Category: Nursing

  • The Health Information System Case Selection and Proposal paper

    The Health Information System Case Selection and Proposal paper

    You will propose how the particular health information system used in your selected case would be applicable in a health care organization of your choice. Refer to your chosen organization as “[ABC] Health Care.” You will be expanding on your selection in the assignments for Weeks 2 through 5, and putting all of your assignments together to create a Final Presentation in Week 6. You will use a proposal form provided here to complete this assignment. (Click on
     QUALITY IMPROVEMENT STUDENT PROJECT PROPOSAL
     
    to view a sample TMIT students’ proposal. While this The Health Information System Case Selection and Proposal paper doesn’t match the proposal form exactly, it will help give you an idea of what a proposal should look like.)

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    Evaluate the needs that are present within your selected case study as it applies to your “ABC Health Care” organization.

    Examine the practices from your selected case study that confirm or contradict that data is complete, accurate, consistent, timely, secure, and fit for use.

    Compare and contrast the different types of data and information generated by the health care organization in your case.

    The Health Information System Case Selection and Proposal paper

    Must be two to three double-spaced pages in length (not including title and references pages) and formatted according to APA style

    Must include a separate title page with the following:

    Title of Proposal

    Student’s name

    Course name and number

    Instructor’s name

    Date submitted

    Must begin with an introductory paragraph that has a succinct thesis statement.

    Must address the topic of the paper with critical thought.

    Must end with a conclusion that reaffirms your thesis.

    Must use at least three scholarly or peer-reviewed sources in addition to the course text

    Must have a separate reference page.

    The Case Study is Kaiser Permanente: Breaching the Security of an Internet Patient Portal. You can google this case.

    Book: Wager, K.A., Lee, F.W. & Glaser, J.P. (2017). Health care information systems: A practice approach for health care management (4
    th
    ed.). Retrieved from
    https://ebookcentral

  • Consumer Health Informatics Essay

    Consumer Health Informatics Essay

    Consumer Health Informatics (CHI) is the field that helps to connect  the gap between patients and health resources. Its focus is to provide  patients with the most complete health information possible.

    Using the South University Online Library or the Internet, research  on CHI. Based on your readings and understanding, create a 3- to 4-page  Microsoft Word report that provides the answers to the following  questions:

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    What role will medical informatics professionals play in CHI? What are some of the barriers to the growing role of CHI?

    What do you believe is the most important thing that needs to happen  next in order for CHI to continue evolving? How can it best be  addressed?

    What are the key factors in training users of health information systems technologies?

    How can personal health record systems and electronic health systems contribute to advancing the role of CHI?

    What are the three options for CHI that could improve healthcare quality and lower costs in the future?

    Consumer Health Informatics Essay Submission Details:

    Support your responses with examples.

    Cite any sources in APA format.

  • NURS 6630 – Psychopharmacologic Approaches to Treatment of Psychopathology

    Psychiatric and Mental Health Nurse Practitioner – NURS 6630 – Psychopharmacologic Approaches to Treatment of Psychopathology

    The Psychiatric and Mental Health Nurse Practitioner (PMHNP) is an advanced practice registered nurse trained to provide a wide range of mental health services to patients and families in a variety of settings. PMHNPs diagnose, conduct therapy, and prescribe medications for patients who have psychiatric disorders, medical organic brain disorders, or substance abuse problems. They are licensed to provide emergency psychiatric services, conduct psychosocial and physical assessment of their patients, develop and manage treatment plans, and provide ongoing manage patient care. They may also serve as consultants or as educators for families and staff. The PMHNP has a focus on making a psychiatric diagnosis, differentiates between medical disorders with psychiatric symptoms, and orders appropriate medications to treat various psychiatric disorders. A PMHNP can often practice autonomously, depending on state licensure laws.

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    NURS 6630 – Psychopharmacologic Approaches to Treatment of Psychopathology Course Readings

    After clicking on a citation below, enter your myWalden user name and password at the prompt.

    Please 
    Ask a Librarian
     if you have any questions about the links.

     

    American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

    Bui, Q. (2012). Antidepressants for agitation and psychosis in patients with dementia. American Family Physician, 85(1), 20-22.

    Crocker, A. G., Prokić, A., Morin, D., & Reyes, A. (2014). Intellectual disability and co-occurring mental health and physical disorders in aggressive behaviour. Journal of Intellectual Disability Research, 58(11), 1032-1044.

    Erickson, S. C., Le, L., Zakharyan, A., Stockl, K. M., Harada, A. M., Borson, S., & … Curtis, B. (2012). New-onset treatment-dependent diabetes mellitus and hyperlipidemia associated with atypical antipsychotic use in older adults without schizophrenia or bipolar disorder. Journal of the American Geriatrics Society, 60(3), 474-479.

    Howland, R. H. (2008). Sequenced Treatment Alternatives to Relieve Depression (STAR*D). Part 1: Study design. Journal of Psychosocial Nursing and Mental Health Services, 46(9), 21-24.

    Howland, R. H. (2008). Sequenced Treatment Alternatives to Relieve Depression (STAR*D). Part 2: Study outcomes. Journal of Psychosocial Nursing and Mental Health Services, 46(10), 21-24.

    Hulvershorn, L. A., Schroeder, K. M., Wink, L. K., Erickson, C. A., & McDougle, C. J. (2015). Psychopharmacologic treatment of children prenatally exposed to drugs of abuse. Human Psychopharmacology, 30(3), 164-172.

    Malhotra, A. K., Zhang, J., & Lencz, T. (2012). Pharmacogenetics in psychiatry: Translating research into clinical practice. Molecular Psychiatry, 17(8), 760-769.

    Naber, D., & Lambert, M. (2009). The CATIE and CUtLASS studies in schizophrenia: Results and implications for clinicians. CNS Drugs, 23(8), 649-659.

    Rao, U. (2013). Biomarkers in pediatric depression. Depression & Anxiety, 30(9), 787-791.

    Stahl, S. M. (2013). 
    Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications
     (4th ed.). New York, NY: Cambridge University Press. 
    Please use the link provided directly in your 
    classroom for all content from this resource.

    Strawn, J. R., Wehry, A. M., DelBello, M. P., Rynn, M. A., & Strakowski, S. (2012). Establishing the neurobiologic basis of treatment in children and adolescents w

    Vitiello, B. (2013). How effective are the current treatments for children diagnosed with manic/mixed bipolar disorder? CNS Drugs, 27(5), 331-333.

  • NURS 6640 – Psychotherapy With Individuals

    Psychiatric and Mental Health Nurse Practitioner -NURS 6640 – Psychotherapy With Individuals

    The Psychiatric and Mental Health Nurse Practitioner (PMHNP) is an advanced practice registered nurse trained to provide a wide range of mental health services to patients and families in a variety of settings. PMHNPs diagnose, conduct therapy, and prescribe medications for patients who have psychiatric disorders, medical organic brain disorders, or substance abuse problems. They are licensed to provide emergency psychiatric services, conduct psychosocial and physical assessment of their patients, develop and manage treatment plans, and provide ongoing manage patient care. They may also serve as consultants or as educators for families and staff. The PMHNP has a focus on making a psychiatric diagnosis, differentiates between medical disorders with psychiatric symptoms, and orders appropriate medications to treat various psychiatric disorders. A PMHNP can often practice autonomously, depending on state licensure laws.

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    NURS 6640 – Psychotherapy With Individuals Course Readings

    After clicking on a citation below, enter your user name and password at the prompt.

    Please 
    Ask a Librarian
     if you have any questions about the links.

    Abeles, N., & Koocher, G. P. (2011). Ethics in psychotherapy. In J. C. Norcross, G. R. VandenBos, D. K. Freedheim, J. C. Norcross, G. R. VandenBos, & D. K. Freedheim (Eds.), History of psychotherapy: Continuity and change (pp. 723–740). Washington, DC: American Psychological Association. doi:10.1037/12353-048

    American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

    Aznar-Martinez, B., Perez-Testor, C., Davins, M., & Aramburu, I. (2016). Couple psychoanalytic psychotherapy as the treatment of choice: Indications, challenges, and benefits. Psychoanalytic Psychology, 33(1), 1–20. doi:10.1037/a0038503

    Bass, C., van Nevel, J., & Swart, J. (2014). A comparison between dialectical behavior therapy, mode deactivation therapy, cognitive behavioral therapy, and acceptance and commitment therapy in the treatment of adolescents. International Journal of Behavioral Consultation and Therapy, 9(2), 4-8.

    Beck, A. (1994). Aaron Beck on cognitive therapy [Video file]. Mill Valley, CA: Psychotherapy.net.

    Bugental , J. (n.d.). Existential-humanistic psychotherapy [Video file]. Mill Valley, CA: Psychotherapy.net.

    Cameron, S., & Turtle-Song, I. (2002). Learning to write case notes using the SOAP format. Journal of Counseling and Development, 80(3), 286-292.

    Dixon-Gordon, K. L., Turner, B. J., & Chapman, A. L. (2011). Psychotherapy for personality disorders. International Review Of Psychiatry (Abingdon, England), 23(3), 282-302. doi:10.3109/09540261.2011.586992

    Eysenck, H. (n.d.). Hans Eysenck on behavior therapy [Video file]. Mill Valley, CA: Psychotherapy.net.

    Fisher, M. A. (2016). The ethical ABCs of conditional confidentiality. In Confidentiality limits in psychotherapy: Ethics checklists for mental health professionals (pp. 13–25). Washington, DC: American Psychological Association. doi:10.1037/14860-002

    Holttum, S. (2014). When bad things happen our brains change but psychotherapy and support can help the recovery of our brains and our lives. Mental Health and Social Inclusion, 18(2), 52
    . NURS 6640 – Psychotherapy With Individuals

    Karbelnig, A. M. (2016). “The analyst is present”: Viewing the psychoanalytic process as performance art. Psychoanalytic Psychology, 33(supplement 1), S153–S172. doi:10.1037/a0037332

    Kernberg, O. (n.d.). Psychoanalytic psychotherapy [Video file]. Mill Valley, CA: Psychotherapy.net.

