Boom of Credit Cards

Visas have become such a recognizable element of the way of life on the planet that it is hard to envision a purchaser economy working without them. The charge cards are these days the most helpful of a wide range of installments. The blast of the Mastercard business has influenced everybody in the realm of the â€Å"plastic money†. That was the name given to the Mastercard directly after it was developed. These days, the â€Å"plastic money† possesses a significant spot in the economy of the nation. â€Å"Settlements demonstrates that the quantity of Visas available for use expanded 34 percent between 1988†¦.. The information additionally show that the estimation of charge card exchanges expanded 98 percent during the equivalent period† (Yoo, p. s. 1997). A great deal of reasons clarify the way that the Mastercards are holding the most significant spot in the wallet and totes today. Behind these reasons , is concealing an essential social wonder that has extremely awful results in the nation, Mastercard misuse. Notwithstanding the measures taken by the authorities, insights demonstrate that the number is expanding regular. Today, Visa and Master card involve a significant spot in the charge card commercial center yet the pioneer in the business stays to be Diners Club. In 1949, as the lunch get-together tables were cleared at the Major†s Cabin Grill, a famous New York eatery of the period whose area nearby of the Empire State Building was then a significant resource, three men sat clustered over a prime table out of the way †¦. In their fervor, they brought over Major, the owner and asked him the amount he would pay for business that he would not usually get. Without jumping, Major answered â€Å"7 percent† , number that set up a significant industry (Lewis, 1990). ' Those three men were Alfred Bloomingdale, Frank Mc Namara and Ralph Snyder. They considered an arrangement for another kind of Mastercard. Not at all like the retail and gas charge cards, which were confined being used to those enterprises, theirs would be â€Å"universal† card that permitted its holders to buy merchandise and ventures at better places the nation over. An industry was conceived, Diners Club As a self evident actuality, the period directly before the First World War, was the principal year for another industry, the charge card industry. Those first Mastercards were not so much Mastercards as they are today since they served uniquely for constrained requirements. They could be utilized uniquely on an extremely low level. The utilization of charge cards by retailers started in 1914†³ (Lewis, 1990). Since that date there was an unfathomable development of Visa creation. Before World War I, scarcely any lodgings, oil organizations and retail chains gave charge cards. At that point in 1931 the carrier organizations presented the Visas in their business (Lewis, 1990). The development and the extension of the card went lide the speed of light. The most significant advance was the acquaintance of the Mastercard with the Internet in the 90†³s. Today, Web servers empower installments with charge card. A Mastercard exchange over the Internet is one of the most widely recognized sorts of installment. In the event that a vendor has a record with a dealer bank that offers Internet Visa preparing, he would have the option to acknowledge charge card installment over the Internet (http://search. netscape. com). â€Å"There was an expansion of $78 billion more than 1994, in only one brief year. We†ve been following it since 1980, and we†ve never observed that sort of increment. † (Glenn, 1984, pp. 857-68). What are the reasons that clarify the quick increment of the utilization of the Visas? As one explanation that may clarify the wonder, a few people may imagine that conveying a Visa is a lot simpler than having money or a checkbook in their wallets or satchels. There is no uncertainty that the â€Å"plastic money† doesn†t trouble in a wallet or a handbag in view of its little size. Another explanation that may clarify the Mastercard fever is that it permits its holders to go through the cash they haven†t got at this point. As a matter of fact, it would appear that free cash, in spite of the fact that it truly isn†t. That is the situation of the undergrads who have Mastercards and whose guardians will pay the obligation their kid has made. The most grounded contention that could be additionally the primary explanation the t clarifies the expanding number of Mastercard exchanges is that a ton of low pay people are conveying â€Å"plastic money† and are utilizing it generally yet not carefully. At the point when the ideal opportunity for taking care of the funds to be paid comes, many individuals need more cash to clear their bills. Here is the start of a cycle that most likely will never stop (Kathy and Bill B. â€Å"s case) until the Mastercard organization or the banks understand that their customer†s obligation is developing each month. Prior to any response of the lenders, the obligation has arrived at a fantastic sum. Because of a non-installment of the bills, the issues in the Visa business started. Notwithstanding lost or taken cards and charging mistakes, a wild marvel was conceived in the business, extortion. Two significant perspectives decide the misrepresentation in the business, taken cards and the bootleg market made around the â€Å"plastic cash. † truth be told, falsifying Visas has taken a significant turn during the 60s. True to form, not long after they had established the spontaneous charge card programs in the late 1960s, the bank started to encounter noteworthy misfortunes because of misrepresentation (Lewis, 1990). Measurements demonstrate how quick the extortion went up in the business. In 1964, the U. S. Mail station researched just fifteen instances of Mastercard misrepresentation. After four years, in 1968, that figure shot up to 360, and the next year, it dramatically increased to 762. In 1970, Andrew Brimmer, one of the Federal Reserve Board†s seven governors, indicated that bank charge card misfortunes had expanded 50 percent that year to $115. 5 million or $3. 4 percent of $3. 4 billion in remarkable Mastercard obligation (Lewis 1990). In 1971, the Los Angeles Police Department made open its initially detailed of forging Visas. The forgers, two ladies and small time who evidently knew about in any event one bank numbering framework utilized bona fide clear cards stock to succeed their activity (Lewis, 1990). The extremely quick presumption of the maltreatment in the Mastercard business made the banks and the Visa organizations consider discovering arrangements that could stop this horrible marvel. Since the significant wellspring of misfortunes in the business was taken cards, it was extremely hard for the charge card organizations to discover an answer that would stop misrepresentation. The extortion in the charge cards industry had a significant effect in the economy of the United States, for example, monetary misfortunes. In 1973 alone, charge cards misfortunes were evaluated to be $288 million-or 1015 percent of the all out Mastercard deals (Lewis, 1990). The misconduct rate has increased four quarter in succession just because since 1991†¦.. Toward the finish of 1991, $3. 4of each $100 owed on charge card was reprobate, up eight percent from 1994 (Business Journal of Charlotte, 1996). Whose duty right? In enormous part, the banks themselves were answerable for their proceeding with misfortunes. In their longing to advertise their cards as effectively as could be expected under the circumstances, they were hesitant to discolor the picture go the Mastercard by publicizing accounts of robberies and misfortunes , so they concealed the data not to caution potential cardholders(Lewis, 1990, p. 8). The administration might be considered dependable too on the grounds that the administration issues cards to the individuals for government travel costs as it were. Shockingly, those cards have been utilized for the acquisition of mixers, gems and blossoms (Fritz, S. 1996, March 16). That is another â€Å"ugly face† of Visa misuse. The individuals who should assist the nation with overcoming the issues misuse escalate the circumstance. As the business was developing, the banks and the charge card enterprises didn't think about any elective that would stop a possible extortion in the business. The absence of the board was one of the significant wellsprings of the issue. As one arrangement that must be discovered, the Mastercards organizations concocted the made sure about Visa that permits the client to spend not more than what the individual in question has in their bank sparing record. That appeared to be a decent answer for stop the extortion however crooks are acceptable to such an extent that they formulated approaches to take advantage of conceivably rewarding business sector. By the mid 1970†³s, the Visa organizations introduced their own law implementation to battle charge card extortion, the Association of Credit Card Investigators (ACCI). The job of this unit o the Mastercard organizations was to have a superior administration of the developing number of clients. One measure started by the ACCI that demonstrated powerful was a blend of a post mailer with double dating on the Visa. A double dating empowers the Mastercard Company to postpone the powerful beginning date of the card until after it ought to have been gotten by the cardholder. The post mailer educated the proposed cardholder that a card had been sent to the person in question and that the charge card Company ought to be told on the off chance that it had not yet been gotten. Therefore to the significant estimates assumed by the praise cards organizations, 75% drop in extortion in the primary years (Ventura, 1992). Another preventive measure received by the Mastercards organizations was an admonition notice making the banks and shippers aware of false cards. All the significant Mastercards organizations didn't affirm this sort of measure. On one hand, American Express, Diners Club felt that the admonition announcements were important to control misrepresentation just as the abuse of cards by delinquents and overspenders. Then again, Visa took the position that cautioning announcements were a bit much and that sending postcard was sufficient. Measurements demonstrated later that Visa was losing a higher level of its charge volume from misrepresentation than American Express and di

Common Hull Shapes on Boats and Ships

Seriously, I Do Not have a Cat COLUMBIA UNIVERSITY - SIPA Admissions Blog

Seriously, I Do Not have a Cat COLUMBIA UNIVERSITY - SIPA Admissions Blog You might not think it, but the process of assembling and reading admission files can take a physical toll on those that work in the office.   I have gotten burned by hot printer parts, gouged by staples, strained muscles when lifting boxes of paper with my back instead of my legs, and felt pain in my wrist after using a manual stapler for days on end.   But the most common injury by far is the paper cut.   Actually we took it to a whole new level a year or two ago when we moved from paper admission folders to plastic ones. Okay, I know I probably just made all those interested in environmental studies and policy cringe with that last sentence . . . but wait, there is logic to it.   When we used to use paper admission folders they were one time use.   We would write all over the front of a file and once the year was done we shred them up and ordered thousands more for the following year. Now we simply reuse plastic file folders year after year and the cover sheet is on the inside of the file, viewable through the plastic.   Take   a look . . . Yes, your file will be placed in a folder just like this one.   All of your precious information is on the inside and when the year is over we can reuse the plastic folder the next year.   Plastic is wonderful for this purpose, but I found out that plastic folders possess the same ability to slice human skin as paper folders. Little paper cuts are annoying but generally do not cause me a lot of grief.   A single sheet of paper will sometimes slice me and I will wince but move right along because upon initial glance there is an indication of the damage, but little to no blood.   However, there are those paper cuts where I wince, grasp at the cut, and immediately shut my eyes.   From the second the slice occurs I can just tell that what I am going to see when I take my uninjured hand away is not going to be good. Maybe you know the kind of cut I am talking about.   Like one in the webbing between your thumb and index finger that is really deep and each time you move you can feel the cut separating in the webbing.   Paper cuts from paper folders, which are pretty heavy gauge, can be brutal and it did not take me long to discover that plastic files can be just as potent. With paper cuts and staple gouging occuring quite frequntly this time of year, I could easily be mistaken a cat owner.   My hands almost appear as if I have tried to give a cat a bath   something I tried in my childhood when my parents went out one night and learned quickly never to do again.   Although I could be mistaken for a cat owner, I am instead the owner of several thousand admission files . . . some of which like to exact their pound of flesh.

Behnam Namdar. Professor Solheim, History 107 . Winter

Behnam Namdar Professor Solheim, History 107 Winter 2017 CRN 25244 Analysis of The Bill of Rights The Bill of Rights it’s made up from the first 10 amendments. Out of a total of 27 amendments, which the house approved 17 amendments and out of these, the senate approved 12 amendments and these amendments were send out to the states for approval at the end 10 amendments out of these 12 amendments were approved and they are now known as the Bill of Rights. The Bill of Rights indicates all the exact preventions on governmental power. The main point of a bill of rights was to prevent the contention between federalists and anti-federalists, which give out specific limits on government power. The main difference between federalists and†¦show more content†¦Also, this amendment mention that people have the freedom of speech which I believe it’s very important for the country especially for United Stated because as I mention this country include many people with different religion, country, ethnicity, believe, †¦ , and all these p eople have different thought and idea which we need to respect to each and give the freedom of speech to people to have the voice to talk about their needs. The second amendment mentioned about having well-developed and structured Militia which is required for the security of a free state. This amendment it’s important for people as others cause the main reason for having the bill of rights is to give people freedom and let them decide for their future and their own country that their living on and maintaining good and safe militia, as this amendment permit the American citizens to have the right to conserve themselves armed and to sustain a militia. As up right now there are several countries that take away the rights for their citizens to be armed such as Great Britain, which the government had voted to authorize their citizens to be disarmed. The third amendment it’s regard to the soldiers, which disallows them from temporality inhabiting in private houses during pe acetime without getting the acquiescence and consent. I personally believe this amendment is very good for keeping the country protected because soldiers are very important for the

