EDI Reference Guide

Imagine you are the office manager at a small doctor’s office. As the office manager, you are in charge of educating new hires.

Write a 700- to 1,050-word reference guide describing electronic data interchange (EDI).

Include the following in your summary:

  • Define EDI.
  • Explain how using EDI facilitates electronic transactions.
  • Explain how HIPAA has changed how health care information is transmitted in EDI.
  • Describe the relationship between Electronic Health Records, reimbursement, HIPAA, and EDI transactions.

Cite a minimum of two outside sources. For additional information on how to properly cite your sources, log on to the Reference and Citation Generator in the Center for Writing Excellence.

Format your assignment according to APA guidelines.

 

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This Way For Vampires

andie Friedman’s “This Way for Vampires: Teaching First-Year Composition in ‘Challenging Times.'”

The past two weeks I’ve asked you to work quite a bit with Sandie Friedman’s “This Way for Vampires: Teaching First-Year Composition in ‘Challenging Times.'”

Do you agree with Friedman that popular culture, current events, and the like are good subjects to write about and discuss in a writing class? Why? Why not?

Your Thursday post should be between 200 – 250 words, and your responses to classmates should be between 50 – 100 words. You should summarize, paraphrase, and quote Friedman in your posts.  Don’t forget to use in-text citation

 

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A Draft Of The Agenda Comparison Grid

Regardless of political affiliation, every citizen has a stake in healthcare policy decisions. Hence, it is little wonder why healthcare items become such high-profile components of presidential agendas. It is also little wonder why they become such hotly debated agenda items.

In Part 1 of this module’s Assignment, you were asked to begin work on an Agenda Comparison Grid to compare the impact of the previous three presidential agendas on the healthcare item you selected for study. In this Discussion, you will share your first draft with your colleagues to receive feedback to be applied to your final version.

 

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medication assistance program

You have been invited to assemble a task force to design a medication assistance program. You need to submit a proposal, regarding who you would invite, to the CEO. Consider the perspectives of prescribers, discharge planners, financial navigators, patients, suppliers, book keepers, subsidizers, lawmakers, etc…. If you were to seek the input of 5-7 stakeholders, who would you invite to the planning table, and why? Consider the need for a group facilitator. Who would that person be, and why?

Submit your group’s presentation as if you were making it for the CEO of a local hospital. It will be in a powerpoint presentation (10 slides, 1 title page, 1 reference page, 8 pages of information listed above).

 

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NURSING: ORGANIZATIONAL DEVELOPMENT AND CHANGE

I need a minimum of 100 words for each of the assignments on both A and B assignments

UNIT 1

A

Describe the role of organizational development in contemporary organizations. How does organizational development help organizations prepare for or implement change? Provide an example from your organization.

B

What environmental forces drive organization development in your field or industry? What are the steps successful organizations take when responding to change? Have you experienced forces of change in your work environment? How did the changes affect your organization?

RESOURCES

Textbook

1. The Heart of Change: Real-Life Stories of How People Change Their Organizations

Read the Introduction and Chapter/Step 1 in The Heart of Change: Real-Life Stories of How People Change Their Organizations.

http://gcumedia.com/digital-resources/harvard-business-school-press/2012/the-heart-of-change_real-life-stories-of-how-people-change-their-organizations_ebook_1e.php

e-Library Resource

1. Chapter 2: Successful Change and the Force That Drives It 

Read “Chapter 2: Successful Change and the Force That Drives It,” by Kotter, from the online eBook, Leading Change (1996).

https://lopes.idm.oclc.org/login?url=http://library.books24x7.com.lopes.idm.oclc.org/library.asp?^B&bookid=3479&chunkid=338027656&rowid=17

2. Chapter Twenty Two: Managing Change

Read “Chapter Twenty Two: Managing Change,” by Lewthwaite, from the online eBook, Everything You Need for an NVQ in Management (2000).

https://lopes.idm.oclc.org/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=bth&AN=22385904&site=eds-live&scope=site

3. Empirical Development of a Model of Performance Drivers in Organizational Change Projects

Read, “Empirical Development of a Model of Performance Drivers in Organizational Change Projects,” by Parry et al., from Journal of Change Management (2014).

https://lopes.idm.oclc.org/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=bth&AN=95211294&site=ehost-live&scope=site

UNIT 2

A

Why is vision essential to facilitating successful change in an organization? What is the correlation between a leader’s role/vision and a successful change initiative? Describe a vision that you have seen/heard/read/viewed that you felt inspired successful change. How did this vision influence people’s behavior and attitudes toward a major change initiative?

B

According to the textbook, people are more motivated when “they are shown a truth that influences their feelings” than they are by analysis. Discuss the relevance of this statement for organizations growing and responding to change. What responsibility does a leader have to honor stakeholder concerns when “feelings” are the primary basis for the concerns?

Resources

Textbook

1. The Heart of Change: Real-Life Stories of How People Change Their Organizations

Read Chapters/Steps 2 and 3 in The Heart of Change: Real-Life Stories of How People Change Their Organizations.

http://gcumedia.com/digital-resources/harvard-business-school-press/2012/the-heart-of-change_real-life-stories-of-how-people-change-their-organizations_ebook_1e.php

e-Library Resource

1. Change Management: The Secret Sauce of Successful Program Building

Read “Change Management: The Secret Sauce of Successful Program Building,” by Periyakoil, from Journal of Palliative Medicine (2009).

https://lopes.idm.oclc.org/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cmedm&AN=19327068&site=ehost-live&scope=site

2. Leading Change Through Vision

Read “Leading Change Through Vision,” by Huyer, from Leadership Excellence Essentials (2014).

https://lopes.idm.oclc.org/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=bth&AN=96583824&site=ehost-live&scope=site

UNIT 3

A

Compare and contrast two different change models. What leadership approach would you use to implement your preferred model? Why?

B

What is “disruptive change,” and how is this different from “incremental change?” How does disruptive change affect an organization? Provide an example.

RESOURCES

Electronic Resource

1. Change Management Models

Read “Change Management Models” page of the Change Management Coach website.

http://www.change-management-coach.com/change-management-models.html

2. Change Management Models

Read “Change Management Models,” by Ramakrishnan (2014), on the Scrum Alliance website.

https://www.scrumalliance.org/community/articles/2014/march/change-management-models

3. Which Change Model Should You Pick?

Read “Which Change Model Should You Pick?” by McCarthy, on the Great Leadership website (2011).

http://www.greatleadershipbydan.com/2011/07/which-change-model-should-you-pick.html

e-Library Resource

1. A Study of Role of McKinsey’s 7S Framework in Achieving Organizational Excellence

Read “A Study of Role of McKinsey’s 7S Framework in Achieving Organizational Excellence,” by Singh, from Organization Development Journal(2013).

https://lopes.idm.oclc.org/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=bth&AN=94502348&site=ehost-live&scope=site

2. Building Agility, Resilience and Performance in Turbulent Environments

Read “Building Agility, Resilience and Performance in Turbulent Environments,” by McCann, Selsky, and Lee, from People & Strategy (2009).

https://lopes.idm.oclc.org/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=bth&AN=44934964&site=eds-live&scope=site

3. Habits as Change Levers

Read “Habits as Change Levers,” by Denison and Nieminen, from People & Strategy (2014).

https://lopes.idm.oclc.org/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=ofs&AN=97590294&site=eds-live&scope=site

4. It Is Possible to Manage Disruptive Change and Take Staff With You

Read “It Is Possible to Manage Disruptive Change and Take Staff With You,” by Smedley, from People Management (2010).

https://lopes.idm.oclc.org/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=bth&AN=51861268&site=ehost-live&scope=site

UNIT 4

A

Discuss the importance of a change agent and a guiding team. What is the purpose of each, and what traits make them successful?

