Jack Taylor is a 34-year-old male who came to the clinic with a complaint of a sinus infection. He had an episode of hematuria yesterday, so the clinic nurse checked his urine sample with a dipstick. The client is six feet tall, 272 pounds, and his vital signs were T.101.6, P. 68, R. 18 and BP. 130/80. The urine sample has the following results: Glucose ++, Protein +, Ketones trace, Blood trace, Specific gravity 1.020, leukocytes none, and Nitrites none. The health care provider schedules the client to return to the clinic tomorrow for diabetic education. The provider also writes an order for home glucose monitoring equipment and for Augmentin 875/125mg tablet by mouth twice a day for 10 days.

Focus Questions

1. Discuss the pathophysiology of diabetes as applied to the client
2. What educational information should the nurse provide the client today?
3. Are there any questions the nurse should ask the client today to assist in preparing for tomorrow’s educational session?
4. What educational information should the nurse prepare for tomorrow’s educational session

Jack returns for his follow-up appointment. He has not eaten breakfast, so a fingerstick fasting glucose is performed. The result is 168 mg dl. He is happy about his sudden diagnosis. He listens politely to the nurse’s information but gives every indication that he will do as he pleases. During the discussion, Jack revealed that he had a work-related accident four years ago, that resulted in permanent disability. He has a weight lifting restriction of 10lbs and cannot stand or walk for more than 20 minutes. His typical meal pattern is one meal for three or four days per week. He usually does not eat on the other days of the week. He is the family cook as he is home while his wife works. There are two children, ages 6 and 9, at home. Jack consumes a wide variety of foods preferring to fry meats.

Focus Questions

1. What adjustments should the nurse make in the teaching plan?
2. What referrals are appropriate for the client?
3. What psychosocial needs might the client have?
4. How will the nurse address the client’s psychosocial needs?

After 3 months Jack returns for a follow-up appointment. His blood glucose monitoring log reveals fasting blood glucose of 155mg dl-210mg dl and evening blood sugars of 220 mg dl to 286mg dl. The client states that he has been watching what he eats and trying to eat more regularly. The client is not exercising. His weight today is pounds. The health care provider orders Glucophage 500mg 1tablet by mouth 3 times per day.

Focus Questions

1. How could the nurse obtain a more accurate picture of the client’s diet?
2. What educational information is appropriate to discuss with the client today?
3. What psychosocial support can the nurse give the client today?

Kojima Berhad is trying to estimate its need of funds for the second quarter of year 2009. The company's actual and forecasted sales are as follows:

Actual                         RM                             Forecasted                             RM

January                       160,000                       April                                        180,000

February                     190,000                       May                                         260,000

March                          140,000                      June                                        220,000

July                                           280,000

b) The collection of sales is as follows:

• 30% is for cash

• 70% is collected one month after sales

c) The purchases of the raw materials are 60% of sales and made one month in advance. The payments are made in the same month in which the sales occur.

d) Rent expenses is RM3.000 per month. 6% of interest payment on RM150,000 notes payable is to be paid in May.

f) Wages and salaries in April, May and June are estimated to be RM10,000, RM12.000 and RM14.000 respectively.

g) Other fixed monthly expenses:

• Depeciation RM15,000

• Insurance RM 3,000

h) The company plans to pay RM10,000 in cash for a new cutting machine in June. This new machine will depreciate RM500 per month.

i) The cost of renovation of RM50,000 will be paid equally in May and June. A quarterly dividend of RM5.000 will be received in June.

k) Kojima Berhad's ending cash balance for March is RM30.000 and a minimum balance the firm wishes to have is RM50.000 per month and the amount will be increased to RM100,000 starting from June.

You are required to prepare a cash budget for Kojima Berhad for the second quarter of year 2009.                                                                                                                             

Piya Jordan is a 68 year old patient who was admitted to the hospital to have surgery to remove an abdominal mass. She underwent a colectomy yesterday removing a mass from her right ascending colon. She has a large abdominal incision with a clean, dry and intact dressing, but fortunately did not require a colostomy. She is on the post operation surgical unit and is requiring post-operative nursing care. She is alert and fully oriented to her surroundings. She has a nasogastric tube in place which has drained 10cc of yellow drainage in the past 8 hours. She is complaining of abdominal discomfort and she states “I’m sick to my stomach and my belly is full”. Please briefly answer to the following questions(NOT long answers because this is a concept map):

1-Plan (treatments)

2-Potential Complications (side effects)/Education

3-Evaluation (what you expect to happen)

A cash flow series is increasing geometrically at the rate of 7% per year. The initial payment at EOY 1 is $5000, with increasing annual payments ending at EOY 20. The interest rate is 17% compounded annually for the first eight years and 5% compounded annually for the remaining 12 years. Find the present amount that is equivalent to this cash flow.  

You are working in a clinic where a 24 year old female is being seen for suspected lithium (Eskalith) toxicity. She reports feeling nauseated, shaky, weak and has had episodes of diarrhea. She takes Lithium (Eskalith )600 mg po tid. She reports taking the medicine as prescribed.
Upon further discussion, she reports feeling “down” recently so she has been running extensively to try and lift her spirits. She asks you if her feelings of depression mean her bipolar disorder is out of control and she asks you “what exactly is bipolar disorder?”. Her serum lithium level is 1.9 mEq/L.
Explain how you will respond to her questions.
Develop a detailed teaching plan for this patient. Be sure to include details about bipolar disorder.
Provide all necessary information regarding Lithium (Eskalith)- including classification, action, side effects, nursing considerations/interventions.
What is a therapeutic serum level?

