NUR7560900 – Advanced Pharmacology
Unit 1: Foundations of Pharmacology
Introduction: Introductions and Foundations of Advanced Pharmacology
Introduction: Introductions and Foundations of Advanced Pharmacology
Welcome to Advanced Pharmacology!
Welcome to Advanced Pharmacology. The first week lays the essential foundation for principles of pharmacology, role, and population considerations. Rational drug selection requires more in-depth knowledge within the context of scope of practice, ethics, and legal issues. Relatively new areas of pharmacotherapeutics include pharmacogenomics and ethnopharmacology, which identifies drugs that are best for certain populations. This week builds upon your undergraduate knowledge and approaches learning from the perspective of a prescriber including clinical judgment in prescribing and collaboration with other providers and is key to your success in this course. In every unit, you will learn about the pharmacodynamics, pharmacokinetics, and pharmacotherapeutics of common drugs used based on each body system or conditions.
Unit 1 Learning Objectives
Manage clients who require pharmacotherapeutic interventions by establishing a foundation of facts and an attitude of inquiry to promote effective and safe prescribing (CLO 1)
Integrate resources that can be utilized to monitor pharmacodynamic, pharmacokinetic, and pharmacotherapeutic interaction to maximize client results and to reduce adverse effects or reactions (CLO 2)
Pharmacogenetics application to practice (CLO 4)
Hypothesize legal and ethical issues in prescribing (CLO 1)
Prescription writing how to (CLO 1, 4)
Unit 1 (Week 1 & 2) “To Do” List
Review course syllabus/course schedule, due dates and the flow of the course
Purchase High-Yield Med Reviews (HYMR) for access to course lectures and e-book
Complete Unit 1 HYMR reading and lecture requirements
Review information on Shadow Health
Register your account in Shadow Health
Complete Shadow Health Orientation and Conversation Concept Lab
Start State Practice Discussion – Initial post due Sunday Week 1 (Peer post due Sunday Week 2)
Review CDC Module 1 and take Quiz
Complete Respondus Practice Quiz (You will need to download the Respondus browser first)
NUR 7560 Course Orientation
NUR 7560 Course Orientation
Learning Materials
Learning Materials
Lecture & E-Book
Busti, A. J. (2022). NP Curriculum Support-Advanced Pharmacology for NPs. MedEducation, LLC.
FOUNDATIONS OF PHARMACOLOGY
Pharmacokinetics Part 1
Pharmacokinetics Part 2
Pharmacokinetics Part 3
Pharmacogenetics in Practice
Drug Interactions
Special Populations
Prescription Writing
Prescription Writing for the Nurse Practitioner.ppsx Prescription Writing for the Nurse Practitioner.ppsx – Alternative Formats
Prescription Template: blank prescription template.docx blank prescription template.docx – Alternative Formats
Link 2: This is an additional 60 second video found on YouTube that is helpful.
Resinger, M. (2017, November 24). How to write a prescription in 60 seconds for PMHNP’s [Video]. YouTube. https://youtu.be/Zy4ypgvLX8o
Supplemental Material (Optional):
Media
Agency for Healthcare Research and Quality. (n.d.). CHAIN ONLINE: Clinical consumer health advisory information network. U.S. Department of Health and Human Services. https://www.ahrq.gov/chain/index.html
Medicocurio. (2020, April 1). Pharmacogenomics: Genes and medicine [Video]. YouTube. https://www.youtube.com/watch?v=RXmrUhSSSlo Canabis/Marijuana
RS TU. (2017, May 3). Pharmacoeconomics [Video]. YouTube. https://www.youtube.com/watch?v=OlxMLG5xs9w
Epocrates is a downloadable app or desktop version with valuable resources for prescribing and managing medications.
Athenahealth, Inc. (n.d). Epocrates. http://www.epocrates.com/
CredibleMeds requires a free registration to access the information. Explore the Medication Safety Tools & Resources section.
CredibleMeds. (n.d.). QTDrugs lists. https://crediblemeds.org/index.php/login/dlcheck
Haymarket Media, Inc. (n.d.). Monthly prescribing reference. http://www.empr.com/ Note: Navigate this site for up-to-date drug safety information and clinical charts that are useful references to print out.
