Chem 1100 Ch 3 Review FLASHCARDS WRITE SPELL TEST MATCH GRAVITY Upgrade to remove ads Only 1month Explain why climate change is not uniform CLICK THE CARD TO FLIP IT Changes in temperature have not been uniform more warming has occurred at the poles compared to the tropics some places on Earths surface have not even cooled yet the average global temperature has increased CLICK THE ARROWS BELOW TO ADVANCE 1 30 Terms in this set 30 Explain why climate change is not uniform Changes in temperature have not been uniform more warming has occurred at the poles compared to the tropics some places on Earths surface have not even cooled yet the average global temperature has increased Why is global warming not gradual In the past changes took place over thousands of years today they are occurring over decades Why are the surface temperatures of venus and earth warmer than expected Because they have atmospheric gases that produce a greenhouse affect sunlight enters the atmosphere warming the surfaces The gases trap the heat Without these gases the temperatures would be as expected Runaway greenhouse affect High concentration of CO2 in venus atmosphere What are the windows of earths greenhouse molecules that are transparent to visible light but absorb the infared region What is the difference between an atmosphere and a greenhouse the windows of a greenhouse are a physical barrier keeping the heat inside Difference between climate and weather Weather short term description of whatever is happening outdoors in a given place at a given time Climate long term conditions in a particular place over a period of years or decades global warming It is estimated that 29 MJm2 of energy comes to the top of our atmosphere from the sun each day but only 17MJm2 reaches the surface What happens to the rest It is either absorbed or reflected by the atmosphere Why isnt earth cooling rapidly Even though the amount of energy emitted from the surface is more than double the amount received from the sun the earth does not cool rapidly because the surface also absorbs a large amount of energy from the atmosphere What allows the atmosphere to absorb energy the greenhouse affect Water vapor and carbon dioxide are greenhouse gases but N2 and O2 are not Explain why When water molecules and carbon dioxide molecules vibrate there is a change in the distribution of electrons that allows these to absorb infrared N2 and O2 are not capable of vibrating or stretching in a way that changes the electron distribution How do CFCs relate to global climate change they reduce the concentration of ozone in the stratosphere which creates a cooling affect Give of protons neutrons and electrons for Ag107 and Ag109 Ag107 P47 N60 E47 Ag109 P47 N62 E47 Other than atmospheric concentration what two other properties are included in the calculation of the global warming potential for a substance The estimated atmospheric lifetime and its ability to absorb infrared radiation How can scientists estimate past temperatures of earth analyze the deuteriumtohydrogen ratio or drilled ocean cores look at the changing alignment of the magnetic field in particles in the sediment What would happen if the greenhouse effect did not exist What is blamed for the rise in the average global temperatures The ave temp would be 15 degrees C the enhanced greenhouse effect What happens to the CO2 that has been emitted from the burning of fossil fuels A third was absorbed by the ocean Carbon dioxide and water vapor both absorb IR Do they also absorb visible radiation Substances that absorb visible radiation have observable colors Because we can not see any color associated with CO2 and water vapor we conclude that they do not absorb visible light Are single bonds weaker or stronger than double bonds How does that affect the energy needed to cause stretching and bending weaker less energy is needed Why does water warm quickly but the glass cup does not Water molecules absorb microwave radiation and when they do so they rotate faster Glass is not a material that absorbs energy from microwave radiation Why is the atmospheric lifetime of a greenhouse gas important It determines the long term impact of the greenhouse gas What are radiative forcings perturbations that affect the amount of heat absorbed by earths surface warming affect positive forcing cooling affectnegative forcing What would be the best replacement for CFCs something with lower GWP and shorter atmospheric lifetime Capandtrade give companies an economic incentive for lowering emissions by trading or selling their unused permits to other companies Carbon tax places a tax on all fossil fuels Why is Chinas coal dependence described as a double edged sword Coal is the economys black gold and and fragile environments dark cloud Montreal Protocol decrease production of ozone Kyoto Protocol reduction of greenhouse gases US withdrew Ozone depletion is caused by A limited group of manufactured chemicals CFCs Global warming is caused by CO2 influenced by human activities

B I O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O


Complex Midterm FLASHCARDS WRITE SPELL TEST MATCH GRAVITY Upgrade to remove ads Only 1month Assessment A 45yearold man is brought in by LifeFlight after a motor vehicle accident in which he was trapped in a burning vehicle The burn team is estimating the patients likelihood of survival based on the severity of the burn injury You know that the severity of the injury is based on what factors Mark all that apply a Age b Depth of the burn c Presence of inhalation injury d Family support e Psychological state of the patient a Age b Depth of the burn c Presence of inhalation injury CLICK THE ARROWS BELOW TO ADVANCE 1 251 Terms in this set 251 Assessment A 45yearold man is brought in by LifeFlight after a motor vehicle accident in which he was trapped in a burning vehicle The burn team is estimating the patients likelihood of survival based on the severity of the burn injury You know that the severity of the injury is based on what factors Mark all that apply a Age b Depth of the burn c Presence of inhalation injury d Family support e Psychological state of the patient a Age b Depth of the burn c Presence of inhalation injury Severity of Burns Age You have just reported to the burn unit to start your shift Four new patients were admitted after you left work yesterday Which patient is most likely to have lifethreatening complications a A 4yearold scald victim burned over 24 of the body b A 27yearold healthy male burned over 36 of his body in a car accident c A 39yearold female with myasthenia gravis burned over 18 of her body d A 60yearold male burned over 16 of his body in a brush fire A A 4yearold scald victim burned over 24 of the body A patient is brought to the ED from a chemical fire The paramedics report that the patient has a burn that involves the epidermis dermis and the muscle and bone of the right arm When you assess the patient he verbalizes no pain in the right arm and the skin appears charred Based upon these assessment findings what is the depth of the burn on the patients right arm Fullthickness The patient comes into the ED in severe pain and reports that a boiling pot of water accidentally spilled on his lower legs The assessment reveals blistered mottled red skin and both feet are edematous Which depth of burn should you document Deep partial thickness A patient is seen in the ED after a barbecue accident The MD diagnoses superficial partialthickness burns The family asks what is involved with this type of burn The most accurate response by the nurse would be that the Epidermis has been damaged A patients deep partialthickness burns differ from fullthickness burns in that with deep partialthickness burns the burned area will Be painful reddened have blisters A child is admitted with partialthickness burns of both arms and the chest The nursing care plan is based on the knowledge that Spontaneous epithelial regeneration should occur within 26 weeks Which of the following is a quick assessment technique to assess the percentage of burn injury a Checking the patients vital signs b Comparing the patients palm with the size of the burn wound c Observing the color of the clients wound d Observing the patients level of consciousness B Comparing the patients palm with the size of the burn wound You have just admitted a patient with a burn You recognize that the patient is likely to experience a local and systemic response to the burn when the burn exceeds a total body surface area TBSA of what 20 You are the triage nurse in the ED and receive a phone call from a frantic father who saw his 4yearold child tip a pot of boiling water onto her chest The father has called an ambulance What