Category: Nursing

B76-year-old black male with disabilities living in an urban setting

y Day 3 of Week 1

Post 
a summary of the interview and a description of the communication techniques you would use with your assigned patient. Explain why you would use these techniques. Identify the risk assessment instrument you selected, and justify why it would be applicable to the selected patient. Provide at least five targeted questions you would ask the patient.

76-year-old black male with disabilities living in an urban setting

Post a summary of the interview and a description of the communication techniques you would use with your assigned patient. Explain why you would use these techniques. Identify the risk assessment instrument you selected, and justify why it would be applicable to the selected patient. Provide at least five targeted questions you would ask the patient 76-year-old black male with disabilities living in an urban setting.

 A strong patient-provider relationship facilitates cooperation and provides greater opportunities to learn about a patient’s unique health needs. This enables providers to better connect patients with the treatments and resources to improve overall health.

How would your communication and interview techniques for building a health history differ with each patient? Before entering the room I would knock and wait for a response The first thing I would do upon entering the room would be a smile and introduction myself.  I would address the patient by his name and ask permission to sit in front of the patient, so I will have eye contact.  I would identify those problems that matters to the patient.  Questions should be tailored base on patient’s age, culture, and cognition (Ball el. al, 2019). Seeking clarity when needed to understand what the patient  is saying 76-year-old black male with disabilities living in an urban setting.

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How might you target your questions for building a health history based on the patient’s social determinants of health? Social determinants of health are the conditions in which people are born, grow, live, work and age that shape health. It’s important to understand that  reviewing the patient social determinants The spiritual, psychosocial, and cultural contexts of the patient’s life are essential to an understanding.  Asking the patients if he has any habits: like nutritional and diet; regularity and patterns of eating and sleeping; quantity of coffee, tea, tobacco, alcohol; Home conditions: housing, economic condition, types of furnishings, pets and their health.eligious and cultural preferences: any religious proscriptions concerning food, medical care; spiritual needs. Access to care: transportation and other resources available to patient, type of health insurance coverage (if any), worries in this regard, primary care provider, customary pattern of seeking care. Social needs: insurance/medication coverage, food insecurity, housing instability, employment assistance need. It is important to have the conversation. Addressing social determinants of health is important for improving health and reducing longstanding disparities in health and health care (Ball el. al, 2019).

What risk assessment instruments would be appropriate to use with each patient, or what questions would you ask each patient to assess his or her health risks?  The Functional. The risk assessment tool that  I would  use  the Home Safety Self-Assessment Tool (HSSAT), this tool was developed to evaluate the living conditions of older adults and whether the home was a safe environment to prevent falls and also provide a space that older adults can stay in their home longer. (Horowitz, Nochajski, & Schweitzer, 2013, p.218). I would also do a functional assessment to prevent further loss of function and to maintain the self-care status of many elders. Performing an office-based functional assessment measures the elder’s ability to perform self-care 76-year-old black male with disabilities living in an urban setting.

Identify any potential health-related risks based upon the patient’s age, gender, ethnicity, or environmental setting that should be taken into consideration. Health risk assessment is an important in identifying risks with  chronic diseases, preventing  complications, and as well as to allowing  providers managed interventions that helps preventive care such as screening for potential health risks (Wu and Orlando, 2015). Obtaining the health history iis the baseline  for assessing the present concern. Major adult illnesses or chronic diseases: tuberculosis, hepatitis, diabetes, hypertension, myocardial infarction, heart disease, stroke, respiratory disease, tropical or parasitic diseases, other infections; any nonsurgical hospital admissions (Lushniak, 2015). Getting the health history is important to help improve health care .

Understanding an older patient’s usual level of functioning and knowing about any recent significant changes are fundamental to providing appropriate health care. The Functional Assessment tool would assist and leeting to provide know what the patient can do for example can the patient completed his ADL. Knowing the limitation of the disability will assist the provider and family to better care for the patient. A functional assessment is a multidimensional and often interdisciplinary diagnostic process, which assesses and quantifies an older adult’s medical, the patient, and family to develop a comprehensive plan for therapy and future care decisions and can also help in the process of long-term care decision-making (Ball el. al, 2019) 76-year-old black male with disabilities living in an urban setting.

Targeted questions you would ask your selected patient to assess his or her health risks and begin building a health history.  I would try to gather data before meeting with the patient. Request previous medical records or, if there is time, mail forms that the patient or a family member can complete at home (Ball el. al, 2019).

 1. What are areas do you think you need help in?

2. Do you live alone?

3. Do you feel safe in your home?

4. Have you fallen recently?

5. What medications are you currently taking and what method do you use to organize your medications?

6. Do you have family that visit?

References

Horowitz, B., Almonte, T., Kaur, S., & Vasil, A. (2016). Use of the home safety self assessment tool (hssat) within community health education to improve home safety. 
American Journal of Occupational Therapy
, 
70
(4_Supplement_1), 7011510221p1. Retrieved September 1, 2021, from 
https://doi.org/10.5014/ajot.2016.70s1-po5081

Lushniak, B. D. (2015). Family health history: Using the past to improve future health. 
Public Health Reports
, 
130
(1), 3–5. Retrieved September 12, 2021, from 
https://doi.org/10.1177/003335491513000102

Wu,, R. A., & Orlando,, L. A. (2015). 
Implementation of health risk assessments with family health history: Barriers and benefits | postgraduate medical journal
 [91 (1079), p 508-513.]. Retrieved September 1, 2021, from 
https://pmj.bmj.com/content/91/1079/508

Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). 
Seidel’s guide to       physical examination: An interprofessional approach 
(9th ed.). Elsevier Mosby.

By Day 6 of Week 1

Respond 
to 
at least two
 of your colleagues 
on 2 different days
 who selected a different patient than you, using one or more of the following approaches:

response

It is crucial for Nurse Practitioners to develop and build a relationship with their patients as you indicated. Making patients feel comfortable physically and emotionally without being judgmental especially when interviewing an elderly patient is highly significant (Ball et al., 2019). Considering factors such as age, gender, functional abilities, culture, and environment that may have a significant impact on a patient’s wellbeing is crucial as well (Ball et al., 2019) 76-year-old black male with disabilities living in an urban setting.

Fall is a leading cause of death among the elderly and performing a comprehensive assessment will guide the practitioner in individualizing a plan of care for the patient. An assessment tool that can be utilized is the Berge Balance Scale; the screening tool used to measure patients’ mobility, balance, transfer, and gait (Landers et al., 2016). As people advance in age, various factors that can impact their health includes; a decline in cognition, life stress, illness, and physical limitations (Ball et al., 2019). It is therefore significant that clinicians have a sound knowledge of health assessment and be able to use different screening tools that would guide diagnosis, treatment, and plan of care (Wu & Orlando, 2015).

 

References

Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., Stewart, R. W. (2019).
 Seidel’s guide to physical examination: An interprofessional approach (9th ed).
 St. Louis, MO: Elsevier Mosby

Landers, M. R., Oscar, S., Sasaoka, J., Vaughn, K. (2016, April). Balance confidence and fear of falling. Avoidance behavior is most predictive of falling in older adults: Prospective Analysis. 
Academic Journal,
 433-442.

Wu, R., & Orlando, L. A. (2015). Implementation of health risk assessments with family health history: barriers and benefits. 
Postgraduate Medical Journal, 91
(1079), 508-513. http://pmj.bmj.com/content/91/1079/508 76-year-old black male with disabilities living in an urban setting

NRNP 6568 Week 7 Knowledge Check

Quiz – Week 7 Knowledge Check

QUESTION 1

In an ambulatory patient, the most common cause of hypercalcemia is ____________.

Hypoparthyroidism

Hypothyroid

Hyperparathyroidism

Hyperthyroid

C

QUESTION 2

Several organizations have come together to define the diagnostic criteria for metabolic syndrome.    One of these criteria is:

Elevated fasting plasma glucose: 100  mg/dL or higher, or drug treatment for elevated glucose

True

False

A

QUESTION 3

Acromegaly is a disease resulting from excessive secretion of growth hormone.

True

False

A

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QUESTION 4

What HgA1C level indicates a diagnosis of diabetes?

5.7

6.0

6.5

7.0

C

QUESTION 5

Several organizations have come together to define the diagnostic criteria for metabolic syndrome.    One of these criteria is:

Reduced HDL cholesterol: below 50 mg/dL in males and below 60 in females, or specific treatment for this lipid abnormality

 

True

False

 

B

QUESTION 6

The only cure for primary hyperparathyroidism is ________________.

Medication

Surgery

Rest

Calcium supplements

B

QUESTION 7

In a patient with hyperglycemia, the intracellular fluid may shift into the extracellular compartment, leading to decreased sodium levels.

True

False

A

QUESTION 8

What are cardinal signs of Type 1 Diabetes Mellitus?

Weight gain, blurred vision, and increased energy

Weight gain, blurred vision, insomnia

Decreased urination, decreased thirst, and decreased appetite

Increased urination, increased thirst, increased appetite

D

QUESTION 9

The NP suspects a patient has hypothyroidism.  The NP would expect TSH and T4 level to be:

Low TSH with High T4 levels

Low TSH and low T4

High TSH and high T4

High TSH and low T4

D

QUESTION 10

In Type 2 Diabetes Mellitus, vascular and neuropathic complications may begin to develop and progress before the diagnosis is made. True or False?

True

False

A NRNP 6568 Week 7 Knowledge Check

38-year-old native American pregnant female living on a reservation

38 Year-old Native American Pregnant Female

            The patient I will interview is a 38-year-old Native American pregnant female living on a reservation. One very important part of building a good relationship with the patient is to build trust and help the patient feel comfortable to discuss anything she may need. It is important for me as the provider to have courtesy and build a connection with the patient (Ball, et al., 2019). Having kindness and building rapport with a patient is a great way for the patient to open up and for me to truly let the patient know they are valued and cared for 38-year-old native American pregnant female living on a reservation.

            The approach I like best is the patient-centered approach. When this approach is used, patients are fully involved in their health care decisions. This is part of rapport building but also helps give the patient a feeling of autonomy, engagement, and control of their health (Bridges, et al., 2018). Health care is better when a patient feels respected and part of the decision process. Especially in this case of the pregnant Native American patient because when it comes to different cultures and when a patient is put first, their culture is not only acknowledged but included with sensitivity in their health care. The patient may have holistic care she would like to use or other cultural factors that I may not be fully aware of.

As this patient’s provider, I would first meet the patient and ask her to tell me about herself. I would ask questions about her family and her support group. I would see what support and resources she has. I would see if she had health insurance through the government and see if she was aware of the resources available to her. According to Kramer et al. (2009) many Native American women have health disparities and do not access all the benefits they could receive through Indian Health care Services. I would make sure she had information given to her in order to speak to someone to utilize the services she could receive 38-year-old native American pregnant female living on a reservation.

I would ask her about her familial history. Finding out about the patient’s risk is very important when assessing a pregnant female. When a provider can truly know the risks the patient may have and can talk about the perceived risks the patient may think they may have, then come to an agreeable level of risk, the baby’s health is positively associated with the congruence of knowledge (Cannella et al., 2013). It is important to truly know all the risk factors and perceived risk factors the patient may have. When the patient is given the time to talk and is not rushed, she may open up a bit more to me as her provider as well. It is important to be patient and to give the patient time to open up.

I would also feel it is part of my duty as a provider to ensure the patient has a safe place to live to ensure the baby gets good prenatal and postnatal care. The patient may not know the importance of eating healthy, taking prenatal vitamins, or about certain foods or drinks in a diet that are good or bad for her. It is important for the provider to make sure the patient knows their social determinants of health. Depending on the patient’s knowledge, she may not know about all the certain risks her culture, age, or health history may have in her pregnancy. According to Tesfalul et al. (2021) some providers do not tell the patients all their potential risks or determinants for health due to anxiety or knowing how to properly tell them 38-year-old native American pregnant female living on a reservation. I would find it my duty to learn about and help my patients know about their social determinants of health. Some things would be about diabetes, living conditions, or even age, as over 35 years is considered a geriatric pregnancy. It is my job to recognize the potential risks and let the patient know of them and assess and manage her healthcare according to her social determinants of health.

I would ask my patient is she felt at risk for her or her child’s wellbeing or safety. I would want to make sure she felt safe and free from violence, poverty, or even mental health. I also definitely would make sure my patient felt she had good support during her pregnancy. I would ask the following questions:

Whom do you live with?

Do you feel safe in your home?

Was your pregnancy planned?

Do you have a partner that supports you?

Do you feel depressed or sad in any way?

What more could I do for you regarding your pregnancy so you feel supported so you can have a safe and successful pregnancy?

