In attempting to define health, what can occur?

Question

1. One of the results of the 2005 Hurricanes Katrina and Rita in Louisiana has been an increase in the influx of Spanish-speaking workers. Incorporating cultural and linguistic competence to meet the health needs of this population would include

a. having health care professional staff from different Spanish-speaking countries at health care facilities.

b. ensuring health services are in varying locations.

c. ensuring that all signage is posted completely in Spanish.

d. having all health care workers speak Spanish.

2. A mechanism health care organizations need to incorporate into their strategic plan for culturally and linguistically appropriate services includes

a. goals, policies, accountability and oversight mechanisms addressing these services.

b. partnerships with community agencies.

c. mechanisms for client service reimbursement.

d. staff con? ict resolution policies.

3. Kwanzaa was created in the 1960s to raise awareness and pride for the African- American community. While its tenets can be applied to all people, this particular celebration was developed to celebrate a specific

a. social class.

b. religion.

c. ethnicity.

d. cultural group.

4. Parish Nursing is an aspect of nursing that is becoming more utilized. One of the bases of parish nursing is the premise that

a. it is easier to provide health services to a de? ned religious community.

b. a faith community has an impact on the health of its members.

c. illness is prevented through parish nursing.

d. members of a religion follow de? ned health practices.

5. After the Vietnam War, many Vietnamese immigrated to the United States and settled in areas where they could maintain many of the cultural customs and traditions of Vietnam, including festivals, Saturday schools to educate the children in the Vietnamese language and planting communal gardens. This is an example of

a. heritage consistency.

b. acculturation.

c. socialization.

d. religious preference.

6. A seminal event in the boomer generation that can still elicit comment today is the question

a. ”How did the Challenger tragedy affect you?”

b. ”Where were you when John F. Kennedy was shot?”

c. ”Do you remember Pearl Harbor?”

d. ”What were you doing on September 11, 2001?”

7. A complaint of the boomer generation about the following generations regards work ethic. The “nester” generation born between 1979 and 1984 is more likely to embrace an ethic

a. of employer loyalty.

b. seeking to fit their lifestyle.

c. seeking maximum financial gain.

d. loyal to one’s skills in the marketplace.

8. The best outcome for health care facilities incorporating cultural care into their practices is

a. increased numbers of clients seeking care at these facilities.

b. improved health outcomes for the clients at these facilities.

c. better health care provided by the facility’s staff.

d. increased reimbursement by insurance companies for provided health services.

9. An important consideration when making a home health visit to a client is to:

a. give a general idea of when the visit will be made.

b. bring a gift to the client’s home on the initial visit.

c. just show up at the client’s home.

d. inform the client the approximate time the visit will be made.

10. Certain cultures place emphasis on eating speci? c foods during pregnancy and after childbirth to ensure a healthy mother and infant. This cultural phenomena is an example of

a. time orientation.

b. environmental control.

c. biological variation.

d. social organization.

11. Touch is an important component of nursing, but using it without understanding the client’s cultural background can be a violation of their

a. social organization.

b. environmental control.

c. space and territoriality.

d. time orientation.

12. Before doing any teaching it is important the client understands what is being taught. The most effective method to determine if the client understands any health teaching is by

a. ask the client if they understand what was said in the teaching.

b. speaking slowly and carefully to the client.

c. having the client repeat back what was said in his/her own words.

d. interpreting the client’s facial gestures.

13. Native Americans have a higher susceptibility to diabetes than other population groups within the United States. This is considered a(n)

a. biological variation.

b. component of heritage consistency.

c. social organization pattern.

d. environmental control.

14. While the Census Bureau has placed race as a sociopolitical construct, placing oneself into a racial category can still present a challenge. Those who consider themselves “Creole” would be more likely to place themselves into the category labeled

a. White.

b. Asian.

c. Black or African American.

d. Hispanic or Latino.

15. While shifts in the population profile are occurring, what is an important consideration to address in health care?

a. More physicians need to be trained to deliver health care.

b. Cultural health needs of varying groups must be considered.

c. Health care providers need to be younger to care for an aging population.

d. Health care needs to be streamlined for consistent care delivery.6

16. With the percentage of the 65+ population greatest among White non-Hispanics in the 2000 Census, health planning needs would indicate

a. there is no need to increase manufacture of childhood immunizations.

b. cultural accommodations for other minority groups can be decreased.

c. planning needs for other segments of the population can be revised downwards.

d. this population will have greater demands on the health care system as they age.

17. Twelve percent of the population in 2000 was age 65 or over. Long-term implications for health for this group include

a. developing systems to provide health care only to those older citizens who remain healthy.

b. providing health care that is focused on gerontological needs.

c. providing health insurance for all age groups.

d. developing medications to prolong life at any cost.

18. A hurdle immigrants face coming to a new country is

a. rejecting their old customs in favor of new customs.

b. having their children learn the customs of the new country.

c. finding their own cultural group in the new country.

d. learning a new way of life that differs from their former way of life.

19. In 1970, the highest percentage of foreign-born legal permanent residents becoming citizens came from Europe. What is true today? The majority of foreign-born legal permanent residents are from

a. Asia.

b. Mexico, China, and the Philippines.

c. Europe.

d. South America.

20. Many people who come to the United States to live seek to get a “green card.” The green card

a. confers automatic U.S. citizenship.

b. legally restricts the holder from becoming a citizen.

c. defines the person as being in the country unlawfully.

d. allows the person legal permanent residency.

21. When seeking permanent U.S. citizenship, legal permanent residents take a naturalization exam that questions them on

a. knowing the Pledge of Allegiance.

b. being able to recite or sing the national anthem.

c. elements of the U.S. government.

d. the Congressional district they live in.

22. Among the very real concerns for all residents of the United States, citizens and legal permanent residents, is the rise in undocumented people entering the country. What impact is this having on health care?

a. Increased numbers of undocumented people are straining health care resources.

b. The rise in undocumented people is contributing to the rise in exotic and rare diseases in the country.

c. There is a concern that undocumented people will lead to bioterrorist attacks.

d. Health insurance is being given to all people in the country ensuring universal coverage.

23. One recognized deterrent to poverty is

a. the presence of two parents in a family structure.

b. not needing to have housing assistance.

c. not needing to utilize food stamps.

d. living in a household of a male income earner.

24. While income is not a restrictor for engaging in health-promoting behaviors, higher income improves them through

a. living in better housing.

b. membership in health clubs in suburban areas.

c. increasing opportunities through nutrition and access to facilities.

d. access to better jobs.

25. Many people and groups have provided definitions of health, but the most widely used definition is that from

a. Nightingale.

b. Rogers.

c. Murray and Zenter.

d. WHO (World Health Organization

26. As people progress through a health profession education program, definitions of health become

a. easier to explain to others.

b. aligned with the client seeking care.

c. more abstract and technical.

d. well articulated and understandable.

27. In attempting to define health, what can occur?

a. Listing categories of health will enable understanding of health.

b. Ambiguity is resolved when health definitions are discussed.

c. Terms and meanings can be challenged by others.

d. A full acceptance can be achieved by all parties.

28. Health status and determinants are used to

a. account for health care expenditures.

b. enforce legislation pertaining to health.

c. determine federal dietary guidelines.

d. measure the health of a nation.

29. Healthy People 2010 represents

a. health policies providing monetary incentives to states who reach the benchmark goals by 2010.

b. a plan to improve the health of everyone in the United States in the ? rst decade of this century.

c. mandated legislation that will result in a healthier population by 2010.

d. a monitoring system evaluating the health of all citizens.

30. As with the many variant definitions of health, illness also has many meanings. Illness and the sick role assigned to it are legitimized by

a. the insurance company that pays for the illness treatment.

b. the person having the illness.

c. the health care profession that diagnoses the illness.

d. society’s view of the illness.

31. Among the sick role components is the

a. mandate of appearing ill and suffering from the illness.

b. necessity of taking medications and staying in bed.

c. exemption from performance of certain normal social obligations.

d. refusal to look to other sources of health care treatments beyond those prescribed.

32. During the stage of patient status, it is expected that

a. symptoms are being experienced, leading to a diagnosis.

b. the patient do all they can do to recover from their illness.

c. the illness is now socially recognized and identified.

d. the person shifts into the role as it is determined by society.

33. Assuming the sick role according to Suchman means the person

a. is aware that something is wrong and responds emotionally.

b. seeks scientific confirrmation that something is wrong.

c. seeks help and shares the problem with family and friends.

d. goes under the control of a physician who plans a treatment of care.

34. A person who has cancer may have followed this illness trajectory:

a. presenting symptoms, followed by treatment and recovery.

b. acute illness, unstable status, deterioration, and recovery.

c. diagnosis, treatment, unstable status, death.

d. presenting symptoms, followed by diagnosis and treatment.

35. When Suchman divides the illness experience into its various stages, the medical care contact stage implies the person is

a. cognitively and physically aware that something is wrong.

b. under medical control and following a prescribed treatment protocol.

c. seeking scientific c rather than lay diagnosis in order to interpret what it all means.

d. seeking help and information from family and friends. 10

36. While HEALTH is considered a balance of the person, ILLNESS would be considered

a. the imbalance of one’s being in and outside the world.

b. actual symptomatology physically manifested.

c. part of the human condition that all must experience.

d. the absence of elements that contribute to health.

