1.Remind me if Xs are highly correlated (scatterplot, VIF, Correlations) if you have a sign switch, correct the situation by throwing one of the variables out of the model. Consider R-squared or adj R-squared when making the decision.
 
 
 
 
 
My Y = Revenue, my company name is Amazon
X variables = Earnings, Revenue, and Industry Revenue.
 
As shown in the first graph above, The X variables are significant and show some linear pattern however it is not a perfect linear line so we can say it is non-linear. The P- values are zero which means there is an evidence of a relationship between the variables. X variables are also statistically significant and co-related as the correlation matrix table shows the amount of correlation between the variables. Only Industry Revenue and Earnings has a low correlation as it has 0.447.
Comparing my tables I do see a sign switch in the Employment as it has a negative sign (-0.000573).
Interpreting the regression analysis in my second graph, we want there to be a relationship between our X and Y variable. X is the independent variable and Y is our dependent variable. So, the relation between X and Y is if the X changes our Y changes as well. The constants are not statistically significant as the P-values are greater than 1. Let’s assume that the unit is 1, My coefficient in Earnings is 114.5 that means is if my Earnings increases by $1, the Revenue will increase by $114.5. In my second X variable, if my Industry Revenue is increased by $1 then my Revenue also increases by $370.1. Also, for the Employment it has a negative coefficient so that means they will move on the opposite direction. Which means if the company employs more than 1 person the revenue will decrease by 0.000573. There is a very low impact so for the company to see a huge difference in the decrease of the revenue the company will need to hire more than 10,000 employs which would decrease by$5.73.
 
 
 
WORKSHEET 1
Regression Analysis: Revenue versus Earnings
Regression Equation

Revenue = -67933 + 114.91 Earnings

Coefficients

Term Coef SE Coef T-Value P-Value VIF
Constant -67933 5923 -11.47 0.000  
Earnings 114.91 8.45 13.60 0.000 1.00

Model Summary

S R-sq R-sq(adj) R-sq(pred)
9225.39 67.27% 66.91% 65.08%

Analysis of Variance

Source DF Adj SS Adj MS F-Value P-Value
Regression 1 15742520392 15742520392 184.97 0.000
  Earnings 1 15742520392 15742520392 184.97 0.000
Error 90 7659698627 85107763    
  Lack-of-Fit 84 7637913547 90927542 25.04 0.000
  Pure Error 6 21785079 3630847    
Total 91 23402219018      

Fits and Diagnostics for Unusual Observations

Obs Revenue Fit Resid Std Resid  
88 60450 32387 28063 3.10 R
90 52890 34685 18205 2.02 R
91 56580 35145 21435 2.38 R
92 72380 35259 37121 4.12 R

R  Large residual
Durbin-Watson Statistic

Durbin-Watson Statistic = 0.186035

 
Considering the R-squared and the VIF table I have decided to take my Employment and industry revenue out. There was a low R-squared in all my three X variables when I ran the Regression analysis, so I decided to choose the one with the higher R-Square and R-sq(adj). The highest R-sq is the Earnings so I will be keeping only one X variable. Also, The P-value is O which is good and VIF is one which is low however this is the best model I have comparatively. Also looking at my VIF which is 1 there is no sign of multicollinearity as it is not greater than 5 or 10.
 
 
 
 
 

  1. Using the scatter plots you generated, identify any nonlinear relationships between Y and X variables.

Try to correct nonlinearity through transformation (page 233-237). If it works, keep the transformed version of the variable. Otherwise, use the original variable, acknowledge the nonlinearity, and move on to the next test. Use 2 different transformations (ex: Log X, 1/X, X^2 or SQRT(X)).
 
 
 
I ran a transformation to see if my nonlinearity changes. Transforming a data means to change its functional form, so I ran Y and X variable to see if my Scatterplot give me a linear or non-linear pattern. Transformation is one way to keep the information content, but we change the functional form also it is not necessary to always work.   However, I do not see drastic changes. I ran Log X and SQRT (X) as my transformation test, but I got same results. The first graph is my Earnings and the second is transformation with Log X and third is SQRT (X). So, I have no choice to acknowledge it and to move on with my non-linearity.
 
 
3.Once you correct for nonlinearity and multicollinearity, check for autocorrelation using DW test. Do you have autocorrelation? Correct for autocorrelation if you have any.
Based on my data since I have decided to keep just one of my x variables that is Earnings. The DW = 0.186035 Durbin-Watson Statistic

Durbin-Watson Statistic = 0.186035

In my 90 row I have lower bound of 1.64 and the upper bound 1.69. My DW is lower than the lower bound based on my decision rule I am going to reject the null and I have an auto correlation. So now I am attempting to fix the auto correlation so I will have one more coefficient. I am going to add a lag value of Yt to attempt to replicate assuming it is coming from the Yt.
So my row is 90 and K=1DL
 
WORKSHEET 1
Regression Analysis: Revenue (yt) versus Earnings, Revenue(yt-1), trend
Method

