Care for a female in labor
you are the nurse providing care for a female in labor experiencing variable decelerations.
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A client with hypovolemia
A client with hypovolemia has been prescribed intravenous fluid at
125 ml/ hr. The iv site provide hydration has infiltrated. what steps will the nurse take to treat the infiltrated iv site? And what will the nurse do to address the client’s hydration needs.
Health care services
Differentiate the roles and responsibilities of the various providers, disciplines, and types of organizations, services, and personnel and their interrelationships across the health care delivery system by providing details about these providers, the documentation supplied by each provider, and the settings in which the patient’s health care services are delivered. (7 paragraphs with the table)
A 58-year old man has had a change in bowel habits and pain and swelling in the left upper quadrant of the abdomen for the past few months. He goes to his PCP (primary care provider) for the pain and the PCP orders an abdominal x-ray at the local hospital. The x-ray report states: “mass in the distal transverse colon, worrisome for malignancy.” The PCP refers him to a gastroenterologist who performs a colonoscopy at the Outpatient Surgery Center, which substantiates the diagnosis of colon cancer. Several weeks later, the patient is sent to the internal medicine surgeon who removes a 1-foot section of colon and performs a colostomy. Before discharge from the hospital, the patient develops an infection and the infectious disease specialist evaluates the patient and provides an appropriate treatment course. He needs IV antibiotics and colostomy care after discharge from the hospital and receives home health care over the next two weeks. Six weeks after surgery, radiation and chemotherapy are initiated by the oncologist to whom the patient is referred, but his condition continues to deteriorate over the new few months with metastasis to the liver and brain, at which point the patient decides to receive only palliative care. The social worker at the oncologist’s office refers the patient to Hospice Care.
- * Evaluate this scenario and list the providers for each stage of the patient’s care as noted in the above scenario and determine the responsibilities of each provider in caring for this patient and the care settings at each stage. Note: identify at least 5 providers and 7 settings
- * Determine and recommend the documentation that each provider will initiate as part of this patient’s record.
Provider Care Setting Responsibilities of Provider Documentation generated by provider in the health
record
Questions regarding sensitive topics
Question 11 pts The client tells you he takes aspirin every day….
Question 11 pts
The client tells you he takes aspirin every day. What question should be asked next?
Group of answer choices
“Does the drug upset your stomach?”
“Was this prescribed by your provider?”
“Have you had any prolonged bleeding or bruising?”
“Why are you taking aspirin daily?”
Flag question: Question 2Question 21 pts
You realize that as an Advanced Practice Nurse you must ask questions regarding sensitive topics. To be most effective you employ the basic principles that guide responses to sensitive topics. The most important rule is:
Group of answer choices
Be nonjudgmental
Be focused
Be direct
Be succinct
Flag question: Question 3Question 31 pts
Cultural competence is best enhanced when the health care provider:
Group of answer choices
Uses self-awareness and reflection.
Relies on group stereotypes
Personally values health
Uses a single-focus approach
Flag question: Question 4Question 41 pts
You are assessing Jenna’s broken arm in the ER and you suspect she may be a victim of violence. What statement triggered your concern?
Group of answer choices
“Can you call my boyfriend?”
“It really hurts.”
“I was in the ER last month for a cold.”
“I hurt it about 4 days ago.”
Flag question: Question 5Question 51 pts
You are going to organize a BP screening fair at the mall. You are involved in
Group of answer choices
Early prevention
Tertiary prevention.
Primary prevention
Secondary prevention
Flag question: Question 6Question 61 pts
Your patient presents with left elbow pain, as you document his HPI you note his c/o swelling.
In your symptom analysis this would be considered:
Group of answer choices
Radiation
Associated symptom
Quality
Severity
Flag question: Question 7Question 71 pts
Your patients daughter is explaining to you why her mother, who has dementia is here. Her mother is not able to articulate the answer. This is an example of…
Group of answer choices
chief complaint
Family History
Objective information
subjective information
Flag question: Question 8Question 81 pts
Mr. Bill presents to your office for a physical. You note that his BMI is 27. You inform him that this is considered…
Group of answer choices
Borderline
Normal for his height
Obesity
Overweight
Flag question: Question 9Question 91 pts
A 44 year old man who admits to drinking “a few beers now and then” presents for examination. After obtaining an excellent health history and performing a physical examination. you suspect he is a heavy drinker. Your next action is to:
Group of answer choices
confront the patient with your observation
obtain liver enzymes
administer the CAGE questionnaire
You need to explain that looks like something he will need to work on in the future
Flag question: Question 10Question 101 pts
You are meeting for the first time a 14 yr old female patient. You would want to include the following in your exam.
