Questions
Mrs Baba is an 84-year old school teacher who was widowed 10 years ago and now...

Mrs Baba is an 84-year old school teacher who was widowed 10 years ago and now lives alone. She developed diabetes mellitus at the age of 58. She has been in failing health for the last 3 years and has been at home with assistance of health care aides and weekly visits by RN. Her coccyx area has had frequent skin breakdown. The home care RN determined she now has stage III pressure ulcer as a result of her being on the bedrest the past week. She is being admitted to the hospital for treatment of ulcer.
a. Identify risk factors for Mrs Baba developing pressure ulcer?
b. Describe the stage III of pressure ulcer?
c. Identify the most effective treatment for the stage III pressure ulcer?
d. Explain why massaging bony prominences should be avoided for clients at risk for pressure ulcer formation?
e. Explain why adequate fluid intake is important in pressure ulcer prevention?
f. Describe how you will prevent pressure ulcer at the bony prominences?
g. Prepare a trolley for management of pressure ulcer prevention?
2. Outline the nurse’s responsibility for insertion of nasogastric tube for a conscious patient.
(10marks)
3. Set a trolley for wound dressing (10marks)

In: Nursing

Business Case – Manchester Business School (Civil Engineering) The Company (Civil Engineers) consists of two divisions....

Business Case – Manchester Business School (Civil Engineering)

The Company (Civil Engineers) consists of two divisions. The divisions are Transportation and Infrastructure. The company sells engineering services to various customers. The following are the bill rates for the various staff classifications:

Vice President

$250/hour

Senior Engineer

$200/hour

Associate Engineer

$190/hour

Staff Engineer

$160/hour

The two divisions expect to bill the following hours:

  • Transportation - 10,000 hours, vice president at 10% of the time, 20% of Senior Engineer time 10% to Associate engineers and remaining to Staff Engineers.
  • Infrastructure - 6,000 hours, vice president at 12% of the time, 20% of Senior Engineer time, 5% to Associate engineers and remaining to Staff Engineers.

The Direct Labor costs per hours are as follows:

Vice President

$90/hour

Senior Engineer

$70/hour

Associate Engineer

$60/hour

Staff Engineer

$50/hour

The utilization (billable ratio to total hours) for each staff member is as follows:

Vice President

60%

Senior Engineer

80%

Associate Engineer

85%

Staff Engineer

90%

The company has the following other costs:

Admin Salaries

$81,000

Rent

$120,000

Utilities

$16,000

Benefits

$75,000

Assume that there are 2080 hours per year that each engineer can work including vacation and other benefit hours.

Question:

You are an outside third party Human Resources consulting firm and the Manchester Company Board of Directors, CFO and the CPO have engaged your company. The goal of the Board, CFO and the CPO is to improve profitability of the divisions and company. Therefore, to accomplish providing engagement advice to the Board, CFO and CPO the consulting team should answer the following questions during the presentation and in the final report.

  1. Prepare a static budget for the company.
  1. Assume that the actual utilization came in at the following rates:

Vice President

50%

Senior Engineer

82%

Associate Engineer

88%

Staff Engineer

93%

  1. Based on the above utilization, prepare a flexible budget and calculate the Level 2/3 variances.
  1. What recommendations can be made for the upcoming year in budgeting to the CFO for additional profitability and increasing revenue?
  1. What approaches would your recommendations to increase the company overall utilization of staff and billable hours?
  1. How will your recommendations impact customer profitability or divisional profitability?

  1. The company wants to add a new division. It will be the Construction Division with 3 people. Please discuss pros and cons of adding a division and when you might consider not adding the division.

In: Accounting

1. You have just graduated from nursing school and you are considering working in forensic nursing....

1. You have just graduated from nursing school and you are considering working in forensic nursing.

a. Explain the psychiatric nurse's role in the forensic milieu.

b. What are your fears in dealing with people in correctional facilities?

c. What do you think would be most difficult about working with the forensic client?

d. Have you ever witnessed acting-out behavior in a client? What happened? How did it make you feel? What do you think about this situation now? Were there any clues that this behavior was imminent? Looking at this situation now, could it have been prevented?

