Nursing

Assignment: Random Asked Questions in Nrsing
Assignment: Random Asked Questions in Nrsing
1. Low plasma albumin causes edema as a result of a reduction in which pressure?
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Capillary hydrostatic
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Interstitial hydrostatic
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Plasma oncotic
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Interstitial oncotic
• Question Points: 2.0 / 2.0
2. An increase of carbon dioxide in arterial blood causes chemoreceptors to stimulate the respiratory centers to:
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decrease respiratory rate.
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increase respiratory rate.
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develop hypocapnia.
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develop hypercapnia.
• Question Points: 2.0 / 2.0
3. What is an example of compensatory hyperplasia?
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Hepatic cells increase cell division after part of the liver is excised.
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Skeletal muscle cells atrophy as a result of paralysis.
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The heart muscle enlarges as a result of hypertension.
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The size of the uterus increases during pregnancy.
• Question Points: 2.0 / 2.0
4. Bacteria that produce endotoxins that stimulate the release of inflammatory mediators that produce fever are called
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pyrogenic bacteria.
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true bacteria.
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exotoxins.
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spirochetes.
• Question Points: 2.0 / 2.0
5. Which NSAID is generally considered the safest for use in patients with coronary artery disease?
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Celecoxib
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Indomethacin
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Naproxen
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Acetaminophen
• Question Points: 2.0 / 2.0
6. Cell wall inhibitors include all of the following except
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penicillins.
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cephalosporins.
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carbapenems.
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tetracylclines.
• Question Points: 2.0 / 2.0
7. In the immediate postnatal period, infants lose approximately 5% of body weight due to
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loss of body water
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inability of the body to digest nutrients
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hemolysis of red blood cells
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poor sucking reflex
• Question Points: 2.0 / 2.0
8. Heparin exerts its therapeutic action by:
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upregulating the activity of one of the body’s natural anticoagulant molecules, antithrombin III.
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deactivating calcium-dependent clotting factors.
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inducing prothrombin formation.
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inducing the formation of fibrin.
• Question Points: 2.0 / 2.0
9. Pulmonary hypertension:
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shows an enlarged pulmonary artery.
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involves deep vein thrombosis.
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shows right ventricular hypertrophy.
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Shows an enlarged pulmonary artery and right ventricular hypertrophy.
10. Which of the following factors do not influence bioavailability?
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First-pass hepatic metabolism
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Solubility of the drug
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Bioequivalence
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Chemical instability
11. Which of the following is true regarding prodrugs?
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They are affected considerably by renal function.
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They are better than amateur drugs.
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They are designed to overcome undesirable properties of an active drug.
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They may be more effective in patients with liver dysfunction.
12. When looking at arterial blood gas readings, you discover the following: pH 7.26, pCO2 56, HCO3 24. What condition are you dealing with?
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Respiratory alkalosis
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Metabolic acidosis
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Metabolic alkalosis
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Respiratory acidosis
• Question Points: 2.0 / 2.0
13. How many months does it take for the newborn to be sufficiently protected by antibodies produced by its own B cells?
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1 to 2
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4 to 5
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6 to 8
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10 to 12
• Question Points: 2.0 / 2.0
14. What mechanism can cause hypernatremia?
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Syndrome of inappropriate antidiuretic hormone
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Hypersecretion of aldosterone
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Brief bouts of vomiting or diarrhea
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Excessive diuretic therapy
15. In the absence of susceptibility data for an acute infection, the choice of an antimicrobial drug is mostly influenced by
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the site of infection and the patient’s history.
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the sensitivity report and the colony count.
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the source of the infection and the color of exudate.
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the host defense mechanism and the immune response.
16. Which of the following increases the potential of cardiac toxicity if taken concurrently with digoxin?
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Chloride
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Potassium
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Sodium
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Zinc
• Question Points: 2.0 / 2.0
17.When looking at arterial blood gas readings, you discover the following: pH 7.75, pCO2 24, HCO3 40. What condition are you dealing with?
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Respiratory alkalosis
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Metabolic acidosis
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Metabolic alkalosis
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Respiratory acidosis
• Question Points: 0.0 / 2.0
18.Which of the following statements is true regarding bioavailability?
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It has little effect on the pharmacokinetics of orally-administered drugs.
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It is a drug-specific property; therefore, bioavailability will be the same regardless of the dosage form used.
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IV-administered drugs have a bioavailability of between 50 and 75 percent.
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It is defined as the amount of administered drug that is available to reach the site of action.
Question Points: 2.0 / 2.0
19.Which of the following drugs are not considered for use with angina?
