Question

1. A couple, married for 65 years, have both become ill with COVID-19. While the husband has smoked for 40 years, he is on a ventilator. His wife, who has no cognitive issues, is mildly ill. The nurse’s instructions are for the wife to go to a unit treating patients suffering mildly from COVID-19. The wife refuses to leave. What is the nurses’ best next action?

   		Listen to how she feels about her life changing situation, then discuss the medical risks of staying. She has legal capacity and autonomy, yet at some point, public health regulations may require her to leave.
   		Wife is in a high risk category, so she is required to follow instructions from the medical team.
   		Call hospital security so that they can safely escort her to the lower risk unit, since she is required to follow public health directives in a publicly-funded hospital.
   		Ask her if she is her husband’s health proxy, the likelihood of his death, and how she plans to continue her life without him.

10 points   

QUESTION 6

1. Could lyme disease be considered either an epidemic, pandemic, or endemic infection?

   		Endemic bacterial infection of Borrelia burgdorferi
   		Endemic infection of a multi-drug resistant bacterial virus
   		Pandemic infection of Yersinia pestis virus
   		Epidemic infection of an enterococcus bacteria

10 points   

QUESTION 7

1. Why has the death rate in Japan been a slowly rising rate, but the Italian death rate has risen swiftly?

   		In Japan, the government put immediate measures in place, while in Italy the government waited until the illness rate had a exponential rise, so the Italian health care system became overwhelmed.
   		In Italy, people are not as densely populated as is the case in Japan, so it may be Japanese genetics which is resisting COVID-19.
   		In Italy, nutrition is not as important as it is in Japan, so Japanese healthy nutrition may be why Japan is not getting ill as quickly as in Italy.
   		In japan, there are younger people compared to Italy, which is why the population did not become rapidly ill, as it has in Italy.

10 points   

QUESTION 8

1. The controversy over the MMR vaccine was caused by a doctor, a medical journal, or an “anti-vaxxer” leader?

   		The controversy surrounding the MMR vaccine was due to a rabbi who told all his religious adherents not to get their children vaccinated
   		There were medical journals, like the Lancet, dispensing faulty medical advice. They were sued by the pharmaceutical company Sanofi, for producing three monovalent vaccines to make more money than was possible with the MMR
   		Andrew Wakefield published a study in a prominent medical journal about 8 pediatric patients suffering from autism after vaccination.   The study had insufficient evidence, there were conflicts of interests and he put millions at risk.
   		Vaccines can be dangerous, since they overstimulate the immune system and cause autoimmune disease.

10 points   

QUESTION 9

1. If the Bubonic Plague is still causing disease around the world, does that mean it is a pandemic, epidemic, or an endemic disease?

   		Once it has become a virulent pandemic as it has killed half of Europe’s population (peaking in 1347-1351) it can re-become virulent, so it remains a pandemic
   		During the late Middle Ages, it had been a pandemic, but for centuries the mortality rate has been low, yet not eradicated. So therefore it has become an endemic.
   		Since the later Middle Ages it is an epidemic since it is only spreading on one continent.
   		Actually, it is an epidemic in India, since overuse of antibiotics is a problem there.

10 points   

QUESTION 10

1. Grandpa Jones, age 55, wanted to buy his Altoprev (lovastatin) 40 mg tabs costing $652 from the pharmacy, which he is used to taking. The pharmacist offered him generic atorvastatin 10mg tabs, costing $68, since his insurance company removed Altoprev from their tiered formulary. Yesterday, he began to have new onset muscle pain. Choose the first response to him the nurse should choose:

   		Direct him to quickly report his new symptoms, since taking this medication, with his Primary Care provider
   		Tell his Insurance company that he felt better with his previous statin brand, and request that they include it in the formulary again.
   		Reassuring him that she will call the insurance company to give them feedback about how it would be important for her patient to have Lovastatin SR 40 tabs reinstated in the formulary.
   		Empathize with this patient’s situation by condemning “Big Pharma” for high prices

Answer 1

●COVID 19 is a highly contagious communicable disease. A person will be always at greater risk if staying with an infected person.The health department in order to stop the chain of infection generally isolates the infected person from others .So that the transmission of infection is broken and prevented.There should be immediate quarentineship between relationship.

As she herself is sick she has to follow the advice of medical professionals to stay out of infection. A person sho is ill means has low immunity thus a high risk case for easy and further infections

She can be escorted if she is adamant to leave asking about proxy will not be helpful here

Ans:Wife is in high risk category, so she has to follow the advice of medical team

Question 6

Lyme disease is caused by Borellia burgdorferi from deer ticks which has the bacteria in spreading the infection. It is found in certain communities or locality so categorized into endemic disease.

Resistant can occur in very rare cases but no multi drug resistant is yet reported

Yersinea pestis can cause plaque once it was a pandemic disease and now it is under control

Enterococcus bacteria are responsible for causing various forms of infection but there are treatment available if taken at right time.

Ans:Endemic bacterial infection of Borrelia burgdorferi

Question 7

The main reason is the delay made by the Italian government in order to get approval and screen the infected and treating earlier

The genetics doesn't plays a role in fighting this COVID 19 infection

Nutrition been an important aspect in both Italisn and in Japanese populations

The older people are more than younger adult in Italy

Ans:In Japan the government put immediate measures in place ,while in Italy the government waited until the illness rate had an exponential rise .So the Italian health system became overwhelmed

Question 8

It was bot the rabbi who told to avoid vaccines

There were certain group of researchers who found that vaccines can cause autism in children

Lancet is a journal which released the news about it and later it was banned

Andrew describes this with 12 autism cases

Vaccines are not dangerous

Ans:There were medical journals like Lancet ,dispensing faulty medical advice