Tag Archive for: nursing

For many of us, one of the most interesting and fun aspects of studying sociology is how relevant the discipline is to our everyday lives. This is even true of the methods we use to study sociology. Hardly a day goes by without reading or hearing about research that can help explain our lives: for example, we are learning that life expectancy in the U.S. is on the decline, which may seem counterintuitive. After all, we are the richest nation on earth with excellent medical care. But when we look a little deeper, we learn that for the wealthiest Americans, life expectancy is on the rise, while for those with the lowest socio-economic status (SES), it is on the decline. Since there are far more people of lower SES than the highest, the overall rate is pushed downward. Describe a current, personal experience that is relevant to research methods. You can describe something that “passes for knowledge” that you observed at home, work, or the community; something you saw or heard in the media, or some other current event. Include a description of the information, how you think that information was created, and your own reaction to that information (to quote a scene from Freaky Friday, how does that make you feel? Do you trust that information and to what degree?). The text of the answer should be at least 250 words in length to get into the kind of depth you need. Include the source(s) in APA style after the text of the post

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For many of us, one of the most interesting and fun aspects of studying sociology is how relevant the discipline is to our everyday lives. This is even true of the methods we use to study sociology. Hardly a day goes by without reading or hearing about research that can help explain our lives: for example, we are learning that life expectancy in the U.S. is on the decline, which may seem

For many of us, one of the most interesting and fun aspects of studying sociology is how relevant the discipline is to our everyday lives. This is even true of the methods we use to study sociology. Hardly a day goes by without reading or hearing about research that can help explain our lives: for example, we are learning that life expectancy in the U.S. is on the decline, which may seem counterintuitive. After all, we are the richest nation on earth with excellent medical care. But when we look a little deeper, we learn that for the wealthiest Americans, life expectancy is on the rise, while for those with the lowest socio-economic status (SES), it is on the decline. Since there are far more people of lower SES than the highest, the overall rate is pushed downward.

Describe a current, personal experience that is relevant to research methods. You can describe something that “passes for knowledge” that you observed at home, work, or the community; something you saw or heard in the media, or some other current event. Include a description of the information, how you think that information was created, and your own reaction to that information (to quote a scene from Freaky Friday, how does that make you feel?  Do you trust that information and to what degree?).

The text of the answer should be at least 250 words in length to get into the kind of depth you need. Include the source(s) in APA style after the text of the post

. After all, we are the richest nation on earth with excellent medical care. But when we look a little deeper, we learn that for the wealthiest Americans, life expectancy is on the rise, while for those with the lowest socio-economic status (SES), it is on the decline. Since there are far more people of lower SES than the highest, the overall rate is pushed downward.

Describe a current, personal experience that is relevant to research methods. You can describe something that “passes for knowledge” that you observed at home, work, or the community; something you saw or heard in the media, or some other current event. Include a description of the information, how you think that information was created, and your own reaction to that information (to quote a scene from Freaky Friday, how does that make you feel?  Do you trust that information and to what degree?).

The text of the answer should be at least 250 words in length to get into the kind of depth you need. Include the source(s) in APA style after the text of the post

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, Lengthy Drug Trials

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In DB6 we will explore data mining.  Start by reading the attached article:

Drugmakers Turn to Data Mining to Avoid Expensive, Lengthy Drug Trials – WSJ.pdf

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Relying on techniques and technologies from database management, statistics, and machine learning, specialists in data mining seek to better understand how to process and draw conclusions from vast amounts of information.  How can data mining be used by pharmaceutical companies, CROs and marketers in lieu of conducting a costly clinical trial?

In addition, you must also do your own research and provide references for both in your initial post.

Initial Post

1. 15 points (2 ways data mining may “substitute” for an actual clinical trial)

2.  7.5 points (1 pro of  data mining)

3. 7.5 points (1 con of data mining)

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(SWOT) analysis

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Write a 4–7-page analysis of your care setting that supports development of a strategic plan and includes both the discovery and dream phases of an appreciative inquiry (AI) project and a strengths, weaknesses, opportunities, and threats (SWOT) analysis of the care setting.

Note: Each assessment in this course builds on the work you completed in the previous assessment. Therefore, you must complete the assessments in this course in the order in which they are presented.

