2025 1 A 40 year old woman who experiences severe seasonal allergies has been referred by her family physician to an

MN551 Advanced Pathophysiology 2025

· 1. A 40-year-old woman who experiences severe seasonal allergies has been referred by her family physician to an allergist for weekly allergy injections. The woman is confused as to why repeated exposure to substances that set off her allergies would ultimately benefit her. Which of the following phenomena best captures the rationale for allergy desensitization therapy? (Points : 0.4) Repeated exposure to offending allergens binds the basophils and mast cells that mediate the allergic response. Exposure to allergens in large, regular quantities overwhelms the IgE antibodies that mediate the allergic response. Repeated exposure stimulates adrenal production of epinephrine, mitigating the allergic response. Injections of allergens simulate production of IgG, which blocks antigens from combining with IgE. Question 2. 2. A 24-year-old woman presents with fever and painful, swollen cervical lymph nodes. Her blood work indicates neutrophilia with a shift to the left. She most likely has: (Points : 0.4) A mild parasitic infection A severe bacterial infection A mild viral infection A severe fungal infection Question 3. 3. A 60-year-old male patient with an acute viral infection is receiving interferon therapy. The nurse practitioner is teaching the family of the patient about the diverse actions of the treatment and the ways that it differs from other anti-infective therapies. Which of the following teaching points should the nurse practitioner exclude? (Points : 0.4) “Interferon can help your father’s unaffected cells adjacent to his infected cells produce antiviral proteins that limit the spread of the infection.” “Interferon can help limit the replication of the virus that’s affecting your father.” “Interferon helps your father’s body recognize infected cells more effectively.” “Interferon can bolster your father’s immune system by stimulating natural killer cells that attack viruses.” Question 4. 4. As part of his diagnostic workup, a 77-year-old man’s nurse practitioner has ordered blood work that includes ferritin levels. The man is very interested in the details of his health care and is unfamiliar with ferritin and its role. He asks his nurse practitioner to explain the significance of it and the rationale for testing it. Which of the following explanations by the nurse practitioner is most accurate? (Points : 0.4) “Ferritin is the activated and usable form of iron that your red blood cells can use to transport oxygen.” “Ferritin is a stored form of iron that indirectly shows me whether you would benefit from iron pills.” “Ferritin is a protein-iron complex that allows your red blood cells to make use of the iron that you consume in your diet.” “Ferritin is the form of iron that is transported in your blood plasma to the red blood cells that need it.” Question 5. 5. A 16-year-old female has been brought to her primary care nurse practitioner by her mother due to the girl’s persistent sore throat and malaise. Which of the following facts revealed in the girl’s history and examination would lead the nurse practitioner to rule out infectious mononucleosis? (Points : 0.4) The girl has a temperature of 38.1°C (100.6°F) and has enlarged lymph nodes. Her liver and spleen are both enlarged. Blood work reveals an increased white blood cell count. Chest auscultation reveals crackles in her lower lung fields bilaterally. Question 6. 6. Which of the following patients is most likely to benefit from transplantation of thymic tissue or major histocompatibility complex (MHC)-compatible bone marrow? (Points : 0.4) A 12-year-old girl with a history of epilepsy and low IgG levels secondary to phenytoin use A 7-year-old boy whose blood work indicates decreased IgA and IgG with increased IgM A 6-year-old boy whose pre-B cells are incapable of translation to normal B cells A 9-year-old girl who has a diagnosis of IgA deficiency Question 7. 7. A 14-year-old boy has been diagnosed with infectious mononucleosis. Which of the following pathophysiological phenomena is most responsible for his symptoms? (Points : 0.4) The Epstein-Barr virus (EBV) is lysing many of the boy’s neutrophils. Viruses are killing some of his B cells and becoming incorporated into the genomes of others. The EBV inhibits the maturation of white cells within his peripheral lymph nodes. The virus responsible for mononucleosis inhibits the maturation of myeloblasts into promyelocytes. Question 8. 8. A 23-year-old man has received a recent diagnosis of appendicitis following 24 hours of acute abdominal pain. The nurse practitioner providing care for the man is explaining that while it is unpleasant, the inflammation of his appendix is playing a role in his body’s fight against the underlying infectious process. Which of the following teaching points should the nurse practitioner eliminate from his teaching for the patient? (Points : 0.4) “Inflammation can help to remove the body tissue cells that have been damaged by infection.” “Inflammation will start your body on the path to growing new, healthy tissue at the site of infection. “Inflammation helps your body to produce the right antibodies to fight the infection.” “Inflammation ultimately aids in eliminating the initial cause of the cell injury in your appendix.” Question 9. 9. A 71-year-old male patient with a history of myocardial infarction and peripheral vascular disease has been advised by his nurse practitioner to begin taking 81 mg aspirin once daily. Which of the following statements best captures an aspect of the underlying rationale for the nurse practitioner’s suggestion? (Points : 0.4) Platelet aggregation can be precluded through inhibition of prostaglandin production by aspirin. Aspirin helps to inhibit adenosine disphosphate (ADP) action and minimizes platelet plug formation. Aspirin can reduce unwanted platelet adhesion by inhibiting thromboxane A2 (TXA2) synthesis. Aspirin inhibits the conversion of fibrinogen into fibrin and consequent platelet plug formation. Question 10. 10. A nurse practitioner is explaining to a 40-year-old male patient the damage that Mycobacterium tuberculosis could do to lung tissue. Which of the following phenomena would underlie the nurse practitioner’s explanation? (Points : 0.4) Tissue destruction results from neutrophil deactivation. Nonspecific macrophage activity leads to pulmonary tissue destruction and resulting hemoptysis. Macrophages are unable to digest the bacteria, resulting in immune granulomas. Neutrophils are ineffective against the Mycobacterium tuberculosis antigens. Question 11. 11. A 2-year-old girl has had repeated ear and upper respiratory tract infections since she was born. A pediatrician has determined a diagnosis of transient hypogammaglobulinemia of infancy. What is the physiological origin of the child’s recurrent infections? (Points : 0.4) Antibody production by plasma cells is compromised because of impaired communication between B and T cells. The child had a congenital absence of immunoglobulin G (IgG) antibodies and her body is only slowly beginning to produce them independently. The child was born with immunoglobulin A (IgA) and immunoglobulin (IgM) antibodies, suggesting intrauterine infection. The child lacks the antigen presenting cells integral to normal B-cell antibody production. Question 12. 