A 72-year old woman is admitted with shortness of breath and difficulty breathing. The client's vital signs are as follows: Temp: 37 C (98.6 F), BP 162/94, pulse 92, and respiratory rate 26 and shallow. Oxygen saturation is 90% on room air. Client states she has been sleeping in a recliner chair for the past three nights because of difficulty breathing. She also states she has lower back pain with a pain level of "5" on a 0-10 pain scale.Upon assessment, the client states, "I am having difficulty breathing. I can't catch my breath when I walk a few feet." Client is oriented to person, place and time. She has a productive cough. Crackles and wheezing heard upon auscultation, diminished breath sounds at bases; capillary refill is four seconds, and slight clubbing of fingers is noted. Ankles and feet are swollen, 2+ pitting edema noted. The client has no known drug allergies. Medical history reveals hypertension, hyperlipidemia, and chronic obstructive pulmonary disease (emphysema). The client takes the following medications:• Furosemide 20 mg po daily• Metoprolol 50 mg po daily • Amlodipine besylate 5 mg po daily• Atorvastatin calcium 10 mg po daily• Albuterol 2 inhalations every 4-6 hours prnThe client is placed on 2 liters of oxygen via nasal cannula. Arterial blood gases (ABGS) are drawn. The client is started on intravenous (IV) fluids and is given acetaminophen 650 mg by mouth for her pain level of "5".Questions: 1. How should the nurse position this client and why?
2. List four signs and symptoms of respiratory distress the nurse may observe in a client with COPD.
3. The client wants her nasal oxygen turned up because she is experiencing increased difficulty breathing. What
should the nurse say to the client? 4. Why is it important to address the client's pain level?
5. List three non-pharmacologic interventions that the nurse could implement to help decrease the client's difficulty breathing.
6. What are the normal ranges for each of the ABG components in an adult: pH, partial pressure of carbon dioxide (PaCO2), bicarbonate (HCO3), partial pressure of oxygen (PaO2) and oxygen saturation (SaO2)?
7. What ABG results would the nurse expect in a client with COPD?
8. Analyze each set of ABG results:
1. pH=7.32 PaCO2-58 mmHg PaO2=60 mmHg
HCO3-32 mEq/L
2. pH=7.22 PaCO2-35 mmHg HCO3=20 mEq/L PaO2=80 mmHg
3. pH=7.52 pCO2-28 mmHg HCO3=24 mEq/L
PaO2=70 mmHg
9. List two nursing diagnoses for this client?

Answers

Answer 1

The nurse should position the client in a high Fowler's position, which allows for maximum lung expansion and oxygenation.

Depending on how comfortable the client is, this position involves raising the head of the bed to an angle between 45 and 90 degrees. This position makes breathing easier for the client and less taxing on the diaphragm.

The following are four indicators of respiratory distress in a client with COPD: breathing issues or shortness of breath, gasping for air or wheezing, chest discomfort or tightness, Lips or nails that are bluish in color (cyanosis).

The client should be informed by the nurse that increasing the oxygen flow rate may actually be harmful and lead to breathing cessation. The nurse should reassure the patient that they are keeping an eye on their oxygen saturation levels and that they will change the flow rate as necessary to keep their oxygenation levels adequate.

It's crucial to address the client's pain level because it can speed up their breathing and worsen respiratory distress. Anxiety and stress brought on by pain can make breathing problems even worse.

Encourage deep breathing exercises and pursed-lip breathing techniques as two non-pharmacologic interventions that the nurse could use to help the client breathe easier, offering a fan or cool mist humidifier to ease irritated airways, Using relaxation methods to lessen stress and anxiety, such as guided imagery or meditation,

The normal ranges for each of the ABG components in an adult are:

pH: 7.35-7.45

PaCO2: 35-45 mmHg

HCO3: 22-28 mEq/L

PaO2: 80-100 mmHg

SaO2: 95-100%

The nurse would anticipate seeing elevated PaCO2 and decreased PaO2 in a client with COPD. Due to the elevated levels of carbon dioxide, the pH may also be lower than usual.

each set of ABG results' analysis

1: PaO2 is low, HCO3 is slightly elevated, pH is slightly low, and PaCO2 is elevated. As a result, there is respiratory acidosis.

