A68-year-old g2p2 woman who has recently moved in with her daughter (a long-standing patient of yours) comes in for a health maintenance examination. a vaginal hysterectomy was done in her fifties for uterine prolapse. she is not sure if her ovaries were removed. she has never had an abnormal mammogram or pap test and has had yearly exams. she stopped hormone replacement therapy 10 years ago. she was recently widowed after being married for 50 years. she does not smoke or drink. her diabetes is well-controlled with metformin; she takes a daily baby aspirin and is on a lipid-lowering agent. on examination, she is a thin elderly woman with a dowager's hump. her breast exam is unremarkable. her lower genital tract is notable for atrophy. no masses are noted on bimanual and recto-vaginal exam. a fecal occult blood test is negative. which of the following tests is not necessary?

answer: a . wheat cereals b eggs.   c. citrus fruits.

explanation:

the american revolution encouraged other countries

explanation:

low context culture   (lc.):

association:    

relationships begin and end quickly. many people can be inside one's circle; circle's boundary is not clear.

things get done by following procedures and paying attention to the goal.

one's identity is rooted in oneself and one's accomplishments.

social structure is decentralized; responsibility goes further down (is not concentrated at the top).

interaction:

low use of nonverbal elements. message is carried more by words than by nonverbal means.

verbal message is explicit. context is less important than words.

verbal message is direct; one spells things out exactly.

communication is seen as a way of exchanging information, ideas, and opinions.  

disagreement is depersonalized. one withdraws from conflict with another and gets on with the task. focus is on rational solutions, not personal ones. one can be explicit about another's bothersome behavior.

territoriality:

space is compartmentalized and privately owned; privacy is important, so people are farther apart.

temporality:

things are scheduled to be done at particular times, one thing at a time. what is important is that activity is done efficiently.

change is fast. one can make change and see immediate results.

time is a commodity to be spent or saved. one’s time is one’s own.

learning:

reality is fragmented and compartmentalized. one source of information is used to develop knowledge. thinking is inductive, proceeds from specific to general. focus is on detail.

learning occurs by following explicit directions and explanations of others.

an individual orientation is preferred for learning and problem solving.

speed is valued. how efficiently something is learned is important.

hope that                                         : )