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When designing health science studies analyzing causal contributory factors influencing diseases, researchers carefully select independent, dependent, and intervening variables shaping inquiries answering hypotheses. Two common intervening variables – mediators and moderators – contribute illuminating effects but differ drastically regarding relationships to variables and subsequent data interpretations.

Clearly distinguishing between the mediator and moderator variable functions proves paramount in conducting accurate analyses. Weigh similarities and contrasts between these research roles below to precisely identify proper classifications when scrutinizing statistics pointing toward publishing.

What is Mediation in Research?

Mediator variables demonstrate intermediary effects coaxed by independent variables, ultimately influencing dependent outcomes down the road. Mediators “speak to” independent variable stimuli answering through identifiable sequential actions affecting the final results registered.

For example, in testing, if nursing communication approaches improve patient medication regimen adherence post-discharge, perceived caring levels by patients mediate influencer communications first before projecting later prescription compliance levels tallied (the dependent outcome). So mediator variables help explicate causal chains flowing from initial IV elements. Researchers confirm mediation by isolating these middleman impacts statistically.

What is Moderation in Research?

Moderators alter the strength or direction of relationships between variables by influencing associated correlations through third-factor introductions such as changes in settings, environments, or supplemental interventions integrated additionally.

For instance, when examining medication regimen adherence improvement interventions, patient age acts as a moderation variable because differently aged demographic groups often demonstrate variable intervention effectiveness intensities (young adult males perform worse than elderly women, etc). Thereby, age moderates the intervention–prescription compliance relationship, warranting further subgroup analysis.

Mediation vs moderator variables

Now that isolated definitions establish baseline understandings around respective mediator and moderator variable roles within studies, how else do these research protagonists differ in analytical interpretations and data applications?

Partial or Complete Mediation

Degrees of mediation spread across a spectrum indicating the strength of intermediary impacts at play ranging from no statistical significance to full mediation accounting for entire effects. Analysts assess partial, incomplete, or complete mediation classification gradients according to the proportions of indirect relationships detected between all variables linked.

Strength and Direction of the Effect

Mediator variables only affirm directional relationships flowing from initial independent causes through outcomes down the line. So whether the IV element increases or decreases then so follows the mediating variable upwards or downwards as well. This allows tracing explanatory effect sequences to reveal why certain phenomena manifest.

In contrast, moderator roles reveal no intrinsic directionality or causation clues between variables themselves but rather apply third-element influences revealing “when or for whom” variabilities emerge between associations tracked. Moderators introduce conditional situations exposing alternative independent and dependent variable interplay intensities.

Mediation Analysis

Proving mediation requires meeting a three-pronged test satisfying:

1. Significant correlation between IV & mediator
2. Significant correlation between mediator & DV
3. Reduced IV & DV relationship after factoring mediator influence.

Researchers lean on regression analysis calculations determining mediation variable impacts if the above associative analysis thresholds reached confirming sequence suspicions.

Moderation Analysis

Demonstrating moderation also utilizes regression approaches, inserting interaction elements combining moderator factors with independent variables initially correlated with outcomes. Resulting strength fluctuations indicate moderation evidence when calculating dependent variable prediction capacities improved or degraded by inserting moderator contributors.

So while both mediator and moderator research roles shape analytical evaluations through supplemental augmentation effects, directionality deductions and spectrum of influences markedly differ. Now onto the application!

Mediator vs. Moderator Examples

Mediator demonstrations: Perceived nurse caring mediates communications influencing patient health information comprehension as an intermediary motivator stimulating knowledge retention efforts.

Moderator demonstrations: Patient gender moderated effects of customized health teaching efficacy revealing males struggled to retain sodium diet details, unlike females in heart failure clinics.

Their mediator transmits communicator vehicle impacts, eventually driving knowledge improvements downstream. Meanwhile, gender activates group variability between intervention method productivity revealing customization proves less universally effective pending audience analyses.

FAQs on Mediation and Moderation Analyses

What is the difference between a confounder and a mediator?

Confounding variables skew connections between independent and dependent variables through unintended third-party relationships, while mediators emerge intentionally from IV origins, sequentially impacting eventual effects purposefully.

Is a mediator an IV or DV?

Mediators classified intermediary variables transmitting entirely new secondary effects stemming from initial independent variables further down the line before reaching terminal dependent outcomes.

How can you tell if a variable is a mediator?

Suspected mediator variables demonstrate multiple correlation associations sequentially aligning first with independent origins and eventual endpoint results weighted through regression calculations confirming proportionate causation contributors flowing through hypothesized sequences.

What is an example of moderation?

Moderator examples include demographic factors like patient age or gender stratifying intervention effectiveness intensities on outcome measures based on subgroup variabilities responding differently to integrated treatments.

Can a variable be both moderating and mediating?

No, because a mediator must transmit effects unidirectionally stemming from earlier elements, while moderators merely multiply the intensities of existing connections rather than propagating new intermediary impacts.

Is a moderator variable a confounder?

No, moderators enter analyses intentionally as designated contributors upholding explanatory powers, unlike unpredictable confounding interlopers skewing links through inadvertent overlapping effects. Think purposeful versus preventable!

How do you identify a moderating variable in research?

Suspected moderating variables require demonstrating interaction effects strengthening or dampening existing correlations between predictors and outcomes after deliberately inserting a third supplemental factor during controlled evaluations, quantifying any fluctuating impact intensities.

What is a mediator relationship?

A mediator demonstrates intermediate interceding effects originating from preceding independent causes, ultimately projecting downstream impacts on terminal dependent outcome measures situated sequentially.

What is a moderator relationship?

A moderator reveals conditional situations where intruding secondary elements alter the strengths or directions of primary correlations between predictor and outcome variables interjecting across initial associations.

