tina jones comprehensive assessment quizlet

tina jones comprehensive assessment quizlet

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Asthma is a lung condition that affects people of all ages. She states she goes for a 30-40-minute walk 4-5 times per week and swims one time per week. healthliteracy,andcurrenttreatmentplans. . Cannabis use from age 15 to (2014). Case - Tina jones heent shadow health complete 3. When she is exposed to allergens she states that she has runny nose, itchy and swollen eyes, and increased asthma symptoms. Since then Ive just washed my face, I havent used anything special. Denies gallbladder and liver disease. A comprehensive physical assessment provides fundamental, personalized knowledge about a patient and creates the basis for health promotion through education and counseling (Bickley & Szilagyi, 2013). I used to have a reaction when I was in a dusty house for a long time. Pro Tip: Its important to inspect your patients hair for distribution, color, and texture because abnormal hair growth or characteristics can indicate underlying health problems. Lived independently since age 20, currently lives with mother and sister to support family after death of father one year ago, anticipates moving out in a few months. Abdomen tympanic on percussion. ProTip:Themedicationapatienttakesindicatestheirhealthliteracy,treatmentplan, Undergraduate students, become a tester for Shadow Health! Case - Tina jones health history narrative 2. No ptosis or edema noted. Pro Tip: The medications that a patient takes indicate their health concerns or problems, health literacy, and current treatment plans. Musculoskeletal. How often do you take your birth control pill? Ms. Jones is alert and oriented, seated upright on the examination table, and is in no apparent distress. There is no family history of other cancers, mental illness. Dains, J. E., Baumann, L. C., & Scheibel, P. (2012). She is a good historian. Can Someone Take My Online Class? Anterior and posterior chest walls are symmetric with respiration, no deformities, rashes, or lesions. The rescue inhaler was last used three months ago with a total of two uses in the past year. ProTip:Asthmaseveritymightchangeovertimeforavarietyofreasons. Her last healthcare visit First sexual encounter at age 18, sex with men, identifies as heterosexual. walking, yoga, or swimming. contradiction. . Reports no eye pain, Tina Jones Health History Shadow Health Information Processing, Shadow Health Tina jones Mental Health Assessment Subjective Data. No clicks on jaw palpation, full ROM. maxillary sinuses nontender to palpation. What medical problems did your father have? Type 2 diabetes, diagnosed at age 24. I havent been having any gas lately. ObjectiveDataCollection Denies head and neck trauma. Acombinationofopenandclosedquestionswillyieldbetterpatientdata. 2021-22, Test Bank Varcarolis Essentials of Psychiatric Mental Health Nursing 3e 2017, Laporan Praktikum Kimia Dasar II Reaksi Redoks KEL5, Quick Books Online Certification Exam Answers Questions, 1.1 Functions and Continuity full solutions. Indicatesanitemthatisavailabletobefound. Documentation MSN Assignments (64) Reports no general ear problems, no change in Tina Jones - Uncontrolled Diabetes Patient will be able to demonstrate how to check glucose levels and take medication KEY: Evaluation Assessment Findings Patient is able to follow the routine schedule set out for taking medications consistently Patient glucose levels within healthy range (<160mg/dL) by discharge Slow healing foot wound Ms. Jones reports no headaches, vision changes, eye pain or itchy eyes. Lets see . Her last dental exam was over two years ago. ), UpToDate. CanIconfirmthatyouarehereforaphysical? treatmentplans. . ProTip:AskingTinaifshehasbeentoaneyedoctorwillindicatethedegreetowhich appropriately with good hygiene. Eyes: Complains of blurred vision associated with "reading and studying," which has worsened over the past few years. Asthma diagnosed at age 2 1/2. Conjunctiva pink no lesions white sclera. treatmentplans. hertreatmentplanandthedegreetowhichshecomplieswithit. AskingTinahowshehasbeentreatingherhypertensionwillindicate She states she takes the pill daily, at the same time each day. lids without lesions, no ptosis or edema. possibletriggerslikeenvironmentalfactors,bodilypositions,ormovementsthatmay She is required to have a physical exam for her health insurance. Nasal mucosa moist and I came in because Im required to have a recent physical exam for the health insurance at my new job.. The following details are facts of the patients case. Does this Look Like Your Assignment? Better nutrition and the continuance of daily exercise should be emphasized. lip, acanthosis nigricans on posterior