text:
1. A patient with suspected acromegaly is seen at the clinic. To assist in making the diagnosis, which question should the nurse ask?
a. "Have you had a recent head injury?"
b. "Do you have to wear larger shoes now?"
c. "Is there any family history of acromegaly?"
d. "Are you experiencing tremors or anxiety?"
Rationale: Acromegaly causes an enlargement of the hands and feet. Head injury and family history are not risk factors for acromegaly. Tremors and anxiety are not clinical manifestations of acromegaly.
Cognitive Level: Application Text Reference: p. 1291
Nursing Process: Assessment NCLEX: Physiological Integrity
2. During preoperative teaching for a patient scheduled for transsphenoidal hypophysectomy for treatment of a pituitary adenoma, the nurse instructs the patient about the need to
a. remain on bed rest for the first 48 hours after the surgery.
b. avoid brushing the teeth for at least 10 days after the surgery.
c. cough and deep-breathe every 2 hours postoperatively.
d. be positioned flat with sandbags at the head postoperatively.
Rationale: To avoid disruption of the suture line, the patient should avoid brushing the teeth for 10 days after surgery. It is not necessary to remain on bed rest after this surgery. Coughing is discouraged because it may cause leakage of cerebrospinal fluid (CSF) from the suture line. The head of the bed should be elevated 30 degrees to reduce pressure on the sella turcica and decrease the risk for headaches.
Cognitive Level: Application Text Reference: p. 1293
Nursing Process: Implementation NCLEX: Physiological Integrity
3. Following a transsphenoidal resection of a pituitary tumor, an important nursing assessment is
a. monitoring hourly urine output.
b. checking the dressings for serous drainage.
c. palpating for dependent pitting edema.
d. obtaining continuous pulse oximetry.
Rationale: After pituitary surgery, the patient is at risk for diabetes insipidus caused by cerebral edema and monitoring of urine output and urine specific gravity is essential. There will be no dressing when the transsphenoidal approach is used. The patient is at risk for dehydration, not volume overload. The patient is not at high risk for problems with oxygenation, and continuous pulse oximetry is not needed.
Cognitive Level: Application Text Reference: p. 1293
Nursing Process: Assessment NCLEX: Physiological Integrity
4. A patient is suspected of having a pituitary tumor causing panhypopituitarism. During assessment of the patient, the nurse would expect to find
a. elevated blood glucose.
b. changes in secondary sex characteristics.
c. high blood pressure.
d. tachycardia and cardiac palpitations.
Rationale: Changes in secondary sex characteristics are associated with decreases in FSH and LH. Fasting hypoglycemia and hypotension occur in panhypopituitarism as a result of decreases in ACTH and cortisol. Bradycardia is likely due to the decrease in TSH and thyroid hormones associated with panhypopituitarism.
Cognitive Level: Application Text Reference: p. 1294
Nursing Process: Assessment NCLEX: Physiological Integrity
5. A patient seen at the clinic for an upper respiratory infection reports receiving subcutaneous somatotropin (Genotropin) when asked by the nurse about current medications. The nurse questions the patient further about a history of
a. adrenal disease.
b. untreated acromegaly.
c. a pituitary tumor.
d. diabetes insipidus (DI).
Rationale: Somatotropin is a recombinant growth hormone product used for adults with growth hormone deficiency, such as that caused by a pituitary tumor. The medication is not used in adrenal disease or DI. The patient with untreated acromegaly will have an excess of growth hormone.
Cognitive Level: Application Text Reference: p. 1294
Nursing Process: Assessment NCLEX: Physiological Integrity
6. A patient with an antidiuretic hormone (ADH)-secreting small-cell cancer of the lung is treated with demeclocycline (Declomycin) to control the symptoms of syndrome of inappropriate secretion of antidiuretic hormone (SIADH). The nurse determines that the demeclocycline is effective upon finding that the
a. patient's daily weight is stable.
b. urine specific gravity is increased.
c. patient's urinary output is increased.
d. peripheral edema is decreased.
Rationale: Demeclocycline blocks the action of ADH on the renal tubules and increases urine output. A stable body weight and an increase in urine specific gravity indicate that the SIADH is not corrected. Peripheral edema does not occur with SIADH; a sudden weight gain without edema is a common clinical manifestation of this disorder.
Cognitive Level: Application Text Reference: p. 1295
Nursing Process: Evaluation NCLEX: Physiological Integrity
7. When teaching a patient with chronic SIADH about long-term management of the disorder, the nurse determines that additional instruction is needed when the patient says,
a. "I need to shop for foods that are low in sodium and avoid adding salt to foods."
b. "I should weigh myself daily and report any sudden weight loss or gain."
c. "I need to limit my fluid intake to no more than 1 quart of liquids a day."
d. "I will eat foods high in potassium because the diuretics cause potassium loss."
Rationale: Patients with SIADH are at risk for hyponatremia, and a sodium supplement may be prescribed. The other patient statements are correct and indicate successful teaching has occurred.
Cognitive Level: Application Text Reference: p. 1296
Nursing Process: Evaluation
NCLEX: Health Promotion and Maintenance
8. A patient is hospitalized with possible SIADH. The patient is confused and reports a headache, muscle cramps, and twitching. The nurse would expect the initial laboratory results to include a
a. serum sodium of 125 mEq/L (125 mmol/L).
b. hematocrit of 52%.
c. blood urea nitrogen (BUN) of 22 mg/dl (11.5 mmol/L).
d. serum chloride of 110 mEq/L (110 mmol/L).
Rationale: When water is retained, the serum sodium level will drop below normal, causing the clinical manifestations reported by the patient. The hematocrit will decrease because of the dilution caused by water retention. The BUN is not helpful in diagnosis of SIADH and this BUN value is increased. The serum chloride level will usually decrease along with the sodium level. This chloride value is elevated.
Cognitive Level: Application Text Reference: p. 1295
Nursing Process: Assessment NCLEX: Physiological Integrity
9. A patient with symptoms of DI is admitted to the hospital for evaluation and treatment of the condition. An appropriate nursing diagnosis for the patient is
a. insomnia related to waking at night to void.
b. risk for impaired skin integrity related to generalized edema.
c. excess fluid volume related to intake greater than output.
d. activity intolerance related to muscle cramps and weakness.
Rationale: Nocturia occurs as a result of the polyuria caused by diabetes insipidus. Edema will not be expected because dehydration is a concern with polyuria. The patient drinks large amounts of fluid to compensate for the losses experienced from diuresis. The patient's fluid and electrolyte status remain normal as long as the patient's oral intake can keep up with fluid losses, so muscle cramps and weakness are not concerns.
Cognitive Level: Analysis Text Reference: p. 1296
Nursing Process: Diagnosis NCLEX: Physiological Integrity
10. Which information obtained when caring for a patient who has just been admitted for evaluation of diabetes insipidus will be of greatest concern to the nurse?
a. The patient has a urine output of 800 ml/hr.
b. The patient's urine specific gravity is 1.003.
c. The patient had a recent head injury.
d. The patient is confused and lethargic.
Rationale: Patients with diabetes insipidus compensate for fluid losses by drinking copious amounts of fluids, but a patient who is lethargic will be unable to drink enough fluids and will become hypovolemic. A high urine output, low urine specific gravity, and history of a recent head injury are consistent with diabetes insipidus, but they do not require immediate nursing action to avoid life-threatening complications.
Cognitive Level: Analysis Text Reference: p. 1297
Nursing Process: Assessment NCLEX: Physiological Integrity
11. When teaching a patient newly diagnosed with Graves' disease about the disorder, the nurse explains that
a. restriction of iodine intake is needed to reduce thyroid activity.
b. exercise is contraindicated to avoid increasing metabolic rate.
c. surgery will eventually be required to remove the thyroid gland.
d. antithyroid medications may take several weeks to have an effect.
Rationale: Improvement usually begins in 1 to 2 weeks with good results at 4 to 6 weeks. Large doses of iodine are used to inhibit the synthesis of thyroid hormones. Exercise using large muscle groups is encouraged to decrease the irritability and hyperactivity associated with high levels of thyroid hormones. Radioactive iodine is the most common treatment for Graves' disease, although surgery may be used.
Cognitive Level: Implementation Text Reference: p. 1301
Nursing Process: Implementation NCLEX: Physiological Integrity
12. A patient with Graves' disease is prepared for surgery with drug therapy consisting of 4 weeks of propylthiouracil (PTU) and 10 days of iodine before surgery. When teaching the patient about the drugs, the nurse explains that the drugs are given preoperatively to
a. eliminate the risk for tetany during the postoperative period.
b. decrease the risk of hypometabolism during and after the surgery.
c. normalize metabolism and decrease the size and vascularity of the gland.
d. assist in differentiating the thyroid and parathyroid glands during surgery.
Rationale: Antithyroid drugs and iodine decrease the levels of thyroid hormone and the vascularity of the thyroid gland prior to surgery and lower the risk for postoperative thyrotoxicosis and hemorrhage. Postoperative tetany might be caused by removal of the parathyroid gland during thyroidectomy. The medications will tend to decrease metabolic rate. The medications will not help in differentiating the tissues of the thyroid and parathyroid glands.
Cognitive Level: Application Text Reference: p. 1302
Nursing Process: Implementation NCLEX: Physiological Integrity
13. During the nursing assessment of a patient with Graves' disease, the nurse notes a bounding, rapid pulse and systolic hypertension. Based on these assessment data, which question is important for the nurse to ask the patient?
a. "Do you have any problem with frequent constipation?"
b. "Have you noticed any recent decrease in your appetite?"
c. "Do you ever have any chest pain?"
d. "Have you had recent muscle aches?"
Rationale: Angina is a possible complication of Graves' disease, especially for a patient with tachycardia and hypertension. The other clinical manifestations are associated with hypothyroidism.
Cognitive Level: Application Text Reference: p. 1300
Nursing Process: Assessment NCLEX: Physiological Integrity
14. While assessing a patient who has just arrived in the postanesthesia recovery unit (PACU) after a thyroidectomy, the nurse obtains these data. Which information is most important to communicate to the surgeon?
a. The patient is complaining of 7/10 incisional pain.
b. The patient's cardiac monitor shows a heart rate of 112.
c. The patient has increasing swelling of the neck.
d. The patient's voice is weak and hoarse sounding.
Rationale: The neck swelling may lead to respiratory difficulty, and rapid intervention is needed to prevent airway obstruction. The incisional pain should be treated but is not unusual after surgery. A heart rate of 112 is not unusual in a patient who has been hyperthyroid and has just arrived in the PACU from surgery. Vocal hoarseness is expected after surgery due to edema.
