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2025 Question 20 A patient recovering from shingles presents with tenderness and sensitivity to the upper back He states it is
by adminnurs 6630 2025
Question 20 A patient recovering from shingles presents with tenderness and sensitivity to the upper back. He states it is bothersome to put a shirt on most days. This patient has end stage renal disease (ESRD) and is scheduled to have hemodialysis tomorrow but states that he does not know how he can lie in a recliner for 3 hours feeling this uncomfortable. What will be the PMHNP’s priority? a) order herpes simplex virus (HSV) antibody testing b) Order a blood urea nitrogen (BUN) and creatinine STAT c) Prescribe lidocaine 5% d) Prescribe hydromorphone (dilaudid) 2mg Question 21 The PMHNP prescribed a patient lamotrigine (Lamictal), 25 mg by mouth daily, for nerve pain 6 months ago. The patient suddenly presents to the office with the complaint that the medication is no longer working and complains of increased pain. What action will the PMHNP most likely take? a) Increase the dose of lamotrigine (Lamictal) to 25mg twice daily b) Ask if the pt has been taking the medication as prescribed c) Order gabapentin, 100mg TID because lamotrigine is no longer working for this patient d) Order a CBC to assess for an infection Question 22 An elderly woman with a hx of alzheimer’s disease, coronary artery disease, and myocardial infarction had a fall at home 3 months ago that resulted in her receiving an open reduction internal fixation. While assessing this patient, the pmhnp is made aware that the patient continues to experience mild to moderate pain. What is the pmhnp most likely to do? a) order an X-ray because it is possible that she dislocated her hip b) order ibuprofen because she mayneed long term treatment and chronic pain is not uncommon c) Order naproxen because she may havarthritis and chronic pain is not uncommon d) Order morphine and physical therapy Question 23 The PMHNP is assessing a 49-year-old male with a history of depression, post-traumatic stress disorder (PTSD), alcoholism with malnutrition, diabetes mellitus type 2, and hypertension. His physical assessment is unremarkable with the exception of peripheral edema bilaterally to his lower extremities and a chief complaint of pain with numbness and tingling to each leg 5/10. The PMHNP starts this patient on a low dose of doxepin (Sinequan). What is the next action that must be taken by the PMHNP? a) Orders liver function tests b) Educate the patient on avoiding grapefruits when taking this medication c) Encourage this patient to keep fluids to 1500ml/day until the swelling subside d) Order BUN/Creatinine test Question 24 The PMHNP is evaluating a 30-year-old female patient who states that she notices pain and a drastic change in mood before the start of her menstrual cycle. The patient states that she has tried diet and lifestyle changes but nothing has worked. What will the PMHNP most likely do ? a) Prescribe estrin FE 24 birth control b) Prescribe Ibuprofen 800mg every 8 hours as needed for pain c) Prescribe desvenlafaxine (Pristiq) 50mg daily d) Prescribe Risperdal 2mg TID Question 25 A patient with chronic back pain has been prescribed a serotonin-norepinephrine reuptake inhibitor (SNRI). How does the PMHNP describe the action of SNRIs on the inhibition of pain to the patient? a) “the SNRI can increase noradrenergic neurotransmission in the descending spinal pathway to the dorsal horn” b) “the SNRI can decrease noradrenergic neurotransmission in the descending spinal pathway to the dorsal horn” c) “the SNRI can reduce brain atrophy by slowing the gray matter loss in the dorsolateral prefrontal cortex” d) “the SNRI can increase neurotransmission to descending neurons” Question 26 A patient with fibromyalgia and major depression needs to be treated for symptoms of pain. Which is the PMHNP most likely to prescribe for this patient? a) Venlafaxine (Effexor) b) Duloxetine (Cymbalta) c) Clozapine (Clozaril) d) Phenytoin (Dilantin) Question 27 The PMHNP prescribes gabapentin (Neurontin) for a patient’s chronic pain. How does the PMHNP anticipate the drug to work? a) It will bind to the alpha-2-delta ligand subunit of voltage-sensitive calcium channels b) It will induce synaptic changes, including sprouting c) It will act on the presynaptic neuron to trigger sodium influx d) It will Inhibit activity of dorsal