Category: Nursing

Chelsea Warren Type 1 Diabetes Shadow health SOAP Note

SOAP Note
Activity Time: 8 min

Subjective Documentation:

Student Response:
Chelse reports feeling better and ready to go home. She was diagnosed with DKA 2 days ago She was having nausea and vomiting before her father brought her to the ED. Chelsea reports that she had been feeling unwell for 10 days before the hospitalization. She reported having excessive thirst and frequent urination for about 10 days before the DKA episode Chelsea Warren Type 1 Diabetes Shadow health SOAP Note.

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Model Note:
CC: “Diabetes” HPI: Chelsea Warren is an 11-year-old Caucasian female hospitalized with new-onset type 1 diabetes. This is day 3 of her hospitalization. She is a good historian and able to answer questions appropriately. Her father is present in the room with her. She is due to be discharged home today. Chelsea Warren Type 1 Diabetes Shadow health SOAP Note. Chelsea was brought to the ED at 8:30pm 3 days ago by her father two days ago with dizziness, vomiting, and lethargy. She wasn’t feeling well during a horseback riding lesson and hadn’t been feeling well for the past few days. She was diagnosed with Diabetic Ketoacidosis and Diabetes Mellitus 1. She has admitted with a blood sugar above 500 mg/dL PMH: No previous hospitalizations. Nearsightedness diagnosed at age 8. Wears corrective lenses. Up to date on immunizations PSH: No previous surgeries Allergies: NKDA Medications: Started during hospitalization- 0.9% NaCl IV continuous 100ml/hr Insulin glargine – 5 units HS Insulin lispro – sliding scale AC BG 125-174 = 1 unit BG 175-224 = 2 units BG 225-274 = 3 units…Chelsea Warren Type 1 Diabetes Shadow health SOAP Note

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NRS-434VN Topic 1 DQ 1

Re: Topic 1 DQ 1

A baby born at an extremely low birth weight (ELBW), is considered a weight less than 1000 grams or five pounds and eight ounces. NRS-434VN Topic 1 DQ 1  On average, babies born with ELBW make about 8 percent of all births in the United States (March of Dimes, 2018). Reasons for a baby to be born with ELBW are due to a premature birth or fetal growth restriction (FGR), which may be caused by chronic medical conditions, infections, use of certain medication, illicit drug use or smoking.Having a ELBW baby is an added stress to families since babies tend to have a higher morbidity rate than babies born with a normal birth weight. Other common conditions with ELBW is respiratory distress syndrome (RDS), intraventricular hemorrhage (IVH), patent ductus arteriosus, necrotizing enterocolitis, retinopathy of prematurity and jaundice. These conditions or diagnosis may require longer hospitalizations, follow up by specialists, surgical intervention, additional tests, or procedures and of course costly to the baby’s family and/or the community. Long term effects found in these infants is that they may have intellectual developmental disabilities, metabolic syndrome, hypertension, diabetes, obesity, and heart disease. Age factors noted are in mothers under the age of 15 and over the age of 35 years of age that are at risk to have a ELBW baby NRS-434VN Topic 1 DQ 1. Racial minority mothers are at a higher risk as well due to health disparities of insufficient health care access or prenatal care, lack of health insurance, financial unavailability to healthy foods, education, and social services resources.March of Dimes is a great resource for premature babies and families to optimize overall health and minimize health risks. They have hospital based resources to educate and promote wellness also through community programs that include patient navigation/care coordination, hospital quality improvement to reduce early elective deliveries, group prenatal care, and smoking cessation, prevention of repeat preterm births, and infection diagnosis and treatment. We also have Early Child Intervention (ECI) is a statewide program within the Texas Health and Human Services Commission for families with children birth up to age 3, with developmental delays, disabilities or certain medical diagnoses that may impact development. ECI services support families as they learn how to help their children grow and learn. A team of licensed or credentialed providers evaluates the child and plans and provides services. The team may include: Early intervention specialists, Speech and language pathologists, Physical and occupational therapists, Psychologists, Registered nurses, Dietitians, Social workers and Counselors.

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Kanitkar M., Mrs (1999). EXTREMELY LOW BIRTH WEIGHT BABIES: (A report of two cases). Medical journal, Armed Forces India, 55(4), 364–366. 
https://doi.org/10.1016/S0377-1237(17)30377-5

March of Dimes. (2018). Low Birthweight. Retrieved on January 13, 2021 from, 
https://www.marchofdimes.org/complications/low-birthweight.aspx

Ratnasiri, A.W.G., Parry, S.S., Arief, V.N., Ian H. DeLacy, Laura A. Halliday, Ralph J. DiLibero & Kaye E. (2018). Recent trends, risk factors, and disparities in low birth weight in California, 2005–2014: a retrospective study. matern health, neonatol and perinatol 4, 15. https://doi.org/10.1186/s40748-018-0084-2 NRS-434VN Topic 1 DQ 1

 

Topic 1 DQ 1

 

Describe the effect of extremely low birth weight babies on the family and community. Consider short-term and long-term impacts, socioeconomic implications, the need for ongoing care, and comorbidities associated with prematurity. Explain how disparities relative to ethnic and cultural groups may contribute to low birth weight babies. Identify one support service within your community to assist with preterm infants and their families and explain how the service adequately addresses the needs of the community, or a population in your community. Provide the link to the resource in your post. NRS-434VN Topic 1 DQ 1

