Category: Solved Questions

• Question 1

	A patient with bipolar disorder is on divalproex sodium (Depakote) for mania. What test(s) would the family nurse practitioner monitor?
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• Question 2

	A 51-year-old female patient has been receiving doxorubicin (Adriamycin) for metastatic breast cancer. Her medical record indicates she has cardiomyopathy and a cumulative dose of 300 mg/m2 of doxorubicin. Which of the following measures would help limit the severity of the cardiomyopathy in this patient?
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• Question 3

	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?
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• Question 4

	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?
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• Question 5

	A Nurse Practitioner is providing patient education to a 50-year-old woman who is taking methotrexate (MTX) for breast cancer. The nurse will instruct the patient to avoid which of the following drugs?
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• Question 6

	The first line drug choice for a previously healthy adult patient who has been diagnosed with community-acquired pneumonia would be
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• Question 7

	A 9-year-old boy was bought to his primary care provider by his mother with signs and symptoms of hookworm infection and will be sent home with a prescription for mebendazole. When provided patient and family education, the nurse should teach the mother with which of the following measures to avoid reinfection following treatment?
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• Question 8

	Morphine has been prescribed for a 28-year-old man with severe pain due to a back injury. The nurse will advise the patient to avoid
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• Question 9

	A 34-year-old male has been diagnosed with TB and will be started on INH therapy. The medication history reveals that he currently takes antacids on a regular basis. The nurse will instruct the patient to take
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• Question 10

	After 6 months of unsuccessfully trying to conceive, a 31-year-old woman and her husband have sought a referral to a fertility specialist in order to explore their options. A nurse at the clinic should recognize that the woman may benefit from
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• Question 11

	A 71-year-old man has just been prescribed finasteride (Proscar). Which of the following complaints by this patient most likely indicated a need for this drug?
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• Question 12

	A Nurse Practitioner is going to administer medication to an infant using a medicine dropper. The best method is to open the child’s mouth by gently squeezing the cheeks and placing the drops
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• Question 13

	The nurse recognizes that the potential for teratogenic drug effects is not static throughout the prenatal and postnatal periods. The potential for teratogenic effects is highest during
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• Question 14

	A 72-year-old patient is prescribed ophthalmic ciprofloxacin for a bacterial infection in her right eye. The nurse will teach her to observe for which of the following adverse effects of the drug?
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• Question 15

	A Nurse Practitioner is working with a 16-year-old pregnant teen and assessing for behavior that may put the baby at risk. The most important assessment the nurse can make is
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• Question 16

	A nurse practitioner orders a single dose of 2 g Metronidazole orally. How many milligrams will the patient receive in one dose?
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• Question 17

	Which test should the NP order for monitoring effectiveness of the patient receiving heparin?
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• Question 18

	Which of the following drugs is most likely to cause sexual dysfunction and males?
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• Question 19

	I did not make drugs have a little effect when administered:
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• Question 20

	A patient is taking flavoxate hydrochloride (Urispas) to help control an overactive bladder. On a follow-up visit to the clinic, the nurse will question the patient about which of the following?
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• Question 21

	A 73-year-old woman has osteoporosis and is prescribed alendronate. She takes calcium and vitamin D supplements, drinks lots of water, and has just quit smoking. The nurse should advise the patient to also
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• Question 22

	A quinolone used to treat a urinary tract infection would be contraindicated in :
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• Question 23

	Women who are prescribed progestin-only contraception need education regarding which common adverse drug effect?
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• Question 24

	An immunocompromised patient with a diagnosis of candidiasis has failed to respond to conservative therapy and has consequently begun treatment with amphotericin B. The nurse is aware that this drug achieves a therapeutic effect by way of its influence on
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• Question 25

	A Nurse Practitioner is discussing with a 58-year-old male patient the causes of erectile dysfunction in men over 50 years of age. Which of the following will the nurse inform the patient is the primary physical cause of erectile dysfunction of men in this age group?
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• Question 26

	A Nurse Practitioner who provides care on a pediatric medicine unit has conducted a medication reconciliation of a recently-admitted patient. In light of the fact that the child takes methylphenidate (Ritalin), the nurse is justified in considering a history of what health problem?
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• Question 27

	A patient reports to a clinic with complaints of breast tenderness, a right lumpy breast, and no breast discharge. The breast tenderness occurs primarily during her menstrual cycle. The nurse practitioner probably suspects
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• Question 28

