Category: Nursing

westcoast nurs521 Week 3 Contemporary Issue Position Essay

Choose a case from the AMA Journal of Ethics Case Index and take a position. For this assignment you will evaluate the ethical arguments for or against the issue. Identify the potential legal arguments (consider current federal guidelines), indicate any potential professional code conflicts you foresee, and support your position with an explanation of your own ethical/moral foundation.

In your 2-3 page westcoast nurs521 Week 3 Contemporary Issue Position Essay paper:

Identify the issue and state your ethical position.

How might this scenario play out or impact you in your role as a nurse practitioner?

Defend your position with legal, ethical, and professional evidence.

As part of your position, propose strategies and solutions for addressing the issues.

What other ethical issues does this case bring to light, if any?

Support your position with at least one scholarly source (it may be your text). Be sure to cite the article you choose, use APA format, and include a title page and reference page.

Review the rubric for further information on how your assignment will be graded.

westcoast nurs521 Week 3 Contemporary Issue Position Essay

NURS 6650 Psychotherapy with Groups and Families Midterm & Final Exam Questions and Answers

The PMHNP is working with a family during their first therapy session. According to the Gestalt school of perception, what must the PMHNP do to change the group behavior?

A.

Create a process/content distinction with the family

B.

C.

D.

None of the above

 

 

The PMHNP is meeting with the parents of a school-aged girl. The mother reports feeling frustrated, because they cannot get their daughter to do her homework. “All she wants to do is play on her phone,” the father reports. The mother tells the PMHNP that they have tried threatening her by telling her that she won’t be able to have her friends over and that she won’t be allowed to watch TV. Which of the following responses made by the PMHNP demonstrates use of the Premack principle? NURS 6650 Psychotherapy with Groups and Families Midterm & Final Exam Questions and Answers.

A.

“Do you know what other parents do for their kids, and does it work for them?”

B.

“Have you tried making her phone privileges contingent on finishing her homework?”

C.

“Why do you think your daughter doesn’t want to do her homework?”

D.

“Can you think of a time when your daughter did her homework without you having to ask her?”

 

During a family therapy session, the mother says, “I don’t know why my son is always in trouble at school. He does what he wants to do.” The father adds, “He’s almost 14 years old. It’s up to him to get his life in order.” What is the most appropriate intervention by the PMHNP?

A.

Encourage the family to spend some time at home becoming enmeshed

B.

Ask the parents to elaborate on why they don’t know much about their son’s life

C.

Give the family an assignment to spend quality time together before the next session

D.

Ask the parents to experiment with being excessively involved in their son’s life

 

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The PMHNP is discussing problem-solving techniques with a married couple. What recommendation will the PMHNP provid

e to the couple?

A.

B.

“Avoid trying to ”

C.

D.

“Speak on behalf of your partner to show that you understand.”

During a family therapy session, the PMHNP hears the father say to the son, “You shouldn’t play video games where you shoot people.” According to the Bion school of thought, what is the content of the message that the father is trying to express? NURS 6650 Psychotherapy with Groups and Families Midterm & Final Exam Questions and Answers

A.

B.

C.

“You’re better at other types of video games.”

D.

A couple and their 13-year-old daughter have been in family therapy. The mother explains that her daughter is unhappy at private school and would like to be in public school. The father has been listening quietly and then says, “We are upset that our daughter wants to leave private school.” When using a systemic family therapy approach, what is the appropriate response by the PMHNP to the father?

A.

B.

“I’d like for you to rephrase your statement starting with ‘I am upset.’”

C.

D.

“If I understand correctly, you are both upset about this situation.”

 NURS 6650 Psychotherapy with Groups and Families Midterm & Final Exam Questions and Answers

The PMHNP is working with a father and his son, who is 7 years old. According to the father, the son frequently experiences outbursts and poor impulse control. Using the differentiation of self-concept, what advice does the PMHNP offer the child?

A.

B.

“You should practice agreeing with your father when he tells you to do something.”

C.

D.

“Let your father know when something he does triggers you to feel bad.”

 

 

The PMHNP is assessing a 19-year-old patient who reports feeling burdened and constrained by her family. “I feel like I can’t live my own life, and like I need their approval for everything I do,” she says during the assessment. Which response by the PMHNP supports the principles of family therapy?

A.

B.

C.

D.

“Family is there for unconditional acceptance of you and your life.”

 

 

The PMHNP is meeting with a woman and her 11-year-old child, who was a victim of sexual abuse. The offender is the child’s stepfather, who is currently in jail. What action does the PMHNP employ with the child and mother during the first session?

A.

Providing the child and mother an outline of the things to cover during the session, to make it easier for them to open up

B.

Asking the child and mother to describe the sexual abuse as it occurred

C.

Telling the child to pretend that the stepfather is in the room now, to discuss how the child feels

D.

Giving the child and mother a choice about how much to discuss

 

 

The PMHNP is working with a patient who is sleep deprived and depressed. Which of the following is an appropriate scaling question for the PMHNP to ask?

A.

B.

NURS 6650 Psychotherapy with Groups and Families Midterm & Final Exam Questions and Answers

C.

D.

“How many”

 

The PMHNP is providing family therapy to two parents and their twin 14-year-old children. The children become defiant around bedtime and are still working on their homework late into the night. How does the PMHNP employ an experiential technique of family sculpting? NURS 6650 Psychotherapy with Groups and Families Midterm & Final Exam Questions and Answers

A.

Asks one of the parents to arrange the family into a typical bedtime scene

B.

Asks each person to comment on bedtime challenges

C.

D.

 

Using a systemic family therapy approach, a PMHNP is meeting with a couple for an initial session and is asking each member to describe why he or she came to family therapy. After creating a genogram, the PMHNP says, “I can see that the men in your family are often the sole providers, and the women have been in charge of running the household.” Which is the most appropriate next response by the PMHNP?

A.

“Do you think this pattern is contributing to your issues?”

B.

“Do you see why this may be causing a dysfunctional relationship?”

C.

“This is likely the reason for your problems.”

D.

“These days, traditional roles are not the norm.”

 

 

A PMHNP learns that the family has been experiencing dysfunction because a mother and her teenage son have been getting easily annoyed and yelling at each other. When using a strategic family therapy approach, which directive should the PMHNP suggest to solve the problem?

A.

B.

C.

D.

All of the above

 

The PMHNP is meeting with parents who are having difficulty disciplining their child at home during his emotional and behavioral outbursts. The mother feels that the father is too strict but realizes that she is tired of getting “walked on” by their child. Which statement made by the PMHNP demonstrates the use of internal family systems therapy model?

A.

“Each person in the family has certain roles to fulfill. You might be taking on a less active role when it comes to disciplining your child because of the experiences you had in your own childhood.”

B.

“As a parent, you can create the dynamic and relationships you want. Maybe you could try asking your husband to be less strict with your child and see what kind of response you get from your child.”

C.

“It sounds like there’s a part of you that thinks your husband is too strict, but another part of you that thinks you should be stricter yourself. What does that second part of you look or sound like?”

D.

NURS 6650 Psychotherapy with Groups and Families Midterm & Final Exam Questions and Answers

 

 

The PMHNP is meeting with a married couple. The woman feels very insecure, particularly when it comes to her husband working with women in his office. She reports, “My girlfriends say that it’s not attractive to be insecure like I am, so I’m really making the problem worse by being so insecure.” How can the PMHNP externalize the woman’s problem?

A.

Have the woman talk to her husband directly about her concerns

B.

Help the woman free herself from the label of “insecure”

C.

Have the woman make a list of all the things about which she is insecure

D.

None of the above

 

 

The PMHNP is working with a married couple who have agreed to seek sex therapy due to the wife’s gradual decrease in interest in sex. The wife explains that she feels as though she cannot feel comfortable naked and enjoying being intimate. The PMHNP recognizes that the couple could possibly benefit from sensate focus. To apply the sensate focus exercise, the PMHNP suggests the couple first do what?

A.

Practice desensitizing themselves from sex so that they do not feel any anxiety

B.

C.

D.

Practice touching one another intimately

The PMHNP works with a husband and a wife, but in separate sessions, to address marital issues. One day, the wife asks the PMHNP how her husband is progressing with his therapy. Which response made by the PMHNP is most appropriate?

A.

“I’m sorry, ”

B.

“I can .”

C.

NURS 6650 Psychotherapy with Groups and Families Midterm & Final Exam Questions and Answers

D.

All of the above

 

The PMHNP is meeting with a family composed of two parents and their two children. The PMHNP observes that the mother projects her concerns onto one of the children, and that child seems to conform to the parents’ way of thinking. The other child seems to be less involved in the family’s fusion. What action taken by the PMHNP demonstrates the use of the Bowen Family Systems Therapy model? NURS 6650 Psychotherapy with Groups and Families Midterm & Final Exam Questions and Answers.

A.

B.

C.

A and B

D.

None of the above

 

 

The PMHNP is performing an intake assessment on parents who had their son later in life. Since their son left for college 6 months ago, the couple reports arguing a lot and not getting along in general. When applying the theory of the family life cycle, what does the PMHNP say in response to this concern?

A.

“These sorts of e

B.

“It’s very co.”

C.

“This is an issue”

D.

None of the above.

 

The PMHNP is meeting with a married couple who have recently had a baby. The transition of becoming new parents has caused a lot of friction and tension in the household. The wife wishes the husband would help out at least once with the nighttime feedings so she can get more than 3 hours of sleep at night. The husband feels like this is an unfair request, because the wife no longer works, but she still asks the husband to do a lot of errands during the day. What does the PMHNP do to create a quid pro quo contract between the husband and wife?

A.

Suggest the wife to agree to do more errands during the day, and then have the husband agree to do one nighttime feeding

B.

Convince the couple that this transition period with a new baby is normal and is not permanent, because soon the baby will start sleeping longer during the night

C.

Recommend that the husband and wife spend more quality time together outside of the home and without the baby around

D.

NURS 6650 Psychotherapy with Groups and Families Midterm & Final Exam Questions and Answers

 

The PMHNP is working with a family consisting of a father, a mother, and a daughter who is a sophomore in high school. The issue being discussed has to do with the daughter’s emotional outbursts about wanting to spend more time with her friends. Recently, the daughter blew up at the parents over the fact that they wouldn’t let her go to a party, since older kids from the school were throwing it. This outburst led to arguments in the household, which led to the daughter getting grounded for 2 weeks. Which theory does the PMHNP recognize as the most applicable?

A.

Systems theory

B.

C.

NURS 6650 Psychotherapy with Groups and Families Midterm & Final Exam Questions and Answers

D.

 

 

The PMHNP is meeting with a mother and her 9-year-old child. The child is upset that the father left the house and hasn’t been back in a long time. Which action will the PMHNP perform to employ the role-playing technique with the child?

A.

Have the child draw his relationship to his father on a piece of paper

B.

C.

D.

Ask the child to discuss how he feels about his father being gone

 

The PMHNP is working with a family that includes two parents and their two children. The PMHNP defined the problem and goal in a previous session. Today, the PMHNP wants to find out whether the family has experienced any attempted solutions. What does the PMHNP identify as an attempted solution that actually perpetuates the family problem?

A.

The parents fail to punish both children for stealing alcohol from the kitchen and drinking in their rooms.

B.

The children crave attention and affection, so the parents buy them each a motorized scooter.

C.

The wife wishes the husband would spend more time at home, and the husband tries to make her feel better by paying for a trip to visit her sister.

D.

All of the above

 

 

 

The PMHNP is working with parents who argue about ways to discipline their school-aged son. The PMHNP initiates enactment, telling the parents to discuss the disciplinary choices directly with each other. At what point does the PMHNP determine that the parents are demonstrating enmeshment?

A.

The mother interrupts the father while he is speaking.

B.

C.

NURS 6650 Psychotherapy with Groups and Families Midterm & Final Exam Questions and Answers

D.

All of the above.

 

The PMHNP is working with 12-year-old twin sisters. Their parents report that the twins got into a big fight recently, which they haven’t been able to overcome. Which cognitive interaction can the PMHNP use to help the sisters gain a new perspective of the argument to help soften their own opinion of it?

A.

B.

Encourage the sisters to write down why they believe they are right

C.

D.

Suggest the sisters find something they both like and can relate to

 

 

The PMHNP has just completed an intake assessment on a 15-year-old patient and believes the patient would benefit from family therapy. How does the PMHNP describe the goals of the therapy to the patient and the patient’s parents?

A.

B.

“Our goal is to strengthen the patient’s internal influences.”

C.

D.

All of the above

 

The PMHNP is working with a family in a group setting. When employing the experiential technique, what action will the PMHNP take with the family during assessment?

A.

B.

C.

Analyze

D.

Ask the family members to

 

 

 

The PMHNP is meeting with a single father and his adolescent daughter. They have been “butting heads” because of the daughter’s differing opinions about her curfew and social life. They haven’t been able to communicate well. The PMHNP tries an experiential technique of family drawing. What will the PMHNP have the father and daughter do for this technique?

A.

Draw a picture as they see themselves in relation to one another

B.

Draw a picture of what they wish they could say to each other

C.

Draw a picture of their behaviors and actions, without using any words

D.

All of the above

 

The PMHNP wants to identify the unique outcomes of a married couple who are having arguments about finances. In particular, the wife is concerned about her husband splurging without consulting her. What question will the PMHNP ask to arrive at the unique outcomes?

A.

“How do these money problems affect you?”

B.

“How do these money problems influence your ideas about yourself?”

C.

“How does the money problem affect the relationship you have with each other?”

D.

All of the above

 

The PMHNP is meeting with a mother and her teenage daughter; they are having trouble getting along. The mother complains that the daughter is defiant and never listens or goes out whenever she wants to. The daughter complains that the mother is too strict and won’t let her see her friends. What does the PMHNP do to employ the use of the paradoxical intervention technique?

A.

Tell the mother to be stricter with her daughter by imposing harsher consequences

B.

Tell the daughter to make plans with her friends whenever she wants to

C.

Tell the mother and daughter to discuss how their actions affect each others’ feelings

D.

A and B

 

The PMHNP meets with an older adult couple having marital problems. The husband and wife both admit to the PMHNP that it is difficult for them to speak to each other because of how much they disagree on things lately. The husband complains that the wife is always talking about their issues to their adult daughter. The wife reports that the husband does the same thing. Using the Bowen Family Systems Therapy model, what does the PMHNP interpret about this family dynamic?

A.

There is an emotional cutoff between the parents and their adult daughter.

B.

C.

D.

All of the above

 

The PMHNP is meeting with a husband and wife who have separated but are trying to rekindle the marriage. The PMHNP asks the couple what they hope to gain from the sessions, and they provide the PMHNP with vague answers. What can the PMHNP can ask the couple to help them create better defined goals?

A.

B.

“How will you know when you solved your problem?”

C.

“What will be the first sign that tells you that you are moving in the right direction?”

D.

 

During a family therapy session, a 10-year-old girl says to her father, “You are at work all the time and are never around.” What is the most appropriate response by the PMHNP to improve communication?

A.

Suggest that the daughter now say something positive to her father

B.

Ask the father what he heard when his daughter made that comment

C.

Tell the daughter that adults may have to work long hours sometimes

D.

Give the father a chance to explain why he is working all the time

 

The PMHNP is working with the parents of an 8-year-old. They are facing challenges with their daughter’s school because of her behavior toward other students. “Our daughter has become a problem,” they explain. Which statement(s) made by the PMHNP supports the use of the narrative therapy model?

A.

“Your daughter is facing a struggle against a problem but is not a problem herself.”

B.

“The problem is the problem, but the problem is not your daughter.”

C.

A and B

D.

None of the above

 

 

A group member realizes he gets anxious when making small talk and tends to talk only about himself. Using the principle of development of socializing techniques, what might the PMHNP recommend that the group do next?

A.

Give the member feedback on what the group participants have noticed about his interaction style, for example, if he does in fact talk only about himself when he seems anxious

B.

Share emotions about similar struggles to improve cohesiveness

C.

Reflect on ways they can work together to achieve catharsis

D.

Discuss how the original family unit might relate to the problem

 

 

The PMHNP is working with the parents of an adolescent daughter. The parents complain that the daughter is misbehaving and having emotional outbursts on a nightly basis. However, the parents cannot agree on ways to discipline and deal with the daughter. This leads to arguments between them. What does the PMHNP do to support the strategic use of rituals? NURS 6650 Psychotherapy with Groups and Families Midterm & Final Exam Questions and Answers

A.

Suggest the mom help the daughter with homework on even days of the week

B.

Ask the dad how his daughter might describe the mother’s attitude in the house

C.

Have the parents reframe their daughter’s symptoms to validate their own relationships

D.

Advise the parents to solicit feedback from their daughter on why she has emotional outbursts

 

 

The PMHNP is meeting with a husband and wife and observes that the husband is able to maintain his composure while the wife becomes more teary and emotional throughout the session. Which principle is used to describe this observation?

A.

Complementary relationship

B.

Symmetrical relationship

C.

Family homeostasis

D.

All of the above

 

NURS 6650 Psychotherapy with Groups and Families Midterm & Final Exam Questions and Answers

The PMHNP is meeting with a family consisting of two parents and their 10-year-old son. The parents are concerned about the child’s behavior. “He keeps disobeying us. All he does is misbehave,” the mother cries. The PMHNP meets individually with the son for a few sessions to learn more about his behavior and identifies that he is participating in attention-seeking behaviors. When the PMHNP invites the parents and son back to a family group setting, what action made by the PMHNP supports the use of constructivism?

A.

Providing the parents with consequences to use when the child misbehaves

B.

C.

Getting the parents to think about their child as being hyperactive, rather than misbehaving

D.

 

The PMHNP is working with a married couple in a family session setting. The wife reports feeling upset because her husband does not pay attention to her. Which statement made by the PMHNP will challenge the wife to see things differently?

A.

“Why do you think your husband ignores you at home?”

B.

“How does it make you feel when your husband ignores you?”

C.

“How might you be contributing to your husband not paying you any attention?”

D.

“What can you say to your husband to get him to change his actions?”

 

 

The PMHNP is working with a father and his teenage daughter. The father has full custody of his daughter as of recently. He reports that the two of them get into arguments all the time over curfew, chores, and the daughter’s lack of responsibility that “she gets from her mother.” The daughter feels like the father never listens to her. Which of the following actions taken by the PMHNP demonstrates unbalancing the relationship?

