which technique would the nurse use to promote medication independence when educating a patient who cannot read

Answers

Answer 1

The nurse use to promote medication independence when educating a patient who cannot read VAKT.

Describe VAKT:

The teaching method known as visual, auditory, kinesthetic, and tactile (VAKT) uses tangible tools and activities to engage as many senses as possible such as images, music, food, and comparisons of new ideas to previous knowledge and/or personal experience.

VAKT multisensory: 

Multisensory learning is the theory that people learn more efficiently if they are exposed to various senses when learning (modality). Visual, auditory, kinesthetic, and tactile senses are typically used in multisensory learning - VAKT (i.e. seeing, hearing, doing, and touching).

Who created the VAKT strategy?

The VAKT approach that the researcher used is the Orton-Gillingham VAKT method, in which the initial learning is focused on mastering the various letter sounds and incorporating letters into words.

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Related Questions

Briefly discuss about Contraceptiv methods​

Answers

Contraceptive methods​ are used for the prevention of the pregnancy, safe sex can prevent the unwanted pregnancy.

What are contraceptive methods​?

Contraception, the term is used for the birth control and fertility control, it is a method or devices for the prevention of unwanted pregnancy.

There are some examples of contraceptive methods:

Oral contraceptive pills.Intrauterine devices.Male and female sterilization. Vaginal rings.Injectables.

Therefore, contraception is the birth control methods or devices for the prevention of unwanted pregnancy.

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A nonstress test is scheduled for a client with preeclampsia. During the nonstress test the nurse concludes that if accelerations of the fetal heart rate occur with fetal movement, this probably indicates what?
1
Fetal well-being
2
Fetal head compression
3
Uteroplacental insufficiency
4
Umbilical cord compression

Answers

A nonstress test is scheduled for a client with preeclampsia. During the nonstress test, the nurse concludes that if accelerations of the fetal heart rate occur with fetal movement, this probably indicates: Fetal well-being

During a nonstress test, the fetal heart rate is monitored for accelerations, which are temporary increases in the fetal heart rate. If accelerations occur with fetal movement, it is a sign of fetal well-being, indicating that the fetus is receiving enough oxygen and nutrients from the placenta. If accelerations do not occur, it may be a sign of fetal distress, which could be due to conditions such as fetal head compression, uteroplacental insufficiency, or umbilical cord compression. However, in this scenario, the nurse concluded that if accelerations occur with fetal movement, it probably indicates fetal well-being.

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The presence of accelerations in the fetal heart rate with fetal movement during a nonstress test is a reassuring sign and indicates fetal well-being.

Accelerations of the fetal heart rate with fetal movement during a nonstress test are reassuring signs and suggest that the fetus is receiving adequate oxygenation and is not under stress. This indicates fetal well-being.

In contrast, a nonreactive nonstress test with no accelerations may indicate fetal distress and require further evaluation. The other options listed are potential complications of pregnancy but would not be indicated by accelerations during a nonstress test.

Therefore, the correct option is 1. Fetal well-being

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Posttest
2. Which of the following is not one of the three steps to identify behaviors?
A
examine the behavior
В.
o explore potential solutions
С.
try different responses
D
notify a psychiatrist
Submit
Submit

Answers

Answer:

D I think

Explanation:

What are the top three factors that contribute to a new graduate’s ability to learn to work with the patient’s electronic medical records?.

Answers

The three factors that contribute to a new graduate’s ability to learn to work with the patient’s electronic medical records are:

Communication SkillsProject Management ExperienceTechnical Proficiency

What are the skills about?

The new graduate’s ability to have a good communication skills is vital because it make sure that your EHR implementation is well-handle as well as been organized.

Project Management Experience is one which a person uses in their EHR implementation team to know the  technical as well as clinical areas of EHR implementation.

Therefore, The three factors that contribute to a new graduate’s ability to learn to work with the patient’s electronic medical records are:

Communication SkillsProject Management ExperienceTechnical Proficiency

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Many drugs are metabolized and detoxified in the liver. Most drug metabolizing occurs in the central zones of the liver. What condition is caused by these drug-metabolizing actions

Answers

Drug-metabolizing actions in the liver can cause a range of conditions, including liver toxicity, liver damage, and drug-drug interactions.

Liver toxicity occurs when the liver is exposed to a drug or toxin, causing the release of enzymes that can damage the liver cells. This can lead to inflammation, scarring, and eventual liver failure.

Liver damage can also occur when drugs are metabolized and detoxified in the liver, leading to cirrhosis, an irreversible scarring of the liver. Drug-drug interactions occur when drugs interact with each other, causing a decrease in the effectiveness of one of the drugs or an increase in the side effects.

