NURS 6521 Advance Care Planning: Multiple Sclerosis

A 64-year-old woman with Multiple Sclerosis is hospitalized. The team feels she may need to be placed on a feeding tube soon to assure adequate nourishment. They ask the patient about this in the morning and she agrees. However, in the evening (before the tube has been placed), the patient becomes disoriented and seems confused about her decision to have the feeding tube placed. She tells the team she doesn’t want it in. They revisit the question in the morning, when the patient is again lucid. Unable to recall her state of mind from the previous evening, the patient again agrees to the procedure. NURS 6521 Advance Care Planning: Multiple Sclerosis.

Is this patient competent to decide?³¹

This patient is competent to decide because her underlying disease is NOT impairing her decision making capacity.
This patient is competent to decide during her lucid periods.
The patient’s decision making capacity is questionable, and getting a surrogate decision maker involved can help determine what her real wishes are.
In this situation where the patient is changing her decision, the doctor should decide whether or not to place a feeding tube.

Assignment Details

For this Assignment, you are going to write a paper explaining how you developed your theory through the four stages (theorizing, syntax, theory testing, and evaluation). Your paper must be 3 to 5 pages, not including the title and reference pages. NURS 6521 Advance Care Planning: Multiple Sclerosis.

To view the Grading Rubric for this Assignment, please visit the Grading Rubrics section of the Course Resources.

Assignment Requirements – NURS 6521 Advance Care Planning: Multiple Sclerosis

Before finalizing your work, you should:

Minimum requirement of at least 5 sources of support
be sure to read the Assignment description carefully (as displayed above);
consult the Grading Rubric (under the Course Resources) to make sure you have included everything necessary; and
utilize spelling and grammar check to minimize errors.

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NURS 6521 Pharmacotherapeutics for Advanced Practices – Lifestyle, Diet and Habits Quiz Questions

1.	Recently a 40-year-old woman has become interested in alternative therapy as a means to maintain and enhance her state of health. However, she has developed hypertension and will be prescribed an antihypertensive agent. The nurse’s health history reveals that the patient eats a balanced diet, swims regularly, and occasionally takes an over-the-counter medication for allergies. A priority assessment for the nurse will be to determine
	A)	the amount of dietary fiber in the patient’s diet.
	B)	how much exercise the patient gets daily.
	C)	if the patient is taking any nutritional supplements.
	D)	if the patient is taking herbal or botanical medications regularly.
	Ans:
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2.	A 70-year-old woman is starting on an acidic drug. The nurse is aware that food and nutrient intake can affect drug excretion by changing the urinary pH. About which of the following will the nurse question the patient concerning her diet?
	A)	The intake of sodium
	B)	The amount of meat and vegetables
	C)	The use of grapefruit
	D)	The intake of foods high in protein
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3.	During a clinic visit, a patient complains of having frequent muscle cramps in her legs. The nurse’s assessment reveals that the patient has been taking over-the-counter laxatives for the past 7 years. The nurse informed the patient that prolonged use of laxatives
	A)	may cause nutrient deficiencies.
	B)	may counter the therapeutic effect of other drugs.
	C)	causes acidic urine and urinary tract infections.
	D)	inhibits biotransformation of drugs.
	Ans:
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NURS 6521 Pharmacotherapeutics for Advanced Practice – Antituberculosis Drug Isoniazid

4.	A patient has recently been diagnosed with diabetes mellitus. The nurse will advise him to prioritize which of the following considerations when planning a meal?
	A)	Amount of protein in the meal
	B)	Vitamin content of the meal
	C)	Glycemic index of the foods in the meal
	D)	Quantity of trace elements in the meal
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5.	A 36-year-old man with a complex medical history is frail and emaciated and recently fainted due to weakness. He has a history of movement disorder and has been prescribed appropriate drugs to treat it. A priority nursing assessment will be to question him concerning his
	A)	professional life.
	B)	marriage and sexual health.
	C)	nutritional intake.
	D)	mental and emotional well-being.
	Ans:
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6.	A nurse is evaluating a patient who is receiving the antituberculosis drug isoniazid. The nurse should be careful to assess for
	A)	a vitamin B6 deficiency.
	B)	a folic acid deficiency.
	C)	the use of bulk-producing laxatives.
	D)	changes in serum potassium levels.
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NURS 6521 Pharmacotherapeutics for Advanced Practice – Antituberculosis Drug Isoniazid

7.	A nurse is talking to an 18-year-old patient who has had a seizure disorder since she was 10 years old and is taking phenytoin (Dilantin). The nurse should suggest that she take which of the following?
	A)	A potassium supplement
	B)	An iron supplement
	C)	Folic acid
	D)	Vitamin C
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NURS 6521 Pharmacotherapeutics for Advanced Practice-Supplements

