Discussion: Examining Nursing Specialties

You have probably seen one or more of the many inspirational posters about decisions. A visual such as a forked road or a street sign is typically pictured, along with a quote designed to inspire.

Decisions are often not so easily inspired. Perhaps you discovered this when choosing a specialty within the MSN program. This decision is a critical part of your plan for success, and you no doubt want to get it right. This is yet another area where your network can help, as well as other sources of information that can help you make an informed choice.

To Prepare:

• Reflect on your decision to pursue a specialty within the MSN program, including your professional and academic goals as they relate to your program/specialization. my specialization is acute care nurse practitioners (ACNP)

Needs help with similar assignment?

We are available 24x7 to deliver the best services and assignment ready within 3-12 hours? PAY FOR YOUR FIRST ORDER AFTER COMPLETION..

Get Answer Over WhatsApp Order Paper Now

Principalism is a one of the approaches used in biomedical ethics to aid in ethical decision making.

The 4 principles of Principalism are:

Respect for autonomy − A principle that requires respect for the decision making capacities of autonomous persons.

Nonmaleficence − A principle requiring that people not cause harm to others.

Beneficence − A group of principles requiring that people prevent harm, provide benefits, and balance benefits against risks and costs.

Justice − A group of principles requiring fair distribution of benefits, risks and costs.

The specific context or ethical dilemma will weigh into the ranking of these principles however generally speaking I would rank nonmaleficence as the #1 consideration or importance to ethical decision making followed by beneficence, respect for autonomy and then justice.  I believe that doing no harm should be the primary concern however the risks and costs associated with a particular ethical decision must be examined closely and promptly (beneficence principle). These two are very close in level of importance to me and really go hand in hand. To not do harm, one should and must balance the benefits with risk and cost. One can even say that the level of harm trying to do the “right” or “best” thing must be considered. For example, a decision to end life sustaining care may be the “best” decision as it creates the least harm and the most benefit in that the patient is no longer suffering from pain etc.

It is easy to see how respect for autonomy is put to a high place as it is a fundamental right for a human being to give consent or not and that decision being respected. It could be seen as the starting point. The gray area for me is the not autonomous individual like a child or a dependent adult who has not had capacity or has lost capacity.

Generally I would say in the context of the biblical narrative, the order would be the same recognizing the context of each situation is different.

I NEED YOU TO COMMENT FROM THIS POST , 150 WORDS NEEDED A REFERENCE PLEASE

Needs help with similar assignment?

We are available 24x7 to deliver the best services and assignment ready within 3-12 hours? PAY FOR YOUR FIRST ORDER AFTER COMPLETION..

Get Answer Over WhatsApp Order Paper Now

Question

Question 1.1. A 72-year-old woman with a recent onset of syncopal episodes has been referred to a cardiology group by her family physician. As part of the patient’s diagnostic workup, the nurse practitioner conducting the intake assessment has ordered a Holter monitor for 24 hours. Which of the following statements best captures an aspect of Holter monitoring? (Points : 0.4)

A Holter monitor is preferable to standard ECG due to its increased sensitivity to cardiac electrical activity.

The primary goal is to allow the cardiologist to accurately diagnose cardiomyopathies.

Accurate interpretation of the results requires correlating the findings with the activity that the woman was doing at the time of recording.

Holter monitors are normally set to record electrical activity of the heart at least once per hour.

Question 2.2. As part of the diagnostic workup for a male patient with a complex history of cardiovascular disease, the care team has identified the need for a record of the electrical activity of his heart, insight into the metabolism of his myocardium, and physical measurements, and imaging of his heart. Which of the following series of tests is most likely to provide the needed data for his diagnosis and care? (Points : 0.4)

Echocardiogram, PET scan, ECG

Ambulatory ECG, cardiac MRI, echocardiogram

Serum creatinine levels, chest auscultation, myocardial perfusion scintigraphy

Cardiac catheterization, cardiac CT, exercise stress testing

Question 3.3. An 81-year-old female patient of a long-term care facility has a history of congestive heart failure. The nurse practitioner caring for the patient has positioned her sitting up at an angle in bed and is observing her jugular venous distention. Why is jugular venous distention a useful indicator for the assessment of the patient’s condition? (Points : 0.4)

Increased cardiac demand causes engorgement of systemic blood vessels, of which the jugular vein is one of the largest.