would you instruct the father to do Immerse the child in a cool bath A young male patient is admitted to the burn center after incurring electrical burns to both hands while playing golf during a lightning storm When assessing the entrance and exit wounds the nurse is aware that electrical injury Causes severe nervous tissue destruction along a path of least resistance Which of the following complications is common among victims of electrical burns a Cardiac dysrhythmia b Infection c Hypovolemic shock d Inhalation injury A Cardiac dysrhythmia A 62yearold patient has extensive blister injuries to the back and both legs caused by exposure to toxic chemicals at work is admitted to the ED Which of these ordered interventions will you perform first A Infuse lactated Ringers solution at 250 mLhr B Irrigate the back legs with 4 L of sterile NS C Obtain blood for a CBC electrolytes D Document the TBSA of the burns B Irrigate the back legs with 4 L of sterile NS A 4 year old male involved in a house fire presents conscious to the ED with dyspnea sooty sputum and a brassy cough He is receiving 100 oxygen via nonrebreather reservoir mask FIRST you should Assess airway and breathing Which finding from the history of a child with extensive burns would make you most conscientious about assessing for respiratory complications a Burning weeds caused the fire b The childs clothing was burned c The child was trapped in a closed burning bedroom d Firemen found the child sobbing silently C The child was trapped in a closed burning bedroom During a firstaid class a student asks what should be done when a person rushes out of a house with burning clothes The nurse explains that after the flames are extinguished it is most important to Assess the persons breathing One of your fraternity brothers shirt ignites while he is lighting a grill at a tailgating party The most effective method for putting out the flames would be Logrolling the man in the grass When a female patient who has partialthickness burns on her chest abdomen right let from a fire at her workplace arrives in the ED the nurses 1st responsibility should be to Evaluate whether heat inhalation had occurred Which of the following explains physiologically the edema formation that occurs with burns a Vasoconstriction b Decreased capillary permeability c Increased capillary permeability d Decreased hydrostatic pressure within capillaries C Increased capillary permeability Which of the following nursing diagnoses is most important during the emergent period of burn care A Altered skin integrity rt epithelial skin loss B Fluid volume deficit rt inc capillary permeability C Inc risk for infection rt loss of skin integrity D Acute pain rt burn injury exposed nerve endings B Fluid volume deficit rt inc capillary permeability The serum laboratory findings of a 16yearold male with burns are BUN 30 mgdL Potassium 63 mEqL pH 71 PO2 90 mm Hg Hgb 74 gdL The nurse is aware that these findings indicate Azotemia Which of the following lab results would you expect during the emergent phase for a male patient with 32 burns A Decreased Na RBC platelets Increased K Hct B Decreased Na RBC platelets Hct Increased K C Decreased Na K RBC platelets Hct D Decreased K RBC Hct Increased Na platelets A Decreased Na RBC platelets Increased K Hct A 6 year old male is admitted to the PICU after sustaining 3rd degree burns to his lower extremities Intravenous therapy for this patient is based on all of the following except a Gender and medical history b Depth and percentage of burn c Urine output and urine specific gravity d Hemoglobin and hematocrit values A Gender and medical history Do you think the fluid resuscitation is adequate for this patient 4 hours post burn Alert oriented x 3 Temp 96 Ax Lips pale Cap Refill 3 HR 108 BP 12076 UOP 32 cchr Urine specific gravity 1033 Yes What conclusions can be drawn regarding the adequacy of fluid replacement for the following patient urinary output 28 mlhr BP 9862 pulse 126 respirations 28 pH 732 He is alert and oriented to time person place Fluid replacement is inadequate Fluid volume deficit inc pulse dec BP and acidotic pH A 45year old female is admitted 8 hours after sustaining 15 partial thickness and 20 full thickness burns to the lower extremities The physician orders intravenous fluids of D5W 100 cchr What is the most appropriate initial action for the nurse to take Contact the physician to determine if the initial intravenous fluid should be Lactated Ringers You are providing care for a 14yearold female that was severely burned during an automobile accident The patient is in the shock phase of the burn injury Which assessment findings would indicate that the patient is receiving adequate fluid volume replacement a Urine output 10 mlh CVP 3 weak pulses potassium level of 53 mEqL b Oriented to person and place only BP 10060 urinary output 30 mlhr c Weak thread pulses BP 7040 pulse 130 hematocrit 52 d Restlessness confusion urinary output 15 mlhr rapidly increasing weight B Oriented to person and place only BP 10060 urinary output 30 mlhr The nurse must be aware that pain management for the hospitalized pediatric burn client with partialthickness seconddegree injuries is best achieved with IV medication after adequate oxygenation and fluid resuscitation are ensured To evaluate your burn patients hydration status you should check the patients Hematocrit A patient with 40 TBSA partialthickness burns has been hospitalized for 2 days Until now her recovery has been uneventful But today she begins to exhibit extreme restlessness The nurse recognizes this most likely indicates that she is developing Cerebral hypoxia The physician of a child with extensive burns tells you an hour after the injury to monitor him carefully Which of the following would be the most important factor to monitor closely a Urinary output b Pupillary reaction c Intracranial pressure d d Sugar and acetone in the urine A Urinary output What is the focus during the Acute Phase of a burn A infection control B wound care and closure C nutritional support D pain management E PT You are caring for a patient during the acute phase of the burn Which of the following would be your responsibility a Restricting visitors to prevent infection b Closely scrutinizing the burn wound to detect early signs of infection c Cleaning the patients room d Maintaining the patients sterile environment B Closely scrutinizing the burn wound to detect early signs of infection A patient with partialthickness and fullthickness burns develops a wound infection The nurse knows that local wound infections are primarily treated with Topical antibiotics You know that a tetanus vaccine booster for a 9year old client with a 20 partialthickness burn is Given if more than 5 years have passed since the last vaccine The most important intervention in the nutritional support of a patient with a burn injury is to provide adequate nutrition and calories to Decrease catabolism During the acute phase of a burn injury the nurse assists a client with deep partialthickness burns of the left arm to make which of the following menu choices that are most appropriate 1 Fried chicken 2 Turkey sandwich w lettuce tomato 3 Barbecued pork on a roll 4 Mashed potatoes 5 Milkshake 6 Cola beverage 1 Fried Chicken 4 Mashed Potatoes 5 Milkshake A highprotein highcalorie diet is encouraged in the child with burns As soon as possible after resolution of paralytic ileus A patient is admitted to the hospital with burns on the trunk arms When oral intake is resumed on the 4th day the nurse helps the patient plan the menu Discussion should focus on the need for a diet that includes High caloric intake liberal K intake 3g proteinkgday The client is admitted with fullthickness and partialthickness burns to more than 30 of the body The nurse is concerned with the clients nutritional status Which intervention should the nurse implement a Encourage the clients family to bring favorite foods b Provide a lowfat lowcholesterol diet for the client c Monitor the clients weight weekly in the same clothes d Make a referral to the hospital social worker a Encourage the clients family to bring favorite foods You are doing a sterile dressing change for a child with infected deep partialthickness burns of the chest and abdomen List the steps of the care plan in the order each should be accomplished 1 Apply silver sulfadiazine Silvadene creme 2 Obtain aerobic and anaerobic wound cultures 3 Administer morphine sulfate 5 mg IV 4 Debride wound of eschar using gauze sponges A 3year old client is scheduled to begin debridement of a partialthickness burn on both arms in 30 minutes The child has a current pain rating of 0 The child has not had any pain