NURS 6640 FINAL EXAM 3: WALDEN UNIVERSITY

NURS 6640 FINAL EXAM 3

NURS 6640 FINAL EXAM 3

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NURS 6640 FINAL EXAM 3: WALDEN UNIVERSITY
Question 1
A PMHNP has been treating a 9-year-old patient who was referred by her school. Students are asked to raise their hands before speaking during group discussion, but the patient seems to blurt out what she wants to say without being called on. She also interrupts other children while they are talking instead of waiting her turn. When the patient gets frustrated, she has trouble controlling her emotions and cries often. Based on the initial information provided, the first focus by PMHNP is the child’s ____________.
B.
self-regulation
Question 2
The PMHNP is caring for a patient who experiences depression caused by the traumatic experience of her dog passing away. She reports not being able to eat or sleep, and sometimes doesn’t want to leave the house at all. Which statement is most appropriate for the PMHNP to maximize the patient’s adaptive coping mechanisms?
Selected Answer:
C. “It’s important to be mindful of how you feel and then to determine what causes those feelings.”
Question 3
A PMHNP is using Gestalt therapy to communicate with a 50-year-old patient who is going through a divorce. As he is calmly sharing the details of his divorce, the PMHNP notices that Dave is tapping his fingers on his legs. What is an appropriate response by the PMHNP using the technique of focusing?
A. “I noticed that your fingers were tapping. Can you give a voice to your fingers?”
Question 4
The PMHNP is meeting with an older, female adult patient and her daughter. The patient has early onset dementia. The daughter expresses concern, saying, “I don’t want you to just stick my mother in a home and give her medicine. I’m worried that’s what people are going to want to do.” What is the best response by the PMHNP to the daughter?
B. “The type of treatment depends on the stage of dementia and safety considerations.”
Question 5
A PMHNP is treating a 10-year-old boy who is exhibiting signs of aggression and attention problems. What type of intervention will the PMHNP consider using a common elements approach?
D. All of the above
Question 6
A 35-year-old male patient is being treated for alcohol addiction. He asks for the PMHNP’s cell phone number to use in case of an emergency. When the PMHNP responds that giving her number would be against therapeutic rules, the patient threatens an act of violence to the therapist. What would be the most appropriate response by the PMHNP?
Selected Answer:
A. Immediately report the threat to the local police department
Question 7
The PMHNP is caring for an adult male patient whose wife left him several months ago. He recently learned that his ex-wife is dating someone much younger. The man feels belittled, sad, and lonely. He talks about trying to meet other women, but says, “I can’t compete with the younger guys these days, with the cool clothes and the vegan diets. I’m bald and overweight, and what woman is going to want to be with me?” How does the PMHNP help raise the man’s self-esteem?
Selected Answer:
A. Correcting cognitive distortions
Question 8
1 out of 1 points
The PMHNP uses therapeutic communication skills while ensuring that the patient understands that he has choices. The PMHNP comprehends and practices motivational interviewing. This is best understood as which of the following?
B. A statement that both challenges the patient’s resistance and offers an opportunity to discuss the issues allows the patient to argue with him/herself to help produce a desired change.

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NURS 6640 FINAL EXAM 4: WALDEN UNIVERSITY

NURS 6640 FINAL EXAM 4

NURS 6640 FINAL EXAM 4

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NURS 6640 FINAL EXAM 4: WALDEN UNIVERSITY
Question 1
1 out of 1 points
A PMHNP is using interpersonal psychotherapy with a 40-year-old patient having relationship problems with his extended family. The patient shares that he has been using the strategies they identified to reduce his distress, but they have not been helping. He is frustrated and is considering stopping treatment. What would be an appropriate step by the PMHNP?
Selected Answer:
A.
Encourage the patient to continue treatment by using alternative strategies
Question 2
0 out of 1 points
The PMHNP has been providing supportive psychodynamic psychotherapy to a patient and is nearing the termination stage. The PMHNP will use which criteria for determining that the patient is ready for termination?
Selected Answer:
D.
Self-analytic capacity has been developed.
Question 3
1 out of 1 points
A PMHNP is using Gestalt therapy to communicate with a 42-year-old patient who is upset with her mother. She says, “I want to tell her how hurt I feel when she doesn’t call me, but I don’t want to upset her.” What technique can the PMHNP use to help Sasha express herself?
Selected Answer:
B.
Empty-chair dialogue
Question 4
1 out of 1 points
The PMHNP is caring for an older patient with major depressive disorder, seasonal pattern. The patient has been resolute about not taking medication to manage the depression brought on by his illness, stating that it is against his yogic lifestyle. In addition to psychotherapy, what can the PMHNP suggest to this patient?
Selected Answer:
A.
“You may want to look into therapeutic oils and aromatherapy as an alternative to medication.”
Question 5
0 out of 1 points
A PMHNP is assessing a 60-year-old patient named Carlos. He has severe PTSD and mild substance abuse issues. The most appropriate setting to treat Carlos would be a _________.
Selected Answer:
A.
primary health care setting with some specialized care

