Pn2

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Pn2

Question 1

A nurse working with clients with sickle cell disease (SCD) teaches about self-management to
prevent exacerbation and sickle cell crises. A client communicates the need for additional
teaching by which of the following statements.

A) “I will avoid extreme stress.”
B) “I will avoid exercise.”
C) “I will drink adequate fluid to avoid dehydration.”
D) I will avoid high altitudes.”

Question 2

A client experiencing a severe asthma attack has the following arterial blood gas results: Ph
7.33; PCO2 48 mm Hg: HCO3 26 mEq/L. Which order should the nurse implement first?

A) Sputum culture
B) Ipratropium inhaler
C) Albuterol nebulizer
D) Chest x-ray

Question 3

A client receiving a heparin infusion demonstrates signs of acute bleeding. Which of the
following should the nurse anticipate the provider to prescribe for to his client?

A) Aspirin
B) Protamine Sulfate
C) Naloxone
D) Vitamin K

Question 4

A nurse is completing the admission assessment of a client who has suspected Pulmonary
edema. Which of the following clinical infestations are expected? (select all that apply.)

A) Thick, yellow sputum
B) Tachypnea
C) Orthopnea
D) Increased urinary output
E) Persistent cough

Question 5

A client is diagnosed with acute peripheral arterial occlusion. The nurse should prepare to
provide which of the following interventions for this client?

A) Apply sequential compression devices (SCDS)
B) Place on a fluid restriction
C) Assist with ambulation
D) Administer heparin as prescribed

Question 6

The post-anesthesia care nurse is caring for a client who just has an aortic valve replacement
surgery. The client’s arterial gases are pH 72..; HCRO3 21 mEQ/L; PCO2 65 mm Hg; and PO2
58 mm Hg. Which is the priority action by the nurse?

A) Increasing the client’s oxygen flow rate
B) Auscultating lung sounds
C) Notifying the provider
D) Documenting the findings

Question 7

A client is receiving spironolactone to treat bilateral lower extremity edema. The nurse should
instruct the client to make which nutritional modification to prevent electrolyte imbalance?

A) Increase intake of milk and milk products
B) Restrict fluid intake to 1,000 ml/day
C) Do not use a salt substitute
D) Increase foods high in sodium

Question 8

A client has a history of heart failure and has been prescribed, digoxin, and potassium chloride.
The client has nausea, blurred vision, headache, and weakness. The nurse notes that the client
is confused, refusing to eat, and complaining of nausea. The nurse should assess the client for
signs of:

A) Pulmonary edema
B) Fluid deficit
C) Hyperkalemia
D) Digoxin toxicity

Question 9

Which action by a client with asthma indicates a good understanding of the nurse’s teaching
about peak flow meter use?

A) The client uses the albuterol metered -dose inhaler for peak flows in the yellow zone
B) The client calls the healthcare provider when the peak flows is in the green zone
C) The client records an average of five peak flow reading every day
D) The client inhales rapidly through the peak flow meter mouthpiece

QUestion 10

A nurse assesses a client in preparation for receiving a blood transfusion. Pre transfusing vitals
are temperature at 98.2 F, heart rate 82 beats/minute, respirations 18 breaths/minute, blood
pressure 1027 mm Hg, and oxygen saturation 96% on room air, fifteen minutes after starting the
transfusion, the nurse measures the following vital signs. Which of the following is the highest
priority of action?

A) Heart rate 112 beats/minute
B) Oxygen saturation 94% on room air
C) Temperature 98.6 F
D) Blood pressure 108/78 mm Hg

Question 11

A client is admitted with an abdominal aortic aneurysm (AAA). For which of the following
complications should the nurse be most concerned?

A) Loss of bowel sounds
B) Cardiac arrhythmias
C) Hypotension
D) ANeurysm rupture

Question 12

Which of the following statements should the nurse teach a client receiving heparin infusion?

A) Vitamin K is used to reverse the effects of heparin
B) International normalized ratio (INR) is use to assess its effectiveness
C) Heparin with facilitate clotting of the blood
D) Partial thromboplastin time value determine the dosage of heparin

Question 13

The nurse is caring for a group of clients on a pulmonary unit. The nurse can delegate which
task to unlicensed assistive personnel (UAP)?