Can a mediator be a moderator?

No, because mediators transmit singular directionality effects stemming from earlier independent origins, while moderators merely multiply the intensities of existing connections rather than producing any new intermediary impacts en route to final targets.

Mental Status Assessment Sample Paper

Introduction

A mental health assessment is a critical part in the determination of the existence of a mental health complication, as well as in the establishment of the appropriate treatment methods. Some of the main components of a mental health assessment include a physical examination, laboratory tests, psychiatric history and a personal history of the patient (Patel & Singh, 2018). It is also critical to assess the patient’s appearance and general conduct, consciousness levels and attention span, mood and affect, speech, insight and higher cognitive functions. In this paper, I shall discus the risk assessment and diagnostic features of a mental health assessment.

Importance of a Therapeutic Relationship

A therapeutic relationship, also known as a therapeutic alliance, refers to the close and continuous association existing between a health care practitioner and an individual undergoing therapy. Further, as Torous and Hsin (2018) notes, therapeutic relationship aids in the betterment of a person’s life as it forms the basis of a safe space where an individual share his or her intimate thoughts, beliefs and emotions triggered by various circumstances in life. It is also critical in determining factors that may exacerbate an individual’s mental condition.

It is very important that the health care professional provides a safe, open and non-judgemental environment where the patient seeking therapy can feel at ease and open up to the therapist. Trust and respect are some of the vital components of an effective therapeutic relationship. The therapist must also demonstrate a sense of empathy towards his patients. There is need to establish boundaries by both parties as they help in defining acceptable and non-acceptable behaviours.

A good therapeutic relationship is one of the key steps towards recovery of the patient. One of the main components of a productive therapeutic relationship is trust. The patient must trust that his or her health care provider is competent and possesses the appropriate knowledge and know how to provide appropriate care. The patient must also be confident and trust that his or her therapist will remain professional and confidential consequently protecting the patient from harm and exploitation.

The establishment of a good therapeutic relationship leads to the establishment of a platform where the patient feels more at ease and easily opens up. The patient readily shares her concerns, a factor that enables the therapist to understand the patient’s feelings, thoughts and motives (Gopalkrishnan, 2018). Ideally, this aids in the determination of the patient’s condition and enables the therapist to initiate the most effective treatment options and other key strategies so as to effectively address the person’s concerns.

A good therapeutic relationship provides an avenue where the patient opens up to the therapist. The therapist is therefore able to comprehend the patient’s social and economic status, past psychiatric history, current medications and prevailing situations in the patient’s life. Comprehension of these various parameters is critical in the establishment of various factors that may be exacerbating the patient’s current mental health condition.

Importance of a Mental Status Examination

            A Mental Status Examination (MSE) is a well-structured assessment of an individual’s behavioural and cognitive functions. It examines the patient’s appearance and behaviour in general, concentration and attention levels, mood and affect; determining whether they are congruent or not, thought process and perception, insight and the patient’s higher functions; which include memory, orientation, intelligence and abstract thinking (Tarafder & Mukhopadhyay, 2018).

An accurately done mental status examination aids in eliciting signs and symptoms of obvious mental conditions and allows for determination of risk factors associated with various mental illnesses. According to Farooq et al. (2020), the mental status examination enables the observation and assessment of an individual’s current mental state. It also provides vital information that is applicable in the diagnosis of a disorder, prognosis determination and assessment of the response towards treatment and management. The Mental Status Examination is a vital assessment tool that aids health care professionals in differentiating various neurologic and psychiatric disorders.

Risk Assessment in MSE

            The Mental Status Examination gives an insight into a patient’s emotions, thought process and behavioural patterns at the time of the assessment. This helps in the determination of the presence of a mental health condition and points out the severity of the present condition. It also highlights the level of risk or exposure to risk factors that a patient poses to himself or herself, or to others in the immediate environment.

Risk assessment aims at identifying hazards and risk factors predisposing one to possible harm. It also aims at analysing and evaluating the risks commonly associated with the various hazards (Graney et al., 2020). The final aim is the elimination of the hazard or reduction in the level of risk in situations where it is impossible to eliminate the hazard. Assessment of the level and intent of risk is very important in psychiatric patients.

Assessment and management of the intent of risk of harm causation to self or to others in the society is very vital. It is important to note that cases exist where it is impossible to eliminate risk. However, even in such cases, it is possible to thoroughly assess and manage the level of risk with better patient outcomes. A history of violent conduct or posing a threat to other people is critical. A clear communication of the outcome of both the assessment and management of the risk is critical.

One of the major risks that a psychiatric patient poses to himself or herself is suicide. While conducting a mental status examination, the therapist takes note of the patient’s appearance, behaviour, speech, mood, thoughts, perceptions, cognition and level of insight (Chunduri et al., 2020). All these components are essential in determining the level of suicide risk that the patient poses. During assessment of the patient’s risk of suicide, it is important to consider the individual patient factors and other situational factors that increase the risk of suicide.

Factors greatly predisposing one to increased risk of suicide include gender, often with males at a greater risk. Others include extremes of age, lack of a reliable support structure, prior suicide attempts, and a family history of suicide and possible triggers. The number and severity of psychiatric symptoms, presence of hallucinations and the use of alcohol and other drugs of abuse greatly increase the risk. The mental status examination allows the determination of these factors and consequently allows for ease of assessment and management.

Importance of Physical Assessment

            Diagnostic overshadowing is harmful to patients as it denies them their right of receiving an appropriate diagnosis and consequently timely treatment. The practitioner can thus minimize or eliminate diagnostic overshadowing by being respectful and retaining confidentiality, ensuring that communication is directly with the patient and paying attention to non-verbal cues and signs (Geiss et al., 2018). In mental health, diagnostic overshadowing refers to a situation where an individual with a mental health condition receives delayed or non-standard treatment resulting from incorrect attribution of their physical symptoms.