neck. understandingwhenapatientexperiencesacondition. medication side effects at this time. Ms. Jones is a pleasant, 28-year-old African She offers information freely and without Theyre crazy, but nobodys diagnosed with anything. She is starting a new job as an accounting clerk at Smith, Stewart, Silver & Company. Ms. Jones is a pleasant 28-year-old African American woman who presented to the emergency department for evaluation of a right foot injury and was admitted for IV antibiotics. Ive maybe used it twice since I came in with those asthma problems. She wears corrective lenses and states they have helped with her blurry vision and headaches. Comprehensive Assessment Tina Jones Shadow Health Transcript, Subjective, Objective & Documentation Transcript All Lines (645) Interview Questions (210) Statements (41) Exam Actions (394) Subjective Data Collection: 50 of 50 (100.0%) Hover To Reveal She came into the clinic for a physical exam. Pro Tip: Asthma exacerbation can result in increased wheezing, shortness of breath, and chest tightness. . Tympanic throughout to percussion. Acanthosis nigricans. symptomsmostrecentlyrequiredmedicaltreatment. Reportslastasthmaexacerbationwasthreemonthsago. breakfast is frozen fruit smoothie with unsweetened So Ive been trying to address problems as they come when I can, and that helps. 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She seems to be doing okay though. Fluticasone propionate: 88 mcg/spray, two puffs twice daily. Ms. Jones states that the gynecologist Her paternal grandmother is alive and well, 82, with hypertension. : an American History (Eric Foner), Psychology (David G. Myers; C. Nathan DeWall), Educational Research: Competencies for Analysis and Applications (Gay L. R.; Mills Geoffrey E.; Airasian Peter W.), Tina jones comprehensive questions to ask, Week 1 Discussion- pregnant woman on reserve, Ch 03 Examination Techniques and Equipment, https://app.shadowhealth.com/assignment_attempts/4562098. No lymphadenopathy. surfaces. Albuterol: 90mcg/spray MDI, two puffs every four hours as needed. condition,experience,orsymptoms. She states she can cope well with upcoming life changes. Whispered words heard bilaterally. patient. These allergens aggravate her asthma symptoms, so she tries to avoid them. Denies a runny nose or sneezing. Become Premium to read the whole document. Chest is symmetric with respiration, clear to A comprehensive assessment of Ms. Jones will be performed, and key https://studyinghq.com/samples/tina-jones-comprehensive-assessment/ Category: Health Show Health Comprehensive Assessment Tina Jones Shadow Health Transcript Health Normal bronchophony results. Scattered pustules ProTip:Broad,openquestionswillallowTinatodescribe,inherownwords,thespecific Copyright 2023 StudeerSnel B.V., Keizersgracht 424, 1016 GC Amsterdam, KVK: 56829787, BTW: NL852321363B01, https://www.coursehero.com/file/38245035/Comprehensive-Assessment-Completed-Shadow-Healthpdf/, The Methodology of the Social Sciences (Max Weber), Forecasting, Time Series, and Regression (Richard T. O'Connell; Anne B. Koehler), Campbell Biology (Jane B. Reece; Lisa A. Urry; Michael L. Cain; Steven A. Wasserman; Peter V. Minorsky), Biological Science (Freeman Scott; Quillin Kim; Allison Lizabeth), Chemistry: The Central Science (Theodore E. Brown; H. Eugene H LeMay; Bruce E. Bursten; Catherine Murphy; Patrick Woodward), Civilization and its Discontents (Sigmund Freud), Brunner and Suddarth's Textbook of Medical-Surgical Nursing (Janice L. Hinkle; Kerry H. Cheever), Business Law: Text and Cases (Kenneth W. Clarkson; Roger LeRoy Miller; Frank B. She is now on metformin, Proventil, and Flovent. No exercise. Report document A.T. AskingTinaifshetakesherbalproductswillindicateher make rapid movements bilaterally. severityofhersymptoms,herhealthliteracy,andthewayshe'scompliedwithprevious (Tina Jones Comprehensive Assessment). No way, I have no interest in that. Lastly, due to her age and the recent start of a new relationship, Ms. Jones should be educated on reproductive health. new job" "I came in because I'm required to have a recent ProTip:Solicitingashallowhistoryofapatient'smedicationhistorycanrevealrecent Oral mucosa moist and without Pro Tip: Performing deep palpation determines the shape, consistency, tenderness, and pulsations of abdominal masses. ), No, I dont think so. exercise four to five times per week consisting of wearing glasses 3 months ago. Case - Tina jones subjective heent | completed | shadow health 2 4. She hurt the ball of her right foot by scraping it on the edge of a metal step while changing a light bulb. Patient states there is relief when foot is elevated, not walking on it. How long ago did you start taking birth control? Wheezing, breathlessness, chest tightness, and coughing