Knowlege check – 2025 QUESTION 1 1 A 28 year old woman presents to the clinic with a

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Knowlege check – 2025

QUESTION 1
1. A 28-year-old woman presents to the clinic with a chief complaint of hirsutism and irregular menses. She describes irregular and infrequent menses (five or six per year) since menarche at 12 years of age. She began to develop dark, coarse facial hair when she was 14 years of age, but her parents did not seek treatment or medical opinion at that time. The symptoms worsened after she gained weight in college. She got married 3 years ago and has been trying to get pregnant for the last 2 years without success. Height 66 inches and weight 198. BMI 32 kg.m2. Moderate hirsutism without virilization noted.  Laboratory data reveal CMP within normal limits (WNL), CBC with manual differential (WNL), TSH 0.9 IU/L SI units (normal 0.4-4.0 IU/L SI units), a total testosterone of 65 ng/dl (normal 2.4-47 ng/dl), and glycated hemoglobin level of 6.1% (normal value ≤5.6%). Based on this information, the APRN diagnoses the patient with polycystic ovarian syndrome (PCOS) and refers her to the Women’s Health APRN for further workup and management.  
Question 1 of 2:
What is the pathogenesis of PCOS? 
1 points   
QUESTION 2
1. A 28-year-old woman presents to the clinic with a chief complaint of hirsutism and irregular menses. She describes irregular and infrequent menses (five or six per year) since menarche at 12 years of age. She began to develop dark, coarse facial hair when she was 14 years of age, but her parents did not seek treatment or medical opinion at that time. The symptoms worsened after she gained weight in college. She got married 3 years ago and has been trying to get pregnant for the last 2 years without success. Height 66 inches and weight 198. BMI 32 kg.m2. Moderate hirsutism without virilization noted.  Laboratory data reveal CMP within normal limits (WNL), CBC with manual differential (WNL), TSH 0.9 IU/L SI units (normal 0.4-4.0 IU/L SI units), a total testosterone of 65 ng/dl (normal 2.4-47 ng/dl), and glycated hemoglobin level of 6.1% (normal value ≤5.6%). Based on this information, the APRN diagnoses the patient with polycystic ovarian syndrome (PCOS) and refers her to the Women’s Health APRN for further workup and management.  
Question 2 of 2:
How does PCOS affect a woman’s fertility or infertility? 
1 points   
QUESTION 3
1. A 20-year-old female college student presents to the Student Health Clinic with a chief complaint of abdominal pain, foul smelling vaginal discharge, and fever and chills for the past 4 days. She denies nausea, vomiting, or difficulties with defecation. Last bowel movement this morning and was normal for her. Nothing has helped with the pain despite taking ibuprofen 200 mg orally several times a day. She describes the pain as sharp and localizes the pain to her lower abdomen. Past medical history noncontributory. GYN/Social history + for having had unprotected sex while at a fraternity party. Physical exam: thin, Ill appearing anxious looking white female who is moving around on the exam table and unable to find a comfortable position. Temperature 101.6F orally, pulse 120, respirations 22 and regular. Review of systems negative except for chief complaint. Focused assessment of abdomen demonstrated moderate pain to palpation left and right lower quadrants. Upper quadrants soft and non-tender. Bowel sounds diminished in bilateral lower quadrants. Pelvic exam demonstrated + adnexal tenderness, + cervical motion tenderness and copious amounts of greenish thick secretions. The APRN diagnoses the patient as having pelvic inflammatory disease (PID).  
Question:
What is the pathophysiology of PID? 
1 points   
QUESTION 4
1. A 27-year-old male comes to the clinic with a chief complaint of a “sore on my penis” that has been there for 3 days. He says it burns and leaked a little fluid. He denies any other symptoms. Past medical history noncontributory. Social history: works as a bartender and he states he often “hooks up” with some of the patrons, both male and female after work. He does not always use condoms. Physical exam within normal limits except for a lesion on the lateral side of the penis adjacent to the glans. The area is indurated with a small round raised lesion. The APRN orders laboratory tests, but feels the patient has syphilis.  
Question:
Describe the 4 stages of syphilis.
1 points   
QUESTION 5
1. A 19-year-old female presents to the clinic with a chief complaint of “fluid filled bumps” and intense pruritis of her vulva. She states these symptoms have been present for about 10 days, but she thought she had a yeast infection. She self-medicated with over the counter (OTC) metronidazole (Flagyl™) intravaginally but the symptoms got worse. No other complaints except for fatigue out of proportion to her activity level. Past medical history noncontributory. Social history: sexually active with several men and did forget to use a condom during one sexual encounter. Physical exam negative except for pelvic exam which revealed multiple fluid filled (vesicular) lesions on the vulva and introitus. Positive lymph nodes in inguinal areas. The APRN diagnoses the patient with herpes simplex virus-type 2 known as genital herpes. 
Question:
What is the pathophysiology of HSV-2? 
1 points   
QUESTION 6
1. A 27-year-old male presents to the clinic with a chief complaint of a gradual onset of scrotal pain and swelling of the left testicle that started 2 days ago.  The pain has gotten progressively worse over the last 12 hours and he now complains of left flank pain. He complains of dysuria, frequency, and urgency with urination. He states his urine smells funny. He denies nausea, vomiting, but admits to urethral discharge just prior to the start of his severe symptoms. He denies any recent heavy lifting or straining for bowel movements. He says the only thing that makes the pain better is if he sits in his recliner and elevates his scrotum on a small pillow. Past medical history negative. Social history + for sexual activity only with his wife of 3 years. Physical exam reveals red, swollen left testicle that is very tender to touch. There is positive left inguinal adenopathy. Clean catch urinalysis in the clinic + for 3+ bacteria. The APRN diagnoses the patient with epididymitis.  
Question:
Discuss how bacteria in the urine causes epididymitis.  
1 points   
QUESTION 7
1. A 42-year-old male presents to the clinic with a chief complaint of fever, chills, malaise, arthralgias, dysuria, urinary frequency, low back pain, perineal, and suprapubic pain. He says he feels like he can’t fully empty his bladder when he voids. He states these symptoms came on suddenly about 12 hours ago and have gotten worse. He noticed some blood in his urine the last time he voided. He tried to have a bowel movement several hours ago but could not empty his bowel due to pain. Past medical and social history noncontributory. Physical exam reveals an ill appearing male. Temperature 101.8 F, pulse 122, respirations 20, BP 108/68. Exam unremarkable apart from left costovertebral angle (CVA) tenderness. Rectal exam difficult due to enlarged and extremely painful prostate.  Complete blood count revealed an elevated white blood cell count, elevated C-reactive protein and elevated sedimentation rate. Urine dip in the clinic + for 2+ bacteria.  
