Posts in category: Nursing Papers

Week_5_Assignment_1_“Captain_of_the_Ship”_Project_–_Bipolar_Disorders.docx (17.25 KB)

NURS6670 Psychiatric Mental Health Nurse Practitioner Role II
Week 5 Assignment 1
Assignment
1: “Captain of the Ship” Project – Bipolar Disorders
Bipolar
disorders are severe disorders of mood that include both depressive episodes
and expansive, grandiose, or manic episodes. During these times, the person may
engage in activities with little awareness of the consequences because of
accompanying psychosis. A diagnosis of bipolar disorder includes periods of
mania or hypomania and periods of depression where the mood is down, hopeless,
and suicidal. The neurovegetative symptoms of bipolar depression can be
incapacitating. It is also important to differentiate the psychosis of bipolar
disorder from schizophrenia.
In this
Assignment, you will become the “captain of the ship” as you provide treatment
recommendations and identify medical management, community support resources,
and follow-up plans for a client with a bipolar disorder.
Learning
Objectives
Students
will:
• Recommend psychopharmacologic
treatments based on therapeutic end points for clients with bipolar disorders
• Recommend psychotherapy based on
therapeutic end points for clients with bipolar disorders
• Identify medical management needs
for clients with bipolar disorders
• Identify community support
resources for clients with bipolar disorders
• Recommend follow-up plans for
clients with bipolar disorders
To prepare
for this Assignment:
• Select an adult or older adult
client with a bipolar disorder that you have seen in your practicum.
In 3-4
pages, write a treatment plan for your client. In which you do the following:
• Describe the HPI and clinical
impression for the client.
• Recommend psychopharmacologic
treatments and describe specific and therapeutic end points for your
psychopharmacologic agent. (This should relate to HPI and clinical
impression.).
• Recommend psychotherapy choices
(individual, family, and group) and specific therapeutic endpoints for your
choices.
• Identify medical management needs,
including primary care needs, specific to this client.
• Identify community support
resources (housing, socioeconomic needs, etc.) and community agencies that are
available to assist the client.
• Recommend a plan for follow-up
intensity and frequency and collaboration with other providers.
By Day 7
Submit your
Assignment.
Submission
and Grading Information
To submit
your completed Assignment for review and grading, do the following:
• Please save your Assignment using
the naming convention “WK5Assgn1+last name+first initial.(extension)” as the
name.
• Click the Week 5 Assignment 1
Rubric to review the Grading Criteria for the Assignment.
• Click the Week 5 Assignment 1 link.
You will also be able to “View Rubric” for grading criteria from this area.
• Next, from the Attach File area,
click on the Browse My Computer button. Find the document you saved as
“WK5Assgn1+last name+first initial.(extension)” and click Open.
• If applicable: From the Plagiarism
Tools area, click the checkbox for I agree to submit my paper(s) to the Global
Reference Database.
• Click on the Submit button to complete your submission.

Walden_NURS6003_Quiz_Week_1.docx (20.61 KB)

Question 1 Students can always edit their posting in
Discussion.
True
False
Question 2 In which area will you retrieve written
assignments with comments from your instructor?
A.
Discussion
B.
My grades area
C.
Assignment Link
Question 3 Where in your online course will you find the
contact information for your Instructor?
A.Syllabus
B.Student Support
C.Contact the Instructor
Question 4 Who should you contact with questions about online
classroom technical concerns?
A.Your Instructor
B.Walden Academic Advisor
C.Student Support
D.Program Director
Question 5 When sending an e-mail to your Instructor or any
Walden staff, your e-mail should:
A.Include color stationary as a background
B.USE ALL CAPITAL LETTERS SO THEY KNOW YOUR EMAIL IS
IMPORTANT
C.Include your full legal name, your program or course, and
your Walden ID Number
Question 6 If you are having trouble accessing your online
classroom, what should you do first?
A.Clean your browser’s cookies and cache
B.Check firewall settings
C.Deactivate pop-up blockers
Question 7 When will you lose access to your completed
courses (excluding this Student Readiness Orientation)?
A.Never
B.30 days after the course end date
C.60 days after the course end date
D.120 days after the course end date
Question 8 In an online course, students can participate in
the online classroom and submit assignments whenever it is convenient for them
to do so.
True
False
Question 9 The online classroom area where you can post an
assignment and have your classmates and instructor respond to your ideas is
called:
My Grades area
Discussion
Assignment Link
Question 10 If you have a question about which courses you should
register for next term, who should you contact?
A.Student Support Team
B.One of your current instructors
C.Your Academic Advisor

NURS_6550_FINAL_EXAM.docx (449.71 KB)

QUESTION 1
1. Mr. Jeffers was admitted 2 days ago for carotid endarterectomy. A Foley catheter
was inserted intraoperatively and remains in place. His urine output has
declined markedly despite continued IV fluid infusion. Today his morning labs
reveal a BUN of 19 mg/dL and a creatinine of 2 mg/dL. A leading differential
includes:
A. Foley lodged in the urethra causing post-renal failure
B. Decreased renal perfusion causing prerenal failure
C. Age-related decreased eGFR causing prerenal failure
D. Post-surgical rhabdomyolysis causing intrarenal failure
1 points
NURS 6550 FINAL EXAM – WALDEN UNIVERSITY Walden nurs6550 final exam 2019 QUESTION 2
1. Janet is admitted with symptomatic tachycardia. Her pulse is 160 b.p.m. and she is weak,
diaphoretic, and anxious. Physical examination reveals a 5’4” 107 lb black
female who is awake, alert, and oriented, anxious, with moist skin and racing
pulse. Her blood pressure is 140/100 mm Hg. Temperature and respiratory rate
are within normal limits. The patient admits to having a “thyroid condition”
but she never followed up on it when she was advised to see an endocrinologist.
The AGACNP anticipates a diagnosis of:
A. Hashimoto’s thyroiditis
B. Cushing’s syndrome
C. Grave’s disease
D. Addison’s disease
1 points