A.

Telling the father that he might be patient enough with the newness of having a teenage daughter in the house all the time

B.

Asking the daughter to describe how she feels about the transition of living with her father full time

C.

Inviting the father to speak directly to the daughter about what she can do to accommodate his lifestyle

D.

Recommending the father find a hobby outside of the house to give his daughter alone time

 

 

A man calls a PMHNP to set up an initial appointment for family therapy.  He explains, “My wife lost her job several months ago. She has been angry and less patient with the kids. All of the stress is taking a toll on me. I can’t focus at the office and I’m mentally exhausted at home.” Based on this phone contact, who would the PMHNP most likely choose to see for the first session?

A.

The husband alone

B.

The wife alone

C.

The couple alone

D.

The family as a unit

 

The PMHNP is assessing a family that consists of a mother and a father and their daughter Rachel. The family is discussing the issue of time management in the home, particularly involving the daughter’s extracurricular schedule. The mother asks, “Rachel, how many times has your father been late to pick you up from soccer?” What does the PMHNP take away from this interaction?

A.

The family uses a

B.

The family is de

C.

The family is involved in

D.

The family requires

 

 

 

The PMHNP meets with the parents of a 3-year-old boy, who was adopted at 6 months of age. The parents ask the PMHNP if he will see the child individually for therapy sessions on a weekly basis, based on the fact that the parents are having difficulty getting their son to listen to them. Which statement made by the PMHNP supports the systems theory approach to treatment?

A.

“It would be difficult for me to make sense of your child’s behavior without the rest of the family around.”

B.

“It would be better for us to meet as a group since your child likely has attachment issues.”

C.

D.

 

The PMHNP is working with a married couple who are having trouble communicating. The wife wants to ask for things from the husband, but she doesn’t want to be perceived as a nag. The husband wants to tell the wife that he needs alone time, but he doesn’t want to hurt her feelings. Which pretend technique can the PMHNP use with the couple?

A.

Ask the husband what he thinks the wife would say about his behavior

B.

Ask the couple to engage in negotiation

C.

Tell the husband to call the wife a nag three times a day

D.

NURS 6650 Psychotherapy with Groups and Families Midterm & Final Exam Questions and Answers

The PMHNP is working with a single mother and her adolescent son. The mother reports to the PMHNP that all she wants is for her son to call her when he is going to be late to dinner, so that she doesn’t worry about where he is. The son explains that his mom is “too paranoid” and calls or texts him constantly throughout the day, even if it doesn’t have to do with his whereabouts. How can the PMHNP advise the mother and son to accommodate one another?

A.

Recommend the mother to limit her texts and calls to her son throughout the day

B.

Recommend the son to send his mother a text when he is going to be late

C.

Recommend the mother and son to stop being so hard on one another

D.

 

A PMHNP is using a structural family therapy approach. During a family therapy session, a child says, “Is that what you really mean?” Tracking the phrase, the PMHNP discovers that the family often uses sarcasm when communicating. What is the appropriate next step by the PMHNP?

A.

Make each member apologize to the other whenever sarcasm is used during the session

B.

Ask the family to point out when a statement is sarcastic so others know they are joking

C.

Listen for the use of sarcasm and, when it occurs, help members communicate more directly

D.

Have members put a quarter in the “sarcasm jar” each time a sarcastic statement is used

 

 

The PMHNP is meeting with a set of parents and their 12-year-old son, who according to the parents is fearful of “nearly everything.” The son admits that he does not like to ride his bike, play with his friends, or participate in activities such as sports, in which he could hurt himself or become dirty. What does the PMHNP say to the son to personify the problem using externalizing conversation techniques?

A.

“What can you do when you become scared of something?”

B.

“How is being fearful controlling your life?”

C.

“How often does fear make you do what it wants you to do?”

D.

NURS 6650 Psychotherapy with Groups and Families Midterm & Final Exam Questions and Answers

 

A PMHNP is working with a mother and daughter to help them improve their communication skills. The mother explains that they have had numerous arguments caused by miscommunication lately. Using a structural family therapy approach, what is the appropriate response by the PMHNP?

A.

“Perhaps we can role play the scenario of a recent argument and then observe how it unfolds so you can find some underlying causes.”

B.

“Please act out what happened during a recent argument, and then try that same enactment using a healthier approach.”

C.

“I’m going to ask you to plan an event together while paying attention to your communication as a mother and as a daughter.”

D.

All of the above

 

 

During family therapy, a husband says to his spouse, “When you ignore me, I can’t help but shout.” Using an emotionally focused family therapy approach, the PMHNP comments to the husband, “You feel like you are invisible and need to be heard.” Why does the PMHNP make this comment?

A.

To assist the couple in creating new attachment patterns

B.

C.

To help the client capture an elusive emotional experience

D.

 

A family is in therapy because they have been unable to resolve conflicts and are arguing frequently. When using a strategic family therapy approach, which of the following directives might the PMHNP suggest to create a sense of togetherness? NURS 6650 Psychotherapy with Groups and Families Midterm & Final Exam Questions and Answers

A.

Encourage the family to address concerns by writing letters to each other

B.

Direct the family to temporarily become overly dependent on one another

C.

Ask the family to engage in pleasant activities following the problem behavior

D.

Exaggerate in a fun family ritual by preparing for the event in a specific order

 

 

The PMHNP is meeting with a family that consists of a husband, wife, and the wife’s mother and sister. The husband complains to the PMHNP that the way his mother-in-law and sister-in-law barge into their home whenever they want, without any warning, is becoming intrusive. He says, “Because, of course, everyone in the family has keys to our home.” Which pattern does the PMHNP identify in this family relationship?

A.

The family is

B.

The family is

C.

The family is

D.

The family is s.

 

 

The PMHNP is meeting with two women, ages 35 and 42, who are concerned about their mother’s use of alcohol. During the meeting, what question(s) should the PMHNP ask the mother to help uncover the potential drinking problem?

A.

“Why do you want to ?”

B.

“How many ?”

C.

“Do you ever ?”

D.

B and C

 

During the initial assessment of a newly married couple, the PMHNP learns that they decided to come to family therapy in order to address their communication problems. Which of the following actions taken by the PMHNP demonstrates the use of the solutions-focused approach? NURS 6650 Psychotherapy with Groups and Families Midterm & Final Exam Questions and Answers

A.

Drawing a communication model for the couple and having them discuss where the communication breakdown occurs

B.

Having the couple take turns describing, in their own words, what the communication problem is

C.

Asking the couple how things will be different in their relationship once their communication problems are solved

D.

NURS 6650 Psychotherapy with Groups and Families Midterm & Final Exam Questions and Answers

 

The PMHNP is leading a group session when a group member who is usually quiet angrily interrupts another group member. He then apologizes for his outburst and explains that he has been having a hard time since his only child left for college. Using a person-centered approach to group psychotherapy, which of the following is the most appropriate response by the PMHNP?

A.

“Thanks for your apology. Do you think the reason you are having a hard time might be related to your fear of abandonment?”

B.

“You sound angry. Can you elaborate on what you are experiencing now as you share this story with the rest of the group?”

C.

NURS 6650 Psychotherapy with Groups and Families Midterm & Final Exam Questions and Answers

D.

“It’s understandable that you are having a hard time. Let’s ask group members to share about the experience of having an empty nest.”

 

 

The PMHNP is meeting with a mother and her adult daughter, who report that they have had a hard time getting long. The adult daughter complains that her mother tells her what to do regarding her children, which puts strain on the adult daughter’s marriage. The mother denies this and explains that she is “only trying to help.” What does the PMHNP say to the mother or daughter to convey acceptance into this family?

A.

B.

“It sounds like you have a difficult time accepting your mom’s help when you don’t ask for it.”

C.

“I have to side with your mom on this issue, since she is older and wiser.”

D.

 

Members of a therapy group have become aligned and are starting to take ownership of their group experience. They are sharing more and are being more open with each other. During the next session, the PMHNP decides to address termination of the group. Which of the following is the most appropriate response by the PMHNP when a group member expresses anxiety about termination?

A.

NURS 6650 Psychotherapy with Groups and Families Midterm & Final Exam Questions and Answers

B.

C.

“I think all of you are ready to leave the group.”

D.

NURS 6650 Psychotherapy with Groups and Families Midterm & Final Exam Questions and Answers

NR526 3Ps Handout Guidelines – Pathophysiology, pharmacology, and health (physical) assessment

3Ps Handout Guidelines & Scoring Rubric

Purpose:

The purpose of this assignment is to synthesize advanced knowledge of pathophysiology, pharmacology, and health (physical) assessment into three handouts for nursing students or staff nurses.

Course Outcomes

Through this assignment, a student will demonstrate the ability to:

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1- Integrate interprofessional collaboration and innovative communication to support and promote the teaching-coaching functions of the nurse educator. (PO 3, 10)

2- Integrate pathophysiologic mechanisms with advanced assessment and pharmacologic concepts to maximize patient outcomes in complex disease states. (PO 1, 4)

3- Distinguish the epidemiology, etiology, developmental considerations, pathogenesis, and clinical and laboratory manifestations of complex disease processes in relation to assessment strategies and pharmacologic interventions. (PO 1, 4)

4- Analyze risk factors associated with complex disease states in individuals, aggregates, and populations to devise effective disease management and/or health promotion strategies that reflect pertinent psychosocial, cultural, legal, ethical, and safety considerations. (PO 4, 6). NR526 3Ps Handout Guidelines – Pathophysiology, pharmacology, and health (physical) assessment

5- Explicate the environmental factors that impinge upon specific physiologic, psychological, and psychosocial states along the health-illness continuum. (PO 1, 4)

6- Examine mechanisms and processes of homeostatic, adaptive, and compensatory physiological functions in complex disease states with an emphasis on appropriate assessment strategies and pharmacologic interventions. (PO 1, 4)

7- Determine clinical data essential to identifying specified pathophysiologic or psychological problems and the best plan of care. (PO 1, 4)

8- Explore age-specific and developmental alterations in physiologic and psychological disease states, assessment strategies, and pharmacologic intervention. (PO 1, 4)

9- Correlate changes and disruptions in major physiological systems and pathophysiological mechanisms with clinical data resulting from physical examination, laboratory data, and diagnostic test data with anticipated pharmacologic treatment. (PO 1, 4, 11)

Due Date:Sunday 11:59 PM MT at the end of Week 7

Total Points Possible: 250

Requirements:

Description of the assignment: This final NR526 assignment requires you to develop a set of 3 handouts on the topic that you chose for the Week 5 assignment. IMPORTANT:

In these handouts, you will present an in-depth application of pathophysiology, pharmacology, and health (physical) assessment concepts related to your chosen topic. You should describe at least one concept in each handout but may display multi-concepts if necessary.

You may use your textbooks as references, but you should also have at least one peer-reviewed article as a reference. Clinical practice guidelines are good sources for this assignment but you may use other peer-reviewed articles in which the evidence-based care of patients is presented. Feel free to use images (see information on copyright), concept maps, tables, or anything else you feel will enhance your handout.

Only use media you develop yourself or that you obtain through this page in the Chamberlain Library:.chamberlain.edu/copyright”>http://library.chamberlain.edu/copyright. You can add web addresses to your handout if you want to link to video or audio files.

Good, relevant, current content is the most important feature of your handouts. For clinical topics, “current” is defined as no more than five years oldNR526 3Ps Handout Guidelines – Pathophysiology, pharmacology, and health (physical) assessment.

Developing the Handouts

1. Your first handout should display information about one or more of the drugs related to the complex health situation you are covering. You may want to focus on just one drug but, in some cases, drugs work together or you may want to compare and contrast two similar or alternate drugs.

2. Your second handout should relate to the pathophysiology of the complex health situation. Examples: How do the various systems interact? What compensatory systems are in play? What is the etiology of this condition?

3. Your third handout should relate to the necessary physical assessments for your topic. Be as comprehensive and holistic as possible. What is your student looking for?

4. Three pages should be adequate unless you prefer to add a reference list for all of your handouts at the end. References can also be incorporated in the handout. The idea is that you should provide your students references so they can access your original sources.

5. You will
not
be penalized if one of your handouts spills over onto another page.

6. Please check your handouts for grammatical errors and misspellings before submitting them.

 

Instructor’s Feedback Table

Category

Possible Points

Points Awarded

Description

Handout 1 Content

35

Handout 1 Design

20

Handout 1 Clarity

20

Handout 2 Content

35

Handout 2 Design

20

Handout 2 Clarity

20

Handout 3 Content

35

Handout 3 Design

20

Handout 3 Clarity

20

Grammar, syntax, spelling

15

APA citations or references

10

Total

250

___of 250

A quality assignment will meet or exceed all of the above requirements.

 

Grading Rubric

Assignment Criteria

Exceptional

(100%)

Outstanding or highest level of performance

Exceeds

(88%)

Very good or high level of performance

Meets

(80%)

Competent or satisfactory level of performance

Needs Improvement

(38%)

Poor or failing level of performance

Developing

(0)

Unsatisfactory level of performance

Content

Possible Points = 225 Points

 NR526 3Ps Handout Guidelines – Pathophysiology, pharmacology, and health (physical) assessment

Handout One

Content

35 Points

31 Points

28 Points

13 Points

0 Points

Covered content demonstrates masterful application of the 3Ps and is well-sourced

Covered content demonstrates good application of the 3Ps and is well-sourced

Covered content demonstrates fair application of the 3Ps and is well-sourced

Covered content demonstrates a minimal application of the 3Ps and is well-sourced

Covered content does not demonstrate application of the 3Ps and is well-sourced

Handout One
Desig
n

20 Points

18 Points

16 Points

8 Points

0 Points

Design elements (images, tables, layout, etc.) demonstrate a great deal of creativity and thoughtfulness

Design elements (images, tables, layout, etc.) demonstrate creativity and thoughtfulness

Design elements (images, tables, layout, etc.) demonstrate a little creativity and thoughtfulness

Design elements (images, tables, layout, etc.) demonstrate a great deal of creativity and thoughtfulness

Design is unimaginative and demonstrates no thoughtfulness or planning

Handout One
Clarity

20 Points

18 Points

16 Points

8 Points

0 Points

Handout is completely clear

Handout is a little unclear

Handout is very unclear

Purpose of the handout is not clear at all

Handout is totally unclear

Handout Two

Conten
t

35 Points

31 Points

28 Points

13 Points

0 Points

Covered content demonstrates masterful application of the 3Ps and is well-sourced

Covered content demonstrates good application of the 3Ps and is well-sourced

Covered content demonstrates fair application of the 3Ps and is well-sourced

Covered content demonstrates a minimal application of the 3Ps and is well-sourced

Covered content does not demonstrate application of the 3Ps and is well-sourced

Handout Two
Design

20 Points

18 Points

16 Points

8 Points

0 Points

Design elements (images, tables, layout, etc.) demonstrate a great deal of creativity and thoughtfulness

Design elements (images, tables, layout, etc.) demonstrate creativity and thoughtfulness

Design elements (images, tables, layout, etc.) demonstrate a little creativity and thoughtfulness

Design elements (images, tables, layout, etc.) demonstrate a great deal of creativity and thoughtfulness

Design is unimaginative and demonstrates no thoughtfulness or planning

Handout Two
Clarity

20 Points

18 Points

16 Points

8 Points

0 Points

Handout is completely clear

Handout is a little unclear

Handout is very unclear

Purpose of the handout is not clear at all

Handout is totally unclear

Handout Three

Conten
t

35 Points

31 Points

28 Points

13 Points

0 Points

Covered content demonstrates masterful application of the 3Ps and is well-sourced

Covered content demonstrates good application of the 3Ps and is well-sourced

Covered content demonstrates fair application of the 3Ps and is well-sourced

Covered content demonstrates a minimal application of the 3Ps and is well-sourced

Covered content does not demonstrate application of the 3Ps and is well-sourced

Handout Three
Design

20 Points

18 Points

16 Points

8 Points

0 Points

Design elements (images, tables, layout, etc.) demonstrate a great deal of creativity and thoughtfulness

Design elements (images, tables, layout, etc.) demonstrate creativity and thoughtfulness

Design elements (images, tables, layout, etc.) demonstrate a little creativity and thoughtfulness

Design elements (images, tables, layout, etc.) demonstrate minimal creativity and thoughtfulness

Design is unimaginative and demonstrates no thoughtfulness or planning

Handout Three
Clarity

20 Points

18 Points

16 Points

8 Points

0 Points

Handout is completely clear

Handout is a little unclear

Handout is very unclear

Purpose of the handout is not clear at all

Handout is totally unclear

____ of 225 Points

Format

Possible Points = 25 Points

Grammar, syntax, and spelling

15 Points

13 Points

12 Points

6 Points

0 Points

Proper grammar, spelling syntax, and punctuation are used, with no more than1-2 errors.

Proper grammar, spelling syntax, and punctuation are used, with no more than3-4 errors.

Proper grammar, spelling syntax, and punctuation are used to some extent, with no more than 5-6 errors.

Proper grammar, spelling syntax, and punctuation are not used; assignment contains 7-9 errors.

Proper grammar, spelling syntax, and punctuation are not used; assignment contains 10 or more errors.

APA citations & references

NOTE: references may be incorporated on the handout.

10 Points

9 Points

8 Points

4 Points

0 Points

There are 0 – 2 APA format errors in the text, title page, citations, and reference page(s)

There are 3 – 5 APA format errors in the text, title page and/or reference page(s)

There are 6 -8 APA format errors in the title page, running head, or reference page (s).

There are 9 APA format errors in the title page, running head, or reference page (s).

There are 10 or more APA format errors in the title page, running head, or reference pages(s).

Format Subtotal

_____of 25 points

Total Points

_____of 250 points

NR526 3Ps Handout Guidelines – Pathophysiology, pharmacology, and health (physical) assessment

South nsg6620 all week discussions

Discussion Question 1: Mission and Vision Statement.

Every healthcare organization must have a mission and vision statement to guide it. Mission and vision statements often come in a variety of formats. Only when there is alignment between the nurse administrator and the organizational mission and vision statement, there is synergy and a sense of purpose. For example, knowing where the organization wants to go assists nurse administrators in helping meet the mission and vision statement through the tasks they undertake along with their subordinates.