Blood backs up into the jugular vein because there are no valves at the point of entry into the heart.

Peripheral dilation is associated with decreased stroke volume and ejection fraction.

Heart valves are not capable of preventing backflow in cases of atrial congestion.

Question 4.4. A physical assessment of a 28-year-old female patient indicates that her blood pressure in her legs is lower than that in her arms and that her brachial pulse is weaker in her left arm than in her right. In addition, her femoral pulses are weak bilaterally. Which of the following possibilities would her care provider be most likely to suspect? (Points : 0.4)

Pheochromocytoma

Essential hypertension

Coarctation of the aorta

An adrenocortical disorder

Question 5.5. A 6-year-old boy has been brought to the emergency department by ambulance after his mother discovered that his heart rate was “so fast I couldn’t even count it.” The child was determined to be in atrial flutter and his mother is seeking an explanation from the health care team. Which of the following points should underlie an explanation to the mother? (Points : 0.4)

The child is experiencing a reentry rhythm in his right atrium.

The resolution of the problem is dependent on spontaneous recovery and is resistant to pacing interventions.

The child is likely to have a normal ECG apart from the rapid heart rate.

The boy’s atria are experiencing abnormal sympathetic stimulation.

Question 6.6. A 66-year-old patient’s echocardiogram reveals a hypertrophied left ventricle, normal chamber volume, and a normal ejection fraction from the heart. What is this patient’s most likely diagnosis? (Points : 0.4)

Mitral valve regurgitation

Aortic valve stenosis

Mitral valve stenosis

Aortic valve regurgitation

Question 7.7. A 70-year-old male patient presents to the emergency department complaining of pain in his calf that is exacerbated when he walks. His pedal and popliteal pulses are faintly palpable and his leg distal to the pain is noticeably reddened. What would his care provider’s preliminary diagnosis and anticipated treatment most likely be?(Points : 0.4)

Acute arterial occlusion that will be treated with angioplasty

Raynaud disease that will require antiplatelet medications

Atherosclerotic occlusive disease necessitating thrombolytic therapy

Giant cell temporal arteritis that will be treated with corticosteroids

Question 8.8. A patient in the intensive care unit has a blood pressure of 87/39 and has warm, flushed skin accompanying his sudden decline in level of consciousness. The patient also has arterial and venous dilation and a decrease in systemic vascular resistance. What is this patient’s most likely diagnosis? (Points : 0.4)

Hypovolemic shock

Septic shock

Neurogenic shock

Obstructive shock

Question 9.9. A 31-year-old woman with a congenital heart defect reports episodes of lightheadedness and syncope, with occasional palpitations.A resting electrocardiogram reveals sinus bradycardia and she is suspected of having sick sinus syndrome. Which of the following diagnostic methods is the best choice to investigate the suspicion? (Points : 0.4)

Signal-averaged ECG

Exercise stress testing

Electrophysiologic study

Holter monitoring

Question 10.10. A nurse practitioner is providing care for several patients on a medical unit of a hospital. In which of the following patient situations would the nurse practitioner be most likely to rule out hypertension as a contributing factor? (Points : 0.4)

A 61-year-old man who has a heart valve infection and recurrent fever

An 81-year-old woman who has had an ischemic stroke and has consequent one-sided weakness

A 44-year-old man awaiting a kidney transplant who requires hemodialysis three times per week

A 66-year-old woman with poorly controlled angina and consequent limited activity tolerance

Question 11.11. A patient is experiencing impaired circulation secondary to increased systemic arterial pressure. Which of the following statements is the most relevant phenomenon?(Points : 0.4)

Increased preload due to vascular resistance

High afterload because of backpressure against the left ventricle

Impaired contractility due to aortic resistance

Systolic impairment because of arterial stenosis

Question 12.12. A number of patients have presented to the emergency department in the last 24 hours with complaints that are preliminarily indicative of myocardial infarction. Which of the following patients is least likely to have an ST-segment myocardial infarction (STEMI)? (Points : 0.4)