QUESTION 3
1. Systemic
lupus erythematosis (SLE) is a multi-organsystem autoimmune disorder that can
prevent with a wide variety of manifestations. Which clinical triad should
prompt an evaluation for SLE?
A. Fever, normal white count, elevated sedimentation rate
B. Hyperkalemia, hyponatremia, low blood pressure
C. Leukocytosis, hyperglycemia, hypokalemia
D. Joint pain, rash, fever
1 points
NURS 6550 FINAL EXAM – WALDEN UNIVERSITY Walden nurs6550 final exam 2019 QUESTION 4
1. A patient presents with profound vertigo of acute onset yesterday. She can barely turn
her head without becoming very vertiginous; she is nauseous and just doesn’t
want to move. This morning when she tried to get out of bed she felt like she
was pushed back down. The vertigo is reproducible with cervical rotation. The
patient denies any hearing loss or tinnitus, she has no fever or other
symptoms. The AGACNP knows that the most helpful intervention will probably be:
A. Meclizine
B. Diazepam
C. Bed rest
D. Epley’s
maneuvers
1 points
NURS 6550 FINAL EXAM – WALDEN UNIVERSITY Walden nurs6550 final exam 2019 QUESTION 5
1. Mrs. Mireya is an 85-year-old female who is admitted for evaluation of acute mental
status change from the long term care facility. She is normally ambulatory and
participates in lots of facility activities. Today a nursing assistant found
her in her room, appearing confused and disconnected from her environment. When
she tried to get up she fell down. Her vital signs are stable excepting a blood
pressure of 90/60 mm Hg. The AGACNP knows that the most likely cause of her
symptoms is:
A. Osteoarthritis
B. Drug or alcohol toxicity
C. Hypotension
D. Urosepsis
1 points
NURS 6550 FINAL EXAM – WALDEN UNIVERSITY Walden nurs6550 final exam 2019 QUESTION 6
1. A patient
with SIADH would be expected to demonstrate which pattern of laboratory
abnormalities?
A. Serum Na+
119 mEq/L, serum osmolality 240 mEq/L, urine Na+ of 28 mEq/L, urine osmolality
of 900 mOsm/kg
B. Serum Na+
152 mEq/L, serum osmolality 315 mEq/L, urine Na+ of 5 mEq/L, urine osmolality
of 300 mOsm/kg
C. Serum Na+
121 mEq/L, serum osmolality 290 mEq/L, urine Na+ of 7 mEq/L, urine osmolality
of 850 mOsm/kg
D. Serum Na+
158 mEq/L, serum osmolality 251 mEq/L, urine Na+ of 20 mEq/L, urine osmolality
of 420 mOsm/kg
1 points
QUESTION 7
1. Sean is a
29-year-old male who presents to the emergency department for evaluation and
treatment of foreign body in the eye. Ophthalmic anesthesia is achieved and removal
is attempted unsuccessfully with a moist cotton tipped swab. A wet fluorescein
stain is applied to the lower eyelid, and a corneal abrasion ruled out but the
AGACNP notes a positive Seidel sign. This indicates:
A. Penetration
of the cornea with resultant aqueous leak
B. A rust
ring remnant due to metal foreign body
C. An
elevated intraocular pressure
D. Paradoxical
pupil dilation in response to light
1 points
NURS 6550 FINAL EXAM – WALDEN UNIVERSITY Walden nurs6550 final exam 2019 QUESTION 8
1. Mrs. Lowen is an 82-year-old female who comes to the emergency department for
evaluation of a fever of 102.9° F. She complains of a headache in the right
side of her temple and some right-sided jaw pain. A urinalysis, chest
radiograph, complete blood count (CBC) and 12-lead ECG are all
non-contributory. A comprehensive metabolic panel is significant only for a
slightly elevated BUN and creatinine. The AGACNP appreciates distinct right
temple tenderness to percussion. Which laboratory test is necessary to support
the suspected diagnosis?
A. An erythrocyte sedimentation rate
B. A white blood cell differential
C. Two sets of blood cultures
D. Echocardiography
1 points
QUESTION 9
1. Ms. Schiebel, a 31-year-old female who is brought to the emergency department by
police after being arrested for disruptive behavior in a public establishment.
The differential diagnosis includes drug and alcohol ingestion/toxicity,
central nervous system disease, severe trauma, and psychotic illness;
ultimately the alcohol and toxicology screen as well as head imaging are
negative. When considering psychotic illness, the AGACP knows that this is a
physiologic imbalance that typically involves an excess of:
A. Serotonin
B. Norepinephrine
C. Acetylcholine
D. Dopamine
1 points
NURS 6550 FINAL EXAM – WALDEN UNIVERSITY Walden nurs6550 final exam 2019 QUESTION 10
1. Mr.
Lincoln is a 55-year-old male who was admitted for management of sepsis
secondary to pneumonia. He has declined rapidly, and today chest radiography
demonstrates a diffuse, bilateral “white-out” appearance. His paO2 is 55 mm Hg.
In order to increase his oxygenation the AGACNP knows that which of the
following interventions is indicated?
A. Increased
FiO2
B. Increased
respiratory rate
C. Increased
tidal volume
D. Increased
PEEP
1 points
QUESTION 11
1. A
29-year-old female patient presents with a complaint of palpitations. Physical
examination reveals an essentially healthy female with no significant medical
history and no maintenance medications; the only thing she can report is that
she had a head cold a week or so ago. The vital signs include a blood pressure
of 139/90 mm Hg, pulse of 105 b.p.m, respiratory rate of 16 b.p.m. and a
temperature of 98.6° F. The only abnormal finding on physical examination is
diffuse anterior neck tenderness with thyroid palpation. The AGACNP considers
which medication for symptom control?
A. Ibuprofen
B. Pseudoephedrine
C. Propranolol
D. Methimazole
1 points
NURS 6550 FINAL EXAM – WALDEN UNIVERSITY Walden nurs6550 final exam 2019 QUESTION 12
1. Jennifer
is an 18-year-old homeless female who was found unresponsive. She was admitted
to the hospital for management of severe bleeding after a spontaneous abortion
escalated to a uterine hemorrhage. An underlying infection and dehydration were
corrected and nutritional supplements were started. Her volume status is
stable, morning labs were all within normal limits and she is to be discharged
today. When the AGACNP enters the room to prepare the patient for discharge,
she finds her agitated, pale, and diaphoretic with vital signs to include a
pulse of 105 bpm, respirations of 24 bpm, blood pressure of 110/76 mm Hg and a
temperature is 97.9° F. The most appropriate action would be to:
A. Order a
CBC to assess for recurrent bleeding
B. Request
and abdominal CT to assess for bleeding
C. Evaluate
the patient for anxiety/panic attack
D. Prescribe
alprazolam 1 mg now
1 points
NURS 6550 FINAL EXAM – WALDEN UNIVERSITY Walden nurs6550 final exam 2019 QUESTION 13
1. Physical
examination findings in a patient with pneumothorax is likely to reveal:
A. Increased
tactile fremitus
B. Low grade
temperature
C. Hyperresonance
to percussion
D. Egophany
1 points
NURS 6550 FINAL EXAM – WALDEN UNIVERSITY Walden nurs6550 final exam 2019 QUESTION 14
1. Mr.
Parker brings his 73-year-old wife to a clinic appointment because he is
worried about her. She has a long history of hypertension and dyslipidemia, but
he says she has taken medication for years and everything has been OK. His
concern today is that for a long time she has been very forgetful, and he has
tried to help her by keeping a strict routine around the house. Over the past
few months, she just seems more and more forgetful, does not seem interested in
doing anything, and now seems to be forgetting how to do simple everyday tasks.
Yesterday she could not figure out which dollar bills to use at the store to
pay the cashier. The AGACNP knows Mrs. Parker should first be screened for:
A. Depression
B. A brain
tumor
C. Hypothyroidism
D. Adrenal
dysfunction
1 points
NURS 6550 FINAL EXAM – WALDEN UNIVERSITY Walden nurs6550 final exam 2019 QUESTION 15
1. M.R. is a
40-year-old female who has a known history of peptic ulcer disease. She has
been admitted through the emergency room with a diagnosis of GI bleeding—she is
vomiting dark blood and had a nasogastric tube placed. When attached to low
intermittent suction it initially drained 400 cc of dark brown/black drainage,
but now it is starting to drain lighter red colored blood. The AGACNP knows
that immediate priorities of care include:
A. Ensuring
hemodynamic stability
B. Beginning
a parenteral proton pump inhibitor
C. Beginning
gastric lavage
D. Ordering
a gastrointestinal consult
1 points
QUESTION 29
1. C.L. is a
48-year-old female who presents complaining of activity intolerance. She is
usually very active and fit^. She jogs regularly and typically does 4-5 miles a
day. About a week ago she became so tired she had to stop, and lately she has
become aware of becoming easily fatigued while going up and down stairs. She
admits that she thinks she is beginning menopause—she is having a lot of
bleeding with her periods, and her periods seem to be more frequent. A complete
blood count (CBC) reveals the following results:
Hgb 10.1 g/dL
Hct 30%
MCV 75 fL
RDW 21%
The AGACNP orders which of the following laboratory test to
confirm the suspected diagnosis?
A. Vitamin
B12
B. Folate
C. Ferritin
D. Hemoglobin
electrophoresis
1 points
NURS 6550 FINAL EXAM – WALDEN UNIVERSITY Walden nurs6550 final exam 2019 QUESTION 30
1. Kevin H.
is a 61-year-old male who presents for treatment of profound anxiety. He has
been treated on and off for years—most recently he was taking escitalopram 20
mg p.o. daily, and although he does admit to some improvement, he still cannot
function appropriately thoughout the day. He has been counseled about poor work
performance and is concerned about losing his job, but he is just so worried
all of the time he cannot concentrate on work. The AGACNP knows that the most
appropriate action is to:
A. Increase
the dose of escitalopram to 40 mg daily
B. Refer
Kevin for a psychiatric consultation
C. Stop
escitalopram and begin venlafaxine
D. Discuss
therapeutic expectations with Kevin
1 points
QUESTION 31
1. When
examining a patient with a skin presentation suggestive of necrotizing
fasciitis, the AGACNP knows that the most important and sensitive diagnostic
test is:
A. A
complete blood count
B. Plain
film radiographs
C. The
finger test
D. CT scan
1 points
NURS 6550 FINAL EXAM – WALDEN UNIVERSITY Walden nurs6550 final exam 2019 QUESTION 32
1. While
evaluating a patient with abdominal pain, the AGACP knows that when the pain is
described as coming in waves or cycles, with periods of relief in between, the
cause likely centers around:
A. Peristalsis
of bowel
B. Disorders
of pelvic organs
C. Organ
inflammation
D. Hyperacidity
1 points
QUESTION 33
1. Which of
the following findings is not typically associated with testicular torsion?
A. Acute
pain
B. Edema
C. High
riding testis
D. Dysuria
1 points
NURS 6550 FINAL EXAM – WALDEN UNIVERSITY Walden nurs6550 final exam 2019 QUESTION 34
1. 152: When
completing this exam, did you comply with Walden University’s Code of Conduct
including the expectations for academic integrity?
Yes
No
1 points
QUESTION 35
1. While
preparing to perform an incision and drainage on a 7 cm fluctuant abscess on a
patients posterior thorax, the AGACNP knows that the most important part of the
procedure is:
A. Immediate
coverage with antistaphylococcal antibiotics
B. Maintaining
sterility with topical betadine and drapes
C. Breaking
up loculations and aggressive irrigation
D. Proper
injection of local anesthetic
1 points
NURS 6550 FINAL EXAM – WALDEN UNIVERSITY Walden nurs6550 final exam 2019 QUESTION 36
1. A patient
is being evaluated with significant nausea, fatigue, and a general sense of feeling
unwell; mild jaundice is noted on physical examination. Transaminases are
markedly elevated and a hepatitis screening is done. Results are as follows:
+ HbsAb
+ anti-HAV IgM
– anti-HCV
The correct interpretation of these findings is:
A. The patient
has acute hepatitis A
B. The
patient has acute hepatitis B
C. The
patient has chronic hepatitis B
D. The
patient has acute hepatitis C
1 points
NURS 6550 FINAL EXAM – WALDEN UNIVERSITY Walden nurs6550 final exam 2019 QUESTION 37
1. When
treating a patient with an unknown overdose or toxicity, the AGACNP knows that all
of the following should be administered except:
A. Dextrose
50%
B. Thiamine
100 mg
C. Nalaxone
0.4 mg
D. Ativan 4
mg
1 points
QUESTION 38
1. The
AGACNP is evaluating 29-year-old female who presents by ambulance and is
unresponsive. There is no witness and no history available; the patient is not
wearing any sort of medic alert bracelet. While assessing for toxicity or
overdose, the patient is found to have vital signs as follows: Temp of 96.2° F,
pulse of 48 b.p.m., respirations of 10 b.p.m., and blood pressure of 84/50 mm
Hg. The patient’s pupils are constricted, but do react briskly to light to 1
mm. The AGACNP suspects which type of substance?
A. Cholinesterase
inhibiting drugs
B. Stimulants
such as MDMA
C. Anticholinergics
D. Ethanol
or opiates
1 points
NURS 6550 FINAL EXAM – WALDEN UNIVERSITY Walden nurs6550 final exam 2019 QUESTION 39
1. The
AGACNP knows that the one class of pain medication that is effective to some
extent for all forms of pain is:
A. NSAIDs
B. Antidepressants
C. Antiepileptics
D. Opiates
1 points
QUESTION 40
1. K.P. is a
76-year-old male admitted for antibiotic management of urosepsis. His medical
history is significant for a CVA with resultant right-sided hemiparesis. He is
nonverbal, maintained on enteral nutritional support and has an indwelling
Foley catheter. The AGACNP knows that which of the following bacteria is the
primary treatment target for this patient’s urosepsis?
A. Proteus
mirabilis
B. Pseudomonas
aeruginosa
C. Staphylococcus
aureus
D. Streptococcus
pneumoniae
1 points
NURS 6550 FINAL EXAM – WALDEN UNIVERSITY Walden nurs6550 final exam 2019 QUESTION 41
1. A patient
is admitted for a COPD exacerbation and placed on mechanical ventilation. His
settings are as follows: FiO2 of 40%, TV of 700mL, SIMV of 12. His morning ABG
reveals a pH of 7.37, paCO2 of 51 mm Hg, paO2 of 84 mm Hg and HCO3 of 30 mm Hg.
The AGACNP knows that the appropriate response is to:
A. Leave the
ventilator settings as is
B. Increase
the SIMV to 16 b.p.m.
C. Increase
the FiO2 to 50%
D. Repeat
the ABG in one hour
1 points
NURS 6550 FINAL EXAM – WALDEN UNIVERSITY Walden nurs6550 final exam 2019 QUESTION 42
1. All of
the following are required for a diagnosis of systemic inflammatory response
syndrome (SIRS) except:
A. White
blood cell count < 4000 or > 12,000 cells/uL
B. Heart
rate > 90 b.p.m.
C. Respiratory
rate > 20 b.p.m. or paCO2 < 32 mm Hg
D. Two sets
of positive blood cultures
1 points
QUESTION 43
1. J.T. is a
41-year-old female patient who presents with a chief complaint of “heartburn.”
She says that it doesn’t really seem to be related to meals or food—it occurs
at random times. She does note, when asked, that it seems to happen a lot at
night and occasionally wakes her up. Her only other symptom complaint is an
occasional cough. It does not produce mucus, and she admits to assuming it was
a “nervous” cough. The next appropriate action for the AGACNP would be to:
A. Order an
H. pylori test
B. Request a
GI consult for endoscopy
C. Order a
proton pump inhibitor 30 minutes before breakfast
D. Request a
72-hour diet history
1 points
NURS 6550 FINAL EXAM – WALDEN UNIVERSITY Walden nurs6550 final exam 2019 QUESTION 44
1. Your
patient has diabetes insipidus (DI). Anticipated physical assessment findings include:
A. Dry skin,
tachycardia, hypertension
B. Weak
pulse, dry skin, decreased skin turgor
C. Thin
hair, thready pulse, dry mucous membranes
D. Hypothermia,
jugular venous distention, bradycardia
1 points
NURS 6550 FINAL EXAM – WALDEN UNIVERSITY Walden nurs6550 final exam 2019 QUESTION 45
1. The
AGACNP is beginning medical management of a patient newly diagnosed with T2DM.
The patient has a BMI of 39 and has been unsuccessful in making significant
diet and lifestyle changes over the last six months. Other than her weight, her
physical examination is essentially within normal limits. Her HgbA1c is 9.5%. A
basic metabolic panel is within normal limits. The medication of choice to
begin therapy will be:
A. A
sulfonyurea
B. A
meglitinide
C. A
biguanide
D. An
incretin mimetic
1 points
NURS 6550 FINAL EXAM – WALDEN UNIVERSITY Walden nurs6550 final exam 2019 QUESTION 46
1. Felty’s
syndrome is a condition of immune neutropenia seen sometimes in patients with:
A. Polymyalgia
rheumatica
B. Giant
cell arteritis
C. Systemic
lupus erythematosus
D. Rheumatoid
arthritis
1 points
QUESTION 47
1. When
treating a patient for the profound cough of acute bronchitis, the AGACNP knows
that the most appropriate pharmacotherapy consists of:
A. An opiate
based cough suppressant
B. Oral
prednisone
C. A first
generation-antihistamine combination
D. An
inhaled anticholinergic
1 points
NURS 6550 FINAL EXAM – WALDEN UNIVERSITY Walden nurs6550 final exam 2019 QUESTION 48
1. Mr.
Truman is transferred to the emergency department by ambulance. His wife called
911 this morning because he was acting “funny” when he woke up. Both the
patient and his wife went to bed last night at approximately 10:30 and
everything was normal. This morning he could not communicate orally and seemed
confused about how to ambulate. Upon arrival to the emergency department his
vital signs are as follows: Temperature 100.9° F, pulse 89 b.p.m., respirations
14 b.p.m. and blood pressure 168/94 mm Hg. A non-contrast CT scan of the head
reveals thrombotic CVA. The AGACNP know that immediate management of this
patient should include:
A. Thrombolytics
B. IV
vasodilators
C. Aspirin
D. Antiepileptics
1 points
QUESTION 49
1. Your
patient is complaining of profound nausea and vomiting that started at bedtime
last night and kept him awake all night long. Early this morning he started
having abdominal cramping and explosive diarrhea. Based upon the character of
symptoms you are suspicious of infection with Staphylococcus aureus. To assess
risk for exposure to this organism, you ask the patient about which meal?
A. Breakfast
yesterday
B. Lunch
yesterday
C. Dinner
yesterday
D. Bedtime
snack yesterday
1 points
NURS 6550 FINAL EXAM – WALDEN UNIVERSITY Walden nurs6550 final exam 2019 QUESTION 50
1. D.R. is a
54-year-old male patient who was admitted for the management of cellulitis and
treated with parenteral antibiotics. He has not been responding as well as
anticipated. During today’s exam the AGACNP appreciates a couple of changes.
All of the following indicate the need for immediate surgical evaluation
except:
A. Skin
anesthesia
B. Violaceous
bullae
C. Gas
bubbles in tissue
D. Lymphangetic
spread
1 points
QUESTION 51
1. R. O. is
a 21-year-old female who comes to the emergency department because of a severe
headache. Her vital signs and neurological examination are within normal
limits. She complains of a pulse-like pain in her right temple and admits that