medication within the last 4 hours The child has the following order May give 2 mg Morphine IV every 3 hours or 325 mg Tylenol po every 4 hours prn for pain Which of the following actions should the nurse take a Administer Morphine for pain management prior to debridement b Administer Tylenol in preparation for debridement since Morphine would not be needed with a pain rating of 0 c Do not administer any pain medication since the pain rating is 0 d Contact the physician and request an order for ibuprofen since it can be used for pain and inflammation A Administer Morphine for pain management prior to debridement When performing a dressing change for a child with severe burns the nurse understands that a basic principle of surgical asepsis is that Sterile objects in contact with clean objects are considered clean It is time to change the dressings on a burn patient What do you do to reduce pain and discomfort at this time Change dressings as quickly as possible When the exposure method of treatment is used in caring for burns the nurse should explain to the patient that Isolation precautions are required The wound of a client with extensive burn injury is being treated with Silvadene Which symptom would indicate to the nurse that the client is experiencing a side effect related to systemic absorption a Pain at the wound site b Burning and itching at the wound site c A localized rash d Photosensitivity D Photosensitivity The patient you are caring for has an electrical burn and has developed thick eschar over the burn wound Which of the following topical antibacterial agents will the nurse expect the physician to order for the wound a Silver sulfadiazine 1 Silvadene water soluble cream b Mafenide acetate 10 Sulfamylon hydrophilic based cream c Silver nitrate 05 aqueous solution d Acticoat B Mafenide acetate 10 Sulfamylon hydrophilic based cream The nurse is applying mafenide acetate Sulfamylon a sulfa antibiotic cream to a clients lower extremity burn Which assessment data would require immediate attention by the nurse a The client complains of pain when the medication is administered b The clients potassium level is 39 mEqL sodium level is 137 mEqL c The clients ABGs are pH 734 PaO2 98 PaCO2 38 HCO3 20 d The client is able to perform active rangeofmotion exercises C The clients ABGs are pH 734 PaO2 98 PaCO2 38 HCO3 20 Baby Gee is an 11month old scheduled for an escharotomy procedure for a fullthickness circumferential leg burn The anticipated therapeutic outcome is Return of distal pulses The method of treatment chosen for a patients burns is the exposure method with application of mafenide Sulfamylon bid When applying this medication the nurse should plan to Give ordered pain medication A patient is admitted to the burn unit after being transported from a facility 1000 miles away The patient has burns to the groin area and both legs The burns to the lower legs are circumferential You know to monitor closely for what as the edema in this patient increases Ischemia Grafts taken from one human body and grafted onto another body are called what Homograft The nurse is aware that a temporary heterograft pig skin is used to treat burns because this graft will Relieve pain promote rapid epithelialization A child who had fullthickness burns is to have skin grafts The nurse explains to the childs parents that for permanent grafts the child must have Autografts Which of the following observations in the patient who has undergone allograft for treatment of a burn site must be reported to the physician immediately a Sanguineous drainage at the allograft donor site b Pain at the allograft donor site c Crackles in the lungs d Decreased pain at the allograft recipient site C Crackles in the lungs A patient with a partialthickness burn injury had Biobrane applied 2 weeks ago You notice that the Biobrane is separating from the burn wound What is the appropriate nursing intervention when this separation occurs Trim away the separated Biobrane A patient with a fullthickness burn receives an allograft Several days later the patient points out that the graft is coming off at the edges The nurses best response would be Its not a permanent graft Ill notify your doctor You are teaching a patient with partialthickness wounds how to wear his elastic pressure garment How would you instruct the patient to wear this garment Continuously When planning care to prevent deformities contractures in a patient with burns the nurse should expect to begin ROM exercises when the patients Vital signs are stable Which of the following instructions should you provide the parents of a pediatric patient with burns who has undergone a skin grafting a Avoid products that claim they minimize the visibility of scars b Avoid sunscreen lotions c Increase the intake of calcium and phosphate d Wear a pressure garment for up to 2 years D Wear a pressure garment for up to 2 years You watch the patient in Room 2 closely because you know that immediately after a burn vasoconstriction of the injured area occurs and leads to Ischemia and possible increase in the depth of the burn A burn patient is transitioning from the acute phase of injury to the rehab phase The patient tells the nurse I cant wait to have surgery to reconstruct my face so I look normal again What would be the nurses best response a You know nothing can be done until the scars mature It is something the doctor will talk to you about in the first few years after discharge b That is something for you to talk to your doctor about c I know this is really important to you but you have to realize that no one can make you look like you used to d You will have most of these scars for the rest of your life D You will have most of these scars for the rest of your life You have just received the changeofshift report in the burn unit Which patient requires the most immediate assessment and intervention A 22 yo admitted 4 days previously w facial burns dt a house fire who has been crying since recent visitors left B 34 yo who returned from skingraft surgery 3 hrs ago is co pain rating 8 C 45 yo w deep partialthickness leg burns who has a temp 1026oF BP 9846 D 57 yo who was admitted w electrical burns 24 hrs ago has a serum K level of 56 C 45 yo w deep partialthickness leg burns who has a temp 1026oF BP 9846 You have just received changeofshift report for the burn unit Which client should you assess first a Room 1 12 year old child with deep partialthickness burns on both legs who is complaining of severe and continuous leg pain b Room 2 14 year old child who has just arrived from the emergency department with facial burns associated with a house fire c Room 3 10 year old child who has just been transferred from the postanesthesia care unit PACU after having skin grafts applied to the anterior chest d Room 4 11 year old child admitted 3 weeks ago with fullthickness leg and buttock burns who has been waiting with his mother for 3 hours to receive discharge teaching B Room 2 14 year old child who has just arrived from the emergency department with facial burns associated with a house fire The acute phase of the burn begins 48 to 72 hours after the burn What begins at this time Diuresis A patient has been admitted to a burn intensive care unit with fullthickness burns over 25 of the body What would be the nurses priority concern about this patient Fluid Status The nurse is evaluating the progress of an adolescent who suffered second and thirddegree burns over 30 of his body 4 days ago Which of the following would indicate that he is improving a He no longer feels pain b All of his blisters have opened c Revascularization occurs d Blanching of the tissues stops C Revascularization occurs A child arrives in the Emergency Department 20 minutes after sustaining a major burn to 40 of the body After starting an IV which of the following interventions should the nurse perform next a Insert an indwelling urinary catheter b Apply Silvadene cream to the burned area c Shave the hair around the burn wound d Obtain cultures from the deepest wound areas A Insert an indwelling urinary catheter The nurse is caring for a patient who has sustained a deep partialthickness burn injury In prioritizing the nursing diagnoses for the plan of care the nurse will give the highest priority to what nursing diagnosis Acute Pain What is a priority in the rehab phase of the burn injury Patient and family education Your patient is in the acute phase of a burn injury One of the nursing diagnoses on the plan of care is ineffective coping due to burn injury and altered body image What interventions can you institute to help this patient cope more effectively Mark all that apply a Promote truthful communication b Allowing the