Using the readings for the week, the South University Online Library, and the Internet, respond to the following:

Describe one example of what happens when the nurse administrator’s values are not congruent with the organizational mission and vision statement.

Locate the mission and vision statement of your current or previous healthcare organization. If you are not working in the field of healthcare, find a mission and vision statement of a healthcare organization using the Internet.

Does this mission and vision statement provide clarity to the organizational direction? Provide a rationale for your answer.

As a nurse administrator, how would you assist subordinates to become familiar with this statement?

Select and research a department of nursing. Then, write a mission and vision statement for this department.

Comment on the postings of at least two peers.

Evaluation Criteria:

Described one example of what happens when the nurse administrator’s values are not congruent with the organizational mission and vision statement.

Explained whether a selected mission and vision statement provides clarity to the organizational direction.

Recommended ways in which a nurse administrator can assist subordinates become familiar with the selected mission and vision statement.

Wrote a mission and vision statement for a nursing department.

Justified your answers with appropriate research and reasoning.

Commented on the postings of at least two peers.

Discussion Question 2: CNO and Medical Staff

CNOs must be skilled and competent communicators to lead and manage the collective work of medical staff members at all levels. Reviewing healthcare literature can help you learn a lot about fostering and promoting interprofessional collaboration in healthcare.

Using the readings for the week, the South University Online Library, and the Internet, respond to the following:

Define and describe the role of the CNO related to medical staff.

Define interprofessional collaboration.

What happens to patient outcomes and quality care when there are disagreements between medical staff and nursing personnel regarding aspects of operations?

As a CNO, describe at least one strategy you would apply in clarifying expectations of other healthcare team members including the medical staff?

Comment on the postings of at least two peers.

Evaluation Criteria:

Defined and described the role of the CNO related to medical staff.

Defined the concept of interprofessional collaboration.

Explained the impact of disagreements between medical staff and nursing personnel regarding aspects of operations on patient outcomes and quality care.

Recommended at least one strategy to clarify expectations of other healthcare team members including the medical staff.

Justified your answers with appropriate research and reasoning.

Commented on the postings of at least two peers

Week 2 – Assignment 1 Discussion

Discussion Question 1: Quality Improvement Projects and the CNO

There has likely never been a time in which healthcare organizations have had to face challenges greater than those in the twenty-first century. For example, in previous decades, bedside nurses cared for patients and were promoted into nursing leadership and nurse executive roles based on the fact that they were “good nurses.” This paradigm no longer exists in contemporary healthcare delivery settings including long-term care, acute care, and community-based settings. The CNO must be prepared to lead and have competency in guiding, leading, and restructuring healthcare delivery systems that are competitive and provide safe, affordable, and efficient quality care at the right time, each time, and every time. CNOs must have skills and competencies that allow them to drive healthcare system changes to meet societal healthcare needs for diverse populations.

You are the CNO in your healthcare organization. Considering this, use the readings for the week, the South University Online Library, and the Internet to respond to the following:

Provide a list of guidelines you would use to develop the quality falls program and the medication safety performance improvement project in your organization.

What challenges would you face in the development of these programs?

Evaluate two competencies you must have to successfully develop these programs.

What will you do if a quality improvement project is needed and there is not enough money in the budget at the time or if the project will add costs that exceed the operating budget?

Comment on the postings of at least two peers.

Evaluation Criteria:

Provided a list of guidelines you would use to develop the quality falls program and the medication safety performance improvement project in your organization.

Explained the challenges you would face in the development of these programs.

Evaluated two competencies you must have to successfully develop these programs.

Recommended ways to handle the situation if a quality improvement project is needed and there is not enough money in the budget at the time or if the project will add costs that exceed the operating budget.

Justified your answers with appropriate research and reasoning.

Commented on the postings of at least two peers.

DQ2

Discussion Question 2: Nurse Sensitive Indicators and the CNO

Nurse sensitive indicators reflect the structure, process, and outcomes of nursing care in a healthcare organization. Key factors influencing nurse sensitive indicators include the structure of nursing care, skill level of nursing staff, and education or certification of nursing staff. Greater quality or quantity of nursing care results in an improvement in patient outcomes that are closely linked to nurse sensitive indicators.

Using the readings for the week, the South University Online Library, and the Internet, respond to the following:

Examine the role of a CNO in relation to nurse sensitive indicators, such as the following:

Central line-associated bloodstream infection (CLABSI)

Catheter-associated urinary tract infection (CAUTI)

Ventilator-associated pneumonia (VAP)

Pressure ulcers

As a CNO, what process will you use for developing a nurse sensitive indicator?

Estimate the time it takes to create and approve a nurse sensitive indicator.

Comment on the postings of at least two peers.

Evaluation Criteria:

Examined the role of CNO in relation to nurse sensitive indicators, such as CLABSI, CAUTI, VAP, and pressure ulcers.

Described the process utilized for developing a nurse sensitive indicator.

Estimated the time it takes to create and approve a nurse sensitive indicator.

Justified your answers with appropriate research and reasoning.

Commented on the postings of at least two peers.

Week 3 – Assignment 1 Discussion

Discussion Question 1: Shared Governance Structure and the CNO

During the 1980s, nursing and healthcare were suffering from challenges of an acute nursing shortage, rampant nurse turnover, and issues with nurse retention. In the mid-1980s, shared governance was instituted to incentivize and empower nurses. Shared governance is an innovative organizational model promoting staff control and autonomy over nursing practice in areas that were previously controlled by managers.

The concept of shared governance may be a challenge to understand because it is not uniformly applied or operationalized and because of the great diversity in shared governance models. Nurses working in organizations with shared governance models are more empowered and have higher levels of satisfaction in their roles.

Using the readings for the week, the South University Online Library, and the Internet, respond to the following:

Compare the roles of the CNO and nursing directors or managers in a shared governance structure.

What steps can the CNO take to enable smooth operations in such a structure?

Identify two challenges CNOs face when working with a shared governance structure.

Compare and contrast a model of shared governance with an authoritarian or autocratic CNO.

Examine the role of the CNO in working to set parameters for nurses in a shared governance structure.

Comment on the postings of at least two peers.

Evaluation Criteria:

Compared the roles of the CNO and nursing directors or managers in a shared governance structure.

Listed steps the CNO can take to enable smooth operations in such a structure.

Identified two challenges CNOs face when working with a shared governance structure.

Compared and contrasted a model of shared governance with an authoritarian or autocratic CNO.

Examined the role of the CNO in working to set parameters for nurses in a shared governance structure.

Justified your answers with appropriate research and reasoning.

Commented on the postings of at least two peers.

DQ2

Discussion Question 2: Staff Concerns and the CNO

Often, gossip mills and rumors tend to circulate very quickly throughout healthcare organizations even though everything is supposed to be confidential. Good and bad news travel quickly; one of the greatest challenges the CNO or vice president for patient care services (VPPCS) faces is to control and share information with the staff members so that they receive the same message in the same way at the same time.

Using the readings for the week, the South University Online Library, and the Internet, respond to the following:

What role does the CNO or VPPCS play in addressing the concerns of the entire staff in nursing town-hall meetings? Why is this role important?

Provide an example of a need for the CNO or VPPCS to schedule an entire staff town-hall meeting.

How can the CNO or VPPCS minimize gossip and information via the “grapevine” before an entire staff town-hall meeting?

How would you craft an agenda and circulate it for a town-hall meeting?

How can the CNO or VPPCS integrate the use of electronic and social media into addressing staff concerns in twenty-first-century healthcare organizations?

Comment on the postings of at least two peers.

Evaluation Criteria:

Described the role of the CNO or VPPCS in addressing the concerns of the entire staff in nursing town-hall meetings, and explained the importance of this role.

Provided an example of a need for the CNO or VPPCS to schedule an entire staff town-hall meeting.

Suggested ways in which the CNO or VPPCS can minimize gossip and information via the “grapevine” before an entire staff town-hall meeting.

Explained how you would craft an agenda and circulate it for a town-hall meeting.

Recommended ways in which the CNO or VPCSS can integrate the use of electronic and social media into addressing staff concerns in twenty-first-century healthcare organizations.

Justified your answers with appropriate research and reasoning.

Commented on the postings of at least two peers.

Week 4 – Assignment 1 Discussion

Discussion Question 1: Strategies for Establishing Operational Budgets

An operational budget is the plan for an organization or unit for daily operating expenses. The operational budget is very similar to how one manages a personal home budget but on a grander scale. For example, there is a balance between accounts receivable and accounts payable, and then there is either a surplus or deficit at the end of the budget period. Most budget periods are a fiscal year or a calendar year.

The unit operating budget is the most critical budget in which unit managers must be involved and have the most control over. Extensive information is needed to prepare the operational budget. For example, the operational budget typically requires information related to workload budgets with activity reports, units of service, and workload calculations like HPPD; expense budgets for personnel, staffing, and supplies equipment; the overhead budget; and the revenue budget. Nurses in the unit are often part of the operational budget to examine, or be aware of, weekly or monthly budget variances. This helps the unit function with a positive versus a negative revenue stream.

Using the readings for the week, the South University Online Library, and the Internet, respond to the following:

Describe at least two strategies for establishing operational budgets.

Examine the advantages and disadvantages of using each strategy.

Explain the strategies your nurse manager or CNO uses to gather and secure the most timely and relevant information to shape future operating budgets.

Identify two challenges the nurse manager or CNO faces with this task.

Examine implications for the nurse manager or CNO when the unit operating budget is running in the “red” or has numerous negative monthly variances.

Comment on the postings of at least two peers.

Evaluation Criteria:

Described at least two strategies for establishing operational budgets.

Examined the advantages and disadvantages of using each strategy.

Explained the strategies your nurse manager or CNO uses to gather and secure the most timely and relevant information to shape future operating budgets.

Identified two challenges the nurse manager or CNO faces with this task.

Examined implications for the nurse manager or CNO when the unit operating budget is running in the “red” or has numerous negative monthly variances.

Justified your answers with appropriate research and reasoning.Commented on the postings of at least two peers.

DQ2

Discussion Question 2: Strategies for Establishing an FTE Budget

Budgeting is a critical and essential component of nursing and patient care. Without proper support for nurses to provide patient-centered care, the organizational mission and goals will not be met.

Full-time equivalent (FTE) measures the number of employees working in an organization, assuming they all work on a full-time basis. It measures each employee’s involvement in the organization. Unit managers and CNOs must have fundamental skills and competencies to establish an FTE budget.

Using the readings for the week, the South University Online Library, and the Internet, respond to the following:

Describe various strategies used for establishing an FTE budget.

Examine the advantages and disadvantages of each strategy.

Discuss how the unit manager or CNO elicits input into the FTE budget.

Describe one software program utilized by the unit manager or CNO to formulate an FTE budget.

Identify the timeline a nurse manager or CNO would utilize to plan the development of an FTE budget.

Comment on the postings of at least two peers.

Evaluation Criteria:

Described various strategies used for establishing an FTE budget.

Examined the advantages and disadvantages of using each strategy.

Discussed how the unit manager or CNO elicits input into the FTE budget.

Described one software program utilized by the unit manager or CNO to formulate an FTE budget.

Identified the timeline a nurse manager or CNO would utilize to plan the development of an FTE budget.

Justified your answers with appropriate research and reasoning.

Commented on the postings of at least two peers.

Week 5 – Assignment 1 Discussion

Discussion Question 1: The Average Daily Census (ADC) and the Target Budget

One of the greatest challenges unit managers and CNOs face is predicting and working with the average daily census (ADC), particularly as it relates to the target budget.

The average daily inpatient census refers to the number of patients present at the official census-taking time each day. For example, a patient admitted to the coronary care unit at 1:00 pm and who dies at 4:00 pm the same day is a patient admitted and discharged the same day. The ADC is typically calculated each night at midnight. It is a challenge to predict what the ADC will be on any given day.

The target budget is targeted or predicted in the zero-based operating budget based on the previous years’ ADC. The target budget is typically projected at least one year in advance. A lot of information goes into the computation of a target budget, and there are many variances once the budget is formulated and approved.

Using the readings for the week, the South University Online Library, and the Internet, respond to the following:

Explain how the ADC contributes to the target budget.

Describe two major challenges in determining the actual target budget and ADC.

Identify two major challenges for unit managers and CNOs due to the variances between the actual target budget and the ADC.

Comment on the postings of at least two peers.

Evaluation Criteria:

Explained how the ADC contributes to the target budget.

Described two major challenges with the actual target budget and ADC.

Identified two major challenges for unit managers and CNOs due to the variances between the actual target budget and the ADC.

Justified your answers with appropriate research and reasoning.

Commented on the postings of at least two peers.

DQ2

Discussion Question 2: Return on Investment

Return on investment (ROI) is a financial performance measure used to evaluate and determine the efficiency of an investment on a number of different measures. The ROI is calculated by examining the benefit (return) of an investment divided by the cost of the investment. The result of this calculation is a percentage or a ratio. For example, the formula for ROI is as follows:

ROI = (Gain from the investment – Cost of the investment) / Cost of the investment

It should be noted that there is more than one way healthcare organizations may compute and calculate the ROI for a new service or product line. The ROI is not always calculated in direct dollars, but it may be calculated as the ability to contribute to the organizational mission and philosophy. For example, a nonprofit healthcare organization may want to partner with a local community endeavor and establish a free clinic with low-dollar ROI but with a tremendous feeder of new patients to primary care services within the organization.

Using the readings for the week, the South University Online Library, and the Internet, respond to the following:

Develop an ROI for a new project (such as the implementation of a new Level 3 neonatal intensive care unit [NICU]).

Summarize the issues and challenges in formulating an accurate ROI for a new product or service line.

Identify two major challenges and two major barriers for unit managers or the CNO accountable for ensuring ROI on a new product or service line.

Comment on the postings of at least two peers.

Evaluation Criteria:

Developed an ROI for a new project (such as the implementation of a new Level 3 neonatal intensive care unit [NICU]).

Summarized the issues and challenges in formulating an accurate ROI for a new product or service line.

Identified two major challenges and two major barriers for unit managers or the CNO accountable for ensuring ROI on a new product or service line.

Justified your answers with appropriate research and reasoning.

Commented on the postings of at least two peers.

Week 6 – Assignment 1 Discussion

Discussion Question 1: Role of the Nurse Executive

There are numerous definitions of what it means to be a nurse executive. The definition may change according to the work environment in your healthcare organization. Some literature refers to the nurse executive as a nurse administrator. The nurse executive must have knowledge, skills, and competencies that foster and promote nursing leadership within the healthcare organization. Nurse executives are in a key leadership role in healthcare organizations and have the capacity to effect positive change and promote a culture of community and excellence.

Using the readings for the week, the South University Online Library, and the Internet, respond to the following:

Examine the role of the nurse executive in a clinical area with staff, patients, and providers. Explain why this role is important.

Explain why the nurse executive needs to delegate. What are some of the challenges nurses face during delegation?

Evaluate the role of the nurse executive in succession planning for the healthcare organization.

Examine the educational preparation and national certification requirements for a nurse executive.

Comment on the postings of at least two peers.

Evaluation Criteria:

Examined the role of the nurse executive in a clinical area with staff, patients, and providers, and explained why this role is important.

Explained why the nurse executive needs to delegate. What are some of the challenges nurses face during delegation?

Evaluated the role of the nurse executive in succession planning for the healthcare organization.

Examined the educational preparation and national certification requirements for a nurse executive.

Justified your answers with appropriate research and reasoning.

Commented on the postings of at least two peers.

DQ2

Discussion Question 2: Characteristics of an Effective Team

As the saying goes, “There is no I in team.” There is another saying, “The whole world is a team.” These two sayings support the fact that everyone in healthcare organizations must work together for the good of patients. There is much in healthcare literature focusing on the role of high-performance teams and their impact on patient quality, patient safety, and healthcare worker satisfaction. One of the greatest “value-added” benefits of high-performance teams is the collaboration and sharing of essential information to enhance quality and patient outcomes. In modern healthcare organizations, effective teams are critical to providing patient and healthcare worker satisfaction.

Using the readings for the week, the South University Online Library, and the Internet, respond to the following:

Describe at least three characteristics of an effective team.

Identify two challenges with interprofessional healthcare teams with respect to the various roles.

Describe one high-performing team in which you are currently engaged or have engaged in the past. What are the reasons for the success or failure of this team?

Examine how education models created for interprofessional healthcare students may develop high-performing healthcare teams.

Comment on the postings of at least two peers.

Evaluation Criteria:

Described at least three characteristics of an effective team.

Identified two challenges with interprofessional healthcare teams with respect to the various roles.

Described one high-performing team in which you are currently engaged or have engaged in the past, and explained the reasons for the success or failure of this team.

Examined how education models created for interprofessional healthcare students may develop high-performing healthcare teams.

Justified your answers with appropriate research and reasoning.

Commented on the postings of at least two peers.

Week 7 – Assignment 1 Discussion

Discussion Question 1: Nurse Leader and Organizational Culture of Caring

Caring is the primary reason nurses enter the field of nursing, and the concept of caring is often thought of as the essence of nursing. Not only do nurses care for patients but they also have to care for each other. Sometimes, nurses tend to focus so much on patients and their families that they forget to care for themselves and one another. This is a major source of compassion fatigue causing nurses to leave the healthcare organization or, worse yet, to totally leave the nursing profession.

Compassion fatigue is the cumulative impact of physical, emotional, and psychological exposure to trauma, stressful events, and the care for patients or nursing colleagues who face many challenges. Compassion fatigue can sabotage nurses in healthcare organizations as it is challenging, and nurses may be harmed by the very work to which they are so devoted. Nurses must be aware of what it means to create a community within the workplace and to offer support and resources to retain nurses the organization has worked so diligently to recruit.

Using the readings for the week, the South University Online Library, and the Internet, respond to the following:

Describe the role of the nursing leader in building a community and creating joy in the workplace.

How does an effective leader create an organizational culture of caring, respect, and dignity for all? Identify one strategy you would use in your own healthcare organization.

Describe two negative outcomes on recruitment and retention of nurses when a culture of community does not exist in the healthcare workplace.

Comment on the postings of at least two peers.

Evaluation Criteria:

Described the role of the nursing leader in building a community and creating joy in the workplace.