    Koocher, G. P. (2003). Ethical issues in psychotherapy with adolescents. Journal of Clinical Psychology, 59(11), 1247–1256. PMID:14566959

    LaMothe, R. (2015). A future project of psychoanalytic psychotherapy: Revisiting the debate between classical/commitment and analytic therapies. Psychoanalytic Psychology, 32(2), 334–351. doi:10.1037/a0035982 

    Linehan, M. M. (n.d.). Dialectical behavior therapy [Video file]. Mill Valley, CA: Psychotherapy.net.

    Lorentzen, S., Ruud, T., Fjeldstad, A., & Høglend, P. A. (2015). Personality disorder moderates outcome in short- and long-term group analytic psychotherapy: A randomized clinical trial. British Journal of Clinical Psychology, 54(2), 129-146. doi:10.1111/bjc.12065

    McGuire, J. (2009). Ethical considerations when working with older adults in psychology. Ethics & Behavior, 19(2), 112–128. doi:10.1080/10508420902772702

    McLeod, B. D., Jensen-Doss, A., Tully, C. B., Southam-Gerow, M. A., Weisz, J. R., & Kendall, P. C. (2016). The role of setting versus treatment type in alliance within youth therapy. Journal of Consulting and Clinical Psychology, 84(5), 453-464.

    Migone, P. (2013). Psychoanalysis on the Internet: A discussion of its theoretical implications for both online and offline therapeutic technique. Psychoanalytic Psychology, 30(2), 281–299. doi:10.1037/a0031507 

    Montefiore Medical Center and Educational Broadcasting Corporation. (2006). Keeping kids healthy: Recognizing borderline personality disorder in children [Video file].

    Nagy, T. F. (2011). Ethics in psychotherapy. In Essential ethics for psychologists: A primer for understanding and mastering core issues (pp. 185–198). Washington, DC: American Psychological Association. doi:10.1037/12345-010

    Ochberg, F. (2012). Psychotherapy for chronic PTSD [Video file]. Mill Valley, CA: Psychotherapy.net.

    Paris, J. (2004). Personality disorders over time: implications for psychotherapy. American Journal Of Psychotherapy, 58(4), 420-429.

    Sommers-Flanagan, J., & Sommers-Flanagan, R. (2012). Clinical interview: Intake, assessment, & therapeutic alliance [Video file]. Mill Valley, CA: Psychotherapy.net.

    Sommers-Flanagan, J., & Sommers-Flanagan, R. (2013). Counseling and psychotherapy theories in context and practice [Video file]. Mill Valley, CA: Psychotherapy.net.

    Steinert, T. (2016). Ethics of coercive treatment and misuse of psychiatry. Psychiatric Services in Advance. doi:10.1176/appi.ps.201600066

    Stuart, S. (2010). Interpersonal psychotherapy: A case of postpartum depression [Video file]. Mill Valley, CA: Psychotherapy.net.

    Swift, J. K., & Greenberg, R. P. (2015). What is premature termination, and why does it occur? In Premature termination in psychotherapy: Strategies for engaging clients and improving outcomes (pp. 11–31). Washington, DC: American Psychological Association. doi:10.1037/14469-002

    Tummala-Narra, P. (2013). Psychoanalytic applications in a diverse society. Psychoanalytic Psychology, 30(3), 471–487. doi:10.1037/a0031375

    Walker, R. (n.d.). Making child therapy work [Video file]. Mill Valley, CA: Psychotherapy.net.

    Zilberstein, K. (2014). The use and limitations of attachment theory in child psychotherapy. Psychotherapy, 51(1), 93-103
    . NURS 6640 – Psychotherapy With Individuals.

  • Nursing Research and Evidence-Based Practice – Walden NURS6052

    Nursing Research and Evidence-Based Practice – Walden NURS6052

    Week 1 discussion

    Nursing Research and Evidence-Based Practice

    In your practice as a nurse, you may use procedures and methods that did not necessarily originate in evidence, but instead were derived from informal and unwritten conventions, traditions, and observations. While these techniques may have merit, practices are constantly being updated and contradicted by information from scholarly research studies and professional guidelines. This new information serves as “evidence” for revising practices to improve outcomes across health care.

    Based on this evidence, you can formulate a question. In this Discussion, you consider the use of evidence-based practice in your own organization and formulate a question that you will need to answer for your portfolio project. This is called a PICOT question. You will also investigate strategies for overcoming barriers to implementing evidence-based practice (EBP).

    To prepare:

    Consider a recent clinical experience in which you were providing care for a patient.

    Determine the extent to which the care that you provided was based on evidence and research findings or supported only by your organization’s standard procedures. How do you know if the tasks were based on research?

    What questions have you thought about in a particular area of care such as a procedure or policy?

    Review Chapter 2, pages 36—39 on “Asking Well worded Clinical Questions” in Polit & Beck and consult the resource from the Walden Student Center for Success: Clinical Question Anatomy & examples of PICOT questions (found in this week’s Learning Resources). Formulate your background questions and PICOT question.

    Reflect on the barriers that might inhibit the implementation of evidence-based practice in your clinical environment.

    Review the article “Adopting Evidence-Based Practice in Clinical Decision Making” in this week’s Learning Resources. Select one of the barriers described that is evident in your organization and formulate a plan for overcoming this barrier.

    By Day 3

    Post an evaluation of the use, or lack thereof, of EBP in a recent clinical experience. Identify which aspects of the care delivered, if any, were based on evidence and provide your rationale. List your background questions and PICOT question about this nursing topic. Critique how the policies, procedures, and culture in your organization may hinder or support the adoption of evidence-based practices. Identify the barrier you selected from the article and explain how this barrier could be overcome within your organization.

    Read a selection of your colleagues’ responses.

    By Day 6

    Respond to at least two of your colleagues on two different days using one or more of the following approaches:

    Ask a probing question, substantiated with additional background information, and evidence.

    Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.

    Validate an idea with your own experience and additional sources.

    Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.

    Expand on your colleagues’ postings by providing additional strategies for addressing barriers to EBP based on readings and evidence.

    Week 2 discussion

    Literature Searches

    An important step in the EBP process is reviewing the current body of literature to better understand the subject or topic in which you are interested. By conducting a review of the literature, you are building foundational knowledge about the topic; later, you can use this background to build new insights.Developing a strong grasp of a topic can only be garnered by taking the time to thoroughly search for relevant information and resources.

    For this Discussion, you will practice searching the literature to find evidence on a specific topic.

    To prepare:

    Choose a simple search term(s) relating to a topic of your PICOT question.

    Review the information on the evidence hierarchy discussed in Chapter 2 of the course text, in the article, “Facilitating Access to Pre-Processed Research Evidence in Public Health,” and in the multimedia presentation “Hierarchy of Evidence Pyramid,” found in this week’s Learning Resources.

    Review the information on the Walden Library’s website, “Levels of evidence.” Take a few minutes to explore the different types of databases available for each level of evidence and focus on the meaning of filtered and non-filtered resources.

    Conduct a literature search in the Walden Library on your selected topic using the databases that you reviewed. Use at least one database for each of the three levels of filtered information and at least one unfiltered database. Record the number of hits that you find at each level of the hierarchy of evidence.

    Select one article from the results at each level of the hierarchy. Compare the articles based on the quality and depth of information. What would be the value of each resource if you were determining an evidence-based practice?

    By Day 3

    Post a summary of your search. Describe what topic you selected, the search term(s) that you used, and the number of results found at each level of the hierarchy. Compare the types of information found in the articles from different levels and the value of the information from each level. Highlight a useful tip that you could share with your colleagues about conducting an effective literature search.

    Read a selection of your colleagues’ responses.

    By Day 6

    Respond to at least two of your colleagues on two different days using one or more of the following approaches:

    Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.

    Validate an idea with your own experience and additional sources.

    Make a suggestion based on additional evidence drawn from readings, or after synthesizing multiple postings.

    Week 3 discussion

    Theory, Research, and Evidence-Based Practice

    As they explore the world around them, young children often want to know the “why” and “how” of the things they observe. This is similar to what researchers do when they approach a new problem. Researchers develop new theories or build on old ones to explain the “why” of the world around them.They use models and conceptual frameworks to help explain “how” the processes and events they observe occur. Together, theories and models provide an understanding of the world and allow researchers to explore it in meaningful ways.

    Virtually all research questions can benefit from the use of an existing theory or model. Researchers should consider their research questions and select the most suitable theory or model, which then serves as a foundation for the research design. The selection of a theory or model is an important part of the research process.

    In this Discussion, you focus on the role of theory and models in research and evidence-based practice.

    To prepare:

    Review the information in Chapter 6 of the course text. Focus on the various conceptual theories and models that are currently used in nursing research.

    Select one of the theories or models described that is of interest to you.

    Using the Walden Library, search for and identify a research article that uses the theory or model you selected.

    Reflect on how the theory or model provides structure to the research study described in the article.

    Now, think about an issue in your practice area that you would be interested in exploring through research.

    Review this week’s media presentation and consider strategies for locating and identifying a relevant theory or model for a research study.

    By Day 3

    Post a summary of the article that you located and explain how the theory or model that you selected was used in the research study. Assess the value of basing research on an established theory or model.

    Read a selection of your colleagues’ responses.

    By Day 6

    Respond to at least two of your colleagues on two different days using one or more of the following approaches:

    Ask a probing question, substantiated with additional background information, and evidence.

    Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.

    Offer and support an alternative perspective using readings from the classroom or from your own review of the literature in the Walden Library.

    Week 4 discussion

    Ethical Dimensions of Research Studies

    In the best-selling book, The Immortal Life of Henrietta Lacks (Skloot, 2010), the author highlights the true story of an African-American woman who died in 1951 from cervical cancer. What makes her story unique is that prior to her death, cells from her tumor were removed and successfully grown in a petri dish. This was the first time scientists were able to successfully replicate cells outside the body, and it is estimated that billions of Lacks’ cells have been used in medical research. However, Henrietta Lacks was never asked for permission to take a sample and her family was never made aware of the widespread use of her cells. Although the culturing of her cells has been pivotal for advancing research, strong ethical concerns later arose about using these cells without patient or family approval.

