A 70-year-old patient has had intermittent back pain secondary to a bulging disk for more than 3 years. In the last year, it is constant (pain scale is 2-3/10) and at times is sharp. She is not a surgical candidate. What class of medication would be a good choice for improvement of

Answers

Answer 1

A 70-year-old patient has had intermittent back pain secondary to a bulging disk for more than 3 years. In the last year, it is constant (the pain scale is 2-3/10) and at times is sharp. She is not a surgical candidate.

What should be prescribed to the patient?

For a 70-year-old patient who is not a surgical candidate but has been experiencing constant back pain secondary to a bulging disk for more than 3 years, a good class of medication that could help improve the pain is analgesics or pain relievers. Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, naproxen, or COX-2 inhibitors can be helpful in reducing inflammation and pain.

Acetaminophen can also be effective in managing mild to moderate pain. In some cases, opioids may be prescribed, but their use should be closely monitored due to the risk of addiction and side effects such as constipation and respiratory depression.

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Related Questions

Question 1
What is the MOST common cause of bacterial meningitis in children under five years of age?
a. Neisseria meningitides
b. Group B Streptococci
c. Streptococcus pneumoniae
d. Haemophilus influenzae type B

Answers

The MOST common cause of bacterial meningitis in children under five years of age is Streptococcus pneumoniae.

Explanation -Meningitis is caused by germs – either bacteria or viruses. A child catches the germs by breathing in the mist or touching the drainage (mucus or saliva) from an infected person. Once the germs enter the child's nose or throat, they can spread quickly through the bloodstream to the meninges. Streptococcus pneumoniae, or pneumococcus, is a Gram-positive, spherical bacteria, alpha-hemolytic member of the genus Streptococcus. They are usually found in pairs and do not form spores and are non motile.

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The advanced practice nurse is examining a client with new onset hypertension. The nurse practitioner recognizes that hypertension may result in significant complications associated with which of following three organs: a. kidneys
b. liver
c. eyes
d. skin
e. brain

Answers

The advanced practice nurse is examining a client with new-onset hypertension. The nurse practitioner recognizes that hypertension may result in significant complications associated with the following three organs: kidneys, eyes, and brain.

Which organs can be at risk due to Hypertension?

The advanced practice nurse should recognize that hypertension may result in significant complications associated with the kidneys, eyes, and brain. High blood pressure can damage the blood vessels in these organs, leading to conditions such as chronic kidney disease, retinopathy, and stroke.

It is important for the nurse practitioner to initiate appropriate treatment for hypertension to prevent these complications from occurring. The advanced practice nurse is examining a client with new-onset hypertension. Hypertension may result in significant complications associated with the following three organs: a. kidneys, c. eyes, and e. brain. High blood pressure can damage these organs, and treatment is necessary to prevent or manage these complications.

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when drawing, the bow arm is ______ toward the target

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When drawing a bow, the bow arm is typically held straight and perpendicular to the target.

This helps to maintain consistency and accuracy in the shot, as the bow arm provides a stable base for the bowstring to be pulled back against. As the archer draws the string back, the bow arm remains extended and steady, helping to keep the bow in alignment with the target. Once the string has been fully drawn back, the archer can release the arrow with precision and accuracy, hitting the intended target. Proper form and technique are crucial when it comes to archery, and mastering the art of drawing the bow is an important part of this. With practice and patience, archers can learn to draw the bow with ease and hit their targets consistently, making the sport both challenging and rewarding.

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_____________ refers to abnormal flexion of the upper extremities and extension of the lower extremities as neurologic function deteriorates and the patient becomes comatose.

Answers

Answer:

Decortication.

Explanation:

Decortication refers to abnormal flexion of the upper extremities and extension of the lower extremities as neurological function deteriorates and the patient becomes comatose.

10.
Doing a six-second muscle contraction right before a fifteen- to thirty-second stretch usually causes that same muscle to be
more tense
none of the above; contracting a muscle usually doesn't cause that same muscle to be
more or less relaxed afterwards
more relaxed

Answers

Answer:

more relaxed is the answer.

Explanation:

the nurse is caring for a hospitalized 8-month-old girl with special health care needs. which intervention would best help this infant grow and develop?

Answers

The nurse is caring for a hospitalized 8-month-old girl with special healthcare needs. One intervention that may help this infant grow and develop is closely monitoring her diet to ensure she is receiving adequate nutrition for her specific needs.