Explained how an effective leader creates an organizational culture of caring, respect, and dignity for all, and identified one strategy you would use in your own healthcare organization.

Described two negative outcomes on recruitment and retention of nurses when a culture of community does not exist in the healthcare workplace.

Justified your answers with appropriate research and reasoning.

Commented on the postings of at least two peers.

DQ2

Discussion Question 2: Performance Appraisals and the Nursing Leader

Performance appraisal is a mechanism or strategy for sharing performance feedback with all employees based on a defined set of performance criteria. Nurses need feedback to flourish and grow as well as develop career goals and a career trajectory. Typically, there are organizational policies guiding time for and methods of performance appraisal. Performance appraisals must be conducted on a regular basis applying the organizational policy and performance appraisal guidelines. They should not be conducted as a punitive process but as a formative process to assist employees in learning and growing to become even more valuable to the healthcare organization. There are a variety of formal and informal processes for performance appraisal. The key purpose of a performance appraisal is to support and assist in professional growth.

Using the readings for the week, the South University Online Library, and the Internet, respond to the following:

Describe the role of the nursing leader related to coaching and guiding of staff during a performance appraisal.

Describe the role of the nursing leader in determining performance appraisal criteria.

Examine the need of the nursing leader to be a role model in giving performance improvement data for novice and experienced nurses.

Comment on the postings of at least two peers.

Evaluation Criteria:

Described the role of the nursing leader related to coaching and guiding of staff during a performance appraisal.

Described the role of the nursing leader in determining performance appraisal criteria.

Examined the need of the nursing leader to be a role model in giving performance improvement data for novice and experienced nurses.

Justified your answers with appropriate research and reasoning.

Commented on the postings of at least two peers.

Week 8 -Assignment 1 Discussion

Discussion Question 1: Key Attributes for Successful Communication

One of the major challenges in nursing and healthcare is learning to communicate effectively and safely with other nurses, staff, the interprofessional healthcare teams, patients, and patients’ families. Nurses and other healthcare workers are often stressed and overworked as they deal with major complexities moment-to-moment during their work hours. Nurses and nurse leaders need to have difficult conversations with staff and patients. For example, part of being an accountable nurse or leader is being a good communicator and having critical conversations even when the conversations involve giving bad news or feedback for improvement. Communication is a powerful skill and a competency that is an integral part of every nurse leader’s role. It is not enough just to communicate; the challenge in a twenty-first-century healthcare organization is to communicate effectively in written words, through body language, and by being mentally and emotionally present during every conversation.

Using the readings for the week, the South University Online Library, and the Internet, respond to the following:

Describe the key attributes of successful communication and relationship management strategies.

Describe the role of the nurse leader in improving communication to enhance nursing professionalism.

Identify two challenges you face when communicating during a conflict.

Discuss communication strategies you would use as a nurse leader to terminate an employee who has violated the organizational policy.

Describe how being emotional during a communication involving conflict can be ineffective and compromise successful communication.

Comment on the postings of at least two peers.

Evaluation Criteria:

Described the key attributes of successful communication and relationship management strategies.

Described the role of the nurse leader in improving communication to enhance nursing professionalism.

Identified two challenges you face when communicating during a conflict.

Discussed communication strategies you would use as a nurse leader to terminate an employee who has violated the organizational policy.

Described how being emotional during a communication involving conflict can be ineffective and compromise successful communication.

Justified your answers with appropriate research and reasoning.

Commented on the postings of at least two peers.

DQ2

Discussion Question 2: Decision Making

Decision making is a skill and a competency nurse leaders must use in every act, word, and deed. A decision involves making a choice between alternatives, and it really is an act of choosing the best plan of action given the information at hand at the time the decision is made. Nurse leaders must be decisive as a decision leads to a definitive plan of action. Some decisions must be taken immediately and others may allow a bit more time. An important concept to remember with respect to decision making is that not making a decision or taking any action is also a decision.

Considering this, nurse leaders must be attentive to every detail. For example, if there is no decision to honor the organizational policy regarding unacceptable behavior or action of an employee, the unacceptable behavior or action is then condoned or perceived as acceptable and may occur again. Nurse leaders’ decisions drive actions!

Using the readings for the week, the South University Online Library, and the Internet, respond to the following:

Describe the importance of making data-driven decisions.

Explain a decision your current or former nurse leader made and how this decision impacted the healthcare organization.

As a nurse leader, you have received information about an executive administrative decision from the board of trustees that you believe is likely to be unpopular. Formulate a plan to share this decision with the nursing staff.

Comment on the postings of at least two peers.

Week 9 – Assignment 1 Discussion

Discussion Question 1: Patient Safety

High-performing teams in healthcare organizations are the key to success in creating cultures of quality and safety. A high-performing team that works collaboratively enhances communication and patient safety. Healthcare teams that are not high performing and do not work well together are actually a liability in patient safety. For example, it is apparent to patients and their families when healthcare teams are not working collaboratively and communicating with each other. Kaiser Permanente has developed a framework of communication that healthcare staff can use to communicate about their patients, called the situation-background-assessment-recommendation (SBAR) technique (Institute for Healthcare Improvement, n.d.). This technique can be used to foster a culture of teamwork and patient safety.

Using the readings for the week, the South University Online Library, and the Internet, respond to the following:

Discuss the role of the nurse leader in fostering and promoting initiatives related to patient safety.

Examine the relationship between patient safety and high-performing interprofessional healthcare teams.

Discuss how the use of communication strategies like SBAR improves the high-performing interprofessional healthcare teams.

Comment on the postings of at least two peers.

Evaluation Criteria:

Discussed the role of the nurse leader in fostering and promoting initiatives related to patient safety.

Examined the relationship between patient safety and high-performing interprofessional healthcare teams.

Discussed how the use of communication strategies like SBAR improves the high-performing interprofessional healthcare teams.

Justified your answers with appropriate research and reasoning.

Commented on the postings of at least two peers.

DQ2

Discussion Question 2: Quality of Care

There are many variables influencing the definition of quality of care. For example, patients and their families may perceive quality in one way and the healthcare provider may perceive quality of care in a much different manner. In assessing quality of care, the nurse leader must create a culture of quality through the structures, processes, and outcomes in the healthcare organization. It is only through commitment and the creation of a culture of quality and safety that healthcare organizations in the twenty-first century can succeed and excel.

Using the readings for the week, the South University Online Library, and the Internet, respond to the following:

Explain the relationship between quality of care and Medicare reimbursement.

Summarize two contemporary external influences to the healthcare organization that are impacting reimbursement to healthcare organizations based on quality of care.

Describe one strategy your current or former healthcare organization uses to assess and measure quality of care.

Comment on the postings of at least two peers.

Evaluation Criteria:

Explained the relationship between quality of care and Medicare reimbursement.

Summarized two contemporary external influences to the healthcare organization that are impacting reimbursement to healthcare organizations based on quality of care.

Described one strategy your current or former healthcare organization uses to assess and measure quality of care.

Justified your answers with appropriate research and reasoning.

Commented on the postings of at least two peers.

Week 10 – Assignment 1 Discussion

Discussion Question 1: Ethical Dilemmas and Nurse Leaders

Almost every day, nurse leaders confront challenges or issues involving ethical dilemmas. Ethical dilemmas occur with respect to staff, patients and their families, or the business or strategic decisions made by the healthcare administration. One of the essential skills and competencies of twenty-first-century nurse leaders is the ability to peel away the layers of each ethical dilemma and determine the underlying ethical principle. There are numerous ethical decision-making models, and it truly does not matter to which model the nurse leader subscribes. However, it does matter that the nurse leader applies concepts of an ethical decision-making model in this executive leadership capacity.

Using the readings for the week, the South University Online Library, and the Internet, respond to the following:

Explain the various steps that nurse leaders can take to prepare themselves and staff nurses for dealing effectively with dilemmas arising from the clash between clinical and organizational ethics.

Identify one ethical decision-making model that is of interest to you for identifying ethical dilemmas.

What is an ethical principle? How you would apply an ethical principle in your current or a former setting to inform ethical decision making on a particular healthcare issue?

Comment on the postings of at least two peers.

Evaluation Criteria:

Explained the various steps that nurse leaders can take to prepare themselves and staff nurses for dealing effectively with dilemmas arising from the clash between clinical and organizational ethics.

Identified one ethical decision-making model that is of interest to you for identifying ethical dilemmas.

Described what an ethical principle is, and how you would apply an ethical principle in your current or a former setting to inform ethical decision making on a particular healthcare issue.

Justified your answers with appropriate research and reasoning.

Commented on the postings of at least two peers.

DQ2

Discussion Question 2: Care Models and the Nurse Leader

There are many ways to organize and deliver nursing care to individual patients and groups of patients. Groups of patients with similar symptoms or like disease diagnoses are referred to as aggregates. There are many different ways nurse leaders organize and determine how the work should be distributed for individuals and aggregate patient populations. Regardless of the care model selected, nurse leaders have many variables to balance to find the right care model that meets and satisfies all key stakeholders. For example, it is not enough to use a care model that meets the nurses’ needs and preferences; finding the balance between comprehensive patient care and satisfaction and nurse satisfaction is required. Patients must have their healthcare needs met and be satisfied, and nurses must be satisfied and want to work in the healthcare organization.

Using the readings for the week, the South University Online Library, and the Internet, respond to the following:

Describe the role of the nurse leader in determining the model of care.

Describe a model of care and include the pros and cons of this model in your description.

Examine the benefit and return on investment to patient quality and outcomes as a result of implementing a model of care.

Explain the human and financial resources needed to implement a selected nursing model of care.

Comment on the postings of at least two peers.

Evaluation Criteria:

Described the role of the nurse leader in determining the model of care.

Described a model of care and included the pros and cons of this model.

Examined the benefit and return on investment to patient quality and outcomes as a result of implementing a model of care.

Explained the human and financial resources needed to implement a selected nursing model of care.

Justified your answers with appropriate research and reasoning.

Commented on the postings of at least two peers.

South nsg6620 all week discussions

NURS 6512 – Advanced Health Assessment and Diagnostic Reasoning – Discussion Essay Papers

Week 1 discussion

Building a Health History

Effective communication is vital to constructing an accurate and detailed patient history. A patient’s health or illness is influenced by many factors, including age, gender, ethnicity, and environmental setting. As an advanced practice nurse, you must be aware of these factors and tailor your communication techniques accordingly. Doing so will not only help you establish rapport with your patients, but it will also enable you to more effectively gather the information needed to assess your patients’ health risks. NURS 6512 – Advanced Health Assessment and Diagnostic Reasoning – Discussion Essay Papers.

For this Discussion, you will take on the role of a clinician who is building a health history for one of the following new patients:

76-year-old Black/African-American male with disabilities living in an urban setting

Adolescent Hispanic/Latino boy living in a middle-class suburb

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55-year-old Asian female living in a high-density poverty housing complex

Pre-school aged white female living in a rural community

16-year-old white pregnant teenager living in an inner-city neighborhood

To prepare:

With the information presented in Chapter 1 in mind, consider the following:

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

How might you target your questions for building a health history based on the patient’s age, gender, ethnicity, or environment? NURS 6512 – Advanced Health Assessment and Diagnostic Reasoning – Discussion Essay Papers.

What risk assessment instruments would be appropriate to use with each patient?

What questions would you ask each patient to assess his or her health risks?

Select one patient from the list above on which to focus for this Discussion.

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

Select one of the risk assessment instruments presented in Chapter 1 or Chapter 26 of the course text, or another tool with which you are familiar, related to your selected patient. NURS 6512 – Advanced Health Assessment and Diagnostic Reasoning – Discussion Essay Papers

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

By Day 3

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

Read a selection of your colleagues’ responses. NURS 6512 – Advanced Health Assessment and Diagnostic Reasoning – Discussion Essay Papers.

By Day 6

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

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

Suggest additional health-related risks that might be considered.

Validate an idea with your own experience and additional research.

Week 2 discussion

DQ1

Assessment Tools and Diagnostic Tests

When seeking to identify a patient’s health condition, advanced practice nurses can use a diverse selection of diagnostic tests and assessment tools; however, different factors affect the validity and reliability of the results produced by these tests or tools. Nurses must be aware of these factors in order to select the most appropriate test or tool and to accurately interpret the results.

In this Discussion, you will consider the validity and reliability of different assessment tools and diagnostic tests. You will explore issues such as sensitivity, specificity, and positive and negative predictive values.

To prepare:

Review this week’s Learning Resources, and consider the factors that impact the validity and reliability of various assessment tools and diagnostic tests.

Select one of the following assessment tools or diagnostic tests to explore for the purposes of this Discussion:

Mammogram

Physical tests for sore throat (inspecting the throat, palpating the head and neck lymph nodes, listening to breath sounds). NURS 6512 – Advanced Health Assessment and Diagnostic Reasoning – Discussion Essay Papers

Prostate-specific antigen (PSA) test

Dix-Hallpike test

Body-mass index (BMI) using waist circumference for adults

Search the Walden Library and credible sources for resources explaining the tool or test you selected. What is its purpose, how is it conducted, and what information does it gather?

Examine the literature and resources you located for information about the validity and reliability of the test or tool you selected. What issues with sensitivity, specificity, and predictive values are related to the test or tool?

Are there any controversies or issues related to any of these tests or tools?

Consider any ethical dilemmas that could arise by using these tests or tools.

By Day 3

Post a description of how the assessment tool or diagnostic test you selected is used in health care. Based on your research, evaluate the test or the tool’s validity and reliability, and explain any issues with sensitivity, reliability, and predictive values. Include references in appropriate APA formatting. NURS 6512 – Advanced Health Assessment and Diagnostic Reasoning – Discussion Essay Papers.

Read a selection of your colleagues’ responses.

By Day 6

Respond to at least one of your colleagues who selected a different tool or test than you, using one or more of the following approaches:

Critique your colleague’s evaluation of the validity and reliability of the tool or test selected.

Suggest alternative or additional tools or tests that should be considered when gathering information about specific conditions or symptoms.

DQ2

Diversity and Health Assessments

In May 2012, Alice Randall wrote an article for The New York Times on the cultural factors that encouraged black women to maintain a weight above what is considered healthy. Randall explained—from her observations and her personal experience as a black woman—that many African-American communities and cultures consider women who are overweight to be more beautiful and desirable than women at a healthier weight. As she put it, “Many black women are fat because we want to be” (Randall, 2012).

Randall’s statements sparked a great deal of controversy and debate; however, they emphasize an underlying reality in the health care field: different populations, cultures, and groups have diverse beliefs and practices that impact their health. Nurses and health care professionals should be aware of this reality and adapt their health assessment techniques and recommendations to accommodate diversity.

In this Discussion, you will consider different socioeconomic, spiritual, lifestyle, and other cultural factors that should be taken into considerations when building a health history for patients with diverse backgrounds. NURS 6512 – Advanced Health Assessment and Diagnostic Reasoning – Discussion Essay Papers

Case 1

Subjective Data

CC: “I came for my annual physical exam, but do not want to be a burden to my daughter.”

History of Present Illness (HPI): At-risk 86-year-old Asian male – who is physically and financially dependent on his daughter, a single mother who has little time or money for her father’s health needs.

PMH: hypertension (HTN), gastroesophageal reflux disease (GERD), b12 deficiency and chronic prostatitis

PSH: S/P cholecystectomy

Drug Hx:

Current Meds: Lisinopril 10mg daily, Prilosec 20mg daily, B12 injections monthly, and cipro 100mg daily.

Review of Systems (ROS)

General: + weight loss of 25 lbs over the past year; no recent fatigue, fever or chills.

Head, eyes, ears, nose & throat (HEENT): no changes in vision or hearing, no difficulty chewing or swallowing.

Neck: no pain or injury

Respiratory:

CV:

GI:

GU: no urinary hesitancy or change in urine stream

Integument: multiple bruises on his upper arms and back.

MS/Neuro: + falls x 2 within the last 6 months; no syncopal episodes or dizziness

Psych:

Objective Data

PE: B/P 188/96; Pulse 89; RR 16; Temp 99.0; Ht 5,6; wt 110; BMI 17.8

HEENT: Atraumatic, normocephalic, PERRLA, EOMI, arcus senilus bilaterally, conjunctiva and sclera clear, nares patent, ornasopharynx clear, edentulous. NURS 6512 – Advanced Health Assessment and Diagnostic Reasoning – Discussion Essay Papers.

Lungs: CTA AP&L

Cor: S1S2 without rub or gallop

Abd: benign, normoactive bowel sounds x 4

Ext: no cyanosis, clubbing or edema

Integument: multiple bruises in different stages of healing – on his upper arms and back.

Neuro: No obvious deformities, CN grossly intact II-XII

Case 2

Subjective Data

CC: “I am here for my annual physical exam and have been having vaginal discharge.”

History of Present Illness (HPI): 32-year-old pregnant lesbian – her pregnancy has been without complication thus far. She has been receiving prenatal care from an obstetrician. She received sperm from a local sperm bank.

Drug Hx:

Current Medications: prenatal vitamins and takes Tylenol over the counter for aches and pains on occasion

Family Hx: She a strong family history of diabetes. Gravida 1; Para 0; Abortions 0.

Review of Systems (ROS)

General: no fatigue, fever or chills.

Head, eyes, ears, nose & throat (HEENT):

Neck: no pain or injury

Respiratory:

CV:

GI:

GU:

Integument: multiple piercings, and tattoos. Old scars related to “cutting”.

Neuro: no syncopal episodes or dizziness, no change in memory or thinking patterns; no twitches or abnormal movements. NURS 6512 – Advanced Health Assessment and Diagnostic Reasoning – Discussion Essay Papers.

Objective Data

PE: B/P 128/76; Pulse 83; RR 16; Temp 99.0; Ht 5,6; wt 128; BMI 20.98

HEENT: Atraumatic, normocephalic, PERRLA, EOMI, conjunctiva and sclera clear; nares patent, ornasopharynx clear, good dentition. Piercing in her right nostril and lower lip.

Lungs: CTA AP&L

Cor: S1S2 without rub or gallop

Abd: benign, normoactive bowel sounds x 4

GU: external genitalia intact, no lesions or masses. White copious discharge with an amine odor; no cervical motion tenderness; adenxa intact.

Ext: no cyanosis, clubbing or edema

Integument: intact without lesions masses or rashes.