    This week’s readings describe historical examples of unethical research, such as a study of syphilis among African-American men in which treatment was withheld and a study in which live cancer cells were injected into elderly patients. Today, stricter controls that seek to protect study participants are placed on researchers, but breaches still occur. Careful attention must be given toward preventing unethical behavior. In this Discussion, you explore ethical considerations and issues in research.

    To prepare:

    Select a current health-related case involving research ethics. (If none come to mind, browse the Internet to familiarize yourself with recent cases.)

    As you review the case that you have selected, reflect on the ethical principles discussed in “What Are the Major Ethical Issues in Conducting Research?” article found in this week’s Learning Resources. Which principles were breached in the case you have identified?

    By Day 3

    Post a description of the case that you selected and the ethical issues involved. Analyze the ethical principles that were breached by the researchers or organizations in your selected case as well as the possible cause of the breach(es). Suggest how the research might have been conducted differently to avoid or minimize the ethical problems. Discuss how research can be done on sensitive issues while still protecting the rights of the research subjects.

    Read a selection of your colleagues’ responses.

    By Day 6

    Respond to at least two of your colleagues on two different days using one or more of the following approaches:

    Ask a probing question, substantiated with additional background information, and evidence.

    Offer and support an alternative perspective using readings from the classroom or from your own review of the literature in the Walden Library.

    Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.

    Week 5 discussion

    Quantitative Research Designs

    In order to find the best information on a topic, not only should you develop a question and search for resources, but you should also know how to analyze the value of the resources that you identify. There are different ways to evaluate resources, such as using the hierarchy of evidence, which you explored in Week 4 of this course. Another way to evaluate resources is to consider the appropriateness of the research design. Understanding how research designs contribute to the quality of a study is essential for being able to analyze resources when conducting a literature review or locating evidence for practice.

    In this Discussion, you consider the different research designs and evaluate how these designs have been used to research a specific topic. You also consider strategies for selecting an appropriate research design.

    To prepare:

    Review the information in the course texton quantitative research designs. Focus on the information in Box 9.1, “Guidelines for Critiquing Research Designs in Quantitative Studies” located on page 230 of the course text.

    Select a topic from the list below and search the Walden Library to find two different quantitative research studies addressing that issue:

    Caregiver stress

    Anxiety in children

    Sleep apnea

    Depression in college freshmen

    Rural health care issues

    Post-traumatic stress syndrome

    Traumatic brain injury in veterans

    Health effects of environmental contaminants

    Bipolar disorder

    End-of-life ethical issues

    Alternative medicine

    For each of the sources that you select, identify the type of quantitative research design used, and evaluate whether it is the most appropriate approach to the research.

    Consider the ramifications of choosing an inappropriate design for a research study.

    By Day 3

    Post the topic you selected, references for the two sources you identified, and the quantitative research design used in each. Critique the appropriateness of the design used and justify your comments with information from the Learning Resources. Discuss the ramifications of choosing an inappropriate design for a research study.

    Read a selection of your colleagues’ responses.

    By Day 6

    Respond to at least two of your colleagues on two different days in one or more of the following ways:

    Ask a probing question, substantiated with additional background information, and evidence.

    Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.

    Offer and support an alternative perspective using readings from the classroom or from your own review of the literature in the Walden Library.

    Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.

    Week 6 discussion

    Validity in Quantitative Research Designs

    Validity in research refers to the extent researchers can be confident that the cause and effect they identify in their research are in fact causal relationships. If there is low validity in a study, it usually means that the research design is flawed and the results will be of little or no value. Four different aspects of validity should be considered when reviewing a research design: statistical conclusion validity, internal validity, construct validity, and external validity. In this Discussion, you consider the importance of each of these aspects in judging the validity of quantitative research.

    To prepare:

    Review the information in Chapter 10 of the course text on rigor and validity.

    Read the method section of one of the following quasi-experimental studies (also located in this week’s Learning Resources). Identify at least one potential concern that could be raised about the study’s internal validity.

    Metheny, N. A., Davis-Jackson, J., & Stewart, B. J. (2010). Effectiveness of an aspiration risk-reduction protocol. Nursing Research, 59(1), 18–25.

    Padula, C. A., Hughes, C., & Baumhover, L. (2009). Impact of a nurse-driven mobility protocol on functional decline in hospitalized older adults. Journal of Nursing Care Quality, 24(4), 325–331.

    Yuan, S., Chou, M., Hwu, L., Chang, Y., Hsu, W., & Kuo, H. (2009). An intervention program to promote health-related physical fitness in nurses. Journal of Clinical Nursing, 18(10), 1,404–1,411.

    Consider strategies that could be used to strengthen the study’s internal validity and how this would impact the three other types of validity.

    Think about the consequences of an advanced practice nurse neglecting to consider the validity of a research study when reviewing the research for potential use in developing an evidence-based practice.

    By Day 3

    Post the title of the study that you selected and your analysis of the potential concerns that could be raised about the study’s internal validity. Propose recommendations to strengthen the internal validity and assess the effect your changes could have with regard to the other three types of validity. Discuss the dangers of failing to consider the validity of a research study.

    Read a selection of your colleagues’ responses.

    By Day 6

    Respond to at least two of your colleagues in one or more of the following ways:

    Ask a probing question, substantiated with additional background information, and evidence.

    Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.

    Offer and support an alternative perspective using readings from the classroom or from your own review of the literature in the Walden Library.

    Validate an idea with your own experience and additional sources.

    Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.

    Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.

    Week 7 discussion

    Qualitative Research Designs

    For the past 2 weeks, you have focused on the features and considerations of quantitative research designs. However, quantitative designs are not appropriate for all research questions. Perhaps you are concerned with how patients react when confronted with negative test results, or you wish to study how views on a certain health topic change over time. In each of these cases, the emphasis is more on understanding the thinking and experiences of an individual or group than on numerical measurements. For these types of questions, a qualitative or mixed methods research design is the most appropriate.

    For this Discussion, you focus on the different types of qualitative research designs, when they are used, and why they are important.

    To prepare:

    Reflect on the comments made by Dr. Mauk in this week’s media presentation on the value of qualitative research in nursing.

    Locate the journal Qualitative Health Research in the Sage Premier database in the Walden Library.

    From this journal, select an article of interest to you that was published within the last 3 years.

    Review the information on different qualitative research designs in Chapter 21 of your course text.

    Determine what qualitative research design was used in your selected article and evaluate whether it was the best choice.

    Consider ethical issues involved in the study and how the researchers addressed them.

    Think about how using a quantitative design would have affected the type of data gathered.

    By Day 3

    Post an APA citation for the article that you selected and provide a brief summary of the content and the qualitative research design used. Evaluate the appropriateness of the design, and explain how ethical issues in the study were addressed. Analyze how the study would have been different if a quantitative design had been used.

    Read a selection of your colleagues’ responses.

    By Day 6

    Respond to at least two of your colleagues on two different days using one or more of the following approaches:

    Ask a probing question, substantiated with additional background information, and evidence.

    Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.

    Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.

    Week 8 discussion

    Planning for Data Collection

    Data collection is an important part of both quantitative and qualitative research. Although the actual approach to gathering information may vary, for either research design, researchers need to plan in advance how the data will be gathered, reported, and stored, and they need to ensure that their methods are both reliable and valid. As nurses review research when considering a new evidence-based practice, it is important to be familiar with sound collection practices in order to ascertain the credibility of the data presented.

    Consider the following scenario:

    Nurses and other health care professionals are often interested in assessing patient satisfaction with health care services. Imagine that you are a nurse working in a suburban primary care setting that serves 10,000 patients annually. Your organization is very interested in understanding the patient’s point of view to help determine areas of care that can be improved. With this focus in mind, consider how you would create a survey to assess patient satisfaction with the services your organization provides. You may wish to consider variables such as the ease of accessing care, patient wait time, friendliness of the staff, or the likelihood that a patient would recommend your organization to others.

    For this Discussion, you generate questions and an overall plan for data collection that would be appropriate for a patient satisfaction survey in relation to the above scenario.

    To prepare:

    Consider the guidelines for generating questions presented in this week’s Learning Resources.

    Review the scenario and formulate at least five questions that you could use to evaluate patient satisfaction.

    Reflect on the different methods or instruments that can be used for gathering data described in Chapter 13 and Chapter 22 of the course text. Which methods or instruments would work well for the scenario?

    Determine an appropriate sample size for the scenario.

    By Day 3

    Post the questions that you created for gathering information about patient satisfaction based on the above scenario. Explain which method or instrument you would use to gather data. Describe the sample size appropriate for the population and how you would select participants. Provide a rationale for your choices, and explain how you can ensure high standard of reliability and validity.

    Read a selection of your colleagues’ responses.

    By Day 6

    Respond to at least two of your colleagues on two different days using one or more of the following approaches:

    Ask a probing question, substantiated with additional background information, and evidence.

    Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.

    Offer and support an alternative perspective using readings from the classroom or from your own review of the literature in the Walden Library.

    Validate an idea with your own experience and additional sources.

    Make a suggestion based on additional evidence drawn from the readings or after synthesizing multiple postings.

    Week 9 discussion

    Data Analysis—Small Group Discussion

    As a nurse engaged in evidence-based practice, it is important to recognize how statistics and other data analysis tools are used to generate and assess evidence. Most nurses need only a foundational understanding of statistical tools and terminology to understand the majority of research studies. As a nurse, you should be able to recognize the most commonly used statistical tests, how and when they are used, and how significance is determined.

    In this Discussion, you examine different types of statistics and statistical tests, when and why these particular tests would be selected for use, and, most importantly, what the results indicate. To this end, you will be assigned to a group by Day 1 of this week. Each group will be assigned one of the five chapters listed in this week’s Learning Resources and will develop a study sheet on their chapter that will be shared with the other groups.

    To prepare:

    Review the information in your assigned chapter.

    As a group, develop a 1-page study sheet that includes the following:

    The key concepts of the chapter: Focus on the basic concepts that are important for nurses to understand as they review research studies.

