Combination of fluoxetine and Olanzapine

Your patient is a 36-year-old woman with bipolar disorder and anxiety. She has been stable on a combination of fluoxetine and olanzapine for two years.  She is morbidly obese at 340 pounds at 5’5″ in height, has type II diabetes, hypertension, and hyperlipidemia.  She has concerns about her weight and has tried numerous ‘fad diets’ to no avail.  She explains she has lost, at most, 15 pounds and has been able to keep it off for three months.

  • She has three children, one of which is severely disabled, and a husband who has a terminal diagnosis. She expresses worry that her weight will impact her ability to care for her disabled child when her husband dies.  She reports she eats out frequently due to her children’s busy schedules.  She is a stay-at-home mother but gets little exercise and performs no regular physical activity.
  • She reports feelings of shame that she can no longer orgasm on the rare occasions her husband has the energy and desire to be intimate.
    • What would be your approach to managing this patient’s weight concern? (Discuss at least two aspects of your approach). Please support your answer with research-based evidence.

Questions:

  • What would be our approach to the sexual side effects she is experiencing?
  • If you suggested additional medication, look up your state’s prescribing laws. Are PMHNP’s able to prescribe the medication you recommended?

Sharp Abdominal pain

A 33 week client presented to the labor and delivery unit with a rigid abdomen, vaginal bleeding, and sharp abdominal pain.  What clinical manifestations would indicate maternal hypovolemic shock

Effective Patient education episode

Formulate a plan to develop an effective patient education episode on MRSA. Provide a rationale for each different approach you may want to use and describe a tool you would use to educate the patient and his or her family

Interventions to decrease 30-day readmission rates for Heart failure patients

looking for PICO question for comparison of two different interventions to decrease 30-day readmission rates for heart failure patients aged 65 and older. Can you please check sample PICO question below? any similia PICO question would be acceptable. I prefer simple and succinct! Thanks in advance

 

In heart failure patients ages 65 and older, how does utilizing post-discharge interventions decrease 30-day hospital readmission rates compared to not receiving follow-up interventions? –> I found this PICO question from Google

The Harvard forum on Gun violence

After watching the Harvard forum on gun violence, summarize the viewpoints of each of the 4 panelists. Post your reactions to what you have learned from this video and any questions you have. https://theforum.sph.harvard.edu/events/preventing-gun-violence

How educators can “Force” a student to play a game

Games are supposed to be fun and voluntary. Explain how educators can “force” a student to play a game and expect it to remain fun and engaging. As well, it can take several hours of gameplay to learn the mechanics of some games, even longer for the more complex games.

If subject matter learning can occur only after this initial game mechanic learning occurs, explain how educators can justify the amount of time a learner must spend within the game just to get to the point where learning begins

Provider payment models

Question 4 (1 point) Listen Which of the following provider payment models is associated with the practice of
“defensive medicine”? O Fee for Service O Bundled Payments/Diagnosis Related Groups (DRG’s)
O Bundled payments Pay for Performance

Evaluating Policy content

Question 8 (1 point) Listen Which of the following is not a relevant question to ask when evaluating policy
content? Are the goals and rationales clearly stated? What are the policy impact following evaluation?

O How
will the outcomes be measured? Who is going to finance the policy?

Certification for Nurse Practitioners

Certification for Nurse Practitioners in Mississippi (HINT: use the two testing websites). briefly discuss the two national certification bodies (AANC and AANP) and discuss which examination you plan to take and why

The National Academy of Medicine

Which of the following are part of The National Academy of Medicine (NAM’s) definition of health care quality?

Question 1

a Patient-centered, competent, free of errors, evaluated, culturally sensitive, and accessible
b Safe, effective, patient-centered, timely, efficient, and equitable
c Cost effectiveness, timeliness, accessibility, economical, pain well controlled, and fair
d Protection against complications, equitable, patient centered, available, patient centered, and fair

Question 2

 

Can a Health Care Organization implement several CQI projects at one time?

Question 2 options:

a No; there should only ever be one at a time.
b Yes; there will occasionally be some overlap.
c Yes; it is necessary and they must be prioritized.
d Yes; often there will be two but never more than six.

Question 3

 

Due to its focus on accreditation and safety, which of the following organizations specifically requires CQI in its mission?