Re: Topic 1 DQ 1

Babies who have extremely low birth weights require hospitalization. They are usually physiologically immature and have complications that require extensive technological and pharmacological interventions. They are likely to have respiratory issues due to deficient surfactant levels, greater risk of collapsed lungs, and immature capillaries in the lungs. These babies are unable to maintain their body temperature and are at a greater risk for hypothermia because they have a limited amount of brown fat and minimal insulating subcutaneous fat, and at risk for infections. For the families of low-birth-weight babies, parents often have difficulty bonding because babies are taken to the NICU or they may have received a poor prognosis; thus, distancing themselves to protect from hurt and grief. Parents must also be given time to grieve over not having the birthing experience that they imagined, planned and hoped for. The birth of extremely low birth weight babies affects the whole family and even grandparents are saddened at the effects of watching their own children experiencing such difficulties. Mothers are prone to post traumatic stress that can hinder their ability to interact with or care for their infant (Forcada-Guex, Borghini, Pierrehumbert, et al., 2011). NRS-434VN Topic 1 DQ 1 Extremely low birth weight survivors are at high risk for neurological and cognitive disabilities in varying degrees of severity such as cerebral palsy, borderline intelligence, and learning disabilities (Daily, Carter, & Carter, 2011) This can have a financial impact on the family as the baby may need medical equipment at home, extra caregivers, and medications etc. These can be short- or long-term impacts. Even short-term impacts can have negatives effects emotionally and mentally on the entire family.The World Health Organization estimates that 9.6% of all births worldwide in 2005 were preterm. The rate of preterm birth is highest in Africa and North America and lowest in Europe (Simhan et al., 2012) In the U.S., non-Hispanic black women have the highest rate of preterm infants, with Hispanic women having a high rate as well but still lower than black women and white women having the lowest rate of preterm infants. Many factors influence the direction in which a pregnancy will progress, such as environment exposures, access to clean water, access to prenatal care and vitamins, access to healthy nutritious food, exposure to lead, smoke and drugs. Cultural aspects and beliefs may also contribute to the importance of prenatal care. For example, in the Mexican Heritage, advice for health care regarding pregnancy come from family members and may delay the patient from seeking prenatal care (Purnell, L. 2014). NRS-434VN Topic 1 DQ 1A support service I was able to find to assist with support of preterm infants and their families is called 
March of Dimes. 
Their mission is helping mothers have full term pregnancies and healthy babies. They offer prenatal education, support and care, resources for pregnant moms and new moms of preemie babies, a My NICU baby app where supportive resources can be found such as NICU initiatives and on line communities that offer support to parents of premature babies. NRS-434VN Topic 1 DQ 1 

Resources

Crum, K. A., Lowdermilk, D. L., Perry, S. E., Cashion, K., & Alden, K. R. (2012). Chapter 32 Labor and Birth Complications. In 
Virtual clinical excursions-obstetrics: for Lowdermilk, Perry, Cashion, and Alden: Maternity & women’s health care 
(11
th
ed., pp. 759-760). Elsevier. NRS-434VN Topic 1 DQ 1

Hockenberry, M.J., Wilson, D., & Rodgers, C. C. (2019). 9 The High-Risk Newborn and Family. In 
Wong’s nursing care of infants and children
 (11
th
 ed., pp. 270-330). Essay, Elsevier.

Our Programs (marchofdimes.org)

Purnell, L. D. (2009). 22 People of Mexican Heritage. 
In Guide to culturally competent heath care 
(3
rd
ed., pp. 309-321). Essay, F.A. Davis Co. NRS-434VN Topic 1 DQ 1

NRS 428VN Topic 1: Community/Public Health Nursing

Objectives:

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Examine the role of the community/public health nurse.

Evaluate the role of community stakeholders as client and community partners.

Discuss the aspects of health promotion in nursing care of populations.

Explain the importance of community resources to planning an intervention.

 

Topic 1 DQ 1

 
NRS 428VN Topic 1: Community/Public Health Nursing

Explain the role of the community health nurse in partnership with community stakeholders for population health promotion. Explain why it is important to appraise community resources (nonprofit, spiritual/religious, etc.) as part of a community assessment and why these resources are important in population health promotion.

Topic 1 DQ 2

 

Discuss how geopolitical and phenomenological place influence the context of a population or community assessment and intervention. Describe how the nursing process is utilized to assist in identifying health issues (local or global in nature) and in creating an appropriate intervention, including screenings and referrals, for the community or population. NRS 428VN Topic 1: Community/Public Health Nursing

NRS 428 VN Topic 1 DQ 1

Explain the role of the community health nurse in partnership with community stakeholders for population health promotion. Explain why it is important to appraise community resources (nonprofit, spiritual/religious, etc.) as part of a community assessment and why these resources are important in population health promotion. NRS 428 VN Topic 1 DQ 1

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Both the community health nursing and public health nursing and pretty much the same. The PHN addresses health promotion incorporating community aspects and global or environment concerns. Public health nursing focuses on groups, populations, or the health of an entire geographical sector (Canales & Drevdahl, 2014; Kulbok, Thatcher, Park, & Meszaros, 2012; Reifsnider & Garcia, 2015). Stakeholders are persons who are both involved and directly affected by the plans, actions, and outcomes of population health care. For example, stakeholders may be local government officials, community groups, faith-based organizations, or local business owners.

So in obviously the PHN and stakeholders focus on the same issues and values. Health promotion and education is often supported through partnerships with employers, faith-based organizations, schools, and health care providers for implementation of initiatives and reinforcement of health information (CDC, 2014). NRS 428 VN Topic 1 DQ 1 Public service announcements are one mechanism in which media and marketing campaigns work to disseminate health information (see Table 1.1).

So the PHN using these resources to inform the public of medical information. Just like right now in our nation. The CDC, CNN, Apple News, Local news, clinics, community health seminars, all these resources are used to inform our citizens about the health crisis we are experiencing today. Right now the top news is the Corona Virus that has spread world wide. We never in a million years would of thought we be in a pandemic. However, right now people are relying on the news to inform us of the vaccination drives etc. NRS 428 VN Topic 1 DQ 1

These organizations are very significant to the people.

American Public Health Association. (2013). The definition and practice of public health nursing. Retrieved from https://www.apha.org/~/media/files/pdf/membergroups/phn/nursingdefinition.ashx NRS 428 VN Topic 1 DQ 1

NRS 428 VN Concepts in Community and Public Health

In a community environment, community health nursing, also called public health nursing or community nursing, blends primary health care and nursing practice. Community health (CH) nurses provide families or populations with health services, preventive care, intervention, and health education. Public health nursing is the practice of promoting and protecting the health of communities using nursing, social, and public health knowledge, according to the American Public Health Association (2013) NRS 428 VN Concepts in Community and Public Health.

