pathophysiology

Week 2: State Specific Guidelines for Prescribing Controlled Substances

Submit Assignment

  • Due Mar 15 by 11:59pm
  • Points 50
  • Submitting a file upload

Purpose

The purpose of this assignment is to provide the student with an opportunity to explore the most recent guidelines and recommendations in the student’s state of practice for pain management therapies and education; as well as to understand specific state regulations governing controlled substance prescriptions.

Activity Learning Outcomes

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

  • Identify and describe at least one current state specific guideline for pain management therapy and education.
  • Explore other organizations or pain initiatives that are offered by the state (if applicable).
  • Describe state specific laws that apply to the authority to prescribe schedule II controlled substances.
  • Explore the state’s Prescription Drug Monitoring Program (PDMP).

Due Date:

Assignment should be submitted to the Week 2 State Specific Guidelines for Prescribing Controlled Substances dropbox by Sunday 11:59 p.m. MST at the end of Week 2. When the assignment is placed in the dropbox, it will automatically be submitted to Turnitin. You may submit the assignment one additional time before the due date to lower the Turnitin score. If you choose to resubmit, the second submission will be considered final and subject to grading. Once the due date for the assignment passes, you may not resubmit to lower a Turnitin score.

This assignment will follow the late assignment policy specified in the course syllabus.

Students are expected to submit assignments by the time they are due. Assignments submitted after the due date and time will receive a deduction of 10% of the total points possible for that assignment for each day the assignment is late. Assignments will be accepted, with penalty as described, up to a maximum of three days late, after which point a zero will be recorded for the assignment.

In the event of a situation that prevents timely submission of an assignment, students may petition their instructor for a waiver of the late submission grade reduction. The instructor will review the student’s rationale for the request and make a determination based on the merits of the student’s appeal. Consideration of the student’s total course performance to date will be a contributing factor in the determination. Students should continue to attend class, actively participate, and complete other assignments while the appeal is pending.

Total Points Possible: 50

Preparing the Paper:

  1. The State Specific Guidelines for Prescribing Controlled Substances paper is worth 50 points and will be graded on the quality of the content, use of citations, use of Standard English grammar, sentence structure, and overall organization based on the required components as summarized in the directions and grading criteria/rubric.
  2. Submit the paper as a Microsoft Word Document, which is the required format at Chamberlain University. You are encouraged to use the APA Academic Writer when creating your assignment.
  3. Follow the directions below and the grading criteria located in the rubric closely. Any questions about this paper may be posted under the Q & A Forum or emailed to your faculty.
  4. The length of the paper should be 2-4 pages, excluding title page and reference page(s). The title and reference pages should be in APA format.
  5. Sources should be obtained directly from the state’s regulatory organization(s) and must be cited appropriately.
  6. It is recommended that you keep a copy of this paper to provide to potential employers or your Board of Nursing in order to demonstrate your knowledge of your state laws.

Requirements:

I. Guidelines and recommendations for your state:

In response to the opioid epidemic, individual states have developed and adopted voluntary guidelines or recommendations for the treatment of acute and chronic non-cancer pain. Based on research done on the state where you will practice clinically, include the following:

  1. Provide the name of your practicing state’s organization, group or task force that created guidelines or recommendations for pain management therapies and education.
  2. Briefly describe an overview of its development and include a web address where this information can be found. If your state does not have guidelines, discuss a federal guideline. (Note: you may need to contact your state’s board of nursing, pharmacy or medicine if you cannot locate it on your own).
  3. Some states have multiple organizations or initiatives (ex: Ohio) in place to combat the opioid epidemic and advocate for safer opioid prescribing. Discuss whether or not your state has other resources, groups or organizations where prescribers can reference best practices for pain management treatment. If applicable, provide a brief overview of the group’s recommendations or initiatives. If your state does not have another state-specific resource, discuss the guidelines published by the American Pain Society.

II. State specific laws on controlled substance prescribing for the nurse practitioner:

Research your state laws on advanced practice nurses’ authority to prescribe controlled substances. Based on research done on the state where you will practice clinically, include the following:

  1. Identify the law, rule, code or statute that describes the advanced practice nurse’s authority to prescribe controlled substances in your state.
  2. Discuss the provisions of the law, rule, code or statute with regard to the following:
    • Conditions or limits on prescribing schedule I-V controlled substances.
    • Requirements (if any) in documentation for treating acute and chronic pain.
    • Are there specific requirements for advanced practice nurses to reference the state’s prescription drug monitoring database before prescribing a controlled substance?  If so, what are they?

III. State Prescription Drug Monitoring Program (PDMP):

Research your state’s PDMP* and provide the following information:

  1. Name of the state’s program.
  2. Website for the state PMDP.
  3. Discuss the registration requirements and process.
  4. Discuss the standards and procedures for the access and review of database information.

* As of 2019, all states except Missouri have a PDMP. If you will be practicing in Missouri, please research one of the bordering states to complete this section.

ASSIGNMENT CONTENT

Category

Points

%

Description

State specific guidelines and recommendations

15

30%

The student:

  1. Provides the name of their practicing state’s organization, group or task force that created guidelines or recommendations for pain management therapies and education.
  2. Briefly describes an overview of its development.
  3. Includes the web address where this information can be found. If the student’s state does not have guidelines, a federal guideline is discussed.
  4. Discusses whether or not their state has other resources, groups or organizations where prescribers can reference best practices for pain management treatment.
  5. Provides a brief overview of that group’s recommendations or initiatives. If the student’s state does not have another state-specific resource, discuss the guidelines published by the American Pain Society.

 

(5 required elements)

State specific laws on controlled substance prescribing for the nurse practitioner

 

15

30%

The student:

  1. Identifies the law, rule, code or statute that describes the advanced practice nurse’s authority to prescribe controlled substances in their state.
  2. Discusses conditions or limits on prescribing schedule I-V controlled substances.
  3. Discusses the requirements (if any) in documentation for treating acute and chronic pain.
  4. Identifies whether or not there are specific requirements for advanced practice nurses to reference the state’s prescription drug monitoring database before prescribing a controlled substance?

( 4 required elements)

State Prescription Drug Monitoring Program (PDMP)

 

 

15

30%

The student:

  1. Provides the name of the state’s PDMP.
  2. Provides the web address for the state’s PMDP.
  3. Discusses the program’s registration requirements and processes.
  4. Discusses the standards and procedures for the access and review of database information.

( 4 required elements)

 

 

 

Total CONTENT Points= 45 points

ASSIGNMENT FORMAT

Category

Points

%

Description

Organization, spelling, grammar and APA format

5

10%

There are minimal APA errors.

 

 

 

Total FORMAT Points= 5 points

 

 

 

ASSIGNMENT TOTAL=50 points

Rubric

NR565_WK2_State Specific Guidelines for Prescribing

NR565_WK2_State Specific Guidelines for Prescribing

CriteriaRatingsPts

This criterion is linked to a Learning OutcomeState specific guidelines and recommendations

The student:1. Provides the name of their practicing state’s organization, group or task force that created guidelines or recommendations for pain management therapies and education.2. Briefly describes an overview of its development.3. Includes the web address where this information can be found. If the student’s state does not have guidelines, a federal guideline is discussed.4. Discusses whether or not their state has other resources, groups or organizations where prescribers can reference best practices for pain management treatment.5. Provides a brief overview of that group’s recommendations or initiatives. If the student’s state does not have another state-specific resource, discuss the guidelines published by the American Pain Society.(5 required elements)

15.0 pts

Excellent

All 5 required elements are present.

14.0 pts

V. Good

4 required elements are present.

12.0 pts

Satisfactory

2-3 required elements are present.

8.0 pts

Needs Improvement

1 required element is present.

0.0 pts

Unsatisfactory

0 required elements are present.

15.0 pts

This criterion is linked to a Learning OutcomeState specific laws on controlled substance prescribing for the nurse practitioner

The student:1. Identifies the law, rule, code or statute that describes the advanced practice nurse’s authority to prescribe controlled substances in their state.2. Discusses conditions or limits on prescribing schedule I-V controlled substances.3. Discusses the requirements (if any) in documentation for treating acute and chronic pain.4. Identifies whether or not there are specific requirements for advanced practice nurses to reference the state’s prescription drug monitoring database before prescribing a controlled substance?(4 required elements)

15.0 pts

Excellent

All 4 required elements are present.

14.0 pts

V. Good

3 required elements are present.

12.0 pts

Satisfactory

2 required elements are present.

8.0 pts

Needs Improvement

1 required element is present.

