Posts in category: Nursing Papers

NURS 6521 FINAL EXAM (3 VERSIONS) & NURS 6521 MIDTERM EXAM (3 VERSIONS) (100 CORRECT Q & A IN EACH VERSION, TOTAL: 600 Q & A)

NURS 6521 FINAL EXAM

A IN EACH VERSION, TOTAL: 600 Q & A)
 
NURS 6521 Final Exam / NURS6521 Final Exam (Latest): Advanced Pharmacology: Walden University
Walden NURS 6521 Final Exam / Walden NURS6521 Final Exam (Latest): Advanced Pharmacology
· Question 1
 
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 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 nurse works at a weight   management clinic. To which of the following overweight patients could the   nurse safely administer dextroamphetamine?
 
· Question 4
 
 
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 5
 
A 38-year-old pregnant patient   admits to the nurse 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 6
 
A nurse practitioner orders 150 mg   of oral fluconazole for a patient with vulvovaginal candidiasis. The patient   should expect to take medication
 
· Question 7
 
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 8
 
A middle-aged patient has received   a diagnosis of GI stromal tumor following an extensive diagnostic workup.   Imatinib has been recommended as a component of the patient’s drug regimen.   What patient education should the nurse provide to this patient?
 
· Question 9
 
A 12-year-old boy is being   discharged from the hospital after major surgery. The boy will be taking two   medications at home for an extended period. The nurse who is discharging the   patient should provide medication teaching specifically to
 
· Question 10
 
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 11
 
A 39-year-old woman is receiving   doxorubicin for the treatment of cancer. After each treatment, the patient   has acute nausea and vomiting accompanied by a slightly increased heart rate.   The nurse will advise her to
 
· Question 12
 
A nurse is caring for a patient   with cancer who has been prescribed dronabinol (Marinol) to help reduce   nausea and vomiting from chemotherapy. The nurse will inform the patient that   he or she is taking an oral form of
 
· Question 13
 
A 46-year-old man is receiving a   quinupristindalfopristin IV infusion for a life-threatening infection. Which   of the following would be most important for the nurse to monitor?
 
· Question 14
 
A woman is receiving prolonged   drug therapy during her complicated pregnancy, and it may pose a risk to both   the mother and the fetus. The primary care physician has made dosage   adjustments to minimize adverse effects and prevent toxicity. The nurse   should make sure
 
· Question 15
 
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 16
 
A 36-year-old patient comes to the   clinic and tells the nurse that she suspects that she is pregnant. During the   initial assessment, the nurse 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 17
 
A male patient with a medical   background tells the nurse that he is not satisfied with the oral synthetic   testosterone that has been prescribed for him and he would like to try a   natural form of oral testosterone. Which of the following would be an   appropriate response by the nurse?
 
· Question 18
 
A male patient is trying to decide   if he should use finasteride (Proscar) to treat benign prostatic hypertrophy   (BPH). When providing information about the drug, the nurse will include   which of the following as a risk associated with finasteride therapy?
 
· Question 19
 
A 2-year-old child is diagnosed   with a minor ailment and is to be administered medications at home for 2   weeks. The child lives with his mother, grandmother, and four other children   between the ages of 14 months and 7 years. The home health nurse is asked to   assess the home environment to determine if it is appropriate for the child   to take his medication at home. Which of the following will have the greatest   impact on the nurse’s assessment?
 
· Question 20
 
A 22-year-old woman has given   birth to an infant who exhibits the signs and symptoms of maternal cocaine   use during pregnancy. These signs and symptoms are a result of what   pathophysiological effect of opioid use during pregnancy?
 
· Question 21
 
A 62-year-old patient taking   tamoxifen exhibits increased bone and tumor pain along with a local disease   flare. The nurse interprets this as an indication of which of the following?
 
· Question 22
 
A female patient is prescribed   oprelvekin therapy to treat thrombocytopenia. Which of the following should   the nurse continuously monitor to determine the efficacy and duration of the   oprelvekin therapy?
 
· Question 23
 
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 24
 
A patient has completed 4 weeks of   treatment with epoetin alfa. Which of the following assessment findings would   most strongly indicate that treatment has been effective?
 
· Question 25
 
A patient has been scheduled to   begin treatment with rituximab for non-Hodgkin’s lymphoma. The nurse who will   administer this drug should understand that it targets
 
· Question 26
 
A 15-year-old boy has been   diagnosed with bone cancer after several months of fatigue and pain. What   question should the nurse include in an assessment when trying to minimize   the potential for adverse drug reactions?
 
· Question 27
 
A 30-year-old man with a BMI of 59   has recently been diagnosed with type 2 diabetes mellitus. In light of the   man’s lack of success with weight loss programs in the past, his care   provider has prescribed sibutramine (Meridia). What instructions should the nurse   consequently provide to this patient?
 
· Question 28
 
A 49-year-old farmer who normally   enjoys good health has become seriously ill in recent days and the results of   an extensive diagnostic work up have resulted in a diagnosis of histoplasmosis.   The patient has been admitted to the hospital and has begun treatment with   amphotericin B. The nurse who is providing care for the patient should   prioritize which of the following diagnostic results during his course of   treatment?
 
· Question 29
 
A patient has just received her   first dose of imatinib and the nurse on the oncology unit is amending the   patient’s care plan accordingly. What nursing diagnosis is most appropriate   in light of this addition to the patient’s drug regimen?
 
· Question 30
 
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 31
 
Which of the following nursing   actions is most important in achieving successful antimicrobial therapy with   vancomycin?
 
· Question 32
 
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 33
 
A patient receiving high-dose   cisplatin therapy exhibits symptoms of hypomagnesemia. Which of the following   should the nurse suggest to help offset the magnesium losses from the   cisplatin therapy?
 
· Question 34
 
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 35
 
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 36
 
A 21-year-old female has a history   of irregular menses. She recently became sexually active, and would like to   begin taking oral contraceptives (OCs). The nurse practitioner recognizes   that most likely this patient would benefit from taking which category of   OCs.
 
· Question 37
 
A 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 38
 
A nurse is providing patient   education to a 13-year-old girl who was just diagnosed with type 1 diabetes mellitus.   Which of the following statements by the patient will alert the nurse that   special instructions regarding insulin are necessary?
 
· Question 39
 
A 28-year-old woman has completed   rituximab therapy for an autoimmune disease. She tells the nurse that she and   her husband would like to start a family. The nurse will advise her to
 
· Question 40
 
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 41
 
A nurse 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 42
 
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 43
 
A nurse is providing patient   education to a 50-year-old woman who is taking methotrexate (MTX) for breast   cancer. The nurse will instruct the patient to avoid which of the following   drugs?
 
· Question 44
 
A nurse is instructing a   19-year-old female patient on the use of fluconazole for candida vaginitis. A   teaching priority will be to
 
· Question 45
 
A nurse 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 46
 
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 47
 
A preterm neonate received   caffeine for the treatment of apnea. The nurse should monitor the neonate for   which of the following?
 
· Question 48
 
A patient has been prescribed   daptomycin for a complicated skin infection. Which of the following will the   nurse advise the patient to report immediately?
 
· Question 49
 
A 7-year-old child has been taking   tetracycline for a bacterial infection. The nurse will be sure to inform the   parents that this drug could cause
 
· Question 50
 
Sulconazole has been prescribed   for a patient with tinea pedis. The nurse will instruct the patient to use   the topical agent
 
· Question 51
 
A nurse has questioned why a   patient’s physician has prescribed a narrow-spectrum antibiotic rather than a   broad-spectrum drug in the treatment of a patient’s infection. Which of the   following facts provides the best rationale for the use of narrow-spectrum   antibiotics whenever possible?
 
· Question 52
 
A female patient has been   prescribed estrogen therapy. Which of the following will the nurse advise the   patient is a common adverse effect of estrogen therapy?
 
· Question 53
 
A nurse is discussing oprelvekin   therapy with a male patient. Which of the following will the nurse tell the   patient is the most common adverse effect of the drug?
 
· Question 54
 
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 55
 
A female patient has follicular   non-Hodgkin’s lymphoma and is receiving thalidomide (Thalomid). It will be   most important for the nurse to monitor this patient for which of the   following?
 
· Question 56
 
A nurse 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 57
 
A nurse is aware that the concept   of selective toxicity is foundational to antimicrobial therapy. Which of the   following statements most accurately describes selective toxicity?
 
· Question 58
 
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 59
 
A nurse has completed a medication   reconciliation of a patient who has been admitted following a motor vehicle   accident. Among the many drugs that the patient has received in the previous   year is rituximab. The nurse would be justified in suspecting the patient may   have received treatment for which of the following diseases?
 
· Question 60
 
A patient asks the nurse   practitioner about food sources such as soybeans and soy products. The nurse   practitioner understands that these foods are considered
 
· Question 61
 
A nurse is providing patient   education to a 23-year-old woman who is starting the norelgestrominethinyl estradiol   transdermal system (Ortho Evra). Because this is the patient’s first time to   use the birth control patch, the nurse will instruct her to apply the patch
 
· Question 62
 
A nurse 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 63
 
Which of the following patients   will be at the greatest risk for anemia and would be the most likely   candidate for epoetin alfa therapy?
 
· Question 64
 
A 35-year-old woman is on a   weight-loss program and is to begin taking sibutramine (Meridia). After   baseline physical data are obtained, the nurse will assess the patient’s   childbearing potential. The nurse will inform the patient that during   sibutramine therapy she should
 
· Question 65
 
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 66
 
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 67
 
A 16-year-old boy is prescribed   cromolyn sodium nasal spray to treat a nasal allergy. To maximize the   therapeutic effects of the drug, which of the following will the nurse   include in instructions to the patient?
 
· Question 68
 
A nurse 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 69
 
A nurse 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 70
 
A nurse 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 71
 
A 10-year-old boy is taking   dextroamphetamine (Dexedrine) daily for ADHD. At each clinic visit, the   nurse’s priority assessment would be
 
· Question 72
 
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 73
 
A 43-year-old man has been   diagnosed with active TB. He is prescribed a multiple drug therapy, including   INH and rifampin. A priority assessment by the nurse will be to monitor which   combination of laboratory test results?
 
· Question 74
 
During ongoing assessment of a   patient receiving 5-FU therapy, the nurse finds the patient’s platelet count   to be 92,000 cellsmm3. The nurse should do which of the following?
 
· Question 75
 
A nurse 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 76
 
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 77
 
A nurse is instructing a colleague   on how an antimicrobial produces a therapeutic effect. Which of the following   should be included in the nurse’s teaching?
 
· Question 78
 
A 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 79
 
A nurse has been assigned to a   55-year-old woman who has a malignant brain tumor. The patient is receiving   her first dose of carmustine. It will be critical for the nurse to observe   for which of the following?
 
· Question 80
 
A man is prescribed ciprofloxacin   to treat a sexually transmitted infection. The nurse will instruct the   patient to
 
· Question 81
 
A 66-year-old man has made an   appointment with his primary care provider to discuss his recent erectile   dysfunction (ED) and has requested a prescription for tadalafil (Cialis)   based on television commercials he has seen. What characteristic of this   patient would most likely contraindicate the use of tadalafil for his ED?
 
· Question 82
 
A nurse 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 83
 
A 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 84
 
A patient is taking rifampin   (Rifadin) for active TB. When discussing this drug with the patient, the   nurse should stress that
 
· Question 85
 
A nurse is administering rituximab   to a patient via the IV route. The nurse will set the IV pump at 50 mghour   for the first half hour of the initial infusion. If there are not apparent   reactions after 30 minutes of the infusion, the nurse will increase the   dosage every 30 minutes by 50 mghour until the maximum infusion rate reaches   which of the following?
 
· Question 86
 
A 60-year-old patient experienced   a sudden onset of chest pain and shortness of breath and was subsequently   diagnosed with a pulmonary embolism in the emergency department. The patient   has been started on an intravenous heparin infusion. How does this drug   achieve therapeutic effect?
 
· Question 87
 
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 88
 
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 89
 
A patient is receiving long-term   clindamycin therapy for a life-threatening infection. The nurse will begin by   monitoring this drug therapy by obtaining
 
· Question 90
 
A patient is prescribed   ganciclovir to treat a CMV infection. An oral dosage is prescribed. To help   increase bioavailability of the drug, the nurse will encourage the patient to   take the medication
 
· Question 91
 
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 92
 
A patient is pregnant and is at 7   weeks’ gestation. She has type 1 diabetes and has been taking insulin since   she was 13 years old. She asks the nurse if the insulin will be harmful to   her baby. The best response to the patient by the nurse would be
 
· Question 93
 
A nurse 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 94
 
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 epoetin alfa with his oncologist. Which of the following facts   should underlie the nurse’s response to Mr. Lepp?
 
· Question 95
 
A patient with a diagnosis of   chronic myeloid leukemia has met with her oncologist, who has recommended treatment   with the kinase inhibitor imatinib. What route of administration should the   nurse explain to the patient?
 
· Question 96
 
A nurse is going to administer   medication to an infant using a medicine dropper. The best method is to open the   child’s mouth by gently squeezing the cheeks and placing the drops
 
· Question 97
 
A nurse practitioner orders a   single dose of 2 g Metronidazole orally. How many milligrams will the patient   receive in one dose?
 