In conclusion, I would want to make sure that my patient leaves the first appointment feeling safe, knowledgeable, and supported. I want her to know I care about her and want the best care for her. I also want her to know I will respect any cultural decisions she makes in her health care. It is also important she knows of potential risks if she does not have good health care while pregnant. I would want to make sure she takes her vitamins, has a healthy diet, feels safe in her environment, and takes the necessary tests since she is considered a geriatric pregnancy. I would make sure she leaves my office feeling aware and empowered in her health care supported during her pregnancy. It is important to know the patient’s history and also future plan and ensure she is making the best decisions possible for her to have a successful and healthy pregnancy 38-year-old native American pregnant female living on a reservation.

References

Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Seidel’s guide to physical examination: An interprofessional approach (9th ed.). Elsevier Mosby.

Bridges, J. F., Crossnohere, N. L., Schuster, A. L., Miller, J. A., Pastorini, C., & Aslakson, R. A. (2018). A patient and community-centered approach selecting endpoints for a randomized trial of a novel advance care planning tool. 
Patient Preference & Adherence
, 
12
, 241–249. 
https://doi-org.ezp.waldenulibrary.org/10.2147/PPA.S150663

Cannella, D., Auerbach, M., & Lobel, M. (2013). Predicting birth outcomes: Together, mother and health care provider know best. 
Journal of Psychosomatic Research, 75
(4), 299–304. https://doi-org.ezp.waldenulibrary.org/10.1016/j.jpsychores.2013.08.004

Kramer, B. J., Jouldjian, S., Washington, D. L., Harker, J. O., Saliba, D., & Yano, E. M. (2009). Health care for American Indian and Alaska Native women. 
Women’s Health Issues, 19
(2), 135–143. https://doi-org.ezp.waldenulibrary.org/10.1016/j.whi.2008.11.002

Tesfalul, M. A., Feuer, S. K., Castillo, E., Coleman-Phox, K., O’Leary, A., & Kuppermann, M. (2021). Patient and provider perspectives on preterm birth risk assessment and communication. 
Patient Education and Counseling
. https://doi-org.ezp.waldenulibrary.org/10.1016/j.pec.2021.03.038 38-year-old native American pregnant female living on a reservation

Discussion: Building a Health History

Effective communication is vital to constructing an accurate and detailed patient history. A patient’s health or illness is influenced by many factors, including age, gender, ethnicity, and environmental setting. As an advanced practice nurse, you must be aware of these factors and tailor your communication techniques accordingly. Doing so will not only help you establish rapport with your patients, but it will also enable you to more effectively gather the information needed to assess your patients’ health risks.

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For this Discussion, you will take on the role of a clinician who is building a health history for a particular new patient assigned by your Instructor.

Photo Credit: Sam Edwards / Caiaimage / Getty Images

To prepare:

With the information presented in Chapter 1 of Ball et al. in mind, consider the following:

By Day 1 of this week, you will be assigned a new patient profile by your Instructor for this Discussion. 
Note
: Please see the “Course Announcements” section of the classroom for your new patient profile assignment.

How would your communication and interview techniques for building a health history differ with each patient?

How might you target your questions for building a health history based on the patient’s social determinants of health?

What risk assessment instruments would be appropriate to use with each patient, or what questions would you ask each patient to assess his or her health risks?

Identify any potential health-related risks based upon the patient’s age, gender, ethnicity, or environmental setting that should be taken into consideration 38-year-old native American pregnant female living on a reservation.

Select 
one
 of the risk assessment instruments presented in Chapter 1 or Chapter 5 of the 
Seidel’s Guide to Physical Examination
 text, or another tool with which you are familiar, related to your selected patient.

Develop 
at least five
 targeted questions you would ask your selected patient to assess his or her health risks and begin building a health history.

By Day 3 of Week 1

Post 
a summary of the interview and a description of the communication techniques you would use with your assigned patient. Explain why you would use these techniques. Identify the risk assessment instrument you selected, and justify why it would be applicable to the selected patient. Provide at least five targeted questions you would ask the patient.

Note:
 For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link, and then select “Create Thread” to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on 
Submit!

Read a selection of your colleagues’ responses.

By Day 6 of Week 1

Respond 
to 
at least two
 of your colleagues 
on 2 different days
 who selected a different patient than you, using one or more of the following approaches:

Share additional interview and communication techniques that could be effective with your colleague’s selected patient.

Suggest additional health-related risks that might be considered 38-year-old native American pregnant female living on a reservation.

Validate an idea with your own experience and additional research.

 

Sample response

Thank you for your insightful post. It was very inclusive regarding the care you would provide to your 38-year-old pregnant native American. Women who experience gestational diabetes (GD) are at greater risk for later developing type two diabetes and increases the risk of hypertension during the pregnancy (Center for Disease Control, 2021). Education regarding prevention and monitoring for symptoms of these two diseases will be optimal for early detection and care during their pregnancy. One way for prevention in gestational diabetes would be education. According to Stotz (2019), many native American women do not know what gestational diabetes is until they are diagnosed with it. Education may be provided on what gestational diabetes is and how it can be prevented to this individual 38-year-old native American pregnant female living on a reservation.

Another area to look at within your interview would be to be culturally sensitive. Some Native American cultures incorporate different beliefs. One question that may be asked during the interview would be: are there any belief practices that you would affect care for yourself of infant? This is an open-ended question for the individual to incorporate any beliefs that they would like for the care of themselves during the pregnancy, delivery, and postpartum care. In previous experiences I have worked on reservations in Minnesota. I have not specifically cared for women during pregnancy however, I have for geriatric patients. When they are in the dying process one ritual that comes to mind would be the burning of sage after death. At the facility I was working at we were able to accommodate this request for the family.

 

Center for Disease Control and Prevention.  (2021, August 10). Gestational diabetes. 
https://cdc.gov/diabetes/basics/gestational.html

Stotz, S., Charron-Prochownik, D., Terry, M.A., Gonzales, K., & Moore, K. (2019). Reducing risk for gestational diabetes mellitus (GDM) through a preconception counseling program for American indian/Alaska native girls: Perceptions from women with type 2 diabetes of a history of GDM. Diabetes Educator, 45(2), 137-145. https//doi-org.ezp.waldenulibrary.org/10.1177/0145721718821663 38-year-old native American pregnant female living on a reservation

NRNP 6531 Final Exam

The nurse practitioner provides a program on nutrition for older adults to a group at a community church. Which of the following is a reason to educate this group about nutrition?

1.

The risks of developing nutritional difficulties are multifactorial.

2.

Only internal conditions affect nutritional status.

3.

Only external conditions affect nutritional status.

4.

Older adults have a decreased risk of developing nutritional deficiencies.

Jean is a breast cancer patient given 2 to 3 years of survival. Her condition is up and down. Which of the following types of care is indicated for the patient? NRNP 6531 Final Exam

1.

Naturopathic care

2.

Complementary care

3.

Maintenance care

4.

Palliative care

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Which of the following statements is true relating the diagnosis of Parkinson’s disease (PD)?

The disease should be addressed aggressively using all medications to minimize progression

Drug therapy focuses on correcting the imbalance of dopamine and acetylcholine.

Exercise is a contraindication to avoid falls.

Anxiety is common in PD and can contribute to worsening of symptoms

 

Geriatric patients in end-of-life conditions suffer from many symptoms. The most prevalent symptoms include delirium, dyspnea, and pain. Which of the following is a common additional symptom for patients in end-of-life conditions?

1.

Insomnia

2.

Speech impairment

3.

Hearing impairment

4.

Tremors

 

Mrs. Morgan is an 70-year-old female who comes to the emergency department with complaints of  pain in her lower leg that is aggravated by movement. Which early treatment does the nurse practitioner implement?

Rest, ice application to affected area,  elevation of the leg

Heat application to the affected area, opioid medication, compression dressing

Opioid medication, compression dressing, ice application to the affected area

Physical therapy, compression dressing, heat to the affected area

 

Women developing ovarian cancer may be asymptomatic, making it hard to detect until the condition has worsened. Which of the following is the best initial diagnostic tool for suspected ovarian cancer?

1.

Transvaginal ultrasonography

2.

Pelvic examination

3.

Laparoscopy

4.

MRI of the abdomen with contrast

David is 66 years old male who presents with complaints of right sided abdominal swelling, weight loss, and skin discoloration.   What initial tests should the NP order to assess for cancer of the liver?

CBC,  AST, ALT, Ultrasound

CBC, Chem-12, contrast MRI of the abdomen

Abdominal X-ray, CBC, lipid profile

Contrast MRI of the abdomen

 

Ms. Jenny is 72 years old and has managed her type 2 diabetes for 30 years. This condition is costly to her in more than one way. Which complications are common?

1.

Financial challenges NRNP 6531 Final Exam.

2.

Good visual acuity.

3.

Good renal functioning.

4.

Increased circulation to lower extremities.

 

Tanya came in for an office visit due to recurrent epistaxis. She also has a diagnosis of systemic lupus erythematosus. CBC with peripheral blood smear was performed and confirmed that she has idiopathic thrombocytopenic purpura (ITP). Which of the following is true relating to the condition of ITP?

Patients 65 years or older have a higher risk of bleeding and mortality.

ITP etiology is known.

ITP affects men more than women

ITP is more common in children.

 

Mr. Sparks is an 88-year-old patient who was recently an inpatient for pneumonia and was bedridden for 1 week. He is now presenting dysuria, suprapubic tenderness accompanied by fever, and increased confusion. Based on his recent history, which of the following conditions may be developing?

1.

Cystitis

2.

Distended bladder

3.

Prostate stones

4.

Subacute prostatitis

 

Jordan is a 75-year-old patient diagnosed with chronic lymphatic leukemia (CLL). All of the following statements are TRUE about CLL EXCEPT:. 

CLL treatment is divided into induction and post-remission or consolidation therapy

CLL is a disease of the older adult

CLL manifests symptoms of fatigue, feeling of fullness in the abdomen, and weight loss

CLL is a common type of adult leukemia in the Western world

 

The treatment of acute lymphoblastic leukemia (ALL) consists of the control of bone marrow and systemic disease. Which of the following therapies eliminates any leukemic cells that may remain?

1.

Consolidation therapy

2.

Maintenance therapy

3.

Induction remission

4.

Central nervous system (CNS) prophylaxis

 

Some common medications, including Metformin, can interfere with the absorption of vitamin B12

True

False

TRUE

Mr. Jameson, 75 years old, comes to the clinic with complaints of severe sharp epigastric pain that radiates to his back. He has been nauseous and has vomited three times today. The nurse practitioner suspects which of the following?

1.

Appendicitis

2.

Gastrointestinal influenza

3.

Acute pancreatitis

4.

Insulin shock

 

Mrs. C. presents for her annual physical exam.   She complains of episodes of abdominal cramps and diarrhea that comes and goes.    What is the next best action for the nurse practitioner to take?

1.

Assess triggers for each episode and the sequence of symptoms.

2.

Conducting a complete urological examination.

3.

Order ultrasound of the abdomen

4.

Complete physical exam

 

During a breast examination, the NP should ask the patient if she has had any history of breast trauma since that is a known risk factor for the development of breast cancer NRNP 6531 Final Exam.

True

False

FALSE

The nurse practitioner is working in a clinic dedicated to patients over age 65 years. The nurse practitioner observes several common characteristics in the posture of elderly patients. Which of the following is common?

1.

Increase in the length of the trunk in relationship to the upper extremities.

2.

Head tips backward.

3.

Disappearance of bony prominences.

4.

IncreasBe in the range of motion (ROM).

 

Symptoms of Acute Lymphocytic Leukemia can include joint pain, enlarged lymph nodes, and abdominal swelling

True

False

TRUE

Which of the following statements is true for untreated symptomatic cystitis?

1.

Untreated symptomatic cystitis can lead to pneumonia.

2.

Untreated symptomatic cystitis can resolve on its own.

3.

Untreated symptomatic cystitis can lead to pyelonephritis, sepsis, shock, and death.

4.

Untreated symptomatic cystitis can lead to prostatitis, vaginitis, and sepsis.

 

Mr. Epstein developed a sudden onset of severe headache, weakness on one side of his body, difficulty speaking, and loss of balance. He was immediately admitted to the hospital with the diagnosis of hemorrhagic stroke. Which of the following is the manifestation of a hemorrhagic stroke?

1.

Leak or rupture in an artery wall.

2.

Leak or rupture in a venous wall.

3.

Blockage in the heart.

4.

Blockage of an artery.

 

Peripheral neuropathy is a disorder of the peripheral nervous system resulting in sensory, motor, and autonomic dysfunction. Which of the following conditions are the treatable causes of peripheral neuropathy?

Radiculopathy and traumatic brain injury

Alcohol use and diabetes

Radiculopathy and alcohol use

Traumatic brain injury and diabetes

 

An 80-year-old woman comes to see the nurse practitioner and complains that she does not seem to be able to tolerate some foods as she once did. The nurse practitioner knows that aging can contribute to which of the following? NRNP 6531 Final Exam

1.

Bone loss in the mouth, causing teeth to be loose.