0.0 pts

Unsatisfactory

0 required elements are present.

15.0 pts

This criterion is linked to a Learning OutcomeState Prescription Drug Monitoring Program (PDMP)

The student:1. Provides the name of the state’s PDMP.2. Provides the web address for the state’s PMDP.3. Discusses the program’s registration requirements and processes.4. Discusses the standards and procedures for the access and review of database information.(4 required elements)

15.0 pts

Excellent

All 4 required elements are present.

14.0 pts

V. Good

3 required elements are present.

12.0 pts

Satisfactory

2 required elements are present.

8.0 pts

Needs Improvement

1 required element is present.

0.0 pts

Unsatisfactory

0 required elements are present.

15.0 pts

This criterion is linked to a Learning OutcomeAPA Formatting:

There are minimal APA errors.

5.0 pts

Excellent

0 to 1 APA error is present.

4.0 pts

V. Good

2–3 APA errors are present.

3.0 pts

Satisfactory

4–5 APA errors are present.

2.0 pts

Needs Improvement

6–7 APA errors are present.

0.0 pts

Unsatisfactory

8 or more APA errors are present.

5.0 pts

This criterion is linked to a Learning OutcomeLate penalty deductions

Students are expected to submit assignments by the time they are due. Assignments submitted after the due date and time will receive a deduction of 10% of the total points possible for that assignment for each day the assignment is late. Assignments will be accepted, with penalty as described, up to a maximum of three days late, after which point a zero will be recorded for the assignment. Quizzes and discussions are not considered assignments and are not part of the late assignment policy.

0.0 pts

Manual Deductions

0.0 pts

Manual Deductions

0.0 pts

Total Points: 50.0

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pathophysiology

Week 8 Reflection Discussion

22 unread replies.22 replies.

Purpose

The purpose of this discussion is to reflect over the past 8 weeks and describe how the achievement of the course outcomes in this course have prepared you to meet the MSN program outcome #1, MSN Essential I, and Nurse Practitioner Core Competencies # 1 Scientific Foundation Competencies

Activity Learning Outcomes

Through this discussion, the student will demonstrate the ability to:

  1. Provide evidence of meeting the achievement of course outcomes (CO 1, 2, 3, 4, 5)
  2. Provide evidence of meeting MSN program outcome 1 (CO 1, 2, 3, 4, 5) 
  3. Provide evidence of meeting Nurse Practitioner Core Competency 1 (CO 1, 2, 3, 4, 5)

Due Date: 

Saturday, Week 8 by 11:59 p.m. MST. NOTHING will be accepted after 11:59pm MT on Saturday 11:59 pm MT. 

Total Points Possible:  50 

Requirements:

Reflect over the past 8 weeks and describe how the achievement of the course outcomes in this course have prepared you to meet the MSN program outcome #1, MSN Essential I, and Nurse Practitioner Core Competencies # 1 Scientific Foundation CompetenciesProgram Outcome #1: Provide high quality, safe, patient-centered care grounded in holistic health principles. (holistic health & patient-centered care)

MSN Essential I: Background for Practice from Sciences and Humanities:

Recognizes that the master’s prepared nurse integrates scientific findings from nursing, biopsychosocial fields, genetics, public health, quality improvement, and organizational sciences for the continual improvement of nursing care across diverse settings.

Nurse Practitioner Core Competencies # 1 Scientific Foundation Competencies

  1. Critically analyzes data and evidence for improving advanced nursing practice.
  2. Integrates knowledge from the humanities and sciences within the context of nursing science.
  3. Translates research and other forms of knowledge to improve practice processes and outcomes.
  4. Develops new practice approaches based on the integration of research, theory, and practice knowledge.

DISCUSSION CONTENT

Category

Points

%

Description

Program Outcome Achievement

15

15%

  1. The reflection specifically identifies and addresses the pre-determined program outcome; AND
  2. Provides two (2) or more examples of how the student specifically achieved or had exposure to this outcome during this course.

MSN Essential Competency Achievement

15

15%

  1. The reflection specifically identifies and addresses the pre-determined MSN Essential Competency; AND
  2. Provides two (2) or more examples of how the student specifically achieved or had exposure to this competency during the course.

NP Competency Achievement

15

15%

  1. The reflection specifically identifies and addresses the pre-determined NP core Competency; AND
  2. Provides two (2) or more examples of how the student specifically achieved or had exposure to this competency during this course.

 

45

90%

Total CONTENT Points= 45 pts

DISCUSSION FORMAT

Category

Points

%

Description

Grammar, Syntax, Spelling, & Punctuation

 

5

5%

Grammar, spelling, and/or punctuation are accurate, or with zero to one error.

Direct quotes in discussions are limited to one short quotation (not to exceed 15 words). The quote adds substantively to the discussion. 

(*) APA style references and in text citations are required; however, there are no deductions for errors in indentation or spacing of references. All elements of the reference otherwise must be included.

 

5

10%

Total FORMAT Points= 5 pts

 

 

 

DISCUSSION TOTAL=50points

 

 

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pathophysiology

Week 7: Recorded Disease Process Presentation Peer Review

22 unread replies.22 replies.

Purpose

The purpose of this assignment is for learners to:

  • Develop professional presentation/communication skills.
  • Demonstrate an advancing understanding of pathophysiological processes of body systems that result in the diagnosis and treatment of patients who present with these disorders in these systems.
  • Demonstrate the ability to analyze the literature to obtain the most current, evidence-based resources on the assigned disease process
  • Demonstrate and practice professional communication and leadership, while advancing the education of peers.

Due Date:  THURSDAY, 11:59 P.M. MT WEEK 7

Course outcomes

  1. Analyze pathophysiological mechanisms associated with select disease states
  2. Relate research findings to the management of patients with complex pathophysiologic dysfunction

Total Points Possible: 50 points

Requirements

Description of the Assignment

Students are to review at least one peer Disease Process Presentation using the guidelines below. The peer review is due by Thursday, 11:59 p.m. MT.Week 7

Criteria for Content

When reviewing a peer’s presentation, choose two of the criteria below and create questions, comments and feedback that center’s on the peer’s content provided under the chosen criteria. In your posting, clearly identify the two criteria chosen for the review. Suggested ways to review a peer’s presentation is to expound on the content provided under a given criterion by providing additional information or other points that could have also been included; ask pertinent questions that allows the peer to clarify and further expound on the criteria; if you disagree with a point made by a peer, explain why and provide further information supported by evidence to defend your position.

  1. Introduce the disease with a brief definition and description.
  2. Discuss the risk factors and the connection to the etiology of the initial injury to the cell/tissue/organ.
  3. Discuss health care provider implications for prevention of the disease.
  4. Show the progression from the initial injury to the defect in the tissue, organ and system functioning.
  5. Link changes in the tissue, organ, and system functioning to the initial presenting signs and symptoms seen in primary care of the disease.
  6. Provide a brief description of how the disease is diagnosed.
  7. Provide a brief description of the pharmacological and non-pharmacological interventions used to treat and manage the disease.
  8. Summarizes the disease on final slide with concluding remarks; includes implication for nurse practitioner practice.
  9. Utilizes at least two current (within 5 years), peer-review scholarly sources to support presentation content.
  10. Reference slide and in-text citations depict references correctly cited according to APA.

 

Students are to review at least one peer’s recorded the presentation and respond to it by Thursday, 11:59 p.m. MT using the Disease Process Peer Review Guidelines.

Presenters are also required to monitor comments and questions from peers and faculty about their presentations and respond appropriately. Make sure to respond to all faculty questions. All responses are due by Sunday 11:59 p.m. MT.

 

**To see view the grading criteria/rubric, please click on the 3 dots in the box at the end of the solid gray bar above the discussion board title and then Show Rubric.

 

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pathophysiology

Week 7 Disease Process Presentation Part 3

Submit Assignment

  • Due Tuesday by 11:59pm
  • Points 200
  • Submitting a text entry box or a media recording

Purpose

This assignment is a culmination of the assignments created in Weeks 2 and 5. Students are expected to incorporate the faculty feedback received on the Week 2 and Week 5 assignments to create the final presentation. The Week 7 presentation is an audio/video recording that is developed using Kaltura. The final presentation will include the student’s voice (audio) along with face clearly visible (video). Students have the opportunity to demonstrate professional presentation/communication and deep knowledge regarding pathophysiology, diagnosis and treatment about a selected disease process. 