U.S. FDA Website provides an abundance of information on various topics:
U.S. Food and Drug Administration. (n.d.). FDA homepage. U.S. Department of Health and Human Services. https://www.fda.gov/
Shadow Health
Shadow Health
The purpose of Shadow Health assignment is to utilize clinical simulation technology to assist in your learning and understanding of advanced pharmacology concepts. The utilization of Shadow Health will apply to the following course learning outcomes (CLOs):
CLO 1: Apply critical thinking and best scientific evidence to the management and evaluation of expected effects, potential adverse effects, and potential interactions of pharmacological agents for the treatment of self-limiting acute conditions and chronic diseases across the lifespan (MSN PLO 7) (ILO 1; MSN Essential VIII; IPEC VE1, VE4, TT3, TT4).
CLO 2: Analyze the pharmacodynamics and the pharmacokinetic impact of pharmacologic therapies in the treatment of diseases and altered states. (MSN PLO 1,7) (ILO 1, 5; MSN Essential I & VIII; IPEC VE1, VE4, VE10, TT3, TT4)
CLO3: Formulate therapeutic regimens for patients, including patients with altered pharmacodynamics and pharmacokinetics special populations, such as infants and children, pregnant and lactating women, and older adults with using cultural competence. (MSN PLO 7) (ILO 1; MSN Essential VIII; IPEC VE1, VE4, TT3, TT4).
CLO 4: Evaluate the impact of pharmacogenomics, access, cost, quality, and safety on prescribing. (MSN PLO 5) (ILO 2; MSN Essential VII; IPEC VE5, RR1, RR6, CC2, CC4, CC5, CC6, TT11).
CLO 5: Examine the significance of interprofessional collaboration on patient outcomes. (MSN PLO 6) (ILO 1; MSN Essential VII; IPEC VE5, RR1, RR6, CC2, CC4, CC5, CC6, TT11).
Assignment: View the following Shadow Health orientation video (ungraded)
Shadow Health DCE Orientation
Assignment: Complete Shadow Health Conversation Concepts (ungraded)
This week you will complete a practice Shadow Health conversation lab. The exercise in the Conversation Concept Lab will help you structure interviews by asking open and closed questions with avatar involvement. On average, this Concept Lab takes 40 minutes to complete.
Login page: “Shadow Health Access” link on left panel
Shadow Health Technical Support
If at any time you have any questions or encounter any technical issues regarding the Digital Clinical Experience, please contact the Shadow Health support specialists by visiting the Learner Support Page at http://support.shadowhealth.com for contact information and hours. You may email the Learner Support team directly at [email protected] at any time or by calling 800.860.3241.
Faculty Lecture: Chapter 1 – The Role of the Advance Practice Nurse Practitioner as Prescriber
Faculty Lecture: Chapter 1 – The Role of the Advance Practice Nurse Practitioner as Prescriber
Attached Files:
Chapter 1 – The Role of the Advance Practice Nurse Practitioner as Prescriber Handout.pdf Chapter 1 – The Role of the Advance Practice Nurse Practitioner as Prescriber Handout.pdf – Alternative Formats (6.97 MB)
Chapter 1 – The Role of the Advance Practice Nurse Practitioner as Prescriber Transcript.pdf Chapter 1 – The Role of the Advance Practice Nurse Practitioner as Prescriber Transcript.pdf – Alternative Formats (57.897 KB)
Unit 1 Discussion
Unit 1 Discussion
This Discussion is intended to allow you to show evidence of achieving the following Course Learning Outcomes (CLO):
CLO 1: Apply critical thinking and best scientific evidence to the management and evaluation of expected effects, potential adverse effects, and potential interactions of pharmacological agents for the treatment of self-limiting acute conditions and chronic diseases across the lifespan (MSN PLO 7) (ILO 1; MSN Essential VIII; IPEC VE1, VE4, TT3, TT4)
CLO 4: Evaluate the impact of pharmacogenomics, access, cost, quality, and safety on prescribing. (MSN PLO 5) (ILO 2; MSN Essential VII; IPEC VE5, RR1, RR6, CC2, CC4, CC5, CC6, TT11).
After review of Unit 1 and Learning Materials, please address all of the following questions. Let’s take a moment and examine the components of your future FNP practice.
In your state, do you need physician collaboration to practice as an NP or can NP’s practice independently? What if any practice restrictions to practice for the NP does your state have?