Neuro: No obvious deficits and CN grossly intact II-XII

Case 3

Subjective Data

CC: “Annual physical exam”

History of Present Illness (HPI): 23-year-old Native American male comes in to see you because he has been having anxiety and wants something to help him. He has been smoking “pot” and says he drinks to help him too. He tells you he is afraid that he will not get into Heaven if he continues in this lifestyle. NURS 6512 – Advanced Health Assessment and Diagnostic Reasoning – Discussion Essay Papers.

Drug Hx:

Current medication – denied

Allergies: no allergies to food or medications.

Family history: is very positive for diabetes, hypertension, and alcoholism.

Review of Systems (ROS)

General: no recent weight gains of losses, fatigue, fever or chills.

Head, eyes, ears, nose & throat (HEENT):

Neck:

Respiratory:

CV: no chest discomfort or palpitations

GI:

GU:

Integument: history of eczema – not active

MS/Neuro: no syncopal episodes or dizziness, no change in memory or thinking patterns; no twitches or abnormal movements

Psych:

Objective Data

PE: B/P 158/90; Pulse 88; RR 18; Temp 99.2; Ht 5,7; wt 208; BMI 32.6

General: 23 year old male appears well developed and well nourished. He is anxious – pacing in the room and fidgeting, but in no acute distress.

HEENT: Atraumatic, normocephalic, PERRLA, EOMI, sclera with mild icterus, nares patent, ornasopharynx clear, poor dentition – multiple carries. NURS 6512 – Advanced Health Assessment and Diagnostic Reasoning – Discussion Essay Papers.

Lungs: CTA AP&L

Cor: S1S2, +II/VI holosystolic murmur; without rub or gallop

Abd: benign, normoactive bowel sounds x 4; Hepatomegaly 2cm below the costal margin.

Ext: no cyanosis, clubbing or edema

Integument: intact without lesions masses or rashes.

Neuro: No obvious deficits and CN grossly intact II-XII

To prepare:

Reflect on your experiences as a nurse and on the information provided in this week’s Learning Resources on diversity issues in health assessments.

Select one of the three case studies. Reflect on the provided patient information.

Reflect on the specific socioeconomic, spiritual, lifestyle, and other cultural factors related to the health of the patient you selected.

Consider how you would build a health history for the patient. What questions would you ask, and how would you frame them to be sensitive to the patient’s background, lifestyle, and culture? Develop five targeted questions you would ask the patient to build his or her health history and to assess his or her health risks. NURS 6512 – Advanced Health Assessment and Diagnostic Reasoning – Discussion Essay Papers

Think about the challenges associated with communicating with patients from a variety of specific populations. What strategies can you as a nurse employ to be sensitive to different cultural factors while gathering the pertinent information?

By Day 3

Post an explanation of the specific socioeconomic, spiritual, lifestyle, and other cultural factors associated with the patient you selected. Explain the issues that you would need to be sensitive to when interacting with the patient, and why. Provide at least five targeted questions you would ask the patient to build his or her health history and to assess his or her health risks.

Read a selection of your colleagues’ responses.

By Day 6

Respond on or before Day 6 to at leastone of your colleagues who selected a different patient than you, using one or more of the following approaches:

Suggest additional socioeconomic, spiritual, lifestyle, and other cultural factors related to the patient.

Critique your colleague’s targeted questions, and explain how the patient might interpret these questions. Explain whether any of the questions would apply to your patient, and why. NURS 6512 – Advanced Health Assessment and Diagnostic Reasoning – Discussion Essay Papers.

Week 3 discussion

Health Assessment of Children’s Weight

Body measurements can provide a general picture of whether a child is receiving adequate nutrition or is at risk for health issues. These data, however, are just one aspect to be considered. Lifestyle, family history, and culture—among other factors—are also relevant. That said, gathering and communicating this information can be a delicate process.

For this Discussion, you will consider examples of children with various weight issues. You will explore how you could effectively gather information and encourage parents and caregivers to be proactive about their children’s health and weight.

To prepare:

Consider the following examples of pediatric patients and their families:

Overweight 5-year-old boy with overweight parents

Slightly overweight 10-year-old girl with parents of normal weight

5-year-old girl of normal weight with obese parents

Slightly underweight 8-year-old boy with parents of normal weight

Severely underweight 12-year-old girl with underweight parents

Select one of the examples on which to focus for this Discussion. What health issues and risks may be relevant to the child you selected? NURS 6512 – Advanced Health Assessment and Diagnostic Reasoning – Discussion Essay Papers.

Based on the risks you identified, consider what further information you would need to gain a full understanding of the child’s health. Think about how you could gather this information in a sensitive fashion.

Consider how you could encourage parents or caregivers to be proactive toward the child’s health.

By Day 3

Post an explanation of the health issues and risks that are relevant to the child you selected. Describe additional information you would need in order to further assess his or her weight-related health. Taking into account the parents’ and caregivers’ potential sensitivities, list at least three specific questions you would ask about the child to gather more information. Provide at least two strategies you could employ to encourage the parents or caregivers to be proactive about their child’s health and weight.

Read a selection of your colleagues’ responses.

By Day 6

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

Suggest additional health risks or issues that could be relevant to the child.

Critique your colleagues’ questions, and suggest how the parents or caregivers might interpret these questions. Provide alternate or additional questions. NURS 6512 – Advanced Health Assessment and Diagnostic Reasoning – Discussion Essay Papers.

Suggest an additional strategy for gathering patient information or promoting proactivity.

Week 4 discussion

Differential Diagnosis for Skin Conditions

Properly identifying the cause and type of a patient’s skin condition involves a process of elimination known as differential diagnosis. Using this process, a health professional can take a given set of physical abnormalities, vital signs, health assessment findings, and patient descriptions of symptoms, and incrementally narrow them down until one diagnosis is determined as the most likely cause.

In this Discussion, you will examine several visual representations of various skin conditions, describe your observations, and use the techniques of differential diagnosis to determine the most likely condition.

Note: Your Discussion post should be in the SOAP (Subjective, Objective, Assessment, and Plan) note format, rather than the traditional narrative style Discussion posting format. Refer to Chapter 2 of the Sullivan text and the Comprehensive SOAP Template in this week’s Learning Resources for guidance. Remember that not all comprehensive SOAP data are included in every patient case.

To prepare:

Review the Skin Conditions document provided in this week’s Learning Resources, and select two conditions to closely examine for this Discussion.

Consider the abnormal physical characteristics you observe in the graphics you selected. How would you describe the characteristics using clinical terminologies?

Explore different conditions that could be the cause of the skin abnormalities in the graphics you selected.

Consider which of the conditions is most likely to be the correct diagnosis, and why. NURS 6512 – Advanced Health Assessment and Diagnostic Reasoning – Discussion Essay Papers.

By Day 3

Post a description of the two graphics you selected (identify each graphic by number). Use clinical terminologies to explain the physical characteristics featured in each graphic. Formulate a differential diagnosis of three to five possible conditions for each. Determine which is most likely to be the correct diagnosis, and explain your reasoning.

Read a selection of your colleagues’ responses.

By Day 6

Respond to at least two of your colleagues on two different days. Make sure that you respond to colleagues who selected at least one graphic that is different from the ones you selected. For each, address all of the following:

Critique your colleague’s clinical description of the physical characteristics of each.

Suggest an additional possible condition for each graphic, and explain your reasoning.

Provide an alternative correct diagnosis, and explain your reasoning.

Validate an idea with your own experience and additional research.

Week 5 discussion

Assessing the Ears, Nose, and Throat

Most ear, nose, and throat conditions that arise in non-critical care settings are minor in nature. However, subtle symptoms can sometimes escalate into life-threatening conditions that require prompt assessment and treatment. Nurses conducting assessments of the ears, nose, and throat must be able to identify the small differences between life-threatening conditions and benign ones. For instance, if a patient with a sore throat and a runny nose also has inflamed lymph nodes, the inflammation is probably due to the pathogen causing the sore throat rather than a case of throat cancer. With this knowledge and a sufficient patient health history, a nurse would not need to escalate the assessment to a biopsy or an MRI of the lymph nodes, but would probably perform a simple strep test. NURS 6512 – Advanced Health Assessment and Diagnostic Reasoning – Discussion Essay Papers.

In this Discussion, you consider case studies of abnormal findings from patients in a clinical setting. You determine what history should be collected from the patients, what physical exams and diagnostic tests should be conducted, and formulate a differential diagnosis with several possible conditions.

Note: By Day 1 of this week, your instructor will have assigned you to one of the following case studies to review for this Discussion. Also, your Discussion post should be in the SOAP Note format, rather than the traditional narrative style Discussion posting format. Refer to Chapter 2 of the Sullivan text and the Comprehensive SOAP Template in the Week 4 Learning Resources for guidance. Remember that not all comprehensive SOAP data are included in every patient case. NURS 6512 – Advanced Health Assessment and Diagnostic Reasoning – Discussion Essay Papers

Case 1: Nose Focused Exam

Richard is a 50-year-old male with nasal congestion, sneezing, rhinorrhea, and postnasal drainage. Richard has struggled with an itchy nose, eyes, palate, and ears for 5 days. As you check his ears and throat for redness and inflammation, you notice him touch his fingers to the bridge of his nose to press and rub there. He says he’s taken Mucinex OTC the past two nights to help him breathe while he sleeps. When you ask if the Mucinex has helped at all, he sneers slightly and gestures that the improvement is only minimal. Richard is alert and oriented. He has pale, boggy nasal mucosa with clear thin secretions and enlarged nasal turbinates, which obstruct airway flow but his lungs are clear. His tonsils are not enlarged but his throat is mildly erythematous. NURS 6512 – Advanced Health Assessment and Diagnostic Reasoning – Discussion Essay Papers.

Case 2: Focused Throat Exam

Lily is a 20-year-old student at the local community college. When some of her friends and classmates told her about an outbreak of flu-like symptoms sweeping her campus over the past two weeks, Lily figured she shouldn’t take her three-day sore throat lightly. Your clinic has treated a few cases similar to Lily’s. All the patients reported decreased appetite, headaches, and pain with swallowing. As Lily recounts these symptoms to you, you notice that she has a runny nose and a slight hoarseness in her voice but doesn’t sound congested.

Case 3: Focused Ear Exam

Martha brings her 11-year old grandson, James, to your clinic to have his right ear checked. He has complained to her about a mild earache for the past two days. His grandmother believes that he feels warm but did not verify this with a thermometer. James states that the pain was worse while he was falling asleep and that it was harder for him to hear. When you begin basic assessments, you notice that James has a prominent tan. When you ask him how he’s been spending his summer, James responds that he’s been spending a lot of time in the pool.

To prepare:

With regard to the case study you were assigned:

Review this week’s Learning Resources and consider the insights they provide.

Consider what history would be necessary to collect from the patient.

Consider what physical exams and diagnostic tests would be appropriate to gather more information about the patient’s condition. How would the results be used to make a diagnosis? NURS 6512 – Advanced Health Assessment and Diagnostic Reasoning – Discussion Essay Papers.

Identify at least 10 possible conditions that may be considered in a differential diagnosis for the patient.

Note: Before you submit your initial post, replace the subject line (“Week 5 Discussion”) with “Review of Case Study ___,” identifying the number of the case study you were assigned.

By Day 3

Post a description of the health history you would need to collect from the patient in the case study to which you were assigned. Explain what physical exams and diagnostic tests would be appropriate and how the results would be used to make a diagnosis. List five different possible conditions for the patient’s differential diagnosis and justify why you selected each.

Read a selection of your colleagues’ responses.

By Day 6

Respond to at least two of your colleagues on two different days who were assigned different case studies than you. Analyze the possible conditions from your colleagues’ differential diagnoses. Determine which of the conditions you would reject and why. Identify the most likely condition and justify your reasoning. NURS 6512 – Advanced Health Assessment and Diagnostic Reasoning – Discussion Essay Papers.

Week 6 discussion

Assessing the Heart, Lungs, and Peripheral Vascular System

Take a moment to observe your breathing. Notice the sensation of your chest expanding as air flows into your lungs. Feel your chest contract as you exhale. How might this experience be different for someone with chronic lung disease or someone experiencing an asthma attack?

In order to adequately assess the chest region of a patient, nurses need to be aware of a patient’s history, potential abnormal findings, and what physical exams and diagnostic tests should be conducted to determine the causes and severity of abnormalities.

In this Discussion, you will consider how a patient’s initial symptoms can result in very different diagnoses when further assessment is conducted.

Note: By Day 1 of this week, your Instructor will have assigned you to one of the video case studies in this week’s Learning Resources titled Advanced health assessment and diagnostic reasoning. Also, your Discussion post should be in the SOAP Note format, rather than the traditional narrative style Discussion posting format. Refer to Chapter 2 of the Sullivan text and the Comprehensive SOAP Template in the Week 4 Learning Resources for guidance. Remember that not all comprehensive SOAP data are included in every patient case. NURS 6512 – Advanced Health Assessment and Diagnostic Reasoning – Discussion Essay Papers.

To prepare:

With regard to the case study you were assigned:

Review this week’s Learning Resources and consider the insights they provide.

Consider what history would be necessary to collect from the patient.

Consider what physical exams and diagnostic tests would be appropriate to gather more information about the patient’s condition. How would the results be used to make a diagnosis?

Identify at least five possible conditions that may be considered in a differential diagnosis for the patient.

Note: Before you submit your initial post, replace the subject line (“Discussion – Week 6”) with “Review of Case Study” identifying the number of the case study you were assigned.

By Day 3

Post a description of the health history you would need to collect from the patient in the case study you were assigned. Explain what physical exams and diagnostic tests would be appropriate and how the results would be used to make a diagnosis. List five different possible conditions for the patient’s differential diagnosis, and justify why you selected each. NURS 6512 – Advanced Health Assessment and Diagnostic Reasoning – Discussion Essay Papers.

Read a selection of your colleagues’ responses.

By Day 6

Respond to at least two of your colleagues on two different days who were assigned different case studies than you. Analyze the possible conditions from your colleagues’ differential diagnoses. Determine which of the conditions you would reject and why. Identify the most likely condition, and justify your reasoning.

Week 7 discussion

Assessing the Abdomen

A woman went to the emergency room for severe abdominal cramping. She was diagnosed with diverticulitis; however, as a precaution, the doctor ordered a CAT scan. The CAT scan revealed a growth on the pancreas, which turned out to be pancreatic cancer—the real cause of the cramping.

Because of a high potential for misdiagnosis, determining the precise cause of abdominal pain can be time-consuming and challenging. By analyzing case studies of abnormal abdominal findings, nurses can prepare themselves to better diagnose conditions in the abdomen. NURS 6512 – Advanced Health Assessment and Diagnostic Reasoning – Discussion Essay Papers.

In this Discussion, you will consider case studies that describe abnormal findings in patients seen in a clinical setting. You will consider what history should be collected from the patients, as well as which physical exams and diagnostic tests should be conducted. You will also formulate a differential diagnosis with several possible conditions.

Note: By Day 1 of this week, your Instructor will have assigned you to one of the following specific case studies for this Discussion. Also, your Discussion post should be in the SOAP Note format, rather than the traditional narrative style Discussion posting format. Refer to Chapter 2 of the Sullivan text and the Comprehensive SOAP Template in the Week 4 Learning Resources for guidance. Remember that not all comprehensive SOAP data are included in every patient case. NURS 6512 – Advanced Health Assessment and Diagnostic Reasoning – Discussion Essay Papers.

Case 1: Abdominal Pain

A 12-year-old female complains of malaise with abdominal pain pointing to the right lower quadrant. The patient has been vomiting and feeling nauseated for several days. The abdominal pain has been insidious and now is more pronounced. Both parents are with the child and are concerned because she has not been eating and has had a fever for the past 3 evenings.

Case 2: Gastrointestinal Pain

A 50-year-old male complains of burning pain starting at the abdomen and rising to the middle of his chest. He describes the pain as a gnawing feeling that begins after meals, especially when lying down.

Case 3: Nausea and Vomiting

A 20-year-old female complains of nausea and has vomited three times over the past 48 hours. The patient also experienced a low-grade fever this morning. She states that she recently ate shellfish at a new restaurant with two friends who are suffering from similar symptoms. NURS 6512 – Advanced Health Assessment and Diagnostic Reasoning – Discussion Essay Papers.

To prepare:

With regard to the case study you were assigned:

Review this week’s Learning Resources, and consider the insights they provide about the case study.

Consider what history would be necessary to collect from the patient in the case study you were assigned.

Consider what physical exams and diagnostic tests would be appropriate to gather more information about the patient’s condition. How would the results be used to make a diagnosis? NURS 6512 – Advanced Health Assessment and Diagnostic Reasoning – Discussion Essay Papers

Identify at least five possible conditions that may be considered in a differential diagnosis for the patient.

Note: Before you submit your initial post, replace the subject line (“Week 7 Discussion”) with “Review of Case Study ___.” Fill in the blank with the number of the case study you were assigned.

By Day 3

Post a description of the health history you would need to collect from the patient in the case study to which you were assigned. Explain which physical exams and diagnostic tests would be appropriate and how the results would be used to make a diagnosis. List five different possible conditions for the patient’s differential diagnosis, and justify why you selected each.

Read a selection of your colleagues’ responses.

By Day 6

Respond to at least two of your colleagues on two different days who were assigned different case studies than you. Analyze the possible conditions from your colleagues’ differential diagnoses. Determine which of the conditions you would reject, and why. Identify the most likely condition, and justify your reasoning.

Week 8 discussion

Assessing Muscoskeletal Pain

The body is constantly sending signals about its health. One of the most easily recognized signals is pain. Musculoskeletal conditions comprise one of the leading causes of severe long-term pain in patients. The musculoskeletal system is an elaborate system of interconnected levers that provide the body with support and mobility. Because of the interconnectedness of the musculoskeletal system, identifying the causes of pain can be challenging. Accurately interpreting the cause of musculoskeletal pain requires an assessment process informed by patient history and physical exams.

In this Discussion, you will consider case studies that describe abnormal findings in patients seen in a clinical setting.

