episodic/focused note template provided in the Week 5 resources. Provide evidence from the literature to support diagnostic tests that would be appropriate for each case. List five different possible conditions for the patient’s differential diagnosis, and justify why you selected each.
Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link, and then select “Create Thread” to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts and post anonymously. Please check your post carefully before clicking on Submit!
Read a selection of your colleagues’ responses.
By Day 6 of Week 8
Respond to at least two of your colleagues on 2 different days who were assigned different case studies than you. Analyze the possible conditions from your colleagues’ differential diagnoses. Determine which of the conditions you would reject and why. Identify the most likely condition, and justify your reasoning.

NURS6512 Advanced Health Assessment and Diagnostic Reasoning Week 3 Assignment Case Study Assignment: Assessment Tools and Diagnostic Tests in Adults and Children
When seeking to identify a patient’s health condition, advanced practice nurses can use a diverse selection of diagnostic tests and assessment tools; however, different factors affect the validity and reliability of the results produced by these tests or tools. Nurses must be aware of these factors in order to select the most appropriate test or tool and to interpret the results accurately.
These diagnostic tests affect adults, but body measurements can also provide a general picture of whether a child is receiving adequate nutrition or is at risk for health issues. These data, however, are just one aspect to be considered. Lifestyle, family history, and culture—among other factors—are also relevant. That said, gathering and communicating this information can be a delicate process.
Photo Credit: Getty Images/Hero Images
For this Assignment, you will consider the validity and reliability of different assessment tools and diagnostic tests. You will explore issues such as sensitivity, specificity, and positive and negative predictive values. You will also consider examples of children with various weight issues. You will explore how you could effectively gather information and encourage parents and caregivers to be proactive about their children’s health and weight.
To Prepare
Review this week’s Learning Resources and consider factors that impact the validity and reliability of various assessment tools and diagnostic tests. You will also review examples of pediatric patients and their families regarding BMI.
By Day 1 of this week, you will be assigned to one of the following Assignment options by your Instructor: Adult Assessment Tools or Diagnostic Tests (option 1) or Child Health Case (Option 2). Note: Please see the “Course Announcements” section of the classroom for your assignments from your Instructor.
Search the Walden Library and credible sources for resources explaining the tool or test you were assigned. What is its purpose, how is it conducted, and what information does it gather?
Also, as you search the Walden library and credible sources, consider what the literature discusses regarding the validity, reliability, sensitivity, specificity, predictive values, ethical dilemmas, and controversies related to the test or tool.
If you are assigned Assignment Option 2 (Child), consider what health issues and risks may be relevant to the child in the health example.
Based on the risks you identified, consider what further information you would need to fully understand the child’s health. Think about how you could sensitively gather this information.
Consider how you could encourage parents or caregivers to be proactive toward the child’s health.

The Assignment
Assignment (3–4 pages, not including title and reference pages):
Assignment Option 1: Adult Assessment Tools or Diagnostic Tests:
Include the following:
A description of how the assessment tool or diagnostic test you were assigned is used in healthcare.
What is its purpose?
How is it conducted?
What information does it gather?
Based on your research, evaluate the test or the tool’s validity and reliability, and explain any issues with sensitivity, reliability, and predictive values. Include references in appropriate APA formatting.
Assignment Option 2: Child Health Case:
Include the following:
An explanation of the health issues and risks that are relevant to the child you were assigned.
Describe additional information you would need in order to assess his or her weight-related health further.
Identify and describe any risks and consider further information you would need to understand the child’s healthfully. Think about how you could sensitively gather this information.
Considering the parents’ and caregivers’ potential sensitivities, list at least three specific questions you would ask about the child to gather more information.
Provide at least two strategies you could employ to encourage the parents or caregivers to be proactive about their child’s health and weight.

