When undertaking a neurological assessment, some of the most common symptoms associated with neurological disease to note include

Cardiac Arrythmia Care Plan

After graduation you plan to sit for the certification exam. How will you prepare for the final test to ensure a positive outcome and earn your CMA/RMA credential?

Q1: Describe the following terms: (7 marks, each one mark)

Activities of Daily Living:

…………………………………………………………………………………………………………………………………………………………………………………………………………………………Curative Care: …………………………………………………………………………………………………………………………………………………………………………………………………………………………

Palliative Care:

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Respite Care

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Skilled Care

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Subacute Care

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Total Parenteral Nutrition

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Q2: The manual and electronic patient record has many purposes, but one goal: documentation of patient care. Regardless of the type of care provided, a health care facility’s patient records contain similar content (e.g., consent forms) and format features (e.g., all records contain patient identification information). Distinguish among patient record formats. (10 marks, each one 2 marks)

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3. Be explicit in your discussion of ED_{50 ,} LD_50, TD₅₀: what each of these are and explain in detail why it matters. Please give 2 examples of each.

Rachael Tomkins is 55 years old and is a certified practising accountant. She works part time and lives with her husband Paul, aged 64 and daughter Marie, aged 17. Her grandmother Jean aged 90, lives in a small flat at the back of their house and her mother Mary, aged 72 lives in an Over 55s housing unit nearby. In her early 20s Rachael’s father, a Vietnam Veteran, committed suicide. Rachael is described by her family as reliable and caring. She has a small group of friends from her local parish church. Rachael has regular contact with her GP to manage her Diabetes Type 2. She is prescribed metformin and has been trying to lose weight. She also sees a psychiatrist Dr Lianne Yu for management of her symptoms of schizophrenia. She is prescribed Olanzapine and Lithium. She was diagnosed with schizophrenia in her early 20’s when she was studying at university. She was hospitalised with acute psychosis several times before her symptoms were stabilised. She was able to complete her university degree and has worked part time. The last time she experienced acute psychosis was 17 years ago, just after the birth of her daughter. Her symptoms stabilised, and she has been maintained in recovery for almost 15 years. This year has been a particularly challenging year for Rachael. Both her husband’s parents passed away within months of each other, her daughter commenced Year 12 and her grandmother had an infection in her middle toe, which resulted in a series of trips to the doctor, hospitalisation and finally amputation of the affected toe. Rachael has become irritable with her family, and has developed erratic sleeping patterns, a lack of interest in grooming, and avoided social interactions with her friends or family. She complained to them that her neighbours were spying on her. In the 48 hours before she was admitted to hospital two incidents escalated Rachael’s need for professional help. In the first episode she yelled and threatened the neighbour across the fence. She accused him of spying on her with a ‘trackamanometer’. Her husband intervened and took her back into the house. In the second incident later that day, Rachael started screaming at her family to evacuate the house because they would be bombed. Rachael insisted the news reader on the TV was giving her this important information and they must all get out of the house. Rachael ran onto the road. A concerned neighbour called the police, who were able to convince her to accompany them to the hospital. She was met by her psychiatrist Dr Yu who reports the following -Rachael is dishevelled, dressed in pyjama top and tract pants, no shoes, she has an exacerbation of auditory hallucinations, with persecutory delusions and disorganised thinking. Rachael agrees to be admitted because she says ‘I’m frightened’. Rachael is admitted for inpatient psychiatric care.
In hospital, Rachael is argumentative and resistive to staff interactions and interventions, and her family are frightened and bewildered by her dramatic deterioration.

1. Identify, from the case study, the positive, negative and cognitive symptoms of schizophrenia experienced by Rachael at this presentation to the mental health service and discuss her prognosis and recovery;
2. Considering the case study, outline some common challenges and nursing interventionsassociated with the clinical presentation of a person who has been diagnosed with schizophrenia;
3. Identify the two psychotropic medicationsprescribed for the treatment of the symptoms of schizophrenia experienced by Rachael, and consider the importance of effective monitoring, consumer experiences (side effects) and safety factors;
4. Draw an ecomap to make a pictorial display of Rachael’s family relationships and medical history; Summarise key features of the ecogram for Rachael and her family and their environment (identify family and community connections, strength and quality (supportive/not supportive) of connections between individuals and community support networks/institutions( Refer to the required text Chapter 22 for more information about Genograms and Ecograms).;
5. Develop three questionsyou would ask Rachael during an interview to complete an MSE. They could be from any MSE area. Explain the reasonyou would ask these questions.
6. Complete a risk assessment(template in this tutorial outline);
7. Rachael will be admitted to the mental health inpatient unit. Write a nursing care planbased on a nursing diagnosis.

Case Study:

You are a nurse caring for a 26-year-old mother of three who presents at your physician’s office with tachypnea, productive cough, hyperthermia, malaise, and insufficient fluid intake. On auscultation, you note coarse rhonchi in bilateral lung fields.

• Outline the rationale for performing a comprehensive physical assessment.
• Prioritize the symptoms to be assessed.
• Explain which system would have the highest priority for this assessment why
• Describe the etiology of this patient’s adventitious lung sounds?
• List appropriate health history questions that could identify this patient’s risk factors for altered pulmonary health.

