Sexually active teenager examination

L. A. is a sexually active 15-year-old who lives in a suburban neighborhood with her parents and two younger sisters. She does not confide in her parents about her activities, but rather discusses them with her two best friends in high school, who also are sexually active. Last week a guest speaker at school discussed the topic of sexually transmitted diseases (STDs) which L. A. thought quite a bit about since the discussion. She has an appointment tomorrow for her annual gynecologic examination.

In the privacy of the examination room, L. A. tells the nurse about her sexual activity and comments that her boyfriend has been experiencing a penile discharge and is concerned that “he may have infected me with some disease.” When questioned by the nurse, L. A. states that she has not experienced any vaginal discharge, odor, itching, or painful intercourse. The nurse collaborates with the gynecologist, who prescribes a C. trachomatis point-of-care test.

1. Discuss the significance of L.A.’s clinical manifestations.

2. Discuss the incidence of chlamydia.

3. What other assessment data would be helpful for the nurse to have to prepare L. A.’s care plan?

4. What are the priorities of care for L. A. during this visit?

5. Discuss the relationship between L. A.’s level of growth and development and her risk for STD.

6. L. A.’s C. trachomatis point-of-care test is positive. What does this finding mean?

7. What are the common complications associated with L.  A.’s condition if it is not effectively treated?

8. L. A. is prescribed doxycycline 100 mg by mouth twice a day for 7 days. Discuss your impression of this prescription.

9. Discuss the adverse effects associated with L. A.’s medication prescription and the appropriate nursing actions when giving L. A. this prescription to fill.

10. Discuss L. A.’s priority teaching needs prior to her discharge from the clinic.

The musculoskeletal system

dentify how changes in specific parts of the musculoskeletal system contribute to the risk of falls. Match the part of the musculoskeletal system affected by ageing to the description. [Answers can be used more than once) Bones Loss of mass accelerates in persons aged 60 years and over and results in reduced function, strength and power. X Muscles Both the amount of tissue and the number and size of fibres decrease, leading to weakness. Bones The mineral content decreases, reducing density and increasing fragility the older a person becomes. Joints As people age, the underlying fabric, collagen, and elastin become weaker and less able to repair. X The connective tissue within ligaments and tendons becomes more rigid and brittle in this body part. This change Joints limits the range of motion. The water content of this cord-like tissue that attaches muscles to bones decreases as we age, making them more Tendons 4 likely to tear. Bones Insufficient levels of calcium or vitamin D in density and an increased risk of fracture. Your answer is partially correct. You have correctly selected 5.

Documentation guidelines to Medicare carriers

Which of the following introduced documentation guidelines to Medicare carriers to ensure services paid for have been provided and were medically necessary?

An emetic patient

Tutoring help is needed with veterinary nursing assignment

attachment1.png

18. Which of the following patient’s should be administered an emetic? A. A ferret that ingested a toxic plant and is unconscious B. A cat that ingested a corrosive toxin from the neighbor’s garbage C. A dog that ingested a full bottle of the owner’s medication. D. A rabbit that ingested a penny. E. None of the above. All of the above. 19. Which non-absorbable suture material is most likely to act as a wick and allow contamination migration? A. Polypropylene B. Silk C. Vicryl D Nylon 20 Which of the following is not a disorder that causes coagulation problems? A. Hemophilia AUTO B. Liver disease C. Vitamin K deficiency D Vitamin A deficiency 21. A gray and red vacutainer tube contains: A. heparin B. silicone serum separation material C thrombin D. silicone coating with no additive

Patient is severely hypoproteinemic

Tutoring help is needed for veterinary nursing assignment

attachment1.png

22. A patient is severely hypoproteinemic. Which of the following anesthetic agents should be avoided? A. fentanyl B. propofol C. ketamine HCI D. Thiopental 23. Which of the following would appear the whitest on an X-ray? A. Bone B. Barium C. Fat D. Organs 24. A technician can use the cellophane tape technique to examine the skin for all of the following except: A. bacteria B. ringworm C. Malassezia D AUTO Surface mites 25. Of the following, the microorganism that is most resistant to disinfectants is: A. fungi B. vegetative bacteria C. lipid-coated viruses D. bacterial endospores