A 70-year-old woman who is complaining of shortness of breath and vague chest discomfort

A 66-year-old man who has presented with fatigue, nausea and vomiting, and cool, moist skin

A 43-year-old man who woke up with substernal pain that is radiating to his neck and jaw

A 71-year-old man who has moist skin, fever, and chest pain that is excruciating when he moves but relieved when at rest

Question 13.13. A formerly normotensive woman, pregnant for the first time, develops hypertension and headaches at 26 weeks’ gestation. Her blood pressure is 154/110 mm Hg and she has proteinuria. What other labs should be ordered for her? (Points : 0.4)

Plasma angiotensin I and II and renin

Urinary sodium and potassium

Platelet count, serum creatinine, and liver enzymes

Urinary catecholamines and metabolites

Question 14.14. An older adult female patient has presented with a new onset of shortness of breath, and the patient’s nurse practitioner has ordered measurement of her BNP levels along with other diagnostic tests. What is the most accurate rationale for the nurse practitioner’s choice of blood work? (Points : 0.4)

BNP is released as a compensatory mechanism during heart failure and measuring it can help differentiate the patient’s dyspnea from a respiratory pathology.

BNP is an indirect indicator of the effectiveness of the RAA system in compensating for heart failure.

BNP levels correlate with the patient’s risk of developing cognitive deficits secondary to heart failure and consequent brain hypoxia.

BNP becomes elevated in cases of cardiac asthma, Cheyne-Stokes respirations, and acute pulmonary edema, and measurement can gauge the severity of pulmonary effects.

Question 15.15. The nurse practitioner for a cardiology practice is responsible for providing presurgical teaching for patients who are about to undergo a coronary artery bypass graft. Which of the following teaching points best conveys an aspect of the human circulatory system? (Points : 0.4)

“Your blood pressure varies widely between arteries and veins, and between pulmonary and systemic circulation.”

“Only around one quarter of your blood is in your heart at any given time.”

“Blood pressure and blood volume roughly mimic one another at any given location in the circulatory system.”

“Left-sided and right-sided pumping action at each beat of the heart must equal each other to ensure adequate blood distribution.”

Question 16.16. A 54-year-old man with a long-standing diagnosis of essential hypertension is meeting with his nurse practitioner. The patient’s nurse practitioner would anticipate that which of the following phenomena is most likely occurring? (Points : 0.4)

The patient’s juxtaglomerular cells are releasing aldosterone as a result of sympathetic stimulation.

Epinephrine from his adrenal gland is initiating the renin-angiotensin-aldosterone system.

Vasopressin is exerting an effect on his chemoreceptors and baroreceptors, resulting in vasoconstriction.

The conversion of angiotensin I to angiotensin II in his lungs causes increases in blood pressure and sodium reabsorption.

Question 17.17. A 22-year-old male is experiencing hypovolemic shock following a fight in which his carotid artery was cut with a broken bottle. What immediate treatments are likely to most benefit the man? (Points : 0.4)

Resolution of compensatory pulmonary edema and heart arrhythmias

Infusion of vasodilators to foster perfusion and inotropes to improve heart contractility

Infusion of normal saline of Ringer lactate to maintain the vascular space

Administration of oxygen and epinephrine to promote perfusion

Question 18.18. A 66-year-old obese man with a diagnosis of ischemic heart disease has been diagnosed with heart failure that his care team has characterized as attributable to systolic dysfunction. Which of the following assessment findings is inconsistent with his diagnosis? (Points : 0.4)

His resting blood pressure is normally in the range of 150/90 and an echocardiogram indicates his ejection fraction is 30%.

His end-diastolic volume is higher than normal and his resting heart rate is regular and 82 beats per minute.

He is presently volume overloaded following several days of intravenous fluid replacement.

Ventricular dilation and wall tension are significantly lower than normal.

