This document contains a knowledge check for a nursing course. It includes 14 scenarios covering various medical conditions and asks questions related to each scenario. The scenarios cover topics like acute lymphoblastic leukemia, sickle cell disease, hemophilia, myelomeningocele, patent ductus arteriosus, lead poisoning, sudden infant death syndrome, Kawasaki disease, asthma, cystic fibrosis, idiopathic scoliosis, hemolytic uremic syndrome, pituitary dwarfism, and osteogenesis imperfecta. For each scenario, students are asked 1-2 questions testing their understanding of the condition's presentation, pathophysiology, diagnosis, or management. Responses of at least 2-4 sentences in length are required.

1. NURS 6501
Knowledge Check: Module 8
Student Response
This Knowledge Check reviews the topics in Module 8 and is
formative in nature. It is worth 20 points where each question is
worth 1 point. You are required to submit a sufficient response
of at least 2-4 sentences in length for each question.
Scenario 1: Acute Lymphoblastic Leukemia (ALL)
A ten-year-old boy is brought to clinic by his mother who states
that the boy has been listless and not eating. She also notes that
he has been easily bruising without trauma as he says he is too
tired to go out and play. He says his bones hurt sometimes.
Mother states the child has had intermittent fevers that respond
to acetaminophen. Maternal history negative for pre, intra, or
post-partum problems. Child’s past medical history negative and
he easily reached developmental milestones. Physical exam
reveals a thin, very pale child who has bruises on his arms and
legs in no particular pattern. The APRN orders complete blood
count (CBC), and complete metabolic profile (CMP). The CBC
revealed Hemoglobin of 6.9/dl, hematocrit of 19%, and platelet
count of 80,000/mm3. The CMP demonstrated a blood urea
nitrogen (BUN) of 34m g/dl and creatinine of 2.9 mg/dl. The
APRN recognizes that the patient appears to have acute
leukemia and renal failure and immediately refers the patient to
the Emergency Room where a pediatric hematologist has been
consulted and is waiting for the boy and his mother. The
diagnosis of acute lymphoblastic leukemia (ALL) was made
after extensive testing.
Question 1 of 2:
What is ALL?
<Type your response here> Acute lymphoblastic leukemia
(ALL) is most common in children and adolescents, ALL

2. represents about 75% of all childhood and 67% of all adolescent
leukemia cases blood and bone marrow that affects white blood
cells. It occurs when a bone marrow cell develops errors in its
DNA and affects the white blood cells. A sibling with acute
lymphocytic leukemia have an increased risk of ALL
Question 2 of 2:
How does renal failure occur in some patients with ALL?
<Type your response here> renal failure occurs in patients with
acute leukemia because of the outcome of the chemotherapeutic
regimen, including leukemic infiltration of the kidneys, therapy-
related side effects such as tumor lysis syndrome, nephrotoxic
drugs, and septicemias.
Scenario 2: Sickle Cell Disease (SCD)
A 12-year-old female with known sickle cell disease
(SCD) present to the Emergency Room in sickle cell crisis. The
patient is crying with pain and states this is the third acute
episode she has had in the last nine months. Both parents are
present and appear very anxious and teary eyed. A diagnosis of
acute sickle cell crisis was made. Appropriate therapeutic
interventions were initiated by the APRN and the patient’s pain
level decreased, and she was transferred to the pediatric
intensive care unit (PICU) for observation and further
management.
Question 1 of 2:
What is the pathophysiology of acute SCD crisis and why is
pain the predominate feature of acute crises?
<Type your response here> SCD is a common hereditary
hemoglobinopathy where HbS is formed by a genetic point
mutation in ß-globin that leads to the replacement of one
glutamate amino acid with a valine amino acid. Sickle cell
disease affects millions of people and is most common among
individuals with ancestors from Africa. SCD is inherited in an
autosomal recessive pattern where each parent carries one copy