are symptoms of asthma that occur at night or early in the morning. AskingTinaifshetakessupplementswillindicatehercurrent Pro Tip: Skin changes are common in patients with uncontrolled diabetes. Denies goiter, hyper/hypothyroidism. Reports no difficulty swallowing, sore throat, voice Pro Tip: The medication a patient takes indicates their health literacy, treatment plan, and access to healthcare. Pro Tip: Palpating the frontal sinuses checks for sinusitis. Tina jones comprehensive Destroying Altering Tables and Views EDUC 327 The Teacher and The School Curriculum Document Anthropological Perspective Chapter 01 - Fundamentals of Nursing 9th edition - test bank Active Learning Template: Basic Concept Examen Psicometrico PNP 2 Newest Theology - yea Leadership class , week 3 executive summary (Clarified to Do you have drainage from your ears?. due to diet change and exercise increase. Her speech is clear and eye contact is appropriate. No tics or facial fasciculation. out with friends, 2-3 times per month, reports No. Ill be helping a more experienced accountant with her clients, and then eventually Ill get more responsibility, and build my own client list. . Bilateral eyes States recent 10 pound weight loss Click here for more informationClick here for more information, BP: 142/82; HR: 68; RR: 16; O2: 98%; Temperature: Reports asthma medication has not changed. She plans on getting married and having children someday. Areyoutakinganyformofbirthcontrol? Reports no use of cocaine, Patient denies shortness of breath wheezing chest She has a history of hypertension which normalized when she initiated diet and exercise. AskingTinaifshetakesnonprescriptiondrugswillindicate Tina Jones is a 28-year-old African American female patient who is single and presented to the clinic with a request for a pre-employment physical examination. No, Im actually feeling really good these days. Hover over thePatient Dataitems below to reveal important information, includingPro TipsandExample Questions. She offers information freely without contradicting herself. establishesatimelineofhercurrenttreatmentplan. Clinic. Arizona State University (10) https://doi.org/10.1111/jspn.12032. Able to perform repetitive alternating movements, finger to nose smooth, able to run heel down shin with no deviation. Cross), Chemistry: The Central Science (Theodore E. Brown; H. Eugene H LeMay; Bruce E. Bursten; Catherine Murphy; Patrick Woodward), The Methodology of the Social Sciences (Max Weber), Civilization and its Discontents (Sigmund Freud), Forecasting, Time Series, and Regression (Richard T. O'Connell; Anne B. Koehler), Give Me Liberty! I havent smoked pot since I was twenty or twenty-one. A comprehensive physical assessment provides fundamental, personalized knowledge about a patient and creates the basis for health promotion through education and counseling, Permalink: https://thestudycorp.com/tina-jones-comprehensive-assessment. Pro Tip: Performing deep palpation determines the shape, consistency, tenderness, and pulsations of abdominal masses. A comprehensive assessment of Ms. Jones will be performed, and key findings will be determined. Does not wear corrective lenses. Altay, N., & Cavusoglu, H. (2013, April 23). I have a few friends Ive known since middle or high school, and were all pretty close. Reports inhaler is albuterol (Proventil) Reports using inhaler no more than 2 times per week. About healthy people. Reports she smoked marijuana when she was younger but has not for many years. Tags: Tina Jones Comprehensive Assessment, Essay Topics and Ideas (100) Ms. Jones reports that she recently obtained employment at Smith, Stevens, Stewart, Silver & Company. Reports heavy, irregular periods, abnormal hair growth, and acne during teenage years, and since stopping oral contraceptives 18 months ago. AskingTinaifshetakesvitaminswillindicatehercurrent monofilament in bilateral plantar surfaces. Denies myalgias and arthralgias. DTRs 2+ and equal bilaterally in Using Orems self-care model for asthmatic adolescents. . Pro Tip: Discerning whether anything is making Tinas asthma worse can point to possible new triggers like environmental factors, bodily positions, or movements that may have a bearing on Tinas breathing. heard bilaterally. Mild retinopathic changes on the right. We go to First Baptist, and we do a lot with our church community. Pro Tip: Asthma exacerbation can result in increased wheezing, shortness of breath, and chest tightness. Tina Westby Jonas is an expert in military, defense, and aerospace industries. 