Note: By Day 1 of this week, your Instructor will have assigned you to one of the following specific case studies for this Discussion. Also, your Discussion post should be in the SOAP Note format, rather than the traditional narrative style Discussion posting format. Refer to Chapter 2 of the Sullivan text and the Comprehensive SOAP Template in the Week 4 Learning Resources for guidance. Remember that not all comprehensive SOAP data are included in every patient case.

Case 1: Back Pain

A 42-year-old male reports pain in his lower back for the past month. The pain sometimes radiates to his left leg. In determining the cause of the back pain, based on your knowledge of anatomy, what nerve roots might be involved? How would you test for each of them? What other symptoms need to be explored? What are your differential diagnoses for acute low back pain? Consider the possible origins using the Agency for Healthcare Research and Quality (AHRQ) guidelines as a framework. What physical examination will you perform? What special maneuvers will you perform?

Note: Please view the Week 8 Discussion area to view the image for Case Study 1.

Case 2: Ankle Pain

A 46-year-old female reports pain in both of her ankles, but she is more concerned about her right ankle. She was playing soccer over the weekend and heard a “pop.” She is able to bear weight, but it is uncomfortable. In determining the cause of the ankle pain, based on your knowledge of anatomy, what foot structures are likely involved? What other symptoms need to be explored? What are your differential diagnoses for ankle pain? What physical examination will you perform? What special maneuvers will you perform? Should you apply the Ottowa ankle rules to determine if you need additional testing? NURS 6512 – Advanced Health Assessment and Diagnostic Reasoning – Discussion Essay Papers.

Note: Please view the Week 8 Discussion area to view the image for Case Study 2.

Case 3: Knee Pain

A 15-year-old male reports dull pain in both knees. Sometimes one or both knees click, and the patient describes a catching sensation under the patella. In determining the causes of the knee pain, what additional history do you need? What categories can you use to differentiate knee pain? What are your specific differential diagnoses for knee pain? What physical examination will you perform? What anatomic structures are you assessing as part of the physical examination? What special maneuvers will you perform?

Note: Please view the Week 8 Discussion area to view the image for Case Study 3.

To prepare:

With regard to the case study you were assigned:

Review this week’s Learning Resources, and consider the insights they provide about the case study.

Consider what history would be necessary to collect from the patient in the case study you were assigned.

Consider what physical exams and diagnostic tests would be appropriate to gather more information about the patient’s condition. How would the results be used to make a diagnosis? NURS 6512 – Advanced Health Assessment and Diagnostic Reasoning – Discussion Essay Papers.

Identify at least five possible conditions that may be considered in a differential diagnosis for the patient.

Note: Before you submit your initial post, replace the subject line (“Discussion – Week 8”) with “Review of Case Study ___.” Fill in the blank with the number of the case study you were assigned.

By Day 3

Post a description of the health history you would need to collect from the patient in the case study to which you were assigned. Explain what physical exams and diagnostic tests would be appropriate and how the results would be used to make a diagnosis. List five different possible conditions for the patient’s differential diagnosis, and justify why you selected each. Include how the patient X-ray helped you to refine the differential diagnosis.

Read a selection of your colleagues’ responses.

By Day 6

Respond to at least two of your colleagues on 2 different days who were assigned different case studies than you. Analyze the possible conditions from your colleagues’ differential diagnoses. Determine which of the conditions you would reject and why. Identify the most likely condition, and justify your reasoning.

Week 9 discussion

Assessing Neurological Symptoms

Imagine not being able to form new memories. This is the reality patients with anterograde amnesia face. Although this form of amnesia is rare, it can result from severe brain trauma. Anterograde amnesia demonstrates just how impactful brain disorders can be to a patient’s quality of living. Accurately assessing neurological symptoms is a complex process that involves the analysis of many factors. NURS 6512 – Advanced Health Assessment and Diagnostic Reasoning – Discussion Essay Papers.

In this Discussion, you will consider case studies that describe abnormal findings in patients seen in a clinical setting.

Note: By Day 1 of this week, your Instructor will have assigned you to one of the following specific case studies for this Discussion. Also, your Discussion post should be in the SOAP Note format, rather than the traditional narrative style Discussion posting format. Refer to Chapter 2 of the Sullivan text and the Comprehensive SOAP Template in the Week 4 Learning Resources for guidance. Remember that not all comprehensive SOAP data are included in every patient case.

Case 1: Headaches

A 20-year-old male complains of experiencing intermittent headaches. The headaches diffuse all over the head, but the greatest intensity and pressure occurs above the eyes and spreads through the nose, cheekbones, and jaw.

Case 2: Numbness and Pain

A 47-year-old obese female complains of pain in her right wrist, with tingling and numbness in the thumb and index and middle fingers for the past 2 weeks. She has been frustrated because the pain causes her to drop her hair-styling tools. NURS 6512 – Advanced Health Assessment and Diagnostic Reasoning – Discussion Essay Papers.

Case 3: Drooping of Face

A 33-year-old female comes to your clinic alarmed about sudden “drooping” on the right side of the face that began this morning. She complains of excessive tearing and drooling on her right side as well.

To prepare:

With regard to the case study you were assigned:

Review this week’s Learning Resources, and consider the insights they provide about the case study.

Consider what history would be necessary to collect from the patient in the case study you were assigned.

Consider what physical exams and diagnostic tests would be appropriate to gather more information about the patient’s condition. How would the results be used to make a diagnosis?

Identify at least five possible conditions that may be considered in a differential diagnosis for the patient.

Note: Before you submit your initial post, replace the subject line (“Discussion – Week 9”) with “Review of Case Study ___.” Fill in the blank with the number of the case study you were assigned.

By Day 3

Post a description of the health history you would need to collect from the patient in the case study to which you were assigned. Explain what physical exams and diagnostic tests would be appropriate and how the results would be used to make a diagnosis. List five different possible conditions for the patient’s differential diagnosis, and justify why you selected each. NURS 6512 – Advanced Health Assessment and Diagnostic Reasoning – Discussion Essay Papers.

Read a selection of your colleagues’ responses.

By Day 6

Respond to at least two of your colleagues on two different days who were assigned different case studies than you. Analyze the possible conditions from your colleagues’ differential diagnoses. Determine which of the conditions you would reject and why. Identify the most likely condition, and justify your reasoning.

Week 10 discussion

Assessing the Genitalia and Rectum

Patients are frequently uncomfortable discussing with health care professionals issues that involve the genitalia and rectum; however, gathering an adequate history and properly conducting a physical exam are vital. Examining case studies of genital and rectal abnormalities can help prepare advanced practice nurses to accurately assess patients with problems in these areas.

In this Discussion, you will consider case studies that describe abnormal findings in patients seen in a clinical setting.

Note: By Day 1 of this week, your Instructor will have assigned you to one of the following specific case studies for this Discussion. Also, your Discussion post should be in the SOAP Note format, rather than the traditional narrative style Discussion posting format. Refer to Chapter 2 of the Sullivan text and the Comprehensive SOAP Template in the Week 4 Learning Resources for guidance. Remember that not all comprehensive SOAP data are included in every patient case. NURS 6512 – Advanced Health Assessment and Diagnostic Reasoning – Discussion Essay Papers.

Case 1: Rectal Bleeding

A 62-year-old male construction worker reports to your clinic after experiencing rectal bleeding for over 1 month. He has noticed small amounts of blood after every bowel movement. He had a colonoscopy 2 years ago with normal results. The patient has no fever, chills, dysuria, abnormal urinary frequency, or abdominal pain. The patient reports occasional rectal itching and pain. He states he has no noticeable sores on his rectal area and no family history of colorectal cancer.

Case 2: Dysuria

A 55-year-old African-American male reports to your clinic complaining of frequent and painful urination for the past 2 months. The patient is sexually active and has been in a monogamous relationship for the past 3 years. He reports no penile discharge, fever, chills, abdominal pain, or back pain. His father is deceased and passed away of colon cancer. His father had a history of benign prostatic hypertrophy (BPH). The patient considers himself as a healthy male. He works for a large American corporation, has a relatively healthy diet, and exercises 4 to 5 times per week. NURS 6512 – Advanced Health Assessment and Diagnostic Reasoning – Discussion Essay Papers

Case 3: Genitalia

A 21-year-old college student reports to your clinic with external bumps on her genital area. The bumps are painless and feel rough. The patient is sexually active and has had more than one partner over the past year. Her initial sexual contact occurred at age 18. The patient reports no abnormal vaginal discharge. She is unsure how long the bumps have been there but noticed them about a week ago. Her last Pap smear exam was 3 years ago, and no dysplasia was found; the exam results were normal. She had one sexually transmitted infection (chlamydia) about 2 years ago. She completed the treatment for chlamydia as prescribed. NURS 6512 – Advanced Health Assessment and Diagnostic Reasoning – Discussion Essay Papers.

To prepare:

With regard to the case study you were assigned:

Review this week’s Learning Resources, and consider the insights they provide about the case study.

Consider what history would be necessary to collect from the patient in the case study you were assigned.

Consider what physical exams and diagnostic tests would be appropriate to gather more information about the patient’s condition. How would the results be used to make a diagnosis?

Identify at least five possible conditions that may be considered in a differential diagnosis for the patient.

Note: Before you submit your initial post, replace the subject line (“Week 10 Discussion”) with “Review of Case Study ___.” Fill in the blank with the number of the case study you were assigned.

By Day 3

Post a description of the health history you would need to collect from the patient in the case study to which you were assigned. Explain what physical exams and diagnostic tests would be appropriate and how the results would be used to make a diagnosis. List five different possible conditions for the patient’s differential diagnosis, and justify why you selected each.

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Read a selection of your colleagues’ responses.

By Day 6

Respond to at least two of your colleagues on two different days who were assigned different case studies than you. Analyze the possible conditions from your colleagues’ differential diagnoses. Determine which of the conditions you would reject, and why. Identify the most likely condition, and justify your reasoning.

Week 11 discussion

Ethical Concerns

As an advanced practice nurse, you will run into situations where a patient’s wishes about his or her health conflict with evidence, your own experience, or a family’s wishes. This may create an ethical dilemma. What do you do when these situations occur?

In this Discussion, you will explore evidence-based practice guidelines and ethical considerations for specific scenarios.

Scenario 1:

The parents of a 5-year-old boy have accompanied their son for his required physical examination before starting kindergarten. His parents are opposed to him receiving any vaccines.

Scenario 2:

A 49-year-old woman with advanced stage cancer has been admitted to the emergency room with cardiac arrest. Her husband and one of her children accompanied the ambulance.

Scenario 3:

A 27-year-old man with Crohn’s disease has been admitted to the emergency room with an extreme flare-up of his condition. He explains that he has not been able to afford his medications for the last few months and is concerned about the costs he may incur for treatment. NURS 6512 – Advanced Health Assessment and Diagnostic Reasoning – Discussion Essay Papers.

Scenario 4:

A single mother has accompanied her two daughters, aged 15 and 13, to a women’s health clinic and has requested that the girls receive a pelvic examination and be put on birth control. The girls have consented to the exam but seem unsettled.

Scenario 5:

A 17-year-old boy has come in for a check-up after a head injury during a football game. He has indicated that he would like to be able to play in the next game, which is in 3 days.

Scenario 6:

A 12-year-old girl has come in for a routine check-up and has not yet received the HPV vaccine. Her family is very religious and believes that the vaccine would encourage premarital sexual activity.

Scenario 7:

A 57-year-old man who was diagnosed with motor neuron disease 2 years ago is experiencing a rapid decline in his condition. He prefers to be admitted to the in-patient unit at a hospice to receive end-of-life care, but his wife wants him to remain at home.

To prepare:

Select three scenarios, and reflect on the material presented throughout this course.

What necessary information would need to be obtained about the patient through health assessments and diagnostic tests?

Consider how you would respond as an advanced practice nurse. Review evidence-based practice guidelines and ethical considerations applicable to the scenarios you selected.

By Day 3

Post the explanation of the health assessment information required for a diagnosis of your selected patients (include the scenario numbers). Explain how you would respond to the scenario as an advanced practice nurse using evidence-based practice guidelines and applying ethical considerations. Justify your responses. NURS 6512 – Advanced Health Assessment and Diagnostic Reasoning – Discussion Essay Papers

Read a selection of your colleagues’ responses.

By Day 6

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

Suggest additional health assessment information that would be necessary to collect from the patient

Critique your colleague’s response, and explain alternative approaches to the situation.

Validate an idea with your own experience and additional research. NURS 6512 – Advanced Health Assessment and Diagnostic Reasoning – Discussion Essay Papers

Role of the APN Essay Assignment

Discussion Part One

Mary, a baccalaureate prepared registered nurse, has been practicing for fifteen years. Throughout her nursing career, she worked in pediatric, surgical, and emergency departments. She worked as a floor nurse, charge nurse, and was recently offered a position as a nursing supervisor. A stipulation for becoming a nursing supervisor is that Mary must attain a Master of Health Administration degree within 2 years of accepting the position. The offer prompted Mary to contemplate her career. She is interested in returning to college, but she realized that she does not want to pursue working in administration and away from patients. Mary decided to become an Advanced Practice Nurse (APN). Mary knows that working as an APN will allow her the opportunity to make a larger contribution to individuals, environment, health, and nursing. She researched graduate nursing programs and discovered that there are four roles of the APN. Mary must choose one role and apply to a program, but she is unsure about the different roles and their individual scopes of practice.

Discussion question:

How would you decide? Develop a pros and cons list to assist Mary in making her decision. Include each role of the APN on the list and be certain to provide appropriate rationales and citations.

Discussion Part Two

A clear definition for the various roles of CNM, CNP, CNS, and CRNA has been convoluted by various state definitions that confuse the roles and often obscure their intended meaning. Such state definitions reveal further confusion with regard to role separation, competency, emphasis, approach, and variation. This misunderstanding extends to nurse educators, providers, reimbursement, and even the public. The lack of clarity regarding initial role preparation versus current certification serves to further frustrate accreditors, consumers, and employers alike.

Discussion question:

How does your state define the role and scope of the CNP? Provide a correctly formatted citation for your reference resource.

Discussion Part Three

Mary expressed that she wants to work directly with patients. She is familiar with working in a large hospital system, and prefers to remain in her current town when she graduates. She has considerable clinical experience in pediatric, surgical, and emergency nursing.

Discussion question:

Based on Mary’s experience and interests, which role would you choose for her, and why?

Role of the APN Essay Assignment

HCA 322 FINAL PAPER

Scenario

Project Assignment: Review your State Government’s website and search for its official Do Not Resuscitate (DNR) Form. Along with the form will be information and instructions regarding the form. In addition, research three area hospitals to determine if they provide separate DNR forms. Then, perform additional research regarding DNR and prepare your Final Paper by analyzing the issues through these steps:

•Analyze the requirements of your State Government’s DNR.

•Identify the requirements of the three hospital’s DNRs.

•Examine the differences and similarities between the state’s and the three hospital’s DNR requirements, and address the following questions:

•What are they?

•Which one should you follow?

•Explain how a DNR is applied if a patient is under hospice care and EMTs are called.

Writing the Final Paper

The Final Paper:

•Must be eight to ten double-spaced pages in length, excluding title and reference pates, and formatted according to APA style as outlined in the Ashford Writing Center.

•Must include a title page with the following:

?Title of paper

?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 eight scholarly sources that were published within the past five years, including a minimum of four from academic journals

HCA 322 FINAL PAPER

Concept Map-Hypertension Written Assignment

Develop and .learntoday.info/Learn/NU254_Fall_14/site/Media/Worksheets/Concept%20Map%20Exemplars.docx”>Concept Map, using the form provided, on the following patient. Include Diagnostic data and medical orders that you expect to be ordered on the patient. Attach references as well in APA format.

T.J., a 30-year-old African American client, is in his last year of law school and is clerking for a prestigious law firm. He and his fiancé plan to marry as soon as he graduates. During the last week he has had four dizzy spells and a headache at the base of his skull upon awakening for the last 2 days. His father has a history of hypertension, so T.J. is aware that his symptoms may indicate high blood pressure. On his way home from work, T.J. stops by the clinic and asks the nurse to check his blood pressure. The nursing assessment yields the following data.

Subjective data: States he has had four dizzy spells and has awakened with a headache in the occipital lobe the last two mornings. T.J. has 1 glass of wine at lunch and 2-3 beers in the evening to relax from the tension of school and work. Most of his meals are at fast-food establishments and have a high fat content. T.J. does not smoke. He used to jog 4 mornings a week but quit when he started clerking. He has had nocturia for the last 3 weeks. He is not taking any medication. T.J. states he is concerned about having hypertension because he does not want to take medication.

Objective data: T 98.6°F(37°C), AP 78 beats/min, R 16 breaths/min, BP 142/92 mm Hg, Wt 190 lbs (optimum weight 160). No edema noted in hands, feet, or legs.

Concept Map-Hypertension Written Assignment

NR507 Advanced Pathophysiology – Full Course (all essay discussions+ midterm and final exam)

Week 1: Altered Immune System and Altered Inflammatory Response

– Discussion Part One

This week’s graded topics relate to the following Course Outcomes (COs).

1 Analyze pathophysiologic mechanisms associated with selected disease states. (PO 1)

2 Differentiate the epidemiology, etiology, developmental considerations, pathogenesis, and clinical and laboratory manifestations of specific disease processes. (PO 1)

3 Examine the way in which homeostatic, adaptive, and compensatory physiological mechanisms can be supported and/or altered through specific therapeutic interventions. (PO 1, 7)

6 Distinguish risk factors associated with selected disease states. (PO 1)

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5 Describe outcomes of disruptive or alterations in specific physiologic processes. (PO 1)

6 Distinguish risk factors associated with selected disease states. (PO 1)

7 Explore age-specific and developmental alterations in physiologic

and disease states. (PO 1, 4)

Discussion

Discussion Part One (graded)

John is a 19-year-old college football player who presents with sneezing, itchy eyes, and nasal congestion that worsens at night. He states that he has a history of asthma, eczema and allergies

to pollen. There is also one other person on the football team that has similar symptoms. His vitals are BP 110/70, P 84, R 18, T 100 F. Write a differential of at least five (5) possible items from the most likely to less likely. For each disease include information about the epidemiology, pathophysiology and briefly argue why this disease fits the presentation and why it might not fit the presentation. NR507 Advanced Pathophysiology – Full Course (all essay discussions+ midterm and final exam)

Week 1: Altered Immune System and Altered Inflammatory Response – Discussion

Part Two

A patient has been admitted into the emergency room that was in the passenger side of a car that collided with another car head on. The patient is pale, barely conscious and has a weak and thready pulse. An IV is started. The vitals are BP 80/50, P 140, T 96.0 and R 26. As the team fights to keep the patient alive they have to remove the spleen. Blood is given but it has been mistyped. A transfusion reaction occurs. Describe the type of hypersensitivity reaction that has occurred and discuss the molecular pathophysiology of the specific type of hypersensitive reaction you have chosen.

