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LIBERTY UNIVERSITY BIBL 104 QUIZ 3

SET 2019:

1. According to our textbook, many church fathers viewed the Song of Songs typologically as a picture of Christ’s love for His bride, the church.

2. ___________________ predictively refer to Christ, the anointed messianic King.

3. Historically, the most common method used in interpreting the Song of Songs was to treat the Song as an allegory of God’s love for Israel.

4. In his response to Job, God appeals to creation as a demonstration of his unfathomable wisdom.

5. According to our textbook, the _____________________ is a reoccurring theme or motif found throughout the book of Ecclesiastes.

6. The list of individuals who composed material in the Psalms includes Moses.

7. The ____________________ are expressions of trust in the Lord and praise to the Lord for the security He provides to those who trust in Him.

8. The Proverbs tell us how to live life successfully.

9. Bildad, one of Job’s three friends, suggests that God may use suffering as a means to
keep men from sin, to chastise, and to maintain a healthy degree of reverence before the Almighty.

10. Job states his faith in the resurrection when he says: “I know that my redeemer
lives…And after my skin has been destroyed, yet in my flesh I will see God.”

11. The _____________ are prayers of extreme emotion and anger calling on God to bring severe judgment on the enemies of God and the psalmist.

12. According to our textbook, the _____________________ is a reoccurring theme or motif found throughout the book of Ecclesiastes.

13. The __________ focus on the Lord’s kingdom rule over His creation.

14. According to our textbook, _________________ is one of the more popular topics in the book of Proverbs.

15. In the second cosmic test in the book of Job, the Lord allows Satan to take Job’s health, but he must preserve Job’s life.

16. The psalms are divided into _____________ books.

17. “Pride comes before destruction, and an arrogant spirit before a fall.” (Prov. 16:18) is an example of

18. In a general sense the proverbs can be grouped into two major forms. One of these forms is

19. The list of individuals who composed material in the Psalms includes Saul.

20. According to our textbook, Job’s three friends are commended for their companionship but are condemned for their false accusations and misguided theology.

21. In the __________________, the psalmist confesses his sin and prays for the Lord’s forgiveness and restoration.

22. Job accuses God of prejudice and curses the day of his birth.

23. According to our textbook, the value of _______________ is a reoccurring theme or motif found throughout the book of Ecclesiastes.

24. The book of Proverbs consistently presents the sluggard as a fool and the diligent person as wise.

25. Proverbs are typically based on education and knowledge.

26. The book of Job concludes with God prospering Job once again and blessing him with twice the wealth.

27. The Proverbs are wise sayings that express deep truths in capsule form.

28. In Proverbs child-rearing is a family affair but discipline begins with the individual.

29. Proverbs are general truths, not specific promises or guarantees from God.

30. Proverbs are written in such a simple way that they produce reflection within the mind of the reader.

31. The list of individuals who composed material in the Psalms includes Solomon.

32. According to our textbook, _____________________ is a reoccurring theme or motif found throughout the book of Ecclesiastes.

33. Most English Bibles translate “Qohelet” as

34. According to our textbook, _________________ is one of the more popular topics in the book of Proverbs.

35. Job’s friends respond to his suffering by saying, “Why don’t you curse God and die?”

36. “Genuine righteousness leads to life, but pursuing evil leads to death.” (Prov. 11:19) is an example of

37. Job’s responds to God in faith knowing it is enough that God is in control.

38. “Good news from a distant land is like cold water to a parched throat.” (Prov. 25:25) is an example of

39. _______________ often teach practical lessons about everyday living.

40. Job’s friends assume he must have done something terribly wrong, unjust, or unwise to
experience such an incredible tragedy.

41. A proverb is a short poetic sentence conveying wisdom in a concise and memorable form.

42. ____________________ are prayers expressing thanks to God for specific answers to prayer or for deliverance from danger.

43. A _________________ is a prayer offered in times of trouble, pleading for God’s help, intervention, and deliverance.

44. According to our textbook, _________________ is one of the more popular topics in the book of Proverbs.

45. While the time of writing for the book of Job is uncertain, internal evidence points to a time before the Mosaic law.