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NURS 6650 FINAL EXAM NEW: WALDEN UNIVERSITY

NURS 6650 FINAL EXAM NEW

NURS 6650 FINAL EXAM NEW
 
Question 1
When completing this exam, did you comply with Walden University’s Code of Conduct including the expectations for academic integrity?
Selected Answer:
Yes
Question 2
One member of a therapy group had been quiet for the first several sessions. The member revealed to the other members feeling of depression and emptiness. This week, the member was full of energy and talking very quickly. The member became irritated with another member tried to interrupt, started yelling, and then broke into a fit of laughter. Based on the situation, what can the PMHNP determine about the member?
Selected Answer:
B.
The member is exhibiting bipolar behaviors.
Question 3
The PMHNP conducts a specialized individual interview with a patient named Sandy. During this interview, Sandy expresses her want of the other members to like her, and she has a deep dread for the first group meeting. How does the PMHNP correctly interpret Sandy’s interpersonal circumplex?
Selected Answer:
B.
Sandy is likely to view members of the group as friendly.

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Nurs 6650 Final Exam

Nurs 6650 Final Exam

Nurs 6650 Final Exam
 
Question 1
Group participation is an important aspect of how successful group therapy will be. The PMHNP recognizes that the gender of group participants can play a role in the likelihood of group participation. Which statement about gender and group composition does the PMHNP take into account?
A.
Men display more intimacy and less competition in all-male groups.
B.
Women display less intimacy and more competition in all-female groups.
C.
Men in evenly mixed groups are more self-disclosing and less aggressive.
D.
Women in evenly mixed groups are equally as active as they are in all-female groups
Question 2
During his second group therapy session, a member, who was quiet the previous week, becomes very judgmental. He criticizes another member by saying, “Mary, you are always late because you don’t respect our group.” Then he adds, “In fact, all of you are disrespectful and uncaring.” What is an appropriate step by the PMHNP?
A.
To learn the underlying meaning of the statements
B.
To ask about his actual motivations and aspirations
C.
To help reveal the impact of the behavior on others
D.
All of the above
Question 3
PMHNP is putting together a heterogeneous, interactional therapy group. During an initial screening, a patient explains that he is unemployed because he keeps getting fired from new jobs after several months. The therapist asks, “Why do you think those companies let you go?” The patient’s reply is, “Those companies are all terrible. They don’t know how to treat employees.” After asking the patient if he thought about his role in getting fired, the patient says, “Why should I? I am not part of the problem.” Based on this information, what is an appropriate observation by the PMHNP?
A.
The patient is able to participate in the group task and would benefit from it.
B.
The patient is able to participate in the group task but may be harmed by it.
C.
The patient should decide if he would feel comfortable joining group therapy.
D.
The patient will likely not benefit from group therapy and should not join.
Question 4
The PMHNP recognizes that hostility is unavoidable in a group and acknowledges that a frequent source of hostility can be parataxic distortions. Which situation is likely to present a parataxic distortion within the group?
A.
Peggy, a 54-year-old woman, acting as a surrogate to Susan, who is a younger and newer member of the group
B.
Jerry, a Mexican medical doctor who denies his heritage and Carlos, a proud Mexican warehouse employee
C.
Spencer, a Caucasian politician with a history of substance abuse, and a Caucasian therapist
D.
A successful entrepreneur and an aspiring spoken-word poet
Question 5
During a first group therapy session, a member is outgoing and participates actively. Based on this information, what is an appropriate prediction about this group member by the PMHNP?
The member may be influential
A patient in group therapy named Ted shares personal information for the first time. He seems nervous but continues to talk. How might the PMHNP use nonverbal positive reinforcement to support Ted’s feeling more comfortable?
A.
Staring intently at Ted while raising an eyebrow
B.
Looking at other members rather than directly at Ted
C.
Leaning forward and nodding as Ted shares his story
D.
Ignoring any members who are not listening to Ted