horn neurons to suppress body input from reaching the brain Question 28 Mrs. Rosen is a 49-year-old patient who is experiencing fibro-fog. What does the PMHNP prescribe for Mrs. Rosen to improve this condition? a) Venlafaxine (Effexor) b) Armodafinil (Nuvigil) c) Bupropion (Wellbutrin) d) All of the above Question 29 The PMHNP is caring for a patient with fibromyalgia. Which second-line treatment does the PMHNP select that may be effective for managing this patient’s pain ? a) Methylphenidate (Ritalin) b) Viloxazine (Vivalan) c) Imipramine (Tofranil) d) Bupropion (Wellbutrin) Question 30 The PMHNP is attempting to treat a patient’s chronic pain by having the agent bind the open channel conformation of VSCCs to block those channels with a “use-dependent” form of inhibition. Which agent will the PMHNP most likely select ? a) Pregabalin (Lyrica) b) Duloxetine (Cymbalta) c) Modafinil (Provigil) d) Atomoxetine (Strattera) Question 31 A patient with irritable bowel syndrome reports chronic stomach pain. The PMHNP wants to prescribe the patient an agent that will cause irrelevant nociceptive inputs from the pain to be ignored and no longer perceived as painful. Which drug will the PMHNP prescribe? a) Pregabalin (Lyrica) b) Gabapentin (Neurontin) c) Duloxetine (Cymbalta) d) B and C Question 32 The PMHNP wants to use a symptom-based approach to treating a patient with fibromyalgia. How does the PMHNP go about treating this patient? a) Prescribing the patient an agent that ignores the painful symptoms by initiating a reaction known as “fibro-fog” b) Targeting the patient’s symptoms with anticonvulsants that inhibits gray matter loss in the dorsolateral prefrontal cortex c) Mzatching the patient’s symptoms with the malfunctioning brain circuits and neurotransimitters that might mediate those symptoms d) None of the above Question 33 The PMHNP is working with the student to care for a patient with diabetic peripheral neuropathic pain. The student asks the PMHNP why SSRIs are not consistently useful in treating this particular patient’s pain. What is the best response by the PMHNP? a) “SSRIs only increase norepinephrine levels” b) “SSRIs only increase serotonin levels” c) “SSRIs only increase serotonin and norepinephrine levels” d) “SSRIs do not increase serotonin or norepinephrine levels” Question 34 A patient with gambling disorder and no other psychiatric comorbidities is being treated with pharmacological agents. Which drug is the PMHNP most likely to prescribe? a) Antipsychotics b) Lithium c) SSRI d) Naltrexone Question 35 Kevin is an adolescent who has been diagnosed with kleptomania. His parents are interested in seeking pharmacological treatment. What does the PMHNP tell the parents regarding his treatment options ? a) “Naltrexone may be an appropriate option to discuss” b) “there are many medicine options that treat Kleptomania” c) “Kevin may need to be prescribed antipsychotics to treat this illness” d) “Lithium has proven effective for treating kleptomania” Question 36 Which statement best describes a pharmacological approach to treating patients for impulsive aggression? a) Anticonvulsant mood stabilizers can eradicate limbic irritability b) Atypical antipsychotics can increase subcortical dopaminergic stimulation c) Stimulants can be used to decrease frontal inhibition d) Opioid antagonists can be used to reduce drive Question 37 A patient with hypersexual disorder is being assessed for possible pharmacologic treatment. Why does the PMHNP prescribe an antiandrogen for this patient? a) It will prevent feelings of euphoria b) It will amplify impulse control c) It will block testosterone d) It will redirect the patient to think about other things Question 38 Mrs. Kenner is concerned that her teenage daughter spends too much time on the Internet. She inquires about possible treatments for her daughter’s addiction. Which response by the PMHNP demonstrates understanding of pharmacologic approaches for compulsive disorders? a) “Compulsive internet use can be treated similarly to how we treat people with substance use disorders” b) “internet addiction is treated with drugs that help block the tension/arousal state your daughter experiences” c) “When it comes to internet addiction, we prefer to treat patients with pharmaceuticals rather than psychosocial methods” d) “there are no evidence-based treatments for internet addiction, but there are behavioral therapies your