12. A nurse practitioner is teaching her colleagues about the role of cytokines in a variety of pathologies. Which of the following teaching points best captures an aspect of the functions and nature of cytokines? (Points : 0.4) “A particular cytokine can have varied effects on different systems, a fact that limits their therapeutic use.” “Cytokine production is constant over time, but effects are noted when serum levels cross a particular threshold.” “Most cytokines are produced by granular leukocytes, and different cells are capable of producing the same cytokine.” * “Cytokine actions are self-limiting in that activation of one precludes activation of other cytokines with similar actions.” Question 13. 13. A child has been diagnosed with thalassemia. Which of the following other health problems is the child at risk for? (Points : 0.4) Hypocoagulation Iron and ferritin deficiencies Splenomegaly and hepatomegaly Neutropenia Question 14. 14. A 44-year-old female patient presents to the emergency department with abnormal bleeding and abdominal pain that is later attributed to gallbladder disease. Which of the following diagnoses would the medical team be most justified in suspecting as a cause of the patient’s bleeding? (Points : 0.4) Calcium deficiency Vitamin K deficiency Hemophilia B Idiopathic ITP Question 15. 15. A 22-year-old female who adheres to a vegan diet has been diagnosed with iron-deficiency anemia. Which of the following components of her diagnostic blood work would be most likely to necessitate further investigation? (Points : 0.4) Decreased mean corpuscular volume (MCV) Decreased hemoglobin and hematocrit Microcytic, hypochromic red cells Decreased erythropoietin levels Question 16. 16. A 66-year-old female patient has presented to the emergency department because of several months of intermittently bloody stools that has recently become worse. The woman has since been diagnosed with a gastrointestinal bleed secondary to overuse of nonsteroidal anti-inflammatory drugs that she takes for her arthritis. The health care team would realize that which of the following situations is most likely? (Points : 0.4) The woman has depleted blood volume due to her ongoing blood loss. She will have iron-deficiency anemia due to depletion of iron stores. The patient will be at risk for cardiovascular collapse or shock. She will have delayed reticulocyte release. Question 17. 17. A nurse practitioner student is familiarizing herself with the overnight admissions to an acute medical unit of a university hospital. Which of the following patients would the student recognize as being least likely to have a diagnosis of antiphospholipid syndrome in his or her medical history? (Points : 0.4) A 66-year-old obese male with left-sided hemiplegia secondary to a cerebrovascular accident A 90-year-old female resident of a long-term care facility who has been experiencing transient ischemic attacks A 30-year-old female with a diagnosis of left leg DVT and a pulmonary embolism A 21-year-old male with a diagnosis of cellulitis and suspected endocarditis secondary to intravenous drug use Question 18. 18. A patient has been admitted to an inpatient medical unit of a hospital with an acute viral infection. The health care team providing care for the patient would recognize which of the following statements as an accurate description of the role of viruses in human infections? (Points : 0.4) Viruses have limited or absent genetic material of their own. Some viruses are capable of transforming normal host cells into malignant cells. Viruses are often implicated in cases of transmissible neurodegenerative disease. Viruses require stimulation after a latent period before they are able to produce symptoms. Question 19. 19. A 30-year-old man has spent 5 hours on a cross-country flight seated next to a passenger who has been sneezing and coughing, and the man has been inhaling viral particles periodically. Which of the following situations would most likely result in the stimulation of the man’s T lymphocytes and adaptive immune system? (Points : 0.4) Presentation of a foreign antigen by a familiar immunoglobulin Recognition of a foreign MHC molecule Recognition of a foreign peptide bound to a self MHC molecule Cytokine stimulation of a T lymphocyte with macrophage or dendritic cell mediation Question 20. 20. A 60-year-old woman is suspected of having non-Hodgkin lymphoma (NHL). Which of the following aspects of her condition would help to rule out Hodgkin lymphoma? (Points : 0.4) Her neoplasm originates in secondary lymphoid structures. The lymph nodes involved are located in a large number of locations in the lymphatic system. The presence of Reed-Sternberg cells has been confirmed. The woman complains of recent debilitating fatigue. Question 21. 21. Following a course of measles, a 5-year-old girl developed scattered bruising over numerous body surfaces and was diagnosed with immune thrombocytopenic purpura (ITP). As part of her diagnostic workup, blood work was performed. Which of the following results is most likely to be considered unexpected by the health care team? (Points : 0.4) Increased thrombopoietin levels Decreased platelet count Normal vitamin K levels Normal leukocyte levels Question 22. 22. Sputum samples from a patient with pneumonia contain an infective agent that has a peptidoglycan cell wall, expresses endotoxins, replicates readily in broth and on agar, grows in clusters, has pili, and does not stain when exposed to crystal violet. This pneumonia is most likely: (Points : 0.4) Chlamydial Viral Mycoplasmal Bacterial Question 23. 23. The blood work of a 44-year-old male patient with a diagnosis of liver disease secondary to alcohol abuse indicates low levels of albumin. Which of the following phenomena would a clinician be most justified in anticipating? (Points : 0.4) * Impaired immune function Acid-base imbalances Impaired thermoregulation Fluid imbalances Question 24. 24. A 29-year-old construction worker got a sliver under his fingernail four days ago. The affected finger is now reddened, painful, swollen, and warm to the touch. Which of the following hematological processes is most likely occurring in response to the infection? (Points : 0.4) Proliferation of immature neutrophils High circulatory levels of myeloblasts Increased segmented neutrophil production Phagocytosis by myelocytes Question 25. 25. A patient presented to the emergency department of the hospital with a swollen, reddened, painful leg wound and has been diagnosed with methicillin-resistant Staphylococcus aureus cellulitis. The patient’s nurse practitioner has ordered a complete blood count and white cell differential. Which of the following blood components would the nurse practitioner most likely anticipate to be elevated? (Points : 0.4) Basophils Eosinophils Platelets Neutrophils Question 1. 