patient to set specific expectations c Assist the patient in practicing appropriate strategies d Stop the patients manipulation of staff e Give positive reinforcement when appropriate A Promote truthful communication C Assist the patient in practicing appropriate strategies E Give positive reinforcement when appropriate During the first 48 hours after a thermal injury the nurse should assess the client for Hyperkalemia and Hyponatremia The nurse is preparing for mechanical debridement and informs the patient that this will involve Use of surgical scissors scalpels or forceps to remove the eschar until the point of pain and bleeding occurs The development of laryngeal cancer is most clearly linked to which of the following factors a High fat low fiber diet b Alcohol and tobacco use c Low socioeconomic status d Overuse of artificial sweeteners B Alcohol and tobacco use During the admission history Mr Lary describes his initial symptom that prompted him to seek medical attention Which of the following is an EARLY sign of laryngeal cancer a Difficulty swallowing b Persistent mild hoarseness c Chronic foul breath d Nagging unproductive cough B Persistent mild hoarseness During your admission of Mr Lary which of the following information will you teach him a Demonstrate the proper method of gargling with normal saline b Perform voice exercises for 30 mins 3xday c Explain that a lighted instrument will be placed in his throat to biopsy the area d Teach him to selfexamine the larynx monthly C Explain that a lighted instrument will be placed in his throat to biopsy the area The initial diagnostic testing reveals that he has laryngeal cancer Next Mr Lary has a procedure to determine if any metastasis has occurred The procedure consists of a small amount of radioactive glucose being injected into a vein and then a machine rotates around the body taking pictures of where glucose is being used in the body Malignant tumor cells show up brighter in the picture because they are more active and take up more glucose than normal cells do Which test is this PET scan Mr Lary is dx with squamous cell carcinoma in the supraglottis He is stage 2 T1 N1 M0 You know that this means that Mr Lary has An intermediate stage of malignant cancer originating from epithelial tissue with the tumor slightly increased in size some involvement of lymph nodes and no distant metastasis Mr Lary is scheduled for radiation therapy You know that radiation at any treatment site may cause a certain adverse effect Therefore you should prepare Mr Lary to expect Fatigue In addition to the side effect in the previous question since Mr Lary is receiving external radiation to the neck which of the following adverse effects should you monitor him for Select all that apply a Thrombocytopenia b Sore throat c Leukopenia d Headache e Xerostomia f Stomatitis g Cystitis h Dysgeusia B Sore throat E Xerostomia F Stomatitis H Dysgeusia Mr Lary has developed alopecia after his radiation therapy He asks When will my hair grow back Which statement should be your response a Your hair should start growing back within 3 weeks b It sounds like you might be concerned about your hair growing back c It may take months if your hair grows back at all d It may take a couple of years for your hair to grow back B It sounds like you might be concerned about your hair growing back You are preparing Mr Lary for a partial laryngectomy in the AM Which intervention would have priority a Take Mr Lary to the ICU for a visit b Explain that he will need to ask for pain meds c Demonstrate the use of an antiembolism hose d Find out if he can read write D Find out if he can read write Which of the following findings during your admission assessment places Mr Badder at the highest risk for development of bladder cancer a Two ppd cigarette use for 25 years b Frequent urinary tract infections c Employment in the textile industry d A history of renal calculi A Two ppd cigarette use for 25 years Mr Badder had a cytoscopy to rule out cancer of the bladder Eight hours postprocedure which of the following symptoms would indicate that Mr Badder has developed a complication after the cystoscopy a Burning with urination b Chills c Pinktinged urine d Bladder spasms B Chills Mr Badder develops lower abdominal pain after the cystoscopy Which of the following interventions will you implement a Apply an ice pack to his pubic area b Massage his abdomen gently c Assist him with ambulation as much as possible d Have him sit in a tub of warm water D Have him sit in a tub of warm water Mr Badder is diagnosed with bladder cancer and begins receiving the alkylating agent thiotepa Thioplex 60 mg weekly for 4 weeks by bladder instillation Mr Badder asks you how the drug works You explain that it Interferes with DNA replication and RNA transcription Following each intravesical instillation of the chemo agent into his bladder you should instruct Mr Badder to Change position every 15 minutes Mr Badders bladder is removed and an ileal conduit is placed You are assessing the urine from Mr Badders ileal conduit and note that the urine is yellow with a moderate amount of mucus Based on this data which of the following nursing interventions would be most appropriate at this time a Change the appliance bag b Notify the physician c Obtain a urine specimen for culture d Encourage a high fluid intake D Encourage a high fluid intake Mr Badder is 1 day postop Which assessment findings indicate that the patient is developing complications Select all that apply a Urine output greater than 30 mLhr b Dusky appearance of the stoma c Stoma protrusion from the skin d Mucus shreds in the urine collection bag e Edema of the stoma f Sharp abdominal pain with rigidity B Dusky appearance of the stoma C Stoma protrusion from the skin F Sharp abdominal pain with rigidity Mr Badders roommate had his bladder removed also and had a continent urinary diversion His roommate is being discharged Which discharge instructions should you provide since he has a continent urinary diversion a Have him demonstrate cathing the stoma b Instruct him on how to pouch the stoma c Explain the use of a bedside drainage bag at night d Tell him to call his MD if his temp is 990F or less A Have him demonstrate cathing the stoma Which of the following assessment findings for Mrs Collon would you identify as the most common symptom of colon cancer a Abdominal pain b Diarrhea c Rectal bleeding d Abdominal distention C Rectal bleeding Which of the following assessment findings for Mrs Collon is the most significant risk factor for the development of her colon cancer a Chronic constipation b Longterm use of laxatives c History of smoking d History of inflammatory bowel disease D History of inflammatory bowel disease Mrs Collon is scheduled for a barium enema as part of her diagnostic workup Which of the following types of meds will be given to Mrs Collon after her barium enema a Laxative b Anticholinergic c Antacid d Demulcent A Laxative Another part of her diagnostic workup will be a colonoscopy While you are providing preop teaching for her colonoscopy Mrs Collon becomes angry threatens to leave the hospital What is the priority diagnosis D Anxiety rt unknown outcomes perceived threats to body integrity Mrs Collon is scheduled for an abdominoperineal resection in the AM During preop teaching you should teach Mrs Collum about C Antibiotics to reduce intestinal bacteria You are assessing the perineal wound for Mrs Collon who has returned from the PACU following an abdominalperineal resection with a colostomy You note serosanguineous drainage from her perineal wound Which nursing intervention is most appropriate a Notify the surgeon immediately b Clamp the penrose drain c Change the dressing as ordered d Remove and replace the perineal packing C Change the dressing as ordered Two days postop Mrs Collon is moving in bed and tells you Feels like my gown popped open Upon exam you note wound evisceration Place the following steps in order for handling this complication a Cover the intestine with sterile moistened gauze b Stay calm stay with Mrs Collon c Monitor her VS especially BP pulse d Have a colleague gather supplies contact the MD stat e Put her into semiFowlers with knees slightly flexed f Prepare Mrs Collon for surgery as ordered B D E A C F Mrs Collon will be treated with doxorubicin Adriamycin In the case of extravasation during therapy you should be prepared to administer C Hyaluronidas Which of the following assessment findings do you anticipate for Mr Lunge who has chronic pain related to lung cancer a Elevated VS physical inactivity facial grimacing periods of anxiety b Normal VS physical inactivity normal facial expressions c Normal VS normal