she has almost vomited. Her mother gets the same type of headache and the last
time this happened R.O. took one of her mother’s prescription headache pills.
They helped a lot, but this time her mother told her she had to come be
evaluated. The AGACNP knows that which of the following is the appropriate
action?
A. A
non-contrast CT scan of the head
B. Administration
of a 5HT agonist
C. Dilaudid
2 mg IM x 1 dose
D. Requesting
a headache diary
1 points
QUESTION 52
1. A
39-year-old female presents for evaluation of a rash. She denies any
significant medical history, and has no other complaints. The rash appeared
suddenly on both forearms approximately one week ago, and she is concerned
because it is not going away. It does not itch or hurt—it is just there. Physical
examination reveals a diffuse macular hypopigmentation on both forearms that
extends to the hands. The patient denies any drug or alcohol use; she is single
and has had 4 unprotected sexual partners in the last year. The AGACNP knows
that initial laboratory testing must include a(n):
A. FTA-Abs
B. Fungal
skin scraping
C. RPR
screening
D. CBC
1 points
NURS 6550 FINAL EXAM – WALDEN UNIVERSITY Walden nurs6550 final exam 2019 QUESTION 53
1. J.S. is a
African-American female who presents for a wellness examination. Her medical
history is significant for beta thalassemia minor. Anticipated red blood cell
differential would include which of the following patterns?
A. Hgb 10.2
g/dL, Hct 30%, MCV 70 fL, RDW 12.6%
B. Hgb 9.9
g/dL, Hct 28%, MCV 83 fL, RDW 13.9%
C. Hgb 11.5
g/dL, Hct 35%, MCV 94 fL, RDW 15.8%
D. Hgb 12.8
g/dL, Hct 38%, MCV 105 fL, RDW 18.1%
1 points
QUESTION 54
1. M.T.
presents complaining of acute pain in his left eye, nausea, and one episode of
vomiting. He denies any significant medical problems, and says that the only
medication that he takes is an occasional over-the-counter sleeping pill.
Physical examination reveals a steamy red cornea and conjunctiva with a pupil that
is 5 mm and not reactive to light. The AGACNP knows that diagnostic testing
should include:
A. A CT scan
of the head
B. An MRI of
the orbit
C. A
toxicology screen
D. A
measurement of intraocular pressure
1 points
NURS 6550 FINAL EXAM – WALDEN UNIVERSITY Walden nurs6550 final exam 2019 QUESTION 55
1. Justin is
a 23-year-old male who is being managed for an acute manic episode. Justin was
diagnosed with bipolar disorder several years ago, but his home life has been
unstable and he has not been very adherent to a medication regimen. Most
recently he was started on the SNRI venlafaxine by his primary care provider,
which he has been taking as prescribed for about 6 weeks, but he began a manic
episode a few days ago which peaked this evening. The AGACNP considers that:
A. The manic
episode is probably a result of medication instability and he should continue
his current regimen with a follow-up in 6-8 weeks
B. A mood
stabilizing agent should be added to the venlafaxine
C. All
medication should be held for 6-8 weeks and the then the patient should be
reevaluated
D. The SNRI
should be stopped and a mood stabilizing agent started
1 points
NURS 6550 FINAL EXAM – WALDEN UNIVERSITY Walden nurs6550 final exam 2019 QUESTION 56
1. Mr.
Livingston is a 79-year-old male who presents from a long term care facility
with a change in mental status. His medical history is significant for T2DM,
CAD, CHF, hypothyroidism, Alzheimer’s dementia and osteoarthritis. He has been
stable, but over the last few days the staff say he has been a bit
disconnected. This morning he was found in his bed in a stuporous state. His
vital signs include a temperture of 98.9° F, pulse of 103 b.p.m., respiratory
rate of 20 b.p.m., and a blood pressure of 92/64 mm Hg. His metabolic panel
demonstrates a Na+ of 129 mEq/L, K+ of 3.3 mEq/L, Cl- of 100 mEq/L, CO2 of 24
mEq/L, glucose of 644 mg/dL, BUN of 51 mg/dL and creatinine of 1.9 mg/dL. The
AGACNP knows that the primary problem is most likely:
A. Diabetic
ketoacidosis
B. Hypertonic
hyponatremia
C. Myxedema
coma
D. Hyperosmolar
hyperglycemic coma
1 points
NURS 6550 FINAL EXAM – WALDEN UNIVERSITY Walden nurs6550 final exam 2019 QUESTION 57
1. The
AGACNP is evaluating a patient with systemic lupus erythematosis who complains
of fatigue. Based upon his knowledge of the most commonly affected visceral
organ, which of the following diagnostic studies should be ordered?
A. Echocardiogram
B. Chest
radiography
C. Hepatic
function enzymes
D. Urinalysis
with microscopic
1 points
QUESTION 58
1. All of
the following are true statements about post-traumatic stress disorders (PTSD)
except:
A. It is
more common in women than men
B. It is
unlikely to occur in children especially < 10 years old
C. It is
differentiated from acute stress reaction by time
D. It is not
likely in persons with no preexisting psychiatric disease
1 points
QUESTION 59
1. Ray M., a
49-year-old male, walks into the emergency room complaining of back pain. He
has never had this problem before and cannot identify any injury, but he is in
such severe pain he is sure something is wrong. He states that his back has
been hurting so badly sometimes he has to stop whatever he is doing and bend
forward at the waist. The pain also travels along the outer edge of his left
thigh to mid-calf, and he reports a small area of numbness on his anterior
thigh. His history and physical examination are otherwise negative. He is an
insurance attorney and is not especially active at work, but goes to the gym 5
days a week. He is not overweight, and his vital signs are normal. Physical
examination reveals no paraspinal tenderness, and his straight leg raise is
negative. A few times during the exam he lay back on the table and grabbed his
left leg, flexed both hip, and pulled his knee to his chest, because it helped
the pain. The AGACNP knows that immediate pain relief measures must include:
A. An opiate
analgesic
B. Systemic
steroids
C. Physical
therapy
D. Bedrest
for 72 hours
1 points
QUESTION 60
1. A patient
with peptic ulcer disease is admitted to the hospital with significant upper
abdominal discomfort. She has guarding and rebound tenderness on examination.
Abdominal radiography demonstrates free air in the abdomen. The AGACNP knows
that the immediate priority is to:
A. Obtain a
stat surgical consult
B. Begin an
IV proton pump inhibitor
C. Order an
abdominal CT scan
D. Obtain a
stat gastroenterology consult
1 points
QUESTION 61
1. Jennifer
is a 15-year-old female who attempted suicide by taking a bottle of
acetaminophen. She took 30, 500 mg tablets approximately six hours ago, but
then became frightened and told her mother what she did. Her mother said that
Jennifer seems OK, other than being a little sick to her stomach, she has no
complaints. The AGACNP knows that the first step in her care includes:
A. N-acetycysteine
in tapering doses over the next 24 hours
B. Oral
administration of activated charcoal
C. Psychiatric
assessment
D. Discharge
to home with follow-up LFTs in 4 days
1 points
QUESTION 62
1. Mrs.
Glassman is a 55-year-old female who presents with a chief complaint of fever.
Her vital signs reveal a temperature of 100.0° F, blood pressure of 100/60 mm
Hg, pulse of 114 b.p.m. and respirations of 20 b.p.m. Her cardiac auscultation
reveals a grade III/VI systolic murmur at the left lower sternal border. Her
history is significant for an eyebrow lift 4 months ago. The AGACNP orders
which test to confirm the suspected diagnosis?
A. Three
sets of blood cultures
B. A chest
radiograph
C. A 12-lead
ECG
D. Induced
sputum culture
1 points
QUESTION 63
1. John is a
17-year-old male who is in the emergency department with abdominal pain. He is
quite uncomfortable and says that it started yesterday and seemed to be “in the
middle of his stomach” but today it has moved over to the right lower side.
During physical examination the abdomen is not distended, but he is guarded,
and right lower quadrant palpation produces significant discomfort, especially
upon release of the palpating hand. He has appreciable pain when his right knee
and hip are bent to a 90° angle. John admits to some nausea but has not
vomited; he has not had a normal bowel movement in two days. His vital signs
are as follows: Temperature 100.9° F, pulse 110 b.p.m. respiratory rate 22
b.p.m., and blood pressure 118/77 mm Hg. The AGACNP orders which of the
following tests to confirm the suspected diagnosis?
A. Complete
blood count
B. Ultrasound
C. CT scan
D. Urinalysis
1 points
QUESTION 64
1. Which of
the following signs is expected in patients with cholecystitis?
A. McBurney’s
B. Cullen’s
C. Spurling’s
D. Murphy’s
1 points
QUESTION 65
1. According
to the World Health Organization’s step-wise approach to pain management,
initial approaches to step 2 might include all of the following except:
A. A weak
opiate
B. A strong
opiate
C. A
non-steroidal antiinflammatory agent
D. An antidepressant.
1 points
QUESTION 66
1. A
patient’s Weber test lateralizes to the right ear and the Rinne test in both
ears is normal. The patient has a:
A. Sensorineural
hearing loss in the left ear
B. Sensorineural
hearing loss in the right ear
C. Conductive
hearing loss in the left ear
D. Conductive
hearing loss in the right ear
1 points
QUESTION 67
1. J.B. is a
62-year-old male who was admitted three days ago for management of
diverticulitis. Today the AGACNP is called to the bedside to evaluate new onset
swelling of the right lower extremity. According to the staff nurse it was not
present yesterday but on today’s assessment the patient had 2A+ edema up to the
thigh. Initial diagnostic evaluation should include:
A. Homan’s
sign
B. A venogram
C. A D-dimer
D. CT of the
chest
1 points
QUESTION 77
1. A
30-year-old male patient presents for evaluation of a lump on his neck. He
denies pain, itch, erythema, edema, or any other symptoms. He is concerned
because it won’t go away. He says, “I noticed it a few months ago, then it
seemed to disappear, and now it is back.” The AGACNP proceeds with a history
and physical exam and concludes which of the following as the leading
differential diagnosis?
A. Subclinical
infection
B. Non-Hodgkin’s
lymphoma
C. Catscratch
disease
D. Syphilis
1 points
QUESTION 78
1. Ms.
Teller presents with a chief complaint of weight loss. She reports an unplanned
10 lb weight loss over the last 5-6 months. She has no significant medical
history, but review of systems reveals bilateral shoulder discomfort and some
impaired range of motion—she has trouble pulling clothing over her head. Over
the last few months she has generalized upper body stiffness, but seems to get
better after an hour or so of activity. When considering a diagnosis of
polymyalgia rheumatica, laboratory assessment may be expected to reveal:
A. An
erythrocyte sedimentation rate (ESR) of 75 mm/hr
B. A
microcytic, hypochromic anemia
C. Elevated
liver function enzymes
D. Positive
antinuclear antibodies
1 points
QUESTION 79
1. When a
patient has lower abdominal discomfort, cervical wall motion tenderness, and
adnexal tenderness, the AGACNP knows that this will likely be treated with:
A. Ceftriaxone
and azithromycin
B. Metronidazole
and ciprofloxacin
C. Trimethoprim/sulfamethoxazole
D. IV fluid
and pain control
1 points
QUESTION 80
1. J.L. is
an 81-year-old female who is admitted from home after her daughter found her
confused and unkempt. She is not a good historian, and her daughter cannot
provide any information—when she saw her mother a week ago, she was fine.
J.L.’s vital signs are as follows: Temperature 101.4° F, pulse 99 b.p.m.,
respirations 22 b.p.m., and blood pressure 90/58 mm Hg. Her urinalysis is shows
+++ leukocytes, + RBC, and + nitrites. Her metabolic panel reveals a BUN of 39
mg/dL and creatinine of 1.5 mg/dL. The AGACNP knows that J.L has findings
consistent with:
A. Pre-renal
failure
B. Intra-renal
failure
C. Post-renal
failure
D. Chronic
renal failure
1 points
QUESTION 81
1. Patients
with giant cell arteritis are at increased risk of:
A. Cerebrovascular
accident
B. Rheumatoid
arthritis
C. Polymyalgia
rheumatica
D. Osteoarthritis
1 points
QUESTION 82
1. The
AGACNP is called to the bedside for a patient who is in cardiopulmonary arrest.
The monitor demonstrates ventricular fibrillation which will not convert
despite several attempts to defibrillate at maximal voltage. While being
briefed by the staff nurse on the patient medical history, he learns that the
patient has a history of Cushing’s syndrome. The AGACNP recognizes that the
patient is probably failing to convert due to:
A. Advanced
atherosclerotic disease
B. Hypokalemia
C. Hypocalcemia
D. Catecholamine
excess
1 points
QUESTION 83
1. When
performing an evaluation of a patient following seizure activity, the AGACNP
knows that the most important component of that evaluation is:
A. A CT scan
of the head
B. Eyewitness
description
C. An EEG
D. Administering
a benzodiazepine
1 points
QUESTION 84
1. Which of
the following etiologic organisms is most likely to appear as lobar
consolidation on chest radiography?
A. Legionella
pneumophilia
B. Streptococcus
pneumoniae
C. Pneumocystis
carinii
D. Mycoplasma
pneumoniae
1 points
QUESTION 85
1. A patient
with chronic kidney disease presents with an eGFR of 30 mL/min/1.73m2. The
AGACNP knows that the most compelling implication of this value is:
A. Control
of risk factors for renal deterioration
B. Careful
attention to renal dosing of medications
C. Referring
the patient for shunt placement
D. Preventing
occurrence of renal ischemia
1 points
QUESTION 86
1. Differential
diagnosis of hematuria include all of the following except:
A. Bladder
cancer
B. Nephrolithiasis
in the renal parenchyma
C. Urinary
tract infection
D. Prerenal
azotemia
1 points
QUESTION 87
1. A
29-year-old male patient presents with acute scrotal pain and dysuria. He has a
temperature of 101.8° F and a pulse of 115 b.p.m. but otherwise vital signs are
within normal limits. He gets some relief of the scrotal discomfort when his
scrotum is elevated on a rolled towel. This is known as:
A. Varicocele
B. Prehn’s
sign
C. Cremasteric
sign
D. Testicular
torsion
1 points
QUESTION 88
1. The
AGACNP knows that patients with psoriasis are at greater risk for:
A. Arthritis
B. Eczema
C. Cellulitis
D. Melanoma
1 points
QUESTION 89
1. Mr.
McCarran is a 68-year-old male with a long history of poorly controlled T2DM.
He has had progressive burning pain in both feet for the last year or so, but
in the last few months it has become increasingly worse. He has tried taking
ibuprofen and naproxyn over-the-counter with no improvement. Now, he is
presenting for more effective pain management. The AGACNP knows that the
medication of choice will be from which drug class?
A. NSAIDs
B. Opiates
C. Antiepileptics
D. Anesthetics
1 points
QUESTION 90
1. Mr.
Starwood is a 61-year-old male who was admitted last night for the management
of acute pancreatitis. He was admitted n.p.o and started on intravenous fluid
and opiate pain management. This morning he reports feeling significantly
better. His C-reactive protein this a.m. is 5 mg/dL, amylase and lipase are
both just over 2 x upper limits of normal, and his Ransom score is 2. The
AGACNP knows that the next step in his care is to:
A. Begin
clear liquids as tolerated
B. Order an
abdominal CT
C. Order an
ERCP
D. Continue
the current management for 24 hours
1 points
QUESTION 91
1. When
beginning pharmacotherapy for depression, the AGACNP discusses with the patient
that a primary safety consideration includes the:
A. Increased
risk of suicide when patients begin antidepressant therapy
B. Potential
for sexual adverse effects
C. Better
likelihood of success when medications and therapy are used together
D. High
incidence of serotonin syndrome
1 points
QUESTION 92
1. When
ruling out meningitis in a patient, the AGACP appreciates that the spinal fluid
is cloudy and the glucose content is 20 cells/microliter. This is most
consistent with:
A. Aseptic
meningitis
B. Septic
meningitis
C. Chemical
meningitis
D. Chronic
meningitis
1 points
QUESTION 93
1. A
44-year-old male patient presents in a hypertensive crisis. The blood pressure
is 240/136 mm Hg, pulse is 128 b.p.m. and the patient is complaining of a
severe, pounding headache. His skin is diaphoretic and he is visibly tremulous.
The first diagnostic study to evaluate the suspected diagnosis should be a:
A. 24 hour
urine for catecholamine metabolites
B. Serum
epinephrine and metanephrines
C. T scan of
the abdomen
D. MRI of
the abdomen
1 points
QUESTION 94
1. An
unidentified patient is brought to the emergency department by ambulance after
being hit by a motor vehicle. She has multiple injuries and an estimated blood
loss of 2 liters. The hematocrit is 19%. The AGACNP expects that the mean cell
volume (MCV) would most likely be:
A. 70 fL
B. 80 fL
C. 90 fL
D. 110 fL
1 points
QUESTION 95
1. Mrs.
Oliver is a 71-year-old petite Caucasian female. During a routine dexa
screening she was found to have a T-score of -3.0. The AGACNP knows that the
first intervention should include:
A. Calcium
B. Vitamin D
C. Bisphosphonates
D. Estrogen
1 points
QUESTION 96
1. When
evaluating a family with suspected carbon monoxide exposure, the AGACNP knows
that assessment should include all of the following except:
A. Vital
signs
B. Pulse
oximetry
C. Cardiac
rhythm strip
D. Carboxyhemoglobin
level
1 points
QUESTION 97
1. Mr. Riley
is a 61-year-old male who just had bilateral knee replacements. There was more
fluid loss than intended during the procedure. The AGACNP knows that metabolic
alkalosis is the most common postoperative acid-base imbalance and is best
treated with:
A. Normal
saline infusion
B. An
insulin drip
C. Low
volume hydrochloric acid
D. Albumin
1 points
QUESTION 98
1. Patients
in advanced stages of chronic kidney disease are at greatest risk for which of
the following conditions?
A. Polycythemia
B. Hypokalemia
C. Metabolic
alkalosis
D. Anemia
1 points
QUESTION 99
1. The
diagnostic study of choice in mesenteric ischemia is:
A. Ultrasound
B. CT
angiography
C. MR
angiography
D. Diagnostic
peritoneal lavage
1 points
QUESTION 100
1. Mr.
Maxwell is a 58-year-old male who presents with left foot pain. Physical
examination reveals a foot that is normal in appearance with DP and PT pulses
that are barely audible by Doppler. The AGACNP has the patient cross the leg
with the left foot resting on the right knee; after 30 seconds that left foot
is briskly lowered to the floor. Instantly the left foot turns bright red. This
is known as:
A. Venous
insufficiency
B. Brawny
hyperpigmentation
C. Homan’s
sign
D. Dependent
rubor
1 points
QUESTION 101
1. 152: When
completing this exam, did you comply with Walden University’s Code of Conduct
including the expectations for academic integrity?
Yes
No