The Definition and Usage of Circumlocution

Circumlocution is the use of unnecessarily wordy and indirect language to avoid getting to the point. Though circumlocution is usually regarded as a stylistic vice in contemporary prose, it can be used for comic effect, as in the passage below by S. J. Perelman. Examples and Observations Monty Pythons Man Who Says Things in a Roundabout WayInterviewer: Good evening. Well, we have in the studio tonight a man who says things in a very roundabout way. Isnt that so, Mr. Pudifoot?Mr. Pudifoot: Yes.Interviewer: Have you always said things in a very roundabout way?Mr. Pudifoot: Yes.Interviewer: Well, I cant help noticing that, for someone who claims to say things in a very roundabout way, your last two answers have had very little of the discursive quality about them.Mr. Pudifoot: Oh, well, Im not very talkative today. Its a form of defensive response to intense interrogative stimuli. I used to get it badly when I was a boy—well, when I say very badly, in fact, do you remember when there was that fashion for, you know, little poodles with small coats.Interviewer: Ah, now youre beginning to talk in a roundabout way.Mr. Pudifoot: Oh, Im sorry.Interviewer: No, no, no, no. Please do carry on because that is in fact why we wanted you on the show.Mr. Pudifoot: I thought it was because you were interested in me as a human being. (gets up and leaves)(Terry Jones and Graham Chapman, Royal Episode 13: The Toad Elevating Moment. Monty Pythons Flying Circus, Dec. 22, 1970)Fed-Speak: The Circumlocutory Federal Reserve Chairman- [Federal Reserve Chairman Alan] Greenspan went on to suggest raising the retirement age, though he slipped it in using his customary circumlocution: Another possible adjustment relates to the age at which Social Security and Medicare benefits will be provided. Under current law, and even with the so-called normal retirement age for Social Security slated to move up to 67 over the next two decades, the ratio of the number of years that the typical worker will spend in retirement to the number of years he or she works will rise in the long term. In other words people are just living too long.(Dan Ackman, The Passion Of The Fed Chairman. Forbes, Feb. 26, 2004)- As Fed chairman, every time I expressed a view, I added or subtracted 10 bas is points from the credit market. That was not helpful. But I nonetheless had to testify before Congress. On questions that were too market-sensitive to answer, no comment was indeed an answer. And so you construct what we used to call Fed-speak. I would hypothetically think of a little plate in front of my eyes, which was the Washington Post, the following morning’s headline, and I would catch myself in the middle of a sentence. Then, instead of just stopping, I would continue on resolving the sentence in some obscure way which made it incomprehensible. But nobody was quite sure I wasn’t saying something profound when I wasn’t. And that became the so-called Fed-speak which I became an expert on over the years. It’s a self-protection mechanism when you’re in an environment where people are shooting questions at you, and you’ve got to be very careful about the nuances of what you’re going to say and what you don’t say.(Alan Gree nspan, quoted by Devin Leonard and Peter Coy. Bloomberg Businessweek, August 13-26, 2012)The Circumlocution OfficeNo public business of any kind could possibly be done at any time without the acquiescence of the Circumlocution Office. Whatever was required to be done, the Circumlocution Office was beforehand with all the public departments in the art of perceiving—HOW NOT TO DO IT.(Charles Dickens, Little Dorrit, 1856)Perelmans ProseIn two shakes of a lambs tail—the official signal for aircraft to land in Palm Springs—the plane had landed and a flourish of trumpets greeted its three passengers, two of whom were familiar to any bystander. They were the renowned vedette Elizabeth Taylor and her producer husband, Mike Todd. The third, who bore more than a passing resemblance to the Apollo Belvedere but could not be said, in all justice, to rank with him in intellect, was the present writer. His chief distinction—if one may borrow G.K. Chestertons facility wi th paradox for a moment—was that he possessed no distinction whatsoever. What startling conjunction of the planets, what mysterious and inexplicable forces of the I Ching had mingled the destiny of this utter cipher with that of these eminent face cards?(S. J. Perelman, The Hindsight Saga. The Last Laugh, 1981)Iranian CircumlocutionsMr. Ahmadinejads habit of answering every question about Iranian policy with a question about American policy was clearly wearing on some of the members, but at the end they acknowledged that he was about as skillful an interlocutor as they had ever encountered. He is a master of counterpunch, deception, circumlocution, Mr. Scowcroft said, shaking his head. Mr. Blackwill emerged from the conversation wondering how the United States would ever be able to negotiate with this Iranian government.(David Sanger, Irans Leader Relishes 2nd Chance to Make Waves. The New York Times, Sep. 21, 2006)Circumlocution as a First StepWe often take circumlocution as evasion, it neednt be. It might be a first step, a first form, triangulation: talk around something long enough and you can divine its center. Circumlocution. Perigraphs. I am going somewhere.(Kevin McFadden, Hardscrabble. University of Georgia Press, 2008)

Challenges and Best Practices in Corporate Governance Free Essays

Former Finance Secretary Jesus Estanislao once compared good corporate governance as keeping one’s house in order. Most people want well-run households, one that keeps a lid on expenses while keeping things neat and clean and takes care of the various needs of family members. In the business setting, a clean house is more attractive to prospective investors. We will write a custom essay sample on Challenges and Best Practices in Corporate Governance or any similar topic only for you Order Now Good corporate governance promotes transparency, accountability and responsibility. Corporate governance is not just about ethical conduct or being transparent and fair to stakeholders, it is also a means to improve a company’s performance, competitiveness and sustainability. In the Philippines, compliance with corporate governance codes is still relatively low. It is probably an offshoot of the way most Asian economies do business, which is largely personal and based on connections—whether by family, affinity or friends. In addition, the adoption of good corporate governance practices is a function of a firm’s financial performance. In Singapore for example, a relatively developed economy, a recent report showed a widening gap between companies with strong and weak corporate governance policies. But it is when crisis occurs when the defects in corporate governance are seen. Learning curves for the adoption of scorecards and best practices for corporate governance are a tad high, and maybe difficult for several companies to implement. Dr. Estanislao once said that his advocacy for companies in the Philippines to adopt good corporate governance standards is a slow burn. But someone has to do it, and progress must start as soon as possible so it can also blossom faster. How to cite Challenges and Best Practices in Corporate Governance, Papers

An Inspector Calls play analysis Essay Example For Students

An Inspector Calls play analysis Essay In this Play the inspector plays various roles. He plays a socialist as he is against capitalist views and because he is not just looking out for himself but others as well. Also he is known to be a catalyst as he brings a split in the Birling family. He plays a ghost as we find out he is not real. Additionally he plays a fraud because he is not a real inspector, but he does act as an Inspector. The inspector adds a great deal of tension and drama to the play. Priestley does this because he brings tension between the younger generation consisting of Sheila and Eric and the older generation consisting of Gerald, Mrs. Birling and Birling because of the inspector. Priestley uses the inspector as a substitute of him self to put his socialist points across this adds drama because we have to think about what he is trying to do. The four Birlings and Gerald are happily seated around the dinner table having an enjoyable night celebrating Sheila and Geralds engagement. All of them are feeling happy and are comfortable and relaxed and do not seem to have a care in the world but all of that is about to change. The scene is set in 1912, which is a pre war time. Also this is the time when the suffragettes were fighting for womens rights. Additionally this was the time that the Titanic was built. The unsinkable ship, which ironically sank, would set sail in a weeks time. The life that the Birlings live is very nice and easy but Priestley is showing how great things always end in disaster like the evening they are having. This is also ironic as he starts by telling us how the Titanic was unsinkable and it ended and just like he will go on to tell us how the Birlings lives are good at the moment but this will soon come to an end. The story does have some relevance to the early nineties even if the novel it was written in 1945. All these points are there to remind us of how not all good things last and how we should all look out for each other and not just for ourselves. An example is We are members of one body, said the inspector. This shows us that the inspector is enforcing the point of being part of one community and that we should look out for one and other. This also shows the link of how the inspector could just be Priestley in another form such as a ghost. I believe that Priestley is reminding us to look out for each other just in case any major wars happen and we have to rely on each other so thats maybe why he is enforcing this. When the inspector first enters the stage the atmosphere changes but not a great deal on first sight of the inspector. The inspector does not appear to be a big man but he does make him self appear strong and confident. He gives an impression that he will destroy them if they toy with him. Sheila changes the way she thinks and decides from now on she is going to be good. She has come to this decision as a result of the influence the inspector has had on her. His socialist views have been understood by Sheila and have changed her because she is going to start to care for other people. For example whoever that inspector was it was anything but a joke. You knew it then. You began to learn something. And now youve stopped, said Sheila. This shows us that the Inspector really has influenced Sheila and she has learnt something from what he is trying to say. Also she is showing the divide between the Birlings when they find out the inspector was not real as they now will not take responsibility for the death of Eva Smith but the youngsters will. The Inspector creates a split between the family by dividing the younger and older generations. He is a catalyst because he divides the family and makes them angry at each other. Gerald and Sheila will not get married because of the inspectors visit. Birling may not get his knighthood because of the visit from the inspector may cause a scandal. All these things are the effects of the Inspectors visit. All Priestley is trying to do is make everyone take responsibility for their actions, for example what he is doing to the Birlings. By doing this it makes the audience feel like they need to do the same thing but not act like the older generation of the Birlings but act like the younger generation. Strife monologue from the play by John Galsworthy EssayPriestley puts across message of capitalism verses socialism as he shows the Inspector, the socialist saying how we should not be like a capitalist but more like a socialist and care for one another. The inspector is a socialist as is Priestley and have socialist views. They are against capitalism, as they do not feel you should just earn a living for money and for yourself but you should help other people. The inspectors name is a pun for ghoul. This then leads us to believe that the inspector does not exist. He is some sort of ghost or phantom who is a nightmare to the Birlings. The Birlings have other beliefs that prove the inspector does not exist like Gerald. He finds out from another police sergeant from the county force that there is no one like or called the inspector they had met. In addition, the older generation seem to think it is all a hoax. For example Its a hoax of some kind, said Gerald. This shows that the older generation thinks it is some old fool playing a trick on them causing a scandal. There is nothing wrong with them believing this as they now have evidence that the inspector really is not an inspector but a fraud but that is only if he really does exist which is unknown to everyone. It could also show that the inspector is a bad ghoul playing tricks on family to have fun. He seems to know about he future because he knows what will happen to Eva Smith that no one else knows about, which may give the audience an idea that he is not a human being. He is another type of life such as a spirit that does not exist in our world, as it is virtually impossible to predict the future. He does make the Birlings scared of him as he breaks them down one by one leading them to confess. This may also show why he is a ghoul because he is scary. The inspector being a ghoul makes the audience more interested in the story because there is no obvious thing at the beginning of the story that gives him away but we all have our suspicions and this leads to tension as we want to continue to view the play to find out whether our suspicions were correct or not. This is another aspect that makes the play so good and again it involves the truth hidden behind the inspector. The inspector had an enormous affect on the Birlings. He caused them to fall out with each other and go against each other. From all what he told them the only people that actually learnt their lesson was the younger generation. The elders did not as when they found out the inspector was a fraud they were celebrating so what the inspector said went through one ear out the other. I think the family could get back to how they were before but it would be on Sheila and Erics conscience that they once helped lead a girl to suicide. Priestleys over all message in this story was we are all part of one community and we have to look after each other rather than just looking out for ourselves. If one person is affected in the community than all of us are. That is what Priestleys over all message is. I believe the over all role of the inspector was to play a substitute of Priestley to get Priestleys messages across to the audience and the Birlings. The Inspector has many hidden messages in him. He plays so many different roles and the he himself makes the whole story. He makes you think and puts across the messages, which to me is the point of the book. He is very effective and adds a great deal of drama.

