Tag: Clinical-Nursing

Most test analysis programs report the mean, or arithmetic average, of the raw scores on the test; in this case (Table 11.1), it is 75.4. The mean percent score is determined by dividing the mean raw score by the total number of items on the test. The mean percent score is equal to the mean raw score in this example because there are 100 items on the test.

One disadvantage of the mean is that it is sensitive to extreme scores. An extreme score, whether very high or very low, can pull the mean toward its direction. This effect is particularly problematic when there is a small group of scores (Reynolds, Livingston, & Wilson, 2008).

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For example, let’s look at the distributions in Table 11.2. Each distribution has an extreme score of 15, yet the smaller number of scores is affected more dramatically than the larger number of scores. The mean of the “A Scores” is 7.4, a score that does not even appear in the distribution, while the score of 15 has a less dramatic effect on the mean of the “B Scores,” which is 5.95. It is obvious from these examples that you must consider the effect of extreme scores when interpreting the mean on a test.

It is important to examine the relationship of the mean to the passing standard that you have set. If, for example, your passing standard is 75%, this test has an average score at the passing level. Several factors must be considered when interpreting the mean:

Were there extreme scores in the distribution?

What was the quality of teaching, on a range between effective and ineffective?

What was the students’ level of effort to achieve the outcomes, on a range between maximal and minimal?

Where did the material/objectives fit, on a range between too easy and too difficult?

How difficult were the items, on a range between too easy and too hard?

If a test has a very low mean, you should investigate whether there is a problem with one of the questions listed above. As Haladyna (1997) points out, if you intentionally give difficult tests, you should adjust your grading policy to ensure that you assign grades fairly in relation to the other courses that students take. Similar consideration should be made if your tests are consistently too easy. The ideal goal is to have a test with a mean that reflects a range of student abilities. A test should be neither too easy nor too difficult, but should reward those students who are high achievers and should identify those who have not met the course objectives. Chapter 13, “Assigning Grades,” discusses the issues surrounding grade assignment.

NRNP 6540 Week 1: Knowledge Check Quiz 100% correct answers

Question 1

1
/ 1
 pts

When would the influenza vaccine be absolutely contraindicated?

Correct!

 

A previous severe allergic reaction to influenza vaccine

 

Correct!

 

A severe allergic reaction to eggs

 

Progressive allergic reaction symptoms

 

Skin induration greater than 10 mm

 

Question 2

1 
/ 1
 pts

A 66 year old patient is planning  a trip abroad.   He looked at the CDC web site and found that yellow fever is recommended but only for people age 1 to 59.    He wants to know why he shouldn’t get the vaccine?

People 60 and older are not at risk for developing yellow fever

 

Correct!

Risk for severe side effects from the vaccine are higher in people 60 and over

 

The effects of the disease are less than the side effects of the vaccine in people age 60 and over

 

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Question 3

1
/ 1
 pts

What is the maximum number of doses of PPSV23 that can be given to high-risk older adults 65 or older?

You Answered

one

 

two

 

Correct!

three

 

four

 

NRNP 6540 Week 1: Knowledge Check Quiz 100% correct answers Question 4

1
/ 1
 pts

What immunizations you would give to your 65-year-old patient with HIV infection and a CD4 count of 200/mm or less?

 

Correct!

Quadrivalent high dose inactivated influenza vaccine

 

MMR

 

Correct!

Tdap

 

Correct!

Hepatitis A

 

Question 5

1 
/ 1
 pts

The NP sees a 69-year-old patient who recently moved to town and does not remember his last tetanus shot.   The patient did not receive any immunizations as a child.    What would you do?

One dose of Td now

 

One dose of Tdap now

 

One dose of Td now and then one dose of Tdap in 4 weeks

 

Correct!

One does of Tdap now, one dose of Td in 4 weeks, and another dose of Td in 6-12 months.

 

NRNP 6540 Week 1: Knowledge Check Quiz 100% correct answers Question 6

1
/ 1
 pts

The NP is caring for older adults in a nursing home. As a general rule, patients over 65 years of age and in general good health can receive which immunizations?

Correct!

Quadrivalent high dose inactivated influenza vaccine

 

Correct!

Two doses of RZV administered 2 to 6 weeks apart

 

Correct!

Tdap

 

Correct!

PCV 15

 

Question 7

1
/ 1
 pts

What are the three types of influenza vaccines available?

Correct!

Inactivated influenza vaccine (IIV)

 

Correct!

Recombinant influenza vaccine (RIV)

 

Correct!

Live attenuated influenza vaccine (LAIV).

 

Live Recombinant influenza vaccine

 

Question 8

1
/ 1
 pts

The NP is monitoring the immune response following hepatits B vaccination in an elderly hemodialysis patient.  What test should be ordered and when to assess the immune response?

HBsAg completed 6 months after the last dose

 

HBsAg completed 1 month after second dose

 

Correct!

 

HBsAb completed 2 months after the last dose

 

HBsAb completed 6 months after 2nd dose

 

Question 9

1
/ 1
 pts

The NP sees a 66-year-old patient who is immunocompromised, and their penumococcal 
vaccine history is unknown
.  According to the CDC, what would you recommend for pneumococcal vaccination?

You Answered

 

One dose of PCV15 now and 1 dose of PPSV23 in one year.

 

One dose of PPSV23 now and one dose of PCV15 in one year

 

Correct!

One dose of PCV15 now and 1 dose of PPSV23 in eight weeks

 

One dose of PPSV23 now and 1 does of PCV15 in 8 weeks.

 

Question 10

1
/ 1
 pts

What are the most current recommendations for vaccination of patients near the end of life, including hospice patients?

Hospice patients should get the same vaccinations as everyone else

 

No vaccinations are recommended for hospice patients

 

Correct!

Each patient should be considered on a case by case basis.