daughter can try” Question 39 Mr. Peterson is meeting with the PMHNP to discuss healthier dietary habits. With a BMI of 33, Mr. Peterson is obese and needs to modify his food intake. “Sometimes I think I’m addicted to food the way some people are addicted to drugs”, he says. Which statement best describes the neurobiological parallels between food and drug addiction? a) There is decreased activation of the prefrontal cortex b) There is increased sensation of the reactive reward system c) There is reduced activation of regions that process palatability d) There are amplified reward circuits that activate upon consumption Question 40 The PMHNP is caring for a patient who reports excessive arousal at nighttime. What could the PMHNP use for a time-limited duration to shift the patient’s brain from a hyperactive state to a sleep state? a) Histamine 2 receptor antagonist b) Benzodiazepines c) Stimulants d) Caffeine Question 41 The PMHNP is caring for a patient who experiences too much overstimulation and anxiety during daytime hours. The patient agrees to a pharmacological treatment but states, “I don’t want to feel sedated or drowsy from the medicine.” Which decision made by the PMHNP demonstrates proper knowledge of this patient’s symptoms and appropriate treatment options? a) Avoiding prescribing the patient a drug that blocks H1 receptors b) Prescribing the patient a drug that acts on H2 receptors c) Stopping the patient from taking medicine that unblocks H1 receptors d) None of the above
Nursing Assignment Help 2025
2025 Week 6 Antipsychotic Therapy According to the National Alliance on Mental Illness approximately
by adminExamine Case Study: Pakistani Woman with Delusional Thought Processes. You will be asked to make three decisions concerning the medication to prescribe to this client. Be sure to consider factors that might impact the client’s pharmacokinetic and pharmaco 2025
Week 6: Antipsychotic Therapy According to the National Alliance on Mental Illness, approximately 100,000 people experience psychosis in the United States each year (NAMI, 2016). In practice, clients may present with delusions, hallucinations, disorganized thinking, disorganized or abnormal motor behavior, as well as other negative symptoms that can be disabling for these individuals. Not only are these symptoms one of the most challenging symptom clusters you will encounter, many are associated with other disorders such as depression, bipolar disorder, and disorders on the schizophrenia spectrum. As a psychiatric mental health nurse practitioner, you must understand the underlying neurobiology of these symptoms to select appropriate therapies and improve outcomes for clients. This week, as you examine antipsychotic therapies, you explore the assessment and treatment of clients with psychosis and schizophrenia. You also consider ethical and legal implications of these therapies. Photo Credit: Ingram Publishing/Getty Images Assignment: Assessing and Treating Clients With Psychosis and Schizophrenia Psychosis and schizophrenia greatly impact the brain’s normal processes, which interferes with the ability to think clearly. When symptoms of these disorders are uncontrolled, clients may struggle to function in daily life. However, clients often thrive when properly diagnosed and treated under the close supervision of a psychiatric mental health practitioner. For this Assignment, as you examine the client case study in this week’s Learning Resources, consider how you might assess and treat clients presenting with psychosis and schizophrenia. Learning Objectives Students will: · Assess client factors and history to develop personalized plans of antipsychotic therapy for clients · Analyze factors that influence pharmacokinetic and pharmacodynamic processes in clients requiring antipsychotic therapy · Evaluate efficacy of treatment plans · Analyze ethical and legal implications related to prescribing antipsychotic therapy to clients across the lifespan Learning Resources Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus. Required Readings Note: All Stahl resources can be accessed through the Walden Library using this link. This link will take you to a log-in page for the Walden Library. Once you log into the library, the Stahl website will appear. Stahl, S. M. (2013). Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). New York, NY: Cambridge University Press. To access the following chapters, click on the Essential Psychopharmacology, 4th ed tab on the Stahl Online website and select the appropriate chapter. Be sure to read all sections on the left navigation bar for each chapter. · Chapter 4, “Psychosis and Schizophrenia” · Chapter 5, “Antipsychotic Agents” Stahl, S. M. (2014b). The prescriber’s guide (5th ed.). New York, NY: Cambridge University Press. To access information on the following medications, click on The Prescriber’s Guide, 5th ed tab on the Stahl Online website and select the appropriate medication. Review the following medications: amisulpride aripiprazole asenapine chlorpromazine clozapine flupenthixol fluphenazine haloperidol iloperidone loxapine lurasidone olanzapine paliperidone perphenazine quetiapine risperidone sulpiride thioridazine thiothixene trifluoperazine ziprasidone Naber, D., & Lambert, M. (2009). The CATIE and CUtLASS studies in schizophrenia: Results and implications for clinicians. CNS Drugs, 23 (8), 649-659. doi:10.2165/00023210-200923080-00002 Note: Retrieved from Walden Library databases. Kay, S. R., Fiszbein, A., & Opler, L. A. (1987). The Positive and Negative Syndrome Scale (PANSS) for schizophrenia. Schizophrenia Bulletin, 13(2), 261-276. Note: Retrieved from Walden Library databases. Clozapine REMS. (2015). Clozapine REMS: The single shared system for clozapine. Retrieved from https://www.clozapinerems.com/CpmgClozapineUI/rems/pdf/resources/Clozapine_REMS_A_Guide_for_Healthcare_Providers.pdf Walden University. (2016). ASC success strategies: Studying for and taking a test. Retrieved from http://academicguides.waldenu.edu/ASCsuccess/ASCtesting Required Media Laureate Education. (2016j). Case study: Pakistani woman with delusional thought processes [Interactive media file]. Baltimore, MD: Author Note: This case study will serve as the foundation for this week’s Assignment. Optional Resources Chakos, M., Patel, J. K., Rosenheck, R., Glick, I. D., Hammer, M. B., Tapp, A., & … Miller, D. (2011). Concomitant psychotropic medication use during treatment of schizophrenia patients: Longitudinal results from the CATIE study. Clinical Schizophrenia & Related Psychoses, 5 (3), 124-134. doi:10.3371/CSRP.5.3.2 Fangfang, S., Stock, E. M., Copeland, L. A., Zeber, J. E., Ahmedani, B. K., & Morissette, S. B. (2014). Polypharmacy with antipsychotic drugs in patients with schizophrenia: Trends in multiple health care systems. American Journal of Health-System Pharmacy, 71 (9), 728-738. doi:10.2146/ajhp130471 Lin, L. A., Rosenheck, R., Sugar, C., & Zbrozek, A. (2015). Comparing antipsychotic treatments for schizophrenia: A health state approach. The Psychiatric Quarterly, 86 (1), 107-121. doi:10.1007/s11126-014-9326-2 To prepare for this Assignment: · Review this week’s Learning Resources. Consider how to assess and treat clients requiring anxiolytic therapy. The Assignment Examine Case Study: Pakistani Woman with Delusional Thought Processes. You will be asked to make three decisions concerning the medication to prescribe to this client. Be sure to consider factors that might impact the client’s pharmacokinetic and pharmacodynamic processes. At each decision point stop to complete the following: · Decision #1 o Which decision did you select? o Why did you select this decision? Support your response with evidence and references to the Learning Resources. o What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources. o Explain any difference between what you expected to achieve with Decision #1 and the results of the decision. Why were they different? · Decision #2 o Why did you select this decision? Support your response with evidence and references to the Learning Resources. o What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources. o Explain any difference between what you expected to achieve with Decision #2 and the results of the decision. Why were they different? · Decision #3 o Why did you select this decision? Support your response with evidence and references to the Learning Resources. o What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources. o Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different? Also include how ethical considerations might impact your treatment plan and communication with clients. Note: Support your rationale with a minimum of three academic resources. While you may use the course text to support your rationale, it will not count toward the resource requirement.