Rows unused 1

Regression Equation

Revenue (yt) = -8952 + 16.4 Earnings + 1.0062 Revenue(yt-1) – 37 trend

Coefficients

Term Coef SE Coef T-Value P-Value VIF
Constant -8952 19638 -0.46 0.650  
Earnings 16.4 39.8 0.41 0.681 117.98
Revenue(yt-1) 1.0062 0.0517 19.47 0.000 3.39
trend -37 174 -0.21 0.833 123.53

Model Summary

S R-sq R-sq(adj) R-sq(pred)
3933.62 94.21% 94.01% 93.00%

Analysis of Variance

Source DF Adj SS Adj MS F-Value P-Value
Regression 3 21921168164 7307056055 472.24 0.000
  Earnings 1 2638051 2638051 0.17 0.681
  Revenue(yt-1) 1 5864694800 5864694800 379.02 0.000
  trend 1 692178 692178 0.04 0.833
Error 87 1346180110 15473335    
Total 90 23267348275      

Fits and Diagnostics for Unusual Observations

Obs Revenue (yt) Fit Resid Std Resid    
77 22720 30943 -8223 -2.16 R  
80 35750 27150 8600 2.23 R  
81 29130 37634 -8504 -2.22 R  
84 43740 34958 8782 2.28 R  
85 35710 46101 -10391 -2.75 R  
88 60450 46171 14279 3.77 R  
89 51049 63046 -11997 -3.41 R X
90 52890 53781 -891 -0.24   X
91 56580 55662 918 0.25   X
92 72380 59354 13026 3.64 R X

R  Large residual
X  Unusual X

Durbin-Watson Statistic

Durbin-Watson Statistic = 2.46865

 
I ran the regression adding a lag, Trend and Revenue(yt-1) which gave me a higher VIF which is more than 117.98 in my X variable. It fixed my DW which is 2.46865 which means there is no autocorrelation detected in the sample. However, I have detected Multicollinearity due to higher VIF. It shows the multicollinearity between my X variable and trend. The T-value from both Earnings and trend are not significant as we can see the P-values which are above 0.05 for both Earnings and trend. This is a consequence of multicollinearity between them two. If I drop the Trend the T-value for earnings will be significant. DW close to close to 0 indicates positive autocorrelation and close to 4 indicates negative autocorrelation. When its close to 2 there is no autocorrelation and that is exactly what we want in the model.
 
So again, I decided to remove trend from my data and run the regression analysis again. This gave me a perfect model which is shown in the graph below.
 
Regression Analysis: Revenue (yt) versus Earnings, Revenue(yt-1)
Method

Rows unused 1

Regression Equation

Revenue (yt) = -4892 + 8.14 Earnings + 1.0037 Revenue(yt-1)

Coefficients

Term Coef SE Coef T-Value P-Value VIF
Constant -4892 4117 -1.19 0.238  
Earnings 8.14 6.54 1.24 0.216 3.21
Revenue(yt-1) 1.0037 0.0500 20.07 0.000 3.21

Model Summary

S R-sq R-sq(adj) R-sq(pred)
3912.21 94.21% 94.08% 93.27%

Analysis of Variance

Source DF Adj SS Adj MS F-Value P-Value
Regression 2 21920475987 10960237993 716.10 0.000
  Earnings 1 23720949 23720949 1.55 0.216
  Revenue(yt-1) 1 6165533565 6165533565 402.83 0.000
Error 88 1346872288 15305367    
Total 90 23267348275      

Fits and Diagnostics for Unusual Observations

Obs Revenue (yt) Fit Resid Std Resid    
77 22720 31089 -8369 -2.17 R  
80 35750 27259 8491 2.20 R  
81 29130 37719 -8589 -2.25 R  
84 43740 34912 8828 2.30 R  
85 35710 46023 -10313 -2.73 R  
88 60450 46113 14337 3.80 R  
89 51049 62933 -11884 -3.36 R X
90 52890 53611 -721 -0.19   X
91 56580 55492 1088 0.30   X
92 72380 59203 13177 3.63 R X

R  Large residual
X  Unusual X

Durbin-Watson Statistic

Durbin-Watson Statistic = 2.46554

 
 
4.Incorporate seasonal dummies and trend into your model. Identify if you have seasonality, trend by checking their significance? Is that consistent with your previous findings?
Dummy variable are also called the indicator variables it is how we incorporate non continuous or qualitative date in our analysis. So, incorporating trend and seasonality in our regression model, Yt which is our dependent variable and is also a function of X1 which is Earnings. The coefficient in front of X1 is the marginal effects and beta zero is the intercept and errors. Anything that is not explained in the model that will go to the error term. So, let us incorporate it in the model so error can look much better. Trend is going to keep a track of the number of years. My sample size is 92 so the trend will increase in the increments of 1. Similarly, seasonality would be into four quarters Q1,Q2,Q3 and Q4.
WORKSHEET 1
Regression Analysis: Revenue versus Earnings, T, q1, q2, q3
Method

Categorical predictor coding (1, 0)