A physical examination is a routine test performed by a health care practitioner to assess the overall health of a patient. It also provides an avenue to highlight the patient’s signs and symptoms and allows the health care practitioner to address any health concerns that the patient may have. Various additional tests can be conducted during the physical examination dependent on the patient’s age, medical and family history. There is need for routine physical examinations, at least once a year for routine checks with the goal of determining any conditions or diseases that may be treatable when diagnosed early.

A thorough physical examination helps in reducing diagnostic overshadowing as the health care practitioner can clearly identify signs and symptoms displayed by the patient at the time of the assessment. This ensures that the primary care provider does not downplay any signs and symptoms presented since they are clear from the examination done. It is clear to the health care practitioner that the patient is not exaggerating his condition. This facilitates early diagnosis of the condition and consequently timely and standard initiation of appropriate treatment. This ensures general positive outcomes.

Conclusion

As broached in this paper, a mental status examination is important in the establishment of diagnosis and the initiation of management. A thorough mental status examination enables the health care practitioner to have a good assessment of the patient’s psychological status. Psychiatric patients pose a great risk to themselves and to others in the society, and as such, assessment of level and intent of risk is critical while conducting a mental status examination.

Diagnostic overshadowing is a common occurrence with health care givers downplaying patient’s presentation resulting in delayed diagnosis and administration of inadequate treatment. A thorough physical examination by a health care practitioner is therefore very vital in reducing and eliminating diagnostic overshadowing. Additionally, this ensures timely diagnosis and treatment initiation resulting in positive health outcomes.

References

• Chunduri, S., Browne, S., Pollio, D. E., Hong, B. A., Roy, W., Roaten, K., & North, C. S. (2019). Suicide risk assessment and management in the psychiatry emergency service: psychiatric provider experience and perceptions. Archives of Suicide Research, 23(1), 1-14. https://doi.org/10.1080/13811118.2017.1414648
• Farooq, S., Tharani, A., Begum, S., & Parpio, Y. (2020). Implementation of Simulation: A Contemporary Strategy to Enhance Clinical Skills of Undergraduate Students in Mental Health Nursing. Issues In Mental Health Nursing, 41(8), 736-740. https://doi.org/10.1080/01612840.2019.1710011
• Geiss, M., Chamberlain, J., Weaver, T., McCormick, C., Raufer, A., Scoggins, L., & Edmonson, D. (2018). Diagnostic overshadowing of the psychiatric population in the emergency department: physiological factors identified for an early warning system. Journal of the American Psychiatric Nurses Association, 24(4), 327-331. https://doi.org/10.1177/1078390317728775
• Graney, J., Hunt, I. M., Quinlivan, L., Rodway, C., Turnbull, P., Gianatsi, M., & Kapur, N. (2020). Suicide risk assessment in UK mental health services: a national mixed-methods study. The Lancet Psychiatry, 7(12), 1046-1053. https://doi.org/10.1016/s2215-0366(20)30381-3
• Gopalkrishnan, N. (2018). Cultural diversity and mental health: Considerations for policy and practice. Frontiers In Public Health, 6, 179. https://doi.org/10.3389/fpubh.2018.00179
• Patel, R. M., & Singh, U. S. (2018). Prevalence study of cognitive impairment and its associated sociodemographic variables using mini-mental status examination among elderly population residing in field practice areas of a medical college. Indian journal of community medicine: official publication of Indian Association of Preventive & Social Medicine, 43(2), 113-116. https://dx.doi.org/10.4103%2Fijcm.IJCM_102_17
• Tarafder, S., & Mukhopadhyay, P. (2018). History Taking, Mental Status Examination and Assessment. Obsessive Compulsive Disorder: A Neuropsychological Approach, 62-82. http://dx.doi.org/10.4135/9789353280765.n3
• Torous, J., & Hsin, H. (2018). Empowering the digital therapeutic relationship: virtual clinics for digital health interventions. NPJ Digital Medicine, 1(1), 1-3. https://doi.org/10.1038/s41746-018-0028-2

MHAFP5032 Policy and Pharmaceutical Regulation Presentation

MHAFP5032 Policy and Pharmaceutical Regulation Presentation

Use the Capella University Library and the Internet to prepare for this assessment. Include the following activities as part of your preparation:

• In addition to reading the suggested articles listed in the Resources, perform a Web search for “oral testimony tips” to compare and contrast suggestions from more than one type of advocacy group.
• Visit the Archives and view three or four recorded oral testimonies.

POWERPOINT PRESENTATION

Condense your written testimony into a 5-minute-long recorded oral presentation. Create a 3–5-slide PowerPoint to present a structure to guide your recording. Follow this structure for your presentation:

• Introductory remarks: Includes acknowledgement of committee chair and members, your credentials as the person preparing the testimony, and the organization you are representing.
• Background: Brief statement regarding justification for the proposed policy.
• Specific aspect of the issue: Summarize key points of the desired outcomes from the proposed policy with cited references. Provide a summary of current interventions for your specific issue and why additional action is needed.
• Recommendations: Provide specific recommendations for the committee and those being implemented by the special interest group.
• Concluding statement: One or two sentences summarizing why the committee should consider your proposed policy.
• Closing: Thank the committee for the opportunity and note your availability for additional discussion or questions.