1. A couple who are expecting their first child have been advised by friends to consider harvesting umbilical cord blood in order to have a future source of stem cells. The couple have approached their nurse practitioner with this request and are seeking clarification of exactly why stem cells are valuable and what they might expect to gain from harvesting them. How can the nurse practitioner best respond to the couple’s inquiry? (Points : 0.4) “Stem cells can help correct autoimmune diseases and some congenital defects.” “Stem cells can be used to regenerate damaged organs should the need ever arise.” “Stem cells can be used as a source of reserve cells for the entire blood production system.” “Stem cells can help treat some cancers and anemias, but they must come from your child himself or herself.” Question 2. 2. A 2-year-old girl has had repeated ear and upper respiratory tract infections since she was born. A pediatrician has determined a diagnosis of transient hypogammaglobulinemia of infancy. What is the physiological origin of the child’s recurrent infections? (Points : 0.4) Antibody production by plasma cells is compromised because of impaired communication between B and T cells. The child had a congenital absence of immunoglobulin G (IgG) antibodies and her body is only slowly beginning to produce them independently. The child was born with immunoglobulin A (IgA) and immunoglobulin (IgM) antibodies, suggesting intrauterine infection. The child lacks the antigen presenting cells integral to normal B-cell antibody production. Question 3. 3. A 40-year-old woman who experiences severe seasonal allergies has been referred by her family physician to an allergist for weekly allergy injections. The woman is confused as to why repeated exposure to substances that set off her allergies would ultimately benefit her. Which of the following phenomena best captures the rationale for allergy desensitization therapy? (Points : 0.4) Repeated exposure to offending allergens binds the basophils and mast cells that mediate the allergic response. Exposure to allergens in large, regular quantities overwhelms the IgE antibodies that mediate the allergic response. Repeated exposure stimulates adrenal production of epinephrine, mitigating the allergic response. Injections of allergens simulate production of IgG, which blocks antigens from combining with IgE. Question 4. 4. A 14-year-old boy has been diagnosed with infectious mononucleosis. Which of the following pathophysiological phenomena is most responsible for his symptoms? (Points : 0.4) The Epstein-Barr virus (EBV) is lysing many of the boy’s neutrophils. Viruses are killing some of his B cells and becoming incorporated into the genomes of others. The EBV inhibits the maturation of white cells within his peripheral lymph nodes. The virus responsible for mononucleosis inhibits the maturation of myeloblasts into promyelocytes. Question 5. 5. A 16-year-old female has been brought to her primary care nurse practitioner by her mother due to the girl’s persistent sore throat and malaise. Which of the following facts revealed in the girl’s history and examination would lead the nurse practitioner to rule out infectious mononucleosis? (Points : 0.4) The girl has a temperature of 38.1°C (100.6°F) and has enlarged lymph nodes. Her liver and spleen are both enlarged. Blood work reveals an increased white blood cell count. Chest auscultation reveals crackles in her lower lung fields bilaterally. Question 6. 6. A 24-year-old woman presents with fever and painful, swollen cervical lymph nodes. Her blood work indicates neutrophilia with a shift to the left. She most likely has: (Points : 0.4) A mild parasitic infection A severe bacterial infection A mild viral infection A severe fungal infection Question 7. 7. Which of the following patients is most likely to benefit from transplantation of thymic tissue or major histocompatibility complex (MHC)-compatible bone marrow? (Points : 0.4) A 12-year-old girl with a history of epilepsy and low IgG levels secondary to phenytoin use A 7-year-old boy whose blood work indicates decreased IgA and IgG with increased IgM A 6-year-old boy whose pre-B cells are incapable of translation to normal B cells A 9-year-old girl who has a diagnosis of IgA deficiency Question 8. 8. Which of the following statements most accurately conveys an aspect of lymphatic system activity? (Points : 0.4) B and T lymphocyte development begins in the bone marrow and ends in the peripheral lymphoid structures. B cells and macrophages are released from the bone marrow in their completed state. Stem cells in the lymph nodes initiate and regulate the process of white cell synthesis. Leukocytes bypass vascular circulation and are distributed instead by the lymphatic system. Question 9. 9. A child has been diagnosed with thalassemia. Which of the following other health problems is the child at risk for? (Points : 0.4) Hypocoagulation Iron and ferritin deficiencies Splenomegaly and hepatomegaly Neutropenia Question 10. 10. The blood work of a 44-year-old male patient with a diagnosis of liver disease secondary to alcohol abuse indicates low levels of albumin. Which of the following phenomena would a clinician be most justified in anticipating? (Points : 0.4) Impaired immune function Acid-base imbalances Impaired thermoregulation Fluid imbalances Question 11. 11. A 60-year-old male patient with an acute viral infection is receiving interferon therapy. The nurse practitioner is teaching the family of the patient about the diverse actions of the treatment and the ways that it differs from other anti-infective therapies. Which of the following teaching points should the nurse practitioner exclude? (Points : 0.4) “Interferon can help your father’s unaffected cells adjacent to his infected cells produce antiviral proteins that limit the spread of the infection.” “Interferon can help limit the replication of the virus that’s affecting your father.” “Interferon helps your father’s body recognize infected cells more effectively.” “Interferon can bolster your father’s immune system by stimulating natural killer cells that attack viruses.” Question 12. 12. A patient has been admitted to an inpatient medical unit of a hospital with an acute viral infection. The health care team providing care for the patient would recognize which of the following statements as an accurate description of the role of viruses in human infections? (Points : 0.4) Viruses have limited or absent genetic material of their own. Some viruses are capable of transforming normal host cells into malignant cells. Viruses are often implicated in cases of transmissible neurodegenerative disease. Viruses require stimulation after a latent period before they are able to produce symptoms. Question 13. 13. A patient presented to the emergency department of the hospital with a swollen, reddened, painful leg wound and has been diagnosed with methicillin-resistant Staphylococcus aureus cellulitis. The patient’s nurse practitioner has ordered a complete blood count and white cell differential. Which of the following blood components would the nurse practitioner most likely anticipate to be elevated? (Points : 0.4) Basophils Eosinophils Platelets Neutrophils Question 14. 