Question:
Explain the differences between acute bacterial prostatitis and nonbacterial prostatitis. 
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1 points   
QUESTION 8
1. A 32-year-old woman presents to the clinic with a chief complaint of pelvic pain, excessive menstrual bleeding, dyspareunia, and inability to become pregnant after 18 months of unprotected sex with her husband. She states she was told she had endometrioses after a high school physical exam, but no doctor or nurse practitioner ever mentioned it again, so she thought it had gone away. She has no other complaints and says she wants to have a family. Past medical history noncontributory except for possible endometriosis as a teenager. Social history negative for tobacco, drugs or alcohol. The physical exam is negative except for the pelvic exam which demonstrated pain on light and deep palpation of the uterus. The APRN believes that the patient does have endometriosis and orders appropriate laboratory and radiological tests. The diagnostics come back highly suggestive of endometriosis.    
Question:
Explain how endometriosis may affect female fertility.
1 points   
QUESTION 9
1. An APRN working in an anticoagulation clinic has been asked by the local college to present a lecture on platelets and their role in blood clotting to the graduate pathophysiology nursing students.  
Question:
What key concepts should the APRN include in the presentation? 
1 points   
QUESTION 10
1. A 36-year-old woman presents to the clinic with complaints of dyspnea on exertion, fatigue, leg cramps on climbing stairs, craving ice to suck or chew and cold intolerance. The symptoms have come on gradually over the past 4 months. The only thing that make the symptoms better is for her to sit or lie down and stop the activity. She denies bruising or bleeding and states this is the first time this has happened. Past medical history noncontributory except for a new diagnosis of benign uterine fibroids 6 months ago after experiencing heavy menstrual bleeding every month. Social history noncontributory and she denies alcohol, tobacco, or drug use. Physical exam: pale, thin, Caucasian female who appears older than stated age. Physical exam remarkable for a soft I/IV systolic murmur, pallor of the mucous membranes, spoon-shaped nails (koilonychia), glossy tongue, with atrophy of the lingual papillae, and fissures at the corners of the mouth. The APRN suspects the patient has iron deficient anemia (IDA) secondary to excessive blood loss from uterine fibroids. The appropriate laboratory tests confirmed the diagnosis.  
Question:
Discuss iron deficiency anemia and how the patient’s menstrual bleeding contributed to the diagnosis. 
1 points   
QUESTION 11
1. A 67-year-old woman presents to the clinic with complaints of weakness, fatigue, paresthesias of the feet and fingers, difficulty walking, loss of appetite, and a sore tongue. These symptoms have been present for several months but the patient thought they were due to her recent retirement and geographic move from the Midwest to New England. The symptoms have gotten worse over the past few weeks and she has noticed that she is much more forgetful. This is of great concern as she worries she might have the beginning stages of Alzheimer’s Disease. Past medical history significant for Hashimoto thyroiditis that she developed in her early 20s. The rest of PMH and social history non- contributory. Physical exam reveals an average sized female whose skin has a sallow appearance. BP 128/74, Pulse 120, respirations 18 and temperature 99.0F orally. Examination of the head and neck reveals a smooth and beefy red tongue. Abdominal exam negative for hepatomegaly or splenomegaly.   
The APRN recognizes these symptoms and physical exam indicate the patient has pernicious anemia. After appropriate laboratory data received, the definitive diagnosis of pernicious anemia was made. 
Question 1 of 2:
How does pernicious anemia develop? 
1 points   
QUESTION 12
1. A 67-year-old woman presents to the clinic with complaints of weakness, fatigue, paresthesias of the feet and fingers, difficulty walking, loss of appetite, and a sore tongue. These symptoms have been present for several months but the patient thought they were due to her recent retirement and geographic move from the Midwest to New England. The symptoms have gotten worse over the past few weeks and she has noticed that she is much more forgetful. This is of great concern as she worries she might have the beginning stages of Alzheimer’s Disease. Past medical history significant for Hashimoto thyroiditis that she developed in her early 20s. The rest of PMH and social history non- contributory. Physical exam reveals an average sized female whose skin has a sallow appearance. BP 128/74, Pulse 120, respirations 18 and temperature 99.0F orally. Examination of the head and neck reveals a smooth and beefy red tongue. Abdominal exam negative for hepatomegaly or splenomegaly.   
The APRN recognizes these symptoms and physical exam indicate the patient has pernicious anemia. After appropriate laboratory data received, the definitive diagnosis of pernicious anemia was made. 
Question 2 of 2:
How does pernicious anemia cause the neurological manifestations that are often seen in patients with PA? 
1 points   
QUESTION 13
1. A 49-year-old man with a 22-year history of severe rheumatoid arthritis (RA) presents to clinic for his preadmission testing (PAT) and medical clearance for a planned right total hip arthroplasty. The patient had been severely limited in ambulation due to the RA. Current medications include prednisone 20 mg po qd and methotrexate 7.5 mg Thursdays, 5mg Fridays, and 7.5 mg Saturdays.  The patient had a complete blood count (CBC) with manual differentiation and red blood cell indices, complete metabolic panel (CMP) and coagulation studies (prothrombin time [PT], international normalized ratio [INR] and activated partial thromboplastin time [aPTT]). All the laboratory studies come back within normal limits except for the red blood cell indices. The hemoglobin and hematocrit were low along with mean corpuscle volume, plasma iron and total iron binding capacity, and transferrin also being low. There was a normal reticulocyte count, normal ferritin, serum B12, folate and bilirubin.  
The APRN in the PAT clinic recognizes that the patient has anemia of chronic disease (ACD).  
Question 1 of 2:
What is ACD and how does it develop? 
1 points   
QUESTION 14
1. A 49-year-old man with a 22-year history of severe rheumatoid arthritis (RA) presents to clinic for his preadmission testing (PAT) and medical clearance for a planned right total hip arthroplasty. The patient had been severely limited in ambulation due to the RA. Current medications include prednisone 20 mg po qd and methotrexate 7.5 mg Thursdays, 5mg Fridays, and 7.5 mg Saturdays.  The patient had a complete blood count (CBC) with manual differentiation and red blood cell indices, complete metabolic panel (CMP) and coagulation studies (prothrombin time [PT], international normalized ratio [INR] and activated partial thromboplastin time [aPTT]). All the laboratory studies come back within normal limits except for the red blood cell indices. The hemoglobin and hematocrit were low along with mean corpuscle volume, plasma iron and total iron binding capacity, and transferrin also being low. There was a normal reticulocyte count, normal ferritin, serum B12, folate and bilirubin.  