Question 19.19. A 68-year-old male complains to his nurse practitioner that when he tests his blood pressure using a machine at his pharmacy, his heart rate is nearly always very low. At other times, he feels that his heart is racing, and it also seems to pause at times. The man has also occasionally had lightheadedness and a recent syncopal episode. What is this patient’s most likely diagnosis and the phenomenon underlying it? (Points : 0.4)

Sick sinus syndrome as a result of a disease of his sinus node and atrial or junctional arrhythmias

Ventricular arrhythmia as a result of alternating vagal and sympathetic stimulation

Torsades de pointes as a result of disease of the bundle of His

Premature atrial contractions that vacillate between tachycardic and bradycardic episodes as a consequence of an infectious process

Question 20.20. An autopsy is being performed on a 44-year-old female who died unexpectedly of heart failure. Which of the following components of the pathologist’s report is most suggestive of a possible history of poorly controlled blood pressure? (Points : 0.4)

“Scarring of urethra suggestive of recurrent urinary tract infections is evident.”

“Bilateral renal hypertrophy noted.”

“Vessel wall changes suggestive of venous stasis are evident.”

“Arterial sclerosis of subcortical brain regions noted.”

Question 21.21. During a routine physical examination of a 66-year-old woman, her nurse practitioner notes a pulsating abdominal mass and refers the woman for further treatment. The nurse practitioner is explaining the diagnosis to the patient, who is unfamiliar with aneurysms.Which of the following aspects of the pathophysiology of aneurysms would underlie the explanation the nurse provides? (Points : 0.4)

Aneurysms are commonly a result of poorly controlled diabetes mellitus.

Hypertension is a frequent modifiable contributor to aneurysms.

Individuals with an aneurysm are normally asymptomatic until the aneurysm ruptures.

Aneurysms can normally be resolved with lifestyle and diet modifications.

Question 22.22. A patient has suffered damage to his pericardium following a motor vehicle accident. Which of the following consequences should the nurse practitioner be most likely to rule out? (Points : 0.4)

Impaired physical restraint of the left ventricule

Increased friction during the contraction/relaxation cycle

Reduced protection from infectious organisms

Impaired regulation of myocardial contraction

Question 23.23. A nurse practitioner is instructing a group of older adults about the risks associated with high cholesterol. Which of the following teaching points should the participants try to integrate into their lifestyle after the teaching session? (Points : 0.4)

“Remember, the ‘H’ in HDL and the ‘L’ in LDL correspond to high danger and low danger to your health.”

“Having high cholesterol increases your risk of developing diabetes and irregular heart rate.”

“Smoking and being overweight increases your risk of primary hypercholesterolemia.”

“Your family history of hypercholesterolemia is important, but there are things you can do to compensate for a high inherited risk.”

Question 24.24. An 81-year-old male resident of a long-term care facility has a long-standing diagnosis of heart failure. Which of the following short-term and longer-term compensatory mechanisms is least likely to decrease the symptoms of his heart failure? (Points : 0.4)

An increase in preload via the Frank-Starling mechanism

Sympathetic stimulation and increased serum levels of epinephrine and norepinephrine

Activation of the renin-angiotensin-aldosterone (RAA) system and secretion of brain natriuretic peptide (BNP)

AV node pacemaking activity and vagal nerve suppression

Question 25.25. A 55-year-old male who is beginning to take a statin drug for his hypercholesterolemia is discussing cholesterol and its role in health and illness with his nurse practitioner. Which of the following aspects of hyperlipidemia would the nurse practitioner most likely take into account when teaching the patient? (Points : 0.4)

Hyperlipidemia is a consequence of diet and lifestyle rather than genetics.

HDL cholesterol is often characterized as being beneficial to health.

Cholesterol is a metabolic waste product that the liver is responsible for clearing.

The goal of medical treatment is to eliminate cholesterol from the vascular system.

1. A nurse practitioner is teaching a student NP about the physiologic basis for damage to the circulatory and neurological systems that can accompany hypotension. Which of the following responses by the student would warrant correction by the nurse practitioner? (Points : 0.4)

“As vessel wall thickness increases, tension decreases.”

“Smaller blood vessels require more pressure to overcome wall tension.”

“The smaller the vessel radius, the greater the pressure needed to keep it open.”

“Tension and vessel thickness increase proportionately.”