37. While complementary alternative medical (CAM) treatments are used by people of all backgrounds, recent research indicates CAM use is greater by

a. men.

b. those who have never been hospitalized.

c. people with rudimentary education.

d. women.

38. Alternative medical traditions are considered

a. an essential component of a cultural heritage medical tradition.

b. for use in concert with other aspects of health care.

c. out of the realm of a person’s cultural heritage medical tradition.

d. traditional methods of health care.

39. The evil eye is defined differently by different populations. Evil is thought to be cast in the Philippines through the

a. mouth or eye.

b. eye or touch.

c. foot.

d. breath.

40. The saying, “An apple a day keeps the doctor away, an onion a day keeps everyone away,” is thought to protect HEALTH by

a. recognizing the special antibiotic properties contained within onions.

b. advertising that onions have special healing abilities.

c. protecting the person from coming in contact with those who might be ill.

d. affirming the belief in the power of onions to prevent disease.

41. Religion has an important role in HEALTH, and ILLNESS can be considered

a. violating dietary practices.

b. failure to wear special amulets to ward it off.

c. a necessary part of religious culture.

d. punishment for breaking a religious code.

42. Eucalyptus is a folk herbal remedy that has applications today. It is used for

a. nasal congestion and sore throat.

b. infant colic.

c. toothache pain.

d. fever.

43. Allopathic medicine terms alternative treatments as complementary or alternative. An alternative therapy for rehabilitation might include ________ as treatment.

a. macrobiotics

b. Santeria

c. Voodoo

d. biofeedback

44. The difference between complementary and alternative medicine is that complementary medicine

a. can be used together with allopathic medicine.

b. is never used with allopathic medicine.

c. lessens a patient’s discomfort with allopathic treatments.

d. replaces allopathic medicine as a primary form of treatment.

45. A reason why people seek alternative care treatments is

a. allopathic treatments may cause adverse effects that a person can’t tolerate.

b. training for alternative care practitioners is closely regulated and licensed.

c. insurance reimburses alternative care treatments at the same rate or better than allopathic treatments.

d. it has a better empirical basis than do allopathic treatments.

46. Many people of Catholic faith pray to ________ for the grace of a happy death.

a. St. Teresa of Avila

b. St. John of God

c. St. Roch

d. St. Joseph

47. While shrines that attract pilgrims can be religious or secular in nature, an essential component to all of them is the

a. feeling of peace and serenity that is conducive to healing.

b. location of the shrine.

c. presence of water so pilgrims can take samples home.

d. numbers of people who are attracted to that site.

48. Lourdes, France, is the site of a revered Roman Catholic shrine. Many people with illnesses visit the shrine with the hope of

a. becoming more prosperous.

b. gaining a better job.

c. receiving a cure through a miracle.

d. being able to live a long life.

49. Historically, early forms of HEALING for illness were equated with

a. performing set rituals to prevent illness.

b. finding the person causing the illness.

c. sacrificial offerings.

d. removing the evil causing the illness.

50. Among alternative treatment modalities utilized during an illness may be the

a. consultation of a healer outside the medical establishment.

b. strict adherence to the prescribed medical regimen.

c. willingness to seek a second medical opinion.

d. refusal to allow any medical treatment to be performed.

51. A potential explanation for healers being used in addition to or instead of traditional medical personnel is their

a. unique language that is characteristic of their calling.

b. exclusive dialogue with the person who is ill.

c. formal relationship with the client.

d. willingness to be available at any time.

52. An illness of the spirit is treated through repentance and is considered

a. physical healing.

b. spiritual healing.

c. inner healing.

d. deliverance.

53. The six-week postpartum check that women have after having a baby closely matches the crucial ________ day practice of ancient times.

a. seventh

b. fortieth

c. third

d. tenth

54. Baptism dates for children have significance within various religions. Water is the common element in baptism as water signifies

a. protecting the child from illness.

b. cleansing the child either from evil or other maladies.

c. the relation of the child to God.

d. dedication of the child to a family group.

55. Wearing white clothes in the Buddhist tradition indicates

a. mourning the death of a relative.

b. recognition of a religious holiday.

c. joy for the birth of an infant.

d. celebration for a marriage.

56. The decline in the use of patent medicine utilization in the United States began with

a. the passage of the Food and Drug Act.

b. increased popularity of over-the-counter medicines.

c. the rise in alternative health care practitioners.

d. Medicare reimbursement for prescription medications.

57. An important health protection practice among Black American Baptists is

a. drinking blackstrap molasses.

b. eating fresh lemons.

c. wearing camphor around the neck in the winter.

d. taking a daily shot of whiskey.

58. Chicken soup is considered a universal HEALTH restoration intervention in which tradition?

a. French

b. Pacific Islander

c. Eastern European Jewish

d. Italian

59. As a HEALTH maintenance practice, the use of cod liver oil is advocated by those of the

a. German Catholic tradition.

b. Italian Catholic tradition.

c. Iranian (U.S.) Islamic tradition.

d. English Episcopal tradition.

60. A HEALTH protection practice among Irish-American Catholics is drinking

a. senna tea.

b. yeast.

c. hot peppermint tea.

d. wine daily.

61. Fr. John’s medicine is suggested as a HEALTH protection practice from November to May for

a. English American Episcopalians.

b. Canadian Catholics.

c. Native American Baptists.

d. Italian American Catholics.

62. Among the HEALTH restoration practices for menstrual cramps for Irish American Catholics is

a. applying Vicks on the abdomen.

b. drinking cod liver oil in orange juice.

c. applying warm oil to the stomach.

d. drinking hot milk sprinkled with ginger.

63. Activities for HEALTH maintenance for Swedish-American Protestants include

a. walking distances on a regular basis.

b. dressing appropriately for the weather.

c. going to a physician twice a year whether needed or not.

d. starting each day with prayer.

64. While dressing properly for season and weather is an important HEALTH protection practice for Iranian-American Moslems, it is also important to

a. keep onions under the bed to keep nasal passages clear.

b. eat sorghum molasses.

c. keep feet from getting wet in the rain.

d. prevent evil spirits by not looking at a mirror at night.

65. A constant for any culture is the

a. ability for it to change quickly to adjust to new challenges.

b. requirement that all members of the culture act the same.

c. socialization into its traditions, language and practices.

d. necessity for its members to be homogenous in all their decisions.

66. Socialization into the health care culture includes an assumption that

a. effective treatment can only be done by educated and licensed professionals.

b. the more technological the intervention, the greater bene? t it yields.

c. interventions for health events must follow a prescribed protocol.

d. alternative complementary treatments have validity.

67. Contemporary per capita U.S. health care expenditures are expected to

a. increase as part of the overall gross domestic product.

b. decrease as health care becomes available for all citizens.

c. match those of other Western countries.

d. have the United States achieve the highest health status in the world.

68. Specified government efforts for health insurance have resulted in

a. decreasing the amount that Medicare covers for prescription medications.

b. decreasing the percentage of uninsured children under age 18.

c. increasing coverage for prenatal and well-baby care.

d. increasing the percentage of uninsured children under age 18.

69. Technology and scientific advances in health care have resulted in more conditions being treated than in previous decades. The most expensive costs for care are for which conditions?

a. Cardiac disease

b. Conditions resulting in transplantation

c. Diabetes care

d. Pulmonary disease

70. In the early part of the twentieth century, health care efforts focused on controlling infectious diseases and improving

a. maternal and child health.

b. the requirements of the medical profession.

c. chronic diseases.

d. health care costs.

71. The United State relies heavily on guest worker/migrant labor for its agriculture industry. Health care can be offered for this population but faces a potential barrier of

a. language.

b. access.

c. racism.

d. homelessness.

72. What differentiates CULTURALCARE from modern medical care in philosophy is that

a. sufficient money, technology and science are used to cure or remedy.

b. premature death must be avoided.

c. holistic care is predicated on cultural health traditions and needs.

d. disease and injury are avoided through health promotion and maintenance.

73. HEALTH for American Indians has a basis in the

a. curing of those conditions that affect the spirit.

b. respecting of others’ beliefs in healing traditions.

c. harmony between nature and the ability to survive.

d. optimism that life creates positive forces.

74. Evil spirits are associated with illness by the

a. Sioux.

b. Cherokee.

c. Passamaquoddy.

d. Hopi.

75. In determining the cause for illness, medicine men and women look for the

a. dietary practices of the person being seen.

b. past medical history as a determinant.

c. spiritual cause of the problem of the person seen.

d. physical symptoms displayed.

76. Use of sand paintings as diagnosis in the Navajo tradition helps to

a. provide an atmosphere of calming for the medicine man.

b. determine cause and treatment of the illness.

c. ensure that appropriate payment is made by the family.

d. create symbolic representations of the client and family.

77. A sequela related to alcohol abuse in American Indians is the rise in

a. malnourishment among children.

b. breast cancer rates.

c. domestic violence against women.

d. unintentional injuries.

78. The provision of health services through the Indian Health Service means

a. having one master health guideline blueprint for consistency of care.

b. partnering and assisting tribes in planning the best delivery of care.

c. allotting health resources based on population numbers.

d. following prescribed federal guidelines and procedures.

