Medical-Surgical

A nurse working at a rehabilitation facility is attending an interdisciplinary team meeting for a client who had a let hemispheric stroke. Which of the following members of the interdisciplinary team should the nurse recommend to assist this client? (Select all that apply) \geoquad A. Nurse \geoquad B. Occupational therapist \geoquad C. Speech therapist \geoquad D. Physical therapist \geoquad E. Respiratory therapist

An 80-year-old man is admitted to the hospital for treatment of pneumonia. On the third day of hospitalization, he becomes acutely confused, disoriented to time and place, and has difficulty maintaining attention during conversation. His symptoms fluctuate throughout the day and worsen in the evening. His past medical history includes hypertension and mild cognitive impairment. Which of the following is the most likely diagnosis?

Which of the following signs is most likely to been in patients with early cholecystitis? Q SHOW CHARACTER HINT Hypothermia Bradycardia Low oxygen saturation Hypertension and Tachycardia Hypotension and Tachycardia Fever

Case Presentation: Samuel Whittemore Samuel is a 45 year old male that presents with symptoms of fatigue, weight gain, and difficulty concentrating. Medical history includes hypertension and a family history of cardiovascular disease. Lifestyle factors include a sedentary job and poor dietary habits. Physical Examination Findings: Body Weight: 209 lbs. Height: 5'10" BMI: 30 kg/m² (Obesity) Blood Pressure: 150/90 mmHg (Elevated) Laboratory Tests: Elevated fasting blood glucose, dyslipidemia. Nutrition Assessment: Components: Dietary recall, anthropometric measurements, biochemical analysis. Purpose: To evaluate Samuel's dietary habits, nutritional status, and lifestyle factors contributing to his health concerns.

What would be an herbal option for a patient for cardiac health? Question 30Select one: a. Saw pawmetto b. Wild yam extract c. Black cohash d. Coenzyme Q10

___________ treatment refers to treatment of the fracture/dislocation without a surgical incision into the site. The physician manipulates the bone fragments without surgical exposure.

Which of the following is best defined as a surgical removal of the gallbladder? Q SHOW CHARACTER HINT Colonoscopy Cholecystectomy Ileostomy Colectomy Cystoscopy Colostomy

Which of the following treatments or interventions is most commonly indicated in a patient with cholecystitis? Q SHOW CHARACTER HINT Paracentesis Stool Transplant Dialysis Analgesics TURP Procedure Cryotherapy

Which of the following treatments or interventions is most commonly indicated in a patient with cholecystitis? Q SHOW CHARACTER HINT Cryotherapy Exchange Transfusion Peritoneal Dialysis Gastric Bypass Surgery Appendectomy Supportive Therapy

Which activity best represents health promotion and maintenance rather than illness prevention or treatment? \geoquad Providing IV antibiotics for infection \geoquad Administering insulin to a patient with diabetes \geoquad Assisting a patient with stroke rehabilitation \geoquad Teaching a prenatal class about nutrition and exercise

ou are caring for a cardiac arrest victim who fell off a two-story roof. He has obvious signs of facial trauma. Which is correct in the management of this case?

hich lifestyle modification is likely to provide the largest reduction in blood pressure for someone with hypertension? \geoquad a. sodium restriction \geoquad b. moderate alcohol consumption \geoquad c. weight reduction of 5 to 10 percent of current weight \geoquad d. physical exercise

Which of the following hemodynamic parameters occur as a result of pancreatic hemorrhage? Q SHOW CHARACTER HINT Normotensive and Tachycardia Hypotension and Bradycardia Normotensive and Bradycardia Hypertension and Tachycardia Hypertension and Bradycardia Hypotension and Tachycardia

A 43-year-old man presents with daily fever, night sweats, weight loss of over 20lb. over the past 4 months, and a cough with occasional blood-streaked sputum. A chest radiograph shows a right upper lobe infiltrate with a 2cm cavity. If you were seeing this patient for the first time in an emergency department, which of the following interventions would you consider most urgent? Group of answer choices Administer oxygen Place the patient in respiratory isolation Stain and review a sputum smear to look for acid-fast bacteria Begin isoniazid, rifampin, pyrazinamide, and ethambutol Begin IV ceftriaxone

A Registered Nurse is working as the charge nurse on a surgical floor. Which of the following tasks may the RN delegate to an LPN to perform without supervision? A) Administering Heparin or saline IV flushes B) Mixing IV solution C) Initiation of plasma expanders D) Initiation of blood products

primary and secondary hypertension (1–11). Explain why the information in these guidelines can better assist a coder to identify codes using levels of specificity.

Ramona Stukes Shirley called the outreach clinic requesting an appointment for Ramona. The receptionist explains that the wound, ostomy, continence (WOC) nurse has appointments available in the urban office; however, the WOC nurse sees patients in the outreach clinic once per month and will not be at the outreach clinic for three weeks. Shirley requests to speak to the triage nurse on behalf of Ramona. Shirley explains to the triage nurse about Ramona's concerns and issues. Which of the following actions should the triage nurse take? (Select all that apply.) Arrange for a home care nurse to see the client. Transport the client via ambulance back to the hospital. Recommend that the client change the appliance more often. Consult the WOC nurse to discuss the client's concerns. Ask to speak directly with the client.

You are managing a patient with an impaled object in the cheek that is not interfering with the patient's ability to breathe. What is the correct field management? Remove the object and apply internal pressure Irrigate the wound thoroughly before transport Apply ice directly over the wound Leave the object in place and stabilize it

A nurse is working in a telemetry unit and assessing a patient with generalized weakness. Nurse's Notes Vital Signs Laboratory Results Provider Orders For each of the findings listed below, indicate whether the finding is commonly associated with untreated left-sided heart failure, untreated right-sided heart failure, or both conditions. Each finding may be associated with more than one condition. ..... • •• 1015 - Patient reports increasing difficulty breathing when lying flat and now requires two pillows to sleep comfortably. Peripheral edema noted to bilateral lower extremities; +2 pitting. Complains of fatigue and inability to complete daily activities, such as walking to the mailbox. 1215 - Patient describes a dry, non-productive cough that worsens at night. Bilateral crackles audible on lung auscultation. Patient appears anxious and reports feeling a sense of 'air hunger'. Patient Findings Left-Sided Heart Failure Right-Sided Heart Failure Peripheral edema 口 Jugular vein distention UVD) 口 Pulmonary crackles Dyspnea on exertion 口 Note: Each category must have at least 1 response option selected. CONTINUE

1 pt Which of the following would be the definitive treatment for a patient diagnosed with septic shock? \geoquad Initiate norepinephrine IV for hypotension when IV crystalloids have failed to resuscitate \geoquad Administer beta-lactam IV within 1 hour of diagnosis \geoquad Surgical consult for source control \geoquad Initiate parenteral nutrition therapy within 72 hrs of diagnosis Question 2 1 pts Outpatient therapy for adults with mild to moderate symptoms of COVID-19 include:

what are the steps to change the dressing on a toe amputation using gauze sponges, skin integrity wound cleanser spray bottle, sodium hypochlorite drop solution, gauze pads, 10% iodine solution, gauze bandage tape, gauze bandages, metal surgical scissors, metal forceps, and iodine swabs?

code class="asciimath">.The nurse is working with a 65-year-old patient whowas recently diagnosed with hypertension. The pa-tient is concerned about their optimal health with theirnew diagnosis. Which nursing action is necessary forhealth promotion with the patient? A. Discussing appropriate stress management tech-niquesB. Sharing with the patient how to increase sodiumconsumptionC. Discussing with the patient exercises that increaseheart rateD. Emphasizing the importance of avoiding flu vacci-nationsA. Dis-cussing appropri-ate stress man-agement tech-niques

OPERATIVE REPORT, DEBRIDEMENT LOCATION: Outpatient, Hospital PATIENT: Peter Gilberth SURGEON: Gary I. Sanchez, M.D. PREOPERATIVE DIAGNOSIS: Necrotizing surgical open wound infection, status post debridement and packing. Performed major procedure one month ago. POSTOPERATIVE DIAGNOSIS: Same. PROCEDURE PERFORMED: Re-exploration of wound and debridement, subcutaneous tissue, subsequent encounter. ANESTHESIA: General endotracheal anesthesia PROCEDURE IN DETAIL: After good general endotracheal anesthesia the patient was prepped and draped in the usual sterile fashion. The packing was removed and the abdominal wound was irrigated and carefully inspected. There were three tiny areas of necrosis; one was the necrotic skin edge along the lower flap. There was also a small 1 cm x 1 cm area of hemorrhagic necrosis along the inferior flap; this was debrided to level of the subcutaneous tissue. There was also a small 1/2 x 1/2 cm area of necrosis superiorly and this was debrided away. The remainder of the wound was inspected and it was rubbed to ascertain that there was a good blood supply and bleeding. After thoroughly inspecting the wound and ascertaining there were no further necrotic areas to be debrided the wound was again irrigated and then packed with saline soaked Kerlix. The patient tolerated the procedure well and was returned to the recovery room in good condition. Pathology Report Later Indicated: Necrotic subcutaneous tissue. CPT: Question Blank 1 of 2 ICD-10-CM Diagnosis: Question Blank 2 of 2

Gordo responded to antimycotic therapy. A bronchodilator would have been another possible treatment choice for pneumonia. What does the medical term bronchodilator mean? (two words)

EMERGENCY DEPARTMENT SERVICES LOCATION: Hospital Emergency Department PATIENT: Paul Hutton PHYSICIAN: Paul Sutton, M.D. CHIEF COMPLAINT: Right eye pain. SUBJECTIVE: This is a pleasant, 45-year-old male with a remote history of corneal ulcers from his contacts. He presents with a 2-day history of right eye sensitivity, photophobia, a little bit of mattering this morning. He does wear contacts. He threw them away yesterday. He said he had them in for a month-and-a-half. It feels "grainy." PAST MEDICAL HISTORY: As above. He is on Toprol and Lotensin presumably for hypertension. REVIEW OF SYSTEMS: As above. PHYSICAL EXAMINATION: Vitals are stable. Visual acuity of 20/50 OD 20/25 OS. On examination, nothing is seen grossly. The eyelids are reverted and nothing was seen. After tetracaine analgesia and fluorescent staining upon slit visualization, there is indeed uptake of a fluorescent between 2 and 3 o'clock right at the edge of the cornea. ASSESSMENT: Corneal abrasion OD due to contact lens PLAN: I told him no more contacts until he sees his physician. I did place some cyclogel and wrote a prescription for some gentamicin drops. I did not patch at this point but wanted him to see his eye doctor. CPT Code and ICD-10-CM Diagnosis:

You are called to the home of an 18-year-old female complaint of generalized lower abdominal pain. You find her laying in her bed curled up with her knee to her chest. She also complains of vomiting in an abnormal vaginal discharge. She’s Libra and her vital signs or a heart rate of 110, a respiratory rate of 24 a blood pressure of 100/64 her symptoms are caused by:

AI Response: In the fictional universe of Grey's Anatomy, the career outlook for a Nurse Practitioner (NP) is highly intense, dramatic, and heavily focused on acute surgical and trauma care. While real-world NPs usually operate in primary care or specific outpatient specialties, a Grey Sloan Memorial Hospital NP operates under unique, television-ized conditions Reflection:

DISCHARGE SUMMARY LOCATION: Inpatient, Hospital PATIENT: Edith Smith PHYSICIAN: Frank Gaul, M.D. PRINCIPAL DIAGNOSIS: Comminuted, displaced, supracondylar left femur fracture. ADDITIONAL DIAGNOSES: 1. Chronic obstructive pulmonary disease with steroid dependence. 2. Oxygen dependency. 3. Severe primary pulmonary hypertension. 4. Diabetes mellitus, type 2. 5. Anemia. PRINCIPAL PROCEDURE PERFORMED: Open reduction and internal fixation of left distal Supracondylar femur fracture. ALLERGIES: Cefoxitin, reaction uncertain. MEDICATIONS: Please see chart. HISTORY: This patient entered the hospital with chief complaint of left thigh pain. This lady apparently was at home when she fell and injured her left leg. She was seen in the emergency room where x-rays revealed a supracondylar fracture of her left femur. She was then referred for further care of this injury to Dr. Mohomad Almaz. Examination found that her left foot was externally rotated. She did have pain with any movement of her left knee. X-rays of her left femur found that she did have a comminuted, displaced supracondylar fracture. Discussion was held, and recommendation was made by Dr. Mohomad Almaz that she be taken to the operating room for an open reduction and internal fixation procedure to stabilize her left femur fracture. She agreed and wanted to go ahead with this. She was taken to the operating room where, under spinal anesthesia, an open reduction and internal fixation of supracondylar fracture, left distal femur, was carried out. At the end of the procedure, sterile dressings were applied, and her left leg was placed into a knee immobilizer. She tolerated the procedure well. Postoperatively, she remained afebrile, other vital signs remained normal as well. Dressings were changed at intervals with no signs of infection noted. CPT: ICD-10-CM Primary Diagnosis: ICD-10-CM Secondary Diagnosis: ICD-10-CM Secondary Diagnosis: ICD-10-CM Secondary Diagnosis: ICD-10-CM Secondary Diagnosis: ICD-10-CM Secondary Diagnosis: ICD-10-CM Secondary Diagnosis:

OPERATIVE REPORT, DEBRIDEMENT LOCATION: Outpatient, Hospital PATIENT: Peter Gilberth SURGEON: Gary I. Sanchez, M.D. PREOPERATIVE DIAGNOSIS: Necrotizing surgical open wound infection, status post debridement and packing. Performed major procedure one month ago. POSTOPERATIVE DIAGNOSIS: Same. PROCEDURE PERFORMED: Re-exploration of wound and debridement, subcutaneous tissue, subsequent encounter. ANESTHESIA: General endotracheal anesthesia PROCEDURE IN DETAIL: After good general endotracheal anesthesia the patient was prepped and draped in the usual sterile fashion. The packing was removed and the abdominal wound was irrigated and carefully inspected. There were three tiny areas of necrosis; one was the necrotic skin edge along the lower flap. There was also a small 1 cm x 1 cm area of hemorrhagic necrosis along the inferior flap; this was debrided to level of the subcutaneous tissue. There was also a small 1/2 x 1/2 cm area of necrosis superiorly and this was debrided away. The remainder of the wound was inspected and it was rubbed to ascertain that there was a good blood supply and bleeding. After thoroughly inspecting the wound and ascertaining there were no further necrotic areas to be debrided the wound was again irrigated and then packed with saline soaked Kerlix. The patient tolerated the procedure well and was returned to the recovery room in good condition. Pathology Report Later Indicated: Necrotic subcutaneous tissue. Question at position 6 6 Fill in the Blank 2 points Question at position 6 CPT: Question Blank 1 of 2 ICD-10-CM Diagnosis: Question Blank 2 of 2

RADIOLOGY REPORT, CHEST LOCATION: Outpatient, Hospital PATIENT: Stephanie Ziggler PHYSICIAN: Monica J. Hamilton, M.D. RADIOLOGIST: Morton Monson, M.D. EXAMINATION OF: Chest, PA and lateral CLINICAL SYMPTOMS: Pre cardiac catheterization procedure. PA LATERAL CHEST, 10:10 PM: The cardiac silhouette is not enlarged. The mediastinum is not widened. The lung fields are relatively clear although moderately hyperinflated with small shadow. Effusions are not seen. Multiple cardiac monitors do superimpose the chest. CONCLUSION: Moderate hyperinflation abnormality noted within the lung fields. The chest is otherwise clear. CPT: ICD-10-CM Primary Diagnosis: ICD-10-CM Secondary Diagnosis:

OPERATIVE REPORT, INCISION AND DRAINAGE ABSCESS LOCATION: Outpatient, Hospital PATIENT: Delores Little SURGEON: Loren White, M.D. PREOPERATIVE DIAGNOSIS: Abscess, right groin crease. POSTOPERATIVE DIAGNOSIS: Same. This is a 41 year old woman with a two week history of a painful groin. She presents today for surgical intervention. PROCEDURE PERFORMED: Incision and drainage of abscess. OPERATIVE NOTE: With the patient under general anesthesia she was put in the frog-legged position. The area of the abscess was shaved and then prepped and draped in a sterile manner. An incision was made over the palpated abscess. We obtained a good deal of very purulent foul smelling material. A culture was taken. The cavity was broken down with an index finger to make sure that there were no lactations. It was then copiously irrigated with sterile saline and then packed with wet 2 inch NuGauze. A sterile dressing was applied. The patient tolerated the procedure well and was discharged from the operating room in stable condition. Pathology Report Later Indicated: Benign abscess fluids of the groin. Question at position 5 5 Fill in the Blank 2 points Question at position 5 CPT: Question Blank 1 of 2 ICD-10-CM Primary Diagnosis: Question Blank 2 of 2

1 pts A 60 -year-old African American patient has a biood pressure of (120)/(80)mmHg and reports a family history of hypertension. The patient has a body mass index of 22.3 . The patient reports consuming alcohol occasionally. Which therapeutic lifestyle change will the nurse expect to teach this patient? \geoquad Sodium restriction \geoquad Potassium supplementation \geoquad Alcohol cessation \geoquad Weight loss 

A nurse has provided education for a patient newly diagnosed with hypertension who is just beginning therapy with antihypertensive medications. Which statement by the patient indicates a need for further teaching? \geoquad "I should report side effects to the provider sinen athar drags may be substituted." \geoquad 4 may experience serious long-term problems even if I am not having symptoms: \geoquad 4, will need to take medications on a long-term basts: \geoquad "When my symptems subside, 1 m ay discontinue the medications: 

of 15 In which patient condition would the administration of a beta agonist be contratindicated? \geoquad A Patients with diabetes mellitus \geoquad B Patients with bronchial asthma \geoquad C Patients with pulmonary disease \geoquad D Patients with a high risk of stroke

Answers to odd-numbered questions can be found in appendix B online. Answers to even-numbered questions are in the instructor materials and are available to approved instructors. Assign the appropriate codes for the following procedures. Include CPT modifiers and HCPO Level II modifiers when applicable. Choose the best answer for each of the following questions. When a diagnostic mammogram is completed on the same day are gram, which modifier is used on the diagnostic mammogram code? a. 22 b. 76 c. GG d. GH The physician performed a transrectal ultrasound-guided biopsy of the prostate. The correct coding for this procedure is: a. 55700,76942 b. 55707 c. 55708 d. 55707,76942 Two views of the second digit on each hand, done in the physician office and read by the physician, are coded for Medicare as a. 73130-50 b. 73130-50,73140-50 c. 73140-F1, 73140-F6 d. 73140-LT-RT The interventional radiologist performs diagnostic angiography of the superior mesen- teric artery. Documentation notes that the catheter was advanced from the right femoral artery to the aorta and the superior mesenteric artery was selectively catheterized. What is the correct coding for this procedure? a. 36215,75726 b. 36245,75774 c. 36245,75726 d. 36245.75705 Ophthalmic ultrasound of the eye with amplitude quantification is coded as a. 76511 b. 76513 c. 76516 d. 76519 Assign the appropriate CPT codes to the following reports. Assume that you are coding for the rofessional and technical reports. Assume that you are coding for the professional and technical components. Renal Ultrasound History: Pyelonephritis Findings: The right kidney measures 11.1 cm and the lef 11.5 cm . Both kidneys are normal in echo texture and smooth in contour. There is ^(n0) mass, calcifical in echo texture and the left measures. There is no fluid collection, or evidence of hydreps mooth in contour. The perinephric fluid collectation, or evidence of hydrosmooth in contour. The perinephric fluid collection or abscess. There is no evidence of focal nephronia. There is a cyst in the upper pole of the right kidney. It measures just under 2 cm and has typical ultrasound characteristics of a benign renal cyst.

During a dressing change, the nurse notes purvient drainage with a foul odor from a pressure injury. Which action reflects appropriate use of the nursing process? \geoquad Apply a dry dressing and reassess in 12 hours \geoquad Collest sumport culture pre protonoli thefore clessing \geoquad Increase the patient's fluid intake to heal the wound \geoquad surth to a new dressing product without provider input

You are presented with the documentation for a complex surgical procedure performed on a patient with multiple health conditions. The procedure involved the removal of a benign tumor from the liver, along with a partial hepatectomy and reconstruction of a bile duct. The surgeon also performed an intraoperative cholangiogram to visualize the bile duct anatomy during the procedure. The patient experienced intraoperative bleeding, which required additional interventions and extended the surgical time. Documentation: Detailed operative report describing the procedure, including pre-operative assessment, surgical steps, complications encountered, and post-operative care instructions. Anesthesia report indicating the administration of general anesthesia for the duration of the surgery. Pathology report confirming the benign nature of the tumor. Coding Questions: Based on the provided documentation, accurately assign the appropriate CPT codes, modifiers, and other relevant codes for this complex surgical procedure. Explain your coding rationale and considerations, identify any potential coding pitfalls or challenges, and discuss the importance of accurate coding in reflecting the complexity of surgical procedures and ensuring appropriate reimbursement. Points to consider for Discussion: Identifying the Primary Procedure: Determine the primary procedure performed in this case based on the documentation.Discuss the importance of accurately identifying the main procedure to ensure correct code assignment. Selecting CPT Codes and Modifiers: Determine the appropriate CPT codes for each component of the surgical procedure (e.g., tumor removal, partial hepatectomy, bile duct reconstruction).Consider the need for any additional modifiers to indicate the complexity, extent, or unusual circumstances of the surgery. Documenting Complications and Additional Interventions: Discuss the documentation of complications encountered during the procedure, such as intraoperative bleeding, and their impact on coding.Explore the coding implications of additional interventions performed to address the complications. Importance of Accurate Coding: Explain the significance of accurate coding in reflecting the complexity of surgical procedures and ensuring appropriate reimbursement.Discuss the potential consequences of inaccurate coding, including legal implications, financial losses, and compromised patient care. Coding Pitfalls and Challenges: Identify potential coding pitfalls or challenges related to this complex surgical procedure.Share strategies to overcome these challenges and ensure accurate coding.

(5 points) \geoquad An interprofessional EBPlteam has been asked to review best practice evidence to develop a CPG on the assessment and management of venous leg ulcers. Who should be on the team? \geoquad The panel should be composed of multidisciplinary major stakeholders for the guideline including users and patients. \geoquad The panel should be composed of national experts who have completed research studies on venous leg ulcer management. \geoquad The panel should be composed of the nurses and providers working in the medical/surgical department. \geoquad The panel should be composed of the medical providers caring for patients with venous leg ulcers. \geoquad Page 12 of 20

A nurse is caring for an older adult client who has aspiration pneumonia. Which of the following age-related changes contributes to the development of aspiration pneumonia? \geoquad A. Decreased gastric secretions \geoquad B. Diminished cough reflex \geoquad C. Decreased sense of smell \geoquad D. Degenerative joint changes

A nurse is beginning a shift on a medical-surgical unit. Which action best demonstrates the nurse's role as a leader during the assessment phase of the nursing process? \geoquad Reviewing delegated tasks completed by assistive personnel \geoquad Gathering relevant client data before assigning care \geoquad Evaluating whether outcomes were achieved during the previous shift \geoquad Documenting completed interventions in the electronic health record

Which nursing actions demonstrate application of evidence-based practice during wound care? Select all that apply. \geoquad Cleansing the wound with sterile normal saline \geoquad Using hydrogen peroxide for routine wound deaning \geoquad Performing hand hygiene before and after the procedure \geoquad Changing dressings based on wound condition and doctor's orders \geoquad Leaving the wound open to air to promote drying

During assessment, the nurse notes a Stage 2 pressure injury on a client's sacrum. Which intervention is appropriate to support optimal tissue integrity? \geoquad Covering the wound with a dry gauze dressing and leaving it open to air \geoquad Using a molsture-retentive dressing to maintain a molst healing embronment \geoquad Increasing mobility restrictions to prevent friction \geoquad Applying hydrogen peroxide dally to clean the wound

A nurse is performing a physical assessment of a client. Which of the following actions should the nurse take to assess the client's tissue perfusion? \geoquad A. Perform a Romberg test \geoquad B. Check nails for Beau's lines \geoquad C. Palpate for respiratory excursion \geoquad D. Perform a blanch test

A nurse auscultates a patient's lungs and hears high-pitched sounds during inspiration over the peripheral lung fields. What does this assessment likely indicate? \geoquad Narrowed airways consistent with asthma \geoquad Fluid in the alveoli due to pneumonia \geoquad Normal breath sounds expected over lung base \geoquad Air movement in the upper airway only 1 pts

A nurse on a medical-surgical unit observes smoke billowing from a client's room. Which of the following actions should the nurse take first? \geoquad A. Close the door to the client's room. \geoquad B. Evacuate the cllent from the room. \geoquad C. Sound the fire alarm. \geoquad D. Activate the fire extingulsher.

