Agenda Comparison Grids,  APA citation, 3 references (200-250 words)

Topic Mental Health Depression

Regardless of political affiliation, every citizen has a stake in healthcare policy decisions. Hence, it is little wonder why healthcare items become such high-profile components of presidential agendas. It is also little wonder why they become such hotly debated agenda items.

In Part 1 of this module’s Assignment, you were asked to begin work on an Agenda Comparison Grid to compare the impact of the current/sitting U.S. president and the two previous presidents’ agendas on the healthcare item you selected for study. In this Discussion, you will share your first draft with your colleagues to receive feedback to be applied to your final version.

To Prepare:

• Review the Resources and reflect on the importance of agenda setting.
• Consider how federal agendas promote healthcare issues and how these healthcare issues become agenda priorities.
• Review Part 1 of the Module 1 Assignment and complete the requirements for this Discussion.

Describe how the educational level achieved by a nurse or the entry point into professional nursing practice affects the quality and competence of a nurse’s participation in policy making.Why it is important for registered nurses to influence the regulatory process? Does the nurses education have influence on their ability to make an impact? 

Comment 1

T-test

The T-Statistic is used in a T test running a hypothesis test.  You will use T-Statistic with a p value.  The p value tells us the odds are that the results could have happened by chance.  A big difference in the t-score is that the population standard deviation will need to be estimated (therefore the population standard deviation is unknown until estimated).

T-test is used when:   the sample size is below 30 and it has an unknown population standard deviation

Z-test

The Z-score (also known as standard score) lets us calculate the probability of a score occurring within a normal frequency distribution.  Also, the Z-score lets us compare two scores from other different normal distributions.  This is done by changing scores in a normal distribution to z-scores resulting in a standard normal distribution.  In a normal frequency distribution by standardizing the score we can find out the probability of the score.  In a normal frequency distribution (bell curve) a z-score is the number of standard deviation from the mean.  This is a measure of how many standard deviations above or below the population mean.  Z-score results are used to compare results from a test to a normal population (Statistics How to, 2018).  For example if you want to compare a student test average to the rest of the class.

Z-test– lets us to decide if the sample is different from the population mean. Four things must be known when using z-score:  1. the population mean  2. The population standard deviation 3. The sample mean and  4. The sample size. 

z-test is used when:  the sample size is above 30 and the standard deviation of the population is known or if the standard deviation of the population is known but the sample size is small then a t-test is used.

Comment 2

Good morning Instructor and classmates; The statistical procedure for testing whether or not a chance s credible for the explanation of an experimental finding is called hypothesis testing. One of the key concepts in hypothesis testing is that of significance  level or, the alpha level, which specifies the probability level for the evidencee to be an unreasonable estimate. (Banerjee, 2009).

An alpha level of 0.05 is the recommended pattern for a two-tailed test. The alpha level is considered based on the individual’s personal conditions of how strong the individual wants the evidence to be. The alpha level is also the probability or p-value that researchers accept as being significant, and can also be interpreted as the opportunity of making a Type I or Type II error. When you set a more stringent (smaller) alpha like such as  .01 or .001 it decreases the probability of making   Type 1 error, the likelihood of making a  Type II error, suggesting that an alpha level .05 is a satisfying compromise between the making of Type I and Type II errors.

For some experiments, if the consequence of the applying of null hypothesis is extremely serious, for example, if null hypothesis applies,  there may be death, injury or serious disease happening, then you want to try your best to avoid the type I error, that is, avoid the situation that null hypothesis is true but you reject it. As the significance level is the probability you will make the type 1 error. So for such experiments with serious results, we want to make the level smaller than standard situation. So  or such experiments, if you can’t tolerate a 5% (0.05) chance of being wrong, use a lower significance level, 0.01 or 0.001 for example. 0.001 is common if there’s a possibility of death or serious disease.

The first kind of error that involves the rejection of a null hypothesis where it is actually true is called Type I error.  Type I errors are equivalent to false positives.  For example,  A drug like Cyclophosphamide (Cytoxan) that is being used to treat various types of cancer can have dangerous results if the Null hypothesis is rejected because this would claim that this drug does not have any effects on the cancer. However, if the Null hypothesis is true, when the drug ( Cytoxan) does not combat cancer. As a result, the drug (Cytoxan) has falsely claimed to have a positive effect on treating the cancer.

Type II error is equivalent to false negatives. A Type II error occurs if it showed that the drug Cyclophosphamide ( Cytoxan) has no effect on treating the cancer, but in actuality it does. In conclusion, even though Type and Type II errors are part of the process of hypothesis testing and errors can’t be completely eliminated, one type of error may be minimize by decreasing the probability of the type of error in order for the probability of the other type of error to increase.

Question 1 2 / 2 points

A patient is seen with a sudden onset of flank pain accompanied by nausea, vomiting, and diaphoresis. In addition to nephrolithiasis, which of the following should be added to the list of differential diagnoses?

