Shelly is a 4-year-old preschooler who lives with her parents and younger brother. She and her brother attend a local daycare center during the week while their parents are at work. In the evenings she and her brother take a bath and then their parents read to them before bedtime at 8:00 P.M. Shelly's daycare class includes many children her age and she enjoys playing outside with them, Although snack times are planned, Shelly would rather play and does not always finish her beverages,

Shelly's mother calls the pediatric clinic in town and tells the nurse that Shelly has been "running a fever of 101 0 F for the past 2 days' and although her temperature decreases to 37.20 C (990 F) with acetaminophen, it returns to 38.4 C, (1010 F) within 4 hours of each dose. Further, her mother says that Shelly complains that hurts when “I pee-pee." Shelly's mother also has noticed that her daughter seems to be in the bathroom every hour" She makes an appointment to see the pediatrician this afternoon

5.     Discuss how Shelly's level of growth and development places her at risk for developing a UTI.

6.     Shelly's urine culture returns positive for Escherichia coli. 'What is the significance of this finding?

7.     What are the priorities for Shelly's care?

8.     Shelly is prescribed trimethoprim-sulfumethoxazole 60 mg every 12 hours for 10 days. What is this drug and is her prescribed dose safe? Shelly weighs 33 lb.

9.     What are the teaching priorities for Shelly and her mother prior to her discharge from the clinic?

10. Shelly is scheduled for a return visit to the clinic in 2 weeks. What is the purpose of this appointment?

Tina Swenson is a 33-year-old attorney who has had a persistent cough and dyspnea for a few weeks. She noted the onset soon after exerting herself in very cold temperatures. She underwent a bronchoscopy during which no endobronchial lesions were noted. Slight erythema was noted in the left upper lobe and bronchial brushings were obtained. These were sent to pathology and were returned as negative for malignant cells. She was discharged to home with a diagnosis of probable bronchitis. She was given instructions for care and follow-up.

What is the CPT code (s)?

Modifiers if appropriate?

Jeremy Crilly is a 7-year-old boy who has just been diagnosed with attention-deficit hyperactivity disorder (ADHD). The provider prescribes methylphenidate as part of his treatment. Jeremy’s mother, Rita, asks, “I want to help him but sometimes, I just get so frustrated with his behavior.”

What is the underlying rationale for the use of methylphenidate?

How might the medication therapy affect Jeremy’s growth? What follow-up would be appropriate to monitor for this effect?

What suggestions can the nurse provide to Jeremy’s mother to help her cope with this disorder?

This 47-year-old female was taken to surgery for treatment of fibroids. She underwent a vaginal hysterectomy with salpingo-oophorectomy. The uterus weighed 250 grams; ovaries and tubes were normal in appearance. The patient is discharged to home in good condition and given instructions on postoperative care and follow-up. She will be seen in the clinic in one week and will call the office for any problems in the meantime.

What is the CPT code(s)?

Modifiers if appropriate?

Why is LDL high in diabetes?

what are some of the key challenges facing state and national policymakers given the current status?

What laws govern or pertain to E-cigarettes?

What cultural values and norms influence E-cigarettes usage?

What cultures or societies are most affected by the issue?

Mr. H is a 30-year-old man. He was riding his bike to work and was struck by a vehicle traveling at 35 miles per hour.  He was comatose with a GCS 7 upon arrival to the ED.

1. What are the leading causes of traumatic brain injury in the United States?  Describe important teaching points in prevention of a TBI.  

2. Traumatic brain injury can be classified into primary brain injury and secondary injury, describe the differences in the two types of injury.  List common types of injury of each.

3. Outline the different components of assessing a patient with a traumatic brain injury.

4. Describe the initial management of a patient with a traumatic brain injury.

5. What are the cardiovascular complication and pulmonary complications from a traumatic brain injury?  Describe the nurse’s role in prevention.  

6. TBI carries a high mortality rate and brain death is an important diagnosis to understand.  Describe what the term brain death means and how the nurse can help the family through this difficult time.