ADDITIONAL REQUIREMENTS for MHAFP5032 Policy and Pharmaceutical Regulation Presentation

• Number of slides: Approximately 3–5 (length should correspond with, and not exceed, content that would amount to five minutes of oral testimony).
• Slide design: Use the notes section for your speaker notes. The slide design must meet the expectations of a professional presentation (bullet points, large font size, plenty of white space).
• Oral communication: Use persuasive oral presentation techniques such as staying on topic, integrating your slides with your presentation, and staying within the time allotment.

This is what needs to be on the PowerPoint Presentation:

MHAFP5032 Policy and Pharmaceutical Regulation Presentation Introduction

A special acknowledgement the committee chairperson who happens to be the president and founder of Patients for Affordable Drugs, I also acknowledge the members of the committee who are boards members of the organization. This testimony has been prepared by the director of Patients for Affordable Drugs.

MHAFP5032 Policy and Pharmaceutical Regulation Presentation Background

Processes followed by pharmaceutical companies in the US are not made known to the public, and the patients have been at a disadvantage owing to the skyrocketed prices. The current pricing policy I place makes an allowance for the manufactures as there are no strict regulations that dictate the way pricing decisions are made.

In addition, brand-named products are facing no significant competition in the market, owing to the stringent approval policies of generic drugs. As of now, the FDA has in place a rigorous metric array which gauges the standards and market-worthiness of any generic drugs.

Moreover, the approval process takes time that is if a generic drug will be accepted by the FDA. All these factors bars competition in the market hence the continuous increase of drug prices in the country. The desired health policy change is centered on loosening the strictness of the FDA in terms of the generic drugs approval process.

Realizing this change will mean that new generic drugs will be easily approved, though complying with all required standards. Competition in the market will be stirred as patients will have alternatives to highly priced brand-name drugs. In response, pharmaceutical companies will be forced to standardize their drugs prices to remain competitive in the market.

MHAFP5032 Policy and Pharmaceutical Regulation Presentation: Specific Aspect of the Issue

The rigorous review process used by the FDA makes it difficult for new generic drug entrants to be approved. Patents also give pharmaceutical companies market exclusivity for a considerable period, a period in which these companies take advantage and come up with outrageous prices considering they have zero competition.

A specific aspect to be zoomed in and addressed is the FDA’s process of reviewing generic drugs applications. The FDA ought to review its policies with respect to reviewing generic drugs but must also ensure integrity and quality of these products. It comes down to developing efficiency of this process.

Reducing the time taken for a generic product to be approved and reducing the market exclusivity period given to brand name drugs.

Though the exclusivity time given to these drugs is attributed to the intensive investment made by the pharmaceutical company over a long period of time so as to manufacture the drug, it is integral to consider that the government partly or fully finances medical research, and the development of new drugs is at times courtesy of the taxpayers money.

On this account, pharmaceutical companies whose researches on drugs were financed by the government ought not to be given a long exclusivity period, but rather, the drugs ought to be sold to the public at low rates.

In any case the price remains to be substantially high, the FDA should embrace leniency in reviewing generic products that are to the required standard.

MHAFP5032 Policy and Pharmaceutical Regulation Presentation: Current programs and Outcomes

In the recent past, other interest groups have been advocating for reduced prescription drug prices in the country.

For example, earlier in the year, some of the states embraced change in policies that now require pharmaceutical companies to be transparent to the government and the public regarding their drug pricing process.

Some of the states that first approved this legislation are Connecticut and Maryland. In the state of Connecticut, an interest group by the name Universal Health Care Foundation of Connecticut was pivotal in creating advocacy for the transparency legislation.

As a result, insures are required to give reports to the state insurance department, elaborating on drugs prices through insure rate review procedure.

In Maryland, Maryland Citizen’s Health Initiative significantly contributed to the approval of the transparency policy whereby pharmaceutical companies are to elaborate the rationale for list prices of drugs.

Outcomes associated with the approval of these legislations are promising, as this has brought a sense of pharmaceutical companies being accountable to the state governments and the general public, getting rid of the opacity of the pricing process.

In the long run, unreasonable drug prices will be challenged if the rationale behind pricing process is not justifiable. A decrease in drug prices, on account of these new policies, is anticipated, making it easier for patients to access quality prescription drugs.

MHAFP5032 Policy and Pharmaceutical Regulation Presentation Recommendations

To further moderate prescription drug prices, the FDA should accelerate its generic drugs approval process so that new entrants can easily create competition in the drug market. The authority also ought to set up regulatory measures to regulate pricing of drugs depending on the authenticity of pricing rationale given by the manufactures.

Policymakers both at the state and federal levels should give ear to interest groups, constantly review policies governing health care products and services to ensure quality, service delivery and affordability of these products as offered to the general public.

A title page is often the first page a reader will see when looking at your research paper, essay, or other academic work. In MLA style formatting, which is used for many humanities and liberal arts subjects, the title page includes important information to identify the paper.

Creating a proper MLA format title page is simple once you know what elements to include. This guide will cover everything you need to make a title page that meets MLA guidelines. Let’s get started!

When to Use an MLA Title Page

The Modern Language Association provides flexible guidelines when it comes to title pages. An MLA title page is not required for most student papers. So when should you create one?

Use a separate MLA format title page in these situations:

• Your instructor explicitly asks you to include a title page – Always follow your teacher’s specific requirements for an assignment. If they request a title page, you need to include it.
• You are writing a lengthy, formal research paper – Title pages are strongly recommended for papers of 10+ pages that involve extensive research and citation.
• Your paper includes many references or source types – The title page establishes you as the authoritative author and distinguishes your unique ideas from the works cited page material.
• You are collaborating on a group project – The title page makes it clear who created the content when there are multiple student authors.
• Your work is being submitted for publication– Title pages are standard practice for manuscript submissions to journals, conferences, publishers, etc.