Regression Equation

q1 q2 q3      
0 0 0 Revenue = 27041 – 71.5 Earnings + 800 T
           
0 0 1 Revenue = 22892 – 71.5 Earnings + 800 T
           
0 1 0 Revenue = 22473 – 71.5 Earnings + 800 T
           
0 1 1 Revenue = 18324 – 71.5 Earnings + 800 T
           
1 0 0 Revenue = 22774 – 71.5 Earnings + 800 T
           
1 0 1 Revenue = 18625 – 71.5 Earnings + 800 T
           
1 1 0 Revenue = 18206 – 71.5 Earnings + 800 T
           
1 1 1 Revenue = 14057 – 71.5 Earnings + 800 T

Coefficients

Term Coef SE Coef T-Value P-Value VIF
Constant 27041 44784 0.60 0.548  
Earnings -71.5 90.6 -0.79 0.432 120.16
T 800 388 2.06 0.042 120.14
q1          
  1 -4267 2664 -1.60 0.113 1.50
q2          
  1 -4568 2662 -1.72 0.090 1.50
q3          
  1 -4149 2661 -1.56 0.123 1.50

Model Summary

S R-sq R-sq(adj) R-sq(pred)
9022.42 70.09% 68.35% 64.94%

Analysis of Variance

Source DF Adj SS Adj MS F-Value P-Value
Regression 5 16401476827 3280295365 40.30 0.000
  Earnings 1 50676370 50676370 0.62 0.432
  T 1 345468005 345468005 4.24 0.042
  q1 1 208856960 208856960 2.57 0.113
  q2 1 239764768 239764768 2.95 0.090
  q3 1 197858706 197858706 2.43 0.123
Error 86 7000742191 81403979    
Total 91 23402219018      

Fits and Diagnostics for Unusual Observations

Obs Revenue Fit Resid Std Resid  
88 60450 35030 25420 2.92 R
89 51049 31134 19915 2.30 R
90 52890 30632 22258 2.60 R
91 56580 31565 25015 2.92 R
92 72380 36443 35937 4.17 R

R  Large residual
Durbin-Watson Statistic

Durbin-Watson Statistic = 0.126943

 
 
 
 
 
 
 
5.Once you corrected for all possible problems, rewrite your final equation, INTERPRET the equation, and forecast y, for 35th in sample observation.
 
6.Analyze the resulting residuals (4-in-11 plot in MINITAB)
 
7.How does regression analysis perform compared to univariate methods you have learned? Create a table that includes the MSD for the univariate models (Trend, Smoothing, Decomposition) and MSE of regression model. (HINT 1: You don’t have to try ALL univariate models. Use your knowledge of your data. For example: If your revenue variable is trending, no need to run single smoothing. Or, if it is linear, no need to run nonlinear trend models etc. HINT 2:Your final is around the corner, no harm in reviewing the previous material ahead of time, either.)
 
 

Guidelines and Grading Rubric

Purpose

The purpose of this assignment is to demonstrate the skills of the professional nurse as an educator. You are to prepare a guide that will serve as a handout to assist a specific patient that you identify. Your guide or handout should help this patient find and evaluate a reliable mobile health, or mHealth application (app) that is already developed. This may be related to his or her disease process or diagnosis, or may be an app that can help a patient maintain or improve good health, and prevent illness.

You will develop the guide using Microsoft PowerPoint. PowerPoint is a versatile application that lets you design slideshows and handouts. For this assignment, you will be using PowerPoint to create a guide or handout that you may print and give to patients and families. You will be submitting this PowerPoint file to the Dropbox.

Course Outcomes

This assignment enables the student to meet the following Course Outcome.

CO#1: Describe patient-care technologies as appropriate to address the needs of a diverse patient population. (PO#1)

CO#5: Identify patient care technologies, information systems, and communication devices that support safe nursing practice. (PO#5)

Points

This assignment is worth a total of 175 points.

Due Date

The Patient Education Technology Guide to a Mobile Health Application PowerPoint assignment is due at the end of Week 2. Submit your completed assignment to the Dropbox by Sunday; 11:59 p.m. MT. You may consult the Policies, under the Course Home tab, for details regarding late assignments. Late assignments will result in loss of points. Post questions about this assignment in the Q & A discussion.

Directions

Use Microsoft PowerPoint to create slides, which will be the basis of the guide or handout. You are required to cite your source(s) as it relates to your application slide. Other citations are permitted, but this is not a requirement for the assignment.

·       Title slide (first slide): Include a title slide with your name and title of the presentation.

·       Scenario Slide (one slide): This slide should include a brief scenario, then identify a patient who is experiencing a specific disease process or diagnosis who would benefit from an already developed and reliable mHealth app. Or, identify a person is currently healthy and would like to maintain or improve health and prevent illness. Be sure to include the nurse’s assessment of the patient’s learning needs and readiness to learn. Be specific.

Example:

Scenario for Ms. Ellis

Jane Doe (your name here)

·       Jennifer Ellis, a 62-year-old African American who has been recently diagnosed with chronic kidney disease (CKD). She has been prescribed several medications she must take every day.

·       The nephrologist has stressed the importance of leading a healthy life style to slow or stop the progression of CKD.