    A description of the statistical methods covered in the chapter, what they measure, and under what circumstances they are used. Identify examples of how the statistical methods have been used in research studies.

    An explanation of the key statistical tests and how they measure significance (if applicable).

    Note: This should be a collaborative effort, with each member of the group making contributions to the design and content of the study sheet. Use the Groups link on the left navigation bar to collaborate with your group. When you have developed your 1-page study sheet, select one member to post it to the Week 9 Discussion Forum so that the rest of your colleagues can access it.

    By Day 5

    Post your group’s study sheet. Discuss why it is important for nurses to understand the basics of these statistical methods.

    Read a selection of your colleagues’ responses.

    By Day 6

    Respond to at least two other groups on two different days using one or more of the following approaches:

    Ask a probing question, substantiated with additional background information, and evidence.

    Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.

    Week 10 discussion

    Weighing the Evidence

    When conducting original research, the final step researchers must complete is weighing the evidence and interpreting the meanings of their data, statistics, and analyses. This is the culmination of the research process in which all of the research methods and designs can be synthesized into a meaningful conclusion. In this stage, researchers should formulate explanations for what their data indicates, determine whether the data answers their initial research question, identify areas of uncertainty, and consider directions for further research.

    In this Discussion, you focus on one of the research articles that you identified for Part 2 of the Course Project (Literature Review). You then explore the process of how the researchers generated conclusions based on their data, consider other possible interpretations of their data, and formulate ideas for further research.

    To prepare:

    Review this week’s Learning Resources, focusing on how researchers find meaning in their data and generate sound conclusions. Pay particular attention to Table 2 in the article, “Study Design in Medical Research.”

    Revisit the 5 articles that you identified in Part 2 of the Course Project. Select one to consider for the purpose of this Discussion.

    Read sections of the chosen article where the data is presented, analyzed, and interpreted for meaning. What reasoning process did the researchers use to formulate their conclusions? What explanation did they give to support their conclusions? Were there any weaknesses in their analysis or conclusions?

    Consider possible alternate conclusions that the researchers could have drawn based on their data.

    Examine the findings that the article presents and consider how well they addressed the researcher’s initial question(s). What additional research could be done to build on these findings and gain a fuller understanding of the question?

    By Day 3

    Post an APA citation and brief summary of the research article that you selected. Describe the data and the results of any statistical tests or analyses presented in the article. Explain how the researchers formulated their conclusion, any weaknesses in their analysis or conclusions, and offer at least one alternate interpretation of their data. Propose at least one additional research study that could be done to further investigate this research topic.

    Read a selection of your colleagues’ responses.

    By Day 6

    Respond to at least two colleagues on two different days using one or more of the following approaches:

    Ask a probing question, substantiated with additional background information, and evidence.

    Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.

    Offer and support an alternative perspective using readings from the classroom or from your own review of the literature in the Walden Library.

    Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.

    Week 11 discussion

    Creating a Culture of Evidence-Based Practice

    An abundance of evidence can be found on almost any medical issue or health topic. Often, the availability of information is not the concern, but rather nurses struggle with how to convey the evidence to others and change practices to better reflect the evidence. Deep-rooted organizational cultures and policies can make some resistant to change, even to changes that can vastly improve the quality, effectiveness, and efficiency of health care. However, there are many strategies that nurses can employ to bring about changes to practice.

    In this Discussion, you focus on how to create an organizational culture that supports evidence-based practice.

    To prepare:

    Review the information in this week’s Learning Resources. Examine the various suggestions for promoting an organizational culture that embraces the use of EBP.

    Reflect on your own organization’s (or one in which you have worked) support of evidence-based practice. Examine how culture and policies impact the adoption of changes to practice based on evidence. What barriers exist?

    Consider the models and suggestions for promoting evidence-based practice featured in this week’s Learning Resources. Identify models and suggestions that would work well in your organization.

    Reflect on the significance of evidence-based practice in health care. What responsibility do nurses have to promote EBP and change practices to better reflect evidence and research findings?

    Reflect on how nurses can disseminate findings from evidence-based practice research.

    By Day 3

    Post an evaluation of your organization’s use of EBP and how it is furthered or hindered by organizational culture and policies. Describe how you could disseminate the findings. Propose a strategy for strengthening the culture of EBP within the organization. Discuss a nurse’s responsibility to further the use of EBP, providing a rationale supported by specific information from the Learning Resources.

    Read a selection of your colleagues’ responses.

    By Day 6

    Respond to at least two of your colleagues on two different days using one or more of the following approaches:

    Ask a probing question, substantiated with additional background information, and evidence.

    Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.

    Offer and support an alternative perspective using readings from the classroom or from your own review of the literature in the Walden Library.

    Validate an idea with your own experience and additional sources.

    Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.

    Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.

    Week 2 project

    Introduction to Course Project

    Evidence-based practice involves a great deal more than simply reading nursing periodicals on a regular basis. Nurses can take a more proactive approach to evidence-based practice by identifying authentic problems and concerns, and then using that to guide their inquiries into current research. In this way, nurses can connect the results of relevant research studies to their nursing practice.

    For the Course Project, you identify and apply relevant research to a specific nursing topic or problem. You begin by formulating an answerable question that is relevant to nursing and evidence-based practice. In later weeks of this course, you continue the Course Project by conducting a literature review and then determining how the evidence from the literature can be applied to nursing practice.

    Before you begin, review the Course Project Overview document located in this week’s Learning Resources.

    Note: This Course Project will serve as the Portfolio Assignment for the course. In addition to submitting portions of this Project in Weeks 2 and 5, you will turn in all three deliverables in Week 10.

    Course Project: Part 1—Identifying a Researchable Problem

    One of the most challenging aspects of EBP is to actually identify the answerable question.

    —Karen Sue Davies

    Formulating a question that targets the goal of your research is a challenging but essential task. The question plays a crucial role in all other aspects of the research, including the determination of the research design and theoretical perspective to be applied, which data will be collected, and which tools will be used for analysis. It is therefore essential to take the time to ensure that the research question addresses what you actually want to study. Doing so will increase your likelihood of obtaining meaningful results.

    In this first component of the Course Project, you formulate questions to address a particular nursing issue or problem. You use the PICOT model—patient/population, intervention/issue, comparison, and outcome—outlined in the Learning Resources to design your questions.

    To prepare:

    Review the article, “Formulating the Evidence Based Practice Question: A Review of the Frameworks,” found in the Learning Resources for this week. Focus on the PICOT model for guiding the development of research questions.

    Review the section beginning on page 71 of the course text, titled, “Developing and Refining Research Problems” in the course text, which focuses on analyzing the feasibility of a research problem.

    Reflect on an issue or problem that you have noticed in your nursing practice. Consider the significance of this issue or problem.

    Generate at least five questions that relate to the issue which you have identified. Use the criteria in your course text to select one question that would be most appropriate in terms of significance, feasibility, and interest. Be prepared to explain your rationale.

    Formulate a preliminary PICO question—one that is answerable—based on your analysis. What are the PICO variables (patient/population, intervention/issue, comparison, and outcome) for this question?

    Note: Not all of these variables may be appropriate to every question. Be sure to analyze which are and are not relevant to your specific question.

    Using the PICOT variables that you determined for your question, develop a list of at least 10 keywords that could be used when conducting a literature search to investigate current research pertaining to the question.

    To complete:

    Write a 3- to 4-page paper that includes the following:

    A summary of your area of interest, an identification of the problem that you have selected, and an explanation of the significance of this problem for nursing practice

    The 5 questions you have generated and a description of how you analyzed them for feasibility

    Your preliminary PICOT question and a description of each PICOT variable relevant to your question

    At least 10 possible keywords that could be used when conducting a literature search for your PICOT question and a rationale for your selections

    By Day 7

    Submit your Project. It will also be a component of your Portfolio Assignment for this course, which is due by Day 7 of Week 10.

    Reference:

    Davies, K. S. (2011). Formulating the evidence based practice question: A review of the frameworks. Evidence Based Library and Information Practice, 6(2), 75–80. Retrieved from https://ejournals.library.ualberta.ca/index.php/EBLIP/article/viewFile/9741/8144

    Submission and Grading Information

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

    Please save your Project using the naming convention “WK2Proj+last name+first initial.(extension)” as the name.

    Click the Week 2 Project Rubric to review the Grading Criteria for the Project.

    Click the Week 2 Project 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 “WK2Proj+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.

    Week 5 project

    Course Project: Part 2—Literature Review

    This is a continuation of the Course Project presented in Week 2. Before you begin, review the Course Project Overview document located in the Week 2 Resources area.

    The literature review is a critical piece in the research process because it helps a researcher determine what is currently known about a topic and identify gaps or further questions. Conducting a thorough literature review can be a time-consuming process, but the effort helps establish the foundation for everything that will follow. For this part of your Course Project, you will conduct a brief literature review to find information on the question you developed in Week 2. This will provide you with experience in searching databases and identifying applicable resources.

    To prepare:

    Review the information in Chapter 5 of the course text, focusing on the steps for conducting a literature review and for compiling your findings.

    Using the question you selected in your Week 2 Project (Part 1 of the Course Project), locate 5 or more full-text research articles that are relevant to your PICOT question. Include at least 1 systematic review and 1 integrative review if possible. Use the search tools and techniques mentioned in your readings this week to enhance the comprehensiveness and objectivity of your review. You may gather these articles from any appropriate source, but make sure at least 3 of these articles are available as full-text versions through Walden Library’s databases.

    Read through the articles carefully. Eliminate studies that are not appropriate and add others to your list as needed. Although you may include more, you are expected to include a minimum of five articles. Complete a literature review summary table using the Literature Review Summary Table Template located in this week’s Learning Resources.

    Prepare to summarize and synthesize the literature using the information on writing a literature review found in Chapter 5 of the course text.

    To complete:

    Write a 3- to 4-page Nursing Research and Evidence-Based Practice – Walden NURS6052 literature review that includes the following:

    A synthesis of what the studies reveal about the current state of knowledge on the question that you developed

    Point out inconsistencies and contradictions in the literature and offer possible explanations for inconsistencies.