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Beta blockers
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Calcium channel blockers
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ACE inhibitors
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Nitrates
• Question Points: 2.0 / 2.0
NUR 440 Final Project Milestone Two: PICO(T) Guidelines and Rubric Overview: In Milestone One, you submitted a topic proposal for instructor approval and feedback. For Milestone Two, you will incorporate any feedback and formulate a PICO(T) question which will guide your research for the integrative review of the literature. Your PICO(T) question will assist you in the process of finding and evaluating evidence related to your outcome as you continue to build upon your final project. Prompt: For this milestone, you will turn your topic into a PICO(T) question by answering each of the questions posed below: ? Identify the population of interest; what are their characteristics? Specifically, what group of individuals will be impacted by your identified intervention? ? What is the intervention of interest? (Intervention) ? What is the comparison intervention? (Comparison) ? What consequences are we interested in? (Outcome) ? What is the time frame? If a specified time frame is not appropriate for your question, please articulate why a time frame is not applicable. For examples of PICO(T), refer to your module resources. Guidelines for Submission: Your PICO(T) question must be submitted as a 1–2 paragraph Microsoft Word document with double spacing, 12-point Times New Roman font, one-inch margins, and any sources cited in APA format
Source: https://www.homeworkjoy.com/questions/health-care/604606-NUR-440-Final-Project-Milestone-Two/
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Assignment: Arab American Femininities
Assignment: Arab American Femininities
Before participating in this discussion, be sure that you have read Chapter 10, “Arab American Femininities,” and Chapter 11, “Becoming La Mujer,” in your textbook. Also, feel free to read the optional article, .
For this discussion activity, compare and contrast the experiences of Nadine Naber (Chapter 10, “Arab American Femininities”) and Marisa Navarro (Chapter 11, “Becoming La Mujer”). Explain also how the constructions, or dominant ways of thinking, of female sexuality vary by race and socioeconomic class.
In response to your classmates, discuss how bodies can serve as battlegrounds.
https://books.google.com/books?id=rjT5pSZgGV4C&pg=PA49&lpg=PA49&dq=Becoming+La+Mujer+by+Marisa+Navarro.&source=bl&ots=UGk6IHygtw&sig=CAc3_NoU1-4Jzl-KYanj0fCPDqs&hl=en&sa=X&ved=0ahUKEwjqqKif4pTQAhUCVyYKHZGKBWMQ6AEINDAE#v=onepage&q=Becoming%20La%20Mujer%20by%20Marisa%20Navarro.&f=false
The relationship between the organization and its members can be greatly influenced by what motivates individuals to work. The style of leadership, job design, resources on the job, and environment can all have a significant effect on the satisfaction of employees and their performance. Performance is also influenced by individual motivations (e.g., social, recognition, financial reward, personal growth and development, and/or intrinsic satisfaction) and can equally impact the organization. There are many theories that attempt to explain the nature of motivation. Write a four- to five-page paper (excluding the title and reference pages) evaluating the relationship between motivation, job satisfaction, and work performance. Be sure to address the following:
1. Describe a performance issue which resulted from a motivational problem (what, why, who).
2. Use a content theory of motivation (e.g., Maslow, Alderfer, Herzberg, or McClelland) or a process theory (i.e., Adams, Locke, or Heider and Kelley) to explain how the issue creates a performance problem for the organization.
3. Use the theory of motivation you selected to describe an intervention/action to change the motivation/behavior and correct the performance problem.

NRS 433 Topic Discussions
Topic 1 DQ 1
PICOT is utilized by the health care community to identify and study a nursing or medical practice problem. Consequently, PICOT examples that may provide insight into the use of the PICOT process, may not be relevant to nursing practice as they are based on a medical practice problem.
Describe the difference between a nursing practice problem and a medical practice problem. Provide one example of each. Discuss why is it important to ensure your PICOT is based on a nursing practice problem.
TOPIC 1 DQ 2
Nursing research is used to study a dilemma or a problem in nursing. Examine a problem you have seen in nursing. Provide an overview of the problem and discuss why the problem should be studied. Provide rational and support for your answer.
TOPIC 2 DQ 1
Qualitative data has been described as voluminous and sometimes overwhelming to the researcher. Discuss two strategies that would help a researcher manage and organize the data.
TOPIC 2 DQ 2
The three types of qualitative research are phenomenological, grounded theory, and ethnographic research. Compare the differences and similarities between two of the three types of qualitative studies and give an example of each.
Re: Topic 2 DQ 2
Two types of qualitative research are phenomenology and grounded theory. Grand Canyon provides the following definitions of both:
“ provides an approach that allows researchers to better understand a person’s lived experiences to gain a deeper understanding of significant phenomena in life. Data is usually collected through extensive interviews and conversations with study subjects. Sample sizes are generally small when this methodology is used” (Grand Canyon University, 2018).
