Nursing

Assignment: Pharmacy Questions
Assignment: Pharmacy Questions
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Question 1
A nurse who provides care on an acute medicine unit has frequently recommended the use of nicotine replacement gum for patients who express a willingness to quit smoking during their admission or following their discharge. For which of the following patients would nicotine gum be contraindicated?
A. A patient whose stage III pressure ulcer required intravenous antibiotics and a vacuum dressing
B. A patient with a history of angina who experienced a non-ST wave myocardial infarction
C. A patient who received treatment for kidney failure due to an overdose of acetaminophen
D. A patient whose pulmonary embolism was treated with a heparin infusion
1 points
Question 2
A patient who has been taking buspirone (BuSpar) for 1 week calls the clinic and reports to the nurse that the drug is not working. The patient informs the nurse that she is still having symptoms of anxiety. The nurse will tell the patient that
A. she will report this to the physician immediately.
B. it may take up to 6 months for the drug to relieve her anxiety.
C. optimum relief of anxiety usually occurs after 3 to 4 weeks of treatment.
D. the drug is not going to work for her and the medication needs to be changed.
1 points
Question 3
A patient has been admitted to the ICU because of multiple traumas due to a motor vehicle accident. The physician has ordered propofol (Diprivan) to be used for maintenance of sedation. Before administration of propofol, a priority assessment by the nurse would be to check for a history of
A. diabetic hyperlipidemia.
B. increased intraocular pressure.
C. seizure disorders.
D. low blood pressure.
1 points
Question 4
A 39-year-old patient who is having trouble sleeping is beginning drug treatment with zaleplon (Sonata). The nurse will be sure to ask the patient if she is taking
A. oxycodone (Percodan).
B. secobarbital (Seconal).
C. cimetidine (Zantac).
D. meperidine (Demerol).
1 points
Question 5
A nurse is caring for a patient who has been admitted with acute cocaine intoxication. Which of the following vital signs would the nurse expect to find initially when assessing the patient?
A. BP: 130/88, P: 92, R: 28
B. Blood pressure (BP): 98/50, pulse (P): 120, respirations (R): 40
C. BP: 170/98, P:110, R: 20
D. BP: 150/90, P: 80, R: 16
1 points
Question 6
A nurse is caring for a patient who abuses marijuana. The treatment for marijuana abuse consists mainly of
A. no nursing action unless the patient experiences a “bad trip.”
B. nonpharmacologic interventions combined with an exercise program.
C. aggressive respiratory assistance
D. drug therapy with bromocriptine (Parlodel).
1 points
Question 7
A patient is suffering from acute inhalant intoxication. The priority nursing intervention will be to
A. assess the patient’s psychosocial status.
B. administer oxygen therapy.
C. provide an emesis basin.
D. administer epinephrine.
1 points
Question 8
A 20-year-old man has begun treatment of the psychotic symptoms of schizophrenia using olanzapine (Zyprexa). Which of the following symptoms would be categorized as a negative symptom of schizophrenia?
A. Visual hallucinations
B. Auditory hallucinations
C. Delusional thinking
D. Lack of interest in normal activities
1 points
Question 9
A homeless man who is well known to care providers at the local hospital has been admitted to the emergency department after having a seizure outside a mall. The man is known to be a heavy alcohol user and is malnourished with a very low body mass index. How are this patient’s characteristics likely to influence possible treatment with phenytoin?
A. The patient’s heavy alcohol use will compete with phenytoin for binding sites and he will require a higher-than-normal dose.
B. The patient’s protein deficit will likely increase the levels of the free drug in his blood.
C. Phenytoin is contraindicated within 48 hours of alcohol use due to the possibility of paradoxical effects.
D. The patient will require oral phenytoin rather than intravenous administration.
1 points
Question 10
The wife of a patient who is taking haloperidol calls the clinic and reports that her husband has taken the first dose of the drug and it is not having a therapeutic effect. An appropriate response by the nurse would be
A. “I’ll ask the nurse practitioner if the dosage can be increased.”
B. “Continue the prescribed dose. It may take several days to work.”
C. “I’ll ask the nurse practitioner if the haloperidol can be discontinued and another drug started.”
D. “I’ll report this to the nurse practitioner and see if he will add another drug to enhance the effects of the haloperidol.”
1 points
Question 11
A patient who is experiencing acute alcohol withdrawal is being treated with intravenous lorazepam (Ativan). This drug achieves a therapeutic effect by
A. inhibiting the action of monoamine oxidase.
B. increasing the effects of the neurotransmitter GABA.
C. increasing the amount of serotonin available in the synapses.
D. affecting the regulation of serotonin and norepinephrine in the brain.
1 points
Question 12
A nurse will be prepared to administer naloxone (Narcan) to a patient who has had an overdose of morphine. Repeated doses of Narcan will be necessary because Narcan
A. has a shorter half-life than morphine.
B. has less strength in each dose than do individual doses of morphine.
C. causes the respiratory rate to decrease.
D. combined with morphine, increases the physiologic action of the morphine.
1 points
Question 13
A 4-year-old child is brought to the emergency department by her mother. The mother reports that the child has been vomiting, and the nurse notes that the child’s face is flushed and she is diaphoretic. The mother thinks that the child may have swallowed carbachol drops. A diagnosis of cholinergic poisoning is made. Which of the following drugs would be administered?