    Preliminary conclusions on whether the evidence provides strong support for a change in practice or whether further research is needed to adequately address your inquiry

    Your literature review summary table with all references formatted in correct APA style

    Note: Certain aspects of conducting a standard review of literature have not yet been covered in this course. Therefore, while you are invited to critically examine any aspect of the studies (e.g., a study’s design, appropriateness of the theoretic framework, data sampling methods), your conclusion should be considered preliminary. Bear in mind that five studies are typically not enough to reflect the full range of knowledge on a particular question and you are not expected to be familiar enough with research methodology to conduct a comprehensive evaluation of all aspects of the studies.

    By Day 7 of Week 5

    This part of the Course Project is due. It will also be a component in your Portfolio Assignment in this course, which is due by Day 7 of Week 10.

    Week 7 assignment

    Assignment: Critiquing Quantitative, Qualitative, or Mixed Methods Studies

    Critiquing the validity and robustness of research featured in journal articles provides a critical foundation for engaging in evidence-based practice. In Weeks 5 and 6, you explored quantitative research designs. In Week 7, you will examine qualitative and mixed methods research designs. For this Assignment, which is due by Day 7 of Week 7, you critique a quantitative and either a qualitative or a mixed methods research study and compare the types of information obtained in each.

    To prepare:

    Select a health topic of interest to you that is relevant to your current area of practice. The topic may be your Course Portfolio Project or a different topic of your choice.

    Using the Walden Library, locate two articles in scholarly journals that deal with your portfolio topic: 1) Select one article that utilizes a quantitative research design and 2) select a second article that utilizes either a qualitative OR a mixed methods design. These need to be single studies not systematic or integrative reviews (including meta-analysis and metasynthesis). You may use research articles from your reference list. If you cannot find these two types of research on your portfolio topic, you may choose another topic.

    Locate the following documents in this week’s Learning Resources to access the appropriate templates, which will guide your critique of each article:

    Critique Template for a Qualitative Study

    Critique Template for a Quantitative Study

    Critique Template for a Mixed-Methods Study

    Consider the fields in the templates as you review the information in each article. Begin to draft a paper in which you analyze the two research approaches as indicated below. Reflect on the overall value of both quantitative and qualitative research. If someone were to say to you, “Qualitative research is not real science,” how would you respond?

    To complete this Assignment:

    Complete the two critiques using the appropriate templates.

    Write a 2- to 3-page paper that addresses the following:

    Contrast the types of information that you gained from examining the two different research approaches in the articles that you selected.

    Describe the general advantages and disadvantages of the two research approaches featured in the articles. Use examples from the articles for support.

    Formulate a response to the claim that qualitative research is not real science. Highlight the general insights that both quantitative and qualitative studies can provide to researchers. Support your response with references to the Learning Resources and other credible sources.

    As you complete this Assignment, remember to:

    Submit your paper to Grammarly and SafeAssign through the Walden Writing Center. Based on the Grammarly and SafeAssign reports, revise your paper as necessary.

    Reminder: The School of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The School of Nursing Sample Paper provided at the Walden Writing Center provides an example of those required elements (available from the Walden University website found in this week’s Learning Resources). All papers submitted must use this formatting.

    Combine all three parts of this assignment into one Word document including both critique templates and the narrative with your references. Submit this combined document.

    By Day 7 of Week 7

    Week 10 course project

    Course Project: Part 3—Translating Evidence Into Practice

    In Part 3 of the Course Project, you consider how the evidence you gathered during Part 2 can be translated into nursing practice.

    Now that you have located available research on your PICOT question, you will examine what the research indicates about nursing practices. Connecting research evidence and findings to actual decisions and tasks that nurses complete in their daily practice is essentially what evidence-based practice is all about. This final component of the Course Project asks you to translate the evidence and data from your literature review into authentic practices that can be adopted to improve health care outcomes. In addition, you will also consider possible methods and strategies for disseminating evidence-based practices to your colleagues and to the broader health care field.

    To prepare:

    Consider Parts 1 and 2 of your Course Project. How does the research address your PICOT question?

    With your PICOT question in mind, identify at least one nursing practice that is supported by the evidence in two or more of the articles from your literature review. Consider what the evidence indicates about how this practice contributes to better outcomes.

    Explore possible consequences of failing to adopt the evidence-based practice that you identified.

    Consider how you would disseminate information about this evidence-based practice throughout your organization or practice setting. How would you communicate the importance of the practice?

    To complete:

    In a 3- to 4-page paper:

    Restate your PICOT question and its significance to nursing practice.

    Summarize the findings from the articles you selected for your literature review. Describe at least one nursing practice that is supported by the evidence in the articles. Justify your response with specific references to at least 2 of the articles.

    Explain how the evidence-based practice that you identified contributes to better outcomes. In addition, identify potential negative outcomes that could result from failing to use the evidence-based practice.

    Outline the strategy for disseminating the evidence-based practice that you identified throughout your practice setting. Explain how you would communicate the importance of the practice to your colleagues. Describe how you would move from disseminating the information to implementing the evidence-based practice within your organization. How would you address concerns and opposition to the change in practice?

    By Day 7 of Week 10

    This part of the Course Project is due. It should be combined with the other two components of the Course Project and turned in as your Portfolio Assignment for this course.

    Note: In addition, include a 1-page summary of your project.

    For this final iteration, you will need to:

    Submit your paper to Grammarly and SafeAssign through the Walden Writing Center. Based on the Grammarly and SafeAssign reports, revise your paper as necessary.

    Reminder: The School of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The School of Nursing Sample Paper provided at the Walden Writing Center provides an example of those required elements (available from the Walden University website found in this week’s Learning Resources). All Nursing Research and Evidence-Based Practice – Walden NURS6052 papers submitted must use this formatting.

  • Evidence-Based Practice Research and PICO Question

    Evidence-Based Practice Research and PICO Question

    Week 2 project

    Introduction to Course Project

    Evidence-based practice involves a great deal more than simply reading nursing periodicals on a regular basis. Nurses can take a more proactive approach to evidence-based practice by identifying authentic problems and concerns, and then using that to guide their inquiries into current research. In this way, nurses can connect the results of relevant research studies to their nursing practice.

    For the Course Project, you identify and apply relevant research to a specific nursing topic or problem. You begin by formulating an answerable question that is relevant to nursing and evidence-based practice. In later weeks of this course, you continue the Course Project by conducting a literature review and then determining how the evidence from the literature can be applied to nursing practice.

    Before you begin, review the Course Project Overview document located in this week’s Learning Resources.

    Note: This Course Project will serve as the Portfolio Assignment for the course. In addition to submitting portions of this Project in Weeks 2 and 5, you will turn in all three deliverables in Week 10.

    Course Project: Part 1—Identifying a Researchable Problem

    One of the most challenging aspects of EBP is to actually identify the answerable question.

    —Karen Sue Davies

    Formulating a question that targets the goal of your research is a challenging but essential task. The question plays a crucial role in all other aspects of the research, including the determination of the research design and theoretical perspective to be applied, which data will be collected, and which tools will be used for analysis. It is therefore essential to take the time to ensure that the research question addresses what you actually want to study. Doing so will increase your likelihood of obtaining meaningful results.

    In this first component of the Course Project, you formulate questions to address a particular nursing issue or problem. You use the PICOT model—patient/population, intervention/issue, comparison, and outcome—outlined in the Learning Resources to design your questions.

    To prepare:

    Review the article, “Formulating the Evidence Based Practice Question: A Review of the Frameworks,” found in the Learning Resources for this week. Focus on the PICOT model for guiding the development of research questions.

    Review the section beginning on page 71 of the course text, titled, “Developing and Refining Research Problems” in the course text, which focuses on analyzing the feasibility of a research problem.

    Reflect on an issue or problem that you have noticed in your nursing practice. Consider the significance of this issue or problem.

    Generate at least five questions that relate to the issue which you have identified. Use the criteria in your course text to select one question that would be most appropriate in terms of significance, feasibility, and interest. Be prepared to explain your rationale.

    Formulate a preliminary PICO question—one that is answerable—based on your analysis. What are the PICO variables (patient/population, intervention/issue, comparison, and outcome) for this question?

    Note: Not all of these variables may be appropriate to every question. Be sure to analyze which are and are not relevant to your specific question.

    Using the PICOT variables that you determined for your question, develop a list of at least 10 keywords that could be used when conducting a literature search to investigate current research pertaining to the question.

    To complete:

    Write a 3- to 4-page paper that includes the following:

    A summary of your area of interest, an identification of the problem that you have selected, and an explanation of the significance of this problem for nursing practice

    The 5 questions you have generated and a description of how you analyzed them for feasibility

    Your preliminary PICOT question and a description of each PICOT variable relevant to your question

    At least 10 possible keywords that could be used when conducting a literature search for your PICOT question and a rationale for your selections

    By Day 7

    Submit your Project. It will also be a component of your Portfolio Assignment for this course, which is due by Day 7 of Week 10.

    Reference:

    Davies, K. S. (2011). Formulating the evidence based practice question: A review of the frameworks. Evidence Based Library and Information Practice, 6(2), 75–80. Retrieved from https://ejournals.library.ualberta.ca/index.php/EBLIP/article/viewFile/9741/8144

    Submission and Grading Information

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

    Please save your Project using the naming convention “WK2Proj+last name+first initial.(extension)” as the name.

    Click the Week 2 Project Rubric to review the Grading Criteria for the Project.

    Click the Week 2 Project 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 “WK2Proj+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.

    Week 5 project

    Course Project: Part 2—Literature Review

    This is a continuation of the Course Project presented in Week 2. Before you begin, review the Course Project Overview document located in the Week 2 Resources area.

    The literature review is a critical piece in the research process because it helps a researcher determine what is currently known about a topic and identify gaps or further questions. Conducting a thorough literature review can be a time-consuming process, but the effort helps establish the foundation for everything that will follow. For this part of your Course Project, you will conduct a brief literature review to find information on the question you developed in Week 2. This will provide you with experience in searching databases and identifying applicable resources.