SHOW LESS

Identifying analysis techniques for assessing competitive advantage is important for building health care strategy. Sustaining health care competitive advantage requires that leaders understand environmental demands to assist with minimizing weakness and threats from the external environment. This assessment provides you with an opportunity to examine your health care environment to determine whether what is being accomplished in your organization, department, team, community project, or other care setting is making a positive difference.

By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:

  • Competency 1: Evaluate qualities and skills that promote effective leadership within health care organizations.
    • Analyze the leadership characteristics and skills most desired in the person leading potential performance improvement projects, taking both an appreciative inquiry (AI) and a strengths, weaknesses, opportunities, and threats (SWOT) approach.
  • Competency 2: Apply strategies to lead high-performing health care teams to meet organizational quality and safety goals.
    • Synthesize stories and evidence about times when a care setting performed at its best with regard to quality and safety goals.
    • Conduct a SWOT analysis of a care setting, with respect to quality and safety goals.
    • Describe an area of concern identified in a SWOT analysis—relevant to a care setting’s mission, vision, and values—that should be improved.
    • Compare the AI and SWOT approaches to analysis with regard to data gathering and interactions with others.
  • Competency 3: Apply cultural, ethical, and regulatory considerations to leadership decision making.
    • Propose positive, attainable quality and safety improvement goals for a care setting.
  • Competency 5: Communicate with stakeholders and constituencies to build collaborative partnerships and create inclusive work environments.
    • Communicate analyses clearly and in a way that demonstrates professionalism and respect for stakeholders and colleagues.
    • Integrate relevant and credible sources of evidence to support assertions, correctly formatting citations and references using APA style.

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Contemporary Nursing Practice

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Contemporary Nursing Practice

The field of nursing has changed over time. In a 750‐1,000 word paper, discuss nursing practice today by addressing the following:

  1. Explain how nursing practice has changed over time and how this evolution has changed the scope of practice and the approach to treating the individual.
  2. Compare and contrast the differentiated practice competencies between an associate and baccalaureate education in nursing. Explain how scope of practice changes between an associate and baccalaureate nurse.
  3. Identify a patient care situation and describe how nursing care, or approaches to decision‐making, differ between the BSN‐prepared nurse and the ADN nurse.
  4. Discuss the significance of applying evidence‐based practice to nursing care and explain how the academic preparation of the RN‐BSN nurse supports its application.
  5. Discuss how nurses today communicate and collaborate with interdisciplinary teams and how this supports safer and more effective patient outcomes.

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

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. Please refer to the directions in the Student Success Center.

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Abdominal Assessment

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Abdominal Assessment Case Study SOAP Note

Subjective:

•CC: “My stomach hurts, I have diarrhea and nothing seems to help.”

•HPI: JR, 47 yo WM, complains of having generalized abdominal pain that started 3 days ago. He has not taken any medications because he did not know what to take. He states the pain is a 5/10 today but has been as much as 9/10 when it first started. He has been able to eat, with some nausea afterwards.

•PMH: HTN, Diabetes, hx of GI bleed 4 years ago

•Medications: Lisinopril 10mg, Amlodipine 5 mg, Metformin 1000mg, Lantus 10 units qhs

•Allergies: NKDA

•FH: No hx of colon cancer, Father hx DMT2, HTN, Mother hx HTN, Hyperlipidemia, GERD

•Social: Denies tobacco use; occasional etoh, married, 3 children (1 girl, 2 boys)

Objective

:•VS: Temp 99.8; BP 160/86; RR 16; P 92; HT 5’10”; WT 248lbs

•Heart: RRR, no murmurs

•Lungs: CTA, chest wall symmetrical

•Skin: Intact without lesions, no urticaria

•Abd: soft, hyperactive bowel sounds, pos pain in the LLQ

•Diagnostics: None

Assessment:

•Left lower quadrant pain

•Gastroenteritis

PLAN: This section is not required for the assignments in this course (NURS 6512) but will be required for future courses.

The Assignment Instructions

Do this assignment in narrative form and not SOAP note form. Please follow the rubric.

Analyze the subjective portion of the note. List additional information that should be included in the documentation.

Analyze the objective portion of the note. List additional information that should be included in the documentation.

Is the assessment supported by the subjective and objective information? Why or why not?