The APRN in the PAT clinic recognizes that the patient has anemia of chronic disease (ACD).  
Question 2 of 2:
Why do patients with chronic kidney disease (CKD) develop ACD? 
1 points   
QUESTION 15
1. A 14-year-old female is brought to the Urgent Care by her mother who states that the girl has had an abnormal number of bruises and “funny looking red splotches” on her legs. These bruises were first noticed about 2 weeks ago and are not related to trauma. Past medical history not remarkable and she takes no medications. The mother does state the girl is recovering from a “bad case of mono” and was on bedrest at home for the past 3 weeks. The girl noticed that her gums were slightly bleeding when she brushed her teeth that morning.  
Labs at Urgent Care demonstrated normal hemoglobin and hematocrit with normal white blood cell (WBC) differential. Platelet count of 100,000/mm3 was the only abnormal finding. The staff also noticed that the venipuncture site oozed for a few minutes after pressure was released. The doctor at Urgent Care referred the patient and her mother to the ED for a complete work up of the low platelet count including a peripheral blood smear for suspected immune thrombocytopenia purpura (ITP). 
Question:
What is ITP and why do you think this patient has acute, rather than chronic, ITP? 
1 points   
QUESTION 16
1. A 22-year-old male is in the Surgical Intensive Care Unit (SICU) following a motor vehicle crash (MVC) where he sustained multiple life-threatening injuries including a torn aorta, ruptured spleen, and bilateral femur fractures. He has had difficulty maintaining his mean arterial pressure (MAP) and has required various vasopressors. He has a triple lumen central venous catheter (CVC) for monitoring his central venous pressure, administration of medications and blood products, as well as total parenteral nutrition. Per hospital protocol, he is receiving an unfractionated heparin 1:1000 flush after administration of each of the triple antibiotics that have been ordered to maintain patency of the lumens.  Seven days post injury, the APRN in the SICU is reviewing the patient’s morning labs and notes that his platelet count has dropped precipitously to 50,000 /mm3 from 148,000/mm3 two days ago. The APRN suspects the patient is developing heparin induced thrombocytopenia (HIT).  
Question 1 of 2:
What is underlying pathophysiology of heparin induced thrombocytopenia? 
1 points   
QUESTION 17
1. A 22-year-old male is in the Surgical Intensive Care Unit (SICU) following a motor vehicle crash (MVC) where he sustained multiple life-threatening injuries including a torn aorta, ruptured spleen, and bilateral femur fractures. He has had difficulty maintaining his mean arterial pressure (MAP) and has required various vasopressors. He has a triple lumen central venous catheter (CVC) for monitoring his central venous pressure, administration of medications and blood products, as well as total parenteral nutrition. Per hospital protocol, he is receiving an unfractionated heparin 1:1000 flush after administration of each of the triple antibiotics that have been ordered to maintain patency of the lumens.  Seven days post injury, the APRN in the SICU is reviewing the patient’s morning labs and notes that his platelet count has dropped precipitously to 50,000 /mm3 from 148,000/mm3 two days ago. The APRN suspects the patient is developing heparin induced thrombocytopenia (HIT).  
Question 2 of 2:
The APRN assesses the patient and notes there is a decreased right posterior tibial pulse with cyanosis of the entire foot. The APRN recognizes this probably represents arterial thrombus formation. How does someone who is receiving heparin develop arterial and venous thrombosis? 
1 points   
QUESTION 18
1. A 33-year-old female is brought to Urgent Care by her husband who states his wife has gotten suddenly confused and complains of a severe headache. He also noticed large bruises on her legs which were not there yesterday. Only significant past medical history is that the patient developed herpes zoster 2 weeks ago and was given acyclovir for treatment. Physical exam revealed well developed female who is only oriented to person. Large areas of ecchymosis noted on both arms and legs. Stat CBC revealed a platelet count of 18,000/mm3, hemoglobin of 8 g/dl and hematocrit of 24%. The patient was immediately transported to the Emergency Room by Emergency Medical Services (EMS) where further work up demonstrated idiopathic thrombotic thrombocytopenic purpura (TTP).  
Question:
What is the pathophysiology of TTP? 
1 points   
QUESTION 19
1. A 64-year man is recovering from a transurethral resection of the prostate for treatment of benign prostate hyperplasia. The patient is receiving intravenous antibiotics for the urinary tract infection that was found on the preoperative urine culture and sensitivity (C & S). The post-operative course has been smooth and the APRN is removing the 3-way Foley catheter when there is a sudden release of bright red blood with many blood clots in the Foley bag. The patient becomes hypotensive, tachycardic and the APRN notes new ecchymoses on the patient’s arms and legs. The patient was immediately transferred to the surgical intensive care unit (SICU) and a stat hematology consult was conducted. Stat CBC, d-dimer, peripheral blood smear, partial thromboplastin time, Prothrombin time/international normalization ratio (INR), and fibrinogen labs were drawn. Results were:  
CBC with markedly decreased platelet count, peripheral blood smear showed decreased number of platelets and presence of large platelets and fragmented red cells (schistocytes), prothrombin time prolonged as was the partial thromboplastin time. The d-dimer was markedly elevated, and fibrinogen level was low. The diagnosis of disseminated intravascular coagulation (DIC) was made based on clinical picture and laboratory data.  
Question 1 of 2:
What is DIC and how does it develop? 
1 points   
QUESTION 20
1. A 64-year man is recovering from a transurethral resection of the prostate for treatment of benign prostate hyperplasia. The patient is receiving intravenous antibiotics for the urinary tract infection that was found on the preoperative urine culture and sensitivity (C & S). The post-operative course has been smooth and the APRN is removing the 3-way Foley catheter when there is a sudden release of bright red blood with many blood clots in the Foley bag. The patient becomes hypotensive, tachycardic and the APRN notes new ecchymoses on the patient’s arms and legs. The patient was immediately transferred to the surgical intensive care unit (SICU) and a stat hematology consult was conducted. Stat CBC, d-dimer, peripheral blood smear, partial thromboplastin time, Prothrombin time/international normalization ratio (INR), and fibrinogen labs were drawn. Results were:  
CBC with markedly decreased platelet count, peripheral blood smear showed decreased number of platelets and presence of large platelets and fragmented red cells (schistocytes), prothrombin time prolonged as was the partial thromboplastin time. The d-dimer was markedly elevated, and fibrinogen level was low. The diagnosis of disseminated intravascular coagulation (DIC) was made based on clinical picture and laboratory data.  
Question 2 of 2:
What factors contribute to the development of DIC?  

