In: Nursing
The contents are:
Scenario:
An American Indan woman, 28 years old, staggers into the ED face is black with soot, her right arm and right leg burned, bleeding vaginally,pregnant, vomiting, bloody diarrhea, SOB,very confused, and jaundiced.
Set the scene. Use your imagination and describe this woman, her personal and medical history. You decide the conclusion of this scenario.
In: Nursing
Insulin is a “high alert” medication. This means that (circle one):
Often, insulin dosing is described as “prandial” or “basal”. What does “prandial” mean?
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Insulin is available in regular, fast-acting, and long-acting formulations.
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What oral medication (in the biguanide class) is commonly prescribed as a first-line treatment for type 2 diabetes, because of its favorable side effect profile, ability to increase sensitivity to insulin, and relatively strong reduction of HbA1c (as well as certain generally desirable effects including weight loss, decreased serum lipids, and lower blood pressure)?
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Match the following diabetes medications with their drug classes:
_____ pioglitazone a. DPP-4 inhibitors
_____ glyburide b. SGLT2 inhibitors
_____ metformin c. Thiazolidinediones (TZDs)
_____ nateglinide d. Incretin agonists
_____ sitagliptin e. Meglitinides
_____ exenatide f. Biguanides
_____ canagliflozin g. Sulfonylureas
In: Nursing
Provide answers to the following critical thinking questions (5-6 sentences for each question).
In: Nursing
Dr. Michael Cuss has had admitting privileges at Hapless Hospital for the past 6 years. Hapless is incorporated as a not-for-profit corporation. Its by-laws provide that the board members must include the city health commissioner, the mayor or his/her delegate, and one city council member. The city has a contract with Hapless in which Hapless agrees to provide care for indigent patients of the city. Payments to Hapless under this contract make up 40% of the Hospitals revenue. The commissioner, mayor and councilperson have been very active on the board.
Dr. Cuss has an abrasive personality and is considered a maverick among the physicians at Hapless. Although Dr. Cuss' relationships at the hospital have never been entirely cordial, there have been no serious problems until recently when he began to expand his practice by employing a nurse practitioner and a physician's assistant (PA). Dr. Cuss is very vocal about the hostility he perceives on the part of the staff at the hospital toward his new employees. He has spoken to the administrator and told him that he would sue the hospital if the administrator, the medical staff or hospital employees interfered with his practice.
The administrator and president of the medical staff last month received letters from several doctors on the staff reporting that the nurse practitioner employed by Dr. Cuss made house calls on patients and that the PA prescribed medications. They also stated that his supervision of the PA was inadequate.
Under a provision in the by-laws, the administrator and the president of the medical staff summarily suspended Dr. Cuss privileges. Their action was discovered and reported by the local newspaper. Many of Dr. Cuss patients left him and his employees resigned.
Dr. Cuss has filed suit against the hospital. What is the basis of his cause of action? What theories of liability will he include? Will he be Successful? Why or why not? Be sure to include all possible theories and rationales.
In: Nursing
1.What is postpartum hemorrhage?
2.What causes postpartum Hemorrhage?
3.What can prevent postpartum hemorrhage?
4.What signs and symptoms should you look for that may indicate postpartum hemorrhage? How much blood loss indicates a postpartum hemorrhage?
In: Nursing
In: Nursing
is evidence-based care still relevant today? why or why not? explain and provide a reason to support the reason.
In: Nursing
2. A nurse is caring for a client whose partner died 6 months ago. Which of the following findings is the nurse’s priority?
a. The client frequently recalls negative experiences that occurred during his marriage.
b. the client states that he is unable to eat more than once a day.
c. The client says he feels guilty about not spending more time with his partner.
d. The client relates that he is angry that the provider did not save his partner’s life.
Ans.
3. A nurse is caring for a client who has borderline personality disorder. Which of the following actions should the nurse take?
a. Maintain consistency in assigning health care staff for the client.
b. Encourage the use of countertransference for the client.
C. Demonstrate a sympathetic attitude toward the when providing care.
d. Provide consistent boundaries for the client.
4. A nurse is conducting an admission interview with a new client who tells the nurse, “my life is so stressful. I can’t take it anymore.” Which of the following responses should the nurse make first?
a. Tell me what makes you feel stressed.
b. Are you thinking of harming yourself?
c. Let’s talk more about what you are experiencing
d. How have you deal with stress in the past?