Create and define

Please see an attachment for details

attachment1.png

Week 4 Integumentary System Medical Terminology Sheet for Integumentary System NSG120 Pathophysiology Skin: cutanc/o, dermat/o, derm/o Sebaceous Glands: seb/o Sweat Glands: hidr/o Hair: pil/i, pil/o Nails: onycho, ungu/o albino/o white -rhea flow epi- Jon, upon, over aria connected with seb/o sebum intra- within alopec baldness sclera/o hard per- through blephar eyelid urtic rash sub- under, below bio pertaining to life xer/o dry -opsy view of chrom color Don’t Forget Words crypl hidden -ous pertaining to epitheli epithelial tissue -osis abnormal condition erythr/o red, flushed -ologist specialist granul granular -plasty surgical repair hirsut hairy -ism a condition or state of kel growth or tumor a condition or state of kerat/o hard phagia eating koil hollow or concave par- longside of lip/o an without melan/o black dys- bad, difficult myclo ungus -itis inflammation oid resembling -oma tumor papill resembling a nipple pertaining to pedicul/o lice -opsy view of prurit tching trans through or across purpur purple ectomy surgical removal of phyma growth rhin nose rhytid/o Tinkle malacia oftening Instructions: Define the following terms using their roots/suffixes, and prefixes. Create and define 10 additional terms. Submit to the Canvas Drop Box. Submissions must be handwritten. (note: this week’s terms need to be defined, use a medical dictionary) I. abrasion 2. abscess 3. bulla 4. collagen 5. contusion 6. crust 7. cyst 8. ecchymosis 9. fissure 10. histamine 1 1. laceration 12. lesion 13. macule 14. nevi 15. nodule 16. papule 17. petechiae 18. plaque 19. pustule 20. scale 21. ulcer 22. vesicle 23, wheal 24, eczema Term Definition 1. 19. 20. Instructions: Create and define 10 additional terms using the prefixes, roots, and suffixes from this week’s list. Term Prefix Root Suffix Definition AMAWN 10.

Fluid in the sac

When a woman is pregnant, what  is too much fluid in the sac called?

