1. Compare and Contrast the common changes in pigmentation.

2. Coding and Billing
As a new nurse practitioner you will be responsible for generating revenue for the practice. Throughtout your program here at University of Phoenix and during your clinical rotations you will have learned about coding and billing practices.
What if your office manager is pushing you to “upcode” visits that do not meet the appropriate E&M coding criteria?
What if they are making changes to your E&M coding or charts without you knowing about it to increase revenue?
How might you respond if you are being pressured to add on services that patients do not really need to gererate more revenue? (keeping in mind that your career might be at stake if you report your conerns).

3. Patient Mario Smith

During a physical exam, you notice a very worrisome lesion on the back of your patient, Mario Smith who is 45.
You are concerned to the degree that you offer to secure an urgent appointment with a dermatologist. Mario has no insurance and says he is flying out of the state in a week and will be gone for one month, so he declines the appointment.
Explain what your responsibility as a practitioner is in this scenario.
How will you explain to him why this situation is so important to him?
How might you ensure that this patient receives proper follow up on this concern?

Textbook: Bates’ Guide to Physical Examination and History Taking, Chapter 6

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