46. According to our textbook, the _____________________ is a reoccurring theme or motif found throughout the book of Ecclesiastes.

47. Job is convinced that if he could only have the opportunity to present his case to God,
then God would realize he is judging the wrong man, and Job would be proclaimed innocent.

48. According to our textbook, perhaps the greatest benefit the believer can gain by studying the Song of Songs is the reminder that love is a gift from God and should be enjoyed as a gift.

49. In the book of Job the Lord presents his servant Job as a model of righteousness before
Satan.

50. The Hebrew word hevel, literally means

Set 2018:

1. The Lord allows Satan to take his health, but he must preserve his life.

2. In response to his friends’ advice, Job admits that he is a sinner but that his sins are not categorically vile. Job asserts that he may have committed mortal sins but he certainly did not commit venial ones.

3. “Pride comes before destruction, and an arrogant spirit before a fall.” (Prov. 16:18) is an example of

4. “Good news from a distant land is like cold water to a parched throat.” (Prov. 25:25) is an example of

5. The Proverbs tell us how to live life successfully.

6. Most proverbs take the form of a four-line unit, with the first line corresponding to the fourth line and the second line corresponding to the third line This correspondence is through some form of parallelism.

7. A proverb is a short poetic sentence conveying wisdom in a concise and memorable form.

8. The Proverbs are wise sayings that express deep truths in capsule form.

9. “The one who conceals hatred has lying lips, and whoever spreads slander is a fool.” (Prov. 10:18) is an example of

10. According to our textbook, Job’s three friends are commended for their companionship but are condemned for their false accusations and misguided theology.

11. In the __________________, the psalmist confesses his sin and prays for the Lord’s forgiveness and restoration.

12. In Proverbs child-rearing is a family affair but discipline begins with the individual.

13. Most English Bibles translate “Qohelet” as

14. In a general sense the proverbs can be grouped into two major forms. One of these forms is

15. According to our textbook, the _____________________ is a reoccurring theme or motif found throughout the book of Ecclesiastes.

16. ________________ are prayers that celebrate the special relationship between the Lord and the house of the Davidic king.

17. According to our textbook, _____________________ is a reoccurring theme or motif found throughout the book of Ecclesiastes.

18. According to our textbook, the _____________________ is a reoccurring theme or motif found throughout the book of Ecclesiastes.

19. Job’s responds to God in faith knowing it is enough that God is in control.

20. According to our textbook, _________________ is one of the more popular topics in the book of Proverbs.

21. The title “Song of Songs” can literally be translated from the Hebrew “The Greatest Song of Solomon.”

22. A _________________ is a prayer offered in times of trouble, pleading for God’s help, intervention, and deliverance.

23. The book of Proverbs consistently presents the sluggard as a fool and the diligent person as wise.

24. _______________ often teach practical lessons about everyday living.

25. Proverbs contains a balanced view of wealth and poverty.

26. According to our textbook, allegorical interpretations of the Song of Songs are correct since they are based on careful exegesis of the text in the Song of Songs.

27. Bildad, one of Job’s three friends, suggests that God may use suffering as a means to
keep men from sin, to chastise, and to maintain a healthy degree of reverence before the Almighty.

28. The ______________ are songs of praise the people sang as they made pilgrimage to Jerusalem.

29. “Qohelet,” a term meaning

30. Proverbs concentrates primarily on practical issues rather than focusing on theological issues.

31. The list of individuals who composed material in the Psalms includes Solomon.

32. “Genuine righteousness leads to life, but pursuing evil leads to death.” (Prov. 11:19) is an example of

33. Proverbs are typically based on education and knowledge.

34. The psalms are divided into _____________ books.

35. ____________________ are prayers expressing thanks to God for specific answers to prayer or for deliverance from danger.

36. The list of individuals who composed material in the Psalms includes Saul.

37. Most of the book of Proverbs is attributed to ______________.

38. While the time of writing for the book of Job is uncertain, internal evidence points to a time before the Mosaic law.

