In a paper of 1,000-1,250 words: Discuss the work of the Robert Wood Johnson Foundation Committee Initiative on the Future of Nursing and the Institute of Medicine research that led to the IOM report, “Future of Nursing: Leading Change, Advancing Health.”

In a formal paper of 1,000-1,250 words you will discuss the work of the Robert Wood Johnson Foundation Committee Initiative on the Future of Nursing and the Institute of Medicine research that led to the IOM report, “Future of Nursing: Leading Change, Advancing Health.” Identify the importance of the IOM “Future of Nursing” report related to nursing practice, nursing education and nursing workforce development. What is the role of state-based action coalitions and how do they advance goals of the Future of Nursing: Campaign for Action?

Explore the Campaign for Action webpage (you may need to research your state’s website independently if it is not active on this site): http://campaignforaction.org/states

Review your state’s progress report by locating your state and clicking on one of the six progress icons for: education, leadership, practice, interpersonal collaboration, diversity, and data. You can also download a full progress report for your state by clicking on the box located at the bottom of the webpage.

In a paper of 1,000-1,250 words:

Discuss the work of the Robert Wood Johnson Foundation Committee Initiative on the Future of Nursing and the Institute of Medicine research that led to the IOM report, “Future of Nursing: Leading Change, Advancing Health.”

Identify the importance of the IOM “Future of Nursing” report related to nursing practice, nursing education and nursing workforce development.

What is the role of state-based action coalitions and how do they advance goals of the Future of Nursing: Campaign for Action?

Summarize two initiatives spearheaded by your state’s action coalition. In what ways do these initiatives advance the nursing profession? What barriers to advancement currently exist in your state? How can nursing advocates in your state overcome these barriers?

A minimum of three scholarly references are required for this assignment.

RUBRICS

1 Provided an original summary of the key messages of the IOM report, Future of Nursing: Leading Change, Advancing Health. Any specific references should be cited.

2 Identify the role of the Robert Wood Johnson Foundation Initiative and the American Association of Retired Persons on the Future of Nursing Campaign for Action and the State Based Action Coalitions

  1. Identify the importance of the IOM FON report related to the nursing workforce

4 Discuss the intent of the Future of Nursing Campaign for Action

5 Identify the rationale of state-based action coalitions

6 Discuss one state-based action coalition and two initiatives

 

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What is the expected moisture and texture of the skin of a patient with hypothyroidism?

Question

Question 1. You are beginning the examination of the skin on a 25-year-old teacher. You have previously elicited that she came to the office for evaluation of fatigue, weight gain, and hair loss. You strongly suspect that she has hypothyroidism. What is the expected moisture and texture of the skin of a patient with hypothyroidism?

Moist and smooth

Moist and rough

Dry and smooth

Dry and rough

Question 2. Question : You are assessing a patient with joint pain and are trying to decide whether it is inflammatory or noninflammatory in nature. Which one of the following symptoms is consistent with an inflammatory process?

Tenderness

Cool temperature

Ecchymosis

Nodules

Question 3. Question : A 68-year-old retired farmer comes to your office for evaluation of a skin lesion. On the right temporal area of the forehead, you see a flattened papule the same color as his skin, covered by a dry scale that is round and feels hard. He has several more of these scattered on the forehead, arms, and legs. Based on this description, what is your most likely diagnosis?

Actinic keratosis

Seborrheic keratosis

Basal cell carcinoma

Squamous cell carcinoma

Question 4. Question : A 28-year-old graduate student comes to your clinic for evaluation of pain “all over.” With further questioning, she is able to relate that the pain is worse in the neck, shoulders, hands, low back, and knees. She denies swelling in her joints. She states that the pain is worse in the morning. There is no limitation in her range of motion. On physical examination, she has several points on the muscles of the neck, shoulders, and back that are tender to palpation. Muscle strength and range of motion are normal. Which one of the following is likely the cause of her pain?

Rheumatoid arthritis

Osteoarthritis

Fibromyalgia

Polymyalgia rheumatica

Question 5. Question : Heberden’s nodes are commonly found in which one of the following diseases?

Rheumatoid arthritis

Degenerative joint disease

Psoriatic arthritis

Septic arthritis

Question 6. Question : A new patient is complaining of severe pruritus that is worse at night. Several family members also have the same symptoms. Upon examination, areas of excoriated papules are noted on some of the interdigital webs of both hands and on the axillae. This finding is most consistent with:

Contact dermatitis

Impetigo

Larva migrans

Scabies

Question 7. Question : An obese 55-year-old woman went through menarche at age 16 and menopause 2 years ago. She is concerned because an aunt had severe osteoporosis. Which one of the following is a risk factor for osteoporosis?

Obesity

Late menopause

Having an aunt with osteoporosis

Delayed menarche

Question 8. Question : Ms. Whiting is a 68-year-old female who comes in for her usual follow-up visit. You notice a few flat red and purple lesions, about 6 centimeters in diameter, on the ulnar aspect of her forearms but nowhere else. She doesn’t mention them. They are tender when you examine them. What should you do?

Conclude that these are lesions she has had for a long time.

Wait for her to mention them before asking further questions.

Ask how she acquired them.

Conduct the visit as usual for the patient.

Question 9. Question : A 58-year-old man comes to your office complaining of bilateral back pain that now awakens him at night. This has been steadily increasing for the past 2 months. Which one of the following is the most reassuring in this patient with back pain?

: Age over 50

Pain at night

Pain lasting more than 1 month or not responding to therapy

Pain that is bilateral

Question 10. Question : The Phalen’s test is used to evaluate:

Inflammation of the median nerve

Rheumatoid arthritis

Degenerative joint changes

Chronic tenosynovitis

  1. Question : Which of the following would lead you to suspect a hydrocele versus other causes of scrotal swelling?

The presence of bowel sounds in the scrotum

Being unable to palpate superior to the mass

A positive transillumination test

Normal thickness of the skin of the scrotum

Question 2. Question : You are examining a newborn and note that the right testicle is not in the scrotum. What should you do next?

Refer to urology

Recheck in six months

Tell the parent the testicle is absent but that this should not affect fertility

Attempt to bring down the testis from the inguinal canal

Question 3. Question : A 50-year-old truck driver comes to your clinic for a work physical. He has had no upper respiratory, cardiac, pulmonary, gastrointestinal, urinary, or musculoskeletal system complaints. His past medical history is significant for mild arthritis and prior knee surgery in college. He is married and just changed jobs, working for a different trucking company. He smokes one pack of cigarettes a day, drinks less than six beers a week, and denies using any illegal drugs. His mother has high blood pressure and arthritis and his father died of lung cancer in his sixties. On examination, his blood pressure is 130/80 and his pulse is 80. His cardiac, lung, and abdominal examinations are normal. He has no inguinal hernia, but on his digital rectal examination you palpate a soft, smooth, and nontender pedunculated mass on the posterior wall of the rectum. What anal, rectal, or prostate disorder best fits his presentation?

Internal hemorrhoid

Prostate cancer

Anorectal cancer

Rectal polyp

Question 4. Question : A 15-year-old high school football player is brought to your office by his mother. He is complaining of severe testicular pain since exactly 8:00 this morning. He denies any sexual activity and states that he hurts so bad he can’t even urinate. He is nauseated and is throwing up. He denies any recent illness or fever. His past medical history is unremarkable. He denies any tobacco, alcohol, or drug use. His parents are both in good health. On examination, you see a young teenager lying on the bed with an emesis basin. He is very uncomfortable and keeps shifting his position. His blood pressure is 150/100, his pulse is 110, and his respirations are 24. On visualization of the penis, he is circumcised and there are no lesions and no discharge from the meatus. His scrotal skin is tense and red. Palpation of the left testicle causes severe pain and the patient begins to cry. His prostate examination is unremarkable. His cremasteric reflex is absent on the left but is normal on the right. By catheter you get a urine sample and the analysis is unremarkable. You send the boy with his mother to the emergency room for further workup.

Acute orchitis

Acute epididymitis

Torsion of the spermatic cord

Prostatitis

Question 5. Question : Which is true of prostate cancer?

It is commonly lethal.

It is one of the less common forms of cancer.

Family history does not appear to be a risk factor.

Ethnicity is a risk factor.

Question 6. Question : Which of the following conditions involves a tight prepuce which, once retracted, cannot be returned?

Phimosis

Paraphimosis

Balanitis

Balanoposthitis

Question 7. Question : A 12-year-old is brought to your clinic by his father. He was taught in his health class at school to do monthly testicular self-examinations. Yesterday, when he felt his left testicle, it was enlarged and tender. He isn’t sure if he has had burning with urination and he says he has never had sexual intercourse. He has had a sore throat, cough, and runny nose for the last three days. His past medical history is significant for a tonsillectomy as a small child. His father has high blood pressure and his mother is healthy. On examination, you see a child in no acute distress. His temperature is 100.8 and his blood pressure and pulse are unremarkable. On visualization of his penis, he is uncircumcised and has no lesions or discharge. His scrotum is red and tense on the left and normal appearing on the right. Palpating his left testicle reveals a mildly sore swollen testicle. The right testicle is unremarkable. An examining finger is put through both inguinal rings, and there are no bulges with bearing down. His prostate examination is unremarkable. Urine analysis is also unremarkable. What abnormality of the testes does this child most likely have?

Acute orchitis

Acute epididymitis

Torsion of the spermatic cord

Prostatitis

Question 8. Question : The most common cause of cancer deaths in males is:

Lung cancer

Prostate cancer

Colon cancer

Skin cancer

Question 9. Question : Important techniques in performing the rectal examination include which of the following?

Lubrication

Waiting for the sphincter to relax

Explaining what the patient should expect with each step before it occurs

All of the above

Question 10. Question : Jim is a 47-year-old man who is having difficulties with sexual function. He is recently separated from his wife of 20 years. He notes that he has early morning erections but otherwise cannot function. Which of the following is a likely cause for his problem?

Decreased testosterone levels

Psychological issues

Abnormal hypogastric arterial circulation

Impaired neural innervation

Question 1. Which of the following is true of human papilloma virus (HPV) infection?

Pap smear is a relatively ineffective screening method.

It commonly resolves spontaneously in one to two years.

It is the second most common STI in the United States.

HPV infections cause a small but important number of cervical cancers.

Question 2. Question : Which of the following is the most effective pattern of palpation for breast cancer?

Beginning at the nipple, make an ever-enlarging spiral.

Divide the breast into quadrants and inspect each systematically.

Examine in lines resembling the back and forth pattern of mowing a lawn.

Beginning at the nipple, palpate vertically in a stripe pattern.

Question 3. Question : A 14-year-old junior high school student is brought in by his mother and father because he seems to be developing breasts. The mother is upset because she read on the Internet that smoking marijuana leads to breast enlargement in males. The young man adamantly denies using any tobacco, alcohol, or drugs. He has recently noticed changes in his penis, testicles, and pubic hair pattern. Otherwise, his past medical history is unremarkable. His parents are both in good health. He has two older brothers who never had this problem. On examination, you see a mildly overweight teenager with enlarged breast tissue that is slightly tender on both sides. Otherwise, his examination is normal. He is agreeable to taking a drug test. What is the most likely cause of his gynecomastia?

Breast cancer

Imbalance of hormones of puberty

Drug use

Question 4. Question : Which of the following represents metrorrhagia?

Fewer than 21 days between menses

Excessive flow

Infrequent bleeding

Bleeding between periods

Question 5. Question : What does a KOH (potassium hydroxide) prep help the nurse practitioner diagnose?

Herpes zoster infections

Yeast infections

Herpes simplex infections

Viral infections

Question 6. Question : Abby is a newly married woman who is unable to have intercourse because of vaginismus. Which of the following is true?

This is most likely due to lack of lubrication.

This is most likely due to atrophic vaginitis.

This is most likely due to pressure on an ovary.

Psychosocial reasons may cause this condition.

Question 7. Question : A 30-year-old man notices a firm, 2-cm mass under his areola. He has no other symptoms and no diagnosis of breast cancer in his first-degree relatives. What is the most likely diagnosis?