14. A 23-year-old man has received a recent diagnosis of appendicitis following 24 hours of acute abdominal pain. The nurse practitioner providing care for the man is explaining that while it is unpleasant, the inflammation of his appendix is playing a role in his body’s fight against the underlying infectious process. Which of the following teaching points should the nurse practitioner eliminate from his teaching for the patient? (Points : 0.4) “Inflammation can help to remove the body tissue cells that have been damaged by infection.” “Inflammation will start your body on the path to growing new, healthy tissue at the site of infection. “Inflammation helps your body to produce the right antibodies to fight the infection.” “Inflammation ultimately aids in eliminating the initial cause of the cell injury in your appendix.” Question 15. 15. A nurse practitioner is teaching her colleagues about the role of cytokines in a variety of pathologies. Which of the following teaching points best captures an aspect of the functions and nature of cytokines? (Points : 0.4) “A particular cytokine can have varied effects on different systems, a fact that limits their therapeutic use.” “Cytokine production is constant over time, but effects are noted when serum levels cross a particular threshold.” “Most cytokines are produced by granular leukocytes, and different cells are capable of producing the same cytokine.” “Cytokine actions are self-limiting in that activation of one precludes activation of other cytokines with similar actions.” Question 16. 16. A nurse practitioner student is familiarizing herself with the overnight admissions to an acute medical unit of a university hospital. Which of the following patients would the student recognize as being least likely to have a diagnosis of antiphospholipid syndrome in his or her medical history? (Points : 0.4) A 66-year-old obese male with left-sided hemiplegia secondary to a cerebrovascular accident A 90-year-old female resident of a long-term care facility who has been experiencing transient ischemic attacks A 30-year-old female with a diagnosis of left leg DVT and a pulmonary embolism A 21-year-old male with a diagnosis of cellulitis and suspected endocarditis secondary to intravenous drug use Question 17. 17. A 66-year-old female patient has presented to the emergency department because of several months of intermittently bloody stools that has recently become worse. The woman has since been diagnosed with a gastrointestinal bleed secondary to overuse of nonsteroidal anti-inflammatory drugs that she takes for her arthritis. The health care team would realize that which of the following situations is most likely? (Points : 0.4) The woman has depleted blood volume due to her ongoing blood loss. She will have iron-deficiency anemia due to depletion of iron stores. The patient will be at risk for cardiovascular collapse or shock. She will have delayed reticulocyte release. Question 18. 18. A tourist presented to a primary care health clinic complaining of malaise, fever, and headache. She has subsequently been diagnosed with Rocky Mountain spotted fever, a pathology caused by Rickettsiaceae. Which of the followed statements best captures a characteristic trait of Rickettsiaceae? (Points : 0.4) They are eukaryotic. They have both RNA and DNA. They have a distinct spiral-shaped morphology. They are neither gram-negative nor gram-positive. Question 19. 19. A nurse practitioner is explaining to a 40-year-old male patient the damage that Mycobacterium tuberculosis could do to lung tissue. Which of the following phenomena would underlie the nurse practitioner’s explanation? (Points : 0.4) Tissue destruction results from neutrophil deactivation. Nonspecific macrophage activity leads to pulmonary tissue destruction and resulting hemoptysis. Macrophages are unable to digest the bacteria, resulting in immune granulomas. Neutrophils are ineffective against the Mycobacterium tuberculosis antigens. Question 20. 20. Following a course of measles, a 5-year-old girl developed scattered bruising over numerous body surfaces and was diagnosed with immune thrombocytopenic purpura (ITP). As part of her diagnostic workup, blood work was performed. Which of the following results is most likely to be considered unexpected by the health care team? (Points : 0.4) Increased thrombopoietin levels Decreased platelet count Normal vitamin K levels Normal leukocyte levels Question 21. 21. A 29-year-old construction worker got a sliver under his fingernail four days ago. The affected finger is now reddened, painful, swollen, and warm to the touch. Which of the following hematological processes is most likely occurring in response to the infection? (Points : 0.4) * Proliferation of immature neutrophils High circulatory levels of myeloblasts Increased segmented neutrophil production Phagocytosis by myelocytes Question 22. 22. As part of his diagnostic workup, a 77-year-old man’s nurse practitioner has ordered blood work that includes ferritin levels. The man is very interested in the details of his health care and is unfamiliar with ferritin and its role. He asks his nurse practitioner to explain the significance of it and the rationale for testing it. Which of the following explanations by the nurse practitioner is most accurate? (Points : 0.4) “Ferritin is the activated and usable form of iron that your red blood cells can use to transport oxygen.” “Ferritin is a stored form of iron that indirectly shows me whether you would benefit from iron pills.” “Ferritin is a protein-iron complex that allows your red blood cells to make use of the iron that you consume in your diet.” “Ferritin is the form of iron that is transported in your blood plasma to the red blood cells that need it.” Question 23. 23. A nurse practitioner is providing prenatal care and education for a first-time expectant mother, 22 weeks’ gestation, who has a diagnosis of a sexually transmitted infection. Which of the following statements by the expectant mother demonstrates an adequate understanding of vertical disease transmission and congenital infections? (Points : 0.4) “Gonorrhea and chlamydia pose the greatest risks of transmission from mother to child.” “I know that my baby will need observation for HIV signs and symptoms in the weeks following my delivery.” “My baby could become infected either across the placenta or during the birth itself.” “Prophylactic immunization will reduce my baby’s chance of being born with an illness.” Question 24. 24. A 71-year-old male patient with a history of myocardial infarction and peripheral vascular disease has been advised by his nurse practitioner to begin taking 81 mg aspirin once daily. Which of the following statements best captures an aspect of the underlying rationale for the nurse practitioner’s suggestion? (Points : 0.4) Platelet aggregation can be precluded through inhibition of prostaglandin production by aspirin. Aspirin helps to inhibit adenosine disphosphate (ADP) action and minimizes platelet plug formation. Aspirin can reduce unwanted platelet adhesion by inhibiting thromboxane A2 (TXA2) synthesis. Aspirin inhibits the conversion of fibrinogen into fibrin and consequent platelet plug formation. Question 25. 25. A 22-year-old female who adheres to a vegan diet has been diagnosed with iron-deficiency anemia. Which of the following components of her diagnostic blood work would be most likely to necessitate further investigation? (Points : 0.4) Decreased mean corpuscular volume (MCV) Decreased hemoglobin and hematocrit Microcytic, hypochromic red cells Decreased erythropoietin levels

