Course Reflection Nursing and the Aging Family.

Guidelines

PURPOSE

The purpose of this assignment is to provide the student an opportunity to reflect competencies acquired through the course Nursing and The Aging Family.

COURSE OUTCOMES

This assignment provides documentation of student ability to meet the following course outcomes:

– The students will identify the physiological process of aging.

– The students will be able to differentiate the adaptive human response to the aging process.

– The student will be able to manage and care older adults and their families.

REQUIREMENTS

1. The Course Reflection will be graded on Original paper (NO plagiarism), quality of self-assessment, use of citations, use of Standard English grammar, sentence structure, and overall organization based on the required components as summarized in the directions and grading

2. The length of the reflection is to be within three to six pages excluding title page and reference pages.

3. APA format is required with both a title page and reference page. Use the required components

of the review as Level 1 headers (upper and lower case, centered):

Note: Introduction – Write an introduction but do not use “Introduction” as a heading in accordance with the rules put forth in the Publication manual of the American Psychological Association (2010, p. 63).

a. Course Reflection

b. Conclusion

PREPARING YOUR REFLECTION

The BSN Essentials (AACN, 2008) outline a number of healthcare policy and advocacy competencies for

the BSN-prepared nurse. Reflect on the course Nursing and The Aging Family readings, discussion threads, and applications you have completed across this course and write a reflective essay regarding the extent to which you feel you are now prepared to:

1. “Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches.

2. Recognize the relationship of genetics and genomics to health, prevention, screening, diagnostics, prognostics, selection of treatment, and monitoring of treatment effectiveness, using a constructed pedigree from collected family history information as well as standardized symbols and terminology. 

3. Implement holistic, patient centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management, and nursing management across the health illness continuum, across the lifespan, and in all healthcare settings.

4. Communicate effectively with all members of the healthcare team, including the patient and the patient’s support network.

5. Deliver compassionate, patient centered, evidence-based care that respects patient and family preferences.

6. Implement patient and family care around resolution of end of life and palliative care issues, such as symptom management, support of rituals, and respect for patient and family preferences.

7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care.

8. Implement evidence-based nursing interventions as appropriate for managing the acute and chronic care of patients and promoting health across the lifespan.

9. Monitor client outcomes to evaluate the effectiveness of psychobiological interventions.

10. Facilitate patient centered transitions of care, including discharge planning and ensuring the caregiver’s knowledge of care requirements to promote safe care.

11. Provide nursing care based on evidence that contributes to safe and high-quality patient outcomes within healthcare microsystems.

12. Create a safe care environment that results in high quality patient outcomes.

13. Revise the plan of care based on an ongoing evaluation of patient outcomes.

14. Demonstrate clinical judgment and accountability for patient outcomes when delegating to and supervising other members of the healthcare team.

15. Manage care to maximize health, independence, and quality of life for a group of individuals that approximates a beginning practitioner’s workload

16. Demonstrate the application of psychomotor skills for the efficient, safe, and compassionate delivery of patient care.

17. Develop a beginning understanding of complementary and alternative modalities and their role in health care.

18. Develop an awareness of patients as well as healthcare professionals’ spiritual beliefs and values and how those beliefs and values impact health care.

19. Manage the interaction of multiple functional problems affecting patients across the lifespan, including common geriatric syndromes.

20. Understand one’s role and participation in emergency preparedness and disaster response with an awareness of environmental factors and the risks they pose to self and patients.

21. Engage in caring and healing techniques that promote a therapeutic nurse patient relationship.

22. Demonstrate tolerance for the ambiguity and unpredictability of the world and its effect on the healthcare system as related to nursing practice.” (pp. 31-32).

Reference:

American Association of Colleges of Nursing [AACN]. (2008). The essentials of baccalaureate education

for professional nursing practice. Washington, DC: Author.

 

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1.   Which one of the following requirements is outlined in the guidelines established in HIPAA’s Privacy Rule? 

    

   A. Hospital administrators must encrypt data within older data files.

   B. Managers must secure medical records immediately following patient admission.

   C. Patients must receive notice if their information will be used or disclosed to third parties.

   D. Physicians must not disclose patient information to consulting physicians.

2.   A tethered health record allows patients to 

    

   A. amend the diagnoses listed in the health record.

   B. use a secure portal to access their own records.

   C. restructure insurance copayments.

   D. compare their health records to the records of patients with similar diagnoses.

3.   A patient sustains a fracture of the femur while playing football in a nearby park. What ICD-10-CM code would be assigned? 

