PIcot reseach

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Part 1 uses your PICOT question- Please use the Evidence-Based Practice Guideline-Searchable Clinical Questions Form to complete this part of the assignment. You can find the form under the Course Resources Tab.

1.) You need to have a strong PICO(T) question in order for the search to make sense. If you are struggling with this please don’t hesitate to email me and send me your question with the PICO(T) breakdown so I can help you with this. Send it early in the week so you have enough time to get my response and do the search. I will comment on everyone’s PICOT in the discussion and make recommendations. Submit early!
2.) When searching you want to make sure you take good notes and write them in the comments side.
3.) The goal is to get between 10 and 15 articles. If you are not within this number keep searching until you have demonstrated it is not likely to reach this goal. Please provide as a rationale when you are not achieving the goal number of articles in your PICOT assignment.
4.) Not only will you be searching individual key terms (your PICO terms) and then combining them, but you will use search limits as well to narrow your search.

You have an example in the Rubric for this assignment. I strongly suggest you look at it and make sure you read the Rubric. This is how I will score your submitted assignment. This part of the assignment is a total of 100 points.

Please contact me early on in the week for any issues.

Part 2 of your assignment is the Annotated Bibliography (100 points)

1. From the articles you found during your database searches, choose 4 scholarly peer reviewed articles that would help provide an answer or provide insight to your clinical research question and write them in an annotated bibliography format. There is an example provided for you under the Course Resource Tab.

2. The paper must be in APA  6th ed format. You will submit the  paper into the Dropbox for a Turn it in Review.

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Nursing homework help

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Overview

Write a 5 page article on a controversial topic related to pharmacology. Explain appropriate use of pharmacology; the relationship between quality patient outcomes, patient safety, and the use of pharmacology; and how the topic affects communities and organizations. Describe inequities regarding access to pharmacological treatments.

By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:

Competency 1: Apply practice guidelines and standards of evidence-based practice related to pharmacology for safe and effective nursing practice.

Explain the appropriate use of pharmacology.

Competency 2: Explain the relationship between quality patient outcomes, patient safety, and the appropriate use of pharmacology and psychopharmacology.

Explain the relationship between quality patient outcomes, patient safety, and the use of pharmacology.

Explain how pharmacology affects communities and organizations.

Competency 3: Apply the principles and practices of cultural competence with regard to pharmacological interventions.

Describe inequities regarding access to pharmacology.

Competency 4: Communicate in a manner that is scholarly, professional, and consistent with expectations of a nursing professional.

Write content clearly and logically with correct use of grammar, punctuation, and mechanics.

Correctly format paper, citations, and references using current APA style.

Context

Professional nursing practice is based on knowledge that comes from research. This research provides nurses with strategies to better communicate with patients, as well as answers to questions such as the following:

What are the most effective pharmacological agents to treat hypertension in an elderly Latino patient?

How do home visits benefit the family of a child with a severe chronic illness?

Are there new pharmacological treatments for mental illness?

Health care is ever changing. Research helps nurses understand what those changes are and build on their knowledge base as they continue to provide quality care to their patients.

 

 

 

Questions to Consider

To deepen your understanding, you are encouraged to consider the questions below and discuss them with a fellow learner, a work associate, an interested friend, or a member of your professional community.

What role does nursing play in clinical trials during the development of a new drug?

Suggested Resources

The following optional resources are provided to support you in completing the assessment or to provide a helpful context.

Library Resources

Bench, S., Day, T., & Metcalfe, A. (2013). Randomised controlled trials: An introduction for nurse researchers. Nurse Researcher, 20(5), 38–44.

Edwards, B., & Chakraborty, S. (2012). Risk communication and the pharmaceutical industry: What is the reality? Drug Safety, 35(11), 1027–1040.

Folmsbee, S. (2014, October 5). Folmsbee: Medical marijuana deserves research. University Wire. Retrieved from http://search.proquest.com.library.capella.edu

Hoffmann, D. E., & Weber, E. (2010). Medical marijuana and the law. The New England Journal of Medicine, 362(16), 1453–1457.

Kubiszyn, T., & Mire, S. S. (2014). A review of recent FDA drug safety communications for pediatric psychotropics. Journal of Child and Family Studies, 23(4), 716–727.

Schwartz, L. M., & Woloshin, S. (2013). The drug facts box: Improving the communication of prescription drug information. Proceedings of the National Academy of Sciences of the United States of America, 110(Supplement 3), 14069–14074.

Ward-Abel, N., Vernon, K., & Warner, R. (2014). An exciting era of treatments for relapsing-remitting multiple sclerosis. British Journal of Neuroscience Nursing, 10(1), 21–28.

Doamekpor, L. A., & Zuckerman, D. M. (2012). Lack of diversity in cancer drug trials may exacerbate racial disparities in mortality rates. Cancer Epidemiology, 38(5), 645–646.

Kesselheim, A. S., & Avorn, J. (2012). The food and drug administration has the legal basis to restrict promotion of flawed comparative effectiveness research. Health Affairs, 31(10), 2200–2205.

Munro, C. L., & Savel, R. H. (2015). Measles 2015: Why public health matters to critical care. American Journal of Critical Care, 24(3), 192–194.

Bookstore Resources

The resources listed below are relevant to the topics and assessments in this course and are not required.

Burchum, J., & Rosenthal, L. (2016). Lehen’s pharmacology for nursing care (9th ed.) St. Louis, MO: Elsevier Saunders.

