HESI Reading Comprehension

It is no secret that the global healthcare system is in despair. Because of the healthcare systems in other parts of the world, many immigrants are trying their best to immigrate to America to receive better healthcare. Because of this phenomenon, American physicians and nurses are seeing a wide range of different cultures. This includes patients that American healthcare workers may not be able to properly communicate with due to language barriers. Cultural humility is important in healthcare. Everyone is entitled to the best care no matter which cultural or ethnicity background they are from. It is important to learn about the different cultures and beliefs of the immigrants coming to America so that one can provide the most valuable care to  patients while acquiring a rapport with each patient as well.  

Holistic nursing involves the patient as a whole. The mind, body, and spirit: all aspects of the patient. When a patient is seen as just a diagnosis and the health care provider is task focused, the patient and the rapport with the physician can really suffer.  It is important to treat patients holistically in order for the patient to receive the best care possible.

According to the accompanying text, one of the reasons for immigration is what?

According to the accompanying text, it is important to establish what with a patient to provide the best healthcare for the patient?

Arkansas requires the registered nurse to have a minimum of a master’s degree in nursing to be eligible to sit for the board exam to obtain an APRN license. Specifically for the adult gerontology APRN the nurse should have a minimum of 500 practicum hours. The registered nurse should also have a minimum of 2000 hours as a RN either in Arkansas or in a compact state. Both classroom and practicum hours are required for the APRN license. The school in which the RN attends must be accredited by the Commision on Collegiate Nursing Education. The Arkansas State Board of Nursing recognizes the CNP, CRNA, CNM, and CNS. For prescriptive authority, a minimum of three semester hours or forty-five contact hours are required in Pharmacokinetics principles and practical application. To be considered for APRN licensure in Arkansas, the registered nurse must first hold a RN license. The nurse must always hold both a RN and APRN license to practice as an APRN. Specifically for the adult gerontology APRN, there is a minimum requirement of 500 practicum hours and 75 continuing education hours during each five-year period. The continuing education hours must be in pharmacology, physical assessment, and physiology. The Arkansas State Board of Nursing is the regulator of all nurses in Arkansas. Their goal is to provide safe care to all patients. The Arkansas State Board of Nursing works in collaboration with the American Medical Association to ensure that all nurse practitioners are working within their scope of practice under a MD that is licensed under the Arkansas Medical Practice Act. Arkansas allows for limited nurse practitioner practice. This means that the nurse practitioner in Arkansas must work under a medical doctor. Because the APRN is only allowed to prescribe schedule III-V drugs, some patients may have to make an appointment with the physician if they need drugs outside of this scope. An example of a medication not approved for the APRN to prescribe is Dilaudid or Demerol. When it comes to prescriptive authority in Arkansas, the APRN must apply for prescriptive authority separately. A DEA certificate must be acquired by the APRN until one receives the full APRN license. The DEA certificate number is needed if the APRN plans to prescribe controlled substances. To prescribe any medications the APRN must complete a 300-hour preceptorship and must hold a collaborative agreement with a medical doctor who is licensed under the Arkansas Medical Practice Act. The APRN is only allowed to prescribe medications that fall under a schedule III-V. Medications that fall under schedule I-II are prohibited for the APRN to prescribe. The APRN must have extra continuing education hours every two-year period to continue to hold prescriptive authority in Arkansas.

According to the accompanying text, the APRN (advanced practice registered nurse) must have how many practicum  hours to be able to take the board exam?

According to the accompanying text, the school that the RN decided to attend must be accredited by whom in order for the RN to receive an APRN license?

According to the accompanying text, in order for the nurse to obtain prescriptive authority as an APRN, the nurse must engage in how many contact hours in Pharmacokinetics?

According to the accompanying text, how many hours of continuing education does the APRN in gerontology need to obtain each 5 year period in order to keep their APRN license up to date?

According to the accompanying text, what is the goal of the Arkansas State Board of Nursing?

According to the accompanying text, the APRN is not allowed to prescribe what schedule of drugs?

According to the accompanying text, an APRN working in Arkansas must work under a MD (medical doctor) that is licensed by whom?

According to the accompanying text, the APRN must complete how many hours of preceptorship with a MD to be able to prescribe medications in Arkansas?

