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First Class Test
Quiz by Geoff Burns
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iO5 design class - First test
______ the sun set, the temperature began to drop. A) After B) While C) Since She studied all night for her test. ______, she was confident when she walked into class. A) Meanwhile B) As a result C) Before We arrived at the park early. ______, we set up our picnic and waited for the others to arrive. A) First B) Later C) Then The alarm rang loudly. ______, I jumped out of bed and rushed to get ready. A) Before B) Immediately C) Eventually The Wright brothers made their first successful flight in 1903. ______, air travel has advanced significantly. A) Since then B) Before C) Meanwhile Example Paragraphs (Choose the Best Transition Word) Cooking Instructions First, preheat the oven to 375°F. ______, mix the flour, sugar, and baking powder in a large bowl. Next, add the eggs and milk, stirring until smooth. (Options: Then, Before, While) Historical Events The Declaration of Independence was signed in 1776. ______, the United States officially became a separate nation from Britain. (Options: As a result, Before, However) Personal Narrative I packed my bags and headed to the airport. ______, I realized I had forgotten my passport at home. (Options: Later, Suddenly, Before) Daily Routine Every morning, I wake up at 6 AM. ______, I brush my teeth and make a cup of coffee. (Options: First, Afterward, Meanwhile) Science Explanation The caterpillar forms a chrysalis. ______, it undergoes metamorphosis and transforms into a butterfly. (Options: Eventually, Meanwhile, Before)
Write questions similar to ______ the sun set, the temperature began to drop. A) After B) While C) Since She studied all night for her test. ______, she was confident when she walked into class. A) Meanwhile B) As a result C) Before We arrived at the park early. ______, we set up our picnic and waited for the others to arrive. A) First B) Later C) Then The alarm rang loudly. ______, I jumped out of bed and rushed to get ready. A) Before B) Immediately C) Eventually The Wright brothers made their first successful flight in 1903. ______, air travel has advanced significantly. A) Since then B) Before C) Meanwhile Example Paragraphs (Choose the Best Transition Word) Cooking Instructions First, preheat the oven to 375°F. ______, mix the flour, sugar, and baking powder in a large bowl. Next, add the eggs and milk, stirring until smooth. (Options: Then, Before, While) Historical Events The Declaration of Independence was signed in 1776. ______, the United States officially became a separate nation from Britain. (Options: As a result, Before, However) Personal Narrative I packed my bags and headed to the airport. ______, I realized I had forgotten my passport at home. (Options: Later, Suddenly, Before) Daily Routine Every morning, I wake up at 6 AM. ______, I brush my teeth and make a cup of coffee. (Options: First, Afterward, Meanwhile) Science Explanation The caterpillar forms a chrysalis. ______, it undergoes metamorphosis and transforms into a butterfly. (Options: Eventually, Meanwhile, Before)
Classroom Expectations and Policies Assessment 1. What should students bring to class every day? a. Only a positive attitude b. Charged Chromebook, writing utensil, and positive attitude c. Just their books d. Snacks and drinks 2. What is the consequence for bullying in the classroom? a. A warning b. A violation card c. Extra homework d. A meeting with the principal 3. If a student breaks a personal item, what must they do? a. Ignore it b. Apologize c. Buy a new one for the teacher d. Ask for forgiveness 4. How should students handle using the futon during class? a. Sit on it every day b. Use it without asking c. Ask first and only use it during work time d. Sit on it during lectures 5. Where will all assignments be posted? a. On the classroom wall b. On Canvas c. Only verbally d. In a textbook 6. What happens if an assignment is submitted late? a. It will be graded normally b. It will not be accepted c. It will drop a letter grade each day it is late d. It will be given extra credit 7. After how many days of lateness will a student receive only half credit for an assignment? a. 1 day b. 2 days c. 3 days d. 4 days 8. What is the policy for retaking tests? a. No retakes allowed b. Students must schedule the retake themselves c. Retakes are given automatically d. Only the teacher can decide on retakes 9. What constitutes cheating in this classroom? a. Asking for help b. Claiming credit for someone else's work c. Working with a partner d. Participating in study groups 10. What is the penalty for cheating? a. A warning b. A failing grade on the assignment and notification of parents c. Extra assignments d. A detention 11. How will grades be determined? a. By participation only b. By points, with tests and quizzes weighted more than classwork c. By effort d. By attendance 12. Where can students use their cell phones? a. In class anytime b. In the commons and hallways during passing time and lunch c. In the restroom d. In the cafeteria only 13. What happens if a student uses their phone during class? a. They will receive a warning b. The phone will be confiscated immediately c. They can keep it if they ask d. They will lose points on their grade 14. What should a student do if they know they will be absent? a. Ignore it and hope for the best b. Come to the teacher at least three days before c. Ask a friend for notes d. Just show up later 15. If a student is sick and cannot do work, what should they focus on? a. Completing all missed assignments b. Getting better c. Emailing the teacher every hour d. Asking for extra credit 16. What is the policy on bringing food or drinks to class? a. It's not allowed at all b. Itâs allowed as long as itâs not a distraction c. Only water is allowed d. Students must share their food 17. How should students contact the teacher with questions? a. Only during class time b. Through social media c. By email or in person d. By sending a friend 18. What happens if a student emails after 9 PM? a. The teacher will respond immediately b. The teacher will respond the next day at 7:45 AM c. The email will be ignored d. The teacher will call the student 19. How do violations accumulate for cell phone use? a. They reset every trimester b. They accumulate throughout the school year c. They reset every week d. They do not count 20. What should students do if they have concerns while the teacher is on maternity leave? a. Contact the principal b. Contact the substitute teacher for assistance c. Wait until the teacher returns d. Handle it on their own Answer Key (Always review AI generated answers for accuracy - Math is more likely to be inaccurate) b. Charged Chromebook, writing utensil, and positive attitude b. A violation card c. Buy a new one for the teacher c. Ask first and only use it during work time b. On Canvas c. It will drop a letter grade each day it is late c. 3 days b. Students must schedule the retake themselves b. Claiming credit for someone else's work b. A failing grade on the assignment and notification of parents b. By points, with tests and quizzes weighted more than classwork b. In the commons and hallways during passing time and lunch b. The phone will be confiscated immediately b. Come to the teacher at least three days before b. Getting better b. Itâs allowed as long as itâs not a distraction c. By email or in person b. The teacher will respond the next day at 7:45 AM b. They accumulate throughout the school year b. Contact the substitute teacher for assistance