Answers to odd-numbered questions can be found in appendix B online. Answers to even-numbered questions are in the instructor materials and are available to approved instructors. Assign the appropriate codes for the following procedures. Include CPT modifiers and HCPO Level II modifiers when applicable. 1.- Radiological examination (x-ray) of the forearm, anteroposterior (AP), and lateral views. What code(s) should be submitted on the claim form for a physician who provided only the S&I (professional component) for this procedure? MRI contrast material. The MRI was performed at an indepen- dent radiology racility, and the facility sent the images to an independent radiologist who ages to an independent radiologist who should be submitted on the claim form A physician performed the radiological S&I for cystography (three views). CT scan of the abdomen with contrast and the pelvis without contrast (same session). High-density barium enema using air contrast for x-ray of colon. The dermatologist used ultrasound guidance to perform radiation treatment to a squa- mous cell carcinoma on the patient's right forearm. The treatment was 350 kV per frac- tion. Cerebral perfusion analysis performed concurrently with CTA of the head and neck with contrast. Bilateral diagnostic mammography using computer-aided detection. Radionuclide imaging of abdomen and chest for localization of inflammation (one-day procedure). Whole-body bone marrow scan (nuclear medicine). Screening ultrasound of abdominal aorta for aneurysm (real time with mag ). Gastric-emptying imaging study (nuclear medicine) with small bower The registered nurse in the cardiologist's office reviewed all information regarding the patient's pacemaker to determine whether it was possible for the patient to have an MRI study of the right knee. The operative report indicating placement of the device along with detailed information from the manufacturer of the device was compiled for the phy- sician's review. The nurse documented 45 minutes spent performing Renal scan with vascular flow and function study (nuclear medicine) without pharmaco- logic intervention. X-ray of clavicle.

Identify 2 risk factors that have likely contributed to Doug's development of asthma and 2 risk factors that likely contribute to his current clinical presentation/recurrent exacerbations. (4 total points; 1 point for each correct risk factor identified)

What are the discharge planning and require followees with patienceith pneumonia

While opening a sterile solution for wound cleansing, the nurse accidentally allows the bottle's lip to touch the inside edge of the sterile container. What is the best action? \geoquad Continue pouring because only the outer bottle surface is unsterile \geoquad Wipe the bottle fip with sterile gruse and proceed \geoquad Pour the solution carefully to avoid direct contact \geoquad ObLin a new sterfie solution before proceeding

A nurse auscultates a patient's lungs and hears high-pitched sounds during inspiration over the peripheral lung fields. What does this assessment likely indicate? \geoquad Narrowed airways consistent with asthma \geoquad Fluid in the alveoli due to pneumonia \geoquad Normal breath sounds expected over lung base \geoquad Air movement in the upper alrway only

A nurse is beginning a shift on a medical-surgical unit. Which action best demonstrates the nurse's role as a leader during the assessment phase of the nursing process? \geoquad Reviewing delegated tasks completed by assistive personnel \geoquad Gathering relevant clead dats bufore senjening care \geoquad Evaluating whether outcomes were achieved during the previous shift \geoquad Decumenting commeted intenventions in the electronk her th recool

A client's wound assessment shows granulation tissue, moderate serous drainage, and intact peri-wound skin. Which interpretation should the nurse make? \geoquad The wound is progressing toward healing. \geoquad The wound shows slgns of infection. \geoquad The wound requires mechanical debridement. \geoquad The wound is demonstrating necrotic deterioration.

A postoperative client with a surgical wound has inadequate nutritional intake. Which intervention is appropriate for promoting tissue repair? \geoquad Offer high-calorie snacks low in protein to increase overall caloric intake \geoquad Encourage intake of foods rich in vitamin C, E, and Zinc with protein \geoquad Limit oral intake to prevent nausea associated with early postoperative stages \geoquad Provide supplemental fats to promote rapid wound closure

While opening a sterile solution for wound cleansing, the nurse accidentally allow the bottle's lip to touch the inside edge of the sterile container. What is the best action? \geoquad Continue pouring because only the outer foretie surface is unsterile \geoquad Whipe the bottle flp with stertle gause and procesed \geoquad Pour the solution carefully to avoid direct contact \geoquad Obtain a new sterile solution before proceeding

Which nursing actions demonstrate application of evidence-based practice during wound care? Select all that apply. \geoquad Cleansing the wound with sterile normal saline \geoquad thing hydrogen peroxide for routine wound cleaning \geoquad Performing hand hygiene before and after the procedure \geoquad Changing dressings based on wound condition and doctor's orders \geoquad texving the wound open to air to promote drying

Caremore Clinic has identified three activities for daily maternity care, cecupancy and teter, um oversees 120 nurses, 20 of whom are maternity nurses (the other nurses are located n oden ers nursing supervisor has three assistants, a secretary, several offices, computen, phones. supervising and 40% of their time as surgical nurses. They each receive a salary of $20 al time supervising, has a salary of $140,000. The secretary receives a salary of 940,000 g The n 0a 0164 (depreciation, utilities, phone, etc.) average $220,000 per year. What is the total cost assigned to nursing supervision using direct tracing

Compare and contrast the various surgical dressing including the type, intended use, sterile application and construction. Choose one intermediate or complicated wound to dress and list the order of application.

In what procedure was the first robotic surgical arm used? Liver resection Neurosurgical biopsy Skin graph Heart transplant

1 of 10 Which diagnosis would the nurse expect for a patient who presents with flat neck veins, an increased heart rate, poor skin turgor, dry mucous membranes, and decreased blood pressure? Stroke Dehydration Heart failure Hypotension 1 Seen Seen N $ 7 3 3 з

develop an informational poster to critically analyse cancellation of surgical procedures or surgery and propose solutions through the principles of clinical governance, quality improvement and risk management supported by contemporary nursing literature

an older adult presents with diffuse ecchymoses on their forearms, chest, and face, as well as several circular burns in different stages of healing. the NP is concerned about potential abuse. in the older adult population, which of the following patient characteristics is associated with an increased risk of physical abuse? high socioeconomic status, history of substanc euse disorder, history of stroke, living alone

Which of the following substances may be needed as a supplement for a patient suffering renal osteodystrophy? Iron Vitamin D Glucosamine Vitamin E Next

of 16 A nursing student writes in her notes, "When the heart is filled with more blood, the heart is able to eject more blood." What term would best fit this description? Cardiac output Afterload Preload Stroke verimume

Which action would the nurse take when performing a focused assessment? Taking a brief medical history Determining the supplies and equipment needed for the patient Auscultating breath sounds on a patient diagnosed with pneumonia Observing the head, chest, abdomen, and extremities of a newly admitted patient

Quitzes 2 0829 Trief lerraling 7 Multiple Choice 1 point Which of the following symptoms would you expect in a patient with isolated right-sided heart failure? Cough Distended jugular veins Tachypnea Pulmonary edema

Which symptom is consistent with cardiac-related chest pain? Drooping face when smiling Squeezing or heavy chest pain Pinpoint pupils The patient is no longer breathing

Which term means "the margins or edges of the wound fit neaty together? Exudte Well approimated Criterbe Hemostryls

Imagine you are working in a referral clinic with a hospitalized foal. You will reference this Case Report as if it were one of your hospitalized cases from the evening before. At the end of your shift, you need to transfer the most crucial information about the case to the next staff member of the veterinary medical team. ObjectiveApply urinary terminology to communicate with another veterinary medical professional about a case.InstructionsRead the Case Report(Case Report Urethral and bladder rupture in a neonatal colt with uroperitoneum C. Castagnetti*, J. Mariella, A. Pirrone, N. Romagnoli, F. Pasquali, F. Parmeggiani† and A. Spadari Veterinary Clinical Department, Faculty of Veterinary Medicine, University of Bologna, 40064, Ozzano dell’Emilia, Bologna, Italy; and ‡Scuderia OM, Le Budrie, 40017 San Giovanni in Persiceto, Bologna, Italy. Keywords: horse; foal; urethra; bladder; uroperitoneum Summary This case report documents uroperitoneum due to bladder and pelvic urethral rupture in a 9 h old Standardbred colt born after severe dystocia. Three surgical procedures were required to manage rupture of the urinary bladder, urethral rupture, and ventral abdominal hernia with evisceration of a loop of jejunum. After 40 days of hospitalisation the colt was discharged without any further complication.eve_40 132..138 Introduction Uroperitoneum (UP) is most commonly the result of a ruptured bladder (Richardson and Kohn 1983; Adams et al. 1988; Lavoie and Harnagel 1988; Kablack et al. 2000; Dunkel et al. 2005), but other defects of the urinary system have been previously reported. These include ruptured urachus, urachal abscessation (Hyman et al. 2002) and ruptures or congenital defects of ureters (Robertson et al. 1983; Divers et al. 1988; Cutler et al. 1997; Jean et al. 1998; Morisset et al. 2002). To the authors’ knowledge, pelvic urethral rupture has not been described in neonatal foals. This case report describes the management of bladder and urethral injury in a neonatal foal with emphasis on the surgical procedure and therapy. Case history and clinical findin in its entirety. Imagine that you are leaving your shift at the hospital prior to the colts first surgery which is detailed in the report. Complete the Case Brief guide to correctly round the patients next medical caretaker on the most pertinent aspects of the case. As this is a veterinary setting and it is crucial for everyone to be on the same page, you must communicate in the universal language of veterinary medical terminology in your completion of the case brief. Time is also of the essence, as it is a busy clinic setting. So, be very brief and clear. Consult the example for an idea of the language and brevity expected in this assignment. Add a list of new terms you learned, at least 5, with their definitions at the end of the document. Submit the completed Case Brief guide when you are finished.Please use credible sources and cite them using APA format.

Discuss the variances between Hypoglycemia and Hyperglycemia and elucidate the medications suitable for treating patients exhibiting symptoms of Diabetes Mellitus. Additionally, delineate the role of a nurse in managing these conditions effectively.

marie has just been diagnosed with type I diabetes. the doctor prescribed injecting humulin nph subcutaneously every morning

Global Care Medical Center 100 Main St, Alfred NY 14802 (607) 555-1234 Ambulatory Surgery Operative Report PATIENT INFORMATION: NAME: SNOW, Chrissy PATIENT NUMBER: ASUCase010 DATE OF SURGERY: 7-23-YYYY SURGEON: Rusty Gates, M.D. ASSISTANT SURGEON: None PREOPERATIVE DIAGNOSIS: Left middle trigger finger. POSTOPERATIVE DIAGNOSIS: Left middle trigger finger. PROCEDURES: Incision of tendon sheath, left middle trigger finger. DESCRIPTION OF PROCEDURE: Under satisfactory IV block anesthesia, the patient was prepped and draped in the usual fashion. A transverse incision was made parallel to the distal palmar crease overlying the middle finger and the wound was then deepened by sharp dissection and blunt dissection being very careful to preserve all blood vessels intact and not to disturb the neurovascular bundle. The flexor tendon sheath was identified and divided longitudinally for a distance of approximately 1/5 cm. There was no bow stringing of the flexor tendon following this and there was good gliding motion of the flexor tendon passively without any obstruction. The patient then had closure of the subcutaneous tissue with on interrupted 4-0 plain catgut suture, and the skin was approximated with 3 interrupted 4-0 nylon vertical mattress sutures. Betadine ointment and dry sterile dressing was applied. Bulky hand dressing was applied. The patient, having tolerated the procedure well, had the tourniquet released without any untoward effects and was returned to ASU in satisfactory condition. SURGEON’S SIGNATURE Reviewed and Approved: Rusty Gates MD ATP-B-S:02:1001261385: Rusty Gates MD (Signed: 7/23/YYYY 2:20:44 PM EST) RG: ygc DD: 07-23-YYYY DT: 07-23-YYYY Rusty Gates, M.D. Global Care Medical Center 100 Main St, Alfred NY 14802 (607) 555-1234 AMBULATORY SURGERY LABORATORY DATA PATIENT NAME: SNOW, Chrissy PATIENT NUMBER: ASUCase010 LOCATION: ASU ASU PHYSICIAN: Rusty Gates, M.D. DATE: 07-26-YYYY SPECIMEN: Blood Test Result Flag Reference Glucose 105 82-115 mg/dl BUN 15 8-25 mg/dl Creatinine 1.0 0.9-1.4 mg/dl Sodium 138 135-145 mmol/L Potassium 3.7 3.6-5.0 mmol/L Chloride 101 99-110 mmol/L CO2 23 21-31 mmol/L Calcium 8.8 8.6-10.2 mg/dl WBC 9.9 4.5-11.0 thous/UL RBC 4.5 5.2-5.4 mill/UL HGB 11.9 11.7-16.1 g/dl HCT 38 35.0-47.0 % Platelets 175 140-400 thous/UL PT 12.0 11.0-13.0 seconds can i code these labs with the surgery

A 28 year old female with a background of Ulcerative Colitis and type 1 diabetes presents with the following skin changes what is the likely diagnosis?