79. Comparing household income levels of $150,000 or more within the Asian subpopulations, the population that has the higher income level is

a. Chinese.

b. Filipino.

c. Indian.

d. Indonesian.

80. The initial impetus for Asian immigration to the United States, specifically with the Chinese population, resulted from the

a. favorable immigration status for the Chinese.

b. high unemployment rates in China.

c. need for cheap labor building railroads in the nineteenth century.

d. demand for menial service jobs.

81. A second-class physician in Chinese medicine:

a. pays the patient’s family if the patient dies.

b. has to wait for patients to become ill before treating them.

c. consults Taoist writings for diagnosis and prescription.

d. receives payment only if the patient is cured.

82. The health and disease beliefs in Ayurveda teach that

a. humans are distinct beings within the universe.

b. disease arises when a person is out of harmony with the universe.

c. at birth, people are not in balance and their lives are spent getting into balance with the universe.

d. living and nonliving things have minor connections with one another.

83. Feeling the pulse is important for a Chinese physician because it

a. can help refine a diagnosis.

b. is only felt on the wrist.

c. indicates a specific treatment.

d. is considered the storehouse of the blood.

84. In acupuncture, needles are inserted at predetermined points called meridians because

a. puncturing the meridians helps to restore yin and yang balance.

b. the best anesthetic response is done through meridian puncture.

c. meridians represent specific yin and yang points.

d. only specific needles can puncture the meridians.

85. While Blacks are represented in every socio-economic group, the percentage of those living in poverty in 2005 was approximately

a. thirty percent.

b. twenty percent.

c. fifty percent.

d. twenty-five percent.

86. Speaking a language other than English at home is highest among immigrants from

a. Nigeria.

b. Somalia.

c. Sudan.

d. Niger.

87. A diabetic Muslim may refuse insulin

a. because it implies the person has not led a holy life.

b. because any injectable medication is forbidden.

c. during Ramadan.

d. if it has a pork base.

88. The leading authority figure within the Black familial structure is the

a. oldest adult child.

b. female.

c. male.

d. minister.

89. When a Black person is being examined, skin pallor can be recognized by

a. palpation.

b. checking the sclera.

c. the absence of underlying red tones.

d. slow blood return.

90. Scars that form at a wound site growing beyond the normal boundaries of the wound are

a. melasma.

b. pseudofolliculitis.

c. keloids.

d. a pigmentary disorder.

91. Educational comparisons of high school graduation and college attendance between Hispanics and non-Hispanic whites indicate

a. Hispanics have a lower rate of graduation and attendance than their

non-Hispanic counterparts.

b. similar percentages of attendance between both groups.

c. more Hispanics attend college than their non-Hispanic counterparts.

d. a higher proportion of non-Hispanic whites fail to complete high school.

92. The largest Hispanic group in the United States comes from Mexico. Which is a true statement reflecting this population?

a. Employment levels are above the national average.

b. Employment in professional areas is stagnant.

c. Migrant farm work is the predominant employment.

d. Most live in urban areas.

93. Visiting a curandero(a) implies a person is seeking

a. holistic care encompassing social, physical, and psychological purposes.

b. care not offered by the medical establishment.

c. care for spiritual distress.

d. specialized herbal preparations not used by the medical establishment.

94. Teas used to treat mental illnesses in the Hispanic population are herbs common in the United States. Yerba buena is an herb used to treat nervousness. Its English name is

a. spearmint.

b. basil.

c. orange leaves.

d. chamomile.

95. The percentage of live births to women receiving third-trimester or no prenatal care is higher for Hispanics than the general population. This would imply that

a. more prenatal services are needed for the general population.

b. some prenatal care is better than no prenatal care.

c. Hispanics possibly have better self-care prenatal practices than the general population.

d. live birth rates would be comparable if all women received appropriate prenatal care.

96. In examining the median age of population groups, the oldest group is

a. African Americans.

b. Hispanics.

c. Whites.

d. Native Americans.

97. While German Americans believe in the germ theory of infection, another potential cause of ILLNESS can be

a. stress-related occurrences.

b. envy by others toward that person.

c. a voodoo curse.

d. unholy actions done in life.

98. Treating a cough in the German tradition may include

a. eating chicken soup.

b. putting wet warm compresses on the chest.

c. drinking lemon juice and whiskey.

d. rubbing goose grease on the chest.

99. To treat a cough, a traditional Polish remedy is

a. taking garlic oil.

b. a mustard plaster on the chest.

c. drinking hot lemonade with whiskey.

d. goose grease rubbed on the throat.

100. When compared to all races, the White population has a higher

a. percentage of low birth-weight infants.

b. percentage of women receiving prenatal care.

c. infant mortality rate.

d. crude birth rate.

 
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Identify and describe at least four medical and/or nursing interventions.

observe the simulated “Home Visit With Sallie Mae Fisher” video (http://lc.gcumedia.com/zwebassets/courseMaterialPages/nrs410v_vp01Alt.php).

Refer to “Sallie Mae Fisher’s Health History and Discharge Orders” for specifics related to the case study used to inform the assignment.

Using “Home Visit With Sallie Mae Fisher” and “Sallie Mae Fisher’s Health History and Discharge Orders,” complete the following components of this assignment:

Essay Portion

After viewing the home visit, write an essay of 500-750-words in which you do the following:

Identify, prioritize, and describe at least four problems.( problems identify are as follows

Mrs. Fisher’s number one problem is dehydration. In the video her vital signs are: Heart rate 58, blood pressure 90/56, respiratory rate 24 and temperature 97.8F (GCU, 2017). Her physical assessment reveals poor skin turgor, tenting, dry mucus membranes, hypoactive bowel sounds, no bowel movement for three days and a 14 pound weight loss in one week (GCU, 2017). She admits to “not having an appetite.” She is taking Lasix, a diuretic further contributing to her fluid loss. All of these finding are consistent with dehydration. Dehydration can lead to a kidney injury, seizures and hypovolemic shock (Mayo Clinic, 2017).

The next problem is an unsafe living environment. In in video we see a loose rug on the floor, prescriptions on the table and mail on the couch. This lack of organization and Mrs. Fisher’s age put at risk for a fall. The Center for Disease Control and Prevention (CDC) states, “One out of five falls in an older adult causes a serious injury such as broken bones or a head injury” (CDC, 2017).

Then we look at her lack of understanding surround her discharge. She is supposed to be on home oxygen but didn’t have it delivered because she thinks she will, “Be in the poor house” due to cost of her medications and medical supplies. The final problem is her depression. Mrs. Fisher explains her husband died. She now lives alone and, “doesn’t even care, is so lonesome and misses him so” (GCU, 2017).

Provide substantiating evidence (assessment data) for each problem identified.

Identify and describe at least four medical and/or nursing interventions.

Discuss your rationale for the interventions identified.

Prepare this step of the assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

Scripted Dialogue Portion

Utilizing the information learned from the home visit, health histories, and discharge orders, write a scripted dialogue in which you provide Sallie Mae with education that describes her problems and the interventions identified to improve her condition. Consider Sallie Mae’s physiological, psychosocial, educational, and spiritual needs when developing your dialogue.

Your dialogue should resemble a script. The following is an example of a few sentences from a scripted dialogue:

Nurse: “Good morning, Salle Mae, my name is ______ and I will be your nurse today. I understand you are experiencing problems with ________.”

APA format is not required for this part of the assignment, but solid academic writing is expected.

Refer to “Home Visit With Sallie Mae Fisher Grading Criteria.”

Entire Assignment

You are required to submit this assignment to Turnitin. Refer to the directions in the Student Success Center. Only Word documents can be submitted to Turnitin.

 
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Which of the following classes of drugs should be used as first-line therapy for treatment of delirium?

NR 511 Week 4 Midterm Exam Version 5

Question 1: How often should the clinician examine the feet of a person with diabetes?

a. Once a year

b. Every 6 months

c. Every 3 months

d. Every visit

Question 2: Which drug for Alzheimer’s disease should be administered beginning at the time of diagnosis?

a. Cholinesterase inhibitors

b. Anxiolytics

c. Antidepressants

d. Atypical antipsychotics

Question 3: Most adult poisonings are:

a. intentional and self-inflicted.

b. accidental.

c. caused by someone wishing to do harm to the person.

d. not attributed to any reason.

Question 4: A 58-year-old woman presents with a breast mass. Which of the following responses by the clinician would be most appropriate?

a. “It is probably just a cyst, because that is the most common breast mass.”

b. “We will order a mammogram and ultrasound to help establish a diagnosis.”

c. “We will go ahead and schedule you for a biopsy because that is the only way to know for sure.”

d. “Because your lump is painful, it is most likely not cancer.”

Question 5: Which of the following is a specific test for multiple sclerosis (MS)?

a. Magnetic resonance imaging (MRI)

b. Computed tomography (CT) scan

c. A lumbar puncture

d. There is no specific test.

