Ohio law provides for a free education for all children between the ages of $6$ and $21.$ In $1971$, widespread student unrest took place in the public schools of Columbus, Ohio. Students who either participated in, or were present at, demonstrations held on school grounds were suspended. Many suspensions were for a period of ten days. Students were not given a hearing before suspension, although at a later date some students and their parents were given informal conferences with the school principal. A number of students, through their parents, sued the board of education, claiming that their right to due process had been violated when they were suspended without a hearing.

In Goss v. Lopez, the U.S. Supreme Court decided that public school students who are suspended for ten days or less are entitled to certain rights before their suspension. These rights include $(1)$ oral or written notice of the charges, $(2)$ an explanation of the evidence against them (if students deny the charges), and $(3)$ an opportunity for students to present their side of the story.

The Court stated that in an emergency, students could be sent home immediately, and a hearing could be held at a later date. The Court did not give students a right to a lawyer, a right to call or cross-examine witnesses, or a right to a hearing before an impartial person.

In Goss, the Court considered the due process interests of harm, cost, and risk. The Court ruled that reputations were harmed and educational opportunities were lost during the suspension; that an informal hearing would not be overly costly for the schools; and that while most disciplinary decisions were probably correct, an informal hearing would help reduce the risk of error.

What happened in the Goss case? What rights did the Supreme Court say the students should be given prior to a brief suspension?

The Saftir-Simpson scale, used ty the National Weather Service since the I970s to classify hurricane strength, ranks storm strength from Level 1 to 5 , and is used to give an extimate of the possible property damage and flooding expected when the hurricane makes landfall. A Categocy 5 storm maintains winds in excess of 155 mph and is capable of causing widespread damages such as destroying or causing extensive structural damage to homes. It can also trigger a stocm suige moee than $18 \mathrm{ft}$ above normal.

Two of the most fundamental steps people can take are ssembling a disaster sapplies kit and making an emergency plan. They are simple meisures, but can make all the difference when disasters strike. 17. For what parpose is the Saffir-Simpoon scale used? A. estimating property damage and flooding efhen a hurricane makes landfall B. estimating the height of a stoem surge above normal C. determining who should be told to evacuate before a hurricane hits D. measuring the strength of an approashing hurricane 18. What can be inferred from this passage? A. Only Category 5 harricanes will cause major damage. B. Only people living along the shoreline are in danget during burricanes. C. Category 5 hurricanes have the potential to cause major damage, D. People should have a disaster supply kit or an evacuation plan in place before a burricane hits.

For what parpose is the Saffir-Simpoon scale used?

A. estimating property damage and flooding efhen a hurricane makes landfall

B. estimating the height of a stoem surge above normal

C. determining who should be told to evacuate before a hurricane hits

D. measuring the strength of an approashing hurricane

F.F., a 58-year-old man with type 2 diabetes mellitus, comes to the emergency department with severe right flank and abdominal pain and nausea and vomiting. The abdomen is soft and without tenderness. The right flank is extremely tender to the touch and to palpation. Vital signs are 142/80, 88, 20, 99$^{\circ}$C F (37.2$^{\circ}$ C). Urinalysis shows haematuria. An IV of 0.9% normal saline is started at 125 ml/ hr. An IV pyelogram (IVP) confirms the diagnosis of a staghorn-type stone in the right renal pelvis. The right kidney looks enlarged. F.F. states that he did not sleep well last night and has not eaten much today. He is obviously fatigued. His laboratory results are listed in the chart. F.F. weighs 277 pounds.
Sodium 144 mEq/L
Potassium 4.0 mEq/L
Chloride 101 mEq/L
Carbon dioxide 26 mEq/L
BUN 30mg/dL
Creatinine 3.6 mg/dL
Glucose 260 mg/dL
Uric acid 5.0 mg/dL
Calcium 9.0 mg/L
Phosphorus 3.2 mg/dL
Total protein 7.8 g/dL
Albumin 4.0 g/dL
Total bilirubin 0.3 mg/dL
Direct bilirubin 0.1 mg/dL
Cholesterol 200 mg/dL
ALP 61 units/L
LOH Total 100 units/L
ALT 13 units/L
AST 38 units/L
Amylase 98 units/L
F.F.'s pain is treated in the ED with IV morphine. It is late afternoon before he is admitted to your unit, and he is scheduled for lithotripsy in the morning. What specific priorities do you identify for F.F.?