facial expressions moaning d Elevated VS grimacing depression B Normal VS physical inactivity normal facial expressions Mr Lunge is 4 hrs postpneumonectomy Which assessment data warrants immediate intervention a Intake of 1500 mL IV fluid output of 1000 mL b 450 mL of bright red blood in the chest tube c Pain rating of 10 d Absent breath sounds on the side of the surgery B 450 mL of bright red blood in the chest tube On the first day following a right pneumonectomy Mr Lunge sits straight up in bed His respirations are labored he is making a crowing sound His skin is pale cool moist You should immediately Auscultate the left lung You identify the collaborative problem of altered nutrition for Mr Lunge Which would be the most important intervention for you to include in the plan of care a Continuous feedings via PEG tube b Have the family bring in foods from home c Assess for food preferences d Refer to the dietitian D Refer to the dietitian Mr Lunge develops SIADH After reporting symptoms of weight gain weakness nausea vomiting to the MD you would anticipate which initial order for the treatment of this patient A Fluid restrictions Mr Lunge tells you Im so tired of all this I might as well just end it all Which should be your first response Determine if Mr Lunge has a plan to carry out suicide Which patient is at greatest risk for pancreatic cancer a An elderly black male with a hx of smoking alcohol use b A young white obese female with no known health issues c A young black make with juvenile onset diabetes d An elderly white female with a hx of pancreatitis A An elderly black male with a hx of smoking alcohol use Mr Pann is admitted to rule out pancreatic islet tumors During your initial assessment he co feeling weak shaky sweaty Which should be the first action you take a Start an IV with D5W b Notify the MD c Perform a bedside glucose check d Give Mr Pann orange juice C Perform a bedside glucose check You are assessing Mr Pann with complaints of vague upper abdominal pain that is worse at night but is relieved by sitting up leaning forward Which assessment question should you ask next a Have you noticed a yellow haze when you look at things b Does the pain get worse when you eat a meal or snack c Have you had your amylase lipase checked recently d How much weight have you gained since you saw your PCP B Does the pain get worse when you eat a meal or snack Mr Pann is receiving chemo You are reviewing his lab results and note that his platelet count is 10000 cellsmm3 Based on this lab value your priority nursing assessment is which of the following a Skin turgor b Temperature c Bowel sounds d Level of consciousness D Level of consciousness An oncology patient is on neutropenic precautions The family brings some gifts to help the patient feel less depressed Which of the following gifts would you prevent the family from giving the patient a A potted plant b Old photos of the family c Pajamas d Homemade cookies A A potted plant Mr Pann has a Whipple procedure performed to resect the tumor You recognize that hemorrhage is a potentially major complication of the Whipple procedure Which of the following assessment findings suggest this complication a Jaundice of the skin and sclera b Hyperglycemia c Oliguria d Bradycardia C Oliguria It has been 2 days since Mr Pann underwent the Whipple procedure During the respiratory assessment you note that he is taking shallow breaths breath sounds are decreased in the bases The best interpretation of these findings is that he is experiencing post op Atelectasis A long term complication that Mr Pann must be made aware of after a pancreaticoduodenectomy is hypoinsulinism You would know that the teaching about hypoinsulinism is understood when he states I should seek medical supervision if I experience Increased thirst Mr Pann is scheduled to resume chemo You are preparing to administer cyclophosphamide Cytoxan and knows that the he will experience a nadir in approximately 9 to 14 days Which laboratory values will indicate that he has reached the nadir a Blood urea nitrogen and creatinine b White blood cell count and absolute neutrophil count c Ionized calcium and phosphorus d Serum albumin and total protein B White blood cell count and absolute neutrophil count Mrs T is being treated with chemo asks you to explain the purpose of leucovorin rescue Which of the following responses is correct a Decreases the amount of time normal cells are exposed to methotrexate b Decreases the incidence of renal failure c Alleviates severe nausea vomiting d Enhances the immune system A Decreases the amount of time normal cells are exposed to methotrexate Following chemo Mrs T is being closely monitored for tumor lysis syndrome Which lab values require particular attention a Platelet count b Electrolytes c Hemoglobin d Hematocrit B Electrolytes You check the AM lab values for Mrs T Based on the following values Hb 12 Hct 34 Plt 108000 WBC 1600 ANC 1000 which actions would be most appropriate for you to implement Select all that apply a Place her in a private room b Wear a protective gown particulate respiratory mask when completing treatments c Handwashing before after entering his room d Screening visitors for illness such as colds e Monitoring his food trays to avoid fresh fruits uncooked veggies f Contacting the MD for an order for Epogen or Procrit A Place her in a private room C Handwashing before after entering his room D Screening visitors for illness such as colds E Monitoring his food trays to avoid fresh fruits uncooked veggies Mrs T states I have young children I am too young to die Which statement is the best response for you to provide a This cancer is treatable you should not give up b Cancer occurs at any age It is just one of those things c You are afraid of dying what will happen to your children d Have you talked to your children about your dying C You are afraid of dying what will happen to your children Mrs T is scheduled for a thyroidectomy Postoperatively you should plan to have Tracheostomy set at her bedside Immediately after Mrs Ts thyroidectomy your priority action should be to Elevate her head to limit edema of her neck Mrs Ts thyroidectomy was a subtotal procedure You plan to assess her for unilateral injury of the laryngeal nerve every 3060 minutes by Asking her to state her name out loud When planning care for Mrs T the nursing action that should be given highest priority during the 1st 24 hrs postop is Checking vital signs every 2 hrs after they have stabilized Mr Pros had a triple lumen central venous catheter inserted into his subclavian vein 30 minutes ago The MD prescribes chemo to begin stat Before beginning chemotherapy what must be done first A blood return from the port must be aspirated to confirm port function Which of the following lab values would you assess for Mr Pros prior to administering the chemo a PSA prostatespecific antigen b Serum calcium level c CBC d AFP alpha fetoprotein C CBC Mr Pros has started therapy with cisplatin Platinol You perform what important intervention during the course of this treatment Ensure that he is well hydrated Mr Pros is also taking allopurinol Xyloprim The purpose of this medication is to prevent Hyperuricemia You are teaching the nursing student about signs and symptoms related to hypercalcemia in a patient with metastatic prostate cancer and you tell the student that which of the following is a serious late sign of this oncological emergency a Headache b Dysphagia c Constipation dElectrocardiographic changes DElectrocardiographic changes Mr Pros is experiencing mucositis Which health teaching would be most appropriate for this condition a b Increase intake of citruscontaining foods and beverages c Eat a bland diet with low roughage and use a soft toothbrush or plain water rinses for oral care d This adverse effect is expected and will disappear within a few days C Eat a bland diet with low roughage and use a soft toothbrush or plain water rinses for oral care You are responding to Mr Pros beeping IV pump When you enter the room the IV bag is empty the IV line is full of air and Mr Pros is dyspneic What is the best initial nursing action for you to perform Clamp the tubing and place the client on the left side with head down Mr Pros was discharged 2 months ago and is now being readmitted for metastatic prostate cancer Which classification of antineoplastic drug therapy will most likely be prescribed a Antimetabolite b Antibiotic c Hormone or hormone antagonist d Alkylating agent C Hormone or hormone antagonist During the admission history you assess the use of interferon therapy for the treatment of her cancer Which statement by Miss Kidney may indicate a need for a change in treatment a I