A) Providing oral care
B) Monitoring client response to ambulation
C) Asserting pain level
D) Teaching the client how to use the incentive spirometer

Question 14

Isoniazid and rifampin have been prescribed for a client with tuberculosis. A nurse reviews the
medical record of the client. Which of the following notes would require the nurse to question the
order for these medications?

A) History of kidney stones
B) Triglyceride level of 142
C) Allergy of penicillin
D) Elevated AST and ALT levels

Question 15

Which of the following conditions is most commonly responsible for left heart failure?

A) Murmur
B) Tricuspid valve regurgitation
C) Hypertension
D) Pulmonary valve stenosis

Question 16

Which laboratory test will be most useful to the nurse in determining whether a client admitted
with acute shortness of breath has heart failure?

A) B-type natriuretic peptide (BNP)
B) Cholesterol
C) Serum creatine kinase (CK)
D) Arterial blood gases (ABGs)

Question 17

Which finding requires immediate intervention when planning care for an adolescent with cystic
fibrosis (CF)?

A) Chest pain with dyspnea
B) Delayed puberty
C) Poor weight gain

D) Large foul-smelling bulky stools

Question 18

A young adult is admitted to the emergency department after an automobile accident. The client
has severe pain in the right chest from contract with the steering wheel. What should the nurse
do first?

A) Perform a focused respiratory assessment
B) Reduce the client’s anxiety
C) Maintain adequate circulating volume
D) Administer pain medication

Question 19

A client who underwent a lobectomy and has a water seal chest drainage system appears to
have an increased work of breathing and a faster respiratory rate than 1 hour ago. The client’s
pulse rate is also increased. The nurse should do which of the following?

A) Check the tubing to ensure that the client is not lying on it or kinking it
B) Ensure that the chest tube has two clamps on it to prevent air leaks
C) Lower the drainage system 2 or 3 feet below the level on the client’s chest
D) Increase the section q

Question 20

The nurse is preparing a teaching plan for a client who is being discharged after being admitted
for atherosclerosis. The client has been taking simvastatin 40 mg for the last two years. The lab
results for the clients lipid panel result are total cholesterol 195 mg/dl; triglycerides 106 mg/dl;
and high-density lipoprotein (HDL) 69 mg/dl. Which action should the nurse take?

A) Tell the client that the cholesterol level are within normal limits
B) Review the chart for lab reports of hemoglobin and hematocrit
C) Instruct the client to lower the saturated fat in their diet
D) Ask if the client is taking the simvastatin regularly

Question 21

A client is experiencing an acute asthmatic attack. The client is noted to have respirations of 40
oxygen saturation 86% on room air, and lungs sounds with audible wheezing. Which arterial
blood response to treatment with albuterol?

A) pH: 7.27, CO2: 41 mm Hg, HCO3: 14 mm Hg
B) pH: 7.6, CO2: 34 mm Hg, HCO3: 24 Hg
C) pH: 7.12, CO2: 47 mm Hg, HCO3: 32 mm Hh
D) pH: 7.39, CO2: 36 mm Hg, HCO3: 23 mm Hg

Question 22

A nurse evaluates the following arterial blood gas and vital sign results for a client with chronic
(COPD):
Arterial Blood Gas REsults
pH=7.32
paO2=46mm Hg
hCO3= 28 mEq/L vital signs
Respiratory rate = 10 breath/min
Blood pressure= 145/65 mm Hg
Heart rate= 110 beats/min
Oxygen saturation= 76% on room air
Which action should the nurse take first

A) Document finding as expected for a client with COP
B) Teach the client diaphragmatic breathing techniques
C) Administer a short-acting beta 2 agonist inhaler
D) Initiate oxygenation therapy and titrate oxygen to achieve a target oxygen saturation of

88-92%

Question 23

The health care provider has just prescribed warfarin sodium for a client with a deep vein
thrombosis (DVT). The nurse knows that his client is still receiving intravenous heparin. Which is
the nurse’s best action?

A) Discontinue the heparin drip completely before warfarin sodium administration.
B) Turn off the heparin drip for 1 hour before administering the warfarin sodium.
C) Hold the dose of warfarin sodium
D) Administer the medication as prescribed

Question 24

A client with chronic bronchitis who has a new prescription for fluticasone and salmeterol
combination inhaler asks the nurse the purpose of using tw drugs. Which is the best response
by the nurse?