A male client with an infected wound tells the nurse that he follows a macrobiotic diet. Which type of foods should the nurse recommend that the client select from the hospital menu? \geoquad Low fat and low sodium foods. \geoquad Combination of plant proteins to provide essential amino acids. \geoquad Limited complex carbohydrates and fiber. \geoquad Increased amount of vitamin C and beta carotene rich foods.

What is the priority safety recommendation the nurse should make for the older adult in regards to changes in the respiratory system? Decongestants for nasal stuffiness Pneumococcal vaccination Limiting physical exertion Humidification while sleeping

Can you please explain about stepped-wedge cluster randomized trial plan for stroke reduction

Discuss stepped-wedge cluster ranmized trial evaluation planfor stroke reduction in rural area.

ol> A patient comes to the clinic complaining of shortness of breath and inability to complete normal activities due to difficulty breathing for the last 3days. He si unable tospeak a fullsentence and wheezes audibly.He currently uses a budesonide/formoterol inhaler, one inhalation in the morning, and an albuterol inhaler two to four puffs as needed (at least 3times daily for the past few days). He is worried because the elevator in his building is broken, and he lives on the fourth floor. Which of the following is the best recommendation to address his current asthma symptoms?

What allows the robotic computer to create and record three-dimensional date of the surgical site?

How are chronic pain and chronic diseases such as hypertension similar? Question 10 options: A) They usually have a short course of illness. B) They're genetically influenced. C) They're difficult to assess. D) Those afflicted usually respond to the same treatments.

Match each laboratory with its corresponding purpose related to perfusion. Prompts BNP Troponin PT and INR PTT BMP WBC CRP Answers Select match Marker of inflammation and a critical component to the development of atherosclerosis. Measures infectious or inflammatory diseases of the heart. Used to measure myocardial muscle protein in the bloodstream, indicating injury, infarction, or necrosis of cardiac muscle. Measures platelet aggregation, or the ability to clump for possible anticoagulation therapies. Used when initiating and maintaining therapy with oral anticoagulants, such as sodium warfarin. They measure the activity of prothrombin, fibrinogen, and factors V, VII, and X. select match

PREOPERATIVE DIAGNOSIS: left middle trigger finger. POSTOPERATIVE DIAGNOSIS: left middle trigger finger. OPERATION PERFORMED: tenolysis Under satisfactory IV block anesthesia, the patient was prepped and draped in the usual fashion. A traverse incision was made parallel to the distal palmar crease area overlying the middle finger, and the wound was then deepened and sharply dissected. All blood vessels were carefully preserved. The flexor tendon sheath was identified and divided longitudinally for a distance of approximately 1.4 cm. There was no bow-stringing of the flexor tendon following this, and there was good gliding motion of the flexor tendon passively without any obstruction. The patient then had closure of the subcutaneous tissue with interrupted 4-0 plain catgut suture, and the skin was approximated with three interrupted 4-0 nylon vertical mattress sutures. Betadine ointment and dry sterile dressing were applied. Bulky hand dressing was applied. The patient, having tolerated the procedure well, had the tourniquet released without any untoward effects and was discharged from the surgical suite in a stable condition.

You are transporting a 55-year-old male with severe upper abdominal pain. He describes the pain as tearing and looks very anxious. The patient’s vitals are pulse 88, respirations 18, and blood pressure 108/70. The patient has a history of diabetes, high blood pressure and chronic constipation. Which IV administration description would you recommend for this patient?

Section 3: Practical Application Choose the correct answer, and select Submit. Q44. You are providing bag-mask ventilations to a patient in respiratory arrest. How often should you provide ventilations? Every 6 seconds Every 12 seconds Every 10 seconds Every 3 seconds Cuhmit 45 of 61

of 45 Your patient has type 1 diabetes mellius. They are found diaphoretio and confused. Their capillary blood glucose reads 33 mg/dL and they are strict NPO for a procedure. What would you administer? \geoquad Denonie BAN IM \geoquad Quition 1 IN D \geoquad Descrow SOFAL IV pulst \geoquad Clucnue tablets 52.

Which factor increases the risk of developing secondary hypertension? Family history of hypertension History of acute glomerulonephritis Increased body mass index African American ethnicity

A nurse is caring for a client who has a prescription for wound irrigation. Which of the following actions should the nurse take? \geoquad Wear sterile gloves when removing the old dressing. \geoquad Warm the irrigation solution to 40.5\deg C (105* F). \geoquad Cleanse the wound from the center outward. \geoquad Use a

Which statement is true related to a flail chest? Select all that apply. One, some, or all responses may be correct. A Paradoxical chest movements involve the affected portion being sucked in during expiration and bulging out during inspiration. B Flail chest results from fracture of two or more nonconsecutive ribs on the same side. C Paradoxical chest movements only occur if the sternum also is fractured. D Splinting of the chest wall is seen only in the unconscious client. E Most clients with a flail chest require mechanical ventilation. F Palpation must be performed to check for crepitus.

Which statement is true related to a flail chest? Select all that apply. One, some, or all responses may be correct. A Paradoxical chest movements involve the affected portion being sucked in during expiration and bulging out during inspiration. Flail chest results from fracture of two or more nonconsecutive ribs on the same side. Paradoxical chest movements only occur if the sternum also is fractured. Splinting of the chest wall is seen only in the unconscious client. Most clients with a flail chest require mechanical ventilation. F Palpation must be performed to check for crepitus.

PREOPERATIVE DIAGNOSIS: Healed comminuted fracture, left distal radius POSTOPERATIVE DIAGNOSIS: Same. PROCEDURE PERFORMED: Removal of hardware, left distal radius INDICATION: Mr. Price had a traumatic distal radius fracture treated with a Synthes dorsal distal radius plate. Because of the risk of atraumatic rupture of the extensor tendons running over the plate, it was elected to remove the plate at this time. OPERATIVE PROCEDURE: After a suitable general anesthesia was achieved, the patient’s left wrist, hand, and forearm were prepped and draped. Before prepping, an arm tourniquet was applied and after draping inflated to 250 mm Hg. Scar on the dorsal aspect of the wrist was used as the site of the incision. The extensor pollicis longus tendon was incised in line with the tendon. The tendon was then retracted. The extensor retinaculum was elevated off at the plate bone level. The plate was then easily exposed. Screws were removed, and the plate was easily elevated. The wound was then irrigated. Skin edges were infiltrated with 0.5% Marcaine with adrenaline. The retinaculum was closed with 2-0 Tycron, subcutaneous tissue with 3-0 Vicryl, and the skin with interrupted 4-0 nylon horizontal mattress sutures. The patient tolerated the procedure well and returned to the recovery room in stable condition.

What intervention should the nurse include in the plan of care for a client who is being treated with an Unna's paste boot for leg ulcers due to chronic venous insufficiency? \geoquad Check capillary refill of toes on lower extremity with Unna's paste boot. \geoquad Apply dressing to wound area before applying the Unna's paste boot. \geoquad Wrap the leg from the knee down towards the foot. \geoquad Remove the Unna's paste boot q8h to assess wound healing.

A nurse is admitting a client who has had a stroke. Which of the following actions should the nurse take? \geoquad Keep the bedside table at the end of the client's bed. \geoquad Place a towel on the client's bathroom floor. \geoquad Raise the four side rails of the client's bed. \geoquad Keep the client's bed in the lowest position.

Which intervention is needed for a client who receives morphine by patient-controlled analgesia and has a respiratory rate of 6 breaths/minute? \geoquad A Nasotracheal suction \geoquad B Mechanical ventilation \geoquad C Noloxone odministrotion \geoquad D Cardiopulmonory resuscitation

Which characteristics are typical of a loop colostomy? Select all that apply. \geoquad Has two distinct stomas \geoquad Has one stoma with two openings \geoquad Has mucus drain from the distal end of the stoma \geoquad Has stool drain from the proximal end of the stoma \geoquad Is a permanent type of colostomy \geoquad Is usually created in an emergency

Perform a thorough review of Jacy Sky Redbird’s EHR, clicking on each tab and reading each note. Then, use the following information to assist in completing the form below after reviewing Jacy Sky Redbird’s chart. Identify which items are present or deficient in Jacy Sky Redbird’s chart. o Present: The relevant information is documented in the patient’s chart o Deficient: The relevant information is not documented in the patient’s chart o Not applicable: The information is not relevant to the patient or the care they are receiving Highlight the correct choice for each numbered question below. Only select one answer per question. Problems The diagnosis, problem and/or reason for admission may be found on the Problems tab, the Admit order on the Orders tab, or the Admission H&P on the Notes tab. Pathology report/results 1. Pathology report/results listed (Pathology report is a document that includes a diagnosis determined by examining cells and tissues under a microscope.) a. Present b. Deficient c. Not applicable Radiology report/results 2. Radiology test listed a. Ultrasound b. CAT scan - Abdomen/Pelvis with and without contrast 3. Reason for exam listed a. Present b. Deficient 4. Impression listed a. Present b. Deficient 5. Findings listed a. Present b. Deficient Physical/Respiratory/Occupational/Speech/Nutrition Therapy notes 6. Therapy note NOT documented for a. Dietetics b. Respiratory Therapy c. Occupational Therapy 7. Corresponding consult order on Orders tab for Respiratory Therapy note a. Present b. Deficient 8. Corresponding consult order on Orders tab for Dietetics note a. Present b. Deficient

Which information would the nurse share with a patient who has a loop colostomy? \geoquad "You will have a lifelong stoma." \geoquad "After your bowels heal, they will be reattached." \geoquad "Your stools will drain from the abdomen indefinitely." \geoquad "The lower intestine will be removed."

A patient with severe dehydration develops oliguria. Which mechanism explains this change? \geoquad Reduced bladder emptying lowers urine output \geoquad Reduced tubular function lowers urine formation \geoquad Reduced renal perfusion lowers glomerular filtration \geoquad Reduced albumin levels lowers fluid retention

A patient presents with atrial fibrillation and a heart rate of 140 beats per minute. Echocardiography reveals a left ventricular ejection fraction of 30%, but there are no clinical signs of acute decompensated heart failure. What is the most appropriate first-line pharmacotherapy for rate control?

Perform a thorough review of Jacy Sky Redbird’s EHR, clicking on each tab and reading each note. Then, use the following information to assist in completing the form below after reviewing Jacy Sky Redbird’s chart. Identify which items are present or deficient in Jacy Sky Redbird’s chart. o Present: The relevant information is documented in the patient’s chart o Deficient: The relevant information is not documented in the patient’s chart o Not applicable: The information is not relevant to the patient or the care they are receiving Highlight the correct choice for each numbered question below. Only select one answer per question. Problems The diagnosis, problem and/or reason for admission may be found on the Problems tab, the Admit order on the Orders tab, or the Admission H&P on the Notes tab. Physician History and Physical 7. Which physician would be queried regarding any missing or deficient information in the History and Physical? a. Kerry West, MD b. Ji-young Sun, MD Daily physician progress report 8. Daily physician progress or SOAP notes a. Present b. Deficient Consent for treatment 9. Consent for treatment signed by patient or representative a. Present b. Deficient 10. Consent for treatment signed by physician a. Present b. Deficient Consent for procedure 11. Consent for procedure signed by patient or representative a. Present b. Deficient 12. Consent for procedure signed by physician a. Present b. Deficient Anesthesia/Surgery 13. Anesthesia report and evaluations a. Present b. Deficient c. Not applicable 14. Operative/surgical report a. Present b. Deficient c. Not applicable Nurse notes 15. Nurse admission note a. Present b. Deficient 16. Nurse discharge note a. Present b. Deficient 17. Nurse daily assessment, progress note, patient change in status a. Present b. Deficient Lab report/results 18. Complete Metabolic Panel results listed a. Present b. Deficient 19. CBC with Differential results listed a. Present b. Deficient 20. Lipid Profile results listed a. Present b. Deficient 21. Urinalysis results listed a. Present b. Deficient 22. Triacylglycerol lipase results listed a. Present b. Deficient 23. Ammonia results listed a. Present b. Deficient 24. Hemoglobin A1C results listed a. Present b. Deficient

(1 point) ✓ Saved A nurse is caring for a client who had a stroke and has aphasia. Which of the following actions should the nurse take to promote communication? SELECT ALL THAT APPLY a) Make sure one person speaks to the client at a time. b) Let the client know if they are not understood. c) Allow time for the client to respond. d) Use long sentences when talking to the client. e) Speak loudly to the client.