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As part of community assessment, it is important to assess history, culture, economics, spiritual, beliefs and values. Such separate and interdependent relationships establish a context in which community members feel belonging. Evaluation and examination of social experiences, shared interests, goals, and various other attributes helps determine health status and health needs.

 

American Public Health Association. (2013). The definition and practice of public health nursing. Retrieved from https://www.apha.org/~/media/files/pdf/membergroups/phn/nursingdefinition.ashx

Topic 1: Community/Public Health Nursing

Objectives:

Examine the role of the community/public health nurse.

Evaluate the role of community stakeholders as client and community partners.

Discuss the aspects of health promotion in nursing care of populations.

Explain the importance of community resources to planning an intervention.

 

Topic 1 DQ 1

 

Explain the role of the community health nurse in partnership with community stakeholders for population health promotion. Explain why it is important to appraise community resources (nonprofit, spiritual/religious, etc.) as part of a community assessment and why these resources are important in population health promotion.

Topic 1 DQ 2

 

Discuss how geopolitical and phenomenological place influence the context of a population or community assessment and intervention. Describe how the nursing process is utilized to assist in identifying health issues (local or global in nature) and in creating an appropriate intervention, including screenings and referrals, for the community or population.

 

Topic 2: Epidemiology and Communicable Diseases

Topic 2 DQ 1

 

What are social determinants of health?  Explain how social determinants of health contribute to the development of disease.  Describe the fundamental idea that the communicable disease chain model is designed to represent. Give an example of the steps a nurse can take to break the link within the communicable disease chain.

Resources within your text covering international/global health, and the websites in the topic materials, will assist you in answering this discussion question.

Topic 2 DQ 2

 

Select a global health issue affecting the international health community. Briefly describe the global health issue and its impact on the larger public health care systems (i.e., continents, regions, countries, states, and health departments). Discuss how health care delivery systems work collaboratively to address global health concerns and some of the stakeholders that work on these issues.

Resources within your text covering international/global health, and the websites in the topic materials, will assist you in answering this discussion question.

 

NRS 428 VN Topic 1 DQ 1

Explain the role of the community health nurse in partnership with community stakeholders for population health promotion. Explain why it is important to appraise community resources (nonprofit, spiritual/religious, etc.) as part of a community assessment and why these resources are important in population health promotion.

Community health nursing is a discipline that incorporates evidenced-based research along with advances in science and new approaches for improving the health The practice takes into consideration the cultural and socioeconomic backgrounds of the people in the community to ensure appropriate interaction and sensitivity when working with them.

A community is a group of people in a specific location, which includes places where people live, work and go to school. Most people belong to multiple types of communities. Community health nursing is commonly practiced in geographic locations like cities and rural areas.

The primary role of community health nurses is to provide treatment to patients. Additionally, community health nurses offer education to community members about maintaining their health so that they can decrease the occurrence of diseases and deaths. They plan educational assemblies, hand -out fliers, conduct health screenings, dispense medications and administer immunizations.

 

Nurses also may distribute health-related items like condoms and pregnancy tests. Examples of some health issues that community health nurses try to control or eliminate are:

 

Infectious and sexually transmitted diseases

Obesity

Poor nutrition

Substance abuse

Smoking

Teen pregnancy

NRS 428 VN Concepts in Community and Public Health

 

The nurse’s role in community health | NSU online
. (2017, September 20). Northeastern State University. 
https://nursingonline.nsuok.edu/articles/rnbsn/nurses-role-in-community-health.aspx

 

 

Write a paper (2,000-2,500 words) in which you apply the concepts of epidemiology and nursing research to a communicable disease. Refer to “Communicable Disease Chain,” “Chain of Infection,” and the CDC website for assistance when completing this assignment.

Communicable Disease Selection

Chickenpox

Tuberculosis

Influenza

Mononucleosis

Hepatitis B

HIV

Ebola

Measles

Polio

Influenza

Epidemiology Paper Requirements

Describe the chosen communicable disease, including causes, symptoms, mode of transmission, complications, treatment, and the demographic of interest (mortality, morbidity, incidence, and prevalence). Is this a reportable disease? If so, provide details about reporting time, whom to report to, etc.

Describe the social determinants of health and explain how those factors contribute to the development of this disease.

Discuss the epidemiologic triangle as it relates to the communicable disease you have selected. Include the host factors, agent factors (presence or absence), and environmental factors. Are there any special considerations or notifications for the community, schools, or general population?

Explain the role of the community health nurse (case finding, reporting, data collection, data analysis, and follow-up) and why demographic data are necessary to the health of the community.

Identify at least one national agency or organization that addresses the communicable disease chosen and describe how the organizations contribute to resolving or reducing the impact of disease.

Discuss a global implication of the disease. How is this addressed in other countries or cultures? Is this disease endemic to a particular area? Provide an example. NRS 428 VN Concepts in Community and Public Health

A minimum of three peer-reviewed or professional references is required.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. Refer to the 
LopesWrite Technical Support articles
 for assistance.
 

 

 

 

 

 

The benchmark assesses the following competencies:

3.3 Provide individualized education to diverse patient populations in a variety of health care settings.

The RN to BSN program at Grand Canyon University meets the requirements for clinical competencies as defined by the Commission on Collegiate Nursing Education (CCNE) and the American Association of Colleges of Nursing (AACN), using nontraditional experiences for practicing nurses. These experiences come in the form of direct and indirect care experiences in which licensed nursing students engage in learning within the context of their hospital organization, specific care discipline, and local communities.