Breast tissue

Fibrocystic disease

Breast cancer

Lymph node

Question 8. Question : Which of the following is true regarding breast self-examination?

It has been shown to reduce mortality from breast cancer.

It is recommended unanimously by organizations making screening recommendations.

A high proportion of breast masses are detected by breast self-examination.

The undue fear caused by finding a mass justifies omitting instruction in breast self-examination.

Question 9. Question : A 23-year-old computer programmer comes to your office for an annual examination. She has recently become sexually active and wants to be placed on birth control. Her only complaint is that the skin in her armpits has become darker. She states it looks like dirt, and she scrubs her skin nightly with soap and water but the color stays. Her past medical symptoms consist of acne and mild obesity. Her periods have been irregular for 3 years. Her mother has type 2 diabetes, and her father has high blood pressure. The patient denies using tobacco but has four to five drinks on Friday and Saturday nights. She denies any illegal drug use. On examination, you see a mildly obese female who is breathing comfortably. Her vital signs are unremarkable. Looking under her axilla, you see dark, velvet-like skin. Her annual examination is otherwise unremarkable. What disorder of the breast or axilla is she most likely to have?

Peau d’orange

Acanthosis nigricans

Hidradenitis suppurativa

Question 10. Question : Which of the following is true of women who have had a unilateral mastectomy?

They no longer require breast examination.

They should be examined carefully along the surgical scar for masses.

Lymphedema of the ipsilateral arm usually suggests recurrence of breast cancer.

Women with breast reconstruction over their mastectomy site no longer require examination.

Question 1. A 76-year-old retired farmer comes to your office complaining of abdominal pain, constipation, and a low-grade fever for about three days. He denies any nausea, vomiting, or diarrhea. The only unusual thing he remembers eating is two bags of popcorn at the movies with his grandson, three days before his symptoms began. He denies any other recent illnesses. His past medical history is significant for coronary artery disease and high blood pressure. He has been married for over fifty years. He denies any tobacco, alcohol, or drug use. His mother died of colon cancer and his father had a stroke. On examination, he appears his stated age and is in no acute distress. His temperature is 100.9 degrees and his other vital signs are unremarkable. His head, cardiac, and pulmonary examinations are normal. He has normal bowel sounds and is tender over the left lower quadrant. He has no rebound or guarding. His rectal examination is unremarkable and his fecal occult blood test is negative.His prostate is slightly enlarged but his testicular, penile, and inguinal examinations are all normal. Blood work is pending.

What diagnosis for abdominal pain best describes his symptoms and signs?

Acute diverticulitis

Acute cholecystitis

Acute appendicitis

Mesenteric ischemia

Question 2. Question : Jim is a 60-year-old man who presents with vomiting. He denies seeing any blood with emesis, which has been occurring for two days. He does note a dark, granular substance resembling the coffee left in the filter after brewing. What do you suspect?

Bleeding from a diverticulum

Bleeding from a peptic ulcer

Bleeding from a colon cancer

Bleeding from cholecystitis

Question 3. Question : A 26-year-old sports store manager comes to your clinic, complaining of severe right-sided abdominal pain for twelve hours. He began having a stomachache yesterday, with a decreased appetite, but today the pain seems to be just on the lower right side. He has had some nausea and vomiting but no constipation or diarrhea. His last bowel movement was the night before and was normal. He has had no fever or chills. He denies any recent illnesses or injuries. His past medical history is unremarkable. He is engaged. He denies any tobacco or drug use and drinks four to six beers per week. His mother has breast cancer and his father has coronary artery disease. On examination, he appears ill and is lying on his right side. His temperature is 100.4 degrees and his heart rate is 110. His bowel sounds are decreased and he has rebound and involuntary guarding, one-third of the way between the anterior superior iliac spine and the umbilicus in the right lower quadrant (RLQ). His rectal, inguinal, prostate, penile, and testicular examinations are normal.

What is the most likely cause of his pain?

Acute appendicitis

Acute mechanical intestinal obstruction

Acute cholecystitis

Mesenteric ischemia

Question 4. Question : Josh is a 14-year-old boy who presents with a sore throat. On examination, you notice dullness in the last intercostal space in the anterior axillary line on his left side with a deep breath. What does this indicate?

His spleen is definitely enlarged and further workup is warranted.

His spleen is possibly enlarged and close attention should be paid to further examination.

His spleen is possibly enlarged and further workup is warranted.

His spleen is definitely normal.

Question 5. Question : Diminished radial pulses may be seen in patients with which of the following?

Aortic insufficiency

Hyperthyroidism

Arterial emboli

Early “warm” septic shock

Question 6. Question : A 42-year-old florist comes to your office, complaining of chronic constipation for the last six months. She has had no nausea, vomiting, or diarrhea, and no abdominal pain or cramping. She denies any recent illnesses or injuries. She denies any changes to her diet or exercise program. She is on no new medications. During the review of systems (ROS), you note that she has felt fatigued, had some weight gain, has irregular periods, and has cold intolerance. Her past medical history is significant for one vaginal delivery and two cesarean sections. She is married, has three children, and owns a flower shop. She denies tobacco, alcohol, or drug use. Her mother has type 2 diabetes and her father has coronary artery disease. There is no family history of cancers. On examination, she appears her stated age. Her vital signs are normal. Her head, eyes, ears, nose, throat, and neck examinations are normal. Her cardiac, lung, and abdominal examinations are also unremarkable. Her rectal occult blood test is negative. Her deep tendon reflexes are delayed in response to a blow with the hammer, especially the Achilles tendons.

What is the best choice for the cause of her constipation?

Large bowel obstruction

Irritable bowel syndrome

Rectal cancer

Hypothyroidism

Question 7. Question : A 57-year-old maintenance worker comes to your office for evaluation of pain in his legs. He has smoked two packs per day since the age of sixteen, but is otherwise healthy. You are concerned that he may have peripheral vascular disease. Which of the following is part of common or concerning symptoms for the peripheral vascular system?

Intermittent claudication

Chest pressure with exertion

Shortness of breath

Knee pain

Question 8. Question : You are assessing a 59-year-old gas station owner for atherosclerosis in the lower extremities. In which of the following locations would the patient’s pain make you concerned for this disease process?

Thigh

Knee

Calf

Ankle

Question 9. Question : A 55-year-old secretary with a recent history of breast cancer, for which she underwent surgery and radiation therapy, and a history of hypertension comes to your office for a routine checkup. Which of the following aspects of the physical are important to note when assessing the patient for peripheral vascular disease in the arms?

Femoral pulse, popliteal pulse

Dorsalis pedis pulse, posterior tibial pulse

Carotid pulse

Radial pulse, brachial pulse

Question 10. Question : Cody is a teenager with a history of leukemia and an enlarged spleen. Today he presents with fairly significant left upper quadrant (LUQ) pain. On examination of this area, a rough grating noise is heard. What is this sound?

It is a splenic rub.

It is a variant of bowel noise.

It represents borborygmi.

It is a vascular noise.

Question 1.A 30-year-old woman with a history of mitral valve problems states that she has been “very tired.” She has started waking up at night and feels like her “heart is pounding.” During the assessment, the nurse practitioner palpates a thrill and lift at the fifth left intercostal space midclavicular line. In the same area the nurse practitioner also auscultates a blowing, swishing sound right after S1. These findings would be most consistent with:

heart failure.

aortic stenosis.

pulmonary edema.

mitral regurgitation.

Question 2. Question : A patient presents with excruciating headache pain on one side of his head, especially around his eye, forehead, and cheek that lasts about 1/2 to 2 hours, occurring once or twice each day. The nurse practitioner suspects:

hypertension.

cluster headaches.

tension headaches.

migraine headaches.

Question 3. Question : A patient complains that while studying for an examination he began to notice a severe headache in the frontotemporal area of his head that is throbbing and is somewhat relieved when he lies down. He tells the nurse practitioner that his mother also had these headaches. The nurse practitioner suspects that he may be suffering from:

hypertension.

cluster headaches.

tension headaches.

migraine headaches.

Question 4. Question : A patient tells the nurse practitioner that he is very nervous, that he is nauseated, and that he “feels hot.” This type of data would be:

objective.

reflective.

subjective.

introspective

Question 5. Question : The most important reason to share information and offer brief teaching while performing the physical examination is to help:

the examiner feel more comfortable and gain control of the situation.

build rapport and increase the patient’s confidence in the examiner.

the patient understand his or her disease process and treatment modalities.

the patient identify questions about his or her disease and potential areas of patient education.

Question 6. Question : A patient says that she has recently noticed a lump in the front of her neck below her “Adam’s apple” that seems to be getting bigger. During the assessment, the finding that reassures the nurse practitioner that this may not be a cancerous thyroid nodule is that the lump (nodule):

is tender.

is mobile and not hard.

disappears when the patient smiles.

is hard and fixed to the surrounding structures.

Question 7. Question : A patient visits the clinic because he has recently noticed that the left side of his mouth is paralyzed. He states that he cannot raise his eyebrow or whistle. The nurse practitioner suspects that he has:

Cushing’s syndrome.

Parkinson’s syndrome.

Bell’s palsy.

had a cerebrovascular accident (stroke).

Question 8. Question : The temporomandibular joint is just below the temporal artery and anterior to the:

hyoid.

vagus.

tragus.

mandible.

Question 9. Question : During an examination of a patient’s abdomen, the nurse practitioner notes that the abdomen is rounded and firm to the touch. During percussion, the nurse practitioner notes a drum-like quality of the sound across the quadrants. This type of sound indicates:

constipation.

air-filled areas.

the presence of a tumor.

the presence of dense organs.

Question 10. Question : A patient tells the nurse that he is allergic to penicillin. What would be the nurse practitioner’s best response to this information?

“Are you allergic to any other drugs?”

“How often have you received penicillin?”

“I’ll write your allergy on your chart so you won’t receive any.”

“Please describe what happens to you when you take penicillin.”

Question 11. Question : A patient’s thyroid is enlarged, and the nurse practitioner is preparing to auscultate the thyroid for the presence of a bruit. A bruit is a:

low gurgling sound best heard with the diaphragm of the stethoscope.

loud, whooshing, blowing sound best heard with the bell of the stethoscope.

soft, whooshing, pulsatile sound best heard with the bell of the stethoscope.

high-pitched tinkling sound best heard with the diaphragm of the stethoscope.

Question 12. Question : After completing an initial assessment on a patient, the nurse practitioner has documented that his respirations are eupneic and his pulse is 58. This type of data would be:

objective.

reflective.

subjective.

introspective.

Question 13. Question : A patient tells the nurse that she has had abdominal pain for the past week. What would be the best response by the nurse?

“Can you point to where it hurts?”

“We’ll talk more about that later in the interview.”

“What have you had to eat in the last 24 hours?”

“Have you ever had any surgeries on your abdomen?”

Question 14. Question : A teenage patient comes to the emergency department with complaints of an inability to “breathe and a sharp pain in my left chest.” The assessment findings include the following: cyanosis, tachypnea, tracheal deviation to the right, decreased tactile fremitus on the left, hyperresonance on the left, and decreased breath sounds on the left. This description is consistent with:

bronchitis.

a pneumothorax.

acute pneumonia.

an asthmatic attack.

Question 15. Question : The inspection phase of the physical assessment:

yields little information.

takes time and reveals a surprising amount of information.

may be somewhat uncomfortable for the expert practitioner.

requires a quick glance at the patient’s body systems before proceeding on with palpation.

Question 16. Question : The mother of a 2-year-old is concerned because her son has had three ear infections in the past year. What would be an appropriate response by the nurse practitioner?

“It is unusual for a small child to have frequent ear infections unless there is something else wrong.”

“We need to check the immune system of your son to see why he is having so many ear infections.”

“Ear infections are not uncommon in infants and toddlers because they tend to have more cerumen in the external ear.”

“Your son’s eustachian tube is shorter and wider than yours because of his age, which allows for infections to develop more easily.”