1. Flammable materials, like alcohol, should never be dispensed or used near A. an open door. B. an open flame. C. another student. D. a sink. 2. If a laboratory fire erupts, immediately A. notify your instructor. B. run for the fire extinguisher. C. throw water on the fire. D. open the windows. 3. Approved eye protection devices (such as goggles) are worn in the laboratory A. to avoid eye strain. B. to improve your vision. C. only if you donât have corrective glasses. D. any time chemicals, heat or glassware are used. 4. If you wear contact lenses in the school laboratory, A. take them out before starting the lab. B. you do not have to wear protective goggles. C. advise your science instructor that you wear contact lenses. D. keep the information to yourself. 5. If you do not understand a direction or part of a lab procedure, you should A. figure it out as you do the lab. B. try several methods until something works. C. ask the instructor before proceeding. D. skip it and go on to the next part. 6. After completing an experiment, all chemical wastes should be A. left at your lab station for the next class. B. disposed of according to your instructorâs directions. C. dumped in the sink. D. taken home. 7. If a lab experiment is not completed, you should A. discuss the issue with your instructor. B. sneak in after school and work alone. C. come in during lunch and finish while eating lunch. D. make up some results. 8. You are heating a substance in a test tube. Always point the open end of the tube A. toward yourself. B. toward your lab partner. C. toward another classmate. D. away from all people. Science Laboratory Safety teSt 9. You are heating a piece of glass and now want to pick it up. You should A. use a rag or paper towels. B. pick up the end that looks cooler. C. use tongs. D. pour cold water on it. 10. You have been injured in the laboratory (cut, burn, etc.). First you should A. visit the school nurse after class. B. see a doctor after school. C. tell the science instructor at once. D. apply first aid yourself. 11. When gathering glassware and equipment for an experiment, you should A. read all directions carefully to know what equipment is necessary. B. examine all glassware to check for chips or cracks. C. clean any glassware that appears dirty. D. All of the above. 12. You want to place a piece of glass tubing into a rubber stopper after the tubing has been fire polished and cooled. This is best done by A. lubricating the tubing with water or glycerin. B. using a towel or cotton gloves for protection. C. twisting the tubing and stopper carefully. D. all of the above. 13. Personal eyeglasses provide as much protection as A. a face shield. B. safety glasses. C. splashproof chemical goggles. D. none of the above. 14. Long hair in the laboratory must be A. cut short. B. held away from the experiment with one hand. C. always neatly groomed. D. tied back or kept entirely out of the way with a hair band, hairpins, or other confining device. 15. In a laboratory, the following should not be worn. A. loose clothing. B. dangling jewelry. C. sandals. D. all of the above. 16. The following footwear is best in the laboratory. A. sandals B. open-toed shoes C. closed-toed shoes D. shoes appropriate for the weather3 Š 2017 Flinn Scientific, Inc. All Rights Reserved. 17. Horseplay or practical jokes in the laboratory are A. always against the rules. B. okay. C. not dangerous. D. okay if you are working alone. 18. If a piece of equipment is not working properly, stop, turn it off, and tell A. the custodian. B. your lab partner. C. your best friend in the class. D. the science instructor. 19. If an acid is splashed on your skin, wash at once with A. soap. B. oil. C. weak base. D. plenty of water. 20. When you finish working with chemicals, biological specimens, and other lab substances, always A. treat your hands with skin lotion. B. wash your hands thoroughly with soap and water. C. wipe your hands on a towel. D. wipe your hands on your clothes. TrueâFalse T F 22. â â Hot glass looks the same as cold glass. 23. â â All chemicals in the lab are to be considered dangerous. 24. â â Return all unused chemicals to their original containers. 25. â â Work areas should be kept clean and tidy. 26. â â Pipets are used to measure and dispense small amounts of liquids. You should draw the liquid into the pipet using your mouth. 27. â â Laboratory work can be started immediately upon entering the laboratory even if the instructor is not yet present. 28. â â Never remove chemicals or other equipment from the laboratory. T F 29. â â Chipped or cracked glassware is okay to use. 30. â â Read all procedures thoroughly before entering the laboratory. 31. â â All unauthorized experiments are prohibited. 32. â â You are allowed to enter the chemical preparation/storage area any time you need to get an item. 33. â â Laboratory aprons should be worn during all lab activities. 34. â â Itâs okay to pick up broken glass with your bare hands as long as the glass is placed in the trash. 35. â â Never leave a lit burner unattended. 21. Draw a diagram of your science room and label the locations of the following: â Fire Blanket â Fire Extinguisher(s) â Exits â Eyewash Station â Emergency Shower â Closest Fire Alarm Station â Waste Disposal Container(s)4 Š 2017 Flinn Scientific, Inc. All Rights Reserved. Name: ________________________________________________ Date: ______________________________________________ 1. Flammable materials, like alcohol, should never be dispensed or used near A. an open door. B. an open flame. C. another student. D. a sink. 2. If a laboratory fire erupts, immediately A. notify your instructor. B. run for the fire extinguisher. C. throw water on the fire. D. open the windows. 3. Approved eye protection devices (such as goggles) are worn in the laboratory A. to avoid eye strain. B. to improve your vision. C. only if you donât have corrective glasses. D. any time chemicals, heat or glassware are used. 4. If you wear contact lenses in the school laboratory, A. take them out before starting the lab. B. you do not have to wear protective goggles. C. advise your science instructor that you wear contact lenses. D. keep the information to yourself. 