Based on the feedback offered by the provider, identify the best approach for teaching. Prepare a presentation based on the Teaching Work Plan and present the information to your community. NRS 428 VN Concepts in Community and Public Health

Options for Delivery

Select one of the following options for delivery and prepare the applicable presentation:

PowerPoint presentation – no more than 30 minutes

Pamphlet presentation – 1 to 2 pages

Audio presentation

Poster presentation

Selection of Community Setting

These are considered appropriate community settings. Choose one of the following:

Public health clinic

Community health center

Long-term care facility

Transitional care facility

Home health center

University/School health center

Church community

Adult/Child care center

NRS 428 VN Concepts in Community and Public Health

Community Teaching Experience Approval Form

Before presenting information to the community, seek approval from an agency administrator or representative using the “Community Teaching Experience Approval Form.” Submit this form as directed in the Community Teaching Experience Approval assignment drop box.

General Requirements

While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are not required to submit this assignment to LopesWrite. NRS 428 VN Concepts in Community and Public Health

NRS 428 Benchmark – Community Teaching Plan: Community Presentation

The benchmark assesses the following competencies:

3.3 Provide individualized education to diverse patient populations in a variety of health care settings.

The RN to BSN program at Grand Canyon University meets the requirements for clinical competencies as defined by the Commission on Collegiate Nursing Education (CCNE) and the American Association of Colleges of Nursing (AACN), using nontraditional experiences for practicing nurses. These experiences come in the form of direct and indirect care experiences in which licensed nursing students engage in learning within the context of their hospital organization, specific care discipline, and local communities. NRS 428 Benchmark – Community Teaching Plan: Community Presentation

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Based on the feedback offered by the provider, identify the best approach for teaching. Prepare a presentation based on the Teaching Work Plan and present the information to your community. NRS 428 Benchmark – Community Teaching Plan: Community Presentation

Options for Delivery

Select one of the following options for delivery and prepare the applicable presentation:

PowerPoint presentation – no more than 30 minutes

Pamphlet presentation – 1 to 2 pages

Audio presentation

Poster presentation

Selection of Community Setting

These are considered appropriate community settings. Choose one of the following:

Public health clinic

Community health center

Long-term care facility

Transitional care facility

Home health center

University/School health center

Church community

Adult/Child care center

NRS 428 Benchmark – Community Teaching Plan: Community Presentation

Community Teaching Experience Approval Form

Before presenting information to the community, seek approval from an agency administrator or representative using the “Community Teaching Experience Approval Form.” Submit this
NRS-428VN-RS5-CommunityTeachingExperienceForm
as directed in the Community Teaching Experience Approval assignment drop box.

General Requirements

While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center. NRS 428 Benchmark – Community Teaching Plan: Community Presentation

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are not required to submit this assignment to LopesWrite. NRS 428 Benchmark – Community Teaching Plan: Community Presentation

NRS 428 VN Epidemiology Paper Assignment

Write a paper (2,000-2,500 words) in which you apply the concepts of epidemiology and nursing research to a communicable disease. Refer to “
Communicable Disease Chain
,” “Chain of Infection,” and the CDC website for assistance when completing this assignment.

Communicable Disease Selection

Chickenpox

Tuberculosis

Influenza

Mononucleosis

Hepatitis B

HIV

Ebola

Measles

Polio

Influenza

NRS 428 VN Epidemiology Paper Assignment

BUY A CUSTOM-WRITTEN, PLAGIARISM-FREE PAPER HERE

Epidemiology Paper Requirements

Describe the chosen communicable disease, including causes, symptoms, mode of transmission, complications, treatment, and the demographic of interest (mortality, morbidity, incidence, and prevalence). Is this a reportable disease? If so, provide details about reporting time, whom to report to, etc.

Describe the social determinants of health and explain how those factors contribute to the development of this disease. NRS 428 VN Epidemiology Paper Assignment

Discuss the epidemiologic triangle as it relates to the communicable disease you have selected. Include the host factors, agent factors (presence or absence), and environmental factors. Are there any special considerations or notifications for the community, schools, or general population?

Explain the role of the community health nurse (case finding, reporting, data collection, data analysis, and follow-up) and why demographic data are necessary to the health of the community. NRS 428 VN Epidemiology Paper Assignment

Identify at least one national agency or organization that addresses the communicable disease chosen and describe how the organizations contribute to resolving or reducing the impact of disease.

Discuss a global implication of the disease. How is this addressed in other countries or cultures? Is this disease endemic to a particular area? Provide an example.

A minimum of three peer-reviewed or professional references is required. NRS 428 VN Epidemiology Paper Assignment

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. Refer to the 
LopesWrite Technical Support articles
 for assistance.
NRS 428 VN Epidemiology Paper Assignment

NRS-428VN-RS2-Communicable Disease Chain

Communicable Disease Chain

BUY A CUSTOM-WRITTEN, PLAGIARISM-FREE PAPER HERE

 
NRS-428VN-RS2-CommunicableDiseaseChain (2)

NURS 6630: Psychopharmalogical Approaches to Treat Psychopathology Final Exam

Question 1

There are many different types of dementia. Which dementia is NOT a direct result of disrupted neurotransmitters, but a result of degeneration of different regions in the brain? Onset of the disease is typically before the age of 60, and very rare after the age of 75.

A.

Alzheimer’s Disease

B.

Dementia with Lewy Bodies

C.

Creutzfeldt-Jakob Disease

D.

Frontotemporal Dementias

 

Question 2

J. is a 55-year-old male who attended a funeral and found himself laughing during the service, but later that evening he was irritated with himself for what he had done. His wife said this was abnormal behavior and took him to his doctor to be evaluated. After L. J.’s MRI was reviewed, he was diagnosed with frontotemporal dementia. Which medication is recommended to help L. J. with his emotional outbursts?

A.

NURS 6630: Psychopharmalogical Approaches to Treat Psychopathology Final Exam

 

B.

NURS 6630: Psychopharmalogical Approaches to Treat Psychopathology Final Exam

 

C.

