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BIBLIOGRAPHY \l 1033 Test Development: Blueprint and Item WritingLaurie PomellaUniversity of South FloridaJune 25, 2012Test Development: Blueprint and Item WritingThe development of test blueprints and writing of test items are skills necessary to be successful in the academic and staff development role of Nurse Educator. The following test blueprint and test items are intended to demonstrate those skills and include the use of alternative format items as defined by the National Council of State Boards of Nursing (NCSBN). The Bloom’s taxonomy level is included with the multiple-choice items, correct answers are highlighted, and validations from two sources are provided for all test items. ContentLevel of Cognitive SkillChronic Neurologic Problems: HeadachesKCApAnTotalI. Etiology and Pathophysiology of Tension-Type Headache, Migraine Headache, and Cluster Headache112II. Clinical Manifestations and Diagnostic Studies of Tension-Type, Migraine, and Cluster Headache1113III. Abortive/Symptomatic Therapies and the Preventative/Prophylactic Therapies Available for Tension-Type, Migraine, and Cluster Headache1113VI. Implementation of the Nursing Management of Tension-Type, Migraine, and Cluster Headache 112Total332210Bloom et al. taxonomy of cognitive objectives (as cited in Oermann & Gaberson, 2009) are represented by the following key:K = KnowledgeC = ComprehensionAp = ApplicationAn = AnalysisBloom’s Level 1 Knowledge:Identify the etiology of tension-type headaches from the following selections: trigeminal nerve pain.dysfunctional intracranial blood vessels.abnormal neuronal sensitivity and pain facilitation.vacillating cervical muscular contractions.(Boss, 2010, pp. 611; Lewis, Dirksen, Heitkemper, Bucher, & Camera, 2011, pp. 1486; Raskin, 2005, pp. 88)The preliminary diagnosis for your patient, a 32 year-old mother of two, is migraine headaches. You recall that all of the following are clinical manifestations of a migraine headache EXCEPT:Pain around the eye radiating to the temple, forehead, cheek, or noseA headache lasting 4-72 hoursPain that is a steady, throbbing pain that correlates with the pulseAura involving sights, smells, or sounds prior to headache(Boss, pp. 610; Lewis et al., pp. 1486; Raskin, pp. 90)Preventative therapy for cluster headaches includes calcium channel blockers, corticosteroids, serotonin antagonists, and ____________.PsychotherapyTricyclic antidepressants (i.e. Elavil, Pamelor, Sinequan)Selective serotonin reuptake inhibitors (SSRIs) (i.e. Prozac, Paxil)α-Adrenergic blockers (ergotamine tartrate)(Boss, pp. 611; Lewis et al., pp. 1489; Raskin, pp. 93-94)Bloom’s Level 2 Comprehension:The gold standard treatment for moderate to severe migraine headaches is Triptans. With which of the following pre-existing conditions should this class of medication be used cautiously, if at all?Chronic renal failure (CRF)Hypertension (HTN)Coronary artery disease (CAD)Congestive obstructive pulmonary disease (COPD)(Lewis et al., pp. 1489; Sarchielli, Mancini, & Calabresi, 2006, pp. 461)Mrs. Greene returns to the clinic with the following headache diary. Based on this data, Mrs. Greene is most likely suffering from what type of headache?Date 5/12/20125/16/20125/28/20126/2/20126/21/20126/26/2012Severity:Mild, Moderate, or SevereModerate unable to function no bed restMild, able to functionSevere, unable to function, bed rest Severe, unable to function, bed restMild, able to functionMild, able to functionDuration:< 4 hr4-12 hr13–24+ hr8 hours20 hours16 hours18 hours60 hours12 hoursSymptoms of this headacheLight and sound sensitive, nausea, irritable Light sensitiveLight and sound sensitive, nausea, irritableLight and sound sensitive, nausea, irritableLight and sound sensitiveLight and sound sensitiveMedications takenTylenol, aspirinaspirinMaxalt, aspirinMaxalt, aspirinTylenol, aspirinTylenol, aspirinTension-type headacheMigraine headacheCluster headacheMedication over-use headache(Boss, pp. 610; Lewis et al., pp. 1486; Raskin, pp. 90)The nurse recognizes that a patient being discharged from the emergency department understands the teaching given to her when she states,“I can have one glass of red wine with my dinner.”“I can’t wait to go home and eat those hotdogs we bought yesterday.”“I am going to get Chinese take-out on the way home.”“I will have to eat breakfast every day from now on.”