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capstone change proposal

July 2, 2025/in Nursing Questions /by Besttutor

Work with your preceptor to assess the organization for required resources needed for the strategic plan if the change proposal were to be implemented. Review your strategic plan and determine what resources would be needed if the change proposal were to be implemented. Write a list of at least four resources you will need in order to implement your change proposal.

The assignment will be used to develop a written implementation plan.

While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center.

You are not required to submit this assignment to LopesWrite.

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Assignment 2: Comprehensive Psychiatric Evaluation and Patient Case Presentation

July 2, 2025/in Nursing Questions /by Besttutor

 PLEASE FOLLOW THE INSTRUCTION &RUBRIC DETAILS, ZERO PLAGIARISM, FIVE REFERENCES LESS THAN FIVE YEARS, SEE TEMPLATE ATTACHED

  • Subjective: What details did the patient provide regarding their personal and medical history? What are their symptoms of concern? How long have they been experiencing them, and what is the severity? How are their symptoms impacting their functioning?
  • Objective: What observations did you make during the interview and review of systems?
  • Assessment: What were your differential diagnoses? Provide a minimum of three (3) possible diagnoses. List them from highest to lowest priority. What was your primary diagnosis, and why?
  • Reflection notes: What would you do differently in a similar patient evaluation?

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week 2 project

July 2, 2025/in Nursing Questions /by Besttutor

Legislative Matrix

For this assignment, you will develop a Legislative Matrix based upon the specific legislators in a residential/geographical legislative district in your state.

You will identify elected six (6) officials from your legislative districts including: 1) local Councilpersons or County Commissioner, 2) Federal House of Representative, 3) Federal Senator, 4) State House of Representative, 5) State Senator, and 6) the Governor.

You will identify the committees each legislator is a member of, and you will discuss any active legislation bills and/or past legislative initiatives he/she is involved individually.

This information will be used to assist in the development of the Legislative Communication assignment next week.

Use the – Legislative Matrix Template.

Assignment example – Legislative Matrix Exemplar Texas

Submission Details:

  • Support your responses with examples.
  • Cite any sources in APA format.
  • Submit your document to the Submissions Area by the due date assigned.

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multidimensional ASSISGNMENT

July 2, 2025/in Nursing Questions /by Besttutor

COMPLETE EVERY QUESTIONS BELOW CORRECTLY, IF NOT POINT WILL BE LOST. ANSWER FROM NURSING PROSEPECTIVE (multidimensional -2)- DUE 12/17/2021 AT . NEEDED IN 8 HOURS

 

 

2. The client has just received a round of chemotherapy and will discharged home. The nurse is educating the client about the concerns of neutropenia and the continuing risk for infection. Which of the following statements would not be appropriate given the client’s situation?

A. “If you experience a fever. Treat it with over-the-counter medication and report it to your physician if symptoms don’t resolve in 48 hours’

B. “bathe daily, or wash armpits and perineal area twice daily with antimicrobial soap.”

C. “Wash your hands thoroughly with an antimicrobial soap before you eat and drink.”

D. “Avoid crowds and other large gatherings of people who might be ill.”

3. A nurse is providing client and family education for a client diagnosed with irritable bowel syndrome. Which of the following is important to include in the education? (Selection all that apply)

A. Adhere to prescribed medications

B. Modify diet

C. Limit fluid intake

D. Stress reduction

E. Limit physical activity

4. After completion of external radiation treatment for cancer, a client tells the oncology nurse about an upcoming vacation to the beach to celebrate. What response by the nurse is most appropriate to the client?

A.” Have a wonderful time and enjoy your vacation”

B. “Remember you should not drink alcohol for a year.”

C. “Avoid submerging in saltwater on the radiation site.”

D.” Protect your skin, avoid exposure of the radiation area to direct sunlight.”

5. A client was admitted with the following arterial blood gas(ABG). How does the nurse interpret these results?

PH 7.35

PaC02 30mm Hg

Hc03 17 mEq/L

Pa02 92 mm Hg

A. Respiratory acidosis with full metabolic compensation

B. Metabolic acidosis with full respiratory compensation

C. Respiratory alkalosis with full metabolic compensation

D. Metabolic alkalosis with full respiratory compensation

 

6. A client is diagnosed with metastatic cancer. The family asks the nurse. “What the difference between hospice and palliative care?” The nurse correctly responds with which statement?

A. “Palliative care is to prevent and treat symptoms and side effects of cancer treatments.”

B.” Hospice is for clients with a prognosis of less than 12 months to live.”

C.” Hospice care allows for continued chemotherapy treatments, and palliative care does not.”

D. “Palliative care requires revaluation every 30 days.”

D.

7. The nurse is assessing a client recently diagnosed with leukemia. Which of the following assessment finding would support that diagnosis?

