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The nurse cares for a patient with a spinal cord injury. The patient has a nursing diagnosis of “constipation related to neuromuscular impairment of the gastrointestinal tract.” As part of the plan of care, the nurse provides education on starting a bowel management program. Which statement by the patient indicates a need for additional teaching?

Suppose a team of researchers studied the association between arsenic exposure and skin cancer using a case-control study. The researchers were interested in studying smoking as an effect modifier of the association between arsenic exposure and skin cancer. To determine if smoking is an effect modifier, the researchers compared the observed joint exposure odds ratio to the expected joint exposure odds ratio. The observed joint exposure odds ratio was 4.25 and the expected joint exposure odds ratio was 2.80.    What is the correct conclusion based on the available information presented above?

The nurse prepares to discharge a patient who experienced a brief episode of diplopia, dysarthria, and dysphagia. The symptoms lasted about one hour and the patient reports no residual effects. The nurse anticipates the health care provider will add which medication to the patient’s home medication regimen?

The clinic nurse assesses a patient with rheumatoid arthritis of the hands and wrists at a follow up appointment. Which finding most concerns the nurse and should be reported to the health care provider?

Which statement is true regarding the recovery from kidney stones? 

The nurse assists a patient with a spinal cord injury during a physical therapy session. The patient works on ambulating with bilateral long leg braces. With which level of injury will this collaborative action most likely be included in the plan of care?

After completing the National Institute of Health Stroke Scale (NIHSS) assessment, a provider determines a patient diagnosed with a stroke should be treated with tPA. The nurse reviews the provider’s orders to be completed before tPA is started. Which order concerns the nurse and requires clarification with the provider?

Case 1 (questions 13-14) Suppose a researcher is interested in studying whether people who have suffered head injuries are more likely to develop epilepsy compared to people who have not suffered head injuries. To study this, the researcher performed a case-control study.   What is the most appropriate measure of association to estimate in the study described in case 1? (max. 2 points) Explain why your chosen measure of association is most appropriate for Case 1 (max. 2 points).

Suppose a team of researchers studied night shift work as a moderator of the effect of sleep quality on metabolic syndrome using a prospective cohort study. The researchers investigated potential effect modification by night shift work by estimating the risk difference and risk ratio separately for people who work night shifts and for people who do not work night shifts. Table 3 shows the results from these analyses.   Table 3. Stratified effect estimates from the hypothetical study on night shift work as an effect modifier of the association between sleep quality and metabolic syndrome.   Estimates for the subsample of people who do work night shifts Estimates for the subsample of people who do not work night shifts Risk difference 0.10 0.05 Risk ratio 1.67 1.50   Is night shift work an effect modifier on the additive scale only, the multiplicative scale only, both the additive and multiplicative scales, or on neither scale? (2 points) Explain why you chose your answer (max. 4 points).

How do opioids function in the body?