Chapters 3, 63, 96, 101, and 110.

Assessment Instructions

In your professional nursing practice, you will likely encounter both patients and coworkers whose personal or cultural views on pharmacology may be quite different from your own. Understanding the most current research on pharmacological topics will help you make informed choices.

For this assessment, imagine your supervisor asks you to write an article on a controversial topic for the organization’s monthly newsletter in which you review the most recent research on the topic. She stresses you must present a balanced overview and equally address the pros and cons of the topic.

Preparation

Complete the following as you prepare to write your article:

Choose a topic from the list below:

The use of medical marijuana.

The use of complementary and alternative medicines (CAM) versus traditional Western medicine.

Experimental drug programs and disease management.

Mandated vaccinations for children and the implications for parental choice not to vaccinate.

Search the Capella library and the Internet to locate peer-reviewed research articles on your selected topic. The information you use to support your work in this assessment must be as recent as possible.

Note: These are very broad topics. Limit your work to the scope of your practice and be mindful of the page-length requirements.

Requirements

Once you have identified your topic, organize your article as you wish. Be sure to include the following:

Explain the appropriate use of the pharmacology related to the topic. Include elements such as diseases or health concerns associated with the topic and the efficacy and applicability of the pharmacology.

Explain the relationship between quality patient outcomes, patient safety, and use of the pharmacology related to the topic. Remember to address both the benefits and limitations of the pharmacology in terms of specific diseases and populations.

Explain how the topic affects both the community and the organization in terms of promoting health and wellness.

Describe any inequities regarding access to the pharmacology related to the topic. Is access limited to specific groups or populations? Who determines access? On what is it based? Does access influence choice?

Follow APA guidelines to format this assessment. Include a title page and reference page.

Additional Requirements

Number of pages: 5.

At least 4 current scholarly or professional resources.

Times New Roman, 12 point, double-spaced font.

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Bone Diseases

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Using an appropriate graphic organizer:

 

Distinguish osteoporosis, osteomalacia, rheumatoid arthritis, gout, and osteoarthritis based on signs and symptoms.

Compare their pathophysiology, etiology, manifestations, possible complications, and treatments.

 

Your responses should clarify your understanding of the topic. They should be your own, original, and free from plagiarism. Use correct medical terminology, spelling, and grammar.

 

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Discussion Board 3

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How does the nurse manager or leader play a role in the reengineering of health care?

 

 

 

The responses should be long enough to answer the question fully, usually about 2-3 cited paragraphs (each paragraph with a minimum of 3-5 sentences). A minimum of one reference is required.

 

Needs to be 100% plagerism free. It will be checked against other posters and previous posters.

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Advanced Pathophysiology Across the Lifespan week 10 quiz

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Question 1.                

A female patient is suspected of having psoriasis. Which of the following aspects of the woman’s history and her care provider’s assessment would be potential contributors to her health problem?

The woman takes an angiotensin-converting enzyme inhibitor for the treatment of hypertension. She has been diagnosed with arthritis.

The woman has a family history of diabetes.

Skin trauma of any kind often precedes an outbreak.

The woman has dark skin.

 

 

Question 2.                

Which of the following pathophysiologic phenomena would be most indicative of ankylosing spondylitis?

Loss of motion in the spinal column and eventual kyphosis

A progressive loss of range of motion in knee and hip joints

A facial “butterfly rash” and multiorgan involvement

Decreased bone density in long bones

 

Question 3.                

The father of an 18-month-old girl noticed a small vesicle on her face several days ago. The lesion ruptured and left a straw-colored crust that remained on the girl’s face. The eruption of new vesicles has prompted him to bring the child to the emergency department. Which of the following treatments for the child’s skin problem is most likely?

A topical antifungal ointment

An oral corticosteroid

An antiviral ointment

A topical antibiotic

 

Question 4.                

Which of the following statements best conveys an aspect of the process of keratinization?

Keratin cells synthesized in the dermis migrate to the surface over 20 to 30 days.

Mitosis that begins with the cells of the stratum granulosum results in a continual supply of new keratinocytes.

The stratum germinativum continuously produces new keratinocytes to replace losses.

The basal cells of the epidermis migrate to the skin surface at a rate that matches superficial losses of skin cells.

 

 

 

 

Question 5.                

A 35-year-old woman who has been in recovery from alcoholism for 2 years presents at her primary care nurse practitioner’s office with chronic hip pain. She reports that as part of her commitment to her recovery, she began exercising regularly about a year earlier. After a month or two, her hip began to hurt when she ran on the treadmill. She stretches, has had a physical trainer check her form to ensure that it is correct, and rests adequately between each workout. Six months ago the pain began awakening her at night, and now it is constant. She is not aware of any injury to her hip and has no other outward symptoms. Which of the following is most likely to be the cause of her pain?

Hematogenous osteomyelitis

Osteomyelitis with vascular insufficiency

Tuberculosis of the bone

Osteonecrosis

 

 

Question 6.                

Clinical investigation of a 40-year-old female patient with diverse dermatologic signs and symptoms has focused on the woman’s basement membrane. Which of the following skin functions would a clinician most likely attribute to a region of the integument other than the basement membrane?

Lack of sensory nerve impulse conduction

Formation of blisters on various skin surfaces

Lack of adhesion between the dermis and epidermis

Large immunoglobulin deposits

 

 

Question 7.                