Question options: 

a) Pancreatitis

b) Peptic ulcer disease

c) Diverticulitis

d) All of the above

Question 2 2 / 2 points

Which of the following would be an appropriate treatment for a patient with mild BPH?

Question options:

a) Refer to a urologist for surgery.

b) Prescribe a trial of tamsulosin.

c) Recommend cranberry supplements.

d) Reevaluate symptoms in 1 to 3 months.

Question 3 2 / 2 points

The result of the patient’s 24-hour urine for protein was 4.2 g/day. The clinician should take which of the following actions?

Question options:

a) Repeat the test.

b) Refer to a nephrologist.

c) Measure the serum protein.

d) Obtain a blood urea nitrogen (BUN) and creatinine.

Question 4 2 / 2 points

Which is the most potent and irritating dose of tretinoin?

Question options:

a) 0.05% liquid formulation

b) 0.1% cream

c) 1% foam

d) 0.02% cream

Question 5 2 / 2 points

Which of the following clinical manifestations are consistent with a patient in ARF?

Question options:

a) Pruritis

b) Glycosuria

c) Irritability

Question 6 2 / 2 points

Which of the following is an infraorbital fold skin manifestation in a patient with atopic dermatitis?

Question options:

a) Keratosis pilaris

b) Dennie’s sign

c) Keratoconus

d) Pityriasis alba

Question 7 2 / 2 points

The patient with BPH is seen for follow-up. He has been taking finasteride (Proscar) for 6 months. The clinician should assess this patient for which of these side effects?

Question options:

a) Erectile dysfunction

b) Glaucoma

c) Hypotension

d) Headache

Question 8 2 / 2 points

When using the microscope for an intravaginal infection, you see something translucent and colorless. What do you suspect?

Question options:

a) A piece of hair or a thread

b) Hyphae

c) Leukocytes

d) Spores

Question 9 2 / 2 points

Your patient is in her second trimester of pregnancy and has a yeast infection. Which of the following is a treatment that you usually recommend/order in nonpregnant patients, but is listed as a Pregnancy category D?

Question options:

a) Vagistat vaginal cream

b) Monistat combination pack

c) Terazol vaginal cream

d) Diflucan, 150 mg

Question 10 2 / 2 points

A patient is seen in the clinic with hematuria confirmed on microscopic examination. The clinician should inquire about the ingestion of which of these substances that might be the cause of hematuria?

Question options:

a) NSAIDs

b) Beets

c) Vitamin A

d) Red meat

Question 11 2 / 2 points

Which of the following tests is most useful in determining renal function in a patient suspected of CRF?

Question options:

a) BUN and creatinine

b) Electrolytes

c) Creatinine clearance

d) Urinalysis

Question 12 2 / 2 points

Eighty percent of men have noticeable hair loss by what age?

Question options:

a) 35

b) 50

c) 70

d) 85

Question 13 0 / 2 points

When looking under the microscope to diagnose an intravaginal infection, you see a cluster of small and oval to round shapes.What do you suspect they are?

Question options:

a) Spores

b) Leukocytes

c) Pseudohyphae

d) Epithelial cells

Question 14 2 / 2 points

Which of the following information is essential before prescribing Bactrim DS to a 24-year-old woman with a UTI?

Question options:

a) Last menstrual period

b) Method of birth control

c) Last unprotected sexual contact

d) All of the above

Question 15 2 / 2 points

What is the treatment of choice for a patient diagnosed with testicular cancer?

Question options:

a) Radical orchidectomy

b) Lumpectomy

c) Radiation implants

d) All of the above

Question 16 2 / 2 points

Which test is used to confirm a diagnosis of epididymitis?

Question options:

a) Urinalysis

b) Gram stain of urethral discharge

c) Complete blood cell count with differential

d) Ultrasound of the scrotum

Question 17 2 / 2 points

Sally, age 25, presents with impetigo that has been diagnosed as infected with Staphylococcus. The clinical presentation is pruritic tender, red vesicles surrounded by erythema with a rash that is ulcerating. Her recent treatment has not been adequate. Which type of impetigo is this?

Question options:

a) Bullous impetigo

b) Staphylococcal scalded skin syndrome (SSSS)

c) Nonbullous impetigo

d) Ecthyma

Question 18 2 / 2 points

An example of ecchymosis is:

Question options:

a) A hematoma

b) A keloid

c) A bruise

d) A patch

Question 19 2 / 2 points

An 82-year-old man is seen in the primary care office with complaints of dribbling urine and difficulty starting his stream. Which of the following should be included in the list of differential diagnoses?

Question options:

a) Benign prostatic hyperplasia (BPH)

b) Parkinson’s disease

c) Prostate cancer

d) All of the above

Question 20 0 / 2 points

A 30-year-old man is seen with a chief complaint of loss of libido. Which of the following laboratory tests would help establish a diagnosis?