Cognitive Level: Application Text Reference: p. 1304
Nursing Process: Assessment NCLEX: Physiological Integrity
15. A few hours after returning to the surgical nursing unit, a patient who has undergone a subtotal thyroidectomy develops laryngeal stridor and a cramp in the right hand. The nurse anticipates that intervention will include
a. administration of IV morphine.
b. administration of IV calcium gluconate.
c. endotracheal intubation with mechanical ventilation.
d. immediate tracheostomy and manual ventilation.
Rationale: The patient's clinical manifestations are consistent with tetany caused by hypocalcemia resulting from damage to the parathyroid glands during surgery. Tracheostomy may be needed if the calcium does not resolve the stridor. There is no indication that morphine is needed. Endotracheal intubation may be done, but only if calcium is not effective in correcting the stridor.
Cognitive Level: Application Text Reference: p. 1304
Nursing Process: Planning NCLEX: Physiological Integrity
16. The nurse identifies a nursing diagnosis of risk for injury: corneal ulceration related to inability to close the eyelids secondary to exophthalmos for a patient with Graves' disease. An appropriate nursing intervention for this problem is to
a. teach the patient to blink every few seconds to lubricate the cornea.
b. elevate the head of the patient's bed to reduce periorbital fluid.
c. apply eye patches to protect the cornea from irritation.
d. place cold packs on the eyes to relieve pain and swelling.
Rationale: The patient should sit upright as much as possible to promote fluid drainage from the periorbital area. With exophthalmos, the patient is unable to close the eyes completely. Lubrication of the eyes, rather than eye patches, will protect the eyes from developing corneal scarring. The swelling of the eye is not caused by excessive blood flow to the eye, so cold packs will not be helpful.
Cognitive Level: Application Text Reference: p. 1303
Nursing Process: Planning NCLEX: Physiological Integrity
17. The first nursing action indicated when a patient returns to the surgical nursing unit following a thyroidectomy is to
a. check the dressing for bleeding.
b. assess respiratory rate and effort.
c. support the patient's head with pillows.
d. take the blood pressure and pulse.
Rationale: Airway obstruction is a possible complication after thyroidectomy because of swelling or bleeding at the site or tetany, and the priority nursing action is to assess the airway. The other actions are also part of the standard nursing care post-thyroidectomy but are not as high in priority.
Cognitive Level: Application Text Reference: p. 1304
Nursing Process: Implementation NCLEX: Physiological Integrity
18. A patient with hyperthyroidism is treated with radioactive iodine (RAI) at a clinic. Before the patient is discharged, the nurse instructs the patient
a. to monitor for symptoms of hypothyroidism, such as easy bruising and cold intolerance.
b. to discontinue the antithyroid medications taken before the radioactive therapy.
c. that symptoms of hyperthyroidism should be relieved in about a week.
d. about radioactive precautions to take with urine, stool, and other body secretions.
Rationale: There is a high incidence of post-radiation hypothyroidism after RAI, and the patient should be monitored for symptoms of hypothyroidism. RAI has a delayed response, with the maximum effect not seen for 2 to 3 months, and the patient will continue to take antithyroid medications during this time. The therapeutic dose of radioactive iodine is low enough that no radiation safety precautions are needed.
Cognitive Level: Application Text Reference: pp. 1304-1305
Nursing Process: Implementation NCLEX: Physiological Integrity
19. A 72-year-old patient is diagnosed with hypothyroidism, and levothyroxine (Synthroid) is prescribed. During initiation of thyroid replacement for the patient, it is most important for the nurse to assess
a. mental status.
b. nutritional level.
c. cardiac function.
d. fluid balance.
Rationale: In older patients, initiation of levothyroxine therapy can increase myocardial oxygen demand and cause angina or dysrhythmias. The medication is also expected to improve mental status and fluid balance and will increase metabolic rate and nutritional needs, but these changes do not indicate a need to change the therapy.
Cognitive Level: Application Text Reference: p. 1306
Nursing Process: Assessment NCLEX: Physiological Integrity
20. While hospitalized for a fractured femur, a 68-year-old patient is diagnosed with hypothyroidism. Which of these medications on the original admission orders will the nurse need to consult with the health care provider about before it is administered?
a. Docusate (Colace)
b. Diazepam (Valium)
c. Ibuprofen (Motrin)
d. Cefoxitin (Mefoxin)
Rationale: Worsening of mental status and myxedema coma can be precipitated by the use of sedatives, especially in older adults. The nurse should discuss the diazepam with the health care provider before administration. The other medications may safely be given to the patient.
Cognitive Level: Application Text Reference: p. 1300
Nursing Process: Implementation NCLEX: Physiological Integrity
21. When teaching a patient with newly diagnosed hypothyroidism about management of the condition, the nurse should
a. delay teaching about the condition until the patient has responded to replacement therapy.
b. provide written handouts of all instructions for continued reference as the patient improves.
c. have a family member teach the patient about the condition when the patient is more alert.
d. arrange for daily home visits by home health nurses to repeat the necessary instructions.
Rationale: Written instructions will be helpful to the patient because initially the hypothyroid patient may be unable to remember to take medications and other aspects of self-care. Teaching should not be delayed, but family members or friends should be included in teaching to assist the patient. The nurse, not a family member, is responsible for patient teaching. Because thyroid replacement does not begin to improve alertness immediately, it is not appropriate to schedule daily home health visits for teaching.
Cognitive Level: Application Text Reference: p. 1308
Nursing Process: Planning NCLEX: Physiological Integrity
22. A patient with primary hyperparathyroidism has a serum calcium level of 14 mg/dl (3.5 mmol/L), phosphorus of 1.7 mg/dl (0.55 mmol/L), serum creatinine of 2.2 mg/dl (194 mmol/L), and a high urine calcium. While the patient awaits surgery, the nurse should
a. institute seizure precautions such as padded siderails.
b. assist the patient to perform range-of-motion exercises QID.
c. monitor the patient for positive Chvostek's or Trousseau's sign.
d. encourage the patient to drink 4000 ml of fluid daily.
Rationale: The patient with hypercalcemia is at risk for kidney stones, which may be prevented by a high fluid intake. Seizure precautions and monitoring for Chvostek's or Trousseau's sign are appropriate for hypocalcemic patients. The patient should engage in weight-bearing exercise rather than range-of-motion because weight-bearing decreases calcium loss from bone.
Cognitive Level: Application Text Reference: pp. 1309-1310
Nursing Process: Implementation NCLEX: Physiological Integrity
23. Following a thyroidectomy, a patient develops carpal spasm while the nurse is taking a blood pressure on the left arm. Which action by the nurse is appropriate?
a. Administer the ordered muscle relaxant.
b. Have the patient rebreathe using a paper bag.
c. Start oxygen at 2 to 3 L/min per cannula.
d. Give the ordered oral calcium supplement.
Rationale: Carpal spasm after a thyroidectomy suggests that the patient has hypocalcaemia caused by damage to the parathyroid glands. The symptoms of hypocalcemia will be temporarily reduced by having the patient breath into a paper bag, which will raise the PaCO2 and create a more acidic pH. The muscle relaxant will not impact on ionized calcium level. There is no indication that the patient is experiencing laryngeal stridor or needs oxygen. IV calcium supplements will be given to normalize calcium level quickly.
Cognitive Level: Application Text Reference: pp. 1310-1311
Nursing Process: Implementation NCLEX: Physiological Integrity
24. After neck surgery, a patient develops hypoparathyroidism. The nurse should plan to teach the patient about
a. calcium supplementation to normalize serum calcium levels.
b. including whole grains in the diet to prevent constipation.
c. use of bisphosphonates to reduce bone demineralization.
d. having a high fluid intake to decrease risk for nephrolithiasis.
Rationale: Oral calcium supplements are used to maintain the serum calcium in normal range and prevent the complications of hypocalcemia. Whole-grain foods decrease calcium absorption and will not be recommended. Bisphosphonates will lower serum calcium level further by preventing calcium from being reabsorbed from bone. Kidney stones are not a complication of hypoparathyroidism and low calcium levels.
Cognitive Level: Application Text Reference: p. 1311
Nursing Process: Planning
NCLEX: Health Promotion and Maintenance
25. A patient with hypoparathyroidism receives instructions from the nurse regarding symptoms of hypocalcemia and hypercalcemia. The nurse teaches the patient that if mild symptoms of hypocalcemia occur, the patient should
a. increase the daily fluid intake to twice the usual amount.
b. self-administer IM calcium before calling the doctor.
c. call an ambulance because the symptoms will progress to seizures.
d. rebreathe with a paper bag and then seek medical assistance.
Rationale: Rebreathing may help alleviate mild symptoms, but it will only temporarily increase ionized calcium level, so the patient should call the health care provider. There is no need to increase fluid intake. Calcium is not given IM but is given slowly through the IV route. Mild hypocalcemia is unlikely to progress to seizures.
Cognitive Level: Application Text Reference: p. 1311
Nursing Process: Implementation
NCLEX: Health Promotion and Maintenance
26. A nursing assessment of a patient with Cushing syndrome reveals that the patient has truncal obesity and thin arms and legs. An additional manifestation of Cushing syndrome that the nurse would expect to find is
a. chronically low blood pressure.
b. decreased axillary and pubic hair.
c. purplish red streaks on the abdomen.
d. bronzed appearance of the skin.
Rationale: Purplish-red striae on the abdomen are a common clinical manifestation of Cushing syndrome. Hypotension and bronzed-appearing skin are manifestations of Addison's disease. Decreased axillary and pubic hair occur with androgen deficiency.
Cognitive Level: Comprehension Text Reference: pp. 1312-1314
Nursing Process: Assessment NCLEX: Physiological Integrity
27. A patient with Cushing syndrome is admitted to the hospital to have laparoscopic adrenalectomy. During the admission assessment, the patient tells the nurse, "The worst thing about this disease is how terrible I look. I feel awful about it." The best response by the nurse is
a. "Let me show you how to dress so that the changes are not so noticeable."
b. "I do not think you look bad. Your appearance is just altered by your disease."
c. "Most of the physical and mental changes caused by the disease will gradually improve after surgery."
d. "You really should not worry about how you look in the hospital. We see many worse things."
