Assignment: Off-Label Drug Use in Pediatrics

Home>Homework Answsers>Nursing homework helpurgentPLEASE FOLLOW THE INSTRUCTIONS AS INDICATED BELOW1). ZERO (0) PLAGIARISM2). ATLEAST 5 REFERENCES, NO MORE THAN 5 YEARS (WITHIN 5YRS, OR LESS THAN 5YRS)3).  PLEASE SEE THE ATTACHMENT FOR RUBRIC DETAILS AND RECOMMENDED WRITING TEMPLATE AND APA 7 STYLE.4). Please review and follow the grading rubric details, and include each component in the assignment as required. Also, follow the APA writing rules and style, Title page, summary, Conclusion, References.5) Please, Include the Title page, Introduction, purpose statement, Literature Review, conclusion, and reference page.Thank you very much.The unapproved use of approved drugs, also called off-label use, with children is quite common. This is because pediatric dosage guidelines are typically unavailable, since very few drugs have been specifically researched and tested with children.When treating children, prescribers often adjust dosages approved for adults to accommodate a child’s weight. However, children are not just “smaller” adults. Adults and children process and respond to drugs differently in their absorption, distribution, metabolism, and excretion.Children even respond differently during stages from infancy to adolescence. This poses potential safety concerns when prescribing drugs to pediatric patients. As an advanced practice nurse, you have to be aware of the safety implications of the off-label use of drugs with this patient group.To PrepareReview the interactive media piece in this week’s Resources and reflect on the types of drugs used to treat pediatric patients with mood disorders.Reflect on situations in which children should be prescribed drugs for off-label use.Think about strategies to make the off-label use and dosage of drugs safer for children from infancy to adolescence. Consider specific off-label drugs that you think require extra care and attention when used in pediatrics.Writea 1-page narrative in APA format that addresses the following:Explain the circumstances under which children should be prescribed drugs for off-label use. Be specific and provide examples.Describe strategies to make the off-label use and dosage of drugs safer for children from infancy to adolescence. Include descriptions and names of off-label drugs that require extra care and attention when used in pediatrics.Therapy for Pediatric Clients with Mood DisordersAn African American Child Suffering From DepressionBACKGROUND INFORMATIONThe client is an 8-year-old African American male who arrives at the ER with his mother. He is exhibiting signs of depression.Client complained of feeling “sad”Mother reports that teacher said child is withdrawn from peers in classMother notes decreased appetite and occasional periods of irritationClient reached all developmental landmarks at appropriate agesPhysical exam unremarkableLaboratory studies WNLChild referred to psychiatry for evaluationMENTAL STATUS EXAMAlert & oriented X 3, speech clear, coherent, goal directed, spontaneous. Self-reported mood is “sad”. Affect somewhat blunted, but child smiled appropriately at various points throughout the clinical interview. He denies visual or auditory hallucinations. No delusional or paranoid thought processes noted. Judgment and insight appear to be age-appropriate. He is not endorsing active suicidal ideation, but does admit that he often thinks about himself being dead and what it would be like to be dead.You administer the Children’s Depression Rating Scale, obtaining a score of 30 (indicating significant depression)RESOURCES§ Poznanski, E., & Mokros, H. (1996). Child Depression Rating Scale–Revised. Los Angeles, CA: Western Psychological Services.PLEASE NOTE BELOW:I have provided all the decision points about the drugs. Decisions point one is to pick one medication to begin, either Zoloft, Paxil, or Wellbutrin. I provided all decision points under each drug to follow if any changes are to be made.For Zoloft:Decision Point OneBegin Zoloft 25 mg orally dailyRESULTS OF DECISION POINT ONEClient returns to clinic in four weeksNo change in depressive symptoms at allDecision Point TwoIncrease dose to Zoloft 50 mg orally dailyRESULTS OF DECISION POINT TWOClient returns to clinic in four weeksDepressive symptoms decrease by 50%. Client tolerating wellDecision Point ThreeMaintain current doseGuidance to StudentAt this point, sufficient symptom reduction has been achieved. This is considered a “response” to therapy. Can continue with current dose for additional 4 week to see if any further reductions in depressive symptoms are noted. An increase in dose may be warranted since this is not “full” remission- Discuss pros/cons of increasing drug dose with client at this time and empower the client to be part of the decision. There is no indication that the drug therapy should be changed to an SNRI at this point as the client is clearly responding to this therapy.For Paxil:Decision Point OneBegin Paxil 10 mg orally dailyRESULTS OF DECISION POINT ONEClient returns to clinic in four weeksReduction in The Children’s Depression Rating Scale by 5 points overall, but with complaints of nausea, vomiting, and diarrheaDecision Point TwoChange to Prozac 10 mg orally dailyRESULTS OF DECISION POINT TWOClient returns to clinic in four weeksThere is a 25% reduction in symptoms, client’s side effects of nausea, vomiting, and diarrhea have resolved. Client reports that he is feeling a “little bit better”Decision Point ThreeContinue current doseGuidance to StudentYou have two equally compelling choices at this point. The client has only been taking the current drug at its current dose for 4 weeks. It would be appropriate to continue at current dose. Additionally, you could also increase the dose to 20 mg orally daily. A discussion of risk/benefits should be had with the childs guardian regarding this and collaborative decision making should occur. There is no indication at this point that augmentation agents are required as the child is showing a partial response to therapy.For  Wellbutrin:Decision Point OneBegin Wellbutrin 75 mg orally BIDRESULTS OF DECISION POINT ONEClient returns to clinic in four weeksChild is unable to fall asleep at nightDecision Point TwoChange to Lexapro 10 mg orally dailyRESULTS OF DECISION POINT TWOClient returns to clinic in four weeksChild is tolerating Lexapro, and is sleeping at night. There is a 40% reduction in symptomsDecision Point ThreeContinue current doseGuidance to StudentAt this point, there is no indicating that you should change back to Wellbutrin as the child is tolerating the current medication without mention of side effects. Also, the child is experiencing a reduction in symptoms. You could also increase the dose to 15 mg orally daily, but the child has only been taking the drug for 4 weeks at this point. It may be more prudent to give the current therapy an additional 4 weeks before making any decisions to change current dose.NURS6521WEEK11ASSIGNMENTRUBRICDETAILS.htmlWritingTemplatewithInstructions.doc4 years ago10.05.202150Report issueAnswer(1)Brainy Brian4.8(904)5.0(213)ChatPurchase the answer to view itOff-LabelUseofDrugs.edited.docx1620599673588_Off-LabelUseofDrugs.pdfRevision-Off-LabelUseofDrugs.edited1.docx4 years agoplagiarism checkPurchase $50Bids(109)PROVEN STERLINGDr.Marie_MicheleMISS HILLARY A+Dr Michelle MayaQuickly answerCreative GeeknicohwilliamWIZARD_KIMSynco_SolutionsYourStudyGuruNightingaleMUSYOKIONES A+Madam MichelleBrainy BrianAmanda SmithRihAN_MendozaRosie SeptemberDr. Ellen SmartPapersGuruDiscount Assignother Questions(10)What are the principles of scholarly discussion in an online environment? How does this differ from a social network? Please cite the sources used to support your response.Foundations of leadership Akademic onlyMeasuring and Interpreting Brand PerformanceclassHomework 1ANN HARRIS can you assist?DerivativesInterpersonal CommunicationI need three different assignments revised.BLANK