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2025 Minimum of 300 words and 2 references each 1 Qualitative data has been described as voluminous and

Qualitative Data 2025

Minimum of 300 words and 2 references each: 1. Qualitative data has been described as voluminous and sometimes overwhelming to the researcher. Discuss two strategies that would help a researcher manage and organize the data. 2. The three types of qualitative research are phenomenological, grounded theory, and ethnographic research. Compare the differences and similarities between two of the three types of qualitative studies and give an example of each.

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2025 Please write responses to each of the questions 1a 2a 3a and 3b listed below for

Evidence based practice 2025

Please write responses to each of the questions (1a., 2a., 3a., and 3b.) listed below for Module 4 Discussion Board: 1. Chapter 2 in Polit and Beck (2020) examines using research as evidence for personal practice and for changing practice in specific settings using evidence based practice (EBP) models. Think about barriers that are associated with implementation of EBP either individually or at a unit /systems level. Please discuss the following question. 1 a.) What is one barrier that you have encountered or anticipate may occur with the implementation of EBP and what are some solutions to overcome that barrier? 2. Chapter 1 and 3 in Polit and Beck (2020) include information about the differences and similarities between quantitative and qualitative research methods. Consider the information about differences and similarities between quantitative and qualitative research methods and discuss the following question. 2 a.) Think about the positivist versus constructivist paradigm. From which perspective (positivist or constructivist paradigm) do you view the world? Explain why. How could the perspective (positivist or constructivist paradigm) in which you view the world influence your research in your practice setting? 3. As you review Chapter 7 in Polit and Beck (2020), particularly Box 7.3, the known aspects of Institutional Review Board (IRB) and safeguarding participants are included. Please discuss the following questions. 3 a.) When reading research, prior to taking this course, were you able to get a sense of the ethical aspects of the research? Explain. 3 b.) After reviewing Chapter 7 in Polit and Beck (2020), speak to how, when reading a research study, you will now be more aware of thinking about 1) vulnerable groups inclusion as well as 2) which groups were omitted with or without a justifiable rationale being included.

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2025 Capstone Change Project Evaluation Plan Review your strategic plan to implement the change

Capstone Change Project Evaluation Plan by 07/02/2021 2025

Capstone Change Project Evaluation Plan Review your strategic plan to implement the change proposal, the objectives, the outcomes, and listed resources. Develop a process to evaluate the intervention if it were implemented. Write a 150-250 word summary of the evaluation plan that will be used to evaluate your intervention. The assignment will be used to develop a written implementation plan. APA style is not required, but solid academic writing is expected. You are not required to submit this assignment to LopesWrite

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2025 Review the Resources and identify a clinical issue of interest that can form the basis

NURS 6052 WEEK 5 ASSIGNMENT 2025

Review the Resources and identify a clinical issue of interest that can form the basis of a clinical inquiry. Develop a PICO(T) question to address the clinical issue of interest you identified in Module 2 for the Assignment. This PICOT question will remain the same for the entire course. Use the key words from the PICO(T) question you developed and search at least four different databases in the Walden Library. Identify at least four relevant systematic reviews or other filtered high-level evidence, which includes meta-analyses, critically-appraised topics (evidence syntheses), critically-appraised individual articles (article synopses). The evidence will not necessarily address all the elements of your PICO(T) question, so select the most important concepts to search and find the best evidence available. Reflect on the process of creating a PICO(T) question and searching for peer-reviewed research. The Assignment (Evidence-Based Project) Part 2: Advanced Levels of Clinical Inquiry and Systematic Reviews Create a 6- to 7-slide PowerPoint presentation in which you do the following: Identify and briefly describe your chosen clinical issue of interest. Describe how you developed a PICO(T) question focused on your chosen clinical issue of interest. Identify the four research databases that you used to conduct your search for the peer-reviewed articles you selected. Provide APA citations of the four relevant peer-reviewed articles at the systematic-reviews level related to your research question. If there are no systematic review level articles or meta-analysis on your topic, then use the highest level of evidence peer reviewed article. Describe the levels of evidence in each of the four peer-reviewed articles you selected, including an explanation of the strengths of using systematic reviews for clinical research. Be specific and provide examples.

