NR 511 Week 4 Midterm Exam Version 5

Question 1: How often should the clinician examine the feet of a person with diabetes?

a. Once a year
b. Every 6 months
c. Every 3 months
d. Every visit

Question 2: Which drug for Alzheimer’s disease should be administered beginning at the time of diagnosis?

a. Cholinesterase inhibitors
b. Anxiolytics
c. Antidepressants
d. Atypical antipsychotics

Question 3: Most adult poisonings are:

a. intentional and self-inflicted.
b. accidental.
c. caused by someone wishing to do harm to the person.
d. not attributed to any reason.

Question 4: A 58-year-old woman presents with a breast mass. Which of the following responses by the clinician would be most appropriate?

a. “It is probably just a cyst, because that is the most common breast mass.”
b. “We will order a mammogram and ultrasound to help establish a diagnosis.”
c. “We will go ahead and schedule you for a biopsy because that is the only way to know for sure.”
d. “Because your lump is painful, it is most likely not cancer.”

Question 5: Which of the following is a specific test for multiple sclerosis (MS)?

a. Magnetic resonance imaging (MRI)
b. Computed tomography (CT) scan
c. A lumbar puncture
d. There is no specific test.

Question 6: After removing a tack from a type 2 diabetic’s heel and evaluating the site for infection, what is the best plan for this patient?

a. Suggest she use a heating pad to improve circulation
b. Refer to a podiatrist for a foot care treatment plan
c. Send her for acupuncture treatments
d. All of the above

Question 7: Which characteristic of delirium helps to distinguish delirium from dementia?

a. Abrupt onset
b. Impaired attention
c. Affective changes
d. Delusions

Question 8: Which clinical feature is the first to be affected in increased intracranial pressure (ICP)?

a. Decrease in level of consciousness (LOC)
b. Headache
c. Nausea
d. Widening pulse pressure

Question 9: Jennifer is an 18-year-old girl who comes to the emergency room after a fall during a soccer game. Jennifer explains that she fell on her left side and kept her arm out straight to break her fall. She has been experiencing severe pain and limited range of motion in her left shoulder. The clinician has diagnosed Jennifer with a dislocated shoulder. Which of the following statements are true concerning shoulder dislocation?

a. Posterior dislocations are more common than anterior dislocations.
b. There is a risk of neurovascular and neurosensory trauma, so the clinician should check for distal pulses.
c. Recurrent dislocations are uncommon and would require a greater force to result in injury.
d. Surgery is most commonly the treatment of choice.

Question 10: Which of the following signs or symptoms indicate an inflammatory etiology to musculoskeletal pain?

a. Decreased C-reactive protein
b. Hyperalbuminemia
c. Morning stiffness
d. Weight gain

Question 11: The clinician sees a patient who is 5 feet tall and weighs 150 pounds. How would the clinician classify this patient?

a. Overweight

b. Mild obesity

c. Moderate obesity
d. Morbid obesity

Question 12: The vegetarian patient with gout asks the clinician about food that he should avoid. The clinician should advise the patient to avoid which of the following foods?

a. Rice
b. Carrots
c. Spinach
d. Potatoes

Question 13: A 23-year-old sexually active woman presents for her first Pap smear. Her history includes nulligravida, age at first intercourse 14, and more than 10 sexual partners. Which of the following conditions should the clinician be particularly alert for during her exam?

a. Human papillomavirus (HPV)
b. Endometrial hyperplasia
c. Vagismus
d. Polycystic ovarian syndrome

Question 14: Which of the following classes of drugs should be used as first-line therapy for treatment of delirium?

a. Benzodiazepines
b. Antipsychotics
c. Anticonvulsants
d. Antidepressants

Question 15: What is the treatment of choice for a patient diagnosed with testicular cancer?

a. Radical orchidectomy

b. Lumpectomy

c. Radiation implants
d. All of the above

Question 16: A 24-year-old woman presents to the clinic with dysuria, dyspareunia, and a mucopurulent vaginal discharge. Her boyfriend was recently treated for nongonococcal urethritis. What sexually transmitted disease (STD) has she most probably been exposed to?

a. Gonorrhea
b. Human papillomavirus (HPV)
c. Chlamydia
d. Trichomonas

Question 17: A 58-year-old woman who had a total abdominal hysterectomy at the age of 45 is diagnosed with atrophic vaginitis. Which of the following is the most appropriate treatment?

