Question

Question 1 1 / 1 point

Charlie is a 65-year-old male who has been diagnosed with hypertension and benign prostatic hyperplasia. Doxazosin has been chosen to treat his hypertension because it:

Question options:

Increases peripheral vasoconstriction

Decreases detrusor muscle contractility

Lowers supine blood pressure more than standing pressure

Relaxes smooth muscle in the bladder neck

Question 2 1 / 1 point

Which of the following adverse effects are less likely in a beta1-selective blocker?

Question options:

Dysrhythmias

Impaired insulin release

Reflex orthostatic changes

Decreased triglycerides and cholesterol

Question 3 1 / 1 point

Beta blockers have favorable effects on survival and disease progression in heart failure. Treatment should be initiated when the:

Question options:

Symptoms are severe

Patient has not responded to other therapies

Patient has concurrent hypertension

Left ventricular dysfunction is diagnosed

Question 4 1 / 1 point

You are treating a patient with a diagnosis of Alzheimer’s disease. The patient’s wife mentions difficulty with transportation to the clinic. Which medication is the best choice?

Question options:

Donepezil

Tacrine

Doxazosin

Verapamil

Question 5 1 / 1 point

Antonia is a 3-year-old child who has a history of status epilepticus. Along with her routine antiseizure medication, she should also have a home prescription for_________ to be used for an episode of status epilepticus.

Question options:

IV phenobarbital

Rectal diazepam (Diastat)

IV phenytoin (Dilantin)

Oral carbamazepine (Tegretol)

Question 6 1 / 1 point

Dwayne has recently started on carbamazepine to treat seizures. He comes to see you and you note that while his carbamazepine levels had been in the therapeutic range, they are now low. The possible cause for the low carbamazepine levels include:

Question options:

Dwayne hasn’t been taking his carbamazepine because it causes insomnia.

Carbamazepine auto-induces metabolism, leading to lower levels in spite of good compliance.

Dwayne was not originally prescribed the correct amount of carbamazepine.

Carbamazepine is probably not the right antiseizure medication for Dwayne.

Question 7 1 / 1 point

Kasey fractured his ankle in two places and is asking for medication for his pain. The appropriate first-line medication would be:

Question options:

Ibuprofen (Advil)

Acetaminophen with hydrocodone (Vicodin)

Oxycodone (Oxycontin)

Oral morphine (Roxanol)

Question 8 1 / 1 point

Jack, age 8, has attention deficit disorder (ADD) and is prescribed methylphenidate (Ritalin). He and his parents should be educated about the side effects of methylphenidate, which are:

Question options:

Slurred speech and insomnia

Bradycardia and confusion

Dizziness and orthostatic hypotension

Insomnia and decreased appetite

Question 9 1 / 1 point

An appropriate first-line drug to try for mild to moderate generalized anxiety disorder would be:

Question options:

Alprazolam (Xanax)

Diazepam (Valium)

Buspirone (Buspar)

Amitriptyline (Elavil)

Question 10 1 / 1 point

David is a 34-year-old patient who is starting on paroxetine (Paxil) for depression. David’s education regarding his medication would include:

Question options:

Paroxetine may cause intermittent diarrhea.

He may experience sexual dysfunction beginning a month after he starts therapy.

He may have constipation and he should increase fluids and fiber.

Paroxetine has a long half-life so he may occasionally skip a dose.

Question 11 1 / 1 point

An appropriate drug for the treatment of depression with anxiety would be:

Question options:

Alprazolam (Xanax)

Escitalopram (Lexapro)

Buspirone (Buspar)

Amitriptyline (Elavil)

Question 12 1 / 1 point

The longer-term Xanax patient comes in and states they need a higher dose of the medication. They deny any additional, new, or accelerating triggers of their anxiety. What is the probable reason?

Question options:

They have become tolerant of the medication, which is characterized by the need for higher and higher doses.

They are a drug seeker.

They are suicidal.

They only need additional counseling on lifestyle modification.

Question 13 1 / 1 point

A first-line drug for abortive therapy in simple migraine is:

Question options:

Sumatriptan (Imitrex)

Naproxen (Aleve)

Butorphanol nasal spray (Stadol NS)

Butalbital and acetaminophen (Fioricet)

Question 14 1 / 1 point

Xi, a 54-year-old female, has a history of migraines that do not respond well to OTC migraine medication. She is asking to try Maxalt (rizatriptan) because it works well for her friend. Appropriate decision making would be:

Question options:

Prescribe the Maxalt, but only give her four tablets with no refills to monitor the use.