An example of phenomenology research could be described as a child with ADD or ADHD who repetitively has to be reminded to stay on task in school, quit talking, stay in your seat, and keeping their hands to themselves. Behaviors sometimes leading to extra attention being placed on them from teachers due to their frequent disruption in class, fellow students looking at them differently, and being portrayed as “trouble makers.” Behaviors and observations could lead to other mental health problems such as depression, anxiety, defiant obedience disorder. Interviewing a group of children with the diagnosis of ADD or ADHD, obtaining their thoughts and point of view of how they feel and perceive they are doing in school, if they are able to get along with others, and what their social interactions are.
is an approach that allows for researchers to consider phenomena of significance to nursing. The aim is to understand actions taken in an area by those who are involved in performing the actions”(Grand Canyon University, 2018). Using the same scenario from above, students with ADD or ADHD, interviewing students asking open-ended questions to find out why they were being disruptive in class, unable to stay in their seats, and unable to keep their hands to themselves.
“Grounded theory studies are generally focused on social processes or actions: they ask about what happens and how people interact. Grounded theory studies begin with open questions, and researchers presume that they may know little about the meanings that drive the actions of their participants”(Sbaraini, Carter, Evans, & Blinkhorn, (2011).
Phenomenology research aims to gain an understanding of a person’s lived experiences to gain a deeper understanding of the significance, whereas grounded theory aims to understand the actions taken by those performing them. Similarly, both methods are considering others significant experience in life.
“Grounded theory and phenomenology appear to be particularly susceptible to the blurring trend observed by Morse (1989). It is not uncommon for an investigator to purport to use one or the other while in fact combining elements of each. The two approaches certainly share a number of characteristics. Both focus on the richness of human experience, seek to understand a situation from subject’s own frame of reference, and use flexible data collection procedures. Nonetheless, they are based on different intellectual assumptions and, flowing from these, have clear differences in purpose and methodological prescriptions”(Baker, Wuest, & Stern, (1992).
Reference:
Baker, C., Wuest, J., & Stern, P. N. (1992). Method slurring: the grounded theory/phenomenology example. Journal of Advanced Nursing, 17(11), 1355–1360. doi: 10.1111/j.1365-2648.1992.tb01859.x
Grand Canyon University (Ed). (2018). Nursing research: Understanding methods for best practice.Retrieved from https://lc.gcumedia.com/nrs433v/nursing-research-understanding-methods-for-best-practice/v1.1ch.2
Sbaraini, A., Carter, S. M., Evans, R. W., & Blinkhorn, A. (2011, September 9). How to do a grounded theory study: a worked example of a study of dental practices. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3184112/
TOPIC 3 DQ 1
Provide examples of experimental and nonexperimental research design. Contrast the levels of control applied to each.
TOPIC 3 DQ 2
Describe sampling theory and provide examples to illustrate your definition. Discuss generalizability as it applies to nursing research.
Re: Topic 3 DQ 2
Sampling theory is a study of relationships existing between a population and samples drawn from the population, Also it is the hypothesis that is pertinent just too arbitrary examples. For this reason, the population or a universe might be characterized as a total of things having a typical characteristic or attributes. At the end of the day, a universe is the complete gathering of things about which information is looked for.
Sampling theory was developed to determine the most effective way to acquire a sample that accurately reflects the population under study. Key concepts of sampling theory include populations, target population, sampling or eligibility criteria, accessible population, elements, representativeness, sampling frames, and sampling plans or methods. (Burns & Groves, 2015). A sampling plan or method outlines strategies used to obtain a sample for a study. As a design, a sampling plan is not specific to a study. The plan is designed to increase representativeness and decrease systematic variation or bias. The sampling plan may use probability (random) or nonprobability (nonrandom) sampling methods. When critically appraising a study, identify the study sampling plan as either probability or nonprobability, and determine the specific method used to select a sample. NRS 433 Topic Discussions
The research design, populations, and setting are important components that help answer the research questions and inform nurses if findings will be relevant to their practice. For nurses to be consumers of research, being able to critique the theory that is being tested, determine if the design is appropriate to answer the question and decide if the sample supports generalization, adds to knowledge translation and depth of research. To help determine when the research can be applied to their practice, they need to be able to assess these components for applicability to their practice and setting.
References
Burns, N., Grove, S. (2011). Understanding Nursing Research, 5th Edition. [Pageburstl]. Retrieved from https://pageburstls.elsevier.com/#/books/978-1-4377-0750-2/
TOPIC 3 DQ 2
Describe sampling theory and provide examples to illustrate your definition. Discuss generalizability as it applies to nursing research.
TOPIC 4 DQ 1
Compare independent variables, dependent variables, and extraneous variables. Describe two ways that researchers attempt to control extraneous variables. Support your answer with peer-reviewed articles.
TOPIC 4 DQ 2
Describe the “levels of evidence” and provide an example of the type of practice change that could result from each.
Re: Topic 4 DQ 2
“According to nurse.com there are 4 levels of evidence. Level A is the strongest and Level C is the weakest with a new level added in 2013, Level ML, multilevel, was added to identify clinical practice guidelines that contain recommendations based on more than one level of evidence”(https://www.nurse.com/evidence-based-practice). NRS 433 Topic Discussions
Level A, the strongest of the levels, consist of evidence obtained from randomized control trials, systemic review or meta- analysis, and clinical practice guidelines.
