Healthy ecosystems are resilient to normal, natural disturbances, which can take on many forms: windstorms, fire, floods, drought, lightning, and immigration of new species. 

A newborn develops coughing, choking, and cyanosis during feedings. The nurse notes excessive drooling and is unable to pass a nasogastric tube into the stomach.   Question: These findings are most consistent with , which places the infant at risk for during feedings and requires the infant to be kept until surgical repair.

Ecosystems can change in structure and function due to natural disturbance events, community succession, and human activities.

Aquatic life zones are differentiated by factors such as depth, ______, and oxygen concentrations.  

I understand that I can use only this computer/laptop and physical calculator for the test; I am NOT allowed to use any online calculating tool, Artificial Intelligence or personal help, or other electronics during the test.  I have turned off (muted) and put away my cell phone, smart watch, tablet, headphone, etc. If not yet, I am putting them away now. I can have one blank scratch paper with me. Any books and notes are put away.  There are no other people in my room; if I am taking the test in public space, I will not talk to other people during the test. I understand that my test session will be recorded and reviewed, and I may receive a zero for the test if I violate anything listed above. 

Using the essay space provided: Record complete and thorough admission orders for the patient with abdominal pain from Scenario C1.   Scenario C1 Reference material below: Patient Door Chart and Note (for reference) Setting: Emergency Room Arrived via ambulance    Patient Name: James Levenstein Age: 17 years old Gender: Male Chief Complaint:    “My left knee hurts after falling off of a ladder while helping my dad with a project.” Triage Vital Signs:  Temperature: 98.8*F / 37.1 *C Heart Rate: 110 beats per minute Blood Pressure: 168/92 mmHg Respiratory Rate: 22 breaths per minute Pulse Oximetry: 99% on RA Weight: 180 lbs / 82 kg Height: 69 inches / 175 cm ____________________________________________________________________________________________ Scenario Remediation C1 – Patient Case Hx, PE, and Diagnostics Patient: James Levenstein Age: 17 yrs old  CC: “My left knee hurts after falling off of a ladder while helping my dad with a project.” History of Present Illness (HPI): Quality/Character: Sharp, severe Onset: Immediately after fall, which occurred just prior to arrival Timing/Duration: Constant, abrupt onset Region/Radiation: Left knee pain with radiation of pain up the left thigh Severity/Intensity: 10 out of 10  Aggravating Factors: Attempting to move the leg in any way makes the pain worse. Pt cannot stand/bear weight as result Alleviating Factors: Nothing has yet made the pain better Precipitating Factors: Lost balance while on a ladder while attempting to help his father with a home improvement project and he then fell approximately 16 feet onto his feet Associated Symptoms: Pertinent Positive: +“Crunch noise” heard and felt in the left knee after the fall +Tingling to the distal aspect of the LLE diffusely without numbness or known weakness +Pt admits to a few small skin abrasions on his palms and elbows B/L as a result of falling forward after hitting the ground +Mild pain to the L ankle without deformity. No loss of ankle ROM Pertinent Negative: No loss of consciousness No head injury associated with the fall No report of the leg being cool/cold to the touch  No pallor to the affected extremity No reported headache, confusion, memory loss No neck pain, back pain, hip pain, or upper extremity pain No blood loss from the fall today   Past Medical History (PMHx):  Illnesses/Injuries: Mild intermittent asthma Hospitalizations: None other than for appendectomy (see below) Surgical History: Appendectomy (age 14) Screening/Preventive History: Pt states he is up to date on all vaccinations and preventative screenings to his knowledge Medications (Prescription, Over the Counter, Supplements):  -Albuterol MDI Inhaler (90 mcg/actuation) – 1-2 puffs q4-6 hrs PRN asthma symptoms Allergies (e.g. environmental, food, medication and reaction): -Sulfa drugs (rash and breathing problems)   Family Medical History:  Mother (alive, age 54) has history of “skin cancer” (pt is unsure of which type) Father (alive, age 51) has history of “high blood pressure, overweight, and high cholesterol” Brother (alive, 21) has history of ADHD No genetic disorders known in family.    Social History: Substance Use / Alcohol Use: No tobacco/vape, substance use, or alcohol use reported.  Diet: Regular diet – (pt last ate last night at 8pm) Home Environment:  Lives with parents in a two-story home, feels safe at home. In one-on-one inquiry, pt denies hx of abuse or harm from family member(s). Occupation: High-school student (senior) Leisure Activities: Running, volleyball, riding her bicycle, and surfing Exercise: Active 4-5 times per week Sleep: 7-8 hours per night normally Religion: Jewish Sexual Health: Not currently sexually active.   ROS (Review of Systems): General: No weight loss, fever/chills, or night sweats. Skin: See HPI – Some superficial skin abrasions reported. Otherwise – no rashes, eczema, or changes reported. HEENT: No headache, neck pain/stiffness, no sore throat. No vision changes or congestion/runny nose. Respiratory: No cough, shortness of breath or wheezing. Cardiovascular: No chest pain or palpitations. Gastrointestinal: Pt reports no diarrhea, constipation, or BRBPR. No n/v. No reported abdominal pain. Genitourinary: No change in urination, flank pain, dysuria, hematuria, or increased urinary frequency. Musculoskeletal: See HPI. No back pain or neck pain reported. Psychiatric: No depression, anxiety, or thoughts of self-harm. No concern for safety at home.  