· Question 98
 
A patient is being treated for   Mycoplasma pneumoniae pneumonia. She is allergic to penicillin and is being   given azithromycin (Zithromax) in capsule form. The nurse will inform the   patient that she will need to take the capsule
 
· Question 99
 
A nurse 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 100
 
A patient has been prescribed oral   tetracycline. The nurse will instruct the patient to take the drug
 
NURS 6521 Midterm Exam / NURS6521 Midterm Exam (Latest): Advanced Pharmacology: Walden University
Walden NURS 6521 Midterm Exam / Walden NURS6521 Midterm Exam (Latest): Advanced Pharmacology
1. Which of the following patients demonstrates the clearest indication for treatment with prednisone?
A) A 66-year-old woman whose history of smoking has culminated in a diagnosis of emphysema
B) A 70-year-old man whose rheumatoid arthritis has not responded to OTC pain relievers
C) A 12-year-old boy whose long-standing fatigue and malaise have been attributed to leukemia
D) A 50-year-old woman who is being treated for hypertension with a diuretic and an ACE inhibitor
2. A nurse has been administering a drug to a patient intramuscularly (IM). The physician discontinued the IM dose and wrote an order for the drug to be given orally. The nurse notices that the oral dosage is consid- erably higher than the parenteral dose and understands that this due to
A) passive diffusion.
B) active transport.
C) glomerular filtration.
D) first-pass effect.
3. A nurse is caring for a postsurgical patient who has small tortuous veins and had a difficult IV insertion. The patient is now receiving IV medications on a regular basis. What is the best nursing intervention to minimize the adverse effects of this drug therapy?
A) Monitor the patient’s bleeding time
B) Check the patient’s blood glucose levels
C) Record baseline vital signs
D) Monitor the IV site for redness, swelling, or pain
4. A patient is in the clinic after 6 weeks of taking riluzole (Rilutek) for a recent diagnosis of amyotrophic lateral sclerosis. The nurse will priori- tize assessment for which of the following?
A) Weight gain
B) Constipation
C) Increased energy
D) Dizziness
5. A cardiac care nurse is monitoring a patient who is receiving lidocaine (Xylocaine) per IV infusion pump for an acute ventricular arrhythmia associated with an acute MI. Which of the following patient manifesta- tions would cause the nurse to notify the physician immediately?
A) Confusion
B) Headache
C) Nausea
D) Leg cramps A
6. A nurse is caring for a patient who is admitted into the cardiac care unit with acute, decompensated heart failure. Nesiritide (Natrecor) has been ordered. When preparing for administration of the drug, the nurse will
A) add the reconstituted vial of medication to a 1,000 mL IV bag.
B) shake the vial vigorously to mix the medication for reconstitution.
C) administer the initial IV bolus over approximately 60 seconds.
D) use the reconstituted solution within a 36-hour period. C
7. A patient has been prescribed lithium therapy. Which of the following signs and symptoms will the nurse tell the patient to report immediately?
A) Increased urination
B) Muscle twitching
C) Hair loss
D) Increased thirst B
8. A nurse is caring for a patient who has just been diagnosed with Parkinson disease. The patient does not understand how the medication ordered, carbidopa-levodopa, is going to help her condition. Which of the following is the correct response by the nurse?
A) “Carbidopa-levodopa will delay the loss of muscle strength and limb function for several months.”
B) “This drug will change the immune processes in your body to help
 
decrease the tissue damage.”
C) “Carbidopa-levodopa increases the activity of dopamine in your body, which will decrease your symptoms.”
D) “Your drug therapy will reduce excessive reflex activity causing your muscle spasms and will allow for muscle relaxation.”
C
9. 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?
A) Chronic diarrhea
B) Dental hygiene practices
C) Headaches
D) Diet B
10. A nurse notes new drug orders for a patient who is already getting several medications. Which of the following is the most important con- sideration when preparing to administer the new drugs?
A) How the patient will feel about new medications added to her drug therapy
B) Possible drug-drug interactions that might occur
C) Any special nursing considerations that the nurse must be aware of
D) If generic preparations of the drugs can be used B
11. A nurse 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?
A) The amount of the drug that must be given to produce a particular re- sponse
B) How well a drug produces its desired effect
C) A drug’s strength of attraction for a receptor site
D) A drug’s ability to stimulate its receptor B
12. A nurse is conducting a medication resolution of a new resident of a care facility and notes that the woman has been taking neostigmine. The nurse should recognize that the woman may have a history of what
 
health problem?
A) Alzheimer disease
B) Parkinson disease
C) Myasthenia gravis
D) Multiple sclerosis C
13. A 77-year-old man’s chronic heart failure is being treated with a regi- men of quinapril (Accupril) and furosemide (Lasix). Which of the fol- lowing assessment findings would suggest that the loop diuretic is con- tributing to a therapeutic effect?
A) The man’s glomerular filtration rate and creatinine levels are within reference ranges.
B) The man’s heart rate is between 60 and 70 beats per minute with a regular rhythm.
C) The man’s potassium and sodium levels remain with reference ranges.
D) The man’s chest sounds are clear and his ankle edema is lessened. D
14. A nurse explains to a patient that nitroglycerin patches should be ap- plied in the morning and removed in the evening. This medication schedule reduces the potential for
A) adverse effects.
B) nitrate dependence.
C) nitrate tolerance.
D) toxic effects. C
15. A nurse who provides care on a busy medical unit of a large hospital is constantly faced with new drugs on patients’ medication administra- tion records. What strategy should the nurse employ to foster up-to-date information about the nursing management of new or uncommon drugs?
A) Focus on learning about a prototype drug that is characteristic of a larger drug class
B) Identify similarities between new drugs and older drugs that are com- monly used on the unit
C) Commit time and energy during each shift to learning about new drugs
 
D) Liaise with pharmacists and pharmacy technicians who work at the hospital
A
16. A 58-year-old man is admitted to the emergency department. A diag- nosis of severe digoxin toxicity is made. Bradycardia is present, and an electrocardiogram (ECG) confirms toxicity. The nurse will administer which of the following drugs?
A) Furosemide
B) Digoxin immune fab
C) Captopril
D) Dopamine B
17. A hospital patient’s physician has prescribed quetiapine (Seroquel) to be administered at bedtime. Being unfamiliar with the medication, the nurse has looked it up in a nursing drug manual and noted that the drug is an antipsychotic that is indicated for the treatment of schizophrenia and bipolar disorder. The patient has no psychiatric history, and upon questioning, the physician states that it is being prescribed to help the patient fall asleep at night. How should the nurse best understand this practice?
A) This off-label use of the drug is prohibited by federal laws and pro- fessional practice standards.
B) This is an appropriate use of the drug, provided it is supported by the literature.
C) This is acceptable if the patient has failed to respond adequately to conventional sleep aids.
D) This is a practice that may negate the physician’s and nurse’s liability insurance.
B
18. A 4-year-old child is brought to the emergency department by her mother. The mother reports that the child has been vomiting, and the nurse notes that the child’s face is flushed and she is diaphoretic. The mother thinks that the child may have swallowed carbachol drops. A di- agnosis of cholinergic poisoning is made. Which of the following drugs would be administered?
 
A) Acetylcholine
B) Atropine
C) Cevimeline
D) Nicotine B
19. A nurse is providing discharge instructions to a patient who will be taking fludrocortisone at home. The nurse will encourage the patient to eat a diet that is
A) low in sodium and potassium.
B) low in sodium, high in potassium.
C) high in iron.
D) low in proteins. B
20. A nurse is developing a care plan for a patient who has multiple scle- rosis. An expected outcome for the patient who is receiving glatiramer would be a decrease in
A) chest pain.
B) fatigue.
C) breathing difficulties.
D) heart palpitations. B
21. An elderly postsurgical patient has developed postoperative pneumo- nia 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?
A) A sublingual benzodiazepine that has been prescribed to help the pa- tient sleep
B) An intravenous (IV) antibiotic that is being administered by IV pig- gyback at 150 mL/hour
C) An oral antidepressant that the patient has been taking daily for sev- eral years
D) An intramuscular (IM) injection of an opioid analgesic C
22. A female patient diagnosed with chronic atrial flutter has been pre- scribed verapamil in conjunction with digoxin to control ventricular rate.
 
To enhance the therapeutic effect of the drug, the nurse will instruct the patient to
A) take the medication with meals.
B) avoid grapefruit and grapefruit juice.
C) take an aspirin every day.
D) avoid fresh fruit. B
23. A 28-year-old patient asks his nurse how phenelzine therapy would help him. An appropriate response by the nurse would be
A) “This therapy will help reduce the severity of your bipolar episodes.”
B) “The drug will enable you to gain the appropriate weight.”
C) “The drug will help increase your attention level.”
D) “This therapy will improve your overall mood and increase your so- cial activity.”
D
24. A nurse is creating a plan of care for a 68-year-old woman with a re- cent diagnosis of unstable angina and new prescription for nitroglycerin. Which of the following nursing diagnoses should the nurse prioritize in the planning of this patient’s care?
A) Incontinence, Functional, related to adverse effects of drug therapy
B) Risk for Fluid Volume Deficit related to adverse effects of drug ther- apy
C) Confusion, Acute, related to adverse effects of drug therapy
D) Acute Pain, Headache, related to adverse effects of drug therapy D
25. A nurse is caring for a 38-year-old female patient who just started taking lithium for bipolar disorder. Which of the following outcomes would be most appropriate for this patient?
A) The patient will reestablish and maintain a normal pattern of bowel functioning.
B) The patient will identify appropriate interventions to promote sleep.
C) The patient will identify satisfying and acceptable sexual practices and some alternative ways of dealing with sexual expression.
D) The patient will adopt strategies to maintain proper fluid balance. D
 
26. A nurse is caring for a patient who is taking sodium polystyrene sul- fonate (Kayexalate) therapy. The nurse will monitor for which of the fol- lowing?
A) Cardiac arrhythmias
B) Ventricular arrhythmias
C) Hypokalemia
D) Cardiotoxicity C
27. A nurse is the cardiac care unit is preparing to hang an intravenous dose of dofetilide (Tikosyn) for a patient who has just been admitted. What is the most likely goal of this intervention?
A) To treat sinus bradycardia accompanied by hypotension
B) To resolve the patient’s uncompensated heart failure
C) To treat the patient’s ventricular tachycardia
D) To convert the patient’s atrial fibrillation to normal sinus rhythm D
28. A nurse is working in a women’s hospital where she is caring for a new mother who is experiencing postpartum urinary retention. Bethane- chol (Urecholine) has been ordered. The nurse will observe for which of the following?
A) Bradycardia
B) Hypertension
C) Hypotension
D) Decreased salivation B
29. A 12-year-old child who has been taking sertraline for the past 2 weeks has returned to the clinic to be seen. It will be critical for the nurse to assess for
A) onset of suicidal ideation.
B) weight loss.
C) feelings of grandiosity.
D) decreased sleep. A
30. A 30-year-old woman is taking phenelzine (Nardil) 30mg PO tid. The nurse knows that at that dosage, the patient will need to be carefully
 
monitored for
A) dizziness.
B) diarrhea.
C) increased secretions.
D) facial flushing.
A
31. A patient has been admitted to the intensive care unit following a myocardial infarction. His nurse is preparing to administer his ordered medications when she notices that one drug ordered is used for treating seizure disorders. The nurse does not find a history of seizures in the pa- tient’s record. The most appropriate action for the nurse is to
A) ask the charge nurse if she knows why the drug has been ordered.
B) look up the drug to see if there are other conditions that the drug could be prescribed for.
C) question the physician about the prescribed medication.
D) call the pharmacist and inquire about therapeutic uses of the drug. C
32. A nurse is aware of the high incidence and prevalence of major de- pression in the population. Which of the following individuals possesses the clearest risk factors for depression?
A) A man who has a history of intravenous drug use and multiple hospi- tal admissions for subsequent infections
B) A woman whose father had a long history of depression before he committed suicide
C) A man who is experiencing significant lifestyle changes after losing his job
D) A woman who has recently begun treatment for idiopathic seizure ac- tivity
B
33. The nurse has been assigned a 49-year-old patient who has acute col- itis, and the nurse just completed gathering data concerning core drug knowledge and core patient variables. To implement nursing manage- ment of drug therapy for this patient, the nurse will then
A) evaluate the outcome of the drug therapy.
B) devise strategies to maximize the therapeutic effects of the drug.
 