Activity Learning Outcomes

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

  1. Demonstrate professional presentation/communication skills.
  2. Demonstrate understanding of the risk factors for disease development. (CO 3)
  3. Demonstrate understanding of the progression of a disease from the initial injury to the defect in the tissue, organ and system functioning. (CO 1, 2)
  4. Link development of presenting signs and symptoms of disease to changes to tissue, organ and system functioning. (CO 3)
  5. Describe how the disease is diagnosed (CO 1, 2)
  6. Describe pharmacological and non-pharmacological interventions for disease management (CO 4)
  7. Describe the role of the health care provider in the prevention of the disease (CO 4)

 

Due Date: Tuesday11:59 PM MT of Week 7

Students are expected to submit assignments by the time they are due. Assignments submitted after the due date and time will receive a deduction of 10% of the total points possible for that assignment for each day the assignment is late. Assignments will be accepted, with penalty as described, up to a maximum of three days late, after which point a zero will be recorded for the assignment. Quizzes and discussions are not considered assignments and are not part of the late assignment policy.

 

Total Points Possible:  200 points 

Requirements:

Content Criteria: 

  1. Introduce the disease with a brief definition and description.
  2. Discuss the Risk Factors and the connection to the Etiology of the initial injury to the cell/tissue/organ.
  3. Discuss health care provider implications for prevention of the disease.
  4. Show the progression from the initial injury to the defect in the tissue, organ and system functioning.
  5. Link changes in the tissue, organ, and system functioning to the initial presenting signs and symptoms seen in primary care of the disease.
  6. Provide a brief description of how the disease is diagnosed.
  7. Provide a brief description of the pharmacological and non-pharmacological interventions used to treat and manage the disease.
  8. Summarizes the disease on final slide with concluding remarks; includes implication for nurse practitioner practice.
  9. Utilizes at least two current (within 5 years), peer-reviewed scholarly sources to support presentation content.
  10. Reference slide and in-text citations depict references correctly cited according to APA.

Format Criteria: 

  1. The presentation should include an audio/video PowerPoint presentation created using Kaltura. The student’s voice must be clearly heard (audio) and the student’s face clearly seen on the video.
  2. There is no slide length requirements. However, the presentation should be no more than 15-20 minutes in recorded length.
  3. The presentation should contain appropriate evidence to support the information presented in APA format.
  4. The presentation slides should be used as cues to topics and key concepts without lengthy sentences and paragraphs- reading information from slides is not professional and therefore not acceptable.
  5. Students should demonstrate understanding and mastery of content via discussion style presentation.

Technology Requirements

The instructions for using Kaltura are located under Resources.

PowerPoint Tips to ensure a professional and organized presentation: 

  1. All font types, size, and color should be the same throughout the presentation
  2. The Title slide should contain: student name, course, professor and title of the presentation
  3. Avoid putting too much information in the slides. Use bullets to highlight main points and then use speaker notes to provide more specifics related to the slide content
  4. The use of pictures and figures are encouraged, however, avoid overcrowding the slides with pictures and figures
  5. Follow the rubric requirements in chronological order to ensure an organized flow of content
  6. Use proper background color so there is good contrast between font color and background

 

ASSIGNMENT CONTENT

Category

Points

%

Description

Application of Course Knowledge

70

70%

  1. Introduces the disease with brief definition and description.
  2. Links risk factors to disease etiology.
  3. Shows progression from the initial injury to the defect in the tissue, organ, and system functioning.
  4. Links changes in the tissue, organ, and system functioning to the initial presenting signs and symptoms seen in primary care of the disease.
  5. Provides a brief description of how the disease is diagnosed
  6. Provides a brief description of the pharmacological and non-pharmacological interventions used to treat and manage the disease.
  7. Discusses role of nurse practitioners in disease prevention, diagnosis and management.  

Support from Evidence-Based Practice

60

60%

  1. Assignment content is supported with appropriate, scholarly sources; AND 
  2. Sources are published within the last 5 years (unless it is the most current clinical practice guideline (CPG); AND
  3. Reference list is provided on reference slide(s) at the end of the presentation match; AND
  4. In-text citations are included on slides where appropriate

Summary of Main Points Highlighted in the Presentation

50

50%

  1. Provides a summary slide at the end of the presentation
  2. States the name of the assigned disease
  3. Main points are highlighted that clearly reflects coverage of all assignment criteria related to the assigned disease
  4. Highlights the role of the nurse practitioner in prevention, diagnosis and management of the assigned disease

Professionalism/ Organization

10

10%

  1. Presentation format flows in a logical, smooth manner
  2. Voice is clearly audible
  3. Face is clearly seen on the video
  4. Slides are developed using main headings that reflect the assignment topics
  5. Slides contain clear bullet points
  6. Slides are used as cues to topics and key concepts without lengthy sentences and paragraphs
  7. Presentation adheres to 15-20 minute time limit

 

190

95%

Total CONTENT Points= 190 pts

ASSIGNMENT FORMAT

Category

Points

%

Description

Grammar, Syntax, APA

10

5%

APA format, grammar, spelling, and/or punctuation are accurate, or with zero to one errors.

 

200

100%

Total FORMAT Points= 10 pts

 

 

 

ASSIGNMENT TOTAL=200points

 

 

Rubric

NR507 Wk7 Disease Process Pres_Pt 3_Sept19

NR507 Wk7 Disease Process Pres_Pt 3_Sept19

CriteriaRatingsPts

This criterion is linked to a Learning OutcomeApplication of Course Knowledge

1. Introduces the disease with brief definition and description.2. Links risk factors to disease etiology.3. Shows progression from the initial injury to the defect in the tissue, organ, and system functioning.4. Links changes in the tissue, organ, and system functioning to the initial presenting signs and symptoms seen in primary care of the disease.5. Provides a brief description of how the disease is diagnosed6. Provides a brief description of the pharmacological and non-pharmacological interventions used to treat and manage the disease.7. Discusses role of nurse practitioners in disease prevention, diagnosis and management.

70.0 pts

Excellent

The presentation includes all required elements

64.0 pts

V. Good

1 required element is missing

58.0 pts

Satisfactory

2-3 required elements are missing

35.0 pts

Needs Improvement

4-6 required elements are missing

0.0 pts

Unsatisfactory

All 7 required elements are missing

70.0 pts

This criterion is linked to a Learning OutcomeSupport from Evidence-Based Practice

1. Assignment content is supported with appropriate, scholarly sources; AND2. Sources are published within the last 5 years (unless it is the most current clinical practice guideline (CPG); AND3. Reference list is provided on reference slide(s) at the end of the presentation match; AND4. In-text citations are included on slides where appropriate

60.0 pts

Excellent

The presentation includes all required elements

55.0 pts

V. Good

1 required element is missing

50.0 pts

Satisfactory

2 required elements are missing

30.0 pts

Needs Improvement

3 required elements are missing

0.0 pts

Unsatisfactory

All 4 required elements are missing

60.0 pts

This criterion is linked to a Learning OutcomeSummary of Main Points Highlighted in the Presentation

1. Provides a summary slide at the end of the presentation2. States the name of the assigned disease3. Main points are highlighted that clearly reflects coverage of all assignment criteria related to the assigned disease4. Highlights the role of the nurse practitioner in prevention, diagnosis and management of the assigned disease

50.0 pts

Excellent

The presentation includes all required elements

46.0 pts

V. Good

1 required element is missing

42.0 pts

Satisfactory

2 required elements are missing

25.0 pts

Needs Improvement

3 required elements are missing

0.0 pts

Unsatisfactory

All 4 required elements are missing

50.0 pts

This criterion is linked to a Learning OutcomeProfessionalism/ Organization

1. Presentation format flows in a logical, smooth manner, adhering to the 15-20 minute time limit2. Slides are developed using main headings that reflect the assignment topics3. Slides contain clear bullet points4. Slides are used as cues to topics and key concepts without lengthy sentences and paragraphs

10.0 pts

Excellent

The presentation includes all required elements

9.0 pts

V. Good

1 required element is missing

8.0 pts

Satisfactory

2 required elements are missing

5.0 pts

Needs Improvement

3 required elements are missing

0.0 pts

Unsatisfactory

All 4 required elements are missing

10.0 pts

This criterion is linked to a Learning OutcomeGrammar, Spelling, Syntax, APA

10.0 pts

Excellent

Grammar, syntax, spelling, and punctuation are accurate, or with zero to one error.