Walden_NURS6640_Final_Exam_July_2019.docx (66.74 KB)

Review Test Submission Week 11 Final Exam: Walden NURS6640 Final Exam Course NURS-6640 Psychotherapy Individual
Course NURS-6640 Psychotherapy Individual
• Question
1 A PMHNP is using Gestalt therapy to communicate with a 50-year-old patient who is going through a divorce.
As he is calmly sharing the details of his divorce, the PMHNP notices that Dave
is tapping his fingers on his legs. What is an appropriate response by the
PMHNP using the technique of focusing?
• Question
2
A
25-year-old female states, “I really need to lose weight. I know I’m the cause
of our problems, if I could just lose
weight he might be more attracted to me. Then we could start a family and we
would be happy. I’m sure of it, right, we would definitely be happy!” Which
statement shows the PMHNP’s ability to apply “summarizing”?
• Question
3
As part
of the PMHNP’s role in the clinic, the PMHNP oversees students that gain
clinical experience at the agency. The student is instructed to use the
supportive psychodynamic therapy approach with the patient. Which action made
by the student causes the PMHNP to intervene, after observing the student interacting
with the patient?
• Question
4
A PMHNP
is using motivational interviewing (MI) with a 50-year-old patient named Dave
to commit to a healthy drug-free lifestyle. By using “change talk,” the PMHNP
hopes to help the patient build self-esteem and hope.
True or false: If Dave is resisting change, the PMHNP should
challenge his resistance in order for MI to be successful.
• Question
5 The PMHNP is actively listening
to Ms. Thomas who is detoxing from alcohol. Ms. Thomas is currently discussing
with the PMHNP the reasons why she feels guilty about her drinking. Ms. Thomas
tearfully states, “I have driven my family and friends away with this terrible
habit. I have no one left. I had more than enough chances and now my children
won’t even talk to me.” Which of the following statements demonstrate a simple
reflection?
• Question
6 A PMHNP is using Gestalt
therapy to communicate with a 42-year-old patient who is upset with her mother.
She says, “I want to tell her how hurt I feel when she doesn’t call me, but I
don’t want to upset her.” What technique can the PMHNP use to help Sasha
express herself?
• Question
7 The PMHNP is meeting with an
older, female adult patient and her daughter. The patient has early onset
dementia. The daughter expresses concern, saying, “I don’t want you to just
stick my mother in a home and give her medicine. I’m worried that’s what people
are going to want to do.” What is the best response by the PMHNP to the
daughter?
• Question
8 The PMHNP meets with a
31-year-old woman who reports feeling as though she is “at her breaking point”
with work. The PMHNP learns that the woman works 12-hour days, including one
day on the weekend, because she is nervous about company layoffs. “I feel like
I need to work myself to death in order to prove that I am valuable to the
organization,” the woman says. Using the supportive psychodynamic therapy
approach, how does the PMHNP respond?
• Question
9 When preparing to terminate a
patient, what does the PMHNP do to organize thoughts about the patient’s progress
made during treatment?
• Question
10 Linda is a 65-year-old patient
who has completed initial treatment for alcohol addiction and anxiety problems.
She is motivated to continue her treatment gains and have a healthy lifestyle.
How would the PMHNP apply a mindfulness approach to this case?
• Question
11 The PMHNP is caring for a young
adult patient with whom the PMHNP decides to use a dynamic supportive therapy
approach in addition to pharmacological intervention. Which therapeutic action
will the PMHNP take to employ the strategy of holding and containing the
patient?
• Question
12 The PMHNP is caring for an adult
male patient whose wife left him several months ago. He recently learned that
his ex-wife is dating someone much younger. The man feels belittled, sad, and
lonely. He talks about trying to meet other women, but says, “I can’t compete
with the younger guys these days, with the cool clothes and the vegan diets.
I’m bald and overweight, and what woman is going to want to be with me?” How
does the PMHNP help raise the man’s self-esteem?
• Question
13 A 43-year-old single mother is
seeing the PMHNP at the request of her sister. “My sister thinks I need to come
here to talk about my feelings,” the patient reports. The PMHNP learns that the
patient has three children from three different men, but is unable to collect
appropriate child support payments from any of the biological fathers.
Additionally, the woman is barely able to afford her apartment or utilities
payments. What is the appropriate response from the PMHNP when using the
psychodynamic psychotherapy technique?
• Question
14 The PMHNP has been providing
interpersonal psychotherapy (IPT) for a patient who the PMHNP observes
implementing new ways of being, such as interacting more with peers and being
less isolated in social scenarios. The PMHNP understands that the patient is
approaching termination. How does the PMHNP address termination with this
patient?
• Question
15 A PMHNP has been treating a
14-year-old patient using interpersonal psychotherapy. The patient has been
depressed since the death of his grandmother. To help the patient recover, the
PMHNP has told the parents:
• Question
16 In the planning phase of change,
a 42-year-old male client who struggles with gambling discusses how he plans to
abstain from gambling. He tells the PMHNP, “I am no longer going to carry cash
to the casino because you can’t spend what you don’t have.” The PMHNP uses an
affirming communication skill when she states:
• Question
17 The PMHNP is assessing a patient
who has been receiving months of outpatient psychotherapy. According to the
PMHNP’s assessment, the patient is nearing the termination phase of their
therapeutic relationship because the patient’s symptoms have improved, and the
patient shows progress managing behaviors and decision-making abilities
according to the diagnosis. How does the PMHNP approach termination with this
patient?
• Question
18 The PMHNP is caring for a
patient who is histrionic. Using the supportive psychodynamic therapy model,
what is the best statement made by the PMHNP?
• Question
19 A cocaine-addicted female
patient is entering residential treatment for substance abuse. Using the 10
guiding principles of recovery, an appropriate step by the PMHNP is to
______________.
• Question
20 A PMHNP is assessing a
40-year-old patient named Sarah who has a severe cocaine addiction and mild
depression. Using the four-quadrant model, what would be the most appropriate setting
to help the patient?
• Question
21 A 21-year-old patient has been
having trouble adjusting to college life. She tells the PMHNP that she had five
alcoholic drinks at a party this past weekend. She also acknowledges that she
drank the same amount of alcohol at a party the previous month. Based on this
information, what would the PMHNP most likely recommend?
• Question
22 A PMHNP is using emotion-focused
therapy to help a 38-year-old patient who says, “I’ve been feeling angry
lately, but I’m not sure why.” The first attempt by the PMHNP is to say:
• Question
23 The PMHNP uses the Adult
Attachment Interview (AAI) with a male patient who reports having had a
difficult time being separated from his parents during his childhood. He
explains that going to school or visiting his relatives without his parents was
troublesome. The PMHNP characterizes the patient as unresolved/disorganized,
according to his outcomes on the AAI. What does the PMHNP anticipate from the
patient?
• Question
24 The PMHNP is interviewing a
patient who is in the process of successfully completing a substance abuse
program. During the interview, the patient states, “I wish I was strong enough
to keep the same friends I had before I came here for treatment. I’m really
afraid of being discharged because I’ll probably run into my old friends
again.” The PMHNP offers a complex reflection when she states the following:
• Question
25 A PMHNP is using interpersonal
psychotherapy with a 40-year-old patient having relationship problems with his
extended family. The patient shares that he has been using the strategies they
identified to reduce his distress, but they have not been helping. He is
frustrated and is considering stopping treatment. What would be an appropriate
step by the PMHNP?
• Question
26 An 8-year-old has been having
trouble making friends at school. His parents initiated treatment when he also
started acting out at home. Which is the most appropriate step that the PMHNP
takes during the assessment process when using an integrated approach?
• Question
27 The PMHNP is treating an older
adult patient who reports symptoms of late-life anxiety. What type of treatment(s)
will the PMHNP consider?
• Question
28 The PMHNP is assessing a patient
who requires cognitive behavioral therapy (CBT). Which of the following
statements made by the PMHNP approach the termination phase for this patient?
• Question
29 A patient’s depression is
affecting her relationship with her spouse. What might the PMHNP ask during the
initial sessions of interpersonal psychotherapy treatment?
• Question
30 A PMHNP is treating a
10-year-old boy who is exhibiting signs of aggression and attention problems.
What type of intervention will the PMHNP consider using a common elements
approach?
• Question
31 The PMHNP who practices
motivational interviewing understands its relationship to patient behaviors
and/or outcomes to mean which of the following?
• Question
32 A PMHNP is treating a
12-year-old girl who witnessed the physical abuse of her sibling. She has been
anxious and irritable since the experience. After speaking with the PMHNP, the
patient says she keeps having anxiety-causing thoughts about the experience.
Using the PRACTICE technique, which skill will best help the patient interrupt
these negative thoughts?
• Question
33 The PMHNP is working with a
patient who describes having a painful and traumatic childhood experience,
which causes her to have anxiety as an adult. When asked how she manages her
anxiety, the patient dismisses it and denies that it is a problem. Using the
supportive psychotherapy approach, the PMHNP will do which of the following
when assessing the patient’s ego strength?
• Question
34 The PMHNP uses therapeutic
communication skills while ensuring that the patient understands that he has
choices. The PMHNP comprehends and practices motivational interviewing. This is
best understood as which of the following?
• Question
35 While assessing a patient using
a humanistic-existential approach, a patient tells the PMHNP, “For the past few
weeks, I’ve felt anxious almost every single day.” What would be an appropriate
next step by the PMHNP?
• Question
36 The PMHNP is meeting with a
patient who has been diagnosed with depression. The patient is having trouble
adjusting to her new job and hasn’t made any new friends there. What would an
appropriate response be by the PMHNP using the interpersonal psychotherapy approach?
• Question
37 A 38-year-old patient tells the
PMHNP that her father went to jail for selling drugs when she was a child. The
patient is visibly upset when discussing what happened. Using a
humanistic-existential approach to psychotherapy, which of the following is the
most appropriate response by the PMHNP?
• Question
38 The PMHNP is assessing an older
adult male patient with depression and comorbidities. According to the medical
chart, the patient takes medication to manage joint and bone pain. The patient
reports feeling “forgetful” and complains that he has a hard time remembering
where he puts things. What is the primary action by the PMHNP?
• Question
39 A 35-year-old male patient is
being treated for alcohol addiction. He asks for the PMHNP’s cell phone number
to use in case of an emergency. When the PMHNP responds that giving her number
would be against therapeutic rules, the patient threatens an act of violence to
the therapist. What would be the most appropriate response by the PMHNP?
• Question
40 The PMHNP is caring for a
geriatric patient who expresses symptoms of gastrointestinal problems, aches
and pains, and loss of appetite. The patient reports feeling lonely, as more of
his friends have been passing away over the recent months and years. The PMHNP
focuses on which therapeutic approach for this patient?
• Question
41 A 12-year-old girl was referred
for treatment after witnessing the physical abuse of her sibling by their
mother. The patient has been anxious and irritable since the experience. What
evidence-based treatment would be most appropriate for the PMHNP to use?
• Question
42 The PMHNP uses the cognitive
behavioral therapy model with Gerald, an older adult patient who is being
treated for depression and mood disorder. What will the PMHNP do with the
patient during the first three sessions?
• Question
43 The PMHNP is initiating a plan
of care for a patient who requires comprehensive psychotherapy to manage his
depression and mood disorder. Throughout the initial sessions, the patient
reports feeling as though he cannot be helped. The PMHNP is concerned about
premature termination initiated by the patient. What strategy can the PMHNP
employ to prevent or reduce premature termination?
• Question
44 How does the PMHNP approach
termination with the patient who has been receiving intermittent therapy?
• Question
45 A PMHNP is treating a
25-year-old patient who has a compulsive urge to exercise to excess. When asked
to describe why she does so much exercise, she says, “I like the compliments I
receive from others on my new level of fitness, and the excitement of getting
more attention.” The PMHNP can use feeling-state therapy to help Monique
___________.
• Question
46 A 19-year-old female patient
named Anna, who was the victim of child abuse and neglect, is also in treatment
for substance abuse. At her most recent appointment, Anna confesses to the
PMHNP that she is having romantic fantasies about him, and explains the he is
one of the few people she trusts. She believes that he is interested in her as
well. What is the most appropriate response by the PMHNP in this situation?
• Question
47 A 21-year-old patient is worried
about starting a new job. She talks about her fears of failure and not making
friends at the office. Using a person-centered approach, an appropriate
response by the PMHNP is to ______________.
• Question
48 The PMHNP initiates
feeling-state therapy to help a 25-year-old patient named Monique who has a
compulsive urge to exercise. Using the Feeling-State Addiction Protocol, what
is an appropriate next step the PMHNP should take after identifying the
specific positive feeling linked with the addictive behavior and its Positive
Feeling Score level?
• Question
49 The PMHNP is caring for an older
adult patient who presents with mixed dysphoric states and whose daughter
reports “is becoming more irritable more easily.” When talking with the
patient, the PMHNP also recognizes displays of cognitive dysfunction. Which
treatment options will the PMHNP most likely suggest?
• Question
50 Following an attempted suicide,
Mr. Durham was admitted to an acute psychiatric facility. After 4 weeks in
treatment, he is preparing for discharge. He is beginning to miss individual
and group therapy sessions and has refused medications twice in the past 2
days. The PMHNP demonstrates understanding in this phase by saying which of the
following statements?
• Question
51 The PMHNP assesses a 27-year-old
patient named Jeff, who was a victim of child abuse and neglect. Jeff says that
he remembers a traumatic situation that he wants to share, but is having
trouble talking about it. Which statement made by the PMHNP demonstrates the
use of emotion-focused therapy?
• Question
52 The PMHNP has been providing
supportive psychodynamic psychotherapy to a patient and is nearing the
termination stage. The PMHNP will use which criteria for determining that the
patient is ready for termination?
• Question
53 The PMHNP has been treating a
patient who is now being transferred to another provider. What is the appropriate
action made by the PMHNP?
• Question
54 A PMHNP has been treating a
9-year-old patient who was referred by her school. Students are asked to raise
their hands before speaking during group discussion, but the patient seems to
blurt out what she wants to say without being called on. She also interrupts
other children while they are talking instead of waiting her turn. When the
patient gets frustrated, she has trouble controlling her emotions and cries
often. Based on the initial information provided, the first focus by PMHNP is
the child’s ____________.
• Question
55 When completing this exam, did
you comply with Walden University’s Code of Conduct including the expectations
for academic integrity?
• Question
56 A 38-year-old patient has been
having trouble communicating with his teenage daughter. Using a
solution-focused therapy approach, the PMHNP responds by saying, “When was a
time that a communication problem could have occurred, but did not?” In this
case, what type of question is the PMHNP asking?
• Question
57 A patient is finishing the
active treatment phase of interpersonal psychotherapy (IPT). After the PMHNP
reminds the patient that she has three sessions left, the patient says nothing,
but looks distressed. What would be the best reply by the PMHNP following IPT
protocol?
• Question
58 The PMHNP is in the process of
terminating treatment with a patient who witnessed the death of her parent who
used to sexually abuse her. What does the PMHNP understand about terminating
this patient?
• Question
59 The PMHNP is caring for an older
patient with major depressive disorder, seasonal pattern. The patient has been
resolute about not taking medication to manage the depression brought on by his
illness, stating that it is against his yogic lifestyle. In addition to
psychotherapy, what can the PMHNP suggest to this patient?
• Question
60 The PMHNP is caring for an older
adult patient who is in the acute phase of schizophrenia. Which therapeutic
model will the PMHNP employ with this patient?
• Question
61 A PMHNP is assessing a
60-year-old patient named Carlos. He has severe PTSD and mild substance abuse
issues. The most appropriate setting to treat Carlos would be a _________.
• Question
62 The PMHNP is terminating
treatment for a patient who has been receiving eye movement desensitization and
reprocessing (EMDR) therapy. What action does the PMHNP take at the final
session to terminate treatment?
• Question
63 The PMHNP is treating an older
adult patient who reports experiencing nightmares associated with an automobile
accident he was in 20 years ago. As the PMHNP formulates the case using the
dynamic supportive therapy model, what questions will the PMHNP use during the
session?
• Question
64 The PMHNP is assessing a new
geriatric patient who reports symptoms of depression. The PMHNP wants to
identify the patient’s symptom severity over time. Which assessment tool will
the PMHNP use to collect this data on the patient?
• Question
65
When
recalling the phases of change, the PMHNP demonstrates “open questioning” in
the “engagement” phase by making which statement?
• Question
66
A 55-year-old
patient recovering from substance abuse tells the PMHNP, “It’s impossible to
meet new people. I really hate being single.” Using existential psychotherapy,
what might the PMHNP say next?
• Question
67
The
PMHNP is communicating with a middle-aged male patient who has a history of
addiction to Percocet (acetaminophen/oxycodone). The patient suddenly yells, “I
do not have a problem with pain pills! I’ve never had an overdose and no one
even knows that I take them unless I tell them.” The PMHNP understands that
there are phases of change and can best demonstrate “focusing” by responding
with:
• Question
68
The
PMHNP is terminating treatment with a patient who is aggressive and has a
history of anger. What does the PMHNP do when terminating treatment with this
patient?
• Question
69
The
PMHNP is assessing a 30-year-old client who reports feeling stressed out due to
his current employment situation. When asked about how he manages this
work-related stress, the patient says that exercise helps him feel less
anxious, so he often spends 2 or more hours at the gym each night. After
completing the patient assessment, the PMHNP has determined that an existential
psychotherapy approach may best benefit this client. What is the PMHNP’s goal
in employing this treatment approach?
• Question
70
The
PMHNP is interviewing a patient with a history of substance abuse. He has
attempted to stop abusing drugs three times before. He states to the PMHNP, “I
just cannot change. How can you help me?!” As it applies to change, the PMHNP
understands the principle of evocation to mean:
• Question
71
A PMHNP
has been working with a 50-year-old patient who has a stressful job and goes to
the casino on weekends to play poker with his friends, which he says relieves
his stress. Tim admits that he sometimes misses work on Monday when he stays
out too late at the casino on Sunday nights. In addition, he once was an avid
runner, and has given up running to spend more time gambling.
True or false: According to the PMHNP, the desired goal
after treatment is not complete abstinence from gambling, but reaching a healthy
level of the behavior.
• Question
72
The
PMHNP is caring for a patient who experiences depression caused by the
traumatic experience of her dog passing away. She reports not being able to eat
or sleep, and sometimes doesn’t want to leave the house at all. Which statement
is most appropriate for the PMHNP to maximize the patient’s adaptive coping
mechanisms?
• Question
73
A
13-year-old patient and his parents are meeting with a PMHNP. When the PMHNP
says hello, the boy just nods. His parents tell the PMHNP that he didn’t want
to come to the session, but they insisted. They explain that their son has been
moody and depressed at home, but is still getting good grades at school. Which
of the following would be the best response by the PMHNP?
• Question
74
The
PMHNP is initiating a plan of care for Holly, a 73-year-old female patient who
has late-life bipolar disorder and reports consuming alcoholic beverages four
times per week. What is the focus of Holly’s therapy going to be?
• Question
75
The
PMHNP continues to meet with Gerald, who is the patient with depression and
mood disorder. The PMHNP uses the CBT approach. Gerald is now meeting with the
PMHNP for his fifth session and feels comfortable with how the therapy works.
What does the PMHNP plan to do with Gerald over the course of the next several
sessions?
• Question
76
Mia is
a 75-year-old patient who has completed initial treatment for depression. What
might a PMHNP ask Mia when using a solution-focused therapy approach?

