Posted: December 22nd, 2022

Advanced Pathophysiology- Alterations in Cellular Processes

NURS 6501: Advanced Pathophysiology Walden University full course – Week 1 discussion post

Alterations in Cellular Processes

Alterations of cellular responses are caused by multiple changes that
occur within the cell due to the environmental stressors. Different diseases can cause alterations of cellular responses that can lead to abnormal changes in the normal response processes, and it can be showed as signs and symptoms. A case study indicates a 16-year-old boy who visit a clinic with chief complaint of sore throat for 3 days presenting in with multiple symptoms. The bacteria that were involved in the disease is called Pharyngitis. Unfortunately, he experiences a severe allergic reaction after the administration of amoxicillin 500 mg. It is a fact genetics, presentation of specific symptoms and the impact of age factor need to be considered.

Role of genetics

Research shows that Streptococcus group A bacteria and is often linked
to genetics and it is the major cause of sore throat that were experienced by most young children. Genetic variations taking place at the HLA region are linked to the recurrent nature of sore throat. More so, some specific variations of the gene are evident during genetic testing and are associated with the immune systems interaction with pathogens. Study indicates that many patients become more susceptible to sore throat following the genetic changes that causes variations due to insufficient responses of the antibody responses against the bacteria.

Why the patient presents with the specific symptoms

The alteration of normal responses within the cells of the body can cause the signs and symptoms of diseases. For example, the invasion of Streptococcus group A bacteria in the body can result to secretion of pus, redness, inflammation of the throat. Clinical manifestations are thus associated with the pharynx colonialization by the fibronectin-binding proteins of Streptococcus pyogenes (Soderholm, Barnett, Sweet & Walker, 2018). However, during treatment with amoxicillin some patient experience sign and symptom that includes difficulty breathing, tachycardia, swelling of lips, vomiting, and wheezing and it was due to allergic responses to the antibiotics.

Physiologic response and cells involved in the process

The physiologic responses for this patient include redness in the posterior pharynx with white exudate on tonsils that are enlarged to 3 plus. The sign will include positive anterior and a posterior cervical adenopathy. The adaptive and innate responses are responsible for the physiologic responses as they create a defense mechanism to fight the infection strep test, the patient turned out positive of Streptococcus group A bacteria. The immune cells involved in this allergic reaction are Helper T cells of type 1, 2, and 17.This allergic reaction is a type I hypersensitivity reaction. The drug is presented to these T cells through the dendritic cells. The antigen binds to TCR receptors on the T cells and activates these immune cells (McCance & Huether, 2019).

How age factor would change the response

Study indicates that people ‘s age can affect the risks of contracting diseases. It includes how some illnesses are more common in the young persons while others are common among the elderly. An increase in rate of pharyngitis is very common in children of between 5 to 15 years old. According to Campbell et al. (2018), a 5 to 10% risk of sore throat infection exists among the adults regardless of the already established strong immune system. Safe pharmacologic treatment of sore throat patients should thus be guided by the age of the patient to prevent adverse reactions and allergies.

References

Campbell, P. T., Frost, H., Smeesters, P. R., Kado, J., Good, M. F., Batzloff, M., … & Steer, A.

(2018). Investigation of group A Streptococcus immune response in an endemic setting, with a particular focus on J8. Vaccine, 36(50), 7618-7624.

Soderholm, A. T., Barnett, T. C., Sweet, M. J., & Walker, M. J. (2018). Group A streptococcal

pharyngitis: Immune responses involved in bacterial clearance and GAS‐associated immunopathology. Journal of leukocyte biology, 103(2), 193-213.

McCance, K. L. & Huether, S. E. (2019). Pathophysiology: The biologic basis for disease in

adults and children (8th ed.). Mosby/Elsevier.

In addition to you points, Allergic reactions to amoxicillin are very common occurrences in the pediatric age group. Amoxicillin is a commonly prescribed antibiotic for treatment of community-acquired bacterial infections in children. Given that it is a first-line treatment for otitis media and sinusitis, and given the high frequency of viral-induced exanthemas including hives in this age group (nih.gov).