Ohio law provides for a free education for all children between the ages of $6$ and $21.$ In $1971$, widespread student unrest took place in the public schools of Columbus, Ohio. Students who either participated in, or were present at, demonstrations held on school grounds were suspended. Many suspensions were for a period of ten days. Students were not given a hearing before suspension, although at a later date some students and their parents were given informal conferences with the school principal. A number of students, through their parents, sued the board of education, claiming that their right to due process had been violated when they were suspended without a hearing.

In Goss v. Lopez, the U.S. Supreme Court decided that public school students who are suspended for ten days or less are entitled to certain rights before their suspension. These rights include $(1)$ oral or written notice of the charges, $(2)$ an explanation of the evidence against them (if students deny the charges), and $(3)$ an opportunity for students to present their side of the story.

The Court stated that in an emergency, students could be sent home immediately, and a hearing could be held at a later date. The Court did not give students a right to a lawyer, a right to call or cross-examine witnesses, or a right to a hearing before an impartial person.

In Goss, the Court considered the due process interests of harm, cost, and risk. The Court ruled that reputations were harmed and educational opportunities were lost during the suspension; that an informal hearing would not be overly costly for the schools; and that while most disciplinary decisions were probably correct, an informal hearing would help reduce the risk of error.

Do you think this case was decided correctly? Give your reasons.

S.B. is a $17$-year-old man who lost control of his sport utility vehicle and struck a tree. Witnesses reported he was not restrained, and his face hit the windshield on impact. When paramedics arrived, S.B. was responsive but confused, had significant facial swelling, and complained of pain in his right wrist and left forearm. The paramedics initiated cervical spine precautions, strapped him to a backboard, started oxygen at $15 \mathrm{~L} / \mathrm{min}$ via a nonrebreather mask, and started a 16 -gauge IV with $0.9 \%$ normal saline. His vital signs were $120 / 75,125,36$, and $\mathrm{SaO}_2 94 \%$. On arrival to the local emergency department (ED) 5 minutes later, his VS were $110/62$, $110$ regular, $28$ to $32$ and shallow, and $\mathrm{SaO}_2 99 \%$. An additional 16-gauge IV was inserted and the following labs were drawn: CBC, type and crossmatch, complete metabolic panel, PT/ PTT INR, and alcohol level. The trauma physician completed a head-to-toe assessment and found the following:

Physician Note

Obeys commands, responds to voice but not oriented to time or place. Generalized facial edema with full-thickness $2$-cm cheek laceration and bilateral mandibular depressed fractures. Blood behind left tympanic membrane, edema with slight discoloration over left mastoid process. Clear drainage coming from the left nare. Mid to upper chest contusions without crepitus, breath sounds clear. Abdomen slightly firm but not tender. Catheterized for $500$ mL clear yellow urine; negative for blood, glucose, ketones. Positive deformity of right wrist and diffuse tenderness of left lower forearm.

What is the most reliable diagnostic indicator for BSF?

Office Pro, Inc., does software development. One important activity in software development is writing software code. The manager of the WordPro Development Team determined that the average software programmer could write $40$ lines of code in an hour. The plan for the first week in May called for $6,000$ lines of code to be written on the WordPro product. The WordPro Team has four programmers. Each programmer is hired from an employment firm that requires temporary employees to be hired for a minimum of a $40$-hour week. Programmers are paid $\$ 28.00$ per hour. The manager offered a bonus if the team could generate more than $6,500$ lines for the week, without overtime. Due to a project emergency, the programmers wrote more code in the first week of May than planned. The actual amount of code written in the first week of May was $7,000$ lines, without overtime. As a result, the bonus caused the average programmer's hourly rate to increase to $\$ 34.00$ per hour during the first week in May.