Blendtec Case Essay Sample free essay sample

For the new media assignment our group decided to analyze a societal media instance. We found the Blendtec instance to be highly interesting and powerful to be shared with the remainder of pupils. The instance describes the tremendous success. â€Å"Blendtec† . an American maker of high public presentation lasting liquidizers had with the aid of Social media selling. BackgroundThe narrative of Blendtec. a company founded by Tom Dickson starts in 1975 in Utah. USA. Tom utilizing a various vacuity cleaner motor combined it with a rotor and stator micronetic-milling chamber. which helped mill wheat rapidly and expeditiously. To get down the concern. Blendtec was provided with the start-up capital by the K-TEC Kitchen Mill. Old ages subsequently as the smoothy revolution was heating up. companies turned to Blendtec to develop high acting. lasting liquidizers for commercial usage ( Blendtec 2012 ) . Today Blendtec liquidizers are used by eating houses. java stores. smoothy bars and domestic families. We will write a custom essay sample on Blendtec Case Essay Sample or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page Since Blendtec had really little advertisement budgets in the beginning. they had to come up with particular viral advertisement musca volitanss that could be found on. or promoted through. societal media platforms. The company’s new Marketing Director George Wright found out that CEO Tom Dickson and his R A ; D Team tested their merchandises by intermixing up wood or other robust stuffs ( Briggs 2009 ) . He saw this as a great manner of selling and asked Dickson to make his unusual quality-control technique trial on camera for posting the short picture online. He bought some marbles. a profligate. a six pack of sodium carbonate. a fast-food value repast and golf balls. set Dickson in forepart of a camera. have oning a lab coat. and asked him to intermix the purchases. These series of pictures were introduced to the populace in 2006 and are known as â€Å"Will it Blend? † ( Briggs 2009 ) . ANALYSIS A ; IMPACTThe picture series on YouTube was an instant success for Wright and Blendtec. In the first hebdomad of publication they had more than six million hits. Sometimes subsequently the company was granted advertisement rights by Yokel! and Google. Blendtec besides used â€Å"The YouTube Tags† . which are of import picture ranking factors in YouTube hunt consequences to better the figure of search engine hits ( Briggs 2009 ) . Within two old ages and 186 pictures subsequently. the run helped to increase retail liquidizer gross revenues by 700 per centum and made Dickson an Internet famous person. Blendtec has received several awards for their selling scheme. including Clio Award. The net Award for viral selling made the YouTube Awards short list in 2007 ( Renberg Winters 2009 ) . Furthermore. Blendtec had several Television visual aspects. planetary interviews. print and electronic articles and web log entries or co-promotions ( Nike. Google or AT A ; T ) ( Briggs. C. 2009 ) . After the tremendous success of their viral pictures on YouTube. Blendtec created their ain web site with the â€Å"Will it Blend? † picture. This microsite is a really active web site. where the consumer acquire wholly involved. The purpose is to demo the clients what the machines are able to intermix and how powerful they are through humourous but reliable ways. Videos on this web site are besides published via Facebook. which about has 25 000 followings ( Facebook 2012 ) . This platform provides interaction and communicating between the company and the clients. The FanPage is more informal and motivates the consumer to urge things Dickson can intermix up. Beside Facebook. Blendtec besides has a Twitter history which accounts about 10 000 followings ( Twitter 2012 ) . The most of import societal media channel is still their YouTube channel. Since 2006 the Blendtec channel registered really successful hits and click rates particularly the â€Å"iPhone† picture. which r eached more than 10 million hits at that clip ( Youtube 2012 ) . Therefore shows an tremendous involvement by consumers. COMPARISON/SIMILARITYIn recent times at that place have been a figure of successful viral runs. Traditionally sellers would develop advertizements and so trust on telecasting and print distribution channels that could be expensive. Viral runs create ballyhoo that enables consumers to distribute the run on their ain. such as Old Spice ( â€Å"The Man Your Man Could Smell Like† ) . Tourism Queensland ( â€Å"The best occupation ever† ) . Blendtec ( â€Å"Will it intermix? † ) . Nike ( â€Å"The Kobe Bryant Jump ) † . Quicksilver ( â€Å"Dynamite Surfing† ) and Samsung ( â€Å"Sheep Art† ) ( ProspectMX 2012 ) . The cardinal subject for all the successful runs are that it was existent people making extraordinary things that made the consumer ask. â€Å"Is that for existent? † There were no particular scene artefacts or digital redaction. All the consumers can see is. ordinary people making something that they could besides make but neer thought of it. In the instance of Nike utilizing Kobe Bryant the celebrated hoops participant. the run demonstrated how talented the hoops participants are. The picture shows how they jump over anything. such as a auto and a pool full of serpents. The run has 2. 5 million viewing audiences ( ProspectMX 2012 ) . Another successful run was Tourism Queensland which fired its two selling specializers and set their wages together to fund â€Å"The best occupation ever† run. A lucky victor get paid $ 150 000 to populate in the Great Barrier Reef Islands and to blog about their experience on the Island ( ProspectMX 2012 ) . Cardinal LESSONS FROM THE ASSIGNMENT The cardinal points is evidently a low budget production but the success showed that advertisement via societal media doesn’t demand to be expensive or professional every bit long as the topographic point reaches the mark group in a suited manner and creates trade name consciousness. But why was this low-budget production so successful? One of the most of import factors of on-line success is the genuineness. All consumers have to watch advertizements that are full of unrealistic state of affairss and semblances. The genuineness of the liquidizer and the CEO. as the chief character. makes the pictures so particular. There is no sham. no illusive universe. It’s world. The following factor is the surprise consequence. Cipher knows what a blended iPhone looks like. It is a surprise and merriment and it satisfies the carving for esthesiss every individual has. This combination amazes many people. which once more leads to the fact that they spread the picture because they want their friends besides to see something like that. Another factor of Blendtec’s success was the engagement of their consumers. They allowed their client base to take part into the procedure by inquiring them what they want to see in the liquidizers. The societal media marketing run of Blendtec besides worked because the company aligned the run to the companies’ trade name and their scheme. They knew their available resources and matched them absolutely with an unconventional thought. And that is precisely how viral selling plants. Therefore. stand out in the right manner to pull people and do it without shams is one of the most of import lessons for the right use of societal media selling. Hence. everything is possible if it is done in the right manner. Recommendation The Blendtec instance is a perfect illustration of how viral selling works absolutely. Up to now the FanPages on Facebook are really active and the â€Å"Will it Blend? † microsite has converting click rates. The company still has a dependable Fanbase. which is truly entertained by the extremely original â€Å"Will it intermix? † picture ( Blendtec 2012. Facebook 2012 ) . But the run started about six old ages ago and for certain the company will non be able to maintain it alive for the following 10 old ages. Therefore the selling manager and his originative squad have to believe about new runs to surprise their client. The clients expect new. unconventional thoughts. which integrated the client e. g. by utilizing new media channels. What we can larn from this particular instance is. that the companies have to believe out of the box. A successful selling run does non ever necessitate to be dearly-won or complex. We are all utilizing Facebook. Twitter and YouTube on mundane footing. That should do us believe that these are the chief selling channels today if we want to make our mark fast and expeditiously and more attempt should be put on the quality of advertizements through these channels. It is of import to incorporate the client base and surprise them in a manner that rivals does non. Furthermore. the companies have to do certain that they are reliable and align the selling run with their trade name and scheme. Customers do non desire to see any â€Å"tricks† . but instead lovingness and affecting manufacturers. Blendtec considered these points successfully. hence able to increase gross revenues by over 700 % . The presented instance is a best pattern of how companies should make it. List OF SOURCES Blendtec. 2012. About us. Online Available: hypertext transfer protocol: //www. blendtec. com/aboutus Accessed: 7 August 2012. Blendtec. 2012. Will it Blend? Online Available: hypertext transfer protocol: //www. blendtec. com/willitblend/ Accessed: 8 August 2012. Briggs. C. 2009: Blendtec Will it Blend? Viral Video Case Study. Online Available: hypertext transfer protocol: //www. socialens. com/wp-content/uploads/2009/04/20090127_case_blendtec11. pdf Accessed: 7 August 2012. Facebook. 2012. Will it Blend? Online Available: hypertext transfer protocol: //www. facebook. com/pages/Will-it-Blend/39599377192 Accessed: 8 August 2012. ProspectMX. 2012. â€Å"15 of the Best Viral Marketing Campaigns† . Online Available: hypertext transfer protocol: //www. prospectmx. com/15-of-the-best-viral-marketing-campaigns/ . Accessed: 12 August 2012. Renberg Winters. C. 2009. Will it intermix? Online Available: hypertext transfer protocol: //magazine. byu. edu/ ? act=view A ; a=2391 Accessed: 8 August 2012. Chirrup. 2012. Will it Blend? Twitter Account. Online Available: hypertext transfer protocol: //twitter. com/Blendtec Accessed: 8 August 2012. Youtube. 2012. Will it intermix? Online Available: hypertext transfer protocol: //www. youtube. com/watch? v=qg1ckCkm8YI Accessed: 8 August 2012.

The Importance of Business Ethics Essay Essays

The Importance of Business Ethics Essay Essays The Importance of Business Ethics Essay Paper The Importance of Business Ethics Essay Paper Under the term business ethics essay, we understand the system of beliefs and moral values, which guide the entrepreneur. Organization or company. These rules guide their decisions, influence their policy as well as have an impact on their activity in general. Exist business requirements, which are mentioned in the company or organization statute, while the law dictates the others. To the list of requirements of business ethics statute, it is possible to include various issues. They depend on the type of the organization and the direction of its activity. It can be environmental regulations, restrictions against trading, government settings, etc. In the company, the management plays a crucial role. It should compulsorily be guided by a specific set of regulations, which will dictate the decisions and serves as a guide for company behavior. Leadership departments rule the employees of the whole company, and they have to stick to specific rules and norms to avoid chaos. If they base the activity of the company or organization on the appropriate business ethics policy, it raises the status of the organization in general. It will also create a long-lasting positive effect. In the future, it will help to attract many clients and earn their credit. Concerning the business ethics for employees, a chief executive officer of the organization has to realize the fact that they will follow the established statute. The behavior of the workers depends directly on the policy implemented by their employers. Workers make better decisions and behave better under the guidance of proper ethical rules. The company has to cultivate such values as honesty and integrity. It helps to increase the productivity of a person and contributes to the overall development of the company. It also helps the managers team to solve ethical dilemmas or biased situations. Specificities of business ethics essay The importance of business ethics policy in the company is undoubtful. It not only influences the overall status of the company but also has a direct impact on its developments and profitability. It controls the reputation of the organization and serves as a critical factor in helping to attract the potential investing bodies. If the company operates in accordance with the ethical principles, its chances to succeed in the market are much higher. Serious and prosperous nowadays are striving to be socially responsible. A smaller organization striving to succeed need to follow this example and attempt to implement and cultivate ethical policies. Each young entrepreneur has to create a business ethics essay to build a solid ground for one’s company. Influential investors and reputable funding bodies rather will choose the company that operates ethical beliefs and rules rather than organization, which ignores them. Following and cultivating a specific rules helps to attract a more significant number of clients as well. The concept of business ethics essay presupposes the discussion of the necessity of sticking to the moral principles and taking responsibility for one’s actions. It should be preserved both by small business spots as well as by big influential companies. To earn the respect of the users, your counterparts and get the support of the prominent investors, one has to stick to norms and moral principles. Business ethics essay discusses the factors that directly influence the developments and reputation of a particular entrepreneur’s organization. Business ethics play in this list one of the most crucial roles. Behavior, policy, decision-making process, traditional customs, and expectations govern ethics. Sticking to proper etiquette and cultivating high moral values helps to create productivity and attract the attention to one’s company. How to create a business ethics essay The creation of the ethics business plan outline is essential. To create an effective business ethics essay one has to stick to specific standards. It will allow forming an active and sense-loaded composition. Primarily, one has to stick to the structure, which includes the introductory part, main body, and conclusion. In the intro, one has to familiarize the target reader with the topic. The author has to provide general material describing the issue and setting the tone for the whole writing. The last sentence of the introduction is the thesis. The thesis is the skeleton of the business ethics essay, which will enable the target reader to get the main point of the writer. The next section is the main body. It has to comprise many supportive arguments related to the thesis. You have to enhance the arguments with compelling examples. The last structural part is the conclusion. It should comprise the generalization of all info presented in the text. It also has to contain the reference to a thesis. One can paraphrase it and add a short comment. The last sentence of the conclusion has to comprise the call to actions sentence. Generally, business ethics essay has to be sense-loaded and informative. It has to describe the necessity of the creation of the business ethics essay. Â  It can also specify all the necessary nuances connected to the notion of business ethics. The text has to include the real-life examples and comprises all the info that will enable the target reader to see the clear picture. Try to make the text maximally sense loaded. Present the information in a clear and condensed way. Implement useful for the reader info. Order business ethics essay on paperap.com To write a business ethics essay, one has to possess a certain level of writing skills and have the experience of creation of a business plan model. For some writers, having no experience, it may be challenging. paperap.com is one of professional business plan writing services, which can provide quick and efficient assistance with the delivery of this type of academic assignment. We hire a crew of advanced authors, who can cope with the task of any level of complexity. To get business plan help from our specialists, one has to enter the website, make an order, mention the deadline and wait until the crew of specialist prepares a premium quality assignment. We offer the best conditions for the clients. The service works 24/7. You can access it at any time and make an order. We hire a crew of advanced experts who can cope with the task of any level of complexity. They are familiar with all the standards and requirements. Our experts take into account all the demands of the customers. We cultivate the client-oriented approach and allow clients to apply for the unlimited number of revisions. We also offer flexible pricing policy for permanent customers as well as regular discounts. Stop looking for unreliable platforms, which will spoil your nerves and reputation. On our service works the customers support department. You can turn to our specialists at any time and get a consultation. You can ask any questions. These specialists will also help you to communicate with the experts working on your order. They can quickly and easily solve all the issues that you worry about. If you have an urgent need to get your business ethics essay ready contact paperap.com! Here you will get the best business ethics essay!

