NU-664B Week 10: Exam 2- Requires Respondus LockDown Browser + Webcam

Value: 100 points

Due: Day 7

Grading Category: Exam 2

Exam 2 features 75 questions and covers all content from Weeks 1–9.

Please review the course syllabus for the Exam Policy; you are responsible for knowing and adhering to these guidelines.

Note: Please complete this exam to test your knowledge of course concepts. Note that you can only attempt this exam once and that it must be completed in one sitting. Do not open the exam until you are ready to complete it. This exam requires the use of Respondus.

Your numerical score will be available upon the completion of this exam, but you will not be able to view the questions or answers once the exam has been submitted.

This quiz has been configured so that students may only attempt it using the Respondus LockDown Browser.

Attempts allowed: 1

Time limit: 1 hour 15 mins

Initial Post

Hi Selah, I am going to be asking you a series of questions to better understand your memory changes. I am going to also occasionally ask Britt as well, if this is okay? (Dunphy et al., 2019)

1.       Selah, have you noticed any changes to your short-term memory? Britt, have you noticed changes to your mother’s short-term memory? If so, can you please provide me an example? (Zverova, 2019).

2.       Selah, have you noticed any changes with language expression? Britt, have you noticed these changes? (Zverova, 2019)

3.       Have you or your daughter noticed any changes to completing activities of daily living, such as preparing meals, cleaning, or bathing? (Zverova, 2019)

4.       When have you noticed the onset of forgetfulness? Was it sudden or close to when the patient had either TIA? (Zverova, 2019)

5.       What type(s) of TIAs did you have/ what was deemed the reasoning for your TIAs? (Farokhi-Sisakht et al., 2019)

6.       Selah, did you ever participate in rehabilitation programs immediately following your TIA(s)? (Farokhi-Sisakht et al., 2019)

7.       Have there been any recent changes to your medications to control your diabetes, or have you noticed a change in your blood glucose levels? If so, which type of change? (Salas & Strooper, 2019)

8.       When did you most recently fall, Selah? Did you notice a change in your memory after the fall? If so, has the change in memory remained consistent since the fall? (Fraser & Mobbs, 2021).

9.       Have you noticed any changes in muscle movements? (Dunphy et al., 2019)

10.   Have you experienced any symptoms of delirium, paranoia, hallucinations, psychosis, or aggressive behaviors? (Dunphy et al., 2019)

11.   Have you recently been consuming multiple alcoholic beverages? (Dunphy et al., 2019)

12.   What medications are you taking for management of hypertension and hyperlipidemia? (Dunphy et al., 2019)

13.   Have you recently started a new medication for management of your hypertension or hyperlipidemia? Or have you recently adjusted the dose of a medication? (Dunphy et al., 2019

14.   Have you experienced any mood changes, such as depression? (Dunphy et al., 2019)

15.   Did you have another recent fall where you hit your head? (Dunphy et al., 2019)

16.   Have you been taking any medications to help you sleep? (Dunphy et al., 2019)

References

Dunphy, L., Winland-Brown, J., Porter, B., & Thomas, D. (2019). Primary care: Art and science of advanced practice nursing – An interprofessional approach. (5th ed.). F.A. Davis.

Farokhi-Sisakht, S., Farhoudi, M., Sadigh-Eteghad, S., Mahmoudi, J., & Mohaddes, G. (2019). Cognitive rehabilitation improves ischemic stroke-induced cognitive impairment: Role of growth factors. Journal of Stroke and Cerebrovascular Diseases, 28(10). https://doi.org/10.1016/j.jstrokecerebrovasdis.2019.07.015

Fraser, C., & Mobbs, R. (2021). Visual effects of concussion: A review. Clinical & Experimental Ophthalmology, 50(1). https://doi.org/10.1111/ceo.13987

Salas, I., & Strooper, B. (2019). Diabetes and Alzheimer’s disease: A link not as simple as it seems. Neurochemical Research, 44, 1271-1278.
https://doi.org/10.1007/s11064-018-2690-9

Zverova, M. (2019). Clinical aspects of Alzheimer’s disease. Clinical Biochemistry, 72, 3-6. https://doi.org/10.1016/j.clinbiochem.2019.04.015

Hello Allison, yes you can ask me and my daughter anything. 

1.       Selah, have you noticed any changes to your short-term memory? Britt, have you noticed changes to your mother’s short-term memory? If so, can you please provide me an example? (Zverova, 2019). I have not noticed any changes, I am getting older and I forget things once in a while but not often. The same as another other woman my age. 

