5. Summarize the details of the three bacterial sexually transmitted infections (STIS) and their treatment.​

Answers

Answer 1

Answer:

There are three common bacterial sexually transmitted infections (STIs), namely chlamydia, gonorrhea, and syphilis. The details of each STI and their treatment are as follows:

Chlamydia: It is caused by the bacterium Chlamydia trachomatis and is one of the most common STIs. Symptoms may include painful urination, discharge, and pelvic pain. Chlamydia can be treated with antibiotics, typically azithromycin or doxycycline, which are taken orally.

Gonorrhea: It is caused by the bacterium Neisseria gonorrhoeae and can cause symptoms such as painful urination, discharge, and pelvic pain. Gonorrhea can be treated with antibiotics, such as ceftriaxone and azithromycin, which are given by injection and orally, respectively.

Syphilis: It is caused by the bacterium Treponema pallidum and is usually divided into four stages. The first stage may cause painless sores or lesions, while the second stage may cause rashes, fever, and fatigue. The third stage is the latent stage, where there are no visible symptoms. The fourth stage may lead to serious health problems such as heart disease, blindness, and paralysis. Syphilis can be treated with antibiotics, such as penicillin, which is given by injection.

It is important to note that all sexual partners of an infected person should also be tested and treated to prevent the spread of these infections. It is also important to practice safe sex, such as using condoms, to reduce the risk of contracting or spreading STIs


Related Questions

8. Discuss Health Insurance Portability and Accountability Act (HIPAA) applications for patients with HIV or AIDS.​

Answers

Answer:

The Health Insurance Portability and Accountability Act (HIPAA) is a federal law that provides privacy protections and rights for patients regarding their health information. For patients with HIV or AIDS, HIPAA has several important applications.

First, HIPAA prohibits healthcare providers, insurance companies, and other covered entities from disclosing a patient's health information without their consent or authorization, including information related to HIV or AIDS. This helps protect the confidentiality of a patient's HIV status and ensures that their health information is only shared with individuals who have a legitimate need to know.

Second, HIPAA allows patients to access and request changes to their own health information, including their HIV or AIDS status. Patients can also request that certain information be kept confidential or not disclosed to certain individuals or entities.

Third, HIPAA requires covered entities to implement appropriate safeguards to protect the privacy and security of patients' health information, including information related to HIV or AIDS. This includes physical, technical, and administrative safeguards to prevent unauthorized access, use, or disclosure of health information.

Overall, HIPAA provides important protections for patients with HIV or AIDS and helps ensure that their health information is kept confidential and secure. However, there are some limited exceptions to HIPAA's privacy protections for certain public health purposes, such as reporting of communicable diseases like HIV or AIDS. Additionally, state laws may also provide additional protections for patients with HIV or AIDS. So it is important for patients to be aware of their rights and protections under both federal and state laws.

Explanation:

Question 12 of 20
In which range does Borg's Scale of Perceived Exertion recommend you
exercise?
O A. In the blue range, which indicates a minimum level of exertion.
B. Equally in each of the ranges, depending on the exercise routine.
C. In the green range, which indicates a medium level of exertion.
D. In the red range, which indicates a maximum level of exertion.

Answers

The Borg Scale of Perceived Exertion recommends exercising in the green range, which indicates a medium level of exertion. Option C

What is the range?

The Borg Scale of Perceived Exertion is a tool used to assess a person's subjective perception of their level of exertion during physical activity or exercise. It has a scale from 0 to 10, with 0 signifying the least amount of effort and 10 signifying the most.

It is commonly used in therapeutic settings, fitness assessments, and research initiatives to help people maintain track of their level of exercise intensity.

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1. Imagine that you are at a party and a friend is drinking heavily. You are becoming
concerned for their saftey and think that they need to leave and get home safely. What is the
best way to approach your friend? What kind of approach would likely not work? If the
situation were reversed, what would you want a friend to do for you?

Answers

The best way to approach your friend in this situation is to be compassionate, non-confrontational, and supportive. Approach them in a private setting, away from the crowd, and calmly express your concern for their safety. You can say something like, "I noticed you've had a lot to drink, and I'm worried about you. Let's get you home safely, okay?" Offer to call a taxi, rideshare service, or drive them home yourself if you are sober.