A. Nicotine
B. Cevimeline
C. Atropine
D. Acetylcholine
1 points
Question 14
A patient with mild low back pain has been advised to take acetaminophen. The nurse will inform him that excessive intake of acetaminophen may result in
A. gastrointestinal distress.
B. cognitive deficits.
C. acute renal failure.
D. liver damage.
1 points
Question 15
A patient has been hospitalized for treatment of substance abuse after being arrested and jailed for the past 24 hours. The patient is experiencing severe muscle and abdominal cramps, seizures, and acute psychosis due to abrupt withdrawal. Which of the following drug classes is the most likely cause of these severe and potentially fatal withdrawal symptoms?
A. Amphetamines
B. Opioids
C. Benzodiazepines
D. Sedative–hypnotic drugs
1 points
Question 16
A 59-year-old woman has presented to a clinic requesting a prescription for lorazepam (Ativan) in order to treat her recurrent anxiety. Her care provider, however, believes that a selective serotonin reuptake inhibitor (SSRI) would be more appropriate. What advantage do SSRIs have over benzodiazepines in the treatment of anxiety?
A. SSRIs have a more rapid therapeutic effect.
B. SSRIs require administration once per week, versus daily or twice daily with benzodiazepines.
C. SSRIs generally have fewer adverse effects.
D. SSRIs do not require serial blood tests during therapy.
1 points
Question 17
A 64-year-old-patient has been prescribed lorazepam (Ativan) because of increasing periods of anxiety. The nurse should be careful to assess for
A. a history of current or past alcohol use.
B. a diet high in fat.
C. current nicotine use.
D. a diet high in carbohydrates.
1 points
Question 18
Which of the following would be an expected outcome in a patient who has been given atropine during a medical emergency?
A. Restoration of normal sinus rhythm
B. Resolution of respiratory acidosis
C. Reduction of severe hypertension
D. Increased level of consciousness
1 points
Question 19
A trauma patient has been receiving frequent doses of morphine in the 6 days since his accident. This pattern of analgesic administration should prompt the nurse to carefully monitor the patient’s
A. bowel patterns.
B. urine specific gravity.
C. skin integrity.
D. core body temperature.
1 points
Question 20
A middle-aged patient was diagnosed with major depression after a suicide attempt several months ago and has failed to respond appreciably to treatment with SSRIs. As a result, his psychiatrist has prescribed phenelzine. When planning this patient’s subsequent care, what nursing diagnosis should the nurse prioritize?
A. Risk for Injury related to drug–drug interactions or drug–nutrient interactions
B. Risk for Constipation related to decreased gastrointestinal peristalsis
C. Risk for Ineffective Peripheral Tissue Perfusion related to cardiovascular effects of phenelzine
D. Risk for Infection related to immunosuppressive effects of phenelzine
1 points
Question 21
A nurse works in a sleep disorder clinic and is responsible for administering medications to the patients. Which of the following patients would be most likely to receive zaleplon (Sonata)?
A. A 20-year-old woman who will take the drug about once a week
B. A 46-year-old man who receives an antidepressant and needs a sleep aid
C. A 35-year-old man who is having difficulty falling asleep, but once asleep can stay asleep
D. A 52-year-old woman who needs to fall asleep quickly and stay asleep all night
1 points
Question 22
A 26-year-old professional began using cocaine recreationally several months ago and has begun using the drug on a daily basis over the past few weeks. He has noticed that he now needs to take larger doses of cocaine in order to enjoy the same high that he used to experience when he first used the drug. A nurse should recognize that this pattern exemplifies
A. drug tolerance.
B. dependence.
C. addiction.
D. withdrawal.
1 points
Question 23
A postsurgical patient has been provided with a morphine patient-controlled analgesic (PCA) but has expressed her reluctance to use it for fear of becoming addicted. How can the nurse best respond to this patient’s concerns?
A. “It is not uncommon to develop a dependence on pain medications, but this usually takes place over a long period and is not the same as addiction.”
B. “You don’t need to worry. It’s actually not true that you can get addicted to the medications we use in a hospital setting.”
C. “It’s important that you accept that your current need to control your pain is more important than fears of becoming addicted.”
D. “If you do become addicted, we’ll make sure to provide you with the support and resources necessary to help you with your recovery.”
1 points
Question 24
A patient has been prescribed zolpidem (Ambien) for short-term treatment of insomnia. Which of the following will the nurse include in a teaching plan for this patient? (Select all that apply.)
A. The drug does not cause sleepiness in the morning.
B. It is available in both quick-onset and continuous-release oral forms.
C. The drug should not be used for longer than 1 month.
D. It should be taken 1 hour to 90 minutes before going to bed.
E. One of the most common adverse effects of the drug is headache.
1 points
Question 25
A patient who is experiencing withdrawal from heavy alcohol use have developed psychosis and been treated with haloperidol. Which of the following assessment findings should prompt the care team to assess the patient for neuroleptic malignant syndrome?
A. The patient develops yellowed sclerae and intense pruritis (itchiness).
B. The patient demonstrates a significant increase in agitation after being given haloperidol.
C. The patient develops muscle rigidity and a sudden, high fever.
D. The patient complains of intense thirst and produces copious amounts of urine.
1 points
Question 26
A nurse is providing care for a patient who suffered extensive burns to his extremities during a recent industrial accident. Topical lidocaine gel has been ordered to be applied to the surfaces of all his burns in order to achieve adequate pain control. When considering this order, the nurse should be aware that
A. there is a risk of systemic absorption of the lidocaine through the patient’s traumatized skin.
B. intravenous lidocaine may be preferable to topical application.
C. lidocaine must be potentiated with another anesthetic in order to achieve pain control.
D. pain relief is unlikely to be achieved due to the destruction of nerve endings in the burn site.
1 points
Question 27
Which of the following drugs used to treat anxiety would be appropriate for a patient who is a school teacher and is concerned about feeling sedated at work?
