The Institute of Medicine has stated a goal that 90% of practice be evidence-based by 2020. According to HealthyPeople.gov, the United States is currently at approximately 15%. Discuss two barriers that might hold nursing practice from achieving this goal, and suggest ways in which identified barriers may be addressed.
I NEED YOU TO ANSWER THIS QUESTION, NO MORE THAN 500 WORDS NEEDED, AND TWO REFERENCES NEEDED THANK YOU
epigastrium-nursing Questions
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
Does objectivism require religion? Is is possible to be moral without a belief in God?
CULTURAL HERITAGE ASSESSMENT
paper
Original Work, NO PLAGERIESM
APPENDIX E.1
CULTURAL HERITAGE ASSESSMENT
EVALUATION CRITERIA (IT 3:3)
1. Use the Heritage Assessment Tool to conduct an interview of someone you do not know, and is a member of a different culture, is from a different country or a different part of the world than you.
2. Make a copy of the interview schedule.
3. If you adapt any of the questions, or ask additional questions, write a note in the margins of the tool. Specify how the question was adapted, or what additional questions were asked, and note the responses.
4. Write a two page reflection paper, which describes what this experience was like for you. What personal insights did you gain through this experience related to your prior assumptions about other cultures, religions or the diversity of our community?
The paper is to be typed in 12 point, Times New Roman font.
A. Identify what stood out for you about this experience and explain why it stood out.
B. Describe the most significant thing you learned about the person you interviewed.
a. Explain why it was significant.
C. Describe the most significant thing you learned about yourself from this experience.
a. Explain why it was significant.
5. Attach the two page reflection paper to your Heritage Assessment Tool with responses indicated.
6. Turn in the Heritage Assessment Tool, responses and reflection by the due date.
APPENDIX E.1
CULTURAL HERITAGE ASSESSMENT
EVALUATION CRITERIA (IT 3:3)
1. Use the Heritage Assessment Tool to conduct an interview of someone you do not know, and is a member of a different culture, is from a different country or a different part of the world than you.
2. Make a copy of the interview schedule.
3. If you adapt any of the questions, or ask additional questions, write a note in the margins of the tool. Specify how the question was adapted, or what additional questions were asked, and note the responses.
4. Write a two page reflection paper, which describes what this experience was like for you. What personal insights did you gain through this experience related to your prior assumptions about other cultures, religions or the diversity of our community?
The paper is to be typed in 12 point, Times New Roman font.
A. Identify what stood out for you about this experience and explain why it stood out.
B. Describe the most significant thing you learned about the person you interviewed.
a. Explain why it was significant.
C. Describe the most significant thing you learned about yourself from this experience.
a. Explain why it was significant.
5. Attach the two page reflection paper to your Heritage Assessment Tool with responses indicated.
6. Turn in the Heritage Assessment Tool, responses and reflection by the due date.
Professional Goals and Self-Assessment of Clinical Skills Assignment
Complete a Practicum Journal Entry that prompts you to reflect on your practicum experiences and relate them to your Professional Goals and Self-Assessment of Clinical Skills Assignment. I need Week 5, 6, 7 , 8, 9, and 10 Journal Entries. Each Journal should be 1/2 page, APA format and at least 2 references. This is MSN-FNP course. Budget $30
Personal and Community Health
Health Application Assignment.
Personal and Community Health
Dr. M.L. Holt
Application #3
Morgan State University
Dr. M.L. Holt
Application #3
Morgan State University
Scenario
John attended a back to school cookout at Blount tours. Everyone has a blast. For awhile it seems almost too warm, but plenty of cold drinks were available and by late afternoon it had become quite pleasant.
A 8 p.m. that night, instead of studying as he planned John was laying in his bed with a stomach. He was experiencing severe diarrhea and had several hurried trips to the bathroom.
The next day John found out that many other people were sick with stomach cramps and diarrhea. John began to think about what a coincidence it was that all of them were sick with the same symptoms at the same time.