	How is hydrocodone eliminated from the body?
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• Question 29

	A Nurse Practitioner 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?
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• Question 30

	Laboratory testing has confirmed that a patient has chloroquine-resistant malaria and the patient’s physician has prescribed quinine along with an adjunctive drug. The nurse should question the physician’s order if the patient has a history of
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• Question 31

	A 56-year-old woman will soon begin treatment of her overactive bladder with tolterodine (Detrol). What patient teaching should the nurse provide to this woman?
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• Question 32

	Mr. Samuels has been prescribed olanzapine (Zyprexa).  The NP know that he should be monitored for:
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• Question 33

	Ms. Carter, a 48 year old female was placed on an aminoglycoside.  The NP knows that an adverse reaction to aminoglycosides is?
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• Question 34

	The NP recognizes that these medications are useful when taken during early symptoms of a migraine. (Select all that apply)
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• Question 35

	A patient is receiving cefazolin in combination with anticoagulants. To minimize the adverse effects during therapy, the nurse will
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• Question 36

	Which of the following is a true statement about aspirin and its action on platelets
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• Question 37

	A patient is to begin taking tobramycin (Nebcin) for a nosocomial infection. Which of the following assessments should the nurse prioritize?
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• Question 38

	A 65-year-old woman has an advanced form of rheumatoid arthritis. Her treatment includes a regular dosage of methotrexate. The APRN will advise her to take which of the following vitamin supplements while taking the drug?
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• Question 39

	A Nurse Practitioner is caring for a 10-year-old boy who complains of chronic headaches. His mother reports that she gives him Tylenol at least three times a day. Which of the following will the nurse work with the physician to evaluate?
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• Question 40

	A patient is receiving radiotherapy for an overactive thyroid gland and asks whether her milk is safe for her baby. If her treatment cannot be discontinued, what should the nurse recommend?
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• Question 41

	A 13-year-old female took a weight loss drug that activated the sympathetic nervous system. Which of the following assessment findings would the nurse expect?
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• Question 42

	A Nurse Practitioner 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?
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• Question 43

	What is the first line treatment for hypertension and a male with benign prosthetic hypertrophy?
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• Question 44

	Some drugs are given to patients using other routes such as sublingual or topical to avoid movement through the liver and possible side effects.  Which of the following effects is the Nurse Practitioner attempting to avoid by administering certain medications via alternative routes?
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• Question 45

	A Nurse Practitioner is assigned to a patient who is at 32 weeks’ gestation and is receiving terbutaline (Brethine) IV for 24 hours to control preterm labor. Which of the following nursing actions will the nurse take to decrease the risk of hypotension and promote circulation to the fetus?
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• Question 46

	A 39-year-old woman is receiving doxorubicin for the treatment of cancer. After each treatment, the patient has acute nausea and vomiting accompanied by a slightly increased heart rate. The nurse will advise her to
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• Question 47

	The Nurse Practitioner knows that Buproprion use (wellbutrin, zyban) is contraindicated in which of the following instances?
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• Question 48

	Which of the following would a Nurse Practitioner assess for in a patient who is taking polymyxin B systemically?
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• Question 49

	A postmenopausal patient is prescribed bisphosphonates to treat osteoporosis. The nurse will instruct the patient to take the drug
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• Question 50

	A 30-year-old African-American woman tested positive for TB and is prescribed isoniazid. The nurse will plan the patient’s care to include close monitoring of the drug therapy because
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• Question 51

	A Nurse Practitioner is caring for a patient with cancer who has been prescribed dronabinol (Marinol) to help reduce nausea and vomiting from chemotherapy. The nurse will inform the patient that he or she is taking an oral form of
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• Question 52

	Which of the following drugs can a person with G6PD deficiency take safely?
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• Question 53

	A child is admitted to the burn unit with second and third degree burns on both arms and part of his or her face. When administering topical medications to the burned areas, the nurse should
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• Question 54

	What is the best initial treatment plan for a sleep disorder in the older adult patient?
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• Question 55

	A school nurse has been teaching high school students about the risks associated with marijuana use. However, the nurse has been met with considerable skepticism on the part of students, most of whom believe that marijuana is a benign drug. Which of the following teaching points should the nurse provide?
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• Question 56

	Phenytoin decreases folic acid absorption by
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• Question 57

	Alendronate (Fosamax) is prescribed for a 67-year-old postmenopausal woman. In order to help prevent gastrointestinal distress, the nurse will advise the patient to
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• Question 58

