1. In which position, the nurse will keep herself while palpating a patient’s neck with lymph-adenopathy?





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MCQ->In which position, the nurse will keep herself while palpating a patient’s neck with lymph-adenopathy?....
MCQ->In which position,the nurse will keep herself while palpating a patient’s neck with lymphadenopathy?....
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MCQ-> Billie Holiday died a few weeks ago. I have been unable until now to write about her, but since she will survive many who receive longer obituaries, a short delay in one small appreciation will not harm her or us. When she died we — the musicians, critics, all who were ever transfixed by the most heart-rending voice of the past generation — grieved bitterly. There was no reason to. Few people pursed self-destruction more whole-heartedly than she, and when the pursuit was at an end, at the age of 44, she had turned herself into a physical and artistic wreck. Some of us tried gallantly to pretend otherwise, taking comfort in the occasional moments when she still sounded like a ravaged echo of her greatness. Others had not even the heart to see and listen any more. We preferred to stay home and, if old and lucky enough to own the incomparable records of her heyday from 1937 to 1946, many of which are not even available on British LP, to recreate those coarse-textured, sinuous, sensual and unbearable sad noises which gave her a sure corner of immortality. Her physical death called, if anything, for relief rather than sorrow. What sort of middle age would she have faced without the voice to earn money for her drinks and fixes, without the looks — and in her day she was hauntingly beautiful — to attract the men she needed, without business sense, without anything but the disinterested worship of ageing men who had heard and seen her in her glory?And yet, irrational though it is, our grief expressed Billie Holiday’s art, that of a woman for whom one must be sorry. The great blues singers, to whom she may be justly compared, played their game from strength. Lionesses, though often wounded or at bay (did not Bessie Smith call herself ‘a tiger, ready to jump’?), their tragic equivalents were Cleopatra and Phaedra; Holiday’s was an embittered Ophelia. She was the Puccini heroine among blues singers, or rather among jazz singers, for though she sang a cabaret version of the blues incomparably, her natural idiom was the pop song. Her unique achievement was to have twisted this into a genuine expression of the major passions by means of a total disregard of its sugary tunes, or indeed of any tune other than her own few delicately crying elongated notes, phrased like Bessie Smith or Louis Armstrong in sackcloth, sung in a thin, gritty, haunting voice whose natural mood was an unresigned and voluptuous welcome for the pains of love. Nobody has sung, or will sing, Bess’s songs from Porgy as she did. It was this combination of bitterness and physical submission, as of someone lying still while watching his legs being amputated, which gives such a blood-curdling quality to her Strange Fruit, the anti-lynching poem which she turned into an unforgettable art song. Suffering was her profession; but she did not accept it.Little need be said about her horrifying life, which she described with emotional, though hardly with factual, truth in her autobiography Lady Sings the Blues. After an adolescence in which self-respect was measured by a girl’s insistence on picking up the coins thrown to her by clients with her hands, she was plainly beyond help. She did not lack it, for she had the flair and scrupulous honesty of John Hammond to launch her, the best musicians of the 1930s to accompany her — notably Teddy Wilson, Frankie Newton and Lester Young — the boundless devotion of all serious connoisseurs, and much public success. It was too late to arrest a career of systematic embittered self-immolation. To be born with both beauty and selfrespect in the Negro ghetto of Baltimore in 1915 was too much of a handicap, even without rape at the age of 10 and drug-addiction in her teens. But, while she destroyed herself, she sang, unmelodious, profound and heartbreaking. It is impossible not to weep for her, or not to hate the world which made her what she was.Why will Billie Holiday survive many who receive longer obituaries?
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MCQ-> Read the passage carefully and answer the questions givenWill a day come when India’s poor can access government services as easily as drawing cash from an ATM? . . . [N]o country in the world has made accessing education or health or policing or dispute resolution as easy as an ATM, because the nature of these activities requires individuals to use their discretion in a positive way. Technology can certainly facilitate this in a variety of ways if it is seen as one part of an overall approach, but the evidence so far in education, for instance, is that just adding computers alone doesn’t make education any better. . . . The dangerous illusion of technology is that it can create stronger, top down accountability of service providers in implementation-intensive services within existing public sector organisations. One notion is that electronic management information systems (EMIS) keep better track of inputs and those aspects of personnel that are ‘EMIS visible’ can lead to better services. A recent study examined attempts to increase attendance of Auxiliary Nurse Midwife (ANMs) at clinics in Rajasthan, which involved high-tech time clocks to monitor attendance. The study’s title says it all: Band-Aids on a Corpse . . . e-governance can be just as bad as any other governance when the real issue is people and their motivation. For services to improve, the people providing the services have to want to do a better job with the skills they have. A study of medical care in Delhi found that even though providers, in the public sector had much better skills than private sector providers their provision of care in actual practice was much worse. In implementation-intensive services the key to success is face-to-face interactions between a teacher, a nurse, a policeman, an extension agent and a citizen. This relationship is about power. Amartya Sen’s . . . report on education in West Bengal had a supremely telling anecdote in which the villagers forced the teacher to attend school, but then, when the parents went off to work, the teacher did not teach, but forced the children to massage his feet. . . . As long as the system empowers providers over citizens, technology is irrelevant. The answer to successfully providing basic services is to create systems that provide both autonomy and accountability. In basic education for instance, the answer to poor teaching is not controlling teachers more . . . The key . . . is to hire teachers who want to teach and let them teach, expressing their professionalism and vocation as a teacher through autonomy in the classroom. This autonomy has to be matched with accountability for results—not just narrowly measured through test scores, but broadly for the quality of the education they provide. A recent study in Uttar Pradesh showed that if, somehow, all civil service teachers could be replaced with contract teachers, the state could save a billion dollars a year in revenue and double student learning. Just the additional autonomy and accountability of contracts through local groups—even without complementary system changes in information and empowerment—led to that much improvement. The first step to being part of the solution is to create performance information accessible to those outside of the government. . . .According to the author, service delivery in Indian education can be improved in all of the following ways EXCEPT through:
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