For most basic student essays and papers up to 10 pages, MLA states a title page is not strictly necessary. However, your instructor may still request one, even for shorter papers.

For nursing students, you will likely need to create title pages for lengthy research papers analyzing topics like nursing practices, medical procedures, patient case studies, and dissertations. Establishing your authorship is crucial for scholarly nursing papers.

What Goes in an MLA Format Title Page

A proper MLA paper title page should include the following core elements:

• Title of the paper
• Your full name
• Name of your school/institution
• Due date of the assignment

Additionally, you may be asked to include:

• Instructor name
• Course name and number
• Any other info the instructor requires

Here are the key facts about what each item on your title page should look like and where it should be positioned:

Title of the Paper

• Centered horizontally and vertically about 1/3 down the page
• Written in title case capitalization (major words capitalized)
• Does NOT use bold, italics, underlining, or quotation marks

Your Name

• On the next line below the title, centered
• Your full name without titles like Ms., Mrs., Dr., etc.

Name of School/Institution

• On the line after your name, centered
• The full official name of your university, college, high school, etc.

Due Date

• On the line following the school name, right aligned or right justified
• Written in this format: Month, Day, Year (e.g., March 14, 2023)

Instructor Name, Course Info, or Other Details

• Centered below the school name
• Include any extra info your instructor requires on the title page

For a nursing student, this might look like:

Improving Medication Administration Safety in Nursing Practice

Mary Watson

University of Michigan School of Nursing

April 30, 2023

NURS 365: Nursing Research Professor Angela Green

This title page includes the core 4 elements plus the extra course details per the instructor’s guidelines.

MLA Title Page Formatting Guidelines

To ensure your title page meets MLA standards, follow these important formatting guidelines:

• 1-inch margins all around the page
• 12 pt. Times New Roman font for all text
• Double-spaced text throughout the page
• The first letter of major words capitalized in the title
• Page number 1 in the top right corner of the page
• Header with your last name and page number on all pages after page 1

Setting 1-inch margins and the Times New Roman 12-point font is essential for MLA compliance. Double spacing every line creates consistent readability.

Capitalizing the first letter of important words in the title is standard title case format. And numbering the title page gives readers context right away that this is the first page of your project.

Finally, including the header with your last name and page number on all pages following the title establishes you as the paper’s author in MLA style.

Title Page vs. MLA Heading on the First Page of Your Paper

Instead of making a completely separate title page, MLA also allows writers to include a heading with title page elements at the very top of page 1.

This first-page heading contains the same information that would appear on a title page, but it’s included above the opening paragraph instead of on its own page.

Here’s an overview of the key differences between the two approaches:

Title PageFirst Page HeadingAppears alone on a dedicated page before page 1Appears at the very top of page 1 above the first paragraphIncludes ONLY the title, author name, organization, and due dateIncludes title, name, organization, date, course name, instructor name, etc.

Unless your professor requests a title page, using a heading on page 1 is the preferred method. It’s simpler for papers that don’t need a standalone title page.

To create an MLA-style first-page heading:

• Center the title on line 1 and apply title case capitalization
• On line 2, center your full name
• On line 3, center your school/organization
• On line 4, right align the due date
• Include any other required info like course, instructor, etc., centered under the organization name

How to Create an MLA Title Page on MS Word

Making a properly formatted title page only takes a few minutes. Follow these steps:

1. Open a new blank Word document and set 1-inch page margins
2. Click the “Insert” tab and go to Page Number > Top of Page > Plain Number 1
3. Hit enter 8-12 times to move the cursor down about 1/3 of the page
4. Type the title centered in bold and title case. Hit enter twice.
5. Type your name centered. Hit enter twice again.
6. Type your school/organization centered. Hit enter once.
7. In the bottom right corner, insert the due date right aligned.
8. Make all text double-spaced. Click after the due date and insert a page break.

This will create a correctly formatted MLA title page like this nursing example:

Reducing Medication Errors Through Barcode Scanning

Jane Lee

Seton Hall University

May 5, 2023

The title is about one-third down, the name and organization are centered, and the due date is right aligned – all with proper spacing and fonts per MLA.

You can quickly customize this for other information your instructor requires. It takes just minutes but makes a huge difference in presenting your paper professionally.

MLA Header and Title Page Examples

Seeing properly formatted sample title pages is helpful for visualizing how all the elements come together.

Here are two examples of MLA title pages made correctly in Word:

Example 1: Title Page with Just Core Elements

Preventing Childhood Obesity Through Nutrition Education

Samantha Jones

Forest Hills High School

September 16, 2023

This title page contains just the required four elements – original title, author name, affiliated school, and due date. The student did not need to include any extra information.

Example 2: Title Page with Instructor Details

The Importance of Vaccinations for Public Health

Jane Anderson

Duke University School of Medicine

Nursing 682: Healthcare Policy & Ethics Professor Taylor

October 28, 2023

For this title page, the nursing student needed to add the specific course name, number, and professor per the instructor’s guidelines. This additional info is centered below the school name.

Once your cover page is complete, simply start page 2 with the proper MLA header and dive into the body of your paper.

How to Create an MLA Title Page on Google Docs

Making an MLA cover page is just as simple on Google Docs as Word. Follow these steps:

1. Open a new Google Doc and set 1-inch margins under File > Page setup
2. Click Insert > Page numbers > Top of the page and select 1
3. Press enter 8-12 times to move the cursor down the page
4. Type the title centered and in the title case. Bold it. Hit enter twice.
5. Type your name centered. Hit enter twice again.
6. Type your school/organization centered. Hit enter once.
7. In the bottom right corner, insert the due date right aligned.
8. Double-space all text. Insert a page break after the due date.

This will generate a correctly formatted title page. You can adjust it easily for any additional details. Then start page 2 with the proper MLA header using Insert > Header.

