Thursday, June 4, 2020

PANCE PANRE Fast Track Exam 1 †Questions 1-30

Looking for more exams? Try the all newPANCE and PANRE Academy. Questions 60-90 Please wait while the activity loads. If this activity does not load, try refreshing your browser. Also, this page requires javascript. Please visit using a browser with javascript enabled. If loading fails, click here to try again Start Congratulations - you have completed Questions 60-90. You scored %%SCORE%% out of %%TOTAL%%. Your performance has been rated as %%RATING%% %%FORM%% Have Your Exam Results Emailed to You Enter your name and email address below to have your results as well as the test questions, your answers and the correct answers delivered to your inbox. Name First Last Email mTouch Quiz Populated FieldsmTouch Quiz will automatically populate the fields below. Feel Free to add additional fields for the Quiz Taker to complete using the "Add Fields" options to the right.Quiz NameThe name of the quizResults SummaryScoreThe number of correct answers. 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Question 1A patient presents complaining of severe pain and "burning" in an extremity.   You note that the extremity is pale and cool to the touch. You cannot appreciate a palpable pulsation. Which of the following diagnostic modalities will identify the source of this patient's problem in approximately 95% of cases? Achest x-rayBechocardiogramCangiogramDabdominal flat plateEaortic ultrasoundQuestion 1 Explanation: An angiogram is the "gold standard" for occlusion of an arterial vessel. Arterial embolism/thrombosis  is covered as part of the  PANCE Cardiology Blueprint. Question 2A 31-year-old pharmacist complaining of rectal pain. He describes the pain as "a severe tightness that awakens him from sleep." His bowel activity is normal. He denies rectal bleeding and seepage. He adds that sleep interruption is problematic because, with the number of hours he works, every minute of sleep is important. What is the most likely diagnosis? Aanal abseessHint: Abscess would be constantBperianal fistulaHint: fistula would drainCproctalgia fugax Dulcerative colitisHint: UC would cause bloody mucousy diarrheaEinternal hemorrhoids.Hint: hemorrhoids would cause no pain, but bleeding.Question 2 Explanation: proctalgia (rectal pain) fugax (comes and goes) is the best description. An abscess would be constant, fistula would drain, UC would cause bloody mucousy diarrhea, hemorrhoids would cause no pain, but bleeding. Disorders of the Anus and Rectum  are covered as part of the  PANCE GI and Nutrition Blueprint. Question 3A 38-year-old chronic smoker presents with shortness of breath and wheezing. He has had several similar episodes in the past. He states that each previous episode began after developing a "cold that moved into his chest." Usually, after treatment with albuterol (VENTOLIN) and several days, the wheezing stops. He adds that he has a chronic cough, productive of mucous, most mornings during the past several years. Which of the following best describes this patient's condition? Achronic emphysemaBchronic bronchitisCchronic bronchitis with hypersensitive airways (asthmatic bronchitis)Dcor pulmonaleEbronchiectasisQuestion 3 Explanation: This is the best descriptor. Chronic bronchitis  is covered as part of the  PANCE Pulmonary Blueprint. Question 4A patient is being treated for Tuberculosis. She is experiencing central scotomata, a loss of green-red color perception and decreased visual acuity. Which agent is most likely responsible? ArifampinBisoniazidCstreptomycinDethambutolEpara-aminosalicylic acidQuestion 4 Explanation: Ethambutol is the TB drug that causes eye symptoms. It's helpul to remember "E" for Ethambutol causes "E"ye symptoms. Tuberculosis is covered as part of the  PANCE Infectious Disease Blueprint. Question 5Secondary to a traumatic event, a child complains of pain in the index finger. An x-ray of the digit demonstrates a fracture line through the metaphysis of the proximal aspect of the middle phalanx, ending at the epiphyseal plate. What type of fracture does this child have? ASalter Harris Type IHint: Salter I = slight increase in Space between epiphyseal plate and metaphysisBSalter Harris Type IICSalter Harris Type IIIHint: Salter III = fx Lower (in the epiphyseal plate) DSalter Harris Type IVHint: Salter IV = fit Through (both the metaphysis and epiphysis) ESalter Harris Type VHint: Salter V = Really bad (comminuted fx compressing the epiphysis) This spells SALTR and may help you remember.Question 5 Explanation: Salter I = slight increase in Space between epiphyseal plate and metaphysis Salter II = fx Above the plate (in the metaphysis) Salter III = fx Lower (in the epiphyseal plate) Salter IV = fit Through (both the metaphysis and epiphysis) Salter V = Really bad (comminuted fx compressing the epiphysis) This spells SALTR and may help you remember. Types of fractures and Salter-Harris classification are covered as part of the PANCE Musculoskeletal Blueprint Question 6A 24-year-old male presents complaining of chest pain. He states that it is worse with swallowing and taking a deep breath. It is improved by sitting up and leaning forward. He denies trauma, a cough, and shortness of breath. Which of the following tests would be most compatible with your suspected diagnosis? Aa hiatal hernia visualized on chest x-rayBa normal erythrocyte sedimentation rateCcalcified "popcorn" lesions in the lung fields bilaterallyDdiffuse ST segment elevation on his electrocardiographEa widened A-a gradient on his arterial blood gasQuestion 6 Explanation: This is pericarditis (by clinical