B

Discuss two strategies that can be used for leading change. How do these strategies increase stakeholder support and create momentum for a change initiative to be successful? Why might you want to consider including the most vocal critic of the change initiative in your guiding team?

RESOURCES

Textbook

1. The Heart of Change: Real-Life Stories of How People Change Their Organizations

Read the Introduction and Chapter/Step 5 in The Heart of Change: Real-Life Stories of How People Change Their Organizations.

http://gcumedia.com/digital-resources/harvard-business-school-press/2012/the-heart-of-change_real-life-stories-of-how-people-change-their-organizations_ebook_1e.php

e-Library Resource

1. Evaluating the Success of Strategic Change Against Kotter’s Eight Steps

Read “Evaluating the Success of Strategic Change Against Kotter’s Eight Steps,” by Spencer and Winn, from Planning for Higher Education (2004/2005).

https://lopes.idm.oclc.org/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=ofs&AN=507948373&site=ehost-live&scope=site

2. Integrating Organizational Change Management and Customer Relationship Management in a Casino

Read “Integrating Organizational Change Management and Customer Relationship Management in a Casino,” by Chi Cong Mai, Perry, and Loh, from UNLV Gaming Research and Review Journal (2014).

https://lopes.idm.oclc.org/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=s3h&AN=100270149&site=ehost-live&scope=site

3. Mastering the Art of Change

Read “Mastering the Art of Change,” by Blanchard, from Training Journal (2010).

https://lopes.idm.oclc.org/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=bth&AN=47573877&site=ehost-live&scope=site

4. Navigating Change

Read “Navigating Change,” by Bisoux, from BizEd (2015).

https://lopes.idm.oclc.org/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=ehh&AN=100345843&site=ehost-live&scope=site

5. Team-Building and Change Management in Respiratory Care: Description of a Process and Outcomes

Read “Team-Building and Change Management in Respiratory Care: Description of a Process and Outcomes,” by Stoller et al., from Respiratory Care (2010).

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6. The Meaning and Measurement of Implementation Climate

Read “The Meaning and Measurement of Implementation Climate,” by Weiner et al., from Implementation Science (2011).

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7. Transformational Change

Read, “Transformational Change,” by Hannon, from Training Journal (2014).

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UNIT 5

A

Explain how successful communication is used throughout a change process to convey vision and strategies to stakeholders. What may be occurring with the communication process if the change process begins to fail?

B

Why is effective and frequent communication so critical to a successful change effort? Describe either a good or a bad example of this from your organization or one that you have studied. Describe how the communication affected the various stakeholders affected by the change effort.

RESOURCES

Textbook

1. The Heart of Change: Real-Life Stories of How People Change Their Organizations

Read Chapter/Step 4 in The Heart of Change: Real-Life Stories of How People Change Their Organizations.

http://gcumedia.com/digital-resources/harvard-business-school-press/2012/the-heart-of-change_real-life-stories-of-how-people-change-their-organizations_ebook_1e.php

e-Library Resource

1. Chapter 5: Communication Approaches and Strategies

Read “Chapter 5: Communication Approaches and Strategies,” by Lewis, from the online eBook, Organizational Change: Creating Change through Strategic Communication (2011).

https://lopes.idm.oclc.org/login?url=http://library.books24x7.com.lopes.idm.oclc.org/library.asp?^B&bookid=41650&chunkid=724090605&rowid=223

2. Chapter 9: Talking to People Affected by Change

Read “Chapter 9: Talking to People Affected by Change,” by Karten, from the online eBook, Changing How You Manage and Communicate Change (2009).

http://site.ebrary.com.lopes.idm.oclc.org/lib/GrandCanyon/reader.action?docID=10438088&ppg=127

3. Effective Change Management: The Simple Truth

Read “Effective Change Management: The Simple Truth,” by Merrell, from Management Services (2012).

https://lopes.idm.oclc.org/login?url=http://search.proquest.com.lopes.idm.oclc.org/docview/1027234230?accountid=7374

UNIT 6

A

What types of obstacles/objections do leaders face from stakeholders when implementing change within an organization? What strategies can leaders use to work with stakeholders, remove obstacles, and address objections?

B

Describe an ethical dilemma that you experienced, or have witnessed in a change leader, when attempting to initiate change. How was the ethical dilemma resolved? What can a change leader use to guide decision making when faced with an ethical dilemma?

RESOURCES

Textbook

1. The Heart of Change: Real-Life Stories of How People Change Their Organizations

Read Chapter/Step 6 in The Heart of Change: Real-Life Stories of How People Change Their Organizations.

http://gcumedia.com/digital-resources/harvard-business-school-press/2012/the-heart-of-change_real-life-stories-of-how-people-change-their-organizations_ebook_1e.php

e-Library Resource

1. Backseat Leaders

Read “Backseat Leaders,” by Schlachter and Hildebrandt, from Leadership Excellence Essentials (2012).

https://lopes.idm.oclc.org/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=bth&AN=82953867&site=ehost-live&scope=site

2. Change Management: Leadership, Values and Ethics

Read “Change Management: Leadership, Values and Ethics,” by By, Burnes, and Oswick, from Journal of Change Management (2012).

https://lopes.idm.oclc.org/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=bth&AN=73326520&site=ehost-live&scope=site

3. Group Imago and Group Development: Two Theoretical Additions and Some Ensuing Adjustments

Read “Group Imago and Group Development: Two Theoretical Additions and Some Ensuing Adjustments,” by Tudor, from Transactional Analysis Journal (2013).

https://lopes.idm.oclc.org/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2014-04423-008&site=ehost-live&scope=site

4. May I Have Your Attention Please? A Review of Change Blindness

Read “May I Have Your Attention Please? A Review of Change Blindness,” by Ellis, from Organization Development Journal (2012).

https://lopes.idm.oclc.org/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=bth&AN=94475438&site=ehost-live&scope=site

UNIT 7

A

Discuss the importance of identifying and acknowledging short-term wins during change. What types of short-term wins are most meaningful? Why?

B

During a change initiative, what can organizations use to identify or verify truly objective and measureable success? What does your organization utilize to measure its level of success?

RESOURCES

Textbook

1. The Heart of Change: Real-Life Stories of How People Change Their Organizations

Read Chapter/Step 7 in The Heart of Change: Real-Life Stories of How People Change Their Organizations.

http://gcumedia.com/digital-resources/harvard-business-school-press/2012/the-heart-of-change_real-life-stories-of-how-people-change-their-organizations_ebook_1e.php

e-Library Resource

1. A Graphic Tour of Success and Failure in Corporate Renewal

Read “A Graphic Tour of Success and Failure in Corporate Renewal,” by Hass, Pryor, and Broders, from Journal of Private Equity (2006).

https://lopes.idm.oclc.org/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=bth&AN=20826519&site=ehost-live&scope=site

2. Achieving Breakthrough Performance

Read “Achieving Breakthrough Performance,” by Gottfredson, Schaubert, and Babcock, from Stanford Social Innovation Review (2008).

https://lopes.idm.oclc.org/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=bth&AN=32613081&site=ehost-live&scope=site

3. Chapter 8 – Generating Short-Term Wins

Read “Chapter 8 – Generating Short-Term Wins,” by Kotter, from the online eBook, Leading Change (1996).

https://lopes.idm.oclc.org/login?url=http://library.books24x7.com.lopes.idm.oclc.org/library.asp?^B&bookid=3479&chunkid=750986081&rowid=85

4. Do 70 Per Cent of All Organizational Change Initiatives Really Fail

Read “Do 70 Per Cent of All Organizational Change Initiatives Really Fail?” by Hughes, from Journal of Change Management (2011).

https://lopes.idm.oclc.org/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=bth&AN=69733274&site=ehost-live&scope=site

5. Error 6: Not Systematically Planning, and Creating, Short-Term Wins

Read “Error 6: Not Systematically Planning, and Creating, Short-Term Wins,” from “Leading Change—Why Transformation Efforts Fail,” by Kotter, included in the online eBook, HBR’s 10 Must-Reads: The Essentials (2011).

https://lopes.idm.oclc.org/login?url=http://library.books24x7.com.lopes.idm.oclc.org/library.asp?^B&bookid=40535&chunkid=511313899&rowid=258¬eMenuToggle=0&leftMenuState=1

UNIT 8

A

Consider an organization in your field or industry. Describe the essential systems necessary to facilitate continuous change without compromising quality or causing burnout among employees. Describe three factors to consider when making sure that the changes made become permanently imbedded in the organization’s culture.