A. Blood in stool

B. Blood in urine

C. Cough or hoarseness

D. Petechiae or ecchymosis

8. Which of the following teaching instructions would not be accurate as a prevention strategy to reduce the risk of oral cancer?

A.” Avoid sun exposure to lip.”

B. “Stop use of tobacco and alcohol.”

C. “Avoid exposure to human papillomavirus (HPV).”

D

9. A nurse is caring for a client admitted with mild acute pancreatitis. Which of the following are treatment options for the early stages of mild acute pancreatitis? (Select all that apply)

A. Assess and manage pain

B. Nothing by mouth for 24 to 48 hours

C. Measure and document accurate intake and output

D. Encourage early oral nutrition

E. Assess labs for amylase and lipase levels

 

10. A nurse is caring for a client recently diagnosed with thyroid cancer. Which of the following lab results will validate this diagnosis?

A. Decreased serum thyroglobulin (TG)

B. Increased serum phosphorus level

C. Increased serum thyroglobulin (TG) level

D. Increased serum calcium level

11. A. A nurse is caring for an adolescent client who has a long history of diabetes mellitus and being admitted to the emergency department confused, flushed, and with an acetone odor on the breath. Diabetic ketoacidosis is suspected. The nurse should anticipate using which of the following types of insulin to be given intravenously to treat client?

A. Insulin detemir

B. Regular

C. NPH insulin

D. Insulin glargine

12. A client underwent a colon resection with colostomy placement. Which of the following would the surgeon consult post-operatively for colostomy management?

A. Wound Ostomy Continence Nurse

B. Dietician

C. Physical therapy

D. Respiratory therapy

13. The laboratory values of a client with diabetes mellitus include a fasting glucose level of 92 mg/dL and hemoglobin A1C of 5.9%. What are the nurse’s interpretations of these findings?

A. The client’s glucose control for the fasting has been poor, and the overall control is poor.

B. The values indicate that the client needs further disease management education

C. The client’s glucose control for the fasting glucose and past 90 days demonstrates good control

D. The values indicate that the client has poorly managed their disease.

14. A nurse is providing care to a client that is diagnosed with hypokalemia. After reviewing the client’s current medications. Which of the following might have contributed to hypokalemia?

A. Opioids

B. Beta-blockers

C. Corticosteroids

D. Loop diuretics

15. Which of the following is a life-threatening emergency and serious complication of untreated or poorly treated hypothyroidism?

A. Thyroid storm

B. Myxedema coma

C. Endemic goiter

D. Multinodular toxic goiter

16. A nurse is caring for a client recently diagnosed with colorectal cancer . Which of the following lab values would confirm the diagnosis?

A. Decreased white blood count

B. Increased carcinoembryonic antigens ( CEA)

C. Increased serum creatinine

D. Decreased albumin

17. A nurse is caring for a client recently diagnosed with diabetes insipidus. Which of the following medication would be appropriate for this disorder?

A. Diltiazem

B. Furosemide

C. Desmopressin

D. Growth hormone antagonist

18.The nurse is providing discharge education to a client diagnosed with anorexia nervosa. Which statement by the client would indication the client needs further education?

A. “ I need to keep a food journal of my progress, food intake, and timing of meals.”

B. “If I feel constipated I will start an over-the- counter oral laxative .”

C. “ I will take my multivitamins, zinc, and iron as prescribed to prevent malnutrition

D.”I will schedule an outpatient session with a counselor to talk about my fear of gaining weight.”

19. A nurse is providing teaching to a client about hyperglycemia. The nurse should recognize that the client understands the teaching when he identifies which of the following as manifestations specific to hyperglycemia? ( Select all that apply)

A. Bradycardia

B. Polyuria

C. Hypervolemia

D. polydipsia

E. Polyphagia

20.The nurse is assessing a client diagnosed with type 1 diabetes mellitus for symptoms associated with diabetic ketoacidosis. Which of following will the nurse most likely assess in this client? ( select all that apply)

A. Fluid overload

B. Fruity breath odor

C. Kussmaul breathing

D. Altered mental status

E. Bradycardia

21. The nurse instructs the client on prologed cortisol therapy to report which signs and symtoms?

A. Anorexia and muscle twitches

B. Hypotension and fluid loss

C. Weight gain and moon face

D. Anuria and hypoglycemia

22.A nurse is caring for a client in the emergency room after a motor vehicle accident. The client is unconscious with a cervical collar in place. The client has been diagnosed with syndrome of inappropriate antidiuretic hormone ( SIADH)secretion. Which of the following lab values validates the diagnosis?

A. Decreased urine osmolality

B.Increased serum sodium

Decreased glomerular filtration rate

D. Decreased serum sodium

23. A nurse caring for a client who has diverticulitis. Which of the following is a clinical manifestation of diverticulitis?