A. Lorazepam (Ativan)
B. Diazepam (Valium)
C. Alprazolam (Xanax)
D. Buspirone (BuSpar)
1 points
Question 28
A nurse is caring for a patient who is in severe pain and is receiving an opioid analgesic. Which of the following would be the nurse’s priority assessments?
A. Liver function studies, pain intensity, and blood glucose level
B. Pain intensity, respiratory rate, and level of consciousness
C. Respiratory rate, seizure activity, and electrolytes
D. Respiratory rate, pain intensity, and mental status
1 points
Question 29
A male patient has been brought to the emergency department during an episode of status epilepticus. Diazepam is to be administered intravenously. The nurse will be sure to
A. administer after diluting the drug with gabapentin in intravenous solution.
B. inject very slowly, no faster than 100 mg/minute.
C. inject the diazepam very quickly, 15 mg in 10 to15 seconds.
D. avoid the small veins in the dorsum of the hand or the wrist.
1 points
Question 30
A 30-year-old woman is taking phenelzine (Nardil) 30mg PO tid. The nurse knows that at that dosage, the patient will need to be carefully monitored for
A. increased secretions.
B. facial flushing.
C. dizziness
Assignment: Pharmacy Questions
Assignment: Pharmacy Questions
Assignment: Pharmacy Questions
Assignment: Pharmacy Questions

Discussion: Stakeholders setting
Discussion: Stakeholders setting
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Summarize the scenario, Identify key points, the stakeholders, setting, and situation.
Read Cespedes, F. V. (2013, June 28). Ron Ventura at Mitchell Memorial Hospital. Harvard Business School.
(a) Read the case study to identify the main point and key players. Highlight the main points and identify themes. Review, asking questions: What is really going on? What are the problems? What is the main issue? How do the problems relate? What are the underlying issues? Describe how or why these issues developed.
(b) Research the problem or issue you have identified to help frame the issue and to make connections to secondary issues. Use journal articles, and not website-based sources.
(c) Decide how to “solve” or manage the issue. Consider who should be involved: what their responsibilities might be, strengths and weaknesses, and so on.
(d) Identify at least two alternative solutions and analyze their strengths and weaknesses (or describe why they would or would not be effective).
(e) Select the best alternative and explain how you will measure effectiveness.
(f) Discuss the specific issue and secondary issues and how they relate. Support your analysis and explain your reasoning.
(g) Describe the role perspective contributing to your solution, identifying strengths and weaknesses. Describe alternatives and the pros and cons of these.
(h) End with a conclusion that addresses how to evaluate the effectiveness of the solution, or describe how effective measures should be measured. Some case studies may conclude with a discussion of implications from the case.
Papers should include a title page, 2–4 pages of writing, and a reference list. Double-space and use Times New Roman 12-point font, one-inch margins, and APA style of writing and scholarly citations in APA format.
(g) Describe the role perspective contributing to your solution, identifying strengths and weaknesses. Describe alternatives and the pros and cons of these.
(h) End with a conclusion that addresses how to evaluate the effectiveness of the solution, or describe how effective measures should be measured. Some case studies may conclude with a discussion of implications from the case.
Papers should include a title page, 2–4 pages of writing, and a reference list. Double-space and use Times New Roman 12-point font, one-inch margins, and APA style of writing and scholarly citations in APA format.

Assignment: Career Planning Discussion
Assignment: Career Planning Discussion
PURPOSE Having a clear vision for the future, setting reasonable goals, and developing strategies for meeting those goals are important steps in ensuring control of one’s professional future. This assignment provides the student with the opportunity to demonstrate a commitment to ongoing personal and professional development through the creation of a one?year and five?year professional career plan in nursing.
REQUIREMENTS In this assignment, the student will be producing a 4?5 page essay that includes the following components:
• Transition into the Professional Nursing Role: Identify actions to be considered in the transition from student to BSN graduate nurse including:
o Identify the state in which the student is seeking employment.
o Detail a minimum of three (3) criteria set forth by the Board of Nursing for obtaining an RN license in that state.
o Conduct a new BSN graduate job search in a 30 mile radius of where the student lives or plans to relocate.
§ Provide the details of what is required to submit an application for hire for the top two choices of employment.
• Holistic Life Balance: Provide a description of the ways in which the student intends to maintain holistic balance in their personal life as well as in the role of professional nurse within the first year and at five years.
• Stressors and Challenges: Identify known stressors and anticipated challenges as well as plans for managing each of them within the first year and at five years.
• Lifelong Learning: Determine a plan for lifelong learning and educational development anticipated within the first year and at five years.
o This plan can include, but is not limited to, specialty certification, advanced nursing education, and the pursuit of formal education outside of the nursing discipline.
• Professional Contributions: Summarize plans for contributing to at least one professional nursing community as well as the student’s general community in the healthcare professional role within the first year and at five years
• Scholarly Resources:
o A minimum of three (3) peer?reviewed scholarly sources are required in support of this assignment.
o A minimum of one (1) professional nursing organization website or Board of Nursing website is required in support of this assignment.