    

   A. S72.003A

   B. S72.001A

   C. S49.006A

   D. S72.009A

4.   Which one of the following structures is part of the male secondary genitalia? 

    

   A. Gonads

   B. Urethra

   C. Testes

   D. Vulva

5.   What is the full code description for 25515? 

    

   A. Open treatment of radial shaft fracture, includes internal fixation, when performed, and open treatment of distal radioulnar joint dislocation (Galeazzi fracture/dislocation), includes internal fixation, when performed, includes repair of triangular fibrocartilage complex

   B. Open treatment of radial shaft fracture, includes internal fixation, when performed

   C. Closed treatment of radial shaft fracture; without manipulation

   D. Closed treatment of ulnar shaft fracture; without manipulation

6.   Another name for XXY syndrome is 

    

   A. Turner’s syndrome.

   B. Huntington’s chorea.

   C. Cooley’s anemia.

   D. Klinefelter syndrome.

7.   The hammer-shaped bone in the middle ear is called the 

    

   A. cochlea.

   B. stapes.

   C. malleus.

   D. incus.

 

8.   Codes beginning with the letter K are related to the _______ system. 

    

   A. circulatory

   B. digestive

   C. endocrine

   D. sensory

9.   Which of the following statements is true of the olfactory nerve? 

    

   A. It’s located in the mitral valve and helps to circulate blood throughout the heart.

   B. It’s found in the nose and allows the senses to detect and distinguish odors.

   C. It’s susceptible to erosion due to Peyronie’s disease.

   D. It conveys the fluid from lymph glands to other areas of the body.

10.   A patient has a Foley catheter inserted prior to a planned surgical procedure. How is this coded? 

    

   A. 55520

   B. 52630

   C. 51702

   D. 52601

11.   What is the CPT code for simple drainage of a finger abscess? 

    

   A. 26010

   B. 26020

   C. 26034

   D. 26011

12.   Usually, a comprehensive EHR includes 

    

   A. secure standalone cluster controllers for hospitals in rural environments.

   B. software, hardware, implementation, and future program upgrades.

   C. coaxial cable connections between mainframe servers only.

   D. customizable XHRLT processes for ambulatory surgery centers.

13.   What ICD-10-CM code would be assigned for a patient with acute tubule-interstitial nephritis? 

    

   A. Z02.6

   B. B96.2

   C. L50.0

   D. N10

14.   An echocardiogram shows that the wall of a patient’s artery has dilated. The dilation has resulted in a saclike swelling. This swelling is called a/an 

    

   A. aneurysm.

   B. cyst.

   C. mesenteric venous thrombosis.

   D. benign tumor.

15.   What is Medicare Part D? 

    

   A. The component of Medicare Part A that covers outpatient surgeries

   B. Supplemental coverage for war veterans and their dependents

   C. Add-on coverage for dental procedures

   D. Add-on coverage for prescription drugs provided through insurance companies approved by Medicare

16.   The suffix –stasis means 

    

   A. flow.

   B. stopping and controlling.

   C. breakdown.

   D. kinetic.

17.   The outcome of delivery code should be 

    

   A. omitted from the maternal record for stillborn delivery.

   B. assigned to the newborn record only.

   C. assigned to both the maternal and newborn records.

   D. assigned to the maternal record when a delivery occurs.

18.   A patient who was involved in a motor vehicle accident is taken to the hospital by ambulance and admitted to the hospital in critical care. The physician sees the patient for 74 minutes in critical care. The physician leaves to attend to other patients in the ICU and the NICU of the same hospital. Five hours later, the physician returns to the patient and continues to treat the patient in critical care for an additional 30 minutes. The patient spends a total of 104 minutes in critical care. What codes are assigned? 

    

   A. 99292, 99292, 99293

   B. 99291, 99291

   C. 99291, 99292

   D. 99292, 99293

19.   The root word OBSTETR/O means 

    

   A. cesarean.

   B. pregnancy.

   C. birth.

   D. midwife.

20.   Coders can use the Microsoft Office suite to create spreadsheets in 

    

   A. Excel.

   B. Lotus 1-2-3.

   C. PowerPoint.

   D. Word.

21.   A patient undergoes an appendectomy and later returns to the operating room for a related procedure the same day. Which modifier should be assigned to the CPT code? 

    

   A. -51

   B. -AA

   C. -76

   D. -78

22.   The concept of meaningful use pertains to 

    

   A. categorization of patient information.

   B. medical office protocol and document organization.

   C. resource management in the inpatient setting.

   D. electronic health record implementation.

23.   The study of disease is called 

    

   A. pathology.

   B. urology.

   C. physiology.

   D. neurology.

24.   Modifier -23 indicates that 

    

   A. a procedure was performed bilaterally.

   B. the patient received general anesthesia for a procedure that would ordinarily be performed with local or no anesthesia.