Swanson's Theory of Caring Essay Example | Topics and Well Written Essays - 1500 words

Swanson's Theory of Caring - Essay Example Clinical observations include temperature, blood pressure and pulses are normal. The model used in this context involves evaluating the caregiver’s attitude. They include being competent, meeting individual needs of the women and respecting their dignity. If proper care is given after a woman miscarries then she has the power to improve on her own. The scenario involves women who had early miscarries and those who had a late miscarriage. Nurses and midwives who care for these women are also considered in this situation. Swanson’s caring categories apply in this scenario that includes â€Å"Maintaining belief†, â€Å"knowing†, â€Å"being with†, â€Å"doing for† and â€Å"enabling† (Brier, 2008). The middle range caring theory The theory is built on the basic Swanson’s fundamental principles. These elements are the usual five that the doctor developed in her theory. The first developed by the doctor in 1991 element is referred to as â€Å"knowing† (Jansson & Adolfsson, 2011). It strives to understand an event in the way it has a meaning in another person’s life. It does not assume that one can know what the other feels or they way he or she is affected by the situation. Instead, it tries to understand and endeavor to take care of the person. The lives of the patients are important and the nurse is obliged to fully understand it. When a nurse embraces ‘knowing’, he or she develops empathy that is important for the care receiver. It encompasses observations, systematic research and prolonged clinical experience. The second process is ‘being with’ and it implies being available or with the woman. It implies stepping into her shoes, providing psychological, emotional and physical support (Krippendorff, 2004). It also involves effective communication and good listening skills. The midwife must display assertiveness, advocacy and competence to protect her interests. ‘ Doing for’ process requires maintenance of both knowledge and skills (Adolfsson et al., 2004). It entails doing what the other person would do to themselves and is a practical side and art of the midwife profession. It can be described as comforting, being protective, anticipatory. Nurses should practice it with competency and use all the available skills. The other process is ‘enabling’. This model describes it as facilitation of an individual’s passage through transitions from unfamiliar events (Jansson & Adolfsson, 2011). It is also referred to as empowerment. To empower the women, nurses must give them choices and be fully informed of them. This enables them to control their decisions regarding pregnancy resulting to equal partnership when giving care. For the midwives to give informed choices, they must be aware of all evidence-based guidelines that are relevant to them (Brier, 2008). Finally yet importantly, ‘maintaining belief’ is the f ifth process and entails fulfilling expectations using realities. However, it is only achieved if the expectations are real. Maintaining belief enables midwives â€Å"to know, be with and do for† (Kvale & Brinkmann, 2009). This final process brings all other processes together thereby forming one whole process. Brier (2008) describes it as holding individuals in esteem; believing in the person’s ability to realize set goals. The goal is to have a normal birth that includes a healthy infant and a well-being mother. In the real world, great emotions are always achieved with the importance of birth. The

CULTURAL VARIATION ACROSS INTERNATIONAL ORGANIZATIONS Essay

CULTURAL VARIATION ACROSS INTERNATIONAL ORGANIZATIONS - Essay Example The encouraging movement of IM&As has been recognised especially in developing countries which has facilitated in providing scope for maximizing and reshaping the financial structure of the global boundaries. With this concern, it can be observed that the Mergers and Acquisitions (M&As) are frequently not able to ascertain the overall financial benefits of M&As due to not keeping abreast with the recent trends (Chapman, 2003). The paper takes into consideration a competitive analysis of increasing amount of FDI through the IM&As and its impact on the culture of the United Kingdom and China. The paper also intends to focus on the various cultural differences and their impacts on the aspect of IM&As. Key Components of Culture Values and Beliefs Individual’s values and beliefs are the fundamental aspects of cultural deviation within a community. The notion of value can be defined as the various evolving aspects that affect a person while acquiring decisions or doing any activity in relation to development of the social culture. The dissimilar national cultures involved within the cross boarder M&As endorse increased opportunities along with augmenting the amount of risks within the enterprises (Comminicaid, n.d.). It has been observed that the process of M&As create certain difficulties for the merging enterprise to be integrated due to its double layered of socialization norms where, the organisations need to fiddle not only with a different national culture but also the values and the traditions of the firms of another country. With this concern, the higher individualistic characteristic within the UK employees enables to ascertain the development of individual performances with their creativity and innovative ideas. However, the values within Chinese culture are frequently observed as a significant aspect in terms of establishing the culture in managerial and organisational practices. The strong importance upon the dimension of collectivism and correlati ve group behaviours are highly observed within the business culture of Chinese organisations (Cheng & Seeger, 2012). Communication Styles The communication style of the business organisations is an important part to negotiate and perform various operational as well as organisational practices. The communication style enables to create a sophisticated relationship between two different organisations having diverse cultural norms. Moreover, communication can be considered as a major aspect that impacts on the business culture in case of M&As. With this concern, the European communication styles play considerably an eminent part in terms of maintaining a positive and comprehensive communication within the various organisational practices. The communication style of the organisations in the UK and China should be adequate to perform an idealistic approach of IM&As (Stahl & Voigt, 2006). Negotiation Styles Negotiation can be considered as a feasible strategy for an organisation to achiev e the height of success in global business. The people of the organisa

Review of literature

Review of literature REVIEW OF LITERATURE Porters (1980) segmentation analysis has plenty of value to describe competition amongst participants. This approach establishes how and by which means positions of dominance are achieved. Studies based on this methodology have been applied to banking to assess the competitive process. Finlay (2000) suggested that Market Penetration fits strategically for a firm when current markets are not saturated for the types of offer the firm is making and its present customers can be induced to buy more. And typically, when a company wants to attack the market share of the competitors, they will undertake market penetration as a way of increasing their own share in the market. Similarly, Oster (1994) contended that the size of the market share held by the firm as well as the size of the major firms in the market are important considerations. He suggests that firms with relatively small market shares can increase their market share many times over without adversely affecting the overall market share of a large market leader. A study by Philp Robert, Haynes Paula, Helms Marilyn (1992) stated that growth through a market penetration strategy, reaching and influencing customers already served, has proved to be a less profitable course of action than expected. This strategy failed to achieve the projected growth not because of the basic plan itself, but rather due to its improper implementation. Financial service providers have typically viewed their primary customer base as males between 30 and 50 years old (Bartos, 1982). These men are seen as the primary wage earners and decision makers for financial planning in their households. Hence, this segment has been considered golden geese of the financial market. While some growth was achieved through the introduction of new financial products and services, the financial services needs of women and of consumers over 50 years of age were blurred for the financial service providers (Javalgi et al., 1990). (Schiele, 1974) suggested that a â€Å"Net† approach should be used to catch the youth market as they drift downstream from adolescence to adulthood. The research findings indicated that this is a simplification of reality and that a number of interrelated streams exist before young people reach the pond of adulthood, at which they are likely to be locked into a financial service organisation. Hence, in the highly competitive retail financial marketplace, it is more critical than ever to narrowly define the markets financial service provider can serve. Differentiation through claims of excellent customer service fails to provide competitive distinctiveness, particularly to key segments of the existing customer base. Many banks, over the years, have relied on intermediaries like DSAs, DSTs to reach out to the customers. Jensen-Macklin (1976) or Diamond (1984) in their studies have tried to justify the existence and effects of intermediaries. For them agents exist to reduce moral hazard and asymmetric information. There are different means adopted by the organizations to increase the number of services availed by the customers. Cross-selling is the practice of promoting additional products and services to existing customers in addition to the ones a customer currently has (Butera, 2000). The interest in cross-selling is due to its advantages for firms. Specifically, the selling of additional services to existing customers could reduce the need to spend money on customer acquisition (e.g. advertising) and lead to a pricing advantage over competitors (Reichheld and Sasser, 1990). It is reasonable to expect that customers with strong repurchase intentions will also be likely to cross-buy from the same service provider. This is consistent with the view that it is easier to cross-sell new services to existing customers than to the new ones. Study conducted by (Day, 2000), suggested that although customers may want to engage in a relationship with a service provider, they may not want to have all th eir services provided by that single provider For some service categories, customers intrinsically develop a multi-brand loyalty (Jacoby and Chestnut, 1978). For example, in the banking industry most households use two or more financial providers. (Reichheld, 1996; Anderson and Mittal, 2000). Howley John, Savage Grahame (1980) in their paper titled, â€Å"Bank marketing in the Personal Sector† discuss about Cross-selling, whereby having opened a current account, customers are sold loans, travel facilities, insurance and other services for further banking penetration of each customer. At the same time, there is a word of caution as well saying that theres undoubtedly great potential here, but there are dangers of placing too much emphasis on peripheral activities to the overall corporate purpose of being a bank. Raj Arora (2008) focussed on yet another important strategy to increase sales to existing customers Price Bundling. The study points out that the intent of bundle pricing is to increase sales by offering a discount when a pre-specified bundle of items is purchased at the same time. Usually, the additional items in the bundle are those that are complementary to the main product. The assumption is that the bundle priced items offer more value and are therefore more attractive to the buyer. The seller makes the buyer aware that the buyer is getting a bargain in the bundle because if the items are purchased separately, the aggregate price far exceeds the bundle price (Yadav and Monroe, 2003). While price bundling is frequently used by marketers, its effectiveness needs more research especially when used with other marketing variables. Murphy Ruth, Bruce Margaret (2003) stated that internet can be used to sell more existing products into existing markets. This can be achieved by using internet for increasing awareness of the firm. Bloch et al. (1996) proposed that e-commerce offers cost advantages to firms via less expensive product promotions. They also advocate that e-commerce can enable a company to implement customer focus strategies through better customer relationships. If the internet segment continues to grow and the branch banking segment shrinks, more customers will be using Internet banks and fewer customers using Branch banks (Heffernan 1996). But evidence also suggests that many companies have engaged in e-commerce activity, whether it is on a business to business or business to consumer basis (B2C), without any consideration towards a return on investment (Damanpour and Madison, 2001). One of the reasons for this may be that many businesses fear that without an Internet presence, the firm will get lef t behind. Hence a number of companies have turned their focus towards e-commerce, often by emulating the business module of another firm, as â€Å"me too† entities. Stafford David, King Susan (1982) stated that Marketing strategies which have been important to recent bank development include branch rationalisation and refurbishment, and promotional activities, especially advertising. Price competition has not yet achieved major importance between the big four and so price structures do tend to be relatively stable and similar between banks. A similar view shared by Neven (1990) and Vives (1991) is that banks, especially retail banks, do not compete in price but in service quality. RESEARCH GAP GOOD WAY TO MAKE GAPS Thus, we observe a number of important gaps in the literature. First, our knowledge is deficient on which foreign market entry modes service firms apply, and similarly, on target market selection. Next, it is also important to investigate if there are systematic differences within service industries in foreign market entry mode selection. Finally, are the internationalization theories and models developed for manufacturing industries applicable to firms in service industries? Or, is the internationalization process of services so unique that there is a need to develop separate theory to explain the internationalization of service firms? OBJECTIVES 1. To measure the penetration of banking products in different demographic profiles. 2. To find the neglected niches in existing markets served by the banks. 3. To identify and compare the means that public private sector banks adopt to attract new customers in existing market. 4. To study the consumer preference regarding the means that banks adopt to attract new customers in existing market. 5. To investigate and compare the methods used by public private sector banks to increase number of services availed by the customers. 6. To study the consumer preference regarding the methods used by banks to increase number of services availed by the customers. 7. To determine ways to increase usage rate of services consumed by the customers. RESEARCH METHODOLOGY Tentative The study will be based on Primary as well as secondary data both with their well known limitations. For collection of data from customers, Stratified Random Sampling will be used. Convenience Sampling will be used for collection of data from the employees as the data will be collected as per availability and convenience. / Structured Interviews The secondary data has and will be collected from various sources such as International Journal of Bank Marketing, Indian Bankers Association Journal, magazines, research papers, books, internet websites etc. Scope of the study: Two Public Sector Banks – Punjab Sind Bank and State Bank of India have been selected for the study. ICICI Bank and HDFC Bank will form part of Private Sector Banks selected for study. Study will be carried out in different areas of Punjab. Universe of the study: Bank employees as well as the customers visiting the bank will be the universe of the study. Sample: Only the employees of the bank working at â€Å"Manager† designation and above will form the sample of the study. For purpose of collection of data from customers, every third customer walking into the bank will form part of the study. Sample size: The respondent data will be collected from 200 customers out of which hundred customers will be taken from public sector banks and rest from private sector banks. Number of employees of banks to be contacted for information will be 40. Out of this, twenty employees will be from Public Sector Banks and rest twenty would be private sector bank employees. Hence, the number of employees from each bank will be ten. Collection of Data: For the purpose of collection of data, two set of questionnaires will be prepared. First questionnaire will help in knowing the strategies being adopted by the banks to increase Market Penetration and would be filled by the bankers. Second questionnaire, to be filled by the customers will be used to collect preferences of customers related to various strategies being adopted by banks to increase Market Penetration. Analysis and Interpretation: The analysis will be done on the basis of review of existing literature and information collected through questionnaires filled by the employees and customers of the Public and Private sector banks. Microsoft Excel and other appropriate statistical tools will be used for Data Analysis. TENTATIVE CHAPTER SCHEME Chapter I Introduction Chapter II Review of literature Chapter III Need, Objectives, Research Methodology Chapter IV Overview of Indian Banking System * Public Sector Banks * Private Sector Banks Chapter V Growth Strategies * Market Penetration * Product Development * Market Development * Diversification Chapter VI Market Penetration in Public Private Sector Banks Chapter VII Data Presentation Analysis Chapter VIII Findings Conclusion Recommendations Appendix Questionnaire Bibliography REFERENCES http://www.businessdictionary.com/definition/market-penetration.html as on Jan 28, 2010. http://knowledge.wharton.upenn.edu/india/article.cfm?articleid=4145, Jan11, 2007 as on Jan 31, 2010 Ansoff, I. (1965), Corporate Strategy, McGraw-Hill, New York, NY Title: Bank Marketing Strategies Author(s): Arthur Meidan Journal: International Journal of Bank Marketing Year: 1983 Volume: 1 Issue: 2 Page: 3 17 Banks to get sops for rural reach 3 Oct 2009, 0307 hrs IST, Anto Antony, ET Bureau http://www.business-standard.com/india/news/public-sector-banks-gain-market-share/383014/ David Stafford and Susan King, Bank Competition and Advertising by David C. Stafford, The Advertising Association, 1982 write references of foll. Articles in Emerald – A survey of critical factors in e-Banking Bank marketing Strategies P. Robert Philp, Paula J. Haynes and Marilyn M. Helms FINANCIAL SERVICE STRATEGIES: NEGLECTED NICHES International Journal of Bank Marketing, Vol. 10 No. 2, 1992, pp. 25-28 Title: Bank Marketing in the Personal Sector Author(s): John C. Howley, Grahame P. Savage Journal: Managerial Finance Year: 1980 Volume: 5 Issue: 3 Page: 271 276 Ruth Murphy and Margaret Bruce, Strategy, accountability, e-commerce and the consumer, Managerial Auditing Journal, 18/3 (2003) pg 193-201 www.emeraldinsight.com/1061-0421.htm Price bundling and framing strategies for complementary products Raj Arora University of Missouri – Kansas City, Kansas City, Kansas, USA Journal of Product Brand Management 17/7 (2008) 475–484 Yadav, M.S. and Monroe, K.B. (2003), â€Å"How buyers perceive savings in a bundle price: an examination of a bundles transaction value†, Journal of Marketing Research, Vol. 30 No. 3, pp. 350-8 Butera, A. (2000), â€Å"Cross-selling: capitalizing on the opportunities†, Hoosier Bank, Vol. 87 No. 7, pp. 14-16. Reichheld, F.F. (1996), The Loyalty Effect: The Hidden Force behind Growth, Profits and Lasting Value, Harvard Business School Press, Boston, MA. Reichheld, F.F. and Sasser, W.E. (1990), â€Å"Zero defections: quality comes to services†, Harvard Business Review, Vol. 68 No. 5, pp. 105-11. Anderson, E.W. and Mittal, V. (2000), â€Å"Strengthening the satisfaction-profit chain†, Journal of Service Research, Vol. 3 No. 2, pp. 107-20. Day, G.S. (2000), â€Å"Managing market relationships†, Journal of Academy of Marketing Science, Vol. 28 No. 1, pp. 24-30. Jacoby, J. and Chestnut, R.W. (1978), Brand Loyalty, John Wiley Sons, New York, NY. Schiele, G.W. (1974), How to Reach the Young Customer, Harvard Business Review, Vol. 52, March-April, pp. 77-86. http://www.answers.com/topic/market-penetration-2 as on Feb 28, 2010