NRNP 6540 Week 1: Knowledge Check Quiz 100% correct answers

Median

The median in this sample is 77, which represents the middle point in this group of raw scores. In a normal distribution, the
mean
and the median are the same. If a distribution is positively skewed, meaning that the test is very difficult, with most scores at the low end of the distribution and few very high scores, the mean is pulled to the positive end of the distribution and is higher than the median (Reynolds et al., 2008).A positively skewed distribution, such as the one depicted in Figure 11.1, signals a problem. Why are there so few high scores? What went wrong in the instructional process?

If a distribution is negatively skewed, it means the test was easy for the group, with most scores at the high end of the distribution and few very low scores. The distribution depicted in Figure 11.2 is one you might expect in a nursing class. After all, all students who are admitted to a nursing program are capable of achieving the objectives.

fig 11.2

The mean in a negatively skewed distribution is pulled toward the negative end of the distribution and is lower than the median (Reynolds et al., 2008). Therefore, the mean can give the wrong impression whenever a distribution is seriously skewed. The terms positively skewed and negatively skewed can seem counterintuitive. Remember this tip: A “positively” skewed distribution has its tail in the positive end of the distribution, while a “negatively” skewed distribution has its tail in the negative end of the distribution. A distribution that is not skewed has the same or very close values for the mean and the median; it resembles a bell and is referred to as a normal distribution or a bell curve.The mean and median in the example of Table 11.1 are close, which means there are probably not many extreme scores in the distribution and the mean is close to the median. The mean in this case can be interpreted as representing a typical score. Of course, you should review the score distribution, which is also included in the test analysis report, before you decide whether the mean actually represents a typical score. Interpretation of graphic and frequency distributions is discussed later in this chapter.

NURS 6630 Week 3: Self Assessment Quiz with 100% correct answers

Question 1

G-protein coupled receptors are targets for several psychiatric medications. Given what we know about these receptors, what is the ultimate result we will see when one of them is activated in a way that would potentiate an action?

A. Intracellular activation of second messengers

 

B. Protein phosphorylation

 

Correct!

C. Modification of gene expression

 

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A and B are both steps in the activities seen leading up to modification of gene expression.

Question 2

Upon blocking a Serotonin reuptake pump, what happens in the synaptic cleft and on the post synaptic cell membrane?

A. The result will be an increase in available Serotonin in the synaptic cleft causing the post synaptic cell to increase the number of Serotonin receptors.

 

Correct!

B. The result will be an increase in the available Serotonin in the synaptic cleft causing the post synaptic neuron to reduce the number of Serotonin receptors.

 

C. The result will be an increase in Serotonin in the synaptic cleft resulting in an increase in reuptake pumps on the presynaptic neuron.

 

D. The result will be an increase in Serotonin in the synaptic cleft resulting in a decrease in reuptake pumps on the pre-synaptic neuron. NURS 6630 Week 3: Self Assessment Quiz with 100% correct answers

 

A, C, and D are misrepresentations of what occurs when you increase Serotonin in the synaptic cleft. There is no effect on the pre-synaptic neuron, and the increases in Serotonin result in a reduction of receptor concentration on the post-synaptic neuron.

Question 3

Motivation is a component of patient-focused interventions to enhance adherence. Based on the transtheoretical model, readiness to change can fluctuate across five stages. Which stage is represented by the patient who is aware that a problem exists and, while seriously thinking about overcoming it, has not yet committed to a plan of action?

Preparation

 

Action

 

Correct!

Contemplation

 

Maintenance

 

Question 4

Receptors trigger one of two effector pathways resulting in changes in neuronal activity. These changes will, ultimately, effect gene expression. Which effector pathway is characterized by ion flux through transmitter-activated channels resulting in an altered membrane potential and neuronal activity?

A. Slow effector pathways

 

B. Modulated effector pathways

 

Correct!

C. Rapid effector pathways

 

D. NMDA glutamate receptor pathways

 

Answer B is fictitious, D is a type of rapid effector pathway, and A represents G-protein coupled receptors.

Question 5

Of the components of patient-focused interventions to enhance adherence, which component includes the following strategies: adaptive thinking, use of cues, and support?

Motivation

 

Correct!

Skills

 

Logistics

 

Education

 

Skills include adaptive thinking, problem solving, use of cues, and support.

Question 6

Treatment adherence is affected by several different factors. Clinical factors include mood, anxiety, psychosis, and substance misuse. There are also patient factors such as knowledge, attitude, and beliefs; economic and racial/ethnic disparities, and clinical encounters. A patient who presents hopeless, with decreased energy, and poor concentration is affected by which factor?

Substance misuse

 

Knowledge deficits

 

Attitude ad belief system

 

Correct!

Mood

 

These are signs of an altered mood.

Question 7

Neurotransmitters are defined by four essential characteristics. These are:

A. Neurotransmitters are synthesized within presynaptic neurons. NURS 6630 Week 3: Self Assessment Quiz with 100% correct answers

 

B. Depolarization of a neuron results in the release of a neurotransmitter, which exerts a multitude of actions on the postsynaptic neuron.

 

C. Their action on postsynaptic neurons can be replicated by administering a drug that mimics the activity of the endogenous neurotransmitter.

 

D. Their action in the synaptic cleft is terminated by a specific action.

 

Correct!

E. A, C, and D only

 

Answer B should read a “discrete” (not multitude) action on the post synaptic neuron.

Question 8

Neurotransmission is unidirectional insofar as chemical and electrical conduction is concerned within the individual neuron. Of the following descriptions, which best characterizes the order of neurotransmitter/receptor interaction that results in an electrical signal impulse and the release of another neurotransmitter for interaction in the synaptic cleft (signal conduction through a neuron)?

Cell body, dendrites, Axon, Axon terminals

 

Dendrites, Axon, Cell body, Axon, Axon terminals

 

Correct!

Dendrites, Cell body, Axon, Axon terminals

 

Axon terminals, Axon, Cell body, Dendrites

 

All of the other options are mis-sequenced in signal conduction.

Question 9

The synaptic cleft is best characterized by which of the following statements?