5. If you do not understand a direction or part of a lab procedure, you should A. figure it out as you do the lab. B. try several methods until something works. C. ask the instructor before proceeding. D. skip it and go on to the next part. 6. After completing an experiment, all chemical wastes should be A. left at your lab station for the next class. B. disposed of according to your instructorâs directions. C. dumped in the sink. D. taken home. 7. If a lab experiment is not completed, you should A. discuss the issue with your instructor. B. sneak in after school and work alone. C. come in during lunch and finish while eating lunch. D. make up some results. 8. You are heating a substance in a test tube. Always point the open end of the tube A. toward yourself. B. toward your lab partner. C. toward another classmate. D. away from all people. Science Laboratory Safety teSt 9. You are heating a piece of glass and now want to pick it up. You should A. use a rag or paper towels. B. pick up the end that looks cooler. C. use tongs. D. pour cold water on it. 10. You have been injured in the laboratory (cut, burn, etc.). First you should A. visit the school nurse after class. B. see a doctor after school. C. tell the science instructor at once. D. apply first aid yourself. 11. When gathering glassware and equipment for an experiment, you should A. read all directions carefully to know what equipment is necessary. B. examine all glassware to check for chips or cracks. C. clean any glassware that appears dirty. D. All of the above. 12. You want to place a piece of glass tubing into a rubber stopper after the tubing has been fire polished and cooled. This is best done by A. lubricating the tubing with water or glycerin. B. using a towel or cotton gloves for protection. C. twisting the tubing and stopper carefully. D. all of the above. 13. Personal eyeglasses provide as much protection as A. a face shield. B. safety glasses. C. splashproof chemical goggles. D. none of the above. 14. Long hair in the laboratory must be A. cut short. B. held away from the experiment with one hand. C. always neatly groomed. D. tied back or kept entirely out of the way with a hair band, hairpins, or other confining device. 15. In a laboratory, the following should not be worn. A. loose clothing. B. dangling jewelry. C. sandals. D. all of the above. 16. The following footwear is best in the laboratory. A. sandals B. open-toed shoes C. closed-toed shoes D. shoes appropriate for the weather5 Š 2017 Flinn Scientific, Inc. All Rights Reserved. 17. Horseplay or practical jokes in the laboratory are A. always against the rules. B. okay. C. not dangerous. D. okay if you are working alone. 18. If a piece of equipment is not working properly, stop, turn it off, and tell A. the custodian. B. your lab partner. C. your best friend in the class. D. the science instructor. 19. If an acid is splashed on your skin, wash at once with A. soap. B. oil. C. weak base. D. plenty of water. 20. When you finish working with chemicals, biological specimens, and other lab substances, always A. treat your hands with skin lotion. B. wash your hands thoroughly with soap and water. C. wipe your hands on a towel. D. wipe your hands on your clothes. 21. Draw a diagram of your science room and label the locations of the following: â Fire Blanket â Fire Extinguisher(s) â Exits â Eyewash Station â Emergency Shower â Closest Fire Alarm Station â Waste Disposal Container(s) TrueâFalse T F 22. â â Hot glass looks the same as cold glass. 23. â â All chemicals in the lab are to be considered dangerous. 24. â â Return all unused chemicals to their original containers. 25. â â Work areas should be kept clean and tidy. 26. â â Pipets are used to measure and dispense small amounts of liquids. You should draw the liquid into the pipet using your mouth. 27. â â Laboratory work can be started immediately upon entering the laboratory even if the instructor is not yet present. 28. â â Never remove chemicals or other equipment from the laboratory. T F 29. â â Chipped or cracked glassware is okay to use. 30. â â Read all procedures thoroughly before entering the laboratory. 31. â â All unauthorized experiments are prohibited. 32. â â You are allowed to enter the chemical preparation/storage area any time you need to get an item. 33. â â Laboratory aprons should be worn during all lab activities. 34. â â Itâs okay to pick up broken glass with your bare hands as long as the glass is placed in the trash. 35. â â Never leave a lit burner unattended.
A BAD CASE OF THE STRIPES By David Shannon Parts(18): Camilla Narrator 1 Narrator 2 Narrator 3 Narrator 4 Mr. Harms Mother Father Dr. Bumble Old Woman Environmental Therapist Dr. Grop Dr. Gourd Dr. Sponge Mr. Mellon Dr. Cricket Dr. Young <><><><><><><><><><><><><><><><><><><><><><><><><><><><><><><><><><><><><><><><><><><><><><><><><> Narrator 1: A BAD CASE OF THE STRIPES By David Shannon Narrator 2: Camilla Cream loved lima beans. But she never ate them. Narrator 3: All of her friends hated lima beans, and she wanted to fit in. Camilla always worried about what other people thought of her. Narrator 4: Today she was fretting even more than usual. It was the very first day of school, and she couldn't decide what to wear. There were so many people to impress! Narrator 1: She tried on forty-two outfits, but none seemed quite right. She put on a pretty red dress and looked in the mirror. Then she screamed. Narrator 2: Her mother ran into the room, and she screamed, too. Mother: "Oh my heavens! You're completely covered with stripes!" Narrator 3: she cried. This was certainly true. Camilla was striped from head to toe. She looked like a rainbow. Narrator 4: Mrs. Cream felt Camilla's forehead. Mother: "Do you feel all right?" Narrator 1: she asked. Camilla: "I feel fine, but just look at me!" Narrator 2: Camilla answered. Mother: "You get back in bed this instant. You're not going to school today." Narrator 3: her mother ordered. Camilla was relieved. She didn't want to miss the first day of school, but she was afraid of what the other kids would say. And she had no idea what to wear with those crazy stripes. Narrator 4: That afternoon, Dr. Bumble came to examine Camilla. Dr. Bumble: "Most extraordinary! I've never seen anything like it! Are you having any coughing, sneezing, runny nose, aches, pains, chills, hot flashes, dizziness, drowsiness, shortness of breath, or uncontrollable twitching?" Narrator 1: he asked. Camilla: "No, I feel fine." Narrator 2: Camilla told him. Dr. Bumble: "Well then, I don't see any reason why she shouldn't go to school tomorrow. Here's some ointment that should help clear up those stripes in a few days. If it doesn't, you know where to reach me." Narrator 3: Dr. Bumble said, turning to Mrs. Cream. And off he went. Narrator 4: The next day was a disaster. Everyone at school laughed at Camilla. They called her "Camilla Crayon" and "Night of the Living Lollipop." Narrator 1: She tried her best to act as if everything were normal, but