What diagnostic tests would be appropriate for this case, and how would the results be used to make a diagnosis?

Would you reject/accept the current diagnosis? Why or why not?

Identify three possible conditions that may be considered as a differential diagnosis for this patient.

Explain your reasoning using at least three different references from current evidence-based literature.

This is the link to download the book

https://www.sendspace.com/file/wd7quh

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Quantitative Critique

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Quantitative Critique

Prompt: Use the attached article provided. Start by filling out the provided Quantitative review worksheet. Then, using the worksheet as your guide, write a critique to dig deeper into each section and identify the specific examples of each element (e.g., what is the research question? Does the author justify the importance of the research? In the case of a literature review, has the author examined the relevant literature?). Elaborate on each section and evaluate it for its strengths and limitations. Be sure to identify your chosen article and address the following critical elements:  Critique o Purpose and Research Question: What is the research question? Does the author justify the importance of the research? o Design and Methods: What design and methods were used? Are they rigorous and systematic? o Validity and Reliability: Is the study valid and reliable? (For qualitative research, this section of your critique should consider the study’s trustworthiness and rigor.) o Findings and Conclusions: Are the conclusions reasonable given the findings?  Evaluation: What are the strengths and weaknesses of the research article? Do you agree with the author’s conclusions? Why or why not? Did the author succeed or fail in the purpose of the study? Recommend areas for improvement or suggest direction for future research. Guidelines for Submission: Your paper must be submitted as a 1–2 page Microsoft Word document with double spacing, 12-point Times New Roman font, oneinch margins, and in APA format.

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Assessing the Genitalia and Rectum

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Assignment 1: Asse

Assignment 1: Assessing the Genitalia and Rectum

Patients are frequently uncomfortable discussing with health care professional’s issues that involve the genitalia and rectum; however, gathering an adequate history and properly conducting a physical exam are vital. Examining case studies of genital and rectal abnormalities can help prepare advanced practice nurses to accurately assess patients with problems in these areas.

In this assignment, you will consider case studies that describe abnormal findings in patients seen in a clinical setting.

In this assignment, you will analyze a SOAP note case study that describes abnormal findings in patients seen in a clinical setting. You will consider what history should be collected from the patients, as well as which physical exams and diagnostic tests should be conducted. You will also formulate a differential diagnosis with several possible conditions.

GENITALIA ASSESSMENT

Subjective:

  • CC: “I have bumps on my bottom that I want to have checked out.”
  • HPI: AB, a 21-year-old WF college student reports to your clinic with external bumps on her genital area. She states the bumps are painless and feel rough. She states she is sexually active and has had more than one partner over the past year. Her initial sexual contact occurred at age 18. She reports no abnormal vaginal discharge. She is unsure how long the bumps have been there but noticed them about a week ago. Her last Pap smear exam was 3 years ago, and no dysplasia was found; the exam results were normal. She reports one sexually transmitted infection (chlamydia) about 2 years ago. She completed the treatment for chlamydia as prescribed.
  • PMH: Asthma
  • Medications: Symbicort 160/4.5mcg
  • Allergies: NKDA
  • FH: No hx of breast or cervical cancer, Father hx HTN, Mother hx HTN, GERD
  • Social: Denies tobacco use; occasional etoh, married, 3 children (1 girl, 2 boys)

answer the following questions and support your answers using current evidence from the literature.

  • Analyze the subjective portion of the note. List additional information that should be included in the documentation.
  • Analyze the objective portion of the note. List additional information that should be included in the documentation.
  • Is the assessment supported by the subjective and objective information? Why or Why not?
  • Would diagnostics be appropriate for this case and how would the results be used to make a diagnosis?
  • Would you reject/accept the current diagnosis? Why or why not? Identify three possible conditions that may be considered as a differential diagnosis for this patient. Explain your reasoning using at least 3 different references from current evidence based literature.

 

Assignment 1: Assessing the Genitalia and Rectum

Patients are frequently uncomfortable discussing with health care professional’s issues that involve the genitalia and rectum; however, gathering an adequate history and properly conducting a physical exam are vital. Examining case studies of genital and rectal abnormalities can help prepare advanced practice nurses to accurately assess patients with problems in these areas.

In this assignment, you will consider case studies that describe abnormal findings in patients seen in a clinical setting.