Question 2.2. A 31-year-old woman with a congenital heart defect reports episodes of lightheadedness and syncope, with occasional palpitations.A resting electrocardiogram reveals sinus bradycardia and she is suspected of having sick sinus syndrome. Which of the following diagnostic methods is the best choice to investigate the suspicion? (Points : 0.4)

Signal-averaged ECG

Exercise stress testing

Electrophysiologic study

Holter monitoring

Question 3.3. Which of the following assessment findings in a newly admitted 30-year-old male patient would be most likely to cause his nurse practitioner to suspect polyarteritis nodosa? (Points : 0.4)

The man’s blood work indicates polycythemia (elevated red cells levels) and leukocytosis (elevated white cells).

The man’s blood pressure is 178/102 and he has abnormal liver function tests.

The man is acutely short of breath and his oxygen saturation is 87%.

The man’s temperature is 101.9°F and he is diaphoretic (heavily sweating).

Question 4.4. An 81-year-old male resident of a long-term care facility has a long-standing diagnosis of heart failure. Which of the following short-term and longer-term compensatory mechanisms is least likely to decrease the symptoms of his heart failure? (Points : 0.4)

An increase in preload via the Frank-Starling mechanism

Sympathetic stimulation and increased serum levels of epinephrine and norepinephrine

Activation of the renin-angiotensin-aldosterone (RAA) system and secretion of brain natriuretic peptide (BNP)

AV node pacemaking activity and vagal nerve suppression

Question 5.5. A nurse practitioner is instructing a group of older adults about the risks associated with high cholesterol. Which of the following teaching points should the participants try to integrate into their lifestyle after the teaching session? (Points : 0.4)

“Remember, the ‘H’ in HDL and the ‘L’ in LDL correspond to high danger and low danger to your health.”

“Having high cholesterol increases your risk of developing diabetes and irregular heart rate.”

“Smoking and being overweight increases your risk of primary hypercholesterolemia.”

“Your family history of hypercholesterolemia is important, but there are things you can do to compensate for a high inherited risk.”

Question 6.6. A 55-year-old male who is beginning to take a statin drug for his hypercholesterolemia is discussing cholesterol and its role in health and illness with his nurse practitioner. Which of the following aspects of hyperlipidemia would the nurse practitioner most likely take into account when teaching the patient? (Points : 0.4)

Hyperlipidemia is a consequence of diet and lifestyle rather than genetics.

HDL cholesterol is often characterized as being beneficial to health.

Cholesterol is a metabolic waste product that the liver is responsible for clearing.

The goal of medical treatment is to eliminate cholesterol from the vascular system.

Question 7.7. A number of patients have presented to the emergency department in the last 24 hours with complaints that are preliminarily indicative of myocardial infarction. Which of the following patients is least likely to have an ST-segment myocardial infarction (STEMI)? (Points : 0.4)

A 70-year-old woman who is complaining of shortness of breath and vague chest discomfort

A 66-year-old man who has presented with fatigue, nausea and vomiting, and cool, moist skin

A 43-year-old man who woke up with substernal pain that is radiating to his neck and jaw

A 71-year-old man who has moist skin, fever, and chest pain that is excruciating when he moves but relieved when at rest

Question 8.8. A patient in the intensive care unit has a blood pressure of 87/39 and has warm, flushed skin accompanying his sudden decline in level of consciousness. The patient also has arterial and venous dilation and a decrease in systemic vascular resistance. What is this patient’s most likely diagnosis? (Points : 0.4)

Hypovolemic shock

Septic shock

Neurogenic shock

Obstructive shock

Question 9.9. A formerly normotensive woman, pregnant for the first time, develops hypertension and headaches at 26 weeks’ gestation. Her blood pressure is 154/110 mm Hg and she has proteinuria. What other labs should be ordered for her? (Points : 0.4)

Plasma angiotensin I and II and renin

Urinary sodium and potassium

Platelet count, serum creatinine, and liver enzymes

Urinary catecholamines and metabolites

Question 10.10. An older adult female patient has presented with a new onset of shortness of breath, and the patient’s nurse practitioner has ordered measurement of her BNP levels along with other diagnostic tests. What is the most accurate rationale for the nurse practitioner’s choice of blood work? (Points : 0.4)

BNP is released as a compensatory mechanism during heart failure and measuring it can help differentiate the patient’s dyspnea from a respiratory pathology.