when the class said the Pledge of Allegiance, her stripes turned red, white, and blue, and she broke out in stars! Narrator 2: The other kids thought this was great. One yelled out, Narrator 3: "Let's see some purple polka dots!" Narrator 4: Sure enough, Camilla turned all purple polka-dotty. Someone else shouted, Narrator 1: "Checkerboard!" Narrator 4: and a pattern of squares covered her skin. Soon everyone was calling out different shapes and colors, and poor Camilla was changing faster than you can change channels on a T.V. Narrator 2: That night, Mr. Harms, the school principal, called. Mr. Harms: "I'm sorry, Mrs. Cream, I'm going to have to ask you to keep Camilla home from school. She's just too much of a distraction, and I've been getting phone calls from the other parents. They're afraid those stripes may be contagious." Narrator 3: he said. Camilla was so embarrassed. She couldn't believe that two days ago everyone liked her. Now, nobody wanted to be in the same room with her. Narrator 1: Her father tried to make her feel better. Father: "Is there anything I can get you, sweetheart?" Narrator 2: he asked. Camilla: "No, thank you," Narrator 3: sighed Camilla. What she really wanted was a nice plate of lima beans, but she had been laughed at enough for one day. Dr. Bumble: "Hmm, well, yes, I see. I think I'd better bring in the Specialists. We'll be right over.â Narrator 4: said Dr. Bumble to Mr. Cream on the phone. About an hour later, Dr. Bumble arrived with four people in long white coats. He introduced them to the Creams. Dr. Bumble: "This is Dr. Grop, Dr. Sponge, Dr. Cricket, and Dr. Young." Narrator 1: Then the Specialists went to work on Camilla. They squeezed and jabbed, tapped and tested. It was very uncomfortable. Dr. Grop: "Well, it's not the mumps." Dr. Sponge: "Or the measles." Dr. Cricket:"Definitely not chicken pox." Dr. Young: "Or sunburn." Narrator 2: replied the Specialists. Specialists:"Try these. Take one of each before bed." Narrator 4: said the specialists. They each handed her a bottle filled with different colored pills. Then they filed out the front door followed by Dr. Bumble. Narrator 1: That night, Camilla took her medicine. It was awful. Narrator 2: When she woke up the next morning, she did feel different, but when she got dressed, her clothes didn't fit right. She looked in the mirror, and there, staring back at her, was a giant, multi-colored pill with a face on it. Narrator 3: Dr. Bumble rushed over as soon as Mrs. Cream called. But this time, instead of the Specialists, he brought the Experts. Narrator 4: Dr. Gourd and Mr. Mellon were the finest scientific minds in the land. Once again, Camilla was poked and prodded, looked at and listened to. Narrator 1: The Experts wrote down lots of numbers. Then they huddled together and whispered. Dr. Gourd finally spoke. Dr. Gourd: "It might be a virus," Narrator 2: he announced with authority. Suddenly, fuzzy little virus balls appeared all over Camilla. Mr. Mellon: "Or possibly some form of bacteria," Narrator 3: said Mr. Mellon. Out popped squiggly little bacteria tails. Dr. Gourd: "Or it could be a fungus," Narrator 4: added Dr. Gourd. Instantly, Camilla was covered with different colored fungus blotches. The experts looked at Camilla, then each other. Experts: "We need to go over these numbers again back at the lab. Weâll call you when we know something," Narrator 1: said the Experts. But the Experts didn't have a clue, much less a cure. Narrator 2: By now, the T.V. news had found out about Camilla. Reporters from every channel were outside her house, telling the story of "The Bizarre Case of the Incredible Changing Kid." Narrator 3: Soon a huge crowd was camped out on the front lawn. Narrator 4: The Creams were swamped with all kinds of remedies from psychologists, allergists, herbalists, nutritionists, psychics, an old medicine man, a guru, and even a veterinarian. Narrator 1: Each so-called cure only added to poor Camilla's strange appearance until it was hard to even recognize her. She sprouted roots and berries and crystals and feathers and a long furry tail. But nothing worked. Narrator 2: One day, a woman who called herself an Environmental Therapist claimed she could cure Camilla. She said, Environmental Therapist: "Close your eyes, breathe deeply, and become one with your room." Camilla: "I wish you hadn't said that," Narrator 3: Camilla groaned. Slowly, she started to melt into the walls of her room. Her bed became her mouth, her nose was a dresser, and two paintings were her eyes. The therapist screamed and ran from the house. Mother: "What are we going to do? It just keeps getting worse and worse!" Narrator 4: cried Mrs. Cream. She began to sob. Narrator 1: At that moment, Mr. Cream heard a quiet little knock at the front door. He opened it, and there stood an old woman who was just as plump and sweet as a strawberry. Old Woman: "Excuse me, but I think I can help." Narrator 2: she said brightly. Narrator 3: She went into Camilla's room and looked around. Old Woman: "My goodness, what we have here is a bad case of the stripes. One of the worst I've ever seen!" Narrator 4: she said with a shake of her head. She pulled a container of small green beans from her bag. She said, Old Woman: "Here. These might do the trick." Mother: "Are those magic beans?" Narrator 1: asked Mrs. Cream. The old woman replied, Old Woman: "Oh my, no, there's no such thing. These are just plain old lima beans. I'll bet you'd like some, wouldn't you?" Narrator 2: she asked Camilla. Camilla wanted a big, heaping plateful of lima beans more than just about anything, but she was still afraid to admit it. She said, Camilla: "Yuck! No one likes lima beans, especially me!" Old Woman: "Oh, dear, I guess I was wrong about you." Narrator 3: said the old woman sadly. She put the beans back in her bag and started toward the door. Narrator 4: Camilla watched the old woman walk away. Those beans would taste so good. And being laughed at for eating them was nothing, compared to what she'd been going through. She finally couldn't stand it. Camilla: "Wait! The truth is...I really love lima beans." Narrator 1: she cried. The old woman smiled, popping a handful of beans into Camilla's mouth, and said, Old Woman: "I thought so." Camilla: "Mmmmmmm," Narrator 2: said Camilla. Suddenly the branches, feathers, and squiggly tails began to disappear.Then the whole room swirled around. When it stopped, there stood Camilla, and everything was back to normal. Camilla: "I'm cured!" Narrator 3: she shouted. The old woman said, Old Woman: "Yes, I knew the real you was in there somewhere." Narrator 4: She patted Camilla on the head and went outside and vanished into the crowd. Narrator 1: Afterward, Camilla wasn't quite the same. Narrator 2: Some of the kids at school said she was weird, but she didn't care a bit. Narrator 3: She ate all the lima beans she wanted, and she never had even a touch of stripes again.