Question 6: After removing a tack from a type 2 diabetic’s heel and evaluating the site for infection, what is the best plan for this patient?

a. Suggest she use a heating pad to improve circulation

b. Refer to a podiatrist for a foot care treatment plan

c. Send her for acupuncture treatments

d. All of the above

Question 7: Which characteristic of delirium helps to distinguish delirium from dementia?

a. Abrupt onset

b. Impaired attention

c. Affective changes

d. Delusions

Question 8: Which clinical feature is the first to be affected in increased intracranial pressure (ICP)?

a. Decrease in level of consciousness (LOC)

b. Headache

c. Nausea

d. Widening pulse pressure

Question 9: Jennifer is an 18-year-old girl who comes to the emergency room after a fall during a soccer game. Jennifer explains that she fell on her left side and kept her arm out straight to break her fall. She has been experiencing severe pain and limited range of motion in her left shoulder. The clinician has diagnosed Jennifer with a dislocated shoulder. Which of the following statements are true concerning shoulder dislocation?

a. Posterior dislocations are more common than anterior dislocations.

b. There is a risk of neurovascular and neurosensory trauma, so the clinician should check for distal pulses.

c. Recurrent dislocations are uncommon and would require a greater force to result in injury.

d. Surgery is most commonly the treatment of choice.

Question 10: Which of the following signs or symptoms indicate an inflammatory etiology to musculoskeletal pain?

a. Decreased C-reactive protein

b. Hyperalbuminemia

c. Morning stiffness

d. Weight gain

Question 11: The clinician sees a patient who is 5 feet tall and weighs 150 pounds. How would the clinician classify this patient?

a. Overweight

b. Mild obesity

c. Moderate obesity

d. Morbid obesity

Question 12: The vegetarian patient with gout asks the clinician about food that he should avoid. The clinician should advise the patient to avoid which of the following foods?

a. Rice

b. Carrots

c. Spinach

d. Potatoes

Question 13: A 23-year-old sexually active woman presents for her first Pap smear. Her history includes nulligravida, age at first intercourse 14, and more than 10 sexual partners. Which of the following conditions should the clinician be particularly alert for during her exam?

a. Human papillomavirus (HPV)

b. Endometrial hyperplasia

c. Vagismus

d. Polycystic ovarian syndrome

Question 14: Which of the following classes of drugs should be used as first-line therapy for treatment of delirium?

a. Benzodiazepines

b. Antipsychotics

c. Anticonvulsants

d. Antidepressants

Question 15: What is the treatment of choice for a patient diagnosed with testicular cancer?

a. Radical orchidectomy

b. Lumpectomy

c. Radiation implants

d. All of the above

Question 16: A 24-year-old woman presents to the clinic with dysuria, dyspareunia, and a mucopurulent vaginal discharge. Her boyfriend was recently treated for nongonococcal urethritis. What sexually transmitted disease (STD) has she most probably been exposed to?

a. Gonorrhea

b. Human papillomavirus (HPV)

c. Chlamydia

d. Trichomonas

Question 17: A 58-year-old woman who had a total abdominal hysterectomy at the age of 45 is diagnosed with atrophic vaginitis. Which of the following is the most appropriate treatment?

a. Conjugated estrogen 0.625 mg/day oral

b. Estradiol 7.5 mcg/24 hr vaginal ring

c. Medroxyprogesterone 10 mg/day oral

d. Conjugated estrogen 0.3 mg + medroxyprogesterone 1.5 mg/day oral

Question 18: 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?

a. Spores

b. Leukocytes

c. Pseudohyphae

d. Epithelial cells

Question 19: Patients with a spontaneous pneumothorax should be counseled that up to what percentage may experience a reoccurrence at some point?

a. 10%

b. 20%

c. 30%

d. 50%

Question 20: John is a 16-year-old boy who presents to the emergency room after hurting his knee in a football game. He described twisting his knee and then being unable to extend it completely. John tells the clinician that he heard a pop when the injury occurred and has been experiencing localized pain. The clinician suspects a meniscal tear. Which test would be most appropriate to assess for the presence of a meniscal tear?

a. Valgus stress test

b. McMurray circumduction test

c. Lachman test

d. Varus stress test

Question 21: During a digital rectal exam (DRE) on a 75-year-old man, the clinician suspects the patient has prostate cancer. What physical finding should make the clinician suspicious?

a. An enlarged rubbery gland

b. A hard irregular gland

c. A tender gland

d. A boggy gland

Question 22: Janet is a 30-year-old woman who has been recently diagnosed with a herniated disc at the level of L5-S1. She is currently in the emergency room with suspicion of cauda equina compression. Which of the following is a sign or symptom of cauda equina compression?

a. Gastrocnemius weakness

b. A reduced or absent ankle reflex

c. Numbness in the lateral foot

d. Paresthesia of the perineum and buttocks

Question 23: The criteria for diagnosing generalized anxiety disorder in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (text revision) (DSM-IV-TR) state that excessive worry or apprehension must be present more days than not for at least:

a. 1 month.

b. 3 months.

c. 6 months.

d. 12 months.

Question 24: A patient is diagnosed with hypothyroidism. Which of the following electrocardiogram (ECG) changes should the clinician expect as a manifestation of the disease?

a. Sinus bradycardia

b. Atrial fibrillation

c. Supraventricular tachycardia

d. U waves

Question 25: Which type of burn injury results in destruction of epidermis with most of the dermis, yet the epidermal cells lining hair follicles and sweat glands remain intact?

a. Superficial burns

b. Superficial partial-thickness burns

c. Deep partial-thickness burns

d. Full-thickness burns

Question 26: Immunizations are an example of which type of prevention?

a. Primary

b. Secondary

c. Tertiary

Question 27: If a previously frostbitten area becomes frostbitten again after it has healed, what might occur?

a. Permanent tissue damage may occur, resulting in necrosis to that body part.

b. The area will be super sensitive.

c. The area is prone to a repeat frostbite.

d. The area is as susceptible as any other area.

Question 28: A 26-year-old woman is seen with complaints of irregular vaginal bleeding. Which of the following tests should be the first priority?

a. Pregnancy test

b. Pelvic ultrasound

c. Endometrial biopsy

d. Platelet count

Question 29: Julie, aged 50, has migraine headaches, frequent asthma attacks, coronary artery disease, and hypertension. Which of the following prophylactic medications would you order for her migraines?

a. Propranolol

c. Ergotamine

b. Timolol

d. Topiramate

Question 30: A 64-year-old man with type 2 diabetes presents to the clinic with the complaint of “my feet feel like they are on fire.” He has a loss of vibratory sense, +1 Achilles reflex, and a tack embedded in his left heel. Which of the following would be an appropriate treatment?

a. Tricyclic antidepressants

b. Capsacin cream

c. Vitamin B12 injections

d. Insulin

 
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Describe how you would address the opponent to your position. Be specific and provide examples.

Assignment: Legislation Comparison Grid and Testimony/Advocacy Statement

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.

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

Part 1: Legislation Comparison Grid

Based on the health-related bill 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?

Is it receiving press coverage?

Part 2: Legislation Testimony/Advocacy Statement

Based on the health-related bill you selected, develop a 1- to 2-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.

Recommend at least one amendment to the bill in support of your position.

 
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identify the clinical problem and how it can result in a positive patient outcome.

A PICOT starts with a designated patient population in a particular clinical area and identifies clinical problems or issues that arise from clinical care. The intervention should be an independent, specified nursing change intervention. The intervention cannot require a provider prescription. Include a comparison to a patient population not currently receiving the intervention, and specify the time frame needed to implement the change process.

Formulate a PICOT statement. (CHILDWOOD OBESITY). The PICOT statement will provide a framework for your capstone project.

In a paper of 750 words, clearly identify the clinical problem and how it can result in a positive patient outcome.

Make sure to address the following on the PICOT statement:

Evidence-Based Solution

Nursing Intervention

Patient Care

Health Care Agency

Nursing Practice

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

NO PLAGIARISM PLEASE. CHECK FOR PLAGIARISM BEFORE GIVING THE ANSWER BACK.

SIX REFERENCES PLEASE. USE THE PREVIOUS WEEK TO ANSWER

 
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Healthcare Issue Description Administration (President Name) Describe the administrative agenda focus related to this issue Allocation of financial and other resources to this issue Notes on Administration’s approach to the issue

Agenda Comparison Grid Template

Use this document to complete the Module 1 Assessment Agenda Comparison Grid and Fact Sheets/Talking Points Brief .

Healthcare Issue

Description

Administration (President Name)

Describe the administrative agenda focus related to this issue

Allocation of financial and other resources to this issue

Notes on Administration’s approach to the issue

General Notes/Comments

Which administrative agency would most likely be responsible for helping you address the healthcare issue you selected?

How does the healthcare issue get on the agenda and how does it stay there?

Who was the entrepreneur/champion/sponsor of the healthcare issue you selected?

Agenda Comparison Grid Template

 
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Analyze how healthcare issues get on administrative agendas

NURS 6050N

Students will:

1. Compare U.S. presidential agenda priorities

Evaluate ways that administrative agencies help address healthcare issues

Analyze how healthcare issues get on administrative agendas

Identify champions or sponsors of healthcare issues

Create fact sheets for communicating with policymakers or legislators

Justify the role of the nurse in agenda setting for healthcare issues

2. Assignment: Agenda Comparison Grid and Fact Sheet or Talking Points Brief
It may seem to you that healthcare has been a national topic of debate among political leaders for as long as you can remember.

Healthcare has been a policy item and a topic of debate not only in recent times but as far back as the administration of the second U.S. president, John Adams. In 1798, Adams signed legislation requiring that 20 cents per month of a sailor’s paycheck be set aside for covering their medical bills. This represented the first major piece of U.S. healthcare legislation, and the topic of healthcare has been woven into presidential agendas and political debate ever since.