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Benchmark – Evidence-Based Practice Project: PICOT Paper

Home>Homework Answsers>Nursing homework helpMSNnursingRefer to the PICOT you developed for your evidence-based practice project proposal.Write a 750-1,000-word paper that describes your PICOT.1.Describe the population’s demographics and health concerns.2.Describe the proposed evidence-based intervention and explain how your proposed intervention incorporates health policies and goals that support health care equity for the population of focus.3.Compare your intervention to previous practice or research.4.Explain what the expected outcome is for the intervention.5.Describe the time for implementing the intervention and evaluating the outcome.6.Explain how nursing science, social determinants of health, and epidemiologic, genomic, and genetic data are applied or synthesized to support population health management for the selected population.7.Create an Appendix for your paper and attach the PICOT. Be sure to review feedback from your previous submission and revise your PICOT accordingly.8.Complete the “APA Writing Checklist” to ensure that your paper adheres to APA style and formatting criteria and general guidelines for academic writing. Include the completed checklist as the final appendix at the end of your paper.Refer to the “Evidence-Based Practice Project Proposal – Assignment Overview” document for an overview of the evidence-based practice project proposal assignments.You are required to cite at least four to six peer-reviewed sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content.Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.You are required to submit this assignment to LopesWrite.Rubric_Print_Format-3.xlsxPICOTFinal_DPolk.docx4 years ago01.06.202150Report issueAnswer(1)Quality Assignments4.9(2k+)4.9(258)ChatPurchase the answer to view itNOT RATEDPICOT2.docx4 years agoplagiarism checkPurchase $50Bids(108)Dr Michelle MayaQuickly answerDr. Adeline ZoeCreative GeekWIZARD_KIMQuality AssignmentsYourStudyGuruNightingaleGreat-WritersBrainy Brianwizard kimDr shamille ClaraJah ProvidesRosie SeptemberDiscount AssignBrilliant Geekbrilliant answersDr. Michelle_KMPapersGuruArizona Writerother Questions(10)1) Harley Motors has $25 million in assets, which were financedcalculus sage Algebra 2 onlineHilton Hotels and Marriott HotelsNegative impact of social media on societyNeed help with finance and accounting quiz, who can help me?week 3BUS 599 Assignment 1Accounting course projectIT 244 Week 7 Individual Access Control Policy Appendix FFINAL PAPER MARKETING ACCOUNTING

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NR283 Pathophysiology

Home>Homework Answsers>Nursing homework helpnursingWeek 4: Discussion: Mr. X.Ebook: Hubert, R. & VanMeter, K. (2018).Gould’s pathophysiology for the health professions(6th ed.). Elsevier.The initial post must include responses to all the questions in both case studies.Mr. X, age 57, presented to his physician with marked fatigue, nausea with occasional diarrhea, and a sore, swollen tongue. Lately, he also has been experiencing a tingling feeling in his toes and a feeling of clumsiness. Microscopic examination of a blood sample indicated a reduced number of erythrocytes, many of which are megaloblasts, and a reduced number of leukocytes, including many large, hypersegmented cells. Hemoglobin and serum levels of vitamin B12 were below normal. Additional tests confirm pernicious anemia.Discussion QuestionsRelate the pathophysiology of pernicious anemia to the manifestations listed above.Discuss how the gastric abnormalities contribute to vitamin B12 and iron deficiency and how vitamin B12 deficiency causes complications associated with pernicious anemia.Discuss other tests that could be performed to diagnose this type of anemia.Discuss the treatment available and the limitations.Ms. L, a 19-year-old woman with no previous medical history, was involved in a serious automobile accident in which her best friend died. Examination by EMT personnel first on the scene revealed she had only minor scrapes and bruises and no sign of head trauma. While en route by ambulance to the hospital, Ms. L complained of thirst and appeared restless. Further examination indicated a rapid pulse and respirations, with her blood pressure now at 100/60 mm Hg. She appeared less responsive to the paramedics. She was slipping into circulatory shock as they checked her again for internal injuries.Discussion QuestionsDiscuss