Chapter 22 Antihypertensive Drugs Hypertension Defined (JNC-8) Pharmacology Overview 7 main categories of drugs to treat HTN Adrenergic drugs (old friend) Angiotensin-converting enzyme (ACE) inhibitors Angiotensin II receptor blockers (ARBs) Calcium channel blockers (CCBs) Diuretics Vasodilators Direct renin inhibitors A. Adrenergic Drugs: 5 Subcategories and where they act A1. Adrenergic neuron blockers (central and peripheral)- we wonât talk about this A2. Alpha1 receptor blockers (peripheral) A3. Alpha2 receptor agonists (central) A4. Beta receptor blockers (peripheral) A5. Combined Îą and β receptor blockers (peripheral) A2. Peripherally Acting Adrenergic DrugAlpha1 Blockers (weâve met these) Doxazosin, prazosin, alfuzosin Block alpha1-receptors which causes BP to decrease Reduces peripheral vascular resistance and BP by dilating both arterial and venous blood vessels Main Use: benign prostatic hyperplasia (BPH) Alpha1 Blockers REMEMBER Tamsulosin (Flomax)* is an Îą1 blocker BUT *Tamsulosin is not used to control BP, just for BPH. A3. Centrally Acting Adrenergic DrugsAlpha 2 agonist Clonidine and methyldopa 1- Stimulate alpha2-adrenergic receptors. in the brain Decreases sympathetic outflow from the CNS which decreases NE production 2. Stimulate alpha2-adrenergic receptors in kidneys remember alpha 2 opposes alpha 1 Dilates peripheral blood vessels â lowers peripheral resistance â Results in decreased BP So âŚ.Clonidine (Catapres) Used primarily for its ability to decrease blood pressure in an urgent setting Also use in opioid withdrawal as previously discussed Oral (multiple times a day), and topical patch formulations Do not stop abruptly as it may lead to rebound hypertension In reality, Clonidine and methyldopa Not prescribed as first-line home antiHTN drugs High incidence of unwanted adverse effects: orthostatic hypotension, fatigue, and dizziness MIGHT be uses as adjunct drugs after other drugs have failed, in conjunction with other antiHTN such as diuretics A4. Adrenergic Drugs Selective Beta 1 Blockers Metoprolol, Atenolol Reduction of HR through β1 receptor blockade (remember adrenergic blocking of this receptor???) HR results in BP Cause reduced secretion of renin = BP A4. Adrenergic Drugs Selective Beta1 Blockers Nebivolol (Bystolic) Uses: hypertension and HF Action: blocks β1 receptors and produces vasodilatation, which results in a decrease in SVR High doses loses selectivity and blocks both β1 and β2 Less sexual dysfunction All BB- Do not stop abruptly; must be tapered over 1 to 2 weeks A4. Adrenergic Drugs NONSelective Beta Blockers Propranolol Acts equally on β1 and β2 Other uses include situational anxiety associated with public speaking, test taking As mentioned on previous slide, nebivolol at high doses becomes beta nonselective A5. Dual-Action Adrenergic Drugs Îą1 and β Receptor Blockers Dual antihypertensive effects of reduction in heart rate (beta1 receptor blockade) and vasodilation (alpha1 receptor blockade) Examples are carvedilol (common) and labetalol (not as common) A5. Dual-Action Adrenergic Drugs Îą1 and β Receptor Blockers Carvedilol (Coreg) Widely used drug that is well tolerated Uses: HTN, mild to moderate HF in conjunction with digoxin, diuretics, and ACE inhibitors Contraindications: severe bradycardia or unstable HF, bronchospastic conditions such as asthma, and various cardiac conduction problems Adrenergic Drugs Indications - HTN But also for Glaucoma (topical) BPH: doxazosin, prazosin, and terazosin (2 for 1) Management of severe HF when used with cardiac glycosides and diuretics Contraindications Acute HF- have to stabilize first MOAIs- yeah doesnât everything interact with MAOIs? Peptic ulcers Severe liver/kidney disease Asthma (with beta blockers) Adrenergic Drugs: Adverse Effects Orthostatic hypotension 1st-dose syncope Rebound hypertension with abrupt discontinuation Most common: Dry mouth, drowsiness, constipation, sedation Interactions- always check for specific drug interactions Can cause additive CNS depression with alcohol, benzodiazepines, opioids Question #1 When administering an alpha-adrenergic drug for hypertension, it is most important for the nurse to assess the patient for the development of what response? Hypotension Hyperkalemia Oliguria Respiratory distress Answer A Hypotension This is a key point in patient education These drugs have strong vasodilating properties and may cause severe hypotension, especially at the beginning of therapy. B. Angiotensin-Converting Enzyme Inhibitorsaka ACE Inhibitors or ACEi Large group of safe and effective drugs Currently are 10 ACEi Often used as first-line drugs for HF and hypertension May be combined with a thiazide diuretic, loop diuretic, or Calcium Channel Blocker (CCB) You need to understand the basics ACE Inhibitors: Review RAAS ACE converts angiotensin I, formed through the action of renin, to angiotensin II Angiotensin 2 is a potent vasoconstrictor and also induces aldosterone secretion by the adrenal glands Aldosterone stimulates sodium resorption (H20 follows Na Both act to raise BP which causes kidneys to reduce renin production ACEi= Great drug to treat HTN BUT contraindicated in pregnancy (2nd,3rd trimester due to fetal renal damage) and breastfeeding first few weeks after birth B. ACE Inhibitors - PRIL Lisinopril (Prinivil) super common, often the 1st drug Enalapril (Vasotec) also common Captopril (Capoten) great if liver disease present Benazepril (Lotensin) Fosinopril (Monopril) Perindopril (Aceon) Quinapril (Accupril) Ramipril (Altace) Trandolapril (Mavik) Primary Effects of the ACE Inhibitors Prevent Na (and H2O) resorption by inhibiting aldosterone secretion (volume reduction) (GO BACK TO RAAS DIAGRAM) blood volume decreases work of the heart preload, or the left ventricular end-diastolic volume which is important in HF ACE SUMMARY OF ACTIVITY 1) Prevent vasoconstriction caused by angiotensin 2 (2) Prevent aldosterone secretion ď¨ less sodium and water resorption Cardioprotective Effects of ACEi They slow progression of left ventricular hypertrophy (ventricular remodeling) after MI so considered cardioprotective ACE inhibitors have been shown to decrease morbidity and