    To prepare:

    Review the information in Chapter 5 of the course text, focusing on the steps for conducting a literature review and for compiling your findings.

    Using the question you selected in your Week 2 Project (Part 1 of the Course Project), locate 5 or more full-text research articles that are relevant to your PICOT question. Include at least 1 systematic review and 1 integrative review if possible. Use the search tools and techniques mentioned in your readings this week to enhance the comprehensiveness and objectivity of your review. You may gather these articles from any appropriate source, but make sure at least 3 of these articles are available as full-text versions through Walden Library’s databases.

    Read through the articles carefully. Eliminate studies that are not appropriate and add others to your list as needed. Although you may include more, you are expected to include a minimum of five articles. Complete a literature review summary table using the Literature Review Summary Table Template located in this week’s Learning Resources.

    Prepare to summarize and synthesize the literature using the information on writing a literature review found in Chapter 5 of the course text.

    To complete:

    Write a 3- to 4-page literature review that includes the following:

    A synthesis of what the studies reveal about the current state of knowledge on the question that you developed

    Point out inconsistencies and contradictions in the literature and offer possible explanations for inconsistencies.

    Preliminary conclusions on whether the evidence provides strong support for a change in practice or whether further research is needed to adequately address your inquiry

    Your literature review summary table with all references formatted in correct APA style

    Note: Certain aspects of conducting a standard review of literature have not yet been covered in this course. Therefore, while you are invited to critically examine any aspect of the studies (e.g., a study’s design, appropriateness of the theoretic framework, data sampling methods), your conclusion should be considered preliminary. Bear in mind that five studies are typically not enough to reflect the full range of knowledge on a particular question and you are not expected to be familiar enough with research methodology to conduct a comprehensive evaluation of all aspects of the studies.

    By Day 7 of Week 5

    This part of the Course Project is due. It will also be a component in your Portfolio Assignment in this course, which is due by Day 7 of Week 10.

    Week 7 assignment

    Assignment: Critiquing Quantitative, Qualitative, or Mixed Methods Studies

    Critiquing the validity and robustness of research featured in journal articles provides a critical foundation for engaging in evidence-based practice. In Weeks 5 and 6, you explored quantitative research designs. In Week 7, you will examine qualitative and mixed methods research designs. For this Assignment, which is due by Day 7 of Week 7, you critique a quantitative and either a qualitative or a mixed methods research study and compare the types of information obtained in each.

    To prepare:

    Select a health topic of interest to you that is relevant to your current area of practice. The topic may be your Course Portfolio Project or a different topic of your choice.

    Using the Walden Library, locate two articles in scholarly journals that deal with your portfolio topic: 1) Select one article that utilizes a quantitative research design and 2) select a second article that utilizes either a qualitative OR a mixed methods design. These need to be single studies not systematic or integrative reviews (including meta-analysis and metasynthesis). You may use research articles from your reference list. If you cannot find these two types of research on your portfolio topic, you may choose another topic.

    Locate the following documents in this week’s Learning Resources to access the appropriate templates, which will guide your critique of each article:

    Critique Template for a Qualitative Study

    Critique Template for a Quantitative Study

    Critique Template for a Mixed-Methods Study

    Consider the fields in the templates as you review the information in each article. Begin to draft a paper in which you analyze the two research approaches as indicated below. Reflect on the overall value of both quantitative and qualitative research. If someone were to say to you, “Qualitative research is not real science,” how would you respond?

    To complete this Assignment:

    Complete the two critiques using the appropriate templates.

    Write a 2- to 3-page paper that addresses the following:

    Contrast the types of information that you gained from examining the two different research approaches in the articles that you selected.

    Describe the general advantages and disadvantages of the two research approaches featured in the articles. Use examples from the articles for support.

    Formulate a response to the claim that qualitative research is not real science. Highlight the general insights that both quantitative and qualitative studies can provide to researchers. Support your response with references to the Learning Resources and other credible sources.

    As you complete this Assignment, remember to:

    Submit your paper to Grammarly and SafeAssign through the Walden Writing Center. Based on the Grammarly and SafeAssign reports, revise your paper as necessary.

    Reminder: The School of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The School of Nursing Sample Paper provided at the Walden Writing Center provides an example of those required elements (available from the Walden University website found in this week’s Learning Resources). All papers submitted must use this formatting.

    Combine all three parts of this assignment into one Word document including both critique templates and the narrative with your references. Submit this combined document.

    By Day 7 of Week 7

    Week 10 course project

    Course Project: Part 3—Translating Evidence Into Practice

    In Part 3 of the Course Project, you consider how the evidence you gathered during Part 2 can be translated into nursing practice.

    Now that you have located available research on your PICOT question, you will examine what the research indicates about nursing practices. Connecting research evidence and findings to actual decisions and tasks that nurses complete in their daily practice is essentially what evidence-based practice is all about. This final component of the Course Project asks you to translate the evidence and data from your literature review into authentic practices that can be adopted to improve health care outcomes. In addition, you will also consider possible methods and strategies for disseminating evidence-based practices to your colleagues and to the broader health care field.

    To prepare:

    Consider Parts 1 and 2 of your Course Project. How does the research address your PICOT question?

    With your PICOT question in mind, identify at least one nursing practice that is supported by the evidence in two or more of the articles from your literature review. Consider what the evidence indicates about how this practice contributes to better outcomes.

    Explore possible consequences of failing to adopt the evidence-based practice that you identified.

    Consider how you would disseminate information about this evidence-based practice throughout your organization or practice setting. How would you communicate the importance of the practice?

    To complete:

    In a 3- to 4-page paper:

    Restate your PICOT question and its significance to nursing practice.

    Summarize the findings from the articles you selected for your literature review. Describe at least one nursing practice that is supported by the evidence in the articles. Justify your response with specific references to at least 2 of the articles.

    Explain how the evidence-based practice that you identified contributes to better outcomes. In addition, identify potential negative outcomes that could result from failing to use the evidence-based practice.

    Outline the strategy for disseminating the evidence-based practice that you identified throughout your practice setting. Explain how you would communicate the importance of the practice to your colleagues. Describe how you would move from disseminating the information to implementing the evidence-based practice within your organization. How would you address concerns and opposition to the change in practice?

    By Day 7 of Week 10

    This part of the Course Project is due. It should be combined with the other two components of the Course Project and turned in as your Portfolio Assignment for this course.

    Note: In addition, include a 1-page summary of your project.

    For this final iteration, you will need to:

    Submit your paper to Grammarly and SafeAssign through the Walden Writing Center. Based on the Grammarly and SafeAssign reports, revise your paper as necessary.

    Reminder: The School of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The School of Nursing Sample Paper provided at the Walden Writing Center provides an example of those required elements (available from the Walden University website found in this week’s Learning Resources). All papers submitted must use this formatting.

  • Zero-Based Operational FTE Budget Assignment

    In Week 7, you began preparing a zero-based operational FTE budget draft for your nursing unit
    .
     This week, you will finalize your budget and submit your assignment in the format of a Microsoft Excel worksheet
    .

    Week 10 Tasks

    Begin this assignment by incorporating the instructor’s feedback on the worksheet you submitted in Week 7
    .

    Then, finalize your zero-based operational FTE budget, and ensure that it covers the following:

    Identify and describe the selected nursing unit on which the zero-based operational FTE budget is performed
    .
     What is the type of service provided by the nursing unit (for example, fifteen-bed intensive care unit or twenty-bed oncology unit)?

    Finalize the budget worksheet or spreadsheet with subcodes
    .
     Make sure to include the following:

    Operating expenses with subcodes

    Description of subcodes

    Prior-year expenses of subcodes

    Original budget allocations for subcodes

    Annualized expense for subcodes

    Budget adjustments for subcodes

    Approved budget for subcodes

    Personnel costs for one nursing unit

    Use APA style and formatting for your assignment
    .
     Make sure to include a title and a reference section for the assignment
    .

    Submit your budget in a Microsoft Excel worksheet to the W10: Assignment 2 Dropbox by Tuesday, November 7, 2017
    .
     Name your document SU_NSG6620_W10_A2_LastName_FirstInitial
    .
    xls
    .

  • Non-Hodgkin’s Lymphoma Essay

    Non-Hodgkin’s Lymphoma Essay

    Case Study: A 65-year-old woman was just been diagnosed with Stage 3 non-Hodgkin’s lymphoma
    .
     She was informed of this diagnosis in her primary care physician’s office
    .
     She leaves her physician’s office and goes home to review all of her tests and lab results with her family
    .
     She goes home and logs into her PHR
    .
     She is only able to pull up a portion of her test results
    .
     She calls her physician’s office with concern
    .
     The office staff discussed that she had gone to receive part of her lab work at a lab not connected to the organization, part was completed at the emergency room, and part was completed in the lab that is part of the doctor’s office organization
    .

    The above scenario might be a scenario that you have commonly worked with in clinical practice
    .
     For many reasons, patients often receive healthcare from multiple organizations that might have different systems
    .

    As you review this scenario, reflect and answer these questions for this discussion
    .

    What are the pros and cons of the situation in the case study?

    What safeguards are included in patient portals and PHRs to help patients and healthcare professionals ensure safety?

    Do you agree or disagree with this process?

    What are challenges for patients that do not have access to all of the EHRs? Remember, only portions of the EHRs are typically included in the PHRs
    .

  • NUR6550 final exam questions

    1. The Valsalva maneuver and the squat-to-stand maneuver are likely to increase the sound of a cardiac murmur associated with which of these conditions?

    2. Which of the following conditions may result in lower extremity edema?

    3. Art Bakke is a 46-year-old male who is being treated for an acute myocardial infarction. He has now developed significant dyspnea at rest and, per physical exam, has coarse rales involving the lower 2/3 of the lung fields bilaterally. You suspect acute pulmonary edema due to papillary-muscle rupture and acute mitral-valve regurgitation.

    Question: Which of the following physical findings would support this diagnostic hypothesis?