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2025 HOMEWORK SLP 2 ASSIGNMENT OPERATING REVENUE REIMBURSEMENT COST VOLUME PROFIT AND BREAK EVEN After completing the required background
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HOMEWORK SLP 2 ASSIGNMENT OPERATING REVENUE, REIMBURSEMENT, COST-VOLUME-PROFIT, AND BREAK-EVEN After completing the required background readings, please complete the following: **Please see attachment Imagine you are the Practice Manager of a multi-physician primary care center in Pennsylvania. The four physician-owners have asked you to make a presentation to them on how their group’s profitability could be improved, without having to raise their charges/rates for services. Using Exhibit 8.5 and 8.6 in Dr. Nowicki’s textbook (see required background reading), as well as some research in peer-reviewed sources of your own, create a professional-looking PowerPoint presentation of 6-8 slides which clearly summarizes the information the physicians are requesting. Include thorough speaker’s notes to further expand upon and explain your points. SLP Assignment Expectations Conduct additional research to gather sufficient information to support your presentation. Provide 6-8 quality powerpoint slides of bulleted-point information content (with speaker’s notes), not including title page and reference slides. Don’t forget to use in-text citations. Support your presentation with peer-reviewed articles and reliable sources. Use at least two peer-reviewed sources. For additional information on how to recognize peer-reviewed journals, see http://www.angelo.edu/services/library/handouts/peerrev.php and for evaluating internet sources: https://www.library.georgetown.edu/tutorials/research-guides/evaluating-internet-content You may use the following source to assist in your formatting your references and in-text citations for your slides: https://owl.english.purdue.edu/owl/resource/560/01/. Paraphrase all source information into your own words carefully and use in-text citations.
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2025 1 Assign CPT code s and appropriate modifiers to each statement The physician performed a complex repair during
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1) Assign CPT code(s) and appropriate modifiers to each statement. The physician performed a complex repair during resection of the diaphragm and closed the residual defect with synthetic graft material. 2) Mediastinotomy to remove foreign body using transthoracic approach, including median sternotomy. 3) Patient underwent repair, laceration of diaphragm. 4) Physician inserted a mediastinoscope through an incision in the sternal notch and performed a mediastinal lymph node biopsy. 5) Physician repaired an acute traumatic diaphragmatic hernia. Patient underwent alveoloplasty to remove sharp areas or undercuts of alveolar bone, one quadrant. Surgeon used a scalpel to slice off a cancerous portion of the vermillion border of the patient’s lip: mucosal advancement was performed after excision. Surgeon made an incision through submucosal tissue and removed a lesion in the vestibule of the mouth. Wound repair was not required. Patient underwent simple incision of the lingual frenum to free the tongue. Patient underwent incision in the parotid gland to remove calcified stone. Surgeon repaired a tear at the pharyngeal esophageal junction. Physician drained and abscess near the tonsil. Surgeon removed an 8 year old patient’s tonsils and adenoids. Physician controlled secondary oropharyngeal hemorrhaging, status post tonsillectomy, by using cellulose sponges that expanded when placed in the tonsillar cavity. Physician performed a tonsillectomy on a 12 year old male patient. Physician inserted a flexible esophagoscope into the esophagus and destroyed a lesion, using snare technique. Surgeon made an incision in the left posterior chest wall into the esophagus to remove a foreign body from the esophagus. Physician inserted a balloon endoscopically for tamponade of bleeding esophageal varices. Dr. Smith performed a partial cervical esophagectomy while Dr. Jones performed a jejunum transfer with microvascular anastomosis. The physyician passed an endoscope through the patient’s mouth and visualized the entire esophagus, stomach, duodenum, and jejunum. One lesion was removed using biopsy forceps. Another was remove using snare. Patient underwent incision of the pyloric muscle. The physician performed an open revision of a previously performed gastric restrictive procedure and reversed the previously partitioned stomach to restore normal gastrointestinal continuity. Using fluoroscopic guidance, the physician repositioned a gastric feeding tube through the duodenum. The physician performed a laparoscopic surgical gastric restrictive procedure with gastric bypass and roux-en-Y gastroenterostomy. The physician percutaneously place a gastrostomy tube into the stomach under fluoroscopic guidance including contrast injection(s), image documentation.
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