NURS 6630: Psychopharmalogical Approaches to Treat Psychopathology Final Exam

 

D.

NURS 6630: Psychopharmalogical Approaches to Treat Psychopathology Final Exam

 

 

Results Displayed

Feedback

·         Question 1

There are many different types of dementia. Which dementia is NOT a direct result of disrupted neurotransmitters, but a result of degeneration of different regions in the brain? Onset of the disease is typically before the age of 60, and very rare after the age of 75.

 

Response Feedback:

under subtitle “Epidemiology and genetic risk factors”

·         Question 2

L. J. is a 55-year-old male who attended a funeral and found himself laughing during the service, but later that evening he was irritated with himself for what he had done. His wife said this was abnormal behavior and took him to his doctor to be evaluated. After L. J.’s MRI was reviewed, he was diagnosed with frontotemporal dementia. Which medication is recommended to help L. J. with his emotional outbursts?

 

Response Feedback:

under Treatment subtitle: “The behavioral features are sometimes helped by SSRIs, and these are the best-studied treatments for these disorders.”

·         Question 3

E. B., a 55-year-old female, is a patient at your clinic today who has a past medical history significant for breast cancer, hypertension, hepatic cirrhosis, type 2 diabetes, and a recent diagnosis of alcohol use disorder. She has no known drug allergies. She states she is ready to quit drinking but fears the cravings that it may bring. Which medication would you recommend for E. B. to begin?

 

Response Feedback:

“It is preferred for patients with liver damage since acamprosate is metabolized through the kidneys and not the liver” & Table 15-3 shows it reduces alcohol cravings; benzodiazepines are used in the acute setting if a patient is experiencing severe alcohol withdrawal that leads to seizures; thiamine is if a patient is admitted for alcohol intoxication.

 

 

 

Question 3

B., a 55-year-old female, is a patient at your clinic today who has a past medical history significant for breast cancer, hypertension, hepatic cirrhosis, type 2 diabetes, and a recent diagnosis of alcohol use disorder. She has no known drug allergies. She states she is ready to quit drinking but fears the cravings that it may bring. Which medication would you recommend for E. B. to begin?

A.

Naltrexone

B.

Acamprosate

C.

Any benzodiazepine

D.

Thiamine

 

Question 4

What should our treatment goal be with our patients when it comes to managing chronic pain?

A.

The goal is to make the pain go completely away.

B.

The goal is to make the patient feel numb so that the pain cannot be thought about.

C.

There are no specific treatment goals that we should discuss with our patients, just so they don’t get their expectations too high.

D.

The goal is to improve their function and to drop their pain scale to less than 5 out of 10.

 

 

Choose the correct statement regarding medications used for alcoholism

A.

Disulfiram: NMDA receptor antagonist & GABAA agonist

B.

Naltrexone: µ-opioid receptor antagonist that reduces the reinforcement/euphoria produced by alcohol

C.

Acamprosate: enhances the effect of the inhibitory neurotransmitter gamma-aminobutyric acid on the GABA receptors by binding to a site that is distinct from the GABA binding site in the central nervous system.

D.

Lorazepam: inhibits alcohol dehydrogenase, leading to a buildup of acetaldehyde

 

 

 

Question 6

Which medication below would you use in addition to benzodiazepine treatment if the patient is experiencing psychosis during alcohol withdrawal delirium?

A.

NURS 6630: Psychopharmalogical Approaches to Treat Psychopathology Final Exam

 

B.

NURS 6630: Psychopharmalogical Approaches to Treat Psychopathology Final Exam

 

C.

NURS 6630: Psychopharmalogical Approaches to Treat Psychopathology Final Exam

 

D.

NURS 6630: Psychopharmalogical Approaches to Treat Psychopathology Final Exam

 

 

Question 7

Of the following neurotransmitters, which ones play a critical role in modulating attention in ADHD?

Dopamine

Epinephrine

GABA

Norepinephrine

Glutamate

A.

II, III, and V

B.

II and IV

C.

I and IV

D.

III only

 

Question 8

Which of the following is the only Black Box Warning associated with the medication atomoxetine?

A.

Increased risk for cardiovascular events

B.

Suicidal ideation

C.

Substance abuse potential

D.

Slight growth inhibition

 

Question 9

Which of the following drugs is structurally similar to tramadol; thus, its opioid-mediated analgesia can be reversed by naloxone in mice?

A.

 

B.

 

C.

NURS 6630: Psychopharmalogical Approaches to Treat Psychopathology Final Exam

 

D.

Gabapentin

 

Question 10

Which medication is a selective alpha-adrenergic agonist that works by mimicking norepinephrine binding in the pre-frontal cortex, which makes it particularly useful in the treatment of ADHD?

A.

NURS 6630: Psychopharmalogical Approaches to Treat Psychopathology Final Exam

 

B.

 

C.

 

D.

 

 

 

Question 11

Daytrana is the MPH transdermal system of methylphenidate approved for the treatment of ADHD in children aged 6 years and older. What is the difference in terms of the metabolism compared to the other formulations in this class?

A.

It is mainly metabolized by the enzyme carboxylesterase once absorbed.

B.

It does not undergo first-pass metabolism by the enzyme carboxylesterase in the liver.

C.

It can be cut up and sprinkled onto food so it can bypass first-pass metabolism in the liver.

D.

It uses an osmotic releasing oral system technology to slowly deliver the drug to the enzyme carboxylesterase in order to make the drug last longer.

 

Question 12

A 59-year-old male has been admitted to the E. D. due to a methamphetamine overdose. The patient’s friend reported he ingested up to 2 grams because “he thought cops were coming to get him.” The patient’s vitals are all within normal limits, except his blood pressure is 180/110. What is the best recommendation to make at this time?

A.

Administer a beta-blocker like labetalol to help bring his blood pressure down

B.

Patient’s blood pressure is considered a hypertension urgency, but it is probably due to the drug overdose. No action is needed at this time until the drug has cleared his system.

C.