   C. a physician reviewed and interpreted a radiology procedure.

   D. two surgeons performed a procedure.

25.   Releasing genetic information is forbidden under the terms of HIPAA because it may 

    

   A. indicate susceptibility to a future illness, without the patient actually being diagnosed with the condition.

   B. allow immediate family members to have access to a patient’s medical records.

   C. not be successfully transmitted to all health care facilities.

   D. require physicians to fulfill contractual obligations for treatments provided in ambulatory surgery centers.

26.   Provision of security against a hurt, loss, or damage with specific cash payments is called 

    

   A. protection.

   B. secured loss.

   C. copayment.

   D. indemnity.

27.   Physicians typically refer to anatomical locations using directional terms, which are often 

    

   A. used primarily by chiropractors.

   B. used to describe surgical incisions.

   C. referenced horizontally.

   D. paired in opposites.

28.   The code for an ESWL would be found in the 

    

   A. Digestive System of CPT.

   B. Urinary and Male Genital Systems of CPT.

   C. Chemotherapy section of HCPCS.

   D. Cardiovascular System of CPT.

29.   What code would be assigned for a tube pericardiostomy? 

    

   A. 33015

   B. 33050

   C. 33026

   D. 33210

30.   HCPCS modifier –E2 indicates that the patient had a surgical procedure performed on the 

    

   A. upper left eyelid.

   B. upper right eyelid.

   C. lower left eyelid.

   D. lower right eyelid.

31.   Providers that receive reimbursement after health care services have been provided are being compensated under the _______ system. 

    

   A. UCR

   B. capitation

   C. retrospective payment

   D. prospective payment

32.   What happens when HIPAA rules conflict with state law? 

    

   A. The interpretation of HIPAA rules is left to the physician’s discretion.

   B. The Supreme Court’s decision becomes final in binding arbitration.

   C. Conflicting state rules are overridden by federal law.

   D. State laws overrule federal law.

33.   The method that physicians use to bill for each service or visit individually rather than on a pre-paid basis is called 

    

   A. pre-paid care.

   B. managed care.

   C. fee-for-service.

   D. capitation.

34.   The suffix -sis means 

    

   A. process.

   B. drooping.

   C. inflammation.

   D. condition.

35.   A new patient is seen in a clinic for complaints of shortness of breath, fever, difficulty swallowing, runny nose, and cough. The physician performs a detailed history, detailed examination, and medical decision making of low complexity. The physician also obtains a chest x-ray and lab workup. Based on the results of the diagnostic tests, the physician renders a diagnosis of upper respiratory tract infection and lymphadenopathy. What ICD-10 and CPT codes are assigned? 

    

   A. 99215, M19.011, R13.10

   B. 99203, J06.9, R59.0

   C. 99213, R06.82, F10.229

   D. 99202, D63.1, J45.909

36.   A physician is called to the intensive care unit for a patient with second-degree burns sustained on 55% of his body while cooking in the kitchen where he works. The physician sees the patient in the critical care unit for two hours, leaves the unit, and returns later the same day to provide an additional hour of critical care. What ICD-10-CM and CPT codes would be assigned? 

    

   A. L91.8, 99291 × 2, 99292 × 4

   B. T31.50, 99291, 99292 × 4

   C. Z30.09, 99293, 99294 × 2

   D. R53.81, 99291, 99293 × 5

37.   A physician who cares for a patient throughout an entire pregnancy, from beginning to end, is providing 

    

   A. comprehensive prenatal management.

   B. routine global obstetric care.

   C. puerperal obstetric care.

   D. antenatal global supervision.

38.   A patient is seen in the emergency room complaining of abdominal pain in the left lower quadrant. It’s determined that the patient is experiencing inflammation of the pancreas, which is also called 

    

   A. pancreaticoduodonal arcade.

   B. pancreatonia.

   C. pancreatolysis.

   D. pancreatitis.

39.   The covering on the brain and spinal cord in the dorsal cavity is called the 

    

   A. sheath.

   B. peritoneum.

   C. ganglia.

   D. meninges.

40.   The regulations in HIPAA apply to three groups of individual and corporate entities, each involved in electronic medical records transfer. These groups are collectively referred to as 

    

   A. health care administrators.

   B. protected personnel.

   C. provisional health care data collectors.

   D. covered entities.

41.   The retention period is the amount of time that 

    

   A. insurance billing documents must be retained in filing cabinets.

   B. medications must be kept in the medical office.

   C. records must be kept.

   D. HIM employee files must be retained upon termination or resignation.

42.   A physician has a meeting with a pharmaceutical sales representative. During the course of the conversation, the physician reveals the diagnosis and past family, medical, and social history of a patient currently being treated with one of the medications that the sales representative is selling. In this situation, the doctor could be sued for 

    

   A. invasion of privacy.

   B. undue harm and fraud.

   C. malice.

   D. malfeasance.

43.   Epithelial tissue that secretes its products directly into the bloodstream is made of 

    

   A. endoplasmic reticulum.

   B. endocrine gland cells.

   C. extracellular matrix.

   D. columnar epithelial cells.

44.   A physician obtains cells from the bone marrow cavity using a needle and a syringe. How would this procedure be coded? 