Rationale: The most reassuring communication to the patient is that the physical and emotional changes caused by the Cushing syndrome will resolve after hormone levels return to normal postoperatively. The response beginning "Let me show you how to dress" indicates that the changes are permanent and that the patient's appearance needs disguising. The response beginning, "I do not think you look bad" does not acknowledge the patient's feelings and also fails to communicate that the changes will be resolved after surgery. And the response beginning "You really should not worry about how you look in the hospital" implies that the patient's appearance is not good.
Cognitive Level: Application Text Reference: p. 1314
Nursing Process: Implementation NCLEX: Psychosocial Integrity
28. When providing postoperative care for a patient who has had bilateral adrenalectomy, which assessment information obtained by the nurse is most important to communicate to the health care provider?
a. The blood glucose is 156 mg/dl.
b. The patient's blood pressure is 102/50.
c. The patient has 5/10 incisional pain.
d. The lungs have bibasilar crackles.
Rationale: During the immediate postoperative period, marked fluctuation in cortisol levels may occur and the nurse must be alert for signs of acute adrenal insufficiency such as hypotension. The nurse should also address the elevated glucose, incisional pain, and crackles with appropriate collaborative or nursing actions, but prevention and treatment of acute adrenal insufficiency is the priority after adrenalectomy.
Cognitive Level: Application Text Reference: p. 1315
Nursing Process: Assessment NCLEX: Physiological Integrity
29. A patient with Cushing syndrome returns to the surgical unit following an adrenalectomy. During the initial postoperative period, the nurse gives the highest priority to
a. monitoring for infection.
b. protecting the patient's skin.
c. maintaining fluid and electrolyte status.
d. preventing severe emotional disturbances.
Rationale: After adrenalectomy, the patient is at risk for circulatory instability caused by fluctuating hormone levels, and the focus of care is to assess and maintain fluid and electrolyte status through the use of IV fluids and corticosteroids. The other goals are also important for the patient but are not as immediately life-threatening as circulatory collapse.
Cognitive Level: Application Text Reference: p. 1315
Nursing Process: Planning NCLEX: Physiological Integrity
30. A patient is hospitalized with acute adrenal insufficiency. The nurse determines that the patient is responding favorably to treatment upon finding
a. decreasing serum sodium.
b. decreasing serum potassium.
c. decreasing blood glucose.
d. increasing urinary output.
Rationale: Clinical manifestations of Addison's disease include hyperkalemia and a decrease in potassium level indicates improvement. Decreasing serum sodium and decreasing blood glucose indicate that treatment has not been effective. Changes in urinary output are not an effective way of monitoring treatment for Addison's disease.
Cognitive Level: Application Text Reference: pp. 1313, 1316
Nursing Process: Evaluation NCLEX: Physiological Integrity
31. A patient is admitted to the hospital in addisonian crisis 1 month after a diagnosis of Addison's disease. The nurse identifies the nursing diagnosis of ineffective therapeutic regimen management related to lack of knowledge of management of condition when the patient says,
a. "I double my dose of hydrocortisone on the days that I go for a run."
b. "I had the stomach flu earlier this week and couldn't take the hydrocortisone."
c. "I frequently eat at restaurants, and so my food has a lot of added salt."
d. "I do yoga exercises almost every day to help me reduce stress and relax."
Rationale: The need for hydrocortisone replacement is increased with stressors such as illness, and the patient needs to be taught to call the health care provider because medication and IV fluids and electrolytes may need to be given. The other patient statements indicate appropriate management of the Addison's disease.
Cognitive Level: Application Text Reference: pp. 1316, 1319
Nursing Process: Diagnosis NCLEX: Physiological Integrity
32. A patient who uses every-other-day prednisone therapy for rheumatoid arthritis complains of not feeling as well on the non-prednisone days and asks the nurse about taking prednisone daily instead. The best response to the patient is that
a. an every-other-day schedule mimics the normal pattern of cortisol secretion from the adrenal gland.
b. glucocorticoids are taken on a daily basis only when they are being used for replacement therapy.
c. if it improves the symptoms, it would be acceptable to take half the usual dose every day.
d. there is less effect on normal adrenal function when prednisone is taken every other day.
Rationale: An alternate-day regimen is given to minimize the impact of exogenous glucocorticoids on adrenal gland function. The normal pattern of cortisol secretion is diurnal. Glucocorticoids are taken daily when being used for replacement therapy, but this is not the only indication for daily use. Taking half the usual dose would not achieve the goal of minimizing adrenal gland suppression.
Cognitive Level: Application Text Reference: p. 1314
Nursing Process: Implementation NCLEX: Physiological Integrity
33. A patient is taking high doses of prednisone to control the symptoms of an acute exacerbation of systemic lupus erythematosus. When teaching the patient about the use of prednisone, which information is most important for the nurse to include?
a. Call the doctor if you experience any mood alterations with the prednisone.
b. Do not stop taking the prednisone suddenly; it should be decreased gradually.
c. Weigh yourself daily to monitor for weight gain caused by water or increased fat.
d. Check your temperature daily because prednisone can hide signs of infection.
Rationale: Acute adrenal insufficiency may occur if exogenous glucocorticoids are suddenly stopped. Mood alterations and weight gain are possible adverse effects of glucocorticoid use, but these are not life-threatening effects. Glucocorticoids do mask the signs of infection, but temperature elevation tends to be suppressed, so other signs of infection should be monitored.
Cognitive Level: Application Text Reference: p. 1314
Nursing Process: Implementation NCLEX: Physiological Integrity
34. A patient has an adrenocortical adenoma causing hyperaldosteronism and is scheduled for laparoscopic surgery to remove the tumor. During care before surgery, the nurse should
a. monitor blood glucose level every 4 hours.
b. provide a potassium-restricted diet.
c. monitor the blood pressure every 4 hours.
d. relieve edema by elevating the extremities.
Rationale: Hypertension caused by sodium retention is a common complication of hyperaldosteronism. Hyperaldosteronism does not cause elevation in blood glucose. The patient will be hypokalemic and require potassium supplementation prior to surgery. Edema does not usually occur with hyperaldosteronism.
Cognitive Level: Application Text Reference: pp. 1319-1320
Nursing Process: Implementation NCLEX: Physiological Integrity
35. A patient with a possible pheochromocytoma is admitted to the hospital for evaluation and diagnostic testing. During an attack, the nurse will monitor for hypertension and
a. hypoglycemia.
b. bradycardia.
c. headache.
d. flushing.
Rationale: The classic clinical manifestations of pheochromocytoma are hypertension, tachycardia, severe headache, diaphoresis, and abdominal or chest pain. Elevated blood glucose may also occur due to sympathetic nervous system stimulation. Bradycardia and flushing would not be expected.
Cognitive Level: Application Text Reference: p. 1320
Nursing Process: Assessment NCLEX: Physiological Integrity
36. RN observes a nursing assistant (NA) caring for a patient after a hypophysectomy. Which action by the NA requires that the RN intervene?
a. The NA lowers the head of the bed to the flat position.
b. The NA cautions the patient to avoid coughing.
c. The NA cleans the patient's mouth with a swab.
d. The NA collects a urine specimen for specific gravity.
Rationale: The head of the bed should be elevated about 30 degrees to decrease pressure on the sella turcica and avoid headaches. The other actions by the NA are appropriate after this surgery.
Cognitive Level: Application Text Reference: p. 1293
Nursing Process: Implementation
NCLEX: Safe and Effective Care Environment
37. After a patient with a pituitary adenoma has had a hypophysectomy, the nurse will plan to do discharge teaching about the need for
a. insulin use to maintain blood glucose at normal levels.
b. sodium restriction to prevent fluid retention and hypertension.
c. oral corticosteroids to replace endogenous cortisol.
d. chemotherapy to prevent reoccurrence of the tumor.
Rationale: ADH, cortisol, and thyroid hormone replacement will be needed for life after hypophysectomy. Without the effects of ACTH and cortisol, the blood glucose and serum sodium will be low unless cortisol is replaced. An adenoma is a benign tumor, and chemotherapy will not be needed.
Cognitive Level: Application Text Reference: p. 1293
Nursing Process: Planning NCLEX: Physiological Integrity
38. A patient is admitted with possible SIADH. Which information obtained by the nurse is most important to communicate rapidly to the health care provider?
a. The patient complains of a severe headache.
b. The patient complains of severe thirst.
c. The patient has a urine specific gravity of 1.025.
d. The patient has a serum sodium level of 119 mEq/L.
Rationale: A serum sodium of less than 120 mEq/L increases the risk for complications such as seizures and needs rapid correction. The other data are not unusual for a patient with SIADH and do not indicate the need for rapid action.
Cognitive Level: Application Text Reference: p. 1295
Nursing Process: Assessment NCLEX: Physiological Integrity
39. When developing a plan of care for a patient with SIADH, which interventions will the nurse include?
a. Encourage fluids to 2000 ml/day.
b. Offer patient hard candies to suck on.
c. Monitor for increased peripheral edema.
d. Keep head of bed elevated to 30 degrees.
Rationale: Sucking on hard candies decreases thirst for patient on a fluid restriction. Patients with SIADH are on fluid restrictions of 800 to 1000 ml/day. Peripheral edema is not seen with SIADH. The head of the bed is elevated no more than 10 degrees to increase left atrial filling pressure and decrease ADH release.
Cognitive Level: Application Text Reference: p. 1296
Nursing Process: Planning NCLEX: Physiological Integrity
40. After receiving change-of-shift report about these four patients, which patient should the nurse assess first?
a. A 22-year-old admitted with SIADH who has a serum sodium level of 130 mEq/L.
b. A 31-year-old who has iatrogenic Cushing's syndrome with a capillary blood glucose level of 244 mg/dl.
c. A 53-year-old who has Addison's disease and is due for a scheduled dose of hydrocortisone (Solu-Cortef).
d. A 70-year-old who recently started levothyroxine (Synthroid) to treat hypothyroidism and has an irregular pulse of 134.
Rationale: Initiation of thyroid replacement in older adults may cause angina and cardiac dysrhythmias. The patient's high pulse rate needs rapid investigation by the nurse to assess for and intervene with any cardiac problems. The other patients also require nursing assessment and/or actions but are not at risk for life-threatening complications.
Cognitive Level: Application Text Reference: p. 1306
Nursing Process: Planning NCLEX: Physiological Integrity