Med-Surg Success a Course Review Applying Critical Thinking

Med-Surg Success A Course Review Applying Critical Thinking to Test Taking Med-Surg Success KATHRYN CADENHEAD COLGROVE RN, MS, CNS, OCN Trinity Valley Community College Kaufman, Texas A Course Review Applying Critical Thinking to Test Taking JUDY CALLICOATT RN, MS, CNS Trinity Valley Community College Kaufman, Texas Consultant: Ray A. Hargrove-Huttel RN, PhD Trinity Valley Community College Kaufman, Texas F. A. Davis Company 1915 Arch Street Philadelphia, PA 19103 www. fadavis. com Copyright  © 2007 by F. A. Davis Company Copyright  © 2007 by F. A. Davis Company. All rights reserved. This book is protected by copyright.No part of it may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without written permission from the publisher. Printed in the United States of America Last digit indicates print number: 10 9 8 7 6 5 4 3 2 1 Publisher, Nursing: Robert G. Martone Content Developm ent Manager: Darlene D. Pedersen Project Editor: Thomas A. Ciavarella Art and Design Manager: Carolyn O’Brien As new scienti? c information becomes available through basic and clinical research, recommended treatments and drug therapies undergo changes.The author(s) and publisher have done everything possible to make this book accurate, up to date, and in accord with accepted standards at the time of publication. The author(s), editors, and publisher are not responsible for errors or omissions or for consequences from application of the book, and make no warranty, expressed or implied, in regard to the contents of the book. Any practice described in this book should be applied by the reader in accordance with professional standards of care used in regard to the unique circumstances that may apply in each situation.The reader is advised always to check product information (package inserts) for changes and new information regarding dose and contraindications before administerin g any drug. Caution is especially urged when using new or infrequently ordered drugs. ISBN 13: 978-0-8036-1576-2 ISBN 10: 0-8036-1576-0 Authorization to photocopy items for internal or personal use, or the internal or personal use of speci? c clients, is granted by F. A. Davis Company for users registered with the Copyright Clearance Center (CCC) Transactional Reporting Service, provided that the fee of $. 0 per copy is paid directly to CCC, 222 Rosewood Drive, Danvers, MA 01923. For those organizations that have been granted a photocopy license by CCC, a separate system of payment has been arranged. The fee code for users of the Transactional Reporting Service is: 8036-1576/07 $. 10. Dedication The authors would like to dedicate this book to the Trinity Valley Community College Associate Degree nursing students who graduated in 2005 and 2006. Thank you for giving of your time to pilot the questions and provide us constructive feedback.We would like to thank Bob Martone for giving u s the opportunity to embark on this endeavor. Our appreciation goes to Barbara Tchabovsky for her assistance in editing the book and answering our numerous questions via e-mail, which is a wonderful invention. Our thanks go to Tom Ciavarella for supporting us through the maze of publishing this book. This book would not be possible without the unbelievable computer skills of Glada Norris. —The Authors I would like to dedicate this book to the memory of my mother, Mary Cadenhead, and grandmother, Elsie Rogers.The Cardiovascular SystemThey always told me that I could accomplish anything I wanted to accomplish. I would like to dedicate this book to my husband, Larry, daughter Laurie and son-in-law Todd, and son Larry Jr. and daughter-in-law Mai, and grandchildren Chris, Ashley, Justin C. , Justin A. , and Connor. Without their support and patience, the book would not have been possible. —Kathryn Colgrove This book is dedicated to my husband, George; my family, and my frie nds, who love and support me. Many thanks are given to the students who teach me and inspire me by persevering through the difficulties of nursing school.I want to extend my gratitude to members of the profession of nursing, both faculty and staff who share their art with nursing students. —Judy Callicoatt This book is dedicated to the memory of my husband, Bill, and my parents, T/Sgt. Leo and Nancy Hargrove, who are the rocks on which my life is built. I would like to thank my sisters, Gail and Debbie; my nephew Benjamin; and Paula for their support and encouragement through the good times and the bad. My children, Teresa and Aaron, are the most important people in my life and I want to thank them for always believing in me. —Ray Hargrove-Huttel v ReviewersFreda Black, MSN, RN, ANP-BC Assistant Professor Ivy Tech State College Gary, Indiana Anne Dunphy, RN, MA, CS Nursing Instructor Delaware Technical & Community College Newark, Delaware Judy R. Hembd, RN, BSN, MSN As sistant Professor Montana State University-Northern Department of Nursing Havre, Montana Linda Ann Kucher, BSN, MSN Assistant Professor of Nursing Gordon College Barnesville, Georgia Regina M. O’Drobinak, MSN, RN, ANP-BC Assistant Professor, Associate of Science in Nursing Ivy Tech State College Gary, Indiana Elizabeth Palmer, PhD, RN Assistant Professor of Nursing Indiana University of Pennsylvania Indiana, Pennsylvania ii Editors and Contributors Joan L. Consullo, RN, MS, CNRN Advanced Clinical Nurse, Neuroscience St. Luke’s Episcopal Hospital Houston, Texas Michelle L. Edwards, RN, MSN, ACNP, FNP Advanced Practice Nurse, Cardiology Acute Care Nurse Practitioner/Family Nurse Practitioner St. Luke’s Episcopal Hospital Houston, Texas Gail F. Graham, APRN, MS, NP-C Advanced Practice Nurse, Internal Medicine Adult Nurse Practitioner St. Luke’s Episcopal Hospital Houston, Texas Elester E. Stewart, RRT, RN, MSN, FNP Advanced Practice Nurse, Pulmonary Family N urse Practitioner St.Luke’s Episcopal Hospital Houston, Texas Leslie Prater, RN, MS, CNS, CDE Clinical Diabetes Educator Associate Degree Nursing Instructor Trinity Valley Community College Kaufman, Texas Helen Reid, RN, PhD Dean, Health Occupations Trinity Valley Community College Kaufman, Texas ix Contents 1 Fundamentals of Critical Thinking Related to Test Taking: The RACE Model . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 GUIDELINES FOR USING THIS BOOK . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 PREPARING FOR LECTURE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 PREPARING FOR AN EXAMINATION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 TAKING THE EXAM . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 U NDERSTANDING THE TYPES OF NURSING QUESTIONS . . . . . . . . . . . . . . . . . . . . . . . . 5 THE RACE MODEL: THE APPLICATION OF CRITICAL THINKING TO MULTIPLE-CHOICE QUESTIONS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 2 Neurological Disorders †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦ 7 PRACTICE QUESTIONS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 Cerebrovascular Accident . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 Head Injury . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 Spinal Cord Injury . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 Seizures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 Brain Tumor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 Meningitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 Parkinson’s Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17 Substance Abuse . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19 Amyotrophic Lateral Sclerosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20 Encephalitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22 PRACTICE QUESTIONS ANSWERS AND RATIONALES . . . . . . . . . . . . . . . . . . . . . . . . . . 24 COMPRE HENSIVE EXAMINATION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47 COMPREHENSIVE EXAMINATION ANSWERS AND RATIONALES . . . . . . . . . . . . . . . . . 54 3 Cardiac Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61 PRACTICE QUESTIONS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62 Congestive Heart Failure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62 Angina/Myocardial Infarction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63 Coronary Artery Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 65 Valvular Heart Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 66 Dysrhythmias and Conduction Problems . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 68 In? ammatory Cardiac Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69 PRACTICE QUESTIONS ANSWERS AND RATIONALES . . . . . . . . . . . . . . . . . . . . . . . . . . 72 COMPREHENSIVE EXAMINATION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 86 COMPREHENSIVE EXAMINATION ANSWERS AND RATIONALES . . . . . . . . . . . . . . . . 90 4 Peripheral Vascular Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 93 PRACTICE QUESTIONS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 94 Arterial Hypertension . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 94 Arterial Occlusive Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 95 Atherosclerosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 97 Abdominal Aortic Aneurysm . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 98 Deep Vein Thrombosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100 Peripheral Venous Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 101 xi xii CONTENTS PRACTICE QUESTIONS ANSWERS AND RATIONALES . . . . . . . . . . . . . . . . . . . . . . . . . 104 COMPREHENSIVE EXAMINATION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 COMPREHENSIVE EXAMINATION ANSWERS AND RATIONALES . . . . . . . . . . . . . . . . 120 5 Hematological Disorder . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 123 PRACTICE QUESTIONS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 124 Leukemia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 124 Lymphoma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 125 Anemia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 127 Bleeding Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 128 Blood Transfusions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 130 Sickle Cell Anemia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 131 PRACTICE QUESTIONS ANSWERS AND RATIONALES . . . . . . . . . . . . . . . . . . . . . . . . . 134 COMPREHENSIV E EXAMINATION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 148 COMPREHENSIVE EXAMINATION ANSWERS AND RATIONALES . . . . . . . . . . . . . . . . 152 6 Respiratory Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 157 PRACTICE QUESTIONS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 158 Upper Respiratory Infection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 158 Lower Respiratory Infection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 159 Chronic Pulmonary Obstructive Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 161 Reactive Airway Disease (Asthma) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 162 Lung Cancer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 164 Cancer of the Larynx . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 166 Pulmonary Embolus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 168 Chest Trauma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 170 Acute Respiratory Distress Syndrome . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 171 PRACTICE QUESTIONS ANSWERS AND RATIONALES . . . . . . . . . . . . . . . . . . . . . . . . . 174 COMPREHENSIVE EXAMINATION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 195 COMPREHENSIVE EXAMINATION ANSWERS AND RATIONALES . . . . . . . . . . . . . . . . 202 Gastrointestinal Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 209 PRACTICE QUESTIONS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 210 Gastroesophageal Re? ux . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 210 In? ammatory Bowel Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 211 Peptic Ulcer Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 213 Colorectal Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 214 Diverticulosis/Diverticulitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 216 Gallbladder Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 217 Liver Failure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 219 Hepatitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 220 Gastroenteritis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 222 Abdominal Surgery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 224 Eating Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 225 Constipation/Diarrhea Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 227 PRACTICE QUESTIONS ANSWERS AND RATIONALES . . . . . . . . . . . . . . . . . . . . . . . . . 229 COMPREHENSIVE EXAMINATION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 255 COMPREHENSIVE EXAMINATION ANSWERS AND RATIONALES . . . . . . . . . . . . . . . . 262 7 8 Endocrine Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 269 PRACTICE QUESTIONS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 270 Diabetes Mellitus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 270 Pancreatitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 273 Cancer of the Pancreas . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 274 Adrenal Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 276 Pituitary Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 278 Thyroid Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 279 CONTENTS PRACTICE QUESTIONS ANSWERS AND RATIONALES . . . . . . . . . . . . . . . . . . . . . . . . 282 COMPREHENSIVE EXAMINATION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 297 COMPREHENSIVE EXAMINATION ANSWERS AND RATIONALES . . . . . . . . . . . . . . . . 