B

What is your reaction to change in your personal history? What personal tools do you implement to help yourself navigate change?

RESOURCES

Textbook

1. The Heart of Change: Real-Life Stories of How People Change Their Organizations

Read Chapter/Step 8 and the Conclusion in The Heart of Change: Real-Life Stories of How People Change Their Organizations.

http://gcumedia.com/digital-resources/harvard-business-school-press/2012/the-heart-of-change_real-life-stories-of-how-people-change-their-organizations_ebook_1e.php

e-Library Resource

1. A Proposed Model for Evaluating the Sustainability of Continuous Change Programmes

Read “A Proposed Model for Evaluating the Sustainability of Continuous Change Programmes,” by Brännmark and Benn, from Journal of Change Management (2012).

https://lopes.idm.oclc.org/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=bth&AN=76170999&site=ehost-live&scope=site

2. Complex Adaptive Systems and Improvisation Theory: Toward Framing a Model to Enable Continuous Change

Read “Complex Adaptive Systems and Improvisation Theory: Toward Framing a Model to Enable Continuous Change,” by Ford, from Journal of Change Management (2008).

https://lopes.idm.oclc.org/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=bth&AN=35582014&site=ehost-live&scope=site

3. Managing Change Through Employee Empowerment

Read “Managing Change Through Employee Empowerment,” by Rothermel and LaMarsh, from Global Business and Organizational Excellence (2012).

https://lopes.idm.oclc.org/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=bth&AN=67697925&site=ehost-live&scope=site

4. Plan Do Stablise Repeat: How to Lead Change Successfully

Read “Plan Do Stablise Repeat: How to Lead Change Successfully,” by Andre, from Management Services (2013).

https://lopes.idm.oclc.org/login?url=http://search.proquest.com.lopes.idm.oclc.org/docview/1348695756?accountid=7374

5. Transformational Leadership, Relationship Quality, and Employee Performance During Continuous Incremental Organizational Change

Read “Transformational Leadership, Relationship Quality, and Employee Performance During Continuous Incremental Organizational Change,” by Carter, Armenakis, Field, and Mossholder, from Journal of Organizational Behavior (2013).

https://lopes.idm.oclc.org/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=bth&AN=90469965&site=ehost-live&scope=site

 

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The Role Of An Administrator In Contrast To A Non-Management Staff Member In Regards To Risk Management Of An ADA Or Workers’

Discus Topic 2: Research the role of an administrator in contrast to a non-management staff member in regards to risk management of an ADA or workers’

This is a discussion post, about 250 WORDS, tittle page not require In- text citation is required original work please, scholarly references are required for this assignment, website source strongly preferred.

QUESTION 2

Research the role of an administrator in contrast to a non-management staff member in regards to risk management of an ADA or workers’ compensation incident in a typical health care organization. What are the minimal responsibilities and reporting duties for each? What recommendations would you suggest to improve organizational compliance with regulatory requirements? Support your analysis with a minimum of 3 peer-reviewed reference. 

 

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Case Study On Death And Dying profile

The practice of health care providers at all levels brings you into contact with people from a variety of faiths. This calls for knowledge and acceptance of a diversity of faith expressions.

The purpose of this paper is to complete a comparative ethical analysis of George’s situation and decision from the perspective of two worldviews or religions: Christianity and a second religion of your choosing. For the second faith, choose a faith that is unfamiliar to you. Examples of faiths to choose from include Sikh, Baha’i, Buddhism, Shintoism, etc.

In your comparative analysis, address all of the worldview questions in detail for Christianity and your selected faith.  Once you have outlined the worldview of each religion, begin your ethical analysis from each perspective.

In a minimum of 2,000 words, provide an ethical analysis based upon the different belief systems, reinforcing major themes with insights gained from your research, and answering the following questions based on the research:

  1. How would each religion interpret the nature of George’s malady and suffering? Is there a “why” to  his disease and suffering? (i.e., is there a reason for why George is ill, beyond the reality of physical malady?)
  2. In George’s analysis of his own  life, how would each religion think about the value of his life as a person, and value of his life with ALS?
  3. What sorts of values and considerations would each religion focus on in deliberating about whether or not George should opt for euthanasia?
  4. Given the above, what options  would be morally justified under each religion for George and why?
  5. Finally, present and defend  your own view.

Support your position by referencing from lectures, the Bible, and the textbooks for each religion. Each religion must have a primary source included. 

A total of six references are required according to the specifications listed above. Incorporate the research into your writing in an appropriate, scholarly manner.

Prepare this assignment according to the guidelines found in the APA Style Guide

 

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Does Psychotherapy Have A Biological Basis?

Post 1

Mental health processes and disorders originate from mechanisms within the brain. There has been the question within the psychiatric field as to whether plastic changes in the brain that can occur with the use of  pharmacological interventions for mental health disorders could also occur with the use of psychotherapy. Psychotherapy is extremely beneficial in treating several mental health issues (Laureate Education, 2016).There is compounding evidence that psychotherapy does have a biological basis and can have a positive impact in brain recovery from the stress response. According to Wheeler (2014), psychotherapy mediates the reintegration and connection of neural networks that have become maladaptively linked due to adverse life events facilitating healing of the brain. Psychotherapy has been found to be an effective treatment method for a variety of mental health disorders such as anxiety, major depression, and post-traumatic stress disorder. According to Fournier (2014), activity in regions associated with negative emotion, emotion regulation, fear, and reward are associated with respones to psychotherapy, and psychotherapy appears to alter the functioning of these regions.

While proven to be an effective treatment modality for mental health disorders, there are factors such as culture, religion, and socioeconomic background that can affect the client and their perspective on the use of psychotherapy. Psychotherapy within itself can bring conflicting emotions for the client and the clinician must be aware of how religion, culture, and socioeconomics can alter how the client perceives psychotherapy and its efficacy in their treatment. According to Wheeler (2014), the powerful influence of culture permeates all dimensions of out life in a way that is often unconscious. For example, if a client comes from a culture where emotions are not to be discusssed or if one discusses there past traumas or fears then the client could be resistant to the role of psychotherapy in their treatment plan. The clinician must be aware of the importance of culture in medical or psychological treatments. Religion also plays an instrumental role in how psychotherapy will be perceived by a client. Many clients may come from a religious background where one only speaks of negative emotions with someone from their clergy or a religious figure. According to Kim, Chen & Brachfeld (2018), religion and spirituality are important issues to consider and address in psychotherapy. Communication could become stagnant if the clinician is not aware of the role religion plays in the psychotherapy framework. Socioeconomic background can also be a variable in one‘s perspective of the value of psychotherapy. Certain traumatic events that a person can suffer throughout their lifetime can be directly correlated to socioeconomic standing. For example, poverty can be associated with depression, anxiety, substance abuse, and mood disorders. Patients from this type of background can experience barriers in both seeking and receiving mental health services. According to Bernal et al. (2017), vulnerable populations such as those low in social status face additional barriers to mental health treatment and experience unique barriers to receiving optimal care.