Group of answer choices
TSH & T4
HCG & GC
HEADS & RAFFT
CBC & PPD
Flag question: Question 11Question 111 pts
As the NP you have given your patient the mini-mental exam. The patient scored 11. Given that the maximum score is 30, What does this score tell you?
Group of answer choices
The patient has severe cognitive impairment
The patient is depressed
The patient is uneducated
The patient has moderate cognitive impairment
Flag question: Question 12Question 121 pts
Which of the following is NOT one of the components of the adult health history?
Group of answer choices
Identifying data
History of present illness
Physical examination
Review of systems
Flag question: Question 13Question 131 pts
Mr. Sherman is a 45 yr. old accountant who presents to your office for an annual routine exam. He reports that he is a smoker (22Pk Yr. Hx). He states that he drinks 4 to 6 cans of beer a day, which he finds helps him to wind down after work. He denies any allergies. He denies any medications. His family history is positive for heart disease. His major leisure activity is watching television. He rarely exercises, but occasionally plays softball on the weekend. He is recently divorced and lives alone in a studio apartment. He has no children. On physical exam you find that his height is 66 in., weight 90 kg (198 lbs), and BP 148/90.
What health problems does Mr. S. present with?
Group of answer choices
Alcohol abuse, depression related to recent divorce, high-fat diet, obesity, hypertension, lives alone, overnutrition, muscle atrophy
Alcohol abuse, exercise intolerance, inactivity, hypertension, obesity, lives alone, recent divorce, social isolation.
Tobacco abuse, obesity, depression, exercise intolerance
Tobacco abuse, alcohol abuse, stress associated with work & recent divorce, inactivity, family history of heart disease, obesity, elevated blood pressure.
Flag question: Question 14Question 141 pts
Mr. Sherman is a 45 yr. old accountant who presents to your office for an annual routine exam. He reports that he is a smoker (22Pk Yr. Hx). He states that he drinks 4 to 6 cans of beer a day, which he finds helps him to wind down after work. He denies any allergies. He denies any medications. His family history is positive for heart disease. His major leisure activity is watching television. He rarely exercises, but occasionally plays softball on the weekend. He is recently divorced and lives alone in a studio apartment. He has no children. On physical exam you find that his height is 66 in., weight 90 kg, and BP 148/90.
Which of the following is not true regarding Mr. Sherman’s weight?
Group of answer choices
He’s at risk for obstructive sleep apnea
He’s not at increased risk; his weight is WNL (within normal limits)
He’s may be self treating depression with food.
He’s at risk for CAD
Flag question: Question 15Question 151 pts
Mr. Sherman is a 45 yr. old accountant who presents to your office for an annual routine exam. He reports that he is a smoker (22Pk Yr. Hx). He states that he drinks 4 to 6 cans of beer a day, which he finds helps him to wind down after work. He denies any allergies. He denies any medications. His family history is positive for heart disease. His major leisure activity is watching television. He rarely exercises, but occasionally plays softball on the weekend. He is recently divorced and lives alone in a studio apartment. He has no children. On physical exam you find that his height is 66 in., weight 90 kg, and BP 148/90.
What risk factors for coronary artery disease does Mr. S. have at this time?
Group of answer choices
Smoking, alcohol abuse, family history, lives alone.
Family history, alcohol abuse, depression.
Family history, obesity, hypertension
Smoking, elevated blood pressure, family history, obesity, age 45.
Flag question: Question 16Question 161 pts
Mr. Jones is a new patient and newly diagnosed diabetic. You realize that in order to get reimbursed at a higher level for the diabetic education you have done, you must document the time spent on this education at least what percentage of the visit.
Group of answer choices
more than 50% of visit
at least 25% of visit
at least 75% of visit
more than 85% of visit
Flag question: Question 17Question 171 pts
Susie Lee (25) presents for a checkup to your office. You have not seen her before. She was last seen by the MD in your group for a URI (upper respiratory infection) 4 years ago. Todays visit would be considered_________ according to the CPT definition.