Instructions
$1$. If the team generated $6,000$ lines of code according to the original plan, what would have been the labor time variance?
$2.$ What was the actual labor time variance as a result of generating $7,000$ lines of code?
$3$. What was the labor rate variance as a result of the bonus?
$4.$ The manager is trying to determine if a better decision would have been to hire a temporary programmer to meet the higher programming demand in the first week of May, rather than paying out the bonus. If another employee was hired from the employment firm, what would have been the labor time variance in the first week?
$5$. Which decision is better, paying the bonus or hiring another programmer?
$6$. $\Longrightarrow$ Are there any performance-related issues that the labor time and rate variances fail to consider? Explain.

J.G., a $49$-year-old man, was seen in the emergency department (ED) $2$ days ago, diagnosed with alcohol intoxication, and released after $8$ hours to his brother's care. He was brought back to the ED $12$ hours ago with an active gastrointestinal (GI) bleed and is being admitted to the intensive care unit (ICU); his diagnosis is upper GI bleed and alcohol intoxication.

You are assigned to admit and care for J.G. for the remainder of your shift. According to the ED notes, his admission vital signs were BP $84/56$ mm Hg, P $110$ bpm, R $26$, and he was vomiting bright red blood. He was given IV fluids and transfused $6$ units of packed red blood cells (PRBCs) in the ED. On initial assessment, you note that J.G.'s VS are blood pressure BP $154/90$ mm Hg, P $110$ bpm; he has a slight tremor in his hands, and he appears anxious. He complains of a headache and appears flushed. You note that he has not had any emesis and has not had any frank red blood in his stool or melena (black tarry stools) over the past $5$ hours. In response to your questions, J.G. denies that he has an alcohol problem but later admits to drinking approximately a fifth of vodka daily for the past $2$ months. He reports that he was drinking vodka just before his admission to the ED. He admits to having had seizures while withdrawing from alcohol in the past.

According to the DSM-IV-TR, what is the difference between alcohol dependence and alcohol abuse?

F.F., a 58-year-old man with type 2 diabetes mellitus, comes to the emergency department with severe right flank and abdominal pain and nausea and vomiting. The abdomen is soft and without tenderness. The right flank is extremely tender to the touch and to palpation. Vital signs are 142/80, 88, 20, 99$^{\circ}$C F (37.2$^{\circ}$ C). Urinalysis shows haematuria. An IV of 0.9% normal saline is started at 125 ml/ hr. An IV pyelogram (IVP) confirms the diagnosis of a staghorn-type stone in the right renal pelvis. The right kidney looks enlarged. F.F. states that he did not sleep well last night and has not eaten much today. He is obviously fatigued. His laboratory results are listed in the chart. F.F. weighs 277 pounds.
Sodium 144 mEq/L
Potassium 4.0 mEq/L
Chloride 101 mEq/L
Carbon dioxide 26 mEq/L
BUN 30mg/dL
Creatinine 3.6 mg/dL
Glucose 260 mg/dL
Uric acid 5.0 mg/dL
Calcium 9.0 mg/L
Phosphorus 3.2 mg/dL
Total protein 7.8 g/dL
Albumin 4.0 g/dL
Total bilirubin 0.3 mg/dL
Direct bilirubin 0.1 mg/dL
Cholesterol 200 mg/dL
ALP 61 units/L
LOH Total 100 units/L
ALT 13 units/L
AST 38 units/L
Amylase 98 units/L
Review F.F.'s lab work, and note any value that might be of concern.