In this assignment, you will analyze a SOAP note case study that describes abnormal findings in patients seen in a clinical setting. You will consider what history should be collected from the patients, as well as which physical exams and diagnostic tests should be conducted. You will also formulate a differential diagnosis with several possible conditions.

GENITALIA ASSESSMENT

Subjective:

  • CC: “I have bumps on my bottom that I want to have checked out.”
  • HPI: AB, a 21-year-old WF college student reports to your clinic with external bumps on her genital area. She states the bumps are painless and feel rough. She states she is sexually active and has had more than one partner over the past year. Her initial sexual contact occurred at age 18. She reports no abnormal vaginal discharge. She is unsure how long the bumps have been there but noticed them about a week ago. Her last Pap smear exam was 3 years ago, and no dysplasia was found; the exam results were normal. She reports one sexually transmitted infection (chlamydia) about 2 years ago. She completed the treatment for chlamydia as prescribed.
  • PMH: Asthma
  • Medications: Symbicort 160/4.5mcg
  • Allergies: NKDA
  • FH: No hx of breast or cervical cancer, Father hx HTN, Mother hx HTN, GERD
  • Social: Denies tobacco use; occasional etoh, married, 3 children (1 girl, 2 boys)

Objective:

  • VS: Temp 98.6; BP 120/86; RR 16; P 92; HT 5’10”; WT 169lbs
  • Heart: RRR, no murmurs
  • Lungs: CTA, chest wall symmetrical
  • Genital: Normal female hair pattern distribution; no masses or swelling. Urethral meatus intact without erythema or discharge. Perineum intact with a healed episiotomy scar present. Vaginal mucosa pink and moist with rugae present, pos for firm, round, small, painless ulcer noted on external labia
  • Abd: soft, normoactive bowel sounds, neg rebound, neg murphy’s, neg McBurney
  • Diagnostics: HSV specimen obtained

Assessment:

  • Chancre
  • PLAN: This section is not required for the assignments in this course (NURS 6512) but will be required for future courses.

To prepare:

With regard to the SOAP note case study provided:

  • Review this week’s Learning Resources, and consider the insights they provide about the case study.
  • Consider what history would be necessary to collect from the patient in the case study.
  • Consider what physical exams and diagnostic tests would be appropriate to gather more information about the patient’s condition. How would the results be used to make a diagnosis?
  • Identify at least five possible conditions that may be considered in a differential diagnosis for the patient.

To complete:

Refer to Chapter 5 of the Sullivan text. Analyze the SOAP note case study.  Using evidence based resources, answer the following questions and support your answers using current evidence from the literature.

  • Analyze the subjective portion of the note. List additional information that should be included in the documentation.
  • Analyze the objective portion of the note. List additional information that should be included in the documentation.
  • Is the assessment supported by the subjective and objective information? Why or Why not?
  • Would diagnostics be appropriate for this case and how would the results be used to make a diagnosis?
  • Would you reject/accept the current diagnosis? Why or why not? Identify three possible conditions that may be considered as a differential diagnosis for this patient. Explain your reasoning using at least 3 different references from current evidence based literature.

Assignment 1: Assessing the Genitalia and Rectum

Assignment 1: Assessing the Genitalia and Rectum

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Client Termination Summary

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Assignment 1: Practicum – Client Termination Summary

Although termination is an inevitable part of the therapeutic process, it is often difficult for clients. However, by discussing termination throughout therapy, you can better prepare your clients for life without you. Once a client has achieved his or her therapeutic goals, termination sessions should be held and documented in a client termination summary. For this Assignment, you have the opportunity to practice writing a termination summary for a client with whom you have worked during your practicum experience.

Learning Objectives

Students will:

· Develop client termination summaries

To prepare:

· For guidance on writing a client termination summary, review pages 693–712 of Wheeler (2014) in this week’s Learning Resources.

· Identify a client who may be ready to terminate therapy.