Question 17. Question : The nurse practitioner would use bimanual palpation technique in which situation?

Palpating the thorax of an infant

Palpating the kidneys and uterus

Assessing pulsations and vibrations

Assessing the presence of tenderness and pain

Question 18. Question : The patient’s record, laboratory studies, objective data, and subjective data combine to form the:

database.

admitting data.

financial statement.

discharge summary.

Question 19. Question : When preparing to perform a physical examination on an infant, the examiner should:

have the parent remove all clothing except the diaper on a boy.

instruct the parent to feed the infant immediately before the exam.

encourage the infant to suck on a pacifier during the abdominal exam.

ask the parent to briefly leave the room when assessing the infant’s vital signs.

Question 20. Question : The nurse practitioner notices that an infant has a large, soft lump on the side of his head and that his mother is very concerned. She tells the nurse practitioner that she noticed the lump about 8 hours after her baby’s birth, and that it seems to be getting bigger. One possible explanation for this is:

hydrocephalus.

craniosynostosis.

cephalhematoma.

caput succedaneum.

Question 21. Question : When examining an infant, the nurse practitioner should examine which area first?

Ear

Nose

Throat

Abdomen

Question 22. Question : When preparing to examine a 6-year-old child, which action is most appropriate?

Start with the thorax, abdomen, and genitalia before examining the head.

Avoid talking about the equipment being used because it may increase the child’s anxiety.

Keep in mind that a child this age will have a sense of modesty.

Have the child undress from the waist up.

Question 23. Question : The nurse practitioner is assessing a patient’s skin during an office visit. What is the best technique to use to best assess the patient’s skin temperature?

Use the fingertips because they’re more sensitive to small changes in temperature.

Use the dorsal surface of the hand because the skin is thinner than on the palms.

Use the ulnar portion of the hand because there is increased blood supply that enhances temperature sensitivity.

Use the palmar surface of the hand because it is most sensitive to temperature variations because of increased nerve supply in this area.

Question 24. Question : Percussion notes heard during the abdominal assessment may include:

flatness, resonance, and dullness.

resonance, dullness, and tympany.

tympany, hyperresonance, and dullness.

resonance, hyperresonance, and flatness.

Question 25. Question : The nurse practitioner is assessing a patient for possible peptic ulcer disease and knows that which condition often causes this problem?

Hypertension

Streptococcus infections

History of constipation and frequent laxative use

Frequent use of nonsteroidal anti-inflammatory drugs

Question 1: You are participating in a health fair and performing cholesterol screens. One person has a cholesterol level of 225. She is concerned about her risk for developing heart disease. Which of the following factors is used to estimate the 10-year risk of developing coronary heart disease?

Ethnicity

Alcohol intake

Gender

Asthma

Question 2. Question : You are concerned that a patient has an aortic regurgitation murmur. Which is the best position to accentuate the murmur?

Upright

Upright, but leaning forward

Supine

Left lateral decubitus

Question 3. Question : You are screening people at the mall as part of a health fair. The first person who comes for screening has a blood pressure of 132/85. How would you categorize this?

Normal

Prehypertension

Stage 1 hypertension

Stage 2 hypertension

Question 4. Question : How should you determine whether a murmur is systolic or diastolic?

Palpate the carotid pulse.

Palpate the radial pulse.

Judge the relative length of systole and diastole by auscultation.

Correlate the murmur with a bedside heart monitor.

Question 5. Question : A 78-year-old retired seamstress comes to the office for a routine check-up. You obtain an electrocardiogram (ECG) because of her history of hypertension. You diagnose a previous myocardial infarction and ask her if she had any symptoms related to this.Which of the following symptoms would be more common in this patient’s age group for an AMI?

Chest pain

Syncope

Pain radiating into the left arm

Pain radiating into the jaw

Question 6. Question : On examination, you find a bounding carotid pulse on a 62-year-old patient. Which murmur should you suspect?

Mitral valve prolapse

Pulmonic stenosis

Tricuspid insufficiency

Aortic insufficiency

Question 7. Question : Which of the following correlates with a sustained, high-amplitude point of maximal impulse (PMI)?

Hyperthyroidism

Anemia

Fever

Hypertension

Question 8. Question : A 68-year-old woman with hypertension and diabetes is seen by the nurse practitioner for a dry cough that worsens at night when she lies in bed. She has shortness of breath, which worsens when she exerts herself. The patient’s pulse rate is 90/min and regular. The patient has gained 6 lbs over the past two months. She is on a nitroglycerine patch and furosemide daily. The explanation for her symptoms is:

Kidney failure

Congestive heart failure

Angiotensin-converting enzyme (ACE) inhibitor induced coughing

Thyroid disease

Question 9. Question : When listening to a soft murmur or bruit, which of the following may be necessary?

Asking the patient to hold their breath.

Asking the patient in the next bed to turn down the TV.

Checking your stethoscope for air leaks.

All of the above.

Question 10. Question : You notice a patient has a strong pulse and then a weak pulse. This pattern continues. Which of the following is likely?

Emphysema

Asthma exacerbation

Severe left heart failure

Cardiac tamponade

Question 1. Question : A patient complains of shortness of breath for the past few days. On examination, you note late inspiratory crackles in the lower third of the chest that were not present a week ago. What is the most likely explanation for these?

Asthma

COPD

Bronchiectasis

Heart failure

Question 2. Question : A sixty-year-old baker presents to your clinic, complaining of increasing shortness of breath and nonproductive cough over the last month. She feels like she can’t do as much activity as she used to do without becoming tired. She even has to sleep upright in her recliner at night to be able to breathe comfortably. She denies any chest pain, nausea, or sweating. Her past medical history is significant for high blood pressure and coronary artery disease. She had a hysterectomy in her 40s for heavy vaginal bleeding. She is married and is retiring from the local bakery soon. She denies any tobacco, alcohol, or drug use. Her mother died of a stroke, and her father died from prostate cancer.She denies any recent upper respiratory illness, and she has had no other symptoms. On examination, she is in no acute distress. Her blood pressure is 160/100, and her pulse is 100. She is afebrile, and her respiratory rate is 16. With auscultation, she has distant air sounds and she has late inspiratory crackles in both lower lobes. On cardiac examination, the S1 and S2 are distant and an S3 is heard over the apex.

Pneumonia

COPD

Pleural pain

Left-sided heart failure

Question 3. Question : A patient with long-standing COPD was told by another practitioner that his liver was enlarged and this needed to be assessed. Which of the following would be reasonable to do next?

Percuss the lower border of the liver.

Measure the span of the liver.

Order a hepatitis panel.

Obtain an ultrasound of the liver.

Question 4. Question : A fifty-five-year-old smoker complains of chest pain and gestures with a closed fist over her sternum to describe it. Which of the following diagnoses should be considered because of her gesture?

Bronchitis

Costochondritis

Pericarditis

Angina pectoris

Question 5. Question : When crackles, wheezes, or rhonchi clear with a cough, which of the following is a likely etiology?

Bronchitis

Simple asthma

Cystic fibrosis

Heart failure

Question 6. Question : Is the following information subjective or objective? Mr. Mazz has shortness of breath that has persisted for the past ten days; it is worse with activity and relieved by rest.

Subjective

Objective

Question 7. Question : All of the following are implicated in causing chronic cough except:

Chronic bronchitis

Allergic rhinitis

Acute viral upper respiratory infection

Gastroesophageal reflux disease

Question 8. Question : A mother brings her infant to you because of a “rattle” in his chest with breathing. Which of the following would you hear if there is a problem in the upper airway?

Different sounds from the nose and the chest

Asymmetric sounds

Inspiratory sounds

Sounds louder in the lower chest

Question 9. Question : Which of the following is consistent with good percussion technique?

Allow all of the fingers to touch the chest while performing percussion.

Maintain a stiff wrist and hand.

Leave the plexor finger on the pleximeter after each strike.

Strike the pleximeter over the distal interphalangeal joint.

 

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1. Which one of the following requirements is outlined in the guidelines established in HIPAA’s Privacy Rule?