text:
Average Ratings
1 out of 1 people recommended this car.
Consumer Reviews
the ferrari
by cece from stl | September 3, 2009
The ferrari is the best car ever because it go up to 199 speed limt i would get this car it is the best car that u would have in your life.
Purchased a new car
Uses car for Just getting around
Does recommend this car
Featured Services for this Ferrari Superamerica
- Sell your current car quickly and easily on Cars.com.
- Not sure what auto repair should cost you? Use our price estimator.
- Get help with car repair now on Cars.com. Visit Repair & Care

subset: commoncrawl


text:
Don Louis Requesens, Governor of the Netherlands, runs out of money to pay his soldiers. They respond by mutinying, and military operations against the rebels are forced to halt for a year.
Please log in to consult the article in its entirety. If you are a member (student of staff) of a subscribing institution (see List), you should be able to access the LE on campus directly (without the need to log in), and off-campus either via the institutional log in we offer, or via your institution's remote access facilities, or by creating a personal user account with your institutional email address. If you are not a member of a subscribing institution, you will need to purchase a personal subscription. For more information on how to subscribe as an individual user, please see under Individual Subcriptions.


text:
"Be steady and well-ordered in your life so that you can be fierce and original in your work."
~ Gustave Flaubert
Time to start the annual house purge...
Every year after Christmas it's nice to do a big "sort and tidy".
Out with the tree and decorations, in with the organization.
A place for everything and everything in its place.
When in doubt, throw it out... is my motto today.
My office is a disaster!
Wish me luck!
Making space so magic can happen.
Previous Entry · Leave a comment · Share · Next Entry
On December 28th, 2013 09:05 pm (UTC), rhodielady_47 commented:
How has your sewing come along?
Have you ever heard of a pattern company called petite plus patterns?
I thought you might like some of their stuff.
On December 30th, 2013 06:15 pm (UTC), Marilyn Scott-Waters replied:
I've been sidetracked by ComicCon costumes for the Boy. I have a knit Vogue tunic cut out and ready to sew together but I put away the machine for the holidays. I'm looking forward to January. :-)
I'll check out the Petite Plus. Thanks for the link!
On December 30th, 2013 06:42 pm (UTC), rhodielady_47 replied:
You're welcome--I'd love to see some pic's of what you've been making lately (if you can share them).


text:
My second attempt - I find it really hard to cluster men themes. Hope this one meets all the criteria Carena. :)
Printable View
My second attempt - I find it really hard to cluster men themes. Hope this one meets all the criteria Carena. :)
Great work Marion - I'd have to agree that clustering with mens kits is much harder to do. It's a great effort Marion. I'd never be that tough as to exclude anyone from the prize. Really, it's more about participation and trying out and learning new things. I know a number of scrappers struggle with clustering and so I a challenge was in order to help challenge them and get them to practice. After all, practice makes perfect and the more you try it - the better you will get.
Just be persistent and it will come. Recommend you study someone else's cluster and try to duplicate it in your own way. It's a great way to learn.
Tin Tin - great job on your layout. I love that texture of the paper showing through the photo. It looks great without overwhelming the photo.
I have not been avoiding this challenge, I have been real busy with a fundraising event for a local Children's hospital. now that has passed this weekend I have lots of photos and more time. Be back in a little bit
Here's one I know it is a little plain but I thought it would be great for the cover of our book
Great job Letha
Here's mine, recolored paper from Fiona's Color Me Up challenge, layered photo with 50% transparency and then layered another copy of the photo with a paper blend by AutisticWonder.
Firstly - thanks to Marion I thought about how often I scrap a masculine page and unfortunately it's not very often and after commenting on the fact that clustering for a masculine page is much harder to do, I thought well there was a challenge I had to try out. So here is my layout.
I don't have many masculine kits in my stash so I went for : Heritage Men by Carena's Designs. (me - LOL). Hmmm - now there is another challenge idea. LOL.
Anyone - up for an extra challenge - Scraplift the same page again but with a masculine kit and try out clusters with it.
QUOTE Used:
The very least you ca do in life is to figure out what you hope for. And the most you can do is to live inside that hope. Not admire it from a distance but to live right in it.
Hi, I am finally back on board! Thank you so much Carena for stepping in at such short notice and doing this challenge. Much appreciated! and a good challenge it is too! I had to have a go at the mens clusters too so her is my page with my Grand daughters husband and my little Great Grandson.
Great work Deanne - Thanks for playing along with me. By the way- lovely new products you have in store. Hugs.


text:
Acer TravelMate 8572TG-5464G64MN
Reviews for the Acer TravelMate 8572TG-5464G64MN
Source: Prohardver.hu HU→EN
Single Review, online available, Medium, Date: 10/08/2010
Rating: display: 60% mobility: 80% workmanship: 80%
NVIDIA GeForce GT 330M: The Nvidia GeForce GT 330M is the successor of the GT 230M and technically just a slightly higher clocked GT 240M (but it should still maintain the power envelope of the GT 230M as the naming suggests).
Non demanding games should be playable with these graphics cards.
» Further information can be found in our Comparison of Mobile Graphics Cards and the corresponding Benchmark List.
460M: The Core i5-460M has only 3 MB L3 Cache (compared to the I7-620M) and clocks between 2.53-2.8 GHz (Turbo Mode). Thanks to Hyperthreading, 4 threads can be processed simultaneously. An integrated graphics card (GMA HD) and a DDR3 memory controller are also included in the package.» Further information can be found in our Comparison of Mobile Processsors.
15-16 inch is a standard display size for laptops and offers the biggest variety of products.» To find out how fine a display is, see our DPI List.
2.8 kg:
This weight is representative for typical laptops with a 14-16 inch display-diagonal.
Acer: Acer Incorporated is a Taiwanese multinational electronics manufacturer. Its product lineup includes desktops and laptops, as well as personal digital assistants (PDAs), servers and storage, displays, peripherals, and e-business services for business, government, education, and home users. Acer is the third largest computer manufacturer in the world (by sales) after HP and Dell Inc (2007). The company owns the largest franchised computer retail chain in Taipei, Taiwan. Originally named Multitech, it was founded in 1976. Gateway and Packard Bell are economically connected with Acer. Market share regarding sales of personal computers in 2007 (market research IDC): HP 18.9 %, Dell 16.4 %, Acer 9.9 %, Lenovo 7.5 %, Apple 5.7 %
» Further information can be found in our Notebook Purchase Guide.
Similar devices from a different Manufacturer
Devices from a different Manufacturer and/or with a different CPU
Devices with the same GPU
Devices with Same Screen Size and/or Weight


text:
I make puree for my son. Can I use chicken broth, swanson brand? he is 7 months, no teeth yet. He can standup.
I make puree for my son. Can I use chicken broth, swanson brand? he is 7 months, no teeth yet. He can standup.
I would say go ahead- but read the ingredients on the side of the package first! A lot of packaged foods are full of things like MSG, preservatives, and other ingredients that you might not want to put in your baby's mouth.
would swanson appropriate? My son loves it when I use this chicken broth. If I just cook rice, potato, carrot, chicken meat with jus a little salt (without swanson chicken broth), he refuses to eat.
MSG is highly salty and addictive (which is why so many of our foods contain MSG). My son loved when I bought whole chickens and then cooked them over 12 hours...using only 2 cups of water. The natural broth gets very flavorful and you can season to taste afterwards. When the chicken is done cooking, you shred it, puree it and use some of the broth to make the consistency you need.
I would strongly advise against store bought broth. They are horrible for you. If you want to use store bought broth, I would advise looking into organic, naturally seasoned broth (using herbs/veggie/chicken).
MSG does terrible things to an adults body, but it can be worse for a child who is still growing.
Could you please let me know step by step how you cook the chicken? I don't mind cooking for him. With 2 cups of water, I am afraid it will dry up.
I have a large roaster oven. I go buy 2 whole chickens (take out the insides...they're usually either cleaned out for you--no gizzards--or they are bagged in plastic) and place them in the roaster oven. I pour 2 cups of water onto the bottom of the oven. Sprinkle garlic powder (not salt), onion powder, parsley, and pepper onto the chicken. Set the Roaster Oven to 200 degrees. Every hour or so, take a baster and baste the chickens. As the chicken cooks, you'll notice that the water goes from a clear to a yellow color. Keep basting the chickens every hour or so...the tops will brown (you can even carefully flip the chickens 1/2 way through the cook time). I start my chickens around 5am (but I'm up that early)...so the broth is done around 5pm and it gives me plenty of time to make some chicken for him.
Ok...so the chickens are ready when the chickens are falling apart. Carefully scoop them out of the broth, then with a slotted spoon, make sure that all bones, etc are out of the broth. I peel the chicken meat from the bones, put some meat and broth aside and the rest goes back into the broth. I add 6 cups of organic broth to that, 1 bag of frozen organic carrots, 1 bag of frozen organic peas, 1 bag of frozen organic green beans, and 1 bag of frozen organic corn. Season to taste after that cooks for 1 hour.
Take the chicken meat and the broth and puree. You can even take the completed chicken soup and puree it all together (as long as you know that everything in it is ok for your son). My son LOVED this...now he eats the regular soup...but he used to get so excited when I was making this. He would stand around me in the kitchen and clap his hands when he saw it was ready.
I gave you a chicken soup recipe (for you) and you can use that broth and meat for your son. If you have any questions, let me know!!
This just made me hungry.
The NY Times had this article rating commercial chicken broths. http://query.nytimes.com/gst/fullpag...52C0A96F958260
The author says that Swanson Natural Goodness Fat Free Chicken Broth is MSG-free. Of course, that doesn't mean it's sugar-free or low in sodium!
If you decide to make home-made broth, good for you! It's really easy, and you can freeze it in ice cube trays or baby food jars (leave a little space at the top so the expanding ice doesn't shatter the glass) so that you have just the right amount to cook baby food with.
Your recipe looks so good. I will buy the roaster over this weekend and try it out sometimes. I am glad that you used the roaster oven, because my big oven is broken. I will go and get the roaster oven this weekend.
I have a couple of questions:
1) "Every hour or so, take a baster and baste the chickens" - I searched yahoo for baster, and it showed me something like the air blower. What do I baste the chicken with?
2) For seasoning, what do you use? Salt?
Just a regular Turkey Baster. You can get them from just about anywhere.
For seasoning, I do add a bit of salt...but we use Himalayan Salt. We do not order from this site (but it gives info on why it's good for you)...you can find Himalayan Salt at most Health Food Stores, or search for a more inexpensive place to buy online.
Hope that helps!