have frequent muscle aches and pains b I rarely have the energy to get out of bed c I take acetaminophen Tylenol every 4 hours d I experience chills after I inject the interferon B I rarely have the energy to get out of bed Physical assessment findings for Miss Kidney include irregular pulse muscle twitching complaints of prickling sensations in the fingers and hands Lab results include a potassium 29 pH 746 bicarb 29 Miss Kidney is experiencing Metabolic alkalosis You are teaching Miss Kidney about highprotein highcalorie diet choices Which snack choice by Miss Kidney indicates that the teaching has been effective a Fresh fruit salad b Orange sherbet c Strawberry yogurt d French fries C Strawberry yogurt You are monitoring Miss Kidney for signs and symptoms related to superior vena cava syndrome Which of the following is an early sign of this oncological emergency a Cyanosis b Arm edema c Periorbital edema d Mental status changes C Periorbital edema You are monitoring Miss Kidney for one of the most serious blood coagulation complications for individuals with cancer and for those undergoing cancer treatments The most common cause of DIC is Sepsis Miss Kidney is receiving chemo that has the potential to cause pulmonary toxicity Which of the following symptoms indicates a toxic response to chemo a Decrease in appetite b Drowsiness c Spasms of the diaphragm d Cough SOB D Cough SOB Miss Kidney is receiving vincristine Oncovin as one of the meds in her chemo regimen What important findings will you monitor to prevent or limit the main doserelated toxicity Select all that apply a Numbness of the hands or feet b Constipation c Diminished reflexes d Dyspnea pleuritis A Numbness of the hands or feet C Diminished reflexes Miss Kidney weighs 143 lbs and is to receive 25 mcgkg IV of vincristine What is the correct dose in micrograms that she should receive 1625 mcg A hemiglossectomy and right radical neck dissection is performed A half hour after returning from the PACU Mr Oro becomes agitated disoriented confused You should Administer the prescribed prn oxygen by nasal cannula Mr Oro has 2 portable drainage catheters in the area of the incision they are attached to Hemovacs Inspection of the neck incision reveals moderate edema of the tissues Due to this problem you should assess him for Restlessness dyspnea Six hours after returning from the PACU one Hemovac accumulates 180 mL of serosanguineous drainage The priority nursing intervention should be to Notify the MD immediately Eight hours after Mr Oro returns from PACU you note that he has a leak of the thoracic duct You anticipate that the initial treatment for this problem would include inserting a Chest tube to drain the fluid TPN bedrest You are working with a tech Which intervention should you delegate to the tech a Assist the patient with abdominal pain to turn to the side flex the knees b Monitor the JP drainage tube to make sure it is draining properly c Check to see if the patient is sleeping after a pain med is given d Empty the bedside commode of a patient who has been having melena Assist the patient with abdominal pain to turn to the side flex the knees Mr Oro is newly diagnosed with radiationinduced thrombocytopenia you should include which intervention in the plan of care a Administering aspirin if the temperature exceeds 102 F 388 C b Inspecting the skin for petechiae q 4 hrs c Providing for frequent rest periods d Placing the client in strict isolation B Inspecting the skin for petechiae q 4 hrs Mr Oro is also receiving carboplatin Paraplatin and filgrastim Neupogen You will explain to Mr Oro that the filgrastim is used for what effect It shortens the duration of neutropenia and associated infection risk related to the carboplatin Mr T is a 28yo male being admitted with testicular cancer is scheduled for a unilateral orchiectomy Which intervention should have priority in his plan of care a Encourage him to bank his sperm b Discuss completing an advanced directive c Explain followup chemo radiation d Allow him to express his feelings regarding having cancer A Encourage him to bank his sperm Mr Gastro has been diagnosed with adenocarcinoma of the stomach is scheduled to undergo a subtotal gastrectomy Billroth II procedure During the preop teaching you reinforce info about the surgery Which of the following explanations is most accurate The procedure will result in a Enlargement of the pyloric sphincter b Anastomosis of the gastric stump c Removal of the duodenum d Repositioning of the vagus nerve B Anastomosis of the gastric stump You understand that the best position for Mr Gastric postop is Low Fowlers After a subtotal gastrectomy you should anticipate that Mr Gastros NG tube drainage will be what color for about 1224 hrs postop Dark Brown After his subtotal gastrectomy care of Mr Gastros NG tube and drainage system should include which of the following nursing interventions a Irrigate the NG tube with 30 mL of sterile water q hr prn b Reposition the NG tube if it is not draining well c Monitor Mr Gastro for nausea vomiting abdominal distention d Turn the machine to high suction if the drainage is sluggish on low suction C Monitor Mr Gastro for nausea vomiting abdominal distention As a result of as gastric resection Mr Gastro is at risk for development of dumping syndrome You would prepare a plan of care for him based on knowledge that his problem stems primarily from which of the following GI changes a Excess secretion of digestive enzymes in the intestines b Rapid emptying of stomach contents into the small intestine c Excess glycogen production by the liver d Loss of gastric enzymes B Rapid emptying of stomach contents into the small intestine

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O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O B I O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O B I O O O O O O O O O O O O O B I O O O O O O O O O O O O O O O B I O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O


Behavior Therapy Counseling Theories FLASHCARDS WRITE SPELL TEST MATCH GRAVITY Upgrade to remove ads Only 1month In terms of ethical accountability behavior therapy CLICK THE CARD TO FLIP IT provides a basis for responsible practice CLICK THE ARROWS BELOW TO ADVANCE 1 20 Terms in this set 20 In terms of ethical accountability behavior therapy provides a basis for responsible practice Behavior therapy groups employ a longterm treatment model false A trend in contemporary behavior therapy is the increased emphasis on the role of thinking and selftalk as a factor in behavior true Which of the following behavior therapists is credited with developing the social cognitive learning model doing much work on observational learning and modeling and writing about selfefficacy Bandura Which of the following interventions is not associated with the third wave of behavior therapy relaxation training A limitation of behavior therapy is none of these Some researchers believe that fear of flying may be due primarily to claustrophobia true There is no place for the role of thinking process and attitudes in contemporary behavior therapy false The premise of the exposurebased therapies is that anxiety is reduced through pairing a feared stimulus with a competing calming response Wolpes systematic desensitization is based on the principles of classical conditioning Behavior therapists tend to all of these During the second wave of behavior therapy therapists all of these Which of the following is not a basic characteristic of behavior therapy The therapist is manipulative and controlling What is not a part of the steps in a selfdirected change program exploration of ones family constellation What would be the most accurate way of describing mindfulnessbased stress reduction MBSR to a friend or colleague All of these All of the following are steps in the use of systematic desensitization except for hypnosis Which of the following is not true regarding behavior therapy The client is merely passive while the therapist uses techniques Behavior therapists look to the current environmental events that maintain problem behaviors and help clients produce behavior change by changing environmental events through a process called functional assessment is a key pioneer of clinical behavior therapy because of his broadening of its conceptual bases and development of multimodal therapy Arnold Lazarus In acceptance and commitment therapy ACT another way to describe the term acceptance is nonjudgmental awareness