Nursing Philosophy (1) – 2025 Nursing Philosophy QEP Writing Assignment The personal philosophy must include the following domains Nursing Environment Health and Person

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Nursing Philosophy (1) – 2025

 Nursing Philosophy/QEP Writing Assignment The personal philosophy must include the following domains: Nursing, Environment, Health and Person. You should include your personal definition of each domain and how these fit into your philosophy of nursing. In preparing your philosophy the faculty require that you review the philosophies of Miami Dade College, Benjamin Leon School of Nursing and at least one hospital. A limit of 1 to 2 pages is acceptable in APA format. The guidance of the assignment rubric should be utilized to achieve maximum points. 

Ethics – 2025 Chapter 4 Ethical Issues 1 Compare and contract legal and ethical issues 2 What determines how a person approaches

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Ethics – 2025

  

Chapter 4—Ethical Issues

1. Compare and contract legal and ethical issues.

2. What determines how a person approaches and solves ethical dilemmas

3. Define moral indifference—provide an example

4. Define moral uncertainty—provide an example from your own healthcare experience

5. Moral distress—provide an example from your own health care experiences

6. What is an ethical dilemma? Give an example

7. Describe deontological approach to ethical decision making? What does this mean?

8. Describe a teleological approach to ethical decision making? What does this mean?

9. Compare and contrast the 4 different frameworks for ethical decision making

10. What is autonomy—give an example from your experience

11. Define the following terms—how have you used/understood these principles in your nursing practice?

12. Beneficence

13. Paternalism

14. Utility

15. Justice

16. Veracity

17. Fidelity

18. Confidentiality

19. What is the MORAL decision-making model—how does this work?

20. Name important strategies to promote ethical behavior in healthcare.

Chapter 5—Legal and Legislative Issues

1. Define civil law and what is involved in civil cases

2. What are the reasons that nurses are at increased risk for legal liability in nursing practice?

3. What does the term Standard of Care mean in nursing? Why is this so important?

4. Define malpractice and the term professional negligence (the 5 criteria needed to fulfill this definition)….provide examples of each criteria to deepen your understanding

5. What does the term “under ordinary circumstances” means as it relates to professional negligence?

6. Define these legal terms that are pertinent to nursing practice—be sure you can relate these term to nursing practice

 

