NR 507 Week 3 Quiz – Essay Furious


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Question 1.1. A 72-year-old woman with a recent onset of syncopal episodes has been referred to a cardiology group by her family physician. As part of the patient’s diagnostic workup, the nurse practitioner conducting the intake assessment has ordered a Holter monitor for 24 hours. Which of the following statements best captures an aspect of Holter monitoring? (Points : 0.4)

 

A Holter monitor is preferable to standard ECG due to its increased sensitivity to cardiac electrical activity.

The primary goal is to allow the cardiologist to accurately diagnose cardiomyopathies.

Accurate interpretation of the results requires correlating the findings with the activity that the woman was doing at the time of recording.

Holter monitors are normally set to record electrical activity of the heart at least once per hour.

Question 2.2. As part of the diagnostic workup for a male patient with a complex history of cardiovascular disease, the care team has identified the need for a record of the electrical activity of his heart, insight into the metabolism of his myocardium, and physical measurements, and imaging of his heart. Which of the following series of tests is most likely to provide the needed data for his diagnosis and care? (Points : 0.4)

 

Echocardiogram, PET scan, ECG

Ambulatory ECG, cardiac MRI, echocardiogram

Serum creatinine levels, chest auscultation, myocardial perfusion scintigraphy

Cardiac catheterization, cardiac CT, exercise stress testing

Question 3.3. An 81-year-old female patient of a long-term care facility has a history of congestive heart failure. The nurse practitioner caring for the patient has positioned her sitting up at an angle in bed and is observing her jugular venous distention. Why is jugular venous distention a useful indicator for the assessment of the patient’s condition? (Points : 0.4)

 

Increased cardiac demand causes engorgement of systemic blood vessels, of which the jugular vein is one of the largest.

Blood backs up into the jugular vein because there are no valves at the point of entry into the heart.

Peripheral dilation is associated with decreased stroke volume and ejection fraction.

Heart valves are not capable of preventing backflow in cases of atrial congestion.

Question 4.4. A physical assessment of a 28-year-old female patient indicates that her blood pressure in her legs is lower than that in her arms and that her brachial pulse is weaker in her left arm than in her right. In addition, her femoral pulses are weak bilaterally. Which of the following possibilities would her care provider be most likely to suspect? (Points : 0.4)

 

Pheochromocytoma

Essential hypertension

Coarctation of the aorta

An adrenocortical disorder

Question 5.5. A 6-year-old boy has been brought to the emergency department by ambulance after his mother discovered that his heart rate was “so fast I couldn’t even count it.” The child was determined to be in atrial flutter and his mother is seeking an explanation from the health care team. Which of the following points should underlie an explanation to the mother? (Points : 0.4)

 

The child is experiencing a reentry rhythm in his right atrium.

The resolution of the problem is dependent on spontaneous recovery and is resistant to pacing interventions.

The child is likely to have a normal ECG apart from the rapid heart rate.

The boy’s atria are experiencing abnormal sympathetic stimulation.

Question 6.6. A 66-year-old patient’s echocardiogram reveals a hypertrophied left ventricle, normal chamber volume, and a normal ejection fraction from the heart. What is this patient’s most likely diagnosis? (Points : 0.4)

 

Mitral valve regurgitation

Aortic valve stenosis

Mitral valve stenosis

Aortic valve regurgitation

Question 7.7. A 70-year-old male patient presents to the emergency department complaining of pain in his calf that is exacerbated when he walks. His pedal and popliteal pulses are faintly palpable and his leg distal to the pain is noticeably reddened. What would his care provider’s preliminary diagnosis and anticipated treatment most likely be?(Points : 0.4)

 

Acute arterial occlusion that will be treated with angioplasty

Raynaud disease that will require antiplatelet medications

Atherosclerotic occlusive disease necessitating thrombolytic therapy

Giant cell temporal arteritis that will be treated with corticosteroids

Question 8.8. A patient in the intensive care unit has a blood pressure of 87/39 and has warm, flushed skin accompanying his sudden decline in level of consciousness. The patient also has arterial and venous dilation and a decrease in systemic vascular resistance. What is this patient’s most likely diagnosis? (Points : 0.4)

 

Hypovolemic shock

Septic shock

Neurogenic shock

Obstructive shock

Question 9.9. A 31-year-old woman with a congenital heart defect reports episodes of lightheadedness and syncope, with occasional palpitations. A resting electrocardiogram reveals sinus bradycardia and she is suspected of having sick sinus syndrome. Which of the following diagnostic methods is the best choice to investigate the suspicion? (Points : 0.4)

 

Signal-averaged ECG

Exercise stress testing

Electrophysiologic study

Holter monitoring

Question 10.10. A nurse practitioner is providing care for several patients on a medical unit of a hospital. In which of the following patient situations would the nurse practitioner be most likely to rule out hypertension as a contributing factor? (Points : 0.4)