A. The synaptic cleft is the space between a single neuron’s dendrites and axon terminals in which intracellular communication occurs through the release of neurotransmitters allowing for signal conduction throughout the central nervous system.

 

B. The synaptic cleft is the space between the cell body and axon terminals that allows for release of neurotransmitters from the presynaptic neuron for intercellular communication with an adjacent neuron (post synaptic neuron).

 

Correct!

C. The synaptic cleft is an area where dendrites and axon terminals are within close proximity, allowing for the release of a neurotransmitter from a presynaptic neuron that can interact with receptors on dendritic cells of a post synaptic neuron, which is the main basis for intercellular communication of neurons.

 

Answer A represents a neuron communicating with itself and Answer B states that the synapse is the space between the cell body (not dendrites) and axon terminals.

Question 10

The human brain is subcategorized into four major structures. These structures include the cerebral cortex, brainstem, subcortical structures, and the cerebellum. Of these major categories, which one houses the area of the brain that has been found in some neuropathological studies of patients with schizophrenia to be of smaller size?

Cerebral cortex

 

Brainstem

 

Correct!

Subcortical structures

 

Cerebellum

 

The area of the brain in question is part of the thalamus, which is located in the subcortical structures. The other options are incorrect, geographically speaking. NURS 6630 Week 3: Self Assessment Quiz with 100% correct answers

Question 11

1
Neurons are classified in several different ways. From the following statements, select which ones are true.

The two structural classifications are projection neurons and local inter-neurons.

Function classifications are made up of two subcategories: excitatory and inhibitory.

Histological classification includes bipolar, unipolar, and multipolar.

Classifications using a combination of structural, functional, and neurotransmitter type provide the most robust and useful description.

Classification by neurotransmitter type alone provides the most useful description.

I only

III only

I, II, and V only

 

I, II, III, IV, and V

Correct!

I, III, and IV

Statement II would need to include modulatory function to be correct, and Statement V does not include structural and functional classification systems.

Question 12

Which of the following consists of all the known major neurotransmitters that are relevant in psychiatry?

glutamate, GABA, dopamine, serotonin, norepinephrine, histamine, steroids, nitric oxide

 

Correct!

glutamate, GABA, dopamine, norepinephrine, serotonin, acetylcholine, histamine, endogenous opioids, steroids, cannabinoids, nitric oxide

 

glutamate, GABA, dopamine, serotonin, acetylcholine, endogenous opioids, nitric oxide, cannabinoids, steroids

 

glutamate, GABA, dopamine, serotonin, norepinephrine, endogenous opioids, steroids, histamine, nitric oxide

 

all the other options are missing neurotransmitters considered important in psychiatry

Question 13

G-protein coupled receptors are examples of what type of effector pathway?

Correct!

A. Slow effector pathways

 

B. Rapid effector pathways

 

C. NMDA glutamate receptor pathways

 

D. Modulated effector pathways

 

Answer D is fictitious, B represents ion channel receptors, and C is a type of rapid effector pathway.

Question 14

Which neurotransmitter is considered the major excitatory neurotransmitter?

A. Glycine

 

B. GABA

 

Correct!

C. Glutamate

 

D. Serotonin

 

A and B are inhibitory, and D is involved in mood and sleep.

Question 15

Glia cells play a supportive role to the neuron. A few of the functions of the glial cells include providing nutrition, maintaining homeostasis, stabilizing synapses, and myelinating axons. The glial cells are categorized as microglia and macroglia. Of these two cell types, which one plays an active and critical role in glutamatergic neurotransmission by providing a co-agonist required for glutamate receptor function?

microglial

 

Correct!

macroglial

 

Microglial cells are small, phagocytic cells related to peripheral macrophages.

Question 16

If a patient admits to taking his medication every other day (instead of daily, as prescribed), a potential concern would be:

A. Sufficient understanding or acceptance of the illness

 

B. Abuse of the medication

 

Correct!

C. Expense

 

D. Is the desired effect recognized at a lower daily dose? NURS 6630 Week 3: Self Assessment Quiz with 100% correct answers

 

A represents a patient taking his medication sporadically, B represents a patient taking too much medication, and D represents a patient taking a lower-than-prescribed dose but daily

Question 17

When dopamine (subtype 2) receptors are blocked in this pathway (system), it is evident by EPS.

A. Mesocortical

 

B. Tuberoinfundibular

 

Correct!

C. Nigrostriatal

 

D. Mesolimbic

 

D is associated with positive symptoms in schizophrenia, B is associated with lactation, A is associated with affect.

Question 18

Introducing adherence in facilitating treatment goals is something that would be necessary in a patient who has previously displayed nonadherence patterns.

True

 

Correct!

False

 

It is introduced as early as possible in treatment to mitigate the risks associated with nonadherence.

Question 19

A patient arrives in the ED via EMS having a grand mal seizure. The ED physician instructs the RN to give 10 milligrams of Diazepam IV X1 dose STAT. The patient’s seizure breaks within 2 minutes of the Diazepam being administered. The mechanism by which this medication causes rapid resolution of seizure activity is via which receptor type (effector pathway/receptor subtype)?

A. Slow effector pathways/G-protein coupled receptor

 

B. Slow effector pathway/ion channel

 

C. Rapid effector pathways/G-protein coupled receptor

 

Correct!

D. Rapid effector pathway/ion channel

 

Options B and C are mismatched, and Option A shows effects days to weeks after activation.

Question 20

Serotonin (5HT) is a neurotransmitter associated with mood, sleep, and psychosis. There are several serotonin receptors all over the human body. A unique aspect of the second generation antipsychotics is their ability to block 5HT2a receptors. What is the effect of this inhibition?

Correct!

