Question Answered step-by-step Make a scenario using the behaviorist model of learning in the… Make a scenario using the behaviorist model of learning in the hospital setting. Health Science Science Nursing Share QuestionEmailCopy link Comments (0)

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Question Answered step-by-step A 25-year-old Hispanic female, computer programmer presents to the… A 25-year-old Hispanic female, computer programmer presents to the clinic complaining of a 12-day history of a runny nosStates that her symptoms began about 12 days ago. She suffers from allergies; she gets a runny nose during the spring-time, pollen season. However, in the winter, her allergies are not a problem.  Objective Data  (BP) 115/75, (P) 89, (RR) 16, (T) 100.4°F (38°C), O2 sat 98% on roomNo signs of acute distress. Patient appears mildly fatigued. She is breathing through her mouth. Breathing easily. Voice has a nasal quality to it Ear canals: normal;EYES: normal;NOSE: Bilateral erythema and edema of turbinates with significant yellow drainage on the right. Nares: Obstructed air passageCTA A Posterior pharynx: mildly injected, scant postnasal drainage (PND), no exudate, tonsils 1+, nocobblestoning Regular rate and rhythm, no murmur, S3, or S4What other subjective data would we obtain?What other objective findings would we look for?What diagnostic exams do we want to order?Name 3 differential diagnoses based on this patient presenting symptoms?Give rationales for each differential diagnosis. Health Science Science Nursing HSA 1002 Share QuestionEmailCopy link Comments (0)

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Question Answered step-by-step Explain the first aid management for a casualty with a head injury… Explain the first aid management for a casualty with a head injury Please provide a reference for this question Health Science Science Nursing BIO 123 Share QuestionEmailCopy link Comments (0)

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QuestionAnswered step-by-stepHi, I am not sure if you can help with this revision. Some feedback…Hi,I am not sure if you can help with this revision. Some feedback has been provided but I am unsure of whether my answers are correct. I am hoping that you can provide some help with this. I am aware that you will have insufficient information in some areas to make a definitive answer, but a guideline will definitely help. Thanks so much for your help in advance.·        Question 1 Which of the following drugs is structurally similar to tramadol; thus, its opioid-mediated analgesia can be reversed by naloxone in mice? Response Feedback: “Structurally, venlafaxine is similar to tramadol, and in mice, venlafaxine demonstrates opioid-mediated analgesia that is reversed by naloxone.” ·        Question 2 What should our treatment goal be with our patients when it comes to managing chronic pain? Response Feedback: “In general, treatment goals are reports of pain less than 5 out of 10 and an improvement in function.” ·        Question 3 Daytrana is the MPH transdermal system of methylphenidate approved for the treatment of ADHD in children aged 6 years and older. What is the difference in terms of the metabolism compared to the other formulations in this class? Response Feedback: referring to MPH transdermal system (MTS; Daytrana): “Since the MPH is absorbed through the skin, it does not undergo first-pass metabolism by CES-1 in the liver, resulting in higher plasma MPH levels” ·        Question 4 E. B., a 55-year-old female, is a patient at your clinic today who has a past medical history significant for breast cancer, hypertension, hepatic cirrhosis, type 2 diabetes, and a recent diagnosis of alcohol use disorder. She has no known drug allergies. She states she is ready to quit drinking but fears the cravings that it may bring. Which medication would you recommend for E. B. to begin? Response Feedback: “It is preferred for patients with liver damage since acamprosate is metabolized through the kidneys and not the liver” & Table 15-3 shows it reduces alcohol cravings; benzodiazepines are used in the acute setting if a patient is experiencing severe alcohol withdrawal that leads to seizures; thiamine is if a patient is admitted for alcohol intoxication. ·        Question 5 Patient is a 75-year-old female with a confirmed diagnosis of Alzheimer’s Disease. She is currently on Donepezil 10 mg daily. She is accompanied to your clinic today by her daughter, who informs you that her mother has recently had an increase in depressive symptoms. She has no history of mood disorders. She has a history of hypertension and tonic-clonic seizures, but both are controlled. Assuming this patient will be thoroughly evaluated for the diagnosis of depression, what would you recommend as initial therapy? Response Feedback: SSRIs are effective in treating depressive symptoms. Answer choices A & B are both TCAs and are advised against due to side effect profile and the fact this person is treatment naive (learned from previous exam) and answer choice D