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NURS 6660 FINAL EXAM

NURS 6660 FINAL EXAM

NURS 6660 FINAL EXAM

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NURS 6660 FINAL EXAM
Question: 1
The PMHNP is evaluating a 15-year-old male patient who has been referred by his courtappointed guardian. He has been in foster care for the last 6 years and maintained a steady pattern of low-level behavior problems such as skipping school and ignoring curfew. He is not openly defiant and has always been described as a ―loner.‖ He just does not follow most rules. During the mental status examination, the PMHNP notes that his expressions are sometimes inconsistent with the topic of conversation, and he does not seem to be able to transition effectively among levels of emotion. This represents an abnormality in:
A. Mood
B. Affect
C. Thought process and content
D. Judgment and insight
Question: 2
A variety of diagnostic instruments are available to assist the PMHNP with comprehensive data collection. Which of the following tools is considered an ―interviewer-based‖ tool designed as a guide to clinicians designed to help clarify answers to questions?
A. The Children’s Interview for Psychiatric Symptoms (ChIPS)
B. The Diagnostic Interview for Children and Adolescents (DICA)
C. The Pictorial Instrument for Children and Adolescents (PICA-III-R)
D. The Child and Adolescent Psychiatric Assessment (CAPA)
3 61 Kevin is a 15-year-old male who presents for court-ordered psychiatric assessment. Kevin comes to his first appointment with both of his parents. He is sitting in the chair with his arms crossed and responds with ―yes‖ and ―no‖ answers to direct questions; otherwise, he volunteers no information. The parents are clearly upset and indicate they just ―don’t know what to do with him anymore.‖ The most appropriate action for the PMHNP would be to:
A. Ask the parents to step out and interview Kevin privately

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NURS 6660 FINAL EXAM

NURS 6660 FINAL EXAM

NURS 6660 FINAL EXAM

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NURS 6660N FINAL EXAM : WALDEN UNIVERSITY
Question: 1
The PMHNP is evaluating a 15-year-old male patient who has been referred by his courtappointed guardian. He has been in foster care for the last 6 years and maintained a steady pattern of low-level behavior problems such as skipping school and ignoring curfew. He is not openly defiant and has always been described as a ―loner.‖ He just does not follow most rules. During the mental status examination, the PMHNP notes that his expressions are sometimes inconsistent with the topic of conversation, and he does not seem to be able to transition effectively among levels of emotion. This represents an abnormality in:
A. Mood
B. Affect
C. Thought process and content
D. Judgment and insight
Question: 2
A variety of diagnostic instruments are available to assist the PMHNP with comprehensive data collection. Which of the following tools is considered an ―interviewer-based‖ tool designed as a guide to clinicians designed to help clarify answers to questions?
A. The Children’s Interview for Psychiatric Symptoms (ChIPS)
B. The Diagnostic Interview for Children and Adolescents (DICA)
C. The Pictorial Instrument for Children and Adolescents (PICA-III-R)
D. The Child and Adolescent Psychiatric Assessment (CAPA)
3 61 Kevin is a 15-year-old male who presents for court-ordered psychiatric assessment. Kevin comes to his first appointment with both of his parents. He is sitting in the chair with his arms crossed and responds with ―yes‖ and ―no‖ answers to direct questions; otherwise, he volunteers no information. The parents are clearly upset and indicate they just ―don’t know what to do with him anymore.‖ The most appropriate action for the PMHNP would be to:
A. Ask the parents to step out and interview Kevin privately
B. Have Kevin complete the standardized-testing assessment
C. Schedule session two after reviewing court documentation
D. Arrange for three sessions with a family therapist then reevaluate Kevin
4 the PMHNP observes separation from and reunion with the parent as part the mental status exam of a 25-month-old toddler. Extremes of emotion during separation or reunion are most consistent with:
A. Normal developmental progression at that age
B. Cognitive dysfunction
C. Neurologic dysfunction
D. Problems with the parent-child relationship
5 the PMHNP is performing an emergency assessment on Renee, a 9-year-old girl who was initially brought to the attention of social services by her maternal grandmother. Renee is reluctant to talk about herself or her home life. The physical examination that acc