An approach that would likely not work is confronting them publicly, being aggressive, or trying to shame them for their behavior. This could make your friend defensive and less likely to accept your help.

If the situation were reversed, you would likely want a friend to approach you with the same level of care and understanding. You'd appreciate it if they didn't judge you or make you feel embarrassed, but rather, focused on ensuring your well-being and getting you home safely.

Define amount of force your muscles can produce

Answers

The maximal force that a muscle or muscle group can produce is known as muscular strength.

More on muscular strength.

How much power you can apply or how much weight you can lift is a measure of your muscular strength. Fewer repetitions with higher weights are used to develop physical strength.

The term "muscular endurance" describes a muscle's capacity to continue contracting repeatedly despite opposition for an extended period of time.

The force you can exert or the weight you can lift is a measure of your muscular strength. How many times you can lift that weight before becoming really exhausted is a measure of muscular endurance.

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Mr. Joseph arrived at the office with an ear infection. After the doctor carefully examined Mr. Joseph’s ears, he noticed that there was something in the left ear. He ordered his medical assistant to perform an ear irrigation on the patient. What instructions should the medical assistant give to the patient regarding the procedure?

Answers

The medical assistant must explain the instructions first to the patient.

What instructions could be given?

The procedure should start by explaining the operation to the patient in plain and simple terms. Tell them the procedure involves using a solution to drain out any earwax or debris that might be the illness's origins.

While ear irrigation is typically a safe and effective procedure, let the patient know that there are some possible adverse effects to be mindful of, such as dizziness or eardrum perforation.

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What does defibrillation mean

Answers

defibrillation is a medical procedure that involves electrical shock to restart your heart during a medical emergency

Drag the steps steps for caring for a suspected head, neck or spinal injury victim who is breathing into the correct order, then select Submit.

Answers

The correct step for caring for a suspected head, neck or spinal injury victim who is breathing is to perform a rescue providing manual in-line stabilization.

What is manual in-line stabilization?

Manual in-line stabilization is a technique used to stabilize the cervical spine (neck) and prevent further movement during the initial care of a person with a suspected head, neck or spinal injury.

It involves the rescuer placing their hands on either side of the person's head and gently applying pressure to maintain the head and neck in a neutral position, without causing any further damage to the spine.

This technique is important to prevent any sudden movements of the head and neck which could potentially cause further injury to the spinal cord.

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20. Which of the following is the relative mass of an object?
A. Body weight
B. Matter
C. Relative matter
D. Weight

Answers

B. Matter

The relative mass of an object refers to the amount of matter it contains, which is directly related to its mass. Mass is a scalar quantity and does not depend on the gravitational force acting on the object. In contrast, weight is a force that depends on both the mass of an object and the acceleration due to gravity. Body weight and weight are affected by gravity, and relative matter is not a standard term used in physics. Therefore, "Matter" is the best answer as it represents the relative mass of an object.

Activities done indoors in the natural setting help in making people realize the great things that nature provides mankind.

Answers

Answer:

false cuz nature is out door not in door

Explanation:

The legal duties of an alcohol server include

Answers

Answer:

Assembly Bill

Explanation:

Assembly Bill 1221 was signed into law in 2017, it defines an alcohol server as anyone that is employed at an ABC on-premises licensed establishment who is responsible for checking identifications, taking customer orders, and pouring or delivering alcoholic beverages.

The legal duties of an alcohol server, also known as a bartender or a server of alcoholic beverages, typically include the following:

1. Checking identification: Alcohol servers are legally required to check the identification of their customers to ensure that they are of legal drinking age. This helps to prevent underage drinking.

2. Monitoring intoxication: Alcohol servers are responsible for monitoring the behavior of their customers to ensure that they are not becoming overly intoxicated. They may be required to stop serving alcohol to individuals who are visibly intoxicated.

3. Serving alcohol responsibly: Alcohol servers are responsible for serving alcohol in a responsible manner, which may include limiting the amount of alcohol served to each customer and ensuring that customers have access to food and non-alcoholic beverages.

4. Refusing service: Alcohol servers have the right to refuse service to customers who are behaving in an inappropriate or dangerous manner, or who are already visibly intoxicated.

5. Reporting incidents: Alcohol servers may be required to report any incidents or accidents that occur on the premises, including fights, accidents, or injuries.