(Boss, pp. 609-610; Lewis et al., pp. 1490; Raskin, pp. 91)Bloom’s Level 3 ApplicationA 35 year-old man comes to the emergency room complaining of a severe sharp stabbing headache that has occurred every afternoon for the past four days and lasts for 45 minutes to an hour. Which of the following statements reflects the cause of this patient’s problem?Trigeminal nerve pain and dysfunction of intracranial blood vesselsNeuronal hyperexcitability with onset after pubertyAbnormal neuronal sensitivity and pain facilitationSevere cervical muscular contractions with nerve compression(Boss, pp. 611; Lewis et al., pp. 1486; Raskin, pp. 88)Imitrex has been prescribed to your patient for abortive treatment of her migraine headaches. As her nurse, you can expect tomonitor for increased sedation and lethargymonitor for chest tightness with the first doseencourage an increase in fluid intakemonitor for signs of gastrointestinal bleeding(Lewis et al., pp. 1489; Sarchielli, Mancini, & Calabresi, 2006, pp. 461)Bloom’s Level 4 Analysis Mr. W comes to the office today with complaints of a headache. He states that his pain is a ten out of ten and has been bothering him for two days now after a fall at home. Mr. W states, “This is the worst headache I have ever had in my whole life.” Mr. W is an 82-year-old Hispanic male that is retired from the furniture making business. He quit smoking 20 years ago and does not drink stating, “I can’t drink with the medications I take.” Mr. W has a health history of emphysema, arthritis, hypertension, atrial fibrillation (taking the blood thinner Coumadin), and uses a walker for gait disturbance. He denies vomiting but complains of nausea. Which of the following tests needs to be performed immediately?magnetic resonance angiography (MRA)magnetic resonance imaging (MRI)head computed tomography (CT)electromyography (EMG)(Lewis et al., pp. 1486; Raskin, pp. 86)Miss V comes to the office today with complaints of a headache. She states that her pain is a seven out of ten and has been daily for the past five days. Miss V states, “My whole head is just aching when I get up in the morning.” Miss V is a 16-year-old Native American female student that denies smoking, alcohol, or substance abuse. Her past medical history is positive for migraine headaches that she takes Triptans as needed. She claims her last migraine headache was last week and that the morning headaches are different, making her nauseous and irritable. Her mother and grandmother are migraine sufferers as well. Miss V denies any allergies to medications or foods, exercises daily during sports training after school. She admits to drinking at least two caffeinated beverages a day. As Miss Z’s nurse, which of the following is the best aspect to teach her about her diagnosis?keep a headache diary for three monthsavoid daily exercising until headache free for one monthdo not take Triptans for your migraine headachesbegin positive coping methods for daily stressors(Lewis et al., pp. 1491; Robinson, 1993, pp. 871)Alternative Style Questions- Any nursing topicMultiple ResponseAcute pyelonephritis, an infection of one or both upper urinary tracts, and is common caused by which of the following? Mark all that apply.PregnancyKidney stonesInfrarenal hypertensionVesicoureteral refluxNeurogenic bladderAutoimmune reaction(Fauci et al., 2009, Acute Pyelonephritis; Huether, 2010, pp. 1377)When educating the patient about migraine headaches, which of the following should be included? Mark all that apply. Six times more common in men than women70% of sufferers have a 1st generation relative with migrainesAssociated with seizures, Tourette’s, and ischemic strokeTriggers include alcohol, odors, and nappingMay have an aura including sights, smells, or sounds prior to pain(Fauci et al., 2009, Migraine; Lewis et al., 2011, 1486)Fill in the BlankYour patient has IV fluids infusing at 75 mL/hr, oral intake includes 2 glasses of water, one bowl of broth, and 2 servings of Jello (125 mL each). The biliary drain holds 150 mL, and has been emptied twice on your shift. The urine output has been marginal at 30 mL/hr. What is the total intake/output balance at the end of your 12-hour shift?+ 1210mL (Sparks Network, 2010; Wight Hat Limited, 2012)Chart/Exhibit In the following diagram, label the structures accordingly.Answers- clockwise, beginning with the center top square: arrector pili muscle, epidermis, dermis, subcutaneous tissue, arteriole, nerves, sebaceous gland, hair (Nicol & Huether, 2010, pp. 1644; Stevens, 2005, pp. 740). Hot SpotMark the following diagram with an ‘X’ where the majority of the reabsorption of solutes takes place.