9.0 pts

V. Good

2-4 errors in grammar, syntax, spelling and punctuation noted

8.0 pts

Satisfactory

5-7 errors in grammar, syntax, spelling and punctuation noted

5.0 pts

Needs Improvement

8-9 errors in grammar, syntax, spelling and punctuation noted

0.0 pts

Unsatisfactory

Presentation contains 10 or greater errors in grammar, syntax, spelling and punctuation noted or repeatedly makes the same errors after faculty feedback

10.0 pts

This criterion is linked to a Learning OutcomeLate penalty deductions

Students are expected to submit assignments by the time they are due. Assignments submitted after the due date and time will receive a deduction of 10% of the total points possible for that assignment for each day the assignment is late. Assignments will be accepted, with penalty as described, up to a maximum of three days late, after which point a zero will be recorded for the assignment. Quizzes and discussions are not considered assignments and are not part of the late assignment policy.

0.0 pts

Manual Deductions

0.0 pts

Manual Deductions

0.0 pts

Total Points: 200.0

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pathophysiology

Week 6 Discussion

22 unread replies.22 replies.

Purpose

The purpose of this discussion is to apply pathophysiological concepts to a child presenting with dermatological dysfunction (urticaria). Related concepts will also be applied that includes alterations in immunity/inflammation, fluid and electrolytes, acid/base balance and pulmonary function.

Activity Learning Outcomes

Through this discussion, the student will demonstrate the ability to:

  1. Explore age-specific and developmental alterations in the dermatological system. (CO 3, 1)
  2. Relate pathophysiological alterations in dermatological processes to the development, diagnosis and treatment of common skin disorders. (CO 4, 2)
  3. Examine current evidence to support the management of patients who present with alterations in the dermatologic system. (CO 5, 3)

Due Date: 

The student must provide an answer to the graded discussion topic posted by the course instructor, by Wednesday, 11:59 p.m. MT, of each week.

Students must post a minimum of two times (response to peers) in the graded discussion. The two posts in the discussion must be on separate days.  Posting twice on two different days meets the minimum requirement.  For full credit, the student must post at least three substantive posts on three different days.In addition, students must respond to all faculty questions.

A 10% late penalty will be imposed for discussions posted after the deadline on Wednesday, 11:59 p.m. MT regardless of the number of days late. NOTHING will be accepted after 11:59pm MT on Sunday (i.e. student will receive an automatic 0). Week 8 discussion closes on Saturday at 11:59pm MT.

A 10% penalty will be imposed for not entering the minimum number/type of interactive dialogue posts OR not posting on the minimum required number of days. NOTHING will be accepted after 11:59pm MT on Sunday (i.e. student will receive an automatic 0).

Total Points Possible:  100 points

Requirements:

A 12-year-old boy is brought to the office for evaluation of hives. He has no significant past medical history and no history of allergies. He has just joined the middle school soccer team and noticed that he gets hives about 10 minutes into practice. The hives are itchy and consist of irregular blotches on his legs and trunk, about 10–20 cm in size, and they persist for about 30 minutes. He does not experience swelling of the lips or oropharynx and denies any wheezing or shortness of breath. His physical examination is normal without skin lesions or oral swelling at that moment, and his lungs are clear. After evaluation, he is diagnosed with urticaria.

  1. Discuss the likely cause of the patient’s urticaria.
  2. Describe the cellular mechanism of urticaria and how it leads to the signs and symptoms experienced by the patient.
  3. Describe the relationship between the patient’s symptoms and the concept of inflammation.
  4. What pharmacological and non-pharmacologic treatment options are available? 
  5. Discuss the complications of urticaria.
  6. What teaching would be appropriate to provide the parent and child about urticaria?
  7. Support your response with at least one current evidence based resource

 

DISCUSSION CONTENT

Category

Points

%

Description

Application of Course Knowledge

30

30%

  1. Posts make direct reference to concepts discussed in the lesson or drawn from relevant, evidence based outside sources, AND
  2. Posts are on topic and answer all presented questions which demonstrates a solid understanding of the topic.
  3. Applies concepts to personal experience in the professional setting and or relevant application to real life, AND
  4. Decisions are well supported with evidence-based arguments that are in-line with the scenario; AND
  5. Proper rationale and reasoning skills are demonstrated; AND
  6. Information is taken from source(s) with appropriate interpretation/evaluation to develop a comprehensive analysis or synthesis of the topic

Support From Evidence Based Practice

30

30%

  1. Discussion post is supported with appropriate, scholarly sources; AND
  2. Sources are published within the last 5 years (unless it is the most current clinical practice guideline (CPG); AND
  3. Reference list is provided and in-text citations match; AND
  4. Provides relevant evidence of scholarly inquiry clearly stating how the evidence informed or changed professional or academic decisions

Interactive Dialogue

30

30%

  1. Student provides a substantive* response to at least two topic-related posts of a peer; AND
  2. Evidence from appropriate scholarly sources are included; AND
  3. Reference list is provided and in-text citations match; AND
  4. Student responds to all direct faculty questions OR if student was not asked a direct question,student responds to either a 3rd peer post or a faculty question directed towards another student

(*) A substantive post adds new content or insights to the discussion thread and information from student’s original post is not reused in peer or faculty response

 

90

90%

Total CONTENT Points= 90 pts

DISCUSSION FORMAT

Category

Points

%

Description

Grammar, Syntax, Spelling, & Punctuation

 

10

10%

Grammar, spelling, and/or punctuation are accurate, or with zero to one error.

Direct quotes in discussions are limited to one short quotation (not to exceed 15 words). The quote adds substantively to the discussion. 

(*) APA style references and in text citations are required; however, there are no deductions for errors in indentation or spacing of references. All elements of the reference otherwise must be included.

 

10

10%

Total FORMAT Points= 10 pts

 

 

 

DISCUSSION TOTAL=100 points

 

 

 

 

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pathophysiology

Week 5: Disease Process Presentation Assignment Part 2

Submit Assignment

  • Due Feb 9 by 11:59pm
  • Points 100
  • Submitting a file upload

Purpose

The purpose of this assignment is to build on the presentation developed in Week 2. To ensure timely development of the final Week 7 assignment and an opportunity to receive feedback from the faculty, students will develop the Week 7 presentation in 2 parts.  Parts 1 and 2 will be submitted as a PowerPoint presentation that contains thorough speaker notes. After students have received faculty feedback on Parts 1 and 2, students will develop the final presentation that is audio and video (with face showing) recorded in Kaltura and uploaded to the Week 7 Discussion Board. Week 5 begins the development of Part 2 of the Disease Process Presentation. It entails students linking the pathophysiological alterations at the tissue, organ and system levels to the patient’s presenting signs and symptoms. Students will also describe how the disease is diagnosed and the pharmacological and non-pharmacological interventions for disease management. 

Activity Learning Outcomes

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

  1. Develop professional presentation/communication skills.
  2. Link development of presenting signs and symptoms of disease to changes to tissue, organ and system functioning. (CO 3)
  3. Describe how the disease is diagnosed (CO 1, 2)
  4. Describe pharmacological and non-pharmacological interventions for disease management (CO 4)

Due Date: Sunday 11:59 PM MT at the end of Week 5

Students are expected to submit assignments by the time they are due. Assignments submitted after the due date and time will receive a deduction of 10% of the total points possible for that assignment for each day the assignment is late. Assignments will be accepted, with penalty as described, up to a maximum of three days late, after which point a zero will be recorded for the assignment. Quizzes and discussions are not considered assignments and are not part of the late assignment policy.

 

Total Points Possible:  100 points

Requirements:

Content Criteria: 

  1. Link changes in the tissue, organ, and system functioning to the initial presenting signs and symptoms seen in primary care of the disease.
  2. Provide a brief description of how the disease is diagnosed.
  3. Provide a brief description of the pharmacological and non-pharmacological interventions used to treat and manage the disease.
  4. Summarizes the disease on the final slide with concluding remarks; includes implication for nurse practitioner practice.
  5. Utilizes at least two current (within 5 years), peer-review scholarly sources to support presentation content.
  6. Reference slide and in-text citations depict references correctly cited according to APA.

Format Criteria: 

  1. The presentation should include a PowerPoint presentation that contains detailed speaker notes.
  2. The presentation contain main heading slides that address the assignment criteria listed above.
  3. The presentation should contain appropriate evidence to support the information presented per APA format.
  4. Slides should be used as cues to topics and key concepts without lengthy sentences and paragraphs
  5. The presentation should contain a reference slide with all sources written in APA format

Technology Requirements

The instructions for using Kaltura are located under Resources.