BNP is an indirect indicator of the effectiveness of the RAA system in compensating for heart failure.

BNP levels correlate with the patient’s risk of developing cognitive deficits secondary to heart failure and consequent brain hypoxia.

BNP becomes elevated in cases of cardiac asthma, Cheyne-Stokes respirations, and acute pulmonary edema, and measurement can gauge the severity of pulmonary effects.

Question 11.11. A nurse practitioner has ordered the measurement of a cardiac patient’s electrolyte levels as part of the patient’s morning blood work. Which of the following statements best captures the importance of potassium in the normal electrical function of the patient’s heart? (Points : 0.4)

Potassium catalyzes the metabolism of ATP, producing the gradient that results in electrical stimulation.

Potassium is central to establishing and maintaining the resting membrane potential of cardiac muscle cells.

The impermeability of cardiac cell membranes to potassium allows for action potentials achieved by the flow of sodium ions.

The reciprocal movement of one potassium ion for one sodium ion across the cell membrane results in the production of an action potential.

Question 12.12. A 70-year-old male patient presents to the emergency department complaining of pain in his calf that is exacerbated when he walks. His pedal and popliteal pulses are faintly palpable and his leg distal to the pain is noticeably reddened. What would his care provider’s preliminary diagnosis and anticipated treatment most likely be? (Points : 0.4)

Acute arterial occlusion that will be treated with angioplasty

Raynaud disease that will require antiplatelet medications

Atherosclerotic occlusive disease necessitating thrombolytic therapy

Giant cell temporal arteritis that will be treated with corticosteroids

Question 13.13. Which of the following situations related to the transition from fetal to perinatal circulation would be most likely to necessitate medical intervention? (Points : 0.4)

Pressure in the pulmonary circulation and the right side of the infant’s heart fall markedly.

Alveolar oxygen tension increases, causing reversal of pulmonary vasoconstriction of the fetal arteries.

Systemic vascular resistance and left ventricular pressure are both increasing.

Pulmonary vascular resistance, related to muscle regression in the pulmonary arteries, rises over the course of the infant’s first week.

Question 14.14. In which of the following patient situations would a nurse practitioner be most justified in preliminarily ruling out pericarditis as a contributing pathology to the patient’s health problems? (Points : 0.4)

A 61-year-old man whose ECG was characterized by widespread T wave inversions on admission but whose T waves have recently normalized

A 77-year-old with diminished S3 and S4 sounds, an irregular heart rate, and a history of atrial fibrillation

A 56-year-old obese man who is complaining of chest pain that is exacerbated by deep inspiration and is radiating to his neck and scapular ridge

A 60-year-old woman whose admission blood work indicates elevated white cells, erythrocyte sedimentation rate, and C-reactive protein levels

Question 15.15. During a routine physical examination of a 66-year-old woman, her nurse practitioner notes a pulsating abdominal mass and refers the woman for further treatment. The nurse practitioner is explaining the diagnosis to the patient, who is unfamiliar with aneurysms.Which of the following aspects of the pathophysiology of aneurysms would underlie the explanation the nurse provides? (Points : 0.4)

Aneurysms are commonly a result of poorly controlled diabetes mellitus.

Hypertension is a frequent modifiable contributor to aneurysms.

Individuals with an aneurysm are normally asymptomatic until the aneurysm ruptures.

Aneurysms can normally be resolved with lifestyle and diet modifications.

Question 16.16. A patient is experiencing impaired circulation secondary to increased systemic arterial pressure. Which of the following statements is the most relevant phenomenon?(Points : 0.4)

Increased preload due to vascular resistance

High afterload because of backpressure against the left ventricle

Impaired contractility due to aortic resistance

Systolic impairment because of arterial stenosis

Question 17.17. A 66-year-old patient’s echocardiogram reveals a hypertrophied left ventricle, normal chamber volume, and a normal ejection fraction from the heart. What is this patient’s most likely diagnosis? (Points : 0.4)