Level A has gone through a filtering process and gathered the most accurate data from research to provide evidence-based practice. Therefore, nursing and medical practice greatly benefits from research from this level in providing the most up to date, accurate care to patients. An example would be doctors not injecting epinephrine into fingers due to research from 1950, that was later discredited stating procaine added to epinephrine was the cause of ischemia not epinephrine. “Further analysis found that the addition of procaine to the epinephrine injection was the cause of the ischemia. The procaine used in these injections included toxic acidic batches that were recalled in 1948. In addition, several cohort studies found no complications from the use of epinephrine in the fingers and hand. The results from these cohort studies increased the level of evidence. Based on the best available evidence from these studies, the hypothesis that epinephrine injection will harm fingers was rejected”(Burns, Rohrich, & Chung, (2011).
Level B consist of evidence obtained from well-designed control trials without randomization, clinical cohort study, case-controlled study, uncontrolled study, epidemiological study, and qualitative/quantitative study. Evidence from this level is still of more accurate research, but not as good as in level A. An example of this would be plastic surgery for silicone breast implants causing lymphoma, but after more research, there was not sufficient evidence to prove the fact. Providers providing care with evidence based practice from level B are using more research based practice with safer practices.
Level C, the weakest of the levels, is consisted of evidence from consensus viewpoint and expert opinion meta synthesis.
Nursing practice provided as a result of research from level C could result in biased, unsafe care. An example would be a provider giving his professional opinion that it is safe to bend and twist six weeks after lumbar surgery. Given this one provider’s opinion is not enough evidence to determine whether it is safe or not for the patient to do those things without more research.
Level ML(multilevel) was added in 2013. It consist of clinical practice guidelines, recommendations based on evidence obtained from more than one level of evidence
Reference:
Burns, P. B., Rohrich, R. J., & Chung, K. C. (2011, July). The levels of evidence and their role in evidence-based medicine. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3124652/
(n.d.). What is Evidence-Based Practice in Nursing? Retrieved from https://www.nurse.com/evidence-based-practice

TOPIC 5 DQ 1
The theoretical foundations of qualitative and quantitative methods are very different, but many researchers believe both methods should be used in the research study to increase validity and reliability. What advantages or disadvantages do you see in using both types of methods in a nursing study? Support your answer with current evidence-based literature.
TOPIC 5 DQ 2
According to the textbook, nurses in various settings are adopting a research-based (or evidence-based) practice that incorporates research findings into their decisions and interactions with clients. How do you see this being applied in your workplace?

Clinical Reasoning: Pediatrics
Clinical Reasoning: Pediatrics
Module 7 discussion
DQ1 Clinical Reasoning: Pediatrics
Respond to the following:
Question 1: How would you organize this visit and what would be your first priority? What should you know about Cystic Fibrosis as a primary care provider?
Question 2: You make a diagnosis of poison ivy, but you decide to draw Measles titer on Jason, out of caution. What should you discuss next with Jason and Ms. Reynolds? What activities would you suggest to promote Jason’s health?
Question 3: Should you consider speaking with Ms. Reynolds during the visit about her possible pregnancy? Discuss the heredity component of cystic fibrosis. What diagram is used to describe dominant and recessive traits?
You are expected to participate in academic conversations with peers and faculty to generate scholarly dialogue. Expectations for participation in the course discussions are described under the Discussion Rubric: Exploration, Spirit of Inquiry, and Engagement (interactions) when relating your experiences, opinions, viewpoints, and ideas supported by evidence.
Submission Instructions
Consult the Discussion Posting Guide for information about writing your discussion posts. It is recommended that you write your post in a document first. Check your work and correct any spelling or grammatical errors. When you are ready to make your initial post, click “Reply.” Then copy/paste the text into the message field, and click “Post Reply.”
To respond to a peer, click “Reply” beneath her or his post and continue as with an initial post.
Evaluation
This discussion will be graded using the discussion board rubric. Please review this rubric, located on the Rubrics page within the Start Here module of the course, prior to beginning your work to ensure your participation meets the criteria in place for this discussion. All discussions combined are worth 15% of your final course grade.
Image Source: www.shutterstock.com
DQ2 Clinical Reasoning: Older Adult
Respond to the following:
Question 1: You are the Nurse Practitioner Hospitalist and you are asked to admit Ms. Winchester to the hospitalist service. What are your concerns regarding the treatment of this patient with Parkinson’s Disease (PD) and mild cognitive impairment (MCI)? How should she be managed in the hospital? What preoperative test(s) should you order for this patient?
Question 2: There are several things that could be causing Ms. Winchester’s acute confused state prior to her fall. What studies should be ordered to rule out another cause of her confusion (other than the fall)?
Question 3: What would you include in your postoperative plan if Ms. Winchester’s surgery goes well? Include her family in this plan.