Which intervention is best for the growth and development of an infant?

The best intervention to help an 8-month-old girl with special health care needs grow and develop while hospitalized would involve creating an individualized care plan that includes proper medical intervention, appropriate hospitalization care, and a tailored diet. This care plan should address the specific needs of the infant, ensuring she receives adequate nutrition, and appropriate medical care, while providing a supportive and comfortable environment during her hospitalization.

Additionally, providing appropriate developmental stimulation and therapy may also be beneficial. Hospitalization may also provide opportunities for close monitoring and intervention to address any health concerns or developmental delays.

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When a person's conscious awareness is said to dissociate from painful memories, thoughts, and feelings is called

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When a person's conscious awareness is said to dissociate from painful memories, thoughts, and feelings, it is called dissociation.

Dissociation is a defense mechanism used by the mind to protect itself from overwhelming psychological trauma or stress.

It can take many forms, including dissociative amnesia, dissociative identity disorder (previously known as multiple personality disorder), and depersonalization/derealization disorder.

Dissociation can cause a person to feel detached from themselves, their surroundings, and their emotions.

It is often associated with post-traumatic stress disorder (PTSD) and can occur in response to a traumatic event or ongoing trauma.

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Which alternative correctly pairs a brain study technique with a key advantage?

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One alternative that correctly pairs a brain study technique with a key advantage is functional magnetic resonance imaging (fMRI) and its ability to provide high spatial resolution.

fMRI is a non-invasive brain imaging technique that measures changes in blood flow to different areas of the brain.

It has become an increasingly popular tool for cognitive neuroscientists because it allows them to identify which brain regions are activated during specific cognitive processes.

One of the key advantages of fMRI is its high spatial resolution, which allows researchers to pinpoint which specific areas of the brain are active during a task.

This is particularly useful in studies that aim to understand the neural basis of cognitive processes such as attention, perception, and memory.

Overall, fMRI's ability to provide high spatial resolution makes it a powerful tool for understanding the neural mechanisms underlying cognition.

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Question 45 Marks: 1 Domestic community water system pumps should be of such capacity as to deliver the average daily water demanded to the storage tank inChoose one answer. a. 4 to 8 hours b. 14 to 18 hours c. 6 to 12 hours d. 18 to 24 hours

Answers

Domestic community water system pumps should be of such capacity as to deliver the average daily water demanded to the storage tank in 6 to 12 hours. The answer is c.

The answer "6 to 12 hours" means that the pump should be able to deliver the average daily water demand to the storage tank within a time frame of 6 to 12 hours. This is considered an appropriate range because it ensures that enough water is available for use without overwhelming the system or causing excessive wear and tear on the pump.

If the pump's capacity is too low, it may not be able to deliver enough water to meet the demand, resulting in water shortages or inadequate water pressure. On the other hand, if the pump's capacity is too high, it may cause excessive cycling of the pump, leading to increased energy consumption, maintenance costs, and potential damage to the pump.

Determining the appropriate pump capacity for a domestic community water system requires consideration of factors such as the average daily water demand, peak water demand periods, storage tank size, and system capacity. This ensures that the pump is appropriately sized to meet the water demand of the community while maintaining efficient and effective operation of the water supply system.

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Both A and B antigens; no antibodies except for the Rh antibody; A-, B-, AB-, O-

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It is AB+ blood type. The red blood cells contain both A and B antigens, and the only antibody they contain is the Rh antibody.

Individuals with this blood type are able to receive blood from any ABO group, but they can only give blood to other AB+ people. The blood type is determined by the A and B antigens on the red blood cells. Which blood types are safe to transfuse into a person depend on whether or not particular antibodies are present in the blood. Since an AB+ person's red blood cells contain both A and B antigens, they can accept blood from any ABO group without their immune system becoming sensitised to it. However, because they only have the anti-Rh antibody, they cannot accept blood from donors who are Rh-negative. Since AB+ people can receive blood from any blood type but can only give to other AB+ people, they are known as the universal recipient blood type.

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4. Explain how opioid addiction occurs.

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Answer:

Why do people become addicted to opioids? Opioids can make your brain and body believe the drug is necessary for survival. As you learn to tolerate the dose you've been prescribed, you may find that you need even more medication to relieve the pain or achieve well-being, which can lead to dependency.

