Walden NURS6501 Week 8 Quiz latest 2017

Question 1

A 40-year-old female presents complaining of pain near the midline in the epigastrium. Assuming the pain is caused by a stimulus acting on an abdominal organ, the pain felt is classified as:

a. Visceral
b. Somatic
c. Parietal
d. Referred

Question 2

An 8-week-old male was recently diagnosed with cystic fibrosis. Which of the following digestive alterations would be expected?

a. Insufficient bile production
b. Gastric atrophy
c. Hypersecretion of stomach acid
d. Nutrient malabsorption

Question 3

In alcoholic cirrhosis, hepatocellular damage is caused by:

a. acetaldehyde accumulation.
b. bile toxicity.
c. acidosis.
d. fatty infiltrations.

Question 4

Where does the nurse expect the obstruction to be in a patient with extrahepatic portal hypertension?

a. Sinusoids
b. Bile ducts
c. Hepatic portal vein
d. Hepatic artery

Question 5

Kwashiorkor is a severe dietary deficiency of:

a. fat-soluble vitamins.
b. carbohydrates.
c. protein.
d. calcium and magnesium.

Question 6

A 27-year-old male presents with fever, GI bleeding, hepatomegaly, and transient joint pain. He reports that as a child he received blood transfusions following a motor vehicle accident. He also indicates he was vaccinated against hepatitis B. Which of the following types of hepatitis does the clinician think he most likely has?

a. A
b. B
c. C
d. D

Question 7

Prolonged diarrhea is more serious in children than adults because:

a. children have lower adipose reserves.
b. fluid reserves are lower in children.
c. children have a lower metabolic rate.
d. children are more resistant to antimicrobial therapy.

Question 8

A 40-year-old male develops an intestinal obstruction related to protrusion of the intestine through the inguinal ring. This condition is referred to as:

a. Intussusception
b. A volvulus
c. A hernia
d. Adhesions

Question 9

A 60-year-old male presents with GI bleeding and abdominal pain. He reports that he takes NSAIDs daily to prevent heart attack. Tests reveal that he has a peptic ulcer. The most likely cause of this disease is:

a. Increasing subepithelial bicarbonate production
b. Accelerating the H+ (proton) pump in parietal cells
c. Inhibiting mucosal prostaglandin synthesis
d. Stimulating a shunt of mucosal blood flow

Question 10

Acute pancreatitis often manifests with pain to which of the following regions?

a. Right lower quadrant
b. Right upper quadrant
c. Epigastric
d. Suprapubic

Question 11

A 60-year-old male is diagnosed with cancer of the esophagus. Which of the following factors most likely contributed to his disease?

a. Reflux esophagitis
b. Intestinal parasites
c. Ingestion of salty foods
d. Frequent use of antacids

Question 12

The primary complication of enterocolitis associated with Hirschsprung disease is related to which finding?

a. Fecal impaction
b. Pancreatic insufficiency
c. Hyperactive peristalsis
d. Ileal atresia

Question 13

The most common cause of chronic vascular insufficiency among the elderly is:

a. Anemia
b. Aneurysm
c. Lack of nutrition in gut lumen
d. Atherosclerosis

Question 14

The most common clinical manifestation of portal hypertension is _____ bleeding.

a. rectal
b. duodenal
c. esophageal
d. intestinal

Question 15

A 54-year-old male is diagnosed with peptic ulcer disease.This condition is most likely caused by:

a. Hereditary hormonal imbalances with high gastrin levels
b. Breaks in the mucosa and presence of corrosive secretions
c. Decreased vagal activity and vascular engorgement
d. Gastric erosions related to high ammonia levels and bile reflux

Question 16

The cardinal sign of pyloric stenosis caused by ulceration or tumors is:

a. Constipation
b. Diarrhea
c. Vomiting
d. Heartburn

Question 17

A 55-year-old male died in a motor vehicle accident. Autopsy revealed an enlarged liver caused by fatty infiltration, testicular atrophy, and mild jaundice secondary to cirrhosis. The most likely cause of his condition is:

a. Bacterial infection
b. Viral infection
c. Alcoholism
d. Drug overdose

Question 18

Manifestations associated with hepatic encephalopathy from chronic liver disease are the result of:

a. hyperbilirubinemia and jaundice.
b. fluid and electrolyte imbalances.
c. impaired ammonia metabolism.
d. decreased cerebral blood flow.