You are expected to participate in academic conversations with peers and faculty to generate scholarly dialogue. Expectations for participation in the course discussions are described under the Discussion Rubric: Exploration, Spirit of Inquiry, and Engagement (interactions) when relating your experiences, opinions, viewpoints, and ideas supported by evidence.
Submission Instructions
Consult the Discussion Posting Guide for information about writing your discussion posts. It is recommended that you write your post in a document first. Check your work and correct any spelling or grammatical errors. When you are ready to make your initial post, click “Reply.” Then copy/paste the text into the message field, and click “Post Reply.”
To respond to a peer, click “Reply” beneath her or his post and continue as with an initial post.
Evaluation
This discussion will be graded using the discussion board rubric. Please review this rubric, located on the Rubrics page within the Start Here module of the course, prior to beginning your work to ensure your participation meets the criteria in place for this discussion. All discussions combined are worth 15% of your final course grade.

Assignment: Event Process
Assignment: Event Process
Permalink:
Final Paper
We have determined that change is inevitable and subject to a number of variables attributing to the success or failure of the change process. The Final Paper is an exploration of a change initiative that you have personally experienced or researched. The paper should demonstrate your knowledge of the change process through a comprehensive analysis and discussion of the following aspects of organizational change. Your paper must include:
An identification and description of a professional change initiative personally experienced or researched.
A discussion of the change initiative as seen through the eyes of the leader and the follower.
A discussion of the successes and failures experienced during the change event.
An analysis of the concepts and theories used to facilitate the change process.
An evaluation of the impact of the change upon the organization.
A discussion on the sustainability of the change effort.
You must incorporate concepts and theories relating to the change process as they apply to each section of the paper.
Writing the Final Paper
The Final Paper:
Must be eight to ten double-spaced pages in length (excluding the title and reference pages), and formatted according to APA style as outlined in the Ashford Writing Center.

Assignment: Capella FP6016 Assessment 3
Assignment: Capella FP6016 Assessment 3
Write a report on the application of population health improvement initiative outcomes to patient-centered care, based on information presented in an interactive multimedia scenario.
In this assessment, you have an opportunity to apply the tenets of evidence-based practice in both patient-centered care and population health improvement contexts. You will be challenged to think critically, evaluate what the evidence suggests is an appropriate approach to personalizing patient care, and determine what aspects of the approach could be applied to similar situations and patients.
By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:
Competency 1: Apply evidence-based practice to plan patient-centered care.
Evaluate the outcomes of a population health improvement initiative.
Develop an approach to personalizing patient care that incorporates lessons learned from a population health improvement initiative.
Competency 2: Apply evidence-based practice to design interventions to improve population health.
Propose a strategy for improving the outcomes of a population health improvement initiative, or for ensuring that all outcomes are being addressed, based on the best available evidence.
Competency 3: Evaluate outcomes of evidence-based interventions.
Propose a framework for evaluating the outcomes of an approach to personalizing patient care and determining what aspects of the approach could be applied to similar situations and patients.
Competency 4: Evaluate the value and relative weight of available evidence upon which to make a clinical decision.
Justify the value and relevance of evidence used to support an approach to personalizing patient care.
Competency 5: Synthesize evidence-based practice and academic research to communicate effective solutions.
Write clearly and logically, with correct grammar and mechanics.
Integrate relevant and credible sources of evidence to support assertions, correctly formatting citations and references using APA style. Assignment: Capella FP6016 Assessment 3
Preparation
In this assessment, you will base your Patient-Centered Care Report on the scenario presented in the Evidence-Based Health Evaluation and Application media piece. Some of the writing you completed and exported from the media piece should serve as pre-writing for this assessment and inform the final draft of your report. Even though the media piece presented only one type of care setting, you can extrapolate individualized care decisions, based on population health improvement initiative outcomes, to other settings.
Requirements
Note: The requirements outlined below correspond to the grading criteria in the scoring guide, so be sure to address each point. In addition, you may want to review the performance level descriptions for each criterion to see how your work will be assessed.
Writing, Supporting Evidence, and APA Style
Write clearly and logically, using correct grammar and mechanics.
Integrate relevant evidence from 3–5 current scholarly or professional sources to support your evaluation, recommendations, and plans.
Apply correct APA formatting to all in-text citations and references.
Attach a reference list to your report.
Report Content
Address the following points in a 4–6 page report:
Evaluate the expected outcomes of the population health improvement initiative that were, and were not, achieved.
Describe the outcomes that were achieved, their positive effects on the community’s health, and any variance across demographic groups.
Describe the outcomes that were not achieved, the extent to which they fell short of expectations, and any variance across demographic groups.
Identify the factors (for example: institutional, community, environmental, resources, communication) that may have contributed to any achievement shortfalls.
Propose a strategy for improving the outcomes of the population health improvement initiative, or ensuring that all outcomes are being addressed, based on the best available evidence.
Describe the corrective measures you would take to address the factors that may have contributed to achievement shortfalls.