a. Conjugated estrogen 0.625 mg/day oral
b. Estradiol 7.5 mcg/24 hr vaginal ring
c. Medroxyprogesterone 10 mg/day oral
d. Conjugated estrogen 0.3 mg + medroxyprogesterone 1.5 mg/day oral

Question 18: When looking under the microscope to diagnose an intravaginal infection, you see a cluster of small and oval to round shapes. What do you suspect they are?

a. Spores

b. Leukocytes

c. Pseudohyphae
d. Epithelial cells

Question 19: Patients with a spontaneous pneumothorax should be counseled that up to what percentage may experience a reoccurrence at some point?

a. 10%

b. 20%

c. 30%
d. 50%

Question 20: John is a 16-year-old boy who presents to the emergency room after hurting his knee in a football game. He described twisting his knee and then being unable to extend it completely. John tells the clinician that he heard a pop when the injury occurred and has been experiencing localized pain. The clinician suspects a meniscal tear. Which test would be most appropriate to assess for the presence of a meniscal tear?

a. Valgus stress test
b. McMurray circumduction test
c. Lachman test
d. Varus stress test

Question 21: During a digital rectal exam (DRE) on a 75-year-old man, the clinician suspects the patient has prostate cancer. What physical finding should make the clinician suspicious?

a. An enlarged rubbery gland

b. A hard irregular gland

c. A tender gland
d. A boggy gland

Question 22: Janet is a 30-year-old woman who has been recently diagnosed with a herniated disc at the level of L5-S1. She is currently in the emergency room with suspicion of cauda equina compression. Which of the following is a sign or symptom of cauda equina compression?

a. Gastrocnemius weakness
b. A reduced or absent ankle reflex
c. Numbness in the lateral foot
d. Paresthesia of the perineum and buttocks

Question 23: The criteria for diagnosing generalized anxiety disorder in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (text revision) (DSM-IV-TR) state that excessive worry or apprehension must be present more days than not for at least:

a. 1 month.
b. 3 months.
c. 6 months.
d. 12 months.

Question 24: A patient is diagnosed with hypothyroidism. Which of the following electrocardiogram (ECG) changes should the clinician expect as a manifestation of the disease?

a. Sinus bradycardia

b. Atrial fibrillation

c. Supraventricular tachycardia
d. U waves

Question 25: Which type of burn injury results in destruction of epidermis with most of the dermis, yet the epidermal cells lining hair follicles and sweat glands remain intact?

a. Superficial burns
b. Superficial partial-thickness burns
c. Deep partial-thickness burns
d. Full-thickness burns

Question 26: Immunizations are an example of which type of prevention?

a. Primary
b. Secondary
c. Tertiary

Question 27: If a previously frostbitten area becomes frostbitten again after it has healed, what might occur?

a. Permanent tissue damage may occur, resulting in necrosis to that body part.
b. The area will be super sensitive.
c. The area is prone to a repeat frostbite.
d. The area is as susceptible as any other area.

Question 28: A 26-year-old woman is seen with complaints of irregular vaginal bleeding. Which of the following tests should be the first priority?

a. Pregnancy test

b. Pelvic ultrasound

c. Endometrial biopsy
d. Platelet count

Question 29: Julie, aged 50, has migraine headaches, frequent asthma attacks, coronary artery disease, and hypertension. Which of the following prophylactic medications would you order for her migraines?

a. Propranolol

c. Ergotamine
b. Timolol

d. Topiramate

Question 30: A 64-year-old man with type 2 diabetes presents to the clinic with the complaint of “my feet feel like they are on fire.” He has a loss of vibratory sense, +1 Achilles reflex, and a tack embedded in his left heel. Which of the following would be an appropriate treatment?

a. Tricyclic antidepressants
b. Capsacin cream
c. Vitamin B12 injections
d. Insulin

• Posted: 2 years ago

Perfect answer to all questions

Purchase the answer to view it



• NR511Week4MidtermExamVersion5.docx

Try it first(plagiarism check)Buy tutorial $20Save time and money!
Our teachers already did such homework, use it as a reference!