2: PaCO2, pH, HCO3, and PaO2 are all below normal, and PaCO2 is significantly below normal. The metabolic acidosis that this shows.

3: PaCO2, pH, and HCO3 are all within normal ranges. PaO2 is slightly depleted. As a result, there is respiratory alkalosis.

Impaired gas exchange related to decreased lung function and respiratory distress and activity intolerance related to shortness of breath and decreased oxygenation are two nursing diagnoses for this client.

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Related Questions

Shirya is at the dentist getting a cavity filled. The doctor injects her with a local anesthetic. Which drug did Shirya most likely receive?

lidocaine or procaine
methohexital or lorazepam
lorazepam or procaine
fentanyl or methohexital

Answers

Answer:
Lidocaine
Hope this helps u

Order: Pfizerpen (penicillin potassium) 200,000 units IM q6h

a) Which concentration is best to administer the dose?

Answers

Answer:

Explanation:

I'm only like 60% sure so you might want to double check this.

Think:

Need 400 mg

Have 100 mg per mL ( Need four times that amount )

Calculate:

Dosage on hand       Dosage desired

                             =

Amount on hand      X Amount desired

Cross multiply  100 mg  400 mg

                          1 mL X  =mL

                          100 X = 400

                          100 X  = 400

Simplify             ----------------------

                          100         100

                          X 4 mL

Withdraw 4 mL of reconstituted Zithromax using 5 mL syringe

Further dilute and give IV

Since single-dose vial, discard any remaining drug

Hopefully this helps!

In a means-end chain for milk, the calcium content of milk leads to healthier bones, which leads to a display of wisdom and a comfortable life free of osteoporosis. The display of wisdom and a comfortable life component of the means-end chain is the: Group of answer choices

Answers

Answer: Leverage point

Explanation:

The display of wisdom and a comfortable life component of the means-end chain is referred to as the leverage point.

The leverage point simply means a message that is passed by the company to the customers and prospective customers or where the company shows the emotional benefits and the advantages that one gets when the product is bought from them than from other competitors.

which of the following is an anesthetic that would be commonly stockpiled and used during a disaster

Answers

Explanation:

A cellular phone network uses towers to

transmit calls. If the equation of the circular area

transmits by the tower is represented by (x-5)2 +

ly-1)2 = 22. Can you identify if you are inside or

outside of the circular area, if your coordinate

location is (6,0)? How about if your location is

(8,2)?

The risk of getting lung cancer at some point in time in one's life for men who have never smoked is about 13 in 1000. The risk for men who smoke is just over 13 times the risk for non-smokers. What is the approximate lifetime risk of getting lung cancer for men who smoke

Answers

0.169  is the approximate lifetime risk of getting lung cancer for men who smoke.

In the United States, about 10 to 20% of lung cancer cases, or 20,000 to 40,000 lung cancers each year, occur in people who have never smoked or have smoked fewer than 100 cigarettes in their lifetime.

In this case, if we talk about the risk of smokers in terms of the risk of non-smokers, so the baseline risk is the risk for the non-smokers. So the baseline risk for lung cancer in men over an entire lifetime is the risk of lung cancer for men who have never smoked, over their lifetime, which is =0.013

The approximate lifetime risk of getting ling cancer, for male smokers, can be calculated as being 13 times the base risk= 0.169

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1-Which of the following is a feature of Irreversible Cell Injury:
a) Glycogen stores are depleted
b) Cytoplasmic sodium increases
c) Nuclei undergo karyorrhexis
d) Intracellular pH diminishes
e) Blebs form on cell membranes

Answers

Answer:

Cytoplasmic sodium increase.

Explanation:

Pls mark as brainliest

Answer:

cevap bursa cytoplasmic sodium increases

How can olive oil help in preventing and managing diabetes when included in the daily diet? suppose a mechanism.​

Answers

Answer:

The rise in blood sugar levels was much smaller after the meal with extra virgin olive oil than after the meal with corn oil. The findings were consistent with previous studies, which have linked extra virgin olive oil to higher levels of insulin, making it beneficial to people with type 2 diabetes.

Explanation:

Answer:

reduces glucose levels LDL (low density lipoprotien) and triglycerdes

Given a 20% w/v solution of chlorhexidine gluconate, what volume is required to make 400 mL of a 2% w/v solution?