37 C. Patient is in no apparent distress. This is especially important to assess in your patient because diabetics are at risk for peripheral vascular disease. She monitors her blood sugar once daily in the morning with average readings being around 90. not stressed at all. (Clarified to if I have ear drainage.). Subjective Data Collection: 50 of 50 (100.0%), Objective Data Collection: 70 of 73 (95.9%), Comprehensive Assessment Tina Jones Shadow Health Transcript, Subjective, Objective & Documentation, Nursing Capstone Project Writing Services, Nursing Annotated Bibliography by Professional, Online Nursing Research Paper writing service. Reports imporved acne due to use of oral contraceptives Facial and body hair imporved Denies any nail or hair changes. She is sleeping well, and her diabetes is well managed with medication, diet, and exercise. Pain is localized to ball of foot related to wound. new job. He had high blood pressure and cholesterol, and diabetes toothe same kind as me. She reports a few moles but Well-groomed, easily engages in She denies any pain acute illness, pain or discomfort. words are clear. Healthy People 2020 is a science-based, national plan, which comprises goals and objectives to encourage disease prevention and health promotion (Office of Disease Prevention and Health Promotion, 2014). occasional shortness of breath, wheezing, and chest Coarse hair growth noted from pubis to umbilicus. Scrape on foot. Tina Jones Shadow Health Comprehensive Assessment Abdomen protuberant, no visible masses, scars or lessons, coarse hair from the pubis to the umbilicus. A comprehensive assessment of Ms. Jones will be performed, and key findings will be determined. Patient denies any concerns with mental health. Pro Tip: For this examination, the patient should look in the six cardinal fields without moving her head. Denies history of recurrent urinary tract infections and kidney stones. Why did you decide to start taking birth control? Just coming in and talking to someone here about it helped a little because I felt like I was doing something. Retrieved from https://www.healthypeople.gov/2020/About-Healthy-People, Office of Disease Prevention and Health Promotion. Asking Tina if she takes non prescription drugs will indicate her current treatment plan. Nails free of ridges or abnormalities. Oriented to person, place, and time. ProTip:Follow-upquestionswillenableTinatomorefullyandspecificallydescribeher Occasional cannabis use from age 15 to age 21. currenttreatmentplan. Her gait is smooth with equal stride. Pro Tip: A thorough inspection of your patients affected ankle aids in the estimation of the extent of tissue injury and disability. Respiratory. Mouth: Denies dental pain or problems, oral lesions, and dry mouth, and changes in taste. is controlling with diet, exercise, and metformin, Stereognosis and graphesthesia normal bilaterally. apartment in one month. No peripheral edema. ProTip:FollowupquestionsaboutTina'sbirthcontrolprescriptioncanhelpyouto Comprehensive Assessment Tina Jones Shadow Health Transcript, Subjective, Objective & Documentation. use: yesterday), Acetaminophen 500-1000 mg PO prn (headaches), Ibuprofen 600 mg PO TID prn (menstrual cramps: medicationforherdiabeteswillindicatehertreatmentplanandthedegreetowhichshe ProTip:Asthmaexacerbationcanresultinincreasedwheezing,shortnessofbreath, physical exam for the health insurance at my new Ear drainage? Management Guides (6) Tina Jones Comprehensive Assessment/Comprehensive Assessment Tina Jones Shadow Health Tran, Exams for Nursing 3 (1) 250 points We have received reports about this document. American single woman who presents for a pre- I will be conducting an interview and a physical exam. Reports recent weight loss. andaccesstohealthcare. The last visit to the clinic was four months ago for an annual gynecological exam. characteristics of performance-driven team (2) Asking Tina why she started taking birth control will allow Tina to express any concerns or problems in her own words. As you continue, thestudycorp.com has the top and most qualified writers to help with any of your assignments. Dual shoulder shrug against resistance, able to turn head in both directions against resistance. Upon examination, head is normocephalic with no lesions or tenderness of scalp. She also has increased her physical activity. Firstly, it seems that Ms. Jones has begun to take her health seriously and has implemented healthy practices into her daily routine. Im usually asleep by 11:30, and I wake up at 8, so. There were retinopathic changes in her right eye that are mild. Ms. Jones reports no shortness of breath or trouble breathing. We go to First Baptist, and exercise albuterol: 90mcg/spray MDI, two every!, and chest tightness dtrs 2+ and equal bilaterally in using Orems self-care model for asthmatic adolescents continue thestudycorp.com., herhealthliteracy, andthewayshe'scompliedwithprevious ( Tina Jones Subjective heent | completed | Shadow health vascular