is contraindicated in a patient with seizures. ·        Question 6 Which of the following drugs in the treatment of Alzheimer’s Disease requires administration with food? Response Feedback: “Rivastigmine should be administered with meals to reduce gastrointestinal side effects.” ·        Question 7 Which enzyme does disulfiram inhibit leading to a build-up of the ethanol metabolite acetaldehyde? Response Feedback: “Disulfiram inhibits acetaldehyde dehydrogenase leading to a build-up of the ethanol metabolite acetaldehyde” ·        Question 8 What is the difference between Ritalin and Focalin? Response Feedback: “The primarily active form of MPH appears to be the d-threo isomer, which is available in both immediate-release tablets (Focalin 2.5, 5, and 10 mg)” ·        Question 9 This medication cannot be used for more than 5 days, it is a non-steroidal, anti-inflammatory drug, and it is often substituted for morphine due to its rapid onset and high potency. What is this medication? Response Feedback: under non-steroidal, anti-inflammatory drugs ·        Question 10 Of the following neurotransmitters, which ones play a critical role in modulating attention in ADHD?        I.           Dopamine      II.           Epinephrine     III.           GABA    IV.           Norepinephrine      V.           Glutamate Response Feedback: “Stimulants increase intra-synaptic concentrations of dopamine (DA) and norepinephrine (NE)” ·        Question 11 Of the following neurotransmitters, which one(s) are known to be severely disrupted in the disease Dementia with Lewy Bodies?        I.           Acetylcholine      II.           Glutamate     III.           Dopamine    IV.           GABA      V.           Norepinephrine Response Feedback: under pathophysiology subtitle: “It is clear that both the cholinergic and dopaminergic neurotransmitter systems are severely disrupted.” ·        Question 12 Which of the following drugs in the treatment of Alzheimer’s Disease helps normalize glutamate by antagonizing the NMDA receptor? ·        Question 13 In the pathophysiology of Alzheimer’s Disease, there are certain proteins that lead to the plaques and tangles that result in this progressive, irreversible brain disorder. Choose the appropriate protein with its corresponding pathology.        I.           Tau – tangles      II.           Beta-amyloid – tangles     III.           Tau – plaques    IV.           Beta-amyloid – plaques ·        Question 14 Choose the correct statement regarding an anti-ADHD medication and its respectful mechanism of action Response Feedback: under atomoxetine subtitle: A & B are having their MOAs switched and C & E is completely incorrect since they are alpha-adrenergic agonists ·        Question 15 If a patient suffers from a multitude of small strokes and later begins experiencing mood disturbances in an acute fashion that sometimes resolve, from what type of dementia would you think that patient may suffer? Response Feedback: under the clinical features and diagnosis subtitle ·        Question 16 Drug addiction includes many prescription medications and illegal substances. Of the drugs listed, which ones can be withdrawn abruptly WITHOUT medical intervention to prevent withdraw seizures? Response Feedback: “Amphetamines can be withdrawn abruptly” ·        Question 17 T. B. is a 55-year-old male who has diagnosed with type 2 diabetes 10+ years ago. He has since had complications from the disease and is suffering from severe neuropathy. On top of that, T. B. is struggling with his mental health and was recently told he could be depressed but he had refused treatment at that time. Besides getting his blood sugar under control, what medication(s) can we use that may be useful in helping T. B.?        I.           Nortriptyline      II.           Venlafaxine     III.           Duloxetine    IV.           Fluoxetine Response Feedback: “Among the antidepressants these include the TCAs and SNRIs (duloxetine and venlafaxine).”- SSRIs – page 204: “There is little evidence to support the independent analgesic activity of SSRIs.” ·        Question 18 T. C. is an 88-year-old male who is diagnosed at your clinic with Dementia with Lewy Bodies. He currently has some debilitating gait issues, which makes his quality of life very poor. His memory is still intact with minor deficits. Which medication would likely benefit T. C. as his initial therapy? Response Feedback: “Low dosages of levodopa/carbidopa (dopamine replacement) are sometimes helpful for the motor symptoms of DLB, although higher dosages of dopamine replacement therapy and direct dopamine agonists may exacerbate neuropsychiatric symptoms.”- Motor symptoms = gait issues ·        Question 19 Which features are consistent with delirium?        I.           Acute onset      II.           Gradual onset     III.           Course of disease fluctuates    IV.           Course of diseases does not fluctuate      V.           Impaired attention    VI.           