An 80-year-old female with a diagnosis of osteoporosis receives daily supplements of calcitonin in the form of a nasal spray that she instills each morning. Which of the following phenomena would her care providers expect to result from her supplementation?

Decreased serum calcium levels

Increased bone resorption

Acceleration of osteoclast action

Increased bone formation

 

 

Question 8.                

A 41-year-old woman has been diagnosed as having a loose body of cartilage in her left knee. What data would be most likely to lead clinicians to this conclusion?

A visible hematoma is present on the anterior portion of the knee.

The woman experiences intermittent, painful locking of her joint.

Computed tomography indicates a complete tear of her knee ligament.

An X-ray shows that her femoral head and tibia are no longer articulated.

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Advanced Pathophysiology

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·         1. A 40-year-old woman who experiences severe seasonal allergies has been referred by her family physician to an allergist for weekly allergy injections. The woman is confused as to why repeated exposure to substances that set off her allergies would ultimately benefit her. Which of the following phenomena best captures the rationale for allergy desensitization therapy? (Points : 0.4)

Repeated exposure to offending allergens binds the basophils and mast cells that mediate the allergic response.
Exposure to allergens in large, regular quantities overwhelms the IgE antibodies that mediate the allergic response.
Repeated exposure stimulates adrenal production of epinephrine, mitigating the allergic response.
Injections of allergens simulate production of IgG, which blocks antigens from combining with IgE.

 

Question 2.2. A 24-year-old woman presents with fever and painful, swollen cervical lymph nodes. Her blood work indicates neutrophilia with a shift to the left. She most likely has: (Points : 0.4)

A mild parasitic infection
A severe bacterial infection
A mild viral infection
A severe fungal infection

 

Question 3.3. A 60-year-old male patient with an acute viral infection is receiving interferon therapy. The nurse practitioner is teaching the family of the patient about the diverse actions of the treatment and the ways that it differs from other anti-infective therapies. Which of the following teaching points should the nurse practitioner exclude? (Points : 0.4)

“Interferon can help your father’s unaffected cells adjacent to his infected cells produce antiviral proteins that limit the spread of the infection.”
“Interferon can help limit the replication of the virus that’s affecting your father.”
“Interferon helps your father’s body recognize infected cells more effectively.”
“Interferon can bolster your father’s immune system by stimulating natural killer cells that attack viruses.”

 

Question 4.4. As part of his diagnostic workup, a 77-year-old man’s nurse practitioner has ordered blood work that includes ferritin levels. The man is very interested in the details of his health care and is unfamiliar with ferritin and its role. He asks his nurse practitioner to explain the significance of it and the rationale for testing it. Which of the following explanations by the nurse practitioner is most accurate? (Points : 0.4)

“Ferritin is the activated and usable form of iron that your red blood cells can use to transport oxygen.”

“Ferritin is a stored form of iron that indirectly shows me whether you would benefit from iron pills.”
“Ferritin is a protein-iron complex that allows your red blood cells to make use of the iron that you consume in your diet.”
“Ferritin is the form of iron that is transported in your blood plasma to the red blood cells that need it.”

 

Question 5.5. A 16-year-old female has been brought to her primary care nurse practitioner by her mother due to the girl’s persistent sore throat and malaise. Which of the following facts revealed in the girl’s history and examination would lead the nurse practitioner to rule out infectious mononucleosis? (Points : 0.4)

The girl has a temperature of 38.1°C (100.6°F) and has enlarged lymph nodes.
Her liver and spleen are both enlarged.
Blood work reveals an increased white blood cell count.
Chest auscultation reveals crackles in her lower lung fields bilaterally.

 

Question 6.6. Which of the following patients is most likely to benefit from transplantation of thymic tissue or major histocompatibility complex (MHC)-compatible bone marrow? (Points : 0.4)

A 12-year-old girl with a history of epilepsy and low IgG levels secondary to phenytoin use
A 7-year-old boy whose blood work indicates decreased IgA and IgG with increased IgM
A 6-year-old boy whose pre-B cells are incapable of translation to normal B cells
A 9-year-old girl who has a diagnosis of IgA deficiency

 

Question 7.7. A 14-year-old boy has been diagnosed with infectious mononucleosis. Which of the following pathophysiological phenomena is most responsible for his symptoms? (Points : 0.4)

The Epstein-Barr virus (EBV) is lysing many of the boy’s neutrophils.
Viruses are killing some of his B cells and becoming incorporated into the genomes of others.
The EBV inhibits the maturation of white cells within his peripheral lymph nodes.
The virus responsible for mononucleosis inhibits the maturation of myeloblasts into promyelocytes.

 

Question 8.8. A 23-year-old man has received a recent diagnosis of appendicitis following 24 hours of acute abdominal pain. The nurse practitioner providing care for the man is explaining that while it is unpleasant, the inflammation of his appendix is playing a role in his body’s fight against the underlying infectious process. Which of the following teaching points should the nurse practitioner eliminate from his teaching for the patient? (Points : 0.4)

“Inflammation can help to remove the body tissue cells that have been damaged by infection.”
“Inflammation will start your body on the path to growing new, healthy tissue at the site of infection.
“Inflammation helps your body to produce the right antibodies to fight the infection.”
“Inflammation ultimately aids in eliminating the initial cause of the cell injury in your appendix.”