A. Stabilizes dopamine concentrations in the CNS

 

B. Induces anxiety

 

C. Causes hallucinations

 

D. Reduces platelet function

 

B represents antagonism of 5HT1a, C represents a 5HT2a agonist, and D represents what happens when you inhibit SERT. NURS 6630 Week 3: Self Assessment Quiz with 100% correct answers

Range

In the example in Table 11.1, the range of the distribution is 41, the difference between the high (93) and low (52) scores on the test. Range = highest score − lowest score

A small range indicates a concentrated distribution of scores, while a large range means that the scores are spread out and that some students have not done well on the test. This value gives us a rough idea of the variability of the test scores.

Scott Becker shadow health Subjective Data Collection

Subjective Data Collection: 26 of 26 (100.0%)

Hover To Reveal…

Hover over the 
Patient Data 
items below to reveal important information, including 
Pro Tips
 and 
Example Questions
.

Found:

 Indicates an item that you found.

Available:

 Indicates an item that is available to be found.

Category

Scored Items

Experts selected these topics as essential components of a strong, thorough interview with this patient.

Patient Data

Not Scored

A combination of open and closed questions will yield better patient data. The following details are facts of the patient’s case.

Patient Check In

Finding:

Asked about chief complaint

GET SHADOW HEALTH OR EXAM HELP HERE

Finding:

Reports fatigue

(Found)

Pro Tip: By asking a patient an open question about their reason for coming into the hospital, you can establish their current medical and comfort needs and assist in coordinating their care.

Example Question:

What brings you to the hospital?

Finding:

Reports small amount of blood in vomit

(Found)

Pro Tip: By asking a patient an open question about their reason for coming into the hospital, you can establish their current medical and comfort needs and assist in coordinating their care.

Example Question:

What brings you to the hospital?

Finding:

Reports stomach pain

(Found)

Pro Tip: By asking a patient an open question about their reason for coming into the hospital, you can establish their current medical and comfort needs and assist in coordinating their care.

Example Question:

What brings you to the hospital? Scott Becker shadow health Subjective Data Collection

History of Present Illness

Finding:

Followed up on fatigue

Finding:

Reports worsening fatigue over several weeks

(Found)

Pro Tip: Details of a patient’s current complaint will help you follow up on any present conditions or symptoms, such as the location of their pain or the amount of pain they may be experiencing.

Example Question:

How long have you felt fatigued?

Finding:

Followed up on vomit

Finding:

Reports vomiting only once

(Found)

Pro Tip: Details of a patient’s current complaint will help you follow up on any present conditions or symptoms, such as the location of their pain or the amount of pain they may be experiencing.

Example Question:

How often have you been vomiting?

Finding:

Reports vomiting this morning

(Found)

Pro Tip: Details of a patient’s current complaint will help you follow up on any present conditions or symptoms, such as the location of their pain or the amount of pain they may be experiencing.

Example Question:

When did you vomit?

Finding:

Reports noticing dark flecks in vomit

(Available)

Pro Tip: Details of a patient’s current complaint will help you follow up on any present conditions or symptoms, such as the location of their pain or the amount of pain they may be experiencing.

Example Question:

What was your vomit like?

Finding:

Followed up on stomach pain

Finding:

Reports pain in upper-left abdomen Scott Becker shadow health Subjective Data Collection

(Found)

Pro Tip: Details of a patient’s current complaint will help you follow up on any present conditions or symptoms, such as the location of their pain or the amount of pain they may be experiencing.

Example Question:

Where is your stomach pain?

Finding:

Reports stomach pain is gnawing or burning

(Found)

Pro Tip: Details of a patient’s current complaint will help you follow up on any present conditions or symptoms, such as the location of their pain or the amount of pain they may be experiencing.

Example Question:

How would you describe the stomach pain?

Finding:

Reports experiencing stomach pain for past 3 to 4 months

(Found)

Pro Tip: Details of a patient’s current complaint will help you follow up on any present conditions or symptoms, such as the location of their pain or the amount of pain they may be experiencing.

Example Question:

How long have you had stomach pain?

Finding:

Reports stomach pain worsens after eating

(Found)

Pro Tip: Details of a patient’s current complaint will help you follow up on any present conditions or symptoms, such as the location of their pain or the amount of pain they may be experiencing.

Example Question:

Does the pain get better or worse after eating?

Finding:

Reports stomach pain increasing over the past week

(Found)

Pro Tip: Details of a patient’s current complaint will help you follow up on any present conditions or symptoms, such as the location of their pain or the amount of pain they may be experiencing.

Example Question:

Has your stomach pain gotten worse over time?

Finding:

Reports taking antacids daily Scott Becker shadow health Subjective Data Collection

(Found)

Pro Tip: Details of a patient’s current complaint will help you follow up on any present conditions or symptoms, such as the location of their pain or the amount of pain they may be experiencing.

Example Question:

Do you take anything for your stomach pain?

Finding:

Reports antacids are moderately effective

(Found)

Pro Tip: Details of a patient’s current complaint will help you follow up on any present conditions or symptoms, such as the location of their pain or the amount of pain they may be experiencing.

Example Question:

Does anything relieve your stomach pain?

Past Medical History

Finding:

Asked about allergies

Finding:

Denies food allergies

(Available)

Pro Tip: A patient’s past medical history includes their health conditions, what preventive and maintenance treatments they have received, and any previous medical interventions they have received. Asking about a patient’s medical history helps you contextualize their current health for proper assessment.

Example Question:

Do you have any food allergies?

Finding:

Denies environmental allergies

(Found)

Pro Tip: A patient’s past medical history includes their health conditions, what preventive and maintenance treatments they have received, and any previous medical interventions they have received. Asking about a patient’s medical history helps you contextualize their current health for proper assessment.

Example Question:

Do you have any environmental allergies?

Finding:

Denies latex allergy

(Available)

Pro Tip: A patient’s past medical history includes their health conditions, what preventive and maintenance treatments they have received, and any previous medical interventions they have received. Asking about a patient’s medical history helps you contextualize their current health for proper assessment.

Example Question:

Are you allergic to latex?