References

Bernal, D.R., Herbst, R.B., Lewis, B.L., & Feibelman, J. (2017). Ethical care for vulnerable populations receiving psychotropic treatment. Ethics & Behavior, 27(7), 582-598. doi:10.1080/10508422.2016.1224187

Fournier, J.C., & Price, R.B. (2014). Psychotherapy and neuroimaging. Psychotherapy: New Evidence and New Approaches, 12(3), 290-298. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4207360

Kim, E.E., Chen, E.C., & Brachfeld, C. (2018). Patients’ experience of spirituality and change in individual psychotherapy at a Christian counseling clinic: A grounded theory analysis. Spirituality in Clinical Practice, doi:10.1037/scp0000176

Laureate Education (Producer). (2016). Introduction to psychotherapy with individuals [Video file]. Baltimore, MD: Author.

Wheeler, K. (Eds.). (2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice (2nd ed.). New York, NY: Springer Publishing Company.

POST 2

Psychotherapy is just as controversial as mental health as a whole is. Some believe it is helpful, others believe it is a waste of time. One question still remains unanswered for many, can talking about feelings help change behavior and therefore sure whatever condition a person is suffering from? I believe psychotherapy has a biological basis. Lyrakos, Spinaris, and Spyropoulos (2017) clearly stated as results of a research that “the use of psychotherapy plays a significant role in achieving optimal health outcomes of psychiatric patients” (p. s753). Pairing psychopharmacology with psychotherapy can make a positive impact towards recovery compared to treatment with just psychopharmacology.

Many different reasons can influence the belief that psychotherapy might or might not work. For example, Adams et al. (2017) concluded in an article that “findings suggest that patients’ attachment characteristics play a role in their views and choices regarding treatments” (p. 194). Other factors that can impact the belief that therapy is a waste of time are culture, religion, and socioeconomic status. A person’s upbringing can be one to avoid talking about feelings with a stranger, or even with a loved one. Religion can also play a role in not receiving this type of treatment as faith in a spiritual belief might be the perceived as the cure to an ailment. Economical status and education level can also negatively impact the decision to avoid this type of treatment as the importance of it might not be completely comprehended or there are no means to afford the treatment. In another study that correlates the importance of psychotherapy, data showed “that children/adolescents with not only behavioral and emotional disorders, but also affective (mood) disorders had a higher chance for nondrug psychiatric/psychotherapeutic treatment compared to children with other psychiatric disorders” (Abbas et al., 2017, p. 442).

References

Lyrakos, G., Spinaris, V., & Spyropoulos, I. (2017). The introduction of psychotherapy in

psychiatric outpatients as part of the treatment in the last four years in a Greek

hospital. European Neuropsychopharmacology, 27(4).

Adams, G. C., McWilliams, L. A., Wrath, A. J., Adams, S., & Souza, D. D. (2017).

Relationships between patients’ attachment characteristics and views and use of

psychiatric treatment. Psychiatry Research, 256:194-201.

Abbas, S., Ihle, P., Adler, J., Engel, S., Günster, C., Holtmann, M., & …Schubert, I. (2017).

Predictors of non-drug psychiatric/psychotherapeutic treatment in children and

adolescents with mental or behavioral disorders. European Child & Adolescent

            Psychiatry, 26(4).

 

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NUR3045 Module 2 Quiz Chapter 5 2017

Question 1 While caring for a patient from the Chinese culture, the nurse learns that the patient has a specific practice that follows yin and yang. What impact will this have on the patient’s dietary intake?

1. The patient will eat only specified combinations of food.
2. Some foods are only eaten at different times of the year.
3. There are specific foods for specific purposes.
4. Identifies if foods should be eaten hot or cold

Question 2 What would the nurse identify as contributors to illness?

Select all that apply.

1. Imbalance of body, mind, or spirit
2. Imbalance with the family
3. Imbalance with the community
4. Imbalance with the forces of the natural world
5. Imbalance with socioeconomic status

Question 3 While performing a home assessment, the home care nurse identifies traditional practices that the patient uses to protect health.Which are practices used to protect health?

Select all that apply.

1. Picture of a saint hanging on the wall in the bedroom
2. String of garlic hanging in the kitchen
3. Burning a candle on the kitchen table
4. Wearing a purple scarf
5. Chanting prayers

Question 4 Which actions would the nurse categorize as traditional mental HEALTH maintenance?

1. Activities to concentrate and stimulate the mind
2. Avoiding physically demanding hobbies
3. Using medications to preserve chemical balance in the brain
4. Wearing head covering in the cold to preserve head warmth

Question 5 Which action do most people take when experiencing a mild illness?

1. Rely on self-treatment or do nothing.
2. Ingest herbs specific to how they are feeling.
3. Consult a local faith HEALER.
4. Immediately seek medical attention.

Question 6 A patient wants to use a complementary medicine approach for a chronic health problem. Which approaches would the nurse suggest the patient use?

Select all that apply.

1. Hypnotherapy
2. Qi gong
3. Biofeedback
4. Reiki

Question 7 During an assessment, a patient tells the nurse, “An onion a day keeps everyone away.” How does this philosophy protect health?

1. An onion protects the person from coming in contact with those who might be ill.
2. This philosophy affirms the belief in the power of onions to prevent disease.
3. This philosophy recognizes the special antibiotic properties contained within onions.
4. This philosophy advertises that onions have special healing abilities.

Question 8 Which action does the nurse recognize as essential for maintaining health?

1. Having a strong familial and social support system
2. Practicing moderation in all activities
3. Ensuring proper balance in all aspects of life
4. Taking a daily multivitamin

Question 9 During a health history, a patient tells the nurse about following traditional epidemiological practices. What is the purpose of these practices?

1. Preserve a heritage
2. Used as a part of the patient’s religion.
3. Cure an illness
4. Uses folk medicine herbal remedies

Question 10 Which activities does the nurse recognize as being used by a patient to restore health?

Select all that apply.

1. Drinking herbal tea
2. Using massage
3. Prayer
4. Meditation
5. Purging

Question 11 A patient tells the nurse that an illness was caused by the evil eye. What are common beliefs about this cause of illness?

Select all that apply.

1. Power comes from the eye and strikes a victim.
2. The onset of illness is sudden.
3. The person who cast the evil eye may not be aware of the power.
4. The illness may be cured with rituals.
5. The illness will become chronic.

Question 12 Which statement would the nurse utilize to define HEALTH?

1. The balance of a person within the outside world
2. A continuous struggle between balance and imbalance
3. Recovering from an illness
4. Physical wholeness for activity

Question 13 While assessing a patient from the Jewish culture, the nurse learns that the patient believes that an illness is being caused by another soul. What is this health belief considered?

1. Aberglobin

2. Kayn aynhoreh

3. Szatan

4. Dybbuk

Question 14 While working with community members of different cultures, the nurse learns a variety of beliefs about the evil eye. What are the consistent variables of this cause of illness?

Select all that apply.

1. How it is cast
2. Who can cast it
3. Who receives it
4. Degree of power it has
5. What body part is afflicted

Question 15 The nurse is trying to determine if a treatment that a patient has been taking for an illness is considered a homeopathic remedy. Which are criteria of homeopathy?

Select all that apply.

1. The person, and not the disease, is being treated.
2. Does not conform to scientific standards
3. A substance used would cause symptoms in a healthy person.
4. Spinal manipulation realigns mental impulses.

Question 16 The nurse notes that a patient’s religion is identified as being Christian Science. How will this religious belief impact the health care that the patient will want?