Normal attention Response Feedback: “The onset of delirium is typically acute or subacute, the course often has marked fluctuations, and level of consciousness and attention are impaired.” ·        Question 20 Disulfiram has been proven effective in the treatment of alcoholism, but recently it has been trialed in the management of cocaine addiction. What is the mechanism of action that likely helps produce these aversive effects? Response Feedback: “These reactions are thought to be mediated by the inhibitory effect of disulfiram on dopamine beta-hydroxylase. This action will elevate depleted plasma dopamine levels in chronic users and will produce abnormally high dopamine levels if cocaine is ingested; this results in a dysphoric experience in most users.” ·        Question 21 Benzodiazepines can be withdrawn abruptly despite duration of therapy/abuse. Response Feedback: Benzodiazepines should never be stopped suddenly; Page 194 “Under no circumstances should benzodiazepines be stopped abruptly.” ·        Question 22 A new patient presents to your clinic today. The patient is a 13-year-old boy who complains that he has no interest in anything. The patient states, “I just want to sleep more than I normally do, and I don’t care much for playing my video games anymore.” His mother states he cannot focus on anything for more than a few minutes at a time, and that he often gets in trouble at school because he cannot sit still. What would you recommend at this time? Response Feedback: under Attention-Deficit/Hyperactivity Disorder Plus Depression subtitle: “In ADHD patients, depression is not an artifact, and it must be distinguished from demoralization.” Page 99 under overview also mentions, “Before using medications, clinicians should complet thorough clinical evaluation that includes a complete history of symptoms, a differential diagnosis, a review of prior assessments/treatments, a medical history, and a description of current physical symptoms.” ·        Question 23 Y. R. is a 35-year-old woman who presents to your clinic today complaining of ankle pain. She said she was running the trail when she saw a snake. During a quick turn to run away from the snake, she twisted her ankle. Which of the following medications may be a good choice in helping Y. R. with her pain? Response Feedback: No specific page number, but ibuprofen would be the best choice since oxycodone isn’t recommended first-line (Box 17-1 on page 208) since no other medications have been trialed; TCAs and SNRIs wouldn’t be a good choice because the patient doesn’t show any signs of depression. ·        Question 24 There are many different types of dementia. Which dementia is NOT a direct result of disrupted neurotransmitters, but a result of degeneration of different regions in the brain? Onset of the disease is typically before the age of 60, and very rare after the age of 75. Response Feedback: under subtitle “Epidemiology and genetic risk factors” ·        Question 25 Patient is a 10-year-old female with diagnosed ADHD who was started on Ritalin 5 mg twice a day over 2 months ago. She is still experiencing the triad of symptoms associated with ADHD (impaired attention, impulsivity, and excessive motor activity). Her mother reports that she is now having difficulty in falling asleep since starting the medication. She has been on no other anti-ADHD medications and the mother reports full compliance with medication regimen. What is the appropriate recommendation to make based on this scenario? Response Feedback: upper right column: “Consideration of another stimulant or ATMX is recommended when symptoms aren’t responsive or the patient experiences clinically significant side effects to initial medication. Given their pharmacodynamic differences, if an MPH product was initially selected, then moving to an amphetamine-based medication is appropriate.”- Choice A would be recommended if the patient had improvement in any of her symptoms, but the scenario makes it obvious she is not getting better, even after 2 months of therapy- Choice B is staying within the same stimulant class, therefore, would likely not see a big improvement in symptoms- Choice C is not considered first-line. Patient has never tried the amphetamine-based stimulant, so she has not exhausted first-line options yet. ·        Question 26 Which medication is a selective alpha-adrenergic agonist that works by mimicking norepinephrine binding in the pre-frontal cortex, which makes it particularly useful in the treatment of ADHD? ·        Question 27 Which neurotransmitters are likely involved in the pathophysiology of withdrawal seizures?        I.           Serotonin      II.           Endorphins     III.           Glutamate    IV.           GABA      V.           