PowerPoint Tips to ensure a professional and organized presentation: 

  1. All font types, size, and color should be the same throughout the presentation
  2. The Title slide should contain: student name, course, professor and title of the presentation
  3. Avoid putting too much information in the slides. Use bullets to highlight main points and then use speaker notes to provide more specifics related to the slide content
  4. The use of pictures and figures are encouraged, however, avoid overcrowding the slides with pictures and figures
  5. Follow the rubric requirements in chronological order to ensure an organized flow of content
  6. Use proper background color so there is good contrast between font color and background

 

ASSIGNMENT CONTENT

Category

Points

%

Description

Application of Course Knowledge

35

35%

The presentation includes all required concepts: 

  1. Links changes in the tissue, organ and system functioning to the initial presenting signs symptoms. 
  2. Provides a brief description of how the disease is diagnosed. 
  3. Provides a brief description of the pharmacological and non-pharmacological interventions used in disease management.
  4. Explains the role of the nurse practitioner in diagnosing and managing the disease

Support from Evidence-Based Practice

30

30%

  1. Assignment content is supported with appropriate, scholarly sources; AND 
  2. Sources are published within the last 5 years (unless it is the most current clinical practice guideline (CPG); AND
  3. Reference list is provided on reference slide(s) at the end of the presentation match; AND
  4. In-text citations are included on slides where appropriate

 

Summary of Main Points Highlighted in the Presentation

25

25%

  1. Provides a summary slide at the end of the presentation
  2. States the name of the assigned disease
  3. Main points are highlighted that clearly reflects coverage of all assignment criteria related to the assigned disease
  4. Highlights the role of the nurse practitioner in diagnosis and management of the assigned disease

Professionalism/ Organization

5

5%

  1. Presentation format flows in a logical, smooth manner, utilizing no more than 8-10 slides, including reference slides
  2. Slides are developed using main headings that reflect the assignment topics
  3. Slides contain clear bullet points
  4. Slides are used as cues to topics and key concepts without lengthy sentences and paragraphs

 

95

95%

Total CONTENT Points= 95 pts

ASSIGNMENT FORMAT

Category

Points

%

Description

Grammar, Syntax, APA

5

5%

APA format, grammar, spelling, and/or punctuation are accurate, or with zero to one errors.

 

5

5%

Total FORMAT Points= 5 pts

 

 

 

ASSIGNMENT TOTAL=100 points

 

 

Rubric

NR507 Disease Process Pres_Pt2 Sept19

NR507 Disease Process Pres_Pt2 Sept19

CriteriaRatingsPts

This criterion is linked to a Learning OutcomeApplication of Course Knowledge

1. Links changes in the tissue, organ and system functioning to the initial presenting signs symptoms.2. Provides a brief description of how the disease is diagnosed.3. Provides a brief description of the pharmacological and non-pharmacological interventions used in disease management.4. Explains the role of the nurse practitioner in diagnosing and managing the disease

35.0 pts

Excellent

The presentation includes all required elements

32.0 pts

V. Good

1 required element is missing

29.0 pts

Satisfactory

2 required elements are missing

18.0 pts

Needs Improvement

3 required elements are missing

0.0 pts

Unsatisfactory

All required elements are missing

35.0 pts

This criterion is linked to a Learning OutcomeSupport from Evidence-Based Practice

1 Assignment content is supported with appropriate, scholarly sources; AND2 Sources are published within the last 5 years (unless it is the most current clinical practice guideline (CPG); AND3 Reference list is provided on reference slide(s) at the end of the presentation match; AND4 In-text citations are included on slides where appropriate

30.0 pts

Excellent

The presentation includes all required elements

27.0 pts

V. Good

1 required element is missing

24.0 pts

Satisfactory

2 required elements are missing

15.0 pts

Needs Improvement

3 required elements are missing

0.0 pts

Unsatisfactory

All required elements are missing

30.0 pts

This criterion is linked to a Learning OutcomeSummary of Main Points Highlighted in the Presentation

1. Provides a summary slide at the end of the presentation2. States the name of the assigned disease3. Main points are highlighted that clearly reflects coverage of all assignment criteria related to the assigned disease4. Highlights the role of the nurse practitioner in diagnosis and management of the assigned disease

25.0 pts

Excellent

The presentation includes all required elements

23.0 pts

V. Good

1 required element is missing

20.0 pts

Satisfactory

2 required elements are missing

13.0 pts

Needs Improvement

3 required elements are missing

0.0 pts

Unsatisfactory

All required elements are missing

25.0 pts

This criterion is linked to a Learning OutcomeProfessionalism/ Organization

1. Presentation format flows in a logical, smooth manner, utilizing no more than 8-10 slides, including reference slides2. Slides are developed using main headings that reflect the assignment topics3. Slides contain clear bullet points4. Slides are used as cues to topics and key concepts without lengthy sentences and paragraphs

5.0 pts

Excellent

The presentation includes all required elements

4.0 pts

V. Good

1 required element is missing

3.0 pts

Satisfactory

2 required elements are missing

2.0 pts

Needs Improvement

3 required elements are missing

0.0 pts

Unsatisfactory

All required elements are missing

5.0 pts

This criterion is linked to a Learning OutcomeGrammar, Spelling, Syntax, APA

APA format, grammar, spelling, and/or punctuation are accurate, or with zero to one errors.

5.0 pts

Excellent

Grammar, syntax, spelling, and punctuation are accurate, or with zero to one error.

4.0 pts

V. Good

2-4 errors in grammar, syntax, spelling and punctuation noted

3.0 pts

Satisfactory

5-7 errors in grammar, syntax, spelling and punctuation noted

2.0 pts

Needs Improvement

8-9 errors in grammar, syntax, spelling and punctuation noted

0.0 pts

Unsatisfactory

Presentation contains ten or greater errors in grammar, syntax, spelling and punctuation noted or repeatedly makes the same errors after faculty feedback

5.0 pts

This criterion is linked to a Learning OutcomeLate penalty deductions

Students are expected to submit assignments by the time they are due. Assignments submitted after the due date and time will receive a deduction of 10% of the total points possible for that assignment for each day the assignment is late. Assignments will be accepted, with penalty as described, up to a maximum of three days late, after which point a zero will be recorded for the assignment. Quizzes and discussions are not considered assignments and are not part of the late assignment policy.

0.0 pts

Manual Deductions

0.0 pts

Manual Deductions

0.0 pts

Total Points: 100.0

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pathophysiology

Week 3 Discussion

No unread replies.No replies.

Purpose

The purpose of this discussion is to apply pathophysiological concepts to an individual presenting with cardiovascular dysfunction (heart failure). Related concepts will also be applied that includes potential alterations in fluid and electrolytes and acid/base balance.

Activity Learning Outcomes

Through this discussion, the student will demonstrate the ability to:

  1. Explore age-specific and developmental alterations in the cardiovascular system. (CO 3, 1)
  2. Relate pathophysiological alterations in cardiovascular processes to the development, diagnosis and treatment of heart failure. (CO 4, 2)
  3. Examine current evidence to support the management of patients who present with alterations in the cardiovascular system. (CO 5, 3)

 

Due Date: 

The student must provide an answer to the graded discussion topic posted by the course instructor, by Wednesday, 11:59 p.m. MT, of each week.

Students must post a minimum of two times (response to peers) in the graded discussion. The two posts in the discussion must be on separate days.  Posting twice on two different days meets the minimum requirement.  For full credit, the student must post at least three substantive posts on three different days.In addition, students must respond to all faculty questions.

A 10% late penalty will be imposed for discussions posted after the deadline on Wednesday, 11:59 p.m. MT regardless of the number of days late. NOTHING will be accepted after 11:59pm MT on Sunday (i.e. student will receive an automatic 0). Week 8 discussion closes on Saturday at 11:59pm MT.

A 10% penalty will be imposed for not entering the minimum number/type of interactive dialogue posts OR not posting on the minimum required number of days. NOTHING will be accepted after 11:59pm MT on Sunday (i.e. student will receive an automatic 0).

Total Points Possible:  100 

Requirements:

A 64-year-old woman presents to the primary care office with shortness of breath, leg swelling, and fatigue. She has a history of type 2 diabetes and hypertension. She reports that recently she had been able to go for daily walks with her friends, but in the past month, the walks have become more difficult due to shortness of breath and fatigue. She also sometimes awakens in the middle of the night due to shortness of breath and has to prop herself up on three pillows. On physical examination, she is tachycardic (110 beats per minute) and has a blood pressure of 106/74 mm Hg. Fine crackles are noted on inspiration in bilateral bases. The cardiac exam reveals the presence of a third and fourth heart sound and jugular venous distension. 2+ pitting edema is noted in the knees bilaterally. An ECG shows sinus rhythm at 110 bpm with Q waves in the anterior leads. An echocardiogram shows decreased wall motion of the anterior wall of the heart and an estimated ejection fraction of 25%. She is diagnosed with systolic heart failure, secondary to a silent MI.