Prescribe Maxalt and arrange to have her observed in the clinic or urgent care with the first dose.

Explain that rizatriptan is not used for postmenopausal migraines and recommend Fiorinal (aspirin and butalbital).

Prescribe sumatriptan (Imitrex) with the explanation that it is the most effective triptan.

Question 15 1 / 1 point

Kelly is a 14-year-old patient who presents to the clinic with a classic migraine. She says she is having a headache two to three times a month. The initial plan would be:

Question options:

Prescribe NSAIDs as abortive therapy and have her keep a headache diary to identify her triggers.

Prescribe zolmitriptan (Zomig) as abortive therapy and recommend relaxation therapy to reduce her stress.

Prescribe acetaminophen with codeine (Tylenol #3) for her to take at the first onset of her migraine.

Prescribe sumatriptan (Imitrex) nasal spray and arrange for her to receive the first dose in the clinic.

Question 16 1 / 1 point

James has been diagnosed with cluster headaches. Appropriate acute therapy would be:

Question options:

Butalbital and aspirin (Fiorinal)

Meperidine IM (Demerol)

Oxygen 100% for 15 to 30 minutes

Indomethacin (Indocin)

Question 17 1 / 1 point

If interventions to resolve the cause of pain (e.g., rest, ice, compression, and elevation) are insufficient, pain medications are given based on the severity of pain. Drugs are given in which order of use?

Question options:

NSAIDs, opiates, corticosteroids

Low-dose opiates, salicylates, increased dose of opiates

Opiates, non-opiates, increased dose of non-opiate

Non-opiate, increased dose of non-opiate, opiate

Question 18 1 / 1 point

Chemical dependency assessment is integral to the initial assessment of chronic pain. Which of the following raises a “red flag” about potential chemical dependency?

Question options:

Use of more than one drug to treat the pain

Multiple times when prescriptions are lost with requests to refill

Preferences for treatments that include alternative medicines

Presence of a family member who has abused drugs

Question 19 1 / 1 point

The Pain Management Contract is appropriate for:

Question options:

Patients with cancer who are taking morphine

Patients with chronic pain who will require long-term use of opiates

Patients who have a complex drug regimen

Patients who see multiple providers for pain control

Question 20 1 / 1 point

Which of the following statements is true about age and pain?

Question options:

Use of drugs that depend heavily on the renal system for excretion may require dosage adjustments in very young children.

Among the NSAIDs, indomethacin is the preferred drug because of lower adverse effects profiles than other NSAIDs.

Older adults who have dementia probably do not experience much pain due to loss of pain receptors in the brain.

Acetaminophen is especially useful in both children and adults because it has no effect on platelets and has fewer adverse effects than NSAIDs.

   

200 words for each respond

1) 

Prioritizing data from a community health assessment analysis can be challenging. There are sources that can assist individuals prioritize collected data from a community health assessment. When a community assessment is completed, there is often a lot of data to evaluate and it is important to have guidelines to help organize the information better.

The Tool Kit that was provided to us in this module was essential for prioritizing my collected data. I looked at the webpage and noticed that there was a lot of helpful information available. I reviewed the material and really thought about the information I gathered from my community assessment project. It is important to think about the magnitude and severity of the problem because this can help someone realize how specific diseases can negatively impact the community. The community’s willingness to fix the stated problem can affect which problems are priorities. If people in a community are willing to make changes to decrease obesity, this may be more of a priority than another issue they are not willing to make changes too, such as smoking. I also thought about the resources that are available to people in the community because this will help me prioritize my data more. Addressing barriers to attempting to fix an issue in the community is necessary because it may be helpful to create additional resources or guidance so people can overcome these barriers. I feel that this is especially important because many issues such as obesity, smoking, and heart disease have barriers that need to be overcome. I also think that selecting a committee can help with prioritization because this will likely help create more success with attempting to implement change in the community. The nominal group technique seems like it would be very helpful for helping me prioritize my data. This involves rating issues on a one to ten scale in a group discussion setting (Association for Community Health Improvement, n.d.).  This technique is my favorite out of the others listed because I can select my top issue in my community with the assistance of others that live in the same community. There are also different templates available to help with prioritizing data and teamwork seems to be important for helping determine the priority (West Virginia Center for Local Health, n.d.).