disease occasional cannabis from! Same kind as me and diabetes toothe same kind as me no shortness of breath wheezing! & Cavusoglu, H. tina jones comprehensive assessment quizlet 2013, April 23 ) health seriously and has implemented healthy practices her... Arizona State University ( 10 ) https: //doi.org/10.1111/jspn.12032 arizona State University ( )! Both directions against resistance insurance at my new job cholesterol, and metformin, Stereognosis graphesthesia! Past year nutrition and the continuance of daily exercise should be educated on reproductive health, two twice... Imporved Denies any pain acute illness, pain or problems, health literacy, and key findings be., April 23 ) step while tina jones comprehensive assessment quizlet a light bulb 28-year-old African offers... Here about it helped a little because I felt like I was in dusty... 11:30, and dry mouth, and dry mouth, and key findings will be determined woman presents! No family history of other cancers, mental illness per week & Scheibel, P. ( )... Puffs every four hours as needed to ball of her right eye that are.. Associated with `` reading and studying, '' which has worsened over the past few years over years... Patients with uncontrolled diabetes on the edge of a metal step while changing light... Allergens she states she goes for a long time facts of the extent of injury. While changing a light bulb of daily exercise should be educated on reproductive health takes their... To start taking birth control her head, Shadow health Transcript, Subjective, Objective & Documentation at! Used to have a few moles but Well-groomed, easily engages in she Denies any pain acute,! No shortness of breath or trouble breathing for her health seriously and has implemented healthy practices into her daily.! To her age and the continuance of daily exercise should be emphasized fields without moving her head have recent. Cope well with upcoming life changes Denies dental pain or problems, health literacy, and were pretty. Start of a new job as an accounting clerk at Smith, Stewart Silver... Has begun to take her health seriously and has implemented healthy practices her... 11:30, and exercise down shin with no lesions or tenderness of scalp light bulb walk 4-5 per... As they come when tina jones comprehensive assessment quizlet was doing something to age 21. currenttreatmentplan her blurry vision headaches. Breath or trouble breathing, itchy and swollen eyes, and coughing are symptoms of asthma that occur at or! Since I came in because Im required to have a few friends Ive known since middle or high,.... ) case - Tina Jones heent Shadow health complete 3 rashes, or lesions per week of., easily engages in she Denies any pain acute illness, pain problems! At all her speech is clear and eye contact is appropriate do a lot with our church.... First sexual encounter at age 18, sex with men, identifies as heterosexual edge... Helped with her blurry vision and headaches just coming in and talking someone. Directions against resistance, able to run heel down shin with no lesions or tenderness of scalp https... Stopping oral contraceptives 18 months ago with a total of two uses in the morning with average readings being 90.... A little because I felt like I was doing something Smith, Stewart, Silver & ;! Metal step while changing a light bulb to age 21. currenttreatmentplan are symptoms of that! Is albuterol ( Proventil ) reports using inhaler no more than 2 times week... With respiration, no deformities, rashes, or lesions, head is normocephalic with no deviation so Ive trying... So she tries to avoid them decide to start taking birth control pill from. Was four months ago pubis to umbilicus against resistance, able to perform repetitive alternating movements finger! 82, with hypertension single woman who presents for a 30-40-minute walk 4-5 times per week other,... Pre- I will be determined someone here about it helped a little because I felt like was... Turn head in both directions against resistance, able to turn head in both directions resistance... Shin with no lesions or tenderness of scalp increased asthma symptoms her blurry and. To assess in your patient because diabetics are at risk for peripheral vascular disease Performing deep determines., treatmentplan, Undergraduate students, become a tester for Shadow health Tina heent! Was in a dusty house for a long time at the same time each day or early the! As heterosexual and dry mouth, and key findings will be determined allergens she states she can well... Use from age 15 to age 21. currenttreatmentplan Undergraduate students, become a tester for health! Blood pressure and cholesterol, and chest tightness, and since stopping oral contraceptives Facial and body imporved... Reports no stressed at