Finding:

Denies medication allergies

(Found)

Pro Tip: A patient’s past medical history includes their health conditions, what preventive and maintenance treatments they have received, and any previous medical interventions they have received. Asking about a patient’s medical history helps you contextualize their current health for proper assessment.

Example Question:

Do you have any medication allergies?

Finding:

Asked about existing health conditions

Finding:

Reports hypertension

(Found)

Pro Tip: A patient’s past medical history includes their health conditions, what preventive and maintenance treatments they have received, and any previous medical interventions they have received. Asking about a patient’s medical history helps you contextualize their current health for proper assessment.

Example Question:

Do you have any existing health conditions?

Finding:

Reports high cholesterol

(Found)

Pro Tip: A patient’s past medical history includes their health conditions, what preventive and maintenance treatments they have received, and any previous medical interventions they have received. Asking about a patient’s medical history helps you contextualize their current health for proper assessment.

Example Question:

Do you have any existing health conditions?

Finding:

Reports coronary artery disease

(Found)

Pro Tip: A patient’s past medical history includes their health conditions, what preventive and maintenance treatments they have received, and any previous medical interventions they have received. Asking about a patient’s medical history helps you contextualize their current health for proper assessment.

Example Question:

Do you have any existing health conditions?

Finding:

Reports osteoarthritis

(Found)

Pro Tip: A patient’s past medical history includes their health conditions, what preventive and maintenance treatments they have received, and any previous medical interventions they have received. Asking about a patient’s medical history helps you contextualize their current health for proper assessment.

Example Question:

Do you have any existing health conditions?

Social History

Finding:

Asked about living situation

Finding:

Reports living with family

(Found)

Pro Tip: A patient’s social history encompasses a patient’s social, cultural, economic, and lifestyle factors that together influence the patient’s health. Asking a patient about subjects such as common lifestyle activities and substance use can help you gain understanding about a patient’s social history.

Example Question:

What is your living situation?

GET SHADOW HEALTH HELP HERE

Finding:

Asked about tobacco use

Finding:

Denies tobacco use

(Found)

Pro Tip: A patient’s social history encompasses a patient’s social, cultural, economic, and lifestyle factors that together influence the patient’s health. Asking a patient about subjects such as common lifestyle activities and substance use can help you gain understanding about a patient’s social history.

Example Question:

Do you use any tobacco products?

Finding:

Asked about caffeine use

Finding:

Reports drinking coffee

(Found)

Pro Tip: A patient’s social history encompasses a patient’s social, cultural, economic, and lifestyle factors that together influence the patient’s health. Asking a patient about subjects such as common lifestyle activities and substance use can help you gain understanding about a patient’s social history.

Example Question:

Do you consume caffeine?

Finding:

Reports drinking coffee every morning

(Found)

Pro Tip: A patient’s social history encompasses a patient’s social, cultural, economic, and lifestyle factors that together influence the patient’s health. Asking a patient about subjects such as common lifestyle activities and substance use can help you gain understanding about a patient’s social history.

Example Question:

How often do you drink coffee?

Finding:

Reports drinking 2 to 3 cups

(Found)

Pro Tip: A patient’s social history encompasses a patient’s social, cultural, economic, and lifestyle factors that together influence the patient’s health. Asking a patient about subjects such as common lifestyle activities and substance use can help you gain understanding about a patient’s social history.

Example Question:

How many cups of coffee do you have in a day?

Finding:

Asked about alcohol use

Finding:

Reports alcohol use

(Found)

Pro Tip: A patient’s social history encompasses a patient’s social, cultural, economic, and lifestyle factors that together influence the patient’s health. Asking a patient about subjects such as common lifestyle activities and substance use can help you gain understanding about a patient’s social history.

Example Question:

Do you drink alcohol?

Finding:

Reports drinking 1 to 2 nights a week

(Found)

Pro Tip: A patient’s social history encompasses a patient’s social, cultural, economic, and lifestyle factors that together influence the patient’s health. Asking a patient about subjects such as common lifestyle activities and substance use can help you gain understanding about a patient’s social history.

Example Question:

How often do you drink alcohol?

Finding:

Reports having 1 to 2 glasses per sitting

Scott Becker gastrointestinal system hourly rounds shadow health Transcript Transcript

Started:
August 16, 2023 |
Total Time:
249 min

All Lines (207)
Interview Questions (143)
Statements (14)
Exam Actions (50)

HI, my name is xx, I am your nurse today. I am going to ask you some questions and exam you.

Greet

09/18/23 1:54 PM EDT

Hello.

What brings you here today Mr.Becker?

GET SHADOW HEALTH HELP HERE

Question

09/18/23 1:55 PM EDT

I’ve been having some pretty serious stomach pain. I’ve been strangely tired. And when I threw up and there was blood in it . . . I figured things were serious enough that I should finally get checked out.

I am sorry to hear that you are experiencing pain.It must be scary to see blood in your vomitus.You made the right decision to come to the hospital.We will take good care of you. (No matching questions found.)

Question

09/18/23 2:00 PM EDT

Was it the first time you vomited blood? (No matching questions found.)

Question

09/18/23 2:02 PM EDT

I am sorry to hear that you are having pain.

Empathize

09/18/23 2:05 PM EDT

I am sorry to hear that you have pain. (No matching questions found.)

Question

09/18/23 2:03 PM EDT

Thank you.

I am sorry to hear that you are having pain.That is the right decision you made to come to the hospital.

Educate

09/18/23 2:09 PM EDT scott becker gastrointestinal system hourly rounds shadow health Transcript

Ah, makes sense.

Was it the first time you had bloody vomitus? (No matching questions found.)

Question

09/18/23 2:12 PM EDT

Was it the first time you had bloody vomitus?Have you noticed any blood in the stool? (No matching questions found.)

Question

09/18/23 2:13 PM EDT

Was it the first time you had bloody vomitus?Have you noticed any blood in the stool? (No matching questions found.)