A. Localized lower abdominal pain

B. Generalized upper abdominal pain

c. Bradycardia

D. Hypertension

24. The nurse is providing care for a client who underwent a parathyroidectomy two days ago . To prevent complications with this surgery, which laboratory value requires close monitoring by the nurse?

A. Serum sodium levels

B. Serum blood glucose levels

C.Serum potassium levels

D. Serum calcium levels

25.A client complains of weight gain, has thin extremities, a buffalo hump, moon face, and a protruding abdomen. The nurse realizes that this client is most likely to be diagnosed with which disease process?

A. Addison’s disease

B. Cushing’s syndrome

C. Pheochromocytoma

D. Cretinism

26. Which nursing intervention helps to prevent adrenocortical insufficiency?

a. Reducing high dose steroid therapy gradually

b. Administer diuretic therapy

c. Discontinuing high dose steroid therapy quickly

d. Teaching the client about a low sodium diet

 

27.The nurse would incorporate which of the following into the plan of care as a primary prevention strategy for reduction of the risk for cervical cancer?

a. Colonoscopy at age 50 and every 10 years as follow up

b. Yearly prostate specific anitigen ( PSA) and digital rectal exam for men aged 50 and over

c. Administering the human papillomavirus(HPV) vaccine

d. Yearly mammography for women age 40 years and older

28. The nurse knows which statement is true about age related charges and the endocrine system in older adults?

a. The thyroid gland enlarges

b. Adrenal glands enlarge

c. Thyroid hormone secretion decreases

d. Decreased hormone sensitivity

29.An 8months old infant is hospitalized with severe diarrhea, The nurse knows that which of the following is the following is the major problem associated with severe diarrhea

a. Electrolyte and fluid loss

b. presence of excessive flatus

c. pain in the abdominal area

d. irritation of the perineal and rectal area

30. The nurse is caring for a client with end stage renal failure. PaO2 is 94 mm hg,Arterial blood gases indicate that she is experiencing metabolic acidosis with partial respiratory compensation. Which of the following arterial blood gases support this?

a. PH=7.37, PaCO2=33mm hg, HCO3=18 mEq/L

b. PH=7.33,PaCO2=31mm hg, HCO3=19 mEq/L

c. PH=7.47, PaCO2=50mm hg, HCO3=30 mEq/L

d. PH=7.32, PaCO2=48mm hg, HCO3=18 mEq/L

31. The nurse is caring for a diabetic client with a blood glucose of 56mg/dL. The client is difficult to arouse. What action would the nurse take?

a. Give a complex carbohydrate and monitor the client

b. Give a glass of orange juice with three sugar packets mixed in and monitor the client.

c. Administer 50% dextrose (D500IV push per order and monitor the client

d. Give a glass of milk and monitor the client

32. The nurse is caring for a client with a new diagnosis of adrenal insufficiency. Which of the following would the nurse expert upon assessment? Select all that apply

a. Hypotension

b. Hyperkalemia

c. Hyponatremia

d. Hyperpigmentation

e. Polyphagia

33. A nurse is caring for a client with an opioid overdose. The client is difficult to arouse. The vita signs include blood pressure 90/60 mm Hg respirations 10/minute heart rate 60beat /minute. The arterial blood gas (ABG) result includes a PH 7.34. Pa Co2 48mm Hg Hco324mEq/L pa02   of 76mm Hg. How would the nurse interpret this result?

 

a. Respiratory acidosis with partial metabolic compensation and hypoxemia

b. Metabolic acidosis not compensated with normal oxygenation.

c. Respiratory alkalosis not compensated with hypoxemia

d. Respiratory acidosis not compensated with hypoxemia

34. The nurse is caring for a 46year old female client who presented to the emergency department with dizziness . Nausea , vomting , and fatigue over the past few days . The client has recently been diagnosed with breast cancer and has been undergoing chemotherapy . The client labs reveal the folowing . Na 150 mEq/MlL , potassium 3.0 mEqmL , calcium 15mg/dl . Which of the following imbalances is the client exhibiling ?

 

a. Hypernatremia,  hypokalemia, hypercalcemia

b. Hypervolemia, hypercalemia , hyperkalemia

c. Hyponatremia, Hypercalcemia

d. Hypovolemia and hypercalcemia

35. A medcation order state, administer 100 mEq of potassium chloride po twice a day . Available is potassium chloride oral soluttion 40mEq15ML. How many ML should the nurse administer per dose?  Rcord answer as a whole number. Do not use a trailing

38

 

36. The nurse is providing care to a client diagnosed with fluid volume deficit. Which of the following assessment dates is greatest cancer?

a. There is prolonged skin tenting over the sterum

b. The blood pressure is 86/40 mm Hg

c. Urine output  is 40 ml over the last hour

d. Oral fluid intake is 100 ml for the last 8 hours

37.  A nurse is caring for a 57years old Hispanic male who was recently diagnosed with cushing disease . Which of the following lab tests validates the diagnosed?

a. Elevated lymphocyte count

b. Elevated urine cortisol level

c. Decrease late – night salivary cortisol test

d. Decrease urine specific gravity

38. A nurse is teaching a client with diabetes mellitius who asks , why  is it necessary to maintain my blood gulcose levels no lowe than about 60 mg/ dl ( 3.3mmol/l ? How would the nurse respond ?

a. Your brain needs a constant suppy of glucose because it cannot store it.

b. Glucose in the blood prevent the formation of lactic and prevent acidosis

c. Glucose is the only fuel used by the body to produce the energy that it needs

d. Without a minimum level of glucose , your body does not make red blood cells.