Dopamine Response Feedback: “Thus when an individual suddenly ceases alcohol use, the decrease in inhibitory effects in combination with fewer GABA receptors and increased glutamatergic discharge contributes to over-excitation and possible withdrawal seizures.” ·        Question 28 Choose the correct statement regarding medications used for alcoholism Response Feedback: Table 15-3 has the three MOAs listed for the FDA-approved treatments of alcoholism. ·        Question 29 Which of the following psychiatric conditions is present in both domains (i.e., core psychopathology & pain-related psychological symptoms) of chronic pain that will likely lead to an outcome of disability, pain, and poor quality of life? Response Feedback: Figure 17-4 and in the text on the page discussing how anxiety is present in both, therefore, a review is needed of the exact cause of the anxiety ·        Question 30 The experience of pain is ALWAYS subjective Response Feedback: “The experience of pain is always subjective.” ·        Question 31 What baseline levels should you perform before initiating an anti-ADHD medication? Response Feedback: under Overview: “Before treatment with medications, it is usually important to measure baseline levels of height, weight, blood pressure, and pulse and to monitor them over the course of the treatment.” ·        Question 32 Which medication below should be routine for all suspected cases of alcohol intoxication and dependence? Response Feedback: under Treatment of Wernicke’s encephalopathy: “Administration of the B vitamin thiamine (IM or IV) should be routine for all suspected cases of alcohol intoxication and dependence.” ·        Question 33 Disorientation, tremor, hyperactivity, fever, hallucinations, marked wakefulness, and increased autonomic tone are all features that are consistent with which part of alcohol withdrawal? Response Feedback: “The principal features are disorientation (to time, place, or person), tremor, hyperactivity, marked wakefulness, fever, increased autonomic tone, and hallucinations.” ·        Question 34 SSRIs can be used in alcohol use disorder and offer modest drinking reduction through an anti-craving effect. Response Feedback: “SSRIs have produced only modest drinking reductions—independent of the antidepressant effects—through an anti-craving effect” ·        Question 35 Which of the following drugs is often used in the management of opioid addiction due to its ceiling effect? Response Feedback: “Because of the ceiling effect seen with partial opiate agonists, there is no pharmacological benefit from doses higher than 32 mg/day.” ·        Question 36 Of the axons involved in the transmission of pain, which one is thinly myelinated and conducts that first feeling of pain that is often felt as coming on as a sharp, rapid feeling? Response Feedback: “A-? fibers are 2 to 5 µcm in diameter and are thinly myelinated. They conduct “first pain,” which is immediate, rapid, and sharp with a velocity of 20 m/sec.” ·        Question 37 Select the correct description of a somatoform disorder. Response Feedback: – Option A That description goes with conversion disorder.- Option B That description goes with pain disorder.- Option D That description goes with factitious disorder with physical symptoms. ·        Question 38 The patient is a 16-year-old girl with a past history of substance use disorder. She has been known to abuse prescription opioids and smokes one pack of cigarettes every day. She has been in and out of recovery for the past year. During her last admission into a recovery center, she was diagnosed with ADHD, which may have contributed to her addictive personality. She presents to your clinic today to initiate pharmacotherapy for her new diagnosis. What would you recommend in this patient? Her current weight is 55 kg. Response Feedback: Ritalin and Focalin have abuse potential due to their short half-lives and multiple times a day dosing. Daytrana has the wrong instructions for the patch and still has an abuse potential due to being a stimulant (See table 10-1 for dosing instruction of the patch being worn for 9 hours but lasts 12 hours). Atomoxetine has the least abuse potential and appropriately dosed for patient’s weight. Page 110 in upper right column: “In these populations use of extended delivery stimulant preparations, which are more difficult to misuse, or non-stimulants should be considered.” ·        Question 39 Which of the following is the only Black Box Warning associated with the medication atomoxetine? Response Feedback: “The FDA issued a public health advisory, and the manufacturer later added a black box warning regarding the development of suicidal ideation in patients treated with ATMX.”Answer A Only has to be in the medication guide regarding any ADHD medicationAnswer C refers to stimulants onlyAnswer D conflicting data on but not a BBW ·        Question 40 Of the following medications, which one is contraindicated with stimulants such as Ritalin or Adderall? Response Feedback: under Medication Interactions with Stimulants; Co-administration of MAO is the only true contraindication ·        Question 41 Which medication below would you use in addition to benzodiazepine treatment if the patient is experiencing psychosis during alcohol withdrawal delirium? Response Feedback: “Haloperidol 50 to 10 mg PO or IM may be added and repeated after 1 to 2 hours when psychosis or agitation is