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2025 Assignment Assessing and Treating Patients With ADHD Not only do children and adults have different presentations for

WK9 ASSIGN NURS 6630 2025

Assignment: Assessing and Treating Patients With ADHD Not only do children and adults have different presentations for ADHD, but males and females may also have vastly different clinical presentations. Different people may also respond to medication therapies differently. For example, some ADHD medications may cause children to experience stomach pain, while others can be highly addictive for adults. In your role, as a psychiatric nurse practitioner, you must perform careful assessments and weigh the risks and benefits of medication therapies for patients across the life span. For this Assignment, you consider how you might assess and treat patients presenting with ADHD. To prepare for this Assignment: Review this week’s Learning Resources, including the Medication Resources indicated for this week. Reflect on the psychopharmacologic treatments you might recommend for the assessment and treatment of patients with ADHD. The Assignment: 5 pages Examine Case Study: A Young Caucasian Girl with ADHD. You will be asked to make three decisions concerning the medication to prescribe to this patient. Be sure to consider factors that might impact the patient’s pharmacokinetic and pharmacodynamic processes. At each decision point, you should evaluate all options before selecting your decision and moving throughout the exercise. Before you make your decision, make sure that you have researched each option and that you evaluate the decision that you will select. Be sure to research each option using the primary literature. Introduction to the case (1 page) Briefly explain and summarize the case for this Assignment. Be sure to include the specific patient factors that may impact your decision making when prescribing medication for this patient. Decision #1 (1 page) Which decision did you select? Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature. Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature. What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature). Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples. Decision #2 (1 page) Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature. Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature. What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature). Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples. Decision #3 (1 page) Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature. Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature. What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature). Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples. Conclusion (1 page) Summarize your recommendations on the treatment options you selected for this patient. Be sure to justify your recommendations and support your response with clinically relevant and patient-specific resources, including the primary literature. Note: Support your rationale with a minimum of five academic resources. While you may use the course text to support your rationale, it will not count toward the resource requirement. You should be utilizing the primary and secondary literature. Week 9: Therapy for Patients With ADHD/ODD Diego, a 9-year-old third grader, had always been an energetic child with a short attention span. For years, his mother attributed his behaviors to him being “all boy” and assumed it would improve as he grew older. Instead, daily tasks like chores and homework became increasingly overwhelming for Diego, resulting in disruptive behaviors at home and school. After being evaluated by his healthcare provider, Diego was diagnosed with and treated for attention deficit hyperactivity disorder (ADHD). ADHD is a prevalent disorder for patients across the lifespan, as more than 6 million children (CDC, n.d.) have been diagnosed with the disorder. Further, consider that about 60% of children with ADHD in the United States become adults with ADHD (ADAA, n.d.). Like Diego, individuals of all ages find that symptoms of ADHD can make life challenging. However, when properly diagnosed and treated, patients often respond well to therapies and have positive health outcomes. This week, as you study ADHD therapies, you examine the assessment and treatment of patients with ADHD. You also explore ethical and legal implications of these therapies. References: Centers for Disease Control and Prevention. (n.d.). Data and statistics about ADHD . https://www.cdc.gov/ncbddd/adhd/data.html Anxiety and Depression Association of America. (n.d.). Adult ADHD (Attention Deficit Hyperactive Disorder). https://adaa.org/understanding-anxiety/related-illnesses/other-related-conditions/adult-adhd Learning Objectives Students will: Assess patient factors and history to develop personalized therapy plans for patients with ADHD Analyze factors that influence pharmacokinetic and pharmacodynamic processes in patients requiring therapy for ADHD Synthesize knowledge of providing care to patients presenting for ADHD Analyze ethical and legal implications related to prescribing therapy for patients with ADHD Identify concepts related to psychopharmacologic treatments and therapy for patients across the lifespan Learning Resources Required Readings (click to expand/reduce) Prince, J. B., Wilens, T. E., Spencer, T. J., & Biederman, J. (2016). Stimulants and other medications for ADHD. In T. A. Stern, M. Favo, T. E. Wilens, & J. F. Rosenbaum. (Eds.), Massachusetts General Hospital psychopharmacology and neurotherapeutics (pp. 99–112). Elsevier. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596 Hodgkins, P., Shaw, M., McCarthy, S., & Sallee, F. R. (2012). The pharmacology and clinical outcomes of amphetamines to treat ADHD: Does composition matter? CNS Drugs, 26 (3), 245–268. https://doi.org/10.2165/11599630-000000000-00000 Martin, L. (2020). A 5-question quiz on ADHD . Psychiatric Times. https://www.psychiatrictimes.com/view/5-question-quiz-adhd Medication Resources (click to expand/reduce) IBM Corporation. (2020). IBM Micromedex . https://www.micromedexsolutions.com/micromedex2/librarian/deeplinkaccess?source=deepLink&institution=SZMC%5ESZMC%5ET43537 Note: To access the following medications, use the IBM Micromedex resource. Type the name of each medication in the keyword search bar. Be sure to read all sections on the left navigation bar related to each medication’s result page, as this information will be helpful for your review in preparation for your Assignments. armodafinil amphetamine (d) amphetamine (d,l) atomoxetine bupropion chlorpromazine clonidine guanfacine haloperidol