True allergic reactions to amoxicillin are mediated by the immune system and are classified into immediate (developing within 30 to 60 minutes of drug ingestion) or non-immediate (beyond 1 hour of ingestion) type reactions (nih.gov). Immediate reactions may range in severity from eruptions limited to the skin (hives/angioedema) to reactions involving more than one organ system or hypotension (that is, anaphylaxis). Non-immediate reactions occur more than 1 hour after ingestion of antibiotic and usually last several days.

In conclusion, many different types of cells are involved in the inflammatory process including mast cells, endothelial cells, platelets, phagocytes (neutrophils, eosinophils, monocytes and macrophages, dendritic cells), natural killer (NK) cells, and lymphocytes (McCance & Huether, 2019).

Immediate and non-immediate allergic reactions to amoxicillin present a diagnostic dilemma. Retrieved March 3, 2022 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4717649/#CR7

McCance, K. L. & Huether, S. E. (2019). Pathophysiology: The biologic basis for disease in adults and children (8th ed.). Mosby/Elsevier.

The symptoms represent pharyngitis caused by viruses, bacteria, chemicals, or even gastroesophageal reflux disease. In this case, the culprit is a streptococcal infection with a low-grade fever, which would indicate pharyngitis. The boy experienced symptoms because of his illness and was treated for the condition, resulting in an anaphylactic reaction. I listed an article that I came across that I thought might interest you regarding clinical and experimental immunology.

The sixteen-year-old boy had an anaphylactic reaction to the Amoxicillin prescribed to treat pharyngitis, which resulted in swelling of the lips and tongue, resulting in audible wheezes from the airway constricting. I read an article that noted that allergic diseases affect pubescent males more than females. The prevalence of many diseases in the female gender and the male gender points to testosterone, which limits immune function, whereas estrogen and progesterone support it (Demartinis et al., 2020, p.4). I had a response from a peer that contradicted this article. I have included that information in my references for you. I also listed an article from the CDC relevant to anaphylactic reactions even though the article was written for COVID-19 vaccinations. “Genes, hormones, environmental and immunological factors affect sex disparities associated with the development and control of allergic diseases, while they more rarely are considered and reported regarding their differences related to social, psychological, cultural, economic, and employment aspects” (Demartinis et al., 2020, p.1).

References

CDC. (2021). Interim considerations: preparing for the potential management of anaphylaxis

after covid-19 vaccination. Centers for Disease Control and Prevention. https://www.cdc.gov/vaccines/covid-19/clinical-considerations/managing-anaphylaxis.html

Cardinale, F., Amato, D., Mastrototaro, M. F., Caffarelli, C., Crisafulli, G., Franceschini, F.,

Liotti, L., Caimmi, S., Bottau, P., Saretta, F., Mori, F., & Bernardini, R. (2019). Drug-induced anaphylaxis in children. Acta Biomedica Atenei Parmensis90(3-S), 30–35. https://doi.org/10.23750/abm.v90i3-S.8172

Davies, F. J., Olme, C., Lynskey, N. N., Turner, C. E., & Sriskandan, S. (2019). Streptococcal

superantigen-induced expansion of human tonsil T cells leads to altered T follicular helper cell phenotype, B cell death and reduced immunoglobulin release. Clinical and Experimental Immunology197(1), 83–94. https://doi.org/10.1111/cei.13282

De Martinis, M., Sirufo, M. M., Suppra, M., Di Silvestre, D., & Ginaldi, L. (2020). Sex and

gender aspects for patient stratification in allergy prevention and treatment. International Journal of Molecular Sciences, 21(4). https://doi.org.10.3390/ijms21041535

Vincent, M. T., Celestin, N., & Hussain, A. (2004). Pharyngitis. American Family Physician.

69(6). 1465-1470. https://www.aafp.org/afp/2004/0315/p1465.html

It is true that cell environment stressors cause alterations within the cell and different diseases cause alterations as cells respond to change. Ultimately, the processes of reacting to change would be expressed as symptoms as evident in the child in the case study. Pharyngitis, caused by bacteria and treatable by administering Amoxicillin 500 mg would involve different processes and responses. Consideration of genetic and age factors become critical in analyzing the symptomatic expressions and the outcome upon administration of the medication (Mccance & Huether, 2018).