 

A 61-year-old man who has a heart valve infection and recurrent fever

An 81-year-old woman who has had an ischemic stroke and has consequent one-sided weakness

A 44-year-old man awaiting a kidney transplant who requires hemodialysis three times per week

A 66-year-old woman with poorly controlled angina and consequent limited activity tolerance

Question 11.11. A patient is experiencing impaired circulation secondary to increased systemic arterial pressure. Which of the following statements is the most relevant phenomenon?(Points : 0.4)

 

Increased preload due to vascular resistance

High afterload because of backpressure against the left ventricle

Impaired contractility due to aortic resistance

Systolic impairment because of arterial stenosis

Question 12.12. A number of patients have presented to the emergency department in the last 24 hours with complaints that are preliminarily indicative of myocardial infarction. Which of the following patients is least likely to have an ST-segment myocardial infarction (STEMI)? (Points : 0.4)

 

A 70-year-old woman who is complaining of shortness of breath and vague chest discomfort

A 66-year-old man who has presented with fatigue, nausea and vomiting, and cool, moist skin

A 43-year-old man who woke up with substernal pain that is radiating to his neck and jaw

A 71-year-old man who has moist skin, fever, and chest pain that is excruciating when he moves but relieved when at rest

Question 13.13. A formerly normotensive woman, pregnant for the first time, develops hypertension and headaches at 26 weeks’ gestation. Her blood pressure is 154/110 mm Hg and she has proteinuria. What other labs should be ordered for her? (Points : 0.4)

 

Plasma angiotensin I and II and renin

Urinary sodium and potassium

Platelet count, serum creatinine, and liver enzymes

Urinary catecholamines and metabolites

Question 14.14. An older adult female patient has presented with a new onset of shortness of breath, and the patient’s nurse practitioner has ordered measurement of her BNP levels along with other diagnostic tests. What is the most accurate rationale for the nurse practitioner’s choice of blood work? (Points : 0.4)

 

BNP is released as a compensatory mechanism during heart failure and measuring it can help differentiate the patient’s dyspnea from a respiratory pathology.

BNP is an indirect indicator of the effectiveness of the RAA system in compensating for heart failure.

BNP levels correlate with the patient’s risk of developing cognitive deficits secondary to heart failure and consequent brain hypoxia.

BNP becomes elevated in cases of cardiac asthma, Cheyne-Stokes respirations, and acute pulmonary edema, and measurement can gauge the severity of pulmonary effects.

Question 15.15. The nurse practitioner for a cardiology practice is responsible for providing presurgical teaching for patients who are about to undergo a coronary artery bypass graft. Which of the following teaching points best conveys an aspect of the human circulatory system? (Points : 0.4)

 

“Your blood pressure varies widely between arteries and veins, and between pulmonary and systemic circulation.”

“Only around one quarter of your blood is in your heart at any given time.”

“Blood pressure and blood volume roughly mimic one another at any given location in the circulatory system.”

“Left-sided and right-sided pumping action at each beat of the heart must equal each other to ensure adequate blood distribution.”

Question 16.16. A 54-year-old man with a long-standing diagnosis of essential hypertension is meeting with his nurse practitioner. The patient’s nurse practitioner would anticipate that which of the following phenomena is most likely occurring? (Points : 0.4)

 

The patient’s juxtaglomerular cells are releasing aldosterone as a result of sympathetic stimulation.

Epinephrine from his adrenal gland is initiating the renin-angiotensin-aldosterone system.

Vasopressin is exerting an effect on his chemoreceptors and baroreceptors, resulting in vasoconstriction.

The conversion of angiotensin I to angiotensin II in his lungs causes increases in blood pressure and sodium reabsorption.

Question 17.17. A 22-year-old male is experiencing hypovolemic shock following a fight in which his carotid artery was cut with a broken bottle. What immediate treatments are likely to most benefit the man?  (Points : 0.4)

 

Resolution of compensatory pulmonary edema and heart arrhythmias

Infusion of vasodilators to foster perfusion and inotropes to improve heart contractility

Infusion of normal saline of Ringer lactate to maintain the vascular space

Administration of oxygen and epinephrine to promote perfusion

Question 18.18. A 66-year-old obese man with a diagnosis of ischemic heart disease has been diagnosed with heart failure that his care team has characterized as attributable to systolic dysfunction. Which of the following assessment findings is inconsistent with his diagnosis? (Points : 0.4)

 

His resting blood pressure is normally in the range of 150/90 and an echocardiogram indicates his ejection fraction is 30%.

His end-diastolic volume is higher than normal and his resting heart rate is regular and 82 beats per minute.

He is presently volume overloaded following several days of intravenous fluid replacement.

Ventricular dilation and wall tension are significantly lower than normal.