B I B I O O O O O O O O O O O O O O O O O B I O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O B I O O O O O O B I O O O O O O O O O O O B I O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O B I O O O O O B I O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O B I O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O B I O O O O O O O O O O O O O O B I O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O B I O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O B I O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O


Unit 3 Vocab FLASHCARDS WRITE SPELL TEST MATCH GRAVITY Upgrade to remove ads Only 1month abominate CLICK THE CARD TO FLIP IT v to have an intense dislike or hatred for CLICK THE ARROWS BELOW TO ADVANCE Terms in this set 55 abominate v to have an intense dislike or hatred for acculturation n the modification of the social patterns traits or structures of one group or society by contact with those of another the resultant blend adventitious adj resulting from chance rather than from an inherent cause or character accidental not essential medicine acquired not congenital ascribe v to assign or refer to as a cause or source attribute circuitous adj roundabout not direct commiserate v to sympathize with have pity or sorrow for share a feeling of distress enjoin v to direct or order to prescribe a course of action in an authoritative way to prohibit expedite v to make easy cause to progress faster ferment n v a state of great excitement agitation or turbulence to be in or work into such a state to produce alcohol by chemical action expiate v to make amends make up for to avert inadvertent adj resulting from or marked by lack of attention unintentional accidental nominal adj existing in name only not real too small to be considered or taken seriously noncommittal adj not decisive or definite unwilling to take a clear position or to say yes or no peculate v to steal something that has been given into ones trust to take improperly for ones own use proclivity n a natural or habitual inclination or tendency especially of human character or behavior sangfroid n composure or coolness especially in trying circumstances seditious adj resistant to lawful authority having the purpose of overthrowing an established government tenuous adj thin slender not dense lacking clarity or sharpness of slight importance or significance lacking a sound basis poorly suported vitriolic adj bitter sarcastic highly caustic or biting like a strong acid wheedle v to use coaxing or flattery to gain some desired end abominate SYN loathe abhor despise detest abominate ANT relish savor cherish esteem acculturation SYN adaptation adventitious SYN extrinsic incidental fortuitious ascribe SYN impute credit attribute circuitous SYN indirect meandering winding circuitous ANT straight direct as the crow flies commiserate SYN feel sorry for empathize commiserate ANT feel no sympathy for enjoin SYN bid charge command adjure enjoin ANT allow permit expedite SYN accelerate facilitate speed up expedite ANT hinder hamper impede obstruct expiate SYN redeem make amends for atone make reparation ferment SYN commotion turmoil unrest ferment ANT peace and quiet tranquility placidity inadvertent SYN accidental unconsidered inadvertent ANT deliberate intentional premeditated nominal SYN titular token trifling inconsequential nominal ANT real actual exorbitant excessive noncommittal SYN cagey uninformative playing it safe playing it close to the vest noncommittal ANT positive definite committed peculate SYN embezzle defraud misappropriate proclivity SYN natural bend penchant propensity proclivity ANT inability or incapacity sangfroid SYN poise selfassurance equanimity sangfroid ANT excitability hysteria flappability seditious SYN mutinous rebellious subversive seditious ANT supportive loyal faithful allegiant tenuous SYN flimsy insubstantial vague hazy tenuous ANT strong solid substantial valid vitriolic SYN withering acerbic mordant vitriolic ANT bland saccharine honeyed sugary wheedle SYN cajole inveigle softsoap sweettalk wheedle ANT coerce browbeat intimidate strongarm

O O B O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O


Chapter 9 Psychology Terms Achievement motivation the desire for significant accomplishment persons with this trait enjoy competitive and complex activities prefer feedback on their performance and are more willing delay gratification for achievement goals achievement tests tests intended to measure an individuals present level of development of a specific skill relative to grade level content standards analytic intelligence problem solving and book smarts the kind of intelligence typically measured by IQ tests aptitude tests tests intended to measure an individuals relative ability to acquire specific skills through enrollment in an appropriate training or educational program CattellHornCarroll Theory of Cognitive Abilities an empirically driven theoretical approach to the measurement of intelligence that measures over 80 abilities that differ with regard to the breadth of their contribution to cognitive processing content validity the degree to which a test assesses the behavior of interest creative intelligence the ability to generate novel solutions to new problems or to create works of art music or literature crystallized intelligence the ability to use skills and knowledge previously acquired from experience it involves the capacity to retrieve information from longterm memory and the expression of cultural and educational experiences in relationship with fluid intelligence Deviation IQ a metric that compares a subjects IQ performance with an agematched reference group necessary to keep IQ scores from dropping when mental age levels out or reaches asymptote in adulthood but chronological age continues to increase emotional intelligence capacity to accurately perceive emotions in other people to understand ones own emotions and to regulate emotions effectively eugenics good genes a social movement intended to promote procreation by people with good genes and hinder procreation by people with bad genes fluid intelligence the capacity to analyze and solve novel problems independent of acquired knowledge it involves logic inductive and deductive reasoning and scientific technical and mathematical problem solving Flynn Effect the gradual increase in IQ scores over time the cause of which is not fully known General Intelligence Theory the theory developed by Charles Spearman that proposed that intelligence is composed of one primary general intelligence factor g and an array of less important specific abilities s GFactor Spearmans construct of a single dominant uniform factor of intelligence Idiot a term historically used to refer to an individual who is unable to maser spoken language and who has a mental age of 3 or less and an IQ score of 25 or less the lowest order of mental retardation Imbecile a term historically used to refer to an individual who is able to speak but unable to learn to read or write and has an IQ score of roughly 2550 and a mental age of 78 the second order of mental retardation Incremental validity the value added by combining to variables together in a prediction equation intelligence a property of the mind associated with an individuals capacity for abstract though reasoning planning problemsolving learning from experience and communication most often measured with IQ tests Intelligence Quotient IQ a measure of intelligence consisting of ones mental age divided by ones chronological age and multiplied by 100 the mean of most IQ tests is 100 and the standard deviation is 15 Intelligence tests tests intended to measure intelligence independently of the subjects diligence in the application of that ability to master specific academic skills measurement error the difference between the actual value of a quantity and the value obtained by the measurement instrument currently employed mild mental retardation an IQ score of 5070 these persons are able to achieve a sixth grade level of mastery and may be able to support self with vocational skills moderate mental retardation an IQ score of 3549 these persons are able to achieve a 2nd grade level of mastery and may contribute to their own support in a shelteredworkshop setting moron a term historically used to refer to an individual who is barely able to read and has an IQ score of roughly 5069 the highest order of mental retardation norms the level of performance of a reference group used as a bench mark in to standardized tests Phrenology cranioscopy a technique intended to measure ones intelligence and mental faculties using variations in the perimeter and shape of the skull practical intelligence tacit intelligence street smarts the ability to size people up and calculate the best strategies to manage challenging or tricky interpersonal situations to get ahead on the job or solve technical problems that require the