I believe that association of streptococcus Group A (SGA) bacteria with genetic variations at the HLA region define the susceptibility of children to SGA (Medline Plus, 2021). This is expressed through symptoms like sore throat as a result of inflammatory reactions that links to the immune cell interaction with the perceived pathogen.  Patients who have an alteration of the gene are not capable of producing g sufficient antibodies in response to the pathogen (Mccance & Huether, 2018). This leads to a recurrence and the need for medication. Inflammatory mediators triggered upon detection of pathogens may lead to redness, heat, swelling and pain.

Type-1 hypersensitive reaction involving immune cells such as the Helper-T cell results to the symptoms evident by the patient. Additionally, I agree that research indicate that there is a relation between age and susceptibility to disease. Some diseases are common among the elderly while some are common among children. It is true that pharyngitis is most common among children between age 5 and 15 (Mccance & Huether, 2018). Adults may also present with sore throat regardless of attaining remarkable immunity. Treatment require consideration of age in order to administer the correct doses and to prevent cases of adverse reactions.

References

Mccance, K. L., & Huether, S. E. (2018). Pathophysiology – e-book: The biologic basis for

disease in adults and children (8th ed.). Mosby.

Medline Plus. (2021, February 22). What is a cell?: Medlineplus genetics. Retrieved March 1,

2022, from https://medlineplus.gov/genetics/understanding/basics/cell/

Week 1: Cellular Processes and the Genetic Environment

One of the more common biology analogies refers to cells as the “building blocks” of life. This rightfully places an emphasis on understanding cells, cellular behavior, and the impact of the environment in which they function.

Such an understanding helps explain how healthy cell activity contributes to good health. Just as importantly, it helps explain how breakdowns in cellular behavior and alterations to cells lead to health issues.

This week, you examine cellular processes that are subject to alterations that can lead to disease. You evaluate the genetic environments within which these processes exist as well as the impact these environments have on disease.

Learning Objectives

Students will:

  • Evaluate cellular processes and alterations within cellular processes
  • Evaluate the impact of the genetic environment on disease

Learning Resources

Required Readings (click to expand/reduce)

McCance, K. L. & Huether, S. E. (2019). Pathophysiology: The biologic basis for disease in adults and children (8th ed.). St. Louis, MO: Mosby/Elsevier.

  • Chapter 1: Cellular Biology; Summary Review
  • Chapter 2: Altered Cellular and Tissue Biology: Environmental Agents (pp. 46-61; begin again with Manifestations of Cellular Injury pp. 83-97); Summary Review
  • Chapter 3: The Cellular Environment: Fluids and Electrolytes, Acids, and Bases
  • Chapter 4: Genes and Genetic Diseases (stop at Elements of formal genetics); Summary Review
  • Chapter 5: Genes, Environment-Lifestyle, and Common Diseases (stop at Genetics of common diseases); Summary Review
  • Chapter 7: Innate Immunity: Inflammation and Wound Healing
  • Chapter 8: Adaptive Immunity (stop at Generation of clonal diversity); Summary Review
  • Chapter 9: Alterations in Immunity and Inflammation (stop at Deficiencies in immunity); Summary Review
  • Chapter 10: Infection (pp. 289–303; stop at Infectious parasites and protozoans); (start at HIV); Summary Review
  • Chapter 11: Stress and Disease (stop at Stress, illness & coping); Summary Review
  • Chapter 12: Cancer Biology (stop at Resistance to destruction); Summary Review
  • Chapter 13: Cancer Epidemiology (stop at Environmental-Lifestyle factors); Summary Review
Required Media (click to expand/reduce)

Module 1 Overview with Dr. Tara Harris 

Dr. Tara Harris reviews the structure of Module 1 as well as the expectations for the module. Consider how you will manage your time as you review your media and Learning Resources throughout the module to prepare for your Discussion and Assignment. (4m)

Foundational Concepts of Cellular Pathophysiology – Week 1 (14m)

Khan Academy (2010, February 24). Inflammatory response | Human anatomy and physiology | Health & medicine [Video file]. Retrieved from https://www.youtube.com/watch?v=FXSuEIMrPQk

Note: The approximate length of the media program is 14 minutes.