NURS3020 Health
Assessment
WEEK 2
Assignment
Digital Clinical Experience: Health History
Throughout this course, you will participate in digital
clinical experiences using the online simulation tool Shadow Health. The Shadow
Health digital clinical experience provides a dynamic, immersive experience
designed to improve nursing skills and clinical reasoning through the
examination of digital standardized patients. Using Shadow Health you will
participate in single-system exams, focused exams, concept labs, and a
comprehensive assessment in the capstone assignment. Below you will find more
details about Shadow Health.
For registration
Shadow Health, Inc. (n.d.). Accessing Shadow Health.
Retrieved from /orders/player.vimeo.com/video/275921826
Review the video link above, then use the Shadow Health link
in the Blackboard menu to access Shadow Health and register following the steps
in the video. You will use the access code provided by the university bookstore
upon purchase of the Shadow Health access. If you should have issues please
contact Shadow Health Support. Review the sections below related to Technical
Requirements and the Shadow Health Support contact information.
Accessing Shadow Health from Shadow Health, Inc. on Vimeo
Technical requirements
Shadow Health Help Desk
Shadow Health. (n.d.). Shadow Health help desk. Retrieved
from /orders/support.shadowhealth.com/hc/en-us>
Note: Please use only Google Chrome with Shadow Health.
Shadow Health support
Shadow Health. (n.d.). Shadow Health help desk. Retrieved
from /orders/support.shadowhealth.com/hc/en-us
Note: If you have questions or encounter technical issues,
regarding the digital clinical experience (DCE), contact Shadow Health at the
link above. If unavailable, contact Walden Student Support.
Topic/Skill Shadow
Health Assignment
Week 1 Taking a Health
History DCE Orientation (15 min)
Conversation Concept Lab (50 min)
Health History (180 min)
Week 2 The General
Survey HEENT (120 min)
Skin, Hair, and Nails (120 min)
Week 3 Assessment of
the Heart, Lungs, and Peripheral Vascular System Respiratory Concept Lab (25 min)
Respiratory (90 min)
Cardiovascular Concept Lab (25 min)
Cardiovascular (90 min)
Week 4 Assessment of
the Abdomen Abdominal Concept Lab (25
min)
Abdominal (90 min)
Week 5 Cognition and
the Neurological and Musculoskeletal Systems Musculoskeletal
(90 min)
Neurological (90 min)
Week 6 Creating Nurse
Patient Synergy No Shadow Health exam due
Assignment submissions
Shadow Health. (n.d.). Shadow Health help desk. Retrieved
from /orders/support.shadowhealth.com/hc/en-us
Students may reopen an assignment attempt before the due
date. Directions on how to enable this option are provided in the above link.
(Note: As the Instructor, you may reopen an attempt for a student at any time.)
This link (above) provides instructions on reopening an
attempt click on “Tutorials” to learn more.
To Prepare
Review Chapters 1–6 in the course text.
Review the Shadow Health Student Orientation media and the
Useful Tips and Tricks document, provided in this week’s Resources.
Review “Applying the Ethics of Care to Your Nursing
Practice” and “Code of Ethics for Nurses,” provided in this week’s Resources.
Review this week’s Writing Resources and Program Success
Tools, and Health Assessment Nursing Documentation Tutorial provided in this
week’s Resources.
Review the Shadow Health Support Resources, provided in this
week’s Resources.
Review Health Assessment: Introduction and Health
Assessment: Taking a Health History, provided in this week’s Media.
Review the Week 1 Assignment 2 Rubric provided in the Course
Information Area or accessible through the link below for details on completing
the Assignment in Shadow Health.
By Day 7
Complete the following in Shadow Health:
Orientation (15 min)
Conversation Concept Lab Conversation (50 min)
Health History (180 min) including ROS
NURS3020 Health
Assessment
WEEK 2
Assignment
Digital Clinical Experience: Hair, Skin, Nails, and HEENT
To Prepare
Review this week’s Resources including the Health Assessment
Nursing Documentation Tutorial.
Review the Shadow Health Assignments Grading Rubric provided
in the Course Information area or accessible through the link below for details
on completing the Assignments in Shadow Health.
By Day 7
Complete the following in Shadow Health:
Single System Exams:
Skin and Nails (70–120min)
HEENT (90–120 min)