3. of the mutated gene. Vaso-occlusive crises (pain crises) are
events of hypoxic injury and infarction that can cause severe
pain in some areas. However, the specific cause of sensory pain
lacks enough characterization.
Question 2 of 2:
Discuss the genetic basis for SCD.
<Type your response here> Sickle cell disease is caused by a
mutation in the hemoglobin-Beta gene seen in chromosome 11.
In people with sickle cell disease, abnormal hemoglobin
molecules - hemoglobin S - stick to one another and form long,
rod-like structures. These structures cause red blood cells to
become stiff, assuming a sickle shape. Hemoglobin transports
oxygen from the lungs to other parts of the body. Red
blood cells with normal hemoglobin (hemoglobin-A) are smooth
and round and glide through blood vessels.
Scenario 3: Hemophilia
The parents of a 9-month boy bring the infant to the
pediatrician’s office for evaluation of a swollen right knee
and excessive bruising. The parents have noticed that the
baby began having bruising about a month ago but thought the
bruising was due to the child’s attempts to crawl. They became
concerned when the baby woke up with a swollen knee. Infant
up to date on all immunizations, has not had any medical
problems since birth and has met all developmental
milestones. Pre-natal, intra-natal, and post-natal history of
mother noncontributory. Family history negative for any history
of bleeding disorders or other major genetic diseases. Physical
exam within normal limits except for obvious bruising on the
extremities and right knee. Knee is swollen but no warmth
appreciated. Range of motion of knee limited due to the
swelling. The pediatrician suspects the child has hemophilia and
orders a full bleeding panel workup which confirms the
diagnosis of hemophilia A.
Question 1 of 2:

4. Explain the genetics of hemophilia
<Type your response here>
Question 2 of 2:
Briefly describe the pathophysiology of Hemophilia
<Type your response here>
Scenario 4: Myelomeningocele
During a routine 16-week pre-natal ultrasound, spina
bifida with myelomeningocele was detected in the fetus. The
parents continued the pregnancy and labor was induced at 38
weeks with the birth of a female infant with an obvious defect
at Lumbar Level 2. The Apgar Score was 7 and 9. The infant
was otherwise healthy. The sac was leaking cerebral spinal fluid
and the child was immediately taken to the operating room
for coverage of the open sac. The infant remained in the
neonatal intensive care unit (NICU) for several weeks then
discharged home with the parents after a prescribed treatment
plan was developed and the parents were educated on how to
care for this infant.
Question 1 of 2:
What is the underlying pathophysiology of myelomeningocele?
<Type your response here>
Question 2 of 2:
Describe the pathophysiology of hydrocephalus in infants with
myelomeningocele.
<Type your response here>
Scenario 5: Patent Ductus Arteriosus (PDA)
A preterm infant was delivered at 32 weeks gestation and was
taken to the NICU for critical care management. Physical
assessment of the chest and heart remarkable for a continuous-
machinery type murmur best heard at the left upper sternal
border through systole and diastole. The infant had bounding

5. pulses, an active precordium, and a palpable thrill. The infant
was diagnosed with a patent ductus arteriosus (PDA).
Question:
Discuss the hemodynamic consequences of a PDA
<Type your response here>
Scenario 6: Lead Poisoning
A 7-year-old male was referred to the school
psychologist for disruptive behavior in the classroom. The
parents told the psychologist that the boy has been difficult to
manage at home as well. His scholastic work has gotten worse
over the last 6 months and he is not
meeting educational benchmarks. His parents are also worried
that he isn’t growing like the other kids in the
neighborhood. He has been bullied by other children which is
contributing to his behaviors. The psychologist suggests that the
parents have some blood work done to check for any
abnormalities. The complete blood count (CBC) revealed a
hypochromic microcytic anemia. Further testing revealed the
child had a venous lead level of 21 mcg/dl (normal is
< 10 mcg/dl). The child was diagnosed with lead poisoning and
it was discovered he lived in public housing that had not
finished stripping lead paint from the walls and woodwork.
Question:
How does lead poisoning account for the child’s symptoms?
<Type your response here>
Scenario 7: Sudden Infant Death Syndrome (SIDS)
Emergency Medical Services (EMS) was dispatched to a
home to evaluate the report of an unresponsive 3-month-
old infant. Upon arrival, the EMS found a frantic attempt by the
presumed father to resuscitate an infant. The EMS took over and
attempted CPR but was unable to restore pulse or respiration.
The infant was transported to the Emergency Room where the
physician pronounced the child dead of Sudden Infant Death