(Bergman, Afifi, & Heidger, 2012, para 7; Huether, 2010, pp. 1353)Mark the following diagram with an ‘X’ where the mitral valve is located. (Brashers & McCance, 2010, pp. 1101; New York Presbyterian Hospital, 2008, para. 1)Ordered ResponsePlace the pathway of cardiac blood flow in proper sequence. Aorta Aortic valveLeft atriumLeft ventricleLungsMitral valvePulmonary arteryPulmonary valvePulmonary veinRight atriumRight ventricleSuperior vena cavaTricuspid valve____________________________________________________Answers: L, J, M, K, H, G, E, I, C, F, D, B, A (Alters & Alters, 2006, video; Brashers & McCance, 2010, pp. 1094)AudioIdentify the heart sounds found within the following audio clip. Normal S1 S2S3S4Pansystolic murmurGraphicWhich of the following would be required for a patient on contact isolation? Mark all that apply.(Centers for Disease Control and Prevention, 2010, pp.70; National Library of Medicine, 2012, Transmission-Based Precautions)Which of the following depicts a stage III pressure ulcer?(National Pressure Ulcer Advisory Panel, 2007, Pressure Ulcer Stages; Nicol & Huether, 2010, pp. 1653)ReferencesAlters, S. & Alters, B. (2006). Blood flow through the human heart. In J. Wiley & Sons, Inc. and Sumanas, Inc., Biology: Understanding life (1st ed.) [Electronic version] Retrieved from Bergman, R. A., Afifi, A. K., & Heidger, P. M. (2012). Urinary System. Retrieved from Blue Sparks Network (2010). Volume conversion. Retrieved from Boss, B. J. (2010). Disorders of the central and peripheral nervous systems and the neuromuscular junction. In McCance, K. L., Huether, S. E., Brashers, V. L. & Rote, N. S. (Eds), Pathophysiology: The biologic basis for disease in adults and children (6th ed., pp. 583-645). Maryland Heights, MI: Mosby/Elsevier. Brashers, V. L. & McCance, K. L. (2010). Structure and function of the cardiovascular and lymphatic systems. In McCance, K. L., Huether, S. E., Brashers, V. L. & Rote, N. S. (Eds), Pathophysiology: The biologic basis for disease in adults and children (6th ed., pp. 1091-1141). Maryland Heights, MI: Mosby/Elsevier.Centers for Disease Control and Prevention (2010). 2007 Guideline for isolation precautions: Preventing transmission of infectious agents in healthcare settings. Retrieved from Fauci, A. S., Braunwald, E., Kaspar, D. L., Hauser, S. L., Kongo, D. L., Jameson, J. L., & Loscalzo, J. (2009). Harrison’s manual of medicine, (17th ed.) [Unbound Medicine, Electronic Version]. Huether, S. E. (2010). Alterations of renal and urinary tract function. In McCance, K. L., Huether, S. E., Brashers, V. L. & Rote, N. S. (Eds), Pathophysiology: The biologic basis for disease in adults and children (6th ed., pp. 1365-1401). Maryland Heights, MI: Mosby/Elsevier.Huether, S. E. (2010). Structure and function of the renal and urologic systems. In McCance, K. L., Huether, S. E., Brashers, V. L. & Rote, N. S. (Eds), Pathophysiology: The biologic basis for disease in adults and children (6th ed., pp. 1344-1364). Maryland Heights, MI: Mosby/Elsevier.Lewis, S.L., Dirksen, S.R., Heitkemper, M.M., Bucher, L., & Camera, I.M. (2011). Nursing management: Chronic neurologic problems. In K. Green & J. Horn (Eds.), Medical-surgical nursing: Assessment and management of clinical problems (8th ed., pp. 1485-1492). St. Louis, MO: Elsevier/Mosby.New York Presbyterian Hospital (2008). Heart valve anatomy and function. Retrieved from National Library of Medicine, National Institutes of Health, Medline Plus (2012). Isolation Precautions. Retrieved from National Pressure Ulcer Advisory Panel (2007). Updated staging system. Retrieved from Nicol, N. H. & Huether, S. E. (2010). Structure, function, and disorders of the integument. In McCance, K. L., Huether, S. E., Brashers, V. L. & Rote, N. S. (Eds), Pathophysiology: The biologic basis for disease in adults and children (6th ed., pp. 1644-1679). Maryland Heights, MI: Mosby/Elsevier.Oermann, M. H. & Gaberson, K. B. (2009). Grading. In M. H. Oermann & K. B. Gaberson (Eds.), Evaluation and testing in nursing education (3rd ed., pp. 359-386). New York, NY: Springer Publishing Company.Raskin, N. H. (2005). Headache. In Kasper, D. L., Braunwald, E., Fauci, A. S., Hauser, S. L., Longo, D. L., & Jameson, J. L. (Eds.), Harrison’s principles of internal medicine (16th ed., pp. 85-94). New York, NY: McGraw-Hill.Robinson, R. G. (1993). Pain relief for headaches: Is self-medication a problem? Canadian Family Physician, 39, 867-872. Retrieved from Sarchielli, P., Mancini, M., & Calabresi, P. (2006). Practical considerations for the treatment of elderly patients with migraine. Drugs & Aging, 23(6), 461-489.Stevens, D. L. (2005). Infections of the skin, muscle, and soft tissues. In Kasper, D. L., Braunwald, E., Fauci, A. S., Hauser, S. L., Longo, D. L., & Jameson, J. L. (Eds.), Harrison’s principles of internal medicine (16th ed., pp. 85-94). New York, NY: McGraw-Hill.Wight Hat Limited (2012). U.S. cups to milliliters converter. Retrieved from ................
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