A) The combination of two drugs work more quickly in an acute asthma attack
B) One drug decreases inflammation, and the other is a bronchodilator.
C) The two drugs work together to block the effects of histamine of the bronchioles
D) It is a combination of long-acting and slow-acting bronchodilators

Question 25

Which assessment finding for a client receiving furosemide 40 mg, twice daily to treat stage 2
hypertension is most important to

A) Blood glucose level of 180 mg/dl
B) Early morning blood pressure reading of 164/90 mm Hg
C) Orthostatic systolic blood pressure decrease of 30 mm Hg
D) Blood potassium level of 4.2 mEq/L

Question 26

Which findings are significant data to gather from a client who has been diagnosed with
pneumonia? ( select all that apply.)

A) Color of nail beds
B) Amount of peripheral edema
C) Occurrence of chest pain
D) Quality of breath sounds
E) Presence of bowel sounds

Question 28

The provider ordered normal Saline with 20 mEQ of KcL to infuse at 100 mL/hr. The first liter
bag was hung at 1500. What time does the nurse anticipate needing to hang the second bag of
Iv fluids? (record answer in military time.)

Answer: 0100

Question 29

A client is undergoing diagnostic testing for infective endocarditis. Which of the following
laboratory tests would be most useful in diagnosis?

A) Reticulocyte count
B) Blood cultures
C) Basic Metabolic panel
D) Prothrombin time

Question 30

Which of the following statements indicated a client’s understanding of managing their
obstructive apnea?

A) “It is possible that my sleep apnea can be corrected if I exercise and watch my diet.”
B) “Using modafinil can cure my obstructive sleep apnea.”

C) “I should wait to take my sleep aid until I am ready for bed.”
D) “I will stop using my continuous positive airway pressure machine if it makes too much

noise.”

Question 31

When a client with hypertension with a new prescription for atenolol returns to the health clinic
after two weeks for a follow-up visit, the blood pressure is unchanged from the previous visit.
Which action should the nurse take first?

A) Remind the client that lifestyle changes also are essential in blood pressure control
B) Teach the client about the reason for a possible change in drug therapy
C) Question the client about whether the medication is actually being taken
D) Provide information about the use of multiple drugs to treat hypertension

Question 32

A client with an acute exacerbation of chronic obstructive pulmonary disease (COPD) is
admitted to the hospital. How can the nurse best position the client to improve gas exchange?

A) Resting in bed in a semi-fowler’s position with the knees flexed.
B) Resting in bed with the head elevated 45 to 60 degrees.
C) In the Trendelenburg position with several pillows behind the head.
D) Sitting up at the bedside or in a chair and leaning slightly forward.

Question 33

A nurse is caring for a client who has valvular heart disease and is at risk of developing
left-sided heart failure. Which of the following manifestations should alert the nurse the client is
developing this condition?

A) Anorexia
B) Dependent edema
C) Orthopnea
D) Weight gain

Question 34

A nurse is assessing a male client who has a diagnosis of acute arterial occlusion. Which of the
following findings should the nurse expect to find on the affected extremity? (select all that
apply.)

A) Pallor
B) Paralysis

C) Paresthesia
D) Petechiae
E) Pulselessness
F) Pain

Question 35

Which of the following would the nurse most likely assess in a client diagnosed with right-sided
heart failure?

A) Syncope
B) Hepatomegaly
C) Crackles
D) Cough with frothy blood-tinged sputum

Question 36

The nurse is caring for a client diagnosed with chronic obstructive pulmonary disease. Which of
the following interventions require extra care by the nurse?

A) Teaching the client diaphragmatic breathing
B) Encouraging fluids
C) Apply a cardiac monitor
D) Administering pain medications

Question 37

A client is having a laboratory test conducted to confirm a diagnosis of atherosclerosis. Which of
the following laboratory values would support this client’s medical diagnosis? (select all that
apply.)

A) Triglycerides 175 mg/dL
B) Blood glucose 115 mg/dL
C) High-density lipoprotein (HDL) 50 mg/dL
D) Serum-cholesterol 195 mg/dL
E) Low-density lipoprotein (LDL) 145 mg/dL
F) Potassium 5.9 mEq/L

Question 38

Of the following client assignments made by the charge nurse, which would be questioned?