    4. The most common ECG finding in a patient with a cardiomyopathy is an ST-elevation MI.

     

    5. Nina Martinez is a 70-year-old female who experienced an episode of acute pulmonary edema following an endovascular aneurysm repair. She was discharged on furosemide 60 mg daily and instructed to follow up with cardiology. She is now seen in the office at 2 weeks post discharge. Her metabolic panel includes the following lab values:Question: This patient has which of the following abnormalities as a likely consequence of diuretic overuse?

    Hyponatremia

    Hypokalemia

    Metabolic acidosis

    ORDER A PLAGIARISM-FREE PAPER

    6. Which of the following are primary cardiomyopathy categories, as described by the World Health Organization (WHO) in 1995?

    7. What is the most common cause of sudden cardiac death in young people?

    What is the most common cause of sudden cardiac death in young people?

    8. Which of the following are treatment options for a patient who presents with peripartum cardiomyopathy while still carrying the fetus? (Select all that apply.)

    9. What are the 3 major clinical complications related to cardiomyopathies?

    Arrhythmias; including ventricular tachycardia and ventricular fibrillation

    Thromboembolic complications; including DVT, PE, and ventricular thrombi

    Acute pulmonary edema

    10. Some patients with primary cardiomyopathies remain asymptomatic throughout their lifetime.

    A 38-year -old woman comes to the emergency department complaining of a rapid heartbeat, tremors, and chest tightness. She reports earlier in the day she was feeling a migraine starting so she took a pill given to her by her friend who also experiences migraines. Her medical history reveals that she is currently taking a monoamine oxidase inhibitor for depression. Which migraine medication did she most likely take?

    Acetaminophen and caffeine (Excedrin ® Migraine)

    Naproxen sodium (Aleve ® )

    Almotriptan (Axert ® )

    Butalbital, acetaminophen and caffeine (Fioricet ® )

     

    well-controlled hypertension, type 2 diabetes mellitus, and dyslipidemia and takes an angiotensin-converting enzyme inhibitor (ACEI), statin, biguanide, and low-dose aspirin (ASA). She worked in a dry cleaning facility until approximately 8 years ago. During her evaluation, she mentions that she sometimes has difficulty understanding conversation, especially in noisy environments. This is likely a:

    Drug-related reaction.

    Consequence of occupational chemical exposure.

    Early sign of dementia.

    Normal age-related change in hearing

     

    While evaluating a 33-year-old female with a 2-day history of dysuria, which of the following findings in urinalysis is most suggestive of urinary tract infection (UTI) caused by a Gram-negative organism?

    Nitrites

    30 mg/dL protein Epithelial cells pH>8

    All of the following are examples of primary prevention strategies except:

     

    Counseling an elderly patient prior to discharge about fall risk at home and how to prevent falls through adequate illumination.

    Performing a hemoglobin A1C for all patients admitted to the hospital.

     

    Conducting a study to identify the leading cause of mortality in teenagers and how to reduce risk.

    Immunizing all adults ?60 years with zoster vaccine.

    A 23-year-old woman is being evaluated for an upper respiratory tract infection. As you prepare for auscultation, the patient states “I have a benign murmur that has been with me my whole life”. Anticipating a physiologic murmur, you would expect which of the following characteristics?

    Usually obliterates S2.

    Becomes softer when going from a supine to standing position.

    Occurs late in systole.

    Has localized area of auscultation

    You see a 73-year-old woman with a 40 pack- year smoking history, chronic obstructive pulmonary disease (COPD) and peripheral arterial disease (PAD) who presents with an ulcer on the sole of her left foot. The ulcer has an irregular edge and pale base and a punched out appearance, with the surrounding skin white and shiny. The patient states that the pain is worse at night in bed and when the legs are elevated. The most likely diagnosis is:

    Pressure ulcer

    Pyoderma gangrenosum

    Venous ulcer

    Arterial ulcer

     

    You see a 76-year-old woman living at home who is accompanied by her home care provider. She has COPD and type 2 diabetes mellitus. An example of a secondary prevention strategy is:

    Administering the seasonal influenza vaccine.

    Screening for physical or financial abuse/Checking her blood glucose level.

    Checking her blood pressure.

    Adjusting her insulin dosing regimen.

     

    A 43-year-old woman is being evaluated in the emergency department with a complaint of a severe headache. She describes a unilateral, pulsing headache that was preceded by a gradual onset of paresthesia affecting the ipsilateral face and arm. The patient stated she noticed a “funny smell” prior to the symptoms starting. This description is most typical of:

    Migraine with aura.

    Cluster headache.

    Transient ischemic attack.

    Tension-type headache.

    You see a 54-year-old man living in subsidized housing with a history of hypertension. He states that he stopped taking his blood pressure medication about 4 months ago because of costs. He is concerned because his blood pressure is high whenever he checks it, though he does not report any symptoms. His BP at this visit is 196/104 mm Hg. Upon examination of this patient, you would expect to detect an S 4 sound heard during:

    Early systole.

    Late systole.

    Early diastole.

    Late diastole.

    32-year-old man requires evaluation for hepatitis infection prior to taking a job as a restaurant cook. He presents with the following laboratory results:

    When evaluating illness symptoms in older patients, the disease will often present differently from younger adults due to:

    The likelihood of polypharmacy.

    Decreased compensatory mechanisms in the elderly.

    An increased physiologic response to illness in the elderly.

    Presence of comorbid conditions.

    When prioritizing risk factors for bacterial endocarditis, the nurse practitioner knows who among the following patients has the highest risk.

    A 55-year-old man with 3-vessel coronary artery bypass grafts with stents.

    A 23-year-old woman with mitral valve prolapse without tissue redundancy.

    A 65-year-old man with nonobstructive cardiomyopathy.

    A 75-year-old woman with a nonorganic prosthetic aortic valve.

    The legal authority for NPs to perform healthcare services as defined by state law is called:

    Duty of care.

    Non-malfeasance.

    Autonomy.

    Scope of practice.

    When developing a management plan for patients with genitourinary infections, which of the following would you most likely recommend for follow-up imaging following resolution of their infection?

    A 27-year-old nonpregnant woman with acute, uncomplicated urinary tract infection (UTI). A 38-year-old nonpregnant woman with 2 acute, uncomplicated UTIs in the past 9 months. A 57-year-old man with acute bacterial prostatitis.

    A 43-year-old man with type 2 diabetes mellitus and recurrent pyelonephritis.

    The NP is called to evaluate Jane, a 43-year- old woman, who presents with a diffuse maculopapular rash that began on the trunk but now covers the entire body, including the palms and soles. The rash is not itchy but wart-like sores are present in the mouth and genital area as well as skin folds. Initial evaluation reveals generalized lymphadenopathy and a low-grade fever, and she complains of lethargy and headache. The patient reports that she had a painless genital ulcer that healed on its own about 3 weeks earlier. Which of the following is the most likely diagnosis?

    Primary syphilis.

    Secondary syphilis.

    Genital herpes.

    Gonorrhea.

    A 27-year-old man presents with a chief concern of an abnormal mass within his left scrotum. He describes it as feeling like a “bag of worms” and is present when he is standing but disappears when he lies down. His past medical history is unremarkable and his BMI is 29 kg/m 2 . He has been in a monogamous relationship for the past 4months. The most likely diagnosis is:

    Testicular torsion.

    Syphilis.

    Varicocele.

    Testicular cancer.

    An 18-year-old man is being evaluated for a severe exacerbation of asthma. He is currently taking an inhaled corticosteroid, a long- acting beta-agonist, and a short-acting beta-agonist on an as needed basis. The most important component of the initial assessment includes a(n):

    Continuous pulse oximetry reading

    Peak expiratory flow reading

    Chest X-ray

    Arterial Blood Gas

    A 67-year-old man is being evaluated for shortness of breath. His medical history reveals that he experienced a myocardial infarction about 2 years ago and a history of hypertension, which is well controlled by diet.. Otherwise, his medical history is unremarkable. Which of the following would you expect to find on electrocardiogram (ECG)?

    T wave inversion.

    Pathologic Q wave.

    ST segment elevation.

    Tall R wave.

    A 74-year-old male with asymptomatic atrial fibrillation underwent electrical cardioversion that successfully restored the heart’s rhythm. Which of the following medications can be considered for the purpose of maintaining the heart’s rhythm?

    Sotalol (Betapace ® )

    Digoxin (Lanoxin ® )

    Dabigatran (Pradaxa ® )

    Enalapri

    A 14-year-old male is brought in for evaluation after he reportedly collapsed during a tennis match, though he quickly regained consciousness. His medical history is otherwise unremarkable. You suspect hypertrophic cardiomyopathy. Which of the following heart murmur characteristics would support the diagnosis?

    Occurs late in systole.

    Widely split S?.

    Becomes louder when going from a supine to standing position.

    Murmur follows mid-systolic click.

    You see a 64-year-old man with an area of erythema concentrated on the left side of his neck with clusters of vesicles forming a line. He reported pain in the area a couple of days before the eruption of the lesions. He states that he recently initiated biologic therapy for rheumatoid arthritis. Which of the following is the most likely diagnosis?

    Impetigo.

    Herpes zoster.

    Drug-related adverse reaction.

    Viral exanthem.

    l (Vasotec ® )

    An NP’s duty of care can be established:

    Only in the setting of a healthcare institution (e.g., hospital, clinic, etc.).

    When the NP gives professional advice or treatment in any setting.

    Only when a fee is charged, either to the patient or third-party payer, for services.

    Only when both the NP and patient acknowledge a patient-provider relationship.

    In managing a 58-year- old woman who is admitted for deep vein thrombosis, caution should be used with which of the following medications due to a risk of drug-induced thrombocytopenia?

    Warfarin (Coumadin®)

    Clopidogrel (Plavix®)

    Dabigatran (Pradaxa®)

    Unfractionated heparin

    An 84-year-old female patient is admitted from a local long-term care facility (illnes). The patient is normally awake, alert, and oriented. She resides in the LTCF because she has not fully recovered from a broken hip resulting from a fall 4 months ago; otherwise she is in relatively good health. She can walk short distances with a walker, though she primarily stays in a wheelchair. Today, however, the nursing staff found her to be acutely confused and unable to ambulate without falling. She was transferred to the emergency department for evaluation. Initial laboratory testing must include:

    2 sets of blood cultures.