As a healthcare professional, you may be called upon to provide expertise, guidance and/or opinions on healthcare matters as they are debated for inclusion into new policy. You may also be involved in planning new organizational policy and responses to changes in legislation. For all of these reasons you should be prepared to speak to national healthcare issues making the news.

In this Assignment, you will analyze recent presidential healthcare agendas. You will also prepare a fact sheet to communicate the importance of a healthcare issue and the impact on this issue of recent or proposed policy.

To Prepare:

· Review the agenda priorities of the last three U.S. presidential administrations.

· Select an issue related to healthcare that was addressed by each of the last three U.S. presidential administrations.

· Reflect on the focus of their respective agendas, including the allocation of financial resources for addressing the healthcare issue you selected.

· Consider how you would communicate the importance of a healthcare issue to a legislator/policymaker or a member of their staff for inclusion on an agenda.

The Assignment: (2- to 3-page Comparison Grid and 1-page Fact Sheet)

Part 1: Agenda Comparison Grid

Based on the presidential administrations you are comparing, complete the Agenda Comparison Grid. Be sure to address the following:

· Identify and provide a brief description of the healthcare issue you selected.

· Identify which administrative agency would most likely be responsible for helping you address the healthcare issue you selected.

· How does the healthcare issue get on the agenda and how does it stay there?

· Who was the entrepreneur/champion/sponsor of the healthcare issue you selected?

Part 2: Fact Sheet or Talking Points Brief

Based on your Agenda Comparison Grid for the healthcare issue you selected, develop a 1-page Fact Sheet or Talking Points Brief that you could use to communicate with a policymaker/legislator or a member of their staff for this healthcare issue. Be sure to address the following:

· Summarize why this healthcare issue is important and should be included in the agenda for legislation.

· Justify the role of the nurse in agenda setting for healthcare issues.

 
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Which of the following medications would the nurse question, if ordered?

Question

Week 6 quiz

Question 1

A 65-year-old woman has an advanced form of rheumatoid arthritis. Her treatment includes a regular dosage of methotrexate. The nurse will advise her to take which of the following vitamin supplements while taking the drug?

A) Vitamin A

B) Vitamin B

C) Vitamin C

D) Vitamin D

Question 2

To minimize the risk of adverse effects of glucagon when given to an unconscious diabetic patient, as the patient regains consciousness, the nurse should

A) administer calcium supplements.

B) position the patient in the side-lying position.

C) administer carbohydrates.

D) monitor for nausea and vomiting.

Question 3

A female patient with a diagnosis of type 1 diabetes mellitus has been experiencing increasing neuropathic pain in recent months, a symptom that has not responded appreciably to conventional analgesics. The patient’s care provider has begun treatment with gabapentin (Neurontin). How is the addition of this drug likely to influence the management of the patient’s existing drug regimen?

A) The patient may be required to temporarily hold her other medications until a stable serum level of gabapentin is achieved.

B) It is unlikely to influence the patient’s other medications because gabapentin does not interact with other drugs.

C) Gabapentin is contraindicated with the use of exogenous insulin.

D) The patient’s medication-related risk for renal failure must be assessed prior to the use of gabapentin.

Question 4

A nurse is caring for a patient who has been diagnosed with hypothyroidism. Levothyroxine (Synthroid) has been prescribed. Before the drug therapy is started, the nurse will assess for which of the following?

A) History of taking anticoagulant drugs

B) Allergy to seafood

C) Hirsutism

D) The patient’s age

Question 5

A nurse is caring for a male patient who has a spinal cord injury due to a motorcycle accident. He has been taking dantrolene (Dantrium) for 2 weeks. The nurse will monitor which of the following?

A) Prothrombin time and partial thromboplastin time

B) Urine specific gravity

C) Alanine aminotransferase and total bilirubin levels

D) Follicle-stimulating hormone levels

Question 6

A nurse is assessing a patient who has come to the emergency department complaining of back spasms. The patient states that he has a history of opioid addiction and does not want to take any drug that “puts me at risk of becoming physically dependent.” Which of the following medications would the nurse question, if ordered?

A) Methocarbamol (Robaxin)

B) Orphenadrine (Norflex)

C) Cyclobenzaprine (Flexeril)

D) Metaxalone (Skelaxin)

Question 7

A 40-year-old woman with a diagnosis of fibromyalgia has been prescribed cyclobenzaprine (Flexeril) as an adjunct to her existing drug regimen. What nursing diagnosis should the nurse prioritize when updating the nursing care plan for this patient?

A) Risk for Injury related to CNS depressant effects

B) Diarrhea related to anticholinergic effects

C) Altered Nutrition, Less than Body Requirements, related to appetite suppression

D) Impaired Swallowing related to increased muscle tone

Question 8

A nurse is working with a 57-year-old man who is a former intravenous drug abuser. He has been prescribed a weekly dosage of methotrexate for his rheumatoid arthritis. Which of the following will the nurse include in her teaching plan for this patient?

A) Avoid high-fat foods

B) Drink plenty of water every day

C) Take the tablets before bedtime

D) Avoid red meat

Question 9

Following an assessment by her primary care provider, a 70-year-old resident of an assisted living facility has begun taking daily oral doses of levothyroxine. Which of the following assessment findings should prompt the nurse to withhold a scheduled dose of levothyroxine?

A) The resident has not eaten breakfast because of a recent loss of appetite

B) The resident’s apical heart rate is 112 beats/minute with a regular rhythm

C) The resident had a fall during the night while transferring from her bed to her bathroom

D) The resident received her annual influenza vaccination the previous day

Question 10

A nurse is caring for a 61-year-old man who has had a severe attack of gout while in the hospital for food poisoning. The nurse administers colchicine intravenously in order to

A) avoid aggravating the gastrointestinal tract.

B) ensure quick distribution of the drug.

C) prevent the risk of infection or bleeding.

D) minimize the risk of depressed bone marrow function.

Question 11

A patient receives 25 units of NPH insulin at 7.AM. At what time of day should the nurse advise the patient to be most alert for a potential hypoglycemic reaction?

A) After breakfast

B) Before lunch

C) Late afternoon

D) Bedtime

Question 12

A male patient is to begin glyburide (Diabeta) for type 2 diabetes. Before the drug therapy begins, a priority action by the nurse will be to assess the patient’s

A) blood pressure.

B) potassium level.

C) use of alcohol.

D) use of salt in his diet.

Question 13

A male patient with a diagnosis of relapsing-remitting multiple sclerosis is in the clinic to discuss with the nurse the possibility of self-administration of glatiramer. During the patient education session for self-administration, the nurse will emphasize

A) the need to rotate the injection site of the drug.

B) the need to avoid crushing the tablet.

C) the need to place the tablet under the tongue.

D) the need to use only the thigh muscle for the drug injection site.

Question 14

A diabetic patient being treated for obesity tells the nurse that he is having adverse effects from his drug therapy. The patient has been taking dextroamphetamine for 2 weeks as adjunct therapy. Which of the following adverse effects would need the nurse’s immediate attention?

A) Decreased libido

B) Increased blood glucose

C) Dry eyes

D) Jittery feeling

Question 15

A patient with diabetes has had a cough for 1 week and has been prescribed a cough syrup (an expectorant). What special instructions should the nurse include in the patient teaching for this situation?

A) Wash hands before and after taking the medicine

B) Keep track of any gastrointestinal tract infections

C) Monitor glucose levels closely

D) Note the time the medicine is taken each day

Question 16

A 13-year-old patient has juvenile arthritis. He has recently had oral surgery and was told by the surgeon to take aspirin for the pain. The nurse will monitor for which of the following?

A) Bronchoconstriction

B) Hepatotoxicity

C) Aplastic anemia

D) Agranulocytosis

Question 17

A nurse has been invited to speak to a support group for persons with movement disorders and their families. Which of the following statements by the nurse addresses the chronic nature of these diseases and the relevant drug therapies?

A) “Drug therapy can consist of one or more drugs to eliminate the symptoms of these diseases.”

B) “Drugs do not cure these disorders; they instead enhance quality of life.”

C) “Persons of all cultures are treated similarly and respond in similar ways to treatment.”

D) “Drugs used to treat these disorders always pose a risk of severe liver and kidney dysfunction.”

Question 18

A patient in need of myocardial infarction prophylaxis has been prescribed sulfinpyrazone for gout. Which of the following will the nurse monitor the patient most closely for?

A) Hypothermia

B) Hypotension

C) Renal dysfunction

D) Bleeding

Question 19

A nurse is developing a care plan for a patient who has multiple sclerosis. An expected outcome for the patient who is receiving glatiramer would be a decrease in

A) chest pain.

B) fatigue.

C) breathing difficulties.

D) heart palpitations.

Question 20

A 32-year-old female patient is taking tizanidine (Zanaflex) for spasticity related to her multiple sclerosis. The nurse will inform the patient and her husband that the adverse effect that poses the greatest safety risk to the patient is

A) constipation.

B) dry mouth.

C) fatigue.

D) hypotension.

Question 21

A 34-year-old male patient is prescribed methimazole (MMI).The nurse will advise him to report which of the following immediately?