·       She is interested in ways in which she can better track her health and make healthier choices.

·       She is a high school graduate and iPhone user, mostly to send text messages to family and friends.

·       She is eager to learn how to use an app that can help her manager her CKD.

Prepare the following slides as if you are presenting them to the patient.

·       mHealth Application Slide (one to three slides): Identify a developed and reliable mHealth app that could benefit the patient. Describe the app including its:

·       Name

·       Purpose

·       Intended audience

·       Mobile device(s) upon which it will operate

·       Where to download or obtain it. Include a working link if it is to be downloaded from a website.

·       And any other information you believe would be pertinent to this situation.

·       Sources that are used are cited.

·       Teaching Slides (one to three slides): Prepare slides that contain important points about the app that you want to teach to the patient such as: how to use the app safely and effectively including how to interpret and act on the information that is provided.

·       Evaluation Slide (one to three slides): Describe how you would determine the success of the patient’s use of this app. For example, include ways to evaluate the effectiveness of the teaching plan that are a good fit for the type of app or focus on specific ways that this app benefits the patient’s health and wellness.

·       References (last slide): List any references for sources that were used or cited in the presentation.

Writing and Design: There should be no spelling or grammatical errors. Writing is concise and clear. Avoid words that the patient may not understand. Slides are visually appealing incorporating graphics, photographs, colors, and themes.

Review the section on Academic Integrity Policy found in the RNBSN Policies. All work must be original (in your own words) unless properly cited.

Best Practices in Preparing PowerPoint Slideshows

·       Be creative, but realistic.

·       Incorporate graphics, color, themes, or photographs to increase interest.

·       Make easy to read with short bullet points and large font.

·       Review directions thoroughly.

·       Cite all sources within the slides with (author, year) as well as on the Reference slide.

·       Proofread prior to final submission.

·       Spell check for spelling and grammar errors prior to final submission.

·       Abide by the Chamberlain academic integrity policy.

·       Tutorial: For those not familiar with the development of a PowerPoint slideshow, the following link to the Microsoft website may be helpful. http://office.microsoft.com/en-us/support/training-FX101782702.aspx The Chamberlain Student Success Strategies (CCSSS) offers a module on Computer Literacy that contains a section on PowerPoint. The link to SSP CCSSS may be found under the Special Courses list in Canvas.

Grading Criteria

Develop and Concept Map, using the form provided, on the following patient. Include Diagnostic data and medical orders that you expect to be ordered on the patient.

T.J., a 30-year-old African American client, is in his last year of law school and is clerking for a prestigious law firm. He and his fiancé plan to marry as soon as he graduates. During the last week he has had four dizzy spells and a headache at the base of his skull upon awakening for the last 2 days. His father has a history of hypertension, so T.J. is aware that his symptoms may indicate high blood pressure. On his way home from work, T.J. stops by the clinic and asks the nurse to check his blood pressure. The nursing assessment yields the following data.

Subjective data: States he has had four dizzy spells and has awakened with a headache in the occipital lobe the last two mornings. T.J. has 1 glass of wine at lunch and 2-3 beers in the evening to relax from the tension of school and work. Most of his meals are at fast-food establishments and have a high fat content. T.J. does not smoke. He used to jog 4 mornings a week but quit when he started clerking. He has had nocturia for the last 3 weeks. He is not taking any medication. T.J. states he is concerned about having hypertension because he does not want to take medication.

Objective data: T 98.6°F(37°C), AP 78 beats/min, R 16 breaths/min, BP 142/92 mm Hg, Wt 190 lbs (optimum weight 160). No edema noted in hands, feet, or legs.

QUESTION

Advanced Medical Surgical Nursing Week 3 Quiz ( Chapters 33-40)

Question

Question 1

A nursing student wants to know why clients with chronic obstructive pulmonary disease tend to be polycythemic. What response by the nurse instructor is best?

a. It is due to side effects of medications for bronchodilation.

b. It is from overactive bone marrow in response to chronic disease.

c. It combats the anemia caused by an increased metabolic rate.

d. It compensates for tissue hypoxia caused by lung disease.

Question 2

A nurse assesses a client who had a myocardial infarction and is hypotensive. Which additional assessment finding should the nurse expect?

a. Heart rate of 120 beats/min

b. Cool, clammy skin

c. Oxygen saturation of 90%

d. Respiratory rate of 8 breaths/min

Question 3

A nurse assesses a client in an outpatient clinic. Which statement alerts the nurse to the possibility of left-sided heart failure?

a.“I have been drinking more water than usual.”

b.“I am awakened by the need to urinate at night.”

c.“I must stop halfway up the stairs to catch my breath.”

d.“I have experienced blurred vision on several occasions.”

Question 4

A nurse assesses clients on a cardiac unit. Which client should the nurse identify as being at greatest risk for the development of left-sided heart failure?

a. A 36-year-old woman with aortic stenosis

b. A 42-year-old man with pulmonary hypertension

c. A 59-year-old woman who smokes cigarettes daily

d. A 70-year-old man who had a cerebral vascular accident

Question 5

A client is receiving rivaroxaban (Xarelto) and asks the nurse to explain how it works. What response by the nurse is best?

a. “It inhibits thrombin.”

b. “It inhibits fibrinogen.”

c. “It thins your blood.”

d. “It works against vitamin K.”