1. Question: Your patient is on Atorvastatin 40 mg daily, and presents for their routine follow up appointment. They complain of extreme fatigue, muscle aches, and dark colored urine. What is your best course of action given presentation?
2. Question: Jillian is a Nurse Practitioner. She recognizes that Nurse Practitioner prescriptive authority Is regulated by:
3. Question: Which of the following is a contraindication for antimuscarinic drugs?
4. Question: Which medication class is recognized for the treatment of moderate to severe dementia?
5. Question: An adult male comes to the clinic with complaints that he is experiencing increased difficulty breathing over the past few days. He has a history of asthma and coronary artery disease. He was recently … with hypertension. Examination reveals no jugular vein distention and no productive cough. Breath sounds are present, but expiratory wheezes are noted bilaterally, and he denies any chest pain. His vital signs are pulse of 74 beats/min, respirations of 32 breaths/min, and BP of 160/100 mm Hg. His current medications are albuterol (Proventil) inhaler 2 puffs every 4 hours prn for wheezing, nitroglycerin transdermal patch, and propranolol (Inderal) 60 mg PO bid. What is the best treatment for this patient?
6. Question: What is … with chronic overtreatment with levothyroxine (Synthroid)?
7. Question: You are seeing a 65 year old male with a long history of COPD who has recently developed hypertension. Which class of antihypertensive agents should the Nurse Practitioner avoid for this patient?
8. Question: The point in time on the drug concentration curve that indicates the first sign of a therapeutic effect is the
9. Question: To minimize the risk of adverse effects of glucagon when given to an unconscious diabetic patient, as the patient regains consciousness, the nurse should
10. Question: A Nurse Practitioneris providing discharge planning for a 45-year-old woman who has a prescription for oral albuterol. The Nurse Practitioner will question the patient about her intake of which of the following?
11. Question: A patient has been … on a treatment regimen that includes levothyroxine. Select the dosage regimen that is most appropriate for a mean replacement dosage. The patient has been … on a treatment regimen that includes levothyroxine. Select the dosage regimen that is most appropriate for a mean replacement dosage.
12. Question: A 34-year-old male patient is … methimazole (MMI). The Nurse Practitionerwill advise him to report which of the following immediately?
13. Question: The Nurse Practitioner is preparing to Prescribe a medication regimen for her patient. He or she recognizes that criteria for choosing an effective drug for any disorder include:
14. Question: A primary therapy for patients with mild ulcerative colitis is:
15. Question: A clinic Nurse Practitioneris 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 … a priority nursing action?
16. Question: Neely was placed on fluoxetine about 8 weeks ago and is doing well on the medication. When initially … the medication, she asks you about the common side effects of this type of medication. Which choice below is correct?
17. Question: A 24-year-old factory worker has been … guaifenesin for the first time. Which of the following will be a priority assessment by the nurse before the patient’s first dose?
18. Question: A patient has a history of tonic-clonic seizures that have been successfully … with phenytoin (Dilantin) for several years. Phenytoin achieves a therapeutic effect by
19. Question: A mother brings her 4-year-old child, who is vomiting and has a temperature of 103°F into the emergency department (ED). The ED physician orders acetaminophen (Tylenol) for the fever. The best form of Tylenol to give the child, considering her presentation, would be
20. Question: The side effects of antihistamines are mostly due to their: conjunction with an SSRI?
21. Question: Drugs that use CYP 3A4 isoenzymes for metabolism may:
22. Question: Successful treatment for an adult patient withHelicobacter pylori (H. pylori)-induced peptic ulcer disease requires therapy with which regimen?
23. Question: The nurse practitioner has … elemental iron 6 mg/kg/day in three … doses for a toddler … with iron-deficiency anemia. What instructions would the family nurse practitioner include for the parents?
24. Question: A 39 y/o female is … with Graves disease.  She also has a small goiter =.  Her symptoms are not … to … severe and propylthiouracil is …. Whare is the most serious potential adverse effect of this medication?
25. Question: Which can elevate theophylline levels?
26. Question: A patient on valproic acid may experience which of the following symptoms?
27. Question: All of the following agents are used to control the inflammatory changes … in the lungs of asthmatics except:
28. Question: A Nurse Practitioneris providing care for a patient who … 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 Practitioner should be aware that
29. Question: Glucocorticoids affect the metabolism of carbohydrates, protein, and fats.
30. Question: A patient with a known history of benign prostatic hyperplasia (BPH) presents to the clinic 4 days after developing a cold. He tells you he began experiencing a sore throat and nasal congestion and began to take an over the counter decongestant. Today, he complains of not urinating over the last 12 hours. He also has suprapubic fullness on exam. Which of the following medications are most likely responsible for this patient’s urinary retention?
31. Question: Susie is a 40 year old female with Type 2 Diabetes. She reports that over the last several days, she has been having some hypoglycemic episodes and feels it is related to medication. Her medication
32. Question: A physician has ordered subcutaneous injections of morphine, a narcotic, every 4 hours as needed for pain for a motor vehicle accident victim. The nurse is aware that there is a high abuse potential for this drug and that it is categorized as a
33. Question: What information would the Nurse Practitioner include in teaching a patient about the treatment of vitamin B₁₂deficiency following a total gastrectomy?
34. Question: Which antihypertensive agent is … with hair growth?
35. Question: During a clinic visit, a patient complains of having frequent muscle cramps in her legs. The nurse’s assessment reveals that the patient has been taking over-the-counter laxatives for the past 7 years. The nurse informed the patient that prolonged use of laxatives
36. Question: What is a serious side effect of ibuprofen in the older adult patient?
37. Question: Biguanides control hyperglycemia in type 2 diabetes primarily by acting at which organ?
38. Question: Advanced practice nurse prescribing of … medications is affected most by:
39. Question: Which of the following is a side effect or precaution … with ACE inhibitors?
40. Question: Which of the following can block the action of heparin?
41. Question: Which of the following serves to protect the public by ensuring the purity of a drug and its contents?
42. Question: Ginger, a 25 year old female presents at the clinic with known history of depression. She reports taking an SSRI with only partial relief. Which of the following drugs can … used safely at any dose in
43. list is as follows: NURS 6521N 29
44. Question: A patient in need of myocardial infarction prophylaxis has been … sulfinpyrazone for gout. Which of the following will the nurse monitor the patient most closely for?
45. Question: A patient is recovering from an acute episode of thrombophlebitis and is being … with warfarin (Coumadin) 5 mg PO daily. In reviewing medication information, the Nurse Practitioner would include what information in their teaching?
46. Question: Which of the following statements best defines how a chemical becomes termed a drug?
47. Question: A common side effect of metformin (Glucophage) therapy is:
48. Question: The APRN’s ability to prescribe … substances is regulated by:
49. Question: Glargine (Lantus) is an insulin analog that essentially has no peak and is usually … :
50. Question: The Nurse Practitioner is following up on a patient who is experiencing acute asthma problems. Albuterol (Proventil) by metered-dose inhaler (MDI) has