Answers

Answer:

Explanation:

A 2% w/v solution contains 2 g in 100 mL, or 8 g in 400 mL.

Is lean good (educational purposes only)

Answers

Always, alwayssssssssss

Medicare Part D covers
A. occupational therapy visits.
B. hospital inpatient stays.
C. physician surgeries.
D. prescription drugs.

Answers

Answer:

D

Explanation:

Medicare Part D, the prescription drug benefit, is the part of Medicare that covers most outpatient prescription drugs.

When should the nurse advise a client being prescribed fluoxetine hydrochloride for depression to take the medication

Answers

The nurse should advise the client to take the prescribed fluoxetine hydrochloride for depression at bedtime.

Fluoxetine hydrochloride is an antidepressant of the selective serotonin reuptake inhibitor (SSRI) class that is marketed under the brand names Prozac and Sarafem, among others. Bulimia nervosa, panic disorder, major depressive disorder, obsessive-compulsive disorder (OCD), and premenstrual dysphoric disorder are among the conditions it is used to treat.

fluoxetine hydrochloride is used to treat depression, obsessive-compulsive disorder (OCD), bulimia nervosa, premenstrual dysphoric disorder (PMDD), and panic disorder

Fluoxetine hydrochloride works by increasing the amount of serotonin (a natural substance) in your brain. Serotonin aids in preserving mental stability. Serotonin levels are raised to help with the symptoms of panic attacks, bulimia nervosa, obsessive-compulsive disorder, and sadness.

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Which best describes how lenalidomine and thalidomide function in the body?

Both drugs treat multiple myeloma by inhibiting inflammation, inhibiting formation of red blood cells, and modulating the immune system to kill cancer cells.
Both drugs treat leukemia by depriving the cancer cells of asparagine and preventing protein formation resulting in cellular death.
Both drugs treat breast cancer by blocking the aromatase enzyme necessary for estradiol production.
Both drugs treat lymphoma by aiding the immune system in identifying and binding to antigen proteins on the surface of cancer cells and triggering the cell to die.

Answers

Answer:

Multiple myeloma is a B-cell malignancy characterized by an excess of monotypic plasma cells in the bone marrow. The molecular mechanisms that are involved in disease progression depend on the interaction between the multiple myeloma cells and the bone microenvironment. Because these mechanisms have been well characterized, it is possible to develop regimens that are more specific to pathways involved in the pathogenesis of multiple myeloma than is typical for conventional chemotherapy in disease management. Thalidomide and immunomodulatory drugs (IMiDs) have now been shown to block several pathways important for disease progression in multiple myeloma. First established as agents with antiangiogenic properties, thalidomide and IMiDs inhibit the production of interleukin (IL)-6, which is a growth factor for the proliferation of myeloma cells. In addition, they activate apoptotic pathways through caspase 8-mediated cell death. At the mitochondrial level, they are responsible for c-jun terminal kinase (JNK)-dependent release of cytochrome-c and Smac into the cytosol of cells, where they regulate the activity of molecules that affect apoptosis. By activating T cells to produce IL-2, thalidomide and IMiDs alter natural killer (NK) cell numbers and function, thus augmenting the activity of NK-dependent cytotoxicity. Data delineating these events have been derived from experiments done in resistant and sensitive multiple myeloma cell lines. Although thalidomide and IMiDs demonstrate similar biologic activities, IMiDs are more potent than thalidomide and achieve responses at lower doses. Lenalidomide, a thalidomide derivative, has also been shown to have a different toxicity profile. Our understanding of the mechanism of action of these agents has provided a platform for exciting clinical trials evaluating combinations of thalidomide and lenalidomide with both conventional chemotherapy and newer targeted agents.

Explanation:

Elaborar un resumen de lo que acostumbramoas a comer en las fiestas familiares y celebraiones comunitarias del país

Answers

Answer:

Navidad Francia - pudín blanco y negro, que es una salchicha que contiene sangre

Canadá francés: postres como rosquillas y pastel de azúcar

Alemania - galletas de jengibre y bombones de licor

Nicaragua: pollo con relleno elaborado con una variedad de frutas y verduras que incluyen tomate, cebolla y papaya.

Rusia: una fiesta de 12 platos diferentes, que representan a los discípulos de Cristo.