the contributing factors to shock in this case and the pathophysiologic changes causing the changes in vital signs.Discuss the signs and symptoms of shock, including the rationale for each, as seen in the early stage, and as compensation mechanisms respond.Discuss emergency and follow-up treatment for shock and for complications that may arise if not treated quickly.Compare the types of shock, giving a specific cause, classification, and any significant changes in onset or manifestations.GUIDELINESWeekly OutcomesArticulate alterations in structure and function of the cardiovascular and hematologic systems. (CO 1)Trace the impact that alterations in the cardiovascular and hematologic systems have on the body. (CO 2)Summarize the impact of alterations in the cardiovascular and hematologic systems on homeostasis. (CO 3)Main Topics and ConceptsAlterations in the cardiovascular system: perfusionAlterations in physical structures and functionsAlterations in cardiac system functionPathophysiologic cardiovascular system response to agingCongenital and genetic influences on cardiovascular system pathology2. Alterations in the hematology systemHematologic response to illness and injuryCancers of the hematologic systemPathophysiologic hematologic system response to agingGenetic influences on hematologic system pathologyWeekly ObjectivesUnderstand normal cardiovascular system disorders.Compare and contrast common cardiovascular conditions: causes, clinical manifestations, diagnostic tests, and treatments.Apply understanding of alterations in and cardiovascular systems across the lifespan to formulate care priorities.Examine responses to aging and its impact on pathophysiologic changes in the cardiovascular system.Describe how heredity and genetics influence pathophysiological alterations in the cardiovascular system.Understand the hematologic response to illness and injury.Examine factors leading to cancers of the hematologic system.Compare and contrast common types of anemias: causes, clinical manifestations, diagnostic tests, and treatments.Apply understanding of alterations in the hematologic system across the lifespan to formulate care priorities.Apply growth and development principles as they relate to the impact of aging on pathophysiologic changes.Describe how genetics influence pathophysiological alterations in the hematologic system.Sub-Concepts with ExemplarFluid imbalances: pulmonary edema; congestive heart failureMetabolism: metabolic syndromePerfusion: pulmonary embolism; heart disease; hypertension; venous versus arteriole disorders; and shock statesAging process: chronic leukemiaAcute versus chronic conditionsCellular adaptation: acute leukemiaPerfusion: polycythemiaOxygenation: anemias and hemoglobin and hematocrit levelsGenetics: hemophilia A, chronic myeloid leukemia (CML)Injury: disseminated intravascular coagulation (DIC)APA format (7th ed.) and is free of errorsGrammar and mechanics are free of errors free of PlagiarismReferences: Use your book, the outside source must be within the last 5 yrs, Scholarly Articles,s or Nurse journals within the last 5 yrs.goulds-pathophysiology-for-the-health-professions-6th-edition.pdfAPA_7th_Edition_Paper_Template_RNBSN.docx4 years ago24.09.20215Report issueAnswer(2)Prof Hangoi4.8(70)5.0(13)ChatPurchase the answer to view itNursing_week_discussion_4.docxRevision.docx4 years agoplagiarism checkPurchase $5Smart Study3.4(425)3.1(5)ChatPurchase the answer to view itNOT RATEDNR283Pathophysiology.docx4 years agoplagiarism checkPurchase $4Bids(129)MUSYOKIONES A+EMMA_WRITERA+GRADE HELPERpacesetters2121Jahky BMajesticMaestroTeacher A+ WorkPROF_ALISTERDiscount AnsRihAN_MendozaColeen AndersonProf. Dr. ReenaLarry Kellyprof bradleyTutor Cyrus KenBrilliant GeekElprofessoriJudithTutorExpert HumairaTopanswersother Questions(10)Ipad task continueThink about the ways people’s physical surroundings (office, weather, house, apartment) affect them. Discuss one important way these surroundings have influenced someon’s behavior. Provide examples in your discussion that explore that relationship between. Use Excel’s Analysis ToolPak (or any statistical package that you are comfortable with) to compute the regression equation for predicting the number of defective flash drives over time (in weeks), the correlation coefficient r and the coefficient of det1Quality Managementhelp with 1 Q for Physiological PsychologyLEG 500 Assignment 2 – Employment-At-Will DoctrineHCAD 520 Assignment 2 Use CasesCritical Analysis 3 pages lawHR