PREPARING THE ASSIGNMENT
• Maximum of 4?5 pages including the title page and the reference page. •
Students may find the following list of resources helpful in completing the assignment:
o American Nurses Credentialing Center at http://www.nursecredentialing.org/certification.aspx o Board of Nursing Contact at
o Holistic Nursing at http://www.ahna.org/About?Us/What?is?Holistic?Nursing o National Council of State Boards of Nursing at
o Nursing Community at
o Robert Wood Johnson Foundation at
o Sigma Theta Tau International at

Assignment: Team Management Activity
Assignment: Team Management Activity
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This assignment focuses on how the management practices of planning, leading, organizing, staffing, and controlling are implemented in your workplace. Using the Ashford University Library and other credible online resources, find three Scholarly, Peer Reviewed, and Other Credible Sources (Links to an external site.)Links to an external site. that provide information on Amazon.com’s business structure.
Here is the scenario and situation:
Assume you are an employee working in the Amazon warehouse, and you pack orders and categorize them into small, medium, and large batches. You are considered a packer. You have experience packing all sizes and have been with the organization for two years. You are considered one of their best employees, you have a solid reputation for being a hard worker, and all of your orders are packed correctly. You have also been busy; you recently completed Amazon’s management training program, and you have completed your BABA degree at the *** School of Business and Technology at **** University.
Congratulations: You have just been promoted to manager. You will be relocated to a new plant that is two hours away that employs 100 employees. You will oversee a team of 10 supervisors and 90 packers and will now oversee the entire warehouse operation. How will you work to use and apply the five functions of management?
Now let’s apply the five functions. In your paper, include the following sections:
• Planning: Examine the specific areas you will choose to manage that fall under the planning function.
o For example, what might be some of the things you will plan to do and implement to build an effective team and culture? People are the most important resource in any business, what do you plan to do to build a positive team culture? What processes and systems do you plan to use?
• Organizing: Assess if the present structure that Amazon has set up is working.
o Do you need to make or suggest any changes to make it more efficient and effective? What structure will you use and implement? Explain how you will use departmentalization in your organizational structure.
• Staffing: Analyze your staffing needs.
o How do you intend to staff your organization and replace members that leave or are promoted? How does the HR process apply? What things (if any) will you suggest?
• Leading: Justify the leadership theory and style you will follow to ensure efficiency.
o Will you use transformational or transactional leadership? Why or why not?
• Controls: Identify what controls and measures you will implement.
o How will you apply the four steps of control (these are in Chapter 5; i.e., establishing standards, measuring performance, comparing performance, and making decisions)?
Be sure to integrate vocabulary learned throughout this course and citations from the text to support your analysis. The paper should be five to six double-spaced pages in length, must include at least three scholarly sources, in addition to the textbook, and be formatted according to APA style guidelines as outlined in the Ashford Writing Center.
The Team Management Activity and Reflection paper
• Must be five to six double-spaced pages in length (not including title and references pages) and formatted according to APA style as outlined in the
• Must include a separate title page with the following:
o Title of paper
o Student’s name
o Course name and number
o Instructor’s name
o Date submitted
• Must use at least three scholarly, peer reviewed, and/or credible sources in addition to the course text.
o The Scholarly, Peer Reviewed, and Other Credible Sources (Links to an external site.)Links to an external site. table offers additional guidance on appropriate source types. If you have questions about whether a specific source is appropriate for this assignment, please contact your instructor. Your instructor has the final say about the appropriateness of a specific source for a particular assignment.
• Must document all sources in APA style
• Must include a separate references page that is formatted according to APA style

Lifestyle Changes for Weight Loss
Lifestyle Changes for Weight Loss
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Sally is a 43-year-old mother of two who has gained 50 pounds over the past five years. She is 64 inches tall and weighs 180 pounds with a BMI of 30.8. Her waist circumference is 37 inches. She acknowledges that she is not as physically active as she would like to be. She also notes how recent stresses in her life have affected her sleep and seem to have triggered her appetite for sweets. Sally’s father recently died from complications of type 2 diabetes and her mother and sisters are overweight. Sally says she is very motivated to “not get diabetes” and is disturbed that her recent physical exam revealed mildly elevated blood pressure, glucose, and cholesterol levels.
1. How does Sally’s family history influence her weight and risk for diabetes? What lifestyle choices may influence her genetic predisposition to be overweight?
2. Using information in this chapter, what is a reasonable goal weight for Sally? How long would you estimate it would take her to safely lose this amount of weight?
3. What weight-loss strategies may help curb Sally’s stress-related eating?
4. Sally has determined that—to lose weight—she needs to limit her daily caloric intake to 1400 kcalories. Use Table 9-2 and show a one-day plan for meals and snacks that meet her nutritional needs within this calorie level.
5. What are some advantages to Sally keeping a food and exercise record? What other factors besides food intake and physical activity may be useful for Sally to record?
6. Why might strength training be an important addition to Sally’s exercise regimen?Sally is a 43-year-old mother of two who has gained 50 pounds over the past five years. She is 64 inches tall and weighs 180 pounds with a BMI of 30.8. Her waist circumference is 37 inches. She acknowledges that she is not as physically active as she would like to be. She also notes how recent stresses in her life have affected her sleep and seem to have triggered her appetite for sweets. Sally’s father recently died from complications of type 2 diabetes and her mother and sisters are overweight. Sally says she is very motivated to “not get diabetes” and is disturbed that her recent physical exam revealed mildly elevated blood pressure, glucose, and cholesterol levels.

Assignment: Drooping of Face Discussion
Assignment: Drooping of Face Discussion
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A 33-year-old female comes to your clinic alarmed about sudden “drooping” on the right side of the face that began this morning. She complains of excessive tearing and drooling on her right side as well.