8.	A 79-year-old patient in a long-term care facility is to receive an intravenous fat emulsion. Which of the following lab values would be a priority for the nurse to assess before administration?
	A)	Blood glucose levels
	B)	Serum potassium levels
	C)	Serum sodium levels
	D)	Triglyceride levels
	Ans:	D
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	Triglycerides are the predominant dietary lipids. Fats should supply no more than 25% to 30% of the total intake of a well-balanced diet. It would be most important for the nurse to know the triglyceride level before administration of the fat emulsion and to monitor the levels as appropriate. …

NURS 6521 Pharmacotherapeutics for Advanced Practice – Antituberculosis Drug Isoniazid

9.	A nurse is counseling a 55-year-old woman regarding her nutritional status, and has explained the role of a particular mineral in neuromuscular transmission, cellular signaling, and blood clotting. The nurse has explained the physiological functions of
	A)	potassium.
	B)	magnesium.
	C)	sodium.
	D)	calcium.
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10.	A patient has taken an overdose of a vitamin/mineral supplement containing magnesium. The nurse will be sure to assess
	A)	blood pressure.
	B)	body temperature.
	C)	fluid intake.
	D)	skin changes.
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11.	A 50-year-old woman has a complex medical history that includes multiple sclerosis and type 2 diabetes. She has recently expressed interest in exploring alternative medications and herbal remedies. The nurse should follow up the woman’s statement with what suggestion?
	A)	“It’s best to try to separate your drugs from your supplements. Take your drugs in the morning and your supplements in the evening, or vice versa.”
	B)	“Make sure you check with your care provider before you start taking any herbal remedies or dietary supplements.”
	C)	“Natural remedies and dietary supplements are useful for people who enjoy good health, but they’re dangerous for people who have an acute or chronic health problem.”
	D)	“If you would prefer natural remedies over drugs, you may need to stop taking your medications for several days before starting to take natural remedies.”
	Ans:
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NURS 6521 Pharmacotherapeutics for Advanced Practice – Antituberculosis Drug Isoniazid

12.	A 70-year-old woman with a history of atrial fibrillation has been admitted with a lower gastrointestinal bleed. During the nurse’s admission assessment, the nurse realizes that the patient has been taking ginkgo biloba supplements in addition to her prescribed warfarin, a combination that has resulted in bleeding. What nursing diagnosis should the nurse identify when planning this patient’s care?
	A)	Risk for Injury related to adverse effects from excessive use of vitamins or herbs
	B)	Health-Seeking Behaviors related to the use of nutritional supplements
	C)	Risk for Injury related to low protein levels and malnutrition
	D)	Risk for Injury related to drug interactions of vitamins, herbs, or food intake with prescribed drug therapy
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NURS 6521 Pharmacotherapeutics for Advanced Practice

13.	A 77-year-old woman who is 5 feet 3 inches tall and weighs 89 lbs has been admitted to the hospital with a diagnosis of failure to thrive. What action should the nurse prioritize when addressing the woman’s apparent lack of nutrition?
	A)	Assess the reasons behind the patient’s poor nutritional status
	B)	Educate the woman about the importance of balanced nutritional intake
	C)	Order double meal trays for the woman for the duration of her hospital stay
	D)	Create incentives for the woman to increase her food intake
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14.	A 59-year-old man has been admitted to the hospital with complications of alcohol abuse. Blood work that was completed on admission reveals that the patient has imbalances in a number of minerals, nutrients, and blood components. The patient may face an increased risk of adverse drug effects if he is deficient in
	A)	calcium.
	B)	serum protein.
	C)	folate.
	D)	magnesium.
	Ans:
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15.	Mr. Thwaites is a 49-year-old man who has just learned that he has type 2 diabetes. He is open to learning about his diagnosis and demonstrates a desire to build his knowledge base in order to manage his disease and minimize the risk of complications. What teaching point should the nurse provide to Mr. Thwaites when explaining the concept of glycemic load?
	A)	“The glycemic load of a food encompasses both the glycemic index and the amount of carbohydrates in that food.”
	B)	“The glycemic load of a food is essentially the ratio of simple carbohydrates to complex carbohydrates in the food.”
	C)	“Glycemic load is synonymous with glycemic index, and both measure how quickly the food increases your blood sugar.”
	D)	“The glycemic load of a food is calculated by subtracting the grams of protein and fats from the grams of complex carbohydrates in the food.”
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NURS 6521 Advance Care Planning: Multiple Sclerosis