  1. Which one of the following requirements is outlined in the guidelines established in HIPAA’s Privacy Rule? A. Hospital administrators must encrypt data within older data files. B. Managers must secure medical records immediately following patient admission. C. Patients must receive notice if their information will be used or disclosed to third parties. D. Physicians must not disclose patient information to consulting physicians.
  2. A tethered health record allows patients to A. amend the diagnoses listed in the health record. B. use a secure portal to access their own records. C. restructure insurance copayments. D. compare their health records to the records of patients with similar diagnoses.
  3. A patient sustains a fracture of the femur while playing football in a nearby park. What ICD-10-CM code would be assigned? A. S72.003A B. S72.001A C. S49.006A D. S72.009A
  4. Which one of the following structures is part of the male secondary genitalia? A. Gonads B. Urethra C. Testes D. Vulva
  5. What is the full code description for 25515? A. Open treatment of radial shaft fracture, includes internal fixation, when performed, and open treatment of distal radioulnar joint dislocation (Galeazzi fracture/dislocation), includes internal fixation, when performed, includes repair of triangular fibrocartilage complex B. Open treatment of radial shaft fracture, includes internal fixation, when performed C. Closed treatment of radial shaft fracture; without manipulation D. Closed treatment of ulnar shaft fracture; without manipulation
  6. Another name for XXY syndrome is A. Turner’s syndrome. B. Huntington’s chorea. C. Cooley’s anemia. D. Klinefelter syndrome.
  7. The hammer-shaped bone in the middle ear is called the A. cochlea. B. stapes. C. malleus. D. incus.
  8. Codes beginning with the letter K are related to the _ system. A. circulatory B. digestive C. endocrine D. sensory
  9. Which of the following statements is true of the olfactory nerve? A. It’s located in the mitral valve and helps to circulate blood throughout the heart. B. It’s found in the nose and allows the senses to detect and distinguish odors. C. It’s susceptible to erosion due to Peyronie’s disease. D. It conveys the fluid from lymph glands to other areas of the body.
  10. A patient has a Foley catheter inserted prior to a planned surgical procedure. How is this coded? A. 55520 B. 52630 C. 51702 D. 52601
  11. What is the CPT code for simple drainage of a finger abscess? A. 26010 B. 26020 C. 26034 D. 26011
  12. Usually, a comprehensive EHR includes A. secure standalone cluster controllers for hospitals in rural environments. B. software, hardware, implementation, and future program upgrades. C. coaxial cable connections between mainframe servers only. D. customizable XHRLT processes for ambulatory surgery centers.
  13. What ICD-10-CM code would be assigned for a patient with acute tubule-interstitial nephritis? A. Z02.6 B. B96.2 C. L50.0 D. N10
  14. An echocardiogram shows that the wall of a patient’s artery has dilated. The dilation has resulted in a saclike swelling. This swelling is called a/an A. aneurysm. B. cyst. C. mesenteric venous thrombosis. D. benign tumor.
  15. What is Medicare Part D? A. The component of Medicare Part A that covers outpatient surgeries B. Supplemental coverage for war veterans and their dependents C. Add-on coverage for dental procedures D. Add-on coverage for prescription drugs provided through insurance companies approved by Medicare
  16. The suffix –stasis means A. flow. B. stopping and controlling. C. breakdown. D. kinetic.
  17. The outcome of delivery code should be A. omitted from the maternal record for stillborn delivery. B. assigned to the newborn record only. C. assigned to both the maternal and newborn records. D. assigned to the maternal record when a delivery occurs.
  18. A patient who was involved in a motor vehicle accident is taken to the hospital by ambulance and admitted to the hospital in critical care. The physician sees the patient for 74 minutes in critical care. The physician leaves to attend to other patients in the ICU and the NICU of the same hospital. Five hours later, the physician returns to the patient and continues to treat the patient in critical care for an additional 30 minutes. The patient spends a total of 104 minutes in critical care. What codes are assigned? A. 99292, 99292, 99293 B. 99291, 99291 C. 99291, 99292 D. 99292, 99293
  19. The root word OBSTETR/O means A. cesarean. B. pregnancy. C. birth. D. midwife.
  20. Coders can use the Microsoft Office suite to create spreadsheets in A. Excel. B. Lotus 1-2-3. C. PowerPoint. D. Word.
  21. A patient undergoes an appendectomy and later returns to the operating room for a related procedure the same day. Which modifier should be assigned to the CPT code? A. -51 B. -AA C. -76 D. -78
  22. The concept of meaningful use pertains to A. categorization of patient information. B. medical office protocol and document organization. C. resource management in the inpatient setting. D. electronic health record implementation.
  23. The study of disease is called A. pathology. B. urology. C. physiology. D. neurology.
  24. Modifier -23 indicates that A. a procedure was performed bilaterally. B. the patient received general anesthesia for a procedure that would ordinarily be performed with local or no anesthesia. C. a physician reviewed and interpreted a radiology procedure. D. two surgeons performed a procedure.
  25. Releasing genetic information is forbidden under the terms of HIPAA because it may A. indicate susceptibility to a future illness, without the patient actually being diagnosed with the condition. B. allow immediate family members to have access to a patient’s medical records. C. not be successfully transmitted to all health care facilities. D. require physicians to fulfill contractual obligations for treatments provided in ambulatory surgery centers.
  26. Provision of security against a hurt, loss, or damage with specific cash payments is called A. protection. B. secured loss. C. copayment. D. indemnity.
  27. Physicians typically refer to anatomical locations using directional terms, which are often A. used primarily by chiropractors. B. used to describe surgical incisions. C. referenced horizontally. D. paired in opposites.
  28. The code for an ESWL would be found in the A. Digestive System of CPT. B. Urinary and Male Genital Systems of CPT. C. Chemotherapy section of HCPCS. D. Cardiovascular System of CPT.
  29. What code would be assigned for a tube pericardiostomy? A. 33015 B. 33050 C. 33026 D. 33210
  30. HCPCS modifier –E2 indicates that the patient had a surgical procedure performed on the A. upper left eyelid. B. upper right eyelid. C. lower left eyelid. D. lower right eyelid.
  31. Providers that receive reimbursement after health care services have been provided are being compensated under the _ system. A. UCR B. capitation C. retrospective payment D. prospective payment
  32. What happens when HIPAA rules conflict with state law? A. The interpretation of HIPAA rules is left to the physician’s discretion. B. The Supreme Court’s decision becomes final in binding arbitration. C. Conflicting state rules are overridden by federal law. D. State laws overrule federal law.
  33. The method that physicians use to bill for each service or visit individually rather than on a pre-paid basis is called A. pre-paid care. B. managed care. C. fee-for-service. D. capitation.
  34. The suffix -sis means A. process. B. drooping. C. inflammation. D. condition.
  35. A new patient is seen in a clinic for complaints of shortness of breath, fever, difficulty swallowing, runny nose, and cough. The physician performs a detailed history, detailed examination, and medical decision making of low complexity. The physician also obtains a chest x-ray and lab workup. Based on the results of the diagnostic tests, the physician renders a diagnosis of upper respiratory tract infection and lymphadenopathy. What ICD-10 and CPT codes are assigned? A. 99215, M19.011, R13.10 B. 99203, J06.9, R59.0 C. 99213, R06.82, F10.229 D. 99202, D63.1, J45.909
  36. A physician is called to the intensive care unit for a patient with second-degree burns sustained on 55% of his body while cooking in the kitchen where he works. The physician sees the patient in the critical care unit for two hours, leaves the unit, and returns later the same day to provide an additional hour of critical care. What ICD-10-CM and CPT codes would be assigned? A. L91.8, 99291 × 2, 99292 × 4 B. T31.50, 99291, 99292 × 4 C. Z30.09, 99293, 99294 × 2 D. R53.81, 99291, 99293 × 5
  37. A physician who cares for a patient throughout an entire pregnancy, from beginning to end, is providing A. comprehensive prenatal management. B. routine global obstetric care. C. puerperal obstetric care. D. antenatal global supervision.
  38. A patient is seen in the emergency room complaining of abdominal pain in the left lower quadrant. It’s determined that the patient is experiencing inflammation of the pancreas, which is also called A. pancreaticoduodonal arcade. B. pancreatonia. C. pancreatolysis. D. pancreatitis.
  39. The covering on the brain and spinal cord in the dorsal cavity is called the A. sheath. B. peritoneum. C. ganglia. D. meninges.
  40. The regulations in HIPAA apply to three groups of individual and corporate entities, each involved in electronic medical records transfer. These groups are collectively referred to as A. health care administrators. B. protected personnel. C. provisional health care data collectors. D. covered entities.
  41. The retention period is the amount of time that A. insurance billing documents must be retained in filing cabinets. B. medications must be kept in the medical office. C. records must be kept. D. HIM employee files must be retained upon termination or resignation.
  42. A physician has a meeting with a pharmaceutical sales representative. During the course of the conversation, the physician reveals the diagnosis and past family, medical, and social history of a patient currently being treated with one of the medications that the sales representative is selling. In this situation, the doctor could be sued for A. invasion of privacy. B. undue harm and fraud. C. malice. D. malfeasance.
  43. Epithelial tissue that secretes its products directly into the bloodstream is made of A. endoplasmic reticulum. B. endocrine gland cells. C. extracellular matrix. D. columnar epithelial cells.
  44. A physician obtains cells from the bone marrow cavity using a needle and a syringe. How would this procedure be coded? A. 38220 B. 36575 C. 35092 D. 37328
  45. The vitreous humor can be found in the A. eye. B. nose. C. tongue. D. ear.
  46. The study of tissue disease using macroscopic or microscopic analysis is called A. microbiology. B. histopathology. C. immunology. D. cytopathology.
  47. Placing a catheter into the aorta or directly into an artery or vein is called A. selective catheter placement. B. brachiocephalic manipulation. C. third order placement. D. nonselective catheter placement.
  48. A patient is diagnosed with acne. What ICD-10-CM code would be assigned? A. L74.2 B. L70.0 C. L72.3 D. L73.1
  49. Members of the uniformed services, their families and survivors, and retired members and their families qualify for A. OIG Recovery. B. Medicaid. C. Medicare. D. TRICARE.
  50. A 35-year-old male is brought to the emergency department with memory disturbance after being accidentally exposed to lead paint. What ICD-10-CM codes should be assigned? A. T42.4X1A, R40.0 B. T23.009A, R23.8 C. T56.0X1A, R41.3 D. T57.0X1A, R10.9
  51. Health care practitioners who submit fraudulent bills to increase reimbursement may A. be listed in the Coding Directory of Fraudulent Billing published annually by the Department of Health and Human Services. B. be reported to the Office of the Attorney General. C. be blacklisted according to geographic location. D. face financial penalties or, in some cases, imprisonment.
  52. A patient comes to the ambulatory surgery center for a fusion of the cervical spine. Prior to the beginning of the surgery, the patient suffers an allergic reaction to the anesthesia shortly after it’s administered. Because of this reaction, the surgery is not performed. What code would be assigned as the first-listed diagnosis? A. The anesthesia administration B. The allergy code C. The reason that the surgery was scheduled to be performed D. The observation code
  53. The root word ENTER/O means A. secretion. B. intestine. C. stomach. D. tooth.
  54. When coding burns, coders should A. assign separate codes for each burn site. B. assign the code for chronic burns. C. classify all burns as acute burns. D. assign the code for third-degree burns.
  55. Which of the following forms is used to bill outpatient charges? A. CMS-1500 or UCF-1500. B. AMA-14 or UCF-1250 C. HCFA-1400 or CMS-1540 D. HCFA-1350 or CMS-650
  56. A significant, separately identifiable E/M service performed by the same physician in conjunction with another service performed on the same day would be reported using what modifier? A. -TC B. -47 C. -90 D. -25
  57. Which of the following modifiers would be assigned for a moribund patient? A. P5 B. P1 C. P4 D. P3
  58. Taking certain steps to protect PHI from being accidentally released to individuals who don’t need to know the information is called the A. minimum necessary standard. B. information provision standard. C. privacy management statute. D. health information guardianship guideline.
  59. Codes for plastic repair of the perineum are found in which code range? A. 57000–57426 B. 57000–57010 C. 57150–57180 D. 56800–56810
  60. A coder overhears a confidential statement made outside of the court, and then, when called to testify, repeats the statement as being truth. This is an example of A. speculation. B. hearsay. C. a direct quote. D. cross-examination.
  61. A nurse sustains an accidental needle pinprick to the right third finger while administering an injection. If an employee has an occupational exposure, what must happen? A. An in-service meeting should be held for all employees who may potentially be exposed to the same occupational hazard. B. The employee should contact the proper authorities. C. Hospital administrators must maintain the nurse’s medical record for the remainder of her employment plus an additional 30 years. D. The guidelines for OSHA should be included in the employment file.
  62. Another name for third-party contractors who have access to medical information is A. healthcare vendors. B. insurance administrators. C. covered entities. D. business associates.
  63. A patient receives two venous pressure clamps for hemodialysis. What HCPCS Level II code is assigned? A. A4751 B. A4918 × 2 C. A4751 × 2 D. A4918
  64. The anatomical location of the calyx is the A. arm. B. kidney. C. spine. D. brain.
  65. A patient comes to the clinic complaining of ongoing headaches. The headaches began one week prior and have persisted ever since. A lumbar spinal tap is performed to pinpoint the source of the patient’s headaches. What CPT and ICD-10-CM codes are assigned? A. 62270, G74.3 B. 62270, G44.1 C. 62141, G46.8 D. 62272, G46.9
  66. A coder assigns a HCPCS Level II code to a patient’s medical record. The code description reads as follows: Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape. Based on this description, which HCPCS Level II code was assigned? A. B4278 B. B4125 C. B4072 D. B4034
  67. To conform to the HIPAA Privacy Rule, which of the following safeguards must be maintained in health care facilities? A. ICD-7 provisional safeguards B. Immunization and injection safeguards C. Reasonable administrative, technical, and physical safeguards D. Hazardous waste protection safeguards
  68. A patient receives a blood glucose monitor. What HCPCS Level II code would be assigned? A. E0976 B. E0562 C. E4752 D. E0607
  69. Alternative dispute resolution (ADR) allows A. lawyer-to-lawyer mediation during trial recess. B. mediating disputes with a judge in the presence of the bailiff. C. resolving medical malpractice suits by submitting pretrial depositions. D. litigants to resolve disputes prior to or after the start of litigation.
  70. A 65-year-old patient is admitted to the hospital for 48 hours to receive treatment from her physician. This patient would be covered under A. Medicare Part B. B. Medicare Part A. C. Medicare Part D. D. Medicare Part C.
  71. Another term for disease evolution is A. remission. B. pathogenesis. C. morphology. D. exacerbation.
  72. In relation to HIPAA regulations regarding the manner in which information can be disclosed, which of the following statements is true? A. Protected health information must be disclosed only when the patient is unable to testify in a court proceeding. B. Protected health information may never be disclosed. C. Protected health information may be disclosed in a judicial or administrative proceeding if the request is made through an order from a court or administrative tribunal. D. Protected health information may be disclosed only within a deposition.
  73. The gatekeeper concept refers to the operation of A. ambulatory payment surgery centers. B. prospective payment organizations. C. retrospective payment organizations. D. health maintenance organizations.
  74. Which of the following procedures would be performed to treat prostate cancer? A. Transurethral resection of the prostate (TURP) B. Meniscectomy C. Vasoconstriction D. Arthroscopy
  75. What diagnosis code would be assigned for a patient diagnosed with Type 2 diabetes mellitus with diabetic nephropathy? A. E11.21 B. E11.01 C. E11.22 D. E11.9
  76. Another name for Medicare Advantage is A. Medicare Part A. B. Medicare Part C. C. Medicare Part B. D. Medicare Part D.
  77. The codes for pacemakers and implantable defibrillators would be found in what section of CPT? A. 33200–33205 B. 33437–33537 C. 33202–33273 D. 33533–33799
  78. A patient comes to the emergency room complaining of abdominal pain. She was previously diagnosed with type I diabetes. She also complains of watery eyes, congestion, pressure in the sinuses, and difficulty breathing. Her final diagnoses are right lower quadrant abdominal pain, type I diabetes, acute sinusitis, and asthma. What CPT and ICD-10-CM codes are assigned? A. 99222, R18.91, E16.9, J01.91, J45.919 B. 99221, R17.41, E17.9, J01.90, J45.909 C. 99223, R14.31, E15.9, J01.90, J45.929 D. 99221, R10.31, E10.9, J01.90, J45.909
