You have just been accepted to nursing school. As a requirement, you have to have a tuberculosis (TB) test as well as a hepatitis B recombinant vaccine. The nurse who administers the TB skin test explains that if significant swelling occurs around the injection site, you will need to have chest x-rays to determine if you are infected with Mycobacterium tuberculosis. On the morning of the second day after the skin test, you awake to find your arm red and swollen in an area about the size of a quarter around the site of the test. It is also tender to the touch. Now you are really worried. Could you have TB?

1. Why does the reaction to the skin test take 36-48 hours to show up? Explain.

2. If you have a tuberculosis infection, why doesn’t the whole body, or at least the respiratory tract, react when the antigen is injected during this diagnostic test? After doing a chest x-ray, your doctor says the results are inconclusive. So, you are put on a six-month course of isoniazid to be safe. About six months later, while sitting in your medical microbiology class during a lecture on tuberculosis, you suddenly realize why you had that positive reaction to the skin test six months earlier. It had nothing to do with being infected, but was because you were born in Norway and your family moved to the United States when you were four years old.

3. What is going on here? Discuss in detail.

4. A while later, you told a friend of yours who is HIV-positive about your TB scare. She said that her doctor doesn't typically use the TB skin test on her, even though people with HIV are more susceptible to TB. Why is the skin test not always a reliable TB test for those with HIV?

Current ICD definitions of malnutrition use biochemical markers as a component of the diagnostic criteria. Explain the effect of inflammation on visceral proteins and how that may impact the clinician’s ability to diagnose malnutrition. What laboratory values may confirm the presence of inflammation?

you're a patient is a 48-year-old female brought to the emergency department for stroke like symptoms what are your primary concerns for this patient and what assessment and interventions will be associated with your concerns and why

1.What is a Fistula? How do you care for it?

2. What are you concerned about if the patient’s peritoneal dialysis outflow is brown/bright yellow

1. You are a nurse admitting a patient to the hospital from the emergency department (ED) with shortness of breath and recent weight loss. After receiving a report from the ED nurse, you ready the patient’s room according to unit specifications and collect the necessary equipment and forms. When the patient arrives, she is using oxygen via a nasal cannula and seems to be comfortable. As you begin your admission activities and paperwork, you note that her shortness of breath slightly increases as she answers your questions. Accompanying the patient is her daughter, who comments, “This is the fourth time she’s been admitted to this hospital in the past year.” The patient and her daughter demonstrate a close, loving relationship. The daughter not only encourages her mother, but also sets boundaries regarding her mother’s anxiety. (Learning Objectives #1 & #3)
   1. What data in this scenario are pertinent?
   2. Which conditions within the case study could be addressed by nursing diagnoses?
   3. Which conditions within the case study would be addressed by a medical diagnosis?
   4. How are medical diagnoses, collaborative diagnoses, and nursing diagnoses different?
   5. Compare how a medical diagnosis is written versus a nursing diagnosis.

2. You are a nurse preparing to receive a new patient, fresh from surgery, to your unit. The patient is a 71-year-old man who underwent a surgical repair of a fractured femur. As you receive a report from the postanesthesia recovery unit, you learn that his medical history includes hypertension, 40 pack-years of smoking, and COPD. His surgical repair was successful but complicated by excessive bleeding, and he is receiving IV fluids to compensate. He is widowed, and his three children are scattered throughout the United States. He lives alone, receives Meals on Wheels, and pays a cleaning service to keep his home clean. (Learning Objective #6)
   1. What data in this scenario are pertinent?
   2. What potential collaborative problem(s) could be applicable in this situation?
   3. Which nursing diagnoses would you expect to be applicable regarding the medical procedures in this situation?
   4. Which nursing diagnoses would you expect to be applicable regarding the nursing/medical history in this situation?
   5. Which nursing diagnoses would you expect to be applicable regarding the discharge planning in this situation?
   6. You are a nurse admitting a patient to the hospital from the emergency department (ED) with shortness of breath and recent weight loss. After receiving a report from the ED nurse, you ready the patient’s room according to unit specifications and collect the necessary equipment and forms. When the patient arrives, she is using oxygen via a nasal cannula and seems to be comfortable. As you begin your admission activities and paperwork, you note that her shortness of breath slightly increases as she answers your questions. Accompanying the patient is her daughter, who comments, “This is the fourth time she’s been admitted to this hospital in the past year.” The patient and her daughter demonstrate a close, loving relationship. The daughter not only encourages her mother, but also sets boundaries regarding her mother’s anxiety. (Learning Objectives #1 & #3)
      1. What data in this scenario are pertinent?
      2. Which conditions within the case study could be addressed by nursing diagnoses?
      3. Which conditions within the case study would be addressed by a medical diagnosis?
      4. How are medical diagnoses, collaborative diagnoses, and nursing diagnoses different?
      5. Compare how a medical diagnosis is written versus a nursing diagnosis.
   8. You are a nurse preparing to receive a new patient, fresh from surgery, to your unit. The patient is a 71-year-old man who underwent a surgical repair of a fractured femur. As you receive a report from the postanesthesia recovery unit, you learn that his medical history includes hypertension, 40 pack-years of smoking, and COPD. His surgical repair was successful but complicated by excessive bleeding, and he is receiving IV fluids to compensate. He is widowed, and his three children are scattered throughout the United States. He lives alone, receives Meals on Wheels, and pays a cleaning service to keep his home clean. (Learning Objective #6)
      1. What data in this scenario are pertinent?
      2. What potential collaborative problem(s) could be applicable in this situation?
      3. Which nursing diagnoses would you expect to be applicable regarding the medical procedures in this situation?
      4. Which nursing diagnoses would you expect to be applicable regarding the nursing/medical history in this situation?
      5. Which nursing diagnoses would you expect to be applicable regarding the discharge planning in this situation?