Blood pressure is not a concern right now, but supportive therapy should be provided in the incidence of respiratory depression.

D.

Administer an alpha-blocker like phentolamine to help bring his blood pressure down.

 

Question 40

SSRIs can be used in alcohol use disorder and offer modest drinking reduction through an anti-craving effect.

A.

True

B.

False

 

 

Question 41

K. is a 72-year-old female who has suffered many strokes in the past, likely due to uncontrolled hypertension and hyperlipidemia. She has now been diagnosed with vascular dementia due to memory loss and motor system slowing. What is the recommended treatment for T. K.?

A.

T. K. needs the drug donepezil to help with her memory loss only.

B.

T. K. needs the drug donepezil to help with her memory loss, but also needs her hypertension and hyperlipidemia controlled.

C.

T. K. needs the drug donepezil to help with her memory loss, but also needs her hypertension controlled.

D.

T. K. needs her hypertension controlled only.

 

 

 

Question 42

The patient is a 16-year-old girl with a past history of substance use disorder. She has been known to abuse prescription opioids and smokes one pack of cigarettes every day. She has been in and out of recovery for the past year. During her last admission into a recovery center, she was diagnosed with ADHD, which may have contributed to her addictive personality. She presents to your clinic today to initiate pharmacotherapy for her new diagnosis. What would you recommend in this patient? Her current weight is 55 kg.

A.

Ritalin 10 mg twice daily

B.

Focalin 10 mg twice daily

C.

Daytrana 30 mg patch worn for 12 hours daily

D.

Atomoxetine 60 mg once daily

 

Question 43

A new patient presents to your clinic today. The patient is a 13-year-old boy who complains that he has no interest in anything. The patient states, “I just want to sleep more than I normally do, and I don’t care much for playing my video games anymore.” His mother states he cannot focus on anything for more than a few minutes at a time, and that he often gets in trouble at school because he cannot sit still. What would you recommend at this time?

A.

Recommend doing a full evaluation to distinguish if this patient is presenting with ADHD symptoms or depressive symptoms

B.

Begin a stimulant at appropriate dose once patient’s weight is known

C.

Refer to a behavioral counselor

D.

Begin an SSRI at lowest initial dose and provide counseling on the increased risk of suicide during the first few months of therapy

 

 

 

Question 44

Disulfiram has been proven effective in the treatment of alcoholism, but recently it has been trialed in the management of cocaine addiction. What is the mechanism of action that likely helps produce these aversive effects?

A.

Inhibition on dopamine beta-hydroxylase

B.

Inhibition on aldehyde dehydrogenase

C.

Inhibition on alcohol dehydrogenase

D.

Inhibition on aldehyde reductase

 

Question 45

Which medication below should be routine for all suspected cases of alcohol intoxication and dependence?

A.

B vitamin thiamine 100 mg

B.

Haloperidol 5 mg

C.

Lorazepam 2 mg

D.

Acamprosate 666 mg

 

Question 46

FILL IN THE BLANK: ___________ is the main neurotransmitter behind reward systems in the brain, which usually leads to addiction when altered in any way.

A.

NURS 6630: Psychopharmalogical Approaches to Treat Psychopathology Final Exam

 

B.

NURS 6630: Psychopharmalogical Approaches to Treat Psychopathology Final Exam

 

C.

NURS 6630: Psychopharmalogical Approaches to Treat Psychopathology Final Exam

 

D.

NURS 6630: Psychopharmalogical Approaches to Treat Psychopathology Final Exam

 

 

Question 47

If a patient suffers from a multitude of small strokes and later begins experiencing mood disturbances in an acute fashion that sometimes resolve, from what type of dementia would you think that patient may suffer?

A.

Vascular Dementia

B.

Frontotemporal Dementias

C.

Alzheimer’s Disease

D.

Dementia with Lewy Bodies

 

 

Question 48

Drug addiction includes many prescription medications and illegal substances. Of the drugs listed, which ones can be withdrawn abruptly WITHOUT medical intervention to prevent withdraw seizures?

A.

Alcohol

B.

Adderall

C.

Lorazepam

D.

Butalbital

 

Question 49

The experience of pain is ALWAYS subjective

A.

True

B.

False

 

Question 50

B. is a 55-year-old male who has diagnosed with type 2 diabetes 10+ years ago. He has since had complications from the disease and is suffering from severe neuropathy. On top of that, T. B. is struggling with his mental health and was recently told he could be depressed but he had refused treatment at that time. Besides getting his blood sugar under control, what medication(s) can we use that may be useful in helping T. B.?

Nortriptyline

Venlafaxine

Duloxetine

Fluoxetine

A.

I, II, and III

B.

I and II

C.

II and III

D.

IV only

NURS 6630: Psychopharmalogical Approaches to Treat Psychopathology Final Exam

NRNP 6531: Advanced Practice Care of Adults across the Lifespan Final Exam

Question 1

A patient expresses concern that she is at risk for breast cancer. To best assess the risk for this patient, what is the best initial action?

a.

Ask if there is a family history of breast cancer.

b.

Gather and record a three-generation pedigree.

c.

Order a genetic test for the breast cancer gene.

d.

Recommend direct-to-consumer genetic testing.

 

 

 

Question 2

What is an important part of patient care that can minimize the risk of a formal patient complaint even when a mistake is made?

Ensuring informed consent for all procedures

Maintaining effective patient communication

Monitoring patient compliance and adherence

Providing complete documentation of visits

 

 

 

Question 3

A patient asks about direct-to-consumer (DTC) genetic testing. What will the provider tell the patient?

a.

It is not useful for identifying genetic diseases.

b.

Much of the information does not predict disease risk.

c.

The results are shared with the patient’s insurance company.

d.

The results must be interpreted by a provider.

 

 

Question 4

A previously healthy patient has an area of inflammation on one leg which has well-demarcated borders and the presence of lymphangitic streaking. Based on these symptoms, what is the initial treatment for this infection?

a.