6. Syndrome (SIDS). The distraught parents were questioned as to
the events surrounding the discovery of the baby. Parents
state the child was in good health, had taken a full 6-
ounce bottle of formula prior to being put down for the evening.
The child had been sleeping through the night prior to this.
Parents stated the baby had had some “sniffles” a few days
before and was taken to the pediatrician who diagnosed the
child with a mild upper respiratory tract viral syndrome. No
other pertinent history.
Question:
What is thought to be the underlying pathophysiology of SIDS?
<Type your response here>
Scenario 8: Kawasaki Disease
A 4-year-old female is brought to the pediatrician by her mother
who states the child has been running a fever to 102.0 F, has
“pink eye”, and that her tongue looks very bright red and
swollen. The mother states the fever has been present for 5
days, noticed the child had developed a rash and that the child’s
legs look “puffy”. No other symptoms noted. Past medical
history noncontributory. All immunizations up to date. Physical
exam remarkable for current fever of 102.8
F, bilateral conjunctivitis without purulent material, oral
mucosa with bright red erythema, dry, with fissuring of the
lips. Legs noted to have peripheral edema and are also
erythematous. Palmar desquamation noted. There is
fine maculopapular rash and + cervical adenopathy. The
presumptive diagnosis currently (pending laboratory data) is
Kawasaki Disease.
Question 1 of 2:
What is Kawasaki Disease and what is the pathophysiology?
<Type your response here>
Question 2 of 2:
How does Kawasaki Disease cause coronary aneurysms?

7. <Type your response here>
Scenario 9: Asthma
A 9-year-old boy was brought to the Urgent Care Center by his
parents who state that the child had a sudden onset of difficul ty
catching his breath, has a new cough and is making a “funny
sound” when he breathes. The parents state there is no prior
history of this, and the child had not been ill prior to the start of
the symptoms. Past medical history noncontributory. No family
history of respiratory problems. No known allergies to drugs or
food. Physical exam positive for respiratory rate of 26, use of
accessory muscles, with suprasternal retractions, heart rate of
132 beats per minute, an audible inspiratory and expiratory
wheeze noted, and the pulse oximetry is 89% on room air. After
the APRN institutes appropriate urgent treatment, the child’s
breathing slowly returned to
normal, vital signs normalize, and the pulse oximetry increases
to 97%. The APRN suspects the child has asthma and tells the
parents that they need to bring the child to a pulmonologist for
further evaluation and care.
Question:
What is the underlying pathophysiology of asthma?
<Type your response here>
Scenario 10: Cystic Fibrosis (CF)
A 24-year-old female with known cystic fibrosis (CF) has been
admitted to the hospital for evaluation for possible lung
transplant. She was diagnosed with CF when she was 9 months
old and has had multiple hospitalizations for pneumonia,
respiratory failure, and small bowel obstructions. She currently
is oxygen dependent and has been told by her physicians that
she has end stage pulmonary disease secondary to CF. The only
recourse for her currently is lung transplant.
Question 1 of 2:
What is cystic fibrosis and discuss the pathophysiology

8. <Type your response here>
Question 2 of 2:
What is the reason people with CF are often malnourished?
<Type your response here>
Scenario 11: Idiopathic Scoliosis
A 14-year old girl who was trying out for
cheerleading underwent a physical examination by the
APRN who notices that the girl had uneven hip height,
asymmetry of the shoulder height, shoulder and
scapular prominence and rib prominence. The rest of the
physical exam was normal and the APRN referred the girl to an
orthopaedist for evaluation for possible scoliosis. Radiographs
in the orthopaedic office confirms the diagnosis of idiopathic
scoliosis. The spinal curve was measured at 26 degrees and it
was recommended that the girl be fit for a low-profile back
brace.
Question:
What is thought to be the pathophysiology of idiopathic
scoliosis?
<Type your response here>
Scenario 12: Hemolytic Uremic Syndrome (HUS)
A 2-year-old boy was brought to Urgent Care by his parents
who state the boy has been having large amounts of diarrhea,
been very irritable and very pale. The parents noticed there was
blood in the diarrhea and when the boy’s legs became swollen,
they sought care. Past medical history noncontributory and all
immunizations up to date. Social history noncontributory and
the child is in day care 5 days a week. No known exposure
to other sick children and the only new event the parents could
think of is the day care workers took the children to a local

9. petting zoo about a week ago. Physical exam revealed a pale, ill
appearing child with swollen legs, tender abdomen, and petechia
on the legs and abdomen. The APRN suspects the child may
have been exposed to a bacterium at the petting zoo and
arranges for the patient to be transferred to the Emergency
Room. There the child was found to be in renal failure, have
hypertension and was diagnosed with hemolytic uremic
syndrome (HUS).
Question:
What is the pathophysiology of HUS?
<Type your response here>
Scenario 13: Pituitary Dwarfism
The parents of a 3-year-old boy bring the child to the
pediatrician with concerns that their child seems “small for his
age”. The parents state that the boy has always been small
but did not worry until the child went to day care and they
noticed other children of the same age were much bigger. They
also note that his teeth were very late in coming in. Normal
prenatal, perinatal and postnatal history and no medical history
on either side of family regarding issues with growth and
development. Physical exam is normal except for short limbs
and small teeth. The pediatrician suspects the child has pituitary
dwarfism. A complete laboratory and radiographic work up
confirmed the diagnosis.
Question:
What is the pathophysiology of pituitary dwarfism?
<Type your response here>
Scenario 14: Osteogenesis Imperfecta (OI)
A 4-year-old boy was brought to the Emergency Room by his
parents with a suspected femur fracture. The parents state the
child was playing on the couch when he rolled off and cried out
in pain. There were no other injuries noted. Review of the
child’s chart revealed this was the 4th Emergency Room visit in
the last 15 months for fractures after low impact injury. The

