A 65-year-old man has been diagnosed with hypothyroidism and will be starting levothyroxine (Synthroid) therapy. He has a history of cardiovascular disease and had two coronary stents inserted 2 years ago, with no problems since that time. He is usually active but states that lately, he has felt tired with no energy to take his usual walks or work around the house. He has been instructed to take the medication in the morning, 1 hour before breakfast, and to return to the clinic in 4 weeks to check his TSH levels. Choose the 3 most likely options for the information missing from the statement below by selecting from the list of options provided. The nurse recognizes that, based on the patient’s history and new treatment plan, he is currently at risk for complications, especially __1__, __2___, and _3____ 

The nurse caring for a client returning to the unit after a right radical mastectomy to treat breast cancer includes which intervention in the nursing plan of care for this client?

For these questions, refer to the following section of a technical document and answer each question. Certain sentences are numbered and are referred to by number in some of the questions. Step 3—Composing Now that you’ve outlined your letter, it is time to write! Remember, the person to whom you are writing has probably never met you before. You cannot count on your stunning smile or your winning personality to convince him or her that what you have to say is important. Your words must be carefully chosen, your arguments must be clear and well thought out, and the tone of your letter must be appropriate. Because this is a formal letter, it is important for your letter to be formatted correctly. Following proper letter format is essential. In the top left-hand corner you should write your address and the date. Beneath that, write the receiver’s (the person to whom you are writing the letter) address. 1700 Danville Avenue Springville, UT 84663 December 5, 2001 Mr. Rasband Marshville Middle School 484 South Marsh St. Marshville, IL 84063 Your introduction will set the tone for your whole letter. (7) You must catch your reader’s interest and let him/her know what you will be talking about. Remember, the way you begin your letter should be appropriate to your topic. If your topic is quite serious, beginning with a joke may not set the right tone in your reader’s mind. Think about why this topic is important to you. How can you make it important to the reader, too? Below is an example of the introduction to a persuasive letter: Dear Mr. Rasband, I am concerned about something that is going on in our school. You must have noticed that in the cafeteria we are often given second-rate utensils to eat our lunches with. This is something that must be stopped. These spoon-forks, or “sporks” as they are sometimes called, are inconvenient and, in fact, damaging to all of our health–students and teachers. After deciding how to begin your letter, it is time to write the body of your letter. You must prove to your reader that what you are talking about really matters and that they have something to gain by agreeing with your view on this particular issue. Use your outline to help you. Try to have at least three different arguments with evidence that supports what you are saying. (8) Remember, if you just say “I think this should be changed,” it probably won’t be, but if you say, “I think this should be changed because of the following reasons,” and if your arguments are clear, maybe it will be. It is important to decide which type of argument will best support your idea. Will an emotional approach be best? Maybe facts and figures through an intellectual approach would help establish the importance of what you are talking about. Is this an ethical question? (9) Think about the audience of your letter, Mr. Rasband, and consider which arguments will appeal to him and his views. Choose your arguments and the style of your arguments carefully and make sure you explain each supporting fact and example clearly. Think of how the personal experience in the paragraph below appeals to emotion. The other day, I was in the lunchroom, innocently eating school lunch. I was so looking forward to the delicious peach half that was in my fruit cup, but, to my dismay, I discovered that the only utensil available to me was a “spork.” I found it impossible to cut my peach in half because the edge was not sharp like a knife. It was impossible to impale my peach because the fork tines, as I am sure you have noticed, are barely long enough to be called tines! I finally tried to resort to simply scooping up a little bit of the juice out of my fruit cup but found that the juice simply dribbled out of my inadequate spork! The following paragraph contains an argument appealing to intellect. For example: Because of my sad experience, I had to go without my peach half, and, consequently, did not have a nutritionally balanced lunch! Studies have shown that 75 percent of all teenagers and adults do not eat nutritiously during the day. We desperately need all of our nutrients. Think of what “sporks” are doing to our nation by depriving us of the vital vitamins and minerals we need! This next argument is ethical and causes the reader to consider whether it is ethical to disregard the feelings of individuals. Most importantly, however, I believe that the use of “sporks” in our cafeteria displays a disregard for our feelings and our health. I am sure that our students must think we have forgotten that their needs matter too. Is is too much to ask that we all are able to eat our lunch with regular utensils? Be sure and include at least one paragraph that presents a possible objection or disagreement that your reader might have. What will be your response to calm that objection? You may be swayed to agree with the “spork” usage because you believe it to be more environmentally sound–fewer utensils used, fewer utensils thrown away, and if there is not a separate fork and spoon there will be fewer utensils. However, “sporks” break so much more easily than regular utensils that each person will have to go through at least three or four per meal. Finally it is time to wrap up and conclude your letter. Your ending should be cordial, but strong. This is one case where it is really important for you to have the last word, and that the last word is expressing how important this issue is! Be sure to thank them for reading your letter—remember the people you are writing are very busy! Mr. Rasband, I appreciate your time in addressing this matter. I am sure that once you give careful thought to this matter and the evidence I have given you, you too will see the importance of eliminating “sporks” from our cafeteria. Sincerely, Barty Bannon (10) Its your turn now; using your outline and the brainstorming charts, begin writing your letter.