text:
6 Parks near Portland, Indiana
Redkey, Indiana 10.61 miles SW
Fort Recovery, Ohio 11.03 miles E
Albany, Indiana 16.49 miles SW
Montpelier, Indiana 17.52 miles NW
Portland, Indiana (map) | (260) 726-9695
Sites: 400 | Latest Rate: $25.00 | 4 Reviews
|Clean Restrooms:
|Clean Showers:
Sep 2010 - $25.00
I really enjoyed staying here. We tent camped for the Labor Day weekend. When we got to our site, there was an RV there, so the people moved it. We had no fire ring or picnic table, but management brought us those items within a reasonable amount of time. There were many activities from community wide garage sales, to Bingo, to a DJ at night. They also had food on site such as breakfast and chicken dinners. The restrooms were not very clean, but I feel it was more due to the campers messiness, than staff's lack of trying to keep clean. They were here often cleaning. The only "dislikes" I have in regards to this campground were that: 1. People weren't made to clean up after pets so there was danger of stepping in doggie doo quite often. 2. Campers had to pay to use the pool. I feel that if you are already paying $25.00 a night to camp, the pool should be included. It was only $1.50 but it is the principle. Overall, this campground was a lot of fun. The people were friendly, and there were always a lot of activities to keep all ages busy! I would definitely come here again. - Shelleystarr2753
Aug 2010 - $25.00
This campground is currently in transition, it has a new owner and they are slowing cleaning it up. This CG was allowed to become run down for years, new owners are trying. This CG is huge with 400 sites and almost of them have old trailers with porches and structures build around them. Many sites are 'for sale' as the new owners are forcing them out. The weekend camping sites are in a nice shaded area close to the bathroom. Water is from a well and has a slight sulfur smell, the hardest water I have ever used, even with a water filter. Lots of golf carts, lots of weekend party type crowd, and even a few beer bottles laying around. The bathroom has a sign to remind people to remove beer bottle from the bathrooms. Has a large swimming pool, several games of Bingo on the weekends, and playground for the kids. Has several lakes with reports of good fishing, catch and release. It's far from Paradise, and was a running joke with our group. If the owners clean up a few more run down trailers, warn you about the drinking water, it might return to being a Paradise. - damonbeals
Aug 2010 - $14.00
This park may not even be open now. When we left, the managers had quit and the owner never showed his face. The electric was okay, the sewer had exposed lines, the water is literally not potable and you are warned not to use it as it is loaded with sulfur. - Cyberdave-1
844 E 900 S Geneva, Indiana 46740 (map) | (260) 589-3536
Sites: 264 | Latest Rate: $27.00 | 9 Reviews
|Clean Restrooms:
|Clean Showers:
Jul 2015 - $27.00
This park caters to seasonal campers and even more in the future with additional sites going into a seasonal pool. About 20 sites will be available for over-nighters once the change is made. The area we have been assigned our last 2 visits can be muddy when wet, this area is where those 20 sites is located. The park has good power and water, but only 1 dump station area with two drains for the entire park. Many kids were present during our visit and running through sites. Even though there are negatives, we would, return since this is the only place in the area for Rvs. The rate reflects 1 night at Passport America and two nights at the normal weekend rate. - Teacher's Pet
Aug 2014 - $16.00
We found this park from our Passport America book after deciding to take the back roads and not the freeways south. What a great find! Gracious hosts checked us in, told of us the sights to see in the quaint Swiss town of Berne. We settled on site 221, a full hookup site with 50 amp electric. Quite a large back-in site and very well cared for grass "carpet" adorning the area we were in. We overlooked corn fields, soon to be harvested. Behind us in a fairly large area were "seasonals", mostly 5th wheels, trailers and motorhomes; did not see many "permanents". We were surprised at how large the campground was. We happened to be here when the annual "small engine festival" was being held in the town of Portland, 12 miles south. The town of Berne is rich in Swiss history, and in the heart of Amish and Mennonite homesteads. We enjoyed driving through the countryside seeing the typical well-kept farms they are famous for. And, of course, the roadside vegetable stands. Downtown Berne has a very large Mennonite church just across the street from Muensterberg Plaza and Clock Tower. The square--a city block--has a unique Glockenspiel, a fountain playground for children, and soon to be finished and dedicated band shell. We were not in town to witness the Glockenspiel play, complete with costumed figures characters dancing. We plan on staying here next year on our trip north. - gatordan
Jul 2014 - $31.00
This campground has many seasonal campers, but it also has a very nice area for overnight campers. It is a very well maintained campground with easy access inside the property. However, the trip down the county roads to get to it can be unnerving for a big rig, with hills and Amish Buggies. - Teacher's Pet
Bluffton, Indiana (map) | (260) 824-0926
Sites: 124 | Latest Rate: $24.00 | 9 Reviews
|Clean Restrooms:
|Clean Showers:
Jul 2015 - $24.00
A very nice state park that happened to be on our cross country route. We stayed in the B loop, as the most helpful ranger we've ever had anywhere understood that we were seeking peace and quiet after the crazy Fourth of July weekend. She placed us in the nicest spot in that gravel-sited loop (#90)--fairly level and very large. The other loop has asphalt sites, which would be useful during heavy rain periods. (This park has a tendency to flood.) Because we were there during bad weather, we weren't able to avail ourselves of the swimming or boat/bike rentals, but those are nice amenities to have. Close to Bluffton for provisioning. - JCLC
Aug 2012 - $25.00
We enjoyed a long weekend at Ouabache. There had been some heavy rain lately and several of the sites had standing water or thick mud so chose carefully. That being said the campground was nice and restrooms cleaned daily. Lots of park activities including bison habitat and pool. There is an admission fee for the pool, but it has a fun water slide and diving boards. - The Flying Dutchman
Aug 2012 - $29.00
We stayed 3 nights at this campground on our latest trip and have stayed here once a year for the last 3 years. Overall of park is nice with the major drawbacks being the showerhouses. Campground patrolled very often by DNR and Sheriff. There were severe storms one night we stayed, and the DNR alerted all campers with the designated alarm (honking horn on truck as they drove through the campground per the posted guidelines at the shower house). They then went from site to site to verbally alert all occupants. The shower house was functional but the showers had a lot a mold and mildew on the walls, shower curtain and floor. The floor throughout the building looked like it had not been scrubbed in quite a while. They closed the bathrooms at 8 a.m. each morning (busiest time of the day) for about an hour for "cleaning" which seemed really just for restocking supplies. It costs $7 for an out-of-state car to enter the park in addition to the camping fees. The pool is nice but is an additional $2 per person. You are not permitted to take in any pool toys or flotation devices including arm floaties or swim vests. They now offer for sale large bundles of wood for $5 each at the campground. Ice is available for purchase at the campground entrance. New this year located at the swimming pool, is a camp store with limited supplies. The trails are nice and the kids enjoy seeing the bison. Most sites have a lot of shade by large trees. Campground A is paved but B has stone drives and pads. Sites are large and the playground in Area A is nice and centrally located. - tbga21
Hartford City, Indiana (map) | (765) 348-2100
Sites: 150 | Latest Rate: $14.00 | 3 Reviews
|Clean Restrooms:
|Clean Showers:
May 2013 - $14.00
We had a group of 12 campers here for 4 days. The owners bent over backwards for us. We had the use of a room for our games and potluck. We will return again next year. They have a lot going on for the weekend. We had no trouble using the dump with a 34 ft FW. - ronstan
Jul 2010 - $24.00
This was a funky little cg on the outskirts of Hartford City. GPS took us on a rather convoluted, circuitous route to get there, easier to just drive into Hartford City and turn left. The park has a lot of permanents and two small lakes. The dump site was totally inaccessible to us in our 33' rig and there were no sewer hookups at our site, so we left without dumping (we only stayed one night). Our site was a pull thru, at the end of a 'row', but there were several overgrown trees lining the site, which made it difficult to pull into. We would not return to this campground. It was OK for an over nighter. - shovelguy
Aug 2005 - $21.00
Very nice place to camp, we stayed for 3 nights in site #55 which is right by one of the "lakes" which has a small island with two big weeping willow trees in the middle of it with a pretty bridge you can walk across to get to. It was so pretty. My husband caught several decent sized catfish while fishing in the lake. They also have another small pond with a swimming beach, mini-golf, live country music, church service, etc. I rated this an 8, since I do feel that it needs a few updates, like adding an additional modern restroom/shower house, and possibly a pool, otherwise I would give it a 10! The owners are so nice, and the guests were also very friendly. It is out in the middle of the country, north of Hartford City. So peaceful and quiet, we will definitely return! - tonya418n12
Celina, Ohio (map) | (419) 586-3239
Sites: 250 | Latest Rate: $10.00 | 14 Reviews
|Clean Restrooms:
|Clean Showers:
Oct 2015 - $10.00
This is an excellent value especially if you have Passport America or Good Sam which gives you 50% discount. Mercer Co residents pay $15. Others pay $20. That is full price. There are some sites on blacktop but most are on grass. I would have given the park a higher rating but because of the lack of showers I didn't. - k m m
May 2014 - $30.00
The sites are large but tend to be soft when it rains. No gravel sites only grass. There's a definite lack of shade even though the park is full of trees. They just are not situated over the campsites. Office staff is friendly and helpful. One drawback for a monthly stay is absolutely no high speed cable internet or phone available. Luckily the 4g network for our own wireless works pretty well. Restrooms are large and clean but plain service. Definitely no frills. - J.Counts
May 2014 - $10.00
Our fee reflects Passport America rates. We were somewhat disappointed staying here on our way to Indiana. The full hookup sites were taken by 2 other campers so we had to use the dump station on site. Don't know where the 250 sites are as there were no site markers. "Sites" were scattered on grassy areas between roads and water spigots were also scattered and shared by several campers. We did luck out and managed to get a site on gravel/mulch with electric and water. We were able to use our satellite via our Verizon MyFi. While here we toured the area, namely St Mary's Grande Lake and the State Park there. We also toured the town to see historic buildings and buy groceries at a large "new" local market. Although this stop was convenient on our travel north we probably would stay at the State Park which also has Passport America rates. - gatordan
Bluffton, Indiana (map) | (260) 824-0127
Sites: 124 | Latest Rate: $55.00 | 30 Reviews
|Clean Restrooms:
|Clean Showers:
Aug 2016 - $55.00
This KOA has very few trees, so good satellite reception, but hot as blazes in the afternoon. There appear to be several full timers along the south edge of the campground. The Saturday and Sunday I was there the park was about 1/2 full. The lady at the front desk was very friendly. Nice in a pinch, but I would not go out of my way to return here. No cable. Excellent Verizon and AT&T coverage. - RVStudent
Aug 2016 - $40.00
Nice park, off the beaten path. Lots are spacious with a sunny/open exposure. Site surface was gravel and featured a picnic table.
My Garmin RV 760 doesn't know where the park entrance is. Led me into a residential area with no turnaround. Not the park's fault! - 5th Wheel Cal
Aug 2016 - $33.00
This park has potential but needs some work. Wifi was good. The sites and road both need fresh gravel. Bathhouse very clean but showers lack pressure (unless you like scalding water). Picnic tables need replacing. Staff (the one we saw) pleasant and accommodating, however more staff is required to ensure rules are followed (unattended dogs and fires, general site messiness, etc.) Bluffton is a small, quiet town. I would probably stay at the nearby state park instead of this KOA. - MSSW