Liver damage can also be caused by the accumulation of drugs in the body, which can lead to drug toxicity. All of these conditions can be very serious and even fatal if left untreated, so it is important to be aware of the potential risks when taking any medications.

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Hehe it got 420 points.. u know what that means

Answers

you don’t have enough points for chicken nuggets

In your own words explain the steps into creating a vaccine.

55 points

Answers

Put the fluid in the bottle.
Put the bottle in the shot. Give it to someone.
I would start by creating a substance that is safe to go into some human body and once it is safe and tested on maybe a dead body I would then get it approved by the nation and I would vaccinate everybody that I could who had it so that everyone could be healthy I would also like to create less pain when it goes in so I would also do a much thinner needle and a lot of fluid that would kill a virus or something.

what is pharmacodynamics?​

Answers

Answer:

Pharmacodynamics is the study of a drug's molecular, biochemical, and physiologic effects or actions.

Explanation:

A client's blood glucose us 23. The client is unresponsive and unable to swallow. What priority action should be taken to increase the blood glucose rapidly?

Answers

According to the research, the correct answer is Option 3. The administration of a glucagon injection is the priority action that should be taken to increase the blood glucose rapidly.

What is hypoglycemia?

It is the clinical syndrome or a condition characterized by low glucose, that is, it appears in those situations in which blood glucose concentrations are below normal.

In this sense, Glucagon is a natural hormone, which has the opposite effect to that of insulin in the human body, which is used when, in cases of severe hypoglycemia, children and adults with diabetes are unable to take sugar orally. This hormone helps the liver break something called “glycogen” into glucose (sugar).

Therefore, in case of severe hypoglycemia in which the person is unable to swallow, glucagon should be administered as a subcutaneous or intramuscular injection.

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Gabe is a nutrition student who is learning that a balanced diet involves consuming foods that have a variety of vitamins in them every day. Why is it advisable to consume vitamins every day?.

Answers

Gabe's understanding of a balanced diet is correct. Consuming vitamins every day is advisable because they play a crucial role in maintaining overall health and well-being. Vitamins are essential nutrients that our bodies need in small amounts to perform various functions, such as energy production, immune support, and cell growth.

There are two types of vitamins: fat-soluble (A, D, E, K) and water-soluble (B-complex, C).

Fat-soluble vitamins are stored in the body's fatty tissues, while water-soluble vitamins are not stored and must be replenished daily through diet. A variety of foods, including fruits, vegetables, whole grains, and lean proteins, provide different vitamins that support our body's functions.

Regular vitamin intake is vital for maintaining healthy skin, bones, and muscles, as well as supporting the nervous and immune systems. Additionally, vitamins act as antioxidants, protecting the body from damage caused by free radicals, which can contribute to chronic diseases and aging.

In summary, consuming vitamins every day is important for overall health, as they help the body perform essential functions and prevent nutritional deficiencies. A balanced diet that includes a variety of nutrient-rich foods ensures we obtain the necessary vitamins for optimal well-being.

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what are the purposes for determining pulse rates and quality of pulses​

Answers

In addition to the rate, it's important to document the rhythm and quality of the pulse. The rhythm will be either regular or irregular, and the quality will usually be described as strong or weak. Most healthy adults have a resting heart rate of between 60 and 100 beats per minute, regular and strong.

a new nurse has been assigned a client who is in the hospital to receive iodine-131 treatment. which action by the nurse is best?

Answers

The best action by the nurse is to maintain a safe distance from the client, following the principles of radiation safety protocols.

Iodine-131 is a radioactive isotope used in medical treatments, particularly for thyroid conditions. It emits radiation, which poses a potential risk to healthcare workers. Maintaining a safe distance from the client minimizes the nurse's exposure to radiation. By adhering to radiation safety protocols, the nurse ensures personal safety while still providing necessary care and support to the client. Additionally, the nurse should follow institutional guidelines regarding the use of protective equipment, such as lead aprons or shields, to further minimize radiation exposure.

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Explain the mechanism for three ways that DNA can be transferred from one prokaryotic cell to another​

Answers

Answer:

Transduction, Transformation, and Conjugation.

Explanation:

Transformation allows for competent cells to take up DNA, released from other cells on their death, into their cytoplasm, where it may recombine with the host genome.

In Generalized Transduction, any piece of chromosomal DNA may be transferred by accidental packaging of the degraded host chromosome into a phage head.