C) implement planned nursing actions.
D) assess for data that will indicate interactions between core drug knowledge and core patient variables.
B
34. A nurse has been caring for a 49-year-old man who was hospitalized with recurrent ventricular fibrillation and received IV amiodarone. The man is now scheduled to be discharged on oral amiodarone, and the nurse has just completed discharge instructions. Which of the following statements made by the patient indicates that further instruction is neces- sary?
A) “I will notify my physician if I develop a cough and have difficulty breathing.”
B) “I am going on a cruise next week and plan to just lie in the sun all day and relax.”
C) “I plan to see my ophthalmologist in 2 weeks.”
D) “It is important for me to have my thyroid gland checked regularly.” B
35. A 73-year-old man was diagnosed with Parkinson disease earlier this year and has begun taking carbidopa-levodopa four times daily in an ef- fort to control the signs and symptoms of the disease. The nurse should recognize that this therapeutic effect is achieved by influencing the
A) uptake of acetylcholine.
B) dopamine receptors in the brain.
C) synthesis of epinephrine.
D) sensitivity of beta-2 receptors. B
36. A patient is admitted to the emergency department with severe chest pain. The emergency department physician orders intravenous nitroglyc- erin 5 mcg/min, titrate dose by 5 mcg/min every 3 to 5 minutes per infu- sion pump as needed. Before administering the nitroglycerin, the nurse should prioritize which of the following assessments?
A) Blood pressure
B) Urinary output
C) Heart rate
D) Blood urea nitrogen (BUN)
 
A
37. A patient has been prescribed several drugs and fluids to be given in- travenously. Before the nurse starts the intravenous administration, a pri- ority assessment of the patient will be to note the
A) heart rate.
B) body weight and height.
C) blood pressure.
D) skin surrounding the potential IV site. D
38. Which of the following patients would a nurse determine to be at the greatest risk for quinidine toxicity?
A) A 30-year-old pregnant woman
B) A 44-year-old man diagnosed with cardiac insufficiency
C) A 50-year-old woman with myasthenia gravis
D) A 55-year-old man diagnosed with complete heart block B
39. A nurse is assigned to a patient who is taking lithium. Which of the following drug serum levels would indicate that the patient is at risk for adverse effects of the drug?
A) 0.3 mEq/L
B) 0.6 mEq/L
C) 1.7 mEq/L
D) 1.2 mEq/L C
40. A patient experiencing a serious allergic reaction to a bee sting is brought to the emergency department. The patient’s right hand is swollen, red, and painful. She is extremely upset, short of breath, and the nurse detects wheezing and stridor. The nurse is ordered to administer epinephrine to relieve the patient’s
A) pain and swelling around the sting site.
B) discoloration in her hand.
C) acute anxiety.
D) acute bronchospasm. D
 
41. A nurse is educating a patient who has Parkinson disease and her husband about the possible adverse effects of carbidopa-levodopa. The nurse should emphasize the need for the patient and her husband to mon- itor for any sudden increase in
A) involuntary movements.
B) perspiration.
C) appetite or thirst.
D) mobility.
A
42. A nurse has an order to apply nitroglycerin topically, twice a day. The nurse’s initial action will be to
A) wipe off the previous dose from the patient’s body.
B) don a pair of gloves.
C) place the ointment on an area free of excessive hair and of unbroken skin.
D) wipe off any medication that is on the outside of the medication con- tainer.
B
43. A woman with an inflammatory skin disorder has begun taking pred- nisone in an effort to control the signs and symptoms of her disease. The nurse who is providing care for this patient should prioritize which of the following potential nursing diagnoses in the organization of the pa- tient’s care?
A) Fluid Volume Excess
B) Constipation
C) Acute Confusion
D) Impaired Gas Exchange A
44. A 38-year-old patient is obese and has abscesses around his inner thigh muscles. He is receiving IV antibiotics, but no improvement has been seen. The patient questions the nurse about the most likely cause for the drug therapy failure. The nurse explains to the patient that the
A) surface area of the abscesses is not large enough for the drug to have the desired therapeutic effect.
B) route of administering the medication should not have been IV.
 
C) distribution of the drug to the area of the abscesses is impaired.
D) distribution of the drug to the thigh muscles is generally impaired, even in healthy individuals.
C
45. A patient is prescribed regular doses of epinephrine. Which of the following nursing diagnoses is related to comfort and would be most ap- propriate for this patient?
A) Imbalanced Nutrition: Less Than Body Requirements
B) Disturbed Sleep Pattern, Insomnia Related to CNS Excitation
C) Disturbed Sensory Perception
D) Ineffective Tissue Perfusion B
46. A 68-year-old female patient who was diagnosed with hypertension 2 weeks ago and was prescribed a new hypertension medication has re- turned to the clinic for a follow-up visit. The nurse notes that the pa- tient’s blood pressure is unchanged from her last clinic visit. When the patient was asked if she was taking the new medication on a regular ba- sis, she stated, “I thought that I was supposed to take the new drug when I had a pounding headache or was in a stressful situation, not all the time.” An appropriate nursing diagnosis for this patient would be which of the following?
A) Knowledge, deficient due to the lack of understanding of treatment regimen
B) Coping, ineffective due to forgetfulness
C) Confusion, acute concerning drug administration
D) Anxiety due to diagnosis of hypertension A
47. A nurse is overseeing the care of a young man whose ulcerative coli- tis is being treated with oral prednisone. Which of the following actions should the nurse take in order to minimize the potential for adverse drug effects and risks associated with prednisone treatment?
A) Avoid OTC antacids for the duration of treatment
B) Advocate for intravenous, rather than oral, administration
C) Teach the patient strategies for dealing with headaches
D) Carefully assess the patient for infections
 
D
48. A nurse is performing an admission assessment of an elderly patient who is being admitted to a medical ward from the emergency depart- ment. Which of the following is an open-ended assessment question?
A) “Have you ever had a bad response to a drug that you’ve taken?”
B) “Does anyone in your immediate family have a history of drug aller- gies?”
C) “Are you comfortable with receiving needles?”
D) “What kind of reactions have you had to medications?” D
49. In order to promote therapeutic drug effects, the nurse should always encourage patients to
A) take their medication with meals.
B) take their medication at the prescribed times.
C) increase medication dosages if necessary.
D) use alternative therapy to increase the effects of their medications. B
50. Frequent episodes of exercise-related chest pain have caused a 79- year-old woman to use her prescribed nitroglycerin spray several times in recent weeks. This patient’s age will have what effect on her use of ni- troglycerin?
A) The woman may experience paradoxical vasoconstriction when tak- ing nitroglycerin.
B) Decreased saliva production will inhibit the absorption of the drug in her mucosa.
C) The woman will need to allow more time between doses in order to facilitate absorption.
D) The woman will be more susceptible to hypotension than a younger patient.
D
51. A 47-year-old woman has been diagnosed with open-angle glau- coma. Pilocarpine drops are prescribed. The nurse’s assessment reveals that the patient has worn soft contact lenses for 15 years. The nurse will instruct the patient to
A) apply the contact lenses and wait 5 minutes before applying the
 
drops.
B) remove the contact lenses before applying the drops.
C) apply the drops directly on the contact lenses.
D) stop wearing the contact lenses during the pilocarpine therapy. B
52. A nurse who provides care on an acute medicine unit has frequently recommended the use of nicotine replacement gum for patients who ex- press a willingness to quit smoking during their admission or following their discharge. For which of the following patients would nicotine gum be contraindicated?
A) A patient who received treatment for kidney failure due to an over- dose of acetaminophen
B) A patient whose pulmonary embolism was treated with a heparin in- fusion
C) A patient with a history of angina who experienced a non-ST wave myocardial infarction
D) A patient whose stage III pressure ulcer required intravenous antibi- otics and a vacuum dressing
C
53. A patient calls the clinic and reports that he is having chest pain. The patient states that “I’m scared that I am going to die and I’ve been pacing up and down my driveway.” After calming the patient, the initial instruc- tion by the nurse would be to
A) ask the patient to call 911 and wait outside for the ambulance to ar- rive.
B) ask the patient to place a nitroglycerin tablet under his tongue imme- diately.
C) have the patient take his pulse for 1 minute.
D) have the patient go into his house and sit or lie down. D
54. Constipation is a major problem in patients with amyotrophic lateral sclerosis (ALS). The nurse will educate the patient and family to
A) choose a laxative at the local drug store.
B) use prune juice only.
 
C) consult their physician before purchasing a laxative.
D) walk at least 500 yards a day. C
55. A nurse has been assigned to care for a 52-year-old attorney who has hypertension and peptic ulcer disease. Before administering his medica- tions, the nurse must complete an initial assessment. Core patient vari- ables will be obtained from which of the following? (Select all that ap- ply.)
A) The patient’s interview
B) The patient’s medical history
C) The patient’s medical record
D) The patient’s physical examination
E) The patient’s health insurer A, B, C, D
56. A 59-year-old woman has long-standing diagnoses of type 1 diabetes and hypertension and has recently been diagnosed with glaucoma. Her ophthalmologist has prescribed pilocarpine (Akarpine), which will achieve its intended therapeutic effect by which of the following means?
A) By blocking receptors of acetylcholine
B) By increasing synthesis of acetylcholine
C) By directly stimulating cholinergic receptors
D) By stimulating nicotinicN receptors C
57. A woman in her twenties has been accompanied to her primary care provider by her mother, who states that her daughter has been experienc- ing increasingly severe episodes of irritable grandiose behavior. The care provider has consequently begun a treatment regimen that includes pharmacological therapies. This patient is most likely experiencing which of the following mood disorders?
A) Bipolar disorder
B) Dysthymic disorder
C) Major depression
D) Personality disorder A
 
58. A patient is treated with an antibiotic for an infection in his leg. Af- ter 2 days of taking the antibiotic, the patient calls the clinic and reports that he has a rash all over his body. The nurse is aware that a rash can be an adverse effect of an antibiotic and can be either a biologic, chemical, or physiologic action of the drug, which is an example of
A) pharmacotherapeutics.
B) pharmacokinetics.
C) pharmacodynamics.
D) pharmacogenetics. C
59. A 70-year-old man with diabetes mellitus is taking metoprolol (Lo- pressor) to manage his hypertension. The nurse would be sure to instruct the patient to
A) take his pulse at least four times a day.
B) weigh himself once a week at the same time of the day.
C) avoid smoke-filled rooms.
D) understand the signs and symptoms of hypoglycemia. D
60. A 45-year-old man enters the emergency department complaining of chest pain. The nurse has an order to administer amyl nitrite. The nurse will
A) administer the medication by intramuscular injection.
B) crush the capsule and ask the patient to inhale the vapors.
C) place the tablet under the patient’s tongue.
D) ask the patient to chew the tablet before swallowing. B
61. Mrs. Houston is a 78-year-old woman who resides in an assisted liv- ing facility. Her doctor prescribed digoxin at her last visit to the clinic and she has approached the nurse who makes regular visits to the as- sisted-living facility about this new drug. What teaching point should the nurse emphasize to Mrs. Houston?
A) The importance of having required laboratory work performed on time
B) The need to take the medication at the same time each day regardless of her heart rate
 
C) The correct technique for using a home blood pressure cuff
D) Timing household activities to coincide with the administration times of her digoxin
A
62. A 62-year-old man is admitted to the hospital with a diagnosis of chest pain. He has an order for 0.3 mg of sublingual nitroglycerin prn for chest pain. Which of the following actions should the nurse do first when he complains of chest pain?
A) Call the physician
B) Ask the patient to lie back and try to relax
C) Have the patient swallow a tablet every 5 minutes for 15 minutes
D) Administer a tablet under his tongue and repeat the action in 5 and 10 minutes if the pain has not subsided
D
63. A nurse on an acute medical unit has rectally administered a dose of sodium polystyrene sulfonate to a patient. What assessment should the nurse prioritize in the 48 hours following the administration of this drug?
A) Monitoring of serum potassium levels
B) Stool testing for occult blood
C) Fluid balance
D) Hemoglobin, hematocrit, and red blood cells A
64. An expected outcome for a patient who has just taken sublingual ni- troglycerin should be
A) increased heart rate and decreased blood pressure.
B) decreased heart rate and decreased blood pressure.
C) increased heart rate and increased blood pressure.
D) decreased heart rate and increased blood pressure. A
65. Which of the following patients should be advised by the nurse to avoid over-the-counter cold and allergy preparations that contain phenylephrine?
A) A 47-year-old female with hypertension
B) A 52-year-old male with adult-onset diabetes
C) A 17-year-old female with symptoms of an upper respiratory infec-
 
tion
D) A 62-year-old male with gout A
66. Which of the following would be an expected outcome in a patient who has been given atropine during a medical emergency?
A) Reduction of severe hypertension
B) Increased level of consciousness
C) Restoration of normal sinus rhythm
D) Resolution of respiratory acidosis C
67. 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?
A) “This schedule will be more convenient for you.”
B) “This schedule will enable you to lose weight.”
C) “This schedule will decrease the cost of your medication.”
D) “This schedule allows rest periods so that adverse effects are de- creased but the anti-inflammatory effects continue.”
D
68. A middle-aged male patient has received a diagnosis of amyotrophic lateral sclerosis (ALS) and has begun treatment with riluzole (Rilutek). The patient’s nurse should recognize what goal of this treatment regi- men?
A) Restoration of normal motor nerve function
B) Maintenance of normal mobility and activities of daily living
C) Delaying of tracheostomy or mechanical ventilation
D) Relief of neuropathic pain C
69. A patient has been prescribed an oral drug that is known to have a high first-pass effect. Which of the following measures has the potential to increase the amount of the free drug that is available to body cells?
A) Giving the drug with food in order to delay absorption
B) Administering the drug in small, frequent doses
 