Question 19.19. A 68-year-old male complains to his nurse practitioner that when he tests his blood pressure using a machine at his pharmacy, his heart rate is nearly always very low. At other times, he feels that his heart is racing, and it also seems to pause at times. The man has also occasionally had lightheadedness and a recent syncopal episode. What is this patient’s most likely diagnosis and the phenomenon underlying it? (Points : 0.4)

 

Sick sinus syndrome as a result of a disease of his sinus node and atrial or junctional arrhythmias

Ventricular arrhythmia as a result of alternating vagal and sympathetic stimulation

Torsades de pointes as a result of disease of the bundle of His

Premature atrial contractions that vacillate between tachycardic and bradycardic episodes as a consequence of an infectious process

Question 20.20. An autopsy is being performed on a 44-year-old female who died unexpectedly of heart failure. Which of the following components of the pathologist’s report is most suggestive of a possible history of poorly controlled blood pressure? (Points : 0.4)

 

“Scarring of urethra suggestive of recurrent urinary tract infections is evident.”

“Bilateral renal hypertrophy noted.”

“Vessel wall changes suggestive of venous stasis are evident.”

“Arterial sclerosis of subcortical brain regions noted.”

Question 21.21. During a routine physical examination of a 66-year-old woman, her nurse practitioner notes a pulsating abdominal mass and refers the woman for further treatment. The nurse practitioner is explaining the diagnosis to the patient, who is unfamiliar with aneurysms.Which of the following aspects of the pathophysiology of aneurysms would underlie the  explanation the nurse provides? (Points : 0.4)

 

Aneurysms are commonly a result of poorly controlled diabetes mellitus.

Hypertension is a frequent modifiable contributor to aneurysms.

Individuals with an aneurysm are normally asymptomatic until the aneurysm ruptures.

Aneurysms can normally be resolved with lifestyle and diet modifications.

Question 22.22. A patient has suffered damage to his pericardium following a motor vehicle accident. Which of the following consequences should the nurse practitioner be most likely to rule out? (Points : 0.4)

 

Impaired physical restraint of the left ventricule

Increased friction during the contraction/relaxation cycle

Reduced protection from infectious organisms

Impaired regulation of myocardial contraction

Question 23.23. A nurse practitioner is instructing a group of older adults about the risks associated with high cholesterol. Which of the following teaching points should the participants try to integrate into their lifestyle after the teaching session? (Points : 0.4)

 

“Remember, the ‘H’ in HDL and the ‘L’ in LDL correspond to high danger and low danger to your health.”

“Having high cholesterol increases your risk of developing diabetes and irregular heart rate.”

“Smoking and being overweight increases your risk of primary hypercholesterolemia.”

“Your family history of hypercholesterolemia is important, but there are things you can do to compensate for a high inherited risk.”

Question 24.24. An 81-year-old male resident of a long-term care facility has a long-standing diagnosis of heart failure. Which of the following short-term and longer-term compensatory mechanisms is least likely to decrease the symptoms of his heart failure? (Points : 0.4)

 

An increase in preload via the Frank-Starling mechanism

Sympathetic stimulation and increased serum levels of epinephrine and norepinephrine

Activation of the renin-angiotensin-aldosterone (RAA) system and secretion of brain natriuretic peptide (BNP)

AV node pacemaking activity and vagal nerve suppression

Question 25.25. A 55-year-old male who is beginning to take a statin drug for his hypercholesterolemia is discussing cholesterol and its role in health and illness with his nurse practitioner. Which of the following aspects of hyperlipidemia would the nurse practitioner most likely take into account when teaching the patient? (Points: 0.4)

 

Hyperlipidemia is a consequence of diet and lifestyle rather than genetics.

HDL cholesterol is often characterized as being beneficial to health.

Cholesterol is a metabolic waste product that the liver is responsible for clearing.

The goal of medical treatment is to eliminate cholesterol from the vascular system.

1. A nurse practitioner is teaching a student NP about the physiologic basis for damage to the circulatory and neurological systems that can accompany hypotension. Which of the following responses by the student would warrant correction by the nurse practitioner? (Points : 0.4)

 

“As vessel wall thickness increases, tension decreases.”

“Smaller blood vessels require more pressure to overcome wall tension.”

“The smaller the vessel radius, the greater the pressure needed to keep it open.”

“Tension and vessel thickness increase proportionately.”

Question 2.2. A 31-year-old woman with a congenital heart defect reports episodes of lightheadedness and syncope, with occasional palpitations.A resting electrocardiogram reveals sinus bradycardia and she is suspected of having sick sinus syndrome. Which of the following diagnostic methods is the best choice to investigate the suspicion? (Points: 0.4)

 

Signal-averaged ECG

Exercise stress testing

Electrophysiologic study

Holter monitoring

Question 3.3. Which of the following assessment findings in a newly admitted 30-year-old male patient would be most likely to cause his nurse practitioner to suspect polyarteritis nodosa? (Points : 0.4)

 

The man’s blood work indicates polycythemia (elevated red cells levels) and leukocytosis (elevated white cells).