1. The patient will choose the method of health care that is the most effective.
2. The patient will use similar treatments for healing disease.
3. The patient uses aromas for healing.
4. The patient will ask for spinal manipulation.

Question 17 The nurse notes that a patient’s religion is identified as being Christian Science. How will this religious belief impact the health care that the patient will want?

1. The patient will choose the method of health care that is the most effective.
2. The patient will use similar treatments for healing disease.
3. The patient uses aromas for healing.
4. The patient will ask for spinal manipulation.

Question 18 In some cultures, spitting is a health protection activity done after giving someone else a compliment. What is the purpose of this action?

1. Prevents the recipient of the compliment from receiving an evil spell
2. Avoids direct speech afterwards with the person who receives the compliment
3. Prevents the recipient of the compliment from being too flattered
4. Makes the air better to take in the compliment

Question 19 Which patient statement reflects a spiritual belief that defines illness?

1. “I am being punished for breaking a religious code.”
2. “It is a necessary part of my religious culture.”
3. “I failed to wear special amulets to ward it off.”
4. “I am sick because I violated dietary practices.”

Question 20 The nurse learns that a patient used to follow homeopathic medicine but now only uses allopathic medicine approaches. What is the significance of allopathic medicine?

1. Espouses empiric methods for treating disease
2. Accepts other forms of therapy as valid for treating disease
3. Is practiced only where it is accepted
4. Encompasses different treatment modalities within its framework

 

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NR 508 Final Exam

Question 1

2 / 2 pts

A patient who has diabetes reports intense discomfort when needing to void. A urinalysis is normal. To treat this, the primary care NP should consider prescribing:

flavoxate (Urispas).

bethanechol (Urecholine).

phenazopyridine (Pyridium).

oxybutynin chloride (Ditropan XL).

Question 2

2 / 2 pts

A patient reports difficulty returning to sleep after getting up to go to the bathroom every night. A physical examination and a sleep hygiene history are noncontributory. The primary care NP should prescribe:

zaleplon.

ZolpiMist.

ramelteon.

chloral hydrate.

Question 3

2 / 2 pts

A 5-year-old child who has no previous history of otitis media is seen in clinic with a temperature of 100° F. The primary care NP visualizes bilateral erythematous, nonbulging, intact tympanic membranes. The child is taking fluids well and is playing with toys in the examination room.The NP should:

prescribe azithromycin once daily for 5 days.

prescribe amoxicillin twice daily for 10 days.

prescribe amoxicillin-clavulanate twice daily for 10 days.

initiate antibiotic therapy if the child’s condition worsens.

Question 4

2 / 2 pts

An 80-year-old patient with congestive heart failure has a viral upper respiratory infection. The patient asks the primary care NP about treating the fever, which is 38.5° C. The NP should:

recommend acetaminophen.

recommend high-dose acetaminophen.

tell the patient that antibiotics are needed with a fever that high.

tell the patient a fever less than 40° C does not need to be treated.

Question 5

2 / 2 pts

A patient who takes levodopa and carbidopa for Parkinson’s disease reports experiencing freezing episodes between doses. The primary care NP should consider using:

selegiline.

amantadine.

apomorphine.

modified-release levodopa.

Question 6

2 / 2 pts

A patient is being tapered from long-term therapy with prednisolone and reports weight loss and fatigue. The primary care NP should counsel this patient to:

consume foods high in vitamin D and calcium.

begin taking dexamethasone because it has longer effects.

expect these side effects to occur as the medication is tapered.

increase the dose of prednisolone to the most recent amount taken.

Question 7

2 / 2 pts

The primary care nurse practitioner (NP) sees a 50-year-old woman who reports frequent leakage of urine. The NP learns that this occurs when she laughs or sneezes. She also reports having an increased urge to void even when her bladder is not full. She is not taking any medications. The NP should:

perform a dipstick urinalysis.

prescribe desmopressin (DDAVP).

prescribe oxybutynin chloride (Ditropan XL).

teach exercises to strengthen the pelvic muscles.

Question 8

2 / 2 pts

A 7-year-old patient who has severe asthma takes oral prednisone daily. At a well-child examination, the primary care NP notes a decrease in the child’s linear growth rate. The NP should consult the child’s asthma specialist about:

gradually tapering the child off the prednisone.

a referral for possible growth hormone therapy.

giving a double dose of prednisone every other day.

dividing the prednisone dose into twice-daily dosing.

Question 9

2 / 2 pts

A patient who is taking isoniazid and rifampin for latent TB is seen by the primary care NP for a routine follow-up visit. The patient reports having nausea, vomiting, and a decreased appetite. The NP should:

ask about alcohol intake.

suggest taking the medications with food.

reassure the patient that these side effects are common.

order liver and renal function tests and serum glucose.

Question 10

2 / 2 pts

A primary care NP sees a child with asthma to evaluate the child’s response to the prescribed therapy. The child uses an ICS twice daily and an albuterol metered-dose inhaler as needed. The child’s symptoms are well controlled. The NP notes slowing of the child’s linear growth on a standardized growth chart. The NP should change this child’s medication regimen to a:

combination ICS/LABA inhaler twice daily.

short-acting 2-agonist (SABA) with oral corticosteroids when symptomatic.

combination ipratropium/albuterol inhaler twice daily.

SABA as needed plus a leukotriene modifier once daily.

Question 11

2 / 2 pts

A patient is newly diagnosed with Alzheimer’s disease stage 6 on the Global Deterioration Scale. The primary care NP should prescribe:

donepezil (Aricept).

rivastigmine (Exelon).

memantine (Namenda).

galantamine (Razadyne).

Question 12

2 / 2 pts

The primary care NP sees a 12-month-old infant who needs the MMR, Varivax, influenza, and hepatitis A vaccines. The child’s mother tells the NP that she is pregnant. The NP should:

administer all of these vaccines today.

give the hepatitis A and influenza vaccines.

give the Varivax, hepatitis A, and influenza vaccines.

withhold all of these vaccines until after the baby is born.

Question 13

2 / 2 pts

A parent brings a 5-year-old child to a clinic for a hospital follow-up appointment. The child is taking a medication at a dose equal to an adult dose.The parent reports that the medication is not producing the desired effects. The NP should:

order renal function tests.

prescribe another medication to treat this child’s symptoms.

discontinue the drug and observe the child for toxic side effects.

obtain a serum drug level and consider increasing the drug dose.

Question 14

2 / 2 pts

An NP orders an inhaled corticosteroid 2 puffs twice daily and an albuterol metered-dose inhaler 2 puffs every 4 hours as needed for cough or wheezing for a 65-year-old patient with recent onset of reactive airways disease who reports symptoms occurring every 1 or 2 weeks. At a follow-up appointment several months later, the patient reports no change in frequency of symptoms. The NP’s initial action should be to:

order spirometry to evaluate pulmonary function.

prescribe a systemic corticosteroid to help with symptoms.

ask the patient to describe how the medications are taken each day.

give the patient detailed information about the use of metered-dose inhalers.

Question 15

2 / 2 pts

A patient is diagnosed with a condition that causes chronic pain. The primary care NP prescribes an opioid analgesic and should instruct the patient to:

wait until the pain is at a moderate level before taking the medication.

take the medication at regular intervals and not just when pain is present.

start the medication at higher doses initially and taper down gradually.

take the minimum amount needed even when pain is severe to avoid dependency.

Question 16

2 / 2 pts

A patient tells the primary care NP that he has difficulty getting and maintaining an erection. The NP’s initial response should be to:

prescribe sildenafil (Viagra).

perform a medication history.

evaluate his cardiovascular status.

order a papaverine injection test to screen for erectile dysfunction.