mastery of knowledge that is developed without formal training predictive validity criterionrelated validity the degree to which a test predicts the behavior it was designed to predict Primary Mental Abilities Theory the theory developed by LL Thurstone that proposed that intelligence is composed of seven independent primary cognitive abilities verbal comprehension reasoning perceptual speed numerical ability word fluency associative memory and spatial visualization processing speed the length of time required to make sense of the information you have received a measure of cognitive proficiency profound mental retardation an IQ below 20 these persons are in need of constant assistance and supervision it occurs in 12 of those with mental retardation psychometrics a branch of psychology devoted to the measurement of attitudes beliefs personality knowledge and intelligence reliability the degree to which a test consistently generates the same results restandardization the process of revising tests to maintain the same mean score and standard deviation sampling error a random deviation of a measured sample from the true characteristics of the entire population of subjects ie the males enrolled in a study being slightly smarter than the average male in a population savantism Savant Syndrome a rare phenomenon in which individuals with mental retardation autism brain injury or other developmental limitations have at least one area of brilliance or unusual expertise Severe Mental Retardation an IQ score of 2034 theses persons may learn to speak and to complete simple tasks under close supervision SFactor Spearmans construct of the strength of various specific abilities an individual possesses it coexists with but is less important than Spearmans gfactor of intelligence Social Intelligence the capacity to comprehend complex social situations accurately and to successfully manage ones self in social situations Standardized Tests tests that are administered scored and interpreted in a predetermined consistent manner Stereotype Threat the concern that an individual will be evaluated not according to his or her level of performance of their potential for future gains in ability but according to a negative stereotype for the group in which they are a member Tacit Intelligence self taught intelligence designed to solve real world personally meaningful problems Test bias when a test predicts outcomes with greater precision for one group of subjects than for another group of subjects Theory of Multiple Intelligences the theory developed by Howard Gardner that proposes that intelligence is composed of 8 or 9 distinct frames of mind linguistic logicomathematical spatial musical bodilykinesthetic interpersonal intrapersonal naturalistic existential Triarchic Theory of Intelligence the theory developed by Robert Sternberg that proposed that intelligence is composed of three different factors analytic intelligence creative intelligence and practical intelligence Validity the degree to which a test measures the attribute it was designed to measure YOU MIGHT ALSO LIKE PSY 120 voc chap 8 42 terms CHP 9 Psychology and Life 35 terms PSY CH 9 Psych Intelligence

O O B I B I O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O


Geology Chap 8 FLASHCARDS WRITE SPELL TEST MATCH GRAVITY Upgrade to remove ads Only 1month 1 26 Terms in this set 26 Our ability to assign an age to geological and archaeological materials is based on our ability to measure the relative abundance of radioactive ___ and their stable decay products isotopes TF Geologists use fossils in sedimentary rocks to assign their correct place in geologic history TRUE The principle of ___ states that an original sedimentary layer extends laterally until it tapers or thins at is edges lateral continuity TF Isotopic dates from volcanic ash or lava flows layered between fossiliferous sedimentary rocks have been used to assign numerical ages to the geologic time scale TRUE TF Under some circumstances correlation between two regions can be made by assuming that similar rock types in the two regions formed at the same time TRUE The relativedating principle of __ states that fragments included in a host rock are older than the host rock inclusion TF The Mesozoic Era precedes is older than the Paleozoic Era FALSE TF The principle of superposition states that within a sequence of undisturbed sedimentary rocks the layers get younger going from bottom to top FALSE TF The principle of original horizontality states that beds of sediment are nearly always deposited as nearly horizontal layers TRUE The halflife of the carbon 14 isotope is 5730 years If there were 4 billion atoms of C14 in a particular organism at the time it died how many atoms of C14 would there be in the remains of that organism 11460 years after it died 1 billion Fossils are common in __ sedimentary rocks The principle of ______ states that fragments included in a host rock must be _______ than the host rock inclusion older than _______ is the spontaneous nuclear change of isotopes with unstable nuclei Radioactive decay In geology _____ usually means determining time equivalency of rock units correlation Isotopic dating has shown that the Precambrian took up ______ of all geologic time 87 Alvarez and others proposed a hypothesis that dinosaur extinction occurred because __ one or more asteroids impacted Earth resulting in environmental change TF Relative time refers to the time sequence in which events take place rather than the number of years involved TRUE TF An index fossil is a fossil from a very shortlived geographically widespread species known to exist during a specific interval of geologic time TRUE TF Earth is between 1 and 2 billion years old FALSE When the ____ came to a close dinosaurs became extinct Mesozoic Era ______ denotes the vast amount of time that precedes the Paleozoic Era Precambrian By the principle of __ the surface feature known as the Grand Canyon is ___ than the sedimentary formations that are exposed in the side walls of the Grand Canyon superposition TF Half life is the time it takes for a given amount of a radioactive isotope to decay to half its original amount TRUE In radioactive decay an _______ emission is the emission of two neutrons and two protons from a nucleus ALPHA The ___ of a radioactive material is the time it takes for a given amount of radioactive isotope to be reduced by half half life In the radioactive decay process of __ decay an electron is emitted from the nucleus of the parent isotope beta

B I I O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O


The Crisis No 1 by Thomas Paine Be able to identify 2 counterarguments made by Paine The timing of the revolution was not right either too early or too late Paine refutes it by saying why does the time matter Were in the middle of the war now so the timing doesnt matter Well give me peace in my day Paine refutes it by saying if theres peace let it be in my childs day Paine thinks having peace in the days of a grownup is completely selfish to their children 1 logical appeal The time frame had it been 8 months earlier it wouldve been much better 1 ethical appeal If there must be trouble let it be in my day when my child has trouble If we obtained cheap we esteem to lightly 1 emotional appeal The summer solider and the sunshine patriot will in this crisis shrink from the service of its country need ppl thats going to be there in the hard times as well Examples of 2 rhetorical devices used by Paine All the appeals Exclamation Paines call to action Fight hard youll appreciate it later You have to go through tough times to get to the good times SOAPSTone Speaker Thomas Paine Occasion Dec 24th Christmas Eve Audience The troops Purpose To motivate them and build the morals of the troops Subject The Revolutionary War Tone Very bold honest does not sugar coat their situation nor the importance of going through the difficult times for the children 2 similarities in Paine Henrys work Both want war fight for freedom A lot of the same rhetorical devices appeals 2 differences in Paine Henrys work Patrick Henry has more logical appeals Thomas Paine uses more ethical emotional appeals Patrick Henrys parallelism is more obvious than Thomas Paines YOU MIGHT ALSO LIKE 16 terms patrick henry speech questions Common Sense by Thomas Paine 14 terms AP Lang Patrick Henry 18 terms Patrick Henry Notes

O O O O O B I O O O O O B O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O B O O O O O O O O O O O O O O O O O O O O O O O O O B I O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O B I O O O O O O O O O O O O O O O O O O O O O O O O O O O B I O O O O O O O O O O O

thomas paine
counterarguments
exclamation