Britt: yes, it seems to be declining over the past 6 months, she has forgotten about appointments a few times or forgot to get the mail lately. She miss places her keys or bills all the time, which is new because she has always been so organized. 

2.       Selah, have you noticed any changes with language expression? Britt, have you noticed these changes? (Zverova, 2019). I have not noticed any changes in language expression 

Britt: yes she often forgets word during conversation, she could not remember the word for washing machine yesterday. She just keep saying the metal box with the clothes is beeping. 

3.       Have you or your daughter noticed any changes to completing activities of daily living, such as preparing meals, cleaning, or bathing? (Zverova, 2019). I live along and can handle myself, I’ve ran a household for longer than both of you have been alive, combined. Sometimes I don’t make dinner because I am too tired for that at my age. 

Britt she still does everything herself because she won’t let anyone help. I think she ends up skipping meals often because she doesn’t want to cook or forgets. There has been food spoiled in the fridge. 

4.       When have you noticed the onset of forgetfulness? Was it sudden or close to when the patient had either TIA? (Zverova, 2019). 

Britt it has been gradual but may have started around the TIA, I am not sure but I am definitely noticing it more lately. But that may be because I am paying attention more and I am around more often in the past 6 month then before. 

5.       What type(s) of TIAs did you have/ what was deemed the reasoning for your TIAs? (Farokhi-Sisakht et al., 2019)

It should be in my chart, probably from my cholesterol. My parents has high cholesterol too. 

6.       Selah, did you ever participate in rehabilitation programs immediately following your TIA(s)? (Farokhi-Sisakht et al., 2019)

I started to for a while but all the appointments just got too much. 

7.       Have there been any recent changes to your medications to control your diabetes, or have you noticed a change in your blood glucose levels? If so, which type of change? (Salas & Strooper, 2019). 

There have not been any changes to my medications for diabetes. I do not check my blood sugars at home. I think my last A1c was 8.0% which my PCP said was improved. 

8.       When did you most recently fall, Selah? Did you notice a change in your memory after the fall? If so, has the change in memory remained consistent since the fall? (Fraser & Mobbs, 2021).

I fell last month going to the bathroom in the middle of the night. I do not think my memory is a problem. 

Britt she has seemed different since her last fall, more withdrawn.  

9.       Have you noticed any changes in muscle movements? (Dunphy et al., 2019). No, I have not noticed any changes in muscle movements but my legs feel weak sometimes, especially at night when I have to get up to go pee. Sometimes my legs just ache lately. 

10.   Have you experienced any symptoms of delirium, paranoia, hallucinations, psychosis, or aggressive behaviors? (Dunphy et al., 2019). Not that I am aware of. 

Britt there was one time a few weeks ago she called me saying a person walking their dog was outside starring at the house. She shut all the curtains and locked the doors. Most of her neighbors are in FL this time of year. 

11.   Have you recently been consuming multiple alcoholic beverages? (Dunphy et al., 2019). I usually drink a few glasses of wine in the evening. Helps me to calm down and sleep. 

Britt she drinks a lot more than she use to since my dad passed away 2 years ago

12.   What medications are you taking for management of hypertension and hyperlipidemia? (Dunphy et al., 2019). I take losartan 50 mg in the morning and metoprolol XL 100 mg in the evening. I’ve been on these doses for a long time. My cholesterol medication was just changed last month from simvastatin to atorvastatin 40 mg daily, I take that at bedtime. 

13.   Have you recently started a new medication for management of your hypertension or hyperlipidemia? Or have you recently adjusted the dose of a medication? (Dunphy et al., 2019). My atorvastatin was just changed, I am suppose to have labs done soon. 

14.   Have you experienced any mood changes, such as depression? (Dunphy et al., 2019). Doesn’t everyone with today’s world? I am fine. 

Britt she has been more depressed since dad passed but since the TIA and falls she seems more down and withdrawn. We use to go out and get our nails done, go out for lunch or shopping but she is not interested in going out anymore. 

15.   Did you have another recent fall where you hit your head? (Dunphy et al., 2019). There have been two falls where I hit my head, the most recent was a month ago when I fell at night and hit my head in the bathroom. 

16.   Have you been taking any medications to help you sleep? (Dunphy et al., 2019)

 The wine usually helps but I have an old prescription from my late husband for Ambien that I take once in a while.