	A 2-year-old child is diagnosed with a minor ailment and is to be administered medications at home for 2 weeks. The child lives with his mother, grandmother, and four other children between the ages of 14 months and 7 years. The home health nurse is asked to assess the home environment to determine if it is appropriate for the child to take his medication at home. Which of the following will have the greatest impact on the nurse’s assessment?
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• Question 59

	A patient has been admitted to the critical care unit of the hospital with bacterial septicemia that has failed to respond to initial antibiotic treatment. The patient’s most recent blood cultures reveal the presence of methicillin-resistant Staphylococcus aureus (MRSA) in the patient’s blood. The nurse will anticipate that this patient will likely require intravenous administration of what antibiotic?
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• Question 60

	The anticoagulant drug that acts as a vitamin K antagonist is:
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• Question 61

	Combination OCs prevent pregnancy primarily by:
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• Question 62

	A nurse practitioner orders 150 mg of oral fluconazole for a patient with vulvovaginal candidiasis. The patient should expect to take medication
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• Question 63

	A Nurse Practitioner has questioned why a patient’s physician has prescribed a narrow-spectrum antibiotic rather than a broad-spectrum drug in the treatment of a patient’s infection. Which of the following facts provides the best rationale for the use of narrow-spectrum antibiotics whenever possible?
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• Question 64

	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?
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• Question 65

	A 30-year-old woman who is in the first trimester of pregnancy has presented to her primary care provider with a 4-day history of a reddened, itchy left eye that is crusted with purulent exudate. The clinician suspects a bacterial, rather than viral, etiology. How will the patient’s pregnancy affect the potential use of ciprofloxacin to treat her conjunctivitis?
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• Question 66

	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
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• Question 67

	Jacob was eating cheese and drinking beer. Thirty minutes Later, he developed severe hypertension, diaphoresis, Flushing, and muscle rigidity. He may have been taken which drug?
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• Question 68

	A 7-year-old child has tonsillitis and is prescribed penicillin V, which is to be administered at home. The nurse will instruct the parents to administer the drug
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• Question 69

	A Nurse Practitioner is caring for a 46-year-old female patient who is taking paclitaxel for ovarian cancer. Two or three days after the infusion of the drug, the nurse must closely monitor for which of the following?
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• Question 70

	A woman has a Chlamydia infection.  Before initiating treatment with a tetracycline antibiotic, the NP should :
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• Question 71

	A female patient is taking filgrastim (Neupogen) to decrease the incidence of infection. The nurse notices a small increase in the neutrophil count 2 days after starting therapy. The nurse’s evaluation of the increase is that
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• Question 72

	The NP is considering a medication to treat Ms. Robert’s Urinary Tract Infection. The NP knows that Trimethoprim sulfamethazole (Bactrim) Is contra indicated in which of the following conditions:
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• Question 73

	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?
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• Question 74

	A Nurse Practitioner is caring for a patient who is at 28 weeks’ gestation and is receiving terbutaline (Brethine) to control preterm labor. Which of the following assessment parameters should the nurse prioritize?
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• Question 75

	A Nurse Practitioner is explaining to a pregnant 21-year-old college student why she cannot continue to take ibuprofen (Advil) for her headaches. The nurse draws a picture depicting drug molecules crossing the placental membrane and entering into the fetal circulation. The nurse tells the patient that the main reason this happens is because
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• Question 76

	A pregnant patient who has diabetes has been admitted to the hospital to begin labor. Since the patient has diabetes, the physician has decided to use oxytocin (Pitocin) to initiate labor contractions. When talking to the patient about the adverse effects of the drug, the nurse should understand that the most common adverse effects of the drug include
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• Question 77

	A 29-year-old pregnant patient is extremely upset about having to take medication for a pre-existing medical condition. She is consumed with fear that her baby will be born with a physical deformity or a congenital anomaly but knows that she has to take the medication. She talks constantly about this and is unable to sleep most nights. Which of the following is the most appropriate nursing diagnosis for this patient is?
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• Question 78

	An immunocompromised cancer patient has developed cryptococcal meningitis and been admitted to the intensive care unit for treatment with amphotericin B. How should the nurse most safely administer this drug?
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• Question 79

	The NP has just placed Mr. Johnson on a selective serotonin reuptake inhibitor. What symptoms should be reviewed with the patient who is newly prescribed this class of medication?
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• Question 80

	What schedule drug is alprazolam?
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• Question 81