A) The RN with 1 year of experience caring for a post-appendectomy client
B) The LPN with 5 years of experience changing a chronic foley

C) The RN with eight years of experience caring for a client with peripheral vascularisation
disease and total cholesterol of 390 mg/dL

D) The LPN with ten years of experience caring for a client with new complaints of chest
pressure

Question 39

Which arterial blood gas (ABG) values are expected with hyperventilation?

A) pH 7.249; PaCO2 64 mmHg
B) pH 7.56; PaC02 25 mmHg
C) pH 7.50; paC02 50 mmHg
D) pH 7.28; PaCO2 28 mmHg

Question 40

The nurse is assessing a client with chronic obstructive pulmonary disease (COPD). Which
requires immediate intervention?

A) Pursed-lip breathing
B) Inability to speak
C) Diminished lung sounds
D) Distant heart sounds

Question 41

A client with a history of aortic valve stenosis tell s the healthcare provider. “I don't have a lot of
energy anymore, and I have to sleep on 3 pillows at night.” Which of these problems does the
healthcare provider conclude is likely the cause of these clinical findings?

A) Left-sided heart failure
B) Right-sided heart failure
C) Peripheral venous disease

Question 42

A client is admitted to the hospital with a diagnosis of chronic venous insufficiency. Which of
these statements by the client is most consistent with the diagnosis?

A) “I can never seem to get my feet warm enough”
B) “I have pain in my legs after I walk three blocks”
C) “I should elevate my legs”
D) “I wake up during the night because my legs hurt”

Question 43

Which of the following medications should be used with caution in clients with asthma or chronic
obstructive pulmonary disease (COPD) due to their potential to cause bronchoconstriction?

A) Calcium channel blockers
B) Thiazide diuretics
C) Beta-blocker
D) ACE Inhibitors

Question 44
Which of the following should the nurse instruct a client newly diagnosed with hypertension on?

A) It can be managed easily
B) It is a short term problem
C) It is a lifelong process
D) It happens only in the very poor, and treatment is expensive

Question 45

The nurse assessing a client diagnosed with an abdominal aortic aneurysm (AAA). WHich of the
following sounds did the nurse likely auscultate during the assessment?

A) Bruit
B) Pleural rub
C) Crackles
D) Hyperactive bowel sounds

Question 46

A client is receiving an intravenous infusion of heparin sodium at 1,770 units/hr. The drug
concentration is heparin sodium 25,000 units/250ml. What is the rate (in mL/hr) the nurse must
infuse the medication at? (round the answer to the nearest whole number. Do not use a trailing
zero.)

Question 47

The nurse is assessing a 48-year-old client with a history of smoking during a routine clinic visit.
The client, who exercises regularly, reports having pain in the calf during the exercise that
disappears at rest. Which finding requires further evaluation?

A) Ankle-brachial index of 0.99
B) Oxygen saturation of 94% on room air
C) Diminished right pedal pulse
D) Heart rate 60 beats/minute

Question 48

The nurse is notifying the healthcare provider via telephone of a change in the condition of a
client diagnosed with exacerbation of asthma. Arrange the nursing statements in order as they
would by communicated using the SBAR method.
1.Mr.Smith was admitted yesterday with an exacerbation of asthma. He typically controls his
asthma with oral medication and inhaler at home. He orders albuterol treatments twice daily.
Oxygen is prescribed for a 2L nasal cannula.
2. I am notifying you because Bob Smith has become increasingly short of breath with audible
wheezing this afternoon.
3. I recommend that we increase his oxygen dose and prescribe an extra albuterol treatment.
4. Hello. My name is Nurse Jones from Unit D.
5. Respirations are now 32/minute. The pulse oximeter is 89% on 2 L nasal cannula. Lungs
reveal wheezing in all lung fields.

A) 4,5,1,2,3
B) 4,2,1,5,3
C) 4,1,2,5,3
D) 4,5,2,1,3

Question 49

The nurse is reviewing a medical record for a client with hypertension. Which of the following
medications may be used in the management of hypertension? (select all that apply)

A) Carvedilol
B) Hydrochlorothiazide
C) Ticagrelor
D) Loratadine
E) Verapamil
F) Valsartan

Question 50

Order for dobutamine to infuse at 20 mcg/kg/min. The client weighs 182 Ib. The pharmacy
supplied a bag of dobutamine 250 mg/250ml. What is the rate (in mL/hr) the nurse infuses the
medication at? (Round the answer to the nearest whole number. Do not use a trailing zero.)?