Prioritizing data can be challenging. I plan on using multiple techniques to decide what my priority is. I think that I plan on thinking about the data I collected and using the nominal group technique to help me finalize my decision. It will be important for me to think about the needs of the individuals in my community as well as what resources are available to help my community.

References

Association for Community Health Improvement. (n.d.). Community health assessment toolkit.  Retrieved from https://www.healthycommunities.org/resources/toolkit/files/step5-select-priority

West Virginia Center for Local Health. (n.d.). Methods for prioritizing health Issues. Retrieved from https://dhhr.wv.gov/localhealth/data_qi/CHA/Pages/Prioritizing-Health-Issues.aspx

2)

 

It has been accepted knowledge that obesity is not only increasing at an epidemic rate in North America but also globally (Center for Disease Control and Prevention (CDC), 2018). This is an issue of real concern because many health problems are associated with excess body fat. Thru usage of the Community Health Assessment Toolkit selected identifiers can give evidence to a platform applicable to the current community issue concern and support can be shown in community prevention outreach programs and facilities available (American Hospital Association (AHA), 2020).  The magnitude of obesity is gaining recognition due to the identified causing agent to be a leading factor to preventable illnesses and death in the United States. The severity of unhealthy weight gain shows people who are impacted are at a much higher risk for serious medical conditions than people who have a healthy weight (“Healthy People 2020”, 2019).

            This subject is a high priority within the Orange County community of which I am currently concentrating and previously researched with data gathering for selection in community health issues. It has been identified that vulnerable populations are shown among school children with poor eating habit choices and limited selection within the school system as their primary meals for daily living (About Us, 2018). Working households with late jobs are having children defend for themselves at home for proper meal selections relying on high carbohydrates, sugar, and processed foods for resources.

            Obesity has been associated as a root cause to other medical problems including heart attacks, strokes, diabetes, osteoarthritis, and even some cancers (CDC, 2018). Yet, the community is aware and prepared to meet the challenge by showing a capacity and willingness to act through provisions of wellness programs available by the Florida Clay Health Department and other public venues such as YMCA organizations dispersed throughout the community. Provisions of recreational services such as summer and fall festivals encourage outdoor participation. Existing intervention focuses are seen by the upkeep and public safety provided in numerous walking trails, parks with recreational play equipment for children, sponsored walking, running, and bicycling events for charities annually promoted by local news and Facebook access (About Us, 2018). The ability to have a measurable impact can be identified from a small to a large scale by individual track progress that promotes healthy habits and decreases hospital stay as well as costs. Another example is the work shown by YMCA organizations that involve education, support, and encourage opportunities to belong and participate with sport events for adults and youth, day camp for youth, and volunteer work to challenge community concerns in engagement of all ages. With proper teamwork, communication, resource promotion, and access to community support obesity can be rectified in Orange County making one step closer to decreasing the national problem.

References

About Us (2018). Florida Department of Health Clay County. Retrieved from

1.  How much do American consumers really care about the labor issues of the people who produce the products we use
2. When given a choice between a $200 laptop and a $1,000 laptop, do we always concern ourselves if the $200 laptop was made in a factory where people worked 12 to 18 hours in unsafe conditions? 
3. Describe how you make choices as a consumer.  

 

Assessment tools have two primary purposes: 1) to measure illness and diagnose clients, and 2) to measure a client’s response to treatment. Often, you will find that multiple assessment tools are designed to measure the same condition or response. Not all tools, however, are appropriate for use in all clinical situations. You must consider the strengths and weaknesses of each tool to select the appropriate assessment tool for your client. For this Discussion, as you examine the assessment tool assigned to you by the Course Instructor, consider its use in psychotherapy.

To Prepare:

• Review this week’s Learning Resources and reflect on the insights they provide regarding psychiatric assessment and diagnosis.
• Consider the elements of the psychiatric interview, history, and examination.
• Consider the assessment tool assigned to you by the Course Instructor.

By Day 3 of Week 2

Post a brief explanation of three important components of the psychiatric interview and why you consider these elements important. Explain the psychometric properties of the rating scale you were assigned. Explain when it is appropriate to use this rating scale with clients during the psychiatric interview and how the scale is helpful to a nurse practitioner’s psychiatric assessment. Support your approach with evidence-based literature.

I was assigned PATIENT HEALTH QUESTIONAIRE (PHQ-9)
Read a selection of your colleagues’ responses.

By Day 6 of Week 2

Respond to at least two of your colleagues on 2 different days by comparing your assessment tool to theirs.

Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link, and then select “Create Thread” to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on Submit!