	A male patient is experiencing climacteric symptoms secondary to androgen deficiency. His physician has prescribed testosterone. The nursing assessment reveals that the patient has had a myocardial infarction. The combination of testosterone therapy and a history of myocardial infarction would place that patient at a significantly higher risk of
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• Question 82

	A man is prescribed ciprofloxacin to treat a sexually transmitted infection. The nurse will instruct the patient to
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• Question 83

	Donald is a nurse practitioner student. He recognizes Which option below could be a secondary use for an anxiolytic medication?
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• Question 84

	Mr. Laird is a 49-year-old electrician who experienced severe burns on his trunk, arms, and hands in a workplace accident 2 weeks ago. Part of his current wound care regimen involves the daily application of silver sulfadiazine to his wounds. The nurses who are providing care for Mr. Laird in the burns and plastics unit of the hospital should perform what action when administering this medication?
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• Question 85

	A Nurse Practitioner is caring for a patient who is on amphotericin B. On morning rounds the patient reports weakness, numbness, and a tingling sensation in his feet. What would be a priority action by the nurse?
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• Question 86

	The  nurse practitioner has prescribed elemental iron 6 mg/kg/day in three divided doses for a toddler diagnosed with iron-deficiency anemia. What instructions would the family nurse practitioner include for the parents?
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• Question 87

	A patient with non-Hodgkin’s lymphoma (NHL) will be starting a course of doxorubicin shortly. When planning this patient’s care, what nursing diagnosis should the nurse prioritize?
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• Question 88

	Sulconazole has been prescribed for a patient with tinea pedis. The nurse will instruct the patient to use the topical agent
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• Question 89

	A patient has been admitted to the critical care unit with a diagnosis of peritonitis that has necessitated treatment with gentamicin. As a result, the care team should be cautious when concurrently administering other medications that may cause
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• Question 90

	A 35-year-old woman is on a weight-loss program and is to begin taking sibutramine (Meridia). After baseline physical data are obtained, the nurse will assess the patient’s childbearing potential. The nurse will inform the patient that during sibutramine therapy she should
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• Question 91

	A 16-year-old boy is prescribed cromolyn sodium nasal spray to treat a nasal allergy. To maximize the therapeutic effects of the drug, which of the following will the nurse include in instructions to the patient?
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• Question 92

	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?
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• Question 93

	Which antibiotic is most frequently associated with “Red man Syndrome”
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• Question 94

	A patient asks the nurse practitioner about food sources such as soybeans and soy products. The nurse practitioner understands that these foods are considered
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• Question 95

	Which adverse reaction is common in the patient taking buspirone?
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• Question 96

	A 45-year-old female patient is prescribed ciprofloxacin to treat a bronchial infection. A nursing assessment revealed that she started taking daily vitamin supplements about 2 years ago. To maximize the therapeutic effects of the ciprofloxacin therapy, the nurse should advise the patient to
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• Question 97

	A Nurse Practitioner is explaining the use of acyclovir therapy to a 72-year-old man. Nephrotoxicity is discussed as a major adverse effect in older patients. To minimize the risk of the patient developing this adverse effect, the nurse will advise him to
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• Question 98

	Cindy has been on Citalopram (Lexapro) For a year and is willing to try tapering off of the selective serotonin reuptake inhibitor. What is the initial dosage adjustment when tapering off antidepressants
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• Question 99

	A male patient has been brought to the emergency department during an episode of status epilepticus. Diazepam is to be administered intravenously. The APRN will be sure to
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• Question 100

	Mr. CW has his routine appointment today in your clinic. He has been taking 10 mg of prednisone per day for the past six months. He should be assessed for
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• Question 101

	When completing this exam, did you comply with Walden University’s Code of Conduct including the expectations for academic integrity?
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Please choose one of the following topics and respond to the thread corresponding to the question you select. Please include at least three scholarly sources within your initial post.

Note: As you are choosing a topic, please try to make sure that all topics are chosen at least by one person. You can see this by noting if anyone has posted to the topic within the corresponding threads.

