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A critical path is one that reaches an end goal in the most direct possible manner. Water in the natural world, will always follow the line of least resistance - riding gravity along the most direct path. Often, we’re hampered throughout our own routines to recognize and chase our daily critical paths. It can be difficult to uncover the best route, and often, even if it is laid out before us – our responsibilities inhibit our progression.


A critical path is one that reaches an end goal in the most direct possible manner. Water in the natural world, will always follow the line of least resistance - riding gravity along the most direct path. Often, we’re hampered throughout our own routines to recognize and chase our daily critical paths. It can be difficult to uncover the best route, and often, even if it is laid out before us – our responsibilities inhibit our progression.


For a fortunate few though; for those selfless enough to sacrifice themselves for the care of the ill and the injured, there exists a beacon. This torch lighting the path of career progression for the CNA, is the “Nursing Ladder of Success”.  A career spent as a CNA, is very respectable. Few will work as hard. However, it is common for the CNA to climb higher through the ranks of the Nursing track.

Clinical settings are full of nursing professionals at various stages of career growth. As a CNA, buzzing through the hospital amongst a swarm of Medical Assistants, LPN’s, RN’s, and NP’s, we’re able to see exactly what’s possible if we continue with our training and coursework. As a pocket guide for the humming hospital hallway, we refer to our “Nursing Ladder of Success”. 

Citation: http://cnanursing.net


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The 2016 CDC guideline for prescribing opioids suggests to reassess the evidence of “individual benefit and risk” when increasing daily dose to above ____ morphine milligrams equivalent per day.
  
a. 30
b. 50
c. 90
d. 120


The 2016 CDC guideline for prescribing opioids suggests to reassess the evidence of “individual benefit and risk” when increasing daily dose to above ____ morphine milligrams equivalent per day.
  
a. 30
b. 50
c. 90
d. 120

Answer(b): The 2016 CDC guideline for prescribing opioids suggests to reassess the evidence of “individual benefit and risk” when increasing daily dose to above 50 morphine milligrams equivalent per day, and avoidance of doses greater than 90 MME per day.


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Which of the following are administered by Centers for Medicare & Medicaid Services (CMS)? [Select ALL That Apply]
 
a. Medicare
b. Medicaid
c. Clinical Laboratory Improvement Amendments (CLIA)
d. Children's Health Insurance Program (CHIP)



Which of the following are administered by Centers for Medicare & Medicaid Services (CMS)? [Select ALL That Apply]
 
a. Medicare
b. Medicaid
c. Clinical Laboratory Improvement Amendments (CLIA)
d. Children's Health Insurance Program (CHIP)

Answer (a, b, c and d). The Centers for Medicare & Medicaid Services (CMS), a component of the Department of Health and Human Services (HHS), administers Medicare, Medicaid, the Children's Health Insurance Program (CHIP), the Clinical Laboratory Improvement Amendments (CLIA) and parts of the Affordable Care Act (ACA.
 
Along with the Departments of Labor and Treasury, CMS also implements the insurance reform provisions of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and most aspects of the Patient Protection and Affordable Care Act (PPACA) of 2010 as amended.
 
The Social Security Administration is responsible for determining Medicare eligibility, eligibility for and payment of Extra Help/Low Income Subsidy payments related to Part D Medicare, and collecting some premium payments for the Medicare program.


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Identify the reacting enzyme in the following figure:
 
 
a. Dopa decarboxylase
b. Dopamine β hydroxylase
c. Tyrosine hydroxylase
d. n-Methyl transferase


Identify the reacting enzyme in the following figure:
 
 
a. Dopa decarboxylase
b. Dopamine β hydroxylase
c. Tyrosine hydroxylase
d. n-Methyl transferase

Answer: Tyrosine hydroxylase.

 



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Illegal Purchases of Controlled Substances Are Made Easier via Rogue Internet Drug Outlets, Reports NABP.