Cite the evidence (from similar projects, research, or professional organization resources) that supports the corrective measures you are proposing.
Explain how the evidence illustrates the likelihood of improved outcomes if your proposed strategy is enacted
Develop an approach to personalizing patient care that incorporates lessons learned from the population health improvement initiative outcomes.
Explain how the outcomes and lessons learned informed the decisions you made in your approach for personalizing care for the patient with a health condition related to the population health concern addressed in the improvement initiative.
Ensure that your approach to personalizing care for the individual patient addresses the patient’s:
Individual health needs.
Economic and environmental realities.
Culture and family.
Incorporate the best available evidence (from both the population health improvement initiative and other relevant sources) to inform your approach and actions you intend to take.
Justify the value and relevance of evidence you used to support your approach to personalizing care for your patient.
Explain why your evidence is valuable and relevant to your patient’s case.
Explain why each piece of evidence is appropriate for both the health issue you are trying to correct and for the unique situation of your patient and their family.
Propose a framework for evaluating the outcomes of your approach to personalizing patient care.
Ensure that your framework includes measurable criteria that are relevant to your desired outcomes.
Explain why the criteria are appropriate and useful measures of success.
Identify the specific aspects of your approach that are most likely to be transferable to other individual cases.

Assignment : Systolic and Diastolic
Assignment : Systolic and Diastolic
Module 4 midterm
Question 1
How should you determine whether a murmur is systolic or diastolic?
Palpate the carotid pulse
Palpate the radial pulse
Judge the relative length of systole and diastole by auscultation
Correlate the murmur with a bedside heart monitor
Question 2
Common or concerning symptoms to inquire about in the General Survey and vital signs include all of the following except _________________.
changes in weight
fatigue and weakness
cough
fever and chills
Question 3
Mrs. Anderson presents with an itchy rash which is raised, and which appears and disappears in various locations. Each lesion lasts for many minutes. What most likely accounts for this rash?
Insect bite
Urticaria or hives
Psoriasis
Purpura
Question 4
Steve has just seen a 5-year-old girl who wheezes when exposed to cats. The patient s family history is positive for asthma. You think the child most likely has asthma. What have you accomplished?
You have tested your hypothesis
You have developed a plan
You have established a working diagnosis
You have created a hypothesis
Question 5
You note a painful ulcerative lesion near the medial malleolus, with accompanying hyperpigmentation. Which of the following etiologies is most likely?
Arterial insufficiency
Neuropathic ulcer
Venous insufficiency
Trauma
Question 6
You notice a strong pulse and then a weak pulse. The pattern continues. Which of the following is most likely?
Emphysema
Asthma exacerbation
Severe left heart failure
Cardiac tamponade
Question 7
Where is the point of maximal impulse (PMI) normally located?
In the left intercostal space, 7 to 9 cm lateral to the sternum
In the 5th intercostal space, 10 to 12 cm lateral to the sternum
In the 5th intercostal space, in the anterior axillary line
In the 5th intercostal space, in the mid-axillary line
Question 8
Sudden, painful unilateral loss of vision may be caused by which of the following conditions?
Vitreous hemorrhage
Central retinal artery occlusion
Macular degeneration
Optic neuritis
Question 9
Which of the following lists the proper sequence of examination for the abdomen?
Auscultation, inspection, palpation, percussion
Inspection, percussion, palpation, auscultation
Inspection, auscultation, percussion, palpation
Auscultation, percussion, inspection, palpation
Question 10
Which valve lesion typically produces a murmur of equal intensity throughout systole?
Aortic stenosis
Mitral insufficiency
Pulmonic stenosis
Aortic insufficiency
Question 11
You are performing a thorough cardiac examination. Which of the following chambers of the heart can you assess by palpation?
Left atrium
Right atrium
Right ventricle
Sinus node
Question 12
You are palpating the apical impulse in a patient with heart disease and find that the amplitude is diffuse and increased. Which of the following conditions could be a potential cause of an increase in the amplitude of the impulse?
Hypothyroidism
Aortic stenosis, with pressure overload of the left ventricle
Mitral stenosis, with volume overload of the left atrium
Cardiomyopathy
Question 13
Which of the following may be missed unless the patient is placed in the left lateral decubitus position and auscultated with the bell of the stethoscope?
Mitral stenosis murmur
Opening sap of the mitral valve
S3 and S4 gallops
All the above
Question 14
You are conducting a workshop on the measurement of jugular venous pulsation. As part of your instruction, you tell the students to make sure that they can distinguish between jugular venous pulsations and the carotid pulse. Which one of the following characteristics is typical of the carotid pulse?
Palpable
Soft, rapid, undulating quality
Pulsation eliminated by light pressure on the vessel
Level of pulsation changes with changes in position
Question 15
Which area of the fundus is the central focal point for incoming images?
The fovea
The macula
The optic disk
The physiologic cup
Question 16
Asymmetric blood pressure results (left versus right sides of the body) are seen in which of the following conditions?