 

39. After chemotherapy for cancer, a client develops chemotherapy induced nausea and vomiting (CINV). For this client, the nurse should give the highest priority to which action in the plan of care?

A. With holding fluids for the first 4-6 hrs after chemotherapy administration

B. Administering an antiemetic medication as prescribed

C. Serving small portions of bland food

D. Encouraging rhythmic breathing exercises

 

40. A nurse assesses a client who is recovering from an ileostomy placement. Which clinical manifestation would alert the nurse to contact the health care provider urgently.

A. A bluish stoma

B. Liquid stool

C. Blood smeared output

D. Ostomy pouch intact

 

41. A nurse is educating a newly diagnosed type 1 diabetic client. Which education topic is the nurse’s priority.

A. Sexual dysfunction can develop

B. Carbohydrate counting

C. Exercise vigorously only if blood glucose is 100-250 mg/dl

D. Signs and symptoms of hypoglycemia

 

42. The nurse is caring for a client diagnosed with diverticulitis. Which of the following orders would be expected for this client?

A. An enema to attempt to flush out the undigested food trapped in the diverticula. Which of the following orders would be expected for this client?

B. Laxatives to ensure passage of fecal matter through the intestines.

C. Stool softeners to prevent constipation which will lead to further complications.

D. A diet consisting of protein from seeds and nuts

43. A 56-year-old male was recently diagnosed with type 2 diabetes. Which of the following diagnostic tests would correlate with this diagnosis? (Select all that apply).

A. Increased random blood glucose

B. Increased hemoglobin A1c

C. Increased fasting blood glucose

D. Increased hemoglobin

44. A 42 year old female presents to the emergency room with mid-upper abdominal pain radiating to her right shoulder, rebound tenderness, nausea and dyspepsia. Based on the client’s presentation, which of the following does the nurse anticipate is the client’s diagnosis

A. Diverticular disease

B. Pancreatitis

C. Appendicitis

D. Cholecystitis

45. A client was admitted with the following arterial blood gas (ABG). How does the nurse interpret these results?

A. PH 7.32

B. PaC02 50 mm Hg

C. Hc03 30 mEq/L

D. Pa02 75 mm Hg

46. A client was admitted with the following arterial blood gas (ABG). How does the nurse interpret these result?

PH 7.48

PaC02 30 mm Hg

Hc03 18 mEq/L

Pa02 85 mm Hg

A. Metabolic acidosis with partial respiratory compensation

B. Metabolic alkalosis with partial respiratory compensation

C. Respiratory alkolosis with partial metabolic compensation

D. Respiratory acidosis with partial metabolic compensation

47. A nurse is caring for a client admitted for an exacerbation of Crohn’s disease. A nasogastric (NG) tube has been placed and is connected to suction, and the client is currently receiving an infusion of total parenteral nutrition via a peripherally inserted central catheter (PICC) line. Which of the following actions should the nurse take?

A. Monitor the flow rate of the parenteral nutrition carefully and increase the rate as needed if it falls behind.

B. Monitor laboratory values and asses for abnormal respiratory or cardiac functioning.

C. Place the parenteral nutrition solution on a warming device during infusion.

D. Remove unused parenteral nutrition after 12 hours of use.

48. A nurse is reviewing lab values for a client and notes a potassium level of 2.3 mEq/L What is the nurse’s priority?

A. Place seizure pads on the bed

B. Initiate fall precautions

C. Assess the clients cardiovascular status

D. Order a high potassium diet

49. A 28-year -old female presented to the emergency room with complaints of abdominal pain, nausea, and vomiting for the past 24 hours. The client is afebrile, heart rate is 130 beats/minute, and blood pressure is 90/60mm Hg. During the pain assessment, the client rates her pain a “10” on a scale of 0-10. The nurse notes the client’s pain to be in the right lower quadrant region. Based on the assessment findings, which of the assessment findings, which of the following would the nurse anticipate as the client’s diagnosis?