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Culture in Nursing Week1

Home>Homework Answsers>Nursing homework helpculturenursingResearchRead chapter 1 of the class textbook and review the attached Power Point presentation.  Once done answer the following questions.1.  In your own words and using the proper evidence-based references define transcultural diversity and Health care and discuss how both term interact and how they help in the delivery of health care to different heritages.2.  Mention and discuss at least 4 variant characteristics of culture.Assignment must be submitted in the discussion forum.  A minimum of 2 evidence-based references no older than 5 years are required.A minimum of 500 words are required.APA StylePlagiarism FREELarryPurnell-TransculturalHealthCare_ACulturallyCompetentApproach-F.A.DavisCompany2012.pdfCH01NursingCulture.ppt5 years ago08.01.202020Report issueAnswer(2)Utah Tutors Club5.0(1)5.0(1)ChatPurchase the answer to view itNOT RATEDSolution.docx5 years agoplagiarism checkPurchase $12kim woods4.5(6k+)4.2(157)ChatPurchase the answer to view itNOT RATEDorder_132380_345755.docorder_132380_345969.doc5 years agoplagiarism checkPurchase $20Bids(61)reliablewriterGradesMaestroQuality AssignmentsACCURACY_MASTERnicohwilliamYourStudyGuruAmanda SmithMath GuruuHomework Prowizard kimMiss LynnProCastrol01Kelly Jacobsbrilliant answersjim claireSasha SpencerTaylor RodmanElprofessoriPROF_TOMMYProf Berryother Questions(10)FINAL EXAM – Creativity Innovation & New Product Development – DUE WITHIN 2 HOURSFrank Hopkins Rights of PrisonersAssignmentYou are now ready to present a process improvement to hotel management in the areas of focus (check-in, checkout, and hotel offerings).who can do this?Excel working problemASSIGNMENT THREEDiscussion Budget : governmental & nonprofit acctI need help with the following assignmentDetermining Business Network Needs