Opioids can make your brain and body believe the drug is necessary for survival. They activate powerful reward centers in your brain.

Which fatty acids elevate LDL cholesterol and thus elevate the risk of heart disease and heart attack?

Answers

The Saturated Fatty acids increase the level of LDL in blood along with trans-fats. The Saturated fatty acids thus increase the level of bad cholesterol and reduce the level of good cholesterol in the body.

The saturated fatty acids are the ones that have all single-bonded carbon atoms, and groups in the long fatty acid chain. The saturated fatty acids are present in animal fat, and plant oils that have solidity in room temperature. These common food items that has saturated fatty acids include; dairy fat, meat fat, palm oil, and coconut oil.

Hence, based on the above-mentioned statements, it can be pointed out that, the saturated fatty acids along with trans fats increase the level of LDL in the body while decreasing the level of HDL.

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what is the first step in dropping batter products?

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The first step in dropping batter products is preheating the utensil to put the batter, use of oil to avoid sticking.

By doing this, you can be sure that the batter-based product will cook uniformly and get a crispy exterior. To ensure that the oil is heated to the correct temperature, it is crucial to follow the recipe's recommendations for oil temperature and to use a cooking thermometer.

Making sure not to overcrowd the pan or fryer, the batter can be dropped into the oil using a spoon or other utensil once the oil has reached the proper temperature. The batter product should be cooked until it is golden brown and crispy. Then, using a slotted spoon or other utensil, it should be removed from the oil and put on a plate covered with paper towels to drain any extra oil to make it healthy.

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Question 20
What is the best means of inhibiting the growth of microorganisms in fresh meat?
a. topical use of approved hypochlorite solutions
b. exposure to ultraviolet light for 30 minutes
c. chemical preservatives
d. adequate refrigeration and cleanliness

Answers

The best means of inhibiting the growth of microorganisms in fresh meat is by ensuring adequate refrigeration and cleanliness.Option D

This is because refrigeration slows down the growth of microorganisms and keeps them at a safe level, while cleanliness helps to prevent contamination from external sources.
While the topical use of approved hypochlorite solutions and exposure to ultraviolet light for 30 minutes can also be effective in reducing microorganisms, they are not as reliable as adequate refrigeration and cleanliness. Chemical preservatives may also be used to inhibit the growth of microorganisms in fresh meat, but they may have negative health effects and are not always approved for use.
Therefore, it is essential to store fresh meat at the right temperature (below 40°F) and to keep it clean and free from any contaminants. This can be achieved by following proper food handling practices, such as washing hands and surfaces regularly, storing meat in sealed containers, and cooking it thoroughly before consumption. By doing so, the risk of foodborne illnesses caused by microorganisms in fresh meat can be significantly reduced.
In conclusion, while there are various means of inhibiting the growth of microorganisms in fresh meat, the best and most reliable approach is through adequate refrigeration and cleanliness.So, option D is correct.

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what is the hold time on 5 oz cupped slaw in the walk in?

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The hold time for a 5 oz cupped slaw in a walk-in refrigerator maintained at 40°F (4°C) or below is approximately 3-5 days. Make sure to follow appropriate food safety practices to ensure the slaw remains safe and fresh for consumption.

To find the hold time for 5 oz cupped slaw in a walk-in refrigerator.The hold time refers to the period during which food can be safely stored at a specific temperature without compromising its quality or safety. For a 5 oz cup of slaw, the hold time depends on the temperature maintained in the walk-in refrigerator.In general, a walk-in refrigerator should be maintained at a temperature of 40°F (4°C) or below to ensure food safety. Following the "2-hour rule," perishable foods like slaw should not be left at room temperature for more than 2 hours, and if the temperature is above 90°F (32°C), this time should be reduced to 1 hour.When stored in a walk-in refrigerator, a 5 oz cup of slaw can have a hold time of 3-5 days, assuming the temperature is consistently maintained at or below 40°F (4°C). Always make sure to store the slaw in a covered container to preserve its freshness and prevent contamination. Additionally, practice proper food handling and storage techniques to further extend the hold time and maintain the slaw's quality.In summary, the hold time for a 5 oz cupped slaw in a walk-in refrigerator maintained at 40°F (4°C) or below is approximately 3-5 days. Make sure to follow appropriate food safety practices to ensure the slaw remains safe and fresh for consumption.