1. Stare decisis

2. Liability

3. tort

4. respondeat superior

5. vicarious liability

6. product liability

7. res ipsa loquitur

7. Define intentional torts and give as many examples as you can related to nursing practice

8. What are some common reasons nurses are sued (claims filed against them)

9. BON—Board of Nursing—what is their responsibility to the public?

10. Define the Nurse Practice Act and its role in your ability to practice nursing?

11. Define, compare and contrast the three forms of consent:

 

1. Informed consent

2. Implied consent

3. Express consent

12. What is HIPAA and what is its importance to healthcare/your nursing practice?

13. What are the parameters of Good Samaritan Immunity?

14. Describe the Patient Self-Determination Act (PSDA) of 1991 and how it changed healthcare

15. List the common causes of nursing license revocation

Legislation Comparison Grid and Testimony/Advocacy Statement – 2025 As a nurse how often have you thought to yourself If I had anything to do about it things

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Legislation Comparison Grid and Testimony/Advocacy Statement – 2025

 

As a nurse, how often have you thought to yourself, If I had anything to do about it, things would work a little differently? Increasingly, nurses are beginning to realize that they do, in fact, have a role and a voice.

Many nurses encounter daily experiences that motivate them to take on an advocacy role in hopes of impacting policies, laws, or regulations that impact healthcare issues of interest. Of course, doing so means entering the less familiar world of policy and politics. While many nurses do not initially feel prepared to operate in this space effectively, the reward is the opportunity to shape and influence future health policy.

To Prepare:

  • Select a bill that has been proposed (not one that has been enacted) using the congressional websites provided in the Learning Resources.

The Assignment: (1- to 2-page Comparison Grid; 1-page Legislation Testimony/Advocacy Statement)

Part 1: Legislation Comparison Grid

Based on the health-related bill (proposed, not enacted) you selected, complete the Legislation Comparison Grid Template. Be sure to address the following:

  • Determine the legislative intent of the bill you have reviewed.
  • Identify the proponents/opponents of the bill.
  • Identify the target populations addressed by the bill.
  • Where in the process is the bill currently? Is it in hearings or committees?

Part 2: Legislation Testimony/Advocacy Statement

Based on the health-related bill you selected, develop a 1-page Legislation Testimony/Advocacy Statement that addresses the following:

  • Advocate a position for the bill you selected and write testimony in support of your position.
  • Describe how you would address the opponent to your position. Be specific and provide examples.

  

PLEASE FOLLOW THE INSTRUCTIONS AS INDICATED BELOW:

1). ZERO (0) PLAGIARISM

2). 5 REFERENCES, NO MORE THAN 5 YEARS

3). PLEASE SEE THE FOLLOWING ATTACHED: RUBRIC DETAILS, AGENDA GRID TEMPLATE.

Thank you so much. 

Advanced pathophysiology – 2025 case study The role genetics plays in the disease Why the patient is presenting with the specific

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Advanced pathophysiology – 2025

case study 

  

· The role genetics plays in the disease.

· Why the patient is presenting with the specific symptoms described.

· The physiologic response to the stimulus presented in the scenario and why you think this response occurred.

· The cells that are involved in this process.

· How another characteristic (e.g., gender, genetics) would change your response

Module 5 Assignment: Case Study Analysis – 2025 An understanding of the neurological and musculoskeletal systems is a critically important component of disease and disorder

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Module 5 Assignment: Case Study Analysis – 2025

An understanding of the neurological and musculoskeletal systems is a critically important component of disease and disorder diagnosis and treatment. This importance is magnified by the impact that that these two systems can have on each other. A variety of factors and circumstances affecting the emergence and severity of issues in one system can also have a role in the performance of the other.

Effective analysis often requires an understanding that goes beyond these systems and their mutual impact. For example, patient characteristics such as, racial and ethnic variables can play a role.

An understanding of the symptoms of alterations in neurological and musculoskeletal systems is a critical step in diagnosis and treatment. For APRNs this understanding can also help educate patients and guide them through their treatment plans.

In this Assignment, you examine a case study and analyze the symptoms presented. You identify the elements that may be factors in the diagnosis, and you explain the implications to patient health.

To prepare:

By Day 1 of this week, you will be assigned to a specific case study scenario for this Case Study Assignment. Please see the “Course Announcements” section of the classroom for your assignment from your Instructor.

Assignment (2-page case study analysis)

In your Case Study Analysis related to the scenario provided, explain the following:

  • Both the neurological and musculoskeletal pathophysiologic processes that would account for the patient presenting these symptoms.
  • Any racial/ethnic variables that may impact physiological functioning.
  • How these processes interact to affect the patient.

Day 7 of Week 8

Submit your Case Study Analysis Assignment by Day 7 of Week 8.

Reminder: 

The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The sample paper provided at the Walden Writing Center provides an example of those required elements (available at https://academicguides.waldenu.edu/writingcenter/templates). All papers submitted must use this formatting.

Ethics Assignment Help! – 2025 Develop in detail a situation in which a health care worker might be confronted with ethical problems related

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Ethics Assignment Help! – 2025

  1. Develop in detail a situation in which a health care worker might be confronted with ethical problems related to patients and prescription drug use OR patients in a state of poverty. Each scenario must be original to you and this assignment. It cannot be from the discussion boards in this class or any other previous forum.Articulate (and then assess) the ethical solutions that can found using “care” (care-based ethics) and “rights” ethics to those problems. (YOU NEED TO CREATE AN ACTUAL FULL SCENARIO)
  • Assessment must ask if the solutions are flawed, practicable, persuasive, etc.
  • What health care technology is involved in the situation? What moral guidelines for using that kind of healthcare 
  • technology should be used there? Explore such guidelines also using utilitarianism, Kantian deontology, ethical egoism, or social contract ethics.
  • Say how social technologies such as blogs, crowdfunding, online encyclopedias can be used in either case. What moral guidelines for using that kind of healthcare technology should be used there? Develop such guidelines also using utilitarianism, Kantian deontology, ethical egoism, or social contract ethics.