text:
22 vehicles matched;
Now showing page 1 of 1. 25 results per page.
Listed by Private Seller
Older Frame off Restoration Power steering Power Disc Brakes new rear end and all new wiring Very nice
Listed by CC Classic Cars
When you hear the term "pictures dont do it justice" sometimes people exaggerate. Well, let us tell you pictures cant
Listed by Barrett Jackson (Auction)
This is a very rare 1964 Chevelle Malibu Super Sport. It has recently gone through a complete frame-on restoration. It
Listed by Gateway Classic Cars
For sale in our Detroit showroom is a fully restored 1964 Chevrolet Chevelle Malibu SS convertible. With a drop top,
Listed by Gateway Classic Cars
1964 Chevrolet Malibu Chevelle SS for sale in our Tampa Showroom. This restomod is incredibly cool with all the looks
Listed by Fast Lane Classic Cars Inc.
This 1964 Chevrolet Malibu has a 350 C.I. Crate V8 w/ 4BBL Carb, TH400 Automatic Transmission, 10 Bolt Rear w/
Listed by Private Seller
Full frame off restoration in 2011, around 500 miles since completed. 5 spd manual transmission, nice cruising car. 350 engine.
Listed by GR Auto Gallery
GR Auto Gallery is pleased to present this 1964 Chevrolet Chevelle Malibu 4-door Station Wagon for purchase. Chevrolet's Chevelle, based
Listed by Gateway Classic Cars
Up for sale in the Orlando showroom is this astounding 1964 Chevrolet Chevelle SS convertible. This car has recently received
Listed by GR Auto Gallery
The Chevelle made its debut with a range of options and body styles that turned in to instant success.
Listed by Private Seller
Restoration Modifications started and well under way. Under the hood is a 327 crate motor putting out 390 ponies, 9.5
Listed by Ellingson Classic Cars, Inc.
Smooth running 327 cu. in. V8 (NOM) Close ratio Muncie 4 speed manual transmission Very good Blue Metallic
Listed by DC Classic Cars
This 1964 Chevrolet Chevelle 2dr Super Sport Clone features a 327 V-8 300 H/P 8cyl Gasoline engine. It is equipped
Listed by Private Seller
283 / 220 HP JG Code engine. ( 4BBL Carb and Dual Exhaust )
Original AM Radio
Listed by Streetside Classics - Charlotte
This is one of those great cruising cars that just seems to get all the details right. After all,
Listed by Private Seller
Beautifully kept in storage and nicely restored 1964 Chevrolet Chevelle SS Convertible!
Original 283 engine was replaced with a
Listed by Private Seller
Listed by Private Seller
This is a beautiful 1964 first year Chevelle Malibu with a recent frame-on restoration. It is powered by a
Listed by Private Seller
Recent Frame-Off Restoration, True Super Sport, original Atlanta build car, beautiful Victory red paint, white vinyl interior, 355 ci engine,
Listed by Private Seller
1964 First year Chevelle with a complete restoration. Rebuilt 396 with a 5 speed manual transmission
Listed by Woottons Redline Classic Cars
JUST REDUCED BY $1,000 FOR QUICK SALE. NOW ONLY $1,995. Rough and Rusty 1964 Chevelle Super Sport convertible. Reall SS
Listed by Private Seller
1964 Chevy Chevelle 396 Big Block. This car was restored with all attention to detail inside and out. Car was


text:
Article From: 3/4/2013 Production Machining
Hydromat Inc.'s EPIC R/T 32/45-16 is for machining stock sizes up to 1.75 inches. This machine utilizes 16 horizontal tool spindles and the capacity of up to eight vertical tool spindles, that's up to 24 tools in the cut at once. The EPIC R/T line-up possess the characteristics of more conventional Hydromats--maintaining the integrity, reliability and flexibility of its predecessors--while featuring the Embedded Motion Control (EMC) technology, a special plug and play control architecture embedded into each tool spindle unit, offering fully independent functionality for each axis motion. Modular tool spindle system with quick-change presettable heads for easy change-over help the EPIC R/T offer quick and easy change-overs – typically 1 to 3 hours. The EPIC R/T 32/45-16, as with all Hydromat rotary transfer machines, supports lean manufacturing principles and competitive manufacturing at small, medium and large production quantities.


text:
Michael E. DeBakey VA Medical Center - Houston, Texas
Michael E. DeBakey VA Medical Center Named 2005 Most Wired Hospital 2nd Year in a Row
July 19, 2005
Michael E. DeBakey VA Medical Center Named 2005 Most Wired Hospital 2nd Year in a Row
New survey demonstrates that technology can play an important role in quality of health care.
HOUSTON - The Michael E. DeBakey Veterans Affairs Medical Center (MEDVAMC) was named one of the nation's "Most Improved" for the second year in a row, according to the results of the 2005 Most Wired Survey and Benchmarking Study recently released.
Survey results found that the hospitals and health systems selected are making significant progress automating four core components of an electronic medical record (EMR): current medical records, medical history, patient demographics, and nurses' notes. The survey measures the nation's hospitals on their use of Internet technologies for quality, customer service, public health and safety, business processes, and workforce issues.
Just over four years ago, the Department of Veterans Affairs introduced the Bar Code Medication Administration (BCMA) process. Administering medications, a significant component of delivering quality care, is a complex process, and previously, primarily paper-based. A breakdown at any step along the way could compromise patient safety. The BCMA process consists of using a scanner, very similar to the device in supermarkets, to scan a patient's hospital identification (ID) band, and then scan the medications the patient is supposed to receive. This allows a nurse or other health care provider to make sure that a veteran is receiving the correct medication in the correct dose at the correct time.
In addition last year, the MEDVAMC entered the remarkable world of the Picture Archiving and Communications System (PACS) and now has a filmless radiology department. PACS is just one part of the facility's Computerized Patient Record System (CPRS).
As more and more doctors and hospitals, like Houston's Methodist Hospital System and St. Luke's Episcopal Health System, are converting paper medical records to electronic versions, CPRS, the computer system in place at the MEDVAMC since 1999, demonstrates the VA is ahead of the game with its unmatched patient care technology. CPRS has allowed the MEDVAMC to dramatically progress in its management and utilization of patient information. The patient directly benefits from the sharper accuracy, consistency, and speed that the system has brought about.
"The Michael E. DeBakey VA Medical Center offers our veterans an innovative medical information and image management system. Our health care providers have access to the exact information they need, when, and where they need it. Once again, the MEDVAMC is ahead of the game with our unmatched patient care technology," said Edgar L. Tucker, MEDVAMC director.
The nation's 100 Most Wired hospitals and health systems - those that have invested significantly in health information technology - have lower mortality rates than other hospitals, according to results of a new analysis released in the July issue of Hospitals & Health Networks magazine. While the new survey does not establish a "cause and effect" relationship between information technology use and improved outcomes, it demonstrates that technology can play an important role in quality.
Since 1999, Hospitals & Health Networks has surveyed the nation's hospitals on their use of information technology to accomplish key goals, including safety and quality objectives. Based on a detailed scoring process, the magazine annually names the 100 Most Wired Hospitals and Health Systems. This year 502 surveys were submitted, representing 1,225 hospitals.
"There are three key differences in how hospitals apply and use information technology to improve care," said Alden Solovy, executive editor of Hospitals & Health Networks, the journal of the American Hospital Association (AHA). "The Most Wired use a wider array of IT tools to address quality and safety, they have a significantly larger percentage of physicians who enter orders themselves and they conduct a larger percentage of clinical activities via information technology." The entire report is available at www.hhnmag.com .


text:
Continuing his adventure, India Defense Minister George Fernandes wore blue overalls and pilot gear yesterday to fly in a MiG-21 for a 25 minutes sortie . This came after MPs in parliament dared Mr Fernandes to fly in the notorious MiG-21, over 100 of which have crashed in the last decade. Wing Commander who flew the MIG said that maneuvers performed included barrel-roll, wing overroll and steep turns.
Not a new thing for George Fernandes who recently flew a Sukhoi and has spent a night in Indian Navy submarine.
The spate of crashes has made Indian media nickname the MIG-21 as "flying coffins", though most of the accidents are due to pilot errors and only 2 were due to mechanical failure.
More details here:


text:
Hackers claim to have jailbroken the Wii U
Apr 30th - Hackers claim to have completely unlocked the Wii U's various encryption protection methods.
Nintendo says attention to detail is why it delays games
Apr 30th - During a question and answer session after the recent financial report, Iwata discusses why Nintendo delays games and what benefit it has to gamers.
Angry Video Game Nerd Adventures confirmed for Wii U
Apr 30th - Angry Video Game Nerd Adventures has been confirmed for release for Wii U and 3DS sometime this summer.
Kung Fu Rabbit trailer for Wii U
Apr 30th - Check out this new trailer for Kung Fu Rabbit, which is seeing release on the Wii U eShop on May 2.
Nintendo UK outs more Virtual Console titles for Wii U
Apr 30th - Nintendo UK has posted a video highlighting several different games that will make their way to the Wii U Virtual Console soon.
Game & Wario may retail for $39.99 in North America
Apr 30th - Wii U's upcoming micro-game collection might launch for $20 less than the standard RRP.
Injustice: Gods Among Us for Wii U contest winner
Apr 29th - We've chosen the winner of our Injustice: Gods Among Us contest announced last week.
Lobo DLC coming to Injustice on May 7
Apr 29th - Developer Ed Boon has confirmed that the first DLC character for Injustice: Gods Among Us will be Lobo.
Wii U Virtual Console review
Apr 29th - You already know all about the games, but what do we think about the service itself and the Wii U specific features it brings?
Watch Dogs for Wii U releasing Nov. 19th
Apr 29th - The release date for Watch Dogs has been officially confirmed.
Hideki Kamiya says The Wonderful 101 is short, but that doesn't matter
Apr 29th - Developer Hideki Kamiya says games are about the fun and experience, not how long they last.
Nyko Pro Commander controller review
Apr 29th - How doe the Nyko Pro Commander controller for Wii U stack up against some of the most popular controllers on the market?
Wii U Virtual Console games may be playable on 3DS
Apr 29th - It's unofficial, but given time, both home and handheld Virtual Consoles may be as one.
Iwata on Wii U being "under-powered"
Apr 28th - Satoru Iwata says it's hard to attract third party developers to the Wii U, but dismisses the notion that it's under-powered.
Why E3 2013 is the most important for Nintendo ever
Apr 27th - E3 2013 is gearing up to be the biggest in years, and probably the biggest ever for Nintendo and the Wii U.
Get Nintendo Land, ZombiU, and Sonic Racing for $60
Apr 27th - Electronics retailer Frys has a Wii U game sale, with a 3-game bundle for $60
Win our copy of Injustice: Gods Among Us! [CONTEST]
Apr 26th - We're giving away our copy of Injustice: Gods Among Us and you have three chances to win!


text: Do you eat sweet potatoes? If you're trying to gain weight, they will be your friend. Also, invest in coconut oil too if you haven't already. Do you have a weight training plan? Maybe give Strong Lifts or Starting Strength a try if you're just beginning. You're off to a good start!


text:
Back in to report my lab results -
Total cholesterol - 179 (optimal <200)
LDL 98 (optimal <100)
HDL 70 (optimal >60)
Triglycerides 55 (optimal <150)
Fasting blood sugar 79 (normal <90 or 70-99 - depends on the source)
Notice I am in the 'optimal' category from WebMD on every number. There is also an 'acceptable' category, which I sneer at. Wish I knew the breakdown of my LDL, as I understand there are two different kinds, one is harmless.
Anyway, I hit all the targets and got the maximum discount on my health insurance.
I am also happy to report that Slim Cat is happily tucking into the healthier Fancy Feast. There is hope for us all.
AND I think my fingernail is going to heal up instead of fall off. Must be accelerated healing from all the fat I consume.