John attended a back to school cookout at Blount tours. Everyone has a blast. For awhile it seems almost too warm, but plenty of cold drinks were available and by late afternoon it had become quite pleasant.
A 8 p.m. that night, instead of studying as he planned John was laying in his bed with a stomach. He was experiencing severe diarrhea and had several hurried trips to the bathroom.
The next day John found out that many other people were sick with stomach cramps and diarrhea. John began to think about what a coincidence it was that all of them were sick with the same symptoms at the same time.
Instructions
Based on the information about what happened to John and the other students, answer the following questions.
Identify what kind of disease type (ex. endemic, pandemic, or epidemic) has occurred and explain why
Name 3 entities on Morgan State University campus that John should notify about the large number of sick students. Justify in your response why he sh0uld contact them
Identify 2 recommendations that you would make to the organizers of the cookout as ways to avoid something like this happening in the future
Based on the information about what happened to John and the other students, answer the following questions.
Identify what kind of disease type (ex. endemic, pandemic, or epidemic) has occurred and explain why
Name 3 entities on Morgan State University campus that John should notify about the large number of sick students. Justify in your response why he sh0uld contact them
Identify 2 recommendations that you would make to the organizers of the cookout as ways to avoid something like this happening in the future
health screening and history on a young adult.
In this assignment, you will be completing a comprehensive health screening and history on a young adult. To complete this assignment, do the following:
Select an adolescent or young adult client on whom to perform a health screening and history. Students who do not work in an acute setting may “practice” these skills with a patient, community member, neighbor, friend, colleague, or loved one.
Complete the “Health History and Screening of an Adolescent or Young Adult Client” worksheet.
Complete the assignment as outlined on the worksheet, including:
- Biographical data
- Past health history
- Family history: Obstetrics history (if applicable) and well young adult behavioral health history screening
- Review of systems
- All components of the health history
- Three nursing diagnoses for this client based on the health history and screening (one actual nursing diagnosis, one wellness nursing diagnosis, and one “risk for” nursing diagnosis)
- Rationale for the choice of each nursing diagnosis.
- A wellness plan for the adolescent/young adult client, using the three nursing diagnoses you have identified.
Format the write-up in a manner that is easily read, computer-generated, neat, and without spelling errors. Use correct acronyms or abbreviations when indicated.
While APA format is not required for the body of this assignment, solid academic writing is expected and in-text citations and references should be presented using APA documentation guidelines, which can be found in the APA Style Guide, located in the Student Success Center.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
substance abuse
1. In your own words define substance abuse and give some examples of some substances and the impact in the health of your community.
2. How can you apply the levels of prevention when dealing with the problem of substance abuse in your community. Give some examples.
3. In your own words define violence and discuss the role of the community health nurse in the management of this public health issue.
4. Discuss recent violence acts that happened in your community of nationally and how do you think it could be prevented and the role of the community nurse in the prevention of them.
Chapter Summary
Smith, Turkel & Wolf (2013) Chapter 12
Summary: The purpose of the weekly reflective journal exercises is to allow for analysis, synthesis and evaluation of nursing theory using guided questions. Reflection has been referred to as a process that happens internally, privately or in isolation (Hill & Watson, 2011). Also a useful definition of reflection has been referred to as the examination of an issue of concern, as a consequence of experience, creating clarity and meaning in terms of self, and which results in a change of perspective ( Boyd & Fales, 1983).
Directions: Complete the Reflective Journal questions presented in your Smith, Turkel, & Wolf (2013) text as defined in the course outline. Post the responses to the questions in the D2L dropbox.
types of variables
- Identify the types of variables you would need to conduct:
- a Chi-square (for students whose last name begins with A-H)
- one-sample t-test (for students whose last name begins with I-P)
- paired t-test (for students whose last name begins with Q-Z)
- Be sure to explain the number of dependent and independent variables, and the types of dependent variables necessary for the statistical analysis.
- Provide a health-related example (or use a peer-reviewed article that used the statistical analysis) to explain your answer.
250 words