2.

Oral mucosa thickening and inhibiting saliva production.

3.

An increase in secretion of hydrochloric acid in the stomach.

4.

A decline in liver function.

 

While conducting a health assessment, the nurse practitioner asks about the three pillars of food security. This includes which of the following?

1.

Food allocation.

2.

Food availability.

3.

Food that is inexpensive.

4.

Food freshness.

 

Acute myeloid leukemia (AML) is a rare and diverse group of diseases. Which of the following statements is true regarding AML?

1.

AML has no CNS involvement.

2.

Laboratory evaluation includes urinalysis.

3.

Initial work-up is to assess and characterize the disease based on prior exposure.

4.

Comorbidities do not apply in the diagnosis of AML.

 

Physiological changes of aging and multiple comorbidities influence the dying process. The growing acceptance of hospice and palliative care is creating a more natural dying experience. Which of the following is true regarding the process of death?

1.

Urinalysis is usually performed as a diagnostic test for further infection.

2.

Age has no bearing on the risk of death.

3.

The meaning and experience of death are often influenced by society.

4.

The meaning and experience of death are often influenced by one’s culture and ethnicity.

 

Which of the following is a neurological disorder characterized by leg cramping, pulling, and tugging sensations, and may have a genetic component?

1.

Radiculopathy

2.

Nerve compression

3.

Restless legs syndrome (RLS)

4.

Sleep impairment

 

Mrs. Smith, 80 years old, has been vomiting and having bouts of loose stools for several days. She is taking several medications that are prescribed. The nurse practitioner conducts a medication review because:

1.

An accounting of all prescribed and over-the-counter (OTC) medications may uncover reasons for her symptoms.

2.

There could be drug–drug interactions leading to her symptoms.

3.

Side effects of the gastrointestinal tract are not seen in many medications.

4.

The administration of some of her medications may be appropriate NRNP 6531 Final Exam.

 

Direct injury to the femur and osteoporosis can contribute to the development of a femoral neck  fracture in an older adult.

True

False

TRUE

Pain is categorized into different types. Which of the following type of pain originates in the thoracic, abdominal, and pelvic viscera and presents diffused pain that often radiates?

1.

Neuropathic pain

2.

Somatic pain

3.

Visceral pain

4.

Mixed pain

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Mr. Smith comes to the health-care clinic with a presenting symptom of not urinating as much as usual. The nurse practitioner assesses Mr. Smith by asking which of the following?

1.

How much do you drink per day?

2.

Is your urine a clear yellow color?

3.

Do you experience urgency and frequency of urination?

4.

What medications have you taken recently or are you currently taking?

 

Ginger is a 65-year-old woman who is suspected of having a brain tumor. The NP orders diagnostic testing for thyroid-stimulating hormone (TSH) and magnetic resonance imaging (MRI) to confirm this. Which of the following statements is true regarding a brain tumor?

1.

Photophobia and headaches are rare presenting symptoms of a brain tumor.

2.

A brain tumor can be a malignant or benign neoplasm.

3.

The etiology of brain tumors is often known.

4.

Brain tumors occur more commonly in females than males.

 

Maria is a 58-year-old woman experiencing itching, discomfort, and bleeding after intercourse. Which of the following conditions may be developing in the patient?

1.

Atrophic vaginitis

2.

Vaginal cancer

3.

Fibroadenoma

4.

Cystitis

 

A  67 year old patient complains of  headaches, changes in mental function, language deficits, and visual problems.  Potential differential diagnosis for this patient includes all of the following EXCEPT:

Stroke

Subdural hematoma

Brain tumor

Venous insufficiency

 

Motor function of the older adult should include body position, involuntary movement, muscle tone, and muscle strength to rule out benign motor function

True

False

True

Which of the following conditions presents nonproliferating lesions and does not affect future cancer risk?

1.

Atypical lobular hyperplasia

2.

Fat necrosis

3.

Radial scar

4.

Papilloma

 

Part of the abdominal examination the nurse practitioner will conduct is the assessment of skin color. As the nurse practitioner assesses the abdominal skin, the findings include which of these signs that are concerning?

1.

Generalized pinkness.

2.

Bluish discoloration on the flanks.

3.

Yellow tint around the lower left quadrant.

4.

Blue in the upper left quadrant.

 

What diagnostic tests would the NP order to confirm the diagnosis of pancreatitis?

BUN, Creatinine, Blood sugar

Amylase and lipase

Abdominal CT

Abdominal MRI

 

Mrs. Cassidy is a 76-year-old woman who comes to see her nurse practitioner for pain in her right thigh. The nurse practitioner assesses that Mrs. Smith has bruises on her thigh and muscle weakness distally, near the knee. The nurse practitioner suspects which of the following?

1.

Musculoskeletal lesions

2.

Tendon rupture

3.

Gout

4.

Arthritis

 

The nurse practitioner explains to older adults that physiological changes can affect nutritional status, changes such as:

1.

An increased sense of smell

2.

An increased sense of taste.

3.

An increased production of saliva.

4.

Dental issues.

 

Pain is a common end-of-life symptom in the older adult.

True

False

True

Mr. Fitzgerald has seizure conditions due to a recent accident causing traumatic brain injury (TBI).    The NP would include which of the following in the patient’s treatment plan?

1.

Discontinuing seizure medication at one year post TBI injury

2.

Family education on patient care during a seizure

3.

Annual EEG for all patients on seizure medication

4.

Referral for group therapy.

 

Mr. King a 57-year-old male, is being seen in the clinic for complaints of pain in his thigh. There is swelling in the soft tissue, dislocation, altered ROM, bruising, local tenderness, and pain with any motion. The nurse practitioner suspects which of the following?NRNP 6531 Final Exam

ACL tear

achilles rupture

femoral neck fracture

pelvic fracture

 

Mr. Abrahams, a 69-year-old Caucasian male, presents with an inability to move his right arm sufficiently. The nurse practitioner tells him that she will perform a physical examination and order tests to rule out which of the following?

1.

Gout

2.

Rheumatoid arthritis (RA)

3.

Muscle weakness from a systemic condition

4.

Osteoarthritis (OA)

 

Vegetarians and those who abuse alcohol are at risk for vitamin B12 deficiency

True

False

TRUE

Thom is 60 years old and has been treated for nonalcoholic fatty liver disease (NAFLD) for over 10 years. He still suffers from fatigue, abdominal pain, and an enlarged liver. The nurse practitioner discusses which of the following plans to assist him in managing his disease?

Weight loss program and anti-lipid medications

Avoid hepatitis A and B vaccines and avoid alcohol

Avoid hepatitis A and B vaccines and anti-lipid medications

Alcohol intake does not affect this disease and a weight loss program

 

Ellen is a 57-year-old woman diagnosed with iron-deficiency anemia (IDA). Her physician orders further diagnostic tests to rule out which of the following?

1.

HIV

2.

Malignancy

3.

Gastritis

4.

Stroke

 

The genitourinary and reproductive systems undergo many age-related changes. Which of the following statements is true about these changes?

1.

The older male patient undergoes more gradual changes than does the older female patient.

2.

The older female patient undergoes more gradual changes than does the older male patient.

3.

Older male and female patients undergo the same changes.

4.

The older male patient undergoes less gradual changes than those of the older female patient.

 

Marie is a fibromyalgia sufferer. Her treatment program includes pain relief, antidepressant medications, and an exercise program. From which of the following types of pain might she be suffering?

1.

Neuropathic pain

2.

Somatic pain

3.

Visceral pain

4.

Mixed pain

 

The main laboratory clinical manifestations of cystitis are pyuria and bacteriuria

True

False

TRUE

An 80 years old  female is diagnosed with 
Clostridium difficile
-associated diarrhea (CDAD) and is questioning the NP about how she was exposed to the disease.   All of the following are correct EXCEPT:

Patients can be exposed in the hospital and community setting

Inflammatory bowel disease and compromised immunity can lead to CDAD

The source of CDAD is currently unknown

Risk factors include antibiotic exposure, being an older adult, and church or synagogue exposure.

 

Chronic inflammation and smoking are are contributing factors to the development of Acute Lymphocytic Leukemia

True

False

TRUE

Mr. Watson, a 77-year-old man, is being seen for his annual physical examination. His serum level of vitamin D is 40 nmol/L. The nurse practitioner explains that this may due to which of the following physiological changes in aging?NRNP 6531 Final Exam

1.

His dislike of milk.

2.

Tastes buds on the tongue not sensing taste as well.

3.

His gastrointestinal (GI) tract not absorbing dairy as it did when he was younger.

4.

The decline in the skin’s ability to metabolize vitamin D.

 

When other symptoms are presented with atrophic vaginitis, a biopsy is used as the diagnostic test to rule out which of the following diagnoses?

UTI, sexually transmitted infection, squamous cell hyperplasia

Sexually transmitted infection, squamous cell hyperplasia, Lichen sclerosis

squamous cell hyperplasia, Lichen sclerosis, Lichen planus

Lichen sclerosis, Lichen planus, UTI

 

A 66 year old patient with rheumatoid arthritis is seeking medication for pain control and that will alter the course of the disease.  What medication should the NP order?

Corticosteroids

NSAIDS

Acetaminophen

Biological disease-modifying antirheumatic drugs (DMARDs)

 

A clinician is performing sensory assessment on a patient presenting signs and symptoms of neurological disease. During the assessment, the clinician notices that the patient has a decreased sense of both pain and temperature. Which of the following may be affected?

1.

Spinothalamic tract

2.

Cranial nerve VII

3.

Posterior column

4.

Posterior horn

 

Which of the following is the best statement regarding dyspnea?

1.

Smoking causes dyspnea.

2.

Dyspnea is one of the most common reasons for visits to the emergency room for individuals with advanced disease.

3.

Dyspnea is a rare symptom as patients approach the end of life.

4.

Females are more likely to develop symptoms of dyspnea. NRNP 6531 Final Exam

40-year-old black recent immigrant from Africa without health insurance

WK 1 Discussion – 40-year-old black recent immigrant from Africa without health insurance

Main Post

My patient is a 40-year-old black recent immigrant from Africa without health insurance. The challenge here lies in the fact that this patient’s English fluency is not indicated. I would begin my interview by offering a friendly smile to make the patient feel comfortable and introduce myself.  I would then ask some basic questions such as name, age, and where the patient resides to assess the patient’s language competency.  If necessary, I may require the assistance of an interpreter, perhaps a software tool to help with translating if an interpreter is not available.  Whereas some African nations do communicate in English, this is not the case for all African nations.  Thus, a language assessment is imperative in obtaining this patient’s comprehensive health history 40-year-old black recent immigrant from Africa without health insurance.

After addressing any communication challenges, I would focus on obtaining basic information such as age, gender, marital status, and occupation.  Thereafter, I would proceed towards obtaining a thorough health assessment by asking specific questions.  The aim of obtaining a high-quality comprehensive patient health history is to identify symptoms that represent a range of pathologies; even by itself, the assessment is a powerful instrument (Diamond-Fox, 2021).  Specifically, I would ask the below five basic questions:

What is the reason for your visit today? By asking this, I would assess the patient’s unexpressed fear or concern.

When did you first begin to feel your symptoms? This question is asked to assess the chronological order of events, as I assess the patient’s most recent state of health prior to the current condition.

Can you describe your symptoms, giving the location, duration, aggravating and alleviating factors, onset, and duration? This inquiry is for symptom analysis.

Do you have any medical conditions, or are you taking medications for any condition?  Perhaps here I can also ask of any childhood illnesses or injuries that may be pertinent to the patient’s chief complaint. Assessing the patient’s past history helps practitioners assess the present issue and also formulizes a risk assessment of their health.

Towards the end, I would like to summarize the data collected with my patient by repeating the information and asking “Am I missing anything? or “Is this information correct?”  This is to correct any errors and ensure that I have in fact obtained the most accurate health history for the patient that can now be established in his chart/profile 40-year-old black recent immigrant from Africa without health insurance.

 

As a provider, I must remain aware of cultural sensitivities to ensure my actions or wording will not be misinterpreted.  Immigrants from Africa in particular faces challenges from the US healthcare system, including the lack of culturally sensitive care and hostile provider attitudes that reinforce their lack of trust in the healthcare system (Omenka et al., 2020). For this reason, it is crucial that I remain empathetic, courteous, and ensure comfort in order to develop a bond of trust. A useful tool that can be applied here is I.C.E. (ideas, concerns, expectations.) This ensures that the provider listens actively, is aware of proper body language, empathizes with the patient, and focuses on the patient’s ideas, concerns, and expectations of healthcare by directly asking the patient “what are your concerns?” (Desai, MD, 2018).