The Assignment

· Identifying information of client (e.g., hypothetical name and age)

· Date the client initially contacted therapist, date therapy began, duration of therapy, and date therapy will end

· Total number of sessions, including number of missed sessions

· Whether termination was planned or unplanned

· Presenting problem

· Major psychosocial issues

· Types of services rendered (e.g., individual, couple/family therapy, group therapy)

· Overview of treatment process

· Goal status (goals met, partially met, unmet)

· Treatment limitations (if any)

· Remaining difficulties and/or concerns

· Recommendations

· Follow-up plan (if indicated)

· Instructions for future contact

· Signatures

With the client you selected in mind, address in a client termination summary (without violating HIPAA regulations) the following:

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 Case Study on Death and Dying

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QUESTION/ Case Study on Death and Dying

Details:

The practice of health care providers at all levels brings you into contact with people from a variety of faiths. This calls for knowledge and acceptance of a diversity of faith expressions.

The purpose of this paper is to complete a comparative ethical analysis of George’s situation and decision from the perspective of two worldviews or religions: Christianity and a second religion of your choosing. For the second faith, choose a faith that is unfamiliar to you. Examples of faiths to choose from include Sikh, Baha’i, Buddhism, Shintoism, etc.

In your comparative analysis, address all the worldview questions in detail for Christianity and your selected faith. Refer to Chapter 2 of Called to Care for the list of questions. Once you have outlined the worldview of each religion, begin your ethical analysis from each perspective.

In a minimum of 1,500-2,000 words, provide an ethical analysis based upon the different belief systems, reinforcing major themes with insights gained from your research, and answering the following questions based on the research:

1. How would each religion interpret the nature of George’s malady and suffering? Is there a “why” to his disease and suffering? (i.e., is there a reason for why George is ill, beyond the reality of physical malady?)

2. In George’s analysis of his own life, how would each religion think about the value of his life as a person, and value of his life with ALS?

3. What sorts of values and considerations would each religion focus on in deliberating about whether or not George should opt for euthanasia?

4. Given the above, what options would be morally justified under each religion for George and why?

5. Finally, present and defend your own view.

Support your position by referencing at least three academic resources (preferably from the GCU Library) in addition to the course readings, lectures, the Bible, and the textbooks for each religion. Each religion must have a primary source included. A TOTAL OF SIX REFERENCES ARE REQUIRED ACCORDING TO THE SPECIFICATIONS LISTED ABOVE. Incorporate the research into your writing in an appropriate, scholarly manner. Prepare this assignment according to the guidelines found in the APA Style Guide

Read “End of Life and Sanctity of Life” in the American Medical Association Journal of Ethics, formerly Virtual Mentor (2005).

http://journalofethics.ama-assn.org/2005/05/ccas2-0505.html

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malpractice suit

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Question 1: In an outpatient setting, what is the most common reason for a malpractice suit?

a. Failure to treat a condition
b. Failure to diagnose correctly
c. Ordering the wrong medication
d. Failure to manage care

Question 2: How often should the clinician examine the feet of a person with diabetes?

a. Once a year
b. Every 6 months
c. Every 3 months
d. Every visit

Question 3: Which drug for Alzheimer’s disease should be administered beginning at the time of diagnosis?

a. Cholinesterase inhibitors
b. Anxiolytics
c. Antidepressants
d. Atypical antipsychotics

Question 4: Which of the following medications is the treatment of choice for trichomonas?

a. Metranidazole

b. Ceftriaxone

c. Diflucan
d. Doxycycline

Question 5: Most adult poisonings are:

a. intentional and self-inflicted.
b. accidental.
c. caused by someone wishing to do harm to the person.
d. not attributed to any reason.

Question 6: A 58-year-old woman presents with a breast mass. Which of the following responses by the clinician would be most appropriate?

a. “It is probably just a cyst, because that is the most common breast mass.”
b. “We will order a mammogram and ultrasound to help establish a diagnosis.”
c. “We will go ahead and schedule you for a biopsy because that is the only way to know for sure.”
d. “Because your lump is painful, it is most likely not cancer.”

Question 7: Which of the following is a specific test for multiple sclerosis (MS)?

a. Magnetic resonance imaging (MRI)
b. Computed tomography (CT) scan
c. A lumbar puncture
d. There is no specific test.

