1. .Which is not true regarding Social Security? SELECT ALL THAT APPLY

(2 Points)

Participation is mandatory through payroll taxes.

All retirees obtain full benefits at age 65.

Benefits are reduced if retirement occurs before full retirement age.

Social Security has reduced the poverty rates of the elderly.

2, Which statements are true regarding palliative care versus hospice care? Select all that apply.

(2 Points)

Palliative care focuses on symptom control and quality of life for patients with non-curable diseases.

Hospice care is for patients with terminal diseases while palliative care is for patients who are clinically stable.

Hospice care and palliative care are synonymous.

Hospice care incorporates palliative care.

3.
Which provisions are part of the Affordable Care Act? Select all that apply.

(2 Points)

Eliminate lifetime caps on coverage

Free medications for Medicare recipients

Free preventive care

Eliminate the ability of insurance companies to rescind coverage

Low income patients may qualify for government subsidies to help purchase health insurance.

You are a nurse on a med/surg unit and have received your patient assignment. In what order will you see your patients?

1. A 34-year-old male with a severe lower back pain and a diagnosis of kidney stone.
2. A 50-year-old male with mild chest pain while sitting up in bed before breakfast.
3. A 90-year-old female; 30 hours post op a total hip replacement with a pain level of 5/10.
4. A 24-year-old female 25 weeks pregnant complaining of nausea and vomiting up her breakfast.
5. A 65 year old male 6 hours post op appendectomy complaining of abdominal pain of 8.

‘Annette Smith’ is a 38-year-old Aboriginal woman who lives in an

outer suburb of Brisbane. She is widowed and lives with her two teenage children, Jack who is 15 and Jess who is 13. Annette is renting a small house which is partially subsided by the Government’s affordable housing scheme. However, to be able to have this assisted living, her and her children had to move from outback Emerald where she was raised with her mob. Annette’s husband was killed in a traffic accident when Jess was just 6 months old and so both children have never really known their father or had a step-father figure in their lives although they are very close to Annette’s parents. Until they relocated closer to Brisbane, the children would spend most weekends with their grandparents whilst Annette worked as a personal carer at a nearby nursing home. Since the move from Emerald about 12 months ago, Annette has found it difficult to keep paid employment. She continues to find work however usually gets let go after several weeks for failing to turn up for shifts. She reportedly fell asleep during a shift at a nursing home last week forcing the employer to dismiss her.
Annette’s mother has called the local health clinic in Brisbane requesting a community nurse visit Annette and check on her welfare, as since moving from her hometown Annette has reported to her mother a weight gain of 16 kilos with a BMI of 30. She states her daughter shows no motivation for life anymore and reports disturbed sleep, managing to get approximately 4 hours each night only. She further reports that Annette is “teary” when they talk on the phone and the children have stated that they are eating “McDonald’s” most nights for dinner. Of further concern Annette has started smoking 5-10 cigarettes each day and stopped attending weekly yoga classes when they moved.

Develop your essay response to this scenario using the following guidelines:

-Write an introduction that introduces the client and outlines the issues that will be addressed in your case study (e.g. 150 words)

-Outline the impact of cardiovascular (CVD) disease in Australian females (e.g. 250 words). Your outline should include current prevalence and mortality rates, impact on health, gender differences, evidenced with literature.

-Describe social and behavioural determinants that increase the risk of developing CVD and how they relate to this case study – evidenced with literature (e.g. 250 words)

-Three of the five pillars of health promotion (as described in the Ottawa Charter (WHO, 1986) are ‘supportive environments’, ‘reorientation of health services’, and ‘community action’. Choose one of these three pillars and describe a potential health promotion action based on that pillar that you and Annette might work on to address her situation supporting your ideas with evidence from the literature (e.g. 300 words)

-Drawing on the fundamental processes and core skills of Motivational Interviewing, give two specific examples of how you would engage Annette in a discussion about the potential health promotion opportunity identified above.  (e.g. 400 words)

-Write a conclusion that summarises your key points, (e.g. 150 words)

The initial post must include responses to all the questions in both case studies.

Ms. F, 48 years old, has been admitted to the hospital with severe abdominal pain. Earlier that day she had generalized abdominal pain, followed by a severe pain in the lower right quadrant of her abdomen, accompanied by nausea and vomiting. That evening she was feeling slightly improved and the pain seemed to subside somewhat. Later that night, severe, steady abdominal pain developed, with vomiting. A friend took her to the hospital, where examination demonstrated lower right quadrant tenderness and mild abdominal rigidity. Fever and leukocytosis indicated infection. A diagnosis of acute appendicitis, with possible perforation, was indicated, with immediate surgery.

Discussion Questions

1. Why is the sequence of pain (location and type of pain) significant in the diagnosis of acute appendicitis? Describe the rational for each type of pain. Does this sequence confirm the diagnosis?
2. Using the pathophysiology, describe the reason for:
   1. the pain subsiding and then recurring.
   2. leukocytosis and fever.
   3. abdominal rigidity.

Ms. T, age 28 years, has noticed urgency, frequency, and dysuria recently, as well as an unusual odor to the urine. Urinalysis indicated a heavy concentration of Escherichia coli in the urine, some pus, and WBCs. Ms. T was prescribed antibiotics, which she took for the first few days. This seemed to give her relief, but she then stopped taking the medication. Within a few days, the symptoms returned, but she decided to “just live with it.”

Discussion Questions

1. Explain why women are predisposed to cystitis.
2. What preventive measures are important in reducing recurrence?
3. Discuss other signs and symptoms that may indicate cystitis.
4. What potential problems may she experience if she does not adhere to the treatment prescribed?