Compare and contrast Aloweni Evaluation of an Evidence-Based Care Bundle for Preventing Hospital-Acquired Pressure Injuries in High-Risk Surgical Patients and Caldwell, Reducing Hospital-Acquired Pressure Injuries in a Cardiothoracic Intensive Care Unit

When addressing the needs of patients with respiratory illnesses such as asthma, COPD, bronchitis, and tuberculosis, understanding the various oxygen delivery devices is crucial

42% complese (1) A patient with acute renal failure has low blood pressure with pale, dammy, and coal skin. The nurse determines that the potient's u than 400 mL per day and the verum patassium level is

29% complete (1) Study Mode \geoquad On Report content error Which instructions regarding bladder training would be included in the teaching plan for the family of a patient who is incontinent because of a stroke? \geoquad A "Use a Foley catheter at night to prevent accidents." \geoquad B "Offer the patient the commode or urinal every 1 to 2 hours." \geoquad C "Decrease the patient's oral fluid intake to 1 L per day." \geoquad D "Instruct the patient to hold the urine as long as possible to restore bladder tone."

A nurse is evaluating a group of clients who are experiencing pain. Which of the following clients should the nurse identify as experiencing neuropathic pain? \geoquad A client who has osteoarthritis and reports difficulty ambulating for the past 6 months \geoquad A client who had surgery to repair a fractured tibia and reports incisional pain \geoquad A client who has diabetes mellitus and reports bilateral burning foot pain without signs of injury \geoquad A hospice client who has prostate cancer and reports pelvic pain

What is the appropriate care plan for a patient with a past medical history of hypertension, hyperlipidemia, coronary artry disease who is newly diagnosed with stable angina pectoris

When caring for a client with emplysema who becomes more restless, which oction would the nurse take first? \geoquad A Auscultate lung sounds. \geoquad B Check oxygen soturation. \geoquad C Observe for increased respiratory effort. \geoquad D Ask about any increased shortness of breath.

A client is experiencing on acute episode of bronchiol asthma. The nurse would focus on which goal when creating the client's plan of care? \geoquad A Curing the condition permanently \geoquad B. Removing mucous secretions from the chest \geoquad C. Limiting pulmonary secretions by decreasing fluid intake \geoquad D Helping the client recognize that the condition is emotionally based

Which observotion would the nurse make first in a focused assessment of the oirway of a client who hos arrived of the medical-surgical unit after discharge from the postonesthesio core unit?- \geoquad A If the client's neck is in proper olignment \geoquad B Dota and the depth of the respiretions \geoquad C Quolity and the pattern of the breathing \geoquad D If the client is using occessory' muscles to breathe

1 pts You are screening a 58-year-old patient with diabetes for early nephropathy. Which laboratory finding provides the most sensitive early marker? \geoquad Total urinary protein \geoquad 24-hour wine wolume \geoquad Serum creatinine \geoquad Microalbuminuria (protein lost into urine)

Which oction will the nurse take ofter noticing condensotion in the tubing of humidified oxygen? \geoquad A Reploce the entire oxygen system. \geoquad a Drain the condensation into o woter trop. \geoquad C Empty the condensation into the humidifier. \geoquad D Reassure the client that no action is needed.

The nurse works on a surgical unit. For which of the following patients would a nurse expect to perform a bladder scan? \geoquad A patient who had an indwelling urinary catheter removed 8 hours ago and voided 30 mL once since it was removed. \geoquad A patient who complains she is having urinary incontinence and never had this problem before. \geoquad A patient who is postoperative for urological surgery. \geoquad A patient who was placed on diuretic therapy to reduce peripheral edema. \geoquad A patient who reports a change in urine color.

Case 3.7 Challenge Fred is a longtime patient in the family practice where you work. Typically he comes in once a year for a physical because his job involves high-steel construction work and his company requires annual checkups. However, during the past six months he has visited the office three times. Fred first came to the office in January complaining of extreme fatigue. He had lost 15 pounds since his checkup the previous May. As part of his examination the physician ordered a standard human immunodeficiency virus (HIV) test (of the ELISA type), which came back negative. He was to come back for a repeat test in May. But he returned one month later because he was experiencing an episode of genital herpes in which the lesions had not healed in over three weeks. The episode eventually subsided and Fred returned in May for his repeat HIV test. During this visit, he told the doctor that he was recovering from a severe respiratory infection that had bothered him for weeks. The physician drew blood; his CD4 count was 200 cells \( / \mathrm{ml} \). This HIV test (again, an ELISA) was also negative. Two months later Fred was admitted to the hospital and a lung biopsy demonstrated Pneumocystis carinii pneumonia, but another HIV test came back negative. He was released after three weeks, but readmitted with the same infection two months later. Again he tested negative for HIV. He died three days after admission to the hospital. 1. What is an ELISA test, and what does the one for HIV actually detect?

CASE STUDY ( 10) Immediately after you finished the physician's assistant program you took a job at a free clinic in the heart of the city. You always wanted to help society, especially those in the direst of life's circumstances. During your first week, you met Dwight, a 53-year-old overweight white man with several obvious problems. Dwight's feet are cracked and blistered and he has three infected toenails. (He tells you he has been homeless for various periods during the last 10 years.) There are seeping sores in the folds of his wrists and under his arms. His gums are bleeding. Dwight is here because he has been greatly confused over the past eight months and it seems to be getting worse. He has episodes of ranting and raving. He reports "feeling crazy" and being very scared. His friends brought him to the clinic and are waiting outside. The supervising physician quickly joins you in the examining room. Together you examine Dwight thoroughly and make a plan for addressing his pressing needs for wound care. The physician starts asking him about his health history. Dwight reveals very little, saying his memory is very bad. But he talks a lot about his past sexual exploits. After the exam, the doctor speaks with you in the hallway. He tells you that mental illness is very common among the homeless population. Dwight needs a thorough psychiatric evaluation. The doctor is fairly sure that some of Dwight's neural symptoms are caused by a sexually transmitted infection. Which sexually transmitted infection is causing the symptoms? What is the causative microorganism?

Which action would the nurse take to prevent postoperative respiratory complications after abdominal surgery? \geoquad A Implement postural drainoge. \geoquad B Encourage pursed-lip breathing. \geoquad C Assist with incentive spirometry. \geoquad D Teach sustained exhalation.

When caring for a client who has ocute respiratory distress syndrome (ARDS), the nurse would implement which measure to promote effective airway clearance? \geoquad A Administer sedatives as frequently as possible. \geoquad B. Turn the client every 4 hours. \geoquad C. Increase ventilator settings every 2 hours. \geoquad D Suction as needed.

Immediately after you finished the physician's assistant program you took a job at a free clinic in the heart of the city You always wanted to help society especially those in the direst of life's circumstances. During your first week, you met Dwight, a 53-year-old overweight white man with several obvious problems. Dwight's feet are cracked and blistered and he has three infected toenails. (He tells you he has been homeless for various periods during the last 10 years.) There are seeping sores in the folds of his wrists and under his arms. His gums are bleeding. Dwight is here because he has been greatly confused over the past eight months and it seems to be getting worse. He has episodes of ranting and raving. He reports "feeling crazy" and being very scared. His friends brought him to the clinic and are waiting outside. The supervising physician quickly joins you in the examining room. Together you examine Dwight thoroughly and make a plan for addressing his pressing needs for wound care. The physician starts asking him about his health history. Dwight reveals very little, saying his memory is very bad. But he talks a lot about his past sexual exploits. 1. The doctor speaks with you in the hallway. He tells you that mental illness is very common among the homeless population. Dwight needs a thorough psychiatric evaluation. The doctor is fairly sure that some of Dwight's neural symptoms are caused by a sexually transmitted infection. Which one? Caused by which microorganism? 2. If the blood test comes back positive, does it mean that Dwight can transmit the disease to others? Explain.

Compare and contrast Evaluation of an Evidence-Based Care Bundle for Preventing Hospital-Acquired Pressure Injuries in High-Risk Surgical Patients and Reducing Hospital-Acquired Pressure Injuries in a Cardiothoracic Intensive Care Unit

CASE STUDY ( 10) Immediately after you finished the physician's assistant program you took a job at a free clinic in the heart of the city. You always wanted to help society, especially those in the direst of life's circumstances. During your first week, you met Dwight, a 53-year-old overweight white man with several obvious problems. Dwight's feet are cracked and blistered and he has three infected toenails. (He tells you he has been homeless for various periods during the last 10 years.) There are seeping sores in the folds of his wrists and under his arms. His gums are bleeding. Dwight is here because he has been greatly confused over the past eight months and it seems to be getting worse. He has episodes of ranting and raving. He reports "feeling crazy" and being very scared. His friends brought him to the clinic and are waiting outside. The supervising physician quickly joins you in the examining room. Together you examine Dwight thoroughly and make a plan for addressing his pressing needs for wound care. The physician starts asking him about his health history. Dwight reveals very little, saying his memory is very bad. But he talks a lot about his past sexual exploits. After the exam, the doctor speaks with you in the hallway. He tells you that mental illness is very common among the homeless population. Dwight needs a thorough psychiatric evaluation. The doctor is fairly sure that some of Dwight's neural symptoms are caused by a sexually transmitted infection. Which sexually transmitted infection is causing the symptoms? What is the causative microorganism? the doctor tells you to expect more cases like this in the future. But a coworker who graduated from nursing school 10 years ago, tells you that this disease especially its later forms, is relatively rare and is decresing in incidence. Who is right?

which prehospital stroke severity tool is utilized to determine the presence of large vessel occlusion?

(1 point) Listen Which of the following treatments would be BEST for a patient with a suspected pelvis fracture and the following vital signs: BP 102/56, pulse 112, respiratory rate of 20 , pupils PERL, lung sounds are clear \geoquad a) Pelvic binder, using scoop stretcher to move the patient to the cot, reassessment every 5 minutes, and emergent transport. \geoquad b) Pelvic binder, moving the patient to a spinal board, reassessment every 5 minutes, and rapid transport. \geoquad c) Compression dressing to the pelvis, using scoop stretcher to move the patient to the cot, reassessment every 5 minutes, and rapid transport. \geoquad d) Pelvic binder, using scoop stretcher to move the patient to the cot. reassessment every 15 minutes, and non-emergent transport

75% complete © The registered nurse (RN) delegates to a licensed proctical nurse (LPN) the task of monitoring in cardiac medical unit. Which component of the nursing process includes delegation? A Planning B. Implementotion C Nursing diagnosis D Solution development

The nurse recognizes that smoking most likely has decreased which underlying respiratory defence? \geoquad A Cough reflex \geoquad B Mucociliary clearance \geoquad C Reflex bronchoconstriction \geoquad D Ability to filter particles from the air

During discharge teaching for a client with chronic obstructive pulmonary disease (COPD) and pneumonia, which vaccine would the nurse recommend \geoquad A Pneumococcol \geoquad B Stophylococcurs ourcus \geoquad C. Hoemophilus influenzae \geoquad D Bacille-Calmette-Guérin (BCG)

A. cliese with a history of chronic obstructive pulmonory diseose (COPD) is odmitted with acute pneumonia. The client is in moderate respiratory distress. The nusse would ploce the client in which poution to enhance comfort? \geoquad A. Side-iying with head elevated 45 degrees \geoquad 8 Modised left lateral recumbent with head ele-coted 90 degrees \geoquad C Secopfowler with legs elevated \geoquad D High Rowler using the beduidé table to rest the arms

The thuse is providing hygiene core to a immobile client who was odmitted for exocerbation of chronic obstructive pulmonory disease [COPD]. Which nursing intervention is priority when the client becomes short of breath during the corg? \geoquad A Obtoin o pulse oximeter to determine the clients oxygen saturation level. \geoquad But the client in a high Fowler position. \geoquad C Dorken the lights and provide o rest persod of at lesst 15 minutes. \geoquad D Cominat the hygiene activities while reossung the client.

(1 point) Linten A rapid trauma assessment should be performed on which of the following patients? \geoquad a) A middle-aged restaurant worker who burnt their hand. \geoquad b) A 14 year old female complaining of wrist pain after falling off her bike. \geoquad c) An 80-year-old male in cardiac arrest. \geoquad d) An unresponsive adult found on the sidewalk.