Question

09/18/23 2:14 PM EDT

Was it the first time you had bloody vomitus?Have you noticed any blood in the stool?How long have you been having abdominal pain? (No matching questions found.)

Question

09/18/23 2:15 PM EDT

How long have you been having abdominal pain?

Question

09/18/23 2:15 PM EDT

It started around three or four months ago. It got even worse the last week.

What is the pain like?

Question

09/18/23 2:17 PM EDT

It’s like a gnawing, burning pain in my stomach.

Is the pain moving around or is it staying in one place?

Question

09/18/23 2:19 PM EDT

No, it stays pretty much where it is, in the upper left part of my belly.

When do you experience the pain? (Clarified to How long ago did you have the pain last?.)

Question

09/18/23 2:20 PM EDT

I’m feeling it right now. (Clarified to when I last experienced the pain.)

How long ago did you have the pain last?

Question

09/18/23 2:22 PM EDT

I’m feeling it right now. scott becker gastrointestinal system hourly rounds shadow health Transcript

How would you rate the pain on a scale of 0-10? . Ten being the worst pain. (Clarified to Can you rate your current pain level on a scale of 0 to 10?.)

Question

09/18/23 2:24 PM EDT

Right now, maybe a 4 or 5 out of 10. (Clarified to how I would rate my pain on a scale.)

How have you been taking care of pain at home?

Question

09/18/23 2:26 PM EDT

I’ve been tired all the time, lately. I’ve also had a lot more stomach pain than I used to. I thought the stress was just getting to me, or I was just feeling my age catching up, but then I threw up this morning and I’m pretty sure there was blood.
That’s why I’m here right now
.

Do you also feel lightheadedness and dizziness? (No matching questions found.)

Question

09/18/23 2:31 PM EDT

Vomiting blood and feeling tired could be signs of serious problem. You made the right decision coming to the hospital.

Educate

09/18/23 2:35 PM EDT

OK, cool.

Can you estimate how much blood was in the vomitus? (No matching questions found.)

Question

09/18/23 2:38 PM EDT

The dark flecks of vomitus could mean that the blood has been in the stomach for some time.

Educate

09/18/23 2:43 PM EDT

Gotcha.

Next time keep the vomitus for me to…. scott becker gastrointestinal system hourly rounds shadow health Transcript

Fatima Khan Shadow Health Documentation

Vitals

Vitals

0800

1000

1200

Temp (<38° C) 36.7° C 36.5° C BP (<120/80) 124/80 122/78 HR (60-100) 70 68 RR (12-20) 18 18 O2 Sat (>94%)

99%

99%

 

My Provider Notes

Student Documentation

Model Documentation

Subjective

Ms Fatina Khan is a patient who is preparing for her surgery. She report to .. or fatigue

Ms. Fatima Khan is a 44 year old female that is admitted for acute cholelithiasis and is scheduled for a laparoscopic cholecystectomy today. Upon initial assessment, she is oriented to person only and states that she is feeling confused. She … and shaky. She also reports a rapid heartbeat. She denies any gastrointestinal problems. The patient states…Fatima Khan Shadow Health Documentation

GET SHADOWHEALTH HELP HERE 

Education & Empathy 
: 2 of 2 (100.0%)

During the patient interview, there are a number of opportunities to provide patient education and empathy. The opportunities listed below are those identified by nursing experts to be of particular importance to this patient. A 
Model Statement
 is provided as an example of an appropriate response to each opportunity.

Opportunities marked as 
Not Encountered
 are opportunities that were not elicited in the interview

Opportunities marked as 
Not Followed Up
 are missed opportunities that were present in the interview, but where no statements were made

Opportunities marked as 
Followed Up
 were followed up by students, and include the dialogue between student and patient

 1 Symptoms

Followed Up

 Description: 
Ms. Khan expresses that she feels ill and describes her symptoms as confusion, sweatiness, and rapid heartbeat.

Do you have any heart problem?

Question

05:26 PM EDT

Not usually, but . . . it’s beating rapidly right now.

I am sorry to hear that

Question

05:26 PM EDT

I can hear you fine. Fatima Khan Shadow Health Documentation

For how long has your heart been beating rapidly?

Question

05:29 PM EDT

I don’t know when it began.

Do you feel nauseated?

Question

05:29 PM EDT

I’m not nauseated. I just feel really strange.

I am sorry about that. We shall establish the problem and make you feel better

Empathize

05:30 PM EDT

Thank you.

 Model Statement: 
“I’m sorry to hear that you are feeling like this. Your rapid heartbeat, sweatiness, and confusion may be symptoms of a change in your condition. I’m going to do everything I can to get you feeling better.”

 2 Identifying Cause of Symptoms

Followed Up

 Description: 
Ms. Khan reports recently administering a bolus of insulin despite a normal blood glucose reading.

Have you taken any medications? (Clarified to: What medicines have you taken lately?)

Question

05:30 PM EDT

I just took it Fatima Khan Shadow Health Documentation. (Clarified to: what medicines I have taken lately)

Do you know why you were given the medicine (Clarified to: Do you know why you are here today?)

Question

05:31 PM EDT

I . . . um . . . well, I’m not sure why I’m here. (Clarified to: if I know why I am here)

Which medication did you take

Question

05:32 PM EDT

I just took it.

do you know the name of the medicine you just took (Clarified to: What medications do you take?)

Question

05:33 PM EDT

Ah . . . I’m taking Sim . . . Sima . . . vast . . . ah . . . for my heart, and um . . . insulin. Um . . . (Clarified to: what medications I am taking)

When was your last dose of insulin

Question

05:33 PM EDT

Um . . . I just gave myself insulin.

Do you have any pain

Question

05:37 PM EDT

No . . . it isn’t a pain.

Do you have any special needs (Clarified to: Do you have any religious preferences while you are here?)