The 70-year-old female who was admitted to the hospital to rule out bowel obstruction continues to have nausea and vomiting. The client remains slightly confused and weak. Bowel sounds are absent in the right and left lower quadrants. Abdomen remains hard and distended. Mucous membranes dry; skin turgor poor. IV of Lactated Ringers is infusing at 100 mL/h in the client’s left hand. A Foley catheter is in place and is draining 20-30 mL/h. NG tube is in place, connected to intermittent suction, and is draining coffee-ground material.

The client’s daughter informs the health care provider (HCP) that her mother has hypertension and takes atenolol every morning. The client has no known drug allergies.

The health care provider (HCP) orders the following:

1. Metoclopramide 10 mg IVPB in 50 mL of D5W q.i.d.
2. Atenolol 50 mg po daily. Hold for systolic BP < 100 and P < 50. May take with sip of water.
3. Cefazolin 500 mg IVPB every 6 hours
4. Meperidine 25 mg IM every 4 hours PRN pain
5. Diet: NPO
6. Vitals signs every 4 hours
7. Monitor I & O every shift

Questions:

1. List the six (6) rights of medication administration.

2. What assessments should be made prior to administration of the following medications: Metoclopramide, Atenolol, Cefazolin, and Meperidine?

3. What is the action of each of the medications prescribed?

4. What are adverse effects of these medications that the nurse should monitor?

5. The HCP has ordered Cefazolin 500 mg IVPB every 6 hours. The pharmacy sends Cefazolin 500 mg in 50 mL of D5/W and it is to run over 1 hour via an infusion pump. The drop factor of the IVPB set is 60 gtt per mL.
   1. What is the hourly rate? __________mL/hr
   2. What would the hourly rate be if the HCP ordered the Cefazolin to run over 30 minutes?_____________ mL/hr

Nursing intervention for hemoglobin A1C

Describe the purpose of the Administrative Simplification provisions of the Health Insurance Portability and Accountability Act (HIPAA).