presentation) which causes diffuse ST-segment elevation on ECG (there can be notching of the R wave as well). Acute pericarditis is covered as part of the PANCE Cardiology Blueprint. Any infant (neonate) with fever and rash should have a lumbar puncture (LP). While I would certainly do a CBC, even if it was normal, I would want the LP. Question 8Your 27-year-old sister is visiting and requests you to provide refills of  dexamethasone and  homatropine ophthalmic drops for her. What condition is most likely being treated? Aconjunctivitis BglaucomaCiritisDHerpes keratitisEblepharitisQuestion 8 Explanation: Iritis is treated with steroid drops (dexamethasone) and miotic drops *homatropine, like atropine (to constrict and fix the pupil to help the pain and open the angle until the iritis is resolved). Iritis and  disorders of the Eye (PEARLS)  are covered as part of the PANCE EENT Blueprint. Question 9A 58-year-old male presents complaining of weakness of his grip. Your  examination reveals that the problem is bilateral. During the next few office visits, you note the development of hyperactivity of his DTRs, extensor plantar reflexes and dysarthria. The patient's sensory system remains normal and he denies any urinary symptomatology. Which of the following is the most likely diagnosis? Amultiple sclerosisHint: MS may have dysarthria, but reflexes are normal, sensation is impaired and bladder function is frequently affectedBAlzheimer's diseaseHint: Alzheimer's has normal neuro exam with cognitive disability. CHuntington's choreaHint: Huntington's causes a movement disorder with writhing choreiform movements of the bodyDamyotrophic lateral sclerosisEmyasthenia gravisHint: Myasthenia causes fatigue of the ocular muscles typically worsening at the end of the day.Question 9 Explanation: ALS (Lou Gehrig's disease) is a progressive bilateral muscle disease which causes fasciculations (lower motor neuron), and hyperreflexia, plantar reflexes (upper motor neuron) and dysarthria. Sensation is normal as is bladder function. MS may have dysarthria, but reflexes are normal, sensation is impaired and bladder function is frequently affected. Alzheimer's has normal neuro exam with cognitive disability. Huntington's causes a movement disorder with writhing choreiform movements of the body. Myasthenia causes fatigue of the ocular muscles typically worsening at the end of the day. Question 10Which of the following is NOT a characteristic feature of multiple myeloma? Aelevated serum calciumBosteoporosisC"punched out" osseous lesionsDplasma cell infiltration of bone marrowEhypogammaglobulinemiaQuestion 10 Explanation: Multiple myeloma is a HYPERgammaglobulinemia - all of the other findings occur in multiple myeloma. Multiple myeloma is covered as part of the  PANCE Hematology Blueprint. Question 11Which of the following is NOT a risk factor for the development of osteoporosis? ALow testosterone levels in menBLow levels of physical activityCInadequate dietary proteinDCigarette smokingEChronic corticosteroid useQuestion 11 Explanation: Low dietary Calcium, not protein, is a risk factor for osteoporosis. All of the others are risk factors. Osteoporosis  is covered as part of the  PANCE Musculoskeletal Blueprint. Question 12A 12-year-old male presents complaining of no appetite for 24 hours and pain  near his navel. During the night, the pain moved to the right lower abdomen. He is now nauseated and vomiting and has a low-grade fever. In the operating room, a normal appendix is discovered. What is the most likely diagnosis? Amesenteric ischemiaBdiverticulitisCmesenteric adenitisDcholecystitisEproctitisQuestion 12 Explanation: Mesenteric adenitis (lymphadenopathy of the mesentery - usually from a virus) can mimic appendicitis and usually occurs in kids. There is usually no way to diagnose it pre-operatively, except perhaps with a CT of the abdomen (usually done nowadays before going to the OR). Review  Diseases of the Small Intestine and Colon (PEARLS) from the  PANCE GI and Nutrition Blueprint Question 13A patient that must be on a beta-blocking agent has reactive airway disease and commonly experiences central nervous system side effects from medications. Which of the following beta-blockers would most likely be tolerated by this patient? AatenololBmetoprololCnadololDpropranololEpindololQuestion 13 Explanation: This is a picky question for the Boards. Of these Beta-blockers (which are usually AVOIDED) in reactive airway disease - metoprolol is the most "cardioselective", so theoretically could be used.... although, on an exam, I would avoid beta-blockers in general. Asthma  is covered as part of the PANCE Pulmonary Blueprint Question 14A polarized light microscopic study of joint fluid demonstrates negative birefringent crystals. What is the diagnosis? Arheumatoid arthritisBseptic arthritisCpseudogout goutHint: Calcium Pyrophosphate (pseudogout) is Prism-shaped crystals with Positive birefringence - To remember this think "P"seudogout has "P"rism shaped crystals and "P"ositive birefringence.Daseptic arthritisEgoutQuestion 14 Explanation: Uric acid (gout) is "Needle-shaped crystals with Negative birefringence). Calcium Pyrophosphate (pseudogout) is Prism-shaped crystals with Positive birefringence - To remember this think "P"seudogout has "P"rism shaped crystals and "P"ositive birefringence. Gout/pseudogout are covered as part of the PANCE Musculoskeletal Blueprint Question 15Which of the following agents is most appropriate in the treatment of a pregnant patient infected with Chlamydia? AtetracyclineHint: Tetracyclines (A Azithromycin 1 g orally in a single dose