text:
24 Simple Scrapbooking Layouts
Bonus: Get our newsletter & special offers for free. We will not share or sell your email address. View our Privacy Policy
Pumpkin Patch Scrapbook Page
By: Stephanie Barnard for Amaco
We are adding the craft to your Craft Projects.
The project was added to your Craft Projects.
Click here to view your Craft Projects.
A pumpkin batch scrapbook page accented with shiny copper is perfect for fall, from AMACO.
- ArtEmboss® soft embossing metal sheets — Medium Weight Copper
- WireMesh® — Copper
- Sizzix Dies — Leaf #1, Leaf #1 Tiny, Fun Serif 'P'
- Ellison Die — Pumpkin #1B
- Krylon Copper Leafing Pen
- DMD Paper Reflections Cardstock
- Glue Dots International Mini Glue Dots
- All Night Media Pop Up Dots
- Tsukineko Pigment Ink
- Bamboo
- Heat Tool (Embossing Heat Gun)
- Using Sizzix die cut machine; cut seven large leaves and seven tiny leaves from copper ArtEmboss® sheet. Cut two letter 'P's from Copper WireMesh®.
- Using a heating tool, carefully heat the copper leaves. The copper will change various colors as heat is applied. Let cool.Using Ellison die cut machine, cut six pumpkins from copper WireMesh®. Hand cut six triangles for photo corners and title block.
- Trim green card stock 1/8 of an inch on two sides and adhere to brown cardstock. Cut light colored cardstock into a strip 2 inches by 12 inches and matt with brown cardstock, to form border.
- Add ink to border. Adhere two pumpkins together with mini glue dots, to make three pumpkins.
- Adhere pop-dots to leaves and pumpkins, then add to border. Adhere tiny leaves to pumpkins with mini glue dots. Adhere border to layout.
- Add photo corners to photograph with glue dots. Matt picture with brown, green and light colored cardstock. Adhere to layout.
- Add die cut letters to title block. Write title with leafing pen. Cut light colored card stock, matt with brown, color with ink, and adhere leaves and triangles. Matt title block to brown, light colored card stock and copper WireMesh®. Adhere to layout.
Tags / Related Topics
Your Recently Viewed Projects
Images from other crafters
Love these projects? Get MORE delivered to your Inbox – FREE Click Here!
Report Inappropriate Comment
Are you sure you would like to report this comment? It will be flagged for our moderators to take action.
Thank you for taking the time to improve the content on our site.
What's Hot
- All Aboard for Adventure Layout
- Beach Day Scrapbook Layout
- "Love Your Smile" Scrapbook Page
- Mr. and Mrs. Wedding Scrapbook Layout
- Baking Together Scrapbook Layout
- "Finally a Teen" Scrapbook Page
- Our Family Scrapbook Layout
- Budding Stars Scrapbook Layout
- Just Married Scrapbook Layout
- Our Family Scrapbook Page
Something worth saving?
- SAVE all your favorite crafts
- ADD personal notes
- QUICKLY reference your crafts
Free eBooks
- 13 Spring Crafts: Easter Craft Ideas, Spring DIY Home Dcor, and More
- 17 Flower Craft Ideas: How To Make Paper Flowers, Easy Fabric Flowers and More
- 18 Projects Every Crafter Wants
- 23 Fabulous Picnic Craft Ideas + Restaurant Copycat Recipes
- 25 Cool Things to Do with Wine Bottles
- 26 Spring Crafts for Kids
- Easter Craft eBook: Blogger Edition
- Garden Crafts
- Hop into Spring: Easter Crafting and Recipe
- Trash to Treasure: 28 Recycled Crafts
Our Newest Projects & Articles
- Purple Beginner Shawl
- Recycled T-Shirt Quilt Pattern
- Shawl Scarf Crochet Pattern
- Stunning Leather Trimmed Crochet Scarf Pattern
- Knit Look Cowl Crochet Pattern
- Bean Stitch Cowl Crochet Pattern
- Plush Basketweave Baby Blanket Pattern
- "18 Projects Every Crafter Wants" free eBook
- Amethyst DIY Jewelry Box Anthropologie Knockoff
- Retro Gumball Machine Craft


text:
Hello IDxAers,
My company is hiring. Would love to hear from you.
HYDRANT (http://www.hydrantsf.com) is looking for an experienced interaction designer / user experience designer to join our team. At HYDRANT interaction designers work closely with clients to define business and user requirements, translate these requirements into design elements and ensure client objectives are satisfied throughout project development. They produce deliverables like user personas, conceptual models, requirements matrices, site/screen maps, process flows, wireframes, etc.
HYDRANT prides itself on a work environment based on creative collaboration where all team members get involved to deliver great designs. Our Sr. interaction designer will be expected to:
• Work closely with clients to understand their business model and help define both business and user project requirements
• Craft an overall user experience strategy that promotes client goals and develop an "interaction language" that supports these goals
• Create and present interaction design deliverables throughout the project
• Work with the creative and technical teams to ensure that client goals and requirements are satisfied throughout the development process
• Design usability testing protocols and manage testing sessions at appropriate milestones during project development
Our Sr. interaction designer must meet the following criteria:
• Minimum 5 years professional experience as an interaction designer, user experience designer, or information architect. Pick your label.
• A comprehensive understanding of usability best practices and user-centered design for websites, web-based applications, software UI and other digital channels. Mobile experience a plus.
• Experience as interaction lead for large, transactional websites or web-based applications
• Experience with user research and usability testing
• Superior client-presentation skills with the ability to talk to and understand stakeholders from creative, marketing and technical teams
• Solid understanding of common front-end and back-end technologies/platforms
• Expert knowledge of Omnigraffle, Visio and/or Adobe CS Suite
• Relaxed and fun-loving work style, bringing passion, excitement and ideas to the table
Full time. Also open to contract-to-hire, or contract as appropriate.
1. We're looking for someone with solid experience designing transactional interactions. As a firm we tend to do stuff a lot more complex than corporate marketing sites.
Alder Yarrow | HYDRANT
Founder & Principal
461 Bush Street, Fourth Floor
D 415.814.6641 | M 415.730.3209 | W www.hydrantsf.com


text:
Inked Girls: Anna Marcella Miglio
Myself in a sentence: I'm a full time law enforcement officer, with a part time addiction to the gym, jack daniels, hunting, and fishing.
Occupation: Senior Corrections Officer, New Jersey Department of Corrections
Hometown: Cape May, New Jersey
The design and themes of my tattoos: My tattoos are all over the place. Some were planned, others were just walking into the shop when I felt inspired. Life is unpredictable, so some of my tattoos are spontaneous and I am A-Ok with that. My favorites are for my dad, but I have some that reflect my Irish heritage as well.
More specifics about my tattoo: My first tattoo was a tribal on my lower back in black and teal ink. My second was my father's duty badge from his police department. I'm not sure of the order of the others. One is the hunting symbol for Mossy Oak on my left hip bone. One is a celtic trinity knot on my left wrist. Then there's the one on my ribs for my dad. Another is on my right foot, it says Alainn, which is Gaelic for beautiful. My last one says bí cróga ná géill choíche, which is Gaelic for be brave never give up (I got it after I completed the police academy in 2009).
My favorite tattoo and the story behind it: My favorite tattoo is one I got for my dad on my ribs, he was a cop that got killed in the line of duty. It says, "All gave some, some gave all. Heroes walk the thin blue line. Ptl. Eugene James Miglio III. End of Watch June 2, 1995." I love it because it memorializes him, and also reminds me how dangerous and unexpected the job can be.
My next tattoo: I debated for a long time over what to get for a half sleeve on my right arm. Being in law enforcement, I'm partial to St. Michael tats. However, I feel like it has been played out (at least where I'm from). I grew up at the beach and have always been drawn to the ocean, so I've decided to go with a nautical theme featuring a pirate ship with a partial skeleton kraken.


text:
Now Hiring
Trusted Edge Marketing, Inc.
Work at home Pt/Ft
Work your own hours and days
Earn $100-$500 Per Week
Full Online Training
Basic Internet Knowledge
Typing ability of at least 40 wpm
Willingness to learn and set goals
Must Have Computer With Internet Access
Valid Email and Paypal Accounts (to get paid)
We are seeking self motivated individuals with
the desire to work with online advertising.
You are required to have a computer with internet
access, an email account, and basic typing skills.
You can choose to work full or part time with your
own hours. The position will involve data
input/completion by processing typed responses
for advertisements placed online. These responses
vary in length according to each client that you
work with. Further inquiries on order/client
matters will be explained in specific detail in the
training manual. All transactions between client
and agent will be processed through your email
account. There is no contract to sign with this
job, and the amount you choose to process is
entirely up to you. As with any job, you must be
able to respond to advertisements in a timely
manner. The beauty of this position is that you can
work at home, and do have the potential to make a
good amount of money.
You will be paid $10.00 to $20.00 for each order
that you process. Paypal will be required,
that is how all jobs are paid out. You can sign up
free at www.paypal.com. The amount of money you earn is
entirely up to you, but please be advised that you
will be responsible for keeping track of your
earnings during tax season, as we do not take
out any taxes or provide you with a 1099 form.
Please contact: firstname.lastname@example.com
Serious Applicants Only Please.
Re: Now Hiring
Confine links to signatures only
Re: Now Hiring
Just wanted to let all of you looking at this that THIS IS A TOTAL SCAM. All it is is you getting money by posting this exact same ad. You don't get paid until some sucker (like me) falls for it and pays you the $15.95 to your paypal account then you just tell them to do the same thing.
Just as warning. --here is the e-mail between Jenn and I about this matter just in case you think I'm lying.
Did you know that most people will get in, even knowing its a scam?? Because it does make a lot of money. Can you imagine the money you could make if you did it daily, instead of once like me?? If people ask me ahead of time, I tell them. If they don't then I don't. If you tell people ahead of time what it is, they will still buy. I am a stay at home mom- and can completely empathize with you 100%. But I need the money just like you... I did the work for it, and if you do it, you will get your money back, easily. I am sorry. If you need to report it, then go ahead. I don't blame you. But you might want to try it out, just being honest about it. The manual said it is legal. Anyway, I told you ahead of time that it was non-refundable. I can't give you a refund, because then I'd have to refund everyone's money, and that just isnt possible. The money is long gone by now.
On 11/7/06, Denise
Of course I would tell people it is a scam!!
Especially other stay at home moms! I can't just lie
to people to try and get money back for my stupidity.
If you are so sorry why aren't you refunding my money?
I will give you until tomorrow to refund my $15.95
before I report this to the Better Business Bureau and
every other WAHM website I can find--including the
one's you have listed on.
--- Jenn Shultz <firstname.lastname@example.com> wrote:
> Hi Denise,
> I know that is exactly how I felt when I first got
> scammed. But I tried it
> because I wanted my money back, after the chick told
> me it was
> non-refundable (as stated in the script)-- but I
> tried it to get my money
> back, 1 1/2 months ago, and I have made over $800
> since then, from just a
> few posts in 1 day. I haven't posted it since
> because I felt bad about it.
> But I suggest you just try it to get your money
> back, and then if you dont
> wanna do it, then just quit. If you tell people it's
> a scam, then you'll
> never get your money back. But either way, I don't
> really care. I'd probably
> do it to. I'm sorry.
> Jenn
> >
> > I have looked over the materials and want my money
> > back. I was under the impression that I would be
> > processing orders for people who are actually
> selling
> > something not just getting other to sign up for
> some
> > scam and not getting paid until some person like
> me
> > falls for it. This is a total scam and I suggest
> you
> > refund my $15.95 before I go onto all of the
> websites
> > that you have posted you "job" and tell them this
> is a
> > scam.
> > Denise :mad:
Re: Now Hiring
Duplicate of Now Hiring. Thread closed.
|All times are GMT +5.5. The time now is 15:59.