• Not rated
  

  NR 511 Week 4 Midterm (Exam Version 5)

  Question 1: How often should the clinician examine the feet of a person with diabetes?

  a. Once a year
  b. Every 6 months
  c. Every 3 months
  d. Every visit

  Question 2: Which drug for …

Blog ArchiveCopyright © 2019 HomeworkMarket.com Read More

• Applied Sciences
• Architecture and Design
• Biology
• Business & Finance
• Chemistry
• Computer Science
• Geography
• Geology
• Education
• Engineering
• English
• Environmental science
• Spanish
• Government
• History
• Human Resource Management
• Information Systems
• Law
• Literature
• Mathematics
• Nursing
• Physics
• Political Science
• Psychology
• Reading
• Science
• Social Science
 

"Looking for a Similar Assignment? Get Expert Help at an Amazing Discount!"

Hiring more nursing assistants to assist during registered nurses'(RNs) shortage can be very challenging. Currently, I am working in the critical care unit (CCU), where we always used total patient care delivery assignments. The staff work 12-hour shifts, and each nurse is assigned for two patients, depending on the patients’ acuity. According to Marquis and Huston (2017), total-patient-care (TPC) nursing is the oldest patient-delivery model. With this model, one bedside nurse oversees the total care of patients during the assigned shift. The total responsibilities of the bedside nurse for a patient’s care include bathing, bed making, administering medications, vital signs, carrying out all ordered treatments, dressing changes, patient teaching, discharge planning, and updating patient care plan, etc (Marquis & Huston, 2017). We do not have nursing assistants in the CCU to help our nurses with all these responsibilities. Unfortunately, two months ago, we have about six nurses who resigned due to professional advancement and relocation.

Since we have a nurses shortage and hiring nurses is a long process, we (CCU leaders and the senior executive leadership) decided to collaborate with other departments to give us task nurses or nursing assistants which we called clinical partners (CP). Since both task nurses and the CPs will work under the supervision of the supervisor or the charge nurse, this delivery care model will fall under the functional-care model. A task nurse is a medical-surgical or telemetry nurse who is responsible for giving medications according to her job descriptions, checking blood sugar, etc. The nursing assistants’ tasks are to help CCU nurses in bathing the patients and foley care, changing linens, answering call lights, etc. 

Marquis and Huston (2017) noted that functional-care model (FCM) was found to be more cost-efficient due to the lower number of RNs required per shift. FCM involves assigning tasks to various team members based on the patients’ complexity or acuity of care needed. Generally, routine tasks are done by persons who are not RN, and the RN oversees more complex patients’ needs. With this model, the unit charge nurse makes the patients’ assignments for the team because she/he has more knowledge of all the patients’ needs (Marquis & Huston, 2017). However, switching from TPC to FCM has a significant impact on the patients’ quality of care in our unit. Our patients’ satisfaction dropped this month by 30%. Marquis and Huston (2017) outlined that the FCM quality of care was found to be less than with the total-patient-care model (Marquis & Huston, 2017). In my experience, hiring more nursing assistants to assist during nurses shortage will help to lessen the nurses’ workload in the CCU temporarily. On the other hand, having more certified critical nurses improve patients’ safety and outcomes. 

Meanwhile, hiring more nursing assistants to assist during nurses’ shortage can impact patients’ quality of care and staff satisfaction on St. Louis Medical Center (SLMC). As a nurse administrator at SLMC, I will use evidence-based practice, current literature, and scientific research to analyze proposed changes in nursing care delivery models. I will also make changes in work design to facilitate meeting organizational goals. Also, I will arrange a departmental meeting involving staff-led representatives from all nursing departments to ensure that everyone has a voice. Finally, I will empower each unit-based practice councils/members to be involved in unit problem solving such as short staffing and develop action plans to resolve the issues. During the meeting, I will seek feedback from my direct reports and the staff and ask them “what’s working well and what is not?” and to know what I can offer for them. 

One of the mechanisms used to promote employees’ growth and development in an organization’s long-term plan is empowerment and to support staff during times of difficult transitions (Choi, Goh, Adam, & Tan, 2016). Johnston and Villa (2018) outline that the Chief Nursing Officer should ensure successful engagement by integrating a shared governance council (SGC). SGC involves monthly meetings with bedside nurses to express issues, share best practices, develop action plans, and raise specific challenges to administration (Johnston & Villa, 2018).

References

Marquis, B. L., & Huston, C. J. (2017). Leadership roles and management functions in nursing: Theory and application. (9th ed.). Philadelphia: Lippincott Williams & Wilkins.