Coronary Artery Disease
Congenital narrowing of the aorta
Diffuse atherosclerosis
Vasculitis as seen in systemic lupus erythematosus
Question 17
Which lung sound possesses the characteristics of being louder and higher in pitch, with a short silence between inspiration and expiration, and with expiration being longer than inspiration?
Bronchovesicular
Vesicular
Bronchial
Tracheal
Question 18
Which of the following is true of a grade 4-intensity murmur?
It is moderately loud.
It can be heard with the stethoscope off the chest
It can be heard with the stethoscope partially off the chest
It is associated with a “thrill”
Question 19
What is responsible for the inspiratory splitting of S2?
Closure of aortic and then the pulmonic valves
Closure of mitral and then the tricuspid valves
Closure of aortic and then the tricuspid valves
Closure of mitral and then the pulmonic valves
Question 20
Which of the following events occurs at the start of diastole?
Closure of the tricuspid valve
Opening of the pulmonic valve
Closure of the aortic valve
Production of the first heart sound S1
Question 21
Which of the following is consistent with good percussion technique?
Allow all of the fingers to touch the chest while performing percussion
Maintain a stiff wrist
Leave the plexor finger on the pleximeter after each strike
Strike the pleximeter over the distal interphalangeal joint
Question 22
Which of the following is consistent with the obturator sign?
Pain distant from the site used to check rebound tenderness
Right hypogastric pain with the right hip and knee flexed and the hip internally rotated
Pain with extension of the right thigh while the patient is on her left side or while pressing her knee against your hand with thigh flexion
Pain that stops inhalation in the right upper quadrant
Question 23
A patient presents for evaluation of a sharp aching chest pain which increases with breathing. Which anatomic area would you localize the symptoms to?
Musculoskeletal
Reproductive
Endocrine
Urinary
Question 24
Which of the following occurs in respiratory distress?
Speaking in sentences of 10 to 20 words
Skin between the ribs moves inward with inspiration
Neck muscles relaxed
Patient torso leans posteriorly
Question 25
Which of the following conditions would produce a hyperresonant percussion note?
Large pneumothorax
Lobar pneumonia
Pleural effusion
Empyema
Question 26
The components of the health history include all of the following except which one?
Review of systems
Thorax and lungs
Present illness
Personal and social items
Question 27
A patient comes to the emergency room for evaluation of shortness of breath. To which anatomical region would you assign symptoms?
Reproductive
Urinary
Cardiac
Hematologic
Question 28
You ask a patient to draw a clock. He fills in all the numbers on the right half of the circle. What do you suspect?
Hemianopsia
Fatigue
Oppositional defiant disorder
Depression
Question 29
Cody is a teenager with a history of leukemia and an enlarged spleen. Today, he presents with fairly significant left-upper quadrant pain. On examination of this area, a rough grating noise is heard. What is this sound?
It is a splenic rub.
It is a type of bowel noise.
It represents borborygmi.
It is a vascular noise.
Question 30
Which of the following is a “red flag” regarding patients presenting with headache?
Unilateral headache
Pain over the sinuses
Age over 50
Phonophobia and photophobia
Assignment: Difference Between Systolic or Diastolic
Assignment: Difference Between Systolic or Diastolic

NUR 440 Final Project Milestone Three Assignment
NUR 440 Final Project Milestone Three: Annotated Bibliography Guidelines and Rubric
Overview: In Milestone Two, you formulated your PICO(T) question. For Milestone Three, you will construct an annotated bibliography by using your PICO(T) to
guide your research. The annotated bibliography will assist you in gathering a detailed list of resources to use in your integrative review of the literature. An
annotated bibliography is an organized list of sources with an accompanying paragraph that describes, explains, and/or evaluates each entry in terms of quality,
authority, and relevance. The purpose of writing an annotated bibliography is to provide an overview of the research that has been published on a particular
topic.
Prompt: For this milestone, you will prepare an annotated bibliography with at least six citations. An annotation concisely paraphrases the main idea and
purpose of the selected resource. The annotation of a scholarly journal should identify the thesis (or research question, or hypothesis), the methods used, and its
discussion or conclusions. Remember that identifying the purpose is a different task than listing the resource’s contents. To be more precise, the annotation
should state why the contents are there. While constructing your annotations, be sure to include the following critical elements:
? Restate argument or thesis, methods, and conclusions (1–2 sentences)
? Evaluate/critique resource (1–2 sentences)
? Make connection to PICO(T) question (1–2 sentences)
Guidelines for Submission: Your annotated bibliography must be submitted as a 4–6 page Microsoft Word document with double spacing, 12-point Times New
Roman font, one-inch margins, and six sources cited in APA format. Your chosen sources must be recent (within the last five years), peer-reviewed, scholarly
journal articles, and should appear in alphabetical order.