SOAP note

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Insomnia

week 2

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Choose a topic related to nursing education. You are to identify an issue, need, gap, or opportunity associated
with:
a. any issue in nursing education at any level (e.g. pre-licensure; post-licensure, graduate);
b. nursing education as it relates to a selected patient population; or
c. nursing education as it relates to healthcare administration. 

Assessment 3

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Assessment 3

Applying Ethical Principles

Competency 3

Apply ethical principles and academic standards to the study of health care.

Criterion

Summarize the facts of a case study using peer-reviewed journal articles as evidence to support analysis of the case.

Your Result: NON_PERFORMANCE

Does not summarize the facts of a case study using peer-reviewed journal articles as evidence to support analysis of the case.

Faculty Comments:

While you mention that the case study is one provided by Capella; unfortunately, you did not select one of the provided case studies that were listed in your instructions. Please review the written instructions and let me know if you have any questions.

Criterion

Discuss the effectiveness of the approach used by the professional in a case study as it relates to the three components of the ethical decision-making model.

Your Result: NON_PERFORMANCE

Does not discuss the effectiveness of the approach used by the professional in a case study as it relates to the three components of the ethical decision-making model.

Faculty Comments:

While you mention that the case study is one provided by Capella; unfortunately, you did not select one of the provided case studies that were listed in your instructions. Please review the written instructions and let me know if you have any questions.

Criterion

Apply ethical principles to a possible solution to the proposed problem or issue from a case study.

Your Result: NON_PERFORMANCE

Does not identify ethical principles related to the possible solution to the proposed problem or issue from the case study.

Faculty Comments:

While you mention that the case study is one provided by Capella; unfortunately, you did not select one of the provided case studies that were listed in your instructions. Please review the written instructions and let me know if you have any questions.

Competency 4

Write for a specific audience, in appropriate tone and style, in accordance with Capella's writing standards.

Criterion

Discuss the effectiveness of the communication approaches present in a case study.

Your Result: NON_PERFORMANCE

Does not discuss the effectiveness of the communication approaches present in a case study.

Faculty Comments:

While you mention that the case study is one provided by Capella; unfortunately, you did not select one of the provided case studies that were listed in your instructions. Please review the written instructions and let me know if you have any questions.

Criterion

Produce text with minimal grammatical, usage, spelling, and mechanical errors.

Your Result: BASIC

Produces text with some grammatical, usage, spelling, and mechanical errors, making text difficult to follow at times.

Faculty Comments:

Again, as mentioned in your previous assessment – your focus gets lost in your extravigant vocabulary. Please take a look at the example paper for ideas as to how your paper should look and sound.

Criterion

Integrate into text appropriate use of scholarly sources, evidence, and citation style.

Your Result: NON_PERFORMANCE

Does not integrate into text appropriate use of scholarly sources, evidence, and citation style.

Faculty Comments:

Your paper does not appear to be in APA format as discussed in the scoring guide of your previous assessment. Please utilize the resources provided to assist you with APA formatting. Additionally, you need to use literature that is recent and peer-reviewed. Resources should be 5 years old or less.

You should check two places for feedback from faculty: in the comments for each criterion above, and within the document itself, either as attached comments or within tracked changes.

Assessment 3 instructions

Introduction

Whether you are a nurse, a public health professional, a health care administrator, or in another role in the health care field, you must base your decisions on a set of ethical principles and values. Your decisions must be fair, equitable, and defensible. Each discipline has established a professional code of ethics to guide ethical behavior. In this assessment, you will practice working through an ethical dilemma as described in a case study. Your practice will help you develop a method for formulating ethical decisions.

Instructions

Note: The requirements outlined below correspond to the grading criteria in the scoring guide. At a minimum, be sure to address each point. In addition, you are encouraged to review the performance-level descriptions for each criterion to see how your work will be assessed.

For this assessment, develop a solution to a specific ethical dilemma faced by a health care professional. In your assessment:

Access the Ethical Case Studies media piece to review the case studies you will be using for this assessment.

Select the case most closely related to your area of interest and use it to complete the assessment.

Note: The case study may not supply all of the information you need. In such cases, you should consider a variety of possibilities and infer potential conclusions. However, please be sure to identify any assumptions or speculations you make.

Include the selected case study in your reference list, using proper APA style and format. Refer to the Evidence and APA section of the Writing Center for guidance.