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NURS 6052N QUIZ 9

NURS 6052N QUIZ 9

NURS 6052N QUIZ 9
Question 1
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
Response Feedback:
Rituximab is not recommended for use in pregnancy or when women are lactating. The patient should consequently be advised to continue using birth control for the duration of treatment.
Question 2
A nurse on an oncology unit is aware of the need to assess for adverse effects in patients who are being treated with rituximab. The risks of adverse effects are highest at what point during the course of treatment?
Response Feedback:
Infusion-related effects reportedly occur in 80% of patients within 30 minutes to 2 hours after beginning the first rituximab infusion. These exceed the incidence of adverse effects at other points in the course of treatment.
Question 3
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?
Response Feedback:
Targeted therapies are generally considered to be less toxic than traditional chemotherapy drugs. However, adverse reactions to targeted therapies can occur such as severe skin reactions, GI toxicities, skin reactions, and thrombosis.
Question 4
A female patient is taking filgrastim (Neupogen) to decrease the incidence of infection. The nurse notices a small increase in the neutrophil count 2 days after starting therapy. The nurse’s evaluation of the increase is that
Response Feedback:
A small increase in the neutrophil count 1 or 2 days after starting therapy indicates only a transient increase and does not indicate the full therapeutic effects of the drug. It indicates neither slow action nor ineffectiveness of the drug.
Question 5
A male patient has been on long-term bicalutamide (Casodex) therapy. In order to assess adverse effects of the drug therapy, the nurse will closely monitor which of the following?
Response Feedback:
It is important for the nurse to monitor the patient’s liver function closely if the patient is on prolonged therapy with an antiandrogenic agent. Adverse effects of the therapy include gynecomastia, diarrhea, hot flashes, breast pain, impotence, loss of libido, and abnormal liver functions. Monitoring of blood counts, an annual pap smear, and regular visual function tests are advised for patients undergoing tamoxifen therapy.
Question 6
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?
Response Feedback:
In patients with cancer, epoetin alfa should only be used when anemia is due to concomitant myelosuppressive chemotherapy and should be discontinued when the chemotherapy course is completed. The use of epoetin alfa during cancer may shorten survival and/or increase the risk of tumor progression or recurrence. Patients with cancer are also at risk for serious cardiovascular and thrombovascular events. Consequently, the benefits of treatment must be considered in light of these potentially adverse effects.

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NURS6531 Advanced Practice Care of Adults Across the Life Span Week 2 Forum
Diagnosing Integumentary Disorders
When entering examination rooms, advanced practice nurses often immediately begin assessing patients by looking for external abnormalities such as skin irritations or cloudy eyes. By making these simple observations, they can determine how to proceed with their patient evaluations. During the patient evaluation, advanced practice nurses will use initial observations to guide them in acquiring the necessary medical history, performing additional assessments, and ordering the appropriate diagnostics. The information obtained during this evaluation process will help in the development of a differential diagnosis. Once a diagnosis is made, the advanced practice nurse can consider potential treatment options and work with the patient to develop a plan of care. For this Forum, consider the following three case studies of patients presenting with integumentary disorders.
Case Study 1
A 46-year-old male presents to the office complaining of a pruritic skin rash that has been present for a few weeks. He initially noted the rash on his feet, but it then spread to between the fingers, his wrist, and waist. He notes that it does not seem to be on his face or trunk. He recently came home from a trip to Florida where he had stayed in multiple hotels. He takes occasional ibuprofen for knee pain, but denies taking other medications or having other health problems. He has no known drug allergies. The physical examination reveals a male with several tiny vesicles and scales in between the fingers, on the feet and ankles, around the patient’s wrist and around the belt line.
Picture of a hand that is covered in a pruritic skin rash between the fingers, which covers the wrist. The rash does not uniformly cover the hand and is scaly in some areas.
Case Study 2
K.B., a 52 year old Irish American patient who present today complaining of “a mole” on the skin that is changing colors. He said he has had this ‘mole’ for almost two years. K.B. is a construction worker currently residing in Hawaii. As a teen he worked outside and visited the tanning bed several times a month. He is a worried that this “mole” doesn’t look like the others on his body.
On your examination, you note, the lesion as round, dark colored in appearance, and scaly. You also note the mole has an irregular border and about 0.2cm in size.
Depicted on the skin are four moles. In the center is a large mole that is dark colored in appearance, with an uneven colored tone, appears scaly, and has an irregular border. The other three moles depicted appear normal in appearance.
Case Study 3
J.V. 50 year old patient with history of eczema is here today complaining of lesions on the right side of her face and neck. She thinks it is a flare up of her eczema and is asking for a refill of her ointment, TAC 0.1%.
She complains of some ‘itching’ and a bit of ‘tingling and pain’ to the lesions. She’s a pharmaceutical worker and thinks that the ‘pain’ maybe due to contaminate exposure. Denies any other associating symptoms. Below is a photo of the lesions.
Patient presents with lesions on the right side of her face and neck. The lesions are red in appearance and vary in size. They appear scaly and do not uniformly cover the entire region of her face or neck.
To prepare:
Review Part 5 of the Buttaro et al. text and the case studies provided
You will either select or be assigned one of the three case studies provided.
Reflect on the provided patient information including history and physical exams.
Think about a differential diagnosis. Consider the role the patient history and physical exam played in your diagnosis.
Reflect on potential treatment options based on your diagnosis.
Note: For this Forum, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Forum Question” link and then select “Create Thread” to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on Submit!
By Day 3
Post an explanation of the primary diagnosis, as well as 3 differential diagnoses, for the patient in the case study that you selected or were assigned. Describe the role the patient history and physical exam played in the diagnosis. Then, suggest potential treatment options based on your patient diagnosis.