Last week, NABP released its Internet Drug Outlet Identification Program Progress Report for State and Federal Regulators: July 2016. The report explores the connection between the dangers of rogue internet drug outlets and the risk of overdose from illegally dispensed prescription controlled substances (CS), as well as possibly tainted counterfeit medicines.
 
Over the past eight years, NABP has worked to identify illegally operating websites to keep consumers safe and to try to decrease the overdoses and fatalities related to prescription drug misuse and abuse. Currently, 11,299 online drug outlets that sell prescription medications have been reviewed by NABP, and 95.79% have been classified as Not Recommended given that the websites are selling prescription medications out of compliance with state and federal laws and/or Association patient safety and pharmacy practice standards.
 
For the full report, visit the Not Recommended Online Pharmacies page in the Acquire Safely section of the AWARXE® Prescription Drug Safety website. You can avoid rogue internet drug outlets by buying from websites with a .pharmacy domain name. To see the list of approved entities with registered .pharmacy domain names, visit the Buying Safely section at www.safe.pharmacy. 


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Pharmacists were rated as the most trusted health care providers, according to a new consumer health survey. The results of the survey show that 60% of consumers trust pharmacists, 56% trust doctors, and 51% trust dentists. The Meyocks Health Survey reports that consumers trust the people who directly provide health care more than others in the health care system. Pharmacists had the highest trust rate and the lowest distrust rate among other groups in the survey, notes Drug Store News.


Pharmacists were rated as the most trusted health care providers, according to a new consumer health survey. The results of the survey show that 60% of consumers trust pharmacists, 56% trust doctors, and 51% trust dentists. The Meyocks Health Survey reports that consumers trust the people who directly provide health care more than others in the health care system. Pharmacists had the highest trust rate and the lowest distrust rate among other groups in the survey, notes Drug Store News.


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North Carolina and Texas Sign Legislation to Make Naloxone More Accessible to Patients


New legislation in North Carolina and Texas make naloxone, the opioid overdose reversal drug, more accessible to patients. North Carolina Governor Pat McCrory signed Senate Bill (SB) 734 into law on June 20, 2016, which authorizes the state health director to prescribe an opioid antagonist using a statewide standing order.

Under the former law, only a practitioner was authorized to prescribe an opioid antagonist pursuant to a standing order. SB 734 became effective the same day, according to the North Carolina Health and Human Services press release.
 
Beginning August 1, 2016, pharmacists in Texas will be authorized to dispense naloxone to patients under a standing order. The legislation will require pharmacists to complete a one-hour course accredited by the Accreditation Council for Pharmacy Education and in coordination with the Texas Pharmacy Association, according to a press release.

SB 1462 states an authorized prescriber may prescribe an opioid antagonist through a standing order. Medical doctors have unlimited, independent prescribing authority in every state. NABP’s 2016 Survey of Pharmacy Law states that pharmacists in Texas may perform specific acts relating to drug therapy management under written protocol from a practitioner including implementing or modifying therapy.


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Delaware Law Requires ID to Buy Certain Cough Medicines


A new Delaware law restricts the sale of over-the-counter (OTC) medicines containing dextromethorphan (DXM) to those aged 18 and older.

Intended to reduce abuse of the cough suppressant among teens, the law requires an ID to be presented at the point of purchase.

Delaware is the 12th state to impose a DXM restriction, reports Drug Store News.


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New Hampshire Pharmacies May Establish Drug Take-Back Programs Under New Law


Retail pharmacies in New Hampshire are authorized to establish pharmaceutical drug take-back programs if their program meets certain federal requirements.

House Bill (HB) 1490 was signed into law by Governor Maggie Hassan and is effective August 6, 2016. Under HB 1490, a registered pharmacy may establish a drug take-back program to collect controlled and non-controlled pharmaceutical drugs.

New Hampshire RSA 318-E:1 defines “pharmaceutical drug” as a prescription or OTC drug, including controlled drugs.




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