1. The following is true about Alzheimer's Disease

   Check all that apply

   1. it is irreversible

   2. it accounts for 2/3 of all dementia conditions

   3. it causes significant cognitive impairment

   4. it can be prevented

2. Question 40

   1 Point

   The Demographic Transition Theory attempts to explain the trends in population aging

   1. True
   2. False

Last night, there was this actress on TV talking about having colon cancer and saying that everybody over 50 should get tested. It brought back memories of my father’s cancer, how thin and weak he got before he went to the doctor, so that by the time they found the cancer it had already spread too far. But I don’t think I’m at risk. I only eat red meat two or three times a week, and I eat a piece of fruit or a vegetable at every meal. I don’t smoke, and I get plenty of exercise, sunshine, and fresh air working in the vineyard.

Which lifestyle factors reduce Gustavo’s risk for cancer? What factors increase his risk? Would you recommend he increase his consumption of fruits and vegetables? Why or why not? If Gustavo were your father, would you urge him to have the screening test for colon cancer?

Some health care providers make patients feel like there is a stigma attached to the use of medications for chronic pain. Discuss any barriers you see that might prevent your colleagues in your clinical practice from responding to a patient in this manner.

A 67-year-old retired businessman has a history of gastric ulcers and ulcerative colitis. He reports eating a well-balanced “mostly vegetarian” diet. He states he dislikes taking prescription drugs and prefers natural herbal remedies because they are “not toxic like drugs.” He takes a variety of herbal preparations to relieve his gastrointestinal problems although he admits he has not experienced any significant relief in symptoms. His doctor prescribed a proton pump inhibitor and sulfasalazine, which he states he takes “reluctantly.” He now reports frequent spells of nausea and occasional diarrhea and notes that he feels more tired than usual.

1. Based on his limited history, what are some common causes that may explain the patient’s nausea and diarrhea?

2. How would you caution him regarding the use of herbal products?

3. To whom would you advise this patient to report any problems or side effects he may experience with his medication?

A 71-year-old woman was recently diagnosed with hypercholesterolemia and depression following the sudden death of her husband of 47 years. Her medical doctor has prescribed simvastatin to help lower her cholesterol and an anti-depressant. During her doctor visit, the patient reports her diet has been erratic due to her emotional state, and decides to make some changes in her diet to improve her well-being. In addition to her usual glass of grapefruit juice at breakfast every morning, she decides to eat more vegetables with her meals. The patient’s friend has also encouraged her to try St. John’s wort to ease her depression. At her one-month follow-up visit with her medical doctor, the patient reports feeling better emotionally although she feels more tired than usual and reports occasionally feeling sick to her stomach. She is also surprised that, in spite of her improved diet, she has gained 5 pounds since her last visit. Her doctor also notes that her blood cholesterol level has decreased. And although she is on a normal dose of simvastatin, her doctor notes an unusually rapid drop in her blood cholesterol from 250 mg/dL to 155 mg/dL.

1. What may explain the patient’s weight gain?

2. What places the patient at increased risk for adverse effects from mediations?

3. What steps could Mrs. Miller’s health care team have taken to prevent adverse effects of her medications?

1. EXPLAIN How nebulizer and inhaler assist in early detection of asthma symptom changes in children and teenagers?

2. Describe How NEBULIZER AND INHALER assist in THE disease management education OF ASTHMA?