  1. Discuss the pathophysiological mechanisms that can lead to heart failure.
  2. Differentiate between systolic and diastolic heart dysfunction
  3. Discuss the causes of the patient’s shortness of breath, awakening in the middle of the night and the need to prop herself up on three pillows. Include pathophysiological mechanisms that causes each of these signs and symptoms.
  4. Include two points of teaching for this patient
  5. Support your response with at least one current evidence based resource.
  6. Students must post a minimum of three times in each graded discussion (see participation guidelines below).

 

DISCUSSION CONTENT

Category

Points

%

Description

Application of Course Knowledge

30

30%

  1. Posts make direct reference to concepts discussed in the lesson or drawn from relevant, evidence based outside sources, AND
  2. Posts are on topic and answer all presented questions which demonstrates a solid understanding of the topic.
  3. Applies concepts to personal experience in the professional setting and or relevant application to real life, AND
  4. Decisions are well supported with evidence-based arguments that are in-line with the scenario; AND
  5. Proper rationale and reasoning skills are demonstrated; AND
  6. Information is taken from source(s) with appropriate interpretation/evaluation to develop a comprehensive analysis or synthesis of the topic

Support From Evidence Based Practice

30

30%

 

  1. Discussion post is supported with appropriate, scholarly sources; AND
  2. Sources are published within the last 5 years (unless it is the most current clinical practice guideline (CPG); AND
  3. Reference list is provided and in-text citations match; AND
  4. Provides relevant evidence of scholarly inquiry clearly stating how the evidence informed or changed professional or academic decisions

 

 

 

 

Interactive Dialogue

30

30%

  1. Student provides a substantive* response to at least two topic-related posts of a peer; AND
  2. Evidence from appropriate scholarly sources are included; AND
  3. Reference list is provided and in-text citations match; AND
  4. Student responds to all direct faculty questions OR if student was not asked a direct question,student responds to either a 3rd peer post or a faculty question directed towards another student

(*) A substantive post adds new content or insights to the discussion thread and information from student’s original post is not reused in peer or faculty response

 

90

90%

Total CONTENT Points= 90 pts

DISCUSSION FORMAT

Category

Points

%

Description

Grammar, Syntax, Spelling, & Punctuation

 

10

10%

Grammar, spelling, and/or punctuation are accurate, or with zero to one error.

Direct quotes in discussions are limited to one short quotation (not to exceed 15 words). The quote adds substantively to the discussion. 

(*) APA style references and in text citations are required; however, there are no deductions for errors in indentation or spacing of references. All elements of the reference otherwise must be included.

 

10

10%

Total FORMAT Points= 10 pts

 

100

100%

DISCUSSION TOTAL=100points

 

 

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Pathophysiology

Pathophysiology Quiz-2

Question 1

A 70-year-old woman has received a diagnosis of chronic myelogenous leukemia (CML) after a clinical investigation sparked by the presence of leukocytosis in her routine blood work. What clinical course should her care provider tell her to expect?

Answers:

A. “It’s likely that this will give you chronic fatigue and malaise for the rest of your life, but that will probably be the extent of your symptoms.”

B. “Unfortunately, your leukemia will likely enter a crisis mode within a few weeks if we don’t treat it immediately.”

C. “You could remain the chronic stage of CML for several years before it accelerates and culminates in a crisis.”

D. “You can expect your blood results, fatigue, and susceptibility to infection to gradually worsen over a few years.”

Question 2

Following an injury resulting in a small cut from a knife, the first cells to go to the area of the cut would be the

Answers:

A. erythrocytes.

B. basophils.

C. neutrophils.

D. albumin.

Question 3

Which of the following diagnostic findings is likely to result in the most serious brain insult?

Answers:

A. Moderate decrease in brain tissue volume secondary to a brain tumor removal

B. High intracellular concentration of glutamate

C. Increased ICP accompanied by hyperventilation

D. Mean arterial pressure (MAP) that equals intracranial pressure (ICP)

Question 4

Which of the following patients would be most likely to be experiencing an increase in renal erythropoietin production?

Answers:

A. A 70-year-old woman admitted with dehydration secondary to an overdose of her potassium-wasting diuretic

B. A 21-year-old man with acute blood loss secondary to a motor vehicle accident 3 hours prior

C. A 68-year-old man with a long-standing diagnosis of polycythemia vera

D. A 71-year-old smoker admitted to hospital with exacerbation of his chronic obstructive pulmonary disease (COPD)

Question 5

A college student has been experiencing frequent headaches that he describes as throbbing and complaining of difficulty concentrating while studying. Upon cerebral angiography, he is found to have an arteriovenous malformation. Which of the following pathophysiological concepts is likely responsible for his symptoms?

Answers:

A. Localized ischemia with areas of necrosis noted on CT angiography

B. High pressure and local hemorrhage of the venous system

C. Hydrocephalus and protein in the cerebral spinal fluid

D. Increased tissue perfusion at the site of the malformation

Question 6

A group of nursing students were studying for their pathophysiology exam by quizzing each other about disorders of WBCs and lymphoid tissue. When asked what the first chromosomal abnormality that identified cancer was, one student correctly answered Answers:

A. interleukin cells.

B. Philadelphia.

C. PSA.

D. BRCA-1.

Question 7

A 47-year-old woman was diagnosed with amyotrophic lateral sclerosis 3 years ago and has experienced a progressive onset and severity of complications. She has been admitted to a palliative care unit due to her poor prognosis? What assessments and interventions should the nursing staff of the unit prioritize in their care?

Answers:

A. Regular pain assessment and administration of opioid analgesics as needed

B. Cardiac monitoring and administration of inotropic medications

C. Assessment and documentation of cognitive changes, including confusion and restlessness

D. Assessment of swallowing ability and respiratory status

Question 8

A 53-year-old man presents with inability to concentrate, itching in his fingers and toes, elevated blood pressure, and unexplained weight loss. He is diagnosed with primary polycythemia. What will be the primary goal of his treatment?

Answers:

A. To increase the amount of oxygen distributed by his red blood cells

B. To reduce the viscosity of his blood

C. To reduce the mean size of his red cells

D. To control his hypertension

Question 9

During a late night study session, a pathophysiology student reaches out to turn the page of her textbook. Which of the following components of her nervous system contains the highest level of control of her arm and hand action?

Answers:

A. Thalamus

B. Cerebellum

C. Frontal lobe

D. Basal ganglia

Question 10

The family members of an elderly patient are wondering why his “blood counts” are not rising after his last GI bleed. They state, “He has always bounced back after one of these episodes, but this time it isn’t happening. Do you know why?” The nurse will respond based on which of the following pathophysiological principles?

Answers:

A. “Don’t worry about it. We can always give him more blood.”

B. “Due to stress, the red blood cells of older adults are not replaced as promptly as younger people.”

C. “Everything slows down when you get older. You just have to wait and see what happens.”

D. “The doctor may start looking for another cause of his anemia, maybe cancer of the bone.”

Question 11

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?

Answers:

A. Hemophilia B

B. Vitamin K deficiency

C. Excess calcium

D. Idiopathic immune thrombocytopenic purpura (ITP)

Question 12

Your ESRD patient is receiving 2 units of packed red blood cells for anemia (Hgb of 8.2). Twenty minutes into the first transfusion, the nurse observes the patient has a flushed face, hives over upper body trunk, and is complaining of pain in lower back. His vital signs include pulse rate of 110 and BP drop to 95/56.What is the nurse’s priority action? Answers:

A. Recheck the type of blood infusing with the chart documentation of patient’s blood type. B. Discontinue the transfusion and begin an infusion of normal saline.

C. Slow the rate of the blood infusion to 50 mL/hour.

D. Document the assessment as the only action.

Question 13

A 5th grade elementary student asks the school nurse how much blood is in an entire body. The nurse should respond that the average grown-up adult has

Answers:

A. 2 to 4 cups of blood in his or her body.

B. 5 to 6 L of blood throughout his or her body.

C. 3 pints of blood in total.

D. 3 to 4 quarts of blood in his or her body.

Question 14

The geriatrician providing care for a 74-year-old man with diagnosis of Parkinson disease has recently changed the client’s medication regimen. What is the most likely focus of the pharmacologic treatment of the man’s health problem?