Question 6

A client undergoing hemodynamic monitoring after a myocardial infarction has a right atrial pressure of 0.5 mm Hg. What action by the nurse is most appropriate?

a. Level the transducer at the phlebostatic axis.

b. Lay the client in the supine position.

c. Prepare to administer diuretics.

d. Prepare to administer a fluid bolus.

Question 7

A nurse assesses a client with atrial fibrillation. Which manifestation should alert the nurse to the possibility of a serious complication from this condition?

a. Sinus tachycardia

b. Speech alterations

c. Fatigue

d. Dyspnea with activity

Question 8

A client has been diagnosed with hypertension but does not take the antihypertensive medications because of a lack of symptoms. What response by the nurse is best?

a.“Do you have trouble affording your medications?”

b.“Most people with hypertension do not have symptoms.”

c.“You are lucky; most people get severe morning headaches.”

d.“You need to take your medicine or you will get kidney failure.”

Question 9

A client received tissue plasminogen activator (t-PA) after a myocardial infarction and now is on an intravenous infusion of heparin. The client’s spouse asks why the client needs this medication. What response by the nurse is best?

a.“The t-PA didn’t dissolve the entire coronary clot.”

b.“The heparin keeps that artery from getting blocked again.”

c.“Heparin keeps the blood as thin as possible for a longer time.”

d.“The heparin prevents a stroke from occurring as the t-PA wears off.”

Question 10

The nurse is reviewing the lipid panel of a male client who has atherosclerosis. Which finding is most concerning?

a. Cholesterol: 126 mg/dL

b. High-density lipoprotein cholesterol (HDL-C): 48 mg/dL

c. Low-density lipoprotein cholesterol (LDL-C): 122 mg/dL

d. Triglycerides: 198 mg/dL

Question 11

A hospitalized client has a platelet count of 58,000/mm3. What action by the nurse is best?

a. Encourage high-protein foods.

b. Institute neutropenic precautions.

c. Limit visitors to healthy adults.

d. Place the client on safety precautions.

Question 12

A client is in the hospital after suffering a myocardial infarction and has bathroom privileges. The nurse assists the client to the bathroom and notes the client’s O2 saturation to be 95%, pulse 88 beats/min, and respiratory rate 16 breaths/min after returning to bed. What action by the nurse is best?

a. Administer oxygen at 2 L/min.

b. Allow continued bathroom privileges.

c. Obtain a bedside commode.

d. Suggest the client use a bedpan

Question 13

A nurse is working with a client who takes atorvastatin (Lipitor). The client’s recent laboratory results include a blood urea nitrogen (BUN) of 33 mg/dL and creatinine of 2.8 mg/dL. What action by the nurse is best?

a. Ask if the client eats grapefruit.

b. Assess the client for dehydration.

c. Facilitate admission to the hospital.

d. Obtain a random urinalysis.

Question 14

While assessing a client on a cardiac unit, a nurse identifies the presence of an S3 gallop. Which action should the nurse take next?

a. Assess for symptoms of left-sided heart failure.

b. Document this as a normal finding.

c. Call the health care provider immediately.

d. Transfer the client to the intensive care unit.

Question 15

The nurse is evaluating a 3-day diet history with a client who has an elevated lipid panel. What meal selection indicates the client is managing this condition well with diet?

a. A 4-ounce steak, French fries, iceberg lettuce

b. Baked chicken breast, broccoli, tomatoes

c. Fried catfish, cornbread, peas

d. Spaghetti with meat sauce, garlic bread

Question 16

A client is in shock and the nurse prepares to administer insulin for a blood glucose reading of 208 mg/dL. The spouse asks why the client needs insulin as the client is not a diabetic. What response by the nurse is best?

a. “High glucose is common in shock and needs to be treated.”

b. “Some of the medications we are giving are to raise blood sugar.”

c. “The IV solution has lots of glucose, which raises blood sugar.”

d. “The stress of this illness has made your spouse a diabetic.”

Question 17

The nurse gets the hand-off report on four clients. Which client should the nurse assess first?

a. Client with a blood pressure change of 128/74 to 110/88 mm Hg

b. Client with oxygen saturation unchanged at 94%

c. Client with a pulse change of 100 to 88 beats/min

d. Client with urine output of 40 mL/hr for the last 2 hours

Question 18

A nurse cares for a client with right-sided heart failure. The client asks, “Why do I need to weigh myself every day?” How should the nurse respond?

a. “Weight is the best indication that you are gaining or losing fluid.”

b. “Daily weights will help us make sure that you’re eating properly.”

c. “The hospital requires that all inpatients be weighed daily.”

d. “You need to lose weight to decrease the incidence of heart failure.”