Mitral valve regurgitation

Aortic valve stenosis

Mitral valve stenosis

Aortic valve regurgitation

Question 18.18. A physical assessment of a 28-year-old female patient indicates that her blood pressure in her legs is lower than that in her arms and that her brachial pulse is weaker in her left arm than in her right. In addition, her femoral pulses are weak bilaterally. Which of the following possibilities would her care provider be most likely to suspect? (Points : 0.4)

Pheochromocytoma

Essential hypertension

Coarctation of the aorta

An adrenocortical disorder

Question 19.19. A 72-year-old woman with a recent onset of syncopal episodes has been referred to a cardiology group by her family physician.As part of the patient’s diagnostic workup, the nurse practitioner conducting the intake assessment has ordered a Holter monitor for 24 hours.Which of the following statements best captures an aspect of Holter monitoring? (Points : 0.4)

A Holter monitor is preferable to standard ECG due to its increased sensitivity to cardiac electrical activity.

The primary goal is to allow the cardiologist to accurately diagnose cardiomyopathies.

Accurate interpretation of the results requires correlating the findings with the activity that the woman was doing at the time of recording.

Holter monitors are normally set to record electrical activity of the heart at least once per hour.

Question 20.20. An 81-year-old female patient of a long-term care facility has a history of congestive heart failure. The nurse practitioner caring for the patient has positioned her sitting up at an angle in bed and is observing her jugular venous distention. Why is jugular venous distention a useful indicator for the assessment of the patient’s condition? (Points : 0.4)

Increased cardiac demand causes engorgement of systemic blood vessels, of which the jugular vein is one of the largest.

Blood backs up into the jugular vein because there are no valves at the point of entry into the heart.

Peripheral dilation is associated with decreased stroke volume and ejection fraction.

Heart valves are not capable of preventing backflow in cases of atrial congestion.

Question 21.21. As part of the diagnostic workup for a male patient with a complex history of cardiovascular disease, the care team has identified the need for a record of the electrical activity of his heart, insight into the metabolism of his myocardium, and physical measurements, and imaging of his heart. Which of the following series of tests is most likely to provide the needed data for his diagnosis and care? (Points : 0.4)

Echocardiogram, PET scan, ECG

Ambulatory ECG, cardiac MRI, echocardiogram

Serum creatinine levels, chest auscultation, myocardial perfusion scintigraphy

Cardiac catheterization, cardiac CT, exercise stress testing

Question 22.22. A 6-year-old boy has been brought to the emergency department by ambulance after his mother discovered that his heart rate was “so fast I couldn’t even count it.” The child was determined to be in atrial flutter and his mother is seeking an explanation from the health care team. Which of the following points should underlie an explanation to the mother? (Points : 0.4)

The child is experiencing a reentry rhythm in his right atrium.

The resolution of the problem is dependent on spontaneous recovery and is resistant to pacing interventions.

The child is likely to have a normal ECG apart from the rapid heart rate.

The boy’s atria are experiencing abnormal sympathetic stimulation.

Question 23.23. A 66-year-old obese man with a diagnosis of ischemic heart disease has been diagnosed with heart failure that his care team has characterized as attributable to systolic dysfunction. Which of the following assessment findings is inconsistent with his diagnosis? (Points : 0.4)

His resting blood pressure is normally in the range of 150/90 and an echocardiogram indicates his ejection fraction is 30%.

His end-diastolic volume is higher than normal and his resting heart rate is regular and 82 beats per minute.

He is presently volume overloaded following several days of intravenous fluid replacement.

Ventricular dilation and wall tension are significantly lower than normal.

Question 24.24. A 54-year-old man with a long-standing diagnosis of essential hypertension is meeting with his nurse practitioner. The patient’s nurse practitioner would anticipate that which of the following phenomena is most likely occurring? (Points : 0.4)

The patient’s juxtaglomerular cells are releasing aldosterone as a result of sympathetic stimulation.

Epinephrine from his adrenal gland is initiating the renin-angiotensin-aldosterone system.

Vasopressin is exerting an effect on his chemoreceptors and baroreceptors, resulting in vasoconstriction.

The conversion of angiotensin I to angiotensin II in his lungs causes increases in blood pressure and sodium reabsorption.