1. Dementia in the elderly. Discuss ways in which the cost associated with dementia can be curtailed along with maintaining the individual’s quality of life. Dementia is not only Alzheimer’s disease, so please consider multiple types of dementia within your answers (types of dementia include Alzheimer’s disease, vascular dementia, dementia with Lewy bodies [DLB], mixed dementia, Parkinson’s disease, frontotemporal dementia, Creutzfeldt-Jakob disease, and normal pressure hydrocephalus).
2. Elder abuse. Include physical, emotional, sexual, etc. How, as an APRN, can you screen for and address elder abuse? What types of health promotion concepts can be used to help advocate for the personal safety of our elders? Are there screening tools available? In what unconventional locations within your community might an elder screening be performed?
3. Fall prevention. What are specific geriatric risk factors that create an increase in fall risks? What can be done from a health promotion standpoint to decrease falls in the elderly? Define fall risk and what types of assessments are available in the outpatient and inpatient settings.
4. Financials, levels of neglect in the elders. Consider financial risk, scams, family, and other pitfalls the elderly may find themselves in relating to their finances. Provide examples and ways to advocate for our patients and our communities as an advanced practice nurse.
5. Components of a well elder evaluation. Define a well elder evaluation. Make sure you address components that pertain to the home environment and the communities in which they live. How can an APRN assist in these evaluations and promote different aspects within your community.
6. Functional status. Consider ADLs and IADLs. What is the difference? What types of assessment can be done and by whom to determine if an elder is capable of caring for themself at home? In addition, what types of services are available to help promote overall elder health not only in their homes but when living with family or in assisted living and nursing homes? What types of supportive services are available to assist the elderly in staying in their own homes?
7. Cognition. Describe how cognitive functioning may change as we age. What are neuropsychological examinations, and when should these be requested? Describe what this type of testing can accomplish and how, as a provider, you would use these results. Discuss ways in which we can improve and maintain our cognitive health (for example, diet, exercise). Provide specifics.
8. Polypharmacy. Consider medication compliance, risk of adverse effects, creatinine clearance <50ml/min. As an Advanced Practice Nurse, how can you address this growing problem? What type of surveillance will you put into place within your own practice, and how can you advocate to help address this concern within your own community?
9. Pain assessment and treatment. Discuss specifics regarding pain within the elder population: perception of pain, pain assessment scales, etc. In addition, provide evidence-based cited information relating to the opioid epidemic within your state and what percentage of addicted individuals are elderly. What type of resources are available in your community to help those with substance abuse problems? Are there any services specific to the elderly?

Reply Posts

Respond to ONE  of your peers who chose a different topic and discuss two separate resources they did not mention. One resource should be aimed at patient education and the second resource should be written for the health professional. Replies to your peers must be on two separate days (minimum) and must utilize at least two scholarly references per peer post.

 

During this assignment, you will be asked to discuss the concepts of health promotion and disease prevention, relating this information to the role of the APRN and applying it to the vulnerable population you selected during Week 1. In Week 6, you submitted a rough draft of your paper and received feedback from faculty, so please make sure you incorporate those comments along with direction you received from SmartThinking, Pearson Writing Center, and the Library.

Health Promotion and Disease Prevention Population-Specific Paper

This paper was to be developed throughout the first six to nine weeks of the course, with an opportunity to submit a rough draft for feedback during Week 6 and your final submission due this week, in Week 10. The goal of this assignment is twofold: 1) for you to demonstrate an understanding of the key concepts of health promotion and disease prevention as related to the role of the APRN while applying this information to a specific vulnerable population; and 2) for you to have an opportunity to develop your writing and APA formatting skills through faculty feedback and the utilization of various tools here at Regis (that is, Regis Library and staff, SmartThinking, Pearson Writing Center, etc.).

The faculty at Regis want you to be successful. Being able to present not only your thoughts but evidence-based practice information in a concise, systematic, and clear manner will be a talent that serves you well.

Note:  You must submit a SmartThinking report from Week 9 or 10 with your paper.  The suggested APA / grammatical corrections must be made along with the faculty-suggested corrections from Week 6.  If this is not done, you will automatically receive a zero.  Do not wait to submit your work to SmartThinking, as they will be backed up, so submit early (that is, the end of Week 8/first part of Week 9).

This entire paper is about your vulnerable population, so each topic listed in the paper needs to be related to your chosen population; from the introduction to the conclusion, it is about your chosen group.

The paper is to be five to eight pages in length, not including the title page, attachments, and reference pages. Note: Points will be deducted for going over the max of 8 pages (5 points for each page).

The paper will be divided into four sections.