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Read the scenario and answer the question.
As she has aged, 65-year-old Isaballa has lost muscle strength. Her doctor has diagnosed her with low bone density.
What is the best way to address both of these problems?
• flexibility training
• avoid exercise to prevent falls
• cardiovascular exercise
• resistance training

Answers

Answer:

The best way to address both of these problems is resistance training.

Resistance training, also known as strength training or weight training, involves exercises that use resistance, such as weights or resistance bands, to build muscle strength and bone density. This type of exercise has been shown to improve both muscle strength and bone density in older adults, which can help reduce the risk of falls and fractures.

Flexibility training can improve mobility and range of motion, but it alone is not enough to address the loss of muscle strength and low bone density. Avoiding exercise altogether is not recommended, as it can lead to further muscle loss and decreased bone density. Cardiovascular exercise is important for overall health, but it does not specifically target muscle and bone strength.

Therefore, the best way to address both muscle strength and low bone density in older adults is through resistance training.

12.
If cardiovascular endurance and muscle strength are equally important to you, it is usually best to _____ and then _____ (when you do these exercises during the same workout
session).
do cardio exercise first; lift weights
lift weights; do cardio exercise
none of the above; it doesn't matter in which order you do the exercises

Answers

If cardiovascular endurance and muscle strength are equally important to you, it is usually best to do cardio exercise first and then lift weights when you do these exercises during the same workout session.

Doing cardio first and then lifting weights is usually best if cardiovascular endurance and muscle strength are equally important as this approach helps optimize energy levels for strength training and minimizes the risk of injury while still effectively targeting both components of fitness. Cardiovascular exercise is exercise that gets your heart rate up. Though some people use it solely for weight loss, cardio has other benefits as well. There are a wide variety of cardiovascular exercises, but consistency, duration, and intensity are the most important factors for meeting your fitness goals. Read on to learn more about what this type of exercise is, the benefits it offers, and how to create a safe and effective cardiovascular routine.

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The American Psychiatric Association describes ____ such as bipolar disorder as emotional disorders.

Answers

The American Psychiatric Association describes mood disorders such as bipolar disorder as emotional disorders.

Emotional Diseases are  internal  ails characterised by acute and  patient sensations of melancholy,  solicitude, or  vexation, among other  feelings. These problems can have a substantial influence on a person's everyday life and  vitiate their capacity to operate  duly. Mood  diseases, anxiety  diseases, and personality  diseases are  exemplifications of emotional  diseases.    

Mood  diseases are a form of emotional condition in which a person's emotional state is  disintegrated,  similar as sadness or mania. Bipolar  complaint is a mood illness that includes bouts of both despair and mania. Depression is characterised by  passions of melancholy, despair, and a loss of interest in formerly  enjoyable conditioning. Mania is characterised by feelings of  intoxication, heightened energy, and impulsivity.

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What part of the brain plays a role in enhancing or suppressing appetite?

Answers

The arcuate nucleus of the hypothalamus :)

Question 67 Marks: 1 Which bacteria can survive cooking to appropriate levels?Choose one answer. a. Salmonella b. Brucella sp. c. Shigella d. Clostridium perfringens

Answers

Clostridium perfringens is a bacterium that can survive cooking to appropriate levels, especially in large cuts of meat or poultry dishes that cool slowly. Option D is the correct answer.

It is one of the most common causes of food poisoning and can lead to diarrhea and abdominal pain. Proper cooking and rapid cooling of foods can prevent the growth of Clostridium perfringens and reduce the risk of foodborne illness.

Salmonella, Brucella sp., and Shigella are not typically able to survive cooking to appropriate levels and are usually destroyed by high temperatures.

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Can you get concussion from being hit by a football?

Answers

Yes, it is possible to get a concussion from being hit by a football.

A concussion is a type of brain injury that occurs when the brain is shaken inside the skull. If a football hits your head with enough force, it can cause your brain to bounce around and hit the sides of your skull, which can result in a concussion. Symptoms of a concussion can include headache, dizziness, confusion, and memory problems. It's important to seek medical attention if you think you may have a concussion, as the injury can have serious consequences if left untreated.

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What do you know about gender? How is it related to biological sex and sexual orientation?

Answers

Gender refers to the socially constructed roles, behaviors, and identities that are associated with being male or female. It is related to but distinct from biological sex and sexual orientation.