Highlight the correct choice for each numbered question below. Only select one answer per question.Overview Allergies identified or No Known Allergies identified a. Present b. Deficient 2. Documentation of Advance Directive(s) status a. Present b. Deficient Daily physician progress report 1. Daily physician progress or SOAP notes a. Present b. Deficient Consent for treatment 2. Consent for treatment signed by patient or representative a. Present b. Deficient 3. Consent for treatment signed by physician a. Present b. Deficient Consent for procedure 4. Consent for procedure signed by patient or representative a. Present b. Deficient 5. Consent for procedure signed by physician a. Present b. Deficient Anesthesia/Surgery 6. Anesthesia report and evaluations a. Present b. Deficient c. Not applicable 7. Operative/surgical report a. Present b. Deficient c. Not applicable Nurse notes 8. Nurse admission note a. Present b. Deficient 9. Nurse discharge note a. Present b. Deficient 10. Nurse daily assessment, progress note, patient change in status a. Present b. Deficient Lab report/results 11. Complete Metabolic Panel results listed a. Present b. Deficient 12. CBC with Differential results listed a. Present b. Deficient 13. Lipid Profile results listed a. Present b. Deficient 14. Urinalysis results listed a. Present b. Deficient 15. Triacylglycerol lipase results listed a. Present b. Deficient 16. Ammonia results listed a. Present b. Deficient 17. Hemoglobin A1C results listed a. Present b. Deficient Pathology report/results 18. Pathology report/results listed (Pathology report is a document that includes a diagnosis determined by examining cells and tissues under a microscope.) a. Present b. Deficient c. Not applicable Radiology report/results 19. Radiology test listed a. Ultrasound b. CAT scan - Abdomen/Pelvis with and without contrast 20. Reason for exam listed a. Present b. Deficient 21. Impression listed a. Present b. Deficient 22. Findings listed a. Present b. Deficient Physical/Respiratory/Occupational/Speech/Nutrition Therapy notes 23. Therapy note NOT documented for a. Dietetics b. Respiratory Therapy c. Occupational Therapy 24. Corresponding consult order on Orders tab for Respiratory Therapy note a. Present b. Deficient 25. Corresponding consult order on Orders tab for Dietetics note a. Present b. Deficient

Highlight the correct choice for each numbered question below. Only select one answer per question. Overview 1. Allergies identified or No Known Allergies identified a. Present b. Deficient 2. Documentation of Advance Directive(s) status a. Present b. Deficient Data Elements 3. Sex identified a. Present b. Deficient Anesthesia/Surgery 1. Anesthesia report and evaluations a. Present b. Deficient c. Not applicable 2. Operative/surgical report a. Present b. Deficient c. Not applicable Nurse notes 3. Nurse admission note a. Present b. Deficient 4. Nurse discharge note a. Present b. Deficient 5. Nurse daily assessment, progress note, patient change in status a. Present b. Deficient Lab report/results 6. Complete Metabolic Panel results listed a. Present b. Deficient 7. CBC with Differential results listed a. Present b. Deficient 8. Lipid Profile results listed a. Present b. Deficient 9. Urinalysis results listed a. Present b. Deficient 10. Triacylglycerol lipase results listed a. Present b. Deficient 11. Ammonia results listed a. Present b. Deficient 12. Hemoglobin A1C results listed a. Present b. Deficient Pathology report/results 13. Pathology report/results listed (Pathology report is a document that includes a diagnosis determined by examining cells and tissues under a microscope.) a. Present b. Deficient c. Not applicable Radiology report/results 14. Radiology test listed a. Ultrasound b. CAT scan - Abdomen/Pelvis with and without contrast 15. Reason for exam listed a. Present b. Deficient 16. Impression listed a. Present b. Deficient 17. Findings listed a. Present b. Deficient Physical/Respiratory/Occupational/Speech/Nutrition Therapy notes 18. Therapy note NOT documented for a. Dietetics b. Respiratory Therapy c. Occupational Therapy 19. Corresponding consult order on Orders tab for Respiratory Therapy note a. Present b. Deficient 20. Corresponding consult order on Orders tab for Dietetics note a. Present b. Deficient

Which schedule will the nurse teach a client who presented to the emergency room for an ocute asthma attock at the time of discharge who is prescribed theophylline 300 mg orolly to be token doily of 9:00 AM? A One hour before or 2 hours after eating B At bedtime C At the specific time prescribed D Doily until symptoms ore goné

Which statement is true related to a flail chest? Select all that apply. One, some, or all responses may be correct. \geoquad A Paradoxical chest movements involve the affected portion being sucked in during expiration and bulging out during inspiration. \geoquad B Flail chest results from fracture of two or more nonconsecutive ribs on the same side. \geoquad C Paradoxical chest movements only occur if the sternum also is fractured. \geoquad D Splinting of the chest wall is seen only in the unconscious client. \geoquad E Most clients with a flail chest require mechanical ventilation. \geoquad F Palpation must be performed to check for crepitus.

Highlight the correct choice for each numbered question below. Only select one answer per question. Overview Allergies identified or No Known Allergies identified a. Present b. Deficient 2. Documentation of Advance Directive(s) status a. Present b. Deficient Physician History and Physical 1. Chief complaint a. Present b. Deficient 2. Relevant histories a. Present b. Deficient 3. Review of systems a. Present b. Deficient 4. Physical exam a. Present b. Deficient 5. Impression/differential diagnosis a. Present b. Deficient 6. Plan for treatment a. Present b. Deficient 7. Which physician would be queried regarding any missing or deficient information in the History and Physical? a. Kerry West, MD b. Ji-yo12. Consent for procedure signed by physician a. Present b. Deficient Anesthesia/Surgery 1. Anesthesia report and evaluations a. Present b. Deficient c. Not applicable 2. Operative/surgical report a. Present b. Deficient c. Not applicable Nurse notes 3. Nurse admission note a. Present b. Deficient 4. Nurse discharge note a. Present b. Deficient 5. Nurse daily assessment, progress note, patient change in status a. Present b. Deficient Lab report/results 6. Complete Metabolic Panel results listed a. Present b. Deficient 7. CBC with Differential results listed a. Present b. Deficient 8. Lipid Profile results listed a. Present b. Deficient 9. Urinalysis results listed a. Present b. Deficient 10. Triacylglycerol lipase results listed a. Present b. Deficient 11. Ammonia results listed a. Present b. Deficient 12. Hemoglobin A1C results listed a. Present b. Deficient Pathology report/results 13. Pathology report/results listed (Pathology report is a document that includes a diagnosis determined by examining cells and tissues under a microscope.) a. Present b. Deficient c. Not applicable

History & Physical Vital Signs Laboratory Diagnostic Results A 68-year-old woman is admitted with difficulty breathing. The client's vital signs are as follows: temperature (T) 98.6\deg F (37\deg C), blood pressure (BP) 162/94 mm Hg, heart rate (HR) 92 beats/minute, and respiratory rate (RR) 26 breaths/minute. Oxygen saturation (Sa02) is 90% on room air. Client states she has been sleeping in a recliner chair for the past three nights due to her labored breathing. She also states she has "5" out of 10 pain in her lower back. Upon assessment, the client states, "I can't catch my breath when I walk a few feet." Client is oriented to person, place, and time. She has a productive cough. Crackles and wheezing heard upon auscultation and diminished breath sounds at bases. The client's capillary refill is 4 seconds with evidence of clubbing to her fingers. Ankles and feet show 1+ pitting edema. The client is allergic to penicillin. Medical history includes hypertension, hyperlipidemia, type 2 diabetes mellitus, and chronic obstructive pulmonary disease (COPD).

Highlight the correct choice for each numbered question below. Only select one answer per question. Overview Allergies identified or No Known Allergies identified a. Present b. Deficient 2. Documentation of Advance Directive(s) status a. Present b. Deficient Physician History and Physical 1. Chief complaint a. Present b. Deficient 2. Relevant histories a. Present b. Deficient 3. Review of systems a. Present b. Deficient 4. Physical exam a. Present b. Deficient 5. Impression/differential diagnosis a. Present b. Deficient 6. Plan for treatment a. Present b. Deficient 7. Which physician would be queried regarding any missing or deficient information in the History and Physical? a. Kerry West, MD b. Ji-yo12. Consent for procedure signed by physician a. Present b. Deficient Anesthesia/Surgery 1. Anesthesia report and evaluations a. Present b. Deficient c. Not applicable 2. Operative/surgical report a. Present b. Deficient c. Not applicable Nurse notes 3. Nurse admission note a. Present b. Deficient 4. Nurse discharge note a. Present b. Deficient 5. Nurse daily assessment, progress note, patient change in status a. Present b. Deficient Lab report/results 6. Complete Metabolic Panel results listed a. Present b. Deficient 7. CBC with Differential results listed a. Present b. Deficient 8. Lipid Profile results listed a. Present b. Deficient 9. Urinalysis results listed a. Present b. Deficient 10. Triacylglycerol lipase results listed a. Present b. Deficient 11. Ammonia results listed a. Present b. Deficient 12. Hemoglobin A1C results listed a. Present b. Deficient Pathology report/results 13. Pathology report/results listed (Pathology report is a document that includes a diagnosis determined by examining cells and tissues under a microscope.) a. Present b. Deficient c. Not applicable Radiology report/results 1. Radiology test listed a. Ultrasound b. CAT scan - Abdomen/Pelvis with and without contrast 2. Reason for exam listed a. Present b. Deficient 3. Impression listed a. Present b. Deficient 4. Findings listed a. Present b. Deficient Physical/Respiratory/Occupational/Speech/Nutrition Therapy notes 5. Therapy note NOT documented for a. Dietetics b. Respiratory Therapy c. Occupational Therapy 6. Corresponding consult order on Orders tab for Respiratory Therapy note a. Present b. Deficient 7. Corresponding consult order on Orders tab for Dietetics note a. Present Deficient

A client with sudden onset of respiratory distress is scheduled for a stat ventilation-perfusion scan. Which explanation would the nurse provide to the client obout the procedure? \geoquad A Radioisotope is injected and inhaled to examine the lungs. \geoquad B You will be sedated during the test to prevent you from moving. \geoquad C We need to be sure there is no metol in your body before this test. \geoquad D You will feel a sensation of chest pressure as the dye circulates through your body.

Which oction will the nurse take in-a client hospitalized for uncontrolled hypertension and chest poin on a daily diuretic for 2 days whose potossium level this morning is

Instructions: Use your CPT manual to assign procedure codes, adding appropriate modifier(s). Percutaneous core needle biopsy, mediastinum; assistant surgeon reporting Electrodesiccation, basal cell carcinoma (1 cm), face Complicated bilateral repair of recurrent inguinal hernia Biopsy of anorectal wall via proctosigmoidoscopy Mastectomy for gynecomastia, bilateral Open reduction, right tibia/fibula shaft fracture, with insertion of screws Excision, condylomata, penis Replacement of breast tissue expander with breast prosthesis (permanent) Closed reduction of closed fracture, right clavicle Incision and drainage of infected bursa, right wrist Cystourethroscopy with brush biopsy of urinary bladder Endoscopic right maxillary sinusotomy with partial polypectomy Insertion of nontunneled Hickman central venous catheter (short-term) (age 70) Avulsion of four nail plates, left foot, nails 2-5 Adjacent tissue transfer, trunk, defect 20.0 sq cm in size

what is the initial diagnostic test for a stroke? non contrast ct, non contrast ct, ekg, or mri

Which of the following is an indication for long-acting beta-2 agonists? Q SHOW CHARACTER HINT Tocolysis Pharyngitis Allergies Lung Cancer Chronic Sinusitis Chronic Obstructive Pulmonary Disease (COPD)

The nurse expects to find which pathological change in a client with pulmonary arterial hypertension? \geoquad A Increased pulmonary vascular resistance \geoquad B Decreased pulmonary vascular resistance \geoquad C Respiratory acidosis with failure to compensate \geoquad D Increased crackles upon auscultation of the lower posterior and lateral lungs

Which of the following is an indication for the long-acting beta-2 agonist, Salmeterol? Q SHOW CHARACTER HINT Asthma Buerger's Disease Cushing's Syndrome Bradycardia Endocardial Fibroelastosis Pneumothorax

A client is odmitted to the emergency deportment with a stab wound of the chest. Which is a priority nursing assessment? \geoquad A Level of poin \geoquad \geoquad B. Quality and dep h of resperctions \geoquad C. Amount of serosonguinous droinoge D Blood pressure and pupillary response

Which statement by the client indicates that discharge teaching for a client hospitalized with pneumonia has been effective? \geoquad A "I will seek immediate medical treatment for any upper respiratory infections." \geoquad B "I should continue to do deep-breathing and coughing exercises for at least 6 weeks." \geoquad C "I will increase my food intake to 2400 calories a day to keep my immune system well." \geoquad D "I must have a follow-up chest

Which risk factor is associated with pulmonary embolism? Select all that apply. One, some, or all responses may be correct. \geoquad A Prolonged air travel \geoquad B Cigarette smoking \geoquad C Malignancy \geoquad D Pneumonia \geoquad E Obesity