Should I include a title in an MLA format paper?

Yes, MLA papers require a title, even if you don’t use a separate title page. Simply place the title centered at the top of page 1 above the opening paragraph.

Should the MLA title page be double-spaced?

Double-space all text on your MLA title page – the title, your name, organization, due date, and any other info should be double-spaced.

Should the MLA Style title page be numbered?

Yes, number the title page as page 1 per official MLA guidelines. Place the page number in the top right corner.

Where should the MLA cover page be placed within the paper?

The title page should be the very first page of your paper. After the title page, include your last name and page number 2 in the header, then begin the introduction.

What goes in the MLA title page?

The title, your name, school/organization, and due date are required. You may need to add your course name, instructor name, or other details requested.

MN 551 Exam Questions and Answers

Question

1. A nurse practitioner is providing care for several patients on a medical unit of a hospital. In which of the following patient situations would the nurse practitioner be most likely to rule out hypertension as a contributing factor? (Points : 0.4)

A 61-year-old man who has a heart valve infection and recurrent fever
An 81-year-old woman who has had an ischemic stroke and has consequent one-sided weakness
A 44-year-old man awaiting a kidney transplant who requires hemodialysis three times per week
A 66-year-old woman with poorly controlled angina and consequent limited activity tolerance

 

Question 2.2. An older adult female patient has presented with a new onset of shortness of breath, and the patient’s nurse practitioner has ordered measurement of her BNP levels along with other diagnostic tests. What is the most accurate rationale for the nurse practitioner’s choice of blood work? (Points : 0.4)

BNP is released as a compensatory mechanism during heart failure and measuring it can help differentiate the patient’s dyspnea from a respiratory pathology.
BNP is an indirect indicator of the effectiveness of the RAA system in compensating for heart failure.
BNP levels correlate with the patient’s risk of developing cognitive deficits secondary to heart failure and consequent brain hypoxia.
BNP becomes elevated in cases of cardiac asthma, Cheyne-Stokes respirations, and acute pulmonary edema, and measurement can gauge the severity of pulmonary effects.

 

Question 3.3. An 81-year-old male resident of a long-term care facility has a long-standing diagnosis of heart failure. Which of the following short-term and longer-term compensatory mechanisms is least likely to decrease the symptoms of his heart failure? (Points : 0.4)

An increase in preload via the Frank-Starling mechanism
Sympathetic stimulation and increased serum levels of epinephrine and norepinephrine
Activation of the renin-angiotensin-aldosterone (RAA) system and secretion of brain natriuretic peptide (BNP)
AV node pacemaking activity and vagal nerve suppression

 

Question 4.4. A patient is experiencing impaired circulation secondary to increased systemic arterial pressure. Which of the following statements is the most relevant phenomenon? (Points : 0.4)

Increased preload due to vascular resistance
High afterload because of backpressure against the left ventricle
Impaired contractility due to aortic resistance
Systolic impairment because of arterial stenosis

 

Question 5.5. During a routine physical examination of a 66-year-old woman, her nurse practitioner notes a pulsating abdominal mass and refers the woman for further treatment. The nurse practitioner is explaining the diagnosis to the patient, who is unfamiliar with aneurysms. Which of the following aspects of the pathophysiology of aneurysms would underlie the explanation the nurse provides?(Points : 0.4)

Aneurysms are commonly a result of poorly controlled diabetes mellitus.
Hypertension is a frequent modifiable contributor to aneurysms.
Individuals with an aneurysm are normally asymptomatic until the aneurysm ruptures.
Aneurysms can normally be resolved with lifestyle and diet modifications.

 

Question 6.6. A 31-year-old woman with a congenital heart defect reports episodes of lightheadedness and syncope, with occasional palpitations. A resting electrocardiogram reveals sinus bradycardia and she is suspected of having sick sinus syndrome. Which of the following diagnostic methods is the best choice to investigate the suspicion? (Points : 0.4)

Signal-averaged ECG
Exercise stress testing
Electrophysiologic study
Holter monitoring

 

Question 7.7. A physical assessment of a 28-year-old female patient indicates that her blood pressure in her legs is lower than that in her arms and that her brachial pulse is weaker in her left arm than in her right. In addition, her femoral pulses are weak bilaterally. Which of the following possibilities would her care provider be most likely to suspect? (Points : 0.4)

Pheochromocytoma
Essential hypertension
Coarctation of the aorta
An adrenocortical disorder

 

Question 8.8. A 70-year-old male patient presents to the emergency department complaining of pain in his calf that is exacerbated when he walks. His pedal and popliteal pulses are faintly palpable and his leg distal to the pain is noticeably reddened. What would his care provider’s preliminary diagnosis and anticipated treatment most likely be? (Points : 0.4)

Acute arterial occlusion that will be treated with angioplasty
Raynaud disease that will require antiplatelet medications
Atherosclerotic occlusive disease necessitating thrombolytic therapy
Giant cell temporal arteritis that will be treated with corticosteroids

 

Question 9.9. A 55-year-old male who is beginning to take a statin drug for his hypercholesterolemia is discussing cholesterol and its role in health and illness with his nurse practitioner. Which of the following aspects of hyperlipidemia would the nurse practitioner most likely take into account when teaching the patient? (Points : 0.4)

Hyperlipidemia is a consequence of diet and lifestyle rather than genetics.
HDL cholesterol is often characterized as being beneficial to health.
Cholesterol is a metabolic waste product that the liver is responsible for clearing.
The goal of medical treatment is to eliminate cholesterol from the vascular system.