A) Vertigo

B) Intolerance to cold

C) Loss of appetite

D) Epigastric distress

Question 22

A 43-year-old woman was diagnosed with multiple sclerosis 2 years ago and has experienced a recent exacerbation of her symptoms, including muscle spasticity. Consequently, she has been prescribed Dantrolene (Dantrium).In light of this new addition to her drug regimen, what teaching point should the woman’s nurse provide?

A) “This will likely relieve your muscle spasms but you’ll probably develop a certain amount of dependence on the drug over time.”

B) “We’ll need to closely monitor your blood sugar levels for the next week.”

C) “There’s a small risk that you might experience some hallucinations in the first few days that you begin taking this drug.”

D) “You might find that this drug exacerbates some of your muscle weakness while it relieves your spasticity.”

Question 23

A patient with type 1 diabetes has been admitted to the hospital for orthopedic surgery and the care team anticipates some disruptions to the patient’s blood glucose levels in the days following surgery. Which of the following insulin regimens is most likely to achieve adequate glycemic control?

A) Small doses of long-acting insulin administered four to five times daily

B) Doses of basal insulin twice daily with regular insulin before each meal

C) Large doses of rapid-acting insulin combined with long-acting insulin each morning and evening

D) Divided doses of intermediate-acting insulin every 2 hours, around the clock

Question 24

During long-term desmopressin therapy in a 48-year-old woman, it will be most important for the nurse to assess which of the following?

A) The patient’s environment

B) The patient’s diet

C) The condition of the patient’s skin

D) The condition of the patient’s nasal passages

Question 25

A 49-year-old woman has been diagnosed with myalgia. The physician has recommended aspirin. The patient is concerned that the aspirin will upset her stomach. The nurse will encourage the patient to

A) crush the tablet before swallowing.

B) swallow the tablet whole.

C) swallow the tablet with milk or food.

D) avoid drinking milk for 3 hours after swallowing the tablet.

Question 26

A nurse will instruct a patient taking allopurinol to take each dose

A) at night.

B) first thing in the morning.

C) after a meal.

D) before a meal.

Question 27

The nurse is conducting a medication reconciliation of a new resident of a long-term care facility. The nurse notes that the resident takes allopurinol on a daily basis for the treatment of gout. What is the primary purpose of this drug?

A) To balance urate concentration and prevent gout attacks

B) To promote the remodeling of damaged synovium

C) To potentiate the metabolism of dietary purines

D) To achieve pain relief in joints affected by gout

Question 28

A nurse is teaching a patient about his newly prescribed drug, colchicine, for gout. The nurse will instruct the patient to avoid which of the following foods?

A) Green beans

B) Shrimp

C) Eggs

D) Milk

Question 29

A nurse is instructing a patient who was recently diagnosed with multiple sclerosis about dantrolene (Dantrium). The patient is a 38-year-old-male and the foreman for a construction company. In order to minimize one important adverse effect of the drug, the nurse will give the patient which of the following instructions?

A) Eat a high-protein diet

B) Decrease the dosage if any adverse effect is experienced

C) Wear appropriate clothing and sunscreen whenever he is in direct sunlight

D) Have a complete blood cell count done weekly

Question 30

A 33-year-old man has developed acute gouty arthritis. He has been prescribed colchicine. When developing a care plan for this patient, which factor will be most important for the nurse to consider?

A) Dietary habits

B) Work environment

C) Typical daily fluid intake

D) Ethnicity

 
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Which of the nurse’s following assessment questions most directly addresses a common adverse effect of filgrastim?

Report Issue

Question 1 A nurse educator who coordinates the staff education on an oncology unit is conducting an inservice on targeted therapies. What potential benefit of targeted therapies should the nurse highlight in this education session?

A) Targeted therapies achieve the therapeutic benefits of traditional chemotherapy with no risk of adverse effects.

B) Targeted therapies have the potential to provide prophylactic protection against neoplasia in high-risk individuals.

C) Targeted therapies are significantly more cost-effective than traditional chemotherapeutic drugs.

D) Targeted therapies have the potential to damage cancerous cells while leaving normal body cells less affected.

Question 2 An oncology nurse is aware of the risks for injury that exist around the preparation, transportation, and administration of chemotherapeutic agents. In order to reduce these risks of injury, the nurse should take which of the following actions?

A) Dispose of intravenous lines used for chemotherapy administration in a covered trash can in the patient’s room.

B) Use an IV system for administration that includes needles to reduce the risk of accidental spills.

C) Prime the IV tubing with an approved IV solution rather than with the drug itself.

D) Encourage patients who have been receiving chemotherapy to use a bedside commode rather than a toilet.

Question 3 A patient has just received her first dose of imatinib and the nurse on the oncology unit is amending the patient’s care plan accordingly. What nursing diagnosis is most appropriate in light of this addition to the patient’s drug regimen?

A) Risk for Infection related to bone marrow suppression

B) Risk for Acute Confusion related to adverse neurological effects of imatinib

C) Risk for Impaired Skin Integrity related to exaggerated inflammatory response

D) Risk for Deficient Fluid Volume related to changes in osmotic pressure

Question 4 A nurse has administered filgrastim to a diverse group of patients in recent months. Which of the following patients should the nurse observe for extremely elevated white blood cell counts following administration of the drug?

A) A 19-year-old male receiving radiotherapy

B) A 25-year-old female with a diagnosis of congenital neutropenia

C) A 39-year-old female with a nonmyeloid malignancy

D) A 47-year-old male with aplastic anemia

Question 5 A patient with chronic lymphocytic leukemia (CLL) will imminently begin a course of treatment with rituximab. In order to minimize the risk of adverse effects, what strategy for administration will be adopted?

A) Admitting the patient to the intensive care unit in anticipation of the initial bolus of the drug

B) Administering diphenhydramine 30 minutes prior to the initial dose of rituximab

C) Administering the drug by slow infusion to two peripheral IV sites simultaneously

D) Administering the initial doses by slow infusion while observing for adverse reactions

Question 6 A 45-year-old woman with acute leukemia is going to begin chemotherapy with vincristine. The nurse is aware that vincristine must always be administered

A) at a rapid infusion rate.

B) at a slow infusion rate.

C) through an IV line primed with vincristine.

D) through a central line.

Question 7 Mr. Singh is a 66-year-old man who is receiving chemotherapy for the treatment of lung cancer that has metastasized to his liver. In an effort to prevent infection, Mr. Singh has been prescribed filgrastim (Neupogen). Which of the nurse’s following assessment questions most directly addresses a common adverse effect of filgrastim?

A) “Have you noticed any bleeding in your gums or cheeks?”

B) “Do you feel like you’re having any pain in your bones?”

C) “Are you experiencing any waves of cool, clammy skin?”

D) “Have you had any shortness of breath lately?”

Question 8 A 67-year-old man who is being treated for prostate cancer is taking epoetin alfa. The nurse will instruct the patient to

A) stop taking the drug after a 2-week period.

B) schedule an appointment to measure hemoglobin twice a week for at least 2 to 6 weeks.

C) schedule an appointment to check if the patient has a high WBC count.

D) begin taking a calcium channel blocker to treat hypertension, which usually develops as an adverse effect of epoetin alfa therapy.

Question 9 A male patient is receiving heparin by continuous intravenous infusion. The nurse will instruct the patient and family members to report which of the following should it occur?

A) A skin rash

B) Sudden occurrence of sleepiness and drowsiness

C) Dizziness

D) Presence of blood in urine or stools

abcd

Question 10 A nurse is caring for a 64-year-old female patient who is receiving IV heparin and reports bleeding from her gums. The nurse checks the patient’s laboratory test results and finds that she has a very high aPTT. The nurse anticipates that which of the following drugs may be ordered?

A) Coumadin

B) Alteplase

C) Ticlopidine

D) Protamine sulfate

Question 11 A nurse has been assigned to a 55-year-old woman who has a malignant brain tumor. The patient is receiving her first dose of carmustine. It will be critical for the nurse to observe for which of the following?

A) Nausea and vomiting

B) Respiratory difficulty

C) Inability to drink fluids for 6 hours

D) Reddish urine

Question 12 A nurse is assessing a patient who has chronic lymphoblastic myelogenous leukemia. The treatment plan includes hydroxyurea (Hydrea). The nurse will assess the patient for which of the following?

A) Diabetes mellitus

B) Hypertension

C) Leukopenia

D) Hypoglycemia

Question 13 A patient’s current course of cancer treatment involves the administration of a conjugated monoclonal antibody. What characteristic of the drug is specified by the fact that it is classified as a conjugated drug?

A) The drug is derived from nonhuman sources.

B) The targeted therapy is combined with another substance that causes cell death.

C) The targeted therapy is combination of a monoclonal antibody, a kinase inhibitor, and an inorganic cytotoxin.

D) The drug is able to adapt its pharmacokinetics to the etiology of the patient’s cancer.

Question 14 An oncology nurse is reviewing the pathophysiology of cancer and is discussing with a colleague the factors that contribute to the success or failure of a patient’s chemotherapy. Which of the following cancerous cells is most susceptible to the effects of chemotherapeutic drugs?

A) Cells with a long generation time

B) Cells that lack contact inhibition

C) Cells that have a rapid mitotic rate

D) Cells that lack a blood supply

Question 15 A patient receiving high-dose cisplatin therapy exhibits symptoms of hypomagnesemia. Which of the following should the nurse suggest to help offset the magnesium losses from the cisplatin therapy?