Año nuevo

Los alimentos tradicionales de Año Nuevo en todo el mundo incluyen:

Grecia: una empanada dulce especial horneada con una moneda dentro

Japón: hasta 20 platos cocinados y preparados una semana antes. Cada comida representa un deseo de Año Nuevo; por ejemplo, las algas marinas piden felicidad en el próximo año

Escocia: haggis (estómago de oveja relleno de avena y despojos), galletas de jengibre y bollos

España - 12 uvas, destinadas a ser puestas en la boca una a la vez en cada campanada del reloj a la medianoche.

Explanation:

If 3 grams of a drug are contained in 50 mL of solution, write the ratio.

Answers

Answer:

3:50

Explanation:

there are 3 g of a drug in 50 ml of solution, so it is 3/50. In a ratio it looks like this: 3:50

HCPCS level II codes are: a. sometimes replaced by HCPCS level III temporary codes. b. intended for use by all private and public health insurers. c. maintained by the AMA's Editorial Board, which makes decisions about additions, revisions, and deletions. d. updated by CMS when necessary, without participation by the HCPCS National Panel.

Answers

Answer:

HCPCS Level II codes are alphanumeric medical procedure codes, primarily for non-physician services such as ambulance services and prosthetic devices,. They represent items, supplies and non-physician services not covered by CPT-4 codes (Level I).

Explanation:

A ________ is not typically used in the prehospital setting for oxygen administration.

Answers

A  partial re-breather mask is not typically used int he prehospital setting for oxygen administration. It is initiated for variety of reasons.

Increased metabolic demand , maintenance of oxygenation while proving anesthesia. This the most common method for home use and provide flow rate of 2 to 6 liter per minute. Allowing the delivery of oxygen while maintaining the patient's ability to utilize their mouth to talk, eat, etc.

The main purpose is  treatment for patient with acute respiratory failure and those with chronic lung disease and hypoglycemia. The maintain normal hemoglobin saturation so as facilitate normal oxygen delivery to peripheral tissues.

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in the ear, the basilar membrane and hair cells are found in the?

Answers

Answer:

cochlea

Explanation:

Answer:

Cochlea

Explanation:

Cross-section of the cochlea. The inner hair cells are located at the termination of the "inner hair cell nerves" and the outer hair cells are located at the termination of the "outer hair cell nerve"

“Diseases of the present age are very different from diseases of the past.

Answers

Answer:

Yes, the diseases of present age are different from those of past. In past, diseases that spread by poor sanitati.

Explanation:

How to keep our surroundings clean?? Explain clearly.​

Answers

Answer:

don't litter

Explanation:

keep roads,,Your house and school clean , try not to litter anywhere , also keeping cleanliness is a good way to become better person

Answer:

A clean environment is essential for the existence of all living beings. People should prompt some laws to reduce environmental pollution.

...

Answer:

Save water.

Save electricity.

Using reusable bags.

Avoid taking cars as much as possible.

Growing more trees and plants.

Reducing pollution.

Saving natural resources.

How can health care professionals prepare for working with various age groups?

Answers

Answer:

They can work with kids and adults and teenager's so that they can see how they have to work in each age group. They have to look at the emotions feelings actions and a bunch of different things so that they can see what working with the different age groups do so that you can become closer to what they are looking for and their needs and create a stronger bond with all of them individually.  But they can start of with maybe baby sitting to help with the younger age and or work at a assisted living facilitys so that you can see what working with the elderly agr group is also for like teenagers you could go work as a school nurse to help with the seeing what it is like.

Hope this helps! :)

When health care professionals take care of the kids and elderly, they should take care of these:

Strive to maintain their dignity as best as you can. Be mindful of their physical and mental health. Particularly in regards to mental health, you need to be mindful and observant of the health status of the individuals you are taking care of.

What are age-specific considerations?

The definition of Age-Specific Considerations in Patient Care is to provide healthcare professionals with notification, about other age groups, how to identify needs related to these age groups, and how to vary approaches to patient care with age-specific needs in mind.

Thus, it is important to prepare for work according to various age groups.

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why do
do halo-halo stores sprout during summer​

Answers

That is the time and season they sprout
Because of the time and the season

The tendency of a person to catastrophize the extent of loss lowers his blood pressure.