Choi, S. L., Goh, C. F., Adam, M. B. H., & Tan, O. K. (2016). Transformational leadership, empowerment, and job satisfaction: the mediating role of employee empowerment. Human Resources for Health, 14(1). doi: 10.1186/s12960-016-0171-2

Johnston, D., & Villa, J. (2018). Shifting culture: A new CNO leading to nursing excellence. Journal of Nursing Administration, 48(9), 422. Retrieved from https://search-ebscohost-com.chamberlainuniversity.idm.oclc.org/login.aspx?direct=true&db=edb&AN=131663203&site=eds-live&scope=site

"Looking for a Similar Assignment? Get Expert Help at an Amazing Discount!"

*Please note that in NR531 students must use at least three scholarly sources and keep all  assignments to a maximum of three pages, excluding the title page and reference list.

Purpose

The purposes of this assignment are to: (a) identify and articulate key concepts of one of the following: either your future pathway to excellence or your shared-governance model you wish to initiate at one of the three areas: 1. Saint Louis Medical Center (SLMC)/community or critical access hospital, 2. Home health/community transition, or 3. Long term care/skilled nursing facility (SNF) or memory care (CO 5), (b) provide empirical, scholarly evidence to support your proposed project (CO 4), and (c) communicate your information in a clear, succinct, and scholarly manner (CO 5).

Note: You are completing this assignment as if you are the nurse executive. You are to decide whether you wish to focus on implementing your pathway to excellence or a shared governance model. You will choose one of the areas to implement either your pathway to excellence or your shared governance model. What elements would like to adopt and implement for your organization?

Course Outcomes

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

(CO4) Apply the use of research in the evaluation of healthcare outcomes, utilizing critical thinking skills, and interprofessional research strategies. (PO4)

(CO5) Examine effective verbal and written communication; utilizing communication skills of the professional role to promote and improve quality and safety in healthcare. (PO1, 2, 5)

"Looking for a Similar Assignment? Get Expert Help at an Amazing Discount!"

Requirements:

1. This paper will be graded on quality of paper information, use of citations, use of Standard English grammar, sentence structure, and organization based on the required components.
2. Create this assignment using Microsoft (MS) Word, which is the required format for all Chamberlain documents. You can tell that the document is saved as a MS Word document because it will end in “.docx”.
3. Submit to the appropriate assignment area by 11:59 p.m. MT on Sunday of the week due. Any questions about this paper may be discussed in the weekly Q & A Discussion topic.
4. The length of the paper is to be no greater than three (3) pages, excluding title page and reference page.
5. APA format using the sixth edition manual is required in this assignment, including a title page and reference page. Use APA level 1 headings for the organizational structure of this assignment. Remember that the introduction does not carry a heading that labels it as a level heading in APA format. The first part of your paper is assumed to be the introduction. See the APA manual sixth edition for details. Use the suggested format and headings to organize your assignment:
   1. Include introduction (do not label as a heading in APA format)
   2. Issue and Magnet Model Component Identified
   3. Key Components of Executive Summary
   4. Supporting Evidence
   5. Conclusion

Preparing the paper

Note: Please use the resources in your Roussel textbook, Chapter 15, to assist with how to write an executive summary format to articulate the results of your Magnet report from ANCC.

1. Clearly introduce your executive summary in the introduction paragraph. Include a sentence that states the purpose of your assignment.
2. Clearly identify and articulate the issue and component from the Magnet model to be communicated to the board of directors at SLMC by you, the nurse executive. Discuss how your choice may affect your healthcare environment and transform healthcare.
3. Key components of an executive summary format, related to the results of the Magnet report, should be included and clearly articulated. (Examples are in your textbook or you may search for them on the web). Include in your executive summary how this assignment relates to the Person-centred Framework by McCormack and McCance (2017).
4. Include of a minimum of three sources of scholarly, empirical evidence to support the issue to be communicated.
5. Provide concluding statements that should summarize your overall assignment content.
6. The paper will be no longer than three pages maximum, excluding title and reference page(s).

Note: There are several formats of an executive summary in your text or on the internet. As the nurse executive, you may choose which style you prefer.

1. Title and reference page(s) must be in APA format using the sixth edition manual.
2. Use 12 Times New Roman font and one-inch margins on all sides of the paper.
3. Note: After submitting your assignment to the Week 7 assignment area, please also upload your completed assignment to the Week 8 designated threaded discussion to share with your peers.

"Looking for a Similar Assignment? Get Expert Help at an Amazing Discount!"