Group of answer choices
an established patient
concurrent care
a new patient
billable at a higher level
Flag question: Question 18Question 181 pts
Your patient is seen for “ankle pain” . In your note you document that he c/o pain in the left lateral ankle radiating to the back of the heel. Pain is a 6 (1-10 scale), and worse when he puts pressure on it. He denies swelling, bleeding or bruising. He’s taken Advil 400mg twice, which helped minimally. In order to have a complete HPI for your CPT code, what is missing?
Group of answer choices
Any family members with osteoarthritis?
What meds is he on?
When did it begin?
What does he think it is?
Flag question: Question 19Question 191 pts
The keys to select the right level for billing include:
Group of answer choices
History, counseling, time
History, exam, decision making
Time, coordination of care, exam
Exam, decision making, time
Flag question: Question 20Question 201 pts
When performing a history & physical on a pediatric patient, which important factor affect the outcome the most:
Group of answer choices
child’s health
child’s fears
child’s verbal ability
child’s development level
Flag question: Question 21Question 211 pts
In medical billing the abbreviation CPT stands for:
Group of answer choices
Current Procedural Terminology
Compendium of Procedures and Therapies
Current Pricing Tier
Clinical Practice Terminology
Flag question: Question 22Question 221 pts
When obtaining a health history from an older client, which characteristics of the older client must be taken into consideration?
Group of answer choices
The older client requires a lot of repetition because the IQ declines with the aging process.
Auditory acuity is the most common sensory loss in the aged population and may hinder the interview.
An older client’s response time to answering a question is just as quick as that of a young client.
The older client responds to pain sensation with the same intensity as a young client.
Flag question: Question 23Question 231 pts
Mr. Williams is a new patient and has no complaints, but wants a physical. His physical exam is unremarkable but some of the findings from his history are concerning. Of the following, which would NOT put him at risk ?
Group of answer choices
3 beers/day
BMI > 26
waist of 32 inches
loose fitting false teeth
Flag question: Question 24Question 241 pts
The most important question to ask as you build your HPI is:
Group of answer choices
Have you ever had this before?
Men, women, or both
What time did it start?
have you had nausea?
Flag question: Question 25Question 251 pts
As an APN you believe strongly in anticipatory guidance and prevention education. You explain that all of the following are steps to address smoking except:
Group of answer choices
advise
assist
assess
arrange
admit
Flag question: Question 26Question 261 pts
Limiting public smoking is an example of tertiary prevention
Group of answer choices
True
False
Flag question: Question 27Question 271 pts
James is a 17 yo old patient who presents for a school physical. You have set aside time for screening prevention. Based on the leading cause of mortality for this student what should you discuss..
Group of answer choices
depression
HIV risk
seat belt use
vaccination status
Flag question: Question 28Question 281 pts
Which of the following women should have screening for cervical cancer?
Group of answer choices
a 19 yo virgin
a 21 yo with one male partner
An 18 yo who has a history of genital warts
a sexually active 16 yo
Flag question: Question 29Question 291 pts
Larry 25yo male presents to have a TB test read. This visit should be billed at:
Group of answer choices
99213
99212
99211
99214
Flag question: Question 30Question 301 pts
Which of the following patients is least likely to become an alcohol abuser?
Group of answer choices
a 19 yo college student who binges on alcohol but only on the weekends
a 70 yo male who feels better after drinking rum in the morning
a 50yo construction worker who drinks 1 beer nightly while watching baseball on TV
a 30 yo nurse who complains that her mother’s comments about her recreational drinking are starting to annoy her and her spouse
Flag question: Question 31Question 311 pts
Ted, who is 15yo has just moved into the community and is staying in a foster home temporarily. There is no record of immunization. His foster mother wants him to be checked before he enters the local high school. Which of the following does he need?
Group of answer choices
All of the above
meningococcal
Tdap
Measles-Mumps-Rubella (MMR)
Flag question: Question 32Question 321 pts
A sedentary, obese 52 yo woman is diagnosed with HTN and states: “It is going to be hard to diet, exercise, and take these pills”. Which of the following responses is the least helpful?
Group of answer choices
“Could you start with reducing the amount of salty foods in your diet?”
“Tell me what you feel will get in your way of improving your health?”
“Perhaps you could try taking your medication when you brush your teeth”
“You really need to try and improve your health.”