Soo, P. (2018, July 28). Pathophysiology Ch 10 alterations in immune function [Video file]. Retrieved from https://www.youtube.com/watch?v=Jz0wx1-jTds

Note: The approximate length of the media program is 37 minutes.

Acid-Base Balance #1

MedCram. (2012, April 28). Medical acid base balance, disorders & ABGs explained clearly [Video file]. Retrieved from https://www.youtube.com/watch?v=4wMEMhvrQxE

Note: The approximate length of the media program is 13 minutes.

Acid-Base Balance #2

MedCram. (2012, April 29). Medical acid base balance, disorders & ABGs explained clearly | 2 of 8 [Video file]. Retrieved from https://www.youtube.com/watch?v=GmEeKVTpOKI

Note: The approximate length of the media program is 15 minutes.

Hyponatremia

MedCram. (2017, December 23). Hyponatremia explained clearly (remastered) – Electrolyte imbalances [Video file]. Retrieved from https://www.youtube.com/watch?v=bLajK5Vy55M

Note: The approximate length of the media program is 15 minutes.

Online Media from Pathophysiology: The Biologic Basis for Disease in Adults and Children

In addition to this week’s media, it is highly recommended that you access and view the resources included with the course text, Pathophysiology: The Biologic Basis for Disease in Adults and Children. Focus on the videos and animations in Chapters 3, 7, and 8 that relate to alterations in immunity, hyponatremia, and acid/base balance.

Note: To access the online resources included with the text, you need to complete the FREE online registration that is located at https://evolve.elsevier.com/cs/store?role=student

To Register to View the Content

  1. Go to https://evolve.elsevier.com/cs/store?role=student
  2. Enter the name of the textbook, Pathophysiology: The Biologic Basis for Disease in Adults and Children, or ISBN 9780323654395 (name of text without the edition number) in the Search textbox.
  3. Complete the registration process.

To View the Content for This Text

  1. Go to https://evolve.elsevier.com/
  2. Click on Student Site.
  3. Type in your username and password.
  4. Click on the Login button.
  5. Click on the plus sign icon for Resources on the left side of the screen.
  6. Click on the name of the textbook for this course.
  7. Expand the menu on the left to locate all the chapters.
  8. Navigate to the desired content (checklists, videos, animations, etc.).

Note: Clicking on the URLs in the APA citations for the Resources from the textbook will not link directly to the desired online content. Use the online menu to navigate to the desired content.


Discussion: Alterations in Cellular Processes

At its core, pathology is the study of disease. Diseases occur for many reasons. But some, such as cystic fibrosis and Parkinson’s Disease, occur because of alterations that prevent cells from functioning normally.

Understanding of signals and symptoms of alterations in cellular processes is a critical step in diagnosis and treatment of many diseases. For the Advanced Practice Registered Nurse (APRN), this understanding can also help educate patients and guide them through their treatment plans.

For this Discussion, you examine a case study and explain the disease that is suggested. You examine the symptoms reported and explain the cells that are involved and potential alterations and impacts.

To prepare:

  • By Day 1 of this week, you will be assigned to a specific scenario for this Discussion. Please see the “Course Announcements” section of the classroom for your assignment from your Instructor.
By Day 3 of Week 1

Post an explanation of the disease highlighted in the scenario you were provided. Include the following in your explanation:

  • The role genetics plays in the disease.
  • Why the patient is presenting with the specific symptoms described.
  • The physiologic response to the stimulus presented in the scenario and why you think this response occurred.
  • The cells that are involved in this process.
  • How another characteristic (e.g., gender, genetics) would change your response.

Read a selection of your colleagues’ responses.

By Day 6 of Week 1

Respond to at least two of your colleagues on 2 different days and respectfully agree or disagree with your colleague’s assessment and explain your reasoning. In your explanation, include why their explanations make physiological sense or why they do not

Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link and then select “Create Thread” to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on Submit!

Submission and Grading Information

Grading Criteria

To access your rubric:

Week 1 Discussion Rubric

Post by Day 3 of Week 1 and Respond by Day 6 of Week 1

To Participate in this Discussion:

Week 1 Discussion


Part 1

Practicum Manual Acknowledgment

The Practicum Manual describes the structure and timing of the classroom-based and practicum experiences and the policies students must follow to be successful in the nurse practitioner (NP) specialties.