In: Nursing

Wells Technical Institute (WTI), a school owned by Tristana Wells, provides training to individuals who pay...

Wells Technical Institute (WTI), a school owned by Tristana Wells, provides training to individuals who pay tuition directly to the school. WTI also offers training to groups in off-site locations. Its unadjusted trial balance as of December 31, 2017, follows. WTI initially records prepaid expenses and unearned revenues in balance sheet accounts. Descriptions of items a through h that require adjusting entries on December 31, 2017, follow.
  
Additional Information Items

An analysis of WTI's insurance policies shows that $2,674 of coverage has expired.

An inventory count shows that teaching supplies costing $2,318 are available at year-end 2017.

Annual depreciation on the equipment is $10,698.

Annual depreciation on the professional library is $5,349.

On November 1, WTI agreed to do a special six-month course (starting immediately) for a client. The contract calls for a monthly fee of $2,900, and the client paid the first five months' fees in advance. When the cash was received, the Unearned Training Fees account was credited. The fee for the sixth month will be recorded when it is collected in 2018.

On October 15, WTI agreed to teach a four-month class (beginning immediately) for an individual for $2,361 tuition per month payable at the end of the class. The class started on October 15, but no payment has yet been received. (WTI's accruals are applied to the nearest half-month; for example, October recognizes one-half month accrual.)

WTI's two employees are paid weekly. As of the end of the year, two days' salaries have accrued at the rate of $100 per day for each employee.

The balance in the Prepaid Rent account represents rent for December.

WELLS TECHNICAL INSTITUTE
Unadjusted Trial Balance
December 31, 2017
Debit Credit
Cash $ 28,000
Accounts receivable 0
Teaching supplies 10,768
Prepaid insurance 16,155
Prepaid rent 2,155
Professional library 32,307
Accumulated depreciation—Professional library $ 9,693
Equipment 75,368
Accumulated depreciation—Equipment 17,232
Accounts payable 36,113
Salaries payable 0
Unearned training fees 14,500
T. Wells, Capital 68,493
T. Wells, Withdrawals 43,078
Tuition fees earned 109,846
Training fees earned 40,923
Depreciation expense—Professional library 0
Depreciation expense—Equipment 0
Salaries expense 51,694
Insurance expense 0
Rent expense 23,705
Teaching supplies expense 0
Advertising expense 7,539
Utilities expense 6,031
Totals $ 296,800 $ 296,800

3-a. Prepare Wells Technical Institute's income statement for the year 2017.
3-b. Prepare Wells Technical Institute's statement of owner's equity for the year 2017.
3-c. Prepare Wells Technical Institute's balance sheet as of December 31, 2017.
  

In: Accounting

Part II – Joyce Snyder After the high school group finishes their tour, Dr. Williams sees...

Part II – Joyce Snyder

After the high school group finishes their tour, Dr. Williams sees two patients.

Joyce Snyder is a biochemist working for a bio-warfare lab at a university. She is working on a project using sarin as a model substance. Suddenly, while working, the lab alarms go off and Joyce accidentally knocks a vial of sarin over and a bit of the liquid splashes onto her arm between her gloves and lab coat.

She suddenly starts to feel dizzy, her heart starts pounding harder than ever, and she has shortness of breath. She feels incredibly sluggish and tries to get to the exit. As she approaches the lab door, her muscles cramp and she falls down and hits her head, knocking her unconscious. Her colleagues from across the hall happen to see her fall and call for help. Joyce is given oxygen and taken to the nearby hospital.

Joyce is admitted to the hospital and Dr. Williams examines her. Joyce is unconscious but seems to be experiencing some paralysis, so Dr. Williams orders blood work. The results are listed in Table 1 below, the top line represents her initial readings; the following three rows are for subsequent time points. You must work with your team members to interpret all clinical values.

Dr. Williams looks over the results and knows from Joyce ’s colleague that she is a bioweapons biochemist. Dr. Williams figures out that Joyce has been working on synthesizing a new sarin-like biochemical weapon and suspects she has a type of poisoning that is like that of sarin.