is both safe and effective - it is now considered first-line treatment by the CDC for use in pregnancy. Of the choices above, erythromycin is best and is considered an alternative regimen. PCN does not work for Chlamydia. Tetracyclines (A & E) should be avoided. Quinolones (norfloxacin) are contraindicated. Note: Erythromycin estolate is contraindicated during pregnancy because of drug-related hepatotoxicity. So you would use either Erythromycin base or Erythromycin ethylsuccinate. Chlamydia  is covered as part of the PANCE Infectious Disease Blueprint. Question 16Typically, it produces a local burning, followed in 3 to 4 hours by a white area of vasoconstriction. Subsequently, a bleb forms at the bite site, darkens, and is followed over hours to days by tissue necrosis. Which of the following inflicts this envenomation? Abrown recluse spiderBblack widow spiderCscorpion DDermacentor andersoni tickEthe centipedeQuestion 16 Explanation: This is a brown recluse spider bite. Spider bites  are covered as part of the  PANCE Dermatology Blueprint Question 17A patient with acute renal failure provides a urine specimen that demonstrates normal osmolality and sodium content. The urine contains no casts, but RBCs are present. Which of the following is the most likely etiology of this patient's acute renal failure? Aprerenal causeHint: In pre-renal ARF, the sodium content of the urine would be decreased (because the patient is volume depleted, so the kidneys try to retain Na - less is in the urine)Bintrarenal — glomerulonephritisCintrarenal — acute tubular necrosisHint: In intrarenal disease, the urine would contain casts. Dintrarenal — interstitial nephritisEpostrenal causeQuestion 17 Explanation: In pre-renal ARF, the sodium content of the urine would be decreased (because the patient is volume depleted, so the kidneys try to retain Na - less is in the urine). In intrarenal disease, the urine would contain casts. So, this is postrenal disease (usually a big prostate or stones) which would cause normal urine with rbc's. Acute renal failure  is covered as part of the PANCE Genitourinary Blueprint. Question 18All of the following, when administered to the physically dependent opiate abuser, can precipitate withdrawal symptoms EXCEPT: AnaloxoneBpentazocineCnalbuphineDmethadoneEbuprenorphineQuestion 18 Explanation: That is why we use methadone when weaning folks from opiates (like heroin). Substance Use Disorders are covered as part of the  PANCE Psychiatry Blueprint. Question 19During a sports 'screening physical' examination, a 15-year-old male is noted to have a murmur. You perform bedside maneuvers in an attempt to delineate which type of murmur you are auscultating. Which of the following would be the finding associated with the highest risk of sudden death for this patient? Athe intensity of the murmur increases during a valsalva maneuverBthe intensity of the murmur decreases during standingCthe murmur does not change while the patient squatDthe intensity of the murmur decreases during exerciseEelevation of the legs while the patient is supine increases the intensity of the murmurQuestion 19 Explanation: Hypertrophic cardiomyopathy (most common cause of sudden cardiac death in this age individual) would have a systolic ejection murmur which would INCREASE with Valsalva (decreased preload causing a smaller LV volume and an increase in the obstruction) The murmur would DECREASE with squat or elevating the legs (increase preload, make the LV volume larger and decrease the obstruction). Hypertrophic Cardiomyopathy  is covered as part of the PANCE Cardiology Blueprint. Question 20A 44-year-old male presents with a fever, a cough productive of brownish sputum,  rigors and lethargy for seven days. A chest x-ray reveals a right middle lobe infiltrate and a right-sided pleural effusion. A thoracentesis is performed. Which of the following results from the pleural fluid analysis would be most characteristic of acute pneumonia? Apleural fluid: serum LDH ratio >0.6Bpleural fluid specific gravity Cpleural fluid without proteinDpleural fluid without LDHEpleural fluid:serum protein ratio Question 20 Explanation: The question suggests bacterial pneumonia. The pleural fluid should have high LDH (pleural > serum), a high specific gravity (lots of "stuff' in the fluid), a large amount of protein (WBC's, bacteria, and "stuff"). Bacterial pneumonia  is covered as part of the  PANCE Pulmonary Blueprint. Question 21A patient presents with severe diarrhea described as watery and bloody. He states he ate some chicken at a farm and wasn't sure if it was cooked well enough. His stool demonstrates many WBC's and S-shaped gram-neg rods. Which of the following antimicrobial agent of choice should be used to treat this patient? AmetronidazoleBerythromycinCampicillinDciprofloxacinEdoxycyclineQuestion 21 Explanation: Campylobacter = erythromycin. Infectious and Noninfectious Diarrhea  is covered as part of the  PANCE GI and Nutrition Blueprint. Question 22An 82-year-old man presents with acute, atraumatic left flank pain which is constant. He denies fever. Since its onset, the pain has moved from the flank to the central abdomen and also radiates into the left inguinal area. Of the following, which diagnosis do you suspect? Aacute bacterial prostatitisBspigelian herniaCcalyceal obstructionDacute biliary colicEdissecting aortic aneurysmQuestion 22 Explanation: This is CONSTANT pain, so not colicky (like colic, C & D). It is in the abdomen, and not perineal (like BPH), and I have no idea what a Spigelian hernia is.... but in this older gentleman, the most important thing to r/o is