Walden_NURS3020_Week_1_Assignment_Latest_2019_JULY.docx (15.19 KB)

Walden NURS3020 Week 1 Assignment Latest NURS3020 Health Assessment WEEK 1 Assignment

Journal: Observe, Process, Reflect Pen and glasses The objective of the Journal Assignment is to
provide you with a private place to “think on the page,” a phrase used to
describe writing as a form of thinking. Some of us process our thoughts out
loud as we describe them to others. In an academic environment, you will be
asked to record your ideas in writing, or “think on the page,” to show the new
knowledge that you’ve acquired through reading and listening to the resources
and completing the assignments. The journal is not a formal type of writing,
and only you and your Instructor will see the journal entry. These entries are
meant to be free writing but should be revised before submitting.
As you write, think about the audience to whom you are
writing, and the difference between personal writing and scholarly writing.
Your journal writing falls into the category of personal writing, and should be
approached in that way. Think of the journal as an academic reflection space.
To Prepare
Review the Week 1 Assignment 1 Rubric provided in the Course
Information area or accessible through the link below.
Review the Syllabus provided in the course. Review material
concerning health histories and physical examinations.
Include the following in your Journal entry:
Think, reflect and record the feelings you have had as you
have prepared to take this course—which may initially seem like a refresher
course for most of you.
Examine and record your strengths and weaknesses concerning
collecting health histories and performing physical examinations.
Describe in your journal what you expect to learn in this
assessment course.
By Day 5
Submit a 150-word Journal entry addressing the three
elements of focus above and in the grading rubric. You may include any other
comments or thoughts unrelated to the listed areas. There are no right or wrong
answers and credit for the Assignment is earned by timely completion and
providing coherent thoughts about the areas of focus.
Please note that this Assignment is due Day 5 of Week 1.
Failure in submitting by Day 5 could result in automatically being dropped from
the course due to lack of participation.