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nursing assessment

Home>Homework Answsers>Nursing homework helpWEEK1/ANSWER TO PROFESSOR/ DICUSSIONfirst part is my discussionPhysical ExaminationPhysical examination is the evaluation of anatomic findings by using observation, percussion, palpation, and auscultation to obtain information about the patient. Many people who visit healthcare providers follow their instructions but wonder what they are doing or what they are looking for. During a physical examination, a healthcare practitioner is gathering cues to be able to diagnose. When a physical examination is thoughtfully integrated with the information that they provide, history, and path physiology, they should yield at least 20% data that is necessary for diagnosis and management of the patient (Sawyer, 2012). An examination of a 12-year-old child to find the likely cause of the symptoms portrayed would assist in diagnosing the child.You are admitting a 12-year-old child to your unit. The mother states that the child has a history of unexplained blackout episodes, headaches, sleep disturbances, and is presently exhibiting tremors. What is the most likely cause of these symptoms? What actions would you take during the interview process? Explain.I have chosen the 12 year old patient for this discussion.When conducting a physical assessment on children it is imperative to start the collaboration relationship process between the patient and their family members and myself, as the nurse with effective communication strategies. I would first introduce myself to the patient and mother of the patient and explain to the both of them the purpose of the assessment being performed and how the information that they provide will be utilize appropriately. One important aspect to explain to both of them is that the information that they provide to me is protected by HIPAA.I would then use open-ended questions (i.e. what brings you in today) to direct the interview to gain the patient’s history from either the child or from the mother. If more information is needed then I would utilize closed-ended questions or direct statements (i.e. how long has these symptoms been going on) to clarify any additional information.Next, I would take the patient’s vitals and a complete head-to-toe assessment with an emphasis on the neurological system exam, all while explaining to the patient and the mother the reason for me having to do this. By me explaining step-by-step what I am doing will help me to better build a rapport with them as well as giving the patient and the mother a sense of being aware of what is going on, so that if they have any questions I will be able to answer these for them.It would be pretty apparent that with the symptoms that the patient is experiencing may be due to some type of neurological condition. Patient would then need to be referred to a neurologist for further testing to confirm a proper diagnosis.Reference:Assessment Technologies Institute. (n.d.). Physical assessment (child). Retrieved fromhttp://www.atitesting.com/ati_next_gen/skillsmodules/content/physical-assessment-child/viewing/Neurological-a.htmlSawyer, S. (2012). Pediatric physical examination & health assessment. Sudbury, MA: Jones & Bartlett Learning.Professor question/ needs to be answer.Strong work.  When we thinking about our 1st pt-Considering all aspects of the patient medical history, including the history of close family members, is important to ensure the complete clinical picture is evident. Asking if family members have a history of depression is an important point we must raise during a history assessment of our first patient. Would you agree?7 years ago23.05.20185Report issueAnswer(2)Wendy Lewis4.7(19k+)4.8(3k+)ChatPurchase the answer to view itNOT RATEDHistoryAssessmentofFirstPatient.doc7 years agoplagiarism checkPurchase $5Wendy Lewis4.7(19k+)4.8(3k+)ChatPurchase the answer to view itNOT RATEDHistoryAssessmentofFirstPatient.doc7 years agoplagiarism checkPurchase $5Bids(26)Talented WriterWendy LewisFrankdocLaiba ElishaMich MichieANN HARRISDR.WISSERYoung Kim hoodsKATHERINE BECKSphyllis youngTutor SuccessCatherine Owensbig tankPhd isaac newtonClytemnestraAmanda SmithAngelina MayTalented GreenProf. Kaylinlopezguru answersother Questions(10)organizational behavior assignment 1prof. speedsterPro. MacQueenECONResponse 1BUSN410 PowerpointOyama v. Californiapapersystem analysis and design assignment help ?Final project

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Technology is integral to successful implementation in many projects, through either support or integration or both