The fact that my patient is an immigrant places him at a greater risk of psychological health problems due to both pre-migration risk factors such as previous traumatic experiences along with post-migration factors such as culture shock, low socioeconomic status, and a possible void in the emotional family/support system (Adu-Boahene et al., 2017). And for this reason, I would add a mental health component in my interview to check for any signs of depression, anxiety, trauma, sleep disturbance, eating disorder, or substance abuse.  There are many tools for mental health that can be utilized such as the PTSD checklist for DSM-5, or an anxiety checklist that gives the provider a general idea of the stress level patient is currently experiencing.

As a provider, I would take all such factors into consideration when developing an appropriate care plan.  An added degree of empathy is required in the assessment of this patient due to the fact that the patient is in a foreign land, dealing with culture shock, communication barriers, and not having health insurance.  This assessment will most likely be a bit longer than the usual admitting patient because of these factors, and this patient will need to be referred to a social worker for assistance in obtaining proper care although uninsured.  In the end, I would hope to have provided comfort and empathy and developed a bond of trust with this patient, in addition to providing proper medical care 40-year-old black recent immigrant from Africa without health insurance.

References

Adu-Boahene, MPH;, A. B., Laws, PhD, MA, M. B., & Dapaah-Afriyie, MD, MBA, K. (2017, January). 
Health-Needs Assessment for West African Immigrants in Greater Providence, RI
. Rhode Island Medical Journal. 
https://www.rimed.org/rimedicaljournal/2017/01/2017-01-47-cont-adu-boahene.pdf

Desai, MD, R. (2018, October 19). 
Clinician’s Corner: Taking a good patient history
 [Video]. Osmosis. 

Diamond-Fox, S. (2021). Undertaking consultations and clinical assessments at advanced level. 
British Journal of Nursing
, 
30
(4), 238-243. 
https://doi.org/10.12968/bjon.2021.30.4.238

Omenka, O. I., Watson, D. P., & Hendrie, H. C. (2020). Understanding the healthcare experiences and needs of African immigrants in the United States: A scoping review. 
BMC Public Health
, 
20
(1). 
https://doi.org/10.1186/s12889-019-8127-9

Discussion: Building a Health History

Effective communication is vital to constructing an accurate and detailed patient history. A patient’s health or illness is influenced by many factors, including age, gender, ethnicity, and environmental setting. As an advanced practice nurse, you must be aware of these factors and tailor your communication techniques accordingly. Doing so will not only help you establish rapport with your patients, but it will also enable you to more effectively gather the information needed to assess your patients’ health risks.

For this Discussion, you will take on the role of a clinician who is building a health history for a particular new patient assigned by your Instructor 40-year-old black recent immigrant from Africa without health insurance.

Photo Credit: Sam Edwards / Caiaimage / Getty Images

To prepare:

With the information presented in Chapter 1 of Ball et al. in mind, consider the following:

By Day 1 of this week, you will be assigned a new patient profile by your Instructor for this Discussion. 
Note
: Please see the “Course Announcements” section of the classroom for your new patient profile assignment.

How would your communication and interview techniques for building a health history differ with each patient?

How might you target your questions for building a health history based on the patient’s social determinants of health?

What risk assessment instruments would be appropriate to use with each patient, or what questions would you ask each patient to assess his or her health risks?

Identify any potential health-related risks based upon the patient’s age, gender, ethnicity, or environmental setting that should be taken into consideration.

Select 
one
 of the risk assessment instruments presented in Chapter 1 or Chapter 5 of the 
Seidel’s Guide to Physical Examination
 text, or another tool with which you are familiar, related to your selected patient.

Develop 
at least five
targeted questions you would ask your selected patient to assess his or her health risks and begin building a health history 40-year-old black recent immigrant from Africa without health insurance.

By Day 3 of Week 1

Post 
a summary of the interview and a description of the communication techniques you would use with your assigned patient. Explain why you would use these techniques. Identify the risk assessment instrument you selected, and justify why it would be applicable to the selected patient. Provide at least five targeted questions you would ask the patient.

Note:
 For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link, and then select “Create Thread” to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on 
Submit!

Read a selection of your colleagues’ responses.

By Day 6 of Week 1

Respond 
to 
at least two
 of your colleagues 
on 2 different days
 who selected a different patient than you, using one or more of the following approaches:

Share additional interview and communication techniques that could be effective with your colleague’s selected patient.

Suggest additional health-related risks that might be considered.

Validate an idea with your own experience and additional research.

responses

Thank you for sharing your informative discussion post. I agree with your assertion that you should offer a friendly smile to make the patient feel comfortable and introduce yourself to warm up the encounter before engaging in any further action(s). According to Omenka et al. (2020), many African immigrants already have substantial health vulnerabilities when they arrive in the United States, which will only worsen if they don’t have access to good treatment. For this reason(s), the practitioner must determine the patient’s needs, establish a suitable treatment plan, obtain reliable information via history collection and a physical examination (Ball et al., 2019). Furthermore, Communication is a two-way process to exchange meaning. As clinicians, we must evaluate the patient’s appearance, exposure or experience, language skills, tone of voice, listening ability, cultural practices/beliefs, and body language to collect the necessary information or create a therapeutic alliance. Furthermore, patient-centered care based on the patient’s knowledge necessitates the use of a unique technique. In an immigrant, the communication tactics should focus on chronic illness, migratory trauma, and socioeconomics to the best of their knowledge. The provider must address the language barrier if applicable in the case of the immigrant and any access to available resources. Although some African countries use English, the majority speak French or dialects. Conscious awareness and ongoing examination of all communication process components can help improve diagnostic abilities and patient compliance 40-year-old black recent immigrant from Africa without health insurance.

According to Ball et al. (2019), Structuring a health history is critical for accurately diagnosing and treating patients. Firstly, I will agree with you to evaluate the patient’s mastery of English and a language interpreter used in a language barrier to facilitate this encounter and after that.  Healthcare practitioners must accept patient variations or backgrounds (considering that this immigrant’s values may vary from U.S. values) and views to make this process comfortable and trustworthy. Also, the patient may be suffering the usual obstacles of cross-continental or geographical travel, such as not finding work. The practitioner, in this instance, must assess the patient’s emotional and psychological well-being as adaptation has been linked to mental illness. Isasi et al. (2016) also notes that, conditions regarding immigration and cultural adaptation also appear to be linked to mental health among immigrants.

Applying I.C.E. (ideas, concerns, expectations.) in your care of this patient and other patients is an excellent tool in achieving excellent care. Incorporating cultural sensitivity into our practice as practitioners increase efficiency in reaching many different groups of people and giving a non-biased approach to care, leading to more valuable services and outreach.

 

References

Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). 
Seidel’s guide to physical examination: An interprofessional approach
 (9th ed.). Mosby.

Isasi, C. R., Rastogi, D., & Molina, K. (2016). Health Issues in Hispanic/Latino Youth
. Journal of Latina/o psychology, 4
(2), 67–82. 
https://doi.org/10.1037/lat0000054

Omenka, O. I., Watson, D. P., & Hendrie, H. C. (2020). Understanding the healthcare experiences and needs of African immigrants in the United States: a scoping review. 
BMC public health, 20
(1), 27 40-year-old black recent immigrant from Africa without health insurance. 
https://doi.org/10.1186/s12889-019-8127-9

response 2

Wow,

You made so many great points and hit so many things, I can already tell you will be a very empathetic practitioner. I like how you included ICE (ideas, concerns, and expectations) in your assessment. I also like your five questions. I haven’t really thought about all the issues that can occur with a patient who is an immigrant where language barriers might be a factor and also when they do not have insurance. It is very sad that some people are unable to receive the same care that others are afforded. Suzanne et al. (2019) agree that ethnic minorities, and those from other countries, are vulnerable and are at a social disadvantage. Many scams are also out there with healthcare letting some believe they will cover things and getting them hooked into paying for insurance that they can’t afford or don’t need. Dagmar Dzúrová et al. (2014) point out that many immigrants just don’t know what to do in order to get healthcare.

I can see how uninsured patients a problematic issue might be so I would make sure to have pamphlets available for the patients about other insurance options. I would also see the need to address as many issues as possible in one visit for the patient because due to the lack of insurance, they might be as willing to return to the office. Radoslaw et al. (2018) point out that those with no insurance or high deductibles have a lower life expectancy than those with insurance. I would try to get as good of a health history as possible so I could see determining factors leading up to the reason for the visit. If possible, I would suggest that the patient get bloodwork to ensure they are healthy. Everything costs money though, and the patient may just need an acute need met rather than a comprehensive exam 40-year-old black recent immigrant from Africa without health insurance.

In the end, you brought some good points at the challenges in helping those that are unaware or unable of the best type of healthcare needed. This is something that will not go away and we will always have challenges how to help all those that need care. To help the patient feel comfortable, I would hope that there is a family member or friend that could come to the appointment to help with translation if needed. I also realize it might be a good idea to invest in a good translation app as language barriers might happen often. I truly believe mental health could be a potential problem with some immigrants depending on the support they have so I think asking mental health questions, or including a mental health questionnaire to be answered if possible would be a great option as well.

Thanks for your post, it opened my eyes and brought many things to light that I didn’t think about before when giving healthcare. I live in Arizona and just started working as a nurse at a prison and I didn’t realize how many people are in the prison that do not speak English. The prison has invested in an interpreter service that we can call with a telephone that really helps when delivering healthcare.

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References

Dagmar Dzúrová, Petr Winkler, & Dušan Drbohlav. (2014). Immigrants’ Access to Health Insurance: No Equality without Awareness. International Journal of Environmental Research and Public Health, 11(7), 7144–7153. https://doi-org.ezp.waldenulibrary.org/10.3390/ijerph110707144

Suzanne G. M. van Hees, Timothy O’Fallon, Miranda Hofker, Marleen Dekker, Sarah Polack, Lena Morgon Banks, & Ernst J. A. M. Spaan. (2019). Leaving no one behind? Social inclusion of health insurance in low- and middle-income countries: a systematic review 40-year-old black recent immigrant from Africa without health insurance. International Journal for Equity in Health, 18(1), 1–19. 
https://doi-org.ezp.waldenulibrary.org/10.1186/s12939-019-1040-0

Radoslaw Panczak, Viktor von Wyl, Oliver Reich, Xhyljeta Luta, Maud Maessen, Andreas E. Stuck, Claudia Berlin, Kurt Schmidlin, David C. Goodman, Matthias Egger, Kerri Clough-Gorr, & Marcel Zwahlen. (2018). Death at no cost? Persons with no health insurance claims in the last year of life in Switzerland. BMC Health Services Research, 18(1), 1–8. https://doi-org.ezp.waldenulibrary.org/10.1186/s12913-018-2984-2

sample response 3

I enjoyed reading your post. As I read through your post, I can identify as that 40-year-old immigrant, and I can correctly validate some of the ideas here in your post. You did a great job by stressing the importance of obtaining a health history and health assessment. You also touched on mental health, which in most African countries, residents still see mental illness as an omen or taboo.

Africa is a continent that is reached in culture. I agree with you 100% that as a provider, you must remain aware of cultural sensitivities to ensure your actions or wording will not be misinterpreted 40-year-old black recent immigrant from Africa without health insurance.

Adequate or appropriate assessment of an African patients would be dependent on how culturally competent and sensitive the provider is.

The provider might be the brightest of all providers, but if not culturally aware of Africans, there would always be a barrier in communication. Most countries in Africa are either Anglophone (English speaking) or francophone (French-speaking) countries, depending on the colonized country in Europe. A 40-year-old from an English-speaking country should have at least a high school diploma. The ability to understand the patient’s accent and be understood by the patient is a big challenge. Sometimes the interpreter is not the solution.

The interview technique would entail speaking slowly, and sometimes, when words are written out, it helps to understand some phonetics.

Smiling at a new patient may mean different things in different cultures. A handshake is always a welcoming and friendly gesture rather than a smile. Lack of eye contact during the interviewing process is not derogatory or bad for this 40-year-old man. Asking about what brought a forty-year-old man to the US is irrelevant to him, but he would appreciate you asking about his goals in American and whom he left behind. This question would guide the provider to recommend the proper health promotion for this immigrant man. These questions are not intrusive, but rather, they help the man open up and tell you more stories about his life and living conditions.

The United States has done so well in health history taking and documentation for the future. The new technological systems have made it easier to keep patient records from birth to old age. Unlike most countries in Africa, there are gaps in medical journals if at all they are found. The life expectancy of a Nigerian male is 60 years compared to a US male of 78-year-old (Varrella, 2021). Social determinants of health are rampant in most African families, such as poor housing conditions, food scarcity, and lack of healthcare. A provider must assess and address which factors impact the patient’s health (Ball et al., 2019). Family health history would be necessary to make a presumptive diagnosis for diabetes, hypertension, and heart disease.

The Center for Disease Control and Prevention (CDC) has a screening tool for new refugee immigrants for providers and clinics to use. This tool is termed the National Standards for Culturally and Linguistically Appropriate Services in Health and Health Care (CLAS Standards) (Center for Disease Control and Prevention CDC, 2020). It is recommended that care providers obtain this tool to appropriately provide that clinical care, address language and cultural barriers that patients may experience (CDC, 2020) 40-year-old black recent immigrant from Africa without health insurance.