301 xiii 9 Genitourinary Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 305 PRACTICE QUESTIONS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 306 Acute Renal Failure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 306 Chronic Renal Failure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 307 Fluid and Electrolyte Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 309 Urinary Tract Infection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 310 Benign Prostatic Hypertrophy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 312 Renal Calculi . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 313 Cancer of the Bladder . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 315 PRACTICE QUESTIONS ANSWERS AND RATIONALES . . . . . . . . . . . . . . . . . . . . . . . . . 317 COMPREHENSIVE EXAMINATION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 332 COMPREHENSIVE EXAMINATION ANSWERS AND RATIONALES . . . . . . . . . . . . . . . . 336 Reproductive Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 341 PRACTICE QUESTIONS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 342 Breast Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 342 Pelvic Floor Relaxation Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 343 Uterine Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 345 Ovarian Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 346 Prostate Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 348 Testicular Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 349 Sexually Transmitted Diseases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 351 PRACTICE QUESTIONS ANSWERS AND RATIONALES . . . . . . . . . . . . . . . . . . . . . . . . . 353 COMPREHENSIVE EXAMINATION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 368 COMPREHENSIVE EXAMINATION ANSWERS AND RATIONALES . . . . . . . . . . . . . . . 372 10 11 Musculoskeletal Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 377 PRACTICE QUESTIONS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 378 Degenerative/Herniated Disc Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 378 Osteoarthritis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 379 Osteoporosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 381 Amputation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 382 Fractures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 384 Joint Replacements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 385 PRACTICE QUESTIONS ANSWERS AND RATIONALES . . . . . . . . . . . . . . . . . . . . . . . . . 388 COMPREHENSIVE EXAMINATION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 00 COMPREHENSIVE EXAMINATION ANSWERS AND RATIONALES . . . . . . . . . . . . . . . . 404 Integumentary Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 409 PRACTICE QUESTIONS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 410 Burns . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 410 Pressure Ulcers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 411 Skin Cancer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 413 Bacterial Skin Infection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 414 Viral Skin Infection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 416 Fungal/Parasitic Skin Infection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 417 PRACTICE QUESTIONS ANSWERS AND RATIONALES . . . . . . . . . . . . . . . . . . . . . . . . . 420 COMPREHENSIVE EXAMINATION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 433 COMPREHENSIVE EXAMINATION ANSWERS AND RATIONALES . . . . . . . . . . . . . . . . 437 12 13 Immune System Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 441 PRACTICE QUESTIONS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 442 Multiple Sclerosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 442 Guillain-Barre Syndrome . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 444 xiv CONTENTS Myasthenia Gravis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 445 Systemic Lupus Erythematous . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 447 Acquired Immunode? ciency Syndrome . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 448 Allergies and Allergic Reactions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 450 Rheumatoid Arthritis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 451 PRACTICE QUESTIONS ANSWERS AND RATIONALES . . . . . . . . . . . . . . . . . . . . . . . . . 454 COMPREHENSIVE EXAMINATION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 469 COMPREHENSIVE EXAMINATION ANSWERS AND RATIONALES . . . . . . . . . . . . . . . . 473 14 Sensory De? cits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 477 PRACTICE QUESTIONS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 478 Eye Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 478 Ear Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 479 PRACTICE QUESTIONS ANSWERS AND RATIONALES . . . . . . . . . . . . . . . . . . . . . . . . . 481 COMPREHENSIVE EXAMINATION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 485 COMPREHENSIVE EXAMINATION ANSWERS AND RATIONALES . . . . . . . . . . . . . . . . 489 15 Emergency Nursing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 493 PRACTICE QUESTIONS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 494 Shock . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 494 Bioterrorism . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 495 Codes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 497 Disaster/Triage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 498 Poisoning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 500 Violence, Physical Abuse, Neglect . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 501 PRACTICE QUESTIONS ANSWERS AND RATIONALES . . . . . . . . . . . . . . . . . . . . . . . . . 504 COMPREHENSIVE EXAMINATION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 518 COMPREHENSIVE EXAMINATION ANSWERS AND RATIONALES . . . . . . . . . . . . . . . 522 16 Perioperative Care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 527 PRACTICE QUESTIONS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 528 Preoperative . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 528 Intraoperative . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 529 Postoperative . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 531 Acute Pain . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 532 PRACTICE QUESTIONS ANSWERS AND RATIONALES . . . . . . . . . . . . . . . . . . . . . . . . . 534 COMPREHENSIVE EXAMINATION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 542 COMPREHENSIVE EXAMINATION ANSWERS AND RATIONALES . . . . . . . . . . . . . . . . 546 17 Cultural Nursing and Alternative Health Care . . . . . . . . . . . . . . . . . . . . . 549 PRACTICE QUESTIONS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 550 PRACTICE QUESTIONS ANSWERS AND RATIONALES . . . . . . . . . . . . . . . . . . . . . . . . . 554 COMPREHENSIVE EXAMINATION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 559 COMPREHENSIVE EXAMINATION ANSWERS AND RATIONALES . . . . . . . . . . . . . . . . 563 18 End-of-Life Issues . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 567 PRACTICE QUESTIONS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 568 Advance Directives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 568 Death and Dying . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 569 Chronic Pain . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 571 Ethical/Legal Issues . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 572 Organ/Tissue Donation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 574 PRACTICE QUESTIONS ANSWERS AND RATIONALES . . . . . . . . . . . . . . . . . . . . . . . . . 576 COMPREHENSIVE EXAMINATION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 587 COMPREHENSIVE EXAMINATION ANSWERS AND RATIONALES . . . . . . . . . . . . . . . . 591 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 595 TEST-TAKING HINTS FOR PHARMACOLOGY QUESTIONS . . . . . . . . . . . . . . . . . . . . . . 595 COMPREHENSIVE EXAMINATION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 600 COMPREHENSIVE EXAMINATION ANSWERS AND RATIONALES . . . . . . . . . . . . . . . . 614 19 Pharmacology CONTENTS xv 20 Comprehensive Final Examination . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 627 COMPREHENSIVE FINAL EXAMINATION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 628 COMPREHENSIVE FINAL EXAMINATION ANSWERS AND RATIONALES . . . . . . . . . . 642 Glossary of English Words Commonly Encountered on Nursing Examinations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 655 Index †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.. 659 Fundamentals of Critical Thinking Related to Test Taking: The RACE Model This book is the second in a series of books, published by the F. A. Davis Company, designed to assist the student nurse in being successful in nursing school and in taking examinations, particularly the NCLEX-RN examination for licensure as a registered nurse. Med-Surg Success: A Course Review Applying Critical Thinking to Test Taking focuses, as its name implies, on critical thinking as it pertains to test-taking skills for examinations in the nursing ? ld. It c ontains the usual practice test questions found in review books, but it also provides important test-taking hints to help in analyzing questions and determining the correct answers. It follows book one of this series— Fundamentals Success: A Course Review Applying Critical Thinking to Test Taking by Patricia Nugent, RN, MA, MS, EdD, and Barbara Vitale, RN, MA—which de? nes critical thinking and the RACE model for applying critical thinking to test taking, but it does not repeat the same speci? c topics.Rather, it focuses on how to use the thinking processes and test-taking skills in answering questions on topics speci? cally addressed in the NCLEX-RN exam and in other nursing exams. Test-taking skills and hints are valuable, but the student and future test taker must remember that the most important aspect of taking any examination is to become knowledgeable about the subject matter the test will cover. There is no substitute for studying the material. 1 GUIDELINES FOR USING THIS BOOK This book contains 19 chapters and a ? nal comprehensive examination. This ntroductory chapter on test taking focuses on guidelines for studying and preparing for an examination, speci? cs about the nature of the NCLEX-RN test and the types of questions contained in it, and approaches to analyzing the questions and determining the correct answer using the RACE model. Thirteen chapters (Chapters 2–14) focus on disorders affecting the different major body systems. Each of these chapters is divided into four major sections: Practice Questions, Practice Questions Answers and Rationales, a Comprehensive Examination, and Comprehensive Examination Answers and Rationales.Key words and abbreviations are also included in each chapter. Different types of multiple-choice questions about disorders that affect a speci? c body system help the test taker to more easily identify speci? c content. The answers to these questions, the explanations for the correct answers, and th e reasons why other possible answer options are wrong or not the best choice reinforce the test taker’s knowledge and ability to discern subtle points in the question. Finally, the test-taking hints provide some clues and tips for answering the speci? c question.The Comprehensive Examination includes questions about the disorders covered in the practice section and questions about other diseases/disorders that may affect the particular body system. Answers and rationales for these examination questions are given, but test-taking hints are not. Chapters 15–18 follow the same pattern but focus on emergency nursing, perioperative nursing, cultural nursing and alternative health care, and end-of-life issues. Chapter 19, the pharmacology chapter, deals speci? cally with what the student nurse should know about the administration of medications, provides test-taking tips speci? to pharmacology questions, and provides questions and answers. A ? nal 100-question comprehensive examination completes the main part of the book. 1 2 Test Taking MED-SURG SUCCESS PREPARING FOR LECTURE To prepare for attending a class on a speci? c topic, students should read the assignment in the textbook and prepare notes to take to class. Highlight any information the test taker does not understand so that the information may be clari? ed during class or, if the instructor does not cover it in class, after the lecture. Writing a prep sheet while reading (studying) is very useful.A single sheet of paper divided into categories of information, as shown in the following, should be sufficient for learning about most disease processes. If students cannot limit the information to one page, they are probably not being discriminatory when reading. The idea is not to rewrite the textbook; the idea is to glean from the textbook the important, need-to-know information. Sample Prep Sheet Medical Diagnosis: Diagnostic Tests: (List normal values) De? nition: Signs and Symptoms Nursing Inte rventions: (Include Teaching)Procedures and Nursing Implications: Medical Interventions: Complete the prep sheet in one color ink. Take the prep sheet to class along with a pen with different color ink or a pencil and a highlighter. Highlight on the prep sheet whatever the instructor emphasizes during the lecture. Write in different color ink or with a pencil any information the instructor emphasizes in lecture that the student did not include on the prep sheet. After the lecture, reread the information in the textbook that