Epidemic, Endemic, and Pandemic Occurrence of Disease(s)

One aspect of epidemiology is the study of the epidemic, endemic, and pandemic occurrence of disease(s). Some critics may argue diseases and conditions such as bird flu are endemic in many countries, and some may argue human immunodeficiency virus (HIV) or AIDS is a series of epidemics.

Using the South University Online Library or the Internet, research about the various epidemic, endemic, and pandemic occurrence of disease(s).

Based on your research and understanding, answer the following questions:

At what point does a disease become an epidemic, endemic, or pandemic? What are the parameters that define each of these states of a disease’s effect?
Do you agree that bird flu, HIV, or AIDS could be described as a series of epidemics? Why or why not?
Should we study epidemiology and disease control as a complement to the provision of healthcare services? Why or why not?
Disease control has evolved since the discoveries and achievements of these epidemiological pioneers— Hippocrates, John Snow, Pasteur, and Koch. Explain the impact of at least one major historical contribution on the current status of epidemiological practices. How can history potentially shape and impact our future work in public health and clinical medicine? Explain.

Ensure that all questions are answered from the To Complete section.

One nursing practice that can be mentioned is wound care and it’s importance of continually assessing

Wounds including taking pictures of the wound when patients are admitted etc.

In Part 3 of the Course Project, you consider how the evidence you gathered during Part 2 can be translated into nursing practice.Now that you have located available research on your PICOT question, you will examine what the research indicates about nursing practices. Connecting research evidence and findings to actual decisions and tasks that nurses complete in their daily practice is essentially what evidence-based practice is all about. This final component of the Course Project asks you to translate the evidence and data from your literature review into authentic practices that can be adopted to improve health care outcomes. In addition, you will also consider possible methods and strategies for disseminating evidence-based practices to your colleagues and to the broader health care field.To prepare:

• Consider Parts 1 and 2 of your Course Project. How does the research address your PICOT question?
• With your PICOT question in mind, identify at least one nursing practice that is supported by the evidence in two or more of the articles from your literature review. Consider what the evidence indicates about how this practice contributes to better outcomes.
• Explore possible consequences of failing to adopt the evidence-based practice that you identified.
• Consider how you would disseminate information about this evidence-based practice throughout your organization or practice setting. How would you communicate the importance of the practice?

To complete:In a 3- to 4-page paper:

• Restate your PICOT question and its significance to nursing practice.
• Summarize the findings from the articles you selected for your literature review. Describe at least one nursing practice that is supported by the evidence in the articles. Justify your response with specific references to at least 2 of the articles.
• Explain how the evidence-based practice that you identified contributes to better outcomes. In addition, identify potential negative outcomes that could result from failing to use the evidence-based practice.
• Outline the strategy for disseminating the evidence-based practice that you identified throughout your practice setting. Explain how you would communicate the importance of the practice to your colleagues. Describe how you would move from disseminating the information to implementing the evidence-based practice within your organization. How would you address concerns and opposition to the change in practice?

PART 1 AND 2 ARE ATTACHED

Question 1 2 / 2 points

A patient is seen with a sudden onset of flank pain accompanied by nausea, vomiting, and diaphoresis. In addition to nephrolithiasis, which of the following should be added to the list of differential diagnoses?

Question options:

a) Pancreatitis

b) Peptic ulcer disease

c) Diverticulitis

d) All of the above

Question 2 2 / 2 points

Which of the following would be an appropriate treatment for a patient with mild BPH?

Question options:

a) Refer to a urologist for surgery.

b) Prescribe a trial of tamsulosin.

c) Recommend cranberry supplements.

d) Reevaluate symptoms in 1 to 3 months.

Question 3 2 / 2 points

The result of the patient’s 24-hour urine for protein was 4.2 g/day. The clinician should take which of the following actions?

Question options:

a) Repeat the test.

b) Refer to a nephrologist.

c) Measure the serum protein.

d) Obtain a blood urea nitrogen (BUN) and creatinine.

Question 4 2 / 2 points

Which is the most potent and irritating dose of tretinoin?

Question options:

a) 0.05% liquid formulation

b) 0.1% cream

c) 1% foam

d) 0.02% cream

Question 5 2 / 2 points

Which of the following clinical manifestations are consistent with a patient in ARF?

Question options:

a) Pruritis

b) Glycosuria

c) Irritability

Question 6 2 / 2 points

Which of the following is an infraorbital fold skin manifestation in a patient with atopic dermatitis?

Question options:

a) Keratosis pilaris

b) Dennie’s sign

c) Keratoconus

d) Pityriasis alba

Question 7 2 / 2 points

The patient with BPH is seen for follow-up. He has been taking finasteride (Proscar) for 6 months. The clinician should assess this patient for which of these side effects?