10. parents were suspected of child abuse and Child and Protective
Services were consulted. The APRN assessing the child noted
that the child had unusually thin and translucent skin, poor
dentition, and blue sclera. The APRN suspects the child may
have osteogenesis imperfecta (OI). Laboratory results revealed
an elevated serum alkaline phosphatase and the diagnosis OI
was made based on the clinical picture and elevated alkaline
phosphatase.
Question:
What is the pathophysiology of OI?
<Type your response here>
© 2020 Walden University 1
Running Head: EDUCATIONAL LEADERSHIP 1
EDUCATIONAL LEADERSHIP 3
Types of Power
Shakethia Lemons
American InterContinental University
Unit 1-Individual Project
May 19, 2020

11. Abstract
What do you perceive about an individual when it comes to
an education leader? Is it how they look, how they carry
themselves, race, religion, culture and/or gender. Ask yourself
what makes a good leader as it relates to education. A person
having the leadership trait and behavior it take to combine into
one is what makes a great leader. In this paper I will introduce
the leader Sigmund Freud and the reason I have choosing. Then,
we will identify the traits and behaviors that make/made
Sigmund Freud an educational leader. Afterwards, I will
identify the outcomes that Sigmund Freud espoused and how he
uses/used his power, influenced and authority to achieve his
accomplishments in the field. Last, I will describe the enduring
impact Sigmund Freud had on education,
When psychoanalysis is mentioned, the first person that comes

12. to mind is Sigmund Freud. Sigmund was an Austrian neurologist
and the well-known founder of the psychoanalytic method of
psychopathology treatment. He believed that talk therapy was
very effective in the treatment of psychological dysfunctions
and this has been used to date. Freud, a man born in 1856, first
qualified as a doctor of medicine at the University of Vienna in
1881. Four years later, Freud completed his habilitation and was
appointed a docent in neuropsychology. In 1886 Freud started
his clinical practice which saw a breakthrough in
psychoanalytic and psychodynamic talk therapy (Freud &
Strachey, 1964). The two concepts were a major contribution to
the field of psychology which are used up to date. Freud later
became an affiliated professor in 1902 and the founder of the
Wednesday psychological society which was later changed to
the Vienna psychoanalytic society. Freud was the president of
the group comprising of 16 professionals across the medical
field. Having died at the age of 83 in 1939, Freud has major
achievements and influence in the field of psychology that will
live to be remembered. He was also seen as a mentor by many
people through his International Psychoanalytic Association
(IPA) with a majority of the members later starting their
schools. Considering his influence on students and other
medical professionals with an aim of educational achievement,
Freud truly deserves to be seen as an educational leader.
According to Murphy, for one to deserve to be seen as an
educational leader, monumental traits and behavior have to be
shown (2002). To start with is the amazing social traits that
were shown by Freud. Sigmund understood the power of
synergy rather than self-power. He believed that teamwork was
very productive and he was able to unite major professionals to
work together to look more deeply into psychoanalysis. His
social traits are majorly portrayed by his running of the
international psychoanalytic association (IPA) and the
Wednesday psychological society. He was the president in
charge of the two psychological movements with many
professionals that looked up to him. The major achievements of