The man’s blood pressure is 178/102 and he has abnormal liver function tests.

The man is acutely short of breath and his oxygen saturation is 87%.

The man’s temperature is 101.9°F and he is diaphoretic (heavily sweating).

Question 4.4. An 81-year-old male resident of a long-term care facility has a long-standing diagnosis of heart failure. Which of the following short-term and longer-term compensatory mechanisms is least likely to decrease the symptoms of his heart failure? (Points : 0.4)

 

An increase in preload via the Frank-Starling mechanism

Sympathetic stimulation and increased serum levels of epinephrine and norepinephrine

Activation of the renin-angiotensin-aldosterone (RAA) system and secretion of brain natriuretic peptide (BNP)

AV node pacemaking activity and vagal nerve suppression

Question 5.5. A nurse practitioner is instructing a group of older adults about the risks associated with high cholesterol. Which of the following teaching points should the participants try to integrate into their lifestyle after the teaching session? (Points : 0.4)

 

“Remember, the ‘H’ in HDL and the ‘L’ in LDL correspond to high danger and low danger to your health.”

“Having high cholesterol increases your risk of developing diabetes and irregular heart rate.”

“Smoking and being overweight increases your risk of primary hypercholesterolemia.”

“Your family history of hypercholesterolemia is important, but there are things you can do to compensate for a high inherited risk.”

Question 6.6. A 55-year-old male who is beginning to take a statin drug for his hypercholesterolemia is discussing cholesterol and its role in health and illness with his nurse practitioner. Which of the following aspects of hyperlipidemia would the nurse practitioner most likely take into account when teaching the patient? (Points : 0.4)

 

Hyperlipidemia is a consequence of diet and lifestyle rather than genetics.

HDL cholesterol is often characterized as being beneficial to health.

Cholesterol is a metabolic waste product that the liver is responsible for clearing.

The goal of medical treatment is to eliminate cholesterol from the vascular system.

Question 7.7. A number of patients have presented to the emergency department in the last 24 hours with complaints that are preliminarily indicative of myocardial infarction. Which of the following patients is least likely to have an ST-segment myocardial infarction (STEMI)? (Points : 0.4)

 

A 70-year-old woman who is complaining of shortness of breath and vague chest discomfort

A 66-year-old man who has presented with fatigue, nausea and vomiting, and cool, moist skin

A 43-year-old man who woke up with substernal pain that is radiating to his neck and jaw

A 71-year-old man who has moist skin, fever, and chest pain that is excruciating when he moves but relieved when at rest

Question 8.8. A patient in the intensive care unit has a blood pressure of 87/39 and has warm, flushed skin accompanying his sudden decline in level of consciousness. The patient also has arterial and venous dilation and a decrease in systemic vascular resistance. What is this patient’s most likely diagnosis? (Points : 0.4)

 

Hypovolemic shock

Septic shock

Neurogenic shock

Obstructive shock

Question 9.9. A formerly normotensive woman, pregnant for the first time, develops hypertension and headaches at 26 weeks’ gestation. Her blood pressure is 154/110 mm Hg and she has proteinuria. What other labs should be ordered for her? (Points : 0.4)

 

Plasma angiotensin I and II and renin

Urinary sodium and potassium

Platelet count, serum creatinine, and liver enzymes

Urinary catecholamines and metabolites

Question 10.10. An older adult female patient has presented with a new onset of shortness of breath, and the patient’s nurse practitioner has ordered measurement of her BNP levels along with other diagnostic tests. What is the most accurate rationale for the nurse practitioner’s choice of blood work? (Points : 0.4)

 

BNP is released as a compensatory mechanism during heart failure and measuring it can help differentiate the patient’s dyspnea from a respiratory pathology.

BNP is an indirect indicator of the effectiveness of the RAA system in compensating for heart failure.

BNP levels correlate with the patient’s risk of developing cognitive deficits secondary to heart failure and consequent brain hypoxia.

BNP becomes elevated in cases of cardiac asthma, Cheyne-Stokes respirations, and acute pulmonary edema, and measurement can gauge the severity of pulmonary effects.

Question 11.11. A nurse practitioner has ordered the measurement of a cardiac patient’s electrolyte levels as part of the patient’s morning blood work. Which of the following statements best captures the importance of potassium in the normal electrical function of the patient’s heart? (Points : 0.4)

 

Potassium catalyzes the metabolism of ATP, producing the gradient that results in electrical stimulation.

Potassium is central to establishing and maintaining the resting membrane potential of cardiac muscle cells.

The impermeability of cardiac cell membranes to potassium allows for action potentials achieved by the flow of sodium ions.

The reciprocal movement of one potassium ion for one sodium ion across the cell membrane results in the production of an action potential.