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NURS6531 Advanced Practice Care of Adults Across the Life Span Week 3 Forum
Diagnosing HEENT Disorders
In clinical settings, advanced practice nurses may initiate a physical examination of a patient by examining the components of the HEENT system. Assessing primary diagnoses and differential diagnoses as they concern the HEENT system are important in informing your practice in providing optimal care.
For this Discussion, consider the following three case studies of patients presenting with head, eyes, ears, nose, and throat disorders.
Case Study 1
An 86-year-old widowed female is brought to the office by her daughter-in-law. The patient complains of constant tearing and an itchy, burning sensation in both eyes. The patient states this is not a new problem, but it has worsened in the past week and is affecting her vision. The patient complains that her eyes are dry. She thinks the problem must be caused by one of her medications. Her patient medical history is positive for hypertension, atrial fibrillation, and heart failure. She has an allergy to erythromycin that causes rash and elevated liver enzymes. Medications currently prescribed include Furosemide 40 milligrams po twice a day, diltiazem 240 milligrams po daily, lisinopril 20 milligrams po daily, and warfarin 3 milligrams po daily. The physical examination reveals a frail older female with some facial dryness and slight scaling. Her visual acuity is 20/60 OU, 20/40 OD, 20/60 OS. The eyelids are erythematous and edematous with yellow crusting around the lashes. Sclera are injected, conjunctiva are pale, and pupils are equal and reactive to light and accommodation.
Case Study 2
A middle-aged male presents to the office complaining of a two-day history of a left earache. The onset was gradual, but has steadily been increasing. It has been constantly aching since last night, and his hearing seems diminished to him. Today he thinks the left side of his face may even be swollen. He denies upper respiratory infection, known fever, or chills. His patient medical history is positive for Type 2 diabetes mellitus, hypertension, and hyperlipidemia. The patient has a known allergy to Amoxicillin that results in pruritus. Medications currently prescribed include Metformin 1,000 milligrams po twice a day, lisinopril 20 milligrams po daily, Aspirin 81 milligrams po daily, and simvastatin 40 milligrams po daily. The physical exam reveals a middle aged male at a weight of 160 pounds, height of 5’8”, temperature of 98.8 degrees Fahrenheit, heart rate of 88, respiratory rate of 18, and blood pressure of 138/76. Further examination reveals the following:
Face: Faint asymmetry with left periauricular area slightly edematous
Eyes: sclera clear, conj wnl
L ear: + tenderness L pinna, + edema, erythema, exudates left external auditory canal, TM not visible
R ear: no tenderness, R external auditory canal clear without edema, erythema, exudates
+ tenderness L preauricular node, otherwise no lymphadenopathy
Cardiac: S1 S2 regular. No S3 S4 or murmur.
Lungs: CTA w/o rales, wheezes, or rhonchi.
Case Study 3
A middle-aged female presents to the office complaining of strep throat. She states she suddenly developed a sore throat yesterday afternoon, and it has gotten worse since then. During the night she felt like she was chilled and feverish. She denies known recent contact with anyone else who had strep throat, but states she has had strep before and it feels like she has strep now. She takes no medications, but is allergic to penicillin. The physical examination reveals a slender female lying on the examination table. She has a temperature of 101 degrees Fahrenheit, heart rate of 112, respiratory rate of 22, and blood pressure of 96/64. The head, eyes, ears, nose, and throat evaluation is positive for bilateral tonsillar swelling without exudates. Her neck is supple with bilateral, tender, enlarged anterior cervical nodes.
To prepare:
Review the case studies provided in this week’s Resources.
You will either select or be assigned one of the three case studies provided.
Reflect on the provided patient information including history and physical exams.
Think about a differential diagnosis. Consider the role the patient history and physical exam played in your diagnosis.
Reflect on potential treatment options based on your diagnosis.