39. Historically, the most common method used in interpreting the Song of Songs was to treat the Song as an allegory of God’s love for Israel.

40. According to our textbook, perhaps the greatest benefit the believer can gain by studying the Song of Songs is the reminder that love is a gift from God and should be enjoyed as a gift.

41. The Hebrew word hevel, literally means

42. The key literary characteristic within the individual proverb is ______________.

43. According to our textbook, the value of _______________ is a reoccurring theme or motif found throughout the book of Ecclesiastes.

44. According to our textbook, the _____________________ is a reoccurring theme or motif found throughout the book of Ecclesiastes.

45. Job’s three friends were Eliphaz, Bildad, and Zophar.

46. According to our textbook, _________________ is one of the more popular topics in the book of Proverbs.

47. Job is convinced that if he could only have the opportunity to present his case to God,
then God would realize he is judging the wrong man, and Job would be proclaimed innocent.

48. According to our textbook, many church fathers viewed the Song of Songs typologically as a picture of Christ’s love for His bride, the church.

49. Proverbs are written in such a simple way that they produce reflection within the mind of the reader.

50. The focus of the Proverbs is heavenly rather than earthly.

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LIBERTY UNIVERSITY BIBL 104 QUIZ 7

1. Paul reminds Titus that since people were saved “not by works of righteousness that we had done, but according to His mercy” and justified by God’s grace, they should live a life of good works toward all men.

2. Paul’s instructs the Corinthians that his perspective on the Gospel ministry includes the idea that the ministry is an opportunity to display the glory of God.

3. One of Paul’s principal achievements was that he wrote thirteen books of the New Testament, which are a primary source of theological information

4. According to the textbook, Paul asserts in 1 Thessalonians that because of the promise of the rapture, believers will not suffer the wrath of the Day of the Lord.

5. According to the textbook, Paul teaches in 2 Thessalonians that the rapture will precede the removal of the “restrainer,” the revealing of the Antichrist, the time of tribulation, and the final Day of the Lord.

6. In 1 Timothy Paul identified two acts of heresy: forbidding marriage and abstinence  from food.

7. In Romans Paul shows that all are accountable and no one can be justified by his own good works, with or without the law.

8. According to the textbook, to keep him from exalting himself, God gave him a thorn in the flesh.

9. In Philemon, Paul pleads with Philemon to take Onesimus back and forgive him for both the crimes of stealing and running away because “you owe me over and above your very soul.”

10. Paul’s hope in Philippians was to offer practical encouragements to his friends at Philippi so they would not be tempted to doubt God’s faithfulness even in dire circumstances.

11. In 2 Corinthians Paul told the church that the Macedonians were giving a contribution for the work of the ministry. Thus, their contribution was appreciated but not needed.

12. According to Paul in Romans, justification was provided by Christ’s substitutionary death on the cross as a satisfaction for man’s sin for all who come to Christ in faith.

13. In the Corinthian church some believed in Christ’s resurrection but not in the resurrection of believers.

14. According to the textbook, Galatians can be termed the Magna Carta of Christian liberty. It states unequivocally that salvation is through faith alone, in Christ alone, by grace alone, without works of any kind.

15. The Roman church consisted of both Jews and Gentiles, but the majority were Jews.

16. Epistles are the most common literary form in the New Testament. They are “occasional” letters; that is, they were designed to deal with specific situations.

17. In Ephesian, Paul pictures believers as being “in Christ.” This is a special relationship with God because they are perfect in Christ.

18. The problems addressed in First Corinthians arose when various groups sided with different leaders who best represented their view of Christianity.

19. According to Paul in Galatians, the law locked imprisoned us, but provided no remedy. Only faith in Christ can atone for sin and free us from the law’s condemnation.

20. According to Paul in Galatians, Christ redeemed us by becoming a _________ for us when He hung on the cross.

21. __________ is a short and extremely practical book that is focused primarily on church ministry and, secondarily, on Christian discipleship.