Question 19

The most common disorder associated with upper GI bleeding is:

a. diverticulosis.
b. hemorrhoids.
c. esophageal varices.
d. cancer.

Question 20

A 3-month-old female develops colicky pain, abdominal distention, and diarrhea after drinking cow’s milk. The best explanation for her symptoms is:

a. Deficiency of bile that stimulates digestive secretions and bowel motility
b. Excess of amylase, which increases the breakdown of starch and causes an osmotic diarrhea
c. Overgrowth of bacteria from undigested fat molecules, which leads to gas formation and de creased bowel motility
d. Excess of undigested lactose in her digestive tract, resulting in increased fluid movement into the digestive lumen and increased bowel motility

Question 21

A 55-year-old female has general symptoms of gallstones but is also jaundiced. IV cholangiography would most likely reveal that the gallstones are obstructing the:

a. Intrahepatic bile canaliculi
b. Gallbladder
c. Cystic duct
d. Common bile duct

Question 22

A 1-week-old female is brought to her pediatrician for abdominal distention and unstable temperature. Physical examination reveals bradycardia and apnea. Tests reveal hypoxic injury to the bowel resulting in bacterial invasion and perforation. This condition is referred to as:

a. Infective enteropathy
b. Necrotizing enterocolitis (NEC)
c. Mucoviscidosis
d. Ileus

Question 23

For the patient experiencing esophageal reflux, the nurse would expect which sphincter to be malfunctioning?

a. Pyloric
b. Lower esophageal
c. Upper esophageal
d. Gastric

Question 24

Cholecystitis is inflammation of the gallbladder wall usually caused by:

a. accumulation of bile in the hepatic duct.
b. obstruction of the cystic duct by a gall-stone.
c. accumulation of fat in the wall of the gallbladder.
d. viral infection of the gallbladder.

Question 25

A 6-month-old male infant is brought to the ER after the sudden development of abdominal pain, irritability, and vomiting followed by passing of “currant jelly” stool. Ultrasound reveals intestinal obstruction in which the ileum collapsed through the ileocecal valve and invaginated into the large intestine. This type of obstruction is referred to as:

a. Prolapse
b. Pyloric stenosis
c. Intussusception
d. Imperforation

Question 26

A 22-year-old male underwent brain surgery to remove a tumor. Following surgery, he experienced a peptic ulcer. His ulcer is referred to as a(n) _____ ulcer.

a. Infectious
b. Cushing
c. Ischemic
d. Curling

Question 27

Chronic gastritis is classified according to the:

a. severity.
b. location of lesions.
c. patient’s age.
d. signs and symptoms.

Question 28

Reflux esophagitis is defined as a(n):

a. Immune response to gastroesophageal reflux
b. Inflammatory response to gastroesophageal reflux
c. Congenital anomaly
d. Secretory response to hiatal hernia

Question 29

The cardinal signs of small bowel obstruction are:

a. Vomiting and distention
b. Diarrhea and excessive thirst
c. Dehydration and epigastric pain
d. Abdominal pain and rectal bleeding

Question 30

The nurse assessing the patient with biliary atresia would expect to find which primary clinical manifestation?

a. Anemia
b. Jaundice
c. Hypobilirubinemia
d. Ascites

Question 31

A 20-year-old male was recently diagnosed with lactose intolerance. He eats an ice cream cone and develops diarrhea. His diarrhea can be classified as _____ diarrhea.

a. Motility
b. Hypotonic
c. Secretory
d. Osmotic

Question 32

Which of the following symptoms would help a health care provider distinguish between ulcerative colitis and Crohn disease?

a. Pattern of remission/exacerbations
b. Abdominal pain
c. Malabsorption
d. Diarrhea

Question 33

A 45-year-old male complains of heartburn after eating and difficulty swallowing. He probably has:

a. Pyloric stenosis
b. Hiatal hernia
c. Gastric cancer
d. Achalasia

Question 34

The exocrine portion of the pancreas contains:

a. alpha cells.
b. beta cells.
c. acinar cells.
d. islets of Langerhans.

Question 35

Outbreaks of hepatitis _____ often occur in young children attending day care centers and can be attributed to poor hand washing.

a. A
b. B
c. C
d. D

Discussion: Developing a Balanced Scorecard

How does a group gauge whether the strategic changes they implement are creating sound business results?

The effective use of a balanced scorecard can facilitate alignment between strategic initiatives and day-to-day operations. The balanced scorecard may serve as a valuable tool for monitoring progress and assessing the outcomes of a strategic plan and provide a practical means of communication.