  79. What is considered to be protected health information (PHI)? A. Any health information that can identify the individual to whom it refers B. Records pertaining to ancestry C. Statistical data compiled for research purposes only D. Census data
  80. In what CPT code range is Surgical Pathology found? A. 88515–88598 B. 88300–88309 C. 88400–80499 D. 88000–80299
  81. The federal law that requires a patient’s written consent prior to disclosure of certain medical information by government agencies is called the A. Health Care Amendment of 1976. B. Privacy Act of 1974. C. Health Information Law of 2002. D. Medical Consent Act of 1965.
  82. Data stored in a health care facility must A. be organized in accordance with state standards for electronic data interchange. B. adhere to OIG policies and procedures. C. conform to the physician’s expectations for data storage. D. comply with HIPAA rules and must be maintained securely.
  83. Under HIPAA, health care facilities must A. maintain a clean, safe working environment. B. choose a privacy officer in accordance with HIPAA policies and procedures. C. keep records of patients who refill prescriptions more than once within a three-month timeframe. D. follow up with patients who repeatedly miss scheduled appointments for mandatory services.
  84. What CPT code would be assigned for a colpocentesis? A. 57135 B. 57859 C. 57600 D. 57020
  85. A patient is prescribed a medication that narrows the blood vessels and raises her blood pressure. The medication is most likely a A. tranquilizer. B. vasoconstrictor. C. cardiotonic. D. cardiogenic.
  86. If patients choose to obtain copies of their medical records, under the terms of HIPAA, providers can A. complete employee paperwork. B. charge a reasonable fee for providing copies of those records. C. reschedule office visits to allow time to update medical records. D. also fulfill requests for prescription data.
  87. According to the CMS National Physician Fee Schedule, what is the conversion factor for basic life support mileage? A. $34.5741 B. $32.4726 C. $28.8457 D. $36.0666
  88. According to HIPAA, a patient’s information may be released for A. determining premiums based on a patient’s past medical history. B. paternity testing. C. research. D. transferring electronic medical records to remote locations.
  89. A patient comes to the clinic complaining of fever, diarrhea, nausea, and vomiting. The patient is diagnosed with salmonella meningitis. What ICD-10-CM code would be assigned? A. A07.21 B. A02.21 C. A05.26 D. A23.24
  90. Which of the following anatomical locations would contain the diaphysis? A. Metatarsal B. Tibia C. Septum D. Diaphragm
  91. A patient comes to the clinic complaining of nausea, vomiting, fever, dizziness, and intermittent confusion. The physician conducts a detailed history and examination and reviews the patient’s lab results. The patient is diagnosed with pyelonephritis and is scheduled for an ultrasound to review the state of the kidneys and other organs. What CPT and ICD-10-CM codes are assigned? A. 76775-TC, N15 B. 71010-26, B12 C. 76775-26, N10 D. 73256-TC, M11
  92. A female patient is diagnosed with breast cancer of the lower-inner quadrant of the right breast. The patient undergoes a modified radical mastectomy of the right breast in an attempt to circumvent the spread of the cancer to any secondary anatomical sites. The procedure was performed in three stages. In addition to the radical mastectomy, the physician also performed a right breast biopsy to treat the breast tumor in the lower-inner quadrant. What ICD-10-CM and CPT codes are assigned? A. 15852-58, Z48.01 B. 19307-58-RT, 19101-59-RT, C50.311 C. 19307-RT, 19101-RT, C50.211 D. 11602, 15240, C50.312
  93. The concept of confidentiality can be substantiated based on the right of A. easement. B. constitutionality. C. totality. D. privacy.
  94. The abbreviation INH indicates what route of drug administration? A. Inhaled and intrathecal administration B. Intrathecal injection C. Inhalant solution D. Inhaled and intravenous administration
  95. A patient is seen in the physician’s office after the results of an earlier mammogram demonstrated microcalcification in the right breast as well as a breast lesion. The lesion is excised using needle localization. The patient’s final diagnosis is fibrosclerosis of the right breast. What CPT and ICD-10-CM codes are assigned? A. 19123-RT, H16.11 B. 19126-LT, M25.1 C. 19125-RT, N60.31 D. 19120-RT, L10.11
  96. What is the code description for 65101-LT? A. Removal of ocular implant performed laterally B. Biopsy of cornea performed on the lower third of the cornea C. Enucleation of eye, without implant, performed on the left side of the body D. Fine needle aspiration of orbital contents on the left third of the orbit
  97. The foramen ovale is found in which anatomical location? A. Fibula B. Heart C. Liver D. Pancreas
  98. During a routine examination, a patient indicates that she is taking an antihypertensive medication that causes her kidneys to excrete more urine. These antihypertensive medications are called A. calcium-channel blockers. B. anticoagulants. C. diuretics. D. beta blockers.
  99. Code range 99231–99233 pertains to A. initial hospital care. B. hospital discharge services. C. consultation services. D. subsequent hospital care.
  100. A 7-year-old patient is seen in follow-up after an earlier diagnosis of excessive daytime sleepiness. The physician obtains a sleep study and then reviews and interprets the results. What CPT and ICD-10-CM codes are assigned? A. 95810-26, R40.0 B. 95811-TC, J14.0 C. 95815-TC, G45.0 D. 95812-26, H40.0
  101. If a physician provides preoperative management only to a patient prior to surgery, which modifier would be added to the surgery code? A. -56 B. -44 C. -32 D. -91
  102. The HIPAA Privacy Rule indicates that A. restrictions on information disclosure exist only for patients with life-threatening illnesses. B. the level of information disclosure permitted is based on the nature of the procedure. C. practitioners should disclose only the minimum amount of health information necessary for the purpose of the disclosure. D. physicians may release medical information at their own discretion.
  103. The atrioventricular (tricuspid) valve is located in the A. fibula. B. lung. C. heart. D. brain.
  104. A physician is analyzing specific organs in a particular region of the patient’s body. In her notes, she refers to the transverse or cross-sectional plane, which divides the body A. horizontally. B. vertically. C. inferiorly. D. bilaterally.
  105. A health care practitioner who knowingly submits false statements to obtain federal health care reimbursement is guilty of A. Medicare fraud. B. DHS claim misrepresentation. C. Health Insurance Privacy and Portability misuse. D. Medicaid omission.
  106. According to the guidelines for medical records outlined in the Health Insurance Portability and Accountability Act (HIPAA), patients A. have the right to have errors reviewed by a hospital administrator. B. do not have the right to have errors corrected, as the data has been previously verified by the physician. C. have the right to have errors in their medical records corrected. D. have the right to correct errors in identification data only.
  107. The Health Insurance Portability and Accountability Act (HIPAA) standards were developed to A. ensure that coders could easily access each medical record. B. determine the structure of insurance carrier payments for health care practitioners. C. protect patient confidentiality when health information is transferred electronically. D. define XLTM standards for health records management.
  108. A coder would assign modifier -53 to report A. procedures cancelled due to the patient’s condition. B. anesthesia administration. C. dental procedures. D. repeat procedures.
  109. A patient is diagnosed with breast cancer and undergoes a partial mastectomy. What CPT code would be assigned? A. 19305 B. 19301 C. 19304 D. 19307
  110. Which of the following anesthesia modifiers indicates a normal, healthy patient? A. P1 B. P4 C. P3 D. P2
  111. A coder searching for codes pertaining to tissue expanders would find them in what section of CPT? A. 16200–16799 B. 12000–12300 C. 11960–11971 D. 15000–15999
  112. A patient comes to the emergency room complaining of abdominal pain, nausea, and intractable vomiting. Unable to pinpoint the source of the patient’s complaints, the physician decides to admit the patient to the hospital. After conducting a complete history and examination, the patient’s final diagnosis is determined to be chronic duodenal ulcer. The patient remains hospitalized for three days. The physician sees the patient on the day of discharge. What ICD-10 and CPT codes are assigned? A. 99223, I48.91 B. 99238, K26.7 C. 99234, N17.9 D. 99291, D63.1
  113. What is the code for excision of Meckel’s diverticulum? A. 44820 B. 44700 C. 44800 D. 44850
  114. The Health Insurance Portability and Accountability Act (HIPAA) was created for the purpose of A. modifying legal and ethical issues surrounding medical records retention. B. stabilizing administrative costs and productivity. C. decreasing employee turnover and reducing the volume of new hire paperwork. D. streamlining claims processing and reducing paperwork through electronic transmission.
  115. The voluntary program that’s financed through a combination of payments from general federal revenues and premiums paid by beneficiaries who elect to participate is called A. CHAMPVA. B. Medicare Part B. C. Medicaid. D. TRICARE.
  116. The I-10 helps coders classify patient A. management information. B. morbidity and mortality. C. evaluation files. D. reimbursement data.
  117. A patient recently became eligible for health insurance through her employer. Her health insurance is considered to be an 80-20 policy. Under the terms of an 80-20 policy, the insurer pays 80 percent and the insured pays 20 percent of expenses. This 80-20 policy is an example of A. coinsurance. B. capitation. C. prospective payment. D. case management.
  118. Performing a daily check for viruses and malware is one of the A. requirements of the Help Desk. B. routine aspects of software maintenance. C. sensible guidelines for Internet use in health care facilities. D. functions of HIM encoders.
  119. Bones inside the nose are called A. septal mucosa. B. maxillae. C. turbinates. D. ethmoids.
  120. A group of doctors who belong to the same network and provide discounted services to enrollees is called a/an A. Managed Care Organization (MCO). B. Individual Practice Association (IPA). C. Health Maintenance Organization (HMO). D. Preferred Provider Organization (PPO).
  121. A female patient is seen for her annual gynecological examination. During the examination, the physician performs a test to detect cervical cancer. This test is called a/an A. Pap smear. B. carcinoembryonic antigen test. C. mycobacterial culture. D. immunoassay test.
  122. Businesses that provide support services, like administration, to individual physicians are called A. integrated provider organizations. B. medical foundations. C. management services organizations. D. physician-hospital organizations
  123. What is the full code description for 33536? A. Repair of double outlet right ventricle with intraventricular tunnel repair B. Repair of postinfarction ventricular septal defect, with or without myocardial resection C. Closure of atrioventricular valve (mitral or tricuspid) by suture or patch D. Coronary artery bypass, using arterial graft(s); 4 or more coronary arterial grafts
  124. The CPT code for thrombolysis is A. 93000. B. 92920. C. 93797. D. 92975.
  125. Which of the following statements is true of the Affordable Care Act? A. It offers parents supplementary coverage for dependents with chronic illness. B. It makes it mandatory for patients to carry health insurance. C. It includes a provision for military service members who served in Afghanistan. D. It requires health care facilities to maintain health records for at least 10 years.
  126. A qualifying circumstance indicates a A. situation that makes anesthesia administration more difficult. B. condition that reduces the average recovery time for a particular type of surgery. C. situation that may extend a patient’s length of stay in the hospital setting. D. condition that impacts the outcome of surgery.
  127. The portion of health insurance that an insured pays before he or she is entitled to receive benefits from an insurance plan is called the A. capitation. B. OPPS reimbursement. C. coinsurance. D. deductible.
  128. A good compliance program in the health care setting includes A. regular audit consultations with trustees of the AAPC. B. HHS surveillance. C. meetings with compliance officers. D. regular tracking and monitoring of coding activities.
  129. A 55-year-old patient was injured while working as a carpenter on a construction site. While framing the roof of a two-story house, he fell and hit his head. He was diagnosed with a concussion to the left side of his head, and underwent a right frontal parietal craniotomy with removal of a subdural hematoma. During the patient’s period of recovery, he was given a medication that resulted in a rash on his abdomen. The physician conducted an expanded problem focused history and exam, with straightforward medical decision making. What CPT code(s) should be assigned? A. 99253 B. 99252 C. 99292, 99291 D. 99251
  130. During a routine examination, a male patient is diagnosed with an elevated PSA. The physician performs a biopsy of the prostate with a rectal ultrasound to pinpoint the source of the problem. Which CPT and ICD-10-CM codes would be assigned? A. 55720, 74000-26, R97.3 B. 55700, 76872-26, R97.2 C. 55734, 73200-26, R97.2 D. 55725, 76000-26, R93.6
  131. When is code 58120 assigned? A. The code is assigned for a patient undergoing dilatation and curettage. B. The code has been deleted and cannot be assigned. C. The code is assigned for permanent pacemaker insertion. D. The code is assigned as an add-on code.
  132. A patient is seen for 167 minutes of critical care. What CPT codes would be assigned? A. 99291, 99292 × 4 B. 99291, 99292 × 2 C. 99291, 99292 × 3 D. 99291, 99292 × 5
  133. The prefix endo- means A. outside of. B. within. C. beneath. D. adjacent to.
  134. A patient comes to the emergency room after having dinner at a restaurant, where she began to experience chest tightness during the meal. She is seen for a cardiology consultation in the outpatient setting for a diagnosis of chest tightness. Which CPT and ICD-10-CM codes would be assigned? A. 99243, R25.96 B. 99242, R17.52 C. 99244, R07.59 D. 99245, R07.89
  135. The prefix sub- means A. above. B. horizontal. C. under. D. lateral.
  136. What CPT code range is used to code for a limited lymphadenectomy? A. 38700–38780 B. 38562–38564 C. 39501–39599 D. 37501–37650
  137. The process of removing tissue for histopathology is called A. excision. B. shaving. C. debridement. D. biopsy.
  138. Which of the following anatomical locations would contain the superior vena cava? A. Heart B. Nose C. Hip D. Lungs
  139. A patient is seen in the office for complaints of dizziness and insomnia. The physician records a chronological description of specific elements of the patient’s condition. This chronological description is called the A. chief complaint. B. review of systems. C. examination. D. history of present illness.
  140. A patient comes to the physician’s office complaining of neck irritation. The physician examines her neck and notes that she has a 15 cm neck scar. Upon further examination, the physician notes that the neck scar requires extensive debridement and retention sutures. The physician performs a dermabrasion to treat the neck scar and then closes the complex wound with the sutures. What ICD-10 and CPT codes are assigned? A. 13132, 13133 × 3, H81.09, L92.9 B. 13133-51, 13131-79, L60.0 C. 13132, 13133 × 2, L90.5 D. 13132, L76.82
  141. The first step in EHR implementation is A. analyzing the content of the traditional medical record. B. conducting an assessment of the goals, needs, and financial stability of the health care practice. C. structuring the timeline for EHR implementation. D. reviewing the list of established patients currently being seen in the practice.
  142. A patient is seen in follow-up two weeks after undergoing cholecystectomy. During the follow-up examination, the physician notes that the abdominal wound has not yet healed. The patient undergoes a split-thickness autograft due to a nonhealing left lower abdominal wound that’s 10 square centimeters. Which CPT and ICD-10-CM codes would be assigned? A. 15200, L85.64 B. 15250, L34.74 C. 15350, L52.64 D. 15100, L76.82
  143. A patient is diagnosed with severe sepsis and septic shock after experiencing a severe drop in blood pressure. What ICD-10-CM code would be assigned? A. T79.4 B. T81.12 C. R65.21 D. R65.10
  144. A patient has a disorder in which the bone marrow produces an overabundance of white blood cells. What is this disorder called? A. Septicemia B. Coagulation C. Leukemia D. Hemophilia
  145. Which modifier indicates a staged or related procedure performed during the postoperative period? A. -59 B. -54 C. -57 D. -58
  146. The Female Genital System subsection covers which CPT code range? A. 56203–56303 B. 56405–58999 C. 56607–56809 D. 56300–56499
  147. A patient with numerous symptoms is seen in the laboratory for a general health panel to gauge her overall physical well-being. What CPT code would be assigned for a general health panel? A. 82136 B. 84135 C. 80051 D. 80050
  148. A patient undergoes a sigmoidoscopy. The coder would assign CPT code A. 45919. B. 45852. C. 45330. D. 45397.
  149. Code 71030-TC indicates a/an A. complete chest x-ray, four views, technical component only. B. incomplete chest x-ray, three views, technical and professional component. C. complete chest x-ray, two views, technical component only. D. incomplete chest x-ray, two views, technical and professional component.
  150. Health care practitioners must maintain records of privacy policy practices and procedures for A. 2 years. B. 20 years. C. 6 years. D. 10 months.
 