22. In order to demonstrate the self-sacrifice and humility of Jesus, Paul boasted in his weakness rather than his strength in 2 Corinthians.

23. In First Corinthians Paul address three moral issues in the church. One of these is the issue

24. In First Corinthians, Paul encouraged these believers to examine their attitudes before partaking in this ordinance of the church.

25. Paul urges the Galatians to “stand firm” in Christ’s liberty and that failing to do this would mean “you have fallen from grace.” This means they will have lost their salvation.

26. Spiritual warfare takes place both in heaven and on earth. Because believers have victory in Christ in heaven, they should and can have victory on this earth. So, Paul exhorts believers in Ephesians to prepare for spiritual battle on this earth.

27. Paul sees believers as having three chief duties. One of these duties is towards the

28. Paul argues in Galatians that the law requires perfect obedience, and since no one is perfect, all are condemned by the law. Only faith in Christ’s finished work can save anyone.

29. One of Paul’s principal achievement was that he was the main leader in extending the church into Asia Minor and Greece, becoming known as the premier apostle to the Gentiles.

30. In Philippians Paul argues that true joy and peace are not contingent on circumstances but rather in knowing that an all-powerful and all-loving God is in control.

31. The book of Colossians can be divided into two section. The first section is a section of doctrine and the second section is a section on

32. 2 Timothy was written by Paul to Timothy just before Paul’s martyrdom.

33. In Philemon, Paul makes himself personally responsible for the amount stolen by Onesimus. He tells Philemon to “Charge that to my account.”

34. In Philippians, Paul asserts that he is pursing Christ as passionately as a runner would pursue the goal and prize of winning a race.

35. Paul tells the Philippians that they should live in unity, humility, and selflessness. He then gives himself as the example for believers to follow when he claims, “follow me as I follow Christ.”

36. Paul’s instructs the Corinthians that his perspective on the Gospel ministry includes the idea that the minister, in response, endures many hardships in order not to discredit the ministry.

37. Paul’s letter to the ___________ includes one of the most complete statements about the true nature of the person of Christ in the New Testament.

38. According to the textbook, Paul asserts in 2 Thessalonians that the Day of the Lord will not begin until the “man of lawlessness” (the Antichrist) is revealed.

39. In First Corinthians Paul address three moral issues in the church. One of these is the issue of

40. In order to “not carry out the desire of the flesh,” Paul urges the Galatians to

41. Paul removed any obstacle Timothy might have had to ministry among Jews by having the young man circumcised.

42. The Galatian Christians were being influenced by Judaizers who would have Gentile believers circumcised and live by the law.

43. The book of Romans can be divided into two major parts. The first part deals with doctrine and the second part deals with

44. In the first section of Romans Paul shows that _____________ are under condemnation.

45. Paul founded the church in Rome on his first missionary journey.

46. In Ephesians, Paul asserts that, while believers are the church and the bride, Christ is the Bridegroom.

47. The dominant theme of 2 Timothy is Timothy’s departure from the truth which Paul was seeking to correct.

48. The task that Paul gives Titus is to appoint elders and reprove the rebellious.

49. According to Paul in Galatians, the law was also “our guardian” to lead us to Christ.

50. According to Paul in Romans, the presence of the indwelling Holy Spirit has set believers free from the law and the rule of sin and death.

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Running Head: A Changing World 1 A Changing World 3 Assignment 1.1: A Changing World Thesis and Outline

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Running Head: A Changing World 1

A Changing World 3

Assignment 1.1: A Changing World Thesis and Outline

Tristanjay V. Llantada

Strayer University

January 22, 2017

Part 1

The discovery of America as well as the discovery of the passage to the East Indies are two historically significant events that have had a huge and relatively transformative impact on humankind and this is evident in the results or outcome of its two discoveries.

The discovery of America was of great significance due to the role it played in facilitating the growth of industries. Trade was the greatest beneficiary with countries such as Spain, England, Portugal and France trading with America. The surplus that were produced in these European countries found a ready market in the United States. The discovery of East Indies was monumental given that it facilitated the bringing together of two worlds that were far apart, an aspect that further contributed towards the growth of trade and industry.