A. Ulcerative colitis

B. Crohn’s disease

C. Cholecystitis

D. Appendicitis

50. A nurse is caring for a client recently diagnosed with cirrhosis. Which of the following are appropriate nursing interventions for this client? (select all that apply)

A. Strict bedrest for 48 hours

B. Allow moderate alcohol intake in diet

C. Monitor lab values.

D. Pain management

E. fiber restriction from diet

 

· 51. Which of the following signs or symptoms indicate a possible upper gastrointestineal (GI0) bleed? Select all that apply?

a .increased blood pressure

b. Weak peripherial pulse

C. Bright red or coffee ground vomitus

d. increased hemoglobin and hematocrit

e. vertigo

52. A nurse cares for a dying client, which manifestation of active dying would the nurse treat first?

a. incontinence

b. Anorexia

c. Nausea

d. pain

53. A nurse is planning to educate a client diagnosed with fluid volume overload. Which of the following would the nurse educate the client to determine gains and losses in fluid?

a. skin turgor

b. monitor daily weights

c. presence of edema

d. Appearance of mucous membranes

54. A nurse is caring for a client who recently underwent a colon resection for colorectal cancer. The client is post op day two and has developed a fever. Vital signs are a temperature of 102 degrees F, heart rate 126 beats /minutes, blood pressure 100/50 mm hg. The client is complaining of increased abdominal pain. Based on this information, which of the following conditions is the client exhibiting?

a.Deep vein thrombosis

b. intestinal obstruction

c. Appendicitis

d. peritonitis

55. A nurse is caring for 60 years old female that underwent a surgical procedure and is post op day four. The client has no active bowel sounds no bowel movement and no movement and no flatulence. Which of the following does the nurse suspect the client experiencing ?

a. perforated colon

b.peritonitis

c. Non-mechanical bowel obstruction

d. Appenicitis

56. The graduate nurse is caring for a client with suspected appendicitis. What intervention by this graduate nurse would be inappropriate or contraindicated in the care of this client?

a.       Contacting the health care provider immediately if the client reports sudden relief of pain

b.       Positioning the client in semi fowlers

c.       Administer an edema for constipation

d.       Administer pain medication every 4 hours PRN as ordered.

57. A nurse is caring for a client recently diagnosed with Addisonian crisis, Which of the following signs and symptoms are consistent with this diagnosis?

a. severe hypotension

b. Hypernatremia

c. Vascular resistance

d. Hypokalemia

 

58. A client was admitted with the following arterial blood gas(ABG). How does the nurse interpret these results?

PH7.45

PaCO2 29mm hg

HcO3 17mEq/L

PaO2 88 mm Hg

a.       Respiratory alkalosis with full metabolic compensation

b.       Respiratory acidosis with full metabolic compensation

c.       Metabolic alkalosis with full respiratory compensation

d.       Respiratory acidosis with full respiratory compensation

 

59. A client was admitted with the following arterial blood gas(ABG). How does the nurse interpret these results?

PH7.44

PaCO2 50mm hg

HcO3 32mEq/L

PaO2 90 mm Hg

a.       Respiratory alkalosis with full metabolic compensation

b.       Respiratory acidosis with full metabolic compensation

c.       Metabolic acidosis with full respiratory compensation

d.       Metabolic alkalosis with full respiratory compensation

 

60. A nurse is caring for a client who is postoperative following abdominal surgery. Which of the following findings wound indicate to the nurse that the client peristalsis in returning?

a. Hypoactive bowel sounds in two quadrants

b. Abdominal distention

c. Request for a cup of tea and some toast

d. passage of flatus

 

61. The nurse is evaluating the serum laboratory results on the following four clients. Which of the following clients would the nurse assess first?

a. a client who osteoporosis with a serum calcium level of 8.1 mg/dL

b. A client with dehydration with a serum sodium level 134mEq/L

c. A client admitted with abdominal; pain and vomiting with a potassium level 2.8mEq/L

d. A client with alcoholism and liver failure with a magnesium level of 1.6mEq/L

 

62. Which of these laboratory results would be most important for a nurse to monitor for a client with lower gastrointestinal bleed?

a. bleeding time

b. platelet level

c. potassium level

d. Hemoglobin and hematocrit

63. Which laboratory report of the highest concern for the nurse to monitor for a client with bone marrow suppression receiving chemotherapy?

a. urine specific gravity

b. white blood cell ( WBC) count

c. Triglycerides

d. serum prostate specific antigen( PSA)

 

64.An older adult client reports lack of energy and needs several naps throughout the day, which problem may these symptoms be associated with that is often seen in older adults?

a. underproduction of glucagon

b. overproduction of cortisol

c. Hypothyroidism

d. Hyperparathyroidism

 

65. A client assessment reveals fatigue, poor memory and weight gain. The lab results reveal elevated thyroid stimulating hormone TSH and decreased T3 and T4 levels. The nurse knows that these are manifestation of which disorder?