Summarize the facts in a case study and use the three components of an ethical decision-making model to analyze an ethical problem or issue and the factors that contributed to it.

Identify which case study you selected and briefly summarize the facts surrounding it. Identify the problem or issue that presents an ethical dilemma or challenge and describe that dilemma or challenge.

Identify who is involved or affected by the ethical problem or issue.

Access the Ethical Decision-Making Model media piece and use the three components of the ethical decision-making model (moral awareness, moral judgment, and ethical behavior) to analyze the ethical issues.

Apply the three components outlined in the Ethical Decision-Making Model media.

Analyze the factors that contributed to the ethical problem or issue identified in the case study.

Describe the factors that contributed to the problem or issue and explain how they contributed.

Apply academic peer-reviewed journal articles relevant to an ethical problem or issue as evidence to support an analysis of the case.

In addition to the readings provided, use the Capella library to locate at least one academic peer-reviewed journal article relevant to the problem or issue that you can use to support your analysis of the situation. The NHS-FPX4000: Developing a Health Care Perspective Library Guide will help you locate appropriate references.

Cite and apply key principles from the journal article as evidence to support your critical thinking and analysis of the ethical problem or issue.

Review the Think Critically About Source Quality resource.

Assess the credibility of the information source.

Assess the relevance of the information source.

Discuss the effectiveness of the communication approaches present in a case study.

Describe how the health care professional in the case study communicated with others.

Assess instances where the professional communicated effectively or ineffectively.

Explain which communication approaches should be used and which ones should be avoided.

Describe the consequences of using effective and non-effective communication approaches.

Discuss the effectiveness of the approach used by a professional to deal with problems or issues involving ethical practice in a case study.

Describe the actions taken in response to the ethical dilemma or issue presented in the case study.

Summarize how well the professional managed professional responsibilities and priorities to resolve the problem or issue in the case.

Discuss the key lessons this case provides for health care professionals.

Apply ethical principles to a possible solution to an ethical problem or issue described in a case study.

Describe the proposed solution.

Discuss how the approach makes this professional more effective or less effective in building relationships across disciplines within his or her organization.

Discuss how likely it is the proposed solution will foster professional collaboration.

Write clearly and logically, with correct use of spelling, grammar, punctuation, and mechanics.

Apply the principles of effective composition.

Determine the proper application of the rules of grammar and mechanics.

Write using APA style for in-text citations, quotes, and references.

Determine the proper application of APA formatting requirements and scholarly writing standards.

Integrate information from outside sources into academic writing by appropriately quoting, paraphrasing, and summarizing, following APA style.

Example Assessment: You may use the following to give you an idea of what a Proficient or higher rating on the scoring guide would look like:

Ethical Case Studies to use for this assignment

Consider the ethical dilemma the health care professional is faced with in the selected case study. Pay particular attention to details that will help you analyze the situation using the three components of the Ethical Decision Making Model (moral awareness, moral judgment, and ethical behavior).

Note: The case study may not supply all of the information you may need for the assignment. In such cases, you should consider a variety of possibilities and infer potential conclusions. However, please be sure to identify any speculations that you make.

Case Study topic is the missing needle protector.

E. L. Straight is director of clinical services at Hopewell Hospital. As in many hospitals, a few physicians provide care that is acceptable, but not of very high quality; they tend to make more mistakes than the others and have a higher incidence of patients going “sour.” Since Straight took the position 2 years ago, new programs have been developed and things seem to be getting better in terms of quality.

Dr. Cutrite has practiced at Hopewell for longer than anyone can remember. Although once a brilliant general surgeon, he has slipped physically and mentally over the years, and Straight is contemplating taking steps to recommend a reduction in his privileges. However, the process is not complete, and Cutrite continues to perform a full range of procedures.

The operating room supervisor appeared at Straight's office one Monday afternoon. “We've got a problem,” she said, somewhat nonchalantly, but with a hint of disgust. “ I'm almost sure we left a plastic needle protector from a disposable syringe in a patient's belly, a Mrs. Jameson. You know, the protectors with the red–pink color. They'd be almost impossible to see if they were in a wound.”

“Where did it come from?” asked Straight.