mortality in patients with HF Renal Protective Effects of ACEi ACE inhibitors: reduce glomerular filtration pressure by volume reduction Cardiovascular drug of choice for patients with diabetes since it helps protect kidneys by reducing pressure. Sometimes used low dose for kidney protection with DM without HTN B. ACEi Enalapril (Vasotec) Only ACEi available in both oral and IV Enalapril IV does not require cardiac monitoring Oral enalapril: prodrug (metabolized in liver) Improves patientâs chances of survival after an MI Reduces the incidence of HF B. ACEi Captopril (Capoten) Uses: prevention of ventricular remodeling after MI; reduce the risk of HF after MI Shortest half-lifeď¨ Must be administered multiple times throughout the day so this limits its use Not a prodrug so good for patient with liver disease Question #2 A patient with diabetes has a new prescription for the ACE inhibitor lisinopril. She questions this order because her provider has never told her that she has hypertension. What is the best explanation for this order? The doctor knows best The patient is confused This medication has cardioprotective properties This medication has a protective effect on the kidneys for patients with diabetes Answer D ACE inhibitors have been shown to have a protective effect on the kidneys because they reduce glomerular filtration pressure. This property makes them the cardiovascular drug of choice for patients with diabetes. Question #3 A patient with a history of pancreatitis and cirrhosis is also being treated for hypertension. Which drug will most likely be ordered for this patient? Clonidine Prazosin Diltiazem Captopril Answer D Captopril Captopril is not a prodrug; therefore, it does not need to be metabolized by the liver to be effective. This is an advantage in patients with liver disease. ACE Inhibitors: Adverse Effects *Dry, nonproductive cough, which reverses when therapy is stopped. This is a class effect Dizziness- Note: First-dose hypotensive effect may occur Headache & Fatigue Possible hyperkalemia ** Angioedema: rare but potentially fatal Not safe in pregnancy-are contraindicated during the second and third trimesters of pregnancy because of increased risk of fetal renal damage C. Angiotensin II Receptor Blockers(ARB) Considered an alternative to ACEi Less likely to cause a dry cough and hyper K+ that is common with ACE inhibitors Angiotensin II Receptor Blockers: Mechanism of Action Go back to RAAS diagram! ARBs affect primarily 2 places 1. Vascular smooth muscle - blocks vasoconstriction 2. Adrenal gland -Selectively blocks the binding of Ang 2 to certain Ang 2 receptors inhibiting secretion of aldosterone Lowers volume retention and BP Angiotensin II Receptor Blockers -ARTAN Losartan (Cozaar)- very common Eprosartan (Teveten) Valsartan (Diovan) Irbesartan (Avapro) Candesartan (Atacand) Olmesartan (Benicar) Telmisartan (Micardis) Azilsartan (Edarbi) C. ARB Losartan (Cozaar) Beneficial in patients with HTN and HF Used with caution in patients with kidney or liver dysfunction and in patients with renal artery stenosis ***Not safe for breastfeeding women and should not be used in pregnancy (Cat C 1st trimester, Cat D 2nd-3rd trimester), potential fetal toxicity Appear to be equally effective for the treatment of hypertension and well tolerated ARBs less likely to cause cough and hyperK+ but can still happen Evidence that ARBs are associated with lower mortality after MI than ACE inhibitors Never take ACEi and ARBs at the same time* 5. Calcium Channel Blockers (CCB) Primary use: HTN, angina, some dysrhythmias Cause smooth muscle relaxation by blocking the binding of calcium to its receptors, preventing muscle contraction Results in: Relaxed blood vessels to the heart Decreased peripheral smooth muscle tone Decreased SVResistance Decreased BP E. Diuretics First-line antiHTN in JNC 8 guidelines Decreases fluid volume The results from diuresis: preload, Peripheral resistance Overall effect ď Decreased workload of the heart and decreased BP Thiazide diuretics are the most commonly used diuretics for HTN Ie hydrochlorothiazide (HCTZ), chlorthalidone We will discuss diuretics further in the chapter on diuretics F. Vasodilators Directly relax arterial or venous smooth muscle (or both) Results in: Decreased SVR Decreased afterload Peripheral vasodilation Indicated for treatment of HTN May be used in combination with other drugs F. Vasodilators Hydralazine (Apresoline) Orally: routine cases of essential hypertension Injectable: hypertensive emergencies BiDil: specifically indicated as an adjunct for treatment of HF in African-American patients F. Vasodilators Sodium Nitroprusside (Nitropress) *Sodium nitroprusside and IV diazoxide are reserved for the management of hypertensive emergencies. Contraindications: severe HF, known inadequate cerebral perfusion (especially during neurosurgical procedures) F. Vasodilators Adverse Effects Hydralazine: dizziness, headache, tachycardia, edema, dyspnea, N/V/D, vitamin B6 deficiency, rash Sodium nitroprusside: hypotension, bradycardia, decreased platelet aggregation, rash G. Direct Renin Inhibitors Aliskirin (Tekturna) Blocks the RAS pathway at the point of activation. Inhibiting renin production prevents the downstream production of Ang II (potent vasoconstrictor) Adverse effects: N/V, severe hypotension, hyponatremia, hyperkalemia⌠Contraindicated in patients with DM taking ACEi or ARB Miscellaneous Antihypertensives Eplerenone (Inspra) Newer class of drugs called selective aldosterone blockers (remember RAAS?) Reduces BP by blocking the actions of aldosterone at its corresponding receptors in the kidney, heart, blood vessels, and brain Indications: routine treatment of hypertension and for post-MI HF Contraindicated if serum potassium levels are high (above 5.6 mEq/L) A Special Form of HTNTreatment of Pulmonary Hypertension Sildenafil and Tadalafil Commonly used for erectile dysfunction Used for pulmonary hypertension but with different trade names Sildenafil: Revatio* (Viagra for ED) Tadalafil: Adcirca* (Cialis for ED)