Some critical questions recommended by CDC are centered around the following during a new immigrant clinic visits includes:

Key Considerations and Best Practices

General and optional laboratory tests

History and Physical

HIV Infection

Immunizations

Intestinal Parasites

Lead

Mental Health

Malaria

Nutrition and Growth

Sexual and Reproductive Health

Tuberculosis

Viral Hepatitis (CDC, 2020)

It is crucial to assess immunization. Ask questions about the last time the patient saw a health care provider and for what reason. The average person has no health insurance in most countries in Africa, so dental checkup is almost nonexistent.

 

 

 

 

References

 

Ball, J., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). 
Seidel’s guide to physical examination: An interprofessional approach
 (9th ed.). St. Louis, MO: Mosby.

Center for Disease Control and Prevention (CDC). (2020, November 06). Refugee Domestic Screening Guidance: Key Considerations and Best Practices. Retrieved from https://www.cdc.gov/immigrantrefugeehealth/guidelines/domestic/screening-guidance.html 40-year-old black recent immigrant from Africa without health insurance

Varrella, S. (2021, February 12). Nigeria: Life expectancy, by gender. https://www.statista.com/statistics/1122851/life-expectancy-in-nigeria-by-gender/ 40-year-old black recent immigrant from Africa without health insurance

NRNP – 6552 Advanced Nurse Practice in Reproductive Health Care Midterm Exam

Olivia presents with a complaint of “bumps” around her vagina. They are nonpainful and nonpruritic. Upon inspection, you note several flesh colored and pearly white papules with depressed centers. This appearance is characteristic of:

A.

Condyloma lata

B.

Genital warts

C.

Malignant melanoma

D.

Molluscum contagiosum

 

Pelvic support structures include:

A.

Muscles and connective tissue of the pelvic floor

B.

Fibromuscular tissue of the vaginal wall

C.

Endopelvic connective tissue

D.

All of the above NRNP – 6552 Advanced Nurse Practice in Reproductive Health Care Midterm Exam.

 

Serum FSH indirectly measures ovarian function, with _______ levels of FSH indicating normally functioning ovaries.

A.

Lower

B.

Median

C.

Higher

D.

Absent

 

The term used to describe painful cramps that occur with menstruation is:

A.

Amenorrhea

B.

Menorrhagia

C.

Uterine atony

D.

Dysmenorrhea

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One of the reasons that substance use is a concern in LBQ and TGNC communities is:

A.

It has been shown to be a confirmed genetic risk

B.

Bars and club scenes have long been safe spaces for gay, LBQ, ad TGNC people

C.

A and B

D.

None of the above

One of the reasons that substance use is a concern in LBQ and TGNC communities is:

A.

It has been shown to be a confirmed genetic risk

B.

Bars and club scenes have long been safe spaces for gay, LBQ, ad TGNC people

C.

A and B

D.

None of the above

 

n physical examination, pale atrophic depigmented tissue that has a “cigarette paper” appearance is consistent with:

A.

Vaginal candidiasis

B.

Contact dermatitis

C.

Lichen sclerosis

D.

Gonorrhea

 

A type of contraceptive that does not contain hormones is:

A.

Paragard IUD

B.

Mirena IUD

C.

Nuvaring

D.

Evra patch

 

The following are the four basic Caldwell-Moloy pelvic types.

A.

Gynecoid, android, anthropoid, platypelloid

B.

Gynecoid, antecoid, retrocoid, flexed

C.

Anterverted, anteflexed, retroverted, retroflexed

D.

None of the above

 

The least invasive way to assess bladder capacity is through:

A.

Filling cystometrogram

B.

3-day voiding diary

C.

Quantified standing stress test

D.

Urethral pressure profile

 

Strong evidence shows that first trimester abortions, whenever performed safely, increases a women’s risks of:

A.

Subsequent infertility

B.

Ectopic pregnancy

C.

Birth defects

D.

None of the above NRNP – 6552 Advanced Nurse Practice in Reproductive Health Care Midterm Exam.

 

Hirsutism is defined as:

A.

Excessive terminal hair loss in women

B.

Excessive nail growth in women

C.

Brittle nail growth in women

D.

Excessive terminal hair growth in women

 

EBP stands for:

A.

Experimental based practice

B.

Evidence based practice

C.

Excellent bedside practice

D.

None of the above

 

The _______________ are easily sensitized and become engorged with blood during sexual arousal.

A.

Labia Minora

B.

Labia Majora

C.

Bartholin’s glands

D.

Mons pubis

 

Menopause is defined as:

A.

Cessation of periods for six months

B.

Cessation of periods for one year

C.

Cessation of periods for two years

D.

None of the above

 

Josefina is a 47-year-old patient with family history of diabetes. Her BMI is 30. She has been healthy except for medication-controlled hypertension. She has been very compliant with her appointments. Today, you tell her you need to check her blood sugar. She says “I just read an article that said I only need to have that checked every three years. You just checked it last year.” You tell her:

A.

You are correct that in many people, testing should only be every year. However, due to your family history of diabetes and your current weight and BMI, this places you in the high-risk category and you should have this done yearly.

B.

You are absolutely correct. I did not see in the chart that we had done that last year. I apologize. You are not due for that for two more years.

C.

I’m not sure the article that you read but the recommendation is that every patient have this test done on a yearly basis.

D.

Actually, we are supposed to be checking it every three months in high risk individuals, so we are behind on our testing!

 

All organizations recommend beginning screening mammograms in average-risk women at age____

A.

<40 years B. 40 to 44 years C. 45 to 49 years D. 55 years and older   The _________ is a sensitive organ that is typically described as the female homologue of the penis. A. Vulva B. Clitoris C. Skene’s gland D. Bartholin’s gland   A person whose gender identity is the same as their sex when he or she was born is: A. Bisexual B. Pansexual C. Intersexual D. Cisgender NRNP – 6552 Advanced Nurse Practice in Reproductive Health Care Midterm Exam.   When females go through puberty, the changes that occur are initiated by the production of: A. Low amounts of estrogen B. High amounts of estrogen C. High amounts of progesterone D. Low amounts of testosterone   Gale is 36 weeks pregnant. She calls the office to report that she has noticed a sticky fluid coming from her breasts. You let her know that this is most likely: A. A serious concern and she needs to be evaluated immediately. B. Colostrum, but she should be evaluated as it should not be noted during pregnancy. C. Colostrum, which is commonly noted toward the end of the pregnancy. D. A hormonal response that is indicative that she will most likely go into labor int the next 48 hours.   Endometrial polyps are most commonly identified by: A. A speculum exam B. A bimanual exam C. A pap smear D. A transvaginal ultrasound   When using the FIGO staging classification for cancer of the ovary, fallopian tube, and peritoneum, Stage I means: A. The tumor is confined to the ovaries or fallopian tube(s) B. The tumor involves one or both ovaries or fallopian tubes with pelvic extension or primary peritoneal cancer C. The tumor involves one or both ovaries or fallopian tubes, or primary periotenal cancer, with cytologically and histologically confirmed spread to the peritoneum outside the pelvis D. There is distant metastasis excluding peritoneal metastasis   First line pharmacologic treatment for women with PCOS is/are: A. Progestin-only birth control pills B. Combined oral contraceptives C. Lasix D. Multivitamins with folic acid   Metabolic syndrome typically includes the following except: A. Sudden weight loss B. Obesity C. Insulin resistance D. Dyslipidemia E. All of the above NRNP – 6552 Advanced Nurse Practice in Reproductive Health Care Midterm Exam. ORDER A CUSTOM-WRITTEN PAPER OR EXAM HERE On vaginal exam you find that Polly’s cervix is in the most common position, which is: A. Antiflexion B. Midline C. Posterior D. Backward   Clinicians can participate in primary sexual violence prevention by applying individual prevention skills, such as: A. Challenging behaviors in others that promote violence B. Engaging in healthy professional and personal relationships C. Learning to identify risk factors for sexually abusive behaviors D. B and C E. A, B, and C   The following is/are types of sexual violence. A. Intentional touching of the breast B. Pornography C. Threats of sexual violence D. All of the above   The only antimicrobial medications that are effective against Trichomoniasis vaginalis are: A. tinidazole or metronidazole B. Amoxicillin or Augmentin C. doxycycline or minocycline D. cephalexin or ceftriaxone   The use of a pain rating scale may assist the clinician to comprehend the intensity of a woman’s pain. Example(s) of pain rating scale(s) include: A. Numeric ranking scale B. Visual analog scale C. Verbal descriptive scale D. All of the above The use of a pain rating scale may assist the clinician to comprehend the intensity of a woman’s pain. Example(s) of pain rating scale(s) include: A. Numeric ranking scale B. Visual analog scale C. Verbal descriptive scale D. All of the above   A cluster of mild to moderate physical and psychological symptoms that occur during the late luteal phase of menses and resolve with menstruation is the definition of A. Premenstrual dysphoric disorder B. Premenstrual syndrome C. Menstrual mood swings D. Psychosocial syndrome   The timing of an adolescent growth spurt typically occurs ____________ in puberty than it does for boys. A. One year later B. Two years earlier C. At a similar time D. None of the above   The following symptoms are consistent with PMS except: A. Depression B. Confusion C. Breast tenderness D. Uncontrollable fits of laughter NRNP – 6552 Advanced Nurse Practice in Reproductive Health Care Midterm Exam.   Reproductive coercion includes behaviors: A. Related to pressuring or coercing a person to have sex without using physical force B. Related to pressuring or coercing a person to have sex using physical force C. That interfere with contraception use and/or pregnancy D. Any of the above   Women in the following profession have a higher rate of UTI A. Nursing B. Housecleaning C. Secretarial D. Those who do not work outside the home   Women in the following profession have a higher rate of UTI A. Nursing B. Housecleaning C. Secretarial D. Those who do not work outside the home   Clinicians are required to report certain STIs to their state public health officials. These include: A. Chlamydia B. Gonorrhea C. Syphilis D. A and B E. A, B, and C   Bone density testing for osteoporosis should start at age _______ for women and age _______ for men. A. 60; 60 B. 65; 70 C. 50; 60 D. 65; men do not need this test   A pharmacologic treatment for patients with Hydradenitis Suppurativa (HI) may include A. Clindamycin B. Minocycline C. Metformin D. All of the above   The following is/are risk factor(s) for bacterial vaginosis. A. Menstrual bleeding B. Douching C. Lack of condom use D. B and C E. A, B, and C   All of the following are risk factors for UTI, except: A. Previous UTI B. Infrequent sexual activity C. Incomplete bladder emptying D. Obesity   n women with PCOS, polycystic ovaries are due to: A. Excessive ovulation B. Chronic anovulation C. Using birth control for an extended period of time D. None of the above   The following symptoms are associated with peri-menopause and menopause. A. Excessive eye tearing B. Headache C. Fatigue D. B and C E. All of the above   Just prior to ovulation, rising levels of estradiol increases the amount of cervical mucus, making it: A. Thick and sticky B. Absent C. Thin and watery D. Yellowish and thicker   The most common type of UTI affecting women is: A. Pyelonephritis B. Asymptomatic bacteriuria C. Acute bacterial cystitis D. None of the above   Criteria for clinical diagnosis of bacterial vaginosis include the presence of three out of four of the following Amsel criteria: A. Yellowish thick vaginal discharge, pH equal or greater than 4.5; positive whiff/KOH test; presence of WBCs on microscopic examination B. Yellowish thick vaginal discharge, pH equal or greater than 4.5; positive whiff/KOH test; presence of clue cells on microscopic examination C. White, thin adherent vaginal discharge, pH equal or greater than 4.5; positive whiff/KOH test; presence of WBCs on microscopic examination D. Yellowish thick vaginal discharge, pH equal or less than 4.5; positive whiff/KOH test; presence of WBCs on microscopic examination   The contraceptive implant that is currently available in the U.S. is: A. Norplant B. Implanon C. Nexplant D. Nexplanon   Approximately 50% to 70% of women with PCOS are insulin resistant. Insulin resistance often results in: A. Compensatory hyperinsulinemia B. Compensatory hypoinsulinemia C. Excessively low blood sugars D. Weight loss   evidence from randomized trials on intimate partner violence screening support the following intervention(s) for women of childbearing age: A. Counseling B. Home visits C. Mentoring support D. A and C E. A, B, and C NRNP – 6552 Advanced Nurse Practice in Reproductive Health Care Midterm Exam   Nearly _________ pregnant women have been abused by the partner. A. 1 in 20 B. 1 in 15 C. 1 in 6 D. 1 in 2   When looking from a feminist perspective at research studies, one of the great concerns is that: A. There are too many studies involving women B. Most of the research is qualitative, which limits the applicability C. For many years, studies were done primarily on men with the findings being generalized to women D. None of the above   Marianne presents for a well woman exam. In gathering her history, she tells you she has been pregnant 3 times. She has two children, both born at 39 weeks, and had one miscarriage. Using the GTPAL system, you note that in her chart as the followingA A. G3 T2 P0 A1 L2 B. G3 T0 P2 A1 L2 C. G2 T2 P0 A1 L2 D. G2 T2 P2 A1 L3   The frontline analgesics for painful menstrual cramps are: A. Opioids B. Corticosteroids C. NSAIDs D. Hormone therapy   The endometrial cycle has three phases, which are: A. Proliferative, luteal, menstrual B. Luteal, menstrual, post-menstrual C. Proliferative, secretory, menstrual * (pg. 91) D. Secretory, luteal, menstrual   A progesterone challenge test that produces withdrawal bleeding is indicative of: A. No ovarian function B. Infertility C. Functioning ovaries D. Uterine cancer     Neisseria gonorrhea is a ___________ bacteria A. Gram positive B. Gram neutral C. Gram negative D. None of the above   Ovarian failure is diagnosed when _______ estrogen production is identified while the serum FSH is __________. A. Low; Low B. Low; High C. High; Low D. High; High   A waiting period of ____________ between bariatric surgery and pregnancy is recommended. A. 6-12 months B. 6-18 months C. 12-24 months D. 3-5 years   Trichomonas vaginalis can be asymptomatic, but when symptomatic, the vaginal discharge tends to be: A. Thick and green non odorous B. Yellow to green  frothy C. Bloody D. Thin and watery NRNP – 6552 Advanced Nurse Practice in Reproductive Health Care Midterm Exam.