Question 17

2 / 2 pts

A 55-year-old patient develops Parkinson’s disease characterized by unilateral tremors only. The primary care NP will refer the patient to a neurologist and should expect initial treatment to be:

levodopa.

carbidopa.

pramipexole.

carbidopa/levodopa.

Question 18

2 / 2 pts

A patient who has migraine headaches without an aura reports difficulty treating the migraines in time because they come on so suddenly. The patient has been using over-the-counter NSAIDs. The primary care NP should prescribe:

frovatriptan (Frova).

sumatriptan (Imitrex).

cyproheptadine (Periactin).

dihydroergotamine (D.H.E. 45).

Question 19

2 / 2 pts

A woman tells a primary care NP that she is considering getting pregnant. During a health history, the NP learns that the patient has seasonal allergies, asthma, and epilepsy, all of which are well controlled with a second-generation antihistamine daily, an inhaled steroid daily with albuterol as needed, and an antiepileptic medication daily. The NP should counsel this patient to:

take her asthma medications only when she is having an acute exacerbation.

avoid using antihistamine medications during her first trimester of pregnancy.

discontinue her seizure medications at least 6 months before becoming pregnant.

use only oral corticosteroids and not inhaled steroids while pregnant for improved asthma control.

Question 20

2 / 2 pts

A patient who has partial seizures has been taking phenytoin (Dilantin). The patient has recently developed thrombocytopenia. The primary care nurse practitioner (NP) should contact the patient’s neurologist to discuss changing the patient’s medication to:

topiramate (Topamax).

levetiracetam (Keppra).

zonisamide (Zonegran).

carbamazepine (Tegretol).

Question 21

2 / 2 pts

A patient is taking dicloxacillin (Dynapen) 500 mg every 6 hours to treat a severe penicillinase-resistant infection. At a 1-week follow-up appointment, the patient reports nausea, vomiting, and epigastric discomfort. The primary care NP should:

change the medication to a cephalosporin.

decrease the dose to 250 mg every 6 hours.

reassure the patient that these are normal adverse effects of this drug.

order blood cultures, a white blood cell (WBC) count with differential, and liver function tests (LFTs).

Question 22

2 / 2 pts

A 75-year-old patient who lives alone will begin taking a narcotic analgesic for pain. To help ensure patient safety, the NP prescribing this medication should:

assess this patient’s usual sleeping patterns.

ask the patient about problems with constipation.

obtain a baseline creatinine clearance test before the first dose.

perform a thorough evaluation of cognitive and motor abilities.

Question 23

2 / 2 pts

A patient has been taking intramuscular (IM) meperidine 75 mg every 6 hours for 3 days after surgery. When the patient is discharged from the hospital, the primary care NP should expect the patient to receive a prescription for _____ mg orally every _____ hours.

hydrocodone 30; 6

hydrocodone 75; 6

meperidine 300;12

meperidine 75; 6

Question 24

2 / 2 pts

A patient who is obese and has hypertension is taking a thiazide diuretic and develops gouty arthritis, which is treated with probenecid. At a follow-up visit, the patient’s serum uric acid level is 7 mg/dL, and the patient denies any current symptoms. The primary care NP should discontinue the probenecid and:

prescribe colchicine.

prescribe febuxostat.

tell the patient to use an NSAID if symptoms recur.

counsel the patient to report recurrence of symptoms.

Question 25

2 / 2 pts

A mother brings her a college-age son to the primary care NP and asks the NP to talk to him about alcohol use. He reports binge drinking on occasion and drinking only beer on weekends. The NP notes diaphoresis, tachycardia, and an easy startle reflex. The NP should:

admit him to the hospital for detoxification.

ask him how much he had to drink last night.

prescribe lorazepam (Ativan) to help with symptoms.

suggest that he talk to a counselor about alcohol abuse.

Question 26

2 / 2 pts

A primary care NP sees a patient who has fever, flank pain, and dysuria. The patient has a history of recurrent urinary tract infections (UTIs) and completed a course of trimethoprim-sulfamethoxazole (TMP/SMX) the week before. A urine test is positive for leukocyte esterase. The NP sends the urine for culture and should treat this patient empirically with:

gemifloxacin.

ciprofloxacin.

azithromycin.

TMP/SMX.

Question 27

2 / 2 pts

A patient who takes carbamazepine (Tegretol) has been seizure-free for 2 years and asks the primary care NP about stopping the medication. The NP should:

order an electroencephalogram (EEG).

prescribe a tapering regimen of the drug.

inform the patient that antiepileptic drug (AED) therapy is lifelong.

tell the patient to stop the drug and use only as needed.

Question 28

2 / 2 pts

A primary care NP has been working with a young woman who wants to quit smoking before she begins having children. She has made several attempts to quit using nicotine replacement therapy and is feeling discouraged. She does not want to take medication at this time. The NP should:

discuss the effects of smoking on fetal development.

ask her to write down any factors that triggered her relapses.

give her information about the long-term effects of smoking.

convince her that taking medication will be essential in her case.

Question 29

2 / 2 pts

A primary care NP prescribes a nonselective NSAID for a patient who has osteoarthritis. The patient expresses concerns about possible side effects of this medication. When counseling the patient about the medication, the NP should tell this patient:

to avoid taking antacids while taking the NSAID.

to take each dose of the NSAID with a full glass of water.

that a few glasses of wine each day are allowed while taking the NSAID.

to decrease the dose of the NSAID if GI symptoms occur.

Question 30

2 / 2 pts

A patient has been taking a COX-2 selective NSAID to treat pain associated with a recent onset of RA. The patient tells the primary care NP that the pain and joint swelling are becoming worse. The patient does not have synovitis or extraarticular manifestations of the disease. The NP will refer the patient to a rheumatologist and should expect the specialist to prescribe:

methotrexate.

corticosteroids.

opioid analgesics.

hydroxychloroquine.

Question 31

2 / 2 pts

A patient has been taking an opioid analgesic for 2 weeks after a minor outpatient procedure. At a follow-up clinic visit, the patient tells the primary care NP that he took extra doses for the past 2 days because of increased pain and wants an early refill of the medication. The NP should suspect:

dependence.

drug addiction.

possible misuse.

increasing pain.

Question 32

2 / 2 pts

An elderly patient with dementia exhibits hostility and uncooperativeness. The primary care NP prescribes clozapine (Clozaril) and should counsel the family about:

a decreased risk of extrapyramidal symptoms.

improved cognitive function.

the need for long-term use of the medication.

a possible increased risk of heart disease and stroke.

Question 33

2 / 2 pts

A patient who was hospitalized for an infection was treated with an aminoglycoside antibiotic. The patient asks the primary care nurse practitioner (NP) why outpatient treatment wasn’t an option. The NP should tell the patient that aminoglycoside antibiotics:

are more likely to be toxic.

cause serious adverse effects.

carry more risk for serious allergic reactions.

must be given intramuscularly or intravenously.

Question 34

2 / 2 pts

A woman who is pregnant tells an NP that she has been taking sertraline for depression for several years but is worried about the effects of this drug on her fetus. The NP will consult with this patient’s psychiatrist and will recommend that she:

stop taking the sertraline now.

continue taking the antidepressant.

change to a monoamine oxidase inhibitor (MAOI).

discontinue the sertraline a week before delivery.

Question 35

2 / 2 pts

A patient who has HIV is being treated with Emtriva. The patient develops hepatitis B. The primary care NP should contact the patient’s infectious disease specialist to discuss:

adding zidovudine.

changing to Truvada.

changing to tenofovir.

ordering Combivir and tenofovir.

Question 36

2 / 2 pts

A patient who was in a motor vehicle accident has been treated for lower back muscle spasms with metaxalone (Skelaxin) for 1 week and reports decreased but persistent pain. A computed tomography scan is normal. The primary care NP should:

suggest ice and rest.

order physical therapy.

prescribe diazepam (Valium).

add an opioid analgesic medication.