Question 3 options:

a The Joint Commission
b The Health Care Organization
c The Office of the Inspector General
d The Institute for Safe Medication Practices (ISMP)

Question 4 

 

In following a Continuous Quality Improvement approach, the nurse administrator would consider the following when a serious error has occurred

Question 4 options:

a an aggressive retraining program for the nurses
b system factors that predispose to errors
c terminating the nurse who made the error
d revising policy to ensure such an error never happens again

Question 5 

 

Focusing on the prevention of harm benefits the Health Care Organization by allowing it to:

Question 5 options:

a construct an in-depth review of the harm data to determine the root cause.
b identify limitations in medication systems and opportunities to learn.
c determine if one unit in particular is having more frequent errors than other units
d construct policies and procedures aimed at units identified as high-risk areas.

Question 6 

 

If a healthcare provider ordered a medication with an inappropriate administration method, what should the clinical decision support system do first?

Question 6 options:

a Send out a recall for the order to the pharmacy.
b Send a correction of the order to the pharmacist and order the pharmacist not to fill the order.
c Alert the nurses to not give the medication as ordered and give her the information on the correct administration method
d Block the order when the provider enters the order and if the warning is overridden, send out a warning alert to the providers device.

Question 7

 

Which of the following factors can contribute to health disparities?

Question 7 options:

a Unequal treatment of minorities and other groups against whom discrimination exists
b Genetic Differences creating differential risks
c Minorities don’t care as much about their health
d A and B only

Question 8

 

Which of the following graphs would best display changes over time?

Question 8 options:

a Radar graph
b Pie chart
c Line graph
d Histogram

Question 9 

 

Which of the following types of variation should the nurse focus attention on first for a quality improvement project

Question 9 options:

a Special Cause Variation
b Random Variation
c Common Cause Variation
d Stable Variation

Question 10 

 

Many HCOs now use electronic records, making data collection easier and more:

Question 10 options:

a interpretive.
b adjustable.
c accurate
d hackable.

Question 11 

 

If a nurse evaluating a quality indicator finds there is only common cause variation in a process, the nurse can conclude:

Question 11 options:

a The process is stable
b The process is unstable
c A new process is needed
d There is no need to try to improve the process

Question 12 

 

There are five rights of medication administration. What two additional rights have been suggested?

Question 12 options:

a Right patient room and right composition
b Right method and right physician
c Right education and right check for allergies
d Right reason and right documentation

Question 13 

 

If a pharmacist aid fails to check the newly ordered drug with the other meds the patient is taking, which of the following can we say is true?

Question 13 options:

a This won’t be a problem because the physician has already checked to make sure the drug won’t interact with the patient’s other meds
b Other parts of the system are changed because changing one part of a system is known to disturb the operation of the system as a whole
c Medication errors are the natural and inevitable consequence of the pharmacy aide’s failure to perform as expected
d There is no way to know what might happen as a result of this failure to perform.

Question 14

 

Which of the following were goals of the Affordable Care Act (Obama Care)?

Question 14 options:

a Improvement in access to health insurance for working class families
b Improvement in quality of care
c Expansion of Medicaid
d All of the above

Question 15 

 

What is at the core of healthcare delivery today and needs to be the core element of any QI program?

Question 15 options:

a Just culture
b Safe Staffing
c Patient-centered care
d Safety circles

Question 16 

 

Which of the following is a key nursing indicator of the need to invest in a quality improvement project?

Question 16 options:

a Low staffing levels
b An increase in patient complaints
c Chronic excess inventory of IV bags
d All of the above

Question 17

 

To practice safely, new NPs should primarily make use of which of the following to guide their practice?

Question 17 options:

a Research results published in the last five years in a peer reviewed medical journal article
b Information gained by reading a meta-analysis on the topic
c National guidelines published by professional or government organizations that have been drawn from reviews of the evidence
d Information obtained through pharmaceutical company vendors, lectures at national clinical conferences, and information in clinical journals

Question 18

 

Which of the following factors is an essential component of every quality improvement project, regardless of focus or methodology?

Question 18 options:

a statistical analysis
b measurement
c process analysis
d final report

Question 19 

 

Who typically develops the overall QI program plan and the operational plan?

Question 19 options:

a A core team of key players
b The team leader alone
c A QI team of internal experts
d An outside team of external experts

Question 20 

 

Which of the following areas of planning is most likely to lead to a project failure if not performed?

Question 20 options:

a Stakeholder analysis
b Gantt chart
c Dedicated team focused solely on the project
d Evaluation report