    

   A. 38220

   B. 36575

   C. 35092

   D. 37328

45.   The vitreous humor can be found in the 

    

   A. eye.

   B. nose.

   C. tongue.

   D. ear.

46.   The study of tissue disease using macroscopic or microscopic analysis is called 

    

   A. microbiology.

   B. histopathology.

   C. immunology.

   D. cytopathology.

47.   Placing a catheter into the aorta or directly into an artery or vein is called 

    

   A. selective catheter placement.

   B. brachiocephalic manipulation.

   C. third order placement.

   D. nonselective catheter placement.

48.   A patient is diagnosed with acne. What ICD-10-CM code would be assigned? 

    

   A. L74.2

   B. L70.0

   C. L72.3

   D. L73.1

49.   Members of the uniformed services, their families and survivors, and retired members and their families qualify for 

    

   A. OIG Recovery.

   B. Medicaid.

   C. Medicare.

   D. TRICARE.

50.   A 35-year-old male is brought to the emergency department with memory disturbance after being accidentally exposed to lead paint. What ICD-10-CM codes should be assigned? 

    

   A. T42.4X1A, R40.0

   B. T23.009A, R23.8

   C. T56.0X1A, R41.3

   D. T57.0X1A, R10.9

51.   Health care practitioners who submit fraudulent bills to increase reimbursement may 

    

   A. be listed in the Coding Directory of Fraudulent Billing published annually by the Department of Health and Human Services.

   B. be reported to the Office of the Attorney General.

   C. be blacklisted according to geographic location.

   D. face financial penalties or, in some cases, imprisonment.

52.   A patient comes to the ambulatory surgery center for a fusion of the cervical spine. Prior to the beginning of the surgery, the patient suffers an allergic reaction to the anesthesia shortly after it’s administered. Because of this reaction, the surgery is not performed. What code would be assigned as the first-listed diagnosis? 

    

   A. The anesthesia administration

   B. The allergy code

   C. The reason that the surgery was scheduled to be performed

   D. The observation code

53.   The root word ENTER/O means 

    

   A. secretion.

   B. intestine.

   C. stomach.

   D. tooth.

54.   When coding burns, coders should 

    

   A. assign separate codes for each burn site.

   B. assign the code for chronic burns.

   C. classify all burns as acute burns.

   D. assign the code for third-degree burns.

55.   Which of the following forms is used to bill outpatient charges? 

    

   A. CMS-1500 or UCF-1500.

   B. AMA-14 or UCF-1250

   C. HCFA-1400 or CMS-1540

   D. HCFA-1350 or CMS-650

56.   A significant, separately identifiable E/M service performed by the same physician in conjunction with another service performed on the same day would be reported using what modifier? 

    

   A. -TC

   B. -47

   C. -90

   D. -25

57.   Which of the following modifiers would be assigned for a moribund patient? 

    

   A. P5

   B. P1

   C. P4

   D. P3

58.   Taking certain steps to protect PHI from being accidentally released to individuals who don’t need to know the information is called the 

    

   A. minimum necessary standard.

   B. information provision standard.

   C. privacy management statute.

   D. health information guardianship guideline.

59.   Codes for plastic repair of the perineum are found in which code range? 

    

   A. 57000–57426

   B. 57000–57010

   C. 57150–57180

   D. 56800–56810

60.   A coder overhears a confidential statement made outside of the court, and then, when called to testify, repeats the statement as being truth. This is an example of 

    

   A. speculation.

   B. hearsay.

   C. a direct quote.

   D. cross-examination.

61.   A nurse sustains an accidental needle pinprick to the right third finger while administering an injection. If an employee has an occupational exposure, what must happen? 

    

   A. An in-service meeting should be held for all employees who may potentially be exposed to the same occupational hazard.

   B. The employee should contact the proper authorities.

   C. Hospital administrators must maintain the nurse’s medical record for the remainder of her employment plus an additional 30 years.