A) Consuming dairy products

B) Consuming chocolates

C) Drinking 2 to 3 liters of fluid a day

D) Consuming potassium-rich foods

Question 16 An older adult woman has been diagnosed with acute lymphoblastic leukemia (ALL) and her care team has identified potential benefits of imatinib. Which of the following characteristics of this patient’s current health status may preclude the use of imatinib?

A) The patient has type 2 diabetes mellitus that is controlled using diet and oral antihyperglycemics.

B) The patient has chronic heart failure resulting in significant peripheral edema.

C) The patient experienced a mild ischemic stroke several years ago and had transient ischemic attacks last year.

D) The patient had a total knee arthroplasty several months earlier.

Question 17 A female patient is prescribed oprelvekin therapy to treat thrombocytopenia. Which of the following should the nurse continuously monitor to determine the efficacy and duration of the oprelvekin therapy?

A) Weight gain

B) Platelet count

C) Red and white blood cell count

D) Cardiac arrhythmias

Question 18 During ongoing assessment of a patient receiving 5-FU therapy, the nurse finds the patient’s platelet count to be 92,000 cells/mm3. The nurse should do which of the following?

A) Consult the prescriber for an increase in dosage

B) Consult the prescriber for a decrease in dosage

C) Consult the prescriber for discontinuation of the drug

D) Continue the therapy as prescribed

Question 19 A nurse has been assigned to a female patient who is to begin chemotherapy. The nurse will initiate the prescribed oprelvekin therapy

A) 6 to 24 hours after chemotherapy.

B) 2 days after chemotherapy.

C) 6 days after chemotherapy.

D) 10 days after chemotherapy.

Question 20 A patient with a recent diagnosis of chronic myelogenous leukemia (CML) is discussing treatment options with his care team.What aspect of the patient’s condition would contraindicate the use of cyclophosphamide for the treatment of leukemia?

A) The patient has a diagnosis of type 2 diabetes and takes oral antihyperglycemics.

B) The patient has had a history of nonadherence to medical treatment.

C) The patient’s bone marrow function is significantly depressed.

D) The patient has decreased renal function.

Question 21 A female patient has follicular non-Hodgkin’s lymphoma and is receiving thalidomide (Thalomid). It will be most important for the nurse to monitor this patient for which of the following?

A) Angina

B) Fever

C) Chills and rigors

D) Bleeding

Question 22 When planning care for a patient who is receiving filgrastim (Neupogen) for a nonmyeloid malignancy, the nurse should formulate which of the following patient outcomes? (Select all that apply.)

A) The patient will not develop an infection.

B) The patient will not experience bone pain.

C) The patient will be able to self-administer filgrastim at home.

D) The patient will not develop febrile neutropenia.

E) The patient will not retain fluid.

Question 23 A nurse is to use a single-dose 1 mL vial to administer 0.5 mL of epoetin alfa to a 39-year-old woman who is being treated for chemotherapy-induced anemia. Which of the following will the nurse do with the unused portion of the drug?

A) Refrigerate the medication for a future use.

B) Discard the unused portion of the drug.

C) Store the medication in the drug cart for the next dose.

D) Put the medication in the freezer compartment of the refrigerator.

Question 24 nurse is discussing oprelvekin therapy with a male patient. Which of the following will the nurse tell the patient is the most common adverse effect of the drug?

A) Medullary bone pain

B) Papilledema

C) Fluid retention/weight gain

D) Atrial arrhythmia

Question 25 A patient with chronic heart failure has begun treatment with epoetin alfa, which she will receive in her own home from a home health nurse. The nurse should teach the patient to supplement this treatment with a diet that is high in

A) iron-rich foods such as beans and leafy green vegetables.

B) complex carbohydrates and vegetable-source proteins.

C) calcium, such as dairy products, fish and vegetables.

D) protein and low in carbohydrates.

Question 26 A nurse is administering rituximab to a patient via the IV route. The nurse will set the IV pump at 50 mg/hour for the first half hour of the initial infusion. If there are not apparent reactions after 30 minutes of the infusion, the nurse will increase the dosage every 30 minutes by 50 mg/hour until the maximum infusion rate reaches which of the following?

A) 250 mg/hour

B) 300 mg/hour

C) 400 mg/hour

D) 500 mg/hour

Question 27 A 62-year-old patient taking tamoxifen exhibits increased bone and tumor pain along with a local disease flare. The nurse interprets this as an indication of which of the following?

A) A hypersensitivity reaction

B) The tumor responding to treatment

C) Nephrotoxic effects of tamoxifen

D) Cardiomyopathy

Question 28 A male patient is receiving rituximab therapy for non-Hodgkin’s lymphoma. Which of the following would be a priority nursing intervention to reduce the risk for cytotoxicity and tumor lysis syndrome?

A) Ensure that the patient maintains a normal breathing pattern.

B) Ensure that the patient maintains a normal fluid and electrolyte balance.

C) Protect the patient from exposure to infections.

D) Monitor the patient for deterioration in renal function.

Question 29 A patient with a diagnosis of chronic myeloid leukemia has met with her oncologist, who has recommended treatment with the kinase inhibitor imatinib. What route of administration should the nurse explain to the patient?

A) Daily intramuscular injections throughout the course of treatment

B) Peripheral IV administration three times a day for 7 to 10 days

C) Weekly IV infusions over 6 to 8 hours through a central line

D) Oral administration of imatinib in a home setting

Question 30 A 60-year-old patient experienced a sudden onset of chest pain and shortness of breath and was subsequently diagnosed with a pulmonary embolism in the emergency department. The patient has been started on an intravenous heparin infusion. How does this drug achieve therapeutic effect?

A) By promoting the rapid excretion of vitamin K by the gastrointestinal mucosa

B) By inhibiting the action of vitamin K at its sites of action

C) By inhibiting platelet aggregation on vessel walls and promoting fibrinolysis

D) By inactivating clotting factors and thus stopping the coagulation cascade

Question 31 A male patient has been on long-term bicalutamide (Casodex) therapy. In order to assess adverse effects of the drug therapy, the nurse will closely monitor which of the following?

A) Visual function

B) Blood counts

C) Pap test results

D) Liver function

Question 32 Intravenous carmustine has been prescribed for a patient with cancer. The nurse should help relieve the discomfort of pain and burning during the infusion by

A) slowing the infusion.

B) decreasing the volume used for dilution.

C) decreasing the total volume of the primary IV infusion.

D) administering a dose of 2 units of bleomycin before carmustine.

Question 33 A middle-aged patient has received a diagnosis of GI stromal tumor following an extensive diagnostic workup. Imatinib has been recommended as a component of the patient’s drug regimen. What patient education should the nurse provide to this patient?

A) “It’s important that you let us know if you develop any significant swelling or puffiness.”

B) “Try to keep your PICC line dressing as dry as possible at all times.”

C) “You’ll likely experience a lot of dry mouth while you’re taking this drug, so it’s helpful to chew ice chips.”

D) “If you experience significant nausea after taking a dose, stop taking the drug and schedule an appointment at the clinic.”

Question 34 A nurse has completed a medication reconciliation of a patient who has been admitted following a motor vehicle accident. Among the many drugs that the patient has received in the previous year is rituximab. The nurse would be justified in suspecting the patient may have received treatment for which of the following diseases?

A) Non-Hodgkin’s lymphoma

B) Malignant melanoma

C) Nonsmall cell lung cancer

D) Renal cell carcinoma

Question 35 Mr. Lepp is a 63-year-old man who was diagnosed with colon cancer several weeks ago and who is scheduled to begin chemotherapy.He reports to the nurse that he read about the need for erythropoietin in an online forum for cancer patients and wants to explore the use of epoetin alfa with his oncologist. Which of the following facts should underlie the nurse’s response to Mr. Lepp?

A) Epoetin alfa is normally contraindicated in patients who are receiving radiotherapy or chemotherapy.

B) Treatment with epoetin alfa will likely begin 4 to 6 days before Mr. Lepp’s first round of chemotherapy and continue indefinitely.

C) The potential benefits of epoetin alfa must be weighed carefully against the potential adverse effects in cancer patients.

D) Mr. Lepp’s oncologist should have begun treatment with epoetin alfa immediately after he was diagnosed.

 
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Which of the following adverse effects would need the nurse’s immediate attention?

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Question 1 A nurse is developing a care plan for a patient who has multiple sclerosis. An expected outcome for the patient who is receiving glatiramer would be a decrease in

A) chest pain

B) fatigue

C) breathing difficulties

D) heart palpitations

Question 2 A nurse is teaching a patient about his newly prescribed drug, colchicine, for gout. The nurse will instruct the patient to avoid which of the following foods?

A) Green beans

B) Shrimp

C) Eggs

D) Milk

Question 3 A patient with type 1 diabetes has been admitted to the hospital for orthopedic surgery and the care team anticipates some disruptions to the patient’s blood glucose levels in the days following surgery. Which of the following insulin regimens is most likely to achieve adequate glycemic control?