You should not be using any text you used in a discussion board or assignment for this class or any previous class.

Cite the textbook and incorporate outside sources, including citations.

Writing Requirements (APA format)

  • Length: 3-4 pages (not including title page or references page)
  • 1-inch margins
  • Double spaced
  • 12-point Times New Roman font
  • Title page
  • References page (minimum of 2 scholarly sources)

Respond to the discussion question. Psychopharmacology – 2025 For this Discussion review the case Learning Resources and the case study excerpt presented Reflect on the case study

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Respond to the discussion question. Psychopharmacology – 2025

  

For this Discussion, review the case Learning Resources and the case study excerpt presented. Reflect on the case study excerpt and consider the therapy approaches you might take to assess, diagnose, and treat the patient’s health needs.  

Case: An elderly widow who just lost her spouse. 

Subjective: A patient presents to your primary care office today with chief complaint of insomnia. Patient is 75 YO with PMH of DM, HTN, and MDD. Her husband of 41 years passed away 10 months ago. Since then, she states her depression has gotten worse as well as her sleep habits. The patient has no previous history of depression prior to her husband’s death. She is awake, alert, and oriented x3. Patient normally sees PCP once or twice a year. Patient denies any suicidal ideations. Patient arrived at the office today by private vehicle. Patient currently takes the following medications: 

• Metformin 500mg BID 

• Januvia 100mg daily 

• Losartan 100mg daily 

• HCTZ 25mg daily 

• Sertraline 100mg daily 

Current weight: 88 kg

Current height: 64 inches

Temp: 98.6 degrees F

BP: 132/86 

By Day 3 of Week 7

Post a response to each of the following:

• List three questions you might ask the patient if she were in your office. Provide a rationale for why you might ask these questions. 

• Identify people in the patient’s life you would need to speak to or get feedback from to further assess the patient’s situation. Include specific questions you might ask these people and why. 

• Explain what, if any, physical exams, and diagnostic tests would be appropriate for the patient and how the results would be used. 

• List a differential diagnosis for the patient. Identify the one that you think is most likely and explain why. 

• List two pharmacologic agents and their dosing that would be appropriate for the patient’s antidepressant therapy based on pharmacokinetics and pharmacodynamics. From a mechanism of action perspective, provide a rationale for why you might choose one agent over the other. 

• For the drug therapy you select, identify any contraindications to use or alterations in dosing that may need to be considered based on the client’s ethnicity. Discuss why the contraindication/alteration you identify exists. That is, what would be problematic with the use of this drug in individuals of other ethnicities?

• Include any “check points” (i.e., follow-up data at Week 4, 8, 12, etc.), and indicate any therapeutic changes that you might make based on possible outcomes that may happen given your treatment options chosen. 

Respond to the these discussions. All questions need to be addressed.

Discussion 1 En

Three questions to ask the patient and a rationale for asking these questions.

How may I be of assistance today? This question creates a rapport between you and the patients, and it makes her know that the doctor is ready to listen and help her.

What are you doing to cope with grief after losing your husband? This question will help the care provider assess the approaches the patient is using to cope with grief and be able to identify the ones working and not working for the patient.

Are you living with someone at home, and are you following your regimen correctly? By asking this question, the care provider will understand the type of support system available at home and know which support to prescribe for the patient and if the support at home is helping the patient follow her regimen correctly.

People in the patient’s life to speak to or get feedback from to further assess the patient

People in the patient’s life to speak to include her children, her aide, and close friend per her authorization. The feedback I will get from these people will help me know the severity of the patient’s problem. Some of the questions I will ask them are;

1. Has the patient been experiencing worse symptoms of depression since her husband’s dead? This question will help me understand people close to her can know when she is depressed.

2. Does the patient complain about her treatment regimen? This question will allow me to know the side effects of the treatment if any.

3. Has the sleeping patterns changes recently? This question will help me understand the severity of insomnia.

Physical and diagnostic tests

The physical exams appropriate for this patient include heart rhythm, eye assessment, and oxyhemoglobin saturation. The diagnostic tests for this patient include polysomnography and actigraphy tests. These tests will be used to measure the patient’s sleep patterns. The actigraphy measures sleep efficiency, sleep latency, and total sleep time, and polysomnography will diagnose sleep disorders (Niel et al., 2020)

Differential diagnoses for the patient

The patient’s differential diagnoses include generalized anxiety disorder, major depressive disorder, and restless leg syndrome. Major depressive disorder (MDD) is likely to explain why the patient is experiencing insomnia. MDD’s clinical presentation include insomnia, difficulty concentrating, appetite loss, and hopelessness. The patient’s husband’s loss contributed to depression, which affected her sleeping pattern. According to Bennabi et al. (2019), patients with MDD are at risk of experiencing sleeping disorders.  Since the patient is responding to grief, her chances of developing MDD are high.

Pharmacologic agents and their dosing

Selegiline Transdermal patch. Apply 6mg daily dose, which is applied every day. If symptoms do not improve, the dose can be increased by 3mg daily for two weeks until it reaches a maximum of 12gm daily. The drug inhibits Monoamine Oxidase-B isoenzyme (Bied et al., 2015).