Question 12.12. A 70-year-old male patient presents to the emergency department complaining of pain in his calf that is exacerbated when he walks. His pedal and popliteal pulses are faintly palpable and his leg distal to the pain is noticeably reddened. What would his care provider’s preliminary diagnosis and anticipated treatment most likely be? (Points : 0.4)

 

Acute arterial occlusion that will be treated with angioplasty

Raynaud disease that will require antiplatelet medications

Atherosclerotic occlusive disease necessitating thrombolytic therapy

Giant cell temporal arteritis that will be treated with corticosteroids

Question 13.13. Which of the following situations related to the transition from fetal to perinatal circulation would be most likely to necessitate medical intervention? (Points : 0.4)

 

Pressure in the pulmonary circulation and the right side of the infant’s heart fall markedly.

Alveolar oxygen tension increases, causing reversal of pulmonary vasoconstriction of the fetal arteries.

Systemic vascular resistance and left ventricular pressure are both increasing.

Pulmonary vascular resistance, related to muscle regression in the pulmonary arteries, rises over the course of the infant’s first week.

Question 14.14. In which of the following patient situations would a nurse practitioner be most justified in preliminarily ruling out pericarditis as a contributing pathology to the patient’s health problems? (Points : 0.4)

 

A 61-year-old man whose ECG was characterized by widespread T wave inversions on admission but whose T waves have recently normalized

A 77-year-old with diminished S3 and S4 sounds, an irregular heart rate, and a history of atrial fibrillation

A 56-year-old obese man who is complaining of chest pain that is exacerbated by deep inspiration and is radiating to his neck and scapular ridge

A 60-year-old woman whose admission blood work indicates elevated white cells, erythrocyte sedimentation rate, and C-reactive protein levels

Question 15.15. During a routine physical examination of a 66-year-old woman, her nurse practitioner notes a pulsating abdominal mass and refers the woman for further treatment. The nurse practitioner is explaining the diagnosis to the patient, who is unfamiliar with aneurysms. Which of the following aspects of the pathophysiology of aneurysms would underlie the  explanation the nurse provides? (Points : 0.4)

 

Aneurysms are commonly a result of poorly controlled diabetes mellitus.

Hypertension is a frequent modifiable contributor to aneurysms.

Individuals with an aneurysm are normally asymptomatic until the aneurysm ruptures.

Aneurysms can normally be resolved with lifestyle and diet modifications.

Question 16.16. A patient is experiencing impaired circulation secondary to increased systemic arterial pressure. Which of the following statements is the most relevant phenomenon?(Points : 0.4)

 

Increased preload due to vascular resistance

High afterload because of backpressure against the left ventricle

Impaired contractility due to aortic resistance

Systolic impairment because of arterial stenosis

Question 17.17. A 66-year-old patient’s echocardiogram reveals a hypertrophied left ventricle, normal chamber volume, and a normal ejection fraction from the heart. What is this patient’s most likely diagnosis? (Points : 0.4)

 

Mitral valve regurgitation

Aortic valve stenosis

Mitral valve stenosis

Aortic valve regurgitation

Question 18.18. A physical assessment of a 28-year-old female patient indicates that her blood pressure in her legs is lower than that in her arms and that her brachial pulse is weaker in her left arm than in her right. In addition, her femoral pulses are weak bilaterally. Which of the following possibilities would her care provider be most likely to suspect? (Points : 0.4)

 

Pheochromocytoma

Essential hypertension

Coarctation of the aorta

An adrenocortical disorder

Question 19.19. A 72-year-old woman with a recent onset of syncopal episodes has been referred to a cardiology group by her family physician. As part of the patient’s diagnostic workup, the nurse practitioner conducting the intake assessment has ordered a Holter monitor for 24 hours.Which of the following statements best captures an aspect of Holter monitoring? (Points: 0.4)

 

A Holter monitor is preferable to standard ECG due to its increased sensitivity to cardiac electrical activity.

The primary goal is to allow the cardiologist to accurately diagnose cardiomyopathies.

Accurate interpretation of the results requires correlating the findings with the activity that the woman was doing at the time of recording.

Holter monitors are normally set to record electrical activity of the heart at least once per hour.

Question 20.20. An 81-year-old female patient of a long-term care facility has a history of congestive heart failure. The nurse practitioner caring for the patient has positioned her sitting up at an angle in bed and is observing her jugular venous distention. Why is jugular venous distention a useful indicator for the assessment of the patient’s condition? (Points : 0.4)

 

Increased cardiac demand causes engorgement of systemic blood vessels, of which the jugular vein is one of the largest.

Blood backs up into the jugular vein because there are no valves at the point of entry into the heart.

Peripheral dilation is associated with decreased stroke volume and ejection fraction.

Heart valves are not capable of preventing backflow in cases of atrial congestion.