Home>Homework Answsers>Nursing homework helpTechnology is integral to successful implementation in many projects, through either support or integration or both. Name at least one technology that could improve the implementation process and the outcomes of your EBP project NEUTROPENIC SEPSIS). Do you plan to use this technology? If not, what are the barriers that prevent its use?7 years ago16.07.20185Report issueAnswer(1)Sasha Spencer4.8(605)4.7(41)ChatPurchase the answer to view itNeutropenicSepsis1.docx7 years agoplagiarism checkPurchase $5Bids(33)Brainy BrianPROF washington watsonprof.TimetestMichelle OwensAll Works solverYourBestTurtorExemplaryTutorsalmansajid1209Sasha SpencerCatherine Owensguru answersAfrika NewbieTeacher TrumahnprofwachgraceTeacher Stevebrilliant answersAleena Sheikhkim woodsDr AngelenaCharandryother Questions(10)this is my second assignment can any one help me?ONLY FOR Sir_EXCELLENCEEconomicsto phyili youngEvaluating Research Questions, Hypotheses, and Quantitative Research DesignsEthics in global bussinessNTC 362 Week 4 Individual: LAN/WANArticalACCOUNTING EXPERTBrief Exercise 6-5 Calculate ending inventory and cost of goods sold using FIFO (LO3)

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Research in Nursing Week 2 – Proposal and Questions

This week, you will submit a topic for your research proposal and presentation as well as the research questions you will be utilizing for your proposal and presentation. Your instructor must approve your research questions and topic for your proposal.

Submit your journal assignment and include the following:

  • Research topic for the proposal and presentation
  • Research questions for the proposal and presentation

Note: Once approved, any changes to your topic or research questions should be approved by your instructor.

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Nursing homework help

NRS-410V Module 5 Evidence-Based Practice Project – Paper on Type 2 Diabetes..13

Pathophysiology and Nursing Management of Clients Health Disorders of the Digestive and Musculoskeletal System

Identify a research or evidence-based article that focuses comprehensively on a specific intervention or new diagnostic tool for the treatment of diabetes in adults or children.

In a paper of 750-1,000 words, summarize the main idea of the research findings for a specific patient population. Research must include clinical findings that are current, thorough, and relevant to diabetes and the nursing practice.

Prepare this assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a grading rubric. Instructors will be using the rubric to grade the assignment; therefore, students should review the rubric prior to beginning the assignment to become familiar with the assignment criteria and expectations for successful completion of the assignment.

You are required to submit this assignment to Turnitin. Refer to the directions in the Student Success Center. Only Word documents can be submitted to Turnitin.

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Assessment#2Class#6

Home>Homework Answsers>Nursing homework helpSee attachment.Assessment2Class6.docx6 years ago04.09.201915Report issueAnswer(1)brilliant answers4.8(29k+)4.9(6k+)ChatPurchase the answer to view itNOT RATEDCurriculumdevelopment.docx6 years agoplagiarism checkPurchase $30Bids(68)Great-WritersPROF. ANNWIZARD_KIMArizona WriterAlamy EleanorSmartwriter14Emily BluntElprofessoriThe grAdeResearchProprofessor mitchWendy Lewissmart-tutorbrilliant answersDr R Judy MarkCatherine OwensRESPECT WRITERkim woodsAll Works solverwizard kimother Questions(10)Week 1 Discussion – The International Marketing Manager Week 1 Discussion – The International Marketing Manager International marketing may seem an overwhelming task. It involves so many critical aspects of a company’s international success. Just to listWeek 10 Homework- Due Sept 7th @ 2:00pmAssignmentAssignmentDiscussion QuestionHomework -Short Paper: Border and Transportation Securityweek 4uggiwhat are some ethical considerations involved in conducting criminalogical research how can researchers make sure th such considerations are met

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Nursing homework help

Question

1. Osteopenia is diagnosed in a 55-year-old woman who has not had a period in 15 months. She has a positive family history of breast cancer. The primary care NP should recommend:

testosterone therapy.

estrogen-only therapy.

nonhormonal drugs for osteoporosis.

estrogen-progesterone therapy for 1 to 2 years.