In this Discussion, you examine the use of a balanced scorecard to measure performance related to finances, customer/client satisfaction, internal processes, and learning and growth.

To prepare:

Review the information in the Learning Resources, including this week’s media presentation, focusing on the development of performance metrics for a strategic plan. See Figure 8-6: Design your Balanced Scorecard in the Sare and Ogilvie course text.

With your Course Project in mind, think about how you would develop a balanced scorecard to measure performance, including the processes you would use to gather appropriate data.

Consider how the use of a balanced scorecard reflects the importance of being able to evaluate progress, assess the impact of planned change on performance, and determine if the costs are justified in terms of the outcomes.

Post an explanation of your plan for creating a balanced scorecard as part of your Course Project, including the processes you would use to gather data to measure performance. Explain how the use of this balanced scorecard would enable you to evaluate progress, assess the impact of your proposed change, and determine if the costs are justified in terms of the outcomes.

Read a selection of your colleagues’ responses. (I will send the peer responses on the handshake private message)

Respond to at least two of your colleagues on two different days by offering suggestions for further developing their balanced scorecards. Ask questions to peer responses at the end of every response. Cite your responses.

Required Readings

Sare, M. V., & Ogilvie, L. (2010). Strategic planning for nurses: Change management in health care. Sudbury, MA: Jones and Bartlett.

Chapter 8, “Overview of Strategic Planning Theories: Strategic Planning Architecture” (pp. 147–166)

Fields, S. A., & Cohen, D. (2011). Performance enhancement using a balanced scorecard in a patient-centered medical home. Family Medicine, 43(10), 735–739.

Copyright 2011 by Society of Teachers of Family Medicine. Reprinted by permission of Society of Teachers of Family Medicine via the Copyright Clearance Center.

The authors discuss using a balanced scorecard for quality improvement in patient-centered medical homes.

Groene, O., Brandt, E., Schmidt, W., & Moeller, J. (Aug 2009). The balanced scorecard of acute settings: Development process, definition of 20 strategic objectives and implementation.International Journal for Quality in Health Care, 21(4), 259–271.

Copyright 2009 by Oxford University Press – Journals. Reprinted by permission of Oxford University Press – Journals via the Copyright Clearance Center.

In this article, the authors discuss the use of a balanced scorecard as a tool for strategic planning in hospitals. The article includes an example of a strategy map, timeline, and balanced scorecard.

Jeffs, L., Merkley, J., Richardson, S., Eli, J., & McAllister, M. (2011). Using a nursing balanced scorecard approach to measure and optimize nursing performance. Nursing Leadership, 24(1), 47–58.

Copyright 2011 by Longwoods Publishing Corporation. Reprinted by permission of Longwoods Publishing Corporation via the Copyright Clearance Center.

Kollberg, B., & Elg, M. (2011). The practice of the balanced scorecard in health care services.International Journal of Productivity and Performance Management, 60(5), 427–445.

Retrieved from the Walden Library databases.

The authors look at the use of a balanced scorecard for health care performance management in Sweden.

Lupi, S., Verzola, A., Carandina, G., Salani, M., Antonioli, P., & Gregorio, P. (2011). Multidimensional evaluation of performance with experimental application of balanced scorecard: A two year experience. Cost Effectiveness and Resource Allocation, 9(1), 7.

Retrieved from the Walden Library databases.

This article examines the application of a balanced scorecard within a unit in a hospital to compare performance results and goal achievement.

Balanced Scorecard Institute. (2013). Balanced scorecard basics. Retrieved fromhttp://www.balancedscorecard.org/BSCResources/AbouttheBalancedScorecard/tabid/55/Default.aspx

View the information on this website to learn about balanced scorecards.

Mountain State Group. (n.d.) Balanced scorecards for small rural hospitals: Concept overview and implementation guidance. Retrieved March 13, 2013, fromhttp://www.ruralcenter.org/sites/default/files/Final%20BSC%20Manual%2010.18F.pdf

The Scarborough Hospital. (2013). Balanced scorecard. Retrieved fromhttp://tsh.to/pages/Balanced-Score-Card

This website provides an example of a balanced scorecard.

Sunnybrook Health Sciences Centre. (2013). Balanced scorecard. Retrieved fromhttp://sunnybrook.ca/scorecard/index.asp#sr

This website provides an example of a balanced scorecard.