Eszopiclone. The required dose is 3mg, which is administered orally before the patient goes to bed. It is the first-line drug for insomnia, and it interacts with gamma-aminobutyric acid (GABA) receptors at the allosterically binding sites at the benzodiazepine receptors. The drug works by slowing brain activities to allow sleep. The drug induces sedation and hypnosis hence causing sleep (Dixon et al., 2015). Since the patient is complaining of insomnia, eszopiclone will be appropriate in improving this symptom.

Drug therapy contraindications

Contraindications of using selegiline transdermal include increased risks of serotonin syndrome. The drug contraindicates in the patients taking selective serotonin reuptake inhibitors, mirtazapine, and other vasoconstrictors and analgesics.

Check points

After administering these drugs, the patient will be assessed after a four-week interval to determine if the symptoms have improved. If the symptoms have not improved after four weeks, selegiline transdermal will be increased by 3mg for four weeks until 12gm, which is the maximum dose per day. If the symptoms improve within the first four weeks, the regimen will be maintained until the patient completes the dose. After completing the dose, the patient will sleep well and the symptoms of depression will be well managed.   

References

Bennabi, D., Charpeaud, T., Yrondi, A., Genty, J. B., Destouches, S., Lancrenon, S., … & Haffen, E. (2019). Clinical guidelines for the management of treatment-resistant depression: French recommendations from experts, the French Association for Biological Psychiatry and Neuropsychopharmacology and the fondation FondaMental. BMC psychiatry, 19(1), 1-12.   https://doi.org/10.1186/s12888-019-2237-x

Bied, A. M., Kim, J., & Schwartz, T. L. (2015). A critical appraisal of the selegiline transdermal system for major depressive disorder. Expert review of clinical pharmacology, 8(6), 673-681. https://doi.org/10.1586/17512433.2016.1093416

Dixon, C. L., Harrison, N. L., Lynch, J. W., & Keramidas, A. (2015). Zolpidem and eszopiclone prime α1β2γ2 GABAA receptors for longer duration of activity. British journal of pharmacology, 172(14), 3522-3536. https://doi.org/10.1111/bph.13142

Niel, K., LaRosa, K. N., Klages, K. L., Merchant, T. E., Wise, M. S., Witcraft, S. M., Hancock, D., Caples, M., Mandrell, B. N., & Crabtree, V. M. (2020). Actigraphy versus polysomnography to measure sleep in youth treated for craniopharyngioma. Behavioral sleep medicine, 18(5), 589-597. https://doi.org/10.1080/15402002.2019.1635133

Adolescence: Contemporary Issues and Resources – 2025 Research the range of contemporary issues teenagers face today In a 500 750 word

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Adolescence: Contemporary Issues and Resources – 2025

Research the range of contemporary issues teenagers face today. In a 500-750-word paper, choose one issue (besides teen pregnancy) and discuss its effect on adolescent behavior and overall well-being. Include the following in your submission:

1-Describe the contemporary issue and explain what external stressors are associated with this issue.

2-Outline assessment strategies to screen for this issue and external stressors during an assessment for an adolescent patient. Describe what additional assessment questions you would need to ask and define the ethical parameters regarding what you can and cannot share with the parent or guardian.

3-Discuss support options for adolescents encountering external stressors. Include specific support options for the contemporary issue you presented. 

Prepare this assignment according to the guidelines found in the APA Style Guide

Area of Interest Power Point Presentation – 2025 For this presentation select an area of nurse practitioner NP practice that is of

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Area of Interest Power Point Presentation – 2025

 

For this presentation, select an area of nurse practitioner (NP) practice that is of interest to you and in which you would like to see a practice change occur. Conduct a review of literature to see what is currently known about the topic and to find research support for the practice change you are recommending.  You may use a topic from the list at the link below or may investigate a topic of your choice as long as it pertains to NP practice. If you are unsure of your topic, please reach out to your instructor.  Be sure to provide speaker’s notes for all slides except the title and reference slides.  

List of Possible Topics (Links to an external site:

· Best evidence available about a topic (i.e. frequency of mammography)

· Screening recommendations (i.e. PSA for prostate cancer)

· Information about a healthcare-related phenomenon (i.e. when to talk to a person about ending treatment for a terminal illness, non-compliance of diet for individuals with congestive heart failure)

· Vaccinations for adults and/or children

· Early assessment for health-related concerns (i.e. depression in teenagers; suicide prevention for the elderly)

· Life style changes (i.e. smoking cessation, increasing activity in teenagers)

· Relationship between events or health concerns (i.e. relationship between dementia and caffeine consumption.