Biological sex refers to the biological differences between males and females, such as reproductive organs, hormones, and chromosomes.

Sexual orientation refers to a person's romantic or sexual attraction to others.

Gender, on the other hand, is a socially constructed concept that includes the roles, behaviors, and identities that are associated with being male or female. It is often used interchangeably with sex, but the two concepts are distinct. Gender is learned and shaped by social and cultural factors, and it can vary across different cultures and historical periods. Gender can also be fluid and may not align with a person's biological sex or sexual orientation. Understanding the differences between gender, biological sex, and sexual orientation is important for promoting inclusivity and understanding the diversity of human experience.

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The nurse provides care to a client with hypermagnesemia. Which will the nurse identify as a risk factor for this electrolyte imbalance?
1. Diarrhea.
2. Alcoholism.
3. Renal failure.
4. Intestinal fistula.

Answers

The nurse provides care to a client with hypermagnesemia. The nurse will identify renal failure as a risk factor for hypermagnesemia.

What would be identified by the nurse as a risk factor?

The nurse would identify "renal failure" as a risk factor for hypermagnesemia in a client. This is because kidney failure can lead to the inability to properly filter and excrete waste products, including excess magnesium, resulting in an electrolyte imbalance. In such cases, dialysis may be necessary to remove the excess magnesium and other excretory waste from the patient's blood.

The kidneys play a crucial role in regulating magnesium levels in the body by excreting excess magnesium through urine. In kidney failure, the kidneys are not able to function properly and excrete excretory waste, including magnesium, leading to an accumulation in the body. Treatment for hypermagnesemia in renal failure may involve dialysis to help remove the excess magnesium from the body. Diarrhea, alcoholism, and intestinal fistula may lead to other electrolyte imbalances but are not directly related to hypermagnesemia.

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Which healthy snack can provide protein after physical activity?

Answers

Answer:

Greek Yogurt with Berries

Common household cleaning products can be a potential health hazard. truefalse

Answers

True because if a kid grabs bleach and drinks it

Diane wants to exercise at a medium to high intensity during her cardio exercise. Based on the Exercise Difficulty Rating scale she should exercise at a rating of about

Answers

According to the Exercise Difficulty Rating scale, Diane should aim for a rating of 6-8, which is considered a medium to high intensity level during her cardio exercise. It is important for her to listen to her body and adjust accordingly to ensure she is working at a level that is challenging yet safe for her fitness level.

Based on the Exercise Difficulty Rating scale, Diane should aim for a rating of about 5-7 during her cardio exercise. This range corresponds to medium to high intensity, which is suitable for achieving her desired level of intensity. To maintain this intensity, Diane should monitor her exertion and adjust her exercise accordingly throughout her cardio session.

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a choking adult become unresponsive while you are doing abdominal thrust for severe chocking. what should you do next?

Answers

Answer:

you should call emergency medical service the carefully and gently lower the person to the ground and start CPR immediately keep doing CPR until medical services arrive or the person starts breathing on their own

Explanation:

how many times do you shake cod after dipping in the batter and before dropping in fryer?

Answers

As per the general cooking guidelines, it is recommended to shake off any excess batter from the cod before dropping it into the fryer. This will help in ensuring that the batter sticks to the fish evenly and does not clump up or fall off during frying.

The number of times you shake the cod after dipping in the batter depends on the thickness and consistency of the batter, as well as personal preference. Some people prefer a thin and crispy coating, while others may prefer a thicker and crunchier one. As a general rule of thumb, you can shake the cod once or twice to remove any excess batter. However, if you notice that the batter is too thick or unevenly coated, you can shake the cod a few more times to even it out. It's important to note that over-shaking can cause the batter to become too thin and fall off during frying, while under-shaking can result in uneven coating and clumping. Therefore, it's essential to find the right balance and adjust accordingly.

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The ACSM says it's a good idea to burn _____ calories in a weekly exercise program.
2500
900-1350
500-750
100-375

Answers

Answer:

900-1350 is the answer.