Answers

Answer: What is the question

Explanation:

what are tubes that carry blood back to the heart ?
a. arteries
b.veins
c.pipes
d.tubes​

Answers

Answer:

arteries and veins

Explanation:

those two are the answers

Answer:

I think it's veins.

Explanation:

Arteries carry the blood away from the heart and the veins carry the blood back to the heart.

A pharmacy technician would tell a patient about a contraindication if the patient is taking

nitroglycerin for angina.
warfarin along with aspirin.
a laxative to manage constipation.
an analgesic and anesthetic for acute pain.

Answers

Answer:

pharmacy

analgesic and aneSTHETIC

what is the WHO formula for ORT​

Answers

Answer:

ORS consists of 4 constituents: 1. sodium chloride, 3.5 grams; 2. trisodium citrate, dihydrate, 2.9 grams; 3. potassium chloride, 1.5 grams; 4.

Explanation:

I think .... im not sure though

you admitted a patient with hypotensive crisis with the following data and doctors
patient juan dela cruz 45 years old NGT for gavage feeding every 4 hours
With indwelling foley catheter for urine output monitoring
6:30 a.m. clients vs bp =70/40 rr = 15 pr = 59 o2sat = 98%
doctor's order fluid regimen
R hand start ivf off d5lrs 1 liter to run 48 hours using macro set with slide drift of levophed to ampules + 96 cc of pnss x 15 ugtts per minute
second line le start ivf pnss 1 l x 10 gttsper minute start blood transfusion of two unit prbc once available properly type and crossmatch
you receive the patient at exactly 7:00 a.m. and started the fluid regimen
8:00 a.m. started gavage feeding of 1 glass osterized feeding with 1/2 glass of plain water to dilute the feeding
8:00 a.m. urine output
8:30 a.m. pack rbc for blood transfusion available
9:00 a.m. started blood transfusion with 250 ml of 1 unit prbc to run for 4 hours no reactions noted
12:00 noon next feeding do but the patient was restless was not available to give the full feeding remaining half glass was discarded
1:00 p.m. urine collected is 200ml
1:30 p.m. finish one prbc, hooked 2nd prbc with same rate
3:00 p.m. no urine output recorded
End of Shift
instruction complete the intake and output form every two hours ​

Answers

Answer:

8

Explanation:

instruction the intake and output

Should psychologists be asking about group differences (different race, sex, culture, etc.) in intellectual ability? What do you think?

Answers

Personally, I think don’t think they should. All of those factors(race, sex, culture) don’t have a big effect on intellectual ability. You can be high on the intellectually ability scale no matter race, sex, or culture.

I think they should not ask about such group differences as race, sex, and culture.

Who are psychologists?

People with psychological abnormalities, behavioral challenges, emotional difficulties, stress, and related concerns receive psychotherapy from counseling psychologists. These specialists have a lot in common with clinical psychologists.

The focus of health psychologists is on how psychology, biology, social structures, and behavior affect wellbeing, ailment, and general health.

To promote well-being and enhance both mental and physical health, they collaborate with people.

Therefore, I think they should not ask about such group differences as race, sex, and culture.

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Alopecia areata has a genetic and
basis.

Answers

Answer:

Sorry you got the wrong question

Answer:

autoimmune

Explanation:

took assignment on edge

Private health insurance is also called
A. individual insurance or non-group insurance.
B. VA Administration Insurance.
C. Schip Third-Party Payor Insurance.
D. Medicode insurance.

Answers

Answer:

Private health insurance is, instead, offered by a private entity instead (most often a for-profit company). You may also hear private health insurance plans called “off-exchange” plans–this means it's a major medical plan

Imagine that you are working with a team of bioarchaeologists that has just excavated a medieval cemetery site in Italy. The cemetery has over 200 graves, with all sexes and ages represented in the skeletal sample. You are interested in knowing whether there were gender differences in health among members of the medieval community. How would you answer this question using the skeletal remains

Answers

Answer:

By analyzing the pelvis bone (sex determination) and the length of the diaphyseal bone and nonsynovial joints (age determination of non-adult skeletons and adult skeletons, respectively)

Explanation:

Bioarchaeologists are professionals that study human skeletons from archaeological sites. Bioarchaeologists can estimate the age and sex of human skeletons and thus determine the health and dynamics of past human populations. In regard to sex determination, the pelvis is a bone that can be used to estimate the sex of an individual with an accuracy higher than 95%. In regard to the age, characteristics associated with bone growth such as, for example, the length of the diaphyseal bone, can be good indicators to estimate the age of non-adult skeletons, while nonsynovial joints (i.e. joints without a synovial membrane) which are commonly called synarthroses or solid joints, can be used to estimate the age of adult skeletons.