Question 8: After removing a tack from a type 2 diabetic’s heel and evaluating the site for infection, what is the best plan for this patient?

a. Suggest she use a heating pad to improve circulation
b. Refer to a podiatrist for a foot care treatment plan
c. Send her for acupuncture treatments
d. All of the above

Question 9: Which characteristic of delirium helps to distinguish delirium from dementia?

a. Abrupt onset
b. Impaired attention
c. Affective changes
d. Delusions

Question 10: Which clinical feature is the first to be affected in increased intracranial pressure (ICP)?

a. Decrease in level of consciousness (LOC)
b. Headache
c. Nausea
d. Widening pulse pressure

Question 11: Jennifer is an 18-year-old girl who comes to the emergency room after a fall during a soccer game. Jennifer explains that she fell on her left side and kept her arm out straight to break her fall. She has been experiencing severe pain and limited range of motion in her left shoulder. The clinician has diagnosed Jennifer with a dislocated shoulder. Which of the following statements are true concerning shoulder dislocation?

a. Posterior dislocations are more common than anterior dislocations.
b. There is a risk of neurovascular and neurosensory trauma, so the clinician should check for distal pulses.
c. Recurrent dislocations are uncommon and would require a greater force to result in injury.
d. Surgery is most commonly the treatment of choice.

Question 12: In the consensus model for Advanced Practice Registered Nurse (APRN) regulation, the “C” of LACE represents?

a. Commitment

b. Consensus

c. Certification
d. Collaboration

Question 13: Which of the following signs or symptoms indicate an inflammatory etiology to musculoskeletal pain?

a. Decreased C-reactive protein
b. Hyperalbuminemia
c. Morning stiffness
d. Weight gain

Question 14: Which of the following statements is true concerning the musculoskeletal exam?

a. The uninvolved side should be examined initially and compared to the involved side.
b. The part of the body that is causing the patient pain should be examined first.
c. The patient should not be asked to perform active range-of-motion (ROM) exercises whenever possible to avoid causing pain.
d. Radiographs should always be obtained prior to examination so as not to cause further injury to the patient.

Question 15: The clinician sees a patient who is 5 feet tall and weighs 150 pounds. How would the clinician classify this patient?

a. Overweight

b. Mild obesity

c. Moderate obesity
d. Morbid obesity

Question 16: S presents in the clinic with pain, tenderness, erythema, and swelling of his left great toe. The clinician suspects acute gout. Which of the following should the clinician suspect in the initial test results for this patient?

a. Elevated uric acid level
b. Elevated blood urea nitrogen (BUN)
c. Decreased urine pH
d. Decreased C-reactive protein (CRP)

Question 17: Which of the following statements is true regarding the treatment of carpal tunnel syndrome?

a. The goal of treatment is to prevent flexion and extension movements of the wrist.
b. Splints are used in carpal tunnel syndrome because they allow for free movement of the fingers and thumb while maintaining the wrist in a neutral position.
c. Corticosteroid injections are discouraged in the treatment of carpal tunnel syndrome because of the risks for median nerve damage, scarring, and infection.
d. All of the above

Question 18: The vegetarian patient with gout asks the clinician about food that he should avoid. The clinician should advise the patient to avoid which of the following foods?

a. Rice
b. Carrots
c. Spinach
d. Potatoes

Question 19: A 23-year-old sexually active woman presents for her first Pap smear. Her history includes nulligravida, age at first intercourse 14, and more than 10 sexual partners. Which of the following conditions should the clinician be particularly alert for during her exam?

a. Human papillomavirus (HPV)
b. Endometrial hyperplasia
c. Vagismus
d. Polycystic ovarian syndrome

Question 20: Which patient is more likely to have a cluster headache?

a. A female in her reproductive years
b. A 40-year-old African American male
c. A 55-year-old female who drinks 10 cups of coffee daily
d. A 45-year-old male awakened at night

Question 21: A sunscreen with a sun-protection factor (SPF) of at least what number will block most harmful ultraviolet (UV) radiation?

a. 4

b. 8 d

c. 10
d. 15

Question 22: Which of the following classes of drugs should be used as first-line therapy for treatment of delirium?

a. Benzodiazepines
b. Antipsychotics
c. Anticonvulsants
d. Antidepressants

Question 23: What is the treatment of choice for a patient diagnosed with testicular cancer?

a. Radical orchidectomy

b. Lumpectomy

c. Radiation implants
d. All of the above

Question 24: Sam, aged 65, is started on L-dopa for his Parkinson’s disease (PD). He asks why this is necessary. You tell him:

a. “L-dopa is neuroprotective.”
b. “The primary goal of therapy is to replace depleted stores of dopamine.”
c. “This is the only drug that can provide symptomatic benefit.”
d. “This is the initial monotherapy drug.”