Conjugation is meditated by the F plasmid, which encodes a conjugation pilus that brings an F plasmid-containing F+ cell into contact with an F- cell.

muscles are not likely to tear from their bones because:
a. The tendons are partially ossified at their attachment points to the periosteum
b. A circumferential lamellaa sandwiches the ends of the tendon onto the surface of an adjacent lamella
c. Perforating fibers of collagen attach the tendon andperosteum to the cortial surface of bone
d. Elastin fibers in the tendon can allow for streching and recoil of the muscle

Answers

Muscles are not likely to tear from their bones because perforating fibers of collagen attach the tendons and periosteum to the cortical surfaces of bone. Option C is correct.

Skeletal muscle accounts for approximately 35% of the weight of the human body. Skeletal muscle functions include movement production, posture maintenance, temperature regulation, and joint stabilization. Skeletal muscle is an endocrine organ as well. The secretome of skeletal muscles contains subsets of 654 distinct proteins as well as lipids, amino acids, metabolites, and short RNAs under various physiological circumstances.

Skeletal muscles are mostly made up of multinucleated contractile muscle fibers (myocytes). Skeletal muscles, on the other hand, include a large number of resident and invading mononuclear cells. Myocytes account for the vast bulk of skeletal muscle volume. Myocytes in skeletal muscle are typically quite big, measuring around 2-3 cm long and 100 m in diameter.

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Why or why not are the majority of Hill's criteria difficult to apply to chronic disease epidemiology

Answers

Answer:

You "ll find your answer here: https://www.chegg.com/homework-help/questions-and-answers/1-majority-hill-s-criteria-difficult-apply-chronic-disease-epidemiology-please-specific-di-q61706853

A nurse is caring for a client who has encephalitis due to West Nile virus. Which of the following actions should the nurse take?

Answers

A nurse caring for a client with encephalitis due to the West Nile virus should take the following actions: Ensure proper hydration of the client.

Ensure respiratory support, as required. Monitor neurological status closely. Administer antipyretics, as prescribed by the physician. West Nile virus (WNV) is a mosquito-borne disease that can cause encephalitis (inflammation of the brain) or meningitis (inflammation of the lining of the brain and spinal cord). Encephalitis due to West Nile virus can be life-threatening and can result in long-term complications such as paralysis, memory loss, and seizures. Treatment of West Nile virus consists of supportive care such as proper hydration and respiratory support, as required. Antipyretics are also administered as prescribed by the physician to lower the patient's fever. Additionally, neurological status is monitored closely to identify any changes in mental status or motor function.

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You have been performing multiple-provider CPR on a
patient in cardiac arrest. The patient is now showing signs of return
of spontaneous circulation (ROSC). Which action(s) would the team
perform?
Select all correct options that apply.
Continue compressions for another minute.
Stop CPR
Check for breathing and pulse.
Give 2 ventilations
Remove the AED pads.

Answers

Answer:

they would preform a miracle

Explanation:

Answer:stop CPR/AED.

Check for breathing and carotid or femoral pulse.

Monitor the patient until the advanced cardiac life support team takes over.

Explanation:

All these are what you should do.

A rare disease, which is due to a recessive allele (a), is lethal when homozygous, and occurs within a specific population at a frequency of one in a million. How many individuals in a town with a population of 14,000 can be expected to 'carriers' of this allele

Answers

Approximately 0.014 individuals (or about 14 individuals) in a town with a population of 14,000 can be expected to be carriers of this allele. A rare disease, which is due to a recessive allele (a), is lethal when homozygous, and occurs within a specific population at a frequency of one in a million.

To determine the number of individuals in a town with a population of 14,000 who can be expected to be carriers of the recessive allele (a), we need to calculate the frequency of carriers in the population.

Given that the disease occurs within the population at a frequency of one in a million, we can infer that the frequency of the recessive allele (a) in the population is also one in a million. This is because carriers are individuals who possess one copy of the recessive allele (a) but do not exhibit the disease.

To calculate the number of carriers in the town, we multiply the frequency of carriers by the total population:

Number of carriers = Frequency of carriers * Population

Frequency of carriers = 1 in 1,000,000 = 1/1,000,000

Population = 14,000

Number of carriers = (1/1,000,000) * 14,000 = 0.014

Therefore, approximately 0.014 individuals (or about 14 individuals) in a town with a population of 14,000 can be expected to be carriers of this allele.

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At the marine aquarium where she works, Meera is in charge of the penguin exhibit. She notices that one of the chinstrap penguins, Bob, looks to be gasping for breath. She calls in the veterinary specialist, who performs tests. The specialist tells Meera that Bob has aspergillosis and will need treatment. Which kind of medication will the specialist MOST likely use to clear up Bob's issue?