To prepare:
With regard to the case study you were assigned:
Review this week’s Learning Resources, and consider the insights they provide about the case study.
Consider what history would be necessary to collect from the patient in the case study you were assigned.
Consider what physical exams and diagnostic tests would be appropriate to gather more information about the patient’s condition. How would the results be used to make a diagnosis?
Identify at least five possible conditions that may be considered in a differential diagnosis for the patient.
Note: Before you submit your initial post, replace the subject line (“Discussion – Week 9”) with “Review of Case Study ___.” Fill in the blank with the number of the case study you were assigned.
By Day 3
Post a description of the health history you would need to collect from the patient in the case study to which you were assigned. Explain what physical exams and diagnostic tests would be appropriate and how the results would be used to make a diagnosis. List five different possible conditions for the patient’s differential diagnosis, and justify why you selected each.
A 33-year-old female comes to your clinic alarmed about sudden “drooping” on the right side of the face that began this morning. She complains of excessive tearing and drooling on her right side as well.
To prepare:
With regard to the case study you were assigned:
Review this week’s Learning Resources, and consider the insights they provide about the case study.
Consider what history would be necessary to collect from the patient in the case study you were assigned.
Consider what physical exams and diagnostic tests would be appropriate to gather more information about the patient’s condition. How would the results be used to make a diagnosis?
Identify at least five possible conditions that may be considered in a differential diagnosis for the patient.

Discussion: Client with schizophrenia
Discussion: Client with schizophrenia
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# 1.52
(1 pts.) In the textbook case, David Marshall’s belief that television commercials were specifically directed to him is referred to as a delusion of
A) persecution.
B) reference.
C) grandeur.
D) nihilism.
# 1.53
(1 pts.) Charlie, a client with schizophrenia, is being encouraged by his therapist to talk with his co-workers and ask them about their personal lives in hopes that he will learn that they are not aliens from Venus trying to take over Earth. The therapist is asking Charlie to use a technique best known as
A) reality testing.
B) labeling.
C) verbal challenge.
D) didactic listening.
# 1.54
(1 pts.) Jennifer recently experienced a brief psychotic episode soon after her miscarriage. The symptoms lasted a little less than a month. Jennifer had experienced
A) schizophreniform disorder.
B) schizoid personality disorder.
C) brief psychotic disorder.
D) disorganized schizophrenia.
# 1.55
(1 pts.) Reggie thinks that the any marital discord between the president and his wife is because the First Lady is secretly in love with him and wishes to spend the rest of her life with him. Which type of psychosis is Reggie suffering from?
A) paranoid schizophrenia
B) delusional disorder, erotomanic type
C) schizoaffective disorder
D) disorganized schizophrenia
# 1.56
(1 pts.) Because of the vagueness and generality of the criteria at the time, an individual diagnosed as having schizophrenia in the 1960s
A) would probably not meet the current criteria for the disorder.
B) would probably not recover as quickly as someone diagnosed now.
C) would probably now be diagnosed as having an organic dementia.
D) would probably have more limited symptoms than someone diagnosed now.
# 1.57
(1 pts.) Frank seems to welcome the sympathy and attention that he gets from his parents when he has a psychotic episode. Which of the following might be maintaining his symptoms?
A) negative reinforcement
B) primary gain
C) secondary gain
D) vicarious reinforcement
# 1.58
(1 pts.) The symptoms of schizophrenia are associated with the overactivity of neurons that respond to which neurotransmitter?
A) norepinephrine
B) GABA
C) serotonin ;
D) dopamine

Assignment: Treatment for peptic ulcer
Assignment: Treatment for peptic ulcer
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Question 1 A 42-year-old man is being treated for a peptic ulcer with ranitidine (Zantac) taken PO at bedtime. Even though few adverse effects are associated with this drug, one common adverse effect that can be severe is
A) headache
B) irritability
C) dry mouth
D) heart palpitations
Question 2 A patient on 5-FU calls the clinic and reports that he has between five and seven loose bowel movements daily. The nurse will instruct the patient to
A) treat the diarrhea with OTC medications
B) avoid protein-rich foods
C) avoid grapefruit and grapefruit juice
D) notify the clinic if the stools are black or if there is evidence of blood
Question 3 A patient has been prescribed a histamine-2 (H2) receptor antagonist for the treatment of GERD. Why are H2RAs more effective than H1 receptor antagonists in the treatment of diseases of the upper GI tract?
A) H2RAs have a longer duration of action and fewer adverse effects than H1RAs
B) The parietal cells of the stomach have H2 receptors but not H1 receptors
C) H2RAs may be administered orally and in an outpatient environment but H1RAs require intravenous administration
D) H2 receptors in the upper GI tract outnumber H1 receptors by a factor of 2:1
Question 4 To maximize the therapeutic effect of diphenoxylate HCl with atropine sulfate, the nurse will instruct the patient to take the medication
A) once a day
B) twice a day
C) every 2 hours
D) four times a day
Question 5 A 22-year-old male college senior has lived with a diagnosis of Crohn’s disease for several years and has undergone several courses of treatment with limited benefit. Which of the following targeted therapies has the potential to alleviate the symptoms of Crohn’s disease?
A) Tositumomab plus 131I (Bexxar)
B) Muromonab-CD3 (Orthoclone OKT3)
C) Infliximab (Remicade)
D) Eculizumab (Soliris)
Question 6 A patient has been prescribed rabeprazole (Aciphex). It will be important for the nurse to assess the patient’s drug history to determine if the patient is taking which of the following drugs?