was included in the lecture but not on the student’s prep sheet.By using this method when studying for the exam, the test taker will be able to identify the information obtained from the textbook and the information obtained in class. The information on the prep sheet that is highlighted represents information that the test taker thought was important from reading the textbook and that the instructor emphasized during lecture. This is need-to know-informat ion for the examination. Please note, however, that the instructor may not emphasize laboratory tests and values but still expect the student to realize the importance of this information.Carry the completed prep sheets in a folder so that it can be reviewed any time there is a minute that is spent idly, such as during children’s sports practices or when waiting for an appointment. This is learning to make the most of limited time. The prep sheets also should be carried to clinical assignments to use when caring for clients in the hospital. If students are prepared prior to attending class, they will ? nd the lecture easier to understand and, as a result, will be more successful during examinations.Being prepared allows students to listen to the instructor and not sit in class trying to write every word from the overhead presentation. Test takers should recognize the importance of the instructor’s hints during the lecture. The instructor may emphasize information by hi ghlighting areas on overhead slides, by repeating information, or by emphasizing a particular fact. This usually means the instruc- CHAPTER 1 FUNDAMENTALS OF CRITICAL THINKING RELATED TO TEST TAKING 3 Test Taking tor thinks the information is very important. Important information usually ? nds its way onto tests at some point.PREPARING FOR AN EXAMINATION There are several steps that the test taker should take in preparing for an examination— some during the course of the class and some immediately before the day of the test. Study, Identify Weaknesses, and Practice The test taker should plan to study three (3) hours for every one (1) hour of class. For example, a course that is three (3) hours of credit requires nine (9) hours of study a week. Cramming immediately prior to the test usually places the test taker at risk for being unsuccessful. The information acquired during cramming is not really learned and is quickly forgotten.And remember: Nursing examinations include mate rial required by the registered nurse when caring for clients at the bedside. The ? rst time many students realize they do not understand some information is during the examination or, in other words, when it is too late. Nursing examinations contain highlevel application questions requiring the test taker to have memorized information and to be able to interpret the data and make a judgment as to the correct course of action. The test taker must recognize areas of weakness prior to seeing the examination for the ? rst time.This book is designed to provide assistance in identifying areas of weakness prior to the examination. Two to 3 days prior to the examination the test taker should compose a practice test or take any practice questions or comprehensive exams in this book that have not already been answered. If a speci? c topic of study—say, the circulatory system and its disorders—proves to be an area of strength, as evidenced by selecting the correct answers to the questions on that system, then the test taker should proceed to study other areas identi? ed as areas of weakness because of incorrect answers in those areas.Prospective test takers who do not understand the rationale for the correct answer should read the appropriate part of the textbook and try to understand the rationale for the correct answer. However, test takers should be cautious when reading the rationale for the incorrect answer options because during the actual examination, the student may remember reading the information and become confused about whether the information applied to the correct answer or to the incorrect option. The Night Before the Exam The night before the examination the test taker should stop studying by 6:00 P.M. or 7:00 P. M. and then do something fun or relaxing until bedtime. Don’t make bedtime too late: A good night’s rest is essential prior to taking the examination. Studying until bedtime or an all-night cram session will leave the test taker tired and sleepy during the examination, just when the mind should be at its top performance. The Day of the Exam Eat a meal before an examination. A source of carbohydrate for energy, along with a protein source, make a good meal prior to an examination. Skipping a meal before the examination leaves the brain without nourishment.A glass of milk and a bagel with peanut butter is an excellent meal; it provides a source of protein and a sustained release of carbohydrates. Do not eat donuts or other junk food or drink soft drinks. They provide energy that is quickly available but will not last throughout the time required for an examination. Excessive ? uid intake may cause the need to urinate during the examination and make it hard for students to concentrate. 4 Test Taking MED-SURG SUCCESS Test-Taking Anxiety Test takers who have test-taking anxiety should arrive at the testing site 45 minutes prior to the examination.Find a seat for the examination and place books there to reserve the desk. Walk for 15 minutes at a fast pace away from the testing site and then turn and walk back. This exercise literally walks anxiety away. If other test takers’ getting up and leaving the room is bothersome, try to get a desk away from the group, in front of the room or facing a wall. Most schools allow students to wear hunter’s earplugs during a test if noise bothers them. Most RN-NCLEX test sites will provide earplugs if the test taker requests them. TAKING THE EXAM The NCLEX-RN examination is a computerized exam. Tests given in nursing schools in speci? subject areas may be computerized or pen and pencil. Both formats include multiple-choice questions and may include several types of alternate questions: a ? ll-in-theblank question that tests math abilities; a select-all-that-apply question that requires the test taker to select more than one option as the correct answer; a prioritizing question that requires the test taker to prioritize the answers 1, 2, 3, 4, and 5 in the order of when the nurse would implement the intervention; and, in the computerized version, a click-and-drag question that requires the test taker to identify a speci? area of the body as the correct answer. Examples of all types of questions are included in this book. In an attempt to illustrate the click-and-drag question, this book has pictures with lines to delineate choices A, B, C, or D. Refer to the National Council of State Boards of Nursing for additional information on the NCLEX-RN examination (http://www. ncsbn. org). Pen-and-Pencil Exam A test taker taking a pen-and-pencil examination in nursing school who ? nds a question that contains totally unknown information should circle the question and skip it. Another question may help to answer the skipped question.Not moving on and worrying over a question will place success on the next few questions in jeopardy. The mind will not let go of the worry, and this may lead to missing important informatio n in subsequent questions. Computerized Test The computerized NCLEX-RN test is composed of from 75 (the minimum number of questions) to 265 questions. The computer determines with a 95% certainty whether the test taker’s ability is above the passing standard before the examination concludes. During the NCLEX-RN computerized test, take some deep breaths and then select an answer.The computer does not allow the test taker to return to a question. Test takers who become anxious during an examination should stop, put their hands in their lap, close their eyes, and take a minimum of ? ve deep breaths before resuming the examination. Test takers must become aware of personal body signals that indicate increasing stress levels. Some people get gastrointestinal symptoms and others feel a tightening of muscles. Test takers should not be overly concerned if they possess only rudimentary computer skills. Simply use the mouse to select the correct answer.Every question asks for a con? rm ation before being submitted as the correct answer. In addition to typing in pertinent personal information, test takers must be able to type numbers and use the drop-down computer calculator. However, test takers can request an erasable slate to calculate math problems by hand. Practice taking tests on the computer before taking the NCLEX-RN examination. Many textbooks contain computer disks with test questions, and there are many on-line review opportunities. CHAPTER 1 FUNDAMENTALS OF CRITICAL THINKING RELATED TO TEST TAKING 5 Test TakingUNDERSTANDING THE TYPES OF NURSING QUESTIONS Components of a Multiple-Choice Question A multiple-choice question is called an item. Each item has two parts. The stem is the part that contains the information that identi? es the topic and its parameters and then asks a question. The second part consists of one or more possible responses, which are called options. One of the options is the correct answer; the others are the wrong answers and are cal led distracters. The client diagnosed with angina complains of chest pain while ambulating in the hall. Which intervention should the nurse implement ? rst? . Have the client sit down. 2. Monitor the pulse oximeter reading. 3. Administer sublingual nitroglycerin. 4. Apply oxygen via nasal cannula. } STEM } OPTIONS } } CORRECT ANSWER DISTRACTERS Cognitive Levels of Nursing Questions Questions on nursing examinations re? ect a variety of thinking processes that nurses use when caring for clients. These thinking processes are part of the cognitive domain, and they progress from the simple to the complex, from the concrete to the abstract, and from the tangible to the intangible. There are four types of thinking processes represented by nursing questions. . Knowledge Questions—These questions emphasize recalling information that has been learned/studied. 2. Comprehension Questions—These questions emphasize understanding the meaning and intent of remembered information. 3. Application Questions—These questions emphasize the use of remembered and understood information in new situations. 4. Analysis Questions—These questions emphasize comparing and contrasting a variety of elements of information. THE RACE MODEL: THE APPLICATION OF CRITICAL THINKING TO MULTIPLE-CHOICE QUESTIONS Answering a test question is like participating in a race.Of course, each test taker wants to come in ? rst and be the winner. However, the thing to remember about a race is that success is not just based on speed but also on strategy and tactics. The same is true about nursing examinations. Although speed may be a variable that must be considered when taking a timed test so that the amount of time spent on each question is factored into the test strategy, the emphasis on RACE is the use of critical-thinking techniques to answer multiplechoice questions. The RACE Model presented here is a critical-thinking strategy to use when answering multiple-choice questions co ncerning nursing.If the test taker follows the RACE Model every time when looking at and analyzing a test question, its use will become second nature. 6 Test Taking MED-SURG SUCCESS This methodical approach will improve the ability to critically analyze a test question and improve the chances of selecting the correct answer. The RACE Model has four steps to answering a test question. The best way to remember the four steps is to refer to the acronym RACE. R — Recognize †¢ What information is in the stem. †¢ The key words in the stem. †¢ Who the client is in the stem. What the topic is about. A — Ask †¢ What is the question asking? †¢ What are the key words in the stem that indicate the need for a response? †¢ What is the question asking the nurse to implement? C — Critically analyze †¢ The options in relation to the question asked in the stem. †¢ Each option in relation to the information in the stem. †¢ A rationale f or each option. †¢ By comparing and contrasting the options in relation to the information in the stem and their relationships to one another. E — Eliminate options †¢ One option at a time. †¢ As many options as possible.The text Fundamentals Success: Course Review Applying Critical Thinking to Test Taking by Patricia Nugent and Barbara Vitale includes a discussion exploring the RACE Model in depth and its relation to the thinking processes used in multiple-choice questions in the ? eld of nursing. The ? rst step toward knowledge is to know that we are not ignorant. —Richard Cecil Neurological Disorders Test-taking hints are useful to discriminate information, but they cannot substitute for knowledge. The student should refer to Chapter 1 for assistance in preparing for class, studying, and taking an examination. This hapter focuses on disorders that affect the neurological system. It provides a list of keywords and abbreviations, practice questions focu sed on disease processes, and a comprehensive examination that includes other content areas involving the neurological system and the disease processes addressed in the practice questions. Answers and reasons why the answer options provided are either correct or incorrect are also provided as are some testtaking hints. The following chapters (Chapters 3–12) focus on disorders that affect other body systems and function. 