NURS 6003/NURS 6003A/NURS 6003F/NRSE 6003C/NURS 6003N/NURS 6003C: Transition to Graduate Study for Nursing

Module 1 (Week 1): Networking for Academic and Professional Success

Laureate Education (Producer). (2018). 
The Foundation of Success
[Video file]. Baltimore, MD: Author.

ureate Education (Producer). (2018).
The Walden Journey to a Masters in Nursing: The Journey Begins
[Video file]. Baltimore, MD: Author.

Laureate Education (Producer). (2018). 
The Walden Journey to a Masters in Nursing: Networking and Collaboration
[Video file]. Baltimore, MD: Author.

Learning Objectives

Students will:

Analyze relationships among Walden’s vision, mission, goals, and social change initiatives to professional and academic goals

Analyze the relationship between MSN program outcomes and perspectives to professional and academic goals

Identify academic and professional collaborators for academic and professional success

Identify concepts for Walden student readiness

Identify individuals or teams to collaborate with for success in the MSN program and as a practicing nurse NURS 6003/NURS 6003A/NURS 6003F/NRSE 6003C/NURS 6003N/NURS 6003C: Transition to Graduate Study for Nursing

 

Due By

Assignment

Week 1, Days 1–2

 

Read the Learning Resources.

Compose your initial Discussion post.

Begin to compose Part 1 of your Assignment.

Week 1, Day 3

 

Post your initial Discussion post.

Begin to check your knowledge with the Quiz.

Continue to work on of Part 1 of your Assignment.

Week 1, Day 4

 

Continue to check your knowledge with the Quiz.

Continue to work on Part 1 of your Assignment

Week 1, Day 5

 

Review peer Discussion posts.

Compose your peer Discussion responses.

Continue to check your knowledge with the Quiz.

Continue to compose your final draft of Part 1 of your Assignment.

Week 1, Day 6

 

Post two peer Discussion responses.

Continue to check your knowledge with the Quiz.

Continue to compose your final draft of Part 1 of your Assignment.

Week 1, Day 7

 

Wrap up Discussion.

Final day to complete Quiz.

Deadline to submit your final draft of Part 1 of your Assignment.

 

Photo Credit: David Baumber/Vetta/Getty Images NURS 6003/NURS 6003A/NURS 6003F/NRSE 6003C/NURS 6003N/NURS 6003C: Transition to Graduate Study for Nursing

Learning Resources

Required Readings

Nurse.org. (n.d.). List of nursing organizations. Retrieved November 14, 2018, from https://nurse.org/orgs.shtml

Schmidt, K. (n.d.). 5 reasons nurses should engage in professional networking [Blog post]. Retrieved November 14, 2018, from https://blog.bluepipes.com/5-reasons-nurses-should-take-professional-networking-seriously/

Walden University. (n.d.). Connect to Walden. Retrieved November 14, 2018, from https://www.waldenu.edu/connect

Walden University. (n.d.). College of Nursing. Retrieved October 5, 2020, from https://academicguides.waldenu.edu/fieldexperience/son#s-lg-box-3837398

Review the College of Nursing’s vision and mission.

Walden University. (n.d.). Walden University catalog. Retrieved October 4, 2019, from https://catalog.waldenu.edu

Select College of Nursing, then Master of Science in Nursing (MSN). Review the MSN Learning Outcomes on this page.

Walden University. (n.d.). Walden University catalog. Retrieved October 4, 2019, from https://catalog.waldenu.edu

Select Introduction, then the link “Vision, Mission, and Goals” under the Introduction header. Review Walden’s vision, mission, and goals.

Walden University. (n.d.). Writing center. Retrieved November 14, 2018, from https://academicguides.waldenu.edu/writingcenter

Wofford, P. (2018). 10 networking tips for nurses who hate networking. Retrieved from https://nurse.org/articles/tips-for-nurse-networking/

Document: 
Academic Success and Professional Development Plan Template (Word document)

Document: 
Discussion Posting Exemplars (PDF) NURS 6003/NURS 6003A/NURS 6003F/NRSE 6003C/NURS 6003N/NURS 6003C: Transition to Graduate Study for Nursing

Discussion: Networking Opportunities

In this module, you begin laying the foundation for your academic and professional success. Your efforts begin with a vision that includes your own definition of success. Your vision may vary from those of your colleagues, but this does not mean you have to take these first steps alone.

Walden University and the College of Nursing also have a vision and mission, which include helping you to make your own vision a reality. Members of your new academic community, such as faculty, support teams, and fellow students, can also be helpful. Current practitioners and other member of the professional community can also help you to clarify your vision.

This Module’s Discussion asks you to consider how the Walden mission and vision as well as the College of Nursing’s mission and vision apply to your professional and academic goals. You will also begin to identify individuals and teams who can help you along the way as you begin designing the “blueprint”—your Academic Success and Professional Development Plan—that will guide you toward your own vision for academic and professional success.

To Prepare:

Review the Walden and College of Nursing mission and vision statements, Walden’s goals and University Outcomes, and the MSN Program Learning Outcomes presented in this Module’s Learning Resources.

Reflect on your professional and academic goals as they relate to your program/specialization.

Consider how the information in these resources fit with your own goals and to your becoming a scholar-practitioner.

Also consider academic and professional individuals and teams with whom you may collaborate in support of your efforts as a student at the university and as a professional within your organization and career NURS 6003/NURS 6003A/NURS 6003F/NRSE 6003C/NURS 6003N/NURS 6003C: Transition to Graduate Study for Nursing.

By Day 3 of Week 1

Post
 a brief introduction of yourself to your colleagues. Include an explanation as to how Walden’s vision, mission, goals, and social change initiatives relate to your professional and academic goals and to your becoming a scholar-practitioner. Also include an explanation for how the Walden MSN Program Outcomes and perspectives relate to your professional and academic goals and to your becoming a scholar-practitioner.

By Day 6 of Week 1

Respond
 to at least 
two
 of your colleagues’ posts by suggesting additional individuals and/or teams with whom you wish to collaborate or by offering additional networking strategies.

Submission and Grading Information

Grading Criteria

To access your rubric:

Week 1 Discussion Rubric

  ORDER A PLAGIARISM FREE PAPER NOW

Post by Day 3 and Respond by Day 6 of Week 1

To participate in this Discussion:

Week 1 Discussion

Quiz: Walden’s Student Readiness Orientation

You probably have a lot of questions (and perhaps some hesitation) about the journey you are undertaking. How do I navigate the online classroom? How can I have access to a library in this environment? The Student Readiness Orientation (SRO) minicourse available on your MyWalden page provides answers to such questions and helps ensure you understand how to navigate the online classroom and utilize the many resources available to you as a student at Walden NURS 6003/NURS 6003A/NURS 6003F/NRSE 6003C/NURS 6003N/NURS 6003C: Transition to Graduate Study for Nursing.

The Readiness Check will help you determine your prepardness for navigating the online classroom.

The questions presented on the Quiz are derived from the readiness check presented in the SRO.

Click on the Week 1 Quiz link after you have read the directions carefully.

The readiness check includes 15 questions in various formats including true/false and multiple choice. If you score 12 or below, please retake the exam. You may retake the exam as many times as you would like in order to achieve your desired score. Your highest score will be recorded. To retake the Quiz, click on “Take Test Again” (this does not appear as a hyperlink but works as a hyperlink when you click on the area).

To view the questions you answered correctly and incorrectly, click on your score in the “My Grades” area.

To Prepare:

Review the Walden’s SRO found on your MyWalden page.

By Day 7

Complete the quiz.

Submission and Grading Information

Submit Your Quiz by Day 7 of Week 1

To submit your Quiz:

Week 1 Quiz

Assignment: Academic Success and Professional Development Plan Part 1: Developing an Academic and Professional Network

When was the last time you read Meditation XVII of John Donne’s 
Devotions Upon Emergent Occasions
?

Unless you are a student of seventeeth-century poetry, you may not be all that familiar with this piece. However, you may be much more familiar with one of its well-known phrases: “No man is an island…”NURS 6003/NURS 6003A/NURS 6003F/NRSE 6003C/NURS 6003N/NURS 6003C: Transition to Graduate Study for Nursing.

As you begin your journey toward achieving your academic and professional goals, you have a great opportunity to network with academics and professionals who can help ensure you do not travel alone. This network can help to clarify your own vision for success and can help guide you now and in the future. To paraphrase Donne, no one is an island.

Begin creating an academic and professional network by identifying which academic and professional connections and resources with which you need to collaborate to succeed in your MSN program and as a practicing nurse.

To Prepare:

Consider individuals, departments, teams, and/or resources within Walden University and within your profession that you believe can support your academic and professional success.

Identify at least two academic and at least two professional individuals, colleagues, or teams that might help you succeed in your MSN program and as a practicing nurse.

Download the 
Academic Success and Professional Development Plan Template
.

The Assignment:

Academic and Professional Network

Complete Part 1 of your 
Academic Success and Professional Development Plan Template
. Be sure to address the following:

Identify 
at least two
 academic and 
at least two
 professional individuals or teams to collaborate with to be successful in your MSN program and as a practicing nurse.

Explain why you selected these individuals and/or teams and how they will support your success in the MSN program and as a practicing nurse.

By Day 7 of Week 1

Submit
 Part 1 of your 
Academic Success and Professional Development Plan Template NURS 6003/NURS 6003A/NURS 6003F/NRSE 6003C/NURS 6003N/NURS 6003C: Transition to Graduate Study for Nursing
.

Submission and Grading Information

To submit your completed Assignment for review and grading, do the following:

Please save your Assignment using the naming convention “WK1Assgn+last name+first initial.(extension)” as the name.

Click the 
Week 1 Assignment Rubric 
to review the Grading Criteria for the Assignment.

Click the 
Week 1 Assignment 
link. You will also be able to “View Rubric” for grading criteria from this area.

Next, from the Attach File area, click on the 
Browse My Computer
 button. Find the document you saved as “WK1Assgn+last name+first initial.(extension)” and click 
Open
.

If applicable: From the Plagiarism Tools area, click the checkbox for 
I agree to submit my paper(s) to the Global Reference Database
.

Click on the 
Submit
 button to complete your submission.

Grading Criteria

To access your rubric:

Week 1 Assignment Rubric

Check Your Assignment Draft for Authenticity

To check your Assignment draft for authenticity:

Submit your Week 1 Assignment draft and review the originality report.

Submit Your Assignment by Day 7 of Week 1

To submit your Assignment:

Week 1 Assignment NURS 6003/NURS 6003A/NURS 6003F/NRSE 6003C/NURS 6003N/NURS 6003C: Transition to Graduate Study for Nursing

NRNP – 6552 Final Exam

This test has a time limit of 2 hours and 30 minutes.

This test will save and submit automatically when the time expires.

This test can be saved and resumed at any point until time has expired. The timer will continue to run if you leave the test.

The HPV vaccine is contraindicated in:

A.

Pregnancy

B.

Breastfeeding

C.

Males

D.

A and B

E.

A, B, and C NRNP – 6552 Final Exam

 

When a woman is pregnant and calculating the last menstrual period (LMP), it should be counted from:

A.

The first day of the last period

B.

The last day of the last period

C.

The middle of the last period

D.

