Question 25:  Use the scaled data data1scale, perform k means clustering analysis, with k=4, and draw the cluster plot using R function >fviz_cluster() in the R package “factoextra”. Please screenshot your figure here. If your “factoextra” package does not load well, you may use R function >plotcluster() in the R package “fpc” instead.

A 55-year-old Black male presents for evaluation of newly diagnosed hypertension. His blood pressure readings average 152/94 mm Hg over multiple visits. He has no history of chronic kidney disease, diabetes, or cardiovascular disease. Which of the following agents are the most appropriate initial pharmacologic therapy for this patient? (Select all that apply)  

A 46-year-old female with moderate persistent asthma presents for follow-up. She reports daily symptoms and nighttime awakenings 3–4 times per week despite adherence to medium-dose inhaled fluticasone/formoterol.  She uses her albuterol inhaler daily. Spirometry shows FEV₁ 68% predicted. Eosinophil count is 420 cells/µL. She has required two oral corticosteroid bursts in the past year. Which of the following is the most appropriate next step in pharmacologic management? (Select all that apply)

A 4-month-old infant diagnosed with gastroesophageal reflux (GER) is thriving without other complications. What should the nurse suggest to minimize reflux?

The nurse is caring for a school-age child with hyperthyroidism (Graves’ disease). Which clinical manifestations should the nurse monitor that may indicate a thyroid storm? (Select all that apply.)

The nurse, caring for an infant whose cleft lip was repaired, should include which intervention into the infant’s postoperative plan of care?

Which of the following is the correct method for mixing insulin?

Hyperglycemia associated with diabetic ketoacidosis is defined as a blood glucose measurement equal to or greater than _____ mg/dl.

Which clinical manifestation may occur in the child who is prescribed methimazole for the treatment of hyperthyroidism (Graves’ disease) and should be immediately reported to the physician?

What is the most common cause of acute renal failure in children?