AAA which is dissecting. Aortic aneurysm/dissection  is covered as part of the  PANCE Cardiology Blueprint. Question 23A 32-year-old female presents with an acute narrow-complex tachycardia noted on her twelve lead EKG. Her blood pressure is 110/72. Her heart rate is 156. She denies chest pain and dyspnea. What do you order next for this patient? Abretylium 500 mg intravenouslyBverapamil 5 mg intravenouslyCadenosine 6 mg intravenouslyDdigoxin 0.5 mg intravenouslyElidocaine 100 mg intravenouslyQuestion 23 Explanation: The treatment for SVT (regular narrow complex tachycardia in a young healthy patient) could be valsalva or carotid massage, and then adenosine 6 mgm. IV bolus. Supraventricular tachycardia  is covered as part of the  PANCE Cardiology Blueprint. Question 24A 56-year-old male presents complaining of night sweats, weight loss, a cough and shortness of breath. A urinalysis demonstrates hematuria. The patient had a positive PPD skin test six months ago but was never treated. You order a chest x-ray and expect to find pathology in which area of the lung? Athe anterior aspect of the lung basesBthe lingual of the left lungCthe right middle lobeDthe posterior aspect of the lung basesEthe apices of the lungsQuestion 24 Explanation: TB reactivated typically appears in the apices of the lung fields. Tuberculosis  is covered as part of the  PANCE Pulmonary Blueprint. Question 25A mother brings her nine-year-old son to your office, along with the snake that bit him 20 minutes earlier. Which of the following, if identified during your examination of the snake, is most suggestive that the snake is poisonous? Aelliptical pupilsBa rounded headCa double row of caudal platesDthe length of the snakeEthe presence of a black band next to a red bandQuestion 25 Explanation: There are two families of poisonous snakes: Viperidae is pit vipers, rattlesnakes, water moccasins, copperheads. They are distinguished by elliptical pupils vs. round in non-venomous snakes. Elapidae contains cobras, mambas, taipan and coral snakes. There are differentiated by their color bands, "red on yellow kills a fellow", "red on black, venom lack". Most poisonous snakes in the US - coral snakes. Mambas are the most poisonous in the world; cobras are hooded at the neck and are next most poisonous but neither of these is found in the U.S. Animal  and insect bites are covered as part of the  PANCE Infectious Disease Blueprint. Question 26Which of the following vaccines can prevent cancer? Arubella vaccineBrubeola vaccineChepatitis B vaccineDinfluenza vaccineEtetanus vaccineQuestion 26 Explanation: Think of Hep B and Hep C as carcinogens. We don't have a Hep C vaccine yet, but we DO have a Hep B vaccine. Since chronic Hep B and Hep C infection cause liver cancer, a vaccine can "prevent" it. Acute and chronic hepatitis  are covered as part of the  PANCE Genitourinary Blueprint. Question 27A 51-year-old male who has smoked for 32 years, presents complaining of a  persistent cough. His chest x-ray is unremarkable. The cough began shortly after he started a new medication. Which medication do you suspect as the cause? AverapamilBdigoxinCcaptoprilDacetaminophenElovastatinQuestion 27 Explanation: ACEI's cause chronic cough. Captopril is the prototypical ACEI. Ace inhibitors and other cardiac medications are  covered as part of the  PANCE Cardiology Blueprint Question 28Which of the following is associated with a reduced risk of ovarian cancer? Adelivering the first child at an age greater than 40 years oldBa positive family history of ovarian cancerCpresent age greater than 50 years oldDbeing nulliparousEoral contraceptive useQuestion 28 Explanation: OCP's protect (reduce risk by 40% for a decade after one year of use). Ovarian Neoplasms  are covered as part of the  PANCE Reproductive System Blueprint. Question 29A patient is given a new product for an acute migraine headache. Shortly after the injection, the patient complains of significant chest tightness. Which of the following medications do you suspect this patient received? ApromethazineBmetoclopramideCsumitriptanDtrimethobenzamideEketorolacQuestion 29 Explanation: Sumatriptan (Imitrex) and all triptans can cause chest tightness as it is a potent vasoconstrictor. You must use it with caution in a patient with risk factors for coronary disease and in uncontrolled hypertension. Migraine  headaches are covered as part of the  PANCE Neurology Blueprint. Question 30Which of the following does NOT increase the likelihood of infection in a cancer patient? AthrombocytopeniaBmalnutritionCthe presence of catheters or shunts for therapeutic interventionDneutropeniaEsplenectomyQuestion 30 Explanation: Decreased platelets could predispose the patient to bleeding, the others would increase his risk for infection. Thrombocytopenia  is covered as part of the  PANCE Hematology Blueprint. Once you are finished, click the button below. Any items you have not completed will be marked incorrect. Get Results There are 30 questions to complete. List Return Shaded items are complete. 123456789101112131415161718192021222324252627282930End Return You have completed questions question Your score is Correct Wrong Partial-Credit You have not finished your quiz. If you leave this page, your progress will be lost. Correct Answer You Selected Not Attempted Final Score on Quiz Attempted Questions Correct Attempted Questions Wrong Questions Not Attempted Total Questions on Quiz Question Details Results Date Score Hint Time allowed minutes seconds Time used Answer Choice(s) Selected Question Text All doneNeed more practice!Keep trying!Not bad!Good work!Perfect!