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Develop a PowerPoint slideshow consisting of 8-15 slides.

  1. Develop a PowerPoint slideshow consisting of 8-15 slides. Include the following. Title slide, written speaker notes, and Reference slide. Do not use Voice Over recordings. All information needs to be written in slides and notes.
  2. You are required to complete the assignment using the productivity tools required by Chamberlain University, which is Microsoft Office Word 2013 (or later version), or Windows and Office 2011 (or later version) for MAC. You must save the file in the “.pptx” format. A later version of the productivity tool includes Office 365, which is available to Chamberlain students for FREE by downloading from the student portal at http://my.chamberlain.edu (Links to an external site.)Links to an external site.. Click on the envelope at the top of the page.
  3. As the leader, you have identified a problem or issue related to one of the National Patient Safety Goals 2018 created by the Joint Commission that will lead to quality improvement. You will find the National Patient Safety Goals using this link: NPSG (Links to an external site.)Links to an external site.
  4. Assess the problem or issue. State the problem/issue and identify three rationales (reasons) that the problem exists.
  5. Determine the people who are involved in the issue and explain three reasons as to how their role will contribute to the problem or issue solution.
  6. Identify three solutions and discuss the purpose, cost and desired outcome.
  7. Pick one solution to share with the director and discuss why this solution was chosen over the others.
  8. Make an action plan to share the solution with the director or staff.
  9. Summarize issue, plan and desired outcome and purpose for quality improvement on slide.
  10. Summarize your learning and value of doing the assignment.
  11. Include written speaker notes for all slides except title slide and reference slide.
  12. Submit your PowerPoint slideshow by 11:59 p.m. MT, Sunday, end of Week 6.
 

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Assign the CPT Code(s) and appropriate modifiers to each statement.

1) Assign the CPT Code(s) and appropriate modifiers to each statement.

The physician treated a soft tissue abscess that was due to osteomyelitis by making an incision and examining, debriding, and draining the subfascia; the physician also irrigated the affected area, examined underlying tissue and bone for signs of infection, and closed the site.

2) Patient underwent exploration of a penetrating wound of the chest, which involve surgical exploration and enlargement of the wound, debridement, removal of a foreign body, and ligation of subcutaneous tissue.

3) Open bone biopsy, superficial, left femur.

4) Patient underwent aspiration of ganglion cyst, right wrist.

5) Patient received a cortisone injection to a single trigger point, which consisted of the trapezius deltoid, and latissimus dorsi muscles.

6) A patient diagnosed with joint contracture of the right ankle underwent application of a multiplane external fixation device.

7) A patient severed his right index finger while using a chain saw. He underwent successful replantation of the index finger, which included metacarpophalangeal (MCP) joint insertion of flexor sublimis tendon.

8) Fascia lata graft was harvested using a stripper.

9) Patient underwent structural allograft as part of an arthrodesis, posterior technique, craniocervical (occiput-C2).

10) Electrical stimulation procedure was performed to aid bone healing, invasive type.

1) Arthrotomy of temporomandibular joint, right and left sides.

2) Excision of two facial bones (due to bone abscesses).

3) Impression and custom preparation of speech aid prosthesis.

4) Sliding osteotomy genioplasty, single piece.

5) Reconstruction midface, Lefort II with anterior intrusion.

6) Osteotomy of mandible, segmental.

7) Malar augmentation with prosthetic material.

8) Closed treatment of orbit fracture, with manipulation.

9) Closed treatment of maxillary alveolar ridge fracture.

10) Open treatment of mandibular condylar fracture.

1) Deep incision with opening of bone cortex, thorax.

2) Hyoid myotomy and suspension.

3) Closed treatment of sternum fracture.

4) Partial excision of rib.

5) Sternal debridement.

6) Needle biopsy, soft tissue, thorax.

7) Excision of tumor, subcutaneous soft tissue of back, 2.5 cm.

8) The physician removed a 4-cm malignant soft tissue tumor, including adjacent tissue, from the patient’s flank. Radial resection was performed to remove the tumor and adjacent tissue. The 5-cm surgical wound was repaired with complex closure.

9) Patient underwent biopsy of superficial soft tissues of the back.

10) Biopsy, soft tissue flank, deep.

1) Patient underwent arthrodesis at L4-L5 interspace. Posterior interbody technique laminectomy was performed. Discectomy was also performed to prepare the verbal interspace for fusion.

2) Physician performed “spinal manipulation under anesthesia, “cervical, thoracic, and lumbar spine.

3) Patient underwent osteotomy and discectomy of a single cervical spine vertebral segmet. Anterior approach was used.

4) Physician performed arthrodesis using posterior technique of atlas-axis (C1-C2) with internal spinal fixation by wiring the spinous processes.

5) Patient underwent poster arthrodesis of L2-L3 for spinal deformity, with casting. Morselized autogenous iliac bone graft was harvested through a separate skin incision.

 

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Prepare this assignment as a 1,500-1,750 word paper using the instructor feedback from the Topic 1, 2, and 3 assignments and the guidelines below.

FOLLOW EVERY INSTRUCTION.. YOU HAVE TO USE THE DOCUMENTS ATTACHED BELLOW TO ANSWER THE SSIGMENT.. USE RUBRICS TO ANSWER THE ASSIGMENT..HAS TO BE FREE OF PLAGIARISM.

Details:

Prepare this assignment as a 1,500-1,750 word paper using the instructor feedback from the Topic 1, 2, and 3 assignments and the guidelines below.

PICOT Statement

Revise the PICOT statement you wrote in the Topic 1 assignment.

The final PICOT statement will provide a framework for your capstone project (the project students must complete during their final course in the RN-BSN program of study).

Research Critiques

In the Topic 2 and Topic 3 assignments you completed a qualitative and quantitative research critique. Use the feedback you received from your instructor on these assignments to finalize the critical analysis of the study by making appropriate revisions.

The completed analysis should connect to your identified practice problem of interest that is the basis for your PICOT statement.

Refer to “Research Critique Guidelines.” Questions under each heading should be addressed as a narrative in the structure of a formal paper.

Proposed Evidence-Based Practice Change

Discuss the link between the PICOT statement, the research articles, and the nursing practice problem you identified. Include relevant details and supporting explanation and use that information to propose evidence-based practice changes.

Prepare this assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to Turnitin. Please refer to the directions in the Student Success Center.