13. these two movements portray how well Freud was able to unite
people to work together towards a common goal.
Freud’s knowledgeable character is another thing that makes
him a true educational leader. Freud invested most of his time
in books and research which led to him being a very
knowledgeable person. It is also evident that Freud was well
informed by the important lectures that he was able to give out.
At first, he was an affiliated professor at the University of
Vienna where he taught on his psychoanalytic therapy approach
psychopathology treatment (Holt, 1989). Freud later delivered
five lectures on psychoanalysis at the Massachusetts Institute of
Technology, where he was later awarded an honorary degree
that marked a major public recognition and media interest in his
work. Freud also had a major passion for philosophy as he saw
it as a pursuit of wisdom. In his writings, Freud majorly used
William Shakespeare’s and Charles Darwin’s earlier work as a
motivation for what he was doing. He was truly passionate and
was thirsty for knowledge. His monumental knowledge is
something very important for educational leadership
Sigmund’s character of commitment and passion is just epic.
According to Holt, Freud lived his whole life committed to
exploring the treatment of psychological dysfunctions through
talk therapy (1989). Sigmund has many known writings such
as the interpretation of dreams and the question of lay analysis.
Later in 1933 after the Nazi party took control of Germany then
destroyed and burned down Freud’s books. Despite all this,
Freud was determined to continue living and working in
Germany despite the risk he was exposed to and continued
underrating the growth of the Nazis. He although had to flee
away later on after the arrest of his sister-in-law and did so
through the help of Ernst Jones, who was the then president of
IPA. Freud continued to pursue deeply into psychology even
after he flee to Britain. This man Freud dedicated his whole life
to helping out in psychopathology treatment which is a great
trait of commitment and passion.
Freud had many outcomes in the psychological field after he

14. carried out much research. Freud was able to apply the talk
therapy and the interpretation of dreams and integrated these
two into which he called psychoanalysis. In talk therapy, Freud
would encourage patients to talk freely and openly without
censorship and inhibition in what he saw a free association. On
the interpretation of dreams, he analyzed dreams to unleash the
complex structure and unconscious state of mind which he saw
as repression that he concluded to be underlay symptom
formation (Freud & Strachey, 1964). Sigmund achieved major
outcomes in helping with psychological views on childhood,
dreams, personality, and sexuality.
Freud was a powerful man considering the powerful friends he
had and his influence on other scientists. Freud used his
influence and power to bring professionals together to dive
more into research based on psychoanalysis. When he was first
a lecturer at the University of Vienna, Freud founded the
Wednesday psychological society, which was a group of
Viennese physicians who were interested in Freud’s work. This
group used to meet up at his home every Wednesday evening as
they deepened their research on psychology and
neuropathology. Wilhelm Stekel, a man who had earlier studied
medicine at the University of Vienna was converted to venture
into psychoanalysis after Freud treated his sexual problems
(Holt, 1989). The Wednesday group later grew into a bigger
society known as the Vienna psychoanalytic society. Freud later
founded the international psychoanalytic association (IPA)
which composed of psychiatrists and physicians from various
parts of the world. Freud also used his power to spread the
psychoanalytic approach of treatment all across the world.
Freud turned to his friends, brill, and jones to spread his
psychoanalytic findings in the English-speaking world (Freud &
Strachey, 1964). Through Jones's advocacy, Freud was able to
make his first lecture in the united states. Freud gave out five
lectures on psychoanalysis at the Massachusetts Institute of
Technology where he was awarded an honorary degree.
Sigmund majorly used his power and influence to venture into

15. better research and better establish psychopathology treatment.
Sigmund Freud’s impact on psychological, psychiatry, and
psychotherapy. He was able to solve the issue of mental illness
that was seen to be a complex issue at that time. The talk
therapy by Sigmund Freud was a breakthrough in solving mental
related disorders. Psychoanalysis by Freud was later used by
other psychologists to come up with the psychodynamic
approach of treatment. Clinical psychology which is a major
branch of psychology is said to have been first seen in by
Sigmund Freud through the talk therapies he used for treatment
(Dreher, 2018). This man Sigmund Freud came up with a career
that many people venture into today. After any diagnosis with
psychological dysfunctions, the talk therapy will always be used
mostly by the psychiatrists and clinical psychologists. Sigmund
also tried to explain the personality of a person using the ego
and id. This concept is used up to date in measuring personality
(Dreher, 2018). Despite major criticism of Freud’s work, i t
cannot be denied the major influence he had on psychology.
Sigmund Freud, the father of psychoanalysis, is a true
educational leader for his influence on students, professors, and
education in general around the psychological field.
Reference
Dreher, A. U. (2018). Foundations for conceptual research in
psychoanalysis. Routledge.
Freud, S., & Strachey, J. E. (1964). The standard edition of the
complete psychological works of Sigmund Freud.
Holt, R. R. (1989). Freud reappraised: A fresh look at
psychoanalytic theory. Guilford Press.

16. Murphy, J. (2002). Reculturing the profession of educational
leadership: New blueprints. Educational Administration
Quarterly, 38(2), 176-191.