Highlight the correct choice for each numbered question below. Only select one answer per question. Overview 1. Allergies identified or No Known Allergies identified a. Present b. Deficient 2. Documentation of Advance Directive(s) status a. Present b. Deficient Data Elements 3. Sex identified a. Present b. Deficient 4. Race/Ethnicity identified a. Present b. Deficient 5. Residence identified a. Present b. Deficient 6. Hospital ID# (SSN or MR#) present a. Present b. Deficient 7. Birth weight of newborn a. Present b. Deficient c. Not applicable 8. Admission Date a. Present b. Deficient 9. Type of Admission listed a. Outpatient b. Inpatient 10. Expected source of payment listed (guarantor and/or insurance information) a. Present b. Deficient . Anesthesia/Surgery 1. Anesthesia report and evaluations a. Present b. Deficient c. Not applicable 2. Operative/surgical report a. Present b. Deficient c. Not applicable Nurse notes 3. Nurse admission note a. Present b. Deficient 4. Nurse discharge note a. Present b. Deficient 5. Nurse daily assessment, progress note, patient change in status a. Present b. Deficient Lab report/results 6. Complete Metabolic Panel results listed a. Present b. Deficient 7. CBC with Differential results listed a. Present b. Deficient 8. Lipid Profile results listed a. Present b. Deficient 9. Urinalysis results listed a. Present b. Deficient 10. Triacylglycerol lipase results listed a. Present b. Deficient 11. Ammonia results listed a. Present b. Deficient 12. Hemoglobin A1C results listed a. Present b. Deficient Pathology report/results 13. Pathology report/results listed (Pathology report is a document that includes a diagnosis determined by examining cells and tissues under a microscope.) a. Present b. Deficient c. Not applicable Radiology report/results 14. Radiology test listed a. Ultrasound b. CAT scan - Abdomen/Pelvis with and without contrast 15. Reason for exam listed a. Present b. Deficient 16. Impression listed a. Present b. Deficient 17. Findings listed a. Present b. Deficient Physical/Respiratory/Occupational/Speech/Nutrition Therapy notes 18. Therapy note NOT documented for a. Dietetics b. Respiratory Therapy c. Occupational Therapy 19. Corresponding consult order on Orders tab for Respiratory Therapy note a. Present b. Deficient 20. Corresponding consult order on Orders tab for Dietetics note a. Present b. Deficient

shook, an internationally educated nurse, is orienting on a surgical recovery unit. how can shook best maintain the public's confidence in the nursing profession

Before discharging a patient from the hospital, a nurse provides detailed instructions to the patient on how to change a wound dressing himself at home. The nurse demonstrates the task and has the patient practice it before discharge. Which delivery strategy is the nurse primarily using here? Group of answer choices Integration of care. Patient engagement. Team-based care. Care coordination.

1 pts Episiotomy is a surgical procedure in which an incision is made in a woman's perineum to enlarge her vaginal opening for delivery. \geoquad True \geoquad False

(1 point) Listen Your patient has a suspected pelvis fracture from falling off a 16 foot deck. Upon arrival, your patient had bilateral radial pulses, however, 10 minutes into the call the radial pulses are now absent. What does this change reflect? \geoquad a) The patient is now relaxed after being treated. \geoquad b) The patient has hidden injuries to both arms. \geoquad c) The patient is becoming hypothermic. \geoquad d) The patient is becoming hypotensive.

Empathy statemnets for a patient with diabetes, asthma who came in for an assessment.

1 pts The combining form "phlebo" in the surgical procedure known as a phlebotomy tells you that

2025 Cnamberlain University LLC. All rights reserved Respiratory Complications The nurse is assessing a client who recently had surgery. Lung sounds on the right base are diminished and there are no breath sounds in the left base. What complication does the nurse suspect? \geoquad Atelectasis \geoquad Pneumonia \geoquad Emboli \geoquad Respiratory infection

Empathy questions for a patient with diabetes, asthma who came in for an assessment.

Educational statement for a patient with diabetes, asthma after a complete heath assessment

A patient with severe dehydration develops oliguria. Which mechanism explains this change? Reduced bladder emptying lowers urine output Reduced albumin levels lowers fluid retention Reduced renal perfusion lowers glomerular filtration Reduced tubular function lowers urine formation

The nurse is coming on day shift in a Medical-Surgical unit and will be caring for Mr. Jones. The nurse reviews Mr. Joney' admiselon and medical history, current medical diagnosis and treatments, and current medications and notes the following. Select the cues that will likely have an impact on the assessment of Mr. Jones' blood pressure (BP). 46-year-old

The nurse is coming on day shift in a Medical-Surgical unit and will be caring for Mr. Jones. The nurse reviews Mr. Jones' admission and medical history, current medical diagnosis and treatments, and current medications and notes the following. Select the cues that will likely have an impact on the assessment of Mr. Jones' blood pressure (BP). 46-year-old

Nursing Diagnoses Which are included in the nursing diagnoses for a client with tachycardia. bradycardia, and/or dysrhythmia? Select all that apply. \geoquad Dehydration \geoquad Impaired verbal communication \geoquad Altered thought processes \geoquad Impaired cardiac function \geoquad Hypervolemia \geoquad Impaired peripheral tissue perfusion \geoquad Activity intolerance \geoquad Functional incontinence

Which of the following is appropriate for use in surgical hand hygiene? A \geoquad ABHR B

A client with obesity reports fatigue and right upper quadrant discomfort. Labs show elevated AST and ALT. Which condition should the nurse suspect? Nonalcoholic fatty liver disease Cystic fibrosis Renal insufficiency Ulcerative colitis

Client: Mrs. Evelyn Carter, 82 years old Setting: General medical unit, admitted from home after a fall (no fracture). History & Risks: Lives alone; spouse deceased; limited family support; no longer drives (transportation barrier). Polypharmacy: 9 daily meds; notes “pills upset my stomach.” PMH: Mild COPD, hypertension, osteoarthritis, early Alzheimer’s disease (mild cognitive impairment). Symptoms (3 months): 8% unintentional weight loss; poor appetite; “food tastes bland”; difficulty chewing (ill‑fitting dentures); fatigue and dizziness. SDOH: Social isolation, limited income, food insecurity (“I sometimes skip meals to pay utilities”). Functional concerns: Trouble opening containers and cooking; tires easily; occasionally coughs with thin liquids (possible dysphagia). Admission Screening (MNA‑SF): Positive screen for malnutrition risk Focused Nutrition Assessment: Physical exam: Loss of triceps subcutaneous fat and temporal muscle wasting; dry mucous membranes; poor dentition; mild ankle edema. Labs: Prealbumin low; albumin mildly low; electrolytes normal; BUN/Cr normal; CBC shows mild normocytic anemia. Intake: Estimated <50% needs for >1 week; tray returns ~50% untouched; last documented oral care >24 hrs ago. Mealtime environment: Bedside commode and urinal on tray table; strong odor in room. Team status: Dietitian consult pending; SLP referral considered but not yet placed. During Mrs. Carter’s admission, the nurse must identify which actions reflect appropriate and immediate nursing responsibilities related to screening, assessment, monitoring, and nutrition-focused care for an older adult at risk of malnutrition. Which actions should the nurse take? Select all that apply. Remove strong odors, bedpans, and urinals from the eating area to improve intake Complete a 72‑hour food diary and full dietary/social assessment Cluster non‑urgent procedures during mealtimes to maximize efficiency Perform the MNA‑SF nutrition screening on admission Trend prealbumin levels every 48–72 hours Provide oral care, seat the client upright, and ensure sensory aids are in place at meals Document triceps fat loss and temporal wasting

Which of the following individuals is NOT following standard precautions? A \geoquad Employee A washes her hands and puts on new gloves to change a pationt's dressing on a large infected abdominal wound. B

Please answer this question based entirely on the details provided in the previous question. The patient tells your partner that she is very sleepy and feels like she has to exert more energy than usual when she exhales. She also indicates that she was vigorously exercising just before EMS arrived. Based strictly on the information provided in the previous question, how would you describe the patient's respiratory rate?

A client with prediabetes asks how to prevent Type 2 diabetes. Which teaching is most appropriate? “You will need lifelong insulin injections.” “Avoid all carbohydrates indefinitely.” “Prediabetes always progresses to Type 2 diabetes.” “Lifestyle changes can prevent or delay progression.”

Nursing Assessment or Respiration Select the impact each of these factors has on respiratory rate. \geoquad Exercise/metabolism

Carlos, a 38-year-old construction worker, arrives at the emergency department with sudden, severe left flank pain radiating to his groin. He is visibly uncomfortable, restless, and frequently shifting positions. He also reports nausea, In the days leading up to this visit, Carlos had been working extended shifts outdoors during a week of extreme heat. His supervisor discouraged frequent breaks, and he had minimal fluid intake for several days before the pain began. Question at position 1 1 Multiple Choice 10 points Question at position 1 Which condition is responsible for Carlos’s symptoms? Muscular strain causing movement-related pain Diverticulitis causing left-sided abdominal pain with fever Renal calculus causing acute obstruction with colicky pain Acute kidney infection causing steady pain with fever

Based on these findings, which condition has most likely developed? Intrarenal kidney injury due to vascular damage Prerenal kidney injury due to decreased renal perfusion Acute kidney injury due to decreased glomerular filtration rate Chronic kidney disease due to long-term nephron loss

A technologist should be particularly cautious when removing IV's on patients receiving thrombolytic therapy because these medications: \geoquad a. Break down existing blood clots or reduce formation of clots \geoquad b. Suppress immune function \geoquad c. Reduce cardiac contractility \geoquad d. Increase platelet production

Nursing Diagnosis The nurse is caring for a client with a nursing clagnosis of risk for impaired thermoregulation; hypothermla related to aging and inability to adapt to environmental temperature. This client, George, is an 82-yearold male who has been admitted to the unit after discharge from post-op following surgery for a spinal cord injury. Based on the information provided, which of the client's cues that support this nursing diagnosis? Select all that apply.

A patient taking muscle relaxants should be monitored closely because these drugs may: \geoquad a. Increase clot formation \geoquad b. Cause renal failure after contrast administration \geoquad c. Increase blood pressure \geoquad d. Suppress respiratory muscle activity

At a 4‑week follow‑up visit, the nurse evaluates Alex’s progress with nutrition‑related diabetes management. Alex reports some improvements but continues to have inconsistent post‑meal glucose readings and difficulty managing food choices, especially when eating away from home. Which findings indicate Alex still needs additional nutrition teaching? Carrying glucose tablets during sports activities Eating breakfast consistently before school Continued mid‑afternoon hunger after eating a low‑fiber lunch Difficulty estimating carbohydrate portions when eating meals prepared outside the home Reporting a recent episode of hyperglycemia after a restaurant meal Drinking only water or unsweetened beverages during the school day Reliance on high‑fat, high‑carb restaurant meals without adjusting insulin

Part 3-Family Education Alex, a 16‑year‑old newly diagnosed with Type 1 Diabetes, reports skipping breakfast, drinking sugar‑sweetened energy drinks at school, and experiencing shakiness during soccer practice. The family expresses confusion about carbohydrate counting and insulin timing. Drag and drop to the correct category; One-Most important Clinical Issue, Two Nursing Interventions and Two Expected Outcomes Clinical Issue Nursing Interventions No Answers Chosen No Answers Chosen Expected Outcomes No Answers Chosen Possible answers Teach carbohydrate counting and food label reading Teach consistent meals/snacks every 3-4 hours Decreased need for carbs on sick days Reduction in hypoglycemic episodes during sports Inconsistent carbohydrate intake Improved glucose stability

John is a 70-year-old patient with end-stage kidney disease secondary to hypertension, who has been on CAPD therapy at home for the past year. His past medical history also includes abdominal aortic aneurysm repair in 1999 and prostate cancer that has been in remission since 2014. Recent labs at his family physician’s office revealed a significantly elevated PSA count. He has also been complaining of left shoulder and lower back pain. A recent scan confirmed metastasis to the bone for which he underwent radiation. At a recent home visit, John’s son reported that the patient’s appetite and functional capacity have diminished significantly in the previous three weeks. On examination, the patient’s blood pressure was 90/50. He appeared visibly weak. John was admitted to hospital last night with weakness and failure to thrive. At his last clinic visit, John stated that his goals of care include attending his granddaughter’s wedding in six months. He also stated that he preferred “no heroic measures” be undertaken should he suffer cardiac or respiratory arrest. What ethical principles could be at play in this situation in terms of John’s current status? Based on the concept of shared decision-making, how would you approach care and management of this patient (and his family)? How would you advocate for this patient? What treatment options are there for John? Thoughts to Ponder • Is John’s current condition his new baseline or is there potential for some improvement, if so, how? • Take into consideration The Renal Physicians Association (RPA) guidelines in regard to dialysis in patients with cancer as well as John’s specific cancer • Research shared decision-making, ethical principles, and the patient’s prognosis, • How long can John survive with this type of cancer? What is the potential for his quality of life? Who decides quality of life? • After you have researched the above, determine what treatment options are available to John.