Pain, increased medications, and functional decline include just a few of the concerns that the nurse practitioner should acknowledge in the geriatric adult population.  In healthcare there are three outcomes that are imperative to the effectiveness of care. Better care for patients, increased health for patients, and decreased cost of healthcare. No matter the outcome of care, the care provided is only effective if it matters to the patient and is beneficial to the patient. The care of a patient should be value-based. When outcomes are measured and reported, it fosters improvement and adoption of best practices, thus further improving outcomes. To ensure effectiveness of care for  patients, healthcare providers should implement the following three interventions: assess pain, assess and reconcile medications, and observe functional decline. As patients age, pain is inevitable. As a nurse practitioner it is imperative to assess pain of the patient in order to promote a good quality of life for the patient. Pain is severely under treated in the geriatric population due to the fear of opioid dependence and the idea that pain is a normal part of aging. Because pain is undertreated, the geriatric population is prone to depression due to untreated pain, falls, slower recovery after a fall or surgery, desocialization, and higher healthcare costs overall. Pain is the fifth vital sign and should be assessed accordingly. However, because the geriatric population is prone to dementia and impaired cognition, pain can be hard to assess for the healthcare professional. When patients feel heard by the medical professional, a rapport can be established between the patient and the medical professional. Rapport can lead to better pain management, which in turn leads to a better quality of life for the patient. This cycle ultimately results in improved patient ratings. When it comes to the fear of opioid addiction, education provided to the patient about opioid addiction is imperative. Furthermore, addressing cost savings, if the patient’s pain is being controlled effectively, the patient is not going to come into the office multiple times addressing uncontrolled pain. Also, mentioned above is the uncontrolled pain that can lead to more falls in the older adult. If the patient falls and breaks a bone, they may need surgery, which is a major cost. The cycle can be vicious. Ensuring an adequate pain management regimen can significantly cut down on costs.  

According to the accompanying text, the care provided is only effective if

According to the accompanying text, To ensure effectiveness of care for  patients, healthcare providers should implement all of the following EXCEPT

According to the accompanying text, the geriatric population is prone to depression due to what?

According to the accompanying text, what action by the healthcare provider (i.e. nurse practitioner or doctor) can directly decrease healthcare costs?

Obesity is an epidemic in the United States. Obesity leads to major health issues like myocardial infarction, coronary artery disease, cerebral vascular accidents, orthopedic impairment, sleep apnea, type II diabetes mellitus, and cancer. These health diseases are all long term, very costly issues for patients. To put things into perspective, Arkansas spends 3.1 billion dollars on diabetes mellitus yearly. This number is very intimidating. Weight loss and physical activity can directly impact the rate of diabetes in a positive way. However, as the rates of obesity steadily climb, so do the number of patients diagnosed with long term health issues like diabetes mellitus. These long-term health diseases can cause one to have a very poor quality of life. Research has concluded that those at risk for obesity are those that do not have a high school education. The reason for this is directly related to lack of ability to obtain a full-time job due to lack of education that is needed to possess such a job. Adults with an annual household income of $25,000 or less are at risk of obesity as they are unable to afford healthy foods or are forced to choose between paying utility bills and healthy food for themselves and their children. This leads to the inability to afford healthy food and poor nutrition, making food insecurity a major issue contributing to obesity in Arkansas. In Arkansas, obesity can be broken down into different ethnic groups, age groups and gender groups. The percentage of white persons that were obese in Arkansas in 2020 was 34.8%; Black persons was 49.5%, and Hispanic persons was 37.7%. In Arkansas 39.7% of the obese population included women. The most obese age group of women in Arkansas was ages 40-60 and older. The obese age group that trumped the others despite gender was 45-75. The World Health Organization’s definition of obesity as “abnormal or excessive fat accumulation that may impair health.” According to past research, America and Canada now classify obesity as a chronic illness, however this is not a widely accepted concept. The issue that Americans face here is that a lot of insurance companies do not consider obesity an illness. This means that American’s that are obese and want to lose weight with the help of a weight loss medication. This causes patients to have to pay out of pocket for weight loss medications; but, because these medications can be so costly, most patients cannot afford these medications. Furthermore, if one has a normal BMI they are not necessarily deemed free of illness. Likewise, one that has a higher BMI is not to be considered “diseased.” There is not a specific number on a scale that classifies one as unhealthy; therefore, it is hard for obesity to be accepted as a disease on a more level platform. Healthy People 2020 recognizes those at high risk for obesity. These include but are not limited to those individuals in rural areas and those that are living below the poverty level in the United States. Those in rural areas with food insecurity are more likely to experience obesity as well. African American and Hispanic ethnicities are of the minority in the US and are more likely to experience obesity than their Caucasian counterparts.

According to the accompanying text, how much money does Arkansas alone spend on treating diabetes?

According to the accompanying text, obesity is directly related to which long term disease?

According to the accompanying text, what is the average household income that places a person at risk for obesity related to food insecurity?

According to the accompanying text, you can conclude that which ethnic group has the highest risk for obesity related to poor food security?

According to the accompanying text, who does Healthy People 2020 recognize as a high risk for obesity?

According to the accompanying text, a person with a normal BMI (Body Mass Index) is