6. Complying with regulations: Alcohol servers must comply with all applicable laws and regulations related to the sale and service of alcohol, including licensing requirements and restrictions on the hours of operation.

Overall, the legal duties of an alcohol server are designed to promote responsible drinking and ensure the safety of both customers and the general public.

When throwing a frisbee a person should aim for the space the person is currently at.

A. True
B. False

Answers

I Believe it is false. I am not sure though you can search on googl
I think true because your goal is to try and get the frisbee to the person. So you’ll have to aim at them (at least I think)

What are some of the negative consequences of continued problematic substance use such as cannabis?​

Answers

Answer:

Some negative consequences of cannabis is addiction, which, in a way, is most common. This could effect their social life as well too. Nausea, vomiting which leads to weight loss most commonly with people with HIV, diabetes, and AIDS. Which also leads to appetite loss muscle spasms, chronic pains. Not very commonly, but could cause seizures.  Most common effects are headaches, dry mouth and dry eyes, light-head-edness and dizziness, drowsiness, fatigue, nausea and vomiting, disorientation, hallucinations, increased heart rate, and much more.

Hope this helps!

Imagine you have mixed together some sand and salt. Based on the Venn diagram, this mixture would be placed where?
Responses
A A
B B
C C
D D

Answers

Answer:

B is the answer.

Explanation:

8. Help the athlete
Question 13
Poor performance in
Question 14
may illustrate to all involved parties that an athlete is not ready to return

Answers

Poor performance in athletic competitions or games may illustrate to all involved parties that an athlete is not ready to return.

How can athletes be proven to be ready to return ?

Athletes who have been injured or are recovering from an illness may be sidelined for a period of time, during which they undergo rehabilitation and training to regain their physical abilities. Once the athlete is cleared to return to competition, poor performance may indicate that they have not fully recovered or are not yet in peak physical condition.

Poor performance can manifest in a variety of ways, including decreased speed, endurance, strength, or agility, as well as mental and emotional factors such as poor decision-making, lack of confidence, or anxiety.

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Which response accurately describes the dermis

Answers

Dermis is the thickest layer of the skin and is present below the epidermis and just above the hypodermis. The dermis consists of two layers called the reticular dermis and the papillary dermis.

It is made up of elastic, fibrous tissues that provide strength and flexibility to the skin. It acts as a support for the epidermis and helps nurture the skin. Due to the presence of nerve endings, it is able to detect stimuli, temperature, touch, and other sensations.

It maintains homeostasis by releasing heat from the body during heat or stress, keeps the skin moist by secreting sebum, and helps produce body hair. Apart from this, the dermis along with the other layers of skin helps protect organs and tissues from any external injury.

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5 sentence helppppp ! please

Answers

Answer:

Yes, I am still friends with some of my friends from middle school. I think it's a good thing because we have known each other for a long time and have a lot of shared memories. It's nice to have people who have known me for so long and who I can rely on. However, it's also important to make new friends and not be limited to just the people I knew in middle school.

What type of pathogens can cause Peter's diseases?

Answers

Answer:

Peter's disease can be brought on by a variety of microbes. There are five main categories of pathogenic organisms: bacteria, fungi, viruses, protozoa, and worms.

Explanation:

September 24, 2010
Dear Dr. Harmon,
Today I treated your patient Dean DaSilva, a local firefighter, for Hepatitis B. Mr.
DaSilva indicated he was at the scene of an accident when an injured party's
blood dripped onto his unprotected skin. I will be monitoring him for the next
few weeks for possible jaundice
(1), Mr. DaSilva also indicated that he
was AIDS
(2)
positive which happened as a result of
(3) while caring for a patient in the hospital at which he
works. I will be monitoring his case closely at this delicate time and have
advised him to return to you for his regular visits.
Sincerely,
Dr. Amani Gray, MD

Answers

The condition which is characterized by yellowness of the skin, eyes, mucous membranes is Jaundice.

What is jaundice ?

Jaundice is a condition that presents as yellowing of the skin, eyes, mucous membranes and excreta due to an accumulation of bilirubin pigment in the body.

This occurs when the liver cannot metabolize the substance effectively - usually during the second phase of hepatitis, which is characterized by inflammation of the organ. It should be noted that jaundice does not qualify as an illness but rather serves as an indicator of other underlying health conditions such as liver damage or hepatitis.