Question options:

a) Erectile dysfunction

b) Glaucoma

c) Hypotension

d) Headache

Question 8 2 / 2 points

When using the microscope for an intravaginal infection, you see something translucent and colorless. What do you suspect?

Question options:

a) A piece of hair or a thread

b) Hyphae

c) Leukocytes

d) Spores

Question 9 2 / 2 points

Your patient is in her second trimester of pregnancy and has a yeast infection. Which of the following is a treatment that you usually recommend/order in nonpregnant patients, but is listed as a Pregnancy category D?

Question options:

a) Vagistat vaginal cream

b) Monistat combination pack

c) Terazol vaginal cream

d) Diflucan, 150 mg

Question 10 2 / 2 points

A patient is seen in the clinic with hematuria confirmed on microscopic examination. The clinician should inquire about the ingestion of which of these substances that might be the cause of hematuria?

Question options:

a) NSAIDs

b) Beets

c) Vitamin A

d) Red meat

Question 11 2 / 2 points

Which of the following tests is most useful in determining renal function in a patient suspected of CRF?

Question options:

a) BUN and creatinine

b) Electrolytes

c) Creatinine clearance

d) Urinalysis

Question 12 2 / 2 points

Eighty percent of men have noticeable hair loss by what age?

Question options:

a) 35

b) 50

c) 70

d) 85

Question 13 0 / 2 points

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?

Question options:

a) Spores

b) Leukocytes

c) Pseudohyphae

d) Epithelial cells

Question 14 2 / 2 points

Which of the following information is essential before prescribing Bactrim DS to a 24-year-old woman with a UTI?

Question options:

a) Last menstrual period

b) Method of birth control

c) Last unprotected sexual contact

d) All of the above

Question 15 2 / 2 points

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

Question options:

a) Radical orchidectomy

b) Lumpectomy

c) Radiation implants

d) All of the above

Question 16 2 / 2 points

Which test is used to confirm a diagnosis of epididymitis?

Question options:

a) Urinalysis

b) Gram stain of urethral discharge

c) Complete blood cell count with differential

d) Ultrasound of the scrotum

Question 17 2 / 2 points

Sally, age 25, presents with impetigo that has been diagnosed as infected with Staphylococcus. The clinical presentation is pruritic tender, red vesicles surrounded by erythema with a rash that is ulcerating. Her recent treatment has not been adequate. Which type of impetigo is this?

Question options:

a) Bullous impetigo

b) Staphylococcal scalded skin syndrome (SSSS)

c) Nonbullous impetigo

d) Ecthyma

Question 18 2 / 2 points

An example of ecchymosis is:

Question options:

a) A hematoma

b) A keloid

c) A bruise

d) A patch

Question 19 2 / 2 points

An 82-year-old man is seen in the primary care office with complaints of dribbling urine and difficulty starting his stream. Which of the following should be included in the list of differential diagnoses?

Question options:

a) Benign prostatic hyperplasia (BPH)

b) Parkinson’s disease

c) Prostate cancer

d) All of the above

Question 20 0 / 2 points

A 30-year-old man is seen with a chief complaint of loss of libido. Which of the following laboratory tests would help establish a diagnosis?

Question options:

a) Testosterone level

b) Prostate-specific antigen

c) Nocturnal penile tumescence and rigidity

d) Prolactin level

Question 21 2 / 2 points

A 35-year-old man presents with complaints of painful erections, and he notices his penis is crooked when erect. What is the most likely diagnosis?

Question options:

a) Peyronie’s disease

b) Damage to the pudendal artery

c) Scarring of the cavernosa

d) All of the above

Question 22 2 / 2 points

A 78-year-old man is diagnosed with C2 prostate cancer, and he asks the clinician what that means. In order to answer the patient, the clinician must have which of these understandings of the Jewett rating system?

Question options:

a) The cancer involves the seminal vesicles.

b) There is metastatic disease to regional lymph nodes.

c) The cancer is confined to the capsule.

d) There is metastasis to distant organs.

Question 23 0 / 2 points

During a DRE on a 75-year-old man, the clinician suspects the patient has prostate cancer. What physical finding should make the clinician suspicious?

Question options:

a) An enlarged rubbery gland

b) A hard irregular gland

c) A tender gland

d) A boggy gland

Question 24 2 / 2 points

Tinea unguium is also known as:

Question options:

a) Onychomycosis

b) Tinea versicolor

c) Tinea manuum

d) Tinea corporis

Question 25 2 / 2 points

The patient is diagnosed with acute renal failure (ARF).Which of the following data obtained from the history should alert the provider that this is a case of prerenal azotemia?