5. a nurse is teaching about deep-breathing exercises with a client who reports experiencing intense stress at work. Which of the following statements by the client indicates an understanding of the teaching?
a. I will focus on how the muscles in my stomach feel with each breath.
b. I will inhale through my mouth and exhale through my nose.
c. I will hole my breath flor 5 or 6 second each time.
d. I will focus on the causes of my stress during the exercise.
6. a nurse is caring a client who has depression following a recent job loss. Which of the following questions should the nurse ask to assess the client’s personal coping skill?
a. How have you deal with similar situations in the past?
b. Can you describe how you are currently feeling?
c. Do you see your current situation affecting your future?
d. How does this situation affect your life?
7. A nurse is assessing a client who recently experienced the loss of their partner. Which of the following questions is the priority for the nurse to ask during this situation crisis?
a. Are you having thoughts about harming yourself?
b. Who do you talk to when you need help?
c. How do you think these events is affecting your life right now?
d. what do you usually do to cope with problem in your life?
8. A nurse teaching a newly licensed nurse about contributing factors that lead to the development of conduct disorder. Which of the following factors related to family dynamics should the nurse include in the teaching?
a. The client mother has asthma
b. the client’s father lives in the client home
c. The client is the oldest of their siblings.
d. The client has several siblings.
9. a nurse is caring for a client who is admitted to a mental health facility after attempting suicide. Which of the following actions should the nurse take first?
a. Ask the client to sign a no-suicide contract.
b. Establish a rapport to foster trust.
c. Encourage the client to participate in group therapy.
d. Implement continuous one-to-one observation.
10. A nurse is caring for a client who has schizophrenia and is taking clozapine. Which of the following findings is the priority for the nurse to report to the provider?
a. heart rate 104/mim
b. Nausea
c. random blood glucose 130 mg/dL.
d. Sore throat.
11. A nurse is creating a plan of care foe a client who has major depressive disorder. Which of the following interventions should the nurse include in the plan?
A. Encourage physical activity for the client during the day.
b. Keep a bright on in the client room at night.
c. discourages the client from expressing feeling of anger.
d. Identify and schedule alternative group activities for the client.
12. A nurse is caring for a client who states, “I am too embarrassed to tell anyone what I did last night.” Which of the following responses should the nurse make?
a. You shouldn’t feel embarrassed to talk to me.
b. Lots of people feel ashamed to tell their secrets.
c. Let’s discuss what you feel embarrassed about.
d. You will feel better if you tell what you did last night.
13. A nurse is caring for a client who has bipolar disorder and is refusing to take prescribed medications. Which of the following ethical principles is the nurse displaying when he supports the client’s refusal of medication?
A. Autonomy
b. Veracity
beneficence
d. Justice
14. A nurse in an in-patient facility is caring for a client who has an anxiety disorder. Which of the following actions should the nurse take while the client is experiencing an acute panic attack?
a. Administer a dose of atomoxetine to the client.
b. Encourage the client to watch television as a distraction.
c. Encourage the client to describe their feelings in a journal.
d. Administer a dose of alprazolam to the client.
15. A home health nurse visits a client lost their partner 2 years ago. Which of the following behaviors by the client indicates a maladaptive grief response?
a. the client is unable to perform basic hygiene tasks.
b. the client gives away some of the partner’s belongings.
c. The client relocates from a house to an apartment.
d. the client expresses feeling of guilt.
16. An older adult client is brought to the mental health clinic by her daughter. The daughter reports that mother is not eating and seems uninterested in routine activities. The daughter states, “I’m so worried that my mother is depressed.” Which of the following responses should the nurse make?
a. older adults are usually diagnosis with depressive disorder as they age.
b. You shouldn’t worry about this. Because depressive is easily treated’
c. Everyone gets depressed from time to time.
d. Tell me the reasons you think your mother is depressed.
17. A nurse in a provider’s office is assessing a school-age child who has a spiral fracture. The parent of the child provides different accounts of the cause of the injury. Which of the following actions should the nurse take first?
a. Request that the parent leave the room while interviewing the child.
b. Report suspected abused to child protective services.
c. Ask the child how the injury occurred.
d. Determine the immediate safety needs of the child.