The nurse is preparing to assess the vital signs of an adult client. Identify the assessment findings that require follow-up prior to the skill being performed. Select all that apply. Client is in a lying position Client quit smoking 1 year ago Client is drinking ice water Client is allergic to latex Client has a surgical history of mastectomy

Describe the various surgical interventions commonly used in the treatment of valvular heart disease. Discuss the preparations that patients undergo during the preoperative phase, the procedures themselves in the intraoperative phase, and the care provided during the postoperative phase. Include any specific considerations or precautions related to valvular surgery.

On Mr. A’s first hospital day with new-onset type 2 diabetes and morbid obesity, place the following nursing actions in order of priority (1 = highest priority during the first 24 hours; 6 = appropriate but lower priority). position 11 Screen feet for neuropathy and skin integrity position 22 Provide label-reading workshop position 33 Arrange DSMES (Diabetes Self‑Management Education Support) class schedule position 44 Initiate supervised Self‑Monitoring of Blood Glucose teaching position 55 Begin motivational interviewing position 66 Assess for signs of hyperglycemic crisis and hydration status

Part 6-Future Treatment Options At Mr. A’s 3‑month follow‑up, his hemoglobin A1C remains greater than 8.5%, weight loss is less than 5%, and knee osteoarthritis continues to limit activity despite adherence to lifestyle changes and metformin therapy. His body mass index is approximately 46 kg/m² (Class III obesity). Based on this clinical presentation, which statements about Mr. A’s eligibility and considerations for bariatric surgery are accurate? Select all that apply. He meets the body mass index criteria for bariatric surgery consideration even without other comorbidities. Bariatric surgery may improve type 2 diabetes control through hormonal mechanisms that extend beyond weight loss alone. He is guaranteed to stop all diabetes medications within one month after surgery. Metformin should be discontinued immediately prior to referral for surgical evaluation. Screening for obstructive sleep apnea, micronutrient deficiencies, and psychosocial readiness is recommended before surgery. Referral to an accredited, multidisciplinary bariatric surgery program is appropriate at this time. The nurse should delay changes and reassess in 6–12 months since he has lost some weight.

Digoxin is prescribed primarily for which therapeutic purpose? \geoquad a. Dilating coronary arteries \geoquad b. Preventing platelet aggregation \geoquad c. Increasing myocardial contractile force \geoquad d. Lowering serum cholesterol

A 16‑year‑old client is admitted with new‑onset Type 1 Diabetes. Admission data include: glucose 368 mg/dL, A1C 11.2%, moderate ketonuria, recent 10‑lb unintentional weight loss, and symptoms of shakiness during soccer practice. The client frequently skips meals, drinks sugar‑sweetened energy drinks during the school day, and has no understanding of carbohydrate counting. The family reports difficulty reading nutrition labels. Which nursing interventions are PRIORITY based on the admission data? Select all that apply Encourage the client to increase protein intake to stabilize blood glucose Provide hydration teaching related to the presence of moderate ketonuria Provide instruction to eliminate all simple carbohydrates from the diet Educate the client to consume 15–30 g of carbohydrates before engaging in physical activity Teach the client to avoid skipping meals and maintain consistent carbohydrate intake throughout the day Teach the family how to read food labels to identify total carbohydrate grams

The nurse is teaching Alex, a 16‑year‑old with Type 1 Diabetes, how different combinations of foods can modify post‑prandial glucose responses. The nurse wants to assess whether Alex can correctly identify which mixed meals or snacks are more likely to produce a delayedrise in blood glucose due to their composition of fiber, fat, and protein. Which of the following food combinations are most likely to result in a slower, delayed glucose rise? (Select all that apply.) Plain pasta with marinara sauce Farro bowl with roasted eggplant and grilled turkey Pretzels eaten with a sports drink Skyr with flaxseed and sliced strawberries Barley and chickpea salad with tahini dressing Rye crispbread topped with peanut butter Fruit smoothie made with pineapple and orange juice

Nursing Diagnoses Which are included in the nursing diagnoses for a client with fachycardia. bradycardia, and/or dysrhythmia? Select all that apply. \geoquad Impaired peripheral tissue perfusion \geoquad Impaired verbal communication \geoquad Hypervolemia \geoquad Activity intolerance \geoquad Impaired cardiac function \geoquad Altered thought processes \geoquad Dehydration \geoquad Functional incontinence

The importance of precise anatomical terminology for communication in health care and science (e.g., ensuring accuracy in surgical procedures or patient care reports).

ADAPTIVE TEST: PARAMEDIC 2025/2026 - TR - TRAUMA (NR2015) 22. You are called to assess and treat a patient who has suffered a deep, penetrating wound to the central chest and is camplaining of difficult and painfur swallowing, pleuritic chest pain, and pain radiating to the mid back. Which of the following treatment options would be contraindicated for this patient? \geoquad Intubation. \geoquad Combitube. \geoquad Fluid resuscitation. \geoquad Positive pressure ventilation. Flag Quesition Submit Feedback Ling latinum Educational Group, LIC.

Nursing Diagnosis The nurse is caring for a client with a nursing diagnosis of risk for impaired thermoregulation; hypothermia related to aging and inability to adapt to environmental temperature. This client, George, is an 82-yearold male who has been admitted to the unit after discharge from post-op following surgery for a spinal cord injury. Based on the information provided, which of the client's cues that support this nursing diagnosis? Select all that apply.

Which of the following is NOT a recommended action to take after a needlestick injury? (6 Points) " \geoquad Washing the area with soup and water \geoquad Squeving the wound to encourage bleeding \geoquad Benperting the 1sucterit to a superimor \geoquad Seveing medical evaluation and following

Which symptom of heart failure is related to the assessment finding of jugular venous distensión

The medical term for an abnormal heartbeat is: Group of answer choices angioplasty. dysrhythmia. myocardial infarction. coronary artery disease.

A nurse is establishing baseline for a client's respirations. Which of the following actions should the nurse take? \geoquad Instruct the client to breathe in and to exhale out as they normally do. \geoquad Count the client's respirations for 15 seconds then multiply by 4. \geoquad Determine if the client has a history of any chronic respiratory problems. \geoquad Observe the client's chest movements while appearing to assess their pulse.

Which of the following best describes heart failure? Group of answer choices heart cannot pump blood effectively. kidneys respond to fluid accumulation in lungs with excessive fluid excretion. pulmonary function testing is helpful in the diagnosis of heart failure. the most common symptoms of heart failure are chest pain and shortness of breath.

A person with a confirmed blood pressure of 125/87 would be classified as Group of answer choices normal prehypertension Stage 1 hypertension Stage 2 hypertension

A nurse is collecting data about a client's respiratory condition. Which of the following actions should the nurse take to determine the depth of the client's respiration? \geoquad Observe the degree of chest-wall movement during inspiration and expiration. \geoquad Count how many breathing cycles are observed per minute. \geoquad Notice whether or not expiration takes longer than inspiration. \geoquad Measure the precise amount of air the client takes in and breathes out.

A 65-year-old woman comes into the clinic during the first week of November for her annual wellness visit. Her last tetanus diphtheria (Td) booster was 9 years ago. Which immunization(s) would you recommend for this visit? Option A Influenza vaccine Option B Pneumococcal (Pneumovax) and influenza vaccines Option C tetanus and influenza vaccines Option D Influenza, tetanus and pneumococcal (Pneumovax) vaccines Selected Question 13 A 65-year-old woman comes into the clinic during the first week of November for her annual wellness visit. Her last tetanus diphtheria (Td) booster was 9 years ago. Which immunization(s) would you recommend for this visit? Option A Influenza vaccine Option B Pneumococcal (Pneumovax) and influenza vaccines Option C tetanus and influenza vaccines Option D Influenza, tetanus and pneumococcal (Pneumovax) vaccines SelectedQuestion 13 A 65-year-old woman comes into the clinic during the first week of November for her annual wellness visit. Her last tetanus diphtheria (Td) booster was 9 years ago. Which immunization(s) would you recommend for this visit? Option A Influenza vaccine Option B Pneumococcal (Pneumovax) and influenza vaccines Option C tetanus and influenza vaccines Option D Influenza, tetanus and pneumococcal (Pneumovax) vaccines SelectedThe primary care nurse practitioner (NP) is seeing a 52-year old female with a history of diabetes, obesity and hypertension. The patient reports that she has been watching her diet and has only been able to lose 4lbs over the last 3 months. The patient's hemoglobin-A1dc today is 7.7% is currently taking Metformin 500mg po BID. What does the NP consider adding to the patient's diabetes regimen that may also help with weight loss? Option A Glipizide 5mg po QD Option B sitagliptin (Januvia) Option C Increase Metformin to 1000mg po BID Option D empagliflozin (Jardiance)

An 82-year-old female client who lives in a senior living facility contacts the nurse after a fall. The client is alert and oriented when the nurse arrives to her room; the client reports, "I was sitting on the toilet and then I was on the floor. I'm not sure what happened but I wasn't feeling well so I used my alert button to call for help." The client's vital signs are: heart rate (HR), 55 beats/min; respirations, 18 breaths/min; blood pressure (BP), 136/48 mm Hg; oxygen saturation, 96% (on room air [RA]). The client has a history of hypertension, coronary artery disease, and gastroesophageal reflux disease (GERD), for which she is prescribed aspirin, atenolol, nifedipine, clopidogrel, and chewable calcium carbonate tabs. Complete the sentences by choosing the most likelyoptions for the missing information from the lists of options provided.

A 45-year-old woman presents with a persistent dry cough for two weeks. She denies wheezing, nasal drainage, or reflux symptoms. Her exam shows mild erythema of the posterior pharynx but no wheezes or postnasal drip. Which of the following is the least likely cause of her cough? Group of answer choices Asthma Gastroesophageal reflux Acute pharyngitis Allergic rhinitis

Kidney asymmetry by >1.5 cm is diagnostic of renal arteries stenosis and occurs in over 2/3 of patients with Reno vascular hypertension, true or false

An 82-year-old female client who lives in a senior living facility contacts the nurse after a fall. The client is alert and oriented when the nurse arrives to her room; the client reports, "I was sitting on the toilet and then I was on the floor. I'm not sure what happened but I wasn't feeling well so I used my alert button to call for help." The client's vital signs are: heart rate (HR), 55 beats/min; respirations, 18 breaths/min; blood pressure (BP), 136/48 mm Hg; oxygen saturation, 96% (on room air [RA]). The client has a history of hypertension, coronary artery disease, and gastroesophageal reflux disease (GERD), for which she is prescribed aspirin, atenolol, nifedipine, clopidogrel, and chewable calcium carbonate tabs. Which questions would the nurse ask to determine the effect of the health history on her recent fall? Select all that apply.

In some patients, gradual and progressive loss of kidney function is appearing in patients who recovered from the infectious state of COVID-19. Which stage of Chronic Kidney Disease (CKD) would dialysis be recommended to improve systemic function? \geoquad Moderate Stage, CKD \geoquad Severe Stage, CKD \geoquad End Stage, needing kidney transplant \geoquad all of these stages would benefit from dialysis treatment

The nurse is developing a plan of care (POC) for a client with type 2 diabetes mellitus (DM) who reports intermittent claudication in the legs. Which outcome should the nurse include in the POC for this client? A. The nurse will instruct the client's family members about the prescribed diet. B. The client's skin on the shins will be intact at the next clinic visit. C. The nurse will show the client how to perform blood glucose checks. D. The client will express acceptance of his changing health status. Answer: B. The client's skin on the shins will be intact at the next clinic visit.

1 Indications for ECMO include: \geoquad Immediate cardiac or respiratory collapse (pulmonary embolism, blocied airway, or unresponsive to optimal care) \geoquad Exacerbation of COPD \geoquad Acute cardiogenli pulmoniary edema \geoquad Acute respiratory failure Question 6 All of the following are signs of spontaneous breathing trail failure except

A patient has acute renal failure. What is another term the nurse can use to describe this condition? \geoquad Glomerulonephritis \geoquad Acute kidney injury \geoquad Acute tubular necrosis \geoquad Kidney stones

The primary care nurse practitioner (NP) is seeing a 52-year old female with a history of diabetes, obesity and hypertension. The patient reports that she has been watching her diet and has only been able to lose 4lbs over the last 3 months. The patient's hemoglobin-A1dc today is 7.7% is currently taking Metformin 500mg po BID. What does the NP consider adding to the patient's diabetes regimen that may also help with weight loss? Option A Glipizide 5mg po QD Option B sitagliptin (Januvia) Option C Increase Metformin to 1000mg po BID Option D empagliflozin (Jardiance)