A) Levodopa
B) Morphine
C) Digoxin
D) Dicyclomine hydrochloride
Question 7 An adult patient who has been diagnosed with a rectal tumor is scheduled to begin treatment with cisplatin. The nurse has conducted patient teaching about the possibility of nausea and vomiting. In order to reduce the patient’s risk of severe nausea, the nurse should
A) place the patient on a low-residue diet
B) ensure that the patient is NPO from midnight prior to receiving the drug
C) administer a combination of antiemetics prior to the administration of the drug
D) encourage the patient to request antiemetics if the nausea becomes unbearable
Question 8 It is determined that a patient, who is in a hepatic coma, needs a laxative. Lactulose is prescribed. Which of the following should the nurse monitor to assess the efficacy of the lactulose therapy?
A) Water levels in the colon
B) Oncotic pressure in the colon
C) Blood ammonia levels
D) Relief from symptoms
Question 9 A 60-year-old man has scheduled a follow-up appointment with his primary care provider stating that the omeprazole (Prilosec) which he was recently prescribed is ineffective. The patient states,“I take it as soon as I feel heartburn coming on, but it doesn’t seem to help at all.” How should the nurse best respond to this patient’s statement?
A) “It could be that Prilosec isn’t the right drug for you, so it would be best to talk this over with your care provider.”
B) “Prilosec won’t really decrease the sensation of heartburn, but it is still minimizing the damage to your throat and stomach that can be caused by the problem.”
C) “Prilosec will help your heartburn but it’s not designed to provide immediate relief of specific episodes of heartburn.”
D) “A better strategy is to take a dose of Prilosec 15 to 30 minutes before meals or drinks that cause you to get heartburn.”
Question 10 A 33-year-old woman has irritable bowel syndrome (IBS). The physician has prescribed simethicone (Mylicon) for her discomfort.Which of the following will the nurse monitor most closely during the patient’s drug therapy?
A) Drug toxicity
B) Anorexia
C) Increased abdominal pain and vomiting
D) Increased urine output
Question 11 Mr. Tan is a 69-year-old man who prides himself in maintaining an active lifestyle and a healthy diet that includes adequate fluid intake. However, Mr. Tan states that he has experienced occasional constipation in recent months. What remedy should be the nurse’s first suggestion?
A) Bismuth subsalicylate
B) A bulk-forming (fiber) laxative
C) A stimulant laxative
D) A hyperosmotic laxative
Question 12 A 29-year-old woman has been prescribed alosetron (Lotronex) for irritable bowel syndrome. Before starting the drug therapy, the nurse will advise the patient about which of the following adverse effect(s)?
A) Constipation
B) Breathlessness and hypotension
C) Hyperthyroidism
D) Impaired cardiac function
Question 13 A 29-year-old female patient has been prescribed orlistat (Xenical) for morbid obesity. The nurse is providing patient education concerning the drug. An important instruction to the patient would be to
A) omit the dose if the meal does not contain fat
B) take orlistat and multivitamins together
C) take orlistat in one dose at breakfast
D) omit the dose if the meal does not contain protein
Question 14 Prior to administering a dose of 5-FU to a patient with pancreatic cancer, the nurse is conducting the necessary drug research. The nurse is aware that 5-FU is a cell cycle–specific chemotherapeutic agent. Which of the following statements best describes cell cycle–specific drugs?
A) They follow a specific sequence of cytotoxic events in order to achieve cell death
B) They affect cancerous cells during a particular phase of cellular reproduction
C) They achieve a synergistic effect when administered in combination with cell cycle–nonspecific drugs
D) They affect cancerous cells and normal body cells in a similar manner
Question 15 A patient with a long history of alcohol abuse has been admitted to an acute medical unit with signs and symptoms of hepatic encephalopathy. His current medication orders include QID doses of oral lactulose. What desired outcomes should the nurse associate with this drug order?
A) Patient will have three to four loose bowel movements each day
B) Patient will express relief from constipation
C) Patient will have formed bowel movements that do not contain frank or occult blood
D) Patient will express an understanding of his current bowel regimen
Question 16 A nurse is assessing a female patient who is taking diphenoxylate HCl with atropine sulfate. Which of the following would lead the nurse to suspect that she is experiencing an allergic reaction?
A) Numbness of extremities
B) Headache and lethargy
C) Toxic megacolon
D) Urticaria
Question 17 A 73-year-old woman has scheduled an appointment with her nurse practitioner to discuss her recurrent constipation. The woman states that she experiences constipation despite the fact that she takes docusate on a daily basis and performs cleansing enemas several times weekly.How should the nurse best respond to this patient’s statements?
A) “Because we become more prone to constipation as we age, you’ll likely need to increase the number of stool softeners you take.”
B) “I’ll refer you to a specialist because it could be that you have a disease affecting your bowels or stomach.”
C) “Taking too many laxatives can make your bowels dependent on them, making you more susceptible to constipation.”
D) “Try using a different over-the-counter laxative and see that if you resolves your problem.”
Question 18 A patient develops diarrhea secondary to antibiotic therapy. He is to receive two tablets of diphenoxylate HCl with atropine sulfate (Lomotil) orally as needed for each loose stool. The nurse should inform him that he may experience
A) dizziness
B) bradycardia
C) muscle aches
D) increase in appetite
Question 19 A patient who takes aluminum hydroxide with magnesium hydroxide (Mylanta) frequently for upset stomach, heartburn, and sour stomach is seen regularly in the clinic. The nurse should assess which of the following?