NURS6512 Advanced Health Assessment and Diagnostic Reasoning Week 4 Assignment Differential Diagnosis for Skin Conditions
Properly identifying the cause and type of a patient’s skin condition involves a process of elimination known as differential diagnosis. Using this process, a health professional can take a given set of physical abnormalities, vital signs, health assessment findings, and patient descriptions of symptoms and incrementally narrow them down until one diagnosis is determined as the most likely cause.
In this Lab Assignment, you will examine several visual representations of various skin conditions, describe your observations, and use differential diagnosis techniques to determine the most likely condition.
To Prepare
Review the Skin Conditions document provided in this week’s Learning Resources, and select one condition to examine for this Lab Assignment closely.
Consider the abnormal physical characteristics you observe in the graphic you selected. How would you describe the characteristics using clinical terminologies?
Explore different conditions that could be the cause of the skin abnormalities in the graphics you selected.
Consider which of the conditions is most likely to be the diagnosis, and why.
Search the Walden library for one evidence-based practice, peer-reviewed article based on the skin condition you chose for this Lab Assignment.
Review the Comprehensive SOAP Exemplar found in this week’s Learning Resources to guide you as you prepare your SOAP note.
Download the SOAP Template found in this week’s Learning Resources, and use this template to complete this Lab Assignment.
The Lab Assignment
Choose one skin condition graphic (identify by number in your Chief Complaint) to document your assignment in the SOAP (Subjective, Objective, Assessment, and Plan) note format rather than the traditional narrative style. Refer to Chapter 2 of the Sullivan text and the Comprehensive SOAP Template in this week’s Learning Resources for guidance. Remember that not all comprehensive SOAP data are included in every patient case.
Use clinical terminologies to explain the physical characteristics featured in the graphic. Formulate a differential diagnosis of three to five conditions for the skin graphic you chose. Determine which is most likely to be the diagnosis and explain your reasoning using at least three references, one from current evidence-based literature from your search and two from this week’s Learning Resources.

NURS6512 Advanced Health Assessment and Diagnostic Reasoning Week 5 Assignment Case Study Assignment: Assessing the Head, Eyes, Ears, Nose, and Throat
Nurses conducting assessments of the ears, nose, and throat must be able to identify the small differences between life-threatening conditions and benign ones. For instance, if a patient with a sore throat and a runny nose also has inflamed lymph nodes, the inflammation is probably due to the pathogen causing the sore throat rather than a case of throat cancer. With this knowledge and a sufficient patient health history, a nurse would not need to escalate the assessment to a biopsy or an MRI of the lymph nodes but would probably perform a simple strep test.
In this Case Study Assignment, you consider case studies of abnormal findings from patients in a clinical setting. You determine what history should be collected from the patients, what physical exams and diagnostic tests should be conducted, and formulate a differential diagnosis with several possible conditions.
To Prepare
By Day 1 of this week, you will be assigned to a specific case study for this Case Study Assignment. Please see the “Course Announcements” section of the classroom for your assignment from your Instructor.
Also, your Case Study Assignment should be in the Episodic/Focused SOAP Note format rather than the traditional narrative style format. Refer to Chapter 2 of the Sullivan text and the Episodic/Focused SOAP Template in the Week 5 Learning Resources for guidance. Remember that all Episodic/Focused SOAP Notes have specific data included in every patient case.
With regard to the case study you were assigned:
Review this week’s Learning Resources and consider the insights they provide.
Consider what history would be necessary to collect from the patient.
Consider what physical exams and diagnostic tests would be appropriate to gather more information about the patient’s condition. How would the results be used to make a diagnosis?
Identify at least five possible conditions that may be considered in a differential diagnosis for the patient.
The Assignment
Use the Episodic/Focused SOAP Template and create an episodic/focused note about the patient in the case study to which you were assigned using the episodic/focused note template provided in the Week 5 resources. Provide evidence from the literature to support diagnostic tests that would be appropriate for each case. List five different possible conditions for the patient’s differential diagnosis and justify why you selected each.

NURS6512 Advanced Health Assessment and Diagnostic Reasoning Week 6 Assignment Assessing the Abdomen
A woman went to the emergency room for severe abdominal cramping. She was diagnosed with diverticulitis; however, the doctor ordered a CT scan as a precaution. The CT scan revealed a growth on the pancreas, which turned out to be pancreatic cancer—the real cause of the cramping.
Because of a high potential for misdiagnosis, determining the precise cause of abdominal pain can be time consuming and challenging. By analyzing case studies of abnormal abdominal findings, nurses can prepare themselves to better diagnose conditions in the abdomen.
In this Lab Assignment, you will analyze an Episodic note case study that describes abnormal findings in patients seen in a clinical setting. You will consider what history should be collected from the patients as well as which physical exams and diagnostic tests should be conducted. You will also formulate a differential diagnosis with several possible conditions.
To Prepare
Review the Episodic note case study your instructor provides you for this week’s Assignment. Please see the “Course Announcements” section of the classroom for your Episodic note case study.
With regard to the Episodic note case study provided:
Review this week’s Learning Resources, and consider the insights they provide about the case study.
Consider what history would be necessary to collect from the patient in the case study.
Consider what physical exams and diagnostic tests would be appropriate to gather more information about the patient’s condition. How would the results be used to make a diagnosis?
Identify at least five possible conditions that may be considered in a differential diagnosis for the patient.
The Assignment
Analyze the subjective portion of the note. List additional information that should be included in the documentation.
Analyze the objective portion of the note. List additional information that should be included in the documentation.
Is the assessment supported by the subjective and objective information? Why or why not?
What diagnostic tests would be appropriate for this case, and how would the results be used to make a diagnosis?
Would you reject/accept the current diagnosis? Why or why not? Identify three possible conditions that may be considered as a differential diagnosis for this patient. Explain your reasoning using at least three different references from current evidence-based literature.