a. Hypoparathyroidism

b. Hyperthyroidism

c. Hyperparathyroidism

d. Hypothyroidism

 

66. The nurse is assessing a client a client that display a positive Chvostek sign.Which of the following is this assessment finding a clinical manifestation of?

a. Hyponatremia

b. Hyperkalemia

c. Hypocalcemia

d. Hy permahnesemia

67. A nurse is caring for a client that has recently been diagnosed with ulcerative colitis. Which of the following statement by the client would indicate an understanding of the disease process?

a. I have to avoid eating nuts and seeds

b. I am at a lower risk of developing cancer

c. it is caused by an inflammatory process of the gastrointestinal tract

d. Diet modification can cure the disease

68. A nurse is preparing to administer levothyroxine 125mcg po daily. Available is levothyroxine 50mcg tablets. How many tablets should the nurse administer per dose? Record answer to the nearest tenth, or one decimal place. Use a leading zero if it applies. Do not use a trailing zero.

2.5

69. The nurse is providing discharge instructions to a client with Hepatitis B. Which of the following statements demonstrates an understanding of the discharge instructions?

a. All food handling practices are the same when traveling overseas.

b. chronic hepatitis will not lead to liver cirrhosis or liver cancer

c. I won’t share my shaving razors with my spouse

d. I don’t have to consider safe sex practices with this form of hepatitis

 

70. A nurse is caring for a client who was prescribed high dose corticosteroid therapy for one month to treat a severe inflammatory condition in the intestines from irritable bowel syndrome. The client symptoms have now resolved. And the client asks, when can I stop taking these medication? How would the nurse respond?

a. The inflammation can’t recur if you stop the medication

b. The drug must be stopped abruptly

c. Once you start corticosteroids, you must be tapered off the medication

d. The medication can be stopped when you start feeling better

 

71.The nurse is caring for a client diagnosed with cholelithiasis. Which of the following nursing instructions should be included as part of the discharge teaching?

a. call the provider if you have ten or more bloody in a 24 hour period

b. removing gluten from your diet can reduce cramping

c. reduce foods high in uric acid from your diet, like anchovies and venison

d. you should limit high fat meats and fried foods from your diet.

 

72. A nurse teaches a client who is diagnosed with diabetes mellitus. Which statement would the nurse include in this clients plan of care to delay the onset of microvascular complication?

a. prevent hypoglycemia by eating a bedtime snack

b. restrict your fluid intake to no more than 2 L a day

c. Limit your intake of protein to prevent ketoacidosis

d. maintain tight glycemic control and prevent hyperglycemia

73.A nurse is preparing to administer cephalexin suspension 2 grams po daily given in four doses. Available is cephalexin suspension 250mg/5ml. How many ml should the nurse administer in one dose? ( record answer as a whole number. Do not use a trailing zero?

10

74. Which of the following surgical procedures is appropriate for a client with chronic pancreatitis?

a. proctocoelectomy

b. sphincterotomy

c. radical pancreatectomy

d. fistulotomy

75.A client with history of vomiting complain of muscles weakness. Heart palpitation and nausea. The clients laboratory findings are as follows: Na 140mEq/L and potassium 26mEq/L. which of the following electrolyte imbalance is the client exhibiting?

a.  Hypocalcemia

b. Hypervolemia

c. Hypokalemia

d.Hyperphosphatemia

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discussion

July 2, 2025/in Nursing Questions /by Besttutor

· Respond by extending, refuting/correcting, or adding additional nuance to their posts. Cited in current APA style with support from 2 academic sources.

· All replies must be constructive and use literature where possible.

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Discussion: Descriptive and Inferential Statistics

July 2, 2025/in Nursing Questions /by Besttutor

P r a c t ic e M a t t e r s R e s e a r c h 101

Sample size in quantitative research Sample size will affect the significance of your research.

By Susan B. Fowler, PhD, RN, CNRN, FAHA, and Valerie Lapp, PhD, RN, NEA-BC, CPN

Editor’s note: This is part o f the American Nurse Today Research 101 series. To read other articles in the series, visit americannursetoday.com/category/Researcbl01.

You’ve probably been asked (or have asked) the question: How many subjects do I need for my re­ search study? That’s your sample size—the number of participants needed to achieve valid conclusions or statistical significance in quantitative research. (Quali­ tative research requires a somewhat different approach.

In this article, we’ll answer these questions about sample size in quantitative research: Why does sample size matter? How do I determine sample size? Which sampling method should I use? What’s sampling bias?

Why does sample size matter? When sample sizes are too small, you run the risk of not gathering enough data to support your hypotheses or expectations. The result may indicate that relation­ ships between variables aren’t statistically significant when, actually, they are. You also may be missing sub­ jects who might give a different answer or perspective to your survey or interview. Samples that are too large may provide data that describe associations or relation­ ships that are due merely to chance. Large samples al­ so may waste time and money.