lisdexamfetamine methylphenidate (d) methylphenidate (d,l) modafinil reboxetine Required Media (click to expand/reduce) Case Study: A Young Caucasian Girl with ADHD Note: This case study will serve as the foundation for this week’s Assignment. Attention Deficit Hyperactivity Disorder A Young Girl With ADHD BACKGROUND Katie is an 8 year old Caucasian female who is brought to your office today by her mother & father. They report that they were referred to you by their primary care provider after seeking her advice because Katie’s teacher suggested that she may have ADHD. Katie’s parents reported that their PCP felt that she should be evaluated by psychiatry to determine whether or not she has this condition. The parents give you a copy of a form titled “Conner’s Teacher Rating Scale-Revised”. This scale was filled out by Katie’s teacher and sent home to the parents so that they could share it with their family primary care provider. According to the scoring provided by her teacher, Katie is inattentive, easily distracted, forgets things she already learned, is poor in spelling, reading, and arithmetic. Her attention span is short, and she is noted to only pay attention to things she is interested in. The teacher opined that she lacks interest in school work and is easily distracted. Katie is also noted to start things but never finish them, and seldom follows through on instructions and fails to finish her school work. Katie’s parents actively deny that Katie has ADHD. “She would be running around like a wild person if she had ADHD” reports her mother. “She is never defiant or has temper outburst” adds her father. SUBJECTIVE Katie reports that she doesn’t know what the “big deal” is. She states that school is “OK”- her favorite subjects are “art” and “recess.” She states that she finds her other subjects boring, and sometimes hard because she feels “lost”. She admits that her mind does wander during class to things that she thinks of as more fun. “Sometimes” Katie reports “I will just be thinking about nothing and the teacher will call my name and I don’t know what they were talking about.” Katie reports that her home life is just fine. She reports that she loves her parents and that they are very good and kind to her. Denies any abuse, denies bullying at school. Offers no other concerns at this time. MENTAL STATUS EXAM The client is an 8 year old Caucasian female who appears appropriately developed for her age. Her speech is clear, coherent, and logical. She is appropriately oriented to person, place, time, and event. She is dressed appropriately for the weather and time of year. She demonstrates no noteworthy mannerisms, gestures, or tics. Self-reported mood is euthymic. Affect is bright. Katie denies visual or auditory hallucinations, no delusional or paranoid thought processes readily appreciated. Attention and concentration are grossly intact based on Katie’s attending to the clinical interview and her ability to count backwards from 100 by serial 2’s and 5’s. Insight and judgment appear age appropriate. Katie denies any suicidal or homicidal ideation. Diagnosis: Attention deficit hyperactivity disorder, predominantly inattentive presentation RESOURCES § Conners, C. K., Sitarenios, G., Parker, J. D. A., & Epstein, J. N. (1998). Revision and restandardization of the Conners’ Teacher Rating Scale (CTRS-R): Factors, structure, reliability, and criterion validity. Journal of Abnormal Child Psychology, 26, 279-291. Decision Point One Select what you should do: Decision Point One Begin Wellbutrin (bupropion) XL 150 mg orally daily RESULTS OF DECISION POINT ONE Client returns to clinic in four weeks Katie’s parents inform you that they stopped giving Katie the medication because about 2 weeks into the prescription, Katie told her parents that she was thinking about hurting herself. This scared the parents, but they didn’t want to “bother you” by calling the office, so they felt that it would be best to just stop the medication as they would be seeing you in two weeks Decision Point Two Educate the parents that Bupropion sometimes causes suicidal ideation in children and that this is normal, and re-start the drug at the previous dose RESULTS OF DECISION POINT TWO Client returns to clinic in four weeks Katie’s parents again report that after about a week of treatment with the Bupropion, Katie began telling her parents that she wanted to hurt herself and began having dreams about being dead. This scared her parents and they stopped giving her the medication At this point, they are quite upset with the results of their daughter’s treatment and are convinced that medication is not the answer Decision Point Three Discuss the use of a medication such as Adderall and its evidence for treating ADHD Guidance to Student Bupropion is used off-label for ADHD and is used more commonly in adults. It’s mechanism of action results in increasing the neurotransmitters norepinephrine/noradrenaline and dopamine. Since dopamine is inactivated by norepinephrine reuptake in frontal cortex, (which largely lacks dopamine transporters) bupropion can increase dopamine neurotransmission in this part of the brain, which may explain its effectiveness in ADHD. However, Bupropion as well as other antidepressants have been linked to suicidal ideation in children and adolescents- despite the fact that it was being used initially to treat ADHD, it is still an antidepressant. At this point, the parents are probably quite frustrated as no parent wants to hear their child talking about hurting themselves or having dreams about being dead. If the parents are adamant about no more medications, referral to a pediatric psychologist or similar therapist skilled in the use of behavioral therapies to treat ADHD in children. However, it should be noted that behavioral therapies work best when combined with medication, however, if the parents are insistent, then behavioral therapy may be the only alternative left in the treatment of Katie. In terms of the pathophysiology of ADHD, whereas it may be true that increasing age may demonstrate some improvement in symptoms (some people will actually experience complete resolution of symptoms by adulthood), it is not helping Katie in the here and now. Katie still needs help with her symptoms which are causing academic issues. You should attempt to repair the rupture in the therapeutic alliance (the parents now believe that medications are not the answer) by explaining rationale for the use of Bupropion (many people like to start with Bupropion because it has a low-risk for addiction). The family should be encouraged to allow you to initiate Adderall as it has a very good track record in terms of its efficacy in treating ADHD.