 

Question 9.9. A 71-year-old male patient with a history of myocardial infarction and peripheral vascular disease has been advised by his nurse practitioner to begin taking 81 mg aspirin once daily. Which of the following statements best captures an aspect of the underlying rationale for the nurse practitioner’s suggestion? (Points : 0.4)

Platelet aggregation can be precluded through inhibition of prostaglandin production by aspirin.
Aspirin helps to inhibit adenosine disphosphate (ADP) action and minimizes platelet plug formation.
Aspirin can reduce unwanted platelet adhesion by inhibiting thromboxane A2 (TXA2) synthesis.
Aspirin inhibits the conversion of fibrinogen into fibrin and consequent platelet plug formation.

 

Question 10.10. A nurse practitioner is explaining to a 40-year-old male patient the damage that Mycobacterium tuberculosis could do to lung tissue. Which of the following phenomena would underlie the nurse practitioner’s explanation? (Points : 0.4)

Tissue destruction results from neutrophil deactivation.
Nonspecific macrophage activity leads to pulmonary tissue destruction and resulting hemoptysis.
Macrophages are unable to digest the bacteria, resulting in immune granulomas.
Neutrophils are ineffective against the Mycobacterium tuberculosis antigens.

 

Question 11.11. A 2-year-old girl has had repeated ear and upper respiratory tract infections since she was born. A pediatrician has determined a diagnosis of transient hypogammaglobulinemia of infancy. What is the physiological origin of the child’s recurrent infections? (Points : 0.4)

Antibody production by plasma cells is compromised because of impaired communication between B and T cells.
The child had a congenital absence of immunoglobulin G (IgG) antibodies and her body is only slowly beginning to produce them independently.
The child was born with immunoglobulin A (IgA) and immunoglobulin (IgM) antibodies, suggesting intrauterine infection.
The child lacks the antigen presenting cells integral to normal B-cell antibody production.

 

Question 12.12. A nurse practitioner is teaching her colleagues about the role of cytokines in a variety of pathologies. Which of the following teaching points best captures an aspect of the functions and nature of cytokines? (Points : 0.4)

“A particular cytokine can have varied effects on different systems, a fact that limits their therapeutic use.”
“Cytokine production is constant over time, but effects are noted when serum levels cross a particular threshold.”
“Most cytokines are produced by granular leukocytes, and different cells are capable of producing the same cytokine.”
* “Cytokine actions are self-limiting in that activation of one precludes activation of other cytokines with similar actions.”

 

Question 13.13. A child has been diagnosed with thalassemia. Which of the following other health problems is the child at risk for? (Points : 0.4)

Hypocoagulation
Iron and ferritin deficiencies
Splenomegaly and hepatomegaly
Neutropenia

 

Question 14.14. A 44-year-old female patient presents to the emergency department with abnormal bleeding and abdominal pain that is later attributed to gallbladder disease. Which of the following diagnoses would the medical team be most justified in suspecting as a cause of the patient’s bleeding? (Points : 0.4)

Calcium deficiency
Vitamin K deficiency
Hemophilia B
Idiopathic ITP

 

Question 15.15. A 22-year-old female who adheres to a vegan diet has been diagnosed with iron-deficiency anemia. Which of the following components of her diagnostic blood work would be most likely to necessitate further investigation? (Points : 0.4)

Decreased mean corpuscular volume (MCV)
Decreased hemoglobin and hematocrit
Microcytic, hypochromic red cells
Decreased erythropoietin levels

 

Question 16.16. A 66-year-old female patient has presented to the emergency department because of several months of intermittently bloody stools that has recently become worse. The woman has since been diagnosed with a gastrointestinal bleed secondary to overuse of nonsteroidal anti-inflammatory drugs that she takes for her arthritis. The health care team would realize that which of the following situations is most likely? (Points : 0.4)

The woman has depleted blood volume due to her ongoing blood loss.
She will have iron-deficiency anemia due to depletion of iron stores.
The patient will be at risk for cardiovascular collapse or shock.
She will have delayed reticulocyte release.

 

Question 17.17. A nurse practitioner student is familiarizing herself with the overnight admissions to an acute medical unit of a university hospital. Which of the following patients would the student recognize as being least likely to have a diagnosis of antiphospholipid syndrome in his or her medical history?(Points : 0.4)

A 66-year-old obese male with left-sided hemiplegia secondary to a cerebrovascular accident
A 90-year-old female resident of a long-term care facility who has been experiencing transient ischemic attacks
A 30-year-old female with a diagnosis of left leg DVT and a pulmonary embolism
A 21-year-old male with a diagnosis of cellulitis and suspected endocarditis secondary to intravenous drug use

 

Question 18.18. A patient has been admitted to an inpatient medical unit of a hospital with an acute viral infection. The health care team providing care for the patient would recognize which of the following statements as an accurate description of the role of viruses in human infections? (Points : 0.4)

Viruses have limited or absent genetic material of their own.
Some viruses are capable of transforming normal host cells into malignant cells.
Viruses are often implicated in cases of transmissible neurodegenerative disease.
Viruses require stimulation after a latent period before they are able to produce symptoms.