NURS6512 Advanced Health Assessment and Diagnostic Reasoning Week 9 Assignment Case Study Assignment: Assessing Neurological Symptoms
Imagine not being able to form new memories. This is the reality patients with anterograde amnesia face. Although this form of amnesia is rare, it can result from severe brain trauma. Anterograde amnesia demonstrates how impactful brain disorders can be to a patient’s quality of life. Accurately assessing neurological symptoms is a complex process involving analyzing many factors.
In this Case Study Assignment, you will consider case studies describing abnormal findings in patients in a clinical setting.
To Prepare
By Day 1 of this week, you will be assigned to a specific case study for this Case Study Assignment. Please see the “Course Announcements” section of the classroom for your assignment from your Instructor.
Also, your Case Study Assignment should be in the Episodic/Focused SOAP Note format rather than the traditional narrative style format. Refer to Chapter 2 of the Sullivan text and the Episodic/Focused SOAP Template in the Week 5 Learning Resources for guidance. Remember that all Episodic/Focused SOAP notes have specific data included in every patient case.
With regard to the case study you were assigned:
Review this week’s Learning Resources, and consider the insights they provide about the case study.
Consider what history would be necessary to collect from the patient in the case study you were assigned.
Consider what physical exams and diagnostic tests would be appropriate to gather more information about the patient’s condition. How would the results be used to make a diagnosis?
Identify at least five possible conditions that may be considered in a differential diagnosis for the patient.
The Case Study Assignment
Use the Episodic/Focused SOAP Template and create an episodic/focused note about the patient in the case study to which you were assigned using the episodic/focused note template provided in the Week 5 resources. Provide evidence from the literature to support diagnostic tests that would be appropriate for each case. List five different possible conditions for the patient’s differential diagnosis, and justify why you selected each.

NURS6512 Advanced Health Assessment and Diagnostic Reasoning Week 10 Assignment Assessing the Genitalia and Rectum

Patients are frequently uncomfortable discussing with healthcare professional’s issues that involve the genitalia and rectum; however, gathering an adequate history and properly conducting a physical exam are vital. Examining case studies of genital and rectal abnormalities can help prepare advanced practice nurses to assess patients with problems in these areas accurately.

In this Lab Assignment, you will analyze an Episodic note case study that describes abnormal findings in patients seen in a clinical setting. You will consider what history should be collected from the patients and which physical exams and diagnostic tests should be conducted. You will also formulate a differential diagnosis with several possible conditions.

To Prepare

· Review the Episodic note case study your instructor provides you for this week’s Assignment. Please see the “Course Announcements” section of the classroom for your Episodic note case study.

· Based on the Episodic note case study:

· Review this week’s Learning Resources and consider their insights about the case study. Refer to Chapter 3 of the Sullivan resource to guide you as you complete your Lab Assignment.

· Search the Walden library or the Internet for evidence-based resources to support your answers to the questions provided.

· Consider what history would be necessary to collect from the patient in the case study.

· Consider what physical exams and diagnostic tests would be appropriate to gather more information about the patient’s condition. How would the results be used to make a diagnosis?

· Identify at least five possible conditions that may be considered in a differential diagnosis for the patient.

The Lab Assignment

Using evidence-based resources from your search, answer the following questions and support your answers using current evidence from the literature.

· Analyze the subjective portion of the note. List additional information that should be included in the documentation.

· Analyze the objective portion of the note. List additional information that should be included in the documentation.

· Is the assessment supported by subjective and objective information? Why or why not?

· Would diagnostics be appropriate for this case, and how would the results be used to make a diagnosis?

· Would you reject/accept the current diagnosis? Why or why not? Identify three conditions that may be considered a differential diagnosis for this patient. Explain your reasoning using at least three different references from current evidence-based literature.