                                             RUBRICS

Benchmark – Research Critiques and PICOT Statement Final Draft

1
Unsatisfactory
0.00%
2
Less than Satisfactory
75.00%
3
Satisfactory
83.00%
4
Good
94.00%
5
Excellent
100.00%
60.0 %Content

5.0 % Nursing Practice Problem and PICOT Statement
A nursing practice problem is not clearly described and/or a PICOT statement is not included.
PICOT statement describes a nursing practice problem but lacks reliable sources.
PICOT statement describes a nursing practice problem and includes a few reliable sources.
PICOT statement articulates a nursing practice problem using supporting information from reliable sources.
PICOT statement clearly articulates a nursing practice problem using substantial supporting information from numerous reliable sources.
5.0 % Background of Study
Background of study including problem, significance to nursing, purpose, objective, and research questions is incomplete.
Background of study including problem, significance to nursing, purpose, objective, and research questions is included but lacks relevant details and explanation.
Background of study including problem, significance to nursing, purpose, objective, and research questions is partially complete and includes some relevant details and explanation.
Background of study including problem, significance to nursing, purpose, objective, and research questions is complete and includes relevant details and explanation.
Background of study including problem, significance to nursing, purpose, objective, and research questions is thorough with substantial relevant details and extensive explanation.
5.0 % Method of Study
Discussion of method of study including discussion of conceptual/theoretical framework is incomplete.
Discussion of method of study including discussion of conceptual/theoretical framework is included but lacks relevant details and explanation.
Discussion of method of study including discussion of conceptual/theoretical framework is partially complete and includes some relevant details and explanation.
Discussion of method of study including discussion of conceptual/theoretical framework is complete and includes relevant details and explanation.
Discussion of method of study including discussion of conceptual/theoretical framework is thorough with substantial relevant details and extensive explanation.
5.0 % Results of Study
Discussion of study results including findings and implications for nursing practice is incomplete.
Discussion of study results including findings and implications for nursing practice is included but lacks relevant details and explanation.
Discussion of study results including findings and implications for nursing practice is partially complete and includes some relevant details and explanation.
Discussion of study results including findings and implications for nursing practice is complete and includes relevant details and explanation.
Discussion of study results including findings and implications for nursing practice is thorough with substantial relevant details and extensive explanation.
5.0 % Ethical Considerations
Discussion of ethical considerations associated with the conduct of nursing research is incomplete.
Discussion of ethical considerations associated with the conduct of nursing research is included but lacks relevant details and explanation.
Discussion of ethical considerations associated with the conduct of nursing research is partially complete and includes some relevant details and explanation.
Discussion of ethical considerations associated with the conduct of nursing research is complete and includes relevant details and explanation.
Discussion of ethical considerations associated with the conduct of nursing research is thorough with substantial relevant details and extensive explanation.
5.0 % Conclusion
Conclusion does not summarize a critical appraisal and applicability of findings.
Conclusion is vague and does not discuss importance to nursing.
Conclusion summarizes utility of the research and importance to nursing practice.
Conclusion summarizes utility of the research from the critical appraisal and the findings importance to nursing practice.
Conclusion summarizes utility of the research from the critical appraisal, knowledge learned, and the importance of the findings to nursing practice.
10.0 % Evidence of Revision
Final paper does not demonstrate incorporation of feedback or evidence of revision on research critiques.
Incorporation of research critique feedback or evidence of revision is incomplete.
Incorporation of research critique feedback and evidence of revision are present.
Evidence of incorporation of research critique feedback and revision is clearly provided.
Evidence of incorporation of research critique feedback and revision is comprehensive and thoroughly developed.
10.0 % PICOT Statement, Research Article, and Nursing Practice Problem Link (C. 2.2)
Discussion of the link between the PICOT statement, research articles, and nursing practice problem is not included.
Discussion of the link between the PICOT statement, research articles, and nursing practice problem is incomplete or incorrect.
Discussion of the link between the PICOT statement, research articles, and nursing practice problem is included but lacks relevant details and supporting explanation.
Discussion of the link between the PICOT statement, research articles, and nursing practice problem is complete and includes relevant details and supporting explanation.
Discussion of the link between the PICOT statement, research articles, and nursing practice problem is extremely thorough with substantial relevant details and extensive supporting explanation.
10.0 % Proposed Evidence-Based Practice Change (C. 3.2)
The proposed evidence-based practice change is not included.
The proposed evidence-based practice change is incomplete or incorrect.
Discussion of the link between the PICOT statement, research articles, and nursing practice problem is included but lacks relevant details and supporting explanation. The proposed evidence-based practice change is included but lacks supporting explanation and relevant details.
The proposed evidence-based practice change is complete and includes supporting explanation and relevant details.
The proposed evidence-based practice change is extremely thorough and includes substantial supporting explanation and numerous relevant details.
30.0 %Organization and Effectiveness

10.0 % Thesis Development and Purpose
Paper lacks any discernible overall purpose or organizing claim.
Thesis is insufficiently developed or vague. Purpose is not clear.
Thesis is apparent and appropriate to purpose.
Thesis is clear and forecasts the development of the paper. Thesis is descriptive and reflective of the arguments and appropriate to the purpose.
Thesis is comprehensive and contains the essence of the paper. Thesis statement makes the purpose of the paper clear.
10.0 % Argument Logic and Construction
Statement of purpose is not justified by the conclusion. The conclusion does not support the claim made. Argument is incoherent and uses noncredible sources.
Sufficient justification of claims is lacking. Argument lacks consistent unity. There are obvious flaws in the logic. Some sources have questionable credibility.
Argument is orderly, but may have a few inconsistencies. The argument presents minimal justification of claims. Argument logically, but not thoroughly, supports the purpose. Sources used are credible. Introduction and conclusion bracket the thesis.
Argument shows logical progressions. Techniques of argumentation are evident. There is a smooth progression of claims from introduction to conclusion. Most sources are authoritative.
Argument is clear and convincing and presents a persuasive claim in a distinctive and compelling manner. All sources are authoritative.
10.0 % Mechanics of Writing (includes spelling, punctuation, grammar, language use)
Surface errors are pervasive enough that they impede communication of meaning. Inappropriate word choice or sentence construction is used.
Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice (register), sentence structure, or word choice are present.
Some mechanical errors or typos are present, but they are not overly distracting to the reader. Correct sentence structure and audience-appropriate language are used.
Prose is largely free of mechanical errors, although a few may be present. A variety of sentence structures and effective figures of speech are used.
Writer is clearly in command of standard, written, academic English.
10.0 %Format

5.0 % Paper Format (use of appropriate style for the major and assignment)
Template is not used appropriately or documentation format is rarely followed correctly.
Template is used, but some elements are missing or mistaken; lack of control with formatting is apparent.
Template is used, and formatting is correct, although some minor errors may be present.
Template is fully used; There are virtually no errors in formatting style.
All format elements are correct.
5.0 % Documentation of Sources (citations, footnotes, references, bibliography, etc., as appropriate to assignment and style)
Sources are not documented.
Documentation of sources is inconsistent or incorrect, as appropriate to assignment and style, with numerous formatting errors.
Sources are documented, as appropriate to assignment and style, although some formatting errors may be present.
Sources are documented, as appropriate to assignment and style, and format is mostly correct.
Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error.
100 % Total Weightage

 

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A 40-year-old female presents complaining of pain near the midline in the epigastrium.

Question 1

A 40-year-old female presents complaining of pain near the midline in the epigastrium. Assuming the pain is caused by a stimulus acting on an abdominal organ, the pain felt is classified as:

a. Visceral

b. Somatic

c. Parietal

d. Referred

Question 2

An 8-week-old male was recently diagnosed with cystic fibrosis. Which of the following digestive alterations would be expected?

a. Insufficient bile production

b. Gastric atrophy

c. Hypersecretion of stomach acid

d. Nutrient malabsorption

Question 3

In alcoholic cirrhosis, hepatocellular damage is caused by:

a. acetaldehyde accumulation.

b. bile toxicity.

c. acidosis.

d. fatty infiltrations.

Question 4

Where does the nurse expect the obstruction to be in a patient with extrahepatic portal hypertension?

a. Sinusoids

b. Bile ducts

c. Hepatic portal vein

d. Hepatic artery

Question 5

Kwashiorkor is a severe dietary deficiency of:

a. fat-soluble vitamins.

b. carbohydrates.

c. protein.

d. calcium and magnesium.

Question 6

A 27-year-old male presents with fever, GI bleeding, hepatomegaly, and transient joint pain. He reports that as a child he received blood transfusions following a motor vehicle accident. He also indicates he was vaccinated against hepatitis B. Which of the following types of hepatitis does the clinician think he most likely has?

a. A

b. B

c. C

d. D

Question 7

Prolonged diarrhea is more serious in children than adults because:

a. children have lower adipose reserves.

b. fluid reserves are lower in children.

c. children have a lower metabolic rate.

d. children are more resistant to antimicrobial therapy.

Question 8

A 40-year-old male develops an intestinal obstruction related to protrusion of the intestine through the inguinal ring. This condition is referred to as:

a. Intussusception

b. A volvulus

c. A hernia

d. Adhesions

Question 9

A 60-year-old male presents with GI bleeding and abdominal pain. He reports that he takes NSAIDs daily to prevent heart attack. Tests reveal that he has a peptic ulcer. The most likely cause of this disease is:

a. Increasing subepithelial bicarbonate production

b. Accelerating the H+ (proton) pump in parietal cells

c. Inhibiting mucosal prostaglandin synthesis

d. Stimulating a shunt of mucosal blood flow

Question 10

Acute pancreatitis often manifests with pain to which of the following regions?

a. Right lower quadrant

b. Right upper quadrant

c. Epigastric

d. Suprapubic

Question 11

A 60-year-old male is diagnosed with cancer of the esophagus. Which of the following factors most likely contributed to his disease?

a. Reflux esophagitis

b. Intestinal parasites

c. Ingestion of salty foods

d. Frequent use of antacids

Question 12

The primary complication of enterocolitis associated with Hirschsprung disease is related to which finding?

a. Fecal impaction

b. Pancreatic insufficiency

c. Hyperactive peristalsis

d. Ileal atresia

Question 13

The most common cause of chronic vascular insufficiency among the elderly is:

a. Anemia

b. Aneurysm

c. Lack of nutrition in gut lumen

d. Atherosclerosis

Question 14

The most common clinical manifestation of portal hypertension is _ bleeding.

a. rectal

b. duodenal

c. esophageal

d. intestinal

Question 15

A 54-year-old male is diagnosed with peptic ulcer disease.This condition is most likely caused by:

a. Hereditary hormonal imbalances with high gastrin levels

b. Breaks in the mucosa and presence of corrosive secretions

c. Decreased vagal activity and vascular engorgement

d. Gastric erosions related to high ammonia levels and bile reflux

Question 16

The cardinal sign of pyloric stenosis caused by ulceration or tumors is:

a. Constipation

b. Diarrhea

c. Vomiting

d. Heartburn

Question 17

A 55-year-old male died in a motor vehicle accident. Autopsy revealed an enlarged liver caused by fatty infiltration, testicular atrophy, and mild jaundice secondary to cirrhosis. The most likely cause of his condition is:

a. Bacterial infection

b. Viral infection

c. Alcoholism

d. Drug overdose

Question 18

Manifestations associated with hepatic encephalopathy from chronic liver disease are the result of:

a. hyperbilirubinemia and jaundice.

b. fluid and electrolyte imbalances.

c. impaired ammonia metabolism.

d. decreased cerebral blood flow.

Question 19

The most common disorder associated with upper GI bleeding is:

a. diverticulosis.

b. hemorrhoids.

c. esophageal varices.

d. cancer.

Question 20

A 3-month-old female develops colicky pain, abdominal distention, and diarrhea after drinking cow’s milk. The best explanation for her symptoms is:

a. Deficiency of bile that stimulates digestive secretions and bowel motility

b. Excess of amylase, which increases the breakdown of starch and causes an osmotic diarrhea

c. Overgrowth of bacteria from undigested fat molecules, which leads to gas formation and de creased bowel motility

d. Excess of undigested lactose in her digestive tract, resulting in increased fluid movement into the digestive lumen and increased bowel motility

Question 21

A 55-year-old female has general symptoms of gallstones but is also jaundiced. IV cholangiography would most likely reveal that the gallstones are obstructing the:

a. Intrahepatic bile canaliculi

b. Gallbladder

c. Cystic duct

d. Common bile duct

Question 22

A 1-week-old female is brought to her pediatrician for abdominal distention and unstable temperature. Physical examination reveals bradycardia and apnea. Tests reveal hypoxic injury to the bowel resulting in bacterial invasion and perforation. This condition is referred to as:

a. Infective enteropathy

b. Necrotizing enterocolitis (NEC)

c. Mucoviscidosis

d. Ileus

Question 23

For the patient experiencing esophageal reflux, the nurse would expect which sphincter to be malfunctioning?

a. Pyloric

b. Lower esophageal

c. Upper esophageal

d. Gastric

Question 24

Cholecystitis is inflammation of the gallbladder wall usually caused by:

a. accumulation of bile in the hepatic duct.

b. obstruction of the cystic duct by a gall-stone.

c. accumulation of fat in the wall of the gallbladder.

d. viral infection of the gallbladder.