text:
Fixed PriceBudget: $5
Start DateJune 12, 2014
I've had this idea that recently came to life in how it would be done. I spoke with a coder who told me to have this technology patented. I'm not 100% sure if it exists and if I should have it patented. I need a patent attorney who I can speak with to discuss if I can patent it, then do extensive search to make sure it doesn't already exist, then file to have it patented. (All of this would happen if it I can actually patent it.)
MY Budget is not actually $5 I have a fairly large budget but I need to speak with someone first to make sure this can be patented.
About the Client
United States
Fairfax 08:17 PM
Jobs Posted
58% Hire Rate, 1 Open Job
Total Spent
19 Hires, 0 Active


text:
Next Slideshow:
Images: Tawon Boyd dies after encounter with Baltimore County police
Then, when you scroll down lower on the weather page, you'll find, (1), the latest weather headlines, (2), our Map Room full of weather graphics, (3), u local weather, where you can share photos and video of the weather conditions where you are, (4) the latest weather and forecast videos, (5), our team of 11 Insta-Weather PLUS meteorologists, and, (6), you're never far away from the latest news headlines, videos and photos, no matter which page you click on.
(See a site map here.) Welcome to the redesigned WBALTV.com that's cleaner and less cluttered while maintaining its focus on delivering latebreaking news from across Maryland from the people you trust.


text:
(877) 668-6872
Welcome back . Log Out
Almost begging you to modify them, ATVs present the rider with almost limitless opportunities for customization and improvement. And with the options available from Motorcycle Superstore's ATV and quad parts department, you can turn your quad into the ultimate hunting platform, work machine or ultra-trick sand dune carver. Browse among winches, plows, LED lights, hunting racks, suspension lift kits, engine guards, flags, billet wheels and windshields. And for those who like to unlock the potential of the motor, we carry exhaust systems, top end kits, chain and sprockets, clutch rebuilds and air filters. Work, play or both, dial in your ATV with brands like FMF, Renthal, Pro Armor, ITP, Hinson, Twin Air and Moose Racing.
For a step by step breakdown of how to prep your ATV for the up coming riding season, check out our pre-season maintenance check list.


text:
This is a discussion on [News] "Vista Capable" a Scam, Linux Reigns Low-cost Laptops - Linux ; Under $1,000 Laptops Perform Better With Linux, Not Vista ,----[ Quote ] | There is good news and a bad news for everyone who is looking for better | laptop options. The good news is that you can get a ...
Under $1,000 Laptops Perform Better With Linux, Not Vista
,----[ Quote ]
| There is good news and a bad news for everyone who is looking for better
| laptop options. The good news is that you can get a good, solid laptop for
| under $1,000 these days. The bad news for âVistaâ users is that majority of
| these cheap laptops coming with âVistaâ do not have sufficient resource base
| to run âVistaâ decently.
| [...]
| Dell and few other small companies, like Asus with its tiny Eee PC 4G UMPC
| are also selling Linux-powered laptops. Vendors make even more upfront profit
| per unit for these sales.
| Steven J. Vaughan makes further analysis and say,â that under-$500 Toshiba
| laptop with Home Basic? With 512MB of RAM and embedded Intel graphics, even
| the already mediocre Home Basic is still going to suck dead snakes through
| rusty tailpipes. Stick any Linux distribution on it; say âFedora 8, gOS 1.02
| or OpenSUSE 10.3â, and youâve got a really useful laptopâ.
| Steven J.Vaughan says, âDo the math. Vista doesnât work for todayâs laptop
| market. XP and Linux do. Itâs really that simpleâ.
Excerpts: Latest filings in 'Vista Capable' lawsuit
,----[ Quote ]
| The lawsuit over Microsoft's "Windows Vista Capable" marketing program has
| reached a key juncture. Lawyers for the plaintiffs have formally requested
| class-action status for the case, seeking to open it up to many more people,
| and Microsoft last week filed its official opposition to that request. The
| filings contain some interesting tidbits on both sides. Â* Â*
Judge Says 'Windows Vista Capable' Lawsuit Can Proceed
,----[ Quote ]
| A federal judge has ruled that two consumers can proceed with a lawsuit that
| claims Microsoft's "Windows Vista Capable" campaign was misleading.
Linux is about to take over the low end of PCs
,----[ Quote ]
| Opinion -- Sometimes, several unrelated changes come to a head at the same
| time, with a result no one could have predicted. The PC market is at such a
| tipping point right now and the result will be millions of Linux-powered PCs
| in users' hands. Â*
| [...]
| Microsoft will fight this trend tooth and nail. It will cut prices to the
| point where it'll be bleeding ink on some of its product lines. And Windows
| XP is going to stick around much longer than Microsoft ever wanted it to.
| Still, it won't be enough. By attacking from the bottom, where Microsoft can
| no longer successfully compete, Linux will finally cut itself a large slice
| of the desktop market pie. Â* Â* Â*
Where does Linux go from here?
,----[ Quote ]
| Linux and free software are here to stay. No single commercial firm will ever
| control the Linux ecosystem like Microsoft has the rest of the software
| industry. Though both may prosper, the bazaar will outlive the boardrooms,
| and Linux popularity will continue to grow on servers, desktops, appliances,
| and embedded devices. Â* Â*
This time for sure on mobile Linux
,----[ Quote ]
| The Wal-Mart Linux PC, priced at $198, is sold out. Zonbu seems to be gaining
| traction, with a notebook priced at $279.
| âYouâre seeing incredibly improved device drivers. Weâve got hundreds now.
| This is a phenomenal effort that plays to the strength of Linux, a volunteer
| community representing millions of dollars in free development. Â*
| âYouâre seeing more manufacturers shipping Linux desktops, PCs and laptops
| but also mobile Internet devices from Acer, Motorolaâs Razr, TiVoâ¦thereâs a
| slew of new devices coming out.â Â*


text:
Joseph Mazzello, Brad Renfro, Annabella Sciorra, Diana Scarwid
Leave those hankies in the drawer! While this is a movie about an 11-year-old boy with AIDS, it is surprisingly unsentimental. Writer Robert Kuhn and director Peter Horton (a thirtysomething alum) coax a few tears, but they don't jerk any. And an abrupt ending preempts what might have been an agonizing hospital-room conclusion.
Mazzello is a junior-high school student who has contracted HIV through a transfusion. He and his loving, single mom, Sciorra, have just moved in next door to Renfro and his insensitive-as-a-brick single mom, Scarwid, in the placid town of Stillwater, Minn.
The gifted Renfro, who made his debut in The Client, skillfully evokes an adolescent's difficulty in befriending an outcast (the other kids yell "Fag!" whenever they see Mazzello). Gradually, though, the boys become close—much too close for Scarwid's small-minded comfort. (Kuhn and Horton deftly sketch their growing friendship, avoiding any hint of homosexuality.)
Eventually the pair start a raft trip down the Mississippi to New Orleans, where (they have read in a tabloid) a doctor has developed a cure for AIDS. En route they encounter enough adventures to reinforce the obvious parallels to Huckleberry Finn.
Kuhn is too corny to be a threat to Mark Twain, but the rapport between Sciorra and Mazzello, as well as the convincing friendship between Mazzello and Renfro and the foolproof premise of a doomed child make this a moving, admirably unhysterical drama. (PG-13)
Picks and Pans Review: The Cure
updated 05/01/1995 AT 01:00 AM EDT
•originally published 05/01/1995 AT 01:00 AM EDT


text:
GODMAN and Churg, in 1954, wrote a comprehensive article on Wegener's granulomatosis. About the time this appeared we were puzzling over an unusual case, the history of which is reported here.
A 42-year-old Hawaiian-Caucasian woman was admitted to the hospital for the second time on Oct. 18, 1954, with a chief complaint of intermittent pains in the costovertebral angles bilaterally, but more pronounced on the right, following a subtotal gastrectomy eight months previously. She also complained of nocturia and of diurinal frequency. A 37 lb. weight loss was noted during this time. Ankle edema and exertional dyspnea had been present intermittently.
The patient had had a "sinus" cough for many years. Two years preceding the present hospitalization, she had an attack of pneumonia. Six months later she was first hospitalized for a benign chronic gastric ulcer, which was resected. Subsequently, a gastroenterostomy was performed. Concurrently, she developed hepatitis. Postoperatively she
Thank you for submitting a comment on this article. It will be reviewed by JAMA Internal Medicine editors. You will be notified when your comment has been published. Comments should not exceed 500 words of text and 10 references.
Do not submit personal medical questions or information that could identify a specific patient, questions about a particular case, or general inquiries to an author. Only content that has not been published, posted, or submitted elsewhere should be submitted. By submitting this Comment, you and any coauthors transfer copyright to the journal if your Comment is posted.
* = Required Field
Disclosure of Any Conflicts of Interest*
Indicate all relevant conflicts of interest of each author below, including all relevant financial interests, activities, and relationships within the past 3 years including, but not limited to, employment, affiliation, grants or funding, consultancies, honoraria or payment, speakers' bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued. If all authors have none, check "No potential conflicts or relevant financial interests" in the box below. Please also indicate any funding received in support of this work. The information will be posted with your response.
Some tools below are only available to our subscribers or users with an online account.
Download citation file:
Customize your page view by dragging & repositioning the boxes below.
More Listings atJAMACareerCenter.com >
Enter your username and email address. We'll send you a link to reset your password.
Enter your username and email address. We'll send instructions on how to reset your password to the email address we have on record.
Need assistance?
Athens and Shibboleth are access management services that provide single sign-on to protected resources. They replace the multiple user names and passwords necessary to access subscription-based content with a single user name and password that can be entered once per session. It operates independently of a user's location or IP address. If your institution uses Athens or Shibboleth authentication, please contact your site administrator to receive your user name and password.


text:
Luke Wilson, George Lopez enjoy party
HOLLYWOOD — The "Henry Poole Is Here" premiere Thursday played out like a neighborhood barbecue. After a screening at the ArcLight, guests were treated to food hot off the grill on the theater's rooftop.
"I hope I can find a hot dog somewhere," said Overture Films topper Chris McGurk who enjoyed the relaxed party environment alongside pic's Luke Wilson, George Lopez, Cheryl Hines and Radha Mitchell.
As for the film, McGurk said he was really taken with it after seeing it at Sundance. "It's a sweet little movie, very inspirational," he said. "We thought it was different than all the movies out there."
Helmer Mark Pellington, said he was just excited to have a soiree following his screening. "I've done three films but I've never had a premiere."