Flag question: Question 33Question 331 pts
A NP is evaluating an 85yo male from a nursing home. The NP instructs the patient to remember the words orange, street, and tiger. The patient is instructed to repeat these words back to the NP in 10 minutes. Which of the tests is being described?
Group of answer choices
Minnesota Multphasic Personality Inventory (MMPI)
The CAGE test
Beck Inventory
Mini-Mental status exam
Flag question: Question 34Question 341 pts
In doing a cultural assessment on your patient all of the following are components of the assessment except:
Group of answer choices
What are the roles in the family?
What religious influences may affect care?
What is the patient’s income?
What are the patient’s personal belief about health?
Flag question: Question 35Question 351 pts
When caring for a patient with sensitive issues, which of the following is the most therapeutic approach?
Group of answer choices
Be vague so you don’t offend the patient.
Push to get the accurate and necessary answers
Offer the patient the opportunity to ask questions
Apologize for having to ask difficult questions
Flag question: Question 36Question 361 pts
The SCOFF screening tool is used to diagnose eating disorders.
Group of answer choices
True
False
Flag question: Question 37Question 371 pts
When researching the elderly population, what is the fastest growing age range?
Group of answer choices
81-84 years
85 and older
71-75 years
76-80 years
Flag question: Question 38Question 381 pts
Your patient is a 43 year old female in today for an annual physical exam. Her history is unremarkable, she has no new diagnosis or surgeries since seen last year and is otherwise health. When you begin questioning her about her cardiac ROS, she becomes tearful and states:” I just know Im going to have a heart ache some day.” Your best response would be:
Group of answer choices
If I were you, I would get an EKG and have a cardiac stress test – I can order those for you today.
Im sure you’ll be just fine, you don’t have a cardiac history.
You don’t need to worry about that, you’re young and healthy.
It sounds like this is a big concern of yours, can you tell me more about it?
Flag question: Question 39Question 391 pts
As a nurse practitioner, you have been asked to serve on a committee to assess the social determinants of health for a community. Of the following considerations, choose the one that is not a social determinant of health.
Group of answer choices
Ease of access to fresh food.
The prevalence of diabetes in a community.
Accessability for persons with disabilities.
Availability of safe recreational areas.
Flag question: Question 40Question 401 pts
When screening a patient for their risk of experiencing violence/domestic violence, there are 2 important questions to ask. Of the following, choose both appropriate questions:
Group of answer choices
Have you ever been hit by your partner?
Has your partner ever given you a sexually transmitted disease?
How many times have you been to the ER in the last year?
Have you been forced to have sex by your partner?
Adverse effect for amenorrhea on norethindrone
What is medication treatment for patient with amenorrhea on norethindrone. What are the adverse effect for amenorrhea on norethindrone, what are the contraindication , what are the drug interaction, what are the dosages and route administration. What nursing care plan can be included in the phase of the nursing process.
Garbage disposal procedures
write down the garbage disposal procedures that should be followed…
write down the garbage disposal procedures that should be followed in an establishment that handles, stores, processes and serves food and beverages for human consumption.
Diagnosis of urinary tract infection and dehydration
Wound Evaluation
Review the Millie Larsen case update within this assignment, read the questions, consult your resources–particularly the texts and National Patient Safety Goals web site concerning Hospital Chapter, Goal 7, NPSG.07.01.01 and NSPG.07.03.01. Brainstorm ideas and formulate your responses. Use the Braden Scale form to score her skin risk; access the Braden Scale form through the link below.
Several weeks have passed since the clinic visit, and Millie is now re-admitted to the hospital with a diagnosis of urinary tract infection and dehydration. Her presentation is atypical, and she is confused. Upon the admission assessment, the nurse notices that Millie has a wound on her sacrum and asks her if it is painful. Millie states that “it does hurt, so I have just been lying down more.” The nurse places a gauze dressing over the wound and continues with the assessment.
She is now being cared for on a medical-surgical unit and because she is confused, she has a bed alarm for her safety. Millie needs much encouragement to get out of bed and walk to the bathroom so has become more incontinent and requires frequent bed changes. She is receiving intravenous fluids and medications for the urinary tract infection. Millie appears weak and underweight as she is only eating about one-quarter of her meals. She refuses to drink the supplements that she is offered and sometimes refuses to take her medications.