Does the NP role in your state need collaboration to prescribe or can NPs independently prescribe? What if any prescription restrictions exist in your state (ie: can the NP prescribe all classes of controlled substances in your state, what levels, restrictions such as length of time or quantity limits)?
Do you think the NP role should have collaboration for practice and/or prescribing? Explain your stance on this position and use scholarly evidenced based information to support your view.
Does your state have a Prescription Drug Monitoring Program (PDMP) or Controlled Substance Utilization Review and Evaluation System (CURES) system? If so, what are the details of this system (timeline for uploading of prescriptions to the system, reporting etc.). How will this affect your future FNP practice?
Initial Post:
Include at least 2 scholarly, peer reviewed, timely sources (within 5 years) in your response.
Writing should be in a professional format with APA appropriate citations and references.
Please note that on submission to the discussion board, Blackboard often alters the formatting of the post. This is taken into consideration when faculty grade the post.
Peer Post:
Respond to at least 2 peers whose state of practice is different than your own.
Include at least 1 scholarly, peer reviewed, timely source (within 5 years) in your response.
Your response should either add to the content of the topic or based on research findings you include ask additional questions on the topic.
Faculty Questions:
Faculty will be present during the week on the discussion board. It is expected that you will respond to any questions posed directly to you by faculty during the week. A failure to respond may result in a deduction of points as indicated in the Discussion Grading Rubric
Please refer to the grading rubric for further details on the content expectations. You can find this under “My Grades”, “Unit 1: Discussion”.
Initial post due date: Day 7 (Sunday) of Unit 1
Peer post and Faculty response to any faculty questions due date: Day 7 (Sunday) of Week 2
Please note: Internet searches will often take you to non-academic information resources such as Wikipedia.com, Ask.com, Encarta.msn.com, Infoplease.com, etc. For a graduate-level course, you may not supplement your literature search with these sources because they do not come under a formal oversight or peer-review process.
CDC Module Training
CDC Module Training
To prepare you for your future practice and management of patient pain, it is important to understand the significance of prescribing opioids. This assignment is intended to allow you to show evidence of achieving the following Course Learning Outcomes (CLO):
CLO 1: Apply critical thinking and best scientific evidence to the management and evaluation of expected effects, potential adverse effects, and potential interactions of pharmacological agents for the treatment of self-limiting acute conditions and chronic diseases across the lifespan (MSN PLO 7) (ILO 1; MSN Essential VIII; IPEC VE1, VE4, TT3, TT4).
CLO 2: Analyze the pharmacodynamics and the pharmacokinetic impact of pharmacologic therapies in the treatment of diseases and altered states. (MSN PLO 1,7) (ILO 1, 5; MSN Essential I & VIII; IPEC VE1, VE4, VE10, TT3, TT4)
CLO3: Formulate therapeutic regimens for patients, including patients with altered pharmacodynamics and pharmacokinetics special populations, such as infants and children, pregnant and lactating women, and older adults with using cultural competence. (MSN PLO 7) (ILO 1; MSN Essential VIII; IPEC VE1, VE4, TT3, TT4).
CLO 4: Evaluate the impact of pharmacogenomics, access, cost, quality, and safety on prescribing. (MSN PLO 5) (ILO 2; MSN Essential VII; IPEC VE5, RR1, RR6, CC2, CC4, CC5, CC6, TT11).
Step 1: View the CDC Module 1: Addressing the Opioid Epidemic https://www.cdc.gov/opioids/providers/training/overview.html
Step 2: Review the CDC Guideline for Prescribing Opioids for Chronic Pain — United States, 2016 https://www.cdc.gov/mmwr/volumes/65/rr/rr6501e1.htm (This guideline is in the process of being updated)
Step 3: There is no longer CEs available for this module, so please proceed to the CDC MODULE QUIZ to recieve credit for this activity.
After viewing the CDC Module 1: Addressing the Opioid Epidemic and CDC Guideline for Prescribing Opioids for Chronic Pain please complete the 5 question quiz. (50 points)
Respondus Practice Quiz – NUR 7560 (ungraded) (**Webcam**) – Requires Respondus LockDown Browser
The purpose of this Respondus Practice Quiz is multifactorial. The purpose is to:
Check the functionality of the Respondus Lockdown Browser on your chosen evice
Review course materials including syllabus and course schedule
Review information from Week 1
Unit 7: Neurologic Pharmacology
Neurologic Pharmacology
Neurologic Pharmacology
Welcome to Unit 7
Drugs that affect the central nervous system can be broadly categorized into those used to treat psychiatric or neurological conditions. These drugs affect neuroreceptors and neurotransmitters, in different parts of the brain, to bring a response. Understanding the central nervous system will have a critical impact on rational drug selection and side effect management.