Alright, Isti â hereâs a longer and more detailed English version of the Isaac Newton text, still written at a level thatâs accessible for Grade 4 students, but rich enough in information to meet PISA literacy expectations and EF A2-level vocabulary. Iâve kept sentences short, clear, and with explanations for new concepts so itâs easier for young learners to follow, while still including both famous facts and lesser-known stories. ⸝ Isaac Newton: The Man Who Changed the Way We See the World A Boy from a Small Village Isaac Newton was born on January 4, 1643, in Woolsthorpe, a small village in England. His life was not easy. His father died before he was born. When he was just a few months old, his mother remarried and left him to live with his grandmother. Isaac missed his parents, but he kept himself busy by making things and exploring the world around him. As a child, Isaac liked to build models and machines. He made a small windmill that could turn with the wind. He built a water clock that told the time by dripping water into a container. He even made a sundial â a clock that tells the time by using the shadow of the sun. đĄ Did you know? The sundial marks that Isaac carved as a boy can still be seen today on the wall of his old house. ⸝ School and Curiosity When Newton first went to school, he was not the top student. At first, he did not pay much attention in class. But one day, another boy teased him for not being smart. Newton decided to study hard to prove him wrong. Soon, he became the best in his class. Isaac loved asking questions. He wanted to know how and why things happened. He enjoyed watching the stars at night and thinking about how the world worked. ⸝ The Falling Apple and Gravity One of the most famous stories about Newton is the falling apple. One afternoon, Isaac sat in his motherâs garden and saw an apple drop from a tree. This made him think: âWhy does the apple fall straight down? Why doesnât it fly up into the sky?â From this question, Newton began to think about gravity â an invisible force that pulls objects toward each other. Gravity is what keeps our feet on the ground. Itâs also what keeps the Moon moving around the Earth and the planets moving around the Sun. đĄ Fun fact: The apple did not hit Newtonâs head. Thatâs just a story people made up later to make the tale more exciting. ⸝ Newtonâs Three Laws of Motion Newton studied movement and wrote three important rules: 1. Objects stay still or keep moving unless something makes them change. ⢠Example: A ball will not roll unless you push it. 2. The bigger the push, the bigger the movement. ⢠Example: If you kick a ball harder, it will go faster and farther. 3. Every action has an equal and opposite reaction. ⢠Example: When you jump off a boat, the boat moves backward as you move forward. These three laws are still used today to understand how cars, rockets, and even roller coasters work. ⸝ Discoveries in Light and Color Newton also studied light. He found that white light is not just one color â it is made of many colors. He used a glass prism to split sunlight into a rainbow. This helped scientists understand how colors work. ⸝ Inventions and New Ideas Newton made a special telescope that used mirrors instead of lenses. This type of telescope made images of planets and stars much clearer. It is still called the Newtonian telescope today. He also worked in mathematics and helped create a new type of math called calculus, which is used to study changes and movement. ⸝ Strange Experiments Newton was so curious that he sometimes tested ideas on himself. Once, he put a thin needle, called a bodkin, beside his eye to see how it would change his vision. It was very dangerous, but luckily he did not go blind. đĄ Did you know? Newton also studied alchemy â an old kind of science where people tried to turn metal into gold. He never succeeded, but it showed how wide his interests were. ⸝ Later Life and Work At the age of 27, Newton became a professor at Cambridge University. He later worked for the Royal Mint, making sure coins were made safely and stopping people from making fake money. He was very strict, and some criminals were sent to prison because of his work. Newton never married. He spent most of his life reading, writing, and doing experiments. ⸝ The End of His Life Isaac Newton died in 1727 at the age of 84. He was buried in Westminster Abbey, a famous place in London where great people of Britain are honored. His work changed the world forever. Even today, scientists, engineers, and students still use Newtonâs laws and ideas. đŹ Newton once said: âIf I have seen further, it is by standing on the shoulders of giants.â This means we can make new discoveries by learning from the work of others who came before us. give 10 questions to each passage with PISA literacy standard for kid 10 years, 1. Nikola Tesla: The Man Who Dreamed of Lightning Born: July 10, 1856 Died: January 7, 1943 When Nikola Tesla was a boy in Croatia, he saw a flash of lightning and asked his mother, âCan we catch the light?â That question never left him. As he grew older, Tesla became a brilliant inventor, especially fascinated by electricity. He believed in a future where energy could be sent wirelessly through the airâlike music through the radio! Tesla invented the alternating current (AC) system, which became the foundation of modern electricity. At the time, Thomas Edison promoted direct current (DC), and the two men had a fierce competition. Many laughed at Tesla's bold ideas, but he never gave up. He dreamed of wireless communication, flying machines, and even free energy for everyone. Though he died alone and poor, today the world honors his vision. Think About It: Why do you think people didnât believe Tesla at first? What can we learn from Teslaâs courage to dream big? 2. Charles Darwin: The Man Who Studied the Worldâs Weirdest Creatures Born: February 12, 1809 Died: April 19, 1882 When young Charles Darwin got on a ship called HMS Beagle, he didnât know he would change science forever. He sailed around the world for five years, collecting plants, animals, and fossils. On the GalĂĄpagos Islands, he noticed something curious: finches had different beaks depending on their island. Why? Darwinâs observations led him to write the theory of evolution by natural selection. It explained how animals adapt and survive. But his ideas shocked many people because they seemed to challenge religious beliefs. Despite the controversy, Darwin continued his work. His book On the Origin of Species changed how we see life on Earth. Think About It: Should scientists share their ideas even if they go against what others believe? How did traveling help Darwin make new discoveries? 