  • Field Experience: MSN Nurse Practitioner Practicum Manual

Click here and follow the instructions to confirm you have downloaded and read the entire MSN Nurse Practitioner Practicum Manual and will abide by the requirements described in order to successfully complete this program.

Part 2

This mandatory assignment is an acknowledgement that you fully understand the course guidelines.

By Day 3 of Week 1

Submit your Assignment.

Submission and Grading Information

Submit Your Assignment by Day 3 of Week 1.

To complete this assignment, follow the link below and answer the questions provided.

Week 1 Assignment

Week 2: Altered Physiology

With a place squarely in the spotlight for patients diagnosed with all manner of disease, APRNs must demonstrate not only support and compassion, but expertise to guide patients’ understanding of diagnoses and treatment plans.

This expertise goes beyond an understanding of disease and sciences, such as cellular pathophysiology. APRNs must become experts in their patients, understanding their medical backgrounds, pertinent characteristics, and other variables that can be factors in their diagnoses and treatments.

This week, you examine alterations in the immune system and the resultant disease processes. You consider patient characteristics, including racial and ethnic variables, and the impact they have on altered physiology.

Learning Objectives

Students will:

  • Evaluate cellular processes and alterations within cellular processes
  • Analyze alterations in the immune system that result in disease processes
  • Identify racial/ethnic variables that may impact physiological functioning
  • Evaluate the impact of patient characteristics on disorders and altered physiology

Module 1 Assignment: Case Study Analysis

An understanding of cells and cell behavior is a critically important component of disease diagnosis and treatment. But some diseases can be complex in nature, with a variety of factors and circumstances impacting their emergence and severity.

Effective disease analysis often requires an understanding that goes beyond isolated cell behavior. Genes, the environments in which cell processes operate, the impact of patient characteristics, and racial and ethnic variables all can have an important impact.

An understanding of the signals and symptoms of alterations in cellular processes is a critical step in the diagnosis and treatment of many diseases. For APRNs, this understanding can also help educate patients and guide them through their treatment plans.

In this Assignment, you examine a case study and analyze the symptoms presented. You identify cell, gene, and/or process elements that may be factors in the diagnosis, and you explain the implications to patient health.

To prepare:

By Day 1 of this week, you will be assigned to a specific case study for this Case Study Assignment. Please see the “Course Announcements” section of the classroom for your assignment from your Instructor.

The Assignment (1- to 2-page case study analysis)

Develop a 1- to 2-page case study analysis in which you:

  • Explain why you think the patient presented the symptoms described.
  • Identify the genes that may be associated with the development of the disease.
  • Explain the process of immunosuppression and the effect it has on body systems.
By Day 7 of Week 2

Submit your Case Study Analysis Assignment by Day 7 of Week 2.

Reminder: The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The sample paper provided at the Walden Writing Center provides an example of those required elements (available at https://academicguides.waldenu.edu/writingcenter/templates). All papers submitted must use this formatting.

Submission and Grading Information

To submit your completed Assignment for review and grading, do the following:

  • Please save your Assignment using the naming convention “M1Assgn+last name+first initial.(extension)” as the name.
  • Click the Module 1 Assignment Rubric to review the Grading Criteria for the Assignment.
  • Click the Module 1 Assignment link. You will also be able to “View Rubric” for grading criteria from this area.
  • Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “M1Assgn+last name+first initial.(extension)” and click Open.
  • If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
  • Click on the Submit button to complete your submission.

What’s Coming Up in Module 2?

In Module 2, you will analyze processes related to cardiovascular and respiratory disorders. To do this, you will analyze alterations in the cardiovascular and respiratory systems and the resultant disease processes. You will also consider patient characteristics, including racial and ethnic variables, which may impact physiological functioning and altered physiology.

Week 3 Knowledge Check: Cardiovascular and Respiratory Disorders

In the Week 3 Knowledge Check, you will demonstrate your understanding of the topics covered during Module 2. This Knowledge Check will be composed of a series of questions related to specific scenarios provided. It is highly recommended that you review the Learning Resources in their entirety prior to taking the Knowledge Check, since the resources cover the topics addressed. Plan your time accordingly.