2 KEYWORDS agnosia akinesia aphasia apraxia are? xia ataxia autonomic dysre? exia bradykinesia decarboxylase diplopia dysarthria dysphagia echolalia epilepsy papilledema paralysis paresthesia paroxysms penumbra postictal ABBREVIATIONS Activities of Daily Living (ADLs) Amyotrophic Lateral Sclerosis (ALS) As Soon As Possible (ASAP) Blood Pressure (BP) Cerebrovascular Accident (CVA) Computed Tomography (CT) Electroencephalogram (EEG) Electromyelogram (EMG) Emergency Department (ED) Enzyme-Linked Immunoassay (ELISA) Health-Care Provider (HCP) Intracranial Pressure (ICP) Intensive Care Department (ICD) Intravenous (IV) Magnetic Resonance Imaging (MRI) Nonsteroidal Anti-In? mmatory Drug (NSAID) Nothing By Mouth (NPO) Parkinson’s Disease (PD) Pulse (P) Range of Motion (ROM) Respiration (R) Rule Out (R/O) Spinal Cord Injury (SCI) STAT—immediately (STAT) Temperature (T) Transient Ischemic Attack (TIA) Traumatic Brain Injury (TBI) Unlicensed Assistive Personnel (UAP) Please note: The term health-care provider, as used in this text, refers to a nurse practitioner (NP), physician (MD), osteopath (DO), or physician assistant (PA) who has prescriptive authority. These providers are responsible for directing the care and providing orders for the clients. 7 PRACTICE QUESTIONSCerebrovascular Accident (Stroke) 1. A 78-year-old client is admitted to the emergency department with numbness and weakness of the left arm and slurred speech. Which nursing intervention is priority? 1. Prepare to administer recombinant tissue plasminogen activator (r t-PA). 2. Discuss the precipitating factors that caused the symptoms. 3. Schedule for a STAT computed tomography (CT) scan of head. 4. Notify the speech pathologist for an emergency consult. 2. The nurse is assessing a client experiencing motor loss as a result of a left-sided cerebrovascular accident (CVA). Which clinical manifestations would the nurse document? . Hemiparesis of the client’s left arm and apraxia. 2. Paralysis of the right side of the body and ataxia. 3. Homonymous hemianopsia and diplopia. 4. Impulsive behavior and hostility toward family. 3. Which client would the nurse identify as being most at risk for experiencing a CVA? 1. A 55-year-old African American male. 2. An 84-year-old Japanese female. 3. A 67-year-old Caucasian male. 4. A 39-year-old pregnant female. 4. The client diagnosed with a right-sided cerebrovascular accident is admitted to the rehabilitation unit. Which interventions should be included in the nursing care plan? Select all that apply. 1 .Position the client to prevent shoulder adduction. 2. Turn and reposition the client every shift. 3. Encourage the client to move the affected side. 4. Perform quadriceps exercises three (3) times a day. 5. Instruct the client to hold the ? ngers in a ? st. 5. The nurse is planning care for a client experiencing agnosia secondary to a cerebrovascular accident. Which collaborative intervention will be included in the plan of care? 1. Observing the client swallowing for possible aspiration. 2. Positioning the client in a semi-Fowler’s position when sleeping. 3. Placing a suction set-up at the client’s bedside during meals. . Referring the client to an occupational therapist for evaluation. 6. The nurse and an unlicensed assistive personnel (UAP) are caring for a client with rightsided paralysis. Which action by the UAP requires the nurse to intervene? 1. The assistant places a gait belt around the client’s waist prior to ambulating. 2. The assistant places the cl ient on the back with the client’s head to the side. 3. The assistant places her hand under the client’s right axilla to help him/her move up in bed. 4. The assistant praises the client for attempting to perform ADLs independently. 7. The client diagnosed with atrial ? rillation has experienced a transient ischemic attack (TIA). Which medication would the nurse anticipate being ordered for the client on discharge? 1. An oral anticoagulant medication. 2. A beta-blocker medication. 3. An anti-hyperuricemic medication. 4. A thrombolytic medication. 8. The client has been diagnosed with a cerebrovascular accident (stroke). The client’s wife is concerned about her husband’s generalized weakness. Which home modi? cation should the nurse suggest to the wife prior to discharge? 1. Obtain a rubber mat to place under the dinner plate. 2. Purchase a long-handled bath sponge for showering. 3.Purchase clothes with Velcro closure devices. 4. Obtain a raised toilet seat for the client’s bathroom. 8 Neurological CHAPTER 2 NEUROLOGICAL DISORDERS 9 9. The client is diagnosed with expressive aphasia. Which psychosocial client problem would the nurse include in the plan of care? 1. Potential for injury. 2. Powerlessness. 3. Disturbed thought processes. 4. Sexual dysfunction. 10. Which assessment data would indicate to the nurse that the client would be at risk for a hemorrhagic stroke? 1. A blood glucose level of 480 mg/dL. 2. A right-sided carotid bruit. 3. A blood pressure of 220/120 mm Hg. 4. The presence of bronchogenic carcinoma. 1. The 85-year-old client diagnosed with a stroke is complaining of a severe headache. Which intervention should the nurse implement ? rst? 1. Administer a nonnarcotic analgesic. 2. Prepare for STAT magnetic resonance imaging (MRI). 3. Start an intravenous line with D5W at 100 mL/hr. 4. Complete a neurological assessment. 12. A client diagnosed with a subarachnoid hemorrhage has undergone a craniotomy for repair of a ruptured aneurysm. Which intervention will the intensive care nurse implement? 1. Administer a stool softener BID. 2. Encourage the client to cough hourly. 3. Monitor neurological status every shift. . Maintain the dopamine drip to keep BP at 160/90. Neurological Head Injury 13. The client diagnosed with a mild concussion is being discharged from the emergency department. Which discharge instruction should the nurse teach the client’s signi? cant other? 1. Awaken the client every two (2) hours. 2. Monitor for increased intracranial pressure. 3. Observe frequently for hypervigilance. 4. Offer the client food every three (3) to four (4) hours. 14. The resident in a long-term care facility fell during the previous shift and has a laceration in the occipital area that has been closed with Steri-Stripsâ„ ¢.Which signs/symptoms would warrant transferring the resident to the emergency department? 1. A 4-cm area of bright red drainage on the dressing. 2. A weak pulse, shallow r espirations, and cool pale skin. 3. Pupils that are equal, react to light, and accommodate. 4. Complaints of a headache that resolves with medication. 15. The nurse is caring for the following clients. Which client would the nurse assess ? rst after receiving the shift report? 1. The 22-year-old male client diagnosed with a concussion who is complaining someone is waking him up every two (2) hours. 2.The 36-year-old female client admitted with complaints of left-sided weakness who is scheduled for a magnetic resonance imaging (MRI) scan. 3. The 45-year-old client admitted with blunt trauma to the head after a motorcycle accident who has a Glasgow Coma Scale score of 6. 4. The 62-year-old client diagnosed with a cerebrovascular accident (CVA) who has expressive aphasia. 10 MED-SURG SUCCESS 16. The client has sustained a severe closed head injury and the neurosurgeon is determining if the client is â€Å"brain dead. † Which data support that the client is brain dead? 1. When th e client’s head is turned to the right, the eyes turn to the right. . The electroencephalogram (EEG) has identi? able waveforms. 3. There is no eye activity when the cold caloric test is performed. 4. The client assumes decorticate posturing when painful stimuli are applied. 17. The client is admitted to the medical ? oor with a diagnosis of closed head injury. Which nursing intervention has priority? 1. Assess neurological status. 2. Monitor pulse, respiration, and blood pressure. 3. Initiate an intravenous access. 4. Maintain an adequate airway. 18. The client diagnosed with a closed head injury is admitted to the rehabilitation department. Which medication order would the nurse question? . A subcutaneous anticoagulant. 2. An intravenous osmotic diuretic. 3. An oral anticonvulsant. 4. An oral proton pump inhibitor. 19. The client diagnosed with a gunshot wound to the head assumes decorticate posturing when the nurse applies painful stimuli. Which assessment data obtained th ree (3) hours later would indicate the client is improving? 1. Purposeless movement in response to painful stimuli. 2. Flaccid paralysis in all four extremities. 3. Decerebrate posturing when painful stimuli are applied. 4. Pupils that are 6 mm in size and nonreactive on painful stimuli. 20.The nurse is caring for a client diagnosed with an epidural hematoma. Which nursing interventions should the nurse implement? Select all that apply. 1. Maintain the head of the bed at 60 degrees of elevation. 2. Administer stool softeners daily. 3. Ensure that pulse oximeter reading is higher than 93%. 4. Perform deep nasal suction every two (2) hours. 5. Administer mild sedatives. 21. The client with a closed head injury has clear ? uid draining from the nose. Which action should the nurse implement ? rst? 1. Notify the health-care provider immediately. 2. Prepare to administer an antihistamine. 3. Test the drainage for presence of glucose. . Place 2 2 gauze under the nose to collect drainage. 2 2. The nurse is enjoying a day out at the lake and witnesses a water skier hit the boat ramp. The water skier is in the water not responding to verbal stimuli. The nurse is the ? rst health-care provider to respond to the accident. Which intervention should be implemented ? rst? 1. Assess the client’s level of consciousness. 2. Organize onlookers to remove the client from the lake. 3. Perform a head-to-toe assessment to determine injuries. 4. Stabilize the client’s cervical spine. 23. The client is diagnosed with a closed head injury and is in a coma.The nurse writes the client problem as â€Å"high risk for immobility complications. † Which intervention would be included in the plan of care? 1. Position the client with the head of the bed elevated at intervals. 2. Perform active range of motion exercises every four (4) hours. 3. Turn the client every shift and massage bony prominences. 4. Explain all procedures to the client before performing them. Neurological CHAPTER 2 NEUROLOGICAL DISORDERS 11 Spinal Cord Injury (SCI) 25. The nurse driving down the highway witnesses a one-car motor vehicle accident and stops to render aid. The driver of the car is unconscious.Which action should the nurse take ? rst? 1. Carefully remove the driver from the car. 2. Assess the client’s pupils for reaction. 3. Stabilize the client’s cervical spine. 4. Attempt to wake the client up by shaking him. 26. In assessing a client with a T-12 SCI, which clinical manifestations would the nurse expect to ? nd to support the diagnosis of spinal shock? 1. No re? ex activity below the waist. 2. Inability to move upper extremities. 3. Complaints of a pounding headache. 4. Hypertension and bradycardia. 27. The rehabilitation nurse caring for the client with an L-1 SCI is developing the nursing care plan.Which intervention should the nurse implement? 1. Keep oxygen on via nasal cannula on at all times. 2. Administer low-dose subcutaneous anticoagulants. 3. P erform active lower-extremity ROM exercises. 4. Refer to a speech therapist for ventilator-assisted speech. 28. The nurse in the neurointensive care unit is caring for a client with a new C-6 SCI who is breathing independently. Which nursing interventions should be implemented? Select all that apply. 1. Monitor the pulse oximetry reading. 2. Provide pureed foods six (6) times a day. 3. Encourage coughing and deep breathing. 4. Assess for autonomic dysre? xia. 5. Administer intravenously corticosteroids. 29. The home health nurse is caring for a 28-year-old client with a T-10 SCI who says, â€Å"I can’t do anything. Why am I so worthless? † Which statement by the nurse would be the most therapeutic? 1. â€Å"This must be very hard for you. You’re feeling worthless? † 2. â€Å"You shouldn’t feel worthless—you are still alive. † 3. â€Å"Why do you feel worthless? You still have the use of your arms. † 4. â€Å"If you attended a work rehab program you wouldn’t feel worthless. † 30. The client is diagnosed with an SCI and is scheduled for a magnetic resonance imaging (MRI) scan.Which question would be most appropriate for the nurse to ask prior to taking the client to the diagnostic test? 1. â€Å"Do you have trouble hearing? † 2. â€Å"Are you allergic to any type of dairy products? † 3. â€Å"Have you had anything to eat in the last eight (8) hours? † 4. â€Å"Are you uncomfortable in closed spaces? † Neurological 24. The 29-year-old client that was employed as a forklift operator sustains a traumatic brain injury secondary to a motor vehicle accident. The client is being discharged from the rehabilitation unit after three (3) months and has cognitive de? cits. Which goal would be most realistic for this client? . The client will return to work within six (6) months. 2. The client is able to focus and stay on task for ten (10) minutes. 3. The client will be able to dress self without assistance. 4. The client will regain bowel and bladder control. 12 MED-SURG SUCCESS 31. The client with a C-6 SCI is admitted to the emergency department complaining of a severe pounding headache and has a BP of 180/110. Which intervention should the emergency department nurse implement? 1. Keep the client ? at in bed. 2. Dim the lights in the room. 3. Assess for bladder distention. 4. Administer a narcotic analgesic. 32.The client with a cervical fracture is being discharged in a halo device. Which teaching instruction should the nurse discuss with the client? 1. Discuss how to remove insertion pins correctly. 2. Instruct the client to report reddened or irritated skin areas. 3. I