For these questions, refer to the following section of a technical document and answer each question. “How to Write a Persuasive Letter” We all have things that we would like to change, whether they are at home, at school, in the community, or in the world. Persuasive writing provides us with the tools needed to effectively persuade others to understand our thoughts and ideas. This document will help you learn how to write a letter to someone asking him or her to change something in the world. For example, you might write your principle about more time at lunch, or you might write the mayor of Springfield, the capital of Illinois, about the need for recycling in your community. There are three main steps to writing a persuasive letter: (1) Brainstorming (2) Outlining (3) Composing Step 1—Brainstorming Using the chart below, brainstorm some issues you would like use as possible topics for your persuasive letter. Also think about whom you would write who could influence such changes. School Community World Issue 1: Why this issue is important: Issue 1: Why this issue is important: Issue 1: Why this issue is important: Whom I would write: Whom I would write: Whom I would write: Issue 2: Why this issue is important: Issue 2: Why this issue is important: Issue 2: Why this issue is important: Whom I would write: Whom I would write: Whom I would write: From the chart above, choose a topic for your persuasive letter and write it in the space below: Now that you have chosen the topic of your letter, you are ready to outline your arguments. Your topic will give you a focus for your letter; it is important that the topic of your letter be something you are passionate about so that you can clearly describe to the audience of your letter why your issue is important.

For these questions, refer to the following section of a technical document and answer each question. Certain sentences are numbered and are referred to by number in some of the questions. Step 2—Outlining (1) Outlining your letter will help you decide how you will convince your reader to reach an agreement with you on the issue you have chosen. (2) When you out line try to decide which arguments you will use to persuade your reader and in what order you will use them. (3) You will need to be very clear in you’re arguments so that you are able to convince your audience to see things the way you do. (4) A good guideline to follow is to be sure to have at least 3 arguments to support the view you express in your letter. (5) More is not always better; it is not necessary to have 15 supporting arguments (you don’t want your reader to fall asleep), but fewer than three arguments may weaken your letter. To support the issue you have chosen, try to incorporate the three different types of arguments: • Emotional argument—An emotional argument is designed to make your audience feel passionate about your issue. Stories, experiences, and specific examples are good ways to invoke an emotional response from your reader. • Logical argument—A logical argument uses facts and evidence to convince your audience that it is “logical” to agree with you. • Ethical argument—An ethical argument appeals to the reader’s sense of what is right and wrong. In an ethical argument, you are trying to make your reader see that agreeing with you is a moral and ethical choice. Outline the arguments for your letter in the chart below: Argument 1: Supporting Facts and Examples: Argument 2: Sopporting Facts and Examples: Argument 3: Supporting Facts and Examples Possible Objections Not everyone is going to agree with you. (6) To be most effective in your letter, try to think ahead and plan for possible objections your reader may have with your view. If you address and answer these possible objections in your letter, you will be more persuasive. Outline how you will address possible objections in the table below: Possible Objection 1: My Answer: Possible Objection 2: My Answer: Now decide the order in which you will present your arguments and in which order you will address possible objections. Remember, you want to start strong and finish strong, so you may want to begin with your second best argument and end with your best reason. Be sure to include your possible objections and your answers to them before your concluding argument. Go back to your brainstorming chart and number your reasons and possible objections in the order that you will present them in your letter.

A 78-year-old client with a history of chronic renal failure arrives to the Emergency Department.  The client reports abdominal cramping and paresthesia progressing to muscle weakness.  The client’s partner reports increasing irritability over the last few days and prominent tremors.  The client typically attends hemodialysis every other day; however, has not had access to transportation for the last 4 days.   Based on the client’s history and manifestations which intervention would the nurse plan administer?

For the Modified Cleaves, what is the correct abduction to best demonstrate the femoral head & neck?

The axiolateral, or horizontal beam, projection of the hip requires the IR to be placed?

Why must the tube be angled 5-7 degrees cephalad on a lateral knee radiograph?

Which projection of the knee will demonstrates the head and neck of the fibula free of superimposition?