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1 (35 pts). Consider the function f(x) = 2.6×2. Find the rate of change between x = 4 and x = 4.001. (Keep six decimal places in the middle of calculation.)   2 (35 pts). Consider the function f(x) = 0.6ex. Find the rate of change between x = 2 at x = 2.001. (Keep six decimal places in the middle of calculation.)

John, a 17-year-old African American male, arrives at the emergency department with complaints of sudden, intense pain in his chest and lower back. He describes the pain as “sharp and throbbing,” and rates it as a 9 out of 10. He has a known history of sickle cell anemia, diagnosed when he was a toddler. His mother reports that John has had similar painful episodes in the past, particularly after physical exertion or dehydration, but this episode seems more severe. Upon examination, John is found to be tachycardic (rapid heart rate) and mildly febrile (temperature of 100.8°F). He appears visibly uncomfortable and is reluctant to move due to the pain. Blood tests reveal a hemoglobin level of 7.5 g/dL (low), a high reticulocyte count, and an elevated white blood cell count, indicating inflammation or infection.  He does have a cough and is complaining of feeling like he can’t take a deep breath.   What are the potential complications of sickle cell anemia that John is at risk for in this situation?

What is one of the sustainability concerns in geothermal energy production in Iceland?

Which type of design involves the development of a new part?

Which component of a thermal system usually prevents overheating and potential leaks?

One reason for the SOX (2002) ban on auditors’ provision of certain types of non-audit services to clients is the potential for economic bonding which increases audit quality.  

At eight years old, Kim was first abused by her uncle and his best friend. The abuse occurred for over two years until the abuse was discovered by her father who killed both men in the girl’s presence. Kim was also sexually attacked in high school when she went to a party at one of her friend’s houses. There was a lot of alcohol consumed and Kim felt guilty that she had gone to the party. She never mentioned the incident to her mother, because of her guilt and her previous experiences. In college, Kim was drugged at a fraternity party and found herself in the bed of what she thought was a male friend being sexually attacked. Kim did not remember any of the abuse until she began therapy at age 30 years. She began to see a therapist after a car accident that caused her to have a flash back. Freud would consider using this kind of coping mechanism what?    

This condition is the most common inherited blood disorder in the United States. It causes episodes of pain, anemia, increased susceptibility to infection. In hemolytic crises the red blood cells break down and in aplastic crises, bone marrow fails to product blood cells. People from a number of countries have this condition, but is more common in the U.S. in persons of African American or Hispanic ancestry. The disease is life threating and can cause stroke. This condition is called what?

During a well child exam on a 4-year-old child, the primary care pediatric nurse practitioner notes that the clinic nurse recorded “20/50” for the child’s vision and noted that the child had difficulty cooperating with the exam. What will the nurse practitioner recommend?

6-year-old female has had a recent growth spurt and an exam reveals breast and pubic hair development. Her bone age is determined to be 8 years. What will the primary care pediatric nurse practitioner do next?