“I'm not absolutely sure,” answered the supervisor. “All I know is that the syringe was among items in a used surgical pack when we did the count.” She went on to describe the safeguards of counts and records. The discrepancy was noted when records were reconciled at the end of the week. A surgical pack was shown as having a syringe, that was not supposed to be there. When the scrub nurse working with Cutrite was questioned, she remembered that he had used a syringe, but, when it was included in the count at the conclusion of surgery, she didn't think about the protective sheath, which must have been on it.

“Let's get Mrs. Jameson back into surgery.” said Straight. “We'll tell her it's necessary to check her incision and deep sutures. She'll never know we're really looking for the needle cover.”

“Too late,” responded the supervisor, “she went home day before yesterday.”

Oh, oh, thought Straight. Now what to do? “Have you talked to Dr. Cutrite?”

The supervisor nodded affirmatively. “He won't consider telling Mrs. Jameson there might be a problem and calling her back to the hospital,” she said. “And he warned us not to do anything either,” she added. “Dr. Cutrite claims it cannot possibly hurt her. Except for a little discomfort, she'll never know it's there.”

Straight called the chief of surgery and asked s hypothetical question about the consequences of leaving a small plastic cap in a patient's belly. The chief knew something was amiss but didn't pursue it. He simply replied there would likely be occasional discomfort, but probably no life–threatening consequences from leaving it in. “Although,” he added, “one never knows.”

Straight liked working at Hopewell Hospital and didn't relish crossing swords with Cutrite, who, although declining clinically, was politically very powerful. Straight had refrained from fingernail biting for years, but that old habit was suddenly overwhelming.

Nursing 8-3

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 Make a quality initiative proposal (7-10 PowerPoint slides) through a presentation, interpreting and communicating dashboard data to support the proposal. 

maternal m2 diss

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Case Study: A 16-year-old arrived at a local family planning clinic with pregnancy concerns due to unprotected intercourse. This encounter occurred two nights prior, and she believes she may be fertile but wants information regarding the “morning-after pill”.

  • What additional information should the nurse obtain during the assessment?
  • What educational information should the nurse provide to the patient regarding emergency contraception treatment and the side effects?

discussion 7 psy

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 Analyze and apply critical thinking skills in the psychopathology of mental health patients and provide treatment and health promotion while applying evidence-based research.Scenario:

Jax is a 66-year-old Caucasian female whose wife has encouraged her to seek treatment. She has never been in therapy before, and has no history of depression or anxiety. However, her alcohol use has recently been getting in the way of her marriage, and interfering with her newly-retired life. She describes drinking increasing amounts over the last year, currently consuming approximately a six-pack of beer per day. She notes that this amount “doesn’t give me the same buzz as it used to.” She denies ever experiencing “the shakes” or any other withdrawal symptoms if she skips a day of drinking.

Jax comments that her wife is her biggest motivation to decrease her alcohol use. She tells Jax that she gets argumentative and irritable when she drinks, though she does not always remember these incidents. She has also fallen while intoxicated twice, causing bruises both times and hitting her head on one of the occasions.

Questions:

Remember to answer these questions from your textbooks and NP guidelines. At all times, explain your answers. 

  1. Describe the presenting problems/issues. Is there any information that was not provided that you would need to formulate a diagnosis?
  2. Generate a primary and differential diagnosis using the DSM5 and ICD 10 codes.
  3. What physiological and psychological processes lead to substance dependence?

Submission Instructions:

  • Your initial post should be at least 500 words, formatted and cited in current APA style with support from at least 2 academic sources.  Your initial post is worth 8 points.
  • You should respond to at least two of your peers by extending, refuting/correcting, or adding additional nuance to their posts. Your reply posts are worth 2 points (1 point per response.) 
  • All replies must be constructive and use literature where possible.
  • Please post your initial response by 11:59 PM ET Thursday, and comment on the posts of two classmates by 11:59 PM ET Sunday.
  • Late work policies, expectations regarding proper citations, acceptable means of responding to peer feedback, and other expectations are at the discretion of the instructor.
  • You can expect feedback from the instructor within 48 to 72 hours from the Sunday due date.

Planning for the future examination

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Please see the attachment for the instructions

WK 9 assigment

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Please see attachment for instructions 

Boards of Nursing (BONs) exist in all 50 states, the District of Columbia, American Samoa, Guam, the Northern Mariana Islands, and the Virgin Islands.

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 Boards of Nursing (BONs) exist in all 50 states, the District of Columbia, American Samoa, Guam, the Northern Mariana Islands, and the Virgin Islands.