Question 25

A 6-month-old male infant is brought to the ER after the sudden development of abdominal pain, irritability, and vomiting followed by passing of “currant jelly” stool. Ultrasound reveals intestinal obstruction in which the ileum collapsed through the ileocecal valve and invaginated into the large intestine. This type of obstruction is referred to as:

a. Prolapse

b. Pyloric stenosis

c. Intussusception

d. Imperforation

Question 26

A 22-year-old male underwent brain surgery to remove a tumor. Following surgery, he experienced a peptic ulcer. His ulcer is referred to as a(n) _ ulcer.

a. Infectious

b. Cushing

c. Ischemic

d. Curling

Question 27

Chronic gastritis is classified according to the:

a. severity.

b. location of lesions.

c. patient’s age.

d. signs and symptoms.

Question 28

Reflux esophagitis is defined as a(n):

a. Immune response to gastroesophageal reflux

b. Inflammatory response to gastroesophageal reflux

c. Congenital anomaly

d. Secretory response to hiatal hernia

Question 29

The cardinal signs of small bowel obstruction are:

a. Vomiting and distention

b. Diarrhea and excessive thirst

c. Dehydration and epigastric pain

d. Abdominal pain and rectal bleeding

Question 30

The nurse assessing the patient with biliary atresia would expect to find which primary clinical manifestation?

a. Anemia

b. Jaundice

c. Hypobilirubinemia

d. Ascites

Question 31

A 20-year-old male was recently diagnosed with lactose intolerance. He eats an ice cream cone and develops diarrhea. His diarrhea can be classified as _ diarrhea.

a. Motility

b. Hypotonic

c. Secretory

d. Osmotic

Question 32

Which of the following symptoms would help a health care provider distinguish between ulcerative colitis and Crohn disease?

a. Pattern of remission/exacerbations

b. Abdominal pain

c. Malabsorption

d. Diarrhea

Question 33

A 45-year-old male complains of heartburn after eating and difficulty swallowing. He probably has:

a. Pyloric stenosis

b. Hiatal hernia

c. Gastric cancer

d. Achalasia

Question 34

The exocrine portion of the pancreas contains:

a. alpha cells.

b. beta cells.

c. acinar cells.

d. islets of Langerhans.

Question 35

Outbreaks of hepatitis _ often occur in young children attending day care centers and can be attributed to poor hand washing.

a. A

b. B

c. C

d. D

 

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Epidemiological rationale for topic

This is an individual assignment. In 1,500-2,000 words, describe the teaching experience and discuss your observations. The written portion of this assignment should include:

Summary of teaching plan

Epidemiological rationale for topic

Evaluation of teaching experience

Community response to teaching

Areas of strengths and areas of improvement

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to Turnitin. Please refer to the directions in the Student Success Center.

1

Unsatisfactory

0.00%

2

Less than Satisfactory

75.00%

3

Satisfactory

83.00%

4

Good

94.00%

5

Excellent

100.00%

80.0 %Content

30.0 %Comprehensive Summary of Teaching Plan With Epidemiological Rationale for Topic

Summary of community teaching plan is not identified or missing.

Summary of community teaching plan is incomplete.

Summary of community teaching plan is offered but some elements are vague.

Focus of community teaching is clear with a detailed summary of each component. Rationale is not provided.

Focus of community teaching is clear, consistent with Functional Health Patterns (FHP) assessment findings and supported by explanation of epidemiological rationale.

50.0 %Evaluation of Teaching Experience With Discussion of Community Response to Teaching Provided. Areas of Strength and Areas of Improvement Described

Evaluation of teaching experience is omitted or incomplete.

Evaluation of teaching experience is unclear and/or discussion of community response to teaching is missing.

Evaluation of teaching experience is provided with a brief discussion of community response to teaching.

A detailed evaluation of teaching experience with discussion of community response to teaching and areas of strength/improvement is provided.

Comprehensive evaluation of teaching experience with discussion of community response provided along with a detailed description of barriers and strategies to overcome barriers is provided.

15.0 %Organization and Effectiveness

5.0 %Thesis Development and Purpose

Paper lacks any discernible overall purpose or organizing claim.

Thesis is insufficiently developed and/or vague; purpose is not clear.

Thesis is apparent and appropriate to purpose.

Thesis is clear and forecasts the development of the paper. It is descriptive and reflective of the arguments and appropriate to the purpose.

Thesis is comprehensive; contained within the thesis is the essence of the paper. Thesis statement makes the purpose of the paper clear.

5.0 %Paragraph Development and Transitions

Paragraphs and transitions consistently lack unity and coherence. No apparent connections between paragraphs are established. Transitions are inappropriate to purpose and scope. Organization is disjointed.

Some paragraphs and transitions may lack logical progression of ideas, unity, coherence, and/or cohesiveness. Some degree of organization is evident.

Paragraphs are generally competent, but ideas may show some inconsistency in organization and/or in their relationships to each other.

A logical progression of ideas between paragraphs is apparent. Paragraphs exhibit a unity, coherence, and cohesiveness. Topic sentences and concluding remarks are appropriate to purpose.

There is a sophisticated construction of paragraphs and transitions. Ideas progress and relate to each other. Paragraph and transition construction guide the reader. Paragraph structure is seamless.

5.0 %Mechanics of Writing (includes spelling, punctuation, grammar, language use)

Surface errors are pervasive enough that they impede communication of meaning. Inappropriate word choice and/or sentence construction are used.

Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice (register), sentence structure, and/or word choice are present.

Some mechanical errors or typos are present, but are not overly distracting to the reader. Correct sentence structure and audience-appropriate language are used.

Prose is largely free of mechanical errors, although a few may be present. A variety of sentence structures and effective figures of speech are used.

Writer is clearly in command of standard, written, academic English.

5.0 %Format

2.0 %Paper Format

Template is not used appropriately or documentation format is rarely followed correctly.

Template is used, but some elements are missing or mistaken; lack of control with formatting is apparent.

Template is used, and formatting is correct, although some minor errors may be present.

Template is fully used; There are virtually no errors in formatting style.

All format elements are correct.

3.0 %Research Citations (In-text citations for paraphrasing and direct quotes, and reference page listing and formatting, as appropriate to assignment)

No reference page is included. No citations are used.

Reference page is present. Citations are inconsistently used.

Reference page is included and lists sources used in the paper. Sources are appropriately documented, although some errors may be present.

Reference page is present and fully inclusive of all cited sources. Documentation is appropriate and style guide is usually correct.

In-text citations and a reference page are complete. The documentation of cited sources is free of error.

100 %Total Weightag

 

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In a 4- to 5-page project proposal written to the leadership of your healthcare organization, propose a nursing informatics project

Review the concepts of technology application

Reflect on how emerging technologies such as artificial intelligence may help fortify nursing informatics as a specialty by leading to increased impact on patient outcomes or patient care efficiencies.

The Assignment: (4-5 pages)

In a 4- to 5-page project proposal written to the leadership of your healthcare organization, propose a nursing informatics project for your organization that you advocate to improve patient outcomes or patient-care efficiency. Your project proposal should include the following:

Describe the project you propose.

Identify the stakeholders impacted by this project.

Explain the patient outcome(s) or patient-care efficiencies this project is aimed at improving and explain how this improvement would occur. Be specific and provide examples.

Identify the technologies required to implement this project and explain why.

Identify the project team (by roles) and explain how you would incorporate the nurse informaticist in the project team.

Rubric

Name: NURS_6051_Module02_Week03_Assignment_Rubric

Grid View

List View

ExcellentGoodFairPoorIn a 4- to 5-page project proposal written to the leadership of your healthcare organization, propose a nursing informatics project for your organization that you advocate to improve patient outcomes or patient care efficiency. Your project proposal should include the following:

· Describe the project you propose.

· Identify the stakeholders impacted by this project.

· Explain the patient outcome(s) or patient-care efficiencies this project is aimed at improving, and explain how this improvement would occur. Be specific and provide examples.

· Identify the technologies required to implement this project and explain why.

· Identify the project team (by roles) and explain how you would incorporate the nurse informaticist in the project team.77 (77%) – 85 (85%)The response accurately and thoroughly describes in detail the project proposed.

The response accurately and clearly identifies the stakeholders impacted by the project proposed.

The response accurately and thoroughly explains in detail the patient outcome(s) or patient-care efficiencies that the project proposed is aimed at improving, including an accurate and detailed explanation, with sufficient supporting evidence of how this improvement would occur.

The response accurately and clearly identifies the technologies required to implement the project proposed with a detailed explanation why.

The response accurately and clearly identifies the project team (by roles) and thoroughly explains in detail how to incorporate the nurse informaticist in the project team.68 (68%) – 76 (76%)The response describes the project proposed.

The response identifies the stakeholders impacted by the project proposed.

The response explains the patient outcome(s) or patient-care efficiencies that the project proposed is aimed at improving, including an explanation, with some supporting evidence of how this improvement would occur.

The response identifies the technologies required to implement the project proposed with an explanation why.

The response identifies the project team (by roles) and explains how to incorporate the nurse informaticist in the project team.60 (60%) – 67 (67%)The response describing the project proposed is vague or inaccurate.

The response identifying the stakeholders impacted by the project proposed is vague or inaccurate.

The response explaining the patient outcome(s) or patient-care efficiencies the project proposed is aimed at improving, including an explanation of how this improvement would occur, is vague or inaccurate, or includes little to no supporting evidence.

The response identifying the technologies required to implement the project proposed with an explanation why is vague or inaccurate.

The response identifying the project team (by roles) and an explanation of how to incorporate the nurse informaticist in the project team is vague or inaccurate.0 (0%) – 59 (59%)The response describing the project proposed is vague and inaccurate, or is missing.

The response identifying the stakeholders impacted by the project proposed is vague and inaccurate, or is missing.

The response explaining the patient outcome(s) or patient-care efficiencies the project proposed is aimed at improving, including an explanation of how this improvement would occur, is vague and inaccurate, includes no supporting evidence, or is missing.

The response identifying the technologies required to implement the project proposed with an explanation why is vague and inaccurate, or is missing.

The response identifying the project team (by roles) and an explanation of how to incorporate the nurse informaticist in the project team is vague and inaccurate, or is missing.Written Expression and Formatting – Paragraph Development and Organization:

Paragraphs make clear points that support well developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused–neither long and rambling nor short and lacking substance.5 (5%) – 5 (5%)Paragraphs and sentences follow writing standards for flow, continuity, and clarity.4 (4%) – 4 (4%)Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time.3.5 (3.5%) – 3.5 (3.5%)Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%- 79% of the time.0 (0%) – 3 (3%)Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time.Written Expression and Formatting – English writing standards:

Correct grammar, mechanics, and proper punctuation5 (5%) – 5 (5%)Uses correct grammar, spelling, and punctuation with no errors.4 (4%) – 4 (4%)Contains a few (1-2) grammar, spelling, and punctuation errors.3.5 (3.5%) – 3.5 (3.5%)Contains several (3-4) grammar, spelling, and punctuation errors.0 (0%) – 3 (3%)Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running head, parenthetical/in-text citations, and reference list.5 (5%) – 5 (5%)Uses correct APA format with no errors.4 (4%) – 4 (4%)Contains a few (1-2) APA format errors.3.5 (3.5%) – 3.5 (3.5%)Contains several (3-4) APA format errors.0 (0%) – 3 (3%)Contains many (≥ 5) APA format errors.Total Points: 100

Name: NURS_6051_Module02_Week03_Assignment_Rubric

 

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