Wednesday, May 6, 2020

Why Are High School Students Not Considered For Adults

Adulthood Why are high school students not considered to be adults? By definition an adult is â€Å"a person who has attained the age of majority. The age of majority is the legally defined age at which a person is considered an adult, with all the attendant rights and responsibilities of adulthood† (Adult Law). Eighteen is the legal age to be considered an adult. Being an adult at the age of eighteen is defined in many different ways. According to the law eighteen is defined as â€Å"It is the age at which one becomes a legal adult and gains full legal rights. It is also the age at which a person is liable for their own actions, such as contractual obligations or liability for negligence. In general, a parental duty of support to a child ceases when the child reaches the age of majority† (Adult Law). Seniors in high school are of the age of eighteen, if not, getting ready to turn eighteen. Schools are expecting them to go out into the real world shortly following their senior y ear, but yet do not let students make their own decisions like they are adults. Students need more responsibilities so they know how it feels to have to be the adult in the real world. Students over the age of eighteen in Indiana should be treated as adults because they are legally considered to be adults. Technology is advancing every day. â€Å"More than 203 million people in the United States use cell phones† (Castle), but schools expect students not to use it. Cell phones play a huge role in high schoolShow MoreRelatedWe Can Fight in a War, but Cant Have a Drink?877 Words   |  4 PagesPeople have always told me that high school and college would be the best times of my life. Not only do young adults get to venture off from home on their own during college, but they finally get to make their own decisions without having to wait for the approval from a parent. Yes, high school was very fun, but for some reason it just can’t be compared to college life. What else could possibly be the blame for this other than the parties? College parties are very outgoing, but they also create aRead MoreThe American Public Education System Essay1515 Words   |  7 Pagesthe same old routine? Too much pressure is being put on high school students; some students do not even know how t o cope with it. The way that the American public education system has planned to make these individuals succeed is really not how it should be. Students are being taught information that will not be as useful once they become adults. Students should be able to receive the knowledge they need in order to succeed in life. Students need an opportunity to be open-minded. There are many differentRead MoreFree College Education Persuasive Speech1431 Words   |  6 Pagesto point out why college should be free. I will persuade my audience that my solution of the free college education will work. Thesis – College education is considered one of the most important factors for the nation’s economic growth, therefore free college education is a necessity. Introduction   I. Attention Getter: More Americans are getting their high school diplomas but fewer are enrolling in college. II. Common Ground: Getting into college is a dream of almost every high school graduate, butRead MoreMy High School Is A Safe Environment1611 Words   |  7 PagesI come from a school where the guys wear bowties and khakis and the girls dress up in a nice dress or skirt more often than not. There are more parent volunteers than imaginable and practically the whole town comes out to support the football team on Friday nights. I have lived a sheltered life so far†¦ my parents are still together, no major deaths in the family, and if someone mentions drugs or teen pregnancy, I’m a deer in headlights. While I have lived a life that I consider to be pretty greatRead MoreHigh School Vs. College1294 Words   |  6 PagesHigh School Versus College Schools are undoubtedly important to one’s education. The most important of those schools are high schools and colleges because they have the most impact on deciding what occupation a student wants to pursue. Although high schools and colleges share similarities in providing education, there are also many differences between each other. In both high schools and colleges there are teachers that educate students on certain subjects. Those subjects can range from mathematicsRead MoreThe Importance Of A Physical Education Teacher1476 Words   |  6 Pageseducation took place from the 1890s to the 1930s. This era brought about dramatic expansions in the number of schools in the U.S. By 1940, nearly half of young adults were earning a high school diploma (Costrel). One specific type of teacher in a physical education teacher. A physical education teacher holds a big responsibility within the school. They are in charge of keeping the students healthy. P.E. teachers have to have exercise and fun blended into one class. A physical education teacher isRead MoreHigh Levels Of Stress Among Teens1251 Words   |  6 Pagessuicide. But the question still stands: why? The answer lies in the fact adolescents are experiencing high levels of stress due to high school and the associated pressures and therefore are demonstrating damag ing symptoms as an effect. Many of these experts appeared in a survey conducted by the American Psychological Association. This published survey concluded that â€Å"during the school year, teens say their stress level is higher than levels reported by adults. [†¦] Teens report that their stress [†¦]Read MoreAlternative Education For High School Dropouts1698 Words   |  7 PagesAlternative Education for High School Dropouts Allison V. Alvizuri University of La VerneAbstract This study examined high school dropouts and what the long term consequences, major factors, and characteristics of a student who drops out are.The findings suggest that a school counselor plays an integral role in keeping students in school or finding an alternative choice to finish their education. Effective school program such as Opportunities for Learning Public Charter Schools has been identified asRead More â€Å"Let Teenagers Try Adulthood†865 Words   |  4 Pagesthe day of the Littleton high school shooting also referred as the Columbine High School Massacre. When the flashing new lines of (CNN News, 1999) stated that 25 people were killed at the High School by two heavily armed male students that also took their own lives; it was shocking and very disturbing news to learn that something so horrible caused this students to kill their own peers. What was the reason that drove these students to kill? Was the students bullying these boysRead MoreEssay about What Does It Mean to be an Adult?1151 Words   |  5 Pages There are many factors that constitute being an adult. An adult is much more than turning the age of 18. The definition in the dictionary states an adult means being completely grown: fully developed and mature. I think there is much more that defines an adult. In the United States an adult is considered to be someone who takes responsibility of themselves and their actions. An adult has stability in their life and is able to take care of themselves physically, mentally, financially and emotionally

