Question 22:  Use the unscaled data1, perform k means clustering analysis, with k=3, and draw the cluster plot using R function >fviz_cluster() in the R package “factoextra”. Please screenshot your figure here. If your “factoextra” package does not load well, you may use R function >plotcluster() in the R package “fpc” instead.

Part II. Short-Answer Questions.  Problem II. Questions 20-25: Unsupervised learning: Clustering. Unsupervised learning: data(LifeCycleSavings) for Clustering. Please answer each question and copy/paste all your R code in the end. Please make sure that you have installed the R package “fpc” and “factoextra”. The “LifeCycleSavings” dataset contains macroeconomic savings data across 50 countries. The variables include savings ratio (sr), percentage of population under 15 (pop15), percentage over 75 (pop75), per-capita disposable income (dpi), and percent growth rate of dpi (ddpi). Now use your M# as seed, randomly sample 90% of data and call it “data1”. Please use your “data1” for all questions below. Question 20: Obtain summary statistics for data1. Please screenshot your output here.

A 70-year-old female with severe chronic obstructive pulmonary disease (COPD) presents for follow-up. She is currently on triple inhaler therapy (LABA/LAMA/ICS). Despite adherence, she reports two exacerbations in the past year, one requiring hospitalization. Laboratory results reveal a blood eosinophil count of 420 cells/µL. She continues to experience dyspnea with minimal exertion. Which of the following best explains the rationale for her current inhaler regimen?

A 55-year-old Black male presents for evaluation of newly diagnosed hypertension. His blood pressure readings average 152/94 mm Hg over multiple visits. He has no history of chronic kidney disease, diabetes, or cardiovascular disease. Which of the following agents are the most appropriate initial pharmacologic therapy for this patient? (Select all that apply)  

A 65-year-old male with a 20 pack-year smoking history presents to the clinic with complaints of daily shortness of breath and occasional wheezing. His eosinophil count is 118. He reports experiencing chronic cough with sputum production for the past two years. He denies any recent hospitalizations but mentions that he had two exacerbations last year that required outpatient treatment with steroids and antibiotics. He has no history of hospitalizations for COPD exacerbations. He has been diagnosed with COPD and classified as Group B. What is the appropriate management for this patient? 

The nurse is implementing strict intake & output (I&O) for an infant with dehydration by the method of

Therapeutic management of most children with Hirschsprung’s disease is primarily

Which of the following laboratory tests measures the waste product of protein metabolism excreted via the kidneys?

The pediatric nurse admits a 14-year-old adolescent to the pediatric floor with probable appendicitis and symptoms that include: periumbilical pain that peaks at 4-hour intervals followed by right lower quadrant pain, which is followed by vomiting. While assessing the patient, the nurse should be alert to recognize what sign of perforation?

Which clinical manifestation would be seen in a child with chronic renal failure?