51. Which of the following would be the best example of an environment(s) that would contribute to a client’s increased confusion: a) Poor lighting, and excessive noise b) Unfamiliar surroundings such as furniture and pictures c) Quiet music playing d) Both a and b

a) Poor lighting, and excessive noise

b) Unfamiliar surroundings such as furniture and pictures

c) Quiet music playing

d) Both a and b

52. Persons with acute confusion should be:

a) Restrained or confined

b) Given complex tasks

c) Distracted

d) Politely reminded of the correct information

53. Your client is exhibiting blurred vision, slurred speech, headache and confusion, what could be happening?

a) Myocardial Infarction

b) Gallbladder attack

c) CVA

d)seizure

54. The GPA or Gentle Persuasive Approach program was designed to teach health care workers how to understand responsive behaviors and how to react to them in a respectful and safe manner:

a)true

b)false

55. People with a mental illness often suffer from:

a) Conceit

b) An affectation

c)stigma

D) Distinction

The ABC organization relies on personal health information provided to their home care nurses from the patients as well as their primary care physicians, specialists or case managers. Briefly explain PHIPA (Personal Health Information Protection Act) outlines regarding the use of patient information. What could and What couldn't they use, share, disclose etc?

_Discuss the techniques and assessment of an adult female external genital and include one usual abnormal finding

_Discuss the techniques and assessment of an adult female external genital and include one usual abnormal finding

Employees of XYZ hospital are divided by the area of the hospital and there is a little cross over- the staff of the ICU tend to socialize with their team, the staff of Emergency department don't converse with other departments. It has now gotten to the point that those nurses who work the night shift don't really have anything to do with those work with day shift and nurse managers are noticing that it is affecting the patient reports at shift change. The lack of communication outside of work is now transferring to a lack of communication for work-related tasks as a result, patient safety is at risk. This issue is not only communication but employees also do not seem motivated to improve upon the feedback given on their lack of communication. Suppose you are a unit manager and have been tasked with putting in place to help improve their communication and lack of motivation. List and clearly describe 3 strategies you might use as a manager in this situation. Please make sure to specifically mention the scenario in your strategies.

35. Your client is disoriented, has limited thinking ability and has difficulty making decisions. The best way to care for her is to:

a) Offer her a variety of choices

b) Give her simple directions

c) Increase her recreational activities and activation

d) Provide variety in her daily routine

36. Moving to a long-term care facility can improve a person’s mental health by:

a) Forcing compliance

b) Lowering self-esteem

c) Diminishing independence

d) Increasing socialization

37. Conditions that start with physical symptoms but will progress to dementia are:

a) Parkinson’s disease

b) Huntington’s disease

c) Acquired immunodeficiency syndrome

d) All of the above

38. All persons, when moved from a personal residence into a nursing home, will experience:

a) Loss and separation

b) Guilt

c) Gains and further independence

d) Anger and hostility

39. A false belief of being persecuted or of being superior to everyone else is a:

a) Hallucination

b) Obsession

c) Delusion

d) Defense mechanism

40. Mr. Baer, a normally independent and cooperative resident, has become hostile and aggressive lately. In dealing with Mr. Baer’s aggressive episodes, the PSW should:

a) Try to physically restrain him

b) Punish him by withholding his dinner

c) Isolate him in a room by himself

d) Encourage him to tell you why he is angry

16. A sudden onset of confusion and disorientation is often associated with:

a) Dementia

b) A developmental disability

c) Aging

d) Delirium

17. Alzheimer’s disease support groups do all the following EXCEPT:

a) Provide care

b) Offer encouragement and care ideas

c) Provide support for the family

d) Promote the sharing of feelings and frustrations

18. Identified risk factors of Alzheimer’s disease include:

a) Age and family history of Alzheimer’s disease

b) A family history of Down syndrome

c) Race and gender

d) Both a and c

19. Cognitive impairment is an effect of the normal aging process on the brain:

a)true

b)false

20. Acute confusion is usually reversible:

a)true

b)false

6. An eating disorder, in which the person has a fear of weight gain and obesity, despite a body weight far below what is normal is:

a) Anorexia Nervosa

B) Anorexia Bulimia

C) Pica

D) Obesity

7. Seeing, hearing, feeling or smelling something that is not real is called:

a) Defence mechanism

b) A hallucination

c) Paranoia

d) Phobia

8. The resident believes he is being harassed and mistreated daily. This belief is called:

a) Fantasy

B) Grieving

C) Oppositional defiant disorder

D)Delusion of persecution

9. Mr. Jones has fatigue, a general lack of interest, an inability to experience pleasure, a feeling of uselessness, anxiety and a slow, unreliable memory. These are symptoms of:

a) Depression

B) Mania and elation

C) Paranoia

D) Agoraphobia

10. The individual set of attitudes, values, beliefs and behaviours that are deeply ingrained in the psyche refers to a person’s:

a) Physiology

b) Anatomy

c) Hormones

d) Personality

1. The ability to cope with and adjust to the stresses of everyday living in a manner that is acceptable to society is called:

a) mental illness

B) mental disorders

C) psychiatric

D) mental health

2. Which one of the following represents the highest level of anxiety?

a) manis

B) stressor

C) panic

D) conversion disorder

3. Psychosis, delusions, hallucinations, and paranoia are symptoms of:

a) Unipolar dipressive disorder

b) clinical depression

c) Antisocial behavioours

d)Schizophrenia

4. Unconscious reactions that block unpleasant or threatening feelings are:

a) Hyperactive

B) Hyperactive responsive

C) Defense mechanism

D) Phobic disorders

5. A person who lacks regard for moral standards and demonstrates a noticeable inability to get along with others or abide by societal rules is displaying which personality disorder?

a) Abusive

B) Paranoid

C) c) Antisocial

D) Co-dependent