Part 2

a) Major Aspects of Old and New World exchanges

There are key aspects that characterize exchanges in the old and new worlds and these have facilitated growth and advancement of the global economy. These aspects are;

i) Supplementation of goods; old and new world exchanges involve the transfer of goods and products from one part of the world where they are in surplus to a different part of the world where they are scarce or relatively few.

ii) Trade routes and platforms; while traditional exchanges followed key routes that were distinct, the exchanges in the New World uses strategic technological platforms.

iii) Demand and supply; Old and New World exchanges are influenced and determined by demand with the level or rate in demand being determined by the needs of societies across the globe.

b) Specific Groups affected by Old and New World exchanges

i) Merchants are one of the groups that benefited from the exchanges. Their benefit was mainly financial since they controlled trading activities, mainly buying and selling goods from one place to another.

ii) The consumers were positively affected by Old and New World exchanges and this mainly happened through the meeting of their needs through enhanced access to goods and services that they needed from different parts of the globe.

iii) Governments; administrations benefited in various countries and this was mainly from an economic perspective with economies in areas where Old and New World exchanges thriving immensely.

iv) Suppliers; the suppliers of products and goods that are traded in the Old and New World exchanges are key beneficiaries and the improvement in their quality of living and standards due to increased income is evidence of the benefits.

v) Middlemen; Big businesses and multinationals are major beneficiaries of New World Exchanges and this is because they act as the middlemen between the consumers and sellers, just like middlemen existed in old exchanges. The success of old and new world exchanges is influenced in a big way based on the level of effectiveness of the middlemen.

c) Impact of new global trade routes on occupations and lifestyles of the Average American working in the colonies

i) Lifestyle improvement; There was a positive improvement on the lifestyle for average Americans working in the colonies due to new trade routes since they were able to earn more from the products they worked on.

ii) New opportunities; There was change in occupation with new opportunities in accounting and management as well as in other areas where trading was done, another positive aspect of new global trade routes o average American that worked in the colonies.

iii) Workforce overexploitation; There was an increase in demand of output and performance in terms of working hours and output for Average American workers in colonies to ensure that needed products and goods are available for trade.

iv) Access to a greater diversity of goods; new global trade routes improved the lifestyles of average American workers through enhancing their access to products and goods from new parts of the world. These workers needed these goofs for the purpose of meeting their needs, an aspect that can also be translated as improved lifestyle for these American workers.

v) Enhancement in specialization among American workers; the new routes led to increased specialization among Average American workers. Specialization was critical because it helped enhance the perfection of individuals and suitability to serve in various occupations.

References

Bancroft, G., & Nye, R. (2005). The History of the United States of America from the Discovery of the Continent. U of Chicago P.

Bouët, A. (2008). The Expected Benefits of Trade Liberalization for World Income and Development: Opening the “black Box” of Global Trade Modeling. International Food Policy Research Institute.

Helpman, E. (2011). Understanding Global Trade. Belknap P of Harvard UP.

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The Assignment: Assessing

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The Assignment: Assessing and Treating Clients with Dementia

 

The Alzheimer’s Association defines dementia as “a general term for a decline in mental ability severe enough to interfere with daily life” (Alzheimer’s Association, 2016). This term encompasses dozens of cognitive disorders of impaired memory formation, recall, and communication. The care and treatment of clients with dementia is dependent on multiple factors, including the stage of dementia, comorbidities, family support, and even the care setting. In your role, as the psychiatric mental health nurse practitioner, you must be prepared to not only treat clients with these various cognitive disorders, but also the multiple behavioral issues that often accompany them. For this Assignment, as you examine the client case study in this week’s Learning Resources, consider how you might assess and treat clients presenting with dementia.

 

Examine Case Study: An Elderly Iranian Man w/ Alzheimer’s Disease

 

You will be asked to make three decisions concerning the medication to prescribe to this client. Be sure to consider factors that might impact the client’s pharmacokinetic and pharmacodynamic processes.