A) Blood glucose level
B) Serum phosphate level
C) Urine specific gravity
D) Aspartate transaminase levels
Question 20 A teenage boy has undergone a diagnostic workup following several months of persistent, bloody diarrhea that appears to lack an infectious etiology. The boy has also experienced intermittent abdominal pain and has lost almost 15 pounds this year. Which of the following medications is most likely to treat this boy’s diagnosis?
A) Lubiprostone
B) Mesalamine
C) Docusate
D) Bismuth subsalicylate
Question 21 Mesalamine (Asacol) is prescribed for a 22-year-old woman with Crohn disease. The nurse will discuss with the patient the possibility for which of the following adverse effects related to the new drug therapy?
A) Hair loss
B) Metallic taste
C) Fatigue
D) Increased appetite
Question 22 A 58-year-old man is prescribed dicyclomine (Bentyl) for irritable bowel syndrome. In which of the following conditions is dicyclomine therapy contraindicated?
A) Hypertension
B) Diabetes mellitus
C) Glaucoma
D) Rheumatoid arthritis
Question 23 A nurse is planning care for a 59-year-old woman who is on ranitidine therapy. The nurse is concerned for the patient’s safety.Which of the following would be an appropriate nursing diagnosis?
A) Diarrhea related to adverse effects of drug therapy
B) Acute Pain related to adverse drug effects, headache
C) Risk for Injury related to drug-induced somnolence, dizziness, confusion, or hallucinations
D) Potential Complication: Electrolyte Imbalance related to hypophosphatemia, secondary to drug therapy
Question 24 A 57-year-old man is to begin 5-FU therapy for colon cancer. It will be most important for the nurse to monitor which of the following during the first 72 hours of the initial treatment cycle?
A) Myelosuppression
B) Cardiac events
C) White blood cell nadir
D) Nausea and vomiting
Question 25 A patient is taking cholestyramine. The nurse will assess for which of the following common adverse effects of the drug?
A) Abdominal pain
B) Headache
C) Constipation
D) Indigestion
Question 26 A patient comes to the clinic asking for help to quit drinking alcohol. She has a 21-year history of heavy drinking and is worried about developing cirrhosis of the liver. The patient agrees to take disulfiram (Antabuse). The nurse will teach the patient that the combination of alcohol and Antabuse will cause which of the following?
A) Bradycardia
B) Diarrhea
C) Nausea
D) Slight headache
Question 27 A 52-year-old man is suffering from a deficiency of exocrine pancreatic secretions and is prescribed pancrelipase (Pancrease MT). Before the medication therapy begins, the nurse will assess for allergies related to
A) ragweed
B) pollen
C) pork
D) shellfish
Question 28 A nurse is providing discharge instructions to a patient who will be taking fludrocortisone at home. The nurse will encourage the patient to eat a diet that is
A) low in sodium and potassium
B) low in sodium, high in potassium
C) high in iron
D) low in proteins
Question 29 A nurse is aware that diphenoxylate HCl with atropine sulfate is an effective adjunct in the treatment of diarrhea. For which of the following patients could the administration of this drug be potentially harmful?
A) An 80-year-old man who has diarrhea secondary to Clostridium difficile infection
B) A woman who has experienced severe diarrhea associated with influenza
C) A man who has experienced diarrhea shortly after beginning tube feeding through a nasogastric tube
D) A 60-year-old woman who tends to get diarrhea during periods of intense stress
Question 30 A clinic nurse is planning care for a 68-year-old man who has been on omeprazole (Prilosec) therapy for heartburn for some time. Regarding the patient’s safety, which of the following would be a priority nursing action?
A) Teach the patient to take omeprazole 1 hour before meals
B) Emphasize that the drug should not be crushed or chewed
C) Coordinate bone density testing for the patient
D) Monitor the patient for the development of diarrhea
Question 31 A nurse is overseeing the care of a young man whose ulcerative colitis is being treated with oral prednisone. Which of the following actions should the nurse take in order to minimize the potential for adverse drug effects and risks associated with prednisone treatment?
A) Avoid OTC antacids for the duration of treatment
B) Advocate for intravenous, rather than oral, administration
C) Teach the patient strategies for dealing with headaches
D) Carefully assess the patient for infections
Question 32 A woman with numerous chronic health problems has been diagnosed with a benign gastric ulcer has begun treatment with ranitidine (Zantac). Which of the following teaching points should the nurse provide to this patient?
A) “Quitting smoking will significantly increase the chance that this drug will heal your ulcer.”
B) “This drug will help to eliminate the bacteria in your stomach that caused your ulcer.”
C) “You should eat several small meals each day rather than three larger meals.”
D) “Take each dose of ranitidine with an antacid of your choice.”
Question 33 A patient has GERD and is taking ranitidine (Zantac). She continues to have gastric discomfort and asks whether she can take an antacid. Which of the following is an appropriate response by the nurse?
A) “Sure, you may take an antacid with ranitidine.”
B) “No, the two drugs will work against each other.”
C) “Yes, but be sure to wait at least 2 hours to take the antacid after you take the ranitidine.”
D) “I wouldn’t advise it. You may experience severe constipation.”
Question 34 A woman with an inflammatory skin disorder has begun taking prednisone in an effort to control the signs and symptoms of her disease. The nurse who is providing care for this patient should prioritize which of the following potential nursing diagnoses in the organization of the patient’s care?