Hematologic: No known easy bruising/bleeding, or gum bleeding. Endocrine: No hot or cold intolerance. Neurologic: See HPI. No HA, confusion, disorientation.    Physical Exam: General: Pt appears uncomfortable, in acute painful distress, and wearing normal street clothes on arrival. Pt is a WDWN male otherwise. Pt is alert and cooperative, though slightly diaphoretic likely due to pain. Skin: Small abrasions noted on palms and posterior elbows B/L. No lacerations, active bleeding, or contusions visualized otherwise. Otherwise, warm skin, no other rashes, normal turgor, no pallor or cyanosis throughout, including distal B/L LEs.  Head: Normocephalic, atraumatic. Eyes: PEERLA B/L, sclera anicteric, conjunctiva clear. Ears, Nose, Throat: Normal ear, nose, and throat inspection. No pharyngeal erythema or lymphadenopathy noted. Ear canals patent B/L. Hearing grossly intact B/L. No hemotympanum, raccoon eyes, Battle sign, or otorrhea noted.  Neck: Non-tender, c-spine ROM intact, no midline TTP, step-offs, or deformity. No visible skin changes, contusion, or abrasion. Pulmonary: Lungs clear to auscultation B/L, no crackles, wheezes, or rhonchi. Cardiac: Normal rate, with normal rhythm, no murmurs, gallops, or rubs. Normal S1 and S2. Peripheral Vascular: Capillary refill less than 2 seconds throughout distal extremities bilaterally. Peripheral pulses full and equal bilaterally. Abdomen: Soft, non-distended, non-tender. Normoactive BS presents in all 4 quadrants.  Rectal: Normal sphincter tone/wink. No appreciated external abnormality. GU: Deferred MSK: Thoracic and lumbar spine are without midline tenderness, step-off or deformity. Pelvis stable and without TTP. No crepitus, or depression appreciated. B/L upper extremities with abrasions as noted above (see “skin” section), with ROM intact in hand/wrist/elbow and shoulder.  Right LE unremarkable, including ROM intact of R hip/knee/ankle/foot without evidence of contusion, deformity, or swelling. Left LE at the hip has passive ROM intact without crepitus or deformity. No TTP along the proximal femur, but TTP is present in the distal aspect when approaching the knee joint. The joint has notable joint effusion / swelling, and pt cannot tolerate ROM or strength assessment at this joint. Mild ecchymosis noted in the knee area. No open fracture visualized. Distal LLE beyond the knee has ROM intact of the L ankle and foot. There is noted L ankle and foot swelling without ecchymoses, deformity, or misalignment.  Neuro: Pt is AAOX4. Sensation equal and intact throughout all extremities. Strength 5/5 all extremities at major joints with exception of L knee which could not be assessed due to pain. CN 2-12 grossly intact. Gait could not be assessed. Reflexes 2+ in all extremities with exception of LLE which could not be assessed due to pain/swelling. No tremor noted. Psychiatric: Appropriate mood and affect; anxiety related to current pain and situation.  Interventions completed thus far in the ER: -18 gauge IV inserted to R arm with 1 L Lactated Ringers IV fluids given -4mg IV morphine x 1 doses. Note: It was shared by nursing that the pt’s pain improved after this intervention  -4mg ondansetron (Zofran) x 1 dose for nausea that developed after pt was given morphine  -EKG, CBC, CMP, INR/aPTT, as well as imaging as noted below   Diagnostic Imaging: AP/Lateral Left Knee X-Ray Interpretation:  “This left knee radiograph series demonstrates a severely comminuted intra-articular fracture of the proximal tibia, the tibial plateau tibial. There is noted depression of a large fragment centrally/medially of the tibial plateau with joint effusion.  The lateral image shows fracturing of the proximal tibia as described above. Overall findings are suggestive of a left Schatzker type IV tibial plateau fracture.” The following additional radiographs were completed: -AP/lateral left femur – Results: unremarkable, no acute injury or fracture -A/P lateral lumbar spine and AP pelvis – Results: unremarkable, no acute injury or fracture -3-view left hip – Results: unremarkable, no acute injury or fracture -3-view left ankle and foot – Results: left ankle with diffuse soft tissue swelling visualized without evidence of fracture. -AP/lateral left tibia/fibula – Results: unremarkable, no acute injury or fracture – END OF CASE Hx/PE/Diagnostics INFORMATION – Pediatric Orthopedic Surgery Consultant Response and Recommendations (via Text Message to you):

Write a Java program that determines whether thisYear it is a leap year or not (divisible by 4).   public static void main(String[] args){ Scanner keyboard = new Scanner(System.in); int thisYear = 2025; if(thisYear                                                     ){

Emotional socialization is the process by which individuals learn to recognize, understand, and manage their emotions in social contexts. According to the National Institutes of Health, emotional socialization usually begins at a young age, within the family or primary setting. It then broadens as children move into wider social environments. Give one example of emotional socialization and explain in detail how it changes across the lifespan. There is no word requirement.

Find the error in the following code and discuss how to fix it.   public class Test{public static void main(String[] args){              double x = 6.50; //we created a double variable              int y;                */In the next line, we convert the double value to an integer value /*              y = (int) x;                }              }

Write a Java program that takes an integer as input and checks if it’s a positive number, a negative number, or 0.   public static void main(String[] args){Scanner keyboard = new Scanner(System.in);int input = keyboard.nextInt();if(input                                             ){System.out.println( );