Answers:

A. Preventing demyelination of the efferent cerebellar pathways

B. Preventing axonal degradation of motor neurons

C. Maximizing acetylcholine release from synaptic vesicles at neuromuscular junctions

D. Increasing the functional ability of the underactive dopaminergic system

Question 15

A student makes the statement to a colleague, “Blood plasma is essentially just a carrier for the formed elements like red blood cells and white blood cells.”What would be the most accurate response to this statement?

Answers:

A. “Not really. Plasma also contributes to the processes of protein synthesis and hematopoiesis.”

B. “Actually, plasma plays a significant role in nutrient and waste transport.”

C. “Actually, plasma is integral to the proper function of the liver and maintenance of acid–base balance.”

D. “That’s not really true. Plasma is crucial in the immune and inflammatory responses.”

Question 16

Several months ago, a 20-year-old male suffered a spinal cord injury brought about by a snowboard trick gone wrong. The lasting effects of his injury include a flaccid bowel and bladder and the inability to obtain an erection. While sensation has been completely preserved in his legs and feet, his motor function is significantly impaired. What type of incomplete spinal cord injury has the man most likely experienced?

Answers:

A. Central cord syndrome

B. Conus medullaris syndrome

C. Brown-Séquard syndrome

D. Anterior cord syndrome

Question 17

A client with a gastrointestinal bleed secondary to alcohol abuse and a hemoglobin level of 5.8 g/dL has been ordered a transfusion of packed red blood cells. The client possesses type B antibodies but lacks type D antigens on his red cells. Transfusion of which of the following blood types would be least likely to produce a transfusion reaction?

Answers:

A. A–

B. A

C. B–

D. B

Question 18

Which of the following clients’ signs and symptoms would allow a clinician to be most justified in ruling out stroke as a cause? An adult

Answers:

A. has vomited and complained of a severe headache.

B. states that his left arm and leg are numb, and gait is consequently unsteady.

C. has experienced a sudden loss of balance and slurred speech.

D. has had a gradual onset of weakness, headache, and visual disturbances over the last 2 days.

Question 19

Amniocentesis has suggested that a couple’s first child will be born with sickle cell disease. The parents are unfamiliar with the health problem, and their caregiver is explaining the complexities. Which of the following statements by the parents would suggest a need for further teaching or clarification?

Answers:

A. “Our baby’s red cells are prone to early destruction because of his or her weak membranes.”

B. “Our son or daughter likely won’t show the effects of sickling until he or she is school-aged because of the different hemoglobin in babies.”

C. “Not all of his or her red cells will be sickled, but low oxygen levels can cause them to become so.”

D. “Sickled cells can block his or her blood vessels, especially in the abdomen, chest, and bones.”

Question 20

During science class, a student asks, “What’s the difference between plasma and serum in the blood?” The nurse responds that the primary difference between plasma and serum is that plasma contains

Answers:

A. hydrogen ions.

B. heparin.

C. white blood cells.

D. fibrinogen.

Question 21

During a flu shot clinic, one of the questions the student nurse asks relates to whether the patient has had Guillain-Barré syndrome in his medical history. The patient asks, “What is that?” How should the nursing student reply?

Answers:

A. “A type of paralysis that affects movement on both sides of the body that may even involve the respiratory muscles”

B. “Influenza-like illness where you had fever and chills for 2 to 3 days after your last flu shot”

C. “A degenerative disease where you have trouble walking without the help of a cane or walker”

D. “Swelling of your arm where you got your flu shot, and maybe your eyes and lips had some swelling as well”

Question 22

A 22-year-old female college student is shocked to receive a diagnosis of myasthenia gravis. What are the etiology and most likely treatment for her health problem?

Answers:

A. Excess acetylcholinesterase production; treatment with thymectomy

B. A decline in functioning acetylcholine receptors; treatment with corticosteroids and intravenous immunoglobulins

C. Cerebellar lesions; surgical and immunosuppressive treatment

D. Autoimmune destruction of skeletal muscle cells; treatment with intensive physical therapy and anabolic steroids

Question 23

A baseball player was hit in the head with a bat during practice. In the emergency department, the physician tells the family that he has a “coup”injury. How will the nurse explain this to the family so they can understand?

Answers:

A. “It’s like squeezing an orange so tight that the juice runs out of the top.”

B. “When the bat hit his head, his neck jerked backward causing injury to the spine.”

C. “Your son has a contusion of the brain at the site where the bat hit his head.”

D. “Your son has a huge laceration inside his brain where the bat hit his skull.”

Question 24

Which of the following glycoproteins is responsible for treating such diseases as bone marrow failure following chemotherapy and hematopoietic neoplasms such as leukemia? Answers:

A. Growth factors and cytokines

B. T lymphocytes and natural killer cells

C. Neutrophils and eosinophils

D. Natural killer cells and granulocytes

Question 25

While being on subcutaneous heparin injections for deep vein thrombosis during her latter pregnancy, a patient begins to experience major side effects. Her OB-GYN physician has called in a specialist who thinks that the patient is experiencing heparin-induced thrombocytopenia. The nurse should anticipate which of the following orders?

Answers:

A. Immediately discontinue the heparin therapy

B. Switch to Coumadin 2.5 mg once/day

C. Decrease the dose of heparin from 5000 units b.i.d to 3000 units b.i.d

D. Infuse FFP stat

Question 26

Which of the following individuals would most likely experience global ischemia to his or her brain?

Answers:

A. A woman who is being brought to hospital by ambulance following suspected carbon monoxide poisoning related to a faulty portable heater

B. A male client who has just had an ischemic stroke confirmed by CT of his head

C. A woman who has been admitted to the emergency department with a suspected intracranial bleed

D. A man who has entered cardiogenic shock following a severe myocardial infarction

Question 27

A new mother and father are upset that their 2-day-old infant is requiring phototherapy for hyperbilirubinemia. The pediatrician who has followed the infant since birth is explaining the multiplicity of factors that can contribute to high serum bilirubin levels in neonates. Which of the following factors would the physician be most likely to rule out as a contributor?

Answers:

A. Transitioning of hemoglobin F (HbF) to hemoglobin A (HbA)

B. Hepatic immaturity of the infant

C. Hypoxia

D. The fact that the infant is being breast-fed

Question 28

A 14-year-old boy has been diagnosed with infectious mononucleosis. Which of the following pathophysiological phenomena is most responsible for his symptoms?

Answers:

A. Viruses are killing some of his B cells and becoming incorporated into the genome of others.

B. The Epstein-Barr virus (EBV) is lysing many of the boy’s neutrophils.

C. The virus responsible for mononucleosis inhibits the maturation of myeloblasts into promyelocytes.

D. The EBV inhibits the maturation of white cells within his peripheral lymph nodes.

Question 29

A 16-year-old female has been brought to her primary care physician 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 physician to rule out infectious mononucleosis?

Answers:

A. Chest auscultation reveals crackles in her lower lung fields bilaterally.

B. Her liver and spleen are both enlarged.

C. Blood work reveals an increased white blood cell count.

D. The girl has a temperature of 38.1°C (100.6°F) and has enlarged lymph nodes.

Question 30

A 30-year-old woman who has given birth 12 hours prior is displaying signs and symptoms of disseminated intravascular coagulation (DIC). The client’s husband is confused as to why a disease of coagulation can result in bleeding. Which of the nurse’s following statements best characterizes DIC?

Answers:

A. “The same hormones and bacteria that cause clotting also cause bleeding.”

B. “Massive clotting causes irritation, friction, and bleeding in the small blood vessels.”

C. “So much clotting takes place that there are no available clotting components left, and bleeding ensues.”

D. “Excessive activation of clotting causes an overload of vital organs, resulting in bleeding.”

Question 31

A 20-year-old has been diagnosed with an astrocytic brain tumor located in the brain stem. Which of the following statements by the oncologist treating the client is most accurate?

Answers:

A. “Our treatment plan will depend on whether your tumor is malignant or benign.”

B. “This is likely a result of a combination of heredity and lifestyle.”

C. “The major risk that you face is metastases to your lungs, liver, or bones.”

D. “Your prognosis will depend on whether we can surgically resect your tumor.”

Question 32

A patient diagnosed with low-risk chronic lymphocytic leukemia (CLL) has recently developed thrombocytopenia. One of the medications utilized to treat this would be Answers:

A. cisplatin, a chemotherapeutic.

B. vincristine, a Vinca alkaloid.

C. dexamethasone, a corticosteroid.

D. doxorubicin, a cytotoxic antibiotic.

Question 33

Two nursing students are attempting to differentiate between the presentations of immune thrombocytopenic purpura (ITP) and thrombotic thrombocytopenic purpura (TTP). Which of the students’ following statements best captures an aspect of the two health problems? Answers:

A. “ITP can be either inherited or acquired, and if it’s acquired, it involves an enzyme deficiency.”

B. “Both of them involve low platelet counts, but in TTP, there can be more, not less, hemostasis.

C. “TTP can be treated with plasmapheresis, but ITP is best addressed with transfusion of fresh frozen plasma.”

D. “Both diseases can result from inadequate production of thrombopoietin by megakaryocytes.”

Question 34

A physician is explaining to a 40-year-old male patient the importance of completing his course of antibiotics for the treatment of tuberculosis. The physician explains the damage that could occur to lung tissue by Mycobacterium tuberculosis. Which of the following phenomena would underlie the physician’s explanation?