Pain management, both acute and chronic, are topics of national concern, due to high rates of controlled substance abuse. The treatment plan is guided by the history, intensity, duration, aggravating and relieving conditions, and structures involved in causing the pain. In this course, we will focus on the pharmacology and the goals of treatment, along with rational drug selection, keeping in mind a safe and effective treatment plan.
Unit Learning Objectives
Examine the principles of pathophysiology and therapeutics that direct the pharmacotherapeutic interventions affecting the nervous system (CLO 1)
Analyze the pharmacokinetic and pharmacodynamic actions of agents affecting the nervous system (CLO 2)
Apply critical-thinking processes to the management and evaluation of expected effects, potential adverse effects, and potential interactions of pharmacological agents affecting the nervous system (CLO 3)
Apply critical-thinking processes to the management and evaluation of expected effects, potential adverse effects, and potential interactions of pharmacological agents affecting the nervous system (CLO 1,2,3
Week 9/Unit 7 “To Do” List
Complete High-Yield Med Review Quiz by Sunday Week 9
Shadow Health Focused Exam: Pain Management due Sunday Week 9
Shadow Health Concept Lab: Analgesics due Sunday Week 9
Unit 6 & 7 Exam is next week; begin studying and preparing
Learning Materials
Learning Materials
Lectures & E-Book
Busti, A. J. (2022). NP Curriculum Support-Advanced Pharmacology for NPs. MedEducation, LLC.
NEUROLOGIC PHARMACOLOGY
Non-opioid Analgesics Review
Opioid Analgesic Review
Opioid Induced Side Effects
Opioid Dose Equivalency
Anticonvulsants Review Part 1
Anticonvulsants Review Part 2
ADVANCED DRUG CLASS REVIEW TOPICS
Alzheimers Disease
Parkinson’s Disease
Optional Learning Resources:
Media
Speed Pharmacology. (2017, December 7). Pharmacology – NSAIDs & prostaglandin analogs (made easy) [Video]. YouTube. https://www.youtube.com/watch?v=I1uHkbocRCw
Speed Pharmacology. (2018, November 5). Antiepileptic drugs (made easy) [Video]. YouTube. https://www.youtube.com/watch?v=xFUHE9gX6W8
Speed Pharmacology. (2019, January 28). Opioids (made easy) [Video]. YouTube. https://www.youtube.com/watch?v=t2tKyjj7u5Y
Websites
Khan Academy. (2018r). Nervous system diseases. Retrieved March 11, 2021, from https://www.khanacademy.org/science/health-and-medicine/nervous-system-disease
University of Florida Health. (2020). Pain management and dosing guide. Retrieved March 11, 2021, from https://pami.emergency.med.jax.ufl.edu/resources/dosing-guide/#:~:text=The%20PAMI%20Pain%20Management%20and%20Dosing%20Guide%20is,chronic%20pain%20and%20procedural%20sedation%20in%20all%20ages.
U.S. Department of Health and Human Services, Centers for Disease Control and Prevention. (2017a). CDC guideline for prescribing opioids for chronic pain. https://www.cdc.gov/drugoverdose/prescribing/guideline.html
U.S. Department of Health and Human Services, Centers for Disease Control and Prevention. (2017b). Training for providers. Retrieved March 11, 2021, from https://www.cdc.gov/drugoverdose/training/index.html
U.S. Department of Health and Human Services, U.S. Food & Drug Administration. (2017b). Training health care providers on pain management and safe use of opioid analgesics – Exploring the path forward. Retrieved March 11, 2021, from https://www.fda.gov/Drugs/NewsEvents/ucm538047.htm
HYMR Quiz – Neurology
Following review of all assigned lectures and correlating E-book chapters in High Yield Med Review, you will complete the module quiz in the HYMR platform.
From the Dashboard select “EXAMS”
Navigate to the “Neurology – Self Assessment”
Click “Take Exam”
You will have one attempt to complete 10 questions in 15 minutes. Once completed, please take a screen shot of your score and upload to this assignment tab for grading. This quiz is worth 20 points, so based on your % score you will receive the correlating points below.