Question 19

A nurse cares for a client who has a heart rate averaging 56 beats/min with no adverse symptoms. Which activity modification should the nurse suggest to avoid further slowing of the heart rate?

a. “Make certain that your bath water is warm.”

b.“Avoid straining while having a bowel movement.”

c.“Limit your intake of caffeinated drinks to one a day.”

d.“Avoid strenuous exercise such as running.”

Question 20

A nurse is caring for a client after surgery. The client’s respiratory rate has increased from 12 to 18 breaths/min and the pulse rate increased from 86 to 98 beats/min since they were last assessed 4 hours ago. What action by the nurse is best?

a. Ask if the client needs pain medication.

b. Assess the client’s tissue perfusion further.

c. Document the findings in the client’s chart.

d. Increase the rate of the client’s IV infusion.

Question 21

An emergency room nurse obtains the health history of a client. Which statement by the client should alert the nurse to the occurrence of heart failure?

a. “I get short of breath when I climb stairs.”

b. “I see halos floating around my head.”

c. “I have trouble remembering things.”

d. “I have lost weight over the past month.”

Question 22

The health care provider tells the nurse that a client is to be started on a platelet inhibitor. About what drug does the nurse plan to teach the client?

a. Clopidogrel (Plavix)

b. Enoxaparin (Lovenox)

c. Reteplase (Retavase)

d. Warfarin (Coumadin)

Question 23

A nurse assesses a client’s electrocardiograph tracing and observes that not all QRS complexes are preceded by a P wave. How should the nurse interpret this observation?

a. The client has hyperkalemia causing irregular QRS complexes.

b. Ventricular tachycardia is overriding the normal atrial rhythm.

c. The client’s chest leads are not making sufficient contact with the skin.

d. Ventricular and atrial depolarizations are initiated from different sites.

Question 24

A nurse caring for a client with sickle cell disease (SCD) reviews the client’s laboratory work. Which finding should the nurse report to the provider?

a. Creatinine: 2.9 mg/dL

b. Hematocrit: 30%

c. Sodium: 147 mEq/L

d. White blood cell count: 12,000/mm3

Question 25

A nurse assesses clients on a medical-surgical unit. Which client should the nurse identify as having the greatest risk for cardiovascular disease?

a. An 86-year-old man with a history of asthma

b. A 32-year-old Asian-American man with colorectal cancer

c. A 45-year-old American Indian woman with diabetes mellitus

d. A 53-year-old postmenopausal woman who is on hormone therapy

Question 26

A student nurse is assessing the peripheral vascular system of an older adult. What action by the student would cause the faculty member to intervene?

a. Assessing blood pressure in both upper extremities

b. Auscultating the carotid arteries for any bruits

c. Classifying capillary refill of 4 seconds as normal

d. Palpating both carotid arteries at the same time

Question 27

A nurse assesses a client after administering a prescribed beta blocker. Which assessment should the nurse expect to find?

a. Blood pressure increased from 98/42 mm Hg to 132/60 mm Hg

b. Respiratory rate decreased from 25 breaths/min to 14 breaths/min

c. Oxygen saturation increased from 88% to 96%

d. Pulse decreased from 100 beats/min to 80 beats/min

Question 28

A nurse evaluates prescriptions for a client with chronic atrial fibrillation. Which medication should the nurse expect to find on this client’s medication administration record to prevent a common complication of this condition?

a. Sotalol (Betapace)

b. Warfarin (Coumadin)

c. Atropine (Sal-Tropine)

d. Lidocaine (Xylocaine)

Question 29

A nurse assesses an older adult client who has multiple chronic diseases. The client’s heart rate is 48 beats/min. Which action should the nurse take first?

a. Document the finding in the chart.

b. Initiate external pacing.

c. Assess the client’s medications.

d. Administer 1 mg of atropine.

Question 30

A client presents to the emergency department in sickle cell crisis. What intervention by the nurse takes priority?

a. Administer oxygen.

b. Apply an oximetry probe.

c. Give pain medication.

d. Start an IV line.

Question 31

A nurse assesses a client admitted to the cardiac unit. Which statement by the client alerts the nurse to the possibility of right-sided heart failure?

a.“I sleep with four pillows at night.”

b.“My shoes fit really tight lately.”

c.“I wake up coughing every night.”

d.“I have trouble catching my breath.”

Question 32

A nursing student is caring for a client who had a myocardial infarction. The student is confused because the client states nothing is wrong and yet listens attentively while the student provides education on lifestyle changes and healthy menu choices. What response by the faculty member is best?

a.“Continue to educate the client on possible healthy changes.”

b.“Emphasize complications that can occur with noncompliance.”

c.“Tell the client that denial is normal and will soon go away.”

d.“You need to make sure the client understands this illness.”

Question 33

A client is receiving an infusion of tissue plasminogen activator (t-PA). The nurse assesses the client to be disoriented to person, place, and time. What action by the nurse is best?

a. Assess the client’s pupillary responses.

b. Request a neurologic consultation.

c. Stop the infusion and call the provider.

d. Take and document a full set of vital signs.