C) Limiting the patient’s protein intake and encouraging fluids
D) Administering the drug intravenously rather than orally D
70. A patient has been receiving regular doses of an agonist for 2 weeks. Which of the following should the nurse anticipate?
A) The drug will decrease in effectiveness
B) The drug will increase in effectiveness
C) There will be a steady state with no anticipated changes
D) The drug will cause excessive therapeutic effects even when adminis- tered in small doses.
A
71. After seeking care for tremors that have become increasingly severe in recent months, a 71-year-old man has been diagnosed with Parkinson disease and will soon begin treatment with carbidopa-levodopa. Which of the following statements indicates that the patient has an accurate un- derstanding of his new medication?
A) “I’ll have to learn how to modify each dose of carbidopa-levodopa based on how bad my symptoms are that day.”
B) “I’ve read that carbidopa-levodopa is quite short-acting so I’ll have to take it several times a day.”
C) “I’ll make sure to stop taking my other medications so that my car- bidopa-levodopa doesn’t interact with them.”
D) “I’ve heard that it can take up to a year for carbidopa-levodopa to cure someone of Parkinson disease.”
B
72. A nurse is caring for a patient who is taking metoprolol (Lopressor). Which of the following statements would indicate that teaching by the nurse concerning the beta-adrenergic antagonist has been effective?
A) “I may have a very dry mouth while taking this drug.”
B) “I should never stop taking this drug abruptly.”
C) “I can stop walking a mile a day.”
D) “Since I am taking this drug, I no longer need to worry about my diet.”
B
 
73. A female patient has been taking prednisone for her asthma for 1 month. The nurse will teach her to gradually decrease her dose of pred- nisone to avoid
A) hypokalemia.
B) gastrointestinal problems.
C) adrenal insufficiency.
D) menstrual irregularities. C
74. A 21-year-old man experienced massive trauma and blood loss dur- ing a motorcycle accident and has been started on a dopamine infusion upon his arrival at the hospital. In light of this drug treatment, what as- sessment should the care team prioritize?
A) Respiratory assessment
B) Arterial blood gases
C) Monitoring of intracranial pressure
D) Cardiac monitoring D
75. A 58-year-old woman was diagnosed with myasthenia gravis many years ago and has been on a regimen of neostigmine (Prostigmin), a re- versible cholinesterase inhibitor. In light of the patient’s drug regimen, a nurse can conclude that the pathophysiology of myasthenia gravis in- volves
A) excessive synthesis and release of acetylcholine at neuromuscular junctions.
B) a lack of functional cholinergic receptors at neuromuscular junctions.
C) an inherent susceptibility to cholinergic crisis.
D) deficient reuptake of acetylcholine. B
76. A nurse has been assigned to a 52-year-old woman who has been hospitalized and has a diagnosis of Parkinson disease. The patient has been taking carbidopa-levodopa for about 1 year. The patient states that she has been having “more side effects from her drugs lately” and the nurse observes that the client appears to be lethargic and have a de- creased attention span. Which of the following would be an appropriate nursing diagnosis based on the statement of the patient and the observa-
 
tions of the nurse?
A) Disturbed Thought Processes
B) Disturbed Sleep Pattern
C) Impaired Physical Mobility
D) Risk for Injury B
77. A patient who is going on a cruise is concerned about motion sick- ness and sees his physician, who prescribes scopolamine. The nurse in- forms the patient that using scopolamine may cause him to experience
A) pupil constriction.
B) drowsiness.
C) diarrhea.
D) urinary incontinence. B
78. A nurse is providing patient education to a female patient who is tak- ing fludrocortisone. The nurse will instruct the patient to monitor which of the following at home?
A) Weight gain
B) Thyroid hormone levels
C) Heart rate
D) Core body temperature A
79. A female patient has been prescribed aminoglutethimide to treat Cushing syndrome. Before therapy begins a priority nursing action would be to review the patient’s
A) current lab results, especially complete blood count.
B) current body weight and height.
C) bilirubin level.
D) last menstrual period. A
80. A nurse is caring for a patient in the critical care unit. Phentolamine (Regitine, OraVerse) has been ordered for the management of tissue necrosis caused by extravasation of parenterally administered drugs. Be- fore administering this drug, the nurse will check the patient’s chart for indications of
 
A) peptic ulcer disease.
B) history of acute myocardial infarction.
C) diabetes mellitus.
D) obesity.
B
81. A 28-year-old man has been taking sertraline for a few months. On a follow-up visit to the clinic, he reports a change in sexual functioning, dizziness, and insomnia. The most appropriate response by the nurse would be
A) “How much of the drug are you taking at one time?”
B) “Have you stopped taking the drug?”
C) “Do you eat a lot of fat in your diet?”
D) “How much alcohol do you consume?” B
82. 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?
A) Oxygen saturation and respiratory rate
B) Heart rate and blood pressure
C) Level of consciousness and pain level
D) Temperature and respiratory rate B
83. A 59-year-old female patient has been prescribed digoxin. The nurse assigned to the patient will instruct her to avoid which of the following?
A) Grapefruit juice
B) Protein-rich foods
C) One glass of red wine per day
D) OTC cold remedies D
84. A female patient is taking 0.125 mg of digoxin daily for heart fail- ure. At a recent clinic visit she reports that since she has been on the drug, she can breathe better and her heart rate has been around 74 beats per minute. The nurse weighs the patient and notices that she has gained 10 pounds since the digoxin therapy was started. The patient is con- cerned that the additional weight will necessitate an increase in the med-
 
ication. Which of the following is an appropriate response by the nurse?
A) “Yes, the drug dosage will probably have to be increased.”
B) “No, the drug dosage will likely stay the same.”
C) “No, the drug dosage will have to be decreased.”
D) “I don’t know; I will have to ask your physician.” B
85. A middle-aged patient was diagnosed with major depression after a suicide attempt several months ago and has failed to respond appreciably to treatment with SSRIs. As a result, his psychiatrist has prescribed phenelzine. When planning this patient’s subsequent care, what nursing diagnosis should the nurse prioritize?
A) Risk for Ineffective Peripheral Tissue Perfusion related to cardiovas- cular effects of phenelzine
B) Risk for Constipation related to decreased gastrointestinal peristalsis
C) Risk for Infection related to immunosuppressive effects of phenelzine
D) Risk for Injury related to drug-drug interactions or drug-nutrient in- teractions
D
86. A woman in her thirties has been experiencing increasing weakness and the results of an edrophonium (Tensilon) test have resulted in a di- agnosis of myasthenia gravis. The patient’s nurse should anticipate that the patient will benefit from treatment with
A) carbidopa-levodopa.
B) a monoclonal antibody.
C) a dopamine agonist.
D) a cholinesterase inhibitor. D
87. A nurse is caring for a patient admitted to the intensive care unit be- cause of heart failure. The patient is prescribed digoxin. Which of the following nursing diagnoses would be appropriate for this patient?
A) Risk for Hyperthyroidism related to adverse effects of drug therapy
B) Decreased Cardiac Output related to altered cardiac function
C) Acute Pain and Headache related to adverse effects of the drug ther- apy
D) Risk of Constipation related to adverse effects of the drug therapy
 
B
88. Which of the following activities would the nurse expect to complete during the evaluation phase of the nursing process in drug therapy?
A) Compare the outcome expected with the actual patient outcome
B) Reconsider core drug knowledge and core patient variables
C) Ask questions to prepare an effective patient education program
D) Establish a baseline for the patient’s treatment and care A
89. A patient is taking tocainide for a life-threatening ventricular ar- rhythmia. The most serious potential adverse effects involve
A) blood dyscrasias.
B) vertigo.
C) paresthesia.
D) visual impairment. A
90. A nurse in the intensive care unit is caring for a patient in shock and has started IV administration of dopamine (Intropin). For a patient in shock, dopamine helps to
A) decrease heart rate.
B) decrease blood pressure.
C) increase blood pressure.
D) increase body temperature. C
91. A 42-year-old African-American man with congestive heart failure has been prescribed hydralazine-isosorbide. The nurse will closely moni- tor for which of the following?
A) Hypertension
B) Hypotension
C) Decrease in body temperature
D) Increased heart rate B
92. After successful treatment for a myocardial infarction, a 69-year-old man has developed a ventricular arrhythmia. His care team has opted for treatment with a Class II antiarrhythmic. The nurse would understand that this patient is likely to be prescribed
 
A) acebutolol.
B) lidocaine.
C) amiodarone.
D) verapamil. A
93. A patient has been prescribed aminoglutethimide 250 mg PO q6h to increase to 2g daily over the next several weeks. The nurse should rec- ognize that this patient most likely has a diagnosis of
A) Cushing syndrome.
B) Addison disease.
C) diabetes insipidus.
D) an autoimmune condition such as asthma. A
94. A patient has a diagnosis of Parkinson disease, and the physician will prescribe carbidopa-levodopa. Before drug therapy, the patient should be carefully assessed for the presence of
A) macular degeneration.
B) closed-angle glaucoma.
C) peptic ulcer disease.
D) diabetes mellitus. B
95. 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?
A) A 25-year-old male with congestive heart failure and atrial fibrilla- tion
B) A 32-year-old female with cardiomegaly
C) A 79-year-old male with cardiomegaly
D) A 42-year-old female with a third heart sound C
96. In which of the following patients would a nurse expect to experi- ence alterations in drug metabolism?
A) A 35-year-old woman with cervical cancer
B) A 41-year-old man with kidney stones
 
C) A 50-year-old man with cirrhosis of the liver
D) A 62-year-old woman in acute renal failure C
97. A patient with class-IV CHF has a medication regimen consisting of metoprolol (Lopressor), enalapril (Vasotec), and furosemide (Lasix). In addition to regularly assessing the patient s heart rate, the nurse should prioritize assessment of the patient’s
A) intake and output.
B) blood pressure.
C) cognition.
D) exercise tolerance. B
98. A nurse is caring for a patient who is taking metoprolol (Lopressor). Which of the following statements would indicate that teaching by the nurse concerning the beta-adrenergic antagonist has been effective?
a. “I may have a very dry mouth while taking this drug.”
b. “I should never stop taking this drug abruptly.”
c. “I can stop walking a mile a day.”
d. “Since I am taking this drug, I no longer need to worry about my diet.”
99. A nurse is developing a care plan for a patient who has multiple scle- rosis. An expected outcome for the patient who is receiving glatiramer would be a decrease in
a. chest pain.
b. fatigue.
c. breathing difficulties.
d. Heart palpitations.
100. An elderly postsurgical patient has developed postoperative pneumo- nia 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?
A. A sublingual benzodiazepine that has been prescribed to help the pa- tient sleep
B. An intravenous (IV) antibiotic that is being administered by IV pig- gyback at 150 mL/hour
C. An oral antidepressant that the patient has been taking daily for sev- eral years
D. An intramuscular