A few days later, it is noted that the wound has worsened and now has purulent drainage with a foul odor which will require referral to a wound nurse for additional care. Wound cultures are positive for methicillin-resistant staphylococcus aureus (MRSA).
Before responding to the questions, review the following videos:
- Obtaining a Wound Culture by Swab (Links to an external site.)
- Removing and Applying Wet to Damp Dressings (Links to an external site.)
- Open-Pore Reticulated Polyurethane Foam Therapy (i.e., Vacuum-Assisted Closure [V.A.C.]) (Links to an external site.)
Respond to the Following Questions
Oval wound on person with deep wound bed. Overall skin color is lightly pigmented. Yellow fatty tissue noted in part of wound bed. Remainder of wound bed is red.
- View the picture to help you assess the wound. What are the “clinical findings” and how would you stage Millie’s wound?
- What would be included in the plan of care for treatment of Millie’s wound? Please include all aspects of a team-based approach that will be utilized in a successful treatment plan.
- What are three (3) nursing interventions that the nurse would incorporate into the plan of care? Give a rationale for each intervention.
- If the wound nurse orders a dressing change for this wound, what technique would be appropriate? (Medical asepsis, clean technique? Or surgical asepsis, sterile technique)? Describe the procedure and give a rationale for your choice.
- What are some of the risks that Millie demonstrates for forming a pressure injury? Using the Braden Scale Download Braden Scale, how would you score Millie at this time?
Signs of contamination
list four signs of contamination you might note when inspecting a work area.
The client with diabetes
uth f Face @ Stuc Lew # x NUI Feel Har | Log| Qui | nro Gab | req & Nur| G . pr| Fe e.com/courses/40072/quizzes/78744/take Maps o Odaano, Desmond… Ryan Sings The Boo… Guthscsa canvas | Home – ATI Testing Microsoft Office Ho.. Students f (5) Facebo D Question 12 5 pts The nurse providing diabetic screening to South Texas community members who have not been diagnosed with diabetes and do not have signs of diabetes. The nurse should consider diabetic screening for which of the following risk factors? (Select all that apply). Age 45 Low activity level Triglyceride 250 mg/dL BMI of 41 kg/m2 A 29-year-old female who had a 9.6 lb baby Great aunt with diabetes O HDL 30 mg/dL D Question 13 5 pts O W Q 60 F 13 14 40 3 5 8 9 4
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Signs of insulin resistance O Increased risk for developing ketoacidosis Good control of blood glucose Increased risk for developing hyperglycemia D Question 9 5 pts The nurse is caring for a client who has thyroid surgery for treatment of hyperthyroidism. Which symptom indicates that damage to the patient’s parathyroid gland may have occurred? Spastic airway obstruction Vocal cord paralysis O Hypocalcemia Reddened neck incision D Question 10 5 pts earch O W P 60OF 13 -* f4 # $ % 3 4 5 16 9 E R P F
uth Fac @ Stu & Lew X NUF | Feel Har | Log|Qui & nro Gab | req Nur G . prc| Fed m/courses/40072/quizzes/78744/take aps oz Odaano, Desmond… Ryan Sings The Boo… uthsosa canvas | Home – ATI Testing Microsoft Office Ho… Students f (5) Facebook A patient with CKD is prescribed epoetin alfa-epbx for anemia. The dose is 75 units/kg 3 times per week and not to exceed a hemoglobin of 10 g/dL. The patient’s weight is 84 kgs. The current hemoglobin is 8.9 g/dL. Available: NDC 0069-1308-01 Rx only Store at 2 to 8 C. RetacritTM Dosage – See Package Epoetin Alfa-epbx Insert. Mfd. by Hospira, Inc., recombinant a subsidiary of Pfizer Inc., RL 10075 Lake Forest, IL 60045 USA FPO 10,000 Units/ml. us License No. 1974 1 mL single-dose vial Dist. by Pfizer Labs Pfizer Biosimilars Division of Pfizer Inc New York, NY 10017 The nurse will administer_ mLs per dose. Rounding rules: Round to the nearest 100th. (example: 5.34 or 0.12) 5 pts D Question 12 w P 60OF O S 8 9 3 4
Patient that have stroke-like symptoms
What are primary concerns for a patient that have stroke-like symptoms
and what assessment and intervention would be associated and why?
Payment Method