 

Question 19.19. A 30-year-old man has spent 5 hours on a cross-country flight seated next to a passenger who has been sneezing and coughing, and the man has been inhaling viral particles periodically. Which of the following situations would most likely result in the stimulation of the man’s T lymphocytes and adaptive immune system? (Points : 0.4)

Presentation of a foreign antigen by a familiar immunoglobulin
Recognition of a foreign MHC molecule
Recognition of a foreign peptide bound to a self MHC molecule
Cytokine stimulation of a T lymphocyte with macrophage or dendritic cell mediation

 

Question 20.20. A 60-year-old woman is suspected of having non-Hodgkin lymphoma (NHL). Which of the following aspects of her condition would help to rule out Hodgkin lymphoma? (Points : 0.4)

Her neoplasm originates in secondary lymphoid structures.
The lymph nodes involved are located in a large number of locations in the lymphatic system.
The presence of Reed-Sternberg cells has been confirmed.
The woman complains of recent debilitating fatigue.

 

Question 21.21. Following a course of measles, a 5-year-old girl developed scattered bruising over numerous body surfaces and was diagnosed with immune thrombocytopenic purpura (ITP). As part of her diagnostic workup, blood work was performed. Which of the following results is most likely to be considered unexpected by the health care team? (Points : 0.4)

Increased thrombopoietin levels
Decreased platelet count
Normal vitamin K levels
Normal leukocyte levels

 

Question 22.22. Sputum samples from a patient with pneumonia contain an infective agent that has a peptidoglycan cell wall, expresses endotoxins, replicates readily in broth and on agar, grows in clusters, has pili, and does not stain when exposed to crystal violet. This pneumonia is most likely: (Points : 0.4)

Chlamydial
Viral
Mycoplasmal
Bacterial

 

Question 23.23. The blood work of a 44-year-old male patient with a diagnosis of liver disease secondary to alcohol abuse indicates low levels of albumin. Which of the following phenomena would a clinician be most justified in anticipating? (Points : 0.4)

* Impaired immune function
Acid-base imbalances
Impaired thermoregulation
Fluid imbalances

 

Question 24.24. A 29-year-old construction worker got a sliver under his fingernail four days ago. The affected finger is now reddened, painful, swollen, and warm to the touch. Which of the following hematological processes is most likely occurring in response to the infection? (Points : 0.4)

Proliferation of immature neutrophils
High circulatory levels of myeloblasts
Increased segmented neutrophil production

Phagocytosis by myelocytes

 

Question 25.25. A patient presented to the emergency department of the hospital with a swollen, reddened, painful leg wound and has been diagnosed with methicillin-resistant Staphylococcus aureus cellulitis. The patient’s nurse practitioner has ordered a complete blood count and white cell differential. Which of the following blood components would the nurse practitioner most likely anticipate to be elevated? (Points : 0.4)

Basophils
Eosinophils
Platelets
Neutrophils

 

 

 

Question 1.1. A couple who are expecting their first child have been advised by friends to consider harvesting umbilical cord blood in order to have a future source of stem cells. The couple have approached their nurse practitioner with this request and are seeking clarification of exactly why stem cells are valuable and what they might expect to gain from harvesting them. How can the nurse practitioner best respond to the couple’s inquiry? (Points : 0.4)

“Stem cells can help correct autoimmune diseases and some congenital defects.”
“Stem cells can be used to regenerate damaged organs should the need ever arise.”
“Stem cells can be used as a source of reserve cells for the entire blood production system.”
“Stem cells can help treat some cancers and anemias, but they must come from your child himself or herself.”

 

Question 2.2. A 2-year-old girl has had repeated ear and upper respiratory tract infections since she was born. A pediatrician has determined a diagnosis of transient hypogammaglobulinemia of infancy. What is the physiological origin of the child’s recurrent infections? (Points : 0.4)

Antibody production by plasma cells is compromised because of impaired communication between B and T cells.
The child had a congenital absence of immunoglobulin G (IgG) antibodies and her body is only slowly beginning to produce them independently.
The child was born with immunoglobulin A (IgA) and immunoglobulin (IgM) antibodies, suggesting intrauterine infection.
The child lacks the antigen presenting cells integral to normal B-cell antibody production.

 

Question 3.3. A 40-year-old woman who experiences severe seasonal allergies has been referred by her family physician to an allergist for weekly allergy injections. The woman is confused as to why repeated exposure to substances that set off her allergies would ultimately benefit her. Which of the following phenomena best captures the rationale for allergy desensitization therapy? (Points : 0.4)

Repeated exposure to offending allergens binds the basophils and mast cells that mediate the allergic response.
Exposure to allergens in large, regular quantities overwhelms the IgE antibodies that mediate the allergic response.
Repeated exposure stimulates adrenal production of epinephrine, mitigating the allergic response.
Injections of allergens simulate production of IgG, which blocks antigens from combining with IgE.

 

Question 4.4. A 14-year-old boy has been diagnosed with infectious mononucleosis. Which of the following pathophysiological phenomena is most responsible for his symptoms? (Points : 0.4)

The Epstein-Barr virus (EBV) is lysing many of the boy’s neutrophils.
Viruses are killing some of his B cells and becoming incorporated into the genomes of others.
The EBV inhibits the maturation of white cells within his peripheral lymph nodes.
The virus responsible for mononucleosis inhibits the maturation of myeloblasts into promyelocytes.

 

Question 5.5. A 16-year-old female has been brought to her primary care nurse practitioner by her mother due to the girl’s persistent sore throat and malaise. Which of the following facts revealed in the girl’s history and examination would lead the nurse practitioner to rule out infectious mononucleosis? (Points : 0.4)

The girl has a temperature of 38.1°C (100.6°F) and has enlarged lymph nodes.
Her liver and spleen are both enlarged.
Blood work reveals an increased white blood cell count.
Chest auscultation reveals crackles in her lower lung fields bilaterally.