Question 21.21. As part of the diagnostic workup for a male patient with a complex history of cardiovascular disease, the care team has identified the need for a record of the electrical activity of his heart, insight into the metabolism of his myocardium, and physical measurements, and imaging of his heart. Which of the following series of tests is most likely to provide the needed data for his diagnosis and care? (Points : 0.4)

 

Echocardiogram, PET scan, ECG

Ambulatory ECG, cardiac MRI, echocardiogram

Serum creatinine levels, chest auscultation, myocardial perfusion scintigraphy

Cardiac catheterization, cardiac CT, exercise stress testing

Question 22.22. A 6-year-old boy has been brought to the emergency department by ambulance after his mother discovered that his heart rate was “so fast I couldn’t even count it.” The child was determined to be in atrial flutter and his mother is seeking an explanation from the health care team. Which of the following points should underlie an explanation to the mother? (Points: 0.4)

 

The child is experiencing a reentry rhythm in his right atrium.

The resolution of the problem is dependent on spontaneous recovery and is resistant to pacing interventions.

The child is likely to have a normal ECG apart from the rapid heart rate.

The boy’s atria are experiencing abnormal sympathetic stimulation.

Question 23.23. A 66-year-old obese man with a diagnosis of ischemic heart disease has been diagnosed with heart failure that his care team has characterized as attributable to systolic dysfunction. Which of the following assessment findings is inconsistent with his diagnosis? (Points : 0.4)

 

His resting blood pressure is normally in the range of 150/90 and an echocardiogram indicates his ejection fraction is 30%.

His end-diastolic volume is higher than normal and his resting heart rate is regular and 82 beats per minute.

He is presently volume overloaded following several days of intravenous fluid replacement.

Ventricular dilation and wall tension are significantly lower than normal.

Question 24.24. A 54-year-old man with a long-standing diagnosis of essential hypertension is meeting with his nurse practitioner. The patient’s nurse practitioner would anticipate that which of the following phenomena is most likely occurring? (Points : 0.4)

 

The patient’s juxtaglomerular cells are releasing aldosterone as a result of sympathetic stimulation.

Epinephrine from his adrenal gland is initiating the renin-angiotensin-aldosterone system.

Vasopressin is exerting an effect on his chemoreceptors and baroreceptors, resulting in vasoconstriction.

The conversion of angiotensin I to angiotensin II in his lungs causes increases in blood pressure and sodium reabsorption.

Question 25.25. The nurse practitioner for a cardiology practice is responsible for providing presurgical teaching for patients who are about to undergo a coronary artery bypass graft. Which of the following teaching points best conveys an aspect of the human circulatory system? (Points : 0.4)

 

“Your blood pressure varies widely between arteries and veins, and between pulmonary and systemic circulation.”

“Only around one quarter of your blood is in your heart at any given time.”

“Blood pressure and blood volume roughly mimic one another at any given location in the circulatory system.”

“Left-sided and right-sided pumping action at each beat of the heart must equal each other to ensure adequate blood distribution.”

Winland-Brown, J.E. and Dunphy, L.M. (2013). Adult-Gerontology and Family Nurse Practitioner Certification Examination: Review Questions and Strategies.

Codina Leik, M.T. (2013). Adult-Gerotonolgy Nurse Practitioner Certification Intensive Review: Fast Facts and Practice Questions. 2ND Ed.

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Sociology Visual Narrative – Part B


Sociology Visual Narrative – Part B

Part B: Visual Narrative (100 points)

The purpose of Part B is to visually illustrate what this social problem looks like. These should be informed by your academic research. There are two options for Part B. First, you can go out and take pictures that represent your social problem yourself. Second, you can use the internet to find pictures that illustrate your topic. For either option, you need to provide a minimum of 5 pictures. You will create a PowerPoint or MS Word document with all 5 of these images, along with a description of each image. Your description should be 1 paragraph per image. Each paragraph should a) describe the image and b) directly address how it illustrates the social problem. You will also need to include a short (200-250 word) reflection on your experience. This should be imbedded in your MS Word Document or PowerPoint file. You will turn in only one file with all of the required components.

Components:

  • 5 images that illustrate your social problem.
  • 1 paragraph per image describing the image and how it illustrates your social problem
  • 1 reflection on your experience (200-250 words)

Your reflection should address the following questions:

  • What did you learn from this process?
  • What role did your academic research play in how you framed your visual narrative?
  • Was it difficult or easy to illustrate your social problem?
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assess-the-investment-climate-of-an-emerging-market-developing-country



This is for an international business class. The objective of the report is to assess the investment climate of an emerging market (developing country). Pick any developing country of your choosing. The report should analyze the economic environment that includes currency exchange rate risk, profit repatriation risk, and purchasing power. The report should also analyze the countrys political risks, understood as the risks associated with […]

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Chapter Reading and Worksheet – Buy Custom Essays


Book required: Foner, Eric. 
Give Me Liberty: An American History, Seagull Fifth Edition, Vol. 2
PDF online is okay
I have attached the PDF book.
READ AND COMPLETE HISTORY READING WORKSHEET FOR CHP. 20,22,23,24,25 and 26
WORKSHEET IS FOR EACH CHAPTER.
So 1 worksheet for chapter 20 and a new one is for chapter 22 and so on…  
“Is this question part of your assignment? We Can Help!”