Question 25: A 60-year-old man presents with an enlarged scrotum. The clinician uses a penlight to transilluminate the scrotum. In a patient with a hydrocele, what would the clinician expect to find?

a. The scrotum will be dark.
b. The scrotum will appear light pink or yellow.
c. The scrotum will appear milky white.
d. The internal structures will be clearly visible.

Question 26: A 24-year-old woman presents to the clinic with dysuria, dyspareunia, and a mucopurulent vaginal discharge. Her boyfriend was recently treated for nongonococcal urethritis. What sexually transmitted disease (STD) has she most probably been exposed to?
a. Gonorrhea
b. Human papillomavirus (HPV)
c. Chlamydia
d. Trichomonas

Question 27: A 58-year-old woman who had a total abdominal hysterectomy at the age of 45 is diagnosed with atrophic vaginitis. Which of the following is the most appropriate treatment?
a. Conjugated estrogen 0.625 mg/day oral
b. Estradiol 7.5 mcg/24 hr vaginal ring
c. Medroxyprogesterone 10 mg/day oral
d. Conjugated estrogen 0.3 mg + medroxyprogesterone 1.5 mg/day oral

Question 28: When looking under the microscope to diagnose an intravaginal infection, you see a cluster of small and oval to round shapes. What do you suspect they are?

a. Conjugated estrogen 0.625 mg/day oral
b. Estradiol 7.5 mcg/24 hr vaginal ring
c. Medroxyprogesterone 10 mg/day oral
d. Conjugated estrogen 0.3 mg + medroxyprogesterone 1.5 mg/day oral

Question 29: A 22-year-old male is seen in the clinic because he found a hard lump in his testicle when performing testicular self-examination (TSE). Which of the following should be included in the list of differential diagnoses?
a. Testicular cancer

b. Inguinal hernia

c. Varicocele
d. All of the above

Question 30: The clinician should Question: the patient with suspected gout about use of which of these medications that may be a risk factor?

a. Low-dose aspirin

b. Thiazide diuretics

c. Ethambutol
d. All of the above

Question 31: What is usually the first sign or symptom that a patient would present with that would make you suspect herpes zoster?
a. A stabbing type of pain on one small area of the body
b. A vesicular skin lesion on one side of the body
c. A pain that is worse upon awakening
d. A lesion on the exterior ear canal

Question 32: Which ethical principle reflects respect for all persons and their self-determination?
a. Autonomy

b. Beneficence

c. Justice
d. Veracity

Question 33: Patients with a spontaneous pneumothorax should be counseled that up to what percentage may experience a reoccurrence at some point?

a. 10%

b. 20%

c. 30%
d. 50%

Question 34: John is a 16-year-old boy who presents to the emergency room after hurting his knee in a football game. He described twisting his knee and then being unable to extend it completely. John tells the clinician that he heard a pop when the injury occurred and has been experiencing localized pain. The clinician suspects a meniscal tear. Which test would be most appropriate to assess for the presence of a meniscal tear?

a. Valgus stress test
b. McMurray circumduction test
c. Lachman test
d. Varus stress test

Question 35: Which of the following laboratory findings should the clinician expect in a patient with untreated Graves’ disease?
a. Elevated thyroid-stimulating hormone (TSH)
b. Elevated T4
c. Elevated TRH
d. All of the above

Question 36: Which drug commonly prescribed for burns is active against a wide spectrum of microbial pathogens and is the most frequently used agent for partial- and full-thickness thermal injuries?
a. Clotrimazole cream (Lotrimen)
b. Mafenide acetate (Sulfamylon)
c. Silver nitrate
d. Silver sulfadiazine (Silvadene)

Question 37: During a digital rectal exam (DRE) on a 75-year-old man, the clinician suspects the patient has prostate cancer. What physical finding should make the clinician suspicious?

a. An enlarged rubbery gland

b. A hard irregular gland

c. A tender gland
d. A boggy gland

Question 38: Janet is a 30-year-old woman who has been recently diagnosed with a herniated disc at the level of L5-S1. She is currently in the emergency room with suspicion of cauda equina compression. Which of the following is a sign or symptom of cauda equina compression?
a. Gastrocnemius weakness
b. A reduced or absent ankle reflex
c. Numbness in the lateral foot
d. Paresthesia of the perineum and buttocks

Question 39: The criteria for diagnosing generalized anxiety disorder in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (text revision) (DSM-IV-TR) state that excessive worry or apprehension must be present more days than not for at least:

a. 1 month.
b. 3 months.
c. 6 months.
d. 12 months.