 

Question 6.6. A 24-year-old woman presents with fever and painful, swollen cervical lymph nodes. Her blood work indicates neutrophilia with a shift to the left. She most likely has: (Points : 0.4)

A mild parasitic infection
A severe bacterial infection
A mild viral infection
A severe fungal infection

 

Question 7.7. Which of the following patients is most likely to benefit from transplantation of thymic tissue or major histocompatibility complex (MHC)-compatible bone marrow? (Points : 0.4)

A 12-year-old girl with a history of epilepsy and low IgG levels secondary to phenytoin use
A 7-year-old boy whose blood work indicates decreased IgA and IgG with increased IgM
A 6-year-old boy whose pre-B cells are incapable of translation to normal B cells
A 9-year-old girl who has a diagnosis of IgA deficiency

 

Question 8.8. Which of the following statements most accurately conveys an aspect of lymphatic system activity? (Points : 0.4)

B and T lymphocyte development begins in the bone marrow and ends in the peripheral lymphoid structures.
B cells and macrophages are released from the bone marrow in their completed state.
Stem cells in the lymph nodes initiate and regulate the process of white cell synthesis.
Leukocytes bypass vascular circulation and are distributed instead by the lymphatic system.

 

Question 9.9. A child has been diagnosed with thalassemia. Which of the following other health problems is the child at risk for? (Points : 0.4)

Hypocoagulation
Iron and ferritin deficiencies
Splenomegaly and hepatomegaly
Neutropenia

 

Question 10.10. The blood work of a 44-year-old male patient with a diagnosis of liver disease secondary to alcohol abuse indicates low levels of albumin. Which of the following phenomena would a clinician be most justified in anticipating? (Points : 0.4)

Impaired immune function
Acid-base imbalances
Impaired thermoregulation
Fluid imbalances

 

Question 11.11. A 60-year-old male patient with an acute viral infection is receiving interferon therapy. The nurse practitioner is teaching the family of the patient about the diverse actions of the treatment and the ways that it differs from other anti-infective therapies. Which of the following teaching points should the nurse practitioner exclude? (Points : 0.4)

“Interferon can help your father’s unaffected cells adjacent to his infected cells produce antiviral proteins that limit the spread of the infection.”
“Interferon can help limit the replication of the virus that’s affecting your father.”
“Interferon helps your father’s body recognize infected cells more effectively.”
“Interferon can bolster your father’s immune system by stimulating natural killer cells that attack viruses.”

 

Question 12.12. A patient has been admitted to an inpatient medical unit of a hospital with an acute viral infection. The health care team providing care for the patient would recognize which of the following statements as an accurate description of the role of viruses in human infections? (Points : 0.4)

Viruses have limited or absent genetic material of their own.
Some viruses are capable of transforming normal host cells into malignant cells.
Viruses are often implicated in cases of transmissible neurodegenerative disease.
Viruses require stimulation after a latent period before they are able to produce symptoms.

 

Question 13.13. A patient presented to the emergency department of the hospital with a swollen, reddened, painful leg wound and has been diagnosed with methicillin-resistant Staphylococcus aureus cellulitis. The patient’s nurse practitioner has ordered a complete blood count and white cell differential. Which of the following blood components would the nurse practitioner most likely anticipate to be elevated? (Points : 0.4)

Basophils
Eosinophils
Platelets
Neutrophils

 

Question 14.14. A 23-year-old man has received a recent diagnosis of appendicitis following 24 hours of acute abdominal pain. The nurse practitioner providing care for the man is explaining that while it is unpleasant, the inflammation of his appendix is playing a role in his body’s fight against the underlying infectious process. Which of the following teaching points should the nurse practitioner eliminate from his teaching for the patient? (Points : 0.4)

“Inflammation can help to remove the body tissue cells that have been damaged by infection.”
“Inflammation will start your body on the path to growing new, healthy tissue at the site of infection.
“Inflammation helps your body to produce the right antibodies to fight the infection.”
“Inflammation ultimately aids in eliminating the initial cause of the cell injury in your appendix.”

 

Question 15.15. A nurse practitioner is teaching her colleagues about the role of cytokines in a variety of pathologies. Which of the following teaching points best captures an aspect of the functions and nature of cytokines? (Points : 0.4)

“A particular cytokine can have varied effects on different systems, a fact that limits their therapeutic use.”
“Cytokine production is constant over time, but effects are noted when serum levels cross a particular threshold.”
“Most cytokines are produced by granular leukocytes, and different cells are capable of producing the same cytokine.”
“Cytokine actions are self-limiting in that activation of one precludes activation of other cytokines with similar actions.”

 

Question 16.16. A nurse practitioner student is familiarizing herself with the overnight admissions to an acute medical unit of a university hospital. Which of the following patients would the student recognize as being least likely to have a diagnosis of antiphospholipid syndrome in his or her medical history?(Points : 0.4)

A 66-year-old obese male with left-sided hemiplegia secondary to a cerebrovascular accident
A 90-year-old female resident of a long-term care facility who has been experiencing transient ischemic attacks
A 30-year-old female with a diagnosis of left leg DVT and a pulmonary embolism
A 21-year-old male with a diagnosis of cellulitis and suspected endocarditis secondary to intravenous drug use

 

Question 17.17. A 66-year-old female patient has presented to the emergency department because of several months of intermittently bloody stools that has recently become worse. The woman has since been diagnosed with a gastrointestinal bleed secondary to overuse of nonsteroidal anti-inflammatory drugs that she takes for her arthritis. The health care team would realize that which of the following situations is most likely? (Points : 0.4)

The woman has depleted blood volume due to her ongoing blood loss.
She will have iron-deficiency anemia due to depletion of iron stores.
The patient will be at risk for cardiovascular collapse or shock.
She will have delayed reticulocyte release.