 

“Are you looking for this answer? We can Help click Order Now”

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NR 507 Week 4 Discussions Alterations in Renal Function – NursingPaperSlayers


Week 4: Alterations in Renal Function

 

Discussion Part One

 

This week’s graded topics relate to the following Course Outcomes (COs).

 

1 Analyze pathophysiologic mechanisms associated with selected disease states. (PO 1)

 

2 Differentiate the epidemiology, etiology, developmental considerations, pathogenesis, and clinical and laboratory manifestations of specific disease processes. (PO 1)

 

3 Examine the way in which homeostatic, adaptive, and compensatory physiological mechanisms can be supported and/or altered through specific therapeutic interventions. (PO 1, 7)

 

4 Distinguish risk factors associated with selected disease states. (PO 1)

 

5 Describe outcomes of disruptive or alterations in specific physiologic processes. (PO 1)

 

6 Distinguish risk factors associated with selected disease states. (PO 1)

 

7 Explore age-specific and developmental alterations in physiologic and disease states. (PO 1)

 

Mrs. Orndorf is a 28-year-old woman married for 3 years who has just returned from an outdoor camping trip with her husband, with symptoms of dysuria with a burning sensation, urgency to urinate, and frequent urination. She said, “I have had similar symptoms three times over the last 2 years. Pubic and low back discomfort awoke me two nights ago and that is why I am here.” On physical examination, her temperature was 98.6° F, blood pressure was 114/64 mm Hg, pulse was 68 beats per minute, and the respiratory rate was 12 breaths per minute. Other than a tender abdominal pelvic area, the examination was unremarkable.

 

• What is your list of differential diagnoses in this case and explain how each of these fits with the case patient as described above. Be sure to list at least four (4) pertinent differential diagnoses. Indicate which of these you would select as the most likely diagnosis and explain why.

 

• According to the first item in your differential, what are the risk factors for this disorder?

 

• What are some treatments for this disorder?

 

Discussion Part Two

 

This week’s graded topics relate to the following Course Outcomes (COs).

 

1 Analyze pathophysiologic mechanisms associated with selected disease states. (PO 1)

 

2 Differentiate the epidemiology, etiology, developmental considerations, pathogenesis, and clinical and laboratory manifestations of specific disease processes. (PO 1)

 

3 Examine the way in which homeostatic, adaptive, and compensatory physiological mechanisms can be supported and/or altered through specific therapeutic interventions. (PO 1, 7)

 

4 Distinguish risk factors associated with selected disease states. (PO 1)

 

5 Describe outcomes of disruptive or alterations in specific physiologic processes. (PO 1)

 

6 Distinguish risk factors associated with selected disease states. (PO 1)

 

7 Explore age-specific and developmental alterations in physiologic and disease states. (PO 1, 4)

 

A 56-year-old female comes into the clinic complaining of intermittent severe pain that radiates from the flank to the groin and sometimes to the inner thigh. Upon further questioning she tell you that she has an urge to always go to the restroom and that she sometime sweats and feels nauseous. A urinalysis provides traces of blood, a few white blood cells and no bacteria.

 

• What is your differential diagnosis? Discuss in detail the pathophysiology of each item in your differential and how it might fit in describing this case.

 

• The x-ray comes back and there is nothing abnormal except a slightly dilated ureter. Does this change your differential or narrow it?

 

• How would you treat the pain in this case?

 

Discussion Part Three

 

This week’s graded topics relate to the following Course Outcomes (COs).

 

1 Analyze pathophysiologic mechanisms associated with selected disease states. (PO 1)

 

2 Differentiate the epidemiology, etiology, developmental considerations, pathogenesis, and clinical and laboratory manifestations of specific disease processes. (PO 1)

 

3 Examine the way in which homeostatic, adaptive, and compensatory physiological mechanisms can be supported and/or altered through specific therapeutic interventions. (PO 1, 7)

 

4 Distinguish risk factors associated with selected disease states. (PO 1)

 

5 Describe outcomes of disruptive or alterations in specific physiologic processes. (PO 1)

 

6 Distinguish risk factors associated with selected disease states. (PO 1)

 

7 Explore age-specific and developmental alterations in physiologic and disease states. (PO 1, 4)

 

A 60-year-old patient comes into your office with a history of hypertension and a myocardial infarction 13 years ago. You notice that both of her ankles are swollen and that her skin seems shiny. She first noticed her ankle swelling 9 months ago and it has gotten progressively worse. She has a smell of ammonia on her. She also has a 2 year history of diabetes.

 

• What are at least five systemic effects of chronic kidney disease?