   D. The guidelines for OSHA should be included in the employment file.

62.   Another name for third-party contractors who have access to medical information is 

    

   A. healthcare vendors.

   B. insurance administrators.

   C. covered entities.

   D. business associates.

63.   A patient receives two venous pressure clamps for hemodialysis. What HCPCS Level II code is assigned? 

    

   A. A4751

   B. A4918 × 2

   C. A4751 × 2

   D. A4918

 

64.   The anatomical location of the calyx is the 

    

   A. arm.

   B. kidney.

   C. spine.

   D. brain.

65.   A patient comes to the clinic complaining of ongoing headaches. The headaches began one week prior and have persisted ever since. A lumbar spinal tap is performed to pinpoint the source of the patient’s headaches. What CPT and ICD-10-CM codes are assigned? 

    

   A. 62270, G74.3

   B. 62270, G44.1

   C. 62141, G46.8

   D. 62272, G46.9

66.   A coder assigns a HCPCS Level II code to a patient’s medical record. The code description reads as follows: Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape. Based on this description, which HCPCS Level II code was assigned? 

    

   A. B4278

   B. B4125

   C. B4072

   D. B4034

67.   To conform to the HIPAA Privacy Rule, which of the following safeguards must be maintained in health care facilities? 

    

   A. ICD-7 provisional safeguards

   B. Immunization and injection safeguards

   C. Reasonable administrative, technical, and physical safeguards

   D. Hazardous waste protection safeguards

68.   A patient receives a blood glucose monitor. What HCPCS Level II code would be assigned? 

    

   A. E0976

   B. E0562

   C. E4752

   D. E0607

69.   Alternative dispute resolution (ADR) allows 

    

   A. lawyer-to-lawyer mediation during trial recess.

   B. mediating disputes with a judge in the presence of the bailiff.

   C. resolving medical malpractice suits by submitting pretrial depositions.

   D. litigants to resolve disputes prior to or after the start of litigation.

70.   A 65-year-old patient is admitted to the hospital for 48 hours to receive treatment from her physician. This patient would be covered under 

    

   A. Medicare Part B.

   B. Medicare Part A.

   C. Medicare Part D.

   D. Medicare Part C.

71.   Another term for disease evolution is 

    

   A. remission.

   B. pathogenesis.

   C. morphology.

   D. exacerbation.

72.   In relation to HIPAA regulations regarding the manner in which information can be disclosed, which of the following statements is true? 

    

   A. Protected health information must be disclosed only when the patient is unable to testify in a court proceeding.

   B. Protected health information may never be disclosed.

   C. Protected health information may be disclosed in a judicial or administrative proceeding if the request is made through an order from a court or administrative tribunal.

   D. Protected health information may be disclosed only within a deposition.

73.   The gatekeeper concept refers to the operation of 

    

   A. ambulatory payment surgery centers.

   B. prospective payment organizations.

   C. retrospective payment organizations.

   D. health maintenance organizations.

74.   Which of the following procedures would be performed to treat prostate cancer? 

    

   A. Transurethral resection of the prostate (TURP)

   B. Meniscectomy

   C. Vasoconstriction

   D. Arthroscopy

75.   What diagnosis code would be assigned for a patient diagnosed with Type 2 diabetes mellitus with diabetic nephropathy? 

    

   A. E11.21

   B. E11.01

   C. E11.22

   D. E11.9

76.   Another name for Medicare Advantage is 

    

   A. Medicare Part A.

   B. Medicare Part C.

   C. Medicare Part B.

   D. Medicare Part D.

77.   The codes for pacemakers and implantable defibrillators would be found in what section of CPT? 

    

   A. 33200–33205

   B. 33437–33537

   C. 33202–33273

   D. 33533–33799

78.   A patient comes to the emergency room complaining of abdominal pain. She was previously diagnosed with type I diabetes. She also complains of watery eyes, congestion, pressure in the sinuses, and difficulty breathing. Her final diagnoses are right lower quadrant abdominal pain, type I diabetes, acute sinusitis, and asthma. What CPT and ICD-10-CM codes are assigned? 

    

   A. 99222, R18.91, E16.9, J01.91, J45.919

   B. 99221, R17.41, E17.9, J01.90, J45.909

   C. 99223, R14.31, E15.9, J01.90, J45.929

   D. 99221, R10.31, E10.9, J01.90, J45.909

79.   What is considered to be protected health information (PHI)? 

    

   A. Any health information that can identify the individual to whom it refers

   B. Records pertaining to ancestry

   C. Statistical data compiled for research purposes only

   D. Census data

 

80.   In what CPT code range is Surgical Pathology found? 

    

   A. 88515–88598

   B. 88300–88309

   C. 88400–80499

   D. 88000–80299

 

81.   The federal law that requires a patient’s written consent prior to disclosure of certain medical information by government agencies is called the 