Question 37

2 / 2 pts

A primary care NP sees a patient who has dysuria, fever, and urinary frequency. The NP orders a urine dipstick, which is positive for nitrates and leukocyte esterase, and sends the urine to the laboratory for a culture. The patient is allergic to sulfa drugs. The NP should:

order cefaclor (Ceclor).

prescribe cefixime (Suprax).

administer intramuscular ceftriaxone (Rocephin).

wait for culture results before ordering an antibiotic.

Question 38

2 / 2 pts

A patient comes to the clinic several days after an outpatient surgical procedure complaining of swelling and pain at the surgical site. The primary care NP notes a small area of erythema but no abscess or induration. The NP should:

prescribe TMP-SMX.

prescribe topical mupirocin four times daily.

suggest that the patient apply warm soaks three times daily.

refer the patient to the surgeon for further evaluation.

Question 39

2 / 2 pts

A patient who has genital herpes has frequent outbreaks. The patient asks the primary care NP why it is necessary to take oral acyclovir all the time and not just for acute outbreaks. The NP should explain that oral acyclovir may:

prevent the virus from developing resistance.

cause episodes to be shorter and less frequent.

actually eradicate the virus and cure the disease.

reduce the chance of transmitting the virus to others.

Question 40

2 / 2 pts

A patient is taking isoniazid, pyrazinamide, rifampin, and streptomycin to treat TB. The primary care NP should routinely perform:

serum glucose and liver function tests (LFTs).

bone marrow density and ophthalmologic tests.

ophthalmologic, hearing, and serum glucose tests.

color vision, serum glucose, and LFTs.

Question 41

2 / 2 pts

A primary care NP sees a patient who was recently hospitalized for infection and treated with gentamicin for 10 days. The patient tells the NP that the drug was discontinued early because “my blood level was too high.” The NP should order:

a serial audiometric test.

a serum blood urea nitrogen (BUN) and creatinine.

a urinalysis and complete blood count.

serum calcium, magnesium, and sodium.

Question 42

2 / 2 pts

A 40-year-old woman asks the primary care NP what she can do to minimize her risk of osteoporosis. She takes 800 mg of calcium and drinks 2 cups of skim milk each day. The NP should recommend that she:

decrease dietary fat.

limit her caffeine intake.

consume a high-protein diet.

drink diet instead of sugary sodas.

Question 43

2 / 2 pts

A patient has a sore throat with fever. The primary care NP observes erythematous 4+ tonsils with white exudate. A rapid antigen strep test is negative, and a culture is pending. The NP orders amoxicillin as empiric treatment. The patient calls the next day to report a rash. The NP should suspect:

penicillin drug allergy.

a viral cause for the patient’s symptoms.

a serum sickness reaction to the penicillin.

scarlatiniform rash from the streptococcal infection.

Question 44

2 / 2 pts

A patient is taking sulfisoxazole. The patient calls the primary care NP to report abdominal pain, nausea, and insomnia. The NP should:

change to TMP/SMX.

tell the patient to stop taking the drug immediately.

reassure the patient that these are minor adverse effects of this drug.

order a CBC with differential, platelets, and a stool culture.

Question 45

2 / 2 pts

A patient is in the clinic with acute symptoms of anxiety. The patient is restless and has not slept in 3 days. The primary care NP observes that the patient is irritable and has moderate muscle tension. The patient’s spouse reports that similar symptoms have occurred before in varying degrees for several years. The NP should refer the patient to a psychologist and should prescribe which drug for short-term use?

Alprazolam

Buspirone

Melatonin

Zolpidem

Question 46

2 / 2 pts

A woman who takes oral contraceptive pills develops vaginal candidiasis. The primary care NP prescribes a single dose of fluconazole. When counseling the patient about this drug, the NP should tell her:

that the drug is safe if she were to become pregnant.

that she may consume alcohol while taking this medication.

to use a backup contraceptive method for the next 2 months.

that she may need a lower dose of fluconazole because she takes oral contraceptive pills.

Question 47

2 / 2 pts

A patient in the clinic reports taking a handful of acetaminophen extra-strength tablets about 12 hours prior. The patient has nausea, vomiting, malaise, and drowsiness. The patient’s aspartate aminotransferase and alanine aminotransferase are mildly elevated. The primary care NP should:

expect the patient to sustain permanent liver damage.

reassure the patient that these symptoms are reversible.

tell the patient that acetylcysteine cannot be given this late.

administer activated charcoal to remove acetaminophen from the body.

Question 48

2 / 2 pts

An NP sees a preschooler in clinic for the first time. When obtaining a medication history, the NP notes that the child is taking a medication for which safety and effectiveness in children has not been established in drug information literature. The NP should:

discontinue the medication.

order serum drug levels to evaluate toxicity.

report the prescribing provider to the Food and Drug Administration (FDA).

ask the parent about the drug’s use and side effects.

Question 49

2 / 2 pts

A patient who has Parkinson’s disease who takes levodopa and carbidopa reports having drooling episodes that are increasing in frequency. The primary care NP should order:

benztropine.

amantadine.

apomorphine.

modified-release levodopa.

Question 50

2 / 2 pts

The primary care NP sees a 6-month-old infant for a routine physical examination and notes that the infant has a runny nose and a cough. The parents report a 2-day history of a temperature of 99° F to 100° F and two to three loose stools per day. Other family members have similar symptoms. The infant has had two sets of immunizations at 2 and 4 months of age. The NP should:

administer the 6-month immunizations at this visit today.

schedule an appointment in 2 weeks for 6-month immunizations.

administer DTaP, Hib, IPV, hepatitis B, and PCV13 today and RV in 2 weeks.

withhold all immunizations until the infant’s temperature returns to normal and the cough is gone.

Question 51

2 / 2 pts

A patient who was recently hospitalized and treated with gentamicin tells the primary care NP, “My kidney function test was abnormal and they stopped the medication.” The patient is worried about long-term effects. The NP should:

monitor renal function for several months.

reassure the patient that complete recovery should occur.

refer the patient to a nephrologist for follow-up evaluation.

monitor serum electrolytes and serum creatinine and BUN.

Question 52

2 / 2 pts

A patient has begun treatment for HIV. The primary care NP should monitor the patient’s complete blood count (CBC) at least every _____ months.

1 to 3

3 to 6

6 to 9

9 to 12

Question 53

2 / 2 pts

A patient who was recently diagnosed with COPD comes to the clinic for a follow-up evaluation after beginning therapy with a SABA as needed for dyspnea. The patient reports occasional mild exertional dyspnea but is able to sleep well. The patient’s FEV1 in the clinic is 85% of predicted, and oxygen saturation is 96%. The primary care NP should recommend:

a combination LABA/ICS twice daily.

influenza and pneumococcal vaccines.

ipratropium bromide (Atrovent) twice daily.

home oxygen therapy as needed for dyspnea.

Question 54

2 / 2 pts

A patient who takes 150 mg of clozapine (Clozaril) twice daily calls the primary care NP at 10:00 AM one day to report forgetting to take the 8:00 AM dose. The NP should counsel the patient to:

take the missed dose now.

take 75 mg of clozapine now.

wait and take the evening dose at the usual time.

take the evening dose 2 hours earlier than usual.

Question 55

2 / 2 pts

A patient has been taking fluoxetine 20 mg every morning for 5 days and calls the primary care NP to report decreased appetite, nausea, and insomnia. The NP should:

suggest taking a sedative at bedtime.

change the medication to bupropion.

add trazodone to the patient’s regimen.

reassure the patient that these effects will subside.