Answers:

A. Tissue destruction results from neutrophil deactivation.

B. Neutrophils are ineffective against the Mycobacterium tuberculosis antigens.

C. Macrophages form a capsule around the Mycobacterium tuberculosis bacteria, resulting in immune granulomas.

D. Nonspecific macrophage activity leads to pulmonary tissue destruction and resulting hemoptysis.

Question 35

A teenager, exposed to West Nile virus a few weeks ago while camping with friends, is admitted with headache, fever, and nuchal rigidity. The teenager is also displaying some lethargy and disorientation. The nurse knows which of the following medical diagnoses listed below may be associated with these clinical manifestations?

Answers:

A. Encephalitis

B. Lyme disease

C. Rocky Mountain spotted fever

D. Spinal infection

Question 36

A patient has been diagnosed with anemia. The physician suspects an immune hemolytic anemia and orders a Coombs test. The patient asks the nurse what this test will tell the doctor. The nurse replies,

Answers:

A. “They are looking for the presence of antibody or complement on the surface of the RBC.”

B. “They will look at your RBCs under a microscope to see if they have an irregular shape (poikilocytosis).”

C. “They will wash your RBCs and then mix the cells with a reagent to see if they clump together.”

D. “They will be looking to see if you have enough ferritin in your blood.”

Question 37

A 29-year-old construction worker got a sliver under his fingernail 4 days ago. The affected finger is now reddened, painful, swollen, and warm to touch. Which of the following hematological processes is most likely occurring in the bone marrow in response to the infection?

Answers:

A. Phagocytosis by myelocytes

B. Increased segmented neutrophil production

C. High circulatory levels of myeloblasts

D. Proliferation of immature neutrophils

Question 38

A surgeon is explaining to the parents of a 6-year-old boy the rationale for the suggestion of removing the boy’s spleen. Which of the following teaching points would be most accurate?

Answers:

A.“We think that his spleen is inhibiting the production of platelets by his bone marrow.”

B.“We believe that your son’s spleen is causing the destruction of many of his blood platelets, putting him at a bleeding risk.”

C.“Your son’s spleen is holding on to too many of his platelets, so they’re not available for clotting.”

D.“Your son’s spleen is inappropriately filtering out the platelets from his blood and keeping them from normal circulation.”

Question 39 A nurse practitioner is providing care for a client with low levels of the plasma protein gamma globulin. The nurse would recognize that the client is at risk of developing which of the following health problems?

Answers:

A. Anemia

B. Blood clots

C. Jaundice

D. Infections

Question 40

A 32-year-old woman presents at her neighborhood health clinic complaining of weakness and a feeling of abdominal fullness. She reports that 6 months earlier she noticed that she had difficulty in maintaining the high level of energy she has relied on during her aerobic workouts over the past few years. Because she felt that she was in overall good health, but knew that women often need additional iron, she added a multiple vitamin with iron and some meat and leafy greens to her diet. She followed her plan carefully but had no increase in energy. Upon examination, her spleen is noted to be enlarged. Which of the following is most likely to be the cause?

Answers:

A. CLL

B. Accelerated CML

C. Infectious mononucleosis

D. Stage A Hodgkin disease

Question 41

A nurse is providing care for several patients on an acute medical unit of a hospital.Which of the following patients would be most likely to benefit from hematopoietic growth factors?

Answers:

A. A 61-year-old female patient with end-stage renal cancer

B. A 55-year-old obese male patient with peripheral neuropathy secondary to diabetes

C. A 51-year-old female patient with liver failure secondary to hepatitis

D. A 44-year-old man with a newly diagnosed brain tumor

Question 42

Misinterpreting her physician’s instructions, a 69-year-old woman with a history of peripheral artery disease has been taking two 325 mg tablets of aspirin daily. How has this most likely affected her hemostatic status?

Answers:

A. The binding of an antibody to platelet factor IV produces immune complexes.

B. The patient’s prostaglandin (TXA2) levels are abnormally high.

C. Irreversible acetylation of platelet cyclooxygenase activity has occurred.

D. She is at risk of developing secondary immune thrombocytopenic purpura (ITP).

Question 43 Which of the following teaching points would be most appropriate with a client who has a recent diagnosis of von Willebrand disease?

Answers:

A. “Make sure that you avoid taking aspirin.”

B. “Your disease affects your platelet function rather than clot formation.”

C. “Clotting factor VIII can help your body compensate for the difficulty in clotting.”

D. “It’s important that you avoid trauma.”

Question 44

A nurse at a long-term care facility provides care for an 85-year-old man who has had recent transient ischemic attacks (TIAs). Which of the following statements best identifies future complications associated with TIAs? TIAs

Answers:

A. are caused by small bleeds that can be a warning sign of an impending stroke.

B. are a relatively benign sign that necessitates monitoring but not treatment.

C. are an accumulation of small deficits that may eventually equal the effects of a full CVA. D. resolve rapidly but may place the client at an increased risk for stroke.

Question 45

Following a motor vehicle accident 3 months prior, a 20-year-old female who has been in a coma since her accident has now had her condition declared a persistent vegetative state. How can her care providers most accurately explain an aspect of her situation to her parents?

Answers:

A. “If you or the care team notices any spontaneous eye opening, then we will change our treatment plan.”

B. “Your daughter has lost all her cognitive functions as well as all her basic reflexes.”

C. “Though she still goes through a cycle of sleeping and waking, her condition is unlikely to change.”

D. “Your daughter’s condition is an unfortunate combination with total loss of consciousness but continuation of all other normal brain functions.”

Question 46

A couple who is expecting their first child has been advised by friends to consider harvesting umbilical cord blood in order to have a future source of stem cells. The couple has approached their caregiver with this request and is seeking clarification of exactly why stem cells are valuable and what they might expect to gain from harvesting it. How can their caregiver best respond to the couple’s enquiry? Stem cells can

Answers:

A. “be used as source of reserve cells for the entire blood production system.”

B. “help treat some cancers and anemias, but they must come from your child himself or herself.”

C. “be used to regenerate damaged organs should the need ever arise.”

D. “help correct autoimmune diseases and some congenital defects.”

Question 47 A surgeon is explaining to the parents of a 6-year-old boy the rationale for the suggestion of removing the boy’s spleen. Which of the following teaching points would be most accurate?

Answers:

A. “Ferritin is a protein–iron complex that allows your red blood cells to make use of the iron that you consume in your diet.”

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

C. “Ferritin is the form of iron that is transported in your blood plasma to red blood cells that need it.”

D. “Ferritin is a stored form of iron that indirectly shows me whether you would benefit from iron pills.”

Question 48

A 13-year-old African American boy comes to the ER complaining of fatigue and a rapid heartbeat. In conversation with the father, it becomes apparent to you that the boy has grown 2 inches in the previous 5 months. What is the first problem the health care team would attempt to rule out?

Answers:

A. Aplastic anemia

B. Sickle cell anemia

C. Thalassemia

D. Iron deficiency anemia

Question 49

In which of the following patients, would diagnostic investigations least likely reveal increased thrombopoietin production?

Answers:

A. A 55-year-old man with dehydration secondary to Crohn disease

B. An 81-year-old woman with diagnoses of rheumatoid arthritis and failure to thrive

C. A 66-year-old woman with a diagnosis of lung cancer with bone metastases

D. A 21-year-old woman awaiting bone marrow transplant for myelogenous leukemia

Question 50

A hospital laboratory technologist is analyzing the complete blood count (CBC) of a patient. Which of the following statements best reflects an aspect of the platelets that would constitute part of the CBC?

Answers:

A. New platelets are released from the bone marrow into circulation.

B. The half-life of a platelet is typically around 8 to 12 days.

C. Platelets originate with granulocyte colony–forming units (CFU).

D. The α-granules of platelets contribute primarily to vasoconstriction.

 

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