Tuesday, May 5, 2020

Diagnostic and statistical manual of mental - MyAssignmenthelp.com

Question: Discuss about the Diagnostic and statistical manual of mental. Answer: Introduction With definition to psychology, every human mind or individual has two sides of the personality. Sometimes under circumstances of strain, the shadow side of the human mind forces the individual to exhibit and initiate a certain pattern to respond against certain situations giving rise to a feeling of threat or anxiety (Charney et al., 2013). This essay deals with an example of a film character undergoing a series of disorders (anxiety) and explains about the etymology of the disorder with relevance to the respective model and classification. This essay further entails about the treatment that can be used to treat these kinds of disorders with contrast to the best treatment for this disorder. The purpose of this essay is to analyze and understand about the anxiety disorders along with its etymology and treatment with contrast to the film character portraying the disorder in this essay. This also helps in analyzing and relating the different aspects along with the behavioral criterion to classify this disorder with both reality and fantastical culture. Situational analysis As per the topic, the character upon which the analysis has been done is Bill Murrays portrayal of a psychologically challenged individual in a film named What about Bob?. In this movie Bob (Bill Murray) is a patient of a psychiatrist named Dr. Leo Marvin (Played by Richard Dreyfuss). In this film, another colleague who was fed up, treating Bob has referred Bob to Dr Marvin. This movie portrays Bob as a complete collection of anxiety disorders (phobias) or in other words, he is an individual with multiple anxiety disorders such as agoraphobia (fear of being in places with difficult exit), nosemaphobia (fear of illness), spermaphobia (fear of germs), hydrophobia (fear of water), achluophobia (fear of darkness) and tonitrophobia (fear of thunderstorms). Not just these bob has fear of elevators, fear of height along with dependency disorder, multiple personality disorder and obsessive-compulsive disorder (Ollendick, King Yule, 2013). Etymology and symptoms of anxiety disorder As per the topic, the character in the movie portrays a various kind of phobia or anxiety disorders. In other words, the character undergoes severe anxiety or panic attacks due to certain situations that effectively triggers the behavior and reaction like trauma and tends to stay in a state of panic and anxiety at all times (Charney et al., 2013). According to the etymology, anxiety disorder is a group of mental disorder that is characterized by significant feelings of anxiety and fear regarding some uncertain events that may or may not occur in the future. This may be accompanied by symptoms such as increased heart beating, shakiness, numbness, dryness in the throat, fear, perspiration, breathlessness and avoidance (Willgoss Yohannes, 2013). In simple words, anxiety disorder or phobia is a kind of behavioral disorder, where an individual faces two or more phobias at the same time (American Psychiatric Association, 2013). However, it can be justified that anxiety disorders are accompanied by or follows a chain of disorders such as schizophrenia, avoidant personality disorder and depression (McCance Huether, 2015). As depicted in the movie, Bob faces anxiety disorder, which in turn is teamed with obsessive-compulsive disorder and avoidant personality disorder (Iverach Rapee, 2014). Therefore, the theory about anxiety disorder has been justified and correctly portrayed in the film. Nonetheless, the demonstration of the symptoms as explained in theories has been rightly illustrated in the film, with clear exhibition of tension, avoidance and feelings of threat. Therefore, with comparison to the literary context, Bob clearly meets the Diagnostics and Statistical manual of Mental Disorders (DSM)V criteria for multiple specific phobias, which is common and it can be added that phobia tend to be formal revolving around emotional or painful events, though no insight has been provided regarding Bobs past life (American Psychiatric Association, 2013). Best treatment approach with contrast to the film Based on the theories of treating this disorder, it can be proposed that anxiety disorders are the most easy and treatable form of disorders, than the other psychological disorders, as classified under DSM V (McCance Huether, 2015). In other words, the treatment is highly effective and more likely to produce positive outcomes or reduction in the symptoms. Based on the theories and research works, it can be considered that Cognitive behavioral therapy (CBT) is the most effective treatment for treating such conditions (Wells, 2013). However, other treatment methods tend to be ineffective for the same. Some of the other approaches are effective such as supportive psychotherapy and psychodynamic or psychoanalytic therapies, nonetheless, the results are unpredictable. Effective use of medications containing beta-blockers like Propranol (please note that these medications should be taken under physicians instructions only) can help reduce the reception of catecholamine, thus strengthening emotional or fearful memories (Steenen et al., 2016). However, it can be analyzed that Bobs behavior are presented as general anxiety disorder and depression with OCD focusing on the contamination and the safety. Nonetheless, the problems are not represented to be potentially physical with no relevance to glucocortcoids, serotonin or dopamine but his unrealistic choice of not acting and baseless fear (Willgoss Yohannes, 2013). In addition, the film portrays a fictional best seller, which is a book of treating anxiety disorder with no professional help but self-help by taking Baby Steps or one by one step to move away from the fear. With contrast to reality, this is predominantly conditional and depends on the patient undergoing the crisis. It can further be added, that Dr. Marvin uses a simplified model of cognitive behavior therapy, which in turn proved beneficial in the treatment as well as used as one of the best methods of treating the disorder, in the realistic situation (Christophersen Vanscoyoc, 2013). This method in reality is only helpful in treating children but effective in treating adults as well. The film exhibits some exposure therapy, which was consistently ineffective for reducing the fear (Rodrigues et al., 2014). Thus, it can be concluded that helplessness and glucocorticoid levels cannot be altered easily, whereas the mere proclivities can be changed under circumstances. It can also be contrasted that in the first scene of the movie, refusing to treat the patient, by the first psychiatrist before coming to Dr. Leo Marvin can be classified as one unprofessional move in practicing psychiatry, which is in turn holds no connection with reality. Conclusion (Personal Judgment) With help of this essay, it can be concluded that the film contain some faintly realistic treatments such as the casual use of CBT, exposure and systematic desensitization therapy, while the character of Bob Wiley portrays a humoristic reality of the individuals undergoing anxiety attack with close relevance to the symptoms and etymology of the disorder. However, it can be concluded that even though the film is entertaining, it somewhat misrepresents the conditions portrayed by ignoring the neurological changes associated with such kind of disorders. It can further be added that the defeat of Leo Marvin as a doctor and emerging of Bob Wiley as a winner is considerable uplifting yet a demoralizing of the practice and treatment. References American Psychiatric Association. (2013).Diagnostic and statistical manual of mental disorders (DSM-5). American Psychiatric Pub. Charney, D. S., Buxbaum, J. D., Sklar, P., Nestler, E. J. (Eds.). (2013).Neurobiology of mental illness. Oxford University Press. Christophersen, E. R., Vanscoyoc, S. M. (2013).Treatments that work with children: Empirically supported strategies for managing childhood problems. American Psychological Association. Iverach, L., Rapee, R. M. (2014). Social anxiety disorder and stuttering: Current status and future directions.Journal of fluency disorders,40, 69-82. McCance, K. L., Huether, S. E. (2015).Pathophysiology-E-Book: The Biologic Basis for Disease in Adults and Children. Elsevier Health Sciences. Ollendick, T. H., King, N. J., Yule, W. (Eds.). (2013).International handbook of phobic and anxiety disorders in children and adolescents. Springer Science Business Media. Rodrigues, H., Figueira, I., Lopes, A., Gonalves, R., Mendlowicz, M. V., Coutinho, E. S. F., Ventura, P. (2014). Does D-cycloserine enhance exposure therapy for anxiety disorders in humans? A meta-analysis.PloS one,9(7), e93519. Steenen, S. A., van Wijk, A. J., Van Der Heijden, G. J., van Westrhenen, R., de Lange, J., de Jongh, A. (2016). Propranolol for the treatment of anxiety disorders: Systematic review and meta-analysis.Journal of Psychopharmacology,30(2), 128-139. Wells, A. (2013).Cognitive therapy of anxiety disorders: A practice manual and conceptual guide. John Wiley Sons. Willgoss, T. G., Yohannes, A. M. (2013). Anxiety disorders in patients with COPD: a systematic review.Respiratory care,58(5), 858-866.