Question options:

a) Testosterone level

b) Prostate-specific antigen

c) Nocturnal penile tumescence and rigidity

d) Prolactin level

Question 21 2 / 2 points

A 35-year-old man presents with complaints of painful erections, and he notices his penis is crooked when erect. What is the most likely diagnosis?

Question options:

a) Peyronie’s disease

b) Damage to the pudendal artery

c) Scarring of the cavernosa

d) All of the above

Question 22 2 / 2 points

A 78-year-old man is diagnosed with C2 prostate cancer, and he asks the clinician what that means. In order to answer the patient, the clinician must have which of these understandings of the Jewett rating system?

Question options:

a) The cancer involves the seminal vesicles.

b) There is metastatic disease to regional lymph nodes.

c) The cancer is confined to the capsule.

d) There is metastasis to distant organs.

Question 23 0 / 2 points

During a DRE on a 75-year-old man, the clinician suspects the patient has prostate cancer. What physical finding should make the clinician suspicious?

Question options:

a) An enlarged rubbery gland

b) A hard irregular gland

c) A tender gland

d) A boggy gland

Question 24 2 / 2 points

Tinea unguium is also known as:

Question options:

a) Onychomycosis

b) Tinea versicolor

c) Tinea manuum

d) Tinea corporis

Question 25 2 / 2 points

The patient is diagnosed with acute renal failure (ARF).Which of the following data obtained from the history should alert the provider that this is a case of prerenal azotemia?

Question options:

a) Recent heat stroke

b) Nephrolithiasis

c) Recent infection where gentamicin was used in treatment

d) All of the above

Question 26 2 / 2 points

Which of the following statements is accurate when you are removing a seborrheic keratosis lesion using liquid nitrogen?

Question options:

a) Do not use lidocaine as it may potentiate bleeding.

b) Pinch the skin taut together.

c) Use gel foam to control bleeding.

d) This should be performed by a dermatologist only.

Question 27 2 / 2 points

A patient is diagnosed with urge incontinence. Before prescribing Detrol XL, the provider should question the patient about which of these contraindications to this medication?

Question options:

a) Diarrhea

b) Parkinson’s disease

c) Closed-angle glaucoma

d) Breast cancer

Question 28 2 / 2 points

Simon presents with alopecia areata with well-circumscribed patches of hair loss on the crown of his head. How do you respond when he asks you the cause?

Question options:

a) “You must be under a lot of stress lately.”

b) “It is hereditary. Did your father experience this also?”

c) “The cause is unknown, but we suspect it is due to an immunologic mechanism.”

d) “We’ll have to do some tests.”

Question 29 2 / 2 points

A 58-year-old patient has been receiving leuprolide as treatment for prostate cancer. The clinician should instruct the patient about which of these side effects?

Question options:

a) Risk of osteoporosis

b) May have hot flushes

c) May have impotence

d) All of the above

Question 30 2 / 2 points

Josh, aged 22, has tinea versicolor. Which description is the most likely for this condition?

Question options:

a) There are round, hypopigmented macules on his back.

b) Josh has red papules on his face.

c) There are crusted plaques in Josh’s groin area.

d) There are white streaks on his neck.

Question 31 2 / 2 points

The most common precancerous skin lesion found in Caucasians is:

Question options:

a) A skin tag

b) Actinic keratosis

c) A melanoma

d) A basal cell lesion

Question 32 2 / 2 points

Which scalp problem can be caused by a fever and certain drugs?

Question options:

a) Telogen effluvium (TE)

b) Trichotillomania

c) Psoriasis

d) Alopecia areata

Question 33 2 / 2 points

A 46-year-old man presents with urinary hesitancy and low back pain. He has no history of UTI. Digital rectal examination (DRE) reveals a normal prostate, and a diagnosis of prostatodynia is made. Which is the appropriate treatment?

Question options:

a) Terazosin 2 mg PO once a day

b) Ice pack to the scrotal area

c) Saw palmetto 320 mg per day

d) All of the above

Question 34 2 / 2 points

A 30-year-old patient presents with pain on urination. The urine microscopy of unspun urine shows greater than 10 leukocytes/mL, and a dipstick is positive for nitrites. What is the probable diagnosis?

Question options:

a) Lower urinary tract infection

b) Chlamydia infection

c) Candidiasis

d) Pyelonephritis

Question 35 2 / 2 points

Which of the following foods should be limited in a patient with CRF?

Question options:

a) Milk

b) Bananas

c) Soy sauce

d) All of the above

Question 36 2 / 2 points

An example of a primary skin lesion is a/an:

Question options:

a) Bulla

b) Scale

c) Excoriation

d) Fissure

Question 37 2 / 2 points

A 76-year-old man is seen in the office for complaints of urinary incontinence. The clinician should explore which of these causes of incontinence in men?