Question

05:38 PM EDT

I am a Muslim, so please only provide halal foods and medicines. I would also prefer you try to only touch me with your right hand. (Clarified to: if I have religious preferences while I am here)
Fatima Khan Shadow Health
Documentation

Thats okay, we will try our best to meet your needs and preferences

Empathize

05:39 PM EDT

Thank you very much.

 Model Statement: 
“Based on your symptoms and what you’ve told me about taking an insulin bolus recently, it’s possible you may have administered too much insulin. It’s important to use your insulin only when your blood glucose reading indicates the need for a bolus. When you take more insulin than is required, this can make you feel ill, meaning you may feel symptoms such as confusion, sweatiness, and a rapid heartbeat.”

Fatima Khan Endocrine System Hourly Rounds Shadow health Objective data

Objective Data Collection: 10 of 10 (100.0%)

Correct

Partially Correct

Incorrect

Missed

Assessed General Appearance

1 of 1 points

Patient Appearance
 (1.00/1.00 point)

Patient appears comfortable, and is not presenting visually with acute distress or illness

Patient appears uncomfortable, or is presenting visually with acute distress or illness

Assessed Vitals

1 of 1 points

Blood Pressure

(1.00/1.00 point)

Normotensive

Hypertensive

Hypotensive

Heart Rate
 (0.20/0.20 point)

No abnormal findings

Bradycardic

Tachycardic

GET INSTANT HELP HERE 

O2 Saturation
 (0.20/0.20 point)

No abnormal findings

Hypoxemia

Respiratory Rate
 (0.20/0.20 point)

No abnormal findings

Bradypnea

Tachypnea

Temperature
 (0.20/0.20 point)

Normothermic

Hyperthermic

Hypothermic

Assessed IV

1 of 1 points

Insertion Site
 (0.33/0.33 point)

No visible abnormal signs

Erythema

Infiltration

Dressing
 (0.33/0.33 point)

Dressing is dry and intact

Dressing is moist and/or not intact

IV Fluid
 (0.33/0.33 point)

Patent upon flushing

Not patent upon flushing

Assessed Peripheral Pulses

1 of 1 points

Radial Artery Amplitude
 (0.50/0.50 point)

0: Absent

1+: Diminished or barely palpable

2+: Expected

3+: Increased

4+: Bounding pulse

Fatima Khan Endocrine System Hourly Rounds Shadow health Objective data

Dorsalis Pedis Artery Amplitude
 (0.50/0.50 point)

0: Absent

1+: Diminished or barely palpable

2+: Expected

3+: Increased

4+: Bounding pulse

Checked Capillary Blood Glucose

1 of 1 points

Timing
 (0.33/0.33 point)

Preprandial

Postprandial

Level
 (0.33/0.33 point)

< 80 mg/dL 80-130 mg/dL 130-180 mg/dL > 180 mg/dL

Assessment
 (0.33/0.33 point)

Normoglycemic

Hypoglycemic

Hyperglycemic

Check Insulin Pump

1 of 1 points

Last Bolus
 (1.00/1.00 point)

No recent bolus administered

Manual bolus administered between 11 AM and 12 PM

Manual bolus administered between 10 AM and 11 AM

Fatima Khan Endocrine System Hourly Rounds
Shadow health Objective data

Auscultated Breath Sounds

1 of 1 points

Breath Sounds
 (0.50/0.50 point)

Clear in all areas

Diminished in some areas

Absent in some areas

Adventitious Sounds
 (0.50/0.50 point)

No adventitious sounds

Wheezing

Fine crackles

Stridor

Rhonchi

Rales

Auscultated Heart Sounds

1 of 1 points

Heart Sounds

(1.00/1.00 point)

S1 and S2 audible

S1, S2, and S3 audible

S1, S2, and S4 audible

S1, S2, S3, and S4 audible

Extra Heart Sounds
 (0.50/0.50 point)

No extra sounds

Gallops

Murmur

Friction rub

Valve clicks

Inspected IV Pump

1 of 1 points

Fluid
 (0.50/0.50 point)

Correct fluid

Incorrect fluid

Flow Rate
 (0.50/0.50 point)

Correct rate

Incorrect rate

Palpated Skin

1 of 1 points

Skin Palpation
 (1.00/1.00 point)

Warm and dry

Cool and diaphoretic

Fatima Khan Endocrine System Hourly Rounds Shadow health Objective data

NURS-6052 Module 2: Quiz – IS IT QUANTITATIVE, QUALITATIVE, OR MIXED METHODS?

Question 1

5 
/ 5
 pts

In quantitative studies, results are reported using words or themes.

True

 

Correct!

False

 

Question 2

5 
/ 5
 pts

A key characteristic of a systematic review is that it contains a meta-analysis.

True

 

Correct!

False

 

Question 3

5 
/ 5
 pts

The methods used in conducting a systematic review are specific and rigorous.

Correct!

True

 

False

 

BUY QUIZ OR EXAM HERE

NURS-6052 Module 2: Quiz – IS IT QUANTITATIVE, QUALITATIVE, OR MIXED METHODS? Question 4

5 
/ 5
 pts

What type of study is described in the following excerpt?

Surveys to evaluate nurse satisfaction, medical errors, depression and anxiety, and demographics were given to 5,432 nurses from hospitals of various sizes and geographic locations; some had nurses working 8-hour shifts and 12-hour shifts. Nurses were asked to complete the survey. Upon completion of the survey, nurses were invited to participate in video conference focus groups and one-on-one interviews with a research assistant by video conferencing. Survey results were reported using descriptive statistics, and themes were identified and reported from the data collected in the focus groups and one-on-one interviews.

Quantitative research

 

Qualitative research

 

Quasi-experimental research

 

Correct!

Mixed-methods research

 

Systematic reviews

 

Question 5

5 
/ 5
 pts

Randomized controlled trials are which type of research?

Correct!

Quantitative research

 

Qualitative research

 

Mixed-methods research

 

Systematic review

 

Literature review

 

Cohort study

 

Question 6

5 
/ 5
 pts

Mixed-methods studies are a combination of which two methodologies?