100%
20 points
90%
18 points
80%
16 points
70%
14 points
60%
12 points
50%
10 points
40%
8 points
30%
6 points
20%
4 points
10%
2 points
No submission
0 points
*Please note, faculty are able to view your time and activity in HYMR.*
Shadow Health: Concept Lab – Analgesics
The purpose of this Shadow Health Concept Lab assignment is to help you achieve the following Course Learning Outcomes 1-5.
Assignment:
This week you will participate in a Shadow Health Concept Lab pertaining to analgesic medications. This will allow you to learn about pharmacological concepts related to commonly administered analgesic drugs. This module should take approximately 30 minutes to complete.
What to Submit:
Upon completion of the assignment:
Submit your completion certificate
Submit your reflection response to the questions below
Reflection Response Instructions: Submit a 1 page reflection response to the questions below. Please use APA format and include one scholarly reference.
How do you identify a patient that may be overusing or abusing prescription pain medications? How would you handle this concern if you are the NP seeing this patient?
Shadow Health Technical Support
If at any time you have any questions or encounter any technical issues regarding the Digital Clinical Experience, please contact the Shadow Health support specialists by visiting the Learner Support Page at http://support.shadowhealth.com for contact information and hours. You may email the Learner Support team directly at [email protected] at any time or by calling 800.860.3241.
Shadow Health: Focused Exam: Pain Management
The purpose of this Shadow Health Focused Exam assignment is to help you achieve Course Learning Outcomes 1-5.
Assignment:
This assignment provides the opportunity to conduct a focused exam on a patient who presents with chronic pain. You will interview Tanner Bailey using therapeutic communication, and obtain enough subjective data to determine the appropriate pharmacological therapy for his condition. After the patient exam, you will select the medication which best suits Mr. Bailey’s needs. If applicable, you will write a prescription for the selected medication. This assignment includes subjective data collection around sensitive topics like gender identity. This module should take approximately 90 minutes.
What to Submit:
Upon completion of the assignment, submit your completion certificate/lab pass that shows the DCE score to this assignment link..
Shadow Health Grading
All assignments will be graded using the DCE Score. Reopening and multiple attempts are allowed so the student can submit the best score for grading. Each student will submit the “lab pass” showing their DCE score to the designated assignment tab in Blackboard. Grading will be based on the DCE score received on the assignment that correlates with the points allocated in the table below. An incomplete assignment will result in the grade of zero. Faculty will monitor student engagement within the Shadow Health platform to ensure active participation to complete all the assignment requirements.
DCE Score
Points
95-100
20
90-94
18
85-89
15
80-84
13
Below 79
10
No submission
0
Login page: “Shadow Health Access” link on left panel
Assignment Due Date: Sunday of Week 6
Shadow Health Technical Support
If at any time you have any questions or encounter any technical issues regarding the Digital Clinical Experience, please contact the Shadow Health support specialists by visiting the Learner Support Page at http://support.shadowhealth.com for contact information and hours. You may email the Learner Support team directly at [email protected] at any time or by calling 800.860.3241.
Unit Conclusion
Unit Conclusion
As we wrap up this week of advanced pharmacology, we learned about the drugs that affect the central nervous system. These drugs affect neuroreceptors and neurotransmitters in different parts of the brain to bring a response. This is not the last time you will learn about neurotransmitters or receptors, so keep this learning in mind as we proceed.
Remember, always focus on the goals of treatment, along with rational drug selection, keeping in mind safe and effective treatment plan.
Unit 10: Women’s Health Pharmacology
Women’s Health Pharmacology
Women’s Health Pharmacology
Welcome to Unit 10 of Advanced Pharmacology
This week will explore the Reproductive System, Contraception, Pregnancy, and Hormone Replacement Therapy. Ironically all these topics cross at some point in many of our lives. Prior concepts of pathophysiology will help build new knowledge for prescriptive management. In these categories. Evaluation of Pharmacokinetics, pharmacodynamics and pharmacotherapeutics will aid in application of these categories to clinical practice.