A developmental red flag

) Which of the following would be a developmental red flag that would trigger further
assessment for a 2-year-old?
A.
Cannot jump; cannot throw object overhand.
B.
Cannot use a three-word sentence; speech only 50% understandable
C.
Cannot use a meaningful two-word phrase; lack of empathy (looking sad
if a child cries)
D.
Never imitates adult activities; cannot do parallel play.
)Which of the following are included in the clinical features of anxiety illness disorder? Check all
that apply.
A.
Persons maintain they have a particular disease or as time progresses their belief
may transfer to another disease.
B.
Lab results, lack of progression of the disease, and appropriate reassurances from the
provider are helpful treatments for the person with the disease.
C.
Preoccupation with illness may or may not interfere with their interaction with family,
friends, and co-workers.
D.
They are often addicted to internet search about their feared illness, inferring the
worst from the information.
) A dementia which usually occurs in the sixth decade of life, characterized by gradual onset
and progressive decline without focal neurological deficits is known as which of the
following?
A.
HIV dementia
B.
Vascular dementia
C.
Lewy-body dementia
D.
Alzheimer’s type dementia
(DAT)
) Which of the following is true about impulses? Check all that apply.
A.
Impulses are acted upon with the expectation of receiving
pleasure
B.
Impulses are usually ego-dystonic.
C.
Impulsive behaviors are characterized by their repetitive
nature.
D.
The repeated acting out of impulses leads to psychological
impairment.
) Which of the following is consistent with dementia in HIV?
A.
The individual’s decline is very slow and may take years to progress.
B.
The individual’s decline is progressive in nature with motoric and behavioral
abnormalities.
C.
The individual’s decline is in a stepwise fashion with motoric and behavioral
abnormalities.
D.
The individual’s decline has marked variability and fluctuating motoric and behavioral
abnormalities.
70) Somatoform disorders represent which type of clinical problem in psychosomatic Medicine?
A.
Co-occurring medical and psychiatric conditions.
B.
Psychiatric complications of medical conditions and
treatments.
C.
Psychiatric symptoms secondary to a medical
condition.
D.
Psychological factors precipitating medical
symptoms.
) A type of delirium characterized by psychomotor retardation and apathy is known as which
of the following?
A.
Mixed delirium
B.
Medical delirium
C.
Hypoactive
delirium
D.
Hyperactive
delirium
A child 0-3 months would be expected to be able to do which of the following?
A.
Develop social smile
B.
React and turn toward
sounds
C.
Watch faces, follows
objects
D.
All the above
The ARNP is meeting with a person who reports a fascination with fire, along with recurrent
deliberate and purposeful setting of fires. The ARNP realizes that these behaviors are
consistent with which of the following disorders?
A.
Pyromania
B Obsessive-compulsive
. disorder
C.
Intermittent explosive
disorder
D.
Pyrophobia
Which of the following supports a good prognosis for a person with a conversion disorder?
A.
Insidious onset
B.
Clearly identifiable stressors at time
of onset
C.
Average intelligence
D.
B and C
Which of the following medications are FDA-approved medications for the treatment of
delirium?
A.
Donepezil
B.
Galantamine
C.
Rivastigmine
D.
None of the
above
Depression secondary to interferon treatments represents which of the following clinical
problems in psychosomatic medicine?
A.
Psychiatric complications of medical conditions and
treatments.
B.
Psychiatric symptoms secondary to a medical condition.
C.
Psychological factors precipitating medical symptoms.
D.
Psychiatric symptoms as a reaction to medical condition or
treatments.
Which of the following is a common visceral symptom of conversion disorder?
A.
Seizures
B.
Diarrhea
C.
Paralysis
D.
Mid-line
anesthesia
Which of the following are common disorders that must be differentiated from dissociative
identity disorder? Check all that apply.
A.
Perimenstrual disorders
B.
Posttraumatic stress
disorder
C.
Obsessive-compulsive
disorder
D.
B and C only
In treating a patient with dementia and a co-occurring depression, which of the following
symptoms should be treated first?
A.
Insomnia
B.
Irritability
C.
Loss of
appetite
D.
Depressed
mood
Which of the following is consistent with normal range gross motor developmental
milestones for a 4 year old?
A.
Walks down stairs, jumps backwards
B.
Balances on one foot for 4 seconds, can broad
jump 1 foot
C.
Writes part of name; copies a square.
D.
Eats independently, unbuttons items
Which of the following social interactions indicates progression into the normal range,
meeting developmental milestones for a 5-year-old?
A.
Shares on own
B.
Engages in imaginative play
C.
Group play; has a preferred friend
D.
Has a group of friends, apologizes
for errors
Visual hallucinations are associated with impairment in which of the following regions of the
brain?
A.
Occipital
B.
Temporal
C.
Left parietal
D.
Frontal,
prefrontal
The ARNP is doing a physical exam on a patient that has a paralyzed hand of unknown