Explanation:

Health Promotion and Maintenance
Techniques of Physical Assessment -
Musculoskeletal and Neurosensory Systems: Assessing Deep Tendon Reflexes (RM FUND 9.0 Ch 31)
-assess them bilaterally and compare results for symmetry
-use a reflex hammer
-types: bicep, brachioradialis, triceps, patellar, achilles
-Grading: 4+ = very brisk with clonus, 3+ =more brisk than average, 2+ = expected!, 1+ =diminished, 0 = no response

Answers

Health Promotion and Maintenance Techniques of Physical Assessment involve observation, palpation, percussion, auscultation, and scent procedures are all part of a physical examination.

Using the senses, such as observing a rash or hearing lung wheezes, a physical assessment is a crucial nursing skill that is used to gather factual information about a client's condition.

With the use of observation, palpitation, percussion, and auscultation, it assesses your body and takes crucial vital signs including your temperature, blood pressure, and heart rate. Utilising tools to peer inside your nose, throat, ears, eyes, and ears is a form of observation.

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The complete question is:

what are the Health Promotion and MaintenanceTechniques of Physical Assessment?

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jasmine said that commutative property always works for addition but never for subtraction Share of disposable income: what has happened in the last century? which of the following statements about actin monomers is true? group of answer choices actin monomers bind gtp actin monomers are composed of alpha and beta actin actin monomers are known as f actin all of the above none of the above What is the effect on present value when net income increases?a. conformityb. depreciationc. increasesd. decreases The layer of connective tissue that surrounds the entire muscle is called the _____.(a) epimysium(b) endomysium(c) fascicle(d) myofibril. Cassie starts college in the fall and has decided to live in an apartment. Her monthly living ex- penses are as follows: Rent with utilities: $800 Hydro: $40 Phone/internet/TV: $129 Groceries: $300 (a) If she attends school for 18 months, what will be her total living expenses? Two countries are negotiating a trade, what are unionized workers most likely to petition the government for Kimani sells life insurance and is considering buying a $50,000 Cadillac for business purposes (thus, the expense reduces her taxable income). If Kimani is in the 40 percent marginal tax bracket, how much after-tax income will she have to give up in order to enjoy the Cadillac?a. $30,000b. $20,000c. $25,000d. $70,000 the spouse states that the client loves applesauce and asks if this is a good snack choice. which response by the nurse is best? An independent insurance agent works directly for you, not for a large, anonymousorganization. The agent must provide you with the best policy at the lowest price ifhe is to remain in business. The agent's job is to help you find a policy that suitsyour needs. This may cover your life, health, home, or automobile Independentinsurance agents are free to recommend the best policy, regardless of whichinsurance company provides it.11. The author shows bias in favor ofA. using an independent insurance agentB. selecting an insurance policy on your ownC. avoiding low-cost insurance policiesD. buying insurance from a well-known company.12. What is the purpose of the author in writing the text?A. to entertainB. to inform C. to persuadeD. to criticize if one-third of this energy goes into heat and other forms of internal energy of the motor, with the rest going to the motor output, how much torque will this engine develop if you run it at 2400 rpm r p m ? true or false? the evidence for a genetic influence of autism includes twin studies which found that identical twins of autistic individuals will also have autism in 9 out of 10 cases. Fiscal policy refers to a. the effect of changes in the money supply on interest rates. b. reductions in private sector borrowing when there's a budget deficit.c. changes in the level of government spending or taxes. d. the Fed's choice of interest rates. sitting down and talking with a child to prevent escape from time-out is acceptable. true or false Based on the audio, what is true? (1 point) aThere are three main threats to this animal. bPeople prefer pets with vibrant colors. cThis animal's habitat is the ocean. dValentina is seeking donations to start a shelter. Rewrite using other words 1 Habia *un desfile* Durante las fiestas del Santo Patron2 Todos Iban *al cementerio* 3 en el cementerio hay * mausoleos*4 los *muertos* estan enterrados en el cementerio5 nadie Sabina quienes eran porque llevaban *mascaras*6 la senora *elaboraba* bizcochos During 2-rescuer CPR, one rescuer provides chest compressions. What is the role of the second rescuer?A. check for a pulse during compressB. maintain an open airway and give breathsC. do nothing until the first rescuer needs reliefD. count compressions aloud What major event throughout Britain that will eventually spark the Industrial Revolution A restaurant raises the price of its signature dish by 15%The new price of the dish is 14.50What was the original price of the dish? City Hospital reported 49 deaths in June. There were 489 discharges. Eight of those deaths occurred within 48 hours of admission. What is the gross death rate?