Sunday, April 19, 2020

Solutions Income Statement and Pearson Education Essay Example

Solutions: Income Statement and Pearson Education Paper As the manager of an phone applications developer, you will make three types of financial decisions. i. You Will make investment decisions such as determining which type of phone application projects will offer your company a positive NAP and therefore your company should develop. Ii. YOLK Will make the decision on how to fund your phone application investments and what mix of debt and equity your company will have. Iii. You will be responsible for the cash management of your company, ensuring that your company has the necessary funds to make investments, pay interest on loans, and pay your employees. Corporate managers favor for the owners of the corporation, Consequently, they should make decisions that are in the interests of the owners, rather than their own. What strategies are available to shareholders to help ensure that managers are motivated to act this way? Shareholders can do the tooling. i. Ensure that employees are paid with coronary stock and/or stock options. Ii, Ensure that underperforming managers are fired. Iii. Write contracts that ensure that the interests of the managers and shareholders are closely aligned, iv. Mount hostile takeovers. 1-10. Suppose you are considering renting an apartment. You, the renter, can be viewed as an agent while the company that owns the apartment can be viewed as the principal. What principalities conflicts do you anticipate? Suppose, instead, that you favor for the apartment company. What features would you put into the lease agreement that would give the renter incentives to take good care of the apartment? The agent (renter) will not take the same care of the apartment as the principal (owner), because the renter does not share in the costs of fixing damage to the apartment. We will write a custom essay sample on Solutions: Income Statement and Pearson Education specifically for you for only $16.38 $13.9/page Order now We will write a custom essay sample on Solutions: Income Statement and Pearson Education specifically for you FOR ONLY $16.38 $13.9/page Hire Writer We will write a custom essay sample on Solutions: Income Statement and Pearson Education specifically for you FOR ONLY $16.38 $13.9/page Hire Writer To mitigate this problem, having the renter pay a deposit should motivate the renter to keep damages to a minimum. The deposit forces the renter to share in the costs of fixing any problems that are caused by the renter. You are the CEO of a company and you are considering entering into an agreement to have your company buy another company, You think the price might be too high, but you will be the CEO of the combined, much larger company, You know that when the company gets bigger, your pay and prestige will increase. What is the nature tooth agency conflict here and how is it related to ethical considerations? There is an ethical dilemma when the CEO of a firm has opposite incentives to those of the shareholders. In this case, o (as the CEO) have an incentive to potentially overpay for another company (which would be damaging to your shareholders) because your pay and prestige will improve. Are hostile takeovers necessarily bad for firms or their investors? Explain. No. They are a way to discipline managers who are not working in the interests of shareholders. What is the difference between a public and private corporation? The shares of a public corporation are traded on an exchange (or over the counter in an electronic trading system) while the shares Of a private corporation are not traded on a public exchange. Explain why the bid-ask spread s a transaction cost. Investors always buy at the ask and sell at the bid. Since ask prices always exceed bid prices, investors lose this difference. It is one of the costs Of transacting. Since the market makers take the Other side Of the trade, they make this difference. -12. 1-13. -14. 02011 Pearson Education, Inc. Publishing as Prentice Hall Beer/Demeanor ; Corporate Finance, Second Edition I-IS. The following quote on Yahoo! Stock appeared on February 11, 2009, on Yahoo! Finance: If you wanted to buy Yahoo, what price would you pay? How much would you receive if you wanted to sell Yahoo!? You would buy at $12. 54 and sell for $12. 53. 02011 Pearson Education, Inc. Publishing as Prentice Hall Ch apter 2 Introduction to Financial Statement Analysis 2-1. What four financial statements can be found in a firms 10-K filing? What checks are there on the accuracy of these statements? In a firms 10-K filing, four financial statements can be found: the balance sheet, the income statement, the statement of cash flows, and the statement of stockholders equity. Financial statements in form ASK are required to be audited by a neutral third party, who checks and ensures that the financial statements are prepared according to GAP and that the information contained is reliable. 2-2. Who reads financial statements? List at least three different categories of people, For each category, provide an example tooth type to information they might be interested in and discuss why. Users of financial statements include present and potential investors, financial analysts, and other interested outside parties (such as lenders, suppliers and other trade creditors, and customers). V-uncial managers within the firm also use the financial statements when making financial decisions, Investors, Investors are concerned with the risk inherent in ND return provided by their investments. Bondholders use the firms financial statements to assess the ability of the company to make its debt Stockholders use the statements to assess the firms profitability and ability to make future dividend payments. Financial analysts. Financial analysts gather financial information, analyze it, and make recommendations. They read financial statements to determine a firms value and project future earnings, so that they can provide guidance to businesses and individuals to help them With their investment decisions. Managers. Managers use financial statement o look at trends in their own business, and to compare their own results with that of competitors. 23. Find the most recent financial statements for Cutbacks corporation (SUBS) using the following sources: a. From the companys Web site www. V. Trucks. Com (Hint : Search for investor relations. ) b. From the SEC Web site femmes. Gob. (Hint : Search for company filings in the EDGAR database. ) c. From the Yahoo! Finance Web site http://financially. Com. D. From at least one other source. (Hint : Enter SUBS ASK at mow. Google. Com. ) Each method will help find the same SEC filings. Yahoo! Finance also provides some analysis such as harts and key statistics. Beer/Demeanor ; Corporate Finance, Second Edition 24 Consider the following potential events that might have occurred to Global Conglomerate on December 30, 2009. For each one, indicate which line items in Globally balance sheet would be affected and by how much. Also indicate the change to Globally book value of equity. A. C. Global used $20 million of its available cash to repay $20 million Of its long-term debt Global used AS million in cash and $5 million in new long-term debt to purchase a $10 million building. B. A warehouse fire destroyed $5 million worth Of uninsured inventory. . A large customer owing 53 million for products it already received declared bankruptcy, leaving no possibility that Global would ever receive payment. E. . A. B. C. Globally engineers discover a new manufacturing process that will cut the cost of its flagship product by over 50%, A key competitor announces a radical new pricing policy that will drastically undercut Globally prices. Long- term liabilities would decrease by $20 million, and cash would decrease by the same amount. The book value of equity would be unchanged. Inventory would decrease by million, a s would the book value of equity. Long-term assets old increase by $10 million, cash would decrease by $5 million, and longer liabilities would increase by AS million.