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NURS6531 Advanced Practice Care of Adults Across the Life Span Week 5 Forum
Examining Chest X-Rays
Chest x-rays are an invaluable diagnostic tool as they can help identify common respiratory disorders such as pneumonia, pleural effusion, and tumors, as well as cardiovascular disorders such as an enlarged heart and heart failure. As an advanced practice nurse, it is important that you are able to differentiate a normal x-ray from an abnormal x-ray in order to identify these disorders. The ability to articulate the results of a chest x-ray with the physician, radiologist, and patient is an essential skill when facilitating care in a clinical setting. In this Discussion, you practice your interprofessional collaboration skills as you interpret chest x-rays and exchange feedback with your colleagues.
Consider the three patient case studies and x-rays
Note: By Day 1 of this week, your Instructor will assign you to post on one of these patient case studies and x-rays:
Case Study 1
35-year-old Asian male presents to your clinic complaining of productive cough for two weeks. Stated he has had mild intermittent fever with myalgia, malaise and occasional nausea.
SH: works as a law clerk
PE: NP noted low grade fever (99 degrees), with very mild wheezing and scattered rhonchi.
An x-ray film is presented which shows a cloudy lung that appears slightly distended.
Case Study 2
This is a 44-year-old Caucasian male being seen at your clinics with complaints of complaints of cough for 4 days and worsening. Stated he has had high grade fever. States he feels weak and has been in bed most of the last two days. Complains of exertional dyspnea, followed by dyspnea at rest, non-productive cough and pleuritic chest pain
MEDS: Zovirax, Diflucan, magic mouth wash, Zofran, mycostatin, filgrastin
PMH: HTN, Hep C, HIV/AIDS, thrush
SH: Past IV Drug abuse; lives in a group home;
PE: VS: Ht: 5’7, Wt: 150#, BMI 23,
Anorexic male, febrile, tachypneic, tachycardic, with rales and rhonchi. You note decreased in breath sounds, dullness, and egophony
An x-ray film is presented which shows petechial markings on the lungs and which are cloudy in appearance.
Case Study 3
A 50 year old Caucasian female presents to the clinic with complaints of cough for almost 2 weeks. Positive productive green sputum with associated chills, sweating, and fever up to 101.5. She manages a daycare and states that many of the children have had upper respiratory symptoms in the last two weeks. PMH: DM diagnosed 7 years ago, controlled on medications.
MEDS: Glyburide 10mg qd
PE: She looks ill with continuous coughing and chills.
BP 100/80, T: 102, HR: 110; O2Sat 97% on RA.
Lungs: +Crackles, increased fremitus
Labs: CBC 17,000 cells/mm3 , blood sugar is 120
An x-ray film is presented which shows cloudiness on the lungs and which also shows some scarring on the lungs.
To prepare:
Review Part 10 of the Buttaro et al. text in this week’s Resources, as well as the provided x-rays.
Reflect on what you see in the x-ray assigned to you by the Course Instructor.
Consider whether the patient in your assigned x-ray has an enlarged heart, enlarged blood vessels, fluid in the lungs, and/or pneumonia in the lungs.

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NURS6531 Week 5

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