F.F., a 58-year-old man with type 2 diabetes mellitus, comes to the emergency department with severe right flank and abdominal pain and nausea and vomiting. The abdomen is soft and without tenderness. The right flank is extremely tender to the touch and to palpation. Vital signs are 142/80, 88, 20, 99degree F (37.2degree C). Urinalysis shows haematuria. An IV of 0.9% normal saline is started at 125 ml/ hr. An IV pyelogram (IVP) confirms the diagnosis of a staghorn-type stone in the right renal pelvis. The right kidney looks enlarged. F.F. states that he did not sleep well last night and has not eaten much today. He is obviously fatigued. His laboratory results are listed in the chart. F.F. weighs 277 pounds.
Sodium 144 mEq/L
Potassium 4.0 mEq/L
Chloride 101 mEq/L
Carbon dioxide 26 mEq/L
BUN 30mg/dL
Creatinine 3.6 mg/dL
Glucose 260 mg/dL
Uric acid 5.0 mg/dL
Calcium 9.0 mg/L
Phosphorus 3.2 mg/dL
Total protein 7.8 g/dL
Albumin 4.0 g/dL
Total bilirubin 0.3 mg/dL
Direct bilirubin 0.1 mg/dL
Cholesterol 200 mg/dL
ALP 61 units/L
LOH Total 100 units/L
ALT 13 units/L
AST 38 units/L
Amylase 98 units/L
Use SBAR (Situation, Background, Assessment, Recommendation) to communicate your concerns about this dose of gentamicin to the physician

Billy was hiking in the mountains one autumn day. Unexpectedly, a cold front moved in and the temperature dropped to well below freezing. Billy was unprepared for the temperature change, and he did not have a hat or earmuffs. As the temperature dropped, his ears and nose became pale in color. After continued exposure to the dropping temperatures, every 15–20 minutes, his ears and nose turned red for 5–10 minutes and then became pale again. After several hours, Billy managed to hike back to the trail head. By then, he was very chilled and had no sensation in his ears or nose. As he looked in the rearview mirror of his car, he could see that the skin of his ears and nose had turned white. It took Billy 2 hours to drive to the nearest emergency room, where he learned that the white skin meant he had frostbite of his ears and nose. About 2 weeks later, the frostbitten skin peeled. Despite treatment with an antibiotic, the skin of his right ear became infected. Eventually, Billy recovered, but he lost part of his right ear.

Frostbite is the most common type of freezing injury. When skin temperature drops below 0 degree celsius (32 degree fahrenheit), the skin freezes and ice crystal formation damages tissues.

Why is a person with frostbite likely to develop an infection of the affected part of the body?Why is a person with frostbite likely to develop an infection of the affected part of the body?

Susan Calles lived with her four daughters—Amanda, age eleven; Victoria, age five; and Jenna and Jillian, age three. In March 1998, Calles bought an Aim N Flame utility lighter, which she stored on the top shelf of her kitchen cabinet. A trigger can ignite the Aim N Flame after an “ON/OFF” switch is slid to the “on” position. On the night of March 31, Calles and Victoria left to get videos. Jenna and Jillian were in bed, and Amanda was watching television. Calles returned to find fire trucks and emergency vehicles around her home. Robert Finn, a fire investigator, determined that Jenna had started a re using the lighter. Jillian sufered smoke inhalation, was hospitalized, and died on April 21. Calles filed a suit in an Illinois state court against Scripto-Tokai Corp., which distributed the Aim N Flame, and others. In her suit, which was grounded, in part, in strict liability claims, Calles alleged that the lighter was an “unreasonably dangerous product.” Scripto filed a motion for summary judgment. [Calles v. Scripto-Tokai Corp., 224 Ill.2d 247, 864 N.E.2d 249, 309 Ill. Dec. 383 (2007)] (See Strict Product Liability.)

(b) Calles presented evidence as to the likelihood and seriousness of injury from lighters that do not have childsafety devices. Scripto argued that the Aim N Flame is an alternative source of fire and is safer than a match. Calles admitted that she knew the dangers presented by lighters in the hands of children. Scripto admitted that it had been a defendant in several suits for injuries under similar circumstances. How should the court rule? Why?