Questions [Critical Thinking]

2. What symptoms is Joyce experiencing?



3. What is the role of AChE in the NMJ?



4. Examine Table 1 below. Fill-in the normal range of values for each of the variables in the last (blank) row.

Table 1. Lab values for Joyce Snyder. (Serum)

Time Point

BP

Temp.

(°F)

Hemat.

(%)

Glucose

(mg/dL)

Na+

(mEq/L)

K+

(mEq/L)

AChE

Activity

(% of normal)

Thyroxine

(pmol/L)

Serum

Triiodothyronine (FT3)

(pg/dL)

Antibodies for Ach Receptors

1

105/65

99.4 °F

37.5%

88 mg/dL

139 mEq/L

3.8 mEq/L

44%

9.1 pmol/L

112 pg/dL

none

2

108/70

100.1 °F

38.0%

100 mg/dL

135 mEq/L

5.0 mEq/L

42%

8.5 pmol/L

100 pg/dL

none

3

130/92

98.0 °F

36.2%

95 mg/dL

132 mEq/L

5.2 mEq/L

50%

10.0 pmol/L

150 pg/dL

none

4

115/85

99.2 °F

36.9%

80 mg/dL

144 mEq/L

3.5 mEq/L

88%

12.0 pmol/L

82 pg/dL

none

Normal Values












Questions [Critical Thinking and Communication and Quantitative]

5. Which of Joyce ’s levels are abnormal and at what time point?


6. What is the mechanism of action of sarin or a sarin-like chemical?


7. How would exposure to a sarin-like poison affect the amounts of Na+ going into the muscle cell? Explain why.


8. How would exposure to a sarin or sarin-like chemical affect Ca2+ levels inside the sarcoplasmic reticulum? Why?


9. How do these altered Ca2+ levels affect the position of the actin and myosin filaments? Why/how?


10. What needs to happen to Joyce’s post-synaptic membrane to remedy her paralysis? Physiologically what do we need more of, and where?

In: Nursing

Paris and Nicole have been friends since elementary school. For the past 6 months Paris has...

Paris and Nicole have been friends since elementary school. For the past 6 months Paris has been working with Nicole on her campaign for mayor of their hometown. Paris has not been paid for this work – she has been an unpaid consultant. As the election gets closer, Nicole convinced Paris to make a contribution to the campaign fund. Paris was happy to provide the contribution to her friend Nicole’s campaign for mayor, especially after she learned from another friend that charitable contributions are tax deductible. Paris has come to you for advice on filing her federal income tax return.

What is the question for the tax scenario?

In: Accounting

A school boasts of its tutoring program offered to students. Two samples of 71 students each are taken.

A school boasts of its tutoring program offered to students.  Two samples of 71 students each are taken.  The first sample consists of students who have not taken part in the tutoring program while the second sample consists of students who have taken part in the tutoring program.  An aptitude test was given to both samples.  The first sample showed a mean score of 150 with a standard deviation of 20 while the second sample showed a mean score of 158 with a standard deviation of 23.  Using a significance level of 1%, can you conclude that the two samples are different?

Null Hypothesis: ____________________            Your Work:

Alternative Hypothesis: ____________________

Critical Value: ____________________

Test Statistic: ____________________

Your Decision: ____________________

In: Statistics and Probability

Wells Technical Institute (WTI), a school owned by Tristana Wells, provides training to individuals who pay...

Wells Technical Institute (WTI), a school owned by Tristana Wells, provides training to individuals who pay tuition directly to the school. WTI also offers training to groups in off-site locations. WTI initially records prepaid expenses and unearned revenues in balance sheet accounts. Its unadjusted trial balance as of December 31 follows along with descriptions of items a through h that require adjusting entries on December 31. Additional Information Items An analysis of WTI's insurance policies shows that $2,400 of coverage has expired. An inventory count shows that teaching supplies costing $2,800 are available at year-end.

Annual depreciation on the equipment is $13,200.

Annual depreciation on the professional library is $7,200. On September 1, WTI agreed to do five courses for a client for $2,500 each.