Question 34

A client in sickle cell crisis is dehydrated and in the emergency department. The nurse plans to start an IV. Which fluid choice is best?

a.0.45% normal saline

b.0.9% normal saline

c. Dextrose 50% (D50)

d. Lactated Ringer’s solution

Question 35

A student is caring for a client who suffered massive blood loss after trauma. How does the student correlate the blood loss with the client’s mean arterial pressure (MAP)?

a. It causes vasoconstriction and increased MAP.

b. Lower blood volume lowers MAP.

c. There is no direct correlation to MAP.

d. It raises cardiac output and MAP.

Question 36

A client has a serum ferritin level of 8 ng/mL and microcytic red blood cells. What action by the nurse is best?

a. Encourage high-protein Foods.

b. Perform a Hemoccult test on the client’s stools.

c. Offer Frequent oral care.

d. Prepare to administer cobalamin (vitamin B12).

Question 37

A nurse is assessing clients on a medical-surgical unit. Which client should the nurse identify as being at greatest risk for atrial fibrillation?

a. A 45-year-old who takes an aspirin daily

b. A 50-year-old who is post coronary artery bypass graft surgery

c. A 78-year-old who had a carotid endarterectomy

d. An 80-year-old with chronic obstructive pulmonary disease

Question 38

A client hospitalized with sickle cell crisis frequently asks for opioid pain medications, often shortly after receiving a dose. The nurses on the unit believe the client is drug seeking. When the client requests pain medication, what action by the nurse is best?

a. Give the client pain medication if it is time for another dose.

b. Instruct the client not to request pain medication too early.

c. Request the provider leave a prescription for a placebo.

d. Tell the client it is too early to have more pain medication.

Question 39

A nurse is caring for a client after surgery who is restless and apprehensive. The unlicensed assistive personnel (UAP) reports the vital signs and the nurse sees they are only slightly different from previous readings. What action does the nurse delegate next to the UAP?

a. Assess the client for pain or discomfort.

b. Measure urine output from the catheter.

c. Reposition the client to the unaffected side.

d. Stay with the client and reassure him or her.

Question 40

A nurse is assessing a dark-skinned client for pallor. What action is best?

a. Assess the conjunctiva of the eye.

b. Have the client open the hand widely.

c. Look at the roof of the client’s mouth.

d. Palpate for areas of mild swelling.

Zara: IT for Fast Fashion

  1. What information does Zara need to operate its business model?
  2. In your opinion, what are the most important aspects of Zara’s approach to information technology?
  3. What current or potential weaknesses (if any) do you see in Zara’s IT infrastructure and IT strategy (Hint – the question asks for BOTH infrastructure AND strategy, so be sure to analyze both)?
  4. How would you advise Salgado to proceed on the issue of upgrading Zara’s POS systems, namely should the company upgrade the POS terminal to a modern operating system?
  5. What one concept from the lecture or the book did you find applicable to this case?

******Answer your questions using the MEAL format (Main idea, Evidence, Analysis, Link).  The first sentence of your answer should include the main idea, or thesis, for the question.  Next, provide evidence with a specific quote or a page number from the case.  Next, analyze the evidence.  Conclude by linking the evidence back to your thesis.

  • attachment

    ZaraCase.pdf

Week 3 Discussion Topic 2:
Instructions:
All posts (both initial and responses) must be substantial (several paragraphs each) and each of your initial posts must be supported by 3 peer reviewed authoritative sources, not including the textbook, cited properly in APA format. Responses should have proper support with at least 1 different source as applicable.
 
https://youtu.be/qwBS_IXw3JQ
 
Review the video above and using peer reviewed articles to back up your position, discuss why you think big data analysis is useful in the retail environment.  As part of your discussion discuss how the goals of big data mentioned in the text would relate to retail operations.  Be sure to provide specific examples to support your position.

Question Description

PATIENT NAME: Catherine Williams

DATE OF BIRTH:3/26/1947DATE OF ADMISSION:1/19/2015

PROGRESS NOTE

HISTORY: Catherine Williams is a 67-year-old Caucasian female who was brought to the hospital via an ambulance and subsequently admitted to the hospital on 1/19/2015 for dysphasia, dysphagia, and right hemiparesis. Ms. Williams has history of HTN, and high cholesterol. Husband states that patient is taking medication daily. No problems have been noted prior to 1 ½ hours ago when she began to show signs of right facial drooping and complained of cephalgia. Husband states the patient was unable to drink her coffee without the liquid spilling down her face.Per the husband, the patient was reaching in the cupboard for a dish, when her right arm started to fall. After sitting at the breakfast table, the patient began to rise, when she fell to the floor, and was unable to stand up without help. She showed a steady decline within minutes developing ataxia, dysphagia, and dysarthria.

OBJECTIVE FINDINGS: Physical examination shows the patient was alert, and oriented x 2. Mild confusion noted to place. Gait was not assessed at this time due to hemiparesis. Grips were unequal. Right pupil was sluggish to respond to light. Right lower extremity was flaccid. Blood pressure was 180/92 mm Hg. Pulse, 78. Respirations, 18. Temperature 98.7.Chest radiograph, Urinalysis, CBC, PTT, Basic Chemistry Panel and ABGs were obtained. ABGs showed low 02saturation. CT scan showed negative for an intracerebral hemorrhage. A neurology consultation was obtained. Neurologist confirmed the diagnosis of an ischemic stroke after an MRI of the brain demonstrated an ischemic area of the left cerebral cortex caused by a cerebral embolism.