Answers

Anti fungal medication will help bob the most. Because the anti fungal medication is a treatment for invasive pulmonary aspergillosis.

The kind of medication that will the specialist most likely use to clear up Bob's issue is anti-fungal medication.

What is medication?

Medication may be characterized as a type of treatment that significantly involves the prescription of a dosage form that contains one or more active and/or inactive ingredients along with extreme care of the patients. It is given to patients when they are suffering from any disease or disorder.

According to the context of this question, anti-fungal medication is a type of medication that prevents the infection caused by invasive fungi which are known as Aspergillus. This type of medication is extremely specific for this disease or infection.

Therefore, the kind of medication that will the specialist most likely use to clear up Bob's issue is anti-fungal medication.

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In this case study, one endocrine imbalance lead to a plethora of health issues in Eric. Based only on all the medical conditions Eric was diagnosed with, indicate how endocrine hormones control a variety of physiological processes? (Select all that apply)

A) Direct the rate and timing of growth and development
B) Exert emergency control during physical and mental stress
C) Regulate metabolism and energy production
D)Oversee reproductive mechanisms
E)Balance the composition and volume of body fluids

Answers

A) Direct the rate and timing of growth and development

C) Regulate metabolism and energy production

D) Oversee reproductive mechanisms

E) Balance the composition and volume of body fluids

How does endocrine hormones work?

Endocrine hormones are chemical messengers secreted by various glands and tissues that help to regulate numerous physiological processes in the body.

Each hormone is designed to act on a specific target tissue or organ, and their actions can be diverse and far-reaching. In the case of Eric, the endocrine imbalance he experienced resulted in a plethora of health issues that affected several aspects of his health.

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What potential causes of disease do you think either or both persons might have?


Nathan Zimmer lives in an area of northeastern Pennsylvania where hydraulic fracturing for natural gas has elevated methane gas levels in his drinking water.


Sandi Smith lives in rural western Nebraska working outdoors much of the time managing her wheat farm.

Answers

Answer:

Nathan Zimmer lives in Northeastern Pennsylvania which is an area with elevated methane gas levels in the drinking water. It is not toxic but highly explosive, however, a high concentration of methane gas level can lead to Asphyxiation. It is a condition that can cause death, in this person can not get enough amount of oxygen to lungs.

Sandi Smith lives in rural western Nebraska spends a long time on a wheat farm who can get allergic reactions due to dust from moldy hay, straw and grain. Pesticides and herbicides can result in chemical burns, respiratory illness, or poisoning.

Nathan Zimmer lives in an area of northeastern Pennsylvania where hydraulic fracturing for natural gas has elevated methane gas levels in his drinking water. Thus, option A is correct.

Where the Nathan Zimmer lives?

Nathan Zimmer lives in Northeastern Pennsylvania which is an area with elevated methane gas levels in the drinking water. It is not toxic but highly explosive, however, a high concentration of methane gas level can lead to Asphyxiation. It is a condition that can cause death, in this person can not get enough amount of oxygen to lungs.

Sandi Smith lives in rural western Nebraska spends a long time on a wheat farm who can get allergic reactions due to dust from moldy hay, straw and grain. Pesticides and herbicides can result in chemical burns, respiratory illness, or poisoning.

Therefore, Nathan Zimmer lives in an area of northeastern Pennsylvania where hydraulic fracturing for natural gas has elevated methane gas levels in his drinking water. Thus, option A is correct.

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assessment of the pulse amplitude is accomplished by:
a. auscultating the flow of blood through an artery.
b. palpating the flow of blood through an artery.
c. auscultating the area of the left ventricle.
d. palpating the area of the left ventricle.

Answers

Assessment of the pulse amplitude is accomplished by: palpating the flow of blood through an artery. The correct option is b.

To assess the pulse amplitude, a healthcare provider typically uses their fingertips to palpate or feel the pulsations of an artery. By applying gentle pressure over the artery, they can perceive the strength or intensity of the pulse.

The pulse amplitude provides information about the volume of blood being pumped by the heart and the elasticity of the arterial walls. It is an essential component of assessing cardiovascular function and can indicate conditions such as weak or bounding pulses.

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Which of the following technical characteristics of a CT system does NOT directly affect patient dose?A. Source-to-detector distanceB. FiltrationC. Detector efficiencyD. Filament size

Answers

The technical characteristic of a CT system that does NOT directly affect patient dose is Source-to-detector distance.