Question options:

a) Urethral polyps

b) Urinary tract infection (UTI)

c) Anticholinergic medication

d) All of the above

Question 38 2 / 2 points

A patient is seen in the clinic with a chief complaint of hematuria. To make a differential diagnosis, which of the following questions should be asked?

Question options:

a) “Do you have a history of liver disease?”

b) “What medications are you currently taking?”

c) “Have you noticed swelling in your ankles?”

d) All of the above

Question 39 2 / 2 points

A 78-year-old man is diagnosed with Stage D bladder cancer and asks the provider what that means. Which is the best response?

Question options:

a) “There is no such thing as Stage D cancer.”

b) “You have cancer that has spread to the surrounding tissue.”

c) “Your cancer has spread to other organs.”

d) “Your cancer can be cured by removing your bladder.”

Question 40 2 / 2 points

Treatment for epididymitis includes which of the following?

Question options:

a) Warm sitz baths

b) Scrotal elevation

c) Masturbation

d) All of the above

Question 41 2 / 2 points

A patient is seen in the office complaining of severe flank pain. The clinician should assess this patient for which risk factor for kidney stones?

Question options:

a) Hypertension

b) Constipation

c) Tubal ligation

d) Diabetes

Question 42 2 / 2 points

A 63-year-old man is seen in the clinic with a chief complaint of nocturia. Which of the following should be included in the differential diagnosis?

Question options:

a) Psychogenic nocturia

b) Urethral polyp

c) Irritative posterior urethral lesion

d) Benign prostatic hypertrophy

Question 43 0 / 2 points

A patient with testicular cancer is being followed after completing treatment 1 year ago. He has been symptom-free with no evidence of disease. How often should he have a CT scan?

Question options:

a) Every month

b) Every 3 to 4 months

c) Every 6 to 12 months

d) Every year

Question 44 2 / 2 points

Mark has necrotizing fasciitis of his left lower extremity.Pressure on the skin reveals crepitus due to gas production by which anaerobic bacteria?

Question options:

a) Staphylococcal aureus

b) Clostridium perfringens

c) S. pyrogenes

d) Streptococcus

Question 45 2 / 2 points

Ian, age 62, presents with a wide, diffuse area of erythematous skin on his lower left leg that is warm and tender to palpation.There is some edema involved. You suspect:

Question options:

a) Necrotizing fasciitis

b) Kaposi’s sarcoma

c) Cellulitis

d) A diabetic ulcer

Question 46 2 / 2 points

Why do people of African descent have a lower incidence of non-melanoma skin cancer?

Question options:

a) They have an increased number of melanocytes.

b) Their darker skin protects from ultraviolet radiation.

c) Their skin is thicker.

d) Their immune system is stronger.

Question 47 2 / 2 points

A 23-year-old sexually active man is seen in the clinic with unilateral painful testicular swelling, and he is diagnosed with epididymitis.In order to prescribe the correct drug, the clinician must understand that which of these is the most common causative organism?

Question options:

a) Escherichia coli

b) Staphylococcus aureus

c) Chlamydia trachomatis

d) Pseudomonas aeruginosa

Question 48 2 / 2 points

When instructing your elderly client about treating her xerosis, what do you tell her?

Question options:

a) A daily hot bath may help the associated pruritus.

b) Rub the skin briskly to make sure it is completely dry after bathing.

c) Only take short tepid showers.

d) Use a gel that is alcohol-based after bathing to soften the skin.

Question 49 2 / 2 points

Which of the following instructions should be given to the patient with nephrolithiasis?

Question options:

a) Take ibuprofen, 600 mg every 8 hours.

b) Take Tums? for stomach upset.

c) Drink more black tea.

d) Increase intake of vegetables, like spinach.

Question 50 2 / 2 points

The 56-year-old man with chronic prostatitis should be treated with trimethoprim 80 mg-sulfamethoxazole 400 mg (TMP-SMX, Bactrim) for how long?

Question options:

a) 3 to 7 days

b) 14 to 21 days

c) 3 to 6 weeks

d) 6 to 12 weeks

 

Breathing, Heart, and Lungs

]An anxious patient is having rapid and shallow breathing. After a few moments, he complains of a tingling sensation.

• What could be the causes of this tingling sensation?
• What are the various patterns of respiration and their significance?
• Ethnicity and culture influence risk factors for heart disease. Do you agree? Why or why not?
• What is the technique of percussion and palpation of the chest wall for tenderness, symmetry, bulges, fremitus, and thoracic expansion? Explain.
• Would you anticipate hearing hyper-resonance on a patient with a history of tobacco use? Why or why not?
• What are the mechanics of breathing with reference to lung borders and the anatomical structure of the lungs and diaphragm?

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