In the event that this patient survived the car accident and the transfusion reaction which organs are most likely to be damaged and why?

Week 1: Altered Immune System and Altered Inflammatory

Response – Discussion Part Three

This week’s graded topics relate to the following Course Outcomes (COs).

1 Analyze pathophysiologic mechanisms associated with selected disease states. (PO 1)

2 Differentiate the epidemiology, etiology, developmental considerations, pathogenesis, and clinical and laboratory manifestations of specific disease processes. (PO 1)

3 Examine the way in which homeostatic, adaptive, and compensatory physiological mechanisms can be supported and/or altered through specific therapeutic interventions. (PO 1,

4 Distinguish risk factors associated with selected disease states.(PO 1)

5 Describe outcomes of disruptive or alterations in specific physiologic processes. (PO 1)

6 Distinguish risk factors associated with selected disease states. (PO 1)

7 Explore age-specific and developmental alterations in physiologic and disease states. (PO 1, 4)

Discussion

A 44-year-old patient presents with lump in the chest of approximately 2 cm in diameter. There is a slight dimple over the location of the lump and when the lump is manipulated it seems to be attached to the surrounding tissue. A lumpectomy is performed and the mass is sent to pathology. The pathology report comes back and the mass is confirmed to be an estrogen receptor negative, a progesterone receptor negative and a her2/neu receptor positive breast cancer. NR507 Advanced Pathophysiology – Full Course (all essay discussions+ midterm and final exam)

What are some of the risk factors for breast cancer?

What tumor suppressor genes are associated with breast cancer?

What tumor oncogenes are associated with breast cancer?

Compare and contrast tumor suppressor genes from oncogenes?

Week2

Week 2: Respiratory Disorders and Alterations in Acid/Base Balance,

Fluid and Electrolytes – Discussion Part One

This week’s graded topics relate to the following Course Outcomes (COs).

Analyze pathophysiologic mechanisms associated with selected disease states. (PO 1)

Differentiate the epidemiology, etiology, developmental considerations, pathogenesis, and clinical and laboratory manifestations of specific disease processes. (PO 1)

Examine the way in which homeostatic, adaptive, and compensatory physiological mechanisms can be supported and/or altered through specific therapeutic interventions. (PO 1, 7)

Distinguish risk factors associated with selected disease states. (PO1)

Describe outcomes of disruptive or alterations in specific physiologic processes. (PO 1)

Distinguish risk factors associated with selected disease states. (PO1)

Explore age-specific and developmental alterations in physiologic and disease states. (PO 1, 4)

Discussion Part One (graded)

A five-month-old Caucasian female is brought into the clinic as the parent complain that she has been having ongoing foul-smelling , greasy diarrhea. She seems to be small for her age and a

bit sickly but, her parent’s state that she has a huge appetite. Upon examination you find that

the patient is wheezing and you observe her coughing.

Write a differential diagnosis of at least five (5) disorders and explain why each might be

a possibility and any potential weaknesses of each differential.

Why is it that the later in age this disease manifest itself, the less severe the disease is?

What tests would you run to clarify your differential and potentially come to a definitive

diagnosis?

If the same child was African in ancestry would this change your initial differential? Why

or why not?

Week 2: Respiratory Disorders and Alterations in Acid/Base Balance, Fluid and Electrolytes – Discussion Part Two

This week’s graded topics relate to the following Course Outcomes (COs). NR507 Advanced Pathophysiology – Full Course (all essay discussions+ midterm and final exam)

1 Analyze pathophysiologic mechanisms associated with selected disease states. (PO 1)

2 Differentiate the epidemiology, etiology, developmental considerations, pathogenesis, and clinical and laboratory manifestations of specific disease processes. (PO 1)

3 Examine the way in which homeostatic, adaptive, and compensatory physiological mechanisms can be supported and/or altered through specific therapeutic interventions. (PO 1, 7)

4 Distinguish risk factors associated with selected disease states. (PO 1)

5 Describe outcomes of disruptive or alterations in specific physiologic processes. (PO 1)

6 Distinguish risk factors associated with selected disease states. (PO 1)

7 Explore age-specific and developmental alterations in physiologic and disease states. (PO 1, 4)

Tammy is a 33-year-old who presents for evaluation of a cough. She reports that about 3 weeks ago she developed a “really bad cold” with rhinorrhea. The cold seemed to go away but then she developed a profound, deep, mucus-producing cough. Now, there is no rhinorrhea or rhinitis—the primary problem is the cough. She develops these coughing fits that are prolonged, very deep, and productive of a lot of green sputum. She hasn’t had any fever but does have a scratchy throat. Tammy has tried over-the-counter cough medicines but has not had much relief. The cough keeps her awake at night and sometimes gets so bad that she gags and dry heaves. NR507 Advanced Pathophysiology – Full Course (all essay discussions+ midterm and final exam)

Write a differential of at least five (5) possible diagnosis’s and explain how each may be a possible answer to the clinical presentation above.

Remember, to list the differential in the order of most likely to less likely.

Based upon what you have at the top of the differential how would you treat this patient?

Suppose now, the patient has a fever of 100.4 and complains of foul smelling mucous and breath. Indeed, she complains of producing cups of mucous some days. She has some trouble breathing on moderate exertion but this is only a minor complaint to her. How does this change your differential and why?

Week 2: Respiratory Disorders and Alterations in Acid/Base Balance,

Fluid and Electrolytes – Discussion Part Three

This week’s graded topics relate to the following Course Outcomes (COs).

Analyze pathophysiologic mechanisms associated with selected disease states. (PO 1)

Differentiate the epidemiology, etiology, developmental considerations, pathogenesis, and clinical and laboratory manifestations of specific disease processes. (PO 1)

Examine the way in which homeostatic, adaptive, and compensatory physiological mechanisms can be supported and/or altered through specific therapeutic interventions. (PO 1, 7)

Distinguish risk factors associated with selected disease states.

Describe outcomes of disruptive or alterations in specific physiologic processes. (PO 1)

Distinguish risk factors associated with selected disease states. (PO

Explore age-specific and developmental alterations in physiologic and disease states. (PO 1, 4)

A nursing student comes into your office because they are struggling with the concept of pulmonary function. They know you as an experienced FNP and so they are comfortable asking if you could clarify the terms residual volume (RV), functional reserve capacity (FRC), total lung capacity (TLC) inspiratory reserve volume (IRV), and expiratory reserve volume (ERV).

Give her a definition of each?

List three (3) disorders that can alter the residual volume and explain how they do so?

Week 3: Cardiovascular, Cellular, and Hematologic Disorders – Discussion

Week 3

Part One

This week’s graded topics relate to the following Course Outcomes (COs).

1 Analyze pathophysiologic mechanisms associated with selected disease states. (PO 1)

2 Differentiate the epidemiology, etiology, developmental considerations, pathogenesis, and clinical and laboratory manifestations of specific disease processes. (PO 1). NR507 Advanced Pathophysiology – Full Course (all essay discussions+ midterm and final exam)

3 Examine the way in which homeostatic, adaptive, and compensatory physiological mechanisms can be supported and/or altered through specific therapeutic interventions. (PO 1, 7)

4 Distinguish risk factors associated with selected disease states. (PO 1)

5 Describe outcomes of disruptive or alterations in specific physiologic processes. (PO 1)

6 Distinguish risk factors associated with selected disease states. (PO 1)

7 Explore age-specific and developmental alterations in physiologic and disease states

A 17-year-old African American from the inner city complains of severe chest and abdominal pain. Upon examination the attending physician performs and EKG, chest x-ray, and an abdominal and chest clinical examination and finds nothing. Assuming, she is drug seeking he sends her home. She comes back to the ER 4 hours later and now you see the patient. She explains that she was running track this past afternoon at school and that despite being very hot (100 F) she pushed on. Afterwards, she starts feeling extensive pain in her chest and abdomen. She has jaundiced eyes, her blood pressure is 98/50, pulse is 112, T = 99.9 F, R = 28. The pain seems out of proportion to the physical findings.

What is your list of differential diagnoses in this case and explain how each of these fits with the case patient as described above. Be sure to list at least four (4) pertinent differential diagnoses. Indicate which of these you would select as the most likely diagnosis and explain why.

Now, as she is in the ER she begins to exhibit stroke like features. ? Does this change your differential? How do you treat this patient now? Are they any preventative actions that could have been taken?

Week 3: Cardiovascular, Cellular, and Hematologic Disorders –

Discussion Part Two

This week’s graded topics relate to the following Course Outcomes (COs).

1 Analyze pathophysiologic mechanisms associated with selected disease states. (PO 1)

2 Differentiate the epidemiology, etiology, developmental considerations, pathogenesis, and clinical and laboratory manifestations of specific disease processes. (PO 1)

3 Examine the way in which homeostatic, adaptive, and compensatory physiological mechanisms can be supported and/or altered through specific therapeutic interventions. (PO 1, 7)

4 Distinguish risk factors associated with selected disease states. (PO 1)

5 Describe outcomes of disruptive or alterations in specific physiologic processes. (PO 1)

6 Distinguish risk factors associated with selected disease states. (PO 1)

7 Explore age-specific and developmental alterations in physiologic and disease states. (PO 1, 4)

Jesse is a 57-year-old male who presents with gradual onset of dyspnea on exertion and fatigue. He also complains of frequent dyspepsia with nausea and occasional epigastric pain. He states that at night he has trouble breathing especially while lying on his back. This is relieved by him sitting up. His vitals are 180/110, P = 88, T = 98.0 C, R = 20.

Write a differential in this case and explain how each item in your differential fits and how it might not fit.

What tests would you order? What immediate treatment would you consider giving this patient and what treatment when he went home? Assume your first differential is definitive. NR507 Advanced Pathophysiology – Full Course (all essay discussions+ midterm and final exam)

Now, he comes back to your clinic 3 months later and both his ankles are slightly swollen. What possible explanations are there for this observation?

Week 3: Cardiovascular, Cellular, and Hematologic Disorders –

Discussion Part Three

A new patient is brought into the office for their annual evaluation. The child is a 6-year-old and appears a bit small for their age but not so small that any alarm bells are set off. The vitals are: P = 116, R = 22, T = 98.6
F
, BP = 110/50. (The normal vitals in a 6-year-old are P = 75 – 120, R = 16 – 22, T = 98.6 , BP = (85-115)/(48-64). Examination of the lungs is normal, HEENT is normal, as is the abdominal exam. The heart however, seems laterally displaced and there appears to be only a continuous murmur which can be described as crescendo/decrescendo systolic murmur that extends into diastole. Because, you were trained at Chamberlain College of Nursing you immediately know that this is probably a patent ductus arteriosus. NR507 Advanced Pathophysiology – Full Course (all essay discussions+ midterm and final exam)

Week 5

Week 5: Alterations in Endocrine Function – Discussion Part One

Week 5: Discussion Part One

Ms. Blake is an older adult with diabetes and has been too ill to get out of bed for 2 days. She has had a severe cough and has been unable to eat or drink during this time. She has a history of Type I diabetes. On admission her laboratory values show:

Sodium (Na+)

156 mEq/L

Potassium (K+)

4.0 mEq/L

Chloride (Cl–)

115 mEq/L

Arterial blood gases (ABGs)

pH- 7.30; Pco2-40; Po2-70; HCO3-20

Normal values

Sodium (Na+)

136-146 mEq/L

Potassium (K+)

3.5-5.1 mEq/L

Chloride (Cl–)

98-106 mEq/L

Arterial blood gases (ABGs)

pH- 7.35-7.45

Pco2- 35-45 mmHg

Po2-80-100 mmHg

HCO3–22-28 mEq/L

List three (3) reasons on why she may have become bed ridden?

Based on these reasons what tests would you order?

Describe the molecular mechanism of the development of ketoacidosis.

Week 5: Discussion Part Two

13 13 unread replies. 39 39 replies.

A three-month-old baby boy comes into your clinic with the main complaint that he frequently vomits after eating. He often has a swollen upper belly after feeding and acts fussy all the time. The vomiting has become more frequent this past week and he is beginning to lose weight. NR507 Advanced Pathophysiology – Full Course (all essay discussions+ midterm and final exam)

Write three (3) differential diagnoses at this time?

Is there any genetic component to the top of your differentials?

What tests would you order?

Week 5: Discussion Part Three

27 27 unread replies. 38 38 replies.

Write a one (1) paragraph case study of your own for a patient with Ulcerative Colitis?

Week 6

Week 6: Discussion Part One

19 19 unread replies. 38 38 replies.

You are contacted by an attorney representing a client who has been charged with child abuse and whom faces loss of her child and 15 years in prison. The record indicated that the child was 4 years old and presented to the ER room with a broken arm and a broken leg. There also appeared to be multiple previous fractures. Now, you examine the child and find blue sclera, a sunken chest wall, severe scoliosis, and you observe a triangular face and prominent forehead. You confirm that there have been multiple previous fractures by evaluating the previous X-rays. This is a genetic disorder.

What is the most likely genetic disease that this presents and why?

What is the molecular basis of this disease?

Before, calling the police what should the initial clinician have done?

Week 6: Discussion Part Two

22 22 unread replies. 37 37 replies.

Johnny is a 5-year-old Asian boy who is brought to a family practice office with a “runny” nose that started about 1 week ago but has not resolved. He has been blowing his nose quite frequently and “sores” have developed around his nose. His mother states, “The sores started as ‘big blisters’ that rupture; sometimes, a scab forms with a crust that looks like “dried maple syrup” but continues to seep and drain.” She is worried because the lesions are now also on his forearm. Johnny’s past medical and family histories are normal. He has been febrile but is otherwise asymptomatic. The physical examination was unremarkable except for moderate, purulent rhinorrhea and 0.5- to 1-cm diameter weeping lesions around the nose and mouth and on the radial surface of the right forearm. There is no regional lymphadenopathy.  NR507 Advanced Pathophysiology – Full Course (all essay discussions+ midterm and final exam)

Write a differential of at least three (3) possible diagnoses and explain how each may be a possible answer to the clinical presentation above. Remember, to list the differential in the order of most likely to less likely.

Based upon what you have at the top of the differentials how would you treat this patient?

When would you allow the student back to school? Elaborate on your reasoning?

Week 6: Discussion Part Three

27 27 unread replies. 32 32 replies.

Keisha, a 13-year-old female, has come into your urgent care center. She has red conjunctiva, a cough and a fever of about 104 F, She also has a rash on her face a possibly the beginning of a rash on her arms. About 10 days ago she was around another student who had similar symptoms. NR507 Advanced Pathophysiology – Full Course (all essay discussions+ midterm and final exam)

Write three (3) differential diagnoses?

What are some of the complications of this disease, assume that the top of your differential is the definitive?

Assume that the second item you place on your differential is the definitive diagnosis. What are some complications of that disease?

Week 7: Reflection

17 17 unread replies. 56 56 replies.

Reflect back over the past eight weeks and describe how the achievement of the course outcomes in this course have prepared you to meet the MSN program outcome #, MSN Essential VIII, and Nurse Practitioner Core Competencies # 1 Scientific Foundation Competencies

Program Outcome #4:
Evaluate the design, implementation, and outcomes of strategies developed to meet healthcare needs (MSN Essentials III, IV, VIII). NR507 Advanced Pathophysiology – Full Course (all essay discussions+ midterm and final exam)

MSN Essential VIII:

Clinical Prevention and Population Health for Improving Health

•Recognizes that the master’s-prepared nurse applies and integrates broad, organizational, client-centered, and culturally appropriate concepts in the planning, delivery, management, and evaluation of evidence-based clinical prevention and population care and services to individuals, families, and aggregates/identified populations.

Nurse Practitioner Core Competencies # 1 Scientific Foundation Competencies

1. Critically analyzes data and evidence for improving advanced nursing practice.

2. Integrates knowledge from the humanities and sciences within the context of nursing science.

3. Translates research and other forms of knowledge to improve practice processes and outcomes.

4. Develops new practice approaches based on the integration of research, theory, and practice knowledge.

Midverm

Question 1

2 / 2 pts

Examination of the throat in a child demonstrating signs and symptoms of acute epiglottitis may contribute to which life-threatening complication?

Retropharyngeal abscess

Laryngospasms

Rupturing of the tonsils

Gagging induced aspiration

Question 2

2 / 2 pts

Causes of hyperkalemia include:

Hyperparathyroidism and malnutrition

Vomiting and diarrhea

Renal failure and Addison disease

Hyperaldosteronism and Cushing disease

Question 3

2 / 2 pts

What is the life span of an erythrocyte (in days)?

20 to 30

60 to 90

100 to 120

200 to 240

Question 4

2 / 2 pts

Which substance has been shown to increase the risk of cancer when used in combination with tobacco smoking?

Alcohol

Steroids

Antihistamines

Antidepressants

Question 5

0 / 2 pts

Which hepatitis virus is known to be sexually transmitted?

A

B

C

D

Question 6

2 / 2 pts

What is the purpose of the spirometry measurement?

To evaluate the cause of hypoxia

To measure the volume and flow rate during forced expiration

To measures the gas diffusion rate at the alveolocapillary membrane

To determine pH and oxygen and carbon dioxide concentrations

Question 7

2 / 2 pts

What is the direct action of atrial natriuretic hormone?

Sodium retention

Sodium excretion

Water retention

Water excretion

Question 8

2 / 2 pts

What is the most important negative inotropic agent?

Norepinephrine

Epinephrine

Acetylcholine

Dopamine

Question 9

2 / 2 pts

What is the primary cause of respiratory distress syndrome (RDS) of the newborn?

Immature immune system

Small alveoli

Surfactant deficiency

Anemia

Question 10

2 / 2 pts

An individual is more susceptible to infections of mucous membranes when he or she has a seriously low level of which immunoglobulin antibody?