NUR 440 Final Project Milestone Two
NUR 440 Final Project Milestone Two: PICO(T) Guidelines and Rubric Overview: In Milestone One, you submitted a topic proposal for instructor approval and feedback. For Milestone Two, you will incorporate any feedback and formulate a PICO(T) question which will guide your research for the integrative review of the literature. Your PICO(T) question will assist you in the process of finding and evaluating evidence related to your outcome as you continue to build upon your final project. Prompt: For this milestone, you will turn your topic into a PICO(T) question by answering each of the questions posed below: ? Identify the population of interest; what are their characteristics? Specifically, what group of individuals will be impacted by your identified intervention? ? What is the intervention of interest? (Intervention) ? What is the comparison intervention? (Comparison) ? What consequences are we interested in? (Outcome) ? What is the time frame? If a specified time frame is not appropriate for your question, please articulate why a time frame is not applicable. For examples of PICO(T), refer to your module resources. Guidelines for Submission: Your PICO(T) question must be submitted as a 1–2 paragraph Microsoft Word document with double spacing, 12-point Times New Roman font, one-inch margins, and any sources cited in APA format. NUR 440 Final Project Milestone Three Assignment

Assignment: Rules of Informed Consent
Assignment: Rules of Informed Consent
NUR3826 Ethical and Legal Aspects of Nursing
Week 2 discussion
DQ1 Are you knowledgeable about your own state statutes and regulations regarding informed consent?
1. Discuss the law or rules of informed consent in your state or workplace organization.
2. What ethical issues should be realized by practicing nurses in regards to consent?
3. How does the process of consenting patients for genetic testing differ?
4. Many patients or family members ask nurses for further clarification regarding genetic testing and often the response is in terms of what the health care provider himself or herself would do. Discuss this phenomenon and include the concept of “paternalism” in your remarks.
DQ2 Please thoroughly review the “Effective Documentation” and Electronic Medical Record (Computerized Charting)” content from Chapter Nine of the Guido (6th ed.) textbook.
After reviewing:
1) Discuss at least two of the findings you consider most important to your practice.
2) Does your present (or past) employer use Electronic Health Records (EHR)? If so, which technology platform is utilized? In your experience, describe your biggest challenges using EHR?
3) How can privacy and confidentiality be ensured with the use of electronic health records?
4) What ethical issues might arise from the use of technology in patient care?
5
Many patients or family members ask nurses for further clarification regarding genetic testing and often the response is in terms of what the health care provider himself or herself would do. Discuss this phenomenon and include the concept of “paternalism” in your remarks.
DQ2 Please thoroughly review the “Effective Documentation” and Electronic Medical Record (Computerized Charting)” content from Chapter Nine of the Guido (6th ed.) textbook.
Many patients or family members ask nurses for further clarification regarding genetic testing and often the response is in terms of what the health care provider himself or herself would do. Discuss this phenomenon and include the concept of “paternalism” in your remarks.
DQ2 Please thoroughly review the “Effective Documentation” and Electronic Medical Record (Computerized Charting)” content from Chapter Nine of the Guido (6th ed.) textbook.

Case Study: Cardiac Status
Case Study: Cardiac Status
This week’s graded discussion topic relates to the following Course Outcomes (COs)
CO1 Utilize prior knowledge of theories and principles of nursing and related disciplines to explain expected client behaviors, while differentiating between normal findings, variations, and abnormalities. (PO 1)
CO3 Utilize effective communication when performing a health assessment. (PO 3)
Esther Jackson is a 56-year-old black female who is 1-day post-op following a left radical mastectomy. During morning rounds, the off-going nurse shares with you during bedside report that the patient has been experiencing increased discomfort in her back throughout the night and has required frequent help with repositioning. She states that the patient was medicated for pain approximately 2 hours ago but is voicing little relief and states that you might want to mention that to the doctor when he rounds later this morning. With the patient appearing to be in no visible distress, you proceed on to the next patient’s room for report.
Approximately 1 hour later, you return to Ms. Jackson’s room with her morning pills and find her slumped over the bedside stand in tears. The patient states, “I don’t know what is wrong, I don’t feel right. My back hurts and I’m just so tired. What is wrong with me?” The patient refuses to take her medications at this time stating that she is starting to feel sick to her stomach.
Just then the nursing assistant comes into the patient’s room to record Ms. Jackson’s vital signs, you take this opportunity to quickly research the patient’s medication record to determine if she has a medication ordered for nausea. Upon return, the nursing assistant hands you the following vital signs: T 37, R 18, and BP 132/54, but states she couldn’t get the patient’s pulse because “it is all over the place.”
Please address the following questions related to the scenario.
What do you suspect is the cause of the patient’s symptoms?
Describe the course of action that you will take to confirm this suspicion and prevent further decline.
What further assessments, lab values, and tests will likely be ordered for this patient and how often? If testing is to be completed more than once, please explain the rationale for doing so.
While you are caring for this patient, how will you ensure that the needs of your other patients are being met?