None of the above

 

The greatest risk factor for ovarian cancer is:

A.

Smoking

B.

Family history of ovarian cancer in a first-degree relative

C.

Taking birth control

D.

None of the above

 

HPV can be spread through:

A.

Skin-to-skin genital contact

B.

Only through actual intercourse

C.

The air as it is an airborne virus

D.

Dirty needles NRNP – 6552 Final Exam

 

ORDER A CUSTOM-WRITTEN PAPER OR EXAM HERE

All women should be offered testing for cystic fibrosis carrier status during pregnancy. This test should be done:

A.

Only once in a lifetime, as the status will not change

B.

With every pregnancy that results in a live birth

C.

With every pregnancy, including those that do not result in a live birth

D.

Every five years

 

The current FDA approval limit for the copper IUD is:

A.

3 years

B.

5 years

C.

7 years

D.

10 years

 

 

Prior to giving semen for an analysis, a male should be abstinent for:

A.

24 hours prior to the test

B.

2-5 days prior to the test

C.

2 weeks prior to the test

D.

None of the above

 

During the second trimester, a test that is offered is the alpha-fetoprotein test. This test indicates:

A.

If the woman will go to full term

B.

If the heart has any defects

C.

Whether the fetal neural tube has properly fused

D.

If the fetus is living

 

When performing a semen analysis, the following is/are measured:

A.

Semen volume

B.

Total motility

C.

pH

D.

A and B

E.

A, B, and C

 

Emergency contraception

A.

Can be used as an ongoing method of contraception

B.

Provides STI protection

C.

Is the only method that can be used after intercourse

D.

Is available by prescription only

 

 

A blood test can help confirm if a woman is beginning menopause. The test measures the level of which of these?

A.

Follicle-stimulating hormone

B.

Estrogen

C.

Progesterone

D.

Cholesterol

 

Depot medroxyprogesterone acetate (DMPA) is widely known as:

A.

Mirena

B.

Depo-Provera

C.

Mini-pill

D.

Nexplanon

 

 

Laboratory testing that might be indicated to rule out vaginal discharge include:

A.

STI testing

B.

Wet Mount

C.

Endocervical curettage

D.

A and B

E.

A, B, and C

 

 

The following vaccine(s) is/are contraindicated in pregnancy:

A.

MMR

B.

Varicella

C.

Tdap

D.

A and B

E.

A, B, and C

 

It is believed that women acquire most of their bone mass

A.

As infants

B.

In early adolescence

C.

In their 20’s

D.

In their 50’s

 

 

Carcinoma of the vulva is most often seen in women who are:

A.

Under the age of 30

B.

Pre-menopausal

C.

Post-menopausal

D.

Actively going through menopause

 

When the cervix softens in pregnancy, this is called:

A.

Goodell’s sign

B.

Cervical lip sign

C.

Mucus plug sign

D.

Vulvar sign

 

 

Pelvic adhesions can be caused by:

A.

Previous surgeries

B.

Infection

C.

Endometriosis

D.

All of the above

 

Which type of intrauterine device (IUD) is available?

A.

Copper

B.

Titanium

C.

Hormonal

D.

A and C

 

 

All of the following are barrier methods of contraception except

A.

Male condom

B.

Female condom

C.

Diaphragm NRNP – 6552 Final Exam

D.

Coitus interruptus

 

The following routines can help with sleep patterns:

A.

Taking a warm bath

B.

Exercising

C.

Changing into sleepwear

D.

A and C only

E.

All of the above

 

 

The following are preventive factors for the development of ovarian cancer:

A.

Pregnancy resulting in at least one full-term birth

B.

Factors that inhibit ovulation

C.

Breastfeeding

D.

A and C

E.

A, B, and C

 

Your patient is pregnant and has three cats. You educate her that she should have someone else clean the litter box as there is an infection that can spread through cat feces that can be harmful to the unborn baby. The infection is called:

A.

E. Coli

B.

Toxoplasmosis

C.

Cat-scratch fever

D.

Tetanus

 

Progestin-only methods are:

A.

Likely to improve menstrual symptoms

B.

Unlikely to ever cause breakthrough bleeding

C.

A and B

D.

None of the above

 

The standard treatment for patients with vulvar cancer regardless of the stage of the disease is:

A.

Laser treatment

B.

Cryosurgery

C.

Surgical resection

D.

Topical medication

 

 

The most frequent causal finding(s) on laparoscopy for chronic pelvic pain is/are:

A.

Endometriosis

B.

Adhesions

C.

Absence of pathologic condition

D.

A and B

E.

A, B, and C

 

The Tanner scale divides sexual physical maturity into ________ stages

A.

Three

B.

Five

C.

Seven

D.

Nine

 

Ectopic pregnancy involves a pregnancy that implants:

A.

Outside of the uterus

B.

In the uterus

C.

Through in vitro fertilization

D.

None of the above

 

ORDER A CUSTOM-WRITTEN PAPER OR EXAM HERE

When presenting the laboratory tests that should be performed during the pregnancy it is important to let the woman know:

A.

She must have all the recommended tests done or it can be considered child abuse

B.

She is required to have all tests done, except for the HIV test

C.

She can “opt out” of any test

D.

She should make sure that her partner signs the consent for all the tests done NRNP – 6552 Final Exam.

 

A woman who is pregnant should never lift more than ___________ during pregnancy.

A.

10 pounds

B.

22 pounds

C.

28 pounds

D.

36 pounds

 

The following is/are types of assisted reproductive technology:

A.

IVF

B.

GIFT

C.

ZIFT

D.

A and B

E.

A, B, and C

 

Contractions that may occur in early pregnancy are called:

A.

Souffle contractions

B.

Chadwick contractions

C.

Uteroplacental contractions

D.

Braxton-Hicks contraction

 

Physiologic methods of contraception include:

A.

Abstinence

B.

Coitus interruptus

C.

Lactational amenorrhea method

D.

B and C

E.

A, B, and C

 

The number one cause of mortality for both women and men in the United States is:

A.

Diabetes Mellitus

B.

Cardiovascular disease

C.

Bone cancer

D.

Dementia

 

 

Women who have a history of immediate hypersensitivity to __________ should not receive the 4-valent or 9-valent HPV series NRNP – 6552 Final Exam.

A.

Milk products

B.

Eggs

C.

Cats

D.

Yeast

 

 

Taylor just found out she is pregnant. She has irregular periods so she is not exactly sure how far along she is, but she thinks it is pretty early. She asks you about an ultrasound to find out how many weeks she is. You tell her that:

A.

Early in the pregnancy is ideal because the ultrasound dating is more accurate than later in the pregnancy

B.

She should wait a couple of months as ultrasound dating is most accurate in the second trimester of pregnancy

C.

An ultrasound really won’t be able to tell her that information

D.

An ultrasound is contraindicated this early in the pregnancy

 

Blood serum pregnancy tests can detect the presence of HCG ________ days after fertilization.

A.

24 hours

B.

1-3 days

C.

3-5 days

D.

8-10 days

 

All of the following are disadvantages of Combined Oral Contraceptives except:

A.

The need for daily pill taking

B.

The ongoing cost of the method for some individuals

C.

Side effects for some women

D.

Reduction in the risk of some types of cancer

 

When assessing fetal heart tones with the doppler, the normal range is:

A.

60-80 BPM

B.

100-120 BPM

C.

120-160 BPM

D.

160-200 BPM

 

Nonlatex condoms:

A.

Fit tighter on the penis than latex condoms

B.

Come in a variety of colors

C.

Have an increased risk of breakage or slippage during intercourse than latex condom

D.

Lead to a greater incidence of allergies than latex condoms

 

A generic prenatal vitamin supplement should be prescribed and should include:

A.

Iron, folic acid, and vitamins

B.

Mercury, folic acid, and vitamins

C.

Vitamins only with no other supplements

D.

Iron and Vitamins with no other supplements NRNP – 6552 Final Exam

 

he bluish hue that the cervix takes on during pregnancy is called:

A.

Goodell’s sign

B.

Baby Blues sign

C.

Cervical ripening sign

D.

Chadwick’s sign

 

WIC is a federally operated assistance program that also offers dietary counseling and provides vouchers for healthy foods for women living at or below 185% of the poverty level. WIC stands for:

A.

Women in Care

B.

Why I Care

C.

Women, Infants, and Children

D.

Wonderful Infants and Children

 

To reduce risk of illness during pregnancy, fish and shellfish should be:

A.

Served raw

B.

Cooked thoroughly

C.

Served at every meal

D.

Encouraged as often as possible

 

As women age, adipose tissue is redistributed and begins to accumulate in the:

A.

Hips and thighs

B.

Breasts

C.

Waist

D.

Triceps area

 

When taking alendronate (Fosamax) for postmenopausal osteoporosis,

A.

It should always be taken with food

B.

It should be taken first think in the morning on an empty stomach

C.

It should be taken with an 8 oz glass of water

D.

B and C

 

The following gonadotropins are responsible for regulating gynecologic organ activities.

A.

Testosterone and androgen

B.

FSH and progesterone

C.

FSH and LH

D.

LH and prolactin

 

In a male, the urethra carries ___________through the penis.

A.

Urine

B.

Semen

C.

Testosterone

D.

A and B

E.

A, B, and C

 

Urogenital changes that can occur with menopause include:

A.

Vaginal dryness

B.

Dyspareunia

C.

Urinary incontinence

D.

A and C

E.

A, B, and C

 

A complete male evaluation usually includes:

A.

Two semen analyses, approximately one hour apart

B.

Two semen analyses, approximately one month apart

C.

One complete semen analysis

D.

A fractionated semen analysis

 

Urine pregnancy tests are considered to be:

A.

Reliable

B.

Unreliable

C.

Expensive

D.

Invasive

 

 

Ibandronate (Boniva, a medication for osteoporosis, can be administered:

A.

Orally

B.

Through an IM injection

C.

Intravenously

D.

A and C

E.

A, B, and C

 

The gold standard for assessing uterine bleeding and diagnosing endometrial cancer is:

A.

Endometrial biopsy

B.

Transvaginal ultrasound

C.

Dilation and curettage

D.

CA-125 levels NRNP – 6552 Final Exam

 

Ovarian reserve testing assesses a woman’s reproductive potential by:

A.

Measuring the quality of her remaining oocytes

B.

Measuring the quantity of her remaining oocytes

C.

Assessing the color and motility of her remaining oocytes

D.

A and B

E.

A, B, and C

 

The vaginal ring (Nuva ring) is:

A.

Replaced on a weekly basis

B.

Left in place for 21 days and then removed for a week

C.

Replaced on a monthly basis

D.

Placed in the vagina at least 2 hours prior to intercourse and removed at least 6 hours after intercourse

 

To reduce the discomfort of hot flashes with menopause, recommendation include:

A.

Wearing breathable fabrics

B.

Wearing silk and polyester

C.

Avoiding a fan as it makes the hot flashes worse

D.

None of the above

 

 

Progestin-only contraceptives are generally considered safer for women who:

A.

Have a diagnosis of Diabetes

B.

Experience Migraines with aura

C.

Are 15 or younger

D.

Overweight

 

The first-line medication for ovulation induction in women who do not have PCOS is:

A.

Clomiphene citrate

B.

Letrozole

C.

Pergonal

D.

Follistim

 

The three trisomies for which testing is offered during the second trimester are:

A.

13. 18, 21

B.

16, 19, 21

C.

3, 9, 19

D.

16, 21, 22

 

The following are risk factors for breast cancer except:

A.

Menarche after the age of 12

B.

Nulliparity

C.

Menopause at age 55 years or older

D.

First full-term pregnancy after age 30

 

Men have little or no measurable decline in fertility before age:

A.

35 to 40

B.

45 to 50

C.

55 to 60

D.

65 to 70

 

In a woman who is 20 weeks pregnant, the fundus is typically the same height as:

A.

The symphysis pubis

B.

The umbilicus

C.

The xiphoid process

D.

None of the above

 

The majority of vulvar malignancies are:

A.

Squamous cell carcinomas

B.

Basal cell carcinomas

C.

Adenocarcinomas

D.

Malignant melanomas

 

During pregnancy, blood volume:

A.

Remains the same as pre-pregnant amounts

B.

Increases by 10%

C.

Increases by 30-50%

D.

Decreases by 20%

 

The following are risk factors associated with acquiring HPV except:

A.

Nulliparity

B.

Early age at first intercourse

C.

Having multiple sexual partners

D.

Smoking NRNP – 6552 Final Exam

NRNP-6565-Synthesis in Advanced Nursing Practice Final Exam

NRNP-6565-4-Syntesis Advanced Nursing Practice Care-2021-Fall-QTR-Term-wks-1-thru-11-(08/30/2021-11/14/2021)-PT27
 

Take Test: Exam – Week 10

Question 1

Osteoporosis is defined as having a T-score of _____ or less than the standard deviation of a healthy individual.