How do I determine sample size? Larger sample sizes typically are more representative of the population you’re studying, but only if you collect data randomly and the population is heterogeneous. Large samples also reduce the chance of outliers. How­ ever, large samples are no guarantee of accuracy. If your population of interest is homogenous, you may need only a small sample.

If you’re studying subjects over longer periods of time, as in longitudinal designs, you can expect subject attrition. Know your population and how responsive they may be to repeated questionnaires and interven­ tions. Even if you’re not conducting a longitudinal study, be realistic about how many people would agree to par­ ticipate in research.

For a pilot study (a small-scale version of a bigger study testing the efficacy of an intervention), you’d usually need around 30 subjects, although that number varies according to different experts.

No matter the type of study you’re conducting, take into account time (yours and the subjects’), subject co­ operation, and resources (such as statistical assistance, access to subjects, managerial support for your study, and co- or sub-investigators).

I

r

I

i

Power analysis Power analysis is a robust way to determine sample size and decrease the risk of type II errors (false-negative conclusions that a finding was due to chance when ac­ tually it was the result of the intervention). A power analysis calculation includes a significance criterion, ef­ fect size, and power to arrive at a sample size. The sig­ nificance criterion is referred to as alpha and usually is set at 0.05, which means that in 5 of 100 situations the result would be due to chance and not the intervention. Effect size (usually described as small, moderate, or large) is the magnitude or strength of the relationship between the variables you’re studying. In nursing, we often propose that variables moderately affect one another

AmericanNurseToday.com May 2019 A merican Nurse Today 61

 

 

or are correlated. For example, when on­ cology nursing stud­ ies about the effec­ tiveness of symptom management interven­ tions were combined and analyzed, a mod­ erate to large effect was found. Power (1- beta) usually is set at .80, which means that there’s a 20% risk of committing a type II error. (See Feel the power?)

Which sampling method should I use? The sampling method isn’t the same as the sample. It’s the proce­ dure you’ll use to select study participants. We’ll look at two sampling methods: nonproba­ bility and probability.

Nonprobability sampling Convenience sampling and snowball sampling are common nonprobability methods. Convenience samples consist of people who are easily accessed and volunteer; however, the sample may not be representative of the population of interest in your study. Convenience sampling is considered the weakest form of sampling.

With snowball sampling, participants are referred by other participants. This method can be used when you have difficulty locating participants. For example, when interviewing undocumented immigrants, the researcher gains the trust of a few participants and relies on them to identify other undocumented immigrants who might participate.

Probability sampling With probability sampling, everyone in an identified population has an equal chance of being in the sam­ ple. You can use a variety of approaches, including simple random, stratified random, multistage cluster, and systematic random sampling. For example, system­ atic random sampling of patients on a medical-surgical floor for an intervention study may include selecting every sixth room number. (Visit bit.ly/2FZLzYX to learn

more about types of probability sampling.)

What’s sampling bias? Sampling bias can occur w hen a partic­ ular overrepresen­ tation or underrep­ resentation of the population occurs. For example, if a re­ searcher wants to study which method of education is more effective by gender in reducing hospital readmissions, the num ber of men and wom en should be evenly distributed. Bias occurs when the researcher deliberate­ ly omits or makes a conscious decision to exclude a participant w ho’s had several re­ admissions for exac­ erbation of his heart failure. Both omis­ sions reflect bias and may distort study re­

sults and underm ine the validity of the study.

What are the practice implications? As nurses becom e more involved in evidence-based practice projects and research investigations, they’ll need to understand key elements of research, such as sample size, so they can critically appraise and gener­ ate evidence. Remember that the “right” num ber of subjects in your investigation impacts statistical and clin­ ical significance support for your study findings. ★

Susan B. F o w le r is a n u rse s c ie n tis t a t O rla n d o H e a lth in O rla n d o , F lo rid a , m e n ­ t o r f a c u lt y a t T ho m as Edison S ta te U n iv e rs ity in T re n to n , N e w Jersey; a n d co n ­ t r ib u t in g fa c u lt y a t W a ld e n U n iv e rs ity in M in n e a p o lis , M in n e s o ta . V a le rie Lapp is a p ro g ra m m a n a g e r fo r n u rs in g a n d sp e cia l p ro je c ts a n d M a g n e t® c o o rd in a to r a t A rn o ld P a lm e r M e d ic a l C e n te r in O rla n d o , F lo rid a .

Selected references Faber J, Fonseca LM. How sample size influences research outcomes. Dental Press J Orthod. 2014; 19C4):27-P. Polit DF, Beck CT. Nursing Research: Generating a n d Assessing Evi­ dence fo r Nursing Practice. Philadelphia, PA: Wolters Kluwer; 2017. Schmidt SAJ, Lo S, Hollestein LM. Research techniques made simple: Sample size estimation and power calculation. / Invest Dermatol. 2018; 138(8):l678-82.