Question 2. A patient takes a cardiac medication that has a very narrow therapeutic range. The primary care NP learns that the particular brand the patient is taking is no longer covered by the patient’s medical plan. The NP knows that the bioavailability of the drug varies from brand to brand. The NP should:

contact the insurance provider to explain why this particular formulation is necessary.

change the patient’s medication to a different drug class that doesn’t have these bioavailability variations.

accept the situation and monitor the patient closely for drug effects with each prescription refill.

ask the pharmaceutical company that makes the drug for samples so that the patient does not incur out-of-pocket expense.

Question 3. A patient brings written information about a medication to a primary care NP about a new drug called Prism and wants to know if the NP will prescribe it. The NP notes that the information is from an internet site called “Prism.com.” The NP should tell this patient that:

this information is probably from a drug advertisement website.

this is factual, evidence-based material with accurate information.

the information is from a nonprofit group that will not profit from drug sales.

internet information is unreliable because anyone can post information there.

Question 4. A primary care NP is reviewing written information about a newly prescribed medication with a patient. To evaluate this patient’s understanding of the information, the NP should ask the patient to:

read the information aloud.

describe how the medication will be taken.

write down questions about the medication.

tell the NP if the information is unclear.

Question 5. A patient is diagnosed with lupus and reports occasional use of herbal supplements. The primary care NP should caution this patient to avoid:

ginseng.

echinacea.

ginkgo biloba.

St. John’s wort.

Question 6. A patient who has chronic pain and who takes oxycodone (Percodan) calls the clinic to ask for a refill of the medication. The primary care NP notes that the medication refill is not due for 2 weeks. The patient tells the NP that the refill is needed because he is going out of town. The NP should:

fill the prescription and document the patient’s explanation of the reason.

review the patient’s chart to see if this is a one-time or repeat occurrence.

call the patient’s pharmacist and report suspicion of drug-seeking behaviors.

confront the patient about misuse of narcotics and refuse to fill the prescription.

Question 7. The primary care NP prescribes an extended-cycle monophasic pill regimen for a young woman who reports having multiple partners.Which statement by the patient indicates she understands the  regimen?

“I have to take a pill only every 3 months.”

“I should expect to have only four periods each year.”

“I will need to use condoms for only 7 more days.”

“This type of pill has fewer side effects than other types.”

Question 8. The primary care NP sees a patient covered by Medicaid, writes a prescription for a medication, and is informed by the pharmacist that the medication is “off-formulary.” The NP should:

inform the patient that an out-of-pocket expense will be necessary.

write the prescription for a generic drug if it meets the patient’s needs.

call the patient’s insurance provider to advocate for this particular drug.

contact the pharmaceutical company to see if medication samples are available.

Question 9. A 55-year-old woman has not had menstrual periods for 5 years and tells the primary care nurse practitioner (NP) that she is having increasingly frequent vasomotor symptoms. She has no family history or risk factors for coronary heart disease (CHD) or breast cancer but is concerned about these side effects of hormone therapy (HT). The NP should:

tell her that starting HT now may reduce her risk of breast cancer.

advise a short course of HT now that may decrease her risk for CHD.

tell her that HT will not help control her symptoms during postmenopause.

recommend herbal supplements for her symptoms to avoid HT side effects.

Question 10. A primary care NP recommends an over-the-counter medication for a patient who has acid reflux. When teaching the patient about this drug, the NP should tell the patient:

to take the dose recommended by the manufacturer.

not to worry about taking this drug with any other medications.

to avoid taking other drugs that cause sedation while taking this drug.

that over-the-counter acid reflux medications are generally safe to take with other medications.

Question 11. A patient will begin taking two drugs that are both protein-bound. The primary care NP should:

prescribe increased doses of both drugs.

monitor drug levels, actions, and side effects.

teach the patient to increase intake of protein.

stagger the doses of drugs to be given 1 hour apart.

Question 12. The primary care NP has referred a child who has significant gastrointestinal reflux disease to a specialist for consideration for a fundoplication and gastrostomy tube placement. The child’s weight is 80% of what is recommended for age, and a recent swallow study revealed significant risk for aspiration. The child’s parents do not want the procedure. The NP should:

compromise with the parents and order a nasogastric tube for feedings.

initiate a discussion with the parents about the potential outcomes of each possible action.

refer the family to a case manager who can help guide the parents to the best decision.

understand that the child’s parents have a right to make choices that override those of the medical team.

Question 13. A primary care NP is developing a clinical practice guideline for management of a patient population in a midsized suburban hospital. The NP should:

use an existing guideline from a leading research hospital.

follow the guideline provided by a third-party payer to help ensure reimbursement.

review expert opinion and experimental, anecdotal, correlational study data.

write the guideline to adhere to long-standing practice protocols already in use.