Question 25.25. The nurse practitioner for a cardiology practice is responsible for providing presurgical teaching for patients who are about to undergo a coronary artery bypass graft. Which of the following teaching points best conveys an aspect of the human circulatory system? (Points : 0.4)

“Your blood pressure varies widely between arteries and veins, and between pulmonary and systemic circulation.”

“Only around one quarter of your blood is in your heart at any given time.”

“Blood pressure and blood volume roughly mimic one another at any given location in the circulatory system.”

“Left-sided and right-sided pumping action at each beat of the heart must equal each other to ensure adequate blood distribution.”

Winland-Brown, J.E. and Dunphy, L.M. (2013). Adult-Gerontology and Family Nurse Practitioner Certification Examination: Review Questions and Strategies.

Codina Leik, M.T. (2013). Adult-Gerotonolgy Nurse Practitioner Certification Intensive Review: Fast Facts and Practice Questions. 2ND Ed.

Needs help with similar assignment?

We are available 24x7 to deliver the best services and assignment ready within 3-12 hours? PAY FOR YOUR FIRST ORDER AFTER COMPLETION..

Get Answer Over WhatsApp Order Paper Now

Cultural Paper: References Assignment Instructions

Overview

Culture uniquely informs how individuals interact with the health care system.  Individuals who work in health care must integrate culture and personal perspectives into the efficient delivery of health services.

Each student will compose a cultural competence paper on one of the five cultural groups reviewed in the text.  Understanding the current scope of the literature is the next important step in developing an analysis of culture and health.

Instructions

Developing the research basis for the cultural paper is an important part of the assignment. For the Cultural Paper: References assignment, each student will individually develop a reference list in proper APA format with at least 10 scholarly references that are no more than 5 years old that support your selected topic.

Scholarly references include but are not limited to scholarly journals, government reports, foundation reports, and cataloged data. Use of commercial websites should be limited and will not count toward the scholarly reference requirement. The use of an APA title page and references are required for the assignment and students should include name, course number and section, and date on the document. First person pronouns are not allowed in the Cultural Paper: References Assignment submission.

 

Needs help with similar assignment?

We are available 24x7 to deliver the best services and assignment ready within 3-12 hours? PAY FOR YOUR FIRST ORDER AFTER COMPLETION..

Get Answer Over WhatsApp Order Paper Now

Essay: Comparative Analysis Assignment Instructions

Overview

The United States health care system has come under much scrutiny over the past several years. According to Organization for Economic Cooperation and Development (OECD), the US health care system has poor health care outcomes despite spending more on health care than any other developed country.

Instructions

In this assignment, you will compare and contrast the US health care system to at least two other countries’ systems across financing systems, cost, and quality. In your analysis, please describe the effects of the Affordable Care Act on the US health care system in terms of cost, quality and access to care. Give a Biblical perspective on the responsibilities the US health care system has to its consumers/patients.

Write a short essay answering the above prompt. Your written communication should reflect scholarly expertise appropriate for upper division collegial work to include critical analysis, application of information, correct use of terms, and grammar/spelling.

Please include these elements

1. Title centered at the top of the first page. Name, date, and instructor’s name in the right corner of the paper. Single spaced.
2. The paper should be 3-5 typed pages, double spaced, Times New Roman 12 point font.
3. Please use scholarly references and cite using appropriate APA formatting for citations and reference page
4. A minimum of 6-8 peer reviewed references, published in the last five years, are required. (Wikis, blogs, internet website sources should not be used as this is not considered academic references)
5. Biblical worldview with support with scripture references. Cite the scripture and apply the scripture references to the healthcare leadership response.
6. Your assignment will be checked for originality via the Turnitin tool.

 

Content Outline

1. Introductory paragraph
2. Analysis of US health care system (cost, quality, and access)
3. Analysis of country #1 (cost, quality, and access)
4. Analysis of country #2  (cost, quality, and access)
5. Analysis of US health system in light of ACA
6. Suggestions for improvement
7. Biblical perspective with scripture support and application
8. Conclusion – summarize the paper in 5-8 sentences

 

 

Needs help with similar assignment?

We are available 24x7 to deliver the best services and assignment ready within 3-12 hours? PAY FOR YOUR FIRST ORDER AFTER COMPLETION..

Get Answer Over WhatsApp Order Paper Now