1. Section 1 (Content can be found in Week 1)
   1. Introduction
      1. WHO’s definition of health
      2. Applying the WHO’s definition of health to your vulnerable population.
      3. The concept of vulnerable individuals and populations, in general and then related to your specific group.
   2. Historical Perspectives of Health
   3. Levels of Prevention – overview, brief
      1. Primordial
      2. Primary
      3. Secondary
      4. Tertiary
      5. Quaternary
   4. The role of nursing, specifically APRNs, in health promotion and disease prevention, and advocacy
2. Section 2 (Content can be found in Week 2 and 3)
   1. Health disparities related to your vulnerable group
   2. Cultural competency as a provider
   3. Defining resilience and applying to the vulnerable, specifically to your group
3. Section 3 (Content can be found in Week 2 through 4. Don’t forget to use the media/website/video links, as they will provide a lot of great information). Focus on your specific vulnerable population group
   1.  Using Mechanic and Tanner’s 2005 article, is your vulnerable population a sinner or a victim and why?
   2. Social justice related to your population
   3. Low literacy within your population and how this affects their health
   4. Evaluate your vulnerable population related to current Healthy People Initiative guidelines – what specifically relates to your group (Connect D and E)
   5. Discuss one primary health concern for your population and include the preventive guideline related to this concern and how you might motivate this group to make behavioral changes.
   6. Discuss use of Community Based Participatory Research (CBPR) with your vulnerable population – pros and cons. How can community-level plans/interventions influence individual and family health?
   7. Discuss what resources are available within your community for your specific population.
4. Section 4
   1. The conclusion of your paper should bring all your information together.
   2. Discuss an approach for improving health literacy within your population
   3. Discuss how, as an APRN, you can impact vulnerable individuals in your community.
   4. Conclude with a summary of how we as a nation are doing with health promotion and disease prevention.

Note: This assignment is to be submitted in an APA paper format (that is, title page, title, introduction and purpose statement, body of the paper with a conclusion, appropriate citations, and reference page(s) along with attachments) as was your SmartThinking Report. Please make sure that ALL paragraphs are well developed, and have five to six sentences each, with citations for validity.

Please refer to the Grading Rubric for details on how the final submission of paper will be graded.

Please submit your Final Paper and a NEW SmartThinking Report.

Note: Failing to submit a NEW SmartThinking Report will result in a ZERO for this assignment.

 

This discussion will allow you to examine several different preventive guidelines related to vaccinations. Please read the following four scenarios and choose ONE for your initial post; be sure to address all the questions posed by the scenario and include at least three scholarly sources within your initial post.

Note: As you are choosing a topic, please try to make sure that all topics are chosen at least by one person. You can see this by noting if anyone has posted to the topic within the corresponding threads

Immunizations

1. Patient #1: Two five-year-old girls are on your schedule for a kindergarten physical. The foster parent of one of the children indicates she received all her immunization from birth to one year of age, but after that the child has not had any further vaccines. The second child appears to have been vaccinated per the CDC schedule.
   • Is there a difference in the immunization plan you will initiate today for these two patients? Why or why not?
   • What immunizations will you be ordering for each of these two patients today?
2. Patient #2: Today you have two patients on your schedule for the HPV vaccine. One is a 27-year-old female. In taking her health history, you find that she is sexually active and that she had a splenectomy when she was 17. The second patient is an eleven-year-old female whose mother is concerned and wants to discuss the vaccine further before consenting. She feels that by giving the child the vaccine she is giving her permission to be sexually active.
   • What type of immunizations will you recommend and why for each of these patients?
   • What type of counseling will you provide in each of these scenarios related to their immunization needs?
3. Patient #3: The following two patients present for their yearly physicals before going to spend the holidays with their grandchildren, who are two months, 18 months, and seven years of age. The 72-year-old male states he “doesn’t want a flu shot” because he’s afraid he will just get sick like his neighbor who got her shot last week; however, his 67-year-old wife (who you are also seeing for a follow-up related to shingles she had a month ago) states, “I want the flu vaccine, but I don’t need the shingles vaccine now since I’ve already had it.”
   • How will you counsel these individuals? Are there risks related to the children from either party?
   • What adult immunization should be recommended for these patients?
   • Should you discuss COVID vaccines? Why or why not?
4. Patient #4: Your final patient of the day is a three-month-old baby. The nurse states that the mom is refusing vaccinations today even though the baby’s records show she is up to date on her immunizations. Mom explains that she feels like her baby is getting “too many” shots and since everyone else is being vaccinated, they can skip a few of the vaccines and her baby will be just fine.
   • What is herd immunity and how can this help protect individuals who are not vaccinated? What are the rates for your state related to immunizations, and how could this affect herd immunity?
   • What immunizations should this patient receive today, and is there any leeway in the schedule to help alleviate some of the mom’s concerns?