Two courses will start immediately and finish before the end of the year.

Three courses will not begin until next year.

The client paid $12,500 cash in advance for all five courses on September 1, and WTI credited Unearned Training Fees.

On October 15, WTI agreed to teach a four-month class (beginning immediately) for an executive with payment due at the end of the class.

At December 31, $7,500 of the tuition has been earned by WTI.

WTI's two employees are paid weekly. As of the end of the year, two days' salaries have accrued at the rate of $100 per day for each employee. The balance in the Prepaid Rent account represents rent for December.

WELLS TECHNICAL INSTITUTE Unadjusted Trial Balance December 31 Debit Credit Cash $ 34,000

Accounts receivable 0 Teaching supplies 8,000 Prepaid insurance 12,000

Prepaid rent 3,000 Professional library 35,000

Accumulated depreciation—Professional library $ 10,000 Equipment 80,000

Accumulated depreciation—Equipment 15,000

Accounts payable 26,000 Salaries payable 0 Unearned training fees 12,500

T. Wells, Capital 90,000

T. Wells, Withdrawals 50,000

Tuition fees earned 123,900

Training fees earned 40,000

Depreciation expense—Professional library 0

Depreciation expense—Equipment 0

Salaries expense 50,000

Insurance expense 0

Rent expense 33,000

Teaching supplies expense 0

Advertising expense 6,000

Utilities expense 6,400

Totals $ 317,400 $ 317,400

\Prepare Wells Technical Institute's income statement for the year.

\ Prepare Wells Technical Institute's statement of owner's equity for the year. The T. Wells, Capital account balance was $90,000 on December 31 of the prior year.

\Prepare Wells Technical Institute's balance sheet as of December 31.

In: Accounting

Student tuition at Boehring University is $160 per semester credit hour. The state supplements school revenue...

Student tuition at Boehring University is $160 per semester credit hour. The state supplements school revenue by $100 per semester credit hour. Average class size for a typical 3 -credit course is 50 students. Labor costs are $4 comma 500 per class, materials costs are $18 per student per class, and overhead costs are $24 comma 000 per class. The multifactor productivity ratio currently is 1.33 and the labor productivity ratio is $174.11 per hour if the instructors work on an average of 14 hours per week for 16 weeks for each 3 -credit class of 50 students.

Coach Bjourn Toulouse led the Big Red Herrings to several disappointing football seasons. Only better recruiting will return the Big Red Herrings to winning form. Because of the current state of the program, Boehring University fans are unlikely to support increases in the $192 season ticket price. Improved recruitment will increase overhead costs to $30 comma 000 per class section from the current $24 comma 000 per class section. The university's budget plan is to cover recruitment costs by increasing the average class size to 70 students. Labor costs will increase to $6 comma 300 per 3 -credit course. Material costs will be about $25 per student for each 3 -credit course. Tuition will be $225 per semester credit, which is supplemented by state support of $100 per semester credit.

a. The multifactor productivity ratio with the university's plan to meet the expenses related to improving recruitment is __.

In: Accounting

An 18-year old high school football player suffered a torn anterior cruciate ligament (ACL) in the...

An 18-year old high school football player suffered a torn anterior cruciate ligament (ACL) in the state playoffs. After undergoing repair, he found it difficult to ambulate with the knee brace. Weighing close to 140 kg (approximately 300 pounds), the athlete found it difficult to stand and balance on one leg. His mother was unable to support him by herself. After one week, the young man began to have increased pain and swelling in the calf of his affected leg. In the middle of the night, the teen called out to his mother, complaining of a shortness of breath and unexplained anxiety. His mother called 9-1-1, and he was taken to a local hospital. In the emergency department, he was diagnosed with a deep vein thrombosis and a pulmonary embolism. Oxygen and low-molecular-weight heparin were administered, and the young man was admitted to the intensive care unit. 2. Question: The young man suffers an infarction or death of a portion of his lung tissue, and it’s determined that blood flow is absent to that section of his lung. Describe what is happening and the long-term effects of this injury.

In: Nursing