Unit Learning Objectives
Examine the principles of pathophysiology and therapeutics that direct the pharmacotherapeutic interventions for the female reproductive system (CLO 1)
Analyze the pharmacokinetic and pharmacodynamic actions of agents used for management of the female reproductive system (CLO 2)
Apply the evidence for pharmacotherapeutic interventions in patients with reproductive system problems and contraceptive management (CLO 3)
Apply critical-thinking processes to the management and evaluation of expected effects and potential adverse effects of pharmacodynamic agents (CLO 1,2,3)
Evaluate the impact of pharmacogenomics, access, cost, quality, and safety on prescribing for drugs affecting the female reproductive system (CLO 4)
Examine the significance of interprofessional collaboration on patient outcomes (CLO 5)
Week 12/Unit 10 “To Do” List
High-Yield Med Review Quiz due by Sunday Week 12
Shadow Health Focused Exam: UTI with Antibiotic Sensitivity due Sunday Week 12
Unit 8-10 Exam is next week, please being preparing!
Learning Materials
Learning Materials
Lectures & E-Book
Busti, A. J. (2022). NP Curriculum Support-Advanced Pharmacology for NPs. MedEducation, LLC.
WOMEN’S HEALTH PHARMACOLOGY
Normal Hormone Physiology in Women
Hormone Regulation of the Menstrual Cycle: Infer & Contraception
Pharmacokinetic Considerations in Pregnancy
Drug Categorization and Risks in Pregnancy
Drugs and Breastfeeding
ADVANCED DRUG CLASS REVIEW TOPICS
Overactive Bladder
Sexual Disorders
Optional Learning Resources:
Media
Khan Academy (Producer). (2014c). Estrogen [Video]. Estrogen
Khan Academy (Producer). (2014f). Testosterone [Video]. https://www.khanacademy.org/science/health-and-medicine/human-anatomy-and-physiology/reproductive-system-introduction/v/testosterone
HYMR Quiz – Women’s Health
Following review of all assigned lectures and correlating E-book chapters in High Yield Med Review, you will complete the module quiz in the HYMR platform.
From the Dashboard select “EXAMS”
Navigate to the “Women’s Health- Self Assessment”
Click “Take Exam”
You will have one attempt to complete 10 questions in 15 minutes. Once completed, please take a screen shot of your score and upload to this assignment tab for grading. This quiz is worth 20 points, so based on your % score you will receive the correlating points below.
100%
20 points
90%
18 points
80%
16 points
70%
14 points
60%
12 points
50%
10 points
40%
8 points
30%
6 points
20%
4 points
10%
2 points
No submission
0 points
*Please note, faculty are able to view your time and activity in HYMR.*
Shadow Health: Focused Exam: UTI/Abx sensitivity
The purpose of this Shadow Health Focused Exam assignment is to help you achieve Course Learning Outcomes 1-5.
Assignment:
This assignment is a focused exam with a patient who presents with a UTI and antibiotic sensitivity. You will conduct an interview Makayla Henderson using therapeutic communication to determine the appropriate pharmacological therapy for her condition. After the exam, you will select the most appropriate medication for Ms. Henderson and educate her on her medication and disease management. If applicable, you will write a prescription for the selected medication.
What to Submit:
Upon completion of the assignment, submit your completion certificate/lab pass that shows the DCE score to this assignment link..
Shadow Health Grading
All assignments will be graded using the DCE Score. Reopening and multiple attempts are allowed so the student can submit the best score for grading. Each student will submit the “lab pass” showing their DCE score to the designated assignment tab in Blackboard. Grading will be based on the DCE score received on the assignment that correlates with the points allocated in the table below. An incomplete assignment will result in the grade of zero. Faculty will monitor student engagement within the Shadow Health platform to ensure active participation to complete all the assignment requirements.
DCE Score
Points
95-100
20
90-94
18
85-89
15
80-84
13
Below 79
10
No submission
0
Login page: “Shadow Health Access” link on left panel
Assignment Due Date: Sunday of Week 12
Shadow Health Technical Support
If at any time you have any questions or encounter any technical issues regarding the Digital Clinical Experience, please contact the Shadow Health support specialists by visiting the Learner Support Page at http://support.shadowhealth.com for contact information and hours. You may email the Learner Support team directly at [email protected] at any time or by calling 800.860.3241.
Unit Conclusion
Unit Conclusion
CONGRATULATIONS! You have officially completed all the High Yield Med Review content and Shadow Health Assignments so you can move on to prepare for the Unit 8-10 Exam and HESI Final Exam.
