(LC) Which оf the fоllоwing is not pаrt of the drаfting process? (4 points)
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(LC) Frоm "The Tyrаnny оf Things" by Elizаbeth Mоrris Once upon а time, when I was very tired, I chanced to go away to a little house by the sea. "It is empty," they said, "but you can easily furnish it." Empty! Yes, thank Heaven! Furnish it? Heaven forbid! Its floors were bare, its walls were bare, its tables there were only two in the house were bare. There was nothing in the closets but books; nothing in the bureau drawers but the smell of clean, fresh wood; nothing in the kitchen but an oil stove, and a few a very few dishes; nothing in the attic but rafters and sunshine, and a view of the sea. After I had been there an hour there descended upon me a great peace, a sense of freedom, of in finite leisure. In the twilight I sat before the flickering embers of the open fire, and looked out through the open door to the sea, and asked myself, "Why?" Then the answer came: I was emancipated from things. There was nothing in the house to demand care, to claim attention, to cumber my consciousness with its insistent, unchanging companionship. There was nothing but a shelter, and outside, the fields and marshes, the shore and the sea. These did not have to be taken down and put up and arranged and dusted and cared for. They were not things at all, they were powers, presences. And so I rested. While the spell was still unbroken, I came away. For broken it would have been, I know, had I not fled first. Even in this refuge the enemy would have pursued me, found me out, encompassed me. If we could but free ourselves once for all, how simple life might become! One of my friends, who, with six young children and only one servant, keeps a spotless house and a soul serene, told me once how she did it. "My dear, once a month I give away every single thing in the house that we do not imperatively need. It sounds wasteful, but I don't believe it really is. Sometimes Jeremiah mourns over missing old clothes, or back numbers of the magazines, but I tell him if he doesn't want to be mated to a gibbering maniac he will let me do as I like." The old monks knew all this very well. One wonders sometimes how they got their power; but go up to Fiesole, and sit a while in one of those little, bare, white-walled cells, and you will begin to understand. If there were any spiritual force in one, it would have to come out there. I have not their courage, and I win no such freedom. I allow myself to be overwhelmed by the invading host of things, making fitful resistance, but without any real steadiness of purpose. Yet never do I wholly give up the struggle, and in my heart I cherish an ideal, remotely typified by that empty little house beside the sea. Which word from the excerpt does Morris use to refer to things? (4 points)
Michаel TоrresAge: 62Visit Type: Estаblished pаtient, face-tо-face оffice visitChief Complaint: “My blood pressure has been high again, and I’ve had more swelling in my ankles.”At baseline Mr. Torres reports home BP in the 120's range. Over the last few weeks noted elevated systolic readings ranging from 140's up to 150's confirmed in office reading of 162/92 mmHg right arm sitting and 160/88 mmHg left arm sitting. Recent Changes: BP at home has been 160s/90s past 2 weeks Mild shortness of breath with exertion. Reports bilateral ankle swelling, worse at end of day. Slight improvement with leg elevation. Denies chest pain, palpitations, or weight gain. No recent changes in diet or increase life stressors.Background and History:PMH:Hypertension (diagnosed 8 years ago)Type 2 Diabetes MellitusHyperlipidemiaCurrent Medications:Lisinopril 20 mg dailyMetformin 1000 mg BIDAtorvastatin 40 mg dailyReview of Systems:Positive for fatigue, swelling, elevated home BPDenies dizziness, chest pain, or vision changesPhysical Exam:Vitals: BP 162/92, HR 78, RR 18, Temp 98.4°F, BMI 29.6General: Alert, in no acute distress, oriented, well-groomed and appears stated ageCardiac: RRR, S1, S2, no murmurs, +2 radial, pedal pulsesLungs: Clear bilaterally anterior/posterior with crackles, wheeze, equal chest expansionExtremities: 1+ pitting edema bilateral ankles, without cyanosisNeuro: Intact, no atrophyMSK: ROM intactSkin: No ulcers or rashesPlan and Management:Assessment:Hypertension – elevatedDiabetes – stableHyperlipidemia – stablePlan:Increase Lisinopril from 20 mg to 40 mg dailyOrder BMP to monitor renal function and electrolytes, order BNPReinforce low-sodium diet and fluid balanceContinue current diabetes and lipid regimenSchedule 2-week follow-up to reassess BP, possible ECGEncourage daily weight and BP logICD-10 Codes:I10 – Essential (primary) hypertensionE11.9 – Type 2 diabetes mellitus without complicationsE78.5 – Hyperlipidemia, unspecifiedR60.0 – Localized edemaQuestion: Which of the following qualifies as “moderate risk” management under MDM guidelines?
Michаel TоrresAge: 62Visit Type: Estаblished pаtient, face-tо-face оffice visitChief Complaint: “My blood pressure has been high again, and I’ve had more swelling in my ankles.”At baseline Mr. Torres reports home BP in the 120's range. Over the last few weeks noted elevated systolic readings ranging from 140's up to 150's confirmed in office reading of 162/92 mmHg right arm sitting and 160/88 mmHg left arm sitting. Recent Changes: BP at home has been 160s/90s past 2 weeks Mild shortness of breath with exertion. Reports bilateral ankle swelling, worse at end of day. Slight improvement with leg elevation. Denies chest pain, palpitations, or weight gain. No recent changes in diet or increase life stressors.Background and History:PMH:Hypertension (diagnosed 8 years ago)Type 2 Diabetes MellitusHyperlipidemiaCurrent Medications:Lisinopril 20 mg dailyMetformin 1000 mg BIDAtorvastatin 40 mg dailyReview of Systems:Positive for fatigue, swelling, elevated home BPDenies dizziness, chest pain, or vision changesPhysical Exam:Vitals: BP 162/92, HR 78, RR 18, Temp 98.4°F, BMI 29.6General: Alert, in no acute distress, oriented, well-groomed and appears stated ageCardiac: RRR, S1, S2, no murmurs, +2 radial, pedal pulsesLungs: Clear bilaterally anterior/posterior with crackles, wheeze, equal chest expansionExtremities: 1+ pitting edema bilateral ankles, without cyanosisNeuro: Intact, no atrophyMSK: ROM intactSkin: No ulcers or rashesPlan and Management:Assessment:Hypertension – elevatedDiabetes – stableHyperlipidemia – stablePlan:Increase Lisinopril from 20 mg to 40 mg dailyOrder BMP to monitor renal function and electrolytes, order BNPReinforce low-sodium diet and fluid balanceContinue current diabetes and lipid regimenSchedule 2-week follow-up to reassess BP, possible ECGEncourage daily weight and BP logICD-10 Codes:I10 – Essential (primary) hypertensionE11.9 – Type 2 diabetes mellitus without complicationsE78.5 – Hyperlipidemia, unspecifiedR60.0 – Localized edemaQuestion: Why does ordering a BMP contribute to a higher level of MDM?