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The rest of the question is:

A condition characterized by yellowness of the skin, eyes, mucous membranes, and excretions: occurs during the second stage of hepatitis. What condition is this?

Write a summary about Ethics Word count: 200

Answers

Ethics refers to the moral principles and values that guide individual behavior, decision making, and actions.

It is a set of principles that define what is considered right and wrong in various aspects of life, including personal, professional, social, and cultural domains. Ethics is an important concept in various fields, including philosophy, law, medicine, and business, among others. In medicine, ethical considerations play a crucial role in healthcare delivery, research, and practice.

Healthcare providers are expected to adhere to ethical principles such as autonomy, beneficence, non-maleficence, and justice when interacting with patients, making treatment decisions, and conducting research. Ethics is also crucial in ensuring fair access to healthcare resources, promoting transparency and accountability, and protecting the rights and dignity of patients.

In business, ethics is important in promoting responsible corporate behavior, sustainability, and social responsibility. Overall, ethics plays a critical role in shaping individual and societal values and actions, and its application is essential for promoting justice, fairness, and the common good.

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Identify the PPE used when giving a bed bath to a resident who has a skin infection or open wound

Answers

You should use gloves, to protect from spread of infection. It’s a more touch/spread situation.

Randall thinks about his future and decides, I want to be well-educated and thoughtful, someone
whose opinion is trusted; I don't want to become a hypocrite like my neighbor. Randall is
considering his
O Personal control options
O Secondary ego
O Possible selves
O Identity vs. isolation crisis

Answers

Answer:  Possible selves

Explanation: Possible selves pertain to the diverse prospective identities or roles that an individual envisions for themselves, which may or may not be congruent with their present self-concept. Randall's aspiration for attaining a level of erudition and discernment, and establishing himself as a credible source of viewpoints reflects his prospective sense of self that he aims to achieve. The process of self-reflection holds significant relevance to the development of one's identity, wherein individuals introspect about their personal values, objectives, and aspirations, and delineate how these interrelate with their self-concept. The notion of possible selves is intricately linked to the theoretical framework of identity formation, wherein the significance of exploration and commitment is underscored in fostering a robust and consistent self-perception.


After your first week of work, Mrs. Wells has a surprise for you. She presents you with a gold watch as a gift and thanks you for the excellent treatment you've given her. What should you do?

A. Decline the gift, since you already have a watch
B. Tell your supervisor that Mrs. Wells is trying to bribe you
C. Decline the gift graciously and tell her you can't accept tips.
D. Accept the gift graciously and thank her for her thoughtfulness

Answers

I will definitely choose D because you can not turn your patient’s gift down :)

1. List three reasons why a mother may choose not to breast-feed.

2. Describe several health and developmental problems that low-birth-weight infants are more likely to experience.

3. List five advantages that breast milk has over formula as the first food for an infant.

Answers

Comments that all women should be required by law to breastfeed have sparked a heated debate over the benefits of breastfeeding.

What is a debate ?

A debate can be an organized event, an informal discussion between two or more people, or a general discussion that involves many people.Speech involves  more 'performance' aspects than debate. Speech events are divided into two categories Public Address and Interpretation.

What is a Speech ?

A speech may be delivered on social issues and in public interests. There can be welcome and farewell speeches, Speech by the chief guest during a function etc.Without communication skills, the ability to progress in the working world and in life, itself, would be nearly impossible. Public speaking is one of the most important and most dreaded forms of communication.

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16. Explain the difference between the human immunodeficiency virus (HIV) and the acquired immunodeficiency syndrome (AIDS). Describe three tests that can be used to diagnose HIV. Summarize the opportunistic infections that are commonly seen in patients with AIDS.​

Answers

Answer:

The human immunodeficiency virus (HIV) and the acquired immunodeficiency syndrome (AIDS) are related but distinct conditions. HIV is a virus that attacks and weakens the immune system, specifically the CD4 T-cells, which are important in fighting off infections. AIDS is a condition that occurs when the immune system is severely damaged by HIV, leading to a variety of opportunistic infections and cancers that can be life-threatening.

HIV can be diagnosed through several tests, including:

Antibody screening tests: These tests detect the presence of antibodies produced by the body in response to HIV infection. These tests may be done using blood, saliva, or urine samples.

Viral load tests: These tests measure the amount of HIV RNA in the blood. This test is used to monitor the progression of HIV and to assess the effectiveness of treatment.