3. Marie Curie: The Woman Who Glowed in the Dark Born: November 7, 1867 Died: July 4, 1934 Marie Curie was born in Poland at a time when girls were not allowed to study science. But that didnât stop her. She moved to France, worked day and night, and discovered radioactivity, a powerful energy hidden inside atoms. She and her husband, Pierre Curie, found two new elements: polonium and radium. She became the first woman to win a Nobel Prize, and the only person to win in two different sciences: physics and chemistry. Even when Pierre died in an accident, Marie continued their work. Her discoveries helped doctors treat cancerâbut working with radioactive materials also harmed her health. She died from radiation exposure, but her legacy lives on. Think About It: What challenges did Marie Curie face as a woman in science? Why is it important to balance discovery with safety? 4. Galileo Galilei: The Star Watcher Who Defied the Church Born: February 15, 1564 Died: January 8, 1642 Galileo loved looking at the stars. He built one of the first powerful telescopes and made stunning discoveries: mountains on the Moon, moons around Jupiter, and that the Earth orbits the Sunânot the other way around. This idea, called heliocentrism, went against the teachings of the Church. He was put on trial and forced to say he was wrong. But he wasnât. He spent his last years under house arrest, quietly writing. Today, Galileo is called the father of modern science for daring to question what others blindly believed. Think About It: Why do you think Galileo was punished for telling the truth? Should science always follow evidence, even if it goes against powerful beliefs? 5. Isaac Newton: The Man Who Asked âWhy?â When an Apple Fell Born: January 4, 1643 Died: March 31, 1727 One day, an apple fell from a tree, and Isaac Newton began to wonder: Why did it fall down, not sideways or up? This simple question led to his theory of gravity. Newton also invented calculus, described the laws of motion, and changed physics forever. But Newton wasnât just a geniusâhe was curious, quiet, and often worked alone. He believed everything in nature followed rules, and it was our job to discover them. Thanks to him, we understand how planets move, how rockets launch, and why you fall when you trip. Think About It: How did Newtonâs curiosity lead to great discoveries? Do you think working alone helped or hurt Newton? 6. Ada Lovelace: The First Computer Programmer Before Computers Existed Born: December 10, 1815 Died: November 27, 1852 Ada Lovelace was the daughter of the famous poet Lord Byron, but she didnât love poetryâshe loved numbers! At a time when girls were expected to sew, Ada studied mathematics. She met Charles Babbage, who designed an early computer called the Analytical Engine. Ada imagined the machine could do more than just mathâit could create music, art, and even write! She wrote what is now considered the first computer program, long before real computers were built. Think About It: How did Ada imagine something that didnât exist yet? Why do we call her a pioneer in technology? 7. Albert Einstein: The Man Who Brought Time and Space Together Born: March 14, 1879 Died: April 18, 1955 Albert Einstein wasnât always a good student. In fact, his teachers thought he was slow. But Einstein thought deeply. He asked big questions like, âWhat if you could ride a beam of light?â His theories of relativity changed how we see space, time, and gravity. He also warned the world about the dangers of nuclear weapons, even though his ideas helped create them. Einstein believed science should help people, not harm them. With his messy hair, kind smile, and brilliant mind, he remains a symbol of genius. Think About It: Can someone be bad in school but still be brilliant? Should scientists be responsible for how their inventions are used? 8. Pythagoras: The Musician Who Loved Math Born: Around 570 BC Died: Around 495 BC Long ago in ancient Greece, Pythagoras believed the universe followed numbers. He discovered the Pythagorean Theorem, a rule about triangles that helps us build houses, design computers, and navigate space. He also believed that music had math inside itâthat certain notes made perfect harmony because of mathematical ratios. Pythagoras started a secret school and taught his students to search for truth through numbers, shapes, and sound. Think About It: Why do you think Pythagoras saw math in everything? How does music relate to math? 9. Rosalind Franklin: The Woman Behind the DNA Discovery Born: July 25, 1920 Died: April 16, 1958 Rosalind Franklin loved looking closely at things. She used a special machine called X-ray crystallography to photograph molecules. One of her greatest photos, called Photo 51, showed the shape of DNA, the molecule that carries lifeâs instructions. But her work was taken without credit. Two men, Watson and Crick, used her photo to build their famous model of DNA and won the Nobel Prize. Rosalind died young and never knew how important her work became. Think About It: Why is it important to give credit in science? What can we learn from Rosalindâs quiet strength? 10. Carl Linnaeus: The Man Who Gave Names to Everything Born: May 23, 1707 Died: January 10, 1778 Have you ever wondered why a tiger is called Panthera tigris? Thatâs thanks to Carl Linnaeus, a Swedish scientist who created a way to name and organize every living thing. His system is still used today in biology. Linnaeus loved nature and spent his life collecting plants, animals, and even rocks. He believed that by organizing life, we could better understand it. Thanks to him, we now have a global âdictionary of nature.â Think About It: Why is it important to name and organize living things? How does order help us understand the world?