Question options:

a) Recent heat stroke

b) Nephrolithiasis

c) Recent infection where gentamicin was used in treatment

d) All of the above

Question 26 2 / 2 points

Which of the following statements is accurate when you are removing a seborrheic keratosis lesion using liquid nitrogen?

Question options:

a) Do not use lidocaine as it may potentiate bleeding.

b) Pinch the skin taut together.

c) Use gel foam to control bleeding.

d) This should be performed by a dermatologist only.

Question 27 2 / 2 points

A patient is diagnosed with urge incontinence. Before prescribing Detrol XL, the provider should question the patient about which of these contraindications to this medication?

Question options:

a) Diarrhea

b) Parkinson’s disease

c) Closed-angle glaucoma

d) Breast cancer

Question 28 2 / 2 points

Simon presents with alopecia areata with well-circumscribed patches of hair loss on the crown of his head. How do you respond when he asks you the cause?

Question options:

a) “You must be under a lot of stress lately.”

b) “It is hereditary. Did your father experience this also?”

c) “The cause is unknown, but we suspect it is due to an immunologic mechanism.”

d) “We’ll have to do some tests.”

Question 29 2 / 2 points

A 58-year-old patient has been receiving leuprolide as treatment for prostate cancer. The clinician should instruct the patient about which of these side effects?

Question options:

a) Risk of osteoporosis

b) May have hot flushes

c) May have impotence

d) All of the above

Question 30 2 / 2 points

Josh, aged 22, has tinea versicolor. Which description is the most likely for this condition?

Question options:

a) There are round, hypopigmented macules on his back.

b) Josh has red papules on his face.

c) There are crusted plaques in Josh’s groin area.

d) There are white streaks on his neck.

Question 31 2 / 2 points

The most common precancerous skin lesion found in Caucasians is:

Question options:

a) A skin tag

b) Actinic keratosis

c) A melanoma

d) A basal cell lesion

Question 32 2 / 2 points

Which scalp problem can be caused by a fever and certain drugs?

Question options:

a) Telogen effluvium (TE)

b) Trichotillomania

c) Psoriasis

d) Alopecia areata

Question 33 2 / 2 points

A 46-year-old man presents with urinary hesitancy and low back pain. He has no history of UTI. Digital rectal examination (DRE) reveals a normal prostate, and a diagnosis of prostatodynia is made. Which is the appropriate treatment?

Question options:

a) Terazosin 2 mg PO once a day

b) Ice pack to the scrotal area

c) Saw palmetto 320 mg per day

d) All of the above

Question 34 2 / 2 points

A 30-year-old patient presents with pain on urination. The urine microscopy of unspun urine shows greater than 10 leukocytes/mL, and a dipstick is positive for nitrites. What is the probable diagnosis?

Question options:

a) Lower urinary tract infection

b) Chlamydia infection

c) Candidiasis

d) Pyelonephritis

Question 35 2 / 2 points

Which of the following foods should be limited in a patient with CRF?

Question options:

a) Milk

b) Bananas

c) Soy sauce

d) All of the above

Question 36 2 / 2 points

An example of a primary skin lesion is a/an:

Question options:

a) Bulla

b) Scale

c) Excoriation

d) Fissure

Question 37 2 / 2 points

A 76-year-old man is seen in the office for complaints of urinary incontinence. The clinician should explore which of these causes of incontinence in men?

Question options:

a) Urethral polyps

b) Urinary tract infection (UTI)

c) Anticholinergic medication

d) All of the above

Question 38 2 / 2 points

A patient is seen in the clinic with a chief complaint of hematuria. To make a differential diagnosis, which of the following questions should be asked?

Question options:

a) “Do you have a history of liver disease?”

b) “What medications are you currently taking?”

c) “Have you noticed swelling in your ankles?”

d) All of the above

Question 39 2 / 2 points

A 78-year-old man is diagnosed with Stage D bladder cancer and asks the provider what that means. Which is the best response?

Question options:

a) “There is no such thing as Stage D cancer.”

b) “You have cancer that has spread to the surrounding tissue.”

c) “Your cancer has spread to other organs.”

d) “Your cancer can be cured by removing your bladder.”

Question 40 2 / 2 points

Treatment for epididymitis includes which of the following?

Question options:

a) Warm sitz baths

b) Scrotal elevation

c) Masturbation

d) All of the above

Question 41 2 / 2 points

A patient is seen in the office complaining of severe flank pain. The clinician should assess this patient for which risk factor for kidney stones?