NRNP 6531: Advanced Practice Care of Adults across the Lifespan Final Exam

b.NRNP 6531: Advanced Practice Care of Adults across the Lifespan Final Exam

c.

NRNP 6531: Advanced Practice Care of Adults across the Lifespan Final Exam

d.

Sulfamethoxazole-trimethoprim

 

 

Question 5

A patient diagnosed with atopic dermatitis asks what can be done to minimize the recurrence of symptoms. What will the provider recommend?

a.

Calcineurin inhibitors

b.

Lubricants and emollients

c.

Oral diphenhydramine

d.

Prophylactic topical steroids

 

 

 

Question 6

Which is the primary symptom causing discomfort in patients with atopic dermatitis (AD)?

a.

Dryness

b.

Erythema

c.

Lichenification

d.

Pruritis

 

 

 

Question 7

A patient experiencing an inflamed pterygia lesion has been prescribed loteprednol topical steroid drops for 7 days. The patient shows no improvement in symptoms. What is the next course of action? NRNP 6531: Advanced Practice Care of Adults across the Lifespan Final Exam

a.

Consult with an ophthalmologist.

b.

Continue the medication for 7 more days.

c.

Prescribe a systemic corticosteroid.

d.

Refer the patient to the emergency department.

 

 

Question 8

A patient experiences a penetrating injury to one eye caused by scissors. The provider notes a single laceration away from the iris that involves the anterior but not the posterior segment. What is the prognosis for this injury?

a.

Because the posterior segment is not involved, the prognosis is good.

b.

Blindness is likely with this type of eye injury.

c.

Massive hemorrhage and loss of intraocular contents is likely.

d.

NRNP 6531: Advanced Practice Care of Adults across the Lifespan Final Exam

 

Question 9

A primary care provider notes painless, hard lesions on a patient’s external ears that expel a white crystalline substance when pressed. What diagnostic test is indicated?

a.

Biopsy of the lesions

b.

Endocrine studies

c.

Rheumatoid factor

d.

Uric acid chemical profile

 

 

 

Question 10

A patient experiencing heart failure with reduced ejection fraction will have which symptoms?

a.

Dyspnea and fatigue without volume overload

b.

Impairment of ventricular filling and relaxation

c.

Mild, exertionally related dyspnea

d.

Pump failure from left ventricular systolic dysfunction

 

 

 

Question 11

A 55-year-old patient has a blood pressure of 138/85 on three occasions. The patient denies headaches, palpitations, snoring, muscle weakness, and nocturia and does not take any medications. What will the provider do next to evaluate this patient?

a.

Assess serum cortisol levels

b.

Continue to monitor blood pressure at each health maintenance visit

c.

Order urinalysis, CBC, BUN, and creatinine

d.

Refer to a specialist for a sleep study

 

 

 

Question 12

A patient who has been diagnosed with heart failure for over a year reports being comfortable while at rest but experiences palpitations and dyspnea when walking to the bathroom. Which classification of heart failure is appropriate based on these symptoms?

a.

ClassI

b.

Class

c.

Class

d.

Class

 

 

 

 

 

 

 

Question 13

A patient who has undergone surgical immobilization for a femur fracture reports dyspnea and chest pain associated with inspiration. The patient has a heart rate of 120 beats per minute. Which diagnostic test will confirm the presence of a pulmonary embolism (PE)?

a.

Arterial blood gases (ABGs)

b.

Computed tomography (CT) angiography

c.

D-dimer

d.

Electrocardiogram (ECG)

 

Question 14

Which method of treatment is used to manage a traumatic pneumothorax?

a.

Needle aspiration of the pneumothorax

b.

Observation for spontaneous resolution

c.

Placement of a small-bore catheter

d.

NRNP 6531: Advanced Practice Care of Adults across the Lifespan Final Exam

 

 

 

 

 

 

Question 15

A patient with a central line develops respiratory compromise. What is the initial intervention for this patient?

a.

Lung ultrasonography (US) to determine the cause

b.

Obtaining cultures and starting antibiotics

c.

Prompt removal of the central line

d.

Rapid assessment and resuscitation

 

 

 

 

 

 

 

 

Question 16

A patient reports lower abdominal cramping and occasional blood in stools. The provider suspects inflammatory bowel disease. Which test will the provider order to determine whether the patient has ulcerative colitis (UC) or Crohn’s disease (CD)? NRNP 6531: Advanced Practice Care of Adults across the Lifespan Final Exam

a.

b.

c.

d.

 

 

 

Question 17

A patient who is asymptomatic tests positive for the hepatitis C virus (HVC). What will the provider tell the patient about managing this illness?

a.

A rapidly fulminant disease ending with cirrhosis is likely.

b.

Administering immunoglobulins helps shorten the course.

c.

Several medications are available based on the type of hepatitis C.

d.

Treatment is supportive since the infection is self-limiting.

 

 

 

Question 18

A patient recovering from chronic alcohol abuse reports nausea, vomiting, diarrhea, and abdominal discomfort. A physical examination is negative for jaundice or ascites. What will the provider do initially?

a.

NRNP 6531: Advanced Practice Care of Adults across the Lifespan Final Exam

b.

NRNP 6531: Advanced Practice Care of Adults across the Lifespan Final Exam

c.

NRNP 6531: Advanced Practice Care of Adults across the Lifespan Final Exam

d.

NRNP 6531: Advanced Practice Care of Adults across the Lifespan Final Exam

 

 

 

 

 

 

Question 19

Paula is a 68 y/o female who presents to the clinic with the following symptoms: bloating and abdominal discomfort, low back pain, pelvic pain, frequency and constipation. The most likely cause of these symptoms is:

A.

Ovarian Cancer

B.

Uterine Cancer

C.

Urethral Cancer

D.

None of the above

 

 

 

 

 

Question 20

A 50-year-old man reports having erectile dysfunction (ED). What is an important response by the provider when developing a plan of care for this patient?

A.

Considering testosterone hormone replacement therapy

B.