A) Small doses of long-acting insulin administered four to five times daily

B) Doses of basal insulin twice daily with regular insulin before each meal

C) Large doses of rapid-acting insulin combined with long-acting insulin each morning and evening

D) Divided doses of intermediate-acting insulin every 2 hours, around the clock

Question 4 A 65-year-old woman has an advanced form of rheumatoid arthritis. Her treatment includes a regular dosage of methotrexate. The nurse will advise her to take which of the following vitamin supplements while taking the drug?

A) Vitamin A

B) Vitamin B

C) Vitamin C

D) Vitamin D

Question 5 A 49-year-old woman has been diagnosed with myalgia. The physician has recommended aspirin. The patient is concerned that the aspirin will upset her stomach. The nurse will encourage the patient to

A) crush the tablet before swallowing

B) swallow the tablet whole

C) swallow the tablet with milk or food

D) avoid drinking milk for 3 hours after swallowing the tablet

Question 6 A nurse is working with a 57-year-old man who is a former intravenous drug abuser. He has been prescribed a weekly dosage of methotrexate for his rheumatoid arthritis. Which of the following will the nurse include in her teaching plan for this patient?

A) Avoid high-fat foods

B) Drink plenty of water every day

C) Take the tablets before bedtime

D) Avoid red meat

Question 7 A male patient with a diagnosis of relapsing-remitting multiple sclerosis is in the clinic to discuss with the nurse the possibility of self-administration of glatiramer. During the patient education session for self-administration, the nurse will emphasize

A) the need to rotate the injection site of the drug

B) the need to avoid crushing the tablet

C) the need to place the tablet under the tongue

D) the need to use only the thigh muscle for the drug injection site

Question 8 A patient in need of myocardial infarction prophylaxis has been prescribed sulfinpyrazone for gout. Which of the following will the nurse monitor the patient most closely for?

A) Hypothermia

B) Hypotension

C) Renal dysfunction

D) Bleeding

Question 9 A nurse will monitor which of the following when assigned to a patient taking allopurinol for chronic gout who visits the clinic every 2 months?

A) Liver function tests

B) Blood sugar levels

C) Blood pressure

D) Body temperature

Question 10 Which of the following would be the most important safety-related instruction for a nurse to give to a patient taking baclofen (Lioresal)?

A) Do not walk or drive after taking the drug

B) Discontinue the use of alcohol

C) Learn to self-administer the drug

D) Take a laxative when needed

Question 11 A diabetic patient being treated for obesity tells the nurse that he is having adverse effects from his drug therapy. The patient has been taking dextroamphetamine for 2 weeks as adjunct therapy. Which of the following adverse effects would need the nurse’s immediate attention?

A) Decreased libido

B) Increased blood glucose

C) Dry eyes

D) Jittery feeling

Question 12 A nurse is caring for a patient who has been diagnosed with hypothyroidism. Levothyroxine (Synthroid) has been prescribed.Before the drug therapy is started, the nurse will assess for which of the following?

A) History of taking anticoagulant drugs

B) Allergy to seafood

C) Hirsutism

D) The patient’s age

Question 13 A nurse is instructing a patient in the administration of regular insulin by the subcutaneous route. Which of the following strategies would the nurse suggest if the goal is to promote absorption of the regular insulin?

A) Rotate injection sites by using the arm one day, the stomach the next day, and the thigh the day after and then repeating the cycle

B) Select one injection site for regular insulin injections and use it exclusively

C) Administer the medication 30 to 60 minutes after a meal

D) Select one anatomic area for regular insulin injections and then use serial locations within that area.

Question 14 A nurse is caring for a male patient who has a spinal cord injury due to a motorcycle accident. He has been taking dantrolene (Dantrium) for 2 weeks. The nurse will monitor which of the following?

A) Prothrombin time and partial thromboplastin time

B) Urine specific gravity

C) Alanine aminotransferase and total bilirubin levels

D) Follicle-stimulating hormone levels

Question 15 The nurse is conducting a medication reconciliation of a new resident of a long-term care facility. The nurse notes that the resident takes allopurinol on a daily basis for the treatment of gout.What is the primary purpose of this drug?

A) To balance urate concentration and prevent gout attacks

B) To promote the remodeling of damaged synovium

C) To potentiate the metabolism of dietary purines

D) To achieve pain relief in joints affected by gout

Question 16 A 33-year-old man has developed acute gouty arthritis. He has been prescribed colchicine. When developing a care plan for this patient, which factor will be most important for the nurse to consider?

A) Dietary habits

B) Work environment

C) Typical daily fluid intake

D) Ethnicity

Question 17 During long-term desmopressin therapy in a 48-year-old woman, it will be most important for the nurse to assess which of the following?

A) The patient’s environment

B) The patient’s diet

C) The condition of the patient’s skin

D) The condition of the patient’s nasal passages

Question 18 A patient is taking gabapentin (Neurontin) for spasticity associated with multiple sclerosis. Which of the following should be the priority for monitoring?

A) Hepatic function

B) Cardiac function

C) Respiratory function

D) Renal function

Question 19 Following an assessment by her primary care provider, a 70-year-old resident of an assisted living facility has begun taking daily oral doses of levothyroxine. Which of the following assessment findings should prompt the nurse to withhold a scheduled dose of levothyroxine?

A) The resident has not eaten breakfast because of a recent loss of appetite

B) The resident’s apical heart rate is 112 beats/minute with a regular rhythm

C) The resident had a fall during the night while transferring from her bed to her bathroom

D) The resident received her annual influenza vaccination the previous day

Question 20 To minimize the risk of adverse effects of glucagon when given to an unconscious diabetic patient, as the patient regains consciousness, the nurse should

A) administer calcium supplements

B) position the patient in the side-lying position

C) administer carbohydrates

D) monitor for nausea and vomiting

Question 21 A 34-year-old male patient is prescribed methimazole (MMI). The nurse will advise him to report which of the following immediately?

A) Vertigo

B) Intolerance to cold

C) Loss of appetite

D) Epigastric distress

Question 22 A male patient is to begin glyburide (Diabeta) for type 2 diabetes. Before the drug therapy begins, a priority action by the nurse will be to assess the patient’s

A) blood pressure

B) potassium level

C) use of alcohol

D) use of salt in his diet

Question 23 A 43-year-old woman was diagnosed with multiple sclerosis 2 years ago and has experienced a recent exacerbation of her symptoms, including muscle spasticity. Consequently, she has been prescribed Dantrolene (Dantrium). In light of this new addition to her drug regimen, what teaching point should the woman’s nurse provide?

A) “This will likely relieve your muscle spasms but you’ll probably develop a certain amount of dependence on the drug over time.”

B) “We’ll need to closely monitor your blood sugar levels for the next week.”

C) “There’s a small risk that you might experience some hallucinations in the first few days that you begin taking this drug.”

D) “You might find that this drug exacerbates some of your muscle weakness while it relieves your spasticity.”

Question 24 A nurse is instructing a patient who was recently diagnosed with multiple sclerosis about dantrolene (Dantrium). The patient is a 38-year-old-male and the foreman for a construction company. In order to minimize one important adverse effect of the drug, the nurse will give the patient which of the following instructions?

A) Eat a high-protein diet

B) Decrease the dosage if any adverse effect is experienced

C) Wear appropriate clothing and sunscreen whenever he is in direct sunlight

D) Have a complete blood cell count done weekly

Question 25 A 40-year-old woman with a diagnosis of fibromyalgia has been prescribed cyclobenzaprine (Flexeril) as an adjunct to her existing drug regimen. What nursing diagnosis should the nurse prioritize when updating the nursing care plan for this patient?

A) Risk for Injury related to CNS depressant effects

B) Diarrhea related to anticholinergic effects

C) Altered Nutrition, Less than Body Requirements, related to appetite suppression

D) Impaired Swallowing related to increased muscle tone

Question 26 A 70-year-old woman who is on long-term ibuprofen therapy for osteoarthritis has returned to the clinic for her regular 6-month visit. In the last couple of months, she has been having increasing periods of abdominal pain. The nurse suspects that this pain may be related to

A) anemia

B) peptic ulcer disease or gastritis

C) interstitial nephritis

D) constipation

Question 27 A 13-year-old patient has juvenile arthritis. He has recently had oral surgery and was told by the surgeon to take aspirin for the pain. The nurse will monitor for which of the following?

A) Bronchoconstriction

B) Hepatotoxicity

C) Aplastic anemia

D) Agranulocytosis

Question 28 A nurse is caring for a 61-year-old man who has had a severe attack of gout while in the hospital for food poisoning. The nurse administers colchicine intravenously in order to

A) avoid aggravating the gastrointestinal tract

B) ensure quick distribution of the drug

C) prevent the risk of infection or bleeding

D) minimize the risk of depressed bone marrow function

Question 29 A 66-year-old woman has experienced a significant decline in her quality of life as a result of worsening rheumatoid arthritis. Her physician has prescribed etanercept and the nurse is responsible for facilitating this new aspect of the patient’s drug regimen. This will involve the administration of

A) daily, outpatient intravenous therapy

B) daily, oral administration

C) weekly subcutaneous injections

D) weekly administration of an enteric coated tablet

Question 30 A clinic nurse is following a 9-year-old boy who is taking somatropin. Which of the following will the nurse monitor periodically?

A) Antidiuretic hormone (ADH) levels

B) Height

C) Dehydration

D) Water retention

 
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