· Evaluate abnormal findings on the genitalia and rectum

· Apply concepts, theories, and principles relating to health assessment techniques and diagnoses for the breasts, genitalia, prostate, and rectum

GENITALIA ASSESSMENT

Subjective:

· CC: “I have bumps on my bottom that I want to have checked out.”

· HPI: AB, a 21-year-old WF college student reports to your clinic with external bumps on her genital area. She states the bumps are painless and feel rough. She states she is sexually active and has had more than one partner during the past year. Her initial sexual contact occurred at age 18. She reports no abnormal vaginal discharge. She is unsure how long the bumps have been there but noticed them about a week ago. Her last Pap smear exam was 3 years ago, and no dysplasia was found; the exam results were normal. She reports one sexually transmitted infection (chlamydia) about 2 years ago. She completed the treatment for chlamydia as prescribed.

· PMH: Asthma

· Medications: Symbicort 160/4.5mcg

· Allergies: NKDA

· FH: No hx of breast or cervical cancer, Father hx HTN, Mother hx HTN, GERD

· Social: Denies tobacco use; occasional etoh, married, 3 children (1 girl, 2 boys)

Objective:

· VS: Temp 98.6; BP 120/86; RR 16; P 92; HT 5’10”; WT 169lbs

· Heart: RRR, no murmurs

· Lungs: CTA, chest wall symmetrical

· Genital: Normal female hair pattern distribution; no masses or swelling. Urethral meatus intact without erythema or discharge. Perineum intact. Vaginal mucosa pink and moist with rugae present, pos for firm, round, small, painless ulcer noted on external labia.

· Abd: soft, normoactive bowel sounds, neg rebound, neg murphy’s, neg McBurney

· Diagnostics: HSV specimen obtained

Assessment:

· Chancre

PLAN: This section is not required for the assignments in this course (NURS 6512) but will be required for future courses.

Assignment: Lab Assignment: Assessing the Genitalia and Rectum

Using evidence-based resources from your search, answer the following questions and support your answers using current evidence from the literature.

· Analyze the subjective portion of the note. List additional information that should be included in the documentation.

· Analyze the objective portion of the note. List additional information that should be included in the documentation.

· Is the assessment supported by subjective and objective information? Why or why not?

· Would diagnostics be appropriate for this case, and how would the results be used to make a diagnosis?

· Would you reject/accept the current diagnosis? Why or why not? Identify three conditions that may be considered a differential diagnosis for this patient. Explain your reasoning using at least three different references from current evidence-based literature.

NURS6512 Advanced Health Assessment and Diagnostic Reasoning Week 11 Assignment Ethical Concerns

Assignment 1: Lab Assignment: Ethical Concerns

As an advanced practice nurse, you will run into situations where a patient’s wishes about his or her health conflict with evidence, your own experience, or a family’s wishes. This may create an ethical dilemma. What do you do when these situations occur?

In this Lab Assignment, you will explore evidence-based practice guidelines and ethical considerations for specific scenarios.

To Prepare

Review the scenarios provided by your instructor for this week’s Assignment. Please see the “Course Announcements” section of the classroom for your scenarios.

• Based      on the scenarios provided:
  • Select one scenario and reflect on the material presented throughout this course.
  • What necessary information would need to be obtained about the patient through health assessments and diagnostic assessments?
  • Consider how you would respond as an advanced practice nurse. Review evidence-based practice guidelines and ethical considerations applicable to the scenarios you selected.

CASE STUDY 1

The parents of a 16-year-old male is seen for his required physical examination before starting sports. His parents are opposed to him receiving any vaccines.

The Lab Assignment

Write a detailed one-page narrative explaining the health assessment information required for diagnosing your selected patient (include the scenario number). Explain how you would respond to the scenario as an advanced practice nurse using evidence-based practice guidelines and applying ethical considerations. Justify your response using at least three different references from current evidence-based literature.