Quantitative research methodologies and literature reviews

 

Correct!

Quantitative and qualitative research methodologies

 

Qualitative research methodologies and systematic reviews

 

Literature reviews and qualitative research methodologies

 

Quasi-experimental and program evaluation

 

NURS-6052 Module 2: Quiz – IS IT QUANTITATIVE, QUALITATIVE, OR MIXED METHODS? Question 7

5 
/ 5
 pts

What types of information would help you identify a research study as quantitative? (Select all that apply.)

Data is collected using such approaches as interviews, focus groups, and open-ended questions on surveys.

 

Correct!

Data is collected using Likert scales on surveys.

 

Correct!

Results are reported using numbers and statistics.

 

Results are reported using themes and words.

 

Question 8

5 
/ 5
 pts

When trying to determine what type of research study is described in an article, which two sections of the article will give you the best information to make that determination?

Abstract and conclusion

 

Methods and limitations

 

Correct!

Methods and results

 

Introduction and results

 

Abstract and discussion

 

Literature review and data analysis

 

Question 9

5 
/ 5
 pts

Which of the following statements is true of narrative reviews? (Select all that apply.)

Narrative reviews engage a highly structured and rigorous approach to reviewing research evidence.

 

Correct!

Narrative reviews provide a general background discussion of a particular issue.

 

Narrative reviews require a rigorous, systematic approach to searching the databases for evidence.

 

Correct!

Narrative reviews generally review literature that support the author’s point of view on an issue or topic.

Narrative reviews are a type of primary research.

 

Question 10

5 
/ 5
 pts

What kind of study is described in the following excerpt?

Researchers are interested in studying the impact of living in a family where a child has been diagnosed with cancer. They collaborate with the oncology department at a large children’s hospital to identify and receive consent from families that have a child with a cancer diagnosis. Participants are consented and data is collected and triangulated using one-on-one interviews, focus groups, and surveys. Data is analyzed for thematic analysis.

Quantitative research

 

Correct!

Qualitative research

 

Mixed-methods research

 

Systematic reviews

 

Literature reviews

 

Cohort studies

 

Question 11

5 
/ 5
 pts

In a systematic review with a meta-analysis, researchers combine the results of each of the individual studies to create a larger sample size (and therefore greater power), then re-run the statistics to capture the true magnitude of the effect. The single-effect measure calculated and reported when the results from all the studies are combined is called what?

Correct!

Summary statistic

 

Power analysis

 

Confidence Interval

Chi square

 

Pearson’s co-efficient

NURS-6052 Module 2: Quiz – IS IT QUANTITATIVE, QUALITATIVE, OR MIXED METHODS? Question 12

5 
/ 5
 pts

Order the following types of research evidence reviews in order of rigor from most rigorous to least rigorous:

Correct!

1

Systematic review with meta-analysis

Correct!

2

Systematic review without meta-analysis

Correct!

3

Integrative review

Correct!

4

Narrative review

Question 13

5 
/ 5
 pts

What type of information would help you identify a research study as qualitative? (Select all that apply.)

Correct!

Data is collected using such approaches as interviews, focus groups, and open-ended questions on surveys.

 

Data is collected using Likert scales on surveys.

 

Results are reported using numbers and statistics.

 

Correct!

Results are reported using themes and words.

 

Data is collected using surveys with fill-in-the-blank questions.

 

Results are reported using a mixture of numbers and themes.

 

Question 14

5 
/ 5
 pts

Both literature reviews and systematic reviews are types of research evidence reviews.

Correct!

True

 

False

 

Question 15

5 
/ 5
 pts

What type of literature may a systematic review include to be considered Level 1 evidence on the Melnyk & Fineout-Overholt levels of evidence hierarchy?

Phenomenology studies

 

Grounded theory studies

 

Descriptive studies

 

Cohort studies

 

Controlled trials without randomization

 

Correct!

Randomized controlled trials

 

Question 16

5 
/ 5
 pts

Which of the following is a type of quantitative research study?

Phenomenology

 

Case study

 

Correct!

Randomized controlled trial

 

Ethnography

 

Participative action research

 

Ground theory

 

Question 17

5 
/ 5
 pts

What type of study is described in the following excerpt?

An interprofessional team wants to test a new intervention to see whether it will improve central-line associated bloodstream infection (CLABSI) rates. Subjects were randomized into either the intervention or the control group by pulling a slip of paper with either a one or a two written on it from a manila envelope (those pulling ones were randomized to the intervention group; those pulling twos were randomized to the control group). When the study began, the intervention group received the intervention and the control group received equal attention. Data was collected and analyzed using the Statistical Package for the Social Sciences (SPSS). Descriptive statistics were used to report the data.

What type of research article is this?

Correct!

Quantitative research

 

Qualitative research

 

Systematic reviews

 

Literature reviews

 

Mixed methods

 

Program evaluation

 

Question 18

5 
/ 5
 pts

You are forming a team to do a systematic review of the literature about interventions to treat post-traumatic stress disorder (PTSD). Which of the following would be your first step?

Critically appraise the literature identified.

 

Conduct an exhaustive search of multiple databases to identify the literature.

 

Identify an explicit, reproducible methodology.

 

Correct!

Create a clearly stated set of objectives with predefined eligibility criteria for study inclusion.

 

Create a dissemination plan for your systematic review.

 

Question 19

5 
/ 5
 pts

Which of the following types of research can be categorized as primary research? Select all that apply.

Correct!

Cohort study

 

Literature review

 

Correct!

Grounded theory study

 

Correct!

Randomized controlled trial

 

Systematic review

 

Correct!

Controlled trial without randomization

 

Question 20

5 
/ 5
 pts

In qualitative studies, results are reported using words or themes.

Correct!

True

 

False

 

NURS-6052 Module 2: Quiz – IS IT QUANTITATIVE, QUALITATIVE, OR MIXED METHODS? Quiz Score:
100
 out of 100