A 18 year loan is being repaid with level payments at the end of each month. The loan rate of interest is 15.6% compounded monthly. In which month is the interest portion approximately equal to 5 times principal the portion? Give an integer answer.

Suppose that 80% of widgets produced by a factory that generates thousands of widgets every year are of acceptable quality.

(a) If a quality control inspector selects 3 widgets independently and at random, what is the probability that at least one will not be of acceptable quality?

(b) Suppose that a quality control inspector selects a random sample of 60 widgets to determine the proportion that have an acceptable level of quality. If Pˆ is the proportion of acceptable widgets he will find in his sample, what is the sampling distribution for Pˆ.

(c) What is the probability that more than 47 of the selected 60 widgets are acceptable?

(d) If the inspector finds that exactly 47 of the widgets selected are acceptable and calculates a 95% confidence interval for the true proportion of widgets from the factory that are acceptable, what would the corresponding margin of error be?

K Company estimates that overhead costs for the next year will be $2,967,000 for indirect labor and $860,000 for factory utilities. The company uses direct labor hours as its overhead allocation base. If 86,000 direct labor hours are planned for this next year, how much overhead would be assigned to a product requiring 6 direct labor hours?

Multiple Choice

• $44.50

• $34.50

• $267.00

• $207.00

• None of the choices

  
  A company has two products: A1 and B2. It uses activity-based costing and has prepared the following analysis showing budgeted cost and activity for each of its three activity cost pools:

• 				Budgeted Activity
  Activity Cost Pool	Budgeted Cost			Product A1			Product B2
  Activity 1	$	64,000			2,800			6,400
  Activity 2	$	79,000			3,840			6,360
  Activity 3	$	112,000			8,800			2,400

  
  Annual production and sales level of Product A1 is 10,080 units, and the annual production and sales level of Product B2 is 23,910 units. What is the approximate overhead cost per unit of Product A1 under activity-based costing?

  Multiple Choice

• $6.96

• $7.75

• $10.00

• $13.61

• $4.93

Rolodex Inc. is in the process of determining its capital budget for the next fiscal year. The firm’s current capital structure, which it considers to be optimal, is contained in the following balance sheet:

Note: For this problem, use the book value of the items to get the capital structure. However, you normally want to use the market values. Long-term debt is the only debt capital structure account. Add common stock, capital in excess of par, and RE to get common equity.

Discussions between the firm’s financial officers and the firm’s investment and commercial bankers have yielded the following information:

• Rolodex can borrow $30 million from its bank at a pretax cost of 11 percent.
• Rolodex can borrow $25 million by issuing bonds at a net price of $875 per bond. The bonds would carry a 13 percent coupon rate and mature in 15 years.
• Additional debt can be issued at a 16 percent pretax cost
• Preferred stock can be issued at a pretax cost of 18 percent.
• Rolodex expects to generate $120 million in net income and pay $2.15 per share in dividends.

Hint: RE = Net income - total common dividends.There are 15m shares shown as outstanding in the balance sheet.

• The $2.15 per share dividend (D₁) represents a growth of 5.5 percent over the previous year’s dividend. This growth rate is expected to continue for the foreseeable future. The firm’s stock currently is trading at $16 per share.
• Rolodex can raise external equity by selling common stock at a net price of $14 per share.
• Rolodex’s marginal tax rate is 40 percent.

Round your answers to two decimal places. 10.12% would be entered as 10.12

• What is the weight on debt?   %
• What is the after-tax cost of debt for the second class of debt?  %
• What is the internal cost of equity?   %
• What is the external cost of equity?   %
• Does debt or equity have the lowest breakpoint? Enter debt or equity.

• Compute Rolodex’s marginal cost of capital schedule.

  	Weighted marginal cost of capital
  First increment:	%
  Second increment:	%
  Third increment:	%
  Additional funds:	%

Diesel: At an activity volume of 60,000 units per year, the unit cost of production of this part is calculated as follows:

An outside supplier offered to sell Carthage Inc. this electrical component at only $ 10 per unit. One-third of the specific fixed manufacturing overhead is made up of foremen's wages and other costs that can be eliminated if the part is purchased. The other two thirds of the specific fixed indirect manufacturing costs consist of the depreciation of the equipment used, which has no resale value. The decision to purchase the part in question from an outside supplier would have no effect on the company's common overhead, and the space currently used for this production could be rented at $ 80,000 per year.

1.a In addition to the quantitative analysis ($), the company must take into account what qualitative consideration.

a. The quality of the component in the event of purchase

b. the reliability of the supplier in terms of compliance with the specifics of the product and delivery.

c. the change in supplier prices during the next periods

d. All the foregoing

1.b Should Carthage Inc. Purchase the Part from the External Supplier? Yes or No.

1.c How much would increase or decrease the company's profits if it decided to buy the component rather than make it itself.
a. profits will decrease by $ 80,000.           b. profits will increase by $ 80,000.            c. profits will increase by $ 25,000. d. profits will decrease by $ 25,000.

1.d The relevant unit cost of production is :

a. 6,75 $            b. 10,25 $         c. 8,25 $            d. 7,25 $