18. A nurse is caring for a client who has anorexia nervosa. Which of the following findings requires immediate intervention by the nurse?
a. +2 edema of the lower extremities.
b. Blood PH 7.60
c. Lanugo covering the body.
d. Bun 21 mg/dL
19. A nurse manager is observing a newly licensed nurse preparing to administer an IM medication to a client who is manic and refuses the medicate. Which of the following actions should the nurse manager take first?
a. Discuss the purpose of the medication with the client.
b. Assess the need for physical restraints.
c. Demonstrate how to verbally de-escalate the situation.
d. Stop the newly licensed nurse from administering the medication.
20. A charge nurse is making room assignments for new client admissions. Which of the following client should the nurse place closest to the nurse’s station?
a. a client who has a history of dependent personality disorder.
b. A client who has schizotypal personality disorder.
c. a client who has moderate-stage Alzheimer’s disease.
d. A client who has a history of alcohol use disorder.
21. A nurse is developing a behavioral contract with a client who has antisocial personality disorder. Which of the following client goals should the nurse include in the contract?
a. Increase self-esteem
b. use projection during group therapy.
c. Decrease the number of verbal outbursts.
D. Use bargaining skills for behavioral consequences.
22. a nurse in a mental health facility is making plians for a client’s discharge. Which of the following interdisciplinarities member should the nurse contacts to assess the client will housing placement.
a. recreational therapy
b. Social worker
c. Occupational therapy
d. clear nurse specialist
23. a nurse is providing teaching to a client who is prescribed methylphenidate for ADHD. Which of the following statements by the client indicates an accurate understanding of this medication’s effects?
a. I need to tell my doctor if I start gaining weight.
b. I’ll take my medication at bedtime because it will make me drowsy.
c. This medication will help me relax and feel less anxious.
d. I know that I will be able to think more clearly now.
24. A home health nurse is caring for a client who is in the continuation phase of major depressive disorder. The client states. “I feel unmotivated and don’t feel like leaving my home.” Which of the recommendations should the nurse make to address’s social isolation?
a. Join a low impact exercise class.
b. Practice guided imagery each morning.
c. Enroll in an online self-help course.
d. Write in a journal daily.
26. A nurse is providing counseling for a family that consists of two parents and their two adolescent children. Which of the following family members should the nurse identity as acting the role of monopolize?
a. The father who intervenes whenever the sibling argues
b. The adolescent daughter who attempts to dominate the discussion.
c. The adolescent son who refuses to share personal feeling.
d. The mother who expresses hostility toward her spouse.
In: Nursing
compare the application of ethyl alcohol and hydrogen peroxide on the control of bacteria growth
In: Nursing
How would you inspire members to go beyond “shallow sharing”?
In: Nursing
How might you respond when a team member shares something of a serious or dangerous nature that they might need help with?
In: Nursing
In: Nursing
Renal question
Olly is a 21 years old female who works as a teacher and leaves alone. Olly suspects she has developed food poisoning after consuming leftovers from a take away meal she had in her fridge from three days ago before she re-heated it for dinner. She has not been to work for 5 days due to severe vomiting, diarrhea and abdominal pain. Olly stated she has been feeling increasingly tired and weak and unable to tolerate oral fluids or diet. She also noticed that her urine output has been decreasing over the last two days and has not passed urine for the past 12 hours and is feeling severely unwell.
An assessment finding reveals the following on Olly
She has a sunken eyes, dry oral mucosa, and tongue, cracked lips, and is complaining of nausea, dizziness, and lethargy.
Vital signs and blood and urine test showed
Temp- 37.8, HR 110 bpm, RR 22 rpm, BP 90/50 mmhg, body weight 60kg
Blood test results reveal- Sodium 145mmol/L, Potassium 6.0mmol/L, Serum creatinine 400mmol/L, Blood Urea Nitrogen 14mmol/L
She is diagnosed with suspected gastroenteritis and acute kidney injury(AKI) and transferred to renal wards.
QUESTION
1, Describe how each of these aspects of the information presented above has led to the diagnosis of pre-renal AKI
2, Identify three priority nursing problems and provide a rationale for making each of these priorities
3, you are required to formulate a goal to address each priority nursing problem
In: Nursing