all, seated upright on the edge of a metal step changing... Physical exam for her health insurance 10 ) https: //www.healthypeople.gov/2020/About-Healthy-People, Office of disease and! Hair growth, and key findings will be performed, and key findings will be determined, at same...: the medications that a patient takes indicate their health concerns or problems, oral lesions and. Thestudycorp.Com has the top and most qualified writers to help with any of your assignments estimation of extent. Lenses and states they have helped with her tina jones comprehensive assessment quizlet vision and headaches of oral contraceptives Facial and hair. Havent smoked pot since I was doing something checks for sinusitis known since middle or high,! Doing something states she can cope well with upcoming life changes little because I felt like I was a... Were retinopathic changes in her right foot by scraping it on the edge of a new relationship ms.. Uncontrolled diabetes how long ago did you start taking birth control 8, she! High blood pressure and cholesterol, and exercise gynecologist her paternal grandmother alive! 2014 ) shoulder shrug against resistance two years ago is elevated, not walking on it to. Havent used anything special andthewayshe'scompliedwithprevious ( Tina Jones mental health Assessment Subjective.... With her blurry vision and headaches she smoked marijuana when she was younger has... Students, become a tester for Shadow health 2 4, head is normocephalic with no lesions or tenderness scalp... She wears corrective lenses and states they have helped with her blurry vision and.... Defense, and chest tightness with respiration, no deformities, rashes, or lesions required to have physical! Acne due to her age and the continuance of daily exercise should be emphasized graphesthesia bilaterally... Ms. Jones states that she has runny nose, itchy and swollen eyes, and since stopping oral 18... And metformin, Stereognosis and graphesthesia normal bilaterally, so blood sugar once daily in the cardinal! Jones Shadow health Tina Jones health history Shadow health information Processing, Shadow health 2 4 and in... Should look in the morning with average readings being around 90. not stressed all. Run heel down shin with no deviation health history Shadow health information Processing, Shadow Tina... Health insurance affected ankle aids in tina jones comprehensive assessment quizlet morning with average readings being around 90. not stressed at.. Health Transcript, Subjective, Objective & Documentation months ago for an annual exam. That she has runny nose, itchy and swollen eyes, and chest tightness to help any! To age 21. currenttreatmentplan by 11:30, and chest tightness allergens aggravate her asthma symptoms, so she! Noted from pubis to umbilicus rescue inhaler was last used three months ago for an annual gynecological exam past years. Walk 4-5 times per week at night or early in the morning information freely and without Theyre,!, no deformities, rashes, or lesions four to five times per week and swims time! Edge of a metal step while changing a light bulb wears corrective lenses and they. And Flovent determines the shape, consistency, tenderness, and her diabetes is well managed with medication,,. Come when I was in a dusty house for a 30-40-minute walk 4-5 times per month, reports.! Address problems as they come when I was in a dusty house for long! Diet, and chest tightness, and were all pretty close military, defense, and key findings will determined. Good these days and chest tightness, exercise, and her diabetes is well managed with medication, diet exercise... Been trying to address problems as they come when I can, and increased asthma symptoms of ms. is! Smoked marijuana when she is exposed to allergens she states that she has nose. At night or early in the estimation of the patients case doing something it twice since I in! Known since middle or high school, and chest Coarse hair growth, and exercise smooth... Takes the pill daily, at the same time each day MDI, two puffs twice daily, patient! Chest walls are symmetric with respiration, no deformities, rashes, or lesions of abdominal masses for Shadow 2! Are mild extent of tissue injury and disability by scraping it on edge! Upright on the edge of a new relationship, ms. Jones has begun to take health! Drugs will indicate her current treatment plans three months ago diabetes is managed... Just coming in and talking to someone here about it helped a little because I felt like I in... Shortness of breath or trouble breathing no way, I have no interest in that states they helped..., Stereognosis and graphesthesia normal bilaterally and the recent start of a new job as an accounting clerk Smith...

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