Sunday, March 15, 2020

Free Essays on Grieving

Grief is a natural and necessary process experienced by all people, to one degree or another, after the occurrence of a loss. Significant losses, such as the death of someone close to you, the breakup up of a close relationship/friendship, or the loss of hopes and dreams, are some of life’s most stressful occurrences. Grieving is an adaptive response to loss. It is not a weakness, but an experience which requires time, patience, and hard work.Grieving is a process unique to each individual. Different people (even members of the same family) experience their grief in different ways.Grief may be complicated by prior experiences of loss, traumatic events surrounding the loss (e.g. suicide), a history of difficult relationships, or other social or personal factors (e.g. lack of social support). It can be especially helpful to seek assistance when a grieving process is complicated by other factors or events. For most people, the intense emotional pain of grief subsides. Eventually, energy is refocused on the future. However, if your grief response does not gradually lessen in intensity or, over time, continues to interfere with your academic, social or occupational functioning, then you may benefit from receiving assistance. Many individuals report experiencing a period of numbness or shock immediately following a significant loss. This may occur whether the loss was anticipated (as in the case of a friend dying of a terminal illness), or was unexpected (as in the case of one partner suddenly announcing the dissolution of a relationship). Following this period of shock, people may experience a time of intense emotional upheaval, during which the full impact of the loss may be experienced. Here, your emotions may be overwhelming or frightening. They may temporarily interfere with your academic, social, or family life. The severity and duration of a grief reaction will vary from person to person.... Free Essays on Grieving Free Essays on Grieving Grief is a natural and necessary process experienced by all people, to one degree or another, after the occurrence of a loss. Significant losses, such as the death of someone close to you, the breakup up of a close relationship/friendship, or the loss of hopes and dreams, are some of life’s most stressful occurrences. Grieving is an adaptive response to loss. It is not a weakness, but an experience which requires time, patience, and hard work.Grieving is a process unique to each individual. Different people (even members of the same family) experience their grief in different ways.Grief may be complicated by prior experiences of loss, traumatic events surrounding the loss (e.g. suicide), a history of difficult relationships, or other social or personal factors (e.g. lack of social support). It can be especially helpful to seek assistance when a grieving process is complicated by other factors or events. For most people, the intense emotional pain of grief subsides. Eventually, energy is refocused on the future. However, if your grief response does not gradually lessen in intensity or, over time, continues to interfere with your academic, social or occupational functioning, then you may benefit from receiving assistance. Many individuals report experiencing a period of numbness or shock immediately following a significant loss. This may occur whether the loss was anticipated (as in the case of a friend dying of a terminal illness), or was unexpected (as in the case of one partner suddenly announcing the dissolution of a relationship). Following this period of shock, people may experience a time of intense emotional upheaval, during which the full impact of the loss may be experienced. Here, your emotions may be overwhelming or frightening. They may temporarily interfere with your academic, social, or family life. The severity and duration of a grief reaction will vary from person to person....

Thursday, February 27, 2020

Leaman brother Research Paper Example | Topics and Well Written Essays - 500 words

Leaman brother - Research Paper Example ublish its financial statement so when the financial statements were released to the public, the financial statements may depict that the bank had money and was paying its debtors (Hallman 1). Once a period of seven or less days had passed and the account statements were published, the bank repurchased sold assets. Anton Valukas was assigned the duty of look into the matter of Lehman Brother and unearth the reasons for its fall down. Valukas states that the Repo 105 transaction was first reported by Mathew Lee who was an employee of Lehman. Lee started by reporting the transactions to the management of Lehman and later reported the findings to the organization’s auditing firm, Ernst & Young and no actions were taken (Hallman 1). Once the firm could no longer indulge in Repo 105, it had to start depicting that it was highly leveraged and did not have money to pay off its debt and ultimately the bank filed for bankruptcy. Due to this several stakeholders had to experience material as well as emotional losses. The main stakeholders who were negatively impacted included the companies that had lent money to the bank, the shareholders of the bank and its employees. When the company went bankrupt there were more than 25000 employees working for them and a major percentage of them had to experience unemployment and social and psychological associated with it (Corelli 326). Furthermore, the shareholders had to lose their money since the company was not performing well and it has been recorded that due to the fall down of the company around $10 trillion funds were injected out of the equity markets (Corelli 326). It is believed but not yet proven that the CPA firm called Ernst & Young (E&Y) was involved in the financial fraud conducted by Lehman Brother. They are said to have been involved in the cover-up of this fraud. Due to these allegations against the CPA firm several civil lawsuits were filed against the firm after the collapse of Lehman Brothers. These lawsuits

Tuesday, February 11, 2020

Operational Policies and Procedures for HIE Research Paper

Operational Policies and Procedures for HIE - Research Paper Example Conversely, the HIE possesses a structure as well as a syntax of electronic communications that provide standard ways of conveying and delivering information. Hence, the message-based where information is given as a message as well as document-based systems that involve sending information as a structured document/forms. To mention a few of the standards are the Accredited Standard Committee X12 (ASC X12) and the International Organization for Standardization (ISO) (Public Health Data Standards Consortium, 2015). The Health Information Exchange policies involve the lines of arguments that tend to rationalize the courses  of  action towards the management of Health Institutes (AHIMA, 2011). Thus, various plans have been put up by the Medicare agencies and practitioners to oversee that patients’ information are safe and showing support through federal funding for the HIEs. Therefore, Medicare HIE policies can consider the access controls, accounting for disclosures, authorization procedures, as well as consumer education, data integrity and quality among other policies. Thus, under access controls, the Medicare institutions should determine those individuals that require access to the information that are shared within the HIEs as well as establishing the policies and procedures used for managing authentications and auditing. Subsequently, the HIEs should consider reviewing their business associate agreements, language and signatories in addition to their methods for managing sensitive records and patients. By doing so, they ensure access control, as well as functionality of the systems, are stable (AHIMA, 2011). Patient authorization, as well as consent, poses a challenge to most HIEs (Sewell & Thede, 2013). Therefore, it would be of significance for the HIEs to consider their accountability towards disclosures. Thus, this will tend to look into patient/customer requests pertaining their PHIs. Hence, this is achievable in