 

Question 10.10. A 22-year-old male is experiencing hypovolemic shock following a fight in which his carotid artery was cut with a broken bottle. What immediate treatments are likely to most benefit the man? (Points : 0.4)

Resolution of compensatory pulmonary edema and heart arrhythmias
Infusion of vasodilators to foster perfusion and inotropes to improve heart contractility
Infusion of normal saline of Ringer lactate to maintain the vascular space
Administration of oxygen and epinephrine to promote perfusion

 

Question 11.11. A 68-year-old male complains to his nurse practitioner that when he tests his blood pressure using a machine at his pharmacy, his heart rate is nearly always very low. At other times, he feels that his heart is racing, and it also seems to pause at times. The man has also occasionally had lightheadedness and a recent syncopal episode. What is this patient’s most likely diagnosis and the phenomenon underlying it? (Points : 0.4)

Sick sinus syndrome as a result of a disease of his sinus node and atrial or junctional arrhythmias
Ventricular arrhythmia as a result of alternating vagal and sympathetic stimulation
Torsades de pointes as a result of disease of the bundle of His
Premature atrial contractions that vacillate between tachycardic and bradycardic episodes as a consequence of an infectious process

 

Question 12.12. A 54-year-old man with a long-standing diagnosis of essential hypertension is meeting with his nurse practitioner. The patient’s nurse practitioner would anticipate that which of the following phenomena is most likely occurring? (Points : 0.4)

The patient’s juxtaglomerular cells are releasing aldosterone as a result of sympathetic stimulation.
Epinephrine from his adrenal gland is initiating the renin-angiotensin-aldosterone system.
Vasopressin is exerting an effect on his chemoreceptors and baroreceptors, resulting in vasoconstriction.
The conversion of angiotensin I to angiotensin II in his lungs causes increases in blood pressure and sodium reabsorption.

 

Question 13.13. A patient has suffered damage to his pericardium following a motor vehicle accident. Which of the following consequences should the nurse practitioner be most likely to rule out? (Points : 0.4)

Impaired physical restraint of the left ventricule

Increased friction during the contraction/relaxation cycle
Reduced protection from infectious organisms
Impaired regulation of myocardial contraction

 

Question 14.14. An 81-year-old female patient of a long-term care facility has a history of congestive heart failure. The nurse practitioner caring for the patient has positioned her sitting up at an angle in bed and is observing her jugular venous distention. Why is jugular venous distention a useful indicator for the assessment of the patient’s condition? (Points : 0.4)

Increased cardiac demand causes engorgement of systemic blood vessels, of which the jugular vein is one of the largest.
Blood backs up into the jugular vein because there are no valves at the point of entry into the heart.
Peripheral dilation is associated with decreased stroke volume and ejection fraction.
Heart valves are not capable of preventing backflow in cases of atrial congestion.

 

Question 15.15. A formerly normotensive woman, pregnant for the first time, develops hypertension and headaches at 26 weeks’ gestation. Her blood pressure is 154/110 mm Hg and she has proteinuria. What other labs should be ordered for her? (Points : 0.4)

Plasma angiotensin I and II and renin
Urinary sodium and potassium
Platelet count, serum creatinine, and liver enzymes
Urinary catecholamines and metabolites

 

Question 16.16. A 6-year-old boy has been brought to the emergency department by ambulance after his mother discovered that his heart rate was “so fast I couldn’t even count it.” The child was determined to be in atrial flutter and his mother is seeking an explanation from the health care team. Which of the following points should underlie an explanation to the mother? (Points : 0.4)

The child is experiencing a reentry rhythm in his right atrium.
The resolution of the problem is dependent on spontaneous recovery and is resistant to pacing interventions.
The child is likely to have a normal ECG apart from the rapid heart rate.
The boy’s atria are experiencing abnormal sympathetic stimulation.

 

Question 17.17. A 66-year-old obese man with a diagnosis of ischemic heart disease has been diagnosed with heart failure that his care team has characterized as attributable to systolic dysfunction. Which of the following assessment findings is inconsistent with his diagnosis? (Points : 0.4)

His resting blood pressure is normally in the range of 150/90 and an echocardiogram indicates his ejection fraction is 30%.
His end-diastolic volume is higher than normal and his resting heart rate is regular and 82 beats per minute.
He is presently volume overloaded following several days of intravenous fluid replacement.
Ventricular dilation and wall tension are significantly lower than normal.

 

Question 18.18. The nurse practitioner for a cardiology practice is responsible for providing presurgical teaching for patients who are about to undergo a coronary artery bypass graft. Which of the following teaching points best conveys an aspect of the human circulatory system? (Points : 0.4)

“Your blood pressure varies widely between arteries and veins, and between pulmonary and systemic circulation.”
“Only around one quarter of your blood is in your heart at any given time.”
“Blood pressure and blood volume roughly mimic one another at any given location in the circulatory system.”

“Left-sided and right-sided pumping action at each beat of the heart must equal each other to ensure adequate blood distribution.”

 

Question 19.19. A nurse practitioner is instructing a group of older adults about the risks associated with high cholesterol. Which of the following teaching points should the participants try to integrate into their lifestyle after the teaching session? (Points : 0.4)

“Remember, the ‘H’ in HDL and the ‘L’ in LDL correspond to high danger and low danger to your health.”
“Having high cholesterol increases your risk of developing diabetes and irregular heart rate.”
“Smoking and being overweight increases your risk of primary hypercholesterolemia.”
“Your family history of hypercholesterolemia is important, but there are things you can do to compensate for a high inherited risk.”