etiology in which the patient’s hand is raised and dropped into the patient’s face. Which of
the following patient responses support the finding of a conversion disorder?
A.
The patient’s hand drops onto the patient’s face.
B.
The patient’s hand falls next to the patient’s face.
C.
The patient’s hand stays in the air when dropped.
D.This would not be an appropriate test for conversion
disorder.
Which of the following are included in the five different milestone skill areas that should be
evaluated?
A.
Social/emotional skills
B.
Gross/fine motor skills
C.
Speech and language
skills
D.
All the above
Which of the following approaches/treatments are recommended in working with patients
with a conversion disorder?
A.
After a very thorough evaluation to r/o any medical cause, tell the patient that the
symptoms are imaginary.
B.
Recommend psychotherapy to focus on issues of stress and coping.
C.
Recommend psychoanalysis to explore intrapsychic conflicts.
D.
B and C only
hich of the following adaptive skills are consist with normal range developmental milestone
of an 18-month-old?
A.
Bite, chews cookie; looks for
fallen item
B.
Finger feeds items; takes off a
hat.
C.
Gets onto a chair; removes
garment
D.
Opens doorknobs; pulls off pants.
N-Methyl D-aspartate glutamate receptor antagonists are used to treat dementia by doing
which of the following?
A.
Stall the neurodegenerative processes
B.
Promotes synaptic plasticity
C.
Prevent over excitation of glutamate
receptors
D.
All of the above
Which of the following is NOT consistent with what is known about intermittent explosive
disorder across the lifespan?
A.
Intermittent explosive disorder may appear at any stage of life.
B.
Intermittent explosive disorder usually appears between late adolescence and
early adulthood.
C.
Intermittent explosive disorder typically increases in severity with the onset of
middle age.
D.
The onset of intermittent explosive disorder may be acute or insidious.
Which of the following is not consistent with what is known about the epidemiology of
dissociative fugue?
A.
It is usually described in adults.
B.
It is commonly described in men
C.
It is more common in women than in men.
D.
It is more common during natural disasters, war time, or times of major social
dislocations and violence.
A cognitive assessment should include which of the following?
A.
Baseline cognitive
functioning
B.
Changes from baseline
functioning
C Speed of onset of cognitive
. changes
D.
All of the above
The ARNP notices that a patient with a conversion disorder unable to walk has an
inappropriately cavalier attitude toward what seems to be a major impairment and
recognizes this an associated psychological symptom known as which of the following?
A.
Identification
B.
Primary gain
C.
Secondary gain
D.
La belle
indifference
Which of the following speech and language skills are consistent with normal developmental
milestones of a 3-year-old?
A.
Uses three-word sentences; names body
parts.
B.
Uses two-word sentences; understands me
and you
C.
Follows three-step request; tells stories
D.
Responds to “why?”; likes rhyming words
A patient presents with persistent feelings of detachment from one’s self, like watching
one’s self in a movie. The ARNP recognizes this as which of the following?
A.
Derealization
B.
Depersonalization
C.
Generalized amnesia
D.
Dissociative identity
disorder
Schizophrenia in a patient with end-stage renal disease is an example of which type of
clinical problem in psychosomatic medicine?
A.
Co-occurring medical and psychiatric conditions
B.
Psychiatric symptoms secondary to a medical
condition
C.
Psychiatric symptoms as a reaction to a medical
condition
D.
Psychiatric complications of medical conditions and
treatments
A person erroneously believes they sustained an emotional or physical trauma in early life is
known as which of the following?
A.
Ganser syndrome
B.
False memory syndrome
C.
Factitious dissociative identity
disorder
D.
Imitative dissociative identity
disorder
MRI findings in patients with intermittent explosive disorder may reveal changes to which
area of the brain that is associated with loss of impulse control?
A.
Cerebellum
B.
Prefrontal
cortex
C.
Temporal lobe
D.
Parietal lobe
The ARNP evaluates a 4-year-old who cannot balance on one foot for 3 seconds, cannot copy
a circle and realizes which of the following?
A.
This is normal for a 4-year-old.
B.
This is a developmental red flag for a 4-year-old that should trigger a specialized
assessment.
C.
This is a developmental red flag for a 5-year-old so do nothing at this point.
D.
This is a minor concern, the APRN advises to enroll the child in gymnastics for
balance and an art class to learn to draw better.
Which of the following is consistent with what is known about treating individuals with
kleptomania?
A.
Insight-oriented psychotherapy has been shown to be effective regardless of
motivation level of the individual.
B.
Psychoanalysis is the treatment of choice.
C.
Behavior therapy including aversion therapy has been reported to be successful with
highly motivated individuals.
D.
A combination of aversive conditioning and alter social contingencies has been
reported successful even when self-motivation was lacking