Walden NURS6521 Week 8 Quiz

Question 1 A 15-year-old boy is being carefully monitored for a skin infection and is being given ciprofloxacin. The nurse will observe for which of the following?
A) Arthropathy
B) Colitis
C) Hepatitis
D) Hypotension
Question 2 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?
A) Vancomycin
B) Penicillin G
C) Cefazolin
D) Doripenem (Doribax)
Question 3 Mr. Laird is a 49-year-old electrician who experienced severe burns on his trunk, arms, and hands in a workplace accident 2 weeks ago. Part of his current wound care regimen involves the daily application of silver sulfadiazine to his wounds.The nurses who are providing care for Mr. Laird in the burns and plastics unit of the hospital should perform what action when administering this medication?
A) Apply a layer of silver sulfadiazine that is sufficiently thick to make the wound bed invisible.
B) Cleanse the wound of debris prior to applying the silver sulfadiazine
C) Apply a thin layer of the drug to Mr. Laird’s wound beds using clean technique.
D) Perform thorough wound care immediately after the application of silver sulfadiazine
Question 4 A patient is prescribed ganciclovir to treat a CMV infection. An oral dosage is prescribed. To help increase bioavailability of the drug, the nurse will encourage the patient to take the medication
A) with high-fat meals
B) with orange juice
C) on an empty stomach
D) with high-protein meals
Question 5 A patient has endocarditis and is taking gentamicin. The nurse will be sure to monitor which of the following?
A) Potassium level
B) Creatinine clearance
C) Serum albumin level
D) Prothrombin time
Question 6 A 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?
A) Ciprofloxacin is safe to use in pregnancy and the patient may use to same dose and route as a nonpregnant patient
B) The use of ciprofloxacin is contraindicated in pregnancy
C) It is safe for the patient to use topical ciprofloxacin but the oral route is potential teratogenic
D) The patient will require a lower dose and longer course of ciprofloxacin than a nonpregnant, adult patient
Question 7 A nurse has questioned why a patient’s physician has prescribed a narrow-spectrum antibiotic rather than a broad-spectrum drug in the treatment of a patient’s infection. Which of the following facts provides the best rationale for the use of narrow-spectrum antibiotics whenever possible?
A) Broad-spectrum antibiotics confound the results of subsequent culture and sensitivity testing.
B) Narrow-spectrum antibiotics normally require a shorter duration of treatment
C) The efficacy of most narrow-spectrum antibiotics has not been proven
D) The use of broad-spectrum antibiotics can create a risk for a superinfection
Question 8 A 72-year-old patient is prescribed ophthalmic ciprofloxacin for a bacterial infection in her right eye. The nurse will teach her to observe for which of the following adverse effects of the drug?
A) Lid margin crusting and pruritus
B) Cognitive changes
C) Nephrotoxicity and neurotoxicity
D) Tendon ruptures
Question 9 A patient has been prescribed oral tetracycline.The nurse will instruct the patient to take the drug
A) on an empty stomach 1 hour before or 2 hours after taking any meals or other drugs.
B) with a meal.
C) with milk or fruit juice.
D) at bedtime only.
Question 10 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?
A) Diarrhea
B) Risk for Injury related to allergic reactions
C) Imbalanced Nutrition: Less than Body Requirements
D) Risk of Injury related to blood dyscrasia
drug therapy, including INH and rifampin. A priority assessment by the nurse will be to monitor which combination of laboratory test results?
A) Serum alanine transaminase, aspartate transaminase, and bilirubin
B) Red blood count, white blood count, and differential
C) Thyroid-stimulating hormone, thyroxine, and triiodothyronine levels
D) Fasting blood sugar and 2-hour postprandial blood sugar
Question 12 An immunocompromised cancer patient has developed cryptococcal meningitis and been admitted to the intensive care unit for treatment with amphotericin B. How should the nurse most safely administer this drug?
A) Hang the drug by piggyback with lactated Ringer’s and infuse over several hours to minimize the risk of infusion reaction
B) Infuse the drug over 2 to 4 hours into a central line using an infusion pump
C) Flush the patient’s central line with normal saline and infuse the amphotericin B by intravenous push over 5 to 7 minutes.
D) Place the patient on a constant infusion of amphotericin B at a rate determined by the patient’s body weight.
Question 13 A nurse is aware that the concept of selective toxicity is foundational to antimicrobial therapy. Which of the following statements most accurately describes selective toxicity?
A) A drug harms microbes without harming human cells
B) A drug’s effect on microorganisms is proportionate to dose
C) Most microbes may be collected from a host and cultured on an alternative medium
D) A drug can be isolated and produced in a controlled manner in a laboratory setting
Question 14 An immunocompromised patient in a critical care setting has developed a respiratory infection that has been attributed to methicillin-resistant Staphylococcus aureus (MRSA). The nurse should anticipate that the patient will require treatment with
A) ciprofloxacin
B) clindamycin
C) vancomycin
D) an antistaphylococcic penicillin
Question 15 Laboratory 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
A) osteoporosis or low bone density
B) chronic obstructive pulmonary disease (COPD)
C) diabetes mellitus
D) cardiac arrhythmias
Question 16 A 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?
A) Increased heart rate
B) Breathlessness
C) Infiltration, edema, or phlebitis at the infusion site
D) Nausea and vomiting
Question 17 A patient with AIDS has developed a number of secondary infections in recent weeks, including Kaposi’s sarcoma. As a result of this most recent diagnosis, his care team has opted to begin treatment with interferon alfa-2a. The nurse is aware that this drug will address the etiology of Kaposi sarcoma by
A) inhibiting tumor growth by enhancing inflammation
B) potentiating the effects of phagocytes and macrophages
C) causing mutations in the DNA of cancerous cells
D) increasing the production of B cells and T cells
Question 18 Sulconazole has been prescribed for a patient with tinea pedis. The nurse will instruct the patient to use the topical agent
A) once a day
B) twice a day
C) three times a day
D) as needed
Question 19 Which of the following is critical to helping prevent development of resistant strains of microbes in patients?
A) Limit the exposure of bacteria to an antimicrobial agent
B) Keep the antimicrobial drug dosage high
C) Maintain the optimum duration of the antimicrobial agent
D) Maintain the maximum safe frequency of antimicrobial drug ingestion
Question 20 Which of the following nursing actions is most important in achieving successful antimicrobial therapy with vancomycin?
A) Provide maximum physical comfort to the patient
B) Monitor serum drug level
C) Taper down the drug dosage gradually
D) Promote adequate intake of fluids and nutrients
Question 21 A patient is being treated for Mycoplasma pneumoniae pneumonia. She is allergic to penicillin and is being given azithromycin (Zithromax) in capsule form. The nurse will inform the patient that she will need to take the capsule
A) with food
B) on an empty stomach
C) with or without food
D) immediately after she eats
Question 22 A patient is taking rifampin (Rifadin) for active TB. When discussing this drug with the patient, the nurse should stress that
A) the drug usually causes cardiac arrhythmias
B) the drug frequently causes seizure activity
C) facial flushing may appear but will go away once therapy is concluded
D) body fluids such as urine, saliva, tears, and sputum may become discolored
Question 23 A nurse 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
A) take the tablets on an empty stomach
B) decrease the drug dosage if initial symptoms of nephrotoxicity appear
C) stay well hydrated by drinking at least eight 8-oz glasses of water daily
D) eat light meals every day
Question 24 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?
A) The importance of vigilant hygiene for the boy and the other members of the family
B) The need for the boy to provide serial stool samples for 6 months following treatment
C) The need to supplement the anthelminthic drug with prophylactic antibiotics
D) The need to use prescription skin cleansers during treatment and for 6 weeks after
Question 25 A nurse 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?
A) Encourage the patient to increase fluid intake
B) Use strict aseptic technique for drug administration
C) Keep the bed in a low position and the side rails up at all times
D) Reduce the drug dosage
Question 26 A nurse is providing education to a patient who is taking INH. The nurse will advise the patient to avoid which of the following foods?
A) Cheese, dairy products, and bananas
B) Potatoes and root vegetables
C) Citrus fruits
D) Chicken and fish
Question 27 A child is taking permethrin for head lice. The nurse will instruct her mother to
A) wash her hair daily with a good shampoo
B) increase her daily intake of milk
C) maximize the child’s fluid intake
D) stop using creams, ointments, and oils on the child’s skin and scalp.
Question 28 A patient is receiving cefazolin in combination with anticoagulants. To minimize the adverse effects during therapy, the nurse will
A) monitor the site of injection
B) monitor the patient for bleeding gums
C) continue therapy until 2 days after symptoms have resolved
D) administer the medication with small amounts of food and fluids
Question 29 Which of the following would a nurse assess for in a patient who is taking polymyxin B systemically?
A) Peripheral neuropathy
B) Nephrotoxicity and hepatotoxicity
C) Hyperkalemia and hyponatremia
D) Endocarditis and hypertension
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
A) the process of drug elimination will be faster in this patient
B) the therapeutic effect of the drug may be too slow to be effective
C) the patient is at greater risk for high serum levels of the drug
D) the process of drug metabolism may be faster in this patient
Question 31 A patient is receiving long-term clindamycin therapy for a life-threatening infection. The nurse will begin by monitoring this drug therapy by obtaining
A) blood glucose levels daily for 1 week
B) establishing the patient’s auditory abilities
C) a baseline complete blood count
D) liver enzymes weekly until the drug therapy is completed
Question 32 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
A) take the vitamins at least 2 hours before or after taking ciprofloxacin
B) alternate the dosage of ciprofloxacin and vitamin supplements
C) reduce the dosage of vitamin supplements
D) reduce the dosage of vitamin supplements and double the dosage of ciprofloxacin
Question 33 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
A) with a sip of water 1 hour before mealtime
B) immediately before or with a meal
C) with a glass of water 1 hour before or 2 hours after a meal
D) intravenously with the assistance of a home health nurse
Question 34 A 15-year-old patient has meningitis caused by Haemophilus influenzae. She is being treated with chloramphenicol. The most important nursing action for this patient would be to monitor
A) blood sugar levels daily
B) liver enzymes monthly
C) plasma concentrations regularly
D) urine output daily
Question 35 A 49-year-old farmer who normally enjoys good health has become seriously ill in recent days and the results of an extensive diagnostic work up have resulted in a diagnosis of histoplasmosis. The patient has been admitted to the hospital and has begun treatment with amphotericin B. The nurse who is providing care for the patient should prioritize which of the following diagnostic results during his course of treatment?
A) Electrolytes, blood urea nitrogen, and creatinine
B) Hemoglobin, hematocrit, and red blood cells
C) PT, PTT, and platelets
D) C-reactive protein
 

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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.

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Discussion: Role of the RN APRN in Policy Evaluation

Discussion: Role of the RN APRN in Policy Evaluation

In the Module 4 Discussion, you considered how professional nurses can become involved in policy-making. A critical component of any policy design is evaluation of the results. How comfortable are you with the thought of becoming involved with such matters?

Some nurses may be hesitant to get involved with policy evaluation. The preference may be to focus on the care and well-being of their patients; some nurses may feel ill-equipped to enter the realm of policy and political activities. However, as you have examined previously, who better to advocate for patients and effective programs and polices than nurses? Already patient advocates in interactions with doctors and leadership, why not with government and regulatory agencies?

In this Discussion, you will reflect on the role of professional nurses in policy evaluation.

To Prepare:

• In the Module 4 Discussion, you considered how professional nurses can become involved in policy-making.
• Review the Resources and reflect on the role of professional nurses in policy evaluation.

Select an existing healthcare program or policy evaluation or choose one of interest to you.

Review community, state, or federal policy evaluation and reflect on the criteria used to measure the effectiveness of the program or policy described.

Post an evaluation topic and a brief description of the evaluation. Discuss how social determinants impact this issue.

By Day 3 of Week 9

Post an explanation of at least two opportunities that currently exist for RNs and APRNs to actively participate in policy review. Explain some of the challenges that these opportunities may present and describe how you might overcome these challenges. Finally, recommend two strategies you might make to better advocate for or communicate the existence of these opportunities. Be specific and provide examples.

Reply to the discussion (Taylor)-Needs 2 paragraph and at least 3 references

Policy Review in Nursing

Main Question Post- Nurses need to be a part of the policy review process to better their organizations and careers. Nurses can participate in policy review by joining a professional nursing organization. According to (Derouin 2019), professional organizations are “asked to assist with data collection and eventual dissemination of summative evaluation data” (p. 122). With nurses helping to gather data, they can participate in policy review by gathering information and knowledge to better a policy and evaluating the outcomes. Professional organizations are a great way to learn from others in your organization and get their opinion on policy review. Nurses can also participate in policy review by using evidence-based research and data to contact their legislation regarding health policy issues or concerns. During policy review, gathering reliable information and reflecting on it can help improve research and implement better policy. By presenting legislation with a concrete proposal to enhance policy, the review process will help improve any issues. Nurses will better understand the importance of policy review by being an active participant.

Challenges may arise when you mix nurses and policy review. When joining a professional organization, you may deal with the others’ opinions that you don’t quite agree upon. Professional organizations help build your networking team, but if your ideas and opinions don’t match others, it can make it difficult for you to build a strong team. According to Derouin (2019), a few challenges to health policy evaluation include lack of resources to complete assessment, lack of comparative results, and social media. Lack of resources could be a challenge, but joining a professional organization can provide you with many resources for a policy review. Lack of results could be a challenge, but engaging in evidence-based research can help you form a proposal to send to the legislature to improve policy review. With the upcoming presidential election, health policy has been discussed a lot on social media. Social media is a great way to discuss and learn the opinions of others. Using social media, Professional Nursing Organizations can share policy information amongst their members and followers (Waddell, 2018). Social media and ever-changing technology can help nursing challenges when participating in policy review, such as HIPPA violations. Policy evaluation “serves as the key to improving quality, safety, efficiency of clinical practice as well as assessing the impact of emerging innovations and science (Polit & Peck, 2012)” (Derouin, 2019, p. 118). Whether it’s through joining a professional organization, accessing social media, or using evidence-based research, nurses need to be active participants in policy review to better their profession, organization, and communities.

Strategies to communicate issues between nurses and policy review are essential. Gazarian et al. (2020) recommended the using research over how to put health policy into action to help determine ways to improve health care.  One strategy to help with writing to the legislature regarding policy review would be to use writing resources, like Grammarly, to help with punctuation and plagiarism. Another approach when writing to legislation would be to research evidence-based data using reliable and credible databases. Nurses need to use evidence-based research to improve health policy as well as healthcare as a whole. The ability to search for reliable and up-to-date information will help you construct a solid proposal to present to the legislature. A strategy to advocate about joining professional organizations would be to reach out to fellow APRNs in your community. Communicate and see if they are involved in any professional organizations and persuade them to join with you. Banding together to work as a team will lead to success.

References

Derouin, A. (2019). Health policy and social program evaluation. In J. A. Milstead, & N. M. Short (Eds.), Health policy and politics: A nurse’s guide (6th ed., pp 115-131). Burlington, MA: Jones & Bartlett Learning

Gazarian, P., Ballout, S., Heelan-Fancher, L., & Sundean, L. J. (2020). Theories, models, and frameworks used in nursing health policy dissertations: A scoping review. Applied Nursing Research. /orders/doi-org.ezp.waldenulibrary.org/10.1016/j.apnr.2020.151234

Waddell, A. (2019). Nursing organizations’ health policy content on facebook and twitter preceding the 2016 united states presidential election. Journal of Advanced Nursing, 75(1), 119–128. /orders/doi-org.ezp.waldenulibrary.org/10.1111/jan.13826

Reply to Leigh- Needs 2 paragraph and at least 3 references

Main Discussion Post

Many nursing professionals hesitate to get involved in either policy-making or policy evaluation due to the lack of confidence in preparedness or knowledge. In opposition, the Institute of Medicine believes that “nurses were vital to the redesign of healthcare systems, needed to be viewed as partners of physicians and other healthcare providers, and needed to be “at the table” to ensure effective planning, implementation, and ongoing evaluation of healthcare policies” (Milstead, J.A., Short, N.M., (2019). Even though nurses struggle with assurance, many opportunities are offered to become educated in policy evaluation.