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2025 Read the Oswego Outbreak Investigation located in the study materials In a 750 1 000 word paper evaluate the situation

Oswego Outbreak Investigation 2025

Read the “Oswego Outbreak Investigation,” located in the study materials. In a 750-1,000 word paper, evaluate the situation and present your findings. Include the following: Refer to the “Oswego Outbreak Investigation.” Read the scenario and review the epidemic curve that describes the time of onset of illness. What does this curve tell you regarding the average incubation period, source, and transmission? Using the incubation range and clinical symptoms, identify potential infectious agents that could be responsible for the outbreak (refer to the study material, “Compendium of Acute Foodborne and Waterborne Diseases”). Provide an explanation for your findings. Why is this considered an outbreak? Discuss the criteria for why it is considered an outbreak. Describe the steps required to investigate an outbreak and apply each step to the Oswego event. Include the relevant information needed for each step to be successful. Discuss the possible routes of transmission for the expected agent. Based on this information, what control measures would you recommend? State a control measure for each prevention level: primary, secondary, and tertiary prevention. You are required to cite to a minimum of three sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and public health content. I have attached two attachments that go along with the assignment. Please review this.

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2025 Instructions Create a teaching tool to promote breastfeeding The material created to educate new mothers on

Assignment Requirements: teaching tool will be a TRIFOLD and must include this relevant content for a mother considering the risks and benefits of breastfeeding a newborn. Include also the information below T 2025

Instructions Create a teaching tool to promote breastfeeding. The material created to educate new mothers on breastfeeding will influence the mother’s decision to breastfeed, including duration, based on the quality and content of the teaching. Assignment Requirements Your teaching tool will be a trifold and must include this relevant content for a mother considering the risks and benefits of breastfeeding a newborn. Explain how breast milk is formed in the mammary glands and the physiology of breast milk Include two 2020 National Health Goals related to newborn nutrition to support breast feeding as the best choice. See the link below: https://www.healthypeople.gov/2020/topics-objectives/topic/maternal-infant-and-child-health Discuss the advantages of breastfeeding related to immunities transferred to the newborn Describe three additional benefits of breast feeding with supporting rationales Include at least two supporting resources Document must be written

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2025 Case Study Severely underweight 12 year old Hispanic girl with underweight parents who has been bullied in

Case Study Assignment: Assessment Tools and Diagnostic Tests in Adults and Children 2025

Case Study: Severely underweight 12-year-old Hispanic girl with underweight parents who has been bullied in school just recently Photo Credit: Getty Images/Hero Images For this Assignment, you will consider the validity and reliability of different assessment tools and diagnostic tests. You will explore issues such as sensitivity, specificity, and positive and negative predictive values. You will also consider examples of children with various weight issues. You will explore how you could effectively gather information and encourage parents and caregivers to be proactive about their children’s health and weight. To Prepare Review this week’s Learning Resources and consider factors that impact the validity and reliability of various assessment tools and diagnostic tests. You also will review examples of pediatric patients and their families as it relates to BMI. By Day 1 of this week, you will be assigned to one of the following Assignment options by your Instructor: Adult Assessment Tools or Diagnostic Tests (option 1), or Child Health Case (Option 2). Note: Please see the “Course Announcements” section of the classroom for your assignments from your Instructor. Search the Walden Library and credible sources for resources explaining the tool or test you were assigned. What is its purpose, how is it conducted, and what information does it gather? Also, as you search the Walden library and credible sources, consider what the literature discusses regarding the validity, reliability, sensitivity, specificity, predictive values, ethical dilemmas, and controversies related to the test or tool. If you are assigned Assignment Option 2 (Child), consider what health issues and risks may be relevant to the child in the health example. Based on the risks you identified, consider what further information you would need to gain a full understanding of the child’s health. Think about how you could gather this information in a sensitive fashion. Consider how you could encourage parents or caregivers to be proactive toward the child’s health. The Assignment Assignment (3–4 pages, not including title and reference pages) : Assignment Option 2: Child Health Case: Include the following: An explanation of the health issues and risks that are relevant to the child you were assigned. Describe additional information you would need in order to further assess his or her weight-related health. Identify and describe any risks and consider what further information you would need to gain a full understanding of the child’s health. Think about how you could gather this information in a sensitive fashion. Taking into account the parents’ and caregivers’ potential sensitivities, list at least three specific questions you would ask about the child to gather more information. Provide at least two strategies you could employ to encourage the parents or caregivers to be proactive about their child’s health and weight. Please pay attention to the case study 5 references not less than 5years zero plagiarism

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2025 Download Options for Reducing the Deficit 2017 to 2026 from the Congressional

Congressional Budget Office: Options for Reducing the Deficit ( FOR (MHA 516 Thom Sloan Instructor)NYANA)
please don’t repurchase this answer if this is your professor 2025

Download Options for Reducing the Deficit: 2017 to 2026 from the Congressional Budget Office website. Read Ch. 5 of the report. Select one of the health options listed. Select a health care facility or service (e.g., hospital, physician practice, long-term care facility, ambulance service, pharmacy, or skilled nursing facility), and evaluate the effects that implementing the health option would have on a health care facility or service you selected. Write a 350- to 525-word article about your evaluation and proposed changes to the facility or service that can help curb negative effects. Publish the article on your own social media account (e.g., LinkedIn, Facebook, etc.), or post it on a health care message board of your choice. Include a citation of your article in your assignment. (I WILL PUBLISH) Cite 3 reputable references to support your assignment (e.g., trade or industry publications, government or agency websites, scholarly works, or other sources of similar quality). attached is the grading rubic for this assignment pay attention Materials Options for Reducing the Deficit: 2017 to 2026 – found on internet Congressional Budget Office- found on internet

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