At each decision point there will be three decisions. I will choose one out of the three and give the outcome. At each decision point these are the thoughts to ponder:

Decision #1

Which decision did you select?

Why did you select this decision? Support your response with evidence and references to the Learning Resources.

What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.

Explain any difference between what you expected to achieve with Decision #1 and the results of the decision. Why were they different?

Decision #2

Why did you select this decision? Support your response with evidence and references to the Learning Resources.

What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.

Explain any difference between what you expected to achieve with Decision #2 and the results of the decision. Why were they different?

Decision #3

Why did you select this decision? Support your response with evidence and references to the Learning Resources.

What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.

Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different?

***Also include how ethical considerations might impact your treatment plan and communication with clients. ***

Finally: 1. Complete the decision tree (keep track of what you selected. come up with a rational reason why you chose it. Come up with patient specific rational reason behind not choosing the other two options not chosen).

2. Write paper addressing all section listed based on the decision tree.

 

Case Study: An Elderly Iranian Man with Alzheimer’s Disease

 

BACKGROUND

 

Mr. Akkad is a 76 year old Iranian male who is brought to your office by his eldest son for “strange behavior.” Mr. Akkad was seen by his family physician who ruled out any organic basis for Mr. Akkad’s behavior. All laboratory and diagnostic imaging tests (including CT-scan of the head) were normal.

According to his son, he has been demonstrating some strange thoughts and behaviors for the past two years, but things seem to be getting worse. Per the client’s son, the family noticed that Mr. Akkad’s personality began to change a few years ago. He began to lose interest in religious activities with the family and became more “critical” of everyone. They also noticed that things he used to take seriously had become a source of “amusement” and “ridicule.”

Over the course of the past two years, the family has noticed that Mr. Akkad has been forgetting things. His son also reports that sometimes he has difficult “finding the right words” in a conversation and then will shift to an entirely different line of conversation.

 

SUBJECTIVE

 

During the clinical interview, Mr. Akkad is pleasant, cooperative and seems to enjoy speaking with you. You notice some confabulation during various aspects of memory testing, so the PMHNP performs a Mini-Mental State Exam. Mr. Akkad scores 18 out of 30 with primary deficits in orientation, registration, attention & calculation, and recall. The score suggests moderate dementia.

 

MENTAL STATUS EXAM

 

Mr. Akkad is 76 year old Iranian male who is cooperative with today’s clinical interview. His eye contact is poor. Speech is clear, coherent, but tangential at times. He makes no unusual motor movements and demonstrates no tic. Self-reported mood is euthymic. Affect however is restricted. He denies visual or auditory hallucinations. No delusional or paranoid thought processes noted. He is alert and oriented to person, partially oriented to place, but is disoriented to time and event [he reports that he thought he was coming to lunch but “wound up here”- referring to your office, at which point he begins to laugh]. Insight and judgment are impaired. Impulse control is also impaired as evidenced by Mr. Akkad’s standing up during the clinical interview and walking towards the door. When the PMHNP asked where he was going, he stated that he did not know. Mr. Akkad denies suicidal or homicidal ideation.

 

Diagnosis: Major neurocognitive disorder due to Alzheimer’s disease (presumptive)

 

Decisions Made and Outcomes (Needed to formulate the paper) (Must use and formulate paper based off of the chosen decision. Then tell why the other two decision were not a good choice with in-text citations noted for each.)

 

Choices for Decision 1: Select what the PMHNP should do:

  1. Begin Exelon (rivastigmine) 1.5 mg orally BID with an increase to 3 mg orally BID in 2 weeks
  2.  Begin Aricept (donepezil) 5 mg orally at BEDTIME
  3.  Begin Razadyne (galantamine) 4 mg orally BID

 

Decision Choice Chosen: Begin Aricept (donepezil) 5 mg orally at BEDTIME

 

***Explain why other two choice were rejected (not adequate choices)***

 

Outcome: RESULTS OF DECISION POINT ONE:

  • Client returns to clinic in four weeks
  • The client is accompanied by his son who reports that his father is “no better” from this medication
  •  He reports that his father is still disinterested in attending religious services/activities, and continues to exhibit disinhibited behaviors
  • You continue to note confabulation and decide to administer the MMSE again. Mr. Akkad again scores 18 out of 30 with primary deficits in orientation, registration, attention & calculation, and recall

 

Choices for Decision 2: Select what the PMHNP should do:

  1.  Increase Aricept to 10 mg orally at BEDTIME
  2.  Discontinue Aricept and begin Razadyne (galantamine) extended release 24 mg orally daily
  3.  Discontinue Aricept and begin Namenda (memantine) extended release, 28 mg orally daily

 

Decision Choice Chosen: Increase Aricept to 10 mg orally at BEDTIME

 

***Explain why other two choice were rejected (not adequate choices)***

 

Outcome: RESULTS OF DECISION POINT TWO:

  • Client returns to clinic in four weeks
  • Client’s son reports that the client is tolerating the medication well, but is still concerned that his father is no better
  •  He states that his father is attending religious services with the family, which the son and the rest of the family is happy about. He reports that his father is still easily amused by things he once found serious

 

Choices for Decision 3: Decision Point Three Select what the PMHNP should do next:

  1.   Continue Aricept 10 mg orally at BEDTIME
  2.  Increase Aricept to 15 mg orally at BEDTIME x 6 weeks, then increase to 20 mg orally at BEDTIME
  3.  Discontinue Aricept and begin Namenda 5 mg orally daily

 

Decision Choice Chosen: Continue Aricept 10 mg orally at BEDTIME

 

***Explain why other two choice were rejected (not adequate choices)***

 

Outcome: Guidance to Student

 

RESULT FROM CHOOSING TO MAINTAIN CURRENT DOSE OF ARICEPT 10 mg ORALLY AT BEDTIME

Guidance to Student

At this point, it would be prudent for the PMHNP to continue Aricept at 10 mg orally at bedtime. Recall that this medication can take several months before stabilization of deterioration is noted. At this point, the client is attending religious services with the family, which has made the family happy. Disinhibition may improve in a few weeks, or it may not improve at all. This is a counseling point that the PMHNP should review with the son.

There is no evidence that Aricept given at doses greater than 10 mg per day has any therapeutic benefit. It can, however, cause side effects. Increasing to 15 and 20 mg per day would not be appropriate.

There is nothing in the clinical presentation to suggest that the Aricept should be discontinued. Whereas it may be appropriate to add Namenda to the current drug profile, there is no need to discontinue Aricept. In fact, NMDA receptor antagonist therapy is often used with cholinesterase inhibitors in combination therapy to treat Alzheimer’s disease. The key to using both medications is slow titration upward toward therapeutic doses to minimize negative side effects.

Finally, it is important to note that changes in the MMSE should be evaluated over the course of months, not weeks. The absence of change in the MMSE after 4 weeks of treatment should not be a source of concern.

 

***Write on each decision. Make sure that in each decision choice that you explain why the other two decisions were not good choices. Use cited sources to validate points. Make sure that this paper has at least 7 References. Please use in-text citations for each section of each decision. Don’t forget the ethical considerations for this assignment. Make it a section by itself.***

***Also please make sure when looking at the ethical consideration for this assignment that you look at how the Caucasian (male) ethnicity and pain medications interact.***

 

Please use the following format when formulating the paragraphs for each section. Don’t forget the intext citations. Remember to use at least 7 references.

 

Introduction

Decision #1

Reasons for Choosing the Decision (Why is it the best choice out of the 3 choices)

Anticipated Results (of Chosen Decision)

Difference in Results (Anticipated VS Actual)

Decision #2

Reasons for Choosing the Decision (Why is it the best choice out of the 3 choices)

Anticipated Results (of Chosen Decision)

Difference in Results (Anticipated VS Actual)

Decision #3

Reasons for Choosing the Decision (Why is it the best choice out of the 3 choices)

Anticipated Results (of Chosen Decision)

Difference in Results (Anticipated VS Actual)

Ethical Considerations

Conclusion

References

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