Opportunities for policy evaluation in the nursing profession are presented at the state and national levels. Joining state nursing associations presents nurses with the opportunity to gain knowledge of policymaking and evaluation. Through attending conferences, connecting with other members throughout your state, lobbying, speaking to the media on nurses’ behalf, protecting your states’ Nursing Practice Act, and advocating allows nurses to advance their policy evaluation knowledge (Arkansas Registered Nurses Association (ARNA), (2020). Even though there are many benefits, challenges are also exposed. Due to an increased workload of Advanced Practicing Registered Nurses (APRNs) and Registered Nurses (RNs), being apart of either state or national level associations presents challenges that may be overcome with proper time management.  

Another opportunity for the professional nursing community is the ability to reach out the local and federal legislation. “Working with your elected representatives on smaller nursing issues related to your experience builds credibility so they’ll be more likely to turn to you when they’re looking for resources for larger nursing issues (Oestberg, Fredrik MSN, RN. (2013). By sharing personal experiences and evidence-based practice research with members of legislation allows nurses to assist in policy evaluation through checking the value, effectiveness, and impact (Oestberg, Fredrik MSN, RN. (2013). Challenges that may be presented are the inabilities to contact local and federal legislation and the differences of opinion. If unable to contact members of legislation, forming relationships with either your organization policy-makers, members of your organization’s administration, or even your educational coordinator may assist in communication.  

In order for the knowledge and confidence of nursing professionals to grow, they have to be informed of the available opportunities. By the encouragement of the administration, management, and educational coordinators, practicing RN’s and APRN’s would have the opportunity to advocate for their healthcare profession.

References:

Arkansas Registered Nurses Association (ARNA). (2020, January 7). Membership Benefits. /orders/arna.org/membership/benefits/.

Milstead, J.A., Short, N.M., (2019). Interprofessional Practice. Health Policy and Politics- A Nurse’s Guide. (pp. 117). Jones and Bartlett Learning.

American Nurses Association (ANA). (n.d.). Health Policy.

Oestberg, Fredrik MSN, RN. (2013). Getting involved in policy and politics, Nursing Critical Care: (Volume 8. Issue 3. pp 48). doi: 10.1097/01.CCN.0000429392.92546.6f

Main Posting Rubric

Excellent 45 (45%) – 50 (50%)

Answers all parts of the discussion question(s) expectations with reflective critical analysis and synthesis of knowledge gained from the course readings for the module and current credible sources.

Supported by at least three current, credible sources.

Written clearly and concisely with no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.

Good 40 (40%) – 44 (44%)

Responds to the discussion question(s) and is reflective with critical analysis and synthesis of knowledge gained from the course readings for the module.

At least 75% of post has exceptional depth and breadth.

Supported by at least three credible sources.

Written clearly and concisely with one or no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.

Fair 35 (35%) – 39 (39%)

Responds to some of the discussion question(s).

One or two criteria are not addressed or are superficially addressed.

Is somewhat lacking reflection and critical analysis and synthesis.

Somewhat represents knowledge gained from the course readings for the module.

Post is cited with two credible sources.

Written somewhat concisely; may contain more than two spelling or grammatical errors.

Contains some APA formatting errors.

Poor 0 (0%) – 34 (34%)

Does not respond to the discussion question(s) adequately.

Lacks depth or superficially addresses criteria.

Lacks reflection and critical analysis and synthesis.

Does not represent knowledge gained from the course readings for the module.

Contains only one or no credible sources.

Not written clearly or concisely.

Contains more than two spelling or grammatical errors.

Does not adhere to current APA manual writing rules and style.

Main Post: Timeliness

Excellent 10 (10%) – 10 (10%)

Posts main post by day 3.

Good 0 (0%) – 0 (0%)

Fair 0 (0%) – 0 (0%)

Poor 0 (0%) – 0 (0%)

Does not post by day 3.

First Response

Excellent 17 (17%) – 18 (18%)

Response exhibits synthesis, critical thinking, and application to practice settings.

Communication is professional and respectful to colleagues.

Responses to faculty questions are fully answered, if posed.

Provides clear, concise opinions and ideas that are supported by at least two scholarly sources.

Demonstrates synthesis and understanding of learning objectives.

Response is effectively written in standard, edited English.

Good 15 (15%) – 16 (16%)

Response exhibits critical thinking and application to practice settings.

Communication is professional and respectful to colleagues.

Responses to faculty questions are answered, if posed.

Provides clear, concise opinions and ideas that are supported by two or more credible sources.

Response is effectively written in standard, edited English.

Fair 13 (13%) – 14 (14%)

Response is on topic and may have some depth.

Responses posted in the discussion may lack effective professional communication.

Responses to faculty questions are somewhat answered, if posed.

Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited.

Poor 0 (0%) – 12 (12%)

Response may not be on topic and lacks depth.

Responses posted in the discussion lack effective professional communication.

Responses to faculty questions are missing.

No credible sources are cited.

Second Response

Excellent 16 (16%) – 17 (17%)

Response exhibits synthesis, critical thinking, and application to practice settings.

Communication is professional and respectful to colleagues.

Responses to faculty questions are fully answered, if posed.

Provides clear, concise opinions and ideas that are supported by at least two scholarly sources.

Demonstrates synthesis and understanding of learning objectives.

Response is effectively written in standard, edited English.

Good 14 (14%) – 15 (15%)

Response exhibits critical thinking and application to practice settings.

Communication is professional and respectful to colleagues.

Responses to faculty questions are answered, if posed.

Provides clear, concise opinions and ideas that are supported by two or more credible sources.

Response is effectively written in standard, edited English.

Fair 12 (12%) – 13 (13%)

Response is on topic and may have some depth.

Responses posted in the discussion may lack effective professional communication.

Responses to faculty questions are somewhat answered if posed.

Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited.

Poor 0 (0%) – 11 (11%)

Response may not be on topic and lacks depth.

Responses posted in the discussion lack effective professional communication.

Responses to faculty questions are missing.

No credible sources are cited.

Participation

Excellent 5 (5%) – 5 (5%)

Meets requirements for participation by posting on three different days.

Good 0 (0%) – 0 (0%)

Fair 0 (0%) – 0 (0%)

Poor 0 (0%) – 0 (0%)

Does not meet requirements for participation by posting on 3 different days.

ADDITIONAL INSTRUCTIONS FOR THE CLASS

SCORE A+ WITH HELP FROM OUR PROFESSIONAL WRITERS – Discussion: Role of the RN APRN in Policy Evaluation

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. Discussion: Role of the RN APRN in Policy Evaluation

• 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. Discussion: Role of the RN APRN in Policy Evaluation

• 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. Discussion: Role of the RN APRN in Policy Evaluation

• 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.

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Assignment: Practicum: Cover Letter, Resume, And Portfolio

Assignment: Practicum: Cover Letter, Resume, And Portfolio

Your cover letter should be:

• -Presented and formatted in a professional business manner
• -Addressed properly
• -Clear and concise and include:
  • Content Introduction
  • Content Body
  • Content Conclusion
• -Personal philosophy statement
• -Self-assessment
• -Personal goals (short term and long term)
• -Achievements
• -2 letter of recomendation

Cover Letter, Resume, and Portfolio
Toussaint Casimir
Walden University
NURS 6660 PMH Nurse Practitioner Role I: Child and Adolescent
February 3, 2019
Personal Philosophy Statement
Patient care is complex system that is delivered by a multidisciplinary team. Its success requires perfect harmony between the all the involving members. It is vital that the care we deliver as healthcare professional is patient – centered. Therefore, it is important to know the population that we are serving, its needs and its cultural background. In the United States more than any other country, healthcare providers should develop their cultural awareness and competence.
The stigma around the mental illness and the quality of treatment that mentally ill individuals receive have inspired me to become a psychiatric mental health nurse practitioner (PMHNP). I have felt the necessity to stand up and do what is right as my contribution to fix this urgent issue. In our society, physical or medical diseases provoke empathy, but we demonstrate disdain for people impacted by mental conditions. Like we always say, “See it and fix it”. So, passivity is as wrong as the wrong doing.
As a psychiatric mental health nurse practitioner, I will have the opportunity to care for a multicultural population with different conceptions or point of view about mental health. It is my role and responsibility to understand the cultural differences and provide support to those in need. I have learned that in the healthcare system, we should not be judgmental. My personal philosophy is to treat each and every patient as I would like to be treated. It is a moral obligation to use my knowledge to serve and educate individuals in my community. As a healthcare professional, I believe that I have the capability to change to way mentally ill individuals are viewed and treated. Through my philosophy, I will be able to advocate for holistic and empathic care for individuals with mental health conditions.
Self – Assessment
I have decided to transition from registered nurse (RN) to psychiatric mental health nurse practitioner (PMHNP) to better serve my community. So, I have always said and believe that the more someone has the he/she can give. When I decided to go back to school to pursue my goal, I said to myself “I have to choose one of the best schools”. Finally, I have chosen Walden University that I believe meet my expectations. For my Practicum, I have chosen the Compass Health System which has been established in the South Florida since 1990, and it is well respected in the community. They offer their services through their offices and most of the hospital with mental health crisis. They are one the major teaching facilities in mental health in the South Florida.
I have selected preceptors who have been working with Compass Health System for several years. So, they acquired a very solid experience in the field. I have taken great advantage of their experience to strengthen my assessment skills to evaluate children adolescents and adults with mental health issues. Because they see patients in office and hospitals, I have been able to learn different approaches for individuals in crisis and non-crisis setting. I have built confidence in my ability to appropriately evaluate, diagnose and treat patient using pharmacologic therapy and non-pharmacologic therapy. I have no doubt in my mind that I am ready to deliver holistic and empathic care for individuals in my community regardless of their cultural background.
Personal goals
Short – term goals
· Become a certified psychiatric mental health nurse practitioner.
· Join one of the institutions that aim to provide the best quality of care for mentally ill individuals in my community.
· Strengthen my ability to accurately diagnose mental health conditions and communicate effective with patients and/or significant others about the condition and all the possible treatment options.
· Become a voice for those in my community who are affected by mental health disorders.
Long – term goals
· Enroll in a doctorate program to complete my DNP as psychiatric mental health nurse practitioner.
· Engage in the fight to change the way mentally ill individuals are viewed and treated in my community.
Achievements
· At the age of 24 I graduated with honor “Cum Laude” with a bachelor’s in agriculture from a prestigious school in the Dominican Republic.
· I worked for CECI in a joint project with the Haitian government for a period of 8 years.
· After entered to the United States in 2009, I decided to pursue my dream in the Healthcare System. And, I graduated in 2014 with “High Honor” with associate degree at Miami Dade College.
· I stated my career in nursing at the Memorial Healthcare System in a “Respiratory Specialty Unit”.
· In December 2015, I completed my bachelor’s degree in nursing.
· I transitioned to a Telemetry Unit at North Shore Medical Center.
· I have been working as psychiatric nurse for 2 ½.
· I am hoping to become certified psychiatric mental health nurse practitioner by the mid of this year.
 

Mrs. Marie Jones
Human resources director
Jackson Memorial Hospital

 
 
Toussaint Casimir, RN, BSN
1200 NE 200 St., Miami FL 33179
Phone: (786)991-3495/ (305)974-2863
E-mail: lecasimir73@hotmail.com
 
OBJECTIVE
Obtain a position in an institution where I can successfully implement my nursing skills and knowledge to provide individuals in my community with the best quality of care possible. And, advocate on behalf of the voiceless.
SUMMARY OF QUALIFICATIONS
· Licensure:        Registered Nurse (Florida Board of Nursing)
· Certification:       CPR; CPI; and 12 lead EKG
· Computer Skills: Microsoft Office
· Languages:        English: spoken, read and written
                             Spanish: spoken, read and written
French: spoken, read and written
Haitian Creole: spoken, read and written

 
WORK EXPERIENCES

Nursing Clinical Experience (12 Months)

 
 References
1. Scott Segal, MD (Psychiatrist)
Compass Health System,
305-891-0050
ssegal@compass.md

2. Richard Douyon, MD (Pychiatrist)
North Shore Medical Center (Medical director)
305-835-6000
Richard.douyon@tenethealth.com

3. Melaine Burnettgrizzle
North Shore Medical Center, Unit Director
305-835-3426
Melai.burnettgrizzle@tenethealth.com
Certifications
CPR; CPI; and 12 lead EKG
Institution Credit   Transcript Totals   

 
 
 
North Shore Med Ctr
CASIMIR, TOUSSAINT
Transcript Range: Feb 4, 2018 through Feb 3, 2019
Report Generated: Feb 03, 2019, 2:55 pm ET
 

 
 
 
Dr. Stephanie Hanna
Senior Associate Professor
 
To whom it may concern
I am delighted to recommend Mr. Toussaint Casimir for a position of psychiatric mental health nurse practitioner at your institution. During my career as professor at Miami Dade College Mr. Casimir has been one of the students, I ever have in my NUR 3069. I personally encouraged him to become member of the PHI THETA KAPPA honor society.
I have known Mr. Casimir as a very dedicated, disciplined, respectful, responsible and with a high sense of integrity and initiative. Thanks to his high degree of responsibility, he was able to manage successfully work, school and his family’ obligation. Despite the role he plays in his family, he demonstrated great flexibility to work with his advisors and participate actively in group assignments.
Mr. Casimir has all the qualities of an ideal employee. He has been always respectful of the rules, punctual, team player, organized and details oriented. He has always demonstrated great sense of leadership by supervising other students in labs and clinicals. Moreover, he has always volunteer to share his knowledge and understanding of subjects with his peers. I strongly believe that your institution would benefit from his optimism, his motivation, and commitment to nursing.
To sum up, I highly recommend that you consider giving a chance to Mr. Casimir to join your organization. And, I strongly believe that your patients would benefit from his sense of compassion, selfless, empathy and tolerance. If necessary, feel free to contact me using my contact information below.
 