NR507 Advanced Pathophysiology – Full Course (all essay discussions+ midterm and final exam)

IgG

IgM

IgA

IgE

Question 11

2 / 2 pts

Low plasma albumin causes edema as a result of a reduction in which pressure?

Capillary hydrostatic

Interstitial hydrostatic

Plasma oncotic

Interstitial oncotic

Question 12

2 / 2 pts

Erythrocyte life span of less than 120 days, ineffective bone marrow response to erythropoietin, and altered iron metabolism describe the pathophysiologic characteristics of which type of anemia?

Aplastic

Sideroblastic

Anemia of chronic disease

Iron deficiency

Question 13

2 / 2 pts

An infant’s hemoglobin must fall below ___ g/dl before signs of pallor, tachycardia, and systolic murmurs occur.

11

9

7

5

Question 14

2 / 2 pts

What part of the kidney controls renal blood flow, glomerular filtration, and renin secretion?

Macula densa

Visceral epithelium

Juxtaglomerular apparatus (JGA)

Filtration slits

Question 15

2 / 2 pts

The lung is innervated by the parasympathetic nervous system via which nerve?

Vagus

Phrenic

Brachial

Pectoral

Question 16

2 / 2 pts

Which statement best describes a Schilling test?

Administration of radioactive cobalamin and the measurement of its excretion in the urine to test for vitamin B12 deficiency

Measurement of antigen-antibody immune complexes in the blood to test for hemolytic anemia

Measurement of serum ferritin and total iron-binding capacity in the blood to test for iron deficiency anemia

Administration of folate and measurement in 2 hours of its level in a blood sample to test for folic acid deficiency anemia.

Question 17

2 / 2 pts

Which disorder results in decreased erythrocytes and platelets with changes in leukocytes and has clinical manifestations of pallor, fatigue, petechiae, purpura, bleeding, and fever?

Idiopathic thrombocytopenic purpura (ITP)

Acute lymphocytic leukemia (ALL)

Non-Hodgkin lymphoma (NHL)

Iron deficiency anemia (IDA)

Question 18

2 / 2 pts

Which compensatory mechanism is spontaneously used by children diagnosed with tetralogy of Fallot to relieve hypoxic spells?

Lying on their left side

Performing the Valsalva maneuver

Squatting

Hyperventilating

Question 19

2 / 2 pts

Which hormone is required for water to be reabsorbed in the distal tubule and collecting duct?

Antidiuretic hormone

Aldosterone

Cortisol

Adrenocorticotropin hormone

Question 20

2 / 2 pts

What is the fundamental physiologic manifestation of anemia?

Hypotension

Hyperesthesia

Hypoxia

Ischemia

Question 21

2 / 2 pts

Continuous increases in left ventricular filing pressures result in which disorder?

Mitral regurgitation

Mitral stenosis

Pulmonary edema

Jugular vein distention

Question 22

2 / 2 pts

Which T-lymphocyte phenotype is the key determinant of childhood asthma?

Cluster of differentiation (CD) 4 T-helper Th1 lymphocytes

CD4 T-helper Th2 lymphocytes

CD8 cytotoxic T lymphocytes

Memory T lymphocytes

Question 23

2 / 2 pts

Innervation of the bladder and internal urethral sphincter is supplied by which nerves?

Peripheral nerves

Parasympathetic fibers

Sympathetic nervous system

Tenth thoracic nerve roots

Question 24

2 / 2 pts

Which of the following is classified as a megaloblastic anemia?

Iron deficiency

Pernicious

Sideroblastic

Hemolytic

Question 25

2 / 2 pts

When an individual aspirates food particles, where would the nurse expect to hear decreased or absent breath sounds?

Left lung

Right lung

Trachea

Carina

Question 26

0 / 2 pts

The most common site of metastasis for a patient diagnosed with prostate cancer is which location?

Bones

Brain

Bladder

Kidney

Question 27

2 / 2 pts

Perceived stress elicits an emotional, anticipatory response that begins where?

Prefrontal cortex

Anterior pituitary

Limbic system

Hypothalamus

Question 28

2 / 2 pts

Which manifestations of vasoocclusive crisis are associated with sickle cell disease (SCD) in infants?

Atelectasis and pneumonia

Edema of the hands and feet

Stasis ulcers of the hands, ankles, and feet

Splenomegaly and hepatomegaly

Question 29

2 / 2 pts

Which cytokines initiate the production of corticotropin-releasing hormone (CRH)?

IL–1 and IL-6

IL-2 and TNF-?

IFN and IL-12

TNF-ß and IL-4

Question 30

2 / 2 pts

The generation of clonal diversity occurs primarily during which phase of life?

Fetal

Neonatal

Infancy

Puberty

Question 31

2 / 2 pts

Where in the respiratory tract do the majority of foreign objects aspirated by children finally lodge?

Trachea

Left lung

Bronchus

Bronchioles

Question 32

2 / 2 pts

Which immunoglobulin (Ig) is present in childhood asthma?

IgM

IgG

IgE

IgA

Question 33

2 / 2 pts

Between which months of age does sudden infant death syndrome (SIDS) most often occur?

0 and 1

2 and 4

5 and 6

6 and 7

Question 34

2 / 2 pts

Which complex (wave) represents the sum of all ventricular muscle cell depolarizations?

PRS

QRS

QT interval

P

Question 35

2 / 2 pts

When a patient has small, vesicular lesions that last between 10 and 20 days, which sexually transmitted infection is suspected?

Genital herpes

Chancroid

Syphilis

Chlamydia

Question 36

2 / 2 pts

What is the chief predisposing factor for respiratory distress syndrome (RDS) of the newborn?

Low birth weight

Alcohol consumption during pregnancy

Premature birth

Smoking during pregnancy

Question 37

2 / 2 pts

Which statement concerning exotoxins is true?

Exotoxins are contained in cell walls of gram-negative bacteria.

Exotoxins are released during the lysis of bacteria.

Exotoxins are able to initiate the complement and coagulation cascades.

Exotoxins are released during bacterial growth.

Question 38

2 / 2 pts

Deficiencies in which element can produce depression of both B- and T-cell function?

Iron

Zinc

Iodine

Magnesium

Question 39

0 / 2 pts

The function of the foramen ovale in a fetus allows what to occur?

Right-to-left blood shunting

Left-to-right blood shunting

Blood flow from the umbilical cord

Blood flow to the lungs

Question 40

2 / 2 pts

Decreased lung compliance means that the lungs are demonstrating which characteristic?

Difficult deflation

Easy inflation

Stiffness

Inability to diffuse oxygen

Question 41

2 / 2 pts

60 to 70

40 to 60

30 to 40

10 to 20

Question 42

2 / 2 pts

Which statement concerning benign tumors is true?

The resulting pain is severe.

Benign tumors are not encapsulated.

Benign tumors are fast growing.

The cells are well-differentiated.

Question 43

2 / 2 pts

How much urine accumulates in the bladder before the mechanoreceptors sense bladder fullness?

75 to 100 ml

100 to 150 ml

250 to 300 ml

350 to 400 ml

Question 44

2 / 2 pts

How high does the plasma glucose have to be before the threshold for glucose is achieved?

126 mg/dl

150 mg/dl

180 mg/dl

200 mg/dl

Question 45

0 / 2 pts

Apoptosis is a(an):

Normal mechanism for cells to self-destruct when growth is excessive

Antigrowth signal activated by the tumor-suppressor gene Rb

Mutation of cell growth stimulated by the TP53 gene

Transformation of cells from dysplasia to anaplasia

Question 46

0 / 2 pts

What is the role of collagen in the clotting process?

Initiates the clotting cascade.

Activates platelets.

Stimulates fibrin.

Deactivates fibrinogen.

Question 47

0 / 2 pts

Infants are most susceptible to significant losses in total body water because of an infant’s:

High body surface–to–body size ratio

Slow metabolic rate

Kidneys are not mature enough to counter fluid losses

Inability to communicate adequately when he or she is thirsty

Question 48

0 / 2 pts

What is the action of urodilatin?

Urodilatin causes vasoconstriction of afferent arterioles.

It causes vasodilation of the efferent arterioles.

Urodilatin inhibits antidiuretic hormone secretion.

It inhibits salt and water reabsorption.

Question 49

0 / 2 pts

Which cardiac chamber has the thinnest wall and why?

The right and left atria; they are low-pressure chambers that serve as storage units and conduits for blood.

The right and left atria; they are not directly involved in the preload, contractility, or afterload of the heart.

The left ventricle; the mean pressure of blood coming into this ventricle is from the lung, which has a low pressure.

The right ventricle; it pumps blood into the pulmonary capillaries, which have a lower pressure compared with the systemic circulation.

Question 50

0 / 2 pts

Research supports the premise that exercise has a probable impact on reducing the risk of which cancer?

Liver

Endometrial

Stomach

Colon

Question 51

0 / 2 pts

What is the trigone?

A smooth muscle that comprises the orifice of the ureter

The inner mucosal lining of the kidneys

A smooth triangular area between the openings of the two ureters and the urethra

One of the three divisions of the loop of Henle

Question 52

2 / 2 pts

What is the most abundant class of plasma protein?

Globulin

Albumin

Clotting factors

Complement proteins

Question 53

2 / 2 pts

The glomerular filtration rate is directly related to which factor?

Perfusion pressure in the glomerular capillaries

Diffusion rate in the renal cortex

Diffusion rate in the renal medulla

Glomerular active transport

Question 54

0 / 2 pts

Which cells have phagocytic properties similar to monocytes and contract like smooth muscles cells, thereby influencing the glomerular filtration rate?

Principle cells

Podocin cells

Mesangial cells

Intercalated cells

Question 55

0 / 2 pts

Why is nasal congestion a serious threat to young infants?

Infants are obligatory nose breathers.

Their noses are small in diameter.

Infants become dehydrated when mouth breathing.

Their epiglottis is proportionally greater than the epiglottis of an adult’s.

Question 56

2 / 2 pts

The risk for respiratory distress syndrome (RDS) decreases for premature infants when they are born between how many weeks of gestation?

16 and 20

20 and 24

24 and 30

30 and 36

Question 57

2 / 2 pts

What is the ratio of coronary capillaries to cardiac muscle cells?

1:1 (one capillary per one muscle cell)

1:2 (one capillary per two muscle cells)

1:4 (one capillary per four muscle cells)

1:10 (one capillary per ten muscle cells)

Question 58

2 / 2 pts

A person with type O blood is considered to be the universal blood donor because type O blood contains which of the following?

NR507 Advanced Pathophysiology – Full Course (all essay discussions+ midterm and final exam)

No antigens

No antibodies

Both A and B antigens

Both A and B antibodies

Question 59

2 / 2 pts

The drug heparin acts in hemostasis by which processes?

Inhibiting thrombin and antithrombin III (AT-III)

Preventing the conversion of prothrombin to thrombin

Shortening the fibrin strands to retract the blood clot

Degrading the fibrin within blood clots

Question 60

2 / 2 pts

What effects do exercise and body position have on renal blood flow?

Exercise and body position activate renal parasympathetic neurons and cause mild vasoconstriction.

They activate renal sympathetic neurons and cause mild vasoconstriction.

Both activate renal parasympathetic neurons and cause mild vasodilation.

They activate renal sympathetic neurons and cause mild vasodilation.

Final exam 

 

Question 1

2 / 2 pts

What is the major virus involved in the development of cervical cancer?

Herpes simplex virus type 6

Herpes simplex virus type 2

Human papillomavirus

Human immunodeficiency virus

Question 2

2 / 2 pts

Which statement accurately describes childhood asthma?

An obstructive airway disease characterized by reversible airflow obstruction, bronchial hyperreactivity, and inflammation

A pulmonary disease characterized by severe hypoxemia, decreased pulmonary compliance, and diffuse densities on chest x-ray imaging

A pulmonary disorder involving an abnormal expression of a protein, producing viscous mucus that lines the airways, pancreas, sweat ducts, and vas deferens

An obstructive airway disease characterized by atelectasis and increased pulmonary resistance as a result of a surfactant deficiency

Question 3

0 / 2 pts

The ability of the pathogen to invade and multiply in the host is referred to as:

Infectivity

Toxigenicity

Pathogenicity

Virulence

Question 4

2 / 2 pts

Obesity creates a greater risk for dehydration in people because:

Adipose cells contain little water because fat is water repelling.

The metabolic rate of obese adults is slower than the rate of lean adults.

The rate of urine output of obese adults is higher than the rate of output of lean adults.

The thirst receptors of the hypothalamus do not function effectively.

Question 5

2 / 2 pts

Continued therapy of pernicious anemia (PA) generally lasts how long?

6 to 8 weeks

8 to 12 months

ORDER A PLAGIARISM-FREE PAPER

Until the iron level is normal

The rest of one’s life

Question 6

2 / 2 pts

Which statement best describes cystic fibrosis?

Obstructive airway disease characterized by reversible airflow obstruction, bronchial hyperreactivity, and inflammation

Respiratory disease characterized by severe hypoxemia, decreased pulmonary compliance, and diffuse densities on chest x-ray imaging

Pulmonary disorder involving an abnormal expression of a protein-producing viscous mucus that obstructs the airways, pancreas, sweat ducts, and vas deferens

Pulmonary disorder characterized by atelectasis and increased pulmonary resistance as a result of a surfactant deficiency

Question 7

2 / 2 pts

What pulmonary defense mechanism propels a mucous blanket that entraps particles moving toward the oropharynx?

Nasal turbinates

Alveolar macrophages

Cilia

Irritant receptors on the nares

Question 8

2 / 2 pts

As stated in the Frank-Starling law, a direct relationship exists between the _____ of the blood in the heart at the end of diastole and the _____ of contraction during the next systole.

Pressure; force

Volume; strength

Viscosity; force

Viscosity; strength

Question 9

2 / 2 pts

The tonic neck reflex observed in a newborn should no longer be obtainable by:

2 years

1 year

10 months

5 months

Question 10

2 / 2 pts

Carcinoma refers to abnormal cell proliferation originating from which tissue origin?

Blood vessels

Epithelial cells

Connective tissue

Glandular tissue

Question 11

2 / 2 pts

Which of the following describes how the body compensates for anemia?

Increasing rate and depth of breathing

Decreasing capillary vasoconstriction

Hemoglobin holding more firmly onto oxygen

Kidneys releasing more erythropoietin

Question 12

2 / 2 pts

What term is used to describe a hernial protrusion of a saclike cyst that contains meninges, spinal fluid, and a portion of the spinal cord through a defect in a posterior arch of a vertebra?

Encephalocele

Meningocele

Spina bifida occulta

Myelomeningocele

Question 13

2 / 2 pts

Chvostek and Trousseau signs indicate which electrolyte imbalance?

Hypokalemia

Hyperkalemia

Hypocalcemia

Hypercalcemia

Question 14

2 / 2 pts

After sexual transmission of HIV, a person can be infected yet seronegative for how many months?

1 to 2

6 to 14

18 to 20

24 to 36

Question 15

2 / 2 pts

Which hormone prompts increased anxiety, vigilance, and arousal during a stress response?

Norepinephrine

Epinephrine

Cortisol

Adrenocorticotropic hormone (ACTH)

Question 16

2 / 2 pts

Which blood cells are the chief phagocytes involved in the early inflammation process?

Neutrophils

Monocytes

Eosinophils

Erythrocytes

Question 17

2 / 2 pts

Where are alveolar macrophages found?

Skin

Breasts

Gastrointestinal tract

Lungs

Question 18

2 / 2 pts

Which normal physiologic change occurs in the aging pulmonary system?

Decreased flow resistance

Fewer alveoli

Stiffening of the chest wall

Improved elastic recoil

Question 19

0 / 2 pts

An infant diagnosed with a small patent ductus arteriosus (PDA) would likely exhibit which symptom?

Intermittent murmur

Lack of symptoms

Need for surgical repair

Triad of congenital defects

Question 20

2 / 2 pts

Hemophilia B is caused by a deficiency of which clotting factor?

V

VIII

IX

X

Question 21

2 / 2 pts

A hypersensitivity reaction that produces an allergic response is called:

Hemolytic shock

Anaphylaxis

Necrotizing vasculitis

Systemic erythematosus

Question 22

2 / 2 pts

Which statement is true regarding pain and cancer?

Pain is primarily a result of pressure caused by the tumor.

Pain indicates the metastasis of a cancer.

Pain is usually the initial symptom of cancer.

Pain is generally associated with late-stage cancer.

Question 23

2 / 2 pts

What is the anomaly in which the soft bony component of the skull and much of the brain is missing?

Anencephaly

Myelodysplasia

Cranial meningocele

Hydrocephaly

Question 24

0 / 2 pts

At birth, which statement is true?

Systemic resistance and pulmonary resistance fall.

Gas exchange shifts from the placenta to the lung.

Systemic resistance falls and pulmonary resistance rises.

Systemic resistance and pulmonary resistance rise.

Question 25

2 / 2 pts

What is the most commonly reported symptom of cancer treatment?

Nausea

Fatigue

Hair loss

Weight loss

Question 26

0 / 2 pts

The common property among the three types of medications used to treat depression is that they:

Increase neurotransmitter levels within the synapse.

Increase neurotransmitter levels in the presynapse.

Decrease neurotransmitter levels in the postsynapse.

Decrease neurotransmitter levels within the synapse.

Question 27

0 / 2 pts

NR507 Advanced Pathophysiology – Full Course (all essay discussions+ midterm and final exam)

iHuman Case Study Paper Assignment – Nsg6420

For this assignment, you will complete an iHuman case study based on the course objectives and weekly content. iHuman cases emphasize core learning objectives for an evidence based primary care curriculum. Throughout your nurse practitioner program you will use iHuman case studies to promote the development of clinical reasoning through the use of ongoing assessment and diagnostic skills and to develop patient care plans that are grounded in the latest clinical guidelines and evidence based practice.

The iHuman assignments are highly interactive and a dynamic way to enhance your learning. Material from the iHuman cases will be present in the weekly quizzes, and mid-term and final exams. You must have all iHuman assignments completed in order to successfully pass the course.

Please access the iHuman tab on the left-hand side of your screen under the Course Home page for log-in instructions. Please follow the instructions located on the start page of your case.

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iHuman Case Study Paper Assignment – Nsg6420