CD4 T-cell count: This test measures the number of CD4 T-cells in the blood. A low CD4 count indicates that the immune system is weakened, which is a sign that HIV has progressed to AIDS.

Patients with AIDS are at increased risk for a variety of opportunistic infections, including:

Pneumocystis pneumonia: This is a fungal infection that can cause severe respiratory symptoms and is a common cause of death in patients with AIDS.

Tuberculosis: This bacterial infection can affect the lungs and other organs and is more common in patients with HIV.

Candidiasis: This is a fungal infection that can affect the mouth, throat, and genital area.

Kaposi's sarcoma: This is a type of cancer that can affect the skin and other organs and is associated with infection by the human herpesvirus 8.

Toxoplasmosis: This is a parasitic infection that can cause neurological symptoms and is more common in patients with HIV.

Overall, HIV and AIDS are related conditions that can have serious health consequences. Early diagnosis and treatment with antiretroviral therapy can help slow the progression of HIV and reduce the risk of developing AIDS and opportunistic infections.

Explanation:

3. Stu is trying to increase his dose of vitamin A to improve his vision. What will happen to Stu's body if he continues eating high quantities of vitamin A after consuming an adequate
amount?
A. He won't experience gny further vision improvement since his body needs only small amounts of vitamin A
OB. He will store the excess vitamin A and experience even more of its positive impacts.
OC. His vitamin A stores will increase, and his vision will continue improving
OD. The excess Vitamin A will be stored and used to produce energy

Answers

A. He won't experience any further vision improvement since his body needs only small amounts of vitamin A.

Vitamin A is a fat-soluble vitamin, which means that the body can store excess amounts in the liver and other fatty tissues. Consuming too much vitamin A can lead to hypervitaminosis A, which can cause various health problems, such as dizziness, nausea, and even hair loss. Once Stu has consumed an adequate amount of vitamin A, further consumption will not improve his vision beyond the necessary levels. It is essential to maintain a balanced intake of vitamin A and not exceed the recommended daily allowance.

Sebastian's school currently offers a limited number of after-school programs for students compared to schools in other neighborhoods. He and his friends are interested in making sure they have the same opportunities to attend a variety of after-school programs. All of the following might be effective ways to address Sebastian's problem EXCEPT
Group of answer choices

call the school transportation department to request buses to and from the schools with programs

start a petition to allow more student-led programs to take place after school on campus

talk to his parents about his friends coming over every day since the school doesn't offer programs

write a letter to the school board to suggest funding for more after-school programs at his school

Answers

Talking to his parents about his friends coming over every day since the school doesn't offer programs is not an effective way to address Sebastian's problem. Option 3 is correct.

This option does not address the problem of limited after-school programs. It only suggests a solution for spending time after school with friends, which does not solve the issue at hand. The other three options listed are all potential solutions for increasing the number of after-school programs available to students, either by providing transportation to off-campus programs, creating more student-led programs, or advocating for funding from the school board.

It's important to address the problem directly by advocating for solutions that will benefit all students and provide them with equal opportunities for enrichment and growth. Talking to parents about spending time with friends may be a temporary solution, but it does not address the larger issue at hand and does not benefit all students in the school community. Hence Option 3 is correct.

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Describe the application of community psychology action and research tools to address issues related to colonization, racism, or immigration within a global context.

Answers

Community psychologists are looking for to recognize the functioning of the community, along with the great of life of individuals within groups, groups and institutions, communities, and society. Their goal is to decorate high-quality of lifestyles through collaborative research and action.

What are the cutting-edge purposes of community psychology?

Researching troubles within a neighborhood and assessing character needs. Finding ways to help disadvantaged or disenfranchised persons feel extra linked with their local communities. Understanding social troubles among minority groups.

Community psychologists comprehensively analyze, investigate, and tackle issues such as financial inequality, violence, substance abuse, homelessness, poverty, and racism.

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why yoga teacher training is so expensive

Answers

Answer:

Explanation:Yoga teacher training programs can seem expensive, but there are a few reasons why they are priced the way they are:

Quality Education: Yoga teacher training programs require highly qualified and experienced instructors to provide comprehensive and in-depth education. This level of expertise and knowledge comes with a price, as the instructors need to be compensated fairly for their time and expertise.