A) Fluid Volume Excess
B) Constipation
C) Acute Confusion
D) Impaired Gas Exchange
Question 35 Following an endoscopy, a 66-year-old man has been diagnosed with a duodenal ulcer resulting from Helicobacter pylori infection. Which of the following medications will likely be used in an attempt to eradicate the patient’s H. pylori infection? (Select all that apply.)is situation?
A) A PPI
B) Antibiotics
C) Cisapride (Propulsid)
D) Aluminum hydroxide

Practicum: Assessing Client Family Progress
Practicum: Assessing Client Family Progress
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Learning Objectives
Students will:
· Create progress notes
· Create privileged notes
· Justify the inclusion or exclusion of information in progress and privileged notes (SEE ATTACHED SAMPLE OF PROGRESS AND PRIVILIGED NOTE)
· Evaluate preceptor notes
To prepare:
· Reflect on the client family you selected for the Week 3 Practicum Assignment (SEE ATTACHED WEEK 3 NOTE),
The Assignment
Part 1: Progress Note
Using the client family from your Week 3 Practicum Assignment address in a progress note (without violating HIPAA regulations) the following:
· Treatment modality used and efficacy of approach
· Progress and/or lack of progress toward the mutually agreed-upon client goals
(reference the treatment plan for progress toward goals)
· Modification(s) of the treatment plan that were made based on progress/lack of
progress
· Clinical impressions regarding diagnosis and or symptoms
· Relevant psychosocial information or changes from original assessment (e.g.,
marriage, separation/divorce, new relationships, move to a new
house/apartment, change of job)
· Safety issues
· Clinical emergencies/actions taken
· Medications used by the patient, even if the nurse psychotherapist was not the
one prescribing them
· Treatment compliance/lack of compliance
· Clinical consultations
· Collaboration with other professionals (e.g., phone consultations with physicians,
psychiatrists, marriage/family therapists)
· The therapist’s recommendations, including whether the client agreed to the
recommendations
· Referrals made/reasons for making referrals
· Termination/issues that are relevant to the termination process (e.g., client
informed of loss of insurance or refusal of insurance company to pay for
continued sessions)
· Issues related to consent and/or informed consent for treatment
· Information concerning child abuse and/or elder or dependent adult abuse,
including documentation as to where the abuse was reported
· Information reflecting the therapist’s exercise of clinical judgment
Note: Be sure to exclude any information that should not be found in a discoverable progress note.
Part 2: Privileged Note
· Based on this week’s readings, prepare a privileged psychotherapy note that you would use to document your impressions of therapeutic progress/therapy sessions for your client family from the Week 3 Practicum Assignment. (SEE ATTACHED WEEK 3 NOTE),
In your progress note, address the following:
· Include items that you would not typically include in a note as part of the clinical record.
· Explain why the items you included in the privileged note would not be included in the client family’s progress note.
· Explain whether your preceptor uses privileged notes. If so, describe the type of information he or she might include. If not, explain why.

Discussion: Glycogen metabolism
Discussion: Glycogen metabolism
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Pharmacology
What occurs when glycogen metabolism is stimulated by insulin?
A. Insulin stimulates glycogen synthase, the first enzyme in glycogen synthesis.
B. Insulin stimulates glycogen synthase, the first enzyme in glycogen synthesis. It also stimulates removal of glucose from the bloodstream into cells and phosphorylation of glucose by the enzyme glucokinase.
C. Insulin stimulates glycogen synthase, the first enzyme in glycogen synthesis. It also stimulates uptake of glucose from the bloodstream into cells and phosphorylation of glucose by the enzyme glucokinase.
D. All of the above
Pharmacology
What is the medical application of cortisone? Cortisone is used to treat:
A. Rheumatoid arthritis, asthma, gastrointestinal disorders, and a variety of skin conditions.
B. Kidney disease, high blood pressure, and osteoporosis.
C. Muscle disorders, tuberculosis, and thyroid disorder.
D. All of the above
Anatomy
Oxygen saturation is likely to be lowest when an asthmatic with a diagnosis of pneumonia is positioned:
A. In a high Fowler position
B. Lying on the left side
C. Lying on the right side
D. Lying supine with the head of the bed flat

Chemistry
Laboratory test results indicative of thrombocytopenia, in addition to a low platelet count, would be:
A. Increased PT
B. Prolonged bleeding time and poor clot retraction.
C. Increased aPTT
D. Decreased RBC count.
Pharmacology
The purposes of epinephrine injection include all of the following except:
A. Stabilizing mast cell membranes.
B. Relaxing bronchial smooth muscle.
C. Supporting arterial blood pressure.
D. Blocking histamine receptors.
Pharmacology
Therapeutic interventions focused on increasing the oxygen supplied to the heart and decreasing the heart’s demand for oxygen include:
A. Antiplatelet drugs
B. Anticoagulants
C. Morphine sulphate
D. Thrombolytic drugs
Pharmacology
An intervention that would contribute toward the healing of a peptic ulcer is:
A. Steroid administration
B. Blocking or neutralizing of acid secretion
C. Surgical removal of the ulcer
D. Intravenous nutritional support
Pharmacology
Aspirin and NSAIDs are causative factors for the development of peptic ulcer disease because they:
A. Increase acid secretion
B. Allow proliferation of H. pylori
C. Damage the mucosal barrier
D. Alter platelet aggregation
Pharmacology
Your patient is interested in trying medication to improve low mood/depression. All of the following medications might be appropriate except:
A. Selective serotonin reuptake inhibitors
B. Amitriptyline
C. Serotonin and norepinephrine reuptake inhibitors
D. Benzodiazepines