Reply Post

Reply to two of your peers who chose two different topics. Provide your own examples of situations in which you have had to discuss immunizations/vaccines. What suggestions might you provide your peers in terms of dealing with misinformation related to this topic? Replies to your peers must be on two separate days (minimum) and must utilize at least two scholarly references per peer post.

 

This week you are to submit your certificates of completion of the following immunization modules from the CDC. These modules were introduced during Week 9 and are due by the end of Week 11 Day 7.

• You Call the Shots: General Best Practice Guidelines for Immunization
• Human Papillomavirus
• Pneumococcal
• Zoster
• Hepatitis B

*As the CDC updates their links frequently, if you are having trouble accessing any of the module direct links, please utilize the CDC You Call The Shots website as an option to locate the appropriate modules.

Upon your completion of these modules, please upload your completion certificates to receive credit for the assignment in the assignment section in Week 11.

All five modules must be completed. Each module represents 20 percent of your score to equal 100 percent%.

To receive your certificates of completion, you will need to register for a FREE account. See the instructions below to complete this step

1. Go to Training and Continuing Education Online (TCEO): Create Account and register for an account.
2. Then, follow the steps listed here: Training and Continuing Education Online (TCEO): 9 Simple Steps to Get Your Continuing Education (CE).

To Submit Your Assignment:

1. Select the Add Submissions button.
2. Drag or upload your file to the File Picker.
3. Select Save Changes .

For this week, you are responsible for completing the following immunization modules from the CDC*.

• WB4265: Immunization:  You Call the Shots-Module Sixteen-Vaccines for Children Program—2020
• WB2660: Immunization:  You Call the Shots-Module Two-DTaP/DT; 2016
• WB4202: Immunization:  You Call the Shots-Module Four-Hemophilus influenza type b (Hib) 2019
• WB4096: Immunization:  You Call the Shots-Module Seven-MMR-2019
• WB2147: Immunization:  You Call the Shots-Module Fourteen-Rotavirus
• WB2709: Immunization:  You Call the Shots-Module Thirteen-Varicella

*As the CDC updates its links frequently, if you are having trouble accessing any of the modules’ direct links, please utilize the CDC You Call The Shots website as an option to locate the appropriate modules.

Upon your completion of these modules, please upload your completion certificates to receive credit for the assignment in the assignment section in Week 11.

All five modules must be completed. Each module represents 20 percent of your score to equal 100 percent.

To receive your certificates of completion, you will need to register for a FREE account. See the instructions below to complete this step

1. Go to Training and Continuing Education Online (TCEO) and register for an account.
2. Then, follow the steps listed  on the 9 Simple Steps to Get Your Continuing Education (CE) page.

To Submit Your Assignment:

1. Select the Add Submissions button.
2. Drag or upload your file to the File Picker.
3. Select Save Changes .

This discussion will allow you to examine several different preventive guidelines related to women’s health. Please read the following three scenarios and choose ONE  for your initial post; be sure to address all the questions posed and include at least three scholarly sources within your initial post.

Note: As you are choosing a topic, please try to make sure that all topics are chosen at least by one person. You can see this by noting if anyone has posted to the topic within the corresponding threads.

Breast Cancer Screening

A 39-year-old female presents to your office for her annual well-woman exam. She reports that she has a maternal aunt and a cousin who have had breast cancer, so she does her self-breast exams every month. She would like to start getting mammograms, but her friends all say she doesn’t need to worry about a mammogram until she’s at least close to 50.

1. What are the mammogram recommendations from American College of Obstetrics and Gynecology (ACOG), American Cancer Society (ACS), and United States Preventive Services Task Force (USPSTF)?
2. What is meant by shared decision-making regarding screening for breast cancer?
3. What are the screening recommendations regarding self-breast exams and clinical breast exams?
4. Based on the scenario provided, what recommendations would you give this patient?
5. What factored into your decision-making?

Cervical Cancer Prevention/Screening

An 18-year-old is accompanied by her mother for her first visit to the gynecologist. She has never been sexually active. She has no concerns with her menses. Her mom reports that she brought her in “because she is 18 and when I turned 18, I had to get my first Pap smear.” Her mother requests the patient have a Pap smear and be tested for HPV “just in case.” The patient is up to date on all vaccines “mandatory for school” but has never had the HPV vaccine.