Program Length: Yoga teacher training programs are typically several weeks long and require a significant time commitment from both instructors and students. This extended duration means that there are significant costs associated with program logistics, such as food, accommodations, and materials.

Certification: Yoga teacher training programs are regulated by various yoga organizations and require certification for graduates to become recognized as yoga teachers. This certification process involves significant administrative and overhead costs, which are reflected in the program fees.

Small Class Sizes: Many yoga teacher training programs limit class sizes to ensure that students receive personalized attention and instruction. This smaller class size means that each student receives more individual attention from the instructor, which is reflected in the program fees.

Overall, while yoga teacher training programs may seem expensive, they provide comprehensive and high-quality education that requires a significant investment of time and resources. The benefits of completing a yoga teacher training program and becoming a certified yoga teacher can far outweigh the costs in the long run.

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Does anyone have any tips on how to do a toe touch for cheer???

Answers

Answer:

Drill Tips for Each Part of Your Body

Legs: Keep your legs straight. Bent knees make a toe touch look sloppy. Toes: Point your toes, and when landing, make sure your feet are together. Back: Once in the air, the easiest way to get higher jumps is to keep your back straight and avoid reaching towards your toes.

Which of the following types of exudate indicates the presence of infection in a wound?

Answers

The type of exudate that indicates the presence of infection in a wound is "purulent exudate."

Purulent exudate, also known as pus, is a thick, yellowish or greenish fluid that is produced by the body in response to an infection. It contains a high concentration of white blood cells, dead tissue, and bacteria.

In a wound, the presence of purulent exudate is a sign of an infection, and it can indicate that the wound is not healing properly. Other signs of infection may include redness, swelling, warmth, pain, and fever.

It is important to note that the presence of purulent exudate does not always indicate infection. In some cases, it may be a normal part of the healing process, especially in wounds that are deep or have a foreign object present. However, if there are other signs of infection present, it is important to seek medical attention to prevent the infection from worsening.

~~~Harsha~~~

Other Questions
8. What is social fractionalization and how does "greater socialfractionalization" affect economic development in developed anddeveloping countries? opponents of judicial elections believe that elections sacrifice judicial ______. Why does MRP decrease? 1. List three reasons why a mother may choose not to breast-feed. 2. Describe several health and developmental problems that low-birth-weight infants are more likely to experience. 3. List five advantages that breast milk has over formula as the first food for an infant. Oracin denotativo con la palabra leon Question 53 Marks: 1 The recommended distance from the bottom of the trench to the ground water table or rock is 62 inches.Choose one answer. a. True b. False what is constitution Imperial England and English soldiers developed a contemptuous attitude toward natives partly through their earlier colonizing experiences in A person acting as an analyst without a proper license or after such license has been revoked is guilty of a misdemeanor and is subject to a maximum fine of $(?)and imprisonment of up to (?) year or both. ( Life and Disability Insurance Analyst Licenses) Look at the image, read, and choose the option with the correct word to complete the sentence._____(our) familia es muy grande.nuestronuestrosnuestrasnuestra A(n) ______ is a cluster of genes that perform related functions, found in ______. Why does the author compare Gaimans success to a tidal wave? What are historical clues for drug induced Parkinosonism as opposed to Parkinsonons Give a marine mammal example of a) sympatric,b) allopatric and c) peripatric speciation. Make sure that you define each of these terms in your answer. help! this is a timed assignment!! As people age from young adulthood to old age, they tend to become __________.less conscientiousmore neurotic and more conscientiousless neuroticmore neurotic Determine the value for c and the covariance and correlation for the joint probability mass function fXY(x,y) = c(x + y) for x = 1, 2, 3 and y = 1, 2, 3 This equation shows how the total number of postcards Cooper buys is related to the number of days he spends on vacation. p = 9d The variable d represents the number of days he spends on vacation, and the variable p represents the total number of postcards he buys. After 2 days of vacation, how many total postcards will Cooper have bought? Government, from a neoclassical perspective, should have the intent to focus lessa) on growth in the long-term.b) on stimulus spending.c) on prices that are flexible a first-grade teacher is reviewing expanded form with her students and is using the number 74 as an example. she explains to students that since the value of the 7 is actually 70, the expanded form of 74 is 70 4. she notices that several students seem confused. what step could she take to improve students' understanding of expanded form?