Required Media

Laureate Education (Producer). (2013a). The balanced scorecard approach [Video file]. Retrieved from the https://class.waldenu.edu

Note: The approximate length of this media piece is 3 minutes.

Dr. Carol Huston discusses the elements and use of a balanced scorecard as a strategic planning evaluation tool.

Details:

Write a 750-1000 word analysis of “Case Study: Fetal Abnormality.” Be sure to address the following questions:

1. Which theory or theories are being used by Jessica, Marco, Maria, and Dr. Wilson to determine the moral status of the fetus? Explain.
2. How does the theory determine or influence each of their recommendation for action?
3. What theory do you agree with? How would that theory determine or influence the recommendation for action?

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 Turnitin. Please refer to the directions in the Student Success Center.

PHI-413V-RS-T2CaseStudy.docx Please Note: Assignment will not be submitted to the faculty member until the “Submit” button under “Final Submission” is clicked.

If you talk about a possible poor health outcome, do you believe that outcome will occur? Do you believe eye contact and personal contact should be avoided?

You would have a difficult time practicing as a nurse if you believed these to be true. But they are very real beliefs in some cultures.

Differences in cultural beliefs, subcultures, religion, ethnic customs, dietary customs, language, and a host of other factors contribute to the complex environment that surrounds global healthcare issues. Failure to understand and account for these differences can create a gulf between practitioners and the public they serve.

In this Assignment, you will examine a global health issue and consider the approach to this issue by the United States and by one other country.

To Prepare:

• Review the World Health Organization’s (WHO) global health agenda and select one global health issue to focus on for this Assignment.
• Select at least one additional country to compare to the U.S. for this Assignment.
• Reflect on how the global health issue you selected is approached in the U.S. and in the additional country you selected.
• Review and download the Global Health Comparison Matrix provided in the Resources.

The Assignment: (2-page Global Health Comparison Matrix; 1-page Plan for Social Change)

Part 1: Global Health Comparison Matrix

Focusing on the country you selected and the U.S., complete the Global Health Comparison Matrix. Be sure to address the following:

• Consider the U.S. national/federal health policies that have been adapted for the global health issue you selected from the WHO global health agenda. Compare these policies to the additional country you selected for study.
• Explain the strengths and weaknesses of each policy.
• Explain how the social determinants of health may impact the global health issue you selected. Be specific and provide examples.
• Using the WHO’s Organization’s global health agenda as well as the results of your own research, analyze how each country’s government addresses cost, quality, and access to the global health issue selected.
• Explain how the health policy you selected might impact the health of the global population. Be specific and provide examples.
• Explain how the health policy you selected might impact the role of the nurse in each country.
• Explain how global health issues impact local healthcare organizations and policies in both countries. Be specific and provide examples.

Part 2: A Plan for Social Change

Reflect on the global health policy comparison and analysis you conducted in Part 1 of the Assignment and the impact that global health issues may have on the world, the U.S., your community, as well as your practice as a nurse leader.

In a 1-page response, create a plan for social change that incorporates a global perspective or lens into your local practice and role as a nurse leader.

• Explain how you would advocate for the incorporation of a global perspective or lens into your local practice and role as a nurse leader.
• Explain how the incorporation of a global perspective or lens might impact your local practice and role as a nurse leader.
• Explain how the incorporation of a global perspective or lens into your local practice as a nurse leader represents and contributes to social change. Be specific and provide examples.

Prepare this assignment as a 1,500-1,750 word paper using the instructor feedback from the previous course assignments and the guidelines below.

PICOT Question

Revise the PICOT question you wrote in the Topic 1 assignment using the feedback you received from your instructor.

The final PICOT question will provide a framework for your capstone project (the project students must complete during their final course in the RN-BSN program of study).

Research Critiques

In the Topic 2 and Topic 3 assignments, you completed a qualitative and quantitative research critique on two articles for each type of study (4 articles total). Use the feedback you received from your instructor on these assignments to finalize the critical analysis of each study by making appropriate revisions.

The completed analysis should connect to your identified practice problem of interest that is the basis for your PICOT question.

Refer to “Research Critiques and PICOT Guidelines – Final Draft.” Questions under each heading should be addressed as a narrative in the structure of a formal paper.

Proposed Evidence-Based Practice Change

Discuss the link between the PICOT question, the research articles, and the nursing practice problem you identified. Include relevant details and supporting explanation and use that information to propose evidence-based practice changes.

General Requirements

Prepare this assignment according to the APA 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.