1

-1.5

-2.5

-3.5

 

Question 2

A smooth round nodule with a pearly gray border and central induration best describes which type of skin lesion? NRNP-6565-Synthesis in Advanced Nursing Practice Final Exam

Seborrheic keratosis

Basal cell carcinoma

Malignant melanoma

Herpes zoster

Question 3

A 59 year old man with chronic prostatitis should be treated with trimethoprim 80mg-sulfamethoxazole 400mg (TMP-SMX,Bactrim) for how long?

3 to 7 days

14-21 days

 3 to 6 weeks

6 to 12 weeks

 

Question 4

Treatment for H. pylori-negative ulcers includes all the following except: NRNP-6565-Synthesis in Advanced Nursing Practice Final Exam

Stop NSAIDS

Stop smoking

Prilosec for 4–8 weeks

Triple therapy including Biaxin, Flagyl, and amoxicillin

ORDER A CUSTOM-WRITTEN PAPER OR EXAM HERE

Question 5

Carlos is a 64 y/o male who has previously been diagnosed as a Category A COPD patient based on Gold guidelines (2017). The Category A patient group includes which of the following?

Minimally symptomatic (low risk of exacerbation)

More symptomatic (low risk of exacerbation)

Minimally symptomatic (high risk of exacerbation)

High risk

 

Question 6

Helicobacter pylori is implicated as a causative agent in the development of duodenal or gastric ulcers.  What teaching should the nurse practitioner plan for a patient who has a positive Helicobacter pylori test?

 It is highly contagious and a mask should be worn

 Treatment regimen is multiple lifetime medications

Treatment regimen is multiple medications taken daily for a few weeks

Treatment regimen is complicated and is not indicated unless the patient is symptomatic NRNP-6565-Synthesis in Advanced Nursing Practice Final Exam

 

 

Question 7

Metabolic syndrome is characterized by all the following traits 
except

Obesity

Hypertension

Dyslipidemia

Hypoglycemia

 

Question 8

What is the first line of treatment for eczema? Select all that apply.

a.

Hydrocortisone 2.5%

b.

Triamcinolone acetonide

c.

Oral steroids

d.

None of the above

 

 

Question 9

Acanthosis nigricans is associated with all the following except:

Diabetes

Metabolic syndrome

Obesity

Cancer of bladder

 

 

Question 10

The NP recognizes that potentially inappropriate medications for older adults (Beers List Criteria) may include:

a.

NSAIDs

b.

Alpha-blockers

c.

Zolpidem

d.

Cardiac drugs

e.

All of the above

 

Question 11

A 19-year-old bisexual female wants to get tested for HIV. Based on CDC guidelines, what is the appropriate order of testing for HIV?

a.

HIV-1/HIV-2 antibodies and P24 antigen

b.

HIV RNA PCR

c.

HIV-1 RNA

d.

HIV antibody differentiation immunoassay

 

 

Question 20

________________vaccine is given in two separate doses to prevent Shingles.

A.

Shingrix

B.

Pneumococcal

C.

Influenza

D.

TDAP

 

Question 21

Mr. Richards is a 65 year old caucasian male who presents to your office with complaints of decreased arm swing and cogwheel rigidity.  What conditions are these symptoms a manifestation of?

 

 

Multiple Sclerosis

Parkinson’s Disease

Vascular Dementia

Rheumatoid Arthritis

 

Question 22

Which of the following glands is responsible for calcium balance in the body?

Posterior pituitary

Parathyroid glands

Thyroid gland

Pineal gland NRNP-6565-Synthesis in Advanced Nursing Practice Final Exam

 

Question 23

The NP recognizes that the main focus of treatment for Anemia is:

replenishing iron stores

 management of the underlying disorder

 providing for adequate nutrition high in iron

administration of monthly vitamin B12 injections

 

Question 24

The use of steroids in the treatment of fungal infections will worsen the infection.

True

False

 

Question 25

State laws about NP practice take two forms:

a.

Regulations and prescriptive authority

b.

Statutes and Regulations

c.

Regulations and prescriptive authority

d.

Regulations and Licensure

 

Question 26

Jason is 72 y/o COPD patient who has a 50-year history of smoking. He now has pneumonia. The most likely causative organism for his pneumonia is: NRNP-6565-Synthesis in Advanced Nursing Practice Final Exam

Mycoplasma pneumoniae

Chlamydia pneumoniae

H. influenzae bacteria

None of the above

 

Question 27

One of the most common side effects of SSRIs is:

 Nausea

 Ataxia

 Erectile dysfunction

 Seizures

 

Question 28

Which of the following are non-antibiotic strategies to prevent UTIs?

Estrogen therapy

Cranberry juice/extract

Methenamine salts

Lactobacillus

All of the above

 

Question 29

A nurse practitioner (NP) is applying for an NPI number. The NP recognizes that the purpose of NPI is to

a.

A number for ICD-10 code

b.

A number for Medicare/Medicaid billing

c.

To reimburse patients for receiving patient care

d.

To bill to Tricare insurance

 

Question 30

You would recommend the pneumococcal vaccine (Pneumovax) to patients with all of the following conditions except:

a.

HIV infection

b.

Asthma

c.

Sickle Cell anemia

d.

G6PD-deficiency anemia

 

Question 31

All of the following are pharmacological treatments for osteoporosis 
except
:

Biphosphates

Thyroid stimulating hormone

Tamoxifen

Parathyroid hormone analog

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Question 32

An older woman with osteoporosis wants to be treated with Fosamax. The nurse practitioner (NP) recognizes that the patient is not a good candidate for this drug because of

a.

Stomach/intestinal problems

b.

Jaw pain

c.

A and B

d.

A only

 

Question 33

A nurse practitioner (NP) portfolio should include some but not all of the following:

a.

Statement of career goals, special interests, transcripts, diploma, letters of recommendation

b.

Statement of career goals, preferred salary, special interests, diploma, letters of recommendation from professors

c.

Statement of career goals, special abilities, preferred salary, special interests, diploma

d.

All of the above NRNP-6565-Synthesis in Advanced Nursing Practice Final Exam

 

 

Question 42

Statues describing NP scope of practice fall into 
all but one
 of the categories:

a.

Defined by statute.

b.

Defined by regulation.

c.

Scope of practice is defined.

d.

Scope of practice is not defined.

 

Question 43

Since UTIs are never “normal” in a male, what should the NP rule out as the cause of the infection?

Ureteral stricture

Acute prostatitis

STDs

All of the above

A & C only

 

Question 44

An NP recognizes that the five major categories of third-party payers are:

a.

Medicare, Medicaid, self-pay, Indemnity insurance companies, HMOs

b.

Medicare, Medicaid, self-pay, PPOs, HMOs

c.

Medicare, Medicaid, Indemnity insurance companies, Managed-care organizations (MCOs)

d.

Indemnity insurance companies, managed-care organizations, PPOs, HMOs, Self-Pay

 

Question 45

Mr. Trellis is a 65 year-old man who presents with complaints of nocturia. Which of the following should be included in the differential diagnosis?

 

Urethral polyp

Constipation

Benign Prostatic Hypertrophy

Posterial Urethral lesion

 

Question 46

Cellulitis is usually caused by a gram-negative bacterium.

True

False

 

Question 47

Juan, an 82 y/o male, is brought to the clinic by his daughter with LLQ pain, anorexia, nausea, and vomiting. Palpation of the abdomen reveals a positive rebound tenderness, positive Rovsing’s sign, and rigid abdomen. The NP in Juan’s case should: NRNP-6565-Synthesis in Advanced Nursing Practice Final Exam

Refer to ER

Try an antiemetic

Draw labs

Send for a CAT scan

 

Question 48

Mr. Knight, an obese middle-aged client presents with a month of nonproductive irritating cough without fever.  He also reports occasional morning hoarseness.  What should the differential include?

 

 

Atypical pneumonia

Peptic ulcer disease

Gastroesophageal reflux

Mononucleosis (Epstein-Barr)

 

 

Question 49

Pneumonia vaccine should be given annually. True or False?

True

False

 

 

Question 50

Ms. Stevens, a 70 year old patient with community acquired pneumonia presents with chills, productive cough, temperature of 102.1, pulse 100, respiration 18, BP 94/52, WBC 12,000, and blood urea nitrogen (BUN) 24mg/dl.  She has a history of mild dementia and his mental status is unchanged from her last visit.  These findings indicate that this patient:

Can be treated as an outpatient

Can be treated with oral antibiotics

Requires a high dose of parenteral antibiotics

requires hospitalization for treatment

 

Question 51

Ms. Roberts is being seen today at your office.  She reports symptoms of Allergic Rhinitis.  The NP recognizes that Second-generation antihistamines such as loratadine (Claritin) are prescribed for seasonal allergies because they:

Are prescription products and are therefore covered by insurance

Are more effective than first-generation antihistamines

are less sedating than first-generation antihistamines

can be taken with CNS sedatives, such as alcohol

Question 52

Folliculitis is most commonly due to:

Staphylococcal infection

Dermatophytes

Varicella zoster

E coli

Question 53

In pulsus paradoxus, even if the pulse cannot be palpated, it can still be heard by using a BP cuff and stethoscope.

True

False

 

Question 54

You are seeing Ms. Ellie,  a 60 year old female with COPD.  She tells you that she has been using albuterol with good relief for shortness of breath. She is using it 3-4 times daily over the past 4 weeks.  How should the NP manage this?

Add a long-acting beta agonist

 Encourage its use at the same time every day xTell him to use it only once a day . Add a long-acting beta agonist

 Add an oral steroid

Add an ace inhibitor

 

Question 55

Bacterial vaginosis has all the following signs/symptoms 
except
:

Fish-like odor

Milk-like discharge

Non-itchy vulva

Red vulvovaginal

 

Question 56

The NP recognizes that the increased presence of which of the following ina  urinalysis indicates the presence of bacteria or protein, which is seen in severe renal disease and could also indicate urinary calculi? NRNP-6565-Synthesis in Advanced Nursing Practice Final Exam

Crystals

Nitrates

Casts

Ketones

 

Question 57

A 25-year-old patient states that he is on an HMO plan. The nurse practitioner (NP) stands for

a.

Home Management Organizations

b.

Health Management Organizations

c.

Health Movement Organizations

d.

Health Maintenance Organizations

 

Question 58

Mr. Reynolds is a 66 year old male who is a Pastor of a church.  He informs you that he has just returned from a 6 month missionary trip to South Africa.  He reports unremitting cough, hemoptysis, and an unintentional weight loss of 10 pounds over the last month.  These symptoms should prompt the clinician to suspect:

Malaria

Tuberculosis

Legionnaires’ Disease

Pneumonia

 

Question 59

Hillary is an 18 y/o Caucasian who comes to the clinic with a chief complaint of hirsutism, acne, and amenorrhea. Her most likely diagnosis is:

Polycystic ovary syndrome (PCOS)

Ovarian cancer

Hyperprolactinemia

Pregnancy

 

Question 60

Abby is a 63 y/o patient who is known to have atrial fibrillation and has been on Coumadin for 2 years. Her INR is 2.4. This ratio is considered:

Normal

High

Low

 

Question 61

As the NP prepares to manage a patient with Anemia, the NP knows that The pathophysiological hallmark of Anemia of Chronic Disease is: NRNP-6565-Synthesis in Advanced Nursing Practice Final Exam

Depleted iron stores

Chronic uncorrectable bleeding

Impaired ability to use iron stores

Reduced intestinal absorption of iron

 

Question 64

Medicare Part A covers all the following except:

a.

Custodial care

b.

Inpatient psychiatric hospital care

c.

Skilled nursing facility care

d.

Inpatient hospital care

 

 

Question 68

Ms. Lashley, a 70  year old obese female presents complaining of persistent right upper quadrant pain.  She reports that she has not had any prior abdominal surgeries.  Which of the following laboratory studies would be most indicative of acute cholecystitis?

 

 

C-reactive protein level of 3 mg

White blood cell count of 11,000

Direct serum bilirubin level of 0.3 mg/dl

Serum amylase level of 145 U/L

 

Question 69

The screening for melanoma includes: (Select all that apply.)

a.

Asymmetry

b.

Black texture

c.

Border irregular

d.

Color varies in the same region

e.

Diameter greater than 6 mm

f.

Change in size

 

uestion 70

If the TSH is decreased then the patient needs to be worked up for hypothyroidism.

True

False

 

Question 71

The diagnosis of a subclinical hypothyroidism would be identified by which lab test results?

Increased TSH and normal free T4

Decreased TSH and normal free T4

Increased TSH and increased free T4

Decreased TSH and decreased free T4

 

S1 points   

Question 72

The most common way for testing COVID-19 is performed by what route? NRNP-6565-Synthesis in Advanced Nursing Practice Final Exam

a.

Oral

b.

Nasopharyngeal

c.

Blood test

d.

None of the above