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How has manufacturing in the united states changed over its history? a student made a mistake while performing gram staining. what is the best explanation for a gram-negative bacterium appearing purple after performing a gram stain? point possible Tap on the reaction coordinate for a two-step, exothermic reaction in which the first step is faster than the second one. . R Potential energy Potential energy R Potential energy P Reaction coordinate Reaction coordinate Reaction coordinate X Selected Answer - Incorrect R R P P Reaction coordinate Reaction coordinate Reaction coordinate 2 1 point possible Rank the following elemental step molecularities in order of speed. Fastest Tetramolecular X Trimolecular X Bimolecular Unimolecular Slowest 1. use the ti 84 calculator to find the z score for which the area to its left is 0.13. Round your answer to two decimal places.2. use the ti 84 calculator to find the z score for which the area to the right is 0.09. round your answer to two decimal places.3. use the ti 84 calculator to find the z scores that bound the middle 76% of the area under the standard normal curve. enter the answers in ascending order and roundto two decimal places.the z scores for the given area are ------- and -------.4. the population has a mean of 10 and a standard deviation of 6. round your answer to 4 decimal places.a) what proportion of the population is less than 21?b) what is the probability that a randomly chosen value will be greater then 7? the series n=1[infinity](1)n 1n converges to s. based on the alternating series error bound, what is the least number of terms in the series that must be summed to guarantee a partial sum that is within 0.03 of S? a. 34 b. 333 c.111 d.9999 PLEASE HELP WITH THIS! PLEASE! SURFACE AREA. I HAVE NO CLUE!! Which of the following correctly accesses the fifth (5th) element stored in foo, an array with 100 elements?Group of answer choicesfoo(5);None of the othersfoo(4);foo(3);foo(6); how to address a cover letter to an unknown person A hair dryer draws a current of 9.1A a. How long does it take for 1.910^3C of charge to pass through the hair dryer? b. How many electrons does this amount of charge represent? time management is very essential for the nurse manager. which of the following is not a good time-management technique? decision-making is described by the nursing educator as the process one uses to: What is 4 across minus 1 across? [Edit 1; (4 across is 647 and 1 across is 133).]I can't find the answer to this and I'm doing a math cross and this is the last one that I can't find the answer to.Please help me with this! Thank you![Edit 2; (I have already found the answer to this question so I don't need the answer to this question anymore but still, feel free to answer this question though!).] Find the inverse Laplace transform f(t)=L1{F(s)} of the function F(s)=5040s78s. f(t)=L1{5040s78s}= Find the formula for an exponential equation that passes through the points (-4,3) and (6,1). The exponential equation should be of the form y=ab^x. Round a and b values to at least 5 decimals, where appropriate. You were hired as a consultant to Keys Company, and you wereprovided with the following data: Target capitalstructure: 40% debt, 10% preferred, and 50% commonequity. The after-tax cost of debt is 4.00%, the cost ofpreferred is 7.50%, and the cost of retained earnings is11.50%. The firm will not be issuing any new stock. What is the firms WACC?(Points: 4)A. 7.55%B. 7.73%C. 7.94%D. 8.10%E. 8.32% let x = (1, 2, 3)t , y = (y1, y2, y3) t , z = (4, 2, 1)t . compute 2x, 3y, x 2y 3z. characters in c/c are only 8 bits and therefore can address anywhere. group of answer choices true false The current model that most organizations typically use for dealing with fraud is: fraud incident, investigation, action, resolution. The last step of the fraud fighting model is follow-up. A researcher was interested in examining the different levels of aggression shown by college students and prisoners with life sentences. Aggression was measured by surveys given during one session. Which analysis should the researcher perform on the mean aggression scores of the groups? Select one: a. related means t test b. independent means t test C. correlation d. regression expectancy theory focuses on our perceptions of how fairly we feel we're being treated relative to others. true or false