Evaluating the patient for cardiovascular disease

C.

Prescribing an oral phosphodiesterase type 5 inhibitor

D.

Referring the patient for psychotherapy and counseling

 

 

 

 

 

Question 21

A primary care provider sees a new patient who reports having a diagnosis of chronic kidney disease for several years. The patient is taking one medication for hypertension which has been prescribed since the diagnosis was made. The provider orders laboratory tests to evaluate the status of this patient. Which laboratory finding indicates a need to refer the patient to a nephrologist?

A.

Albumin/creatinine ratio (ACR) of 325 mg/g

B.

Blood pressure of 145/85 mm H

C.

Glomerular filtration rate (eGFR) of 35

D.

Urine red blood cell (RBC) count of 15/hpf

 

 

 

Question 22

Elijah is a 72 y/o African American male who presents to the clinic with the following symptoms: low back pain, perineal pain, weak urinary stream and multiple trips to the bathroom during the night. Labs taken one week ago show a PSA of 6.0 ng/ml. The most likely diagnosis is:

A.

Prostate Cancer

B.

Testicular Cancer

C.

Prostatitis

D.

Epididymis

Question 88

A young male patient is reported to be more withdrawn from his peers than usual and has dropped out of college and quit his job within the last 5 months. The parent is concerned that the patient may have schizophrenia because a maternal uncle has the disease. What will the provider do next?

A.

Ask about the patient’s speech and thinking patterns

B.

Consider treatment with antipsychotic medications

C.

Reassure that classic symptoms of schizophrenia are not present

D.

Refer the patient for inpatient psychiatric treatment

 

 

 

 

Question 89

Michael is an 18 y/o male who has recently been suffering from insomnia. During your evaluation you learn that Michael lost his best friend in a roadside bomb in Afghanistan.

Michael’s insomnia could be treated with which of the following natural supplements:

A.

B.

C.

D.

All the above

D

 

 

 

 

Question 90

A patient reports symptoms of restlessness, fatigue, and difficulty concentrating. The provider determines that these symptoms occur in relation to many events and concerns. What other things will the provider question this patient about?

A.

Ability to manage social situations

B.

Body image and eating habits

C.

Headaches and bowel habits

D.

Occupational performance

C

 

 

 

 

 

Question 91

A college student is brought to clinic by a parent who is concerned about increasingly bizarre behavior and poor school performance. The provider notes difficulty engaging the patient in an organized conversation. The patient denies any concerns about behavior. What will the provider do initially to manage this patient’s symptoms?

a.

b.

c.

Counsel the parent to report any symptoms of depression

d.

Schedule an appointment with a psychiatrist

 

 

 

 

 

Question 92

A college student is brought to the emergency department by a roommate who is concerned about symptoms of extreme restlessness, nausea, and vomiting. The provider notes elevations of the pulse and blood pressure and pupillary dilation, along with hyperactive bowel sounds. The provider suspects withdrawal from which substance?

A.

Alcohol

B.

Cocaine

C.

LSD

D.

Opioids

 

 

 

 

 

 

Question 93

Angela is a 28 y/o female who comes to the clinic with her partner. During the history taking her partner does not all Angela to answer any of the questions but instead answers all the questions for her.

In doing the physical exam on Angela the NP should do all the following except:

A.

Have

B.

Collect

C.

Interview

D.

When appropriate develop a plan of safety

 

 

 

 

Question 94

An 18-year-old male is brought to the clinic by a parent who is concerned that the patient has become more isolated and withdrawn. The patient has expressed suspicions that his teachers hate him and want him to fail. What will the provider tell this parent?

A.

The adolescent should be evaluated by a psychiatrist.

B.

The adolescent should be given a trial of antipsychotic medications.

C.

These are common adolescent behaviors and will eventually go away.

D.

These signs are diagnostic for schizophrenia.

 

 

 

 

 

 

Question 95

Jason a 46 y/o male has a smoking addition and has smoke 2 packs /day for the past 26 years. Given this information his pack years for smoking would be:

A.

26 pack years

B.

38 pack years

C.

52 pack years

D.

62 Pack years

 

 

 

question 96

Jason a 46 y/o male has a smoking addition and has smoke 2 packs /day for the past 26 years.

Laboratory findings related to Jason’s smoking addiction would include all the following except:

A.

Decreased Hct

B.

Increased WBC

C.

Increased platelet count

D.

Decreased Vitamin C levels

 

 

 

 

question 97

A patient is brought to the emergency department experiencing disorientation, confusion, and fever. The patient describes visual and auditory hallucinations. The patient’s spouse states that the patient had several drinks 12 hours prior to passing out. A blood alcohol level is 0.2%. What is the recommended treatment?

A.

NRNP 6531: Advanced Practice Care of Adults across the Lifespan Final Exam

B.

NRNP 6531: Advanced Practice Care of Adults across the Lifespan Final Exam

C.

NRNP 6531: Advanced Practice Care of Adults across the Lifespan Final Exam

D.

NRNP 6531: Advanced Practice Care of Adults across the Lifespan Final Exam

 

 

 

 

Question 98

In the elderly, depression often exists with dementia.

True

False

 

Question 99

A patient is seen in clinic 2 weeks after the death of a parent. The patient reports feelings of sadness and hopelessness and a feeling that the parent is still present, even to the point of hearing the parent’s voice at times. What will the provider determine from these findings?

A.

There is a concern for hypermania.

B.

There is a possibility of manic episodes.

C.

These are concerning for depression.

D.

These are normal grief responses.

 

Question 100

Michael is an 18 y/o male who has recently been suffering from insomnia. During your evaluation you learn that Michael lost his best friend in a roadside bomb in Afghanistan. Michaels insomnia can be classified as:

A.

Primary Insomnia

B.

Secondary Insomnia

C.

Short term Insomnia

D.

Chronic Insomnia

NRNP 6531: Advanced Practice Care of Adults across the Lifespan Final Exam