· Selection on an intervention (i.e. use of small group theory to lessen anxiety)

· Symptom management (i.e. pain, vomiting)

Create an 8-12 slide PowerPoint Presentation that includes the following: 

  1. Introduction: slide should identify concepts to be addressed and sections of the presentation. Include speaker’s notes that explain, in more detail, what will be covered. 
  2. Evidence-based projects: slide should explain the general importance of master’s-prepared nurses engaging in evidence-based projects related to nursing practice and profession. Provide speaker’s notes with additional detail and support from at least one outside scholarly source (not the textbook or course lesson). 
  3. Conceptual Model: slide should provide an illustration of a conceptual model that could be used to develop an evidence-based project. Possible models include The John’s Hopkins or Advancing Research and Clinical Practice through Close Collaboration (ARCC) Models or you may select another model you find in the literature. In the speaker’s notes, explain how the model would be applied to the development of an evidence-based project. Provide support from at least one outside scholarly source (not the textbook or course lesson). 
  4. Area of Interest: identify an area of interest related to NP practice in which a practice change may be needed. Slide should identify the area of interest and what is currently known on the topic. Speaker’s notes more fully explain what is currently known and should provide rationale for why the area of interest is important to NP practice. Provide support from at least one outside scholarly source (not the textbook or course lesson). 
  5. Issue/concern and recommendation for change: slide should identify a specific concern related to your general area of interest and your recommendation for a practice change. Speaker’s notes should more fully explain the recommended change and rationale for the change. Recommendation should be supported by at least one outside scholarly source (not the textbook or course lesson). 
  6. Factors Influencing Change: slide should identify at least 2 internal and external factors that could impact your ability to implement your recommended change. Speaker’s notes should more fully explain how the factors you’ve identified would support or impede the implementation of your recommendations. Factors may be based on personal experience or on information you found in your research. If the identified factors come from the literature, provide reference citations to support your ideas. 
  7. NONPF Competencies: slide identifies at least two NONPF Competencies that are relevant to an evidence-based project related to your area of interest. Speaker’s notes should explain how the competencies relate to your area of interest. Provide support from at least one outside scholarly source (not the textbook or course lesson). 
  8. Conclusion: slide provides summary points of presentation. Speaker’s notes provide final comments on the topic.  

Preparing the presentation 

Submission Requirements 

  1. Application: Use Microsoft Power Point™ to create the PowerPoint presentation.  
  2. Length: The PowerPoint presentation must be 8-12 total slides (excluding title and reference slides).   
  3. Speaker notes are used and include in-text citations when applicable. 
  4. A minimum of four (4) scholarly literature references must be used. 
  5. Submission: Submit your file: Last name_First initial_Wk6Assessment_Area of Interest. 

Best Practices in Preparing the Project 

The following are best practices in preparing this project: 

  1. Review directions thoroughly. 
  2. Follow submission requirements. 
  3. Make sure all elements on the grading rubric are included. 
  4. Rules of grammar, spelling, word usage, and punctuation are followed and consistent with formal, scientific writing. 
  5. Review the Creating a Professional Presentation located resource.  
  6. Ideas and information that come from scholarly literature must be cited and referenced correctly. 
  7. Abide by CCN academic integrity policy. 

ASSIGNMENT CONTENT 

Category 

Points 

% 

Description 

Introduction 

9 

5% 

Slide should identify concepts to be addressed and sections of the presentation. Include speaker’s notes that explain, in more detail, what will be covered. 

Evidence-based projects  

12 

7% 

Slide should explain the general importance of master’s-prepared nurses engaging in evidence-based projects related to nursing practice and profession. Provide speaker’s notes with additional detail and support from at least one outside scholarly source (not the textbook or course lesson). 

Conceptual Model 

18 

10% 

Slide should provide an illustration of a conceptual model that could be used to develop an evidence-based project. Possible models include The John’s Hopkins or Advancing Research and Clinical Practice through Close Collaboration (ARCC) Models or you may select another model you find in the literature. In the speaker’s notes, explain how the model would be applied to the development of an evidence-based project. Provide support from at least one outside scholarly source (not the textbook or course lesson). 

Area of Interest 

35 

20% 

Identify an area of interest related to NP practice in which a practice change may be needed. Slide should identify the area of interest and what is currently known on the topic. Speaker’s notes more fully explain what is currently known and should provide rationale for why the area of interest is important to NP practice. Provide support from at least one outside scholarly source (not the textbook or course lesson). 

Issue/concern and recommendation for change 

35 

20% 

Slide should identify a specific concern related to your general area of interest and your recommendation for a practice change. Speaker’s notes should more fully explain the recommended change and rationale for the change. Recommendation should be supported by at least one outside scholarly source (not the textbook or course lesson). 

Factors Influencing Change 

17 

10% 

Slide should identify at least 2 internal and external factors that could impact your ability to implement your recommended change. Speaker’s notes should more fully explain how the factors you’ve identified would support or impede the implementation of your recommendations. Factors may be based on personal experience or on information you found in your research. If the identified factors come from the literature, provide reference citations to support your ideas. 

NONPF Competencies 

14 

8% 

Slide identifies at least two NONPF Competencies that are relevant to an evidence-based project related to your area of interest. Speaker’s notes should explain how the competencies relate to your area of interest. Provide support from at least one outside scholarly source (not the textbook or course lesson). 

Conclusion 

9 

5% 

Slide provides summary points of presentation. Speaker’s notes provide final comments on the topic.  

149 

85% 

Total CONTENT Points= 149 points 

ASSIGNMENT FORMAT 

Category 

Points 

% 

Description 

APA Formatting 

8 

5% 

1) References on reference slide must be in APA format. May use bullets instead of hanging indents.

2) In-text citations on slides and in speaker’s notes must be in APA format. 

Writing Mechanics 

9 

5% 

Writing mechanics follow the rules of grammar, spelling, word usage, punctuation, and other aspects of formal written work as found in the current edition of the APA manual. Presentation length meets assignment guidelines. 

Slide Formatting 

9 

5% 

1) Presentation has title slide 

2) Presentation has reference slide(s)  

3) Slides are professional in appearance and tone;  

4) Slides are balanced spatially, including words and graphics. 

26 

15% 

Total FORMAT Points= 26 points 

175 

100% 

ASSIGNMENT TOTAL=175 points