Next Module

Week 4: Alterations in the Cardiovascular and Respiratory Systems

Cardiovascular and respiratory disorders can quickly become dangerous healthcare matters, and they routinely land among the leading causes of hospital admissions. Disorders in these areas are complicated by the fact that these two systems work so closely as contributors to overall health. APRNs working to form a similarly close partnership with patients must demonstrate not only support and compassion, but expertise to guide the understanding of diagnoses and treatment plans. This includes an understanding of patient medical backgrounds, relevant characteristics, and other variables that can be factors in their diagnoses and treatments.

This week, you examine alterations in the cardiovascular and respiratory systems and the resultant disease processes. You also consider patient characteristics, including racial and ethnic variables, and the impact they have on altered physiology.

Learning Objectives

Students will:

  • Analyze processes related to cardiovascular and respiratory disorders
  • Analyze alterations in the cardiovascular and respiratory systems and the resultant disease processes
  • Analyze racial/ethnic variables that may impact physiological functioning
  • Evaluate the impact of patient characteristics on disorders and altered physiology

Module 2 Assignment: Case Study Analysis

An understanding of the cardiovascular and respiratory systems is a critically important component of disease diagnosis and treatment. This importance is magnified by the fact that these two systems work so closely together. A variety of factors and circumstances that impact the emergence and severity of issues in one system can have a role in the performance of the other.

Effective disease analysis often requires an understanding that goes beyond these systems and their capacity to work together. The impact of patient characteristics, as well as racial and ethnic variables, can also have an important impact.

An understanding of the symptoms of alterations in cardiovascular and respiratory systems is a critical step in diagnosis and treatment of many diseases. For APRNs this understanding can also help educate patients and guide them through their treatment plans.

In this Assignment, you examine a case study and analyze the symptoms presented. You identify the elements that may be factors in the diagnosis, and you explain the implications to patient health.

To prepare:

By Day 1 of this week, you will be assigned to a specific case study scenario for this Case Study Assignment. Please see the “Course Announcements” section of the classroom for your assignment from your Instructor.

Assignment (1- to 2-page case study analysis)

In your Case Study Analysis related to the scenario provided, explain the following

  • The cardiovascular and cardiopulmonary pathophysiologic processes that result in the patient presenting these symptoms.
  • Any racial/ethnic variables that may impact physiological functioning.
  • How these processes interact to affect the patient.
By Day 7 of Week 4

Submit your Case Study Analysis Assignment by Day 7 of Week 4

Reminder: The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The sample paper provided at the Walden Writing Center provides an example of those required elements (available at https://academicguides.waldenu.edu/writingcenter/templates). All papers submitted must use this formatting.

Submission and Grading Information

To submit your completed Assignment for review and grading, do the following:

  • Please save your Assignment using the naming convention “M2Assgn+last name+first initial.(extension)” as the name.
  • Click the Module 2 Assignment Rubric to review the Grading Criteria for the Assignment.
  • Click the Module 2 Assignment link. You will also be able to “View Rubric” for grading criteria from this area.
  • Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “M2Assgn+last name+first initial.(extension)” and click Open.
  • If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
  • Click on the Submit button to complete your submission.
Grading Criteria

To access your rubric:

Module 2 Assignment Rubric

Check Your Assignment Draft for Authenticity

To check your Assignment draft for authenticity:

Submit your Module 2 Assignment draft and review the originality report.


What’s Coming Up in Module 3?

In Module 3, you will analyze processes related to gastrointestinal and hepatobiliary disorders through case study analysis. To do this, you will analyze alterations in the relevant systems and the resultant disease processes. You will also consider patient characteristics, including racial and ethnic variables, which may impact physiological functioning and altered physiology.

Week 5 Knowledge Check: Gastrointestinal and Hepatobiliary Disorders

In Week 5 Knowledge Check, you will demonstrate your understanding of the topics covered during Module 3. This Knowledge Check will be composed of a series of questions related to specific scenarios provided. It is highly recommended that you review the Learning Resources in their entirety prior to taking the Knowledge Check since the resources cover the topics addressed. Plan your time accordingly.

Next Module

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