    Serum thyroid stimulating hormone (TSH) level.

    Urinalysis.

    Lumbar puncture.

    A 23-year-old college student presents with a 2-day history of severe sore throat and difficulty eating or drinking due to trouble swallowing. A physical examination reveals exudative pharyngitis and minimally tender anterior and posterior cervical lymphadenopathy. The NP suspects infectious mononucleosis and would expect which of the following laboratory findings?

    Neutrophilia with reactive forms.

    Thrombocytosis.

    Lymphocytosis with atypical lymphocytes.

    Diminished ALT/AST levels.

    “Incident-to” services are defined as those which are “an integral, although incidental, part of the physician’s personal professional services in the course of diagnosis or treatment of an injury or illness”. As long as certain criteria are met, “incident to” billing is an option in all of the following settings except:

    Office visits.

    Hospital.

    Nursing home.

    Home visits.

    A 78-year- old male is being treated for a hypoglycemic episode. He has a long history of type 2 diabetes mellitus as well as congestive heart failure and COPD. He is currently taking basal insulin with a sulfonylurea. What is the acceptable A1C goal for this patient?

    ?6.5%

    ?7.0%

    ?8.0%

    ?9.0%

    You see a 74- year-old male who is accompanied by his granddaughter who lives with him. He has hypertension, a prior myocardial infarction, long-standing type 2 diabetes, and recently underwent a lower limb amputation secondary to diabetes. He is currently taking an ACE inhibitor, statin, low-dose aspirin, biguanide, and insulin. The granddaughter reports that since the amputation, her grandfather sometimes becomes withdrawn, irritable and moody for no apparent reason, does not want to participate in the typical activities he enjoys, and often does not appear to eat much during the day. She also states that he often complains of being tired but normally wakes up in the early morning hours. The most appropriate action is to evaluate the patient for:

    Dementia.

    Depression.

    Delirium.

    Drug interaction.

    You see a 58-year-old man who complains of a persistent dry, hacking cough. He reports that he recently started taking a medication to treat high blood pressure. He is most likely taking a(n):

    Angiotensin-converting enzyme (ACE) inhibitor

    Alpha-adrenergic antagonist

    Angiotensin receptor blocker

    Beta-adrenergic antagonist

    A 77-year-old woman is accompanied by her husband for evaluation. She is currently being treated with metoprolol (Lopressor ® ) for hypertension and digoxin (Lanoxin ® ) for atrial fibrillation. He reports that his wife is becoming increasingly forgetful over the past year, failing to note important family events such as birthdays, and sometimes becomes confused with driving directions to familiar locations. She has no previous psychiatric history. The most likely diagnosis is:

    Parkinson’s disease.

    Delirium.

    Dementia.

    Early stage of congestive heart failure.

    Mrs. Conner is a 76- year-old woman living in a long-term care facility and has been bedridden with a respiratory infection for the past 4 days. She is brought in for evaluation and you note signs of dehydration as well as a section of epidermal skin loss about 3 cm in diameter on her right hip. The dermal layer appears intact. This would be considered a pressure ulcer of Stage:

    1

    2

    3

    4

    Which of the following represents the highest level of scientific evidence when evaluating clinical research?

    A randomized controlled trial.

    Systematic review/ Meta-analysis of randomized controlled troals.

    Observational study.

    Cohort study.

    A 64-year- old woman with chronic kidney disease presents with a chief complaint of lethargy. His hemogram is as follows:

    -Hemoglobin (Hg)=9.9 g/dL (12–14 g/dL -Hematocrit (Hct)=30% (36%–42%) -Mean cell volume (MCV)=81 fL (80–96 fL -Reticulocytes=0.7% (1%–2%)

    These findings are most consistent with:

    Iron deficiency anemia.

    Anemia of chronic disease.

    Folate deficiency anemia.

    Thalassemia trait.

    You see a 68-year-old woman who is being treated for moderate depression. She complains that her medication is causing symptoms of dry mouth and constipation. She is most likely taking which of the following medications?

    Venlafaxine (Effexor ® )

    Citalopram (Celexa ® )

    Fluoxetine (Prozac ® )

    Nortriptyline (Pamelor ® )

    All of the following persons are eligible for Medicare services except:

    A 74-year-old ex-smoker with COPD and high income from assets.

    A 69-year-old undocumented resident in the US with atrial fibrillation.

    A 62-year-old with a permanent physical disability due to a motor vehicle accident. A 72-year-old permanent legal resident (non-US citizen) with type 1 diabetes mellitus.

     

    When initiating therapy with spironolactone for a patient who is also on an ACE inhibitor, you advise the patient to return in 5 days to check which of the following laboratory parameters?

    Sodium

    Calcium

    Potassium

    Chloride

    When considering an end-of-life decision for a terminally ill person with Alzheimer-type dementia who can no longer communicate, all of the following can be used as an advanced directive except:

    Testimony from a family member or close friend

    A living will.

    A “do not resuscitate” order.

    A durable power of attorney for healthcare.

     

    Which of the following types of clinical studies represents the lowest level of evidence used to guide medical decisions?

    Clinical experience of renowned expert in field.

    Non-randomized controlled study.

    Observational study.

    Case-control study.

    Which of the following electrocardiogram (ECG) changes do you expect to find in a person with myocardial ischemia?calcium

    Pathologic Q wave

    Tall R wave

    T wave inversion

    ST segment elevation

    Which of the following statements is false regarding end-of-life decision-making for a patient that is hopelessly and terminally ill?

    A durable power of attorney for healthcare can be used to authorize another person to make healthcare decisions. A videotaped or audiotaped discussion with the patient can include advanced directives.

    Advanced directives are legally binding and recognized in all 50 states.

     

    Living wills and do not resuscitate orders are examples of advanced directives.

    The nurse practitioner is evaluating a 19-year- old male suffering from a severe headache. He has a history of headaches that tend to occur in clusters over a few days. He has unsuccessfully tried several therapeutic modalities. A positive response to which of the following interventions supports the diagnosis of cluster headache?

    Oxygen therapy.

    Beta-adrenergic blockade.

    Tricyclic antidepressant.

    Dietary reduction of amines.

    All of the following are required Medicare terms and conditions for paying NP services except:

    The services are within the NP’s scope of practice as defined by state law.

    The services performed are those for which a physician would be able to bill Medicare. The services are performed in collaboration with a physician.

    Separate charges are billed for NP services and facility charges.

     

    A 28- year- old male with asthma presents with a chief complaint that he has to use his rescue inhaler multiple times each day. An evaluation reveals that he has moderate-to-severe asthma and requires Step 4 treatment. An appropriate regimen would include:

    Low-dose inhaled corticosteroid (ICS)

    Medium-dose ICS

    Medium-dose ICS plus a long-acting beta?-agonist (LABA)

    High-dose ICS plus LABA plus omalizumab (Xolair ® )

     

    A 62-year-old woman presents in the emergency department complaining of severe toe pain that originated overnight. She has a history of renal disease and is currently taking a thiazide diuretic. Her BMI is 37 kg/m 2 . In considering a diagnosis of acute gouty arthritis, the nurse practitioner knows that the best diagnostic indicator is:

    Serum uric acid.

    Joint X-ray.

    Erythrocyte sedimentation rate (ESR).

    Analysis of joint aspirate for urate crystals.

     

    Which of the following is the most appropriate antibiotic for a 57-year-old man with acute bacterial rhinosinusitis and who has type 2 diabetes mellitus, COPD and a beta-lactam allergy?

    Cephalexin (Keflex ® ).

    Amoxicillin-clavulanate (Augmentin ® ).

    Trimethoprim with or without sulfamethoxazole (Primsol ® , Bactrim ® ).

    Levofloxacin (Levaquin ® )

  • Case Reports Essay

    Case Reports Essay

    Instructions for CLET 4840 Paper:

    Basic Outline:

    A case study or literature review paper assignment will be due Friday @11:00am week 7. If you are late (after 11am Friday week 7 and before Friday @ 11am week 10), after 11a.m. the paper will be accepted to complete the course work, but will receive a grade of 0. Failure to submit the paper will result in a zero in the lab, which results in a failure in the class. Electronic copies of the paper will NOT be accepted. Your option is to write a paper on any topic that is relevant and/or related extremity condition or complaint. It can be a literature search or a case study. You will need references from legitimate sources like PubMed, Scopus or ICL (Index to Chiropractic Literature), they must be included and you 
    cannot
     use Souza.

    A case study
     must follow the introduction, case report, discussion, conclusion format. The case reports should include all aspects of the patient encounter as well as interventions and a comprehensive discussion on the subject matter. Written permission must be attained to write a case report on any patient you are treating.

    Research Literature Review
    must select 5-7 published research articles or case reports on an extremity condition or complaint either resolved by or currently under chiropractic care. A literature search is defined as “a comprehensive sourcing of published information from databases based on specific specifications”. This means that once you have chosen your topic, you may go to Scopus, Pub-med orICL (Index to Chiropractic Literature) and search their data base for similar papers that have been published on that topic. You will then write your own paper including an introduction, comprehensive discussion of the topic and a conclusion with your own thoughts and opinions based on the information you have gathered from your literature search.

    In addition, a 
    200-word abstract
     must be included. Abstracts should be concise and informative and must outline the basic tenets of the main paper.

    The references page
     will follow the College of Chiropractic reference citation style guide as posted in this section. At least 5-7 articles will be required form Scopus, Pub-med or Please look in the folder for the instructions. If you need further assistance in how to write the case report or the literature search paper, please look in this folder for the articles posted for further information.

    Plagiarism will not be tolerated and when detected will result in a zero on the paper and zero in the lab, which will result in a failure in the class. The paper will count 5% of your Lab grade. Further details will be posted on the BB site under course information. The project must be no less than 1000 words in double spaced, Arial 12-point font.