 

Question 18.18. A tourist presented to a primary care health clinic complaining of malaise, fever, and headache. She has subsequently been diagnosed with Rocky Mountain spotted fever, a pathology caused by Rickettsiaceae. Which of the followed statements best captures a characteristic trait of Rickettsiaceae?(Points : 0.4)

They are eukaryotic.
They have both RNA and DNA.
They have a distinct spiral-shaped morphology.

They are neither gram-negative nor gram-positive.

 

Question 19.19. A nurse practitioner is explaining to a 40-year-old male patient the damage that Mycobacterium tuberculosis could do to lung tissue. Which of the following phenomena would underlie the nurse practitioner’s explanation? (Points : 0.4)

Tissue destruction results from neutrophil deactivation.
Nonspecific macrophage activity leads to pulmonary tissue destruction and resulting hemoptysis.
Macrophages are unable to digest the bacteria, resulting in immune granulomas.
Neutrophils are ineffective against the Mycobacterium tuberculosis antigens.

 

Question 20.20. Following a course of measles, a 5-year-old girl developed scattered bruising over numerous body surfaces and was diagnosed with immune thrombocytopenic purpura (ITP). As part of her diagnostic workup, blood work was performed. Which of the following results is most likely to be considered unexpected by the health care team? (Points : 0.4)

Increased thrombopoietin levels
Decreased platelet count
Normal vitamin K levels
Normal leukocyte levels

 

Question 21.21. A 29-year-old construction worker got a sliver under his fingernail four days ago. The affected finger is now reddened, painful, swollen, and warm to the touch. Which of the following hematological processes is most likely occurring in response to the infection? (Points : 0.4)

* Proliferation of immature neutrophils
High circulatory levels of myeloblasts
Increased segmented neutrophil production

Phagocytosis by myelocytes

 

Question 22.22. As part of his diagnostic workup, a 77-year-old man’s nurse practitioner has ordered blood work that includes ferritin levels. The man is very interested in the details of his health care and is unfamiliar with ferritin and its role. He asks his nurse practitioner to explain the significance of it and the rationale for testing it. Which of the following explanations by the nurse practitioner is most accurate? (Points : 0.4)

“Ferritin is the activated and usable form of iron that your red blood cells can use to transport oxygen.”

“Ferritin is a stored form of iron that indirectly shows me whether you would benefit from iron pills.”
“Ferritin is a protein-iron complex that allows your red blood cells to make use of the iron that you consume in your diet.”
“Ferritin is the form of iron that is transported in your blood plasma to the red blood cells that need it.”

 

Question 23.23. A nurse practitioner is providing prenatal care and education for a first-time expectant mother, 22 weeks’ gestation, who has a diagnosis of a sexually transmitted infection. Which of the following statements by the expectant mother demonstrates an adequate understanding of vertical disease transmission and congenital infections? (Points : 0.4)

“Gonorrhea and chlamydia pose the greatest risks of transmission from mother to child.”
“I know that my baby will need observation for HIV signs and symptoms in the weeks following my delivery.”
“My baby could become infected either across the placenta or during the birth itself.”
“Prophylactic immunization will reduce my baby’s chance of being born with an illness.”

 

Question 24.24. A 71-year-old male patient with a history of myocardial infarction and peripheral vascular disease has been advised by his nurse practitioner to begin taking 81 mg aspirin once daily. Which of the following statements best captures an aspect of the underlying rationale for the nurse practitioner’s suggestion? (Points : 0.4)

Platelet aggregation can be precluded through inhibition of prostaglandin production by aspirin.
Aspirin helps to inhibit adenosine disphosphate (ADP) action and minimizes platelet plug formation.
Aspirin can reduce unwanted platelet adhesion by inhibiting thromboxane A2 (TXA2) synthesis.
Aspirin inhibits the conversion of fibrinogen into fibrin and consequent platelet plug formation.

 

Question 25.25. A 22-year-old female who adheres to a vegan diet has been diagnosed with iron-deficiency anemia. Which of the following components of her diagnostic blood work would be most likely to necessitate further investigation? (Points : 0.4)

Decreased mean corpuscular volume (MCV)
Decreased hemoglobin and hematocrit
Microcytic, hypochromic red cells
Decreased erythropoietin levels

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Nursing homework help

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Max Points: 5.0
Find an organization related to your health care discipline and identify the mission and vision statement. Based on your experiences as a member of the health care team, explain how the values of the organization are or are not reflected in these statements.

 

It needs to be at least 500 word, APA format and a couple references. I work in Long term care facility. Psych facility.

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Nursing homework help

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From the topics covered in Weeks 3-4, select one law related to financial management in health care organizations. We discussed such laws as False Claims Act, Stark Law etc. Include a cover page and a list of references at the end of the paper in APA Format.  Paper will be double spaced and be 4 pages in 12 point New Times Roman font.

The assignment is to be written in clear, concise narrative. All sections in the outline for Assignment #2 are required.