 

• How would you modify the diet and what is the rationale to the changes of the diet that you make?

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What are your thoughts?? The most important part of servant leadership is being a servant first. As part of that, there are 10 principles that make up the qualities of a servant leader. Listening wher


What are your thoughts??

The most important part of servant leadership is being a servant first. As part of that, there are 10 principles that make up the qualities of a servant leader.

Listening

where the servant-leader works to identify the will of the group along with reflection on their own inner voice. Next is

empathy

. Here the leader is understanding others and assuming good intentions by all.

Healing

follows where the leader is attempting to help the broken and themselves from emotional hurt.

Awareness

makes the servant leader stronger by identifying issues of ethics and values.

Persuasion

where the leader convincing rather than using positional authority.

Conceptualization

where the leader looks further than just day to day.

Foresight

where the leader looks at past, present and future

. Stewardship

reinforces the commitment to serving the needs of others as they are the health care organization in trust for the greater good.

Commitment

to the growth of people is a commitment to each worker as they are valued for more than just their work. Lastly,

building community

within the group of employees that work within the healthcare organization.

Out of the ten, I think listening is one of the qualities at the center of servant leadership. Simplest thing about listening is the person speaking gets full focus and attention. The leader also listens carefully to both the spoken and unspoken words shared by the employees. The leader can then integrate the communication conversations into elements of the unit’s work. When the unit knows that everyone in the unit is wanted and could contribute to organizational goals, the nurse leader can translate the results of her listening into meaningful action by identifying and generating opportunities for nurses to develop innovations to improve the delivery of healthcare services. Along with listening, empathy goes hand in hand as the leader should be trying to understand the situation and circumstances of those in the unit. The nurse leader should take the time to learn the viewpoints of her unit along with helping the individuals in the unit realize their work goals. Empathy also includes large amounts of selflessness and that is demonstrated by never asking a unit member to do anything that the leader would not do herself. “A leader who is dedicated to enhancing the capabilities of the organization’s membership and willing to embrace collective leadership can advance the image, expectations, and effectiveness of healthcare organizations” (Neill, Saunders, 2008).

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Drug powerpoint presentation | Nursing homework help


 

For this assignment, you will select a drug from the list below and create a PowerPoint Presentation. 

  • Metformin
  • Losartan
  • Amoxicillin
  • Lisinopril
  • Albuterol
  • Namenda
  • Atrovent
  • Nitrofurantoin
  • Synthroid
  • Desmopressin
  • Miconazole
  • Methotrexate
  • Ibandronate
  • Buspar
  • Gabapentin
  • Sumatriptan
  • Propranolol

The purpose of the presentation is for you to educate your colleagues on the drug you have selected. The presentation must include information about the:

  • Drug pharmacology, pharmacokinetics
  • Brand name
  • Generic name
  • Dosing
  • Indications for use
  • Side effects
  • Contraindications
  • Pregnancy class
  • You must also perform a cost analysis of the drug.
  • Provide a patient case study on a patient in which you would utilize the drug you have selected and include at least two peer-reviewed evidence-based studies related to the drug.
  • Describe the appropriate patient education.
  • What is your role as a Nurse Practitioner for prescribing this medication to this patient on your case study presentation?
  • Describe the monitoring and follow-up.

Submission Instructions:

  • Presentation is original work and logically organized in current APA style including citation of references.
  • Incorporate a minimum of 4 current (published within last five years) scholarly journal articles or primary legal sources (statutes, court opinions) within your work. 
  • PowerPoint presentation with 12 slides, excluding the title slide and the reference slide.
  • The presentation is clear and concise and students will lose points for improper grammar, punctuation, and misspelling.
  • Speaker notes expanded upon and clarified content on the slides.

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The days of working on an individual basis in the workplace are over. Positions that are not involved in a team, committee, or work group at some point during the year are extremely rare. Unless forma


The days of working on an individual basis in the workplace are over. Positions that are not involved in a team, committee, or work group at some point during the year are extremely rare. Unless formal training is provided for a team, it is common to find dysfunction within a team.

Discussion: how can organizations address change management in the workplace such that healthy stress is created? Be creative in your answer! (At least 250 words)

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Monopolistic Competition Profit Maximization and Oligopoly Strategies


Please see attached word doc which is assignment and rubric for assignment questions and details, thank you.

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Manifestation determination reviews | Education homework help


350-word analysis regarding any legal issues raised by a principal’s decision to change a special education student’s transportation WITHOUT MEETING WITH THE IEP TEAM. 

The IEP states that the special education student rides the “general education” school bus. Due to recent inappropriate behaviors with the bus driver, the principal has expelled the student from riding the “general education” bus and giving her special transportation. The special education student also received 11 days suspension from school due to behavioral problems on the bus. 

Reference relevant statutes, regulations, and case decisions as appropriate.

Support your findings with a minimum of three scholarly resources.

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