F.F., a 58-year-old man with type 2 diabetes mellitus, comes to the emergency department with severe right flank and abdominal pain and nausea and vomiting. The abdomen is soft and without tenderness. The right flank is extremely tender to the touch and to palpation. Vital signs are 142/80, 88, 20, 99$^{\circ}$C F (37.2$^{\circ}$ C). Urinalysis shows haematuria. An IV of 0.9% normal saline is started at 125 ml/ hr. An IV pyelogram (IVP) confirms the diagnosis of a staghorn-type stone in the right renal pelvis. The right kidney looks enlarged. F.F. states that he did not sleep well last night and has not eaten much today. He is obviously fatigued. His laboratory results are listed in the chart. F.F. weighs 277 pounds.
Sodium 144 mEq/L
Potassium 4.0 mEq/L
Chloride 101 mEq/L
Carbon dioxide 26 mEq/L
BUN 30mg/dL
Creatinine 3.6 mg/dL
Glucose 260 mg/dL
Uric acid 5.0 mg/dL
Calcium 9.0 mg/L
Phosphorus 3.2 mg/dL
Total protein 7.8 g/dL
Albumin 4.0 g/dL
Total bilirubin 0.3 mg/dL
Direct bilirubin 0.1 mg/dL
Cholesterol 200 mg/dL
ALP 61 units/L
LOH Total 100 units/L
ALT 13 units/L
AST 38 units/L
Amylase 98 units/L
What problems are possible as a result of the staghorn stone?

Assume that you are the president of Gaslight Company. At the end of the first year (December 31, 2011) of operations, the following financial data for the company are available:

$$\begin{array} {lrrrrr} \text{Cash }& \hspace{10pt}\text{\$\hspace{10pt}24,500}&\\ \text{Receivables from customers (all considered collectible)}& \hspace{10pt}\text{10,800}&\\ \text{Inventory of merchandise (based on physical count and priced at cost)}& \text{81,000}&\\ \text{Equipment owned, at cost less used portion}& \hspace{10pt}\text{40,700}&\\ \text{Accounts payable owed to suppliers}& \hspace{10pt}\text{46,140}&\\ \text{Salary payable for 2011 (on December 31, 2011, this was}\\ \hspace{10pt}\text{owed to an employee who was away because of an emergency; will return}\\ \hspace{10pt}\text{around January 10, 2012, at which time the payment will be made)}& \text{1,800}&\\ \text{Total sales revenue}& \hspace{10pt}\text{126,000}&\\ \text{Expenses, including the cost of the merchandise sold (excluding income taxes) }& \text{80,200}&\\ \text{Income taxes expense at 30\\\%}\times \text{pretax income; all paid during 2011}& \hspace{10pt}\text{?}&\\ \text{Contributed capital, 7,000 shares outstanding}& \hspace{10pt}\text{87,000}&\\ \text{Dividends declared and paid during 2011}& \text{10,000}&\\ \end{array}$$

Required:

Using the financial statement exhibits in the chapter as models and showing computations:

1. Prepare a summarized income statement for the year 2011.

2. Prepare a statement of retained earnings for the year 2011.

3. Prepare a balance sheet at December 31, 2011.

Billy was hiking in the mountains one autumn day. Unexpectedly, a cold front moved in and the temperature dropped to well below freezing. Billy was unprepared for the temperature change, and he did not have a hat or earmuffs. As the temperature dropped, his ears and nose became pale in color. After continued exposure to the dropping temperatures, every 15–20 minutes, his ears and nose turned red for 5–10 minutes and then became pale again. After several hours, Billy managed to hike back to the trail head. By then, he was very chilled and had no sensation in his ears or nose. As he looked in the rearview mirror of his car, he could see that the skin of his ears and nose had turned white. It took Billy 2 hours to drive to the nearest emergency room, where he learned that the white skin meant he had frostbite of his ears and nose. About 2 weeks later, the frostbitten skin peeled. Despite treatment with an antibiotic, the skin of his right ear became infected. Eventually, Billy recovered, but he lost part of his right ear.

Frostbite is the most common type of freezing injury. When skin temperature drops below 0 degree celsius (32 degree fahrenheit), the skin freezes and ice crystal formation damages tissues.

Explain what happened when Billy’s ears and nose periodically turned red. How is this beneficial when the ambient temperature is very cold?