Feel the power Betty, a pediatric nurse, w ants to study th e effect o f distraction on children’s disco m fo rt d u rin g insertion o f an I.V. catheter before a procedure in th e ra­ d io lo g y d epartm ent. She reaches o u t to experts at her fa cility to help her determ ine how many subjects she needs fo r her study.

Researchers assist her using G*Power, a free o nline pow er analysis tool. (V anderbilt U niversity also has a free pow er and sample size calculation program th a t can be d o w n lo a d e d at b io sta t.m c.va n d e rb ilt.e d u /w iki/M a in / PowerSampleSize.)

W ith significance set at 0.05, a m oderate effect size o f 0.3, and pow er at .80, Betty w ill need 82 subjects (see below).

62 American Nurse Today Volume 14, Number 5 AmericanNurseToday.com

 

 

Copyright of American Nurse Today is the property of HealthCom Media and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder’s express written permission. However, users may print, download, or email articles for individual use.

 

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Personal Theory Improvement

July 2, 2025/in Nursing Questions /by Besttutor

Discussion Prompt

Use the theory that you developed in week two.  Improve it by using the information you have obtained in the intervening weeks.  Use the Conceptual – Theoretical – Empirical Model (CTE) (see attached samples) to link the operational definitions with the empirical indicators with the theoretical concepts and the conceptual model components.  Post your revised theory and explain how you would measure the concepts and proposition in a research study.

You only have ONE assignment: take the theory you created earlier and expand upon it. You have your concepts, your proposition (your theory), and now you need to develop your outcomes and evaluation measures. See the sample I attached

 

Expectations

Initial Post:

APA format with in-text citations (APA formatting correct on the reference page)

Word count minimum of 250

References: at least 2, within the last 5 years in APA format.

Plagiarism free.

Turnitin receipt.

See the sample I attached:

 

561 CTE model from fall 1 2021.docx (19.88 KB)      
561 sample CTE postings .docx (152.67 KB)      

 

 

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Cultural and Diversity Awareness in Health Assessment

July 2, 2025/in Nursing Questions /by Besttutor

CASE STUDY/SENARIO

Paloma Hernandez, 26-year-old, Spanish speaking patient who presents to the clinic for the last 2 days in a row complaining of abdominal pain that is getting worse. The first visit the staff relied on her younger bilingual daughter to translate. She was treated with Omeprazole and encouraged to take OTC medication. Today she presents with the same problem. Her daughter states it is the same problem but worse today.

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

The question

1. Explain the specific socioeconomic, spiritual, lifestyle, and other cultural factors associated with the patient you were assigned.

2. Explain the issues that you would need to be sensitive to when interacting with the patient, and why.

3. 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.

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Assignment 1: Prescribing for Children and Adolescents

July 2, 2025/in Nursing Questions /by Besttutor

WEEK 3 ASSIGNMENT TOPIC  GIVEN TO ME TO ADDRESS IS MAJOR DEPRESSIVE DISORDER.

Off-label prescribing is when a physician gives you a drug that the U.S. Food and Drug Administration (FDA) has approved to treat a condition different than your condition. This practice is legal and common. In fact, one in five prescriptions written today are for off-label use.

—Agency for Healthcare Research and Quality

 

Psychotropic drugs are commonly used for children and adolescents to treat mental health disorders, yet many of these drugs are not FDA approved for use in these populations. Thus, their use is considered “off-label,” and it is often up to the best judgment of the prescribing clinician. As a PMHNP, you will need to apply the best available information and research on pharmacological treatments for children in order to safely and effectively treat child and adolescent patients. Sometimes this will come in the form of formal studies and approvals for drugs in children. Other times you may need to extrapolate from research or treatment guidelines on drugs in adults. Each individual patient case will need to be considered independently and each treatment considered from a risk assessment standpoint. What psychotherapeutic approach might be indicated as an initial treatment? What are the potential side effects of a particular drug?

For this Assignment, you consider these questions and others as you explore FDA-approved (“on label”) pharmacological treatments, non-FDA-approved (“off-label”) pharmacological treatments, and nonpharmacological treatments for disorders in children and adolescents.

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power point

July 2, 2025/in Nursing Questions /by Besttutor

Assignment:

After researching HP2020, Kaiser Family Foundation, the ANA and your State Board of Nursing:

Please submit one APA formatted presentation (PowerPoint®, Prezi®, etc.) identifying and describing how these agencies and leadership are addressing health disparities. This PowerPoint® (Microsoft Office) or Impress® (Open Office) presentation should be a minimum of 20 slides, including a title, introduction, conclusion and reference slide, with detailed speaker notes and recorded audio comments for all content slides. Use at least 6 scholarly sources and make certain to review the module’s Assignment Rubric before starting your presentation.

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