NURS6512 Advanced Health Assessment and Diagnostic Reasoning Week 6 Exam
Question 1

You are palpating a patient’s thyroid and find that its broadest dimension measures 4 cm. The right lobe is 25% larger than the left. These data would indicate:
Answers:
B. a multinodular goiter.
D. thyroiditis.
A. a congenital anomaly.
C. a normal thyroid gland.
Question 2Mrs. Britton brings her 16-year-old son in with a complaint that he is not developing correctly into adolescence. Which structures disproportionately enlarge in the male during adolescence?
Answers:
A. Coronal sutures
D. Nose and thyroid cartilages
C. Mandible and maxilla bones
B. Hyoid and cricoid cartilages
Question 3Peritonitis produces bowel sounds that are:
Answers:
hyperactive.
absent.
high pitched.
hypoactive.
Question 4When communicating with older children and teenagers, you should be sensitive to their:
Answers:
desire for adult companionship.
natural urge to communicate.
need for verbal instructions.
typical reluctance to talk.
Question 5The review of systems is a component of the:
Answers:
assessment.
physical examination.
health history.
past medical/surgical history.
Question 6You are examining a pregnant patient and have noted a vascular lesion. When you blanche over the vascular lesion, the site blanches and refills evenly from the center outward. The nurse documents this lesion as a:
Answers:
D. purpura.
A. telangiectasia.
B. spider angioma.
C. petechiae.
Question 7Mr. Akins is a 78-year-old patient who presents to the clinic with complaints of hearing loss. Which of the following are changes in hearing that occur in the elderly? Select all that apply.

Answers:
a. Loss of high frequency
b. Progression is slow
c. Bone conduction heard longer than air conduction
d. Sounds may be garbled and difficult to localize
e. Results from cranial nerve VII
f. Unable to hear in a crowded room
Question 8A guideline for history taking is for caregivers to:
Answers:
write detailed information as stated by patients so that their priorities are reflected.
make notes sparingly so that patients can be observed during the history taking.
ask direct questions before open-ended questions so that data move from simple to complex.
ask for a complete history at once so that data are not forgotten between meetings.
Question 9Mr. Johnson presents with a freely movable cystic mass in the midline of the high neck region at the base of the tongue. This is most likely a:
Answers:
A. parotid gland tumor.
B. branchial cleft cyst.
C. Stensen duct stone.
D. thyroglossal duct cyst.
Question 10A 51-year-old woman calls with complaints of weight loss and constipation. She reports enlarged hemorrhoids and rectal bleeding. You advise her to:
Answers:
use topical over-the-counter hemorrhoid treatment for 1 week.
eat six small meals a day.
come to the laboratory for a stool guaiac test.
exercise and eat more fiber.
Question 11
Which cranial nerves innervate the face?
Answers:
D. VIII and IX
B. III and VI
A. II and V
C. V and VII
Question 12Mr. Black is a 44-year-old patient who presents to the clinic with complaints of neck pain that he thinks is from his job involving computer data entry. As the examiner, you are checking the range of motion in his neck and note the greatest degree of cervical mobility is at:
Answers:
D. C4 to C5.
B. C2 to C3.
C. C3 to C4.
A. C1 to C2.
Question 13Expected hair distribution changes in older adults include:
Answers:
increased terminal hair follicles on the scalp.
more prominent peripheral extremity hair production.
more prominent axillary and pubic hair production.
increased terminal hair follicles to the tragus of men’s ears.
Question 14The attitudes of the health care professional:
Answers:
do not influence patient behavior.
are culturally derived.
are largely irrelevant to the success of relationships with the patient.
are difficult for the patient to sense.
Question 15Which of the following is the most vital nutrient?
Answers:
Protein
Carbohydrate
Water
Fat
Question 16The recommended minimum daily protein requirement for the normal adult is ______.
Answer:
Evaluation Method          Answer  Case Sensitivity
Match  10% to 35% of total calories
Contains              10 to 35 percent
Pattern Match    It is recommended that protein content of the diet be 10% to 35% of total calories, or 46 g in adults.
Contains              10% to 35%
Question 17Mr. Mills is a 55-year-old patient who presents to the office for an initial visit for health promotion. A survey of mobility and activities of daily living (ADLs) is part of a(an):
Answers:
ethnic assessment.
functional assessment.
social history.
genetic examination.
Question 18When examining the skull of a 4-month-old baby, you should normally find:
Answers:
D. overlap of cranial bones.
A. closure of the anterior fontanel.
C. ossification of all sutures.
B. closure of the posterior fontanel.
Question 19Periods of silence during the interview can serve important purposes, such as:
Answers:
allowing the clinician to catch up on documentation.
increasing the length of the visit.
providing time for reflection.
promoting calmness.
Question 20After thorough inspection of the abdomen, the next assessment step is:
Answers:
palpation.
percussion.
rectal examination.
auscultation.

Walden NURS6512 Exam Latest

Walden NURS6512 Week 6 Exam Latest

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