 

Question 20.20. A 66-year-old patient’s echocardiogram reveals a hypertrophied left ventricle, normal chamber volume, and a normal ejection fraction from the heart. What is this patient’s most likely diagnosis? (Points : 0.4)

Mitral valve regurgitation
Aortic valve stenosis
Mitral valve stenosis
Aortic valve regurgitation

 

Question 21.21. In which of the following patient situations would a nurse practitioner be most justified in preliminarily ruling out pericarditis as a contributing pathology to the patient’s health problems? (Points : 0.4)

A 61-year-old man whose ECG was characterized by widespread T wave inversions on admission but whose T waves have recently normalized
A 77-year-old with diminished S3 and S4 sounds, an irregular heart rate, and a history of atrial fibrillation
A 56-year-old obese man who is complaining of chest pain that is exacerbated by deep inspiration and is radiating to his neck and scapular ridge
A 60-year-old woman whose admission blood work indicates elevated white cells, erythrocyte sedimentation rate, and C-reactive protein levels

 

Question 22.22. Which of the following assessment findings in a newly admitted 30-year-old male patient would be most likely to cause his nurse practitioner to suspect polyarteritis nodosa? (Points : 0.4)

The man’s blood work indicates polycythemia (elevated red cells levels) and leukocytosis (elevated white cells).
The man’s blood pressure is 178/102 and he has abnormal liver function tests.
The man is acutely short of breath and his oxygen saturation is 87%.
The man’s temperature is 101.9°F and he is diaphoretic (heavily sweating).

 

Question 23.23. As part of the diagnostic workup for a male patient with a complex history of cardiovascular disease, the care team has identified the need for a record of the electrical activity of his heart, insight into the metabolism of his myocardium, and physical measurements, and imaging of his heart. Which of the following series of tests is most likely to provide the needed data for his diagnosis and care? (Points : 0.4)

Echocardiogram, PET scan, ECG
Ambulatory ECG, cardiac MRI, echocardiogram

Serum creatinine levels, chest auscultation, myocardial perfusion scintigraphy
Cardiac catheterization, cardiac CT, exercise stress testing

 

Question 24.24. An autopsy is being performed on a 44-year-old female who died unexpectedly of heart failure. Which of the following components of the pathologist’s report is most suggestive of a possible history of poorly controlled blood pressure? (Points : 0.4)

“Scarring of urethra suggestive of recurrent urinary tract infections is evident.”
“Bilateral renal hypertrophy noted.”
“Vessel wall changes suggestive of venous stasis are evident.”
“Arterial sclerosis of subcortical brain regions noted.”

 

Question 25.25. A nurse practitioner has ordered the measurement of a cardiac patient’s electrolyte levels as part of the patient’s morning blood work. Which of the following statements best captures the importance of potassium in the normal electrical function of the patient’s heart?(Points : 0.4)

Potassium catalyzes the metabolism of ATP, producing the gradient that results in electrical stimulation.
Potassium is central to establishing and maintaining the resting membrane potential of cardiac muscle cells.
The impermeability of cardiac cell membranes to potassium allows for action potentials achieved by the flow of sodium ions.
The reciprocal movement of one potassium ion for one sodium ion across the cell membrane results in the production of an action potential.

Answered by Expert Tutors

1. A 61-year-old man who has a heart valve infection and recurrent fever
2. BNP is released as a compensatory mechanism during heart failure and measuring it can help differentiate the patient’s dyspnea from a respiratory pathology
3. AV node pacemaking activity and vagal nerve suppression
4. High afterload because of backpressure against the left ventricle
5. Hypertension is a frequent modifiable contributor to aneurysms
6. Electrophysiologic study
7. Coarctation of the aorta
8. Atherosclerotic occlusive disease necessitating thrombolytic therapy
9. HDL cholesterol is often characterized as being beneficial to health.
10.  Infusion of normal saline of Ringer lactate to maintain the vascular space
11. Sick sinus syndrome as a result of a disease of his sinus node and atrial or junctional arrhythmias
12. The conversion of angiotensin I to angiotensin II in his lungs causes increases in blood pressure and sodium reabsorption
13. Impaired physical restraint of the left ventricule

14.

1. A nurse practitioner is providing ca…itioner be most likely to rule out hyp

Blood backs up into the jugular vein because there are no valves at the point of entry into the heart.

15. A nurse practitioner is providing ca…itioner be most likely to rule out hyp Platelet count, serum creatinine, and liver enzymes

16. A nurse practitioner is providing ca…itioner be most likely to rule out hyp

The child is experiencing a reentry rhythm in his right atrium.

17. A nurse practitioner is providing ca…itioner be most likely to rule out hyp

Ventricular dilation and wall tension are significantly lower than normal.

18. A nurse practitioner is providing ca…itioner be most likely to rule out hyp

“Your blood pressure varies widely between arteries and veins, and between pulmonary and systemic circulation.”

19. A nurse practitioner is providing ca…itioner be most likely to rule out hyp

“Your family history of hypercholesterolemia is important, but there are things you can do to compensate for a high inherite

1. A nurse practitioner is providing ca…itioner be most likely to rule out hyp d risk.”

20. A nurse practitioner is providing ca…itioner be most likely to rule out hyp

Aortic valve stenosis

21.

A 77-year-old with diminished S3 and S4 sounds, an irregular heart rate, and a history of atrial fibrillation

22.

1. A nurse practitioner is providing ca…itioner be most likely to rule out hyp

The man’s blood pressure is 178/102 and he has abnormal liver function tests.

23. A nurse practitioner is providing ca…itioner be most likely to rule out hyp

Echocardiogram, PET scan, ECG

 

24.

1. A nurse practitioner is providing ca…itioner be most likely to rule out hyp

“Arterial sclerosis of subcortical brain regions noted.”

25. A nurse practitioner is providing ca…itioner be most likely to rule out hyp

The impermeability of cardiac cell membranes to potassium allows for action potentials achieved by the flow of sodium ions.

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