Outline:  Must use the underlined headings from the outline below in your paper and the paper must be in narrative form not outline or bullet format. 5% penalty deducted from paper if underlined headings not used in your paper.

1.    Name of the Law and or laws: 

State the official title of the federal and/or state law, the statute and section number.  Must be either a federal statute or state statute and you must cite both if applicable. Thus if there is both a federal and state law that covers your subject picked then you must cite both. Do not assume that there is just a federal and or state law. In most cases there is both a federal and state law. You must use the laws cited in this section throughout the rest of the paper.

2.  Management’s Financial Responsibilities: 

What are the health care organization’s responsibilities under this financial management statute you stated above? Provide a comprehensive discussion of three (3) specific responsibilities under the financial management statute. State specifically after each responsibility where this responsibility is stated in the federal or state law.  Describe the appropriate behavior and expectation. Include the citations and source of documents describing the organization’s responsibilities.

  1. Consequences for Ethical or Legal Breach:

Discuss in general the civil and criminal consequences from the law. Then identify from the news, three (3) specific case examples of health care organizations or health care providers found guilty of a legal or ethical breach relative to the law you have cited in first part of paper. Identify the specific legal and/or ethical breach and the penalties assessed to the health service organizations and/or individuals found guilty of violating the law or ethics [provide citation of law].  At the end of each case, discuss in detail whether you agree or not with the decision and why. Bring in the facts of the case to support your comments. Students should use a minimum of three (3) documented specific examples retrieved from the print media.

  1. HCO Management’s remedial steps to reverse the non-compliance organizations:

Describe in detail three (3) specific management actions or remedial steps you would take to ensure the financial management in the health care organization meets or exceeds the federal law or state law relative to the requirements of the law you cited above. Discuss specifically how each of the three management actions specifically meets or exceeds the specific federal or state law you cited. Note: These actions may include specific uses of technology, procedures, human resource training, and other management tools.  However these action steps must be within the control of a manager.

5. Conclusion: Summary your findings above

  1. Reference List [APA Format]

The paper must be:

  • Late penalties: Paper is due by due date but if there occurs an extraordinary event beyond your control, then you need to contact me as to the reason and then we can discuss a new due date if I agree with your excuse. In every case of an extension you will be penalized 11% [no chance for an A on the paper] for the first day late and an additional -1pt for each day thereafter, no matter the excuse.   The rubric points are 100 so in the rubric you will lose -11pts if one day late.
  • Be sure and use the underlined headings found in the outline below in your paper. Paper must be in narrative format not outline or bullets.
  • Double spaced and be 4 pages in 12 point New Times Roman font.
  • Include a cover page [not counted as a page] which should have student name and title of your paper [Provide a short name for the legal responsibility the specific health care organization has for one type of patient right in a specific setting ]
  • A the end of the paper a list of references in APA Format [not counted as a page]
  • Be prepared using word-processing software and saved with a .doc, .docx, or .rtf extension. No pdf.
  • Be uploaded to your Assignments Folder by 11:59 p.m. EST on the due date.
  • The paper is to be posted in Assignment #2 drop box.
  • Must cite to the source for all your facts in the text of your paper in APA format.

Example of an in text citation:

(Ernst, & Young, 2000 p14).

Example of source cited on Reference page:

References

Healthcare Financial Management Association (U.S.), Ernst, & Young. (2000). Health care system reform: A provider perspective : survey results. Westchester, Ill.: Healthcare Financial Management Association.

Except where noted, the assignment is written in clear, concise narrative. All sections of Assignment #2 are required.

Grading Rubric for written Assignment #2 is in Assignments area of the class.

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Discussion Question # 2 W2

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Diversity among individuals, as well as cultures, provides a challenge for nurses when it comes to delivering meaningful health promotion and illness prevention-based education. How do teaching principles, varied learning styles (for both nurses and patients), and teaching methodologies impact the approach to education? How do health care providers overcome differing points of view regarding health promotion and disease prevention? Provide an example.

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Environmental Factors and Health Promotion Pamphlet: Accident Prevention and Safety Promotion for Parents and Caregivers of Infants

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Part I: Indirect Care Experience

  1. Develop a pamphlet to inform parents and caregivers about environmental factors that can affect the health of infants.
  2. Use the “Pamphlet Template” document to help you create your pamphlet. Include the following:
  3. Select an environmental factor that poses a threat to the health or safety of infants.
  4. Explain how the environmental factor you selected can potentially affect the health or safety of infants.
  5. Offer recommendations on accident prevention and safety promotion as they relate to the selected environmental factor and the health or safety of infants.
  6. Offer examples, interventions, and suggestions from evidence-based research. A minimum of three scholarly resources are required.
  7. Provide readers with two community resources, a national resource, and a Web-based resource. Include a brief description and contact information for each resource.
  8. In developing your pamphlet, take into consideration the healthcare literacy level of your target audience.

Part II: Direct Care Experience

  1. Share the pamphlet you have developed with a parent of an infant child. The parent may be a person from your neighborhood, a parent of an infant from a child-care center in your community, or a parent from another organization, such as a church group with which you have an affiliation.
  2. Provide a written summary of the teaching / learning interaction. Include in your summary:
  3. Demographical information of the parent and child (age, gender, ethnicity, educational level).
  4. Description of parent response to teaching.
  5. Assessment of parent understanding.
  6. Your impressions of the experience; what went well, what can be improved.

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