Best regards,
Stephanie Hanna
Dr. Stephanie Hanna
Senior Associate Professor
Miami Dade College
School of Nursing
Phone: 305-237-4331
shanna@mdc.edu
Danielle Orr, RN, BSN
Nurse Manager, Respiratory Care Unit
To whom it may concern,
It is a great privilege to recommend Mr. Toussaint Casimir for a position at your organization. I am very proud to say that I am the first one to offer him an opportunity as a new grad.
I interviewed Mr. Casimir among several other nurses, and most of them with previous nursing experiences. But, Mr. Casimir convinced me that he was the right person for the job. I was impressed by his ability to communicate and the language that he used to convey his message. Even though he was a new nurse, he demonstrated great understanding of the role he had to play in our nursing team.
I never regret a bit the choice I made when I hired him. I felicitate myself for being able to recognize a talent when see it. Mr. Casimir is an easygoing person, highly motivated, dedicated and responsible. It was with heartbreaking when we had to let him go due to his familial obligation.
I highly recommend that you give him a chance to sell himself through and interview, and you will be able to get your own opinion. I am at your disposition, so you can reach at your convenience through my phone: 954-303-9170 or via email: Danielleorr@msh.net.
 
Best regards,
 
Danielle Orr
Nurse Manager
Memorial Healthcare System
(954) 883-7071/954-303-9170
danielleorr@mhs.net

Assignment 1: Supportive Psychotherapy Versus Interpersonal Psychotherapy

Assignment Instructions. Please read carefully to the end before starting

Assignment: Supportive Psychotherapy versus Interpersonal Psychotherapy

Amelia, a 16-year-old high school sophomore, presents with symptoms of weight loss and a very obvious concern for her weight. She has made several references to being “fat” and “pudgy” when, in fact, she is noticeably underweight. Her mother reports that she is quite regimented in her eating and that she insists on preparing her own meals as her mother “puts too many fattening things in the food” that she cooks. After discovering that during the past 3 months Amelia has lost 15 pounds and is well under body weight for someone of similar age/sex/developmental trajectory, the psychiatric mental health nurse practitioner diagnosed Amelia with anorexia nervosa.
Evidence-based research shows that clients like Amelia may respond well to supportive psychotherapy and interpersonal psychotherapy. So which approach might you select? Are both equally effective for all clients? In practice, you will find that many clients may be candidates for both of these therapeutic approaches, but factors such as a client’s psychodynamics and your own skill set as a therapist may impact their effectiveness.
This week, you continue exploring therapeutic approaches and their appropriateness for clients as you examine supportive psychotherapy and interpersonal psychotherapy. You also assess progress for a client receiving psychotherapy and develop progress and privileged psychotherapy notes for the client.
Photo Credit: Laureate Education
 
Although supportive psychotherapy and interpersonal psychotherapy share some similarities, these therapeutic approaches have many differences. When assessing clients and selecting therapies, it is important to recognize these differences and how they may impact your clients. For this Assignment, as you compare supportive and interpersonal psychotherapy, consider which therapeutic approach you might use with your clients.
 
To prepare:
· Review the media in this week’s Learning Resources.
· Reflect on supportive and interpersonal psychotherapeutic approaches.
 
The Assignment
In a 1- to 2-page paper, address the following:
Briefly describe how supportive and interpersonal psychotherapies are similar.
 
Explain at least three differences between these therapies. Include how these differences might impact your practice as a mental health counselor.
 
Explain which therapeutic approach you might use with clients and why. Support your approach with evidence-based literature.
 
References
Wheeler, K. (Ed.). (2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice (2nd ed.). New York, NY: Springer Publishing Company.
· Chapter 5, “Supportive and Psychodynamic Psychotherapy” (pp. 238–242)
· Chapter 9, “Interpersonal Psychotherapy” (pp. 347–368)
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
 
Note: You will access this text from the Walden Library databases.
Abeles, N., & Koocher, G. P. (2011). Ethics in psychotherapy. In J. C. Norcross, G. R. VandenBos, D. K. Freedheim, J. C. Norcross, G. R. VandenBos, & D. K. Freedheim (Eds.), History of psychotherapy: Continuity and change (pp. 723–740). Washington, DC: American Psychological Association. doi:10.1037/12353-048
 
Note: You will access this resource from the Walden Library databases.
Cameron, S., & Turtle-Song, I. (2002). Learning to write case notes using the SOAP format. Journal of Counseling and Development, 80(3), 286–292. Retrieved from the Academic Search Complete database. (Accession No. 7164780)
 
Note: You will access this article from the Walden Library databases.
 
Nicholson, R. (2002). The dilemma of psychotherapy notes and HIPAA. Journal of AHIMA, 73(2), 38–39. Retrieved from http://library.ahima.org/doc?oid=58162#.V5J0__krLZ4http://library.ahima.org/doc?oid=58162#.V5J0__krLZ4
 
U.S. Department of Health & Human Services. (n.d.). HIPAA privacy rule and sharing information related to mental health. Retrieved from http://www.hhs.gov/hipaa/for-professionals/special-topics/mental-health/
 
Sommers-Flanagan, J., & Sommers-Flanagan, R. (2013). Counseling and psychotherapy theories in context and practice [Video file]. Mill Valley, CA: Psychotherapy.net.
 
Note: For this week, view Reality Therapy, Feminist Therapy, and Solution-Focused Therapy only. You will access this media from the Walden Library databases.
Stuart, S. (2010). Interpersonal psychotherapy: A case of postpartum depression [Video file]. Mill Valley, CA: Psychotherapy.net.
 
Note: You will access this media from the Walden Library databases. The approximate length of this media piece is 110 minutes.
Note:  The School of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The Sample Paper provided at the Walden Writing Center provides an example of those required elements (available at  http://academicguides.waldenu.edu/writingcenter/templates  ). All papers submitted must use this formatting.

ADDITIONAL INSTRUCTIONS FOR THE CLASS

SCORE A+ WITH HELP FROM OUR PROFESSIONAL WRITERS – Assignment 1: Supportive Psychotherapy Versus Interpersonal Psychotherapy

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. Assignment 1: Supportive Psychotherapy Versus Interpersonal Psychotherapy

• 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. Assignment 1: Supportive Psychotherapy Versus Interpersonal Psychotherapy

• 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

Assignment 1: Assessing The Genitalia And Rectum

Assignment 1: Assessing The Genitalia And Rectum

IT IS A SOAP NOTE, PROFESSOR ONLY ACCEPTED CLASS RESOURCES.

Patients are frequently uncomfortable discussing with health care 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 accurately assess patients with problems in these areas.

In this assignment, you will consider case studies that describe abnormal findings in patients seen in a clinical setting.
In this assignment, you will analyze a SOAP 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.
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 over 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 with a healed episiotomy scar present. 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.

To prepare:
With regard to the SOAP 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.

To complete:
Refer to Chapter 5 of the Sullivan text. Analyze the SOAP note case study.  Using evidence based resources, 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 the 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 possible conditions that may be considered as a differential diagnosis for this patient. Explain your reasoning using at least 3 different references from current evidence based literature.

CALSS RESOURCES

Learning Resources

Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.

Required Readings

Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2015). Seidel’s guide to physical examination (8th ed.). St. Louis, MO: Elsevier Mosby.
Chapter 16, “Breasts and Axillae” (pp. 350-369)
This chapter focuses on examining the breasts and axillae. The authors describe the examination procedures and the anatomy and physiology of breasts.
Chapter 18, “Female Genitalia” (pp. 416-465)
In this chapter, the authors explain how to conduct an examination of female genitalia. The chapter also describes the form and function of female genitalia.
Chapter 19, “Male Genitalia” (pp. 466-484)
The authors explain the biology of the penis, testicles, epididymides, scrotum, prostate gland, and seminal vesicles. Additionally, the chapter explains how to perform an exam of these areas.
Chapter 20, “Anus, Rectum, and Prostate” (pp. 485-500)
This chapter focuses on performing an exam of the anus, rectum, and prostate. The authors also explain the anatomy and physiology of the anus, rectum, and prostate.

Dains, J. E., Baumann, L. C., & Scheibel, P. (2016). Advanced health assessment and clinical diagnosis in primary care (5th ed.). St. Louis, MO: Elsevier Mosby.
Chapter 5, “Amenorrhea” (pp. 47-60)
Amenorrhea, or the absence of menstruation, is the focus of this chapter. The authors include key questions to ask patients when taking histories and explain what to look for in the physical exam.
Chapter 6, “Breast Lumps and Nipple Discharge” (pp. 61-72)
This chapter focuses on the important topic of breast lumps and nipple discharge. Because breast cancer is the most common type of cancer in women, it is important to get an accurate diagnosis. Information in the chapter includes key questions to ask and what to look for in the physical exam.
Chapter 7, “Breast Pain” (pp. 73-80)
Determining the cause of breast pain can be difficult. This chapter examines how to determine the likely cause of the pain through diagnostic tests, physical examination, and careful analysis of a patient’s health history.
Chapter 27, “Penile Discharge” (pp. 318-324)
The focus of this chapter is on how to diagnose the causes of penile discharge. The authors include specific questions to ask when gathering a patient’s history to narrow down the likely diagnosis. They also give advice on performing a focused physical exam.
Chapter 36, “Vaginal Bleeding” (pp. 419-433)
In this chapter, the causes of vaginal bleeding are explored. The authors focus on symptoms outside the regular menstrual cycle. The authors discuss key questions to ask the patient, as well as specific physical examination procedures and laboratory studies that may be useful in reaching a diagnosis.
Chapter 37, “Vaginal Discharge and Itching” (pp. 434-445)
This chapter examines the process of identifying causes of vaginal discharge and itching. The authors include questions on the characteristics of the discharge, the possibility of the issues being the result of a sexually transmitted infection, and how often the discharge occurs. A chart highlights potential diagnoses based on patient history, physical findings, and diagnostic studies.

Sullivan, D. D. (2012). Guide to clinical documentation (2nd ed.). Philadelphia, PA: F. A. Davis.
Chapter 3, “Adult Preventative Care Visits” (“Gender Specific Screenings”; pp. 48–49)Note: Download the Physical Examination Objective Data Checklist to use as you complete the Head-to-Toe Physical Assessment Video assignment.

Seidel, H. M., Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2011). Physical examination objective data checklist. In Mosby’s guide to physical examination (7th ed.). St. Louis, MO: Elsevier Mosby.
This Physical Examination Objective Data Checklist was published as a companion to Seidel’s guide to physical examination (8th ed.), by Ball, J. W., Dains, J. E., & Flynn, J. A. Copyright Elsevier (2015). From /orders/evolve.elsevier.com/

Cucci, E. Santoro, A., DiGesu, C., DiCerce, R., & Sallustio, G. (2015). Sclerosing adenosis of the breast: Report of two cases and review of the literature. Polish Journal of Radiology, 80, 122–127. doi:10.12659/PJR.892706. Retrieved from /orders/www.ncbi.nlm.nih.gov/pmc/articles/PMC4356184/ 

Sabbagh, C., Mauvis, F., Vecten, A., Ainseba, N., Cosse, C., Diouf, M., & Regimbeau, J. M. (2014). What is the best position for analyzing the lower and middle rectum and sphincter function in a digital rectal examination? A randomized, controlled study in men. Digestive and Liver Disease, 46(12), 1082–1085. doi:10.1016/j.dld.2014.08.045
Retrieved from the Walden Library Databases.

Westhoff, C. L., Jones, H. E., & Guiahi, M. (2011). Do new guidelines and technology make the routine pelvic examination obsolete? Journal of Women’s Health, 20(1), 5–10.
Retrieved from the Walden Library databases.
This article describes the benefits of new technology and guidelines for pelvic exams. The authors also detail which guidelines and technology may become obsolete.

Centers for Disease Control and Prevention. (2012). Sexually transmitted diseases (STDs). Retrieved from http://www.cdc.gov/std/#
This section of the CDC website provides a range of information on sexually transmitted diseases (STDs). The website includes reports on STDs, related projects and initiatives, treatment information, and program tools.

University of Virginia. (n.d.). Introduction to radiology: An online interactive tutorial. Retrieved from http://www.med-ed.virginia.edu/courses/rad/index.html
This website provides an introduction to radiology and imaging. For this week, focus on genitourinary radiology, as well as the cross-sectional female pelvis and the cross-sectional male pelvis in abdominal radiology.