IMPRESSION: Hemiparesis, HTN, Ischemic Stroke

TREATMENT SUMMARY: The patient was given Alteplase 0.9 mg/kg IV infused over 1 hour for first bolus. Continued with 0.81 mg/kg as continuous infusion over 60 minutes. Mannitol was started IV post Alteplase infusion. Patient transferred to ICU.Neuro checks ordered q 2 hrs.On the second hospital day, the patient developed hypotension, N & V. Reglan given IV and normal saline was increased to 150 drops per minute for 2 hours, then titrated down to 75. After 5 hours, patient BP was within normal limits, N & V subsided.Aggrenox started one capsule bid. Third day inpatient stay was unremarkable. Patient was transferred to medical floor.PT/OT, speech therapy ordered. Neuro checks reduced to every 4 hours. No further decline noted. Fourth inpatient stay, patient responding to PT/OT well. Use of walker with one assist. Gait and grip improving. No further neurological deficits noted. Discharge planning started. Rehabilitation facility recommended for continued PT/OT and speech therapy. Family educated on treatment plan, patient transferred to extended care facility for rehabilitation. Continue antiplatelet therapy. Informed patient and family to follow-up with neurologist one week after discharge from rehab.

PART 1: Using the information provided in Progress Note above, please complete the following information.

In this Assignment 2, imagine you are a medical professional working at XYZ Medical Center. Your patient is Mrs. Williams. Her son, Sam Williams, has just arrived from Montana. He is concerned about his mother’s wellbeing. You will be meeting with the patient’s son to update him on what has occurred during her hospital stay, the subsequent transfer to the rehabilitation facility and a discharge plan.

Use the information from the Progress Note to update Sam Williams on his mother’s condition. You will be translating the medical information from the report into layman’s terms in order for the patient and patient’s daughter to understand.

Please be sure use complete sentences, proper grammar, and spelling. You can use medical terms, however, you must also use layman’s terminology. Remember, it is your job to explain to the patient’s son what has occurred. You must use outside sources, including your textbook.

Your explanation to Sam Williams should be 500 words or more. Cite your reference/referencesin APA format at the end of your explanation.

Written Assignment requirements: Written work should be free of spelling, grammar, and APA errors. Points deducted from the grade for each writing, spelling, or grammar error are at your instructor’s discretion. Please be sure to view “Writing Center Resources” to assist you with meeting APA expectations. You may also access the link from Course Resources/AcademicSupport Center.

The Quality and Sustainability Paper is a practice immersion assignment designed to be completed in three sections. This is part one of the assignment. Learners are required to analyze and apply quality and/or safety measures specific to contemporary nursing science. General Guidelines: Use the following information to ensure successful completion of the assignment: · This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion. · Doctoral learners are required to use APA style for their writing assignments. · This assignment requires that you support your position by referencing at least six to eight scholarly resources. At least three of your supporting references must be from scholarly sources other than the assigned readings. · This Assignment will be thoroughly checked for Plagiarism. Directions: Write a 1,250-1,500 word paper discussing the role of quality and/or safety in nursing science. Include the following: 1. Define quality or safety measures and describe their relationship and role in nursing science today. 2. Provide a contemporary example of how quality or safety measures are applied in nursing science. 3. Identify the quality and/or components needed to analyze a health care program’s outcomes. Portfolio Practice Hours: Practice immersion assignments are based on your current course objectives, and are intended to be application-based learning using your real-world practice setting. You are required to complete your assignment using real-world application. Real-world application requires the use of evidence-based data, contemporary theories, and concepts presented in the course. The culmination of your assignment must present a viable application in a current practice setting.

Need a 100-300 words post Identifying healthcare FINANCIAL MANAGEMENT ISSUES for nurse managers. It can be about the pressure of reducing healthcare delivery cost and being able to provide quality care.
You may use Google scholars or any other nursing journal.
Make sure all reference sources are within 5 years.
APA format and not Turnitin but plagiarism-free.
Please use this website for more help Reference List: Other Print Sources // Purdue Writing Lab
ALWAYS use in-text citation, many only used reference, but without in-text citation your work could be considered a plagiarism.
Always use the article ( this time it as Reese) in your writing, some people did not use it,  used other sources. You can use both.

Objectives:

  1. Defend the claim that bone is a living organ.
  2. Describe the different functions of the skeletal system.
  3. Differentiate between the structural components and overall functions of the axial and appendicular skeletons.
  4. Compare and contrast the structure and function of the upper limbs to the lower limbs.
  5. Explain how the pectoral and pelvic girdles serve as attachment points for the appendicular skeleton to the axial skeleton. Specify the points of attachment for the appendages and include why the structure of each aids in its unique function for the skeleton.
  6. Explain how and why the pelvic girdles of females differ from those in males.
  7. Differentiate between true ribs, false ribs, and floating ribs.