    

   A. Health Care Amendment of 1976.

   B. Privacy Act of 1974.

   C. Health Information Law of 2002.

   D. Medical Consent Act of 1965.

82.   Data stored in a health care facility must 

    

   A. be organized in accordance with state standards for electronic data interchange.

   B. adhere to OIG policies and procedures.

   C. conform to the physician’s expectations for data storage.

   D. comply with HIPAA rules and must be maintained securely.

83.   Under HIPAA, health care facilities must 

    

   A. maintain a clean, safe working environment.

   B. choose a privacy officer in accordance with HIPAA policies and procedures.

   C. keep records of patients who refill prescriptions more than once within a three-month timeframe.

   D. follow up with patients who repeatedly miss scheduled appointments for mandatory services.

84.   What CPT code would be assigned for a colpocentesis? 

    

   A. 57135

   B. 57859

   C. 57600

   D. 57020

85.   A patient is prescribed a medication that narrows the blood vessels and raises her blood pressure. The medication is most likely a 

    

   A. tranquilizer.

   B. vasoconstrictor.

   C. cardiotonic.

   D. cardiogenic.

86.   If patients choose to obtain copies of their medical records, under the terms of HIPAA, providers can 

    

   A. complete employee paperwork.

   B. charge a reasonable fee for providing copies of those records.

   C. reschedule office visits to allow time to update medical records.

   D. also fulfill requests for prescription data.

87.   According to the CMS National Physician Fee Schedule, what is the conversion factor for basic life support mileage? 

    

   A. $34.5741

   B. $32.4726

   C. $28.8457

   D. $36.0666

88.   According to HIPAA, a patient’s information may be released for 

    

   A. determining premiums based on a patient’s past medical history.

   B. paternity testing.

   C. research.

   D. transferring electronic medical records to remote locations.

89.   A patient comes to the clinic complaining of fever, diarrhea, nausea, and vomiting. The patient is diagnosed with salmonella meningitis. What ICD-10-CM code would be assigned? 

    

   A. A07.21

   B. A02.21

   C. A05.26

   D. A23.24

90.   Which of the following anatomical locations would contain the diaphysis? 

    

   A. Metatarsal

   B. Tibia

   C. Septum

   D. Diaphragm

91.   A patient comes to the clinic complaining of nausea, vomiting, fever, dizziness, and intermittent confusion. The physician conducts a detailed history and examination and reviews the patient’s lab results. The patient is diagnosed with pyelonephritis and is scheduled for an ultrasound to review the state of the kidneys and other organs. What CPT and ICD-10-CM codes are assigned? 

    

   A. 76775-TC, N15

   B. 71010-26, B12

   C. 76775-26, N10

   D. 73256-TC, M11

92.   A female patient is diagnosed with breast cancer of the lower-inner quadrant of the right breast. The patient undergoes a modified radical mastectomy of the right breast in an attempt to circumvent the spread of the cancer to any secondary anatomical sites. The procedure was performed in three stages. In addition to the radical mastectomy, the physician also performed a right breast biopsy to treat the breast tumor in the lower-inner quadrant. What ICD-10-CM and CPT codes are assigned? 

    

   A. 15852-58, Z48.01

   B. 19307-58-RT, 19101-59-RT, C50.311

   C. 19307-RT, 19101-RT, C50.211

   D. 11602, 15240, C50.312

93.   The concept of confidentiality can be substantiated based on the right of 

    

   A. easement.

   B. constitutionality.

   C. totality.

   D. privacy.

94.   The abbreviation INH indicates what route of drug administration? 

    

   A. Inhaled and intrathecal administration

   B. Intrathecal injection

   C. Inhalant solution

   D. Inhaled and intravenous administration

 

95.   A patient is seen in the physician’s office after the results of an earlier mammogram demonstrated microcalcification in the right breast as well as a breast lesion. The lesion is excised using needle localization. The patient’s

 

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Slides should be professional in appearance and easy to read

disease & background

Identify the disease condition and give a brief statement of incidence and prevalence in the U.S. Discuss the pathophysiology of the disease and typical clinical presentation seen in patients with the condition. 

Publication & Applicability in Primary Care

Identify the author, organization or group that developed the CPG along with the year of the original guideline publication.  Discuss why the CPG is applicable in the primary care setting.

Key Action statements and Body of Evidence

Provide each of the CPG’s “Key Action” or “Guideline Statements” up to a maximum of 5 relevant recommendations. Identify the evidence strength for each recommendation. If the statement has applicability to other groups, only discuss the relevant primary care ones.

article to be used

Kapur, V.K., Auckley, D.H., Chowdhuri, S., Kuhlmann, D.C., Mehra, R., et al. (2017). Clinical Practice Guideline for the Diagnostic Testing for Adult Obstructive Sleep Apnea: An American Academy of Sleep Medicine Clinical Practice Guideline. Journal of Clinical Sleep Medicine, 13(3).