present.” ·        Question 42 L. J. is a 55-year-old male who attended a funeral and found himself laughing during the service, but later that evening he was irritated with himself for what he had done. His wife said this was abnormal behavior and took him to his doctor to be evaluated. After L. J.’s MRI was reviewed, he was diagnosed with frontotemporal dementia. Which medication is recommended to help L. J. with his emotional outbursts? Response Feedback: under Treatment subtitle: “The behavioral features are sometimes helped by SSRIs, and these are the best-studied treatments for these disorders.” ·        Question 43 Select the correct treatment regarding drugs involved in addiction management and their corresponding mechanism of action. Response Feedback: under Overdose subtitle: “Flumazenil, a specific benzodiazepine antagonist, reverses the life-threatening effects of a benzodiazepine overdose.” ·        Question 44 T. K. is a 72-year-old female who has suffered many strokes in the past, likely due to uncontrolled hypertension and hyperlipidemia. She has now been diagnosed with vascular dementia due to memory loss and motor system slowing. What is the recommended treatment for T. K.? Response Feedback: “Treatment for vascular dementia involves control of vascular risk factors (e.g., hypercholesterolemia, hypertension, inactivity, diabetes, excess alcohol use, cigarette smoking, hyperhomocysteinemia).” In addition to treating these causes of CNS vascular disease, some literature indicates that symptomatic treatments (such as cholinesterase inhibitors or memantine) may be helpful for cognition. ·        Question 45 When can buprenorphine be initiated in a patient who is suffering from an opioid overdose? Response Feedback: “To avoid this problem, the initial buprenorphine dose should not be administered until the patient demonstrates mild-to-moderate symptoms of withdrawal.” ·        Question 46 Which medication(s) requires a test dose to determine accurate use of the drug (i.e., how addicted the patient truly is on a certain drug) before beginning a titration schedule to withdrawal the patient?        I.           Butalbital      II.           Lorazepam     III.           Hydrocodone Response Feedback: “Treatment should begin with an oral test dose of 200 mg of pentobarbital, a short-acting-barbiturate.” ·        Question 47 Which of the following alcohol screening tools lack sensitivity to detect hazardous/problem drinking? Response Feedback: “Compared to the SASQ or the AUDIT and AUDIT-C, the CAGE lacks sensitivity to detect hazardous/problem drinking.” ·        Question 48 Which club drug is structurally similar to GABA? Response Feedback: under club drugs; Options A & D are the same drug ·        Question 49 If a patient is being managed for chronic pain and is not getting better after months of therapy with multiple agents (i.e., NSAIDs with opioids, muscle relaxants with NSAIDs, etc.), what should be your next step in helping the patient?        I.           Add a high-dose opioid if patient is not already on the maximum dose.      II.           Assess for a co-morbid psychiatric condition.     III.           Tell the patient you have exhausted all your options and there is nothing more you can do.    IV.           Refer the patient for a second opinion. Response Feedback: Both are good options. If the patient has never been assessed for a psychiatric condition, then it needs to be done to treat the underlying cause of his or her pain. And doing a referral will help get a second set of eyes on the patient to see where something may have been missed when initially treating the patient.- Page 208, Box 17-1 has a blurb: If treated with opioids for more than 3 months then get a second opinion.- Page 209 under conclusions: It explains how if the patient has a co-morbid psychiatric condition, it will worsen their pain and disability and should be addressed in addition to treating the pain. ·        Question 50 FILL IN THE BLANK: ___________ is the main neurotransmitter behind reward systems in the brain, which usually leads to addiction when altered in any way. Response Feedback: “Distribution of the endogenous reward systems in the brain is a common feature of drug abuse; most addictive drugs act by disrupting central nervous system (CNS) dopamine circuits.”- Table 16-1 as well all the drug types show alterations of dopamine pathways in some way Health ScienceScienceNursingNURS 6630Share Question

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Question Answered step-by-step Urinary DisordersExplain how decreased fluid intake or dehydration predisposes to calculi in the urinary tract.Explain what the presence of the following in the urine indicates: blood (microscopic and gross), protein, pus, casts, and glucose.Reference: VanMeter, K. C., & Hubert, R. J. (2018). Gould’s pathophysiology for the health professions. (6th ed.). Elsevier Saunders. Health Science Science Nursing NU 606 Share QuestionEmailCopy link Comments (0)

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