Question 40: The clinician has instructed Sam, a 25-year-old patient with low back strain, to use NSAIDs to manage his symptoms of pain and discomfort. Which of the following statements would be most appropriate when teaching Sam about the use of NSAIDs to manage his pain?

a. You should start with the lowest dose that is effective in managing your pain, because long-term use of NSAIDs can result in gastrointestinal (GI) disorders such as ulcers and hemorrhage.
b. You should start with the lowest dose that is effective in managing your pain in order to avoid developing tolerance to the medication.
c. You should take the maximum recommended dose of NSAIDs so that you will not need to take narcotics to control your pain.
d. It is important to take NSAIDs on an empty stomach in order to increase absorption.

Question 41: A patient is diagnosed with hypothyroidism. Which of the following electrocardiogram (ECG) changes should the clinician expect as a manifestation of the disease?

a. Sinus bradycardia

b. Atrial fibrillation

c. Supraventricular tachycardia
d. U waves

Question 42: Sam is a 25-year-old man who has been diagnosed with low back strain based on his history of localized low back pain and muscle spasm along with a normal neurological examination. As the clinician, you explain to Sam that low back pain is a diagnosis of exclusion. Which of the following symptoms would alert the clinician to the more serious finding of a herniated nucleus pulposus or ruptured disc?
a. Morning stiffness and limited mobility of the lumbar spine
b. Unilateral radicular pain symptoms that extend below the knee and are equal to or greater than the back pain
c. Fever, chills, and elevated erythrocyte sedimentation rate
d. Pathologic fractures, severe night pain, weight loss, and fatigue

Question 43: Which type of burn injury results in destruction of epidermis with most of the dermis, yet the epidermal cells lining hair follicles and sweat glands remain intact?
a. Superficial burns
b. Superficial partial-thickness burns
c. Deep partial-thickness burns
d. Full-thickness burns

Question 44: Immunizations are an example of which type of prevention?

a. Primary
b. Secondary
c. Tertiary

Question 45: If a previously frostbitten area becomes frostbitten again after it has healed, what might occur?

a. Permanent tissue damage may occur, resulting in necrosis to that body part.
b. The area will be super sensitive.
c. The area is prone to a repeat frostbite.
d. The area is as susceptible as any other area.

Question 46: In the United States, what is the second most common connective tissue disease and the most destructive to the joints?

a. Osteoarthritis
b. Systemic lupus erythematosus (SLE)
c. Rheumatoid arthritis (RA)
d. Sjogren’s syndrome

Question 47: A 26-year-old woman is seen with complaints of irregular vaginal bleeding. Which of the following tests should be the first priority?
a. Pregnancy test

b. Pelvic ultrasound .

c. Endometrial biopsy
d. Platelet count

Question 48: A 45-year-old woman is seen in the clinic with complaints of a vaginal discharge. The clinician identifies clue cells on the vaginal smear. Which of the following diagnoses is associated with this finding?
a. Trichomonas
b. Bacterial vaginosis
c. Human papillomavirus (HPV)
d. Herpes simplex virus (HSV)

Question 49: Julie, aged 50, has migraine headaches, frequent asthma attacks, coronary artery disease, and hypertension. Which of the following prophylactic medications would you order for her migraines?

a. Propranolol

b. Timolol

c. Ergotamine
d. Topiramate

Question 50: A 64-year-old man with type 2 diabetes presents to the clinic with the complaint of “my feet feel like they are on fire.” He has a loss of vibratory sense, +1 Achilles reflex, and a tack embedded in his left heel. Which of the following would be an appropriate treatment?

a. Tricyclic antidepressants
b. Capsacin cream
c. Vitamin B12 injections
d. Insulin

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