Rubric

Disease & Background

Student: 1)  Identifies the disease condition 2) Gives a brief statement of incidence and prevalence in the US 3) The student briefly summarizes the disease pathophysiology and 4) Identifies the typical clinical presentation seen in a patient with the disease (4 critical elements).

Publication & Applicability in Primary Care

The student: 1) Identifies the author, organization or group that developed the CPG, 2) Student denotes the year of the original guideline publication, 3) Student identifies  any subsequent revisions (student’s reference should be the most recent version), and 4) Student discusses the applicability for use of this CPG in the primary care setting (4 critical elements).

Key Action Statements & Body of Evidence

The student: 1)Provides each of the CPG’s “Key Action” or “Guideline Statements”  up to a maximum of 5 relevant recommendations, 2)  Provides the body of evidence strength for each, and 3) If the statement has applicability to other groups, only discuss the relevant primary care ones (3 critical elements).

 

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Introduction

To understand emerging and reemerging diseases, you must understand the interconnectedness between human health and the environment and have a grasp on epidemiology.

Human Health

Epidemiology, the study of determinates and distribution of disease in populations, is essential in protecting public health and controlling health problems. Before moving into the specifics of epidemiology, you need to understand some of the basics of human anatomy and physiology; specifically, how the immune system protects us from disease.

Your body’s first line of defense against a foreign invader is keeping the invader out. The skin is part of that defense, as it creates a barrier over most of the body. This defense continues with the mucous membranes lining your nasal pathway, and the hairs help catch particles and keep them from entering your lungs. Tears and saliva both contain lysozymes, which can break down foreign invaders. Bleeding from an open wound helps to rinse away dirt and other particles, and clotting helps keep anything from entering the body through that wound. Your body contains many different types of white blood cells that can fight off a variety of pathogens.

If an invader gets past the first line of the defense, the body’s second line of defense is the immune system. We can acquire natural immunity in two different ways: naturally acquired active immunity occurs when we are exposed to a disease-causing agent (for example, getting chicken pox as a child), and naturally acquired passive immunity occurs when antibodies are received through the placenta or breast milk. We can also attain immunity through vaccinations; this is called artificially acquired active immunity. Persons with severe immunodeficiency may be given antibody-containing serums or immunoglobins from a person or animal.

Many cells and chemicals that are part of the immune system work to destroy foreign substances as they enter the body. Macrophages circulate throughout the body and digest any foreign substances they run into. Interferons are chemicals released when a cell is attacked by a virus. These and other chemicals signal surrounding cells to shut down and prevent the virus from spreading. Lymphocytes are a type of white blood cell that produces antigens that respond to specific viruses. So, if you had chicken pox as a child, then your body will produce antibodies to protect you if the chicken pox virus enters your body again.

The state of the environment also plays a role in disease transmission. For example, the changing weather patterns associated with global warming affect disease patterns. The increased rainfall and flooding in some areas has increased the populations of a major carrier of disease—mosquitoes. The warm winters and hot dry summers in many areas are also affecting the transmission of vector-borne diseases; for example, ticks spread Lyme disease and bacteria spread cholera. There is significant evidence that outbreaks of Ebola are related to unusual patterns in the wet or dry cycle. Increases in international travel have also increased the spread of diseases worldwide. In the United States, emerging diseases such as West Nile Virus cause severe illness and sometimes death (World Health Organization, 2011). As diseases spread, or new diseases are recognized, fear of a major epidemic has caused public health agencies to prepare plans for mass epidemics or bioterrorism events.

Disease Transmission Routes

• Airborne (coughing, sneezing).
• Fecal-oral transmission (improper hand washing contaminating food, untreated sewage contaminating water supply).
• Waterborne (drinking, swimming, eating, improper hand washing).
• Direct contact (athlete’s foot, warts, STDs).
• Zoonoses (animal bites, scratches, meat, hides, feces).
• Vector-transmitted (insects, rodents).
• Soil contamination (landfill leaching).
• Fomite (transferred from inanimate objects like handrails, doorknobs, grocery carts, clothing, toys).
• Nosocomial (transferred from health workers). (Hilgenkamp, 2006, p. 54).