Question 14. The primary care nurse practitioner (NP) writes a prescription for an antibiotic using an electronic drug prescription system. The pharmacist will fill this prescription when:

the electronic prescription is received.

the patient brings a written copy of the prescription.

a copy of the written prescription is faxed to the pharmacy.

the pharmacist accesses the patient’s electronic record to verify.

Question 15. A primary care NP is preparing to prescribe a drug and notes that the drug has nonlinear kinetics. The NP should:

monitor frequently for desired and adverse effects.

administer a much higher initial dose as a loading dose.

monitor creatinine clearance at baseline and periodically.

administer the drug via a route that avoids the first-pass effect.

Question 16. An important difference between physician assistants (PAs) and NPs is PAs:

always work under physician supervision.

are not required to follow drug treatment protocols.

may write for all drug categories with physician co-signatures.

have both inpatient and outpatient independent prescriptive authority.

Question 17. A primary care NP writes a prescription for an off-label use for a drug. To help ensure compliance, the NP should:

include information about the off-label use on the E-script.

provide the patient with written instructions about how to use the medication.

tell the patient to let the pharmacist know that the drug is being used for an off-label use.

follow up by phone in several days to see if the patient is using the drug appropriately.

Question 18. A patient reports taking antioxidant supplements to help prevent cancer. The primary care NP should:

review healthy dietary practices with this patient.

make sure that the supplements contain large doses of vitamin A.

tell the patient that antioxidants are especially important for patients who smoke.

tell the patient that evidence shows antioxidants to be effective in preventing cancer.

Question 19. A woman comes to the clinic to talk about weight reduction. The primary care nurse practitioner (NP) calculates a body mass index (BMI) of 28. The woman’s waist measures 34 inches. The woman tells the NP that she would like to lose 20 lb for her daughter’s wedding in 6 months. The NP should:

suggest she try over-the-counter (OTC) orlistat.

consider prescribing phentermine short-term.

discuss her short-term and long-term weight loss goals.

give her information about physical activity and diet modification.

Question 20. A patient comes to the clinic and asks the primary care NP about using a newly developed formulation of the drug the patient has been taking for a year. When deciding whether or not to prescribe this formulation, the NP should:

tell the patient that when postmarketing data is available, it will be considered.

review the pharmaceutical company promotional materials about the new medication.

prescribe the medication if it is less expensive than the current drug formulation.

prescribe the medication if the new drug is available in an extended-release form.

Question 21. An adolescent girl has chosen Depo-Provera as a contraceptive method and tells the primary care NP that she likes the fact that she won’t have to deal with pills or periods. The primary care NP should tell her that she:

should consider another form of contraception after 1 year.

may have irregular bleeding, especially in the first month or so.

will need to take calcium and vitamin D every day while using this method.

will have to take oral contraceptive pills in addition to Depo-Provera when she takes antibiotics.

Question 22. A patient receives an inhaled corticosteroid to treat asthma. The patient asks the primary care NP why the drug is given by this route instead of orally. The NP should explain that the inhaled form:

is absorbed less quickly.

has reduced bioavailability.

has fewer systemic side effects.

provides dosing that is easier to regulate.

Question 23. A patient who has breast cancer has been taking toremifene for 2 weeks. She tells her primary care NP that she thinks her tumor has grown larger. The NP should:

schedule her for a breast ultrasound.

reassure her that this is common and will subside.

tell her she may need an increased dose of this medication.

contact her oncologist to discuss adding another medication.

Question 24. The primary care NP is prescribing a medication for an off-label use. To help prevent a medication error, the NP should:

write “off-label use” on the prescription and provide a rationale.

call the pharmacist to explain why the instructions deviate from common use.

write the alternative drug regimen on the prescription and send it to the pharmacy.

tell the patient to ignore the label directions and follow the verbal instructions given in the clinic.

Question 25. The primary care NP sees a woman who has been taking HT for menopausal symptoms for 3 years. The NP decreases the dosage, and several weeks later, the woman calls to report having several hot flashes each day. The NP should:

increase the HT dose.

discontinue HT.

recommend black cohosh to alleviate symptoms.

reassure her that these symptoms will diminish over time.

 

 

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