1. What are the recommendations on the HPV vaccine?
2. How would you counsel this patient about the HPV vaccine?
3. What are the current ASCCP guidelines for Pap smears and HPV testing?
4. How will you explain the rationale to the patient and the mother?

STI Prevention and Screening

A 52-year-old female presents to your clinic concerned that she may have contracted a sexually transmitted infection (STI). She states she is recently divorced and admits she never had to practice “safe sex” before and that she has been with several people over the last few months. She has been drinking “way too much” and feels she should just be tested for everything as she has been experimenting.

1. What type of questions would you want to ask to begin to focus your plan? How will her risk factors affect your screening?
2. There are several preventive guidelines related to STI risk and screening. What do the current guidelines indicate she should be screened for?
3. What recommendations should you make regarding “safe sex” practices?
4. Are there any other preventive guidelines you should address with this patient?

Reply Posts

Review the presentations of two other peers who chose two different topics. Discuss how health disparities in women could affect their care (for example, geographic location, race, finances, literacy, etc.). Use the UpToDate database  as one of your required references and a second scholarly reference of your choice; remember you should have at least two references for each peer post.

In reading your assigned textbook chapters and select articles, and reviewing the CDC website link on IPV found within the Learning Material section of this module, you will have looked at both ends of the spectrum—from disparity to privilege—and at triggers, which are not bound by any social class, leading to intimate partner violence. Consider the following:

1. Does trauma-informed care apply to IPV? Why or why not?
2. Review the maternal and infant mortality statistics within our country and your state. Do you note any disparity?
3. How can “privilege” become a beacon for change?
4. Intimate partner violence expresses a need for power and control by many methods. Would you recognize them all?
5. Is there a path that most violent individuals follow?

Reflect on the content presented and submit a one- to two-page journal (this does not include the title or reference pages) providing an example of how you have been witness to IPV, disparity, and or privilege and outline how you, as an APRN, can recognize and reduce violence and health disparity in women.

You may journal in first person, and this assignment does not require references as it is your thoughts; however, be sure to review the rubric, as a minimum of one reference is required to be considered exemplary work. If you choose to use quotes or citable material, you are expected to follow APA formatting.

 

Consider what you learned from the video, along with other content that has been discussed in this course. For your initial post, choose one of the three scenarios presented below and answer the following questions. (Please include at least three scholarly sources within your initial post):

Questions:

• As an APRN, how could you positively affect the health of the woman in the scenario you chose?
• What would be the pros and cons of utilizing the technique of Motivational Interviewing with the woman in the scenario.
• Trial the techniques you have read about over the previous few weeks related to Motivational Interviewing with a coworker, family or friend. What was this experience like? Do you see benefits to becoming more comfortable with this technique? Why or why not?

Note: As you are choosing a topic, please try to make sure that all topics are chosen at least by one person. You can see this by noting if anyone has posted to the topic within the corresponding threads

Scenarios:

1. A 34-year-old female who is 36 weeks pregnant – G2P1AB0 – presents to your office complaining of shortness of breath and ankle swelling. She states she has had “the flu” for several days and is insistent that this is why she can’t stop coughing. She is obviously short of breath when talking. In reviewing her chart, you can see she has a history of hypertension. She states she “”officially” stopped her blood pressure medications when she found out she was pregnant but admits that she rarely took her pills anyway, so “no big deal.”
2. Sumar has just found out she is pregnant and presents to the local free clinic. She is a 26-year-old G2P0AB1, and her first OB appointment is in two weeks. Sumar thinks she is about 12 to 14 weeks pregnant. She has come to the clinic complaining of indigestion. You notice the strong smell of cigarette smoke, and she admits she smokes one pack of cigarettes a day but states she is smoking less now since she started vaping.
3. You are seeing a 19-year-old female for STI screening. When reviewing her health and sexual history to determine her risk, she indicates she has had several new partners over the past six months and that she has not been using condoms but does have an IUD. She has started smoking marijuana and has dabbled with some other prescription medications over the previous two months. She is worried about having contracted an STI because she has noticed some “cauliflower” type bumps “down there” and would like to be tested.

Reply Posts

Reply to at least two of your classmates on two separate days (minimum) who chose the two other topics utilizing at least two scholarly references per peer post. What did you learn from your experience with Motivational Interviewing this week that could help your peer better address the preventive guidelines for the women in the scenario?