Required Media

Online media for Seidel’s Guide to Physical Examination
It is highly recommended that you access and view the resources included with the course text, Seidel’s Guide to Physical Examination. Focus on the videos and animations in Chapters 16 and 18–20 that relate to special examinations, including breast, genital, prostate, and rectal. Refer to the Week 4 Learning Resources area for access instructions on /orders/evolve.elsevier.com/.

Optional Resources

LeBlond, R. F., Brown, D. D., & DeGowin, R. L. (2014). DeGowin’s diagnostic examination (10th ed.). New York, NY: McGraw Hill Medical.
Chapter 8, “The Chest: Chest Wall, Pulmonary, and Cardiovascular Systems; The Breasts” (Section 2, “The Breasts,” pp. 434–444)
Section 2 of this chapter focuses on the anatomy and physiology of breasts. The section provides descriptions of breast examinations and common breast conditions.
Chapter 11, “The Female Genitalia and Reproductive System” (pp. 541–562)
In this chapter, the authors provide an overview of the female reproductive system. The authors also describe symptoms of disorders in the reproductive system.
Chapter 12, “The Male Genitalia and Reproductive System” (pp. 563–584)
The authors of this chapter detail the anatomy of the male reproductive system. Additionally, the authors describe how to conduct an exam of the male reproductive system.
Review of Chapter 9, “The Abdomen, Perineum, Anus, and Rectosigmoid” (pp. 445–527)

ADDITIONAL INSTRUCTIONS FOR THE CLASS

SCORE A+ WITH HELP FROM OUR PROFESSIONAL WRITERS –  Assignment 1: Assessing The Genitalia And Rectum

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. Assignment 1: Assessing The Genitalia And Rectum

• 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. Assignment 1: Assessing The Genitalia And Rectum

• 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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• 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.

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NURS6003 Week 8 Discussion Strategies for Academic Portfolios

NURS 6003 Week 8 Discussion Strategies for Academic Portfolios

Discussion: Strategies For Academic Portfolios

NURS 6050 Week 9 Discussion: Legal and Ethical Conduct

Week 9 Discussion: Legal and Ethical Conduct

As emphasized in this week’s media presentation, all nurses need to be familiar with the laws and regulations that govern their practice: their state’s Nurse Practice Act, ANA’s Nursing: Scope and Standards of Practice, specialty group standards of practice, etc. In addition, basic ethical principles guide nurses’ decision-making process every day. ANA’s Code of Ethics and ANA’s Social Policy Statement are two important documents that outline nurses’ ethical responsibilities to their patients, themselves, and their profession. This said, there is a dilemma: The laws are not always compatible with the ethical positions nurses sometimes take. This week’s Discussion focuses on such a dilemma.
To prepare:
Review this week’s Learning Resources, focusing on the information in the media presentation about the relationship between the law and ethics.
Consider the ethical responsibility of nurses in ensuring patient autonomy, beneficence, non-malfeasance, and justice.
Read the following scenario:
Lena is a community health care nurse who works exclusively with HIV-positive and AIDS patients. As a part of her job, she evaluates new cases and reviews confidential information about these patients. In the course of one of these reviews, Lena learns that her sister’s boyfriend has tested HIV positive. Lena would like to protect her sister from harm and begins to consider how her sister can find out about her boyfriend’s health status.
Consult at least two resources to help you establish Lena’s legal and ethical position. These resources might include your state’s Nurse Practice Act, the ANA’s Code of Ethics, ANA’s Nursing: Scope and Standards of Practice, and internal or external standards of care.
Consider what action you would take if you were Lena and why.
Determine whether the law and the ANA’s standards support or conflict with that action.
Post a description of the actions you would take in this situation, and why. Justify these actions by referencing appropriate laws, ethical standards, and professional guidelines.
Required Readings
Milstead,  J. A. (2019). Health policy and politics: A nurse’s guide (6th ed.).  Burlington, MA: Jones and Bartlett Publishers.
Chapter 4, “Government Response: Regulation” (pp. 56-81)
This chapter explains the major concepts of the regulation of health professionals, with emphasis on advanced practice nurses (APN) and the process of licensure and credentialing.
ANA’s Foundation of Nursing Package – (Access this resource from the Walden Library databases through your NURS 6050 Course Readings List)
Guide to the Code of Ethics: Interpretation and Application
This guide details the history, purpose and theory, application, and case studies of this must-have Code of Ethics.
Nursing Social Policy Statement
The Nursing Social Policy Statement provides an understanding of the social framework and obligations of the nursing profession.
Nursing: Scope & Standards of Practice
This book contains several national standards of practice that can be used to inform the decision-making process, development, implementation, and evaluation of several functions and aspects of advanced practice nursing.
NOTE: CHECK THE DOCUMENTS, BOOK AND MEDIA PRESENTATION VIDEO ATTACHED BELLOW TO COMPLETE THE DISCUSSION QUESTION

 A PICOt Question

Prepare this assignment as a 1,500-1,750 word paper using the instructor feedback from the previous course assignments and the guidelines below.

PICOT Question

Revise the PICOT question you wrote in the Topic 1 assignment using the feedback you received from your instructor.

The final PICOT question will provide a framework for your capstone project (the project students must complete during their final course in the RN-BSN program of study).

Research Critiques

In the Topic 2 and Topic 3 assignments, you completed a qualitative and quantitative research critique on two articles for each type of study (4 articles total). Use the feedback you received from your instructor on these assignments to finalize the critical analysis of each study by making appropriate revisions.

The completed analysis should connect to your identified practice problem of interest that is the basis for your PICOT question.

Refer to “Research Critiques and PICOT Guidelines – Final Draft.” Questions under each heading should be addressed as a narrative in the structure of a formal paper.

Proposed Evidence-Based Practice Change

Discuss the link between the PICOT question, the research articles, and the nursing practice problem you identified. Include relevant details and supporting explanation and use that information to propose evidence-based practice changes.

PICOT QUESTION 1: Describe the difference between a nursing practice problem and a medical practice problem. Provide one example of each. Discuss why is it important to ensure your PICOT is based on a nursing practice problem.

ANSWER TO QUESTION:

Pathology is unique to a medical diagnosis, the emphasis is on the disease. On the other hand, nursing diagnosis focuses on the patient and the reaction to physiology and psychology.

The doctors who make the medical diagnosis come up with such a diagnosis that will cure the medical condition, while the nurses’ diagnosis, thus a nursing diagnosis, focuses on treating such patients. Furthermore, a medical model deals with sickness or medical status. Using a problem-solving technique, the doctor focuses on the defect, or dysfunction, within the patient. The nursing model is not established, but nursing has several practice models/theories that emphasize nursing’s more holistic approach to disease. Finally, a model of nursing deals with the human reaction to real or possible responses, this kind of practice problem looks at the clinical judgment about an individual patient, a family, or a community and how they respond to actual or potential health problems that they are exposed to. A nursing practice problem,therefore, provides nurses with a basis from which they select appropriate. 

On a clinical level, ethical questions arise every day. In a study of the ethical issues encountered by nurses, Ulrich et al. (2010) found that more than 60% of nurses identified patient’s rights, autonomy, and informed consent as frequent or daily problems. Other common issues included advanced care planning, surrogate decision making, end-of-life decision making, and breeches of confidentiality (Ulrich et al., 2007).  Such problems include acute pain, nausea, constipation, self-care deficit,and risk injury among others. For example, the complimentary nurse practice problems ofimpaired verbal communication, interrupted family processes, the risk for falls, and powerlessness provides a general and a more holistic understanding of the impacts of a condition on a particular patient or family. Also, they help direct nursing interventions .

Ulrich, C. M., Taylor, C., Soeken, K., O’Donnell, P., Farrar, A., Danis, M., & Grady, C. (2010). Everyday ethics: ethical issues and stress in nursing practice. Journal of advanced nursing, 66(11), 2510-2519.

Ulrich, C., O’donnell, P., Taylor, C., Farrar, A., Danis, M., & Grady, C. (2007). Ethical climate, ethics stress, and the job satisfaction of nurses and social workers in the United States. Social science & medicine, 65(8), 1708-1719.

PROFESSOR’S RESPONSE: TOPIC 2

Cinita, Thank you for posting DQ1 Module 2.

You discussed strategies that would help a researcher manage and organize qualitative data. References included. Your post was 1 day late. Per GCU policy, 10% deducted from the grade.

PROFESSOR’S RESPONSE TOPIC 3″:

Cinita, Thank you for posting DQ1 Module 3. Examples of experimental and non-experimental research design presented. Level of control for reach research included in post. References included. Good job

NRS 433V RS5 Research Critique PICOT Guidelines

Research Critiques and PICOT Question Guidelines – Final Draft

Use this document to organize the content from your four studies into your final draft.

Quantitative and Quantitative Studies

Background

1. Summary of studies. Include problem, significance to nursing, purpose, objective, and research question.

How do these two articles support the nurse practice issue you chose?

1. Discuss how these articles will be used to answer your PICOT question.

2. Describe how the interventions and comparison groups in the articles compare to those identified in your PICOT question.

Method of Study:

1. State the methods of the articles you are comparing and describe how they are different.

2. Consider the methods you identified in your chosen articles and state one benefit and one limitation of each method.

Results of Study

1. Summarize the key findings of each of the studies into a comprehensive summary.

2. What are the implications of the four studies you chose in nursing practice?

Ethical Considerations

1. Discuss two ethical consideration in conducting research.

2. Describe how the researchers in the four articles you choose took these ethical considerations into account while performing their research.

Outcomes Comparison

1. What are the anticipated outcomes for your PICOT question?

2. How do the outcomes of the four articles you chose compare to your anticipated outcomes?

ADDITIONAL INSTRUCTIONS FOR THE CLASS

SCORE A+ WITH HELP FROM OUR PROFESSIONAL WRITERS – A PICOt Question

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
• A PICOt Question

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

Assignment: The Nurse Leader as Knowledge Worker

Assignment: The Nurse Leader as Knowledge Worker

The term “knowledge worker” was first coined by management consultant and author Peter Drucker in his book, The Landmarks of Tomorrow (1959). Drucker defined knowledge workers as high-level workers who apply theoretical and analytical knowledge, acquired through formal training, to develop products and services. Does this sound familiar?
Nurses are very much knowledge workers. What has changed since Drucker’s time are the ways that knowledge can be acquired. The volume of data that can now be generated and the tools used to access this data have evolved significantly in recent years and helped healthcare professionals (among many others) to assume the role of knowledge worker in new and powerful ways.
In this Assignment, you will consider the evolving role of the nurse leader and how this evolution has led nurse leaders to assume the role of knowledge worker. You will prepare a presentation with an infographic to educate others on the role of nurse as knowledge worker.
Reference: Drucker, P. (1959). The landmarks of tomorrow. New York, NY: HarperCollins Publishers.
To Prepare:
Review the concepts of informatics as presented in the Resources.
Reflect on the role of a nurse leader as a knowledge worker.
Consider how knowledge may be informed by data that is collected/accessed.
The Assignment:
Explain the concept of a knowledge worker.
Define and explain nursing informatics and highlight the role of a nurse leader as a knowledge worker.
Develop a simple infographic to help explain these concepts.
NOTE: For guidance on infographics, including how to create one in PowerPoint, see “How to Make an Infographic in PowerPoint” as presented in the Resources.
Present the hypothetical scenario you originally shared in the Discussion Forum( the answer of the discussion question is attached bellow in a document). Include your examination of the data that you could use, how the data might be accessed/collected, and what knowledge might be derived from that data. Be sure to incorporate feedback received from your colleagues’ replies.
Learning Resources
Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.
Required Readings
McGonigle, D., & Mastrian, K. G. (2017). Nursing informatics and the foundation of knowledge (4th ed.). Burlington, MA: Jones & Bartlett Learning.
• Chapter 1, “Nursing Science and the Foundation of Knowledge” (pp. 7–19)
• Chapter 2, “Introduction to Information, Information Science, and Information Systems” (pp. 21–33)
• Chapter 3, “Computer Science and the Foundation of Knowledge Model” (pp. 35–62)
24Slides. (2018). How to make an infographic in PowerPoint. Retrieved September 27, 2018, from /orders/24slides.com/presentbetter/how-make-infographic-powerpoint/
Nagle, L., Sermeus, W., & Junger, A. (2017). Evolving role of the nursing informatics specialist. In J. Murphy, W. Goossen, & P. Weber (Eds.), Forecasting Competencies for Nurses in the Future of Connected Health (212–221). Clifton, VA: IMIA and IOS Press. Retrieved from /orders/serval.unil.ch/resource/serval:BIB_4A0FEA56B8CB.P001/REF
Sweeney, J. (2017). Healthcare informatics. Online Journal of Nursing Informatics, 21(1).
Note: You will access this article from the Walden Library databases.
Required Media
Laureate Education (Producer). (2018). Health Informatics and Population Health: Trends in Population Health [Video file]. Baltimore, MD: Author.
 
Accessible player
Public Health Informatics Institute. (2017). Public Health Informatics: “translating” knowledge for health [Video file]. Retrieved from /orders/www.youtube.com/watch?v=fLUygA8Hpfo.

ADDITIONAL INSTRUCTIONS FOR THE CLASS

SCORE A+ WITH HELP FROM OUR PROFESSIONAL WRITERS – Assignment: The Nurse Leader as Knowledge Worker

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. Assignment: The Nurse Leader as Knowledge Worker

• 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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