Environmental Health

As the human population and technology have grown, our impact on the environment—and subsequently, on our own health—has also grown. The World Health Organization (2014) defines environmental health as “all the physical, chemical, and biological factors external to a person, and all the related factors impacting behaviors. It encompasses the assessment and control of those environmental factors that can potentially affect health. It is targeted towards preventing disease and creating health-supportive environments. This definition excludes behavior not related to environment, as well as behavior related to the social and cultural environment, and genetics.”

To understand environmental health, we must first understand the environment and its many interrelated systems. We do not often think about the Earth beyond what we see around us every day, but the environment spans from the core of the Earth to the outer reaches of the troposphere. The four main divisions of the Earth system are the lithosphere (crust and mantle), hydrosphere (water), atmosphere (gases surrounding earth), and biosphere (area supporting life). Life on Earth depends on the biogeochemical cycles that occur within each of these regions. Biogeochemical cycles recycle energy and chemicals through the lithosphere, hydrosphere, atmosphere, and biosphere. Within the biosphere there are specific divisions called biomes. Biomes are characterized by similar climate, soil, plants, and animals. Because humans dominate most ecosystems on Earth, we have a large impact on the environment. Overpopulation and demands on natural resources can degrade the environment. Since the environment provides us with so many resources such as clean air, clean water, and nutrients, environmental degradation directly influences human health.

Environmental scientists and government officials look for ways to preserve the environment and conserve environmental resources. By monitoring human demand on the environment, laws such as the Endangered Species Act, Clean Air Act, and Clean Water Act have worked to protect the environment for future generations. While technology has created many problems for the environment, it is also being used to benefit the environment and human health. New farming techniques, waste management methods, and pollution control devices all help to keep the environment healthy and protect human health. Environmental health is everyone’s responsibility. Public health officials and governmental leaders are on the front lines, but the decisions made daily by businesses and individuals directly affect our health and the health of the environment.

References

Hilgenkamp, K. (2006). Environmental health: Ecological perspectives. Sudbury, MA: Jones and Bartlett.

World Health Organization. (2011). West nile virus. Retrieved from http://www.who.int/mediacentre/ factsheets/fs354/en/

World Health Organization Regional Office for Europe. (2014). Environmental health. Retrieved from http://www.who.int/topics/environmental_health/en/

Demonstration of Proficiency

By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:

• Competency 1: Assess basic environmental health principles, theories, and issues.
  • Analyze an emerging or reemerging disease.
  • Describe how an emerging disease is transmitted.
  • Describe the incubation period of an emerging disease.
  • Describe how an emerging disease is treated.
  • Predict prognosis of recovery and residual effects of an emerging disease.
  • Assess the role of vaccines in disease prevention.
• Competency 4: Communicate effectively in a variety of formats.
  • Write coherently to support a central idea in appropriate format with correct grammar, usage, and mechanics.

Preparation

Select one emerging or reemerging disease to research for this report. Note: You may use the WHO Infectious Diseases and CDC websites (both linked in Resources: Diseases and Pathogens), which list a variety of relevant diseases.

Instructions

To begin, select one emerging or reemerging disease to research for this report.

Then, craft a 3–4-page report that analyzes the disease and addresses the following points:

• Provide a brief historical account of the disease selected. Consider why this disease is emerging or reemerging.
• What areas of the globe are currently affected by this disease?
• How is it transmitted?
• What is the incubation period?
• What is the treatment for this disease?
• What is the role of vaccines in combatting this disease? If there is no vaccine, why not?
• What is the predicted prognosis of recovery and residual effect?

Your report should be logically organized around a point you would like to make regarding the emerging or reemerging disease you select. Consider the MEAL Plan to help organize your thoughts:

• Main Idea: What is the main point or idea that you want your reader to remember about this disease?
• Evidence: What does the research say? Support your point with evidence from the literature you have researched. (This is where you would include facts about the history, transmission, incubation, treatment, and prevention of the disease. Refer to your sources when you provide your evidence.)
• Assess: Summarize main ideas from articles related to the disease. Apply health principles and theories that relate directly or indirectly to your main point. Make explicit links between source articles and your current report.
• Link: Integrate and combine information from your source articles to your main point or idea.

Additional Requirements

Use the APA Paper Template (linked in Resources: Writing, Research, and APA) to format your report.

• Written Communication: Written communication should be free of errors that detract from the overall message.
• Length: This report should be 3–4 pages in content length. Include a separate title page and a separate references page.
• Font and Font Size: Times New Roman, 12-point, double-spaced. Use Microsoft Word.
• APA Formatting: Resources and in-text citations should be formatted according to the current APA style and formatting.
• Number of Resources: You are required to cite a minimum of 2 scholarly resources. You may conduct independent research for resources and references to support your report. Provide a reference list and in-text citations for all your resources, using APA format. You may cite texts and authors from the Resources.

 

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