Question 56

2 / 2 pts

A female patient presents with grayish, odorous vaginal discharge. The primary care NP performs a gynecologic examination and notes vulvar and vaginal erythema. Testing of the discharge reveals a pH of 5.2 and a fishy odor when mixed with a solution of 10% potassium hydroxide. The NP should:

order topical fluconazole.

order metronidazole 500 mg twice daily for 7 days.

withhold treatment until culture results are available.

prescribe a clotrimazole vaginal suppository for 7 days.

Question 57

2 / 2 pts

An 80-year-old patient has a diagnosis of glaucoma, and the ophthalmologist has prescribed timolol (Timoptic) and pilocarpine eye drops. The primary care NP should counsel this patient:

that systemic side effects of these medications may be severe.

that the combination of these two drugs may cause drowsiness.

to begin an exercise program to improve cardiovascular health.

that a higher dose of one or both of these medications may be needed.

Question 58

2 / 2 pts

An 18-month-old child who attends day care has head lice and has been treated with permethrin 1% (Nix). The parent brings the child to the clinic 1 week later, and the primary care NP notes live bugs on the child’s scalp. The NP should order:

lindane.

malathion.

ivermectin.

permethrin 5%.

Question 59

2 / 2 pts

An adult patient who has a viral upper respiratory infection asks the primary care nurse practitioner (NP) about taking acetaminophen for fever and muscle aches. To help ensure against possible drug toxicity, the NP should first:

determine the patient’s height and weight.

ask the patient how high the temperature has been.

tell the patient to take 325 mg initially and increase as needed.

ask the patient about any other over-the-counter (OTC) cold medications being used.

Question 60

2 / 2 pts

The primary care NP follows a patient who is being treated for RA with methotrexate. The patient asks the NP why the medication does not seem to alleviate pain. The NP tells the patient that:

an immunomodulator may be needed to control pain.

a higher dose of methotrexate may be needed to achieve pain control.

if methotrexate does not control pain, an opioid analgesic may be necessary.

methotrexate is used to slow disease progression and preserve joint function.

Question 61

2 / 2 pts

A patient has a UTI and will begin treatment with an antibiotic. The patient reports moderate to severe suprapubic pain. The primary care NP should prescribe:

ibuprofen as needed.

bethanechol (Urecholine).

phenazopyridine (Pyridium).

increased oral fluid intake to dilute urine.

Question 62

2 / 2 pts

The parent of an 8-year-old child recently diagnosed with AD/HD verbalizes concerns about giving the child stimulants. The primary care NP should recommend:

modafinil (Provigil).

guanfacine (Intuniv).

bupropion (Wellbutrin).

atomoxetine (Strattera).

Question 63

2 / 2 pts

The primary care NP is performing a medication reconciliation on a patient who takes digoxin for congestive heart failure and learns that the patient uses ibuprofen as needed for joint pain. The NP should counsel this patient to:

use naproxen (Naprosyn) instead of ibuprofen.

increase the dose of digoxin while taking the ibuprofen.

use an increased dose of ibuprofen while taking the digoxin.

take potassium supplements to minimize the effects of the ibuprofen.

Question 64

2 / 2 pts

A patient who takes valproic acid for a seizure disorder is preparing to have surgery. The primary care NP should order:

coagulation studies.

a complete blood count.

an EEG.

a creatinine clearance test.

Question 65

2 / 2 pts

A patient who has Alzheimer’s disease is taking 10 mg of donepezil daily and reports difficulty sleeping. The primary care NP should recommend:

decreasing the dose to 5 mg.

increasing the dose to 15 mg.

taking the drug in the morning.

taking the drug in the evening.

Question 66

2 / 2 pts

A child has been taking methylphenidate 5 mg at 8 AM, 12 PM, and 4 PM for 30 days after a new diagnosis of AD/HD and comes to the clinic for evaluation. The child’s mother reports that the child exhibits some nervousness and insomnia but is doing much better in school. The primary care NP should suggest:

discontinuing the 4 PM dose.

increasing the dose to 10 mg each time.

giving 10 mg at 8 AM and 5 mg at noon.

changing the dosing to 15 mg twice daily.

Question 67

2 / 2 pts

A 60-year-old woman is in the clinic for an annual well-woman examination. She has been taking alendronate (Fosamax) 10 mg daily for 4 years.Her last bone density test yielded a T-score of 2.0. Her urine NTx level today is 22. She walks daily. Her fracture risk is low. The primary care NP should recommend that she:

take a 1- to 2-year drug holiday.

change to 70 mg of alendronate weekly.

decrease the alendronate dose to 5 mg daily.

change to ibandronate (Boniva) 3 mg IV every 3 months.

Question 68

2 / 2 pts

The primary care nurse practitioner (NP) is seeing a patient who reports chronic lower back pain. The patient reports having difficulty sleeping despite taking ibuprofen at bedtime each night. The NP should prescribe:

diazepam (Valium).

metaxalone (Skelaxin).

methocarbamol (Robaxin).

cyclobenzaprine (Flexeril).

Question 69

2 / 2 pts

A patient reports smoking two or more packs of cigarettes per day and expresses a desire to quit smoking. The primary care NP learns that the patient smokes heavily during breaks at work and during the evening but with no established schedule. The NP should recommend:

bupropion (Wellbutrin).

nicotine replacement gum or nasal spray.

a high-dose 24-hour nicotine patch.

intensive smoking cessation counseling.

Question 70

2 / 2 pts

A patient is seen in the clinic with a 1-week history of frequent watery stools. The primary care NP learns that a family member had gastroenteritis a week prior. The patient was treated for a UTI with a sulfonamide antibiotic 2 months prior. The NP should suspect:

Clostridium difficile–associated disease (CDAD).

viral gastroenteritis.

serum sickness reaction.

recurrence of the UTI.

Question 71

2 / 2 pts

A female patient has vaginal candidiasis and has taken a single dose of fluconazole without resolution of the infection. The primary care NP obtains a culture and should order:

oral ketoconazole.

griseofulvin for 4 weeks.

another dose of fluconazole.

topical miconazole (Monistat).

Question 72

2 / 2 pts

A patient reports difficulty falling asleep and staying asleep every night and has difficulty staying awake during the commute to work every day.The NP should:

suggest the patient try diphenhydramine first.

perform a thorough history and physical examination.

teach about avoiding caffeine and good sleep hygiene.

suggest melatonin and consider prescribing Ambien if this is not effective.

Question 73

2 / 2 pts

A patient who is newly diagnosed with schizophrenia is overweight and has a positive family history for type 2 diabetes mellitus. The primary care NP should consider initiating antipsychotic therapy with:

ziprasidone (Geodon).

olanzapine (Zyprexa).

risperidone (Risperdal).

chlorpromazine (Thorazine).

Question 74

2 / 2 pts

A patient asks an NP about using an oral over-the-counter decongestant medication for nasal congestion associated with a viral upper respiratory illness. The NP learns that this patient uses loratadine (Claritin), a ?-adrenergic blocker, and an intranasal corticosteroid. The NP would be concerned about which adverse effects?

Liver toxicity

Excessive drowsiness

Rebound congestion

Tremor, restlessness, and insomnia

Question 75

2 / 2 pts

A patient has been taking paroxetine (Paxil) for major depressive symptoms for 8 months. The patient tells the primary care NP that these symptoms improved after 2 months of therapy. The patient is experiencing weight gain and sexual dysfunction and wants to know if the medication can be discontinued. The NP should:

change to a tricyclic antidepressant medication.

begin to taper the paroxetine and instruct the patient to call if symptoms increase.

tell the patient to stop taking the medication and to call if symptoms get worse.

continue the medication for several months and consider adding bupropion (Wellbutrin).

 

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