The theory of evolution

Material for Week 2 (Week of Jan 24 for posts the week of January 31)TopicReadingAssignment for next week’s post

 

:  Evolution

:  Etcoff Ch. 1 & 2

 

:  Please read the narrative below.  Use the suggested websites to familiarize yourself with the theory of evolution.  Use what you have learned about evolution in your reflection next week on chapters 1 & 2 of the Etcoff text, be sure to refer to material from at least 2 of the websites suggested below (be sure to clearly cite the websites you visited to ensure you get credit).  Post your reflections and by Wednesday February 2, and reply to another students post by Sunday the 6th.

 

For this weeks post:  Your posts on last week’s material (Self introductions and responses to the several questions I raised in the course material) are due by 11:59 pm Wednesday January 26, responses to another students post by NOON Sunday January 30.

 

Evolution and Darwin

 

We begin the course by considering how biology can explain human development and interaction.  The main theme of the Etcoff text is that we are treated differently by others based on our appearance, and many of the differences in our responses to people who are “prettier” compared to those who are not can be explained based on the theory of evolution.  The Etcoff book is one of many recent publications in the area of evolutionary psychology – a field that seeks to understand human behavior in light of the evolutionary pressures our species has faced in the past. Next week, we will focus on evolutionary psychology and the related area of sociobiology.  This week, we will look at the theory of evolution itself and the person who presented the modern version of the theory, Charles Darwin. Darwin’s theory (evolution through natural and sexual selection) is the single most revolutionary idea of the past 200 years, with wide-spread implications in all areas of life, including the understanding of social behavior.

 

Evolution through Natural Selection:  The theory of evolution through natural selection, first suggested by Charles Darwin in 1854, argues that species change through a simple process of competition between individuals.  Darwin was attempting to understand a puzzle about the nature of living things on earth. The puzzle was that at the same time, living things on earth are amazingly diverse (millions and millions of different unique species of living things), while being amazingly similar (all mammals have roughly the same skeletal structure, the same internal organs, at a cellular level the cells of all living things look the same, and at a molecular level all life on earth has DNA composed of the same 4 nucleic bases – although Darwin had no knowledge of DNA and the later discovery of this mechanism of inheritance is one of the great supporting arguments for the validity of his theory).  How could so much diversity, and at the same time so much similarity, be explained? The only explanation generally accepted for much of western history was that of divine creation.  But why would a divine creator create so many distinct life forms?  Why millions of different types of bugs?  And why create them all so much the same?  A theory that had become increasingly popular over about a century or so before Darwin was a theory called Evolution.  The theory of evolution argued that the similarity between species could be explained if we assume that all life started as a single form that changed (or evolved) over time into all the different forms we see around us.  The problem with the theory of evolution before Darwin was that there was no viable mechanism that would explain why change would happen – why would one original species change into other species?  Darwin’s great contribution to science was the discovery of that mechanism of change. Darwin’s theory, known as “Natural Selection” (and a later modification called “Sexual Selection”) has revolutionized our understanding of life, and nothing in the study of living things (including human development) can be fully understood without a grounding in evolution.  You can learn about the history and impact of the theory of evolution and about the evidence supporting the theory here:  http://www.ucmp.berkeley.edu/history/evolution.html, and more specifically, you can learn about the history of the theory here: http://www.ucmp.berkeley.edu/history/evothought.html.

 

One of the important facts about the history of the theory of evolution is that it was not Charles Darwin who came up with the theory – as we will discuss in more detail next week, Darwin proposed a viable mechanism for evolution, but the theory had been around for a long time.  Here is a brief review of pre-Darwinian views on evolution:   http://sci.waikato.ac.nz/evolution/DevelopmentEvolThought.shtml.

 

For your post next week, please discuss what you learned from at least two of the websites above, along with summarizing and discussing the first two chapters of the Etcoff text.  Be sure to clearly cite your sources, your post should be detailed and in-depth enough to demonstrate that you have thoroughly read and thought about the chapters in the book and that you have read the course material above and visited some of the websites I have recommended.  Each week, your points for discussion board posts will be based in part on how thoroughly you discuss and summarize both the readings and the course material from the previous week.  Also please keep the minimum length requirement for posts in mind.

The importance of CPT coding

As we continue our discussions on the importance of CPT coding, please start to think about the following as well:

  • What do modifiers mean?
  • When are they appropriate to use?