Question options:

a) Hypertension

b) Constipation

c) Tubal ligation

d) Diabetes

Question 42 2 / 2 points

A 63-year-old man is seen in the clinic with a chief complaint of nocturia. Which of the following should be included in the differential diagnosis?

Question options:

a) Psychogenic nocturia

b) Urethral polyp

c) Irritative posterior urethral lesion

d) Benign prostatic hypertrophy

Question 43 0 / 2 points

A patient with testicular cancer is being followed after completing treatment 1 year ago. He has been symptom-free with no evidence of disease. How often should he have a CT scan?

Question options:

a) Every month

b) Every 3 to 4 months

c) Every 6 to 12 months

d) Every year

Question 44 2 / 2 points

Mark has necrotizing fasciitis of his left lower extremity.Pressure on the skin reveals crepitus due to gas production by which anaerobic bacteria?

Question options:

a) Staphylococcal aureus

b) Clostridium perfringens

c) S. pyrogenes

d) Streptococcus

Question 45 2 / 2 points

Ian, age 62, presents with a wide, diffuse area of erythematous skin on his lower left leg that is warm and tender to palpation.There is some edema involved. You suspect:

Question options:

a) Necrotizing fasciitis

b) Kaposi’s sarcoma

c) Cellulitis

d) A diabetic ulcer

Question 46 2 / 2 points

Why do people of African descent have a lower incidence of non-melanoma skin cancer?

Question options:

a) They have an increased number of melanocytes.

b) Their darker skin protects from ultraviolet radiation.

c) Their skin is thicker.

d) Their immune system is stronger.

Question 47 2 / 2 points

A 23-year-old sexually active man is seen in the clinic with unilateral painful testicular swelling, and he is diagnosed with epididymitis.In order to prescribe the correct drug, the clinician must understand that which of these is the most common causative organism?

Question options:

a) Escherichia coli

b) Staphylococcus aureus

c) Chlamydia trachomatis

d) Pseudomonas aeruginosa

Question 48 2 / 2 points

When instructing your elderly client about treating her xerosis, what do you tell her?

Question options:

a) A daily hot bath may help the associated pruritus.

b) Rub the skin briskly to make sure it is completely dry after bathing.

c) Only take short tepid showers.

d) Use a gel that is alcohol-based after bathing to soften the skin.

Question 49 2 / 2 points

Which of the following instructions should be given to the patient with nephrolithiasis?

Question options:

a) Take ibuprofen, 600 mg every 8 hours.

b) Take Tums? for stomach upset.

c) Drink more black tea.

d) Increase intake of vegetables, like spinach.

Question 50 2 / 2 points

The 56-year-old man with chronic prostatitis should be treated with trimethoprim 80 mg-sulfamethoxazole 400 mg (TMP-SMX, Bactrim) for how long?

Question options:

a) 3 to 7 days

b) 14 to 21 days

c) 3 to 6 weeks

d) 6 to 12 weeks

In the Module 4 Discussion, you considered how professional nurses can become involved in policy-making. A critical component of any policy design is evaluation of the results. How comfortable are you with the thought of becoming involved with such matters?

Some nurses may be hesitant to get involved with policy evaluation. The preference may be to focus on the care and well-being of their patients; some nurses may feel ill-equipped to enter the realm of policy and political activities. However, as you have examined previously, who better to advocate for patients and effective programs and polices than nurses? Already patient advocates in interactions with doctors and leadership, why not with government and regulatory agencies?

In this Discussion, you will reflect on the role of professional nurses in policy evaluation.

To Prepare:

In the Module 4 Discussion, you considered how professional nurses can become involved in policy-making.
Review the Resources and reflect on the role of professional nurses in policy evaluation.

Post an explanation of at least two opportunities that currently exist for RNs and APRNs to actively participate in policy review. Explain some of the challenges that these opportunities may present and describe how you might overcome these challenges. Finally, recommend two strategies you might make to better advocate for or communicate the existence of these opportunities. Be specific and provide examples.

4 to 4 References

Reflect on the concepts and practices you have learned in NR506 on healthcare systems, politics, and health policy. Read the article that is linked below and share insights as how to make informed decisions on nursing practice and patient outcomes on a global basis.  In addition, state how you will apply what you have learned in this course to your upcoming practicum experience.

Read the article by:

Kohl, H.W., Craig, C. L., Lambert, E.V., Inoue, S., Alkandari, J.R., Leetonngin, G., & Kahlmeier, K. (2012). The

pandemic of physical inactivity: Global action for public health. The Lancet, 380(9838), 294-305. doi:

http://dx.doi.org/10.1016/S0140-6736(12)60898-8. Link to article (Links to an external site.)Links to an external site.

A systems approach to dealing with the global concern of physical inactivity is discussed.