Walden_NURS6650_final_exam_july_2019.docx (63.78 KB)

• Question 1 When completing this exam, did you comply with Walden
University’s Code of Conduct including the expectations for academic integrity?
• Question 2 One member of a therapy group had been quiet for the first
several sessions. The member revealed to the other members feeling of
depression and emptiness. This week, the member was full of energy and talking
very quickly. The member became irritated with another member tried to
interrupt, started yelling, and then broke into a fit of laughter. Based on the
situation, what can the PMHNP determine about the member?
• Question 3 The PMHNP conducts a specialized individual interview with
a patient named Sandy. During this interview, Sandy expresses her want of the
other members to like her, and she has a deep dread for the first group
meeting. How does the PMHNP correctly interpret Sandy’s interpersonal
circumplex?
• Question 4 A PMHNP has been holding group therapy sessions for several
weeks and notices that a patient is timid and predictable in his or her
responses. When the patient does speak, he or she avoids saying anything to
contradict anyone in the group. Based on this information, what is an
appropriate question the PMHNP should ask herself?
• Question 5 When discussing the role of the consultant in the parenting
group session, Dr. Carlson explains that the consultant should use several
skills in order to help keep the group going and should enable group members to
become very engaged with one another. The consultant should use all of the
following skills to achieve this, except:
• Question 6 During an initial screening session, the PMHNP is
considering a patient for group therapy. The patient is recently divorced and
says he is lonely and depressed. What is the best referral by the PMHNP?
• Question 7 A PMHNP is leading a group therapy session for patients
with substance abuse problems. After a productive session in which all members
participated, the following week was not as productive. In order to help the
group members assume responsibility for evaluating the meeting, what is an
appropriate comment for the PMHNP to make?
• Question 8
Following the PMHNP’s
cancellation of a group session, he or she notices a decrease in compliance and
attendance within the group. What does the PMHNP identify as the group’s reason
for noncompliance?
A.
The group did not expect to have time off, so it may take up to a month to get
back into a routine.
B. The group members may believe that the
group is not important to the PMHNP.
C. The PMHNP’s absence gave the members a
reason to also be absent.
D. The group members feel let down, because
the PMHNP cancelled a meeting.
• Question 9 A client has attended five group therapy sessions yet has
not engaged verbally with others in the group. The PMHNP has identified the
client as a “silent member.” Which statement is true about silent members as
related to group therapy?
• Question 10 For several months, a patient in group therapy always
participated in conversation but only shared positive stories about her own
life. During the next session, she finally confessed that she has been
depressed and cutting herself. What is the best response by the PMHNP?
• Question 11 A 14-year-old girl named Laura and her parents are meeting
with a PMHNP. The parents explain why they are there by saying, “Laura has been
unhappy since she moved to a new school. She has been moody and often talks
back to us.” Laura sits quietly and looks uncomfortable. Which is the best
response by the PMHNP?
• Question 12 Members of a therapy group have been meeting for several
weeks. While a member named Margaret is talking about how her spouse ignores
her when she tries to tell him what to do, another member named Nicole
interrupts and says, “Maybe he thinks you are being bossy.” Margaret replies by
saying, “At least I’m not an alcoholic like you are!” What is an appropriate
response by the PMHNP?
• Question 13 Group participation is an important aspect of how successful
group therapy will be. The PMHNP recognizes that the gender of group
participants can play a role in the likelihood of group participation. Which
statement about gender and group composition does the PMHNP take into account?
• Question 14 A patient has had a problem with substance use and has been
receiving treatment for addiction. Which additional step might the PMHMP
suggest to help the patient maintain abstinence from drugs during and after
treatment?
• Question 15 Jane has been attending group therapy for the past year; she
and the therapist have determined that she has met her goals. Jane has been
arriving to group late or not coming to group at all. How does the PMHNP
correctly interpret Jane’s behavior?
• Question 16 Peter, a successful businessman, is introduced to the group
during the twelfth week. Following Peter’s introduction, Joseph, a long-term
member in the group, begins to lead the group and discuss all of the things
that he has personally accomplished. In what way does the PMHNP correctly interpret
Joseph’s behavior? D
• Question 17 When the counselor discussed assertiveness with the group
members, she began the session by providing definitions and asking group
members to line up consistent with where they feel they are currently in terms
of assertiveness. Why did she do this?
• Question 18
A 21-year-old client with
narcissistic traits is noted to continuously disrupt the group by speaking
while others are speaking. It becomes evident that the client is purposely
disrupting the group and decreasing the group’s productivity. What does the
PMHNP identify as a cause of the client’s behavior?
• Question 19 A narcissistic patient was unhappy that other members did not
seem concerned about his or her dating problems, which the patient spent half
the session talking about. The patient confronted the group by saying, “All of
you are rude and uncaring!” When group members ignored this comment, the
patient said, “And no one said anything nice about my new haircut either!” What
is an appropriate response by the PMHNP?
• Question 20
During a group session, a member
turns to the PMHNP and says, “I need some advice. My manager asked me to take
on an extra project, and now I’m overwhelmed. I don’t want to seem incompetent,
so I agreed to the extra work. What do you recommend I do?” What is the best
response by the PMHNP in order to shape group behavior?B
A.
“I am sorry to hear you feel overwhelmed, and I have several suggestions
that you might find helpful.”
B.
“Let’s ask the group what they think. Does anyone have feedback about this
situation?”
C. “Before I give recommendations, please
explain why turning down the project might make you seem incompetent.”?
• Question 21 In a group therapy session for patients with anxiety
problems, a patient named Eve was afraid to disclose to the other members that
she was a victim of sexual abuse. She kept the secret for months, although she
hinted at it to other members. During a meeting, another member tried to
pressure Eve to disclose her secret, but she was flustered and not ready to
share. What is an appropriate response by the PMHNP?
• Question 22
A PMHNP is leading a group
therapy session for patients with substance abuse problems. After one member
shares a problem, other members offer support, concern, and observations. The
PMHNP points out that the group is offering many truthful reactions and helpful
feedback. Which principle does this illustrate?
• Question 23 During an initial meeting, a PMHNP spends time speaking with
a patient who suffers from social anxiety. The therapist finds the patient
extremely loud and overbearing. The PMHNP’s negative feelings continue no
matter how hard he or she tries to feel differently toward the patient. What is
the most appropriate next step by the PMHNP?
• Question 24
The PMHNP recognizes that
hostility is unavoidable in a group and acknowledges that a frequent source of
hostility can be parataxic distortions. Which situation is likely to present a
parataxic distortion within the group?
• Question 25 During the “mid-group debrief” the clinical supervisor
focused on the following areas with the two counselors except:
• Question 26 Harold Wyman is a 74-year-old man who is trying to mend a
relationship with his adult daughter. Based on his intake assessment, the PMHNP
believes that the father has depression. The daughter and Harold meet with the
PMNHP, and the daughter explains that her father always appears mopey and
withdrawn and refuses to do anything about it. When asked, the father reports
feeling sad all the time. Which action will the PMNHP employ with Harold using
the interpersonal psychotherapy approach throughout the various sessions?
• Question 27 A patient who has been depressed is seeing a PMHNP for
individual therapy. The patient explains that he has been avoiding most social
activities for the past few months. He is divorced and has joint custody of his
10-year-old daughter. Based on this information, what recommendation by the
PMHNP would most benefit the patient?
• Question 28 The PMHNP explains during a discussion that subgrouping has
the potential to make group therapy more complicated and less rewarding. Tara,
a member of the group, angrily states, “Well, Jack and I have been meeting
outside of the group for weeks now.” What is the PMHNP’s most appropriate
response?
• Question 29
Members of group therapy have
been meeting for several weeks. The PMHNP often starts sentences with a thank
you or compliment such as, “Good observation.” The PMHNP notices that some of
the group members having been starting their statements with compliments. To
which principle can the PMHNP attribute this process?
• Question 30 Many key principles assist with composing intensive
interactional psychotherapy groups. When composing a psychotherapy group,
utilizing the intensive interactional approach, which key principle does the PMHNP
identify as being false?
• Question 31 Members of a therapy group have been meeting for several
months. During group therapy, a patient is bossy and controlling. During this week’s
session, she is confronted by another group member about her behavior and
replies, “This is not how I normally act. You are not my family and friends. I
don’t act the same way around them.” What can the PMHNP deduce from her
behavior?
• Question 32
The PMHNP is meeting with an
older married couple. The couple reports having concerns about becoming
dependent on their adult children someday, since several of their other friends
have had to move in with their kids. They make it clear to the PMHNP that they
aren’t keen on therapy or taking medicine but would be willing to try some
alternative therapies. What does the PMHNP suggest for evidence-based CAM modalities?
• Question 33 The PMHNP understands that conflicts within the psychotherapy
group can be troublesome for clients and have the potential to reduce the
effectiveness of the group process. As it pertains to group meetings, the PMHNP
understands which statement to be true about conflict?
• Question 34 During a group therapy session, a member comments that
another member named Ted had no compassion. Ted replies, “Why does it matter if
I care one way or another. I can’t solve their problems.” The other member
starts crying and blames Ted for this. He shrugs and answers, “I don’t
understand why you are crying.” Based on this information, what is the most
likely determination the PMHNP can make about Ted?
• Question 35
During a first group therapy
session, a member is outgoing and participates actively. Based on this
information, what is an appropriate prediction about this group member by the
PMHNP?
• Question 36
A PMHNP has a therapy group in
which many members have been dropping out over the past several weeks. Members
have complained that they do not feel part of the group. What is an appropriate
step for the PMHNP to take?
• Question 37
A PNHNP is holding a group
therapy session for a father and his 10-year-old son, whom the father explains
has been acting out lately. The son says, “He is always telling me what to do
and never listens when I have an idea.” Which solution would the PMHNP most
likely suggest as an approach to the problem?
A.
Role-playing exercises
B. Intrapersonal skills training
C. Psychological testing
D. Individual therapy
• Question 38
A patient has attended three
group therapy sessions and has remained silent throughout each. The patient
has, however, been listening to the other members. When the therapist makes eye
contact with the patient, he or she forces a smile but has clenched fists. What
is the most appropriate response by the PMHNP to help the patient? A
A.
“Your clenched fists indicate that you might be tense or angry about
something.”
B. “If you do not feel comfortable
speaking, I think it would be best if you just listen.”
C. “Today, we are all going to focus on
what you want to get out of group therapy.”?
D. “Since it is our fourth therapy
session, I expect everyone to join in the conversation.”
• Question 39 A member in group therapy named Tom asked others for
suggestions to a problem he was having. He did not think a suggestion by a
member named Steve would work, and for the rest of session, the group took
sides arguing why the idea would work or would not work. The session ended with
Tom agreeing to try the suggestion and report back to the group the following
week. Based on this session, what is an appropriate step by the PMHNP?B
• Question 40
A patient named Tyrone was
nervous sharing personal information with the group. To compensate, he makes
comments on other members’ problems as if he were the therapist. Another member
of the group asked him, “Do you think you’re better than everyone here?” What
might the PMHNP help Tyrone gain from this exchange?
• Question 41
A patient in group therapy
discloses her concern about feeling suicidal again in the future. Using the
principle of universality, what is an appropriate step by the PMHNP?
• Question 42 In the parent consultation session, the parent discusses her
son “Blake” who has changed since his 13th birthday. Dr. Carlson discusses the
power conflict that the parent appears to be getting into with her son. When
they discuss approaches they can use to help Blake experience increased
responsibility, Dr. Carlson explains that the parent must make a commitment
with her son by agreeing to:
• Question 43
A patient in group therapy,
Monique, describes another member, Anna, as bossy and selfish; however, the
PMHNP does not notice this behavior at all. In addition, other members have
expressed how thoughtful and caring Anna is to them. Based on this information,
what is an appropriate observation by the PMHNP?
• Question 44
During a group therapy session,
a member shares that she often feels lonely and depressed. She has been turning
down invitations to spend time with friends lately, because she does not want
to leave the house. What is an appropriate step for the PMHNP to take?
• Question 45
The social microcosm theory is a
theory that relates to group composition. In accordance with this theory, the
PMHNP is aware that the group must consist of which of the following?
• Question 46
A client is observed discussing
many problems and complaints during group therapy. However, when other group
members attempt to offer advice, the client does not accept it. Based on this
observation, what can the PMHNP determine about the client?
• Question 47
The PMHNP is meeting with an
adult woman and her father, who is 85 years old. The father stays quiet most of
the session. The daughter explains he is mad at her for “bringing him to a see
a shrink.” The daughter reports that things have been tense in the house since
her father moved in. The father has a history of depression, though he does not
take any medication for it. In addition, lately the father seems to never
sleep. “I hear him rummaging around in the kitchen, the garage, the living
room, at all hours of the night. Sometimes he’ll nap during the day, but not
much. This is putting a strain on my marriage, because my husband can’t sleep
with all of this going on.” Which therapeutic approach does the PMHNP identify
as most appropriate for the 85-year-old father?
• Question 48
A patient in group therapy named
Ted shares personal information for the first time. He seems nervous but
continues to talk. How might the PMHNP use nonverbal positive reinforcement to
support Ted’s feeling more comfortable?
• Question 49
A 36-year-old client attends
group therapy regularly but is consistently tardy. The client explains that job
and family obligations interfere with attendance to the group. What is the most
appropriate intervention by the PMHNP?
• Question 50
A
group member who suffers from depression and anxiety says during the session,
“I don’t see how any of this is going to help. I am still too anxious to leave
the house and do the things I want to do.” What is an appropriate response by
the PMHNP?
• Question 51 A PMHNP is putting together a heterogeneous, interactional
therapy group. During an initial screening, a patient explains that he is
unemployed because he keeps getting fired from new jobs after several months.
The therapist asks, “Why do you think those companies let you go?” The
patient’s reply is, “Those companies are all terrible. They don’t know how to
treat employees.” After asking the patient if he thought about his role in
getting fired, the patient says, “Why should I? I am not part of the problem.”
Based on this information, what is an appropriate observation by the PMHNP?
• Question 52
One group member is identified
by the PMHNP as the monopolist of the group. Which behavior does the PMHNP believe
this member is most likely to display?
• Question 53 The PMHNP provides cognitive behavioral therapy (CBT) to an
older adult patient with depression. The patient’s 41-year-old daughter and
32-year-old son attend one of his sessions with the PMHNP so that they can
learn more about how to help their father. What does the PMHNP say to the
daughter and son about the goals of their father’s CBT?
• Question 54
In a group therapy session for
adolescents, a 15-year-old patient says he has trouble making conversation with
people he does not know well. Based on the principle of development of
socializing techniques, what explicit approach might the PMHNP take?
• Question 55 A PMHNP is treating a 7-year-old child exhibiting signs of
aggression and attention problems. Before suggesting an intervention using a
common elements approach, what may the PMHNP consider?
• Question 56 A PMHNP is meeting with the mother of a 10-year-old boy named
Malik, who has been depressed since his parents’ divorce. The mother explains
that her goal for treatment is to help Malik feel better so he can become his
“usual outgoing self.” She insists that she does not want him on medication.
Which is the best response by the PMHNP?
• Question 57 A PNHNP is holding a group therapy session. Today, several
members have expressed fears about being unlovable. Based on this information,
what is an appropriate step by the PMHNP to raise the members’ self-esteem?
• Question 58 During an initial meeting, a patient who has been discussing
suicide says to the PMHNP, “I’m so depressed that I don’t want to leave my
house. All I want to do is stay in bed.”
What
type of therapy would the PMHNP most likely recommend to this patient?
• Question 59 During his second group therapy session, a member, who was
quiet the previous week, becomes very judgmental. He criticizes another member by
saying, “Mary, you are always late because you don’t respect our group.” Then
he adds, “In fact, all of you are disrespectful and uncaring.” What is an appropriate
step by the PMHNP?
• Question 60 A PMHNP notices that adolescents in a therapy group have not
been getting along. They are divided into two main groups and each
automatically dislikes members of the other group. What is an appropriate step
for the PMHNP to take?
• Question 61 A PMHNP is treating an 8-year-old child who was at a cousin’s
house during a domestic violence situation. Using a common factors model, the
PMHNP wants to pay attention to cultivating the relationship with the parents
and child. After the child talks about how nervous he or she has been since
witnessing the trauma, what is an appropriate response by the PMHNP?
• Question 62
A client diagnosed with
depression has begun to feel despair and expresses a desire to leave the group
because he or she does not believe it is helpful. Which action by the PMHNP
will most likely contribute to the client staying in the group?
• Question 63
A PMHNP is treating a patient in
individual therapy and thinks the patient may be a good candidate for group
therapy. The patient is motivated to start group therapy, which meets twice a
month. Then the patient adds, “I can come to the first two meetings, but then
will be away on business for at least a month, maybe longer. But then I can
come to the at least one meeting before my next trip.” Based on this
information, what is the most likely recommendation by the PMHNP? B
• Question 64
During therapy, a patient named
Maria states she is unhappy that other members did not express missing her
while she was away the previous week. She confronted the PMHNP by saying,
“Nobody here cares about this stupid group!” What might the PMHNP say to increase
group cohesiveness?
• Question 65
A PMHNP is meeting with parents and their 10-year-old child. The child is having trouble paying attention at
school and has been getting easily frustrated at home when doing homework,
which often results in everyone arguing. What step might the PMHNP take as part
of a family-centered, solution-oriented approach?
• Question 66
A PMHNP is creating a therapy group and is including a patient with borderline personality disorder. Which
action would most likely reduce the patient’s chance of separation anxiety?
• Question 67
When forming a group for
therapy, which action would the PMHNP likely take as a predictor for group
behavior?
• Question 68
The PMHNP is working with an older adult woman and her adult children. The children report that the mother was diagnosed with dementia, and they are all concerned about her welfare. The
plan is for the mother to move in with one of the children, but they are still
worried about how the mother will manage during the day when she is left alone.
What does the PMHNP identify as the
focus of the family therapy?
• Question 69
Gregory is a middle-aged veteran participant in a group led by the PMHNP. Since Gregory has been attending group, he frequently interrupts others and seems to take much of the group time
for himself. The PMHNP identifies Gregory as a monopolist and confronts him.
She explains that she does not want him to talk less; instead, she actually
encourages him to talk more. What is the likely cause of the PMHNP’s
explanation?
• Question 70
Two PMHNPs are in charge of a therapy group that has experienced several maladaptive interpersonal dramas lately. One of the patients has been described by other members as
argumentative. After a particularly awkward session, one of the therapists
feels that his own interpersonal distortion of the session may be clouding his
observation. What is an appropriate step by that PMHNP?
• Question 71
A patient in group therapy for
people dealing with panic disorder is describing a recent panic attack. He
says, “During this attack, I felt like I was dying.” What is an appropriate
response by the PMHNP using didactic instruction?
• Question 72
The PMHNP is meeting with a
married couple. The husband is 81 years old, and the wife is 78 years old. They
tell the PMHNP that many of their friends have passed away over the last couple
of years, and it’s making them feel sentimental about their lives and the fact
that they are getting older. Hearing this, the PMHNP uses a life review
approach with the couple. What action will the PMHNP employ?
• Question 73
During the first group meeting,
a client states, “I am here because I am very shy. I don’t mesh well with
others and I rarely get invitations to go anywhere.” Which statement about the
client’s reason for seeking help and treatment best applies?
• Question 74
According to Dr. Carlson, since
Adler talked about how the social setting in which we live influences our
lives, the best way parents can change their children’s behavior is to change:
• Question 75
Self-disclosure is a very
important part of group therapy. Which of the following conditions does the
PMHNP identify in his or her own life as a possible hindrance to
self-disclosure?
• Question 76 The leader begins a group meeting by doing the “names
activity.” At the completion of the activity, the leader explains that the
activity is useful for all of the following reasons, except:

NURS 6050 Week 4 assignment: Legislation Comparison Grid and Testimony/Advocacy Statement Example

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

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

To Prepare:

Select a bill that has been proposed (not one that has been enacted) using the congressional websites provided in the Learning Resources.
The Assignment: (1- to 2-page Comparison Grid; 1- to 2-page Legislation Testimony/Advocacy Statement)

Part 1: Legislation Comparison Grid

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

Determine the legislative intent of the bill you have reviewed.
Identify the proponents/opponents of the bill.

NURS 6050 Week 4 assignment: Legislation Comparison Grid and Testimony/Advocacy Statement Example
Identify the target populations addressed by the bill.
Where in the process is the bill currently? Is it in hearings or committees?
Is it receiving press coverage?
Part 2: Legislation Testimony/Advocacy Statement

Based on the health-related bill you selected, develop a 1- to 2-page Legislation Testimony/Advocacy Statement that addresses the following:

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

NURS 6050 Week 4 assignment: Legislation Comparison Grid and Testimony/Advocacy Statement Example 1

Part 1. Legislative comparison grid

Part 2. Legislation testimony/advocacy statement

There is a need for the legislation to be reauthorized in its current form as the Autism CARES Act of 2019. That is because it seeks to increase the federal investment across the government departments concerned with addressing the increasing needs of persons with autism spectrum disorder. Should the Bill fail to be reauthorized by the 30^th September 2019 deadline, then efforts to address autism spectrum disorders are likely to hindered and past gains reversed. In fact, failing to reauthorized the Bill would deny the Interagency Autism Coordinating Committee the authority to coordinate federal efforts targeted at autism. This would increase the possibility of efforts being duplicated and resources wasted. Besides that, autism is a present concern since 1.67% of children are suffering from the disorder, a significant population and yet management efforts are hindered by a dearth of information that would be best addressed through research. NURS 6050 Week 4 assignment: Legislation Comparison Grid and Testimony/Advocacy Statement Example. Through passing the bill, significant advances would be reported in three areas. Firstly, research efforts would be coordinated through supporting research funded by the National Institute of Health. Secondly, streamlining data and surveillance through building infrastructure at CDC to monitor autism.

Finally, supporting training efforts to address the reported shortages of personnel who address screening, diagnosis and treatment efforts (Autism Society, 2019). Although the Bill seeks to improve autism management, there is a legitimate concern that it would increase federal spending on health and the federal deficit. This objection is in reference to Section 3 Part e of the Bill that amends appropriations authorization to increase funding for federal programs. This concern can be addressed through making two amendments to the Bill. The first amendment is to eliminate the part that seeks to increasing federal funding for autism management (repeal authorizations of appropriations) so that the federal deficit concerns are eliminated (Saba & McCormick, 2015). The second amendment is to mobilize funding from non-governmental and private donors who support a similar heath agenda. This would ensure that although federal funding is not used, the autism management activities identified by the Bill are not discontinued and they continue to receive funding (Feldstein, 2006). Overall, the Autism CARES Act of 2019 has much value, and could be improved to receive greater support if federal funding is reduced and alternative non-government funding is sourced. NURS 6050 Week 4 assignment: Legislation Comparison Grid and Testimony/Advocacy Statement Example.

References

Autism Society (2019). Autism CARES Act Reauthorization (2019). Retrieved from /orders/www.autism-society.org/public-policy/autism-cares-act-reauthorization-2019/

Feldstein, P. (2006). The politics of health legislation: an economic perspective (3^rd ed.). Chicago, IL: Health Administration Press.

Saba, V. & McCormick, K. (2015). Essentials of nursing informatics (6^th ed.). New York, NY: McGraw-Hill. NURS 6050 Week 4 assignment: Legislation Comparison Grid and Testimony/Advocacy Statement Example