What is a CT system?CT stands for computerized tomography, a medical imaging technique that uses digital computers to produce images of internal body parts. This is an efficient technique for detecting and diagnosing conditions of the human body. The technical characteristics of a CT system are as follows: Tube voltage tube currentExposure timeFiltrationSlice thicknessPitchCollimationReconstruction algorithmThe technical characteristic of a CT system that does NOT directly affect patient dose is Source-to-detector distance. The reason is that the distance between the source and the detector only affects the image quality and not the patient dose. In this case, the dose of radiation received by the patient is controlled by the other parameters used in CT imaging, such as the tube voltage, tube current, and exposure time. The other options like Filtration, Detector efficiency, and Filament size have a direct impact on patient dose.

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in modern chinese medicine, cannabis seeds have little medicinal value. true/false

Answers

In modern Chinese medicine, cannabis seeds have little medicinal value is true. Because cannabis seeds are believed to have a variety of health advantages, including the ability to regulate digestion and prevent digestive system problems, manage weight, and control diabetes.

Cannabis seeds are a fantastic source of nutrition, with a high concentration of fatty acids and essential amino acids. They also contain antioxidants, iron, and zinc, among other important nutrients.

Cannabis seeds are rich in antioxidants, which can help to improve the immune system and reduce inflammation. In addition, consuming cannabis seeds may help to enhance the functioning of the liver, reducing the risk of liver disease.

It is beneficial for health but modern Chinese medicine does not value cannabis seeds much due to various reasons. Thus, it can be concluded that cannabis seeds have little medicinal value in modern Chinese medicine.

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Which of the following changes in flow rate or in solute concentrations would NOT occur if the blood inflow rate were increased, increasing the pressure in the dialysis chamber?
A) The blood volume reaching the outflow tube per unit time would increase.
B) The osmotic concentration of proteins in the dialysate fluid would increase
C) The osmotic concentration of proteins in the blood outflow would increase or remain unchanged.
D) The filtration rate across the dialysis membrane would increase.

Answers

Answer:

The correct answer is - B) The osmotic concentration of proteins in the dialysate fluid would increase

Explanation:

If the blood inflow rate were increased, increasing the pressure in the dialysis chamber, there would be increase in the blood volume comes to the outflow tube per unit time. The filtration rate across the membrane would increase because the pressure in the chamber would be greater

The osmotic concentration of proteins would not be expected to increase in the dialysate fluid because proteins generally do not pass through the membrane

22. Which of the following is a precursor to vitamin D?A. CholineB.LecithinC.CholesterolD.Chylomicrons

Answers

Cholesterol is a precursor to vitamin D. So, the correct option is (C).

What is Vitamin D?

Vitamin D is defined as a group of fat-soluble secosteroids which is responsible for enhancing intestinal absorption of calcium, magnesium, and phosphate, and for a number of other biological effects. The most important compounds it contains in humans are vitamin D₃ and vitamin D₂.

Cholesterol is the precursor of Vitamin D. It is a fat-soluble vitamin which is known to help the body absorb and retain calcium and phosphorus. These are important for bone formation. Vitamin D may reduce cancer cell growth, help control infection, and reduce inflammation.

Thus, Cholesterol is a precursor to vitamin D. So, the correct option is (C).

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2. What are two things that are stated on the agreement for the
skills lab?

Answers

which skills lab? can you provide more information?

undernutrition results in stunted growth in about _______ of the world's children.

Answers

Undernutrition results in stunted growth in about one-third of the world's children.

Undernutrition denotes insufficient intake of energy and nutrients to meet an individual's needs to maintain good health. In most literature, undernutrition is used synonymously with malnutrition. In the strictest sense, malnutrition denotes both undernutrition and overnutrition. This condition is caused by a lack of essential nutrients, which can have long-term effects on a child's physical and cognitive development.

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According to the powerpoint lecture, rainfall is only one environmental variable that influences the growth and function of vegetation, but is usually the most limiting factor in ______ ecosystems.

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According to the powerpoint lecture, rainfall is only one environmental variable that influences the growth and function of vegetation, but is usually the most limiting factor in arid or desert ecosystems.

In the context of the powerpoint lecture, rainfall is acknowledged as just one among several environmental factors that impact the growth and functioning of vegetation. However, in arid or desert ecosystems, rainfall emerges as the primary limiting factor. These ecosystems typically experience low precipitation levels, resulting in water scarcity. As a result, vegetation in such regions has adapted to survive with limited water availability. Plants have developed various strategies to cope with arid conditions, such as drought tolerance, deep root systems, water storage mechanisms, and reduced leaf surface area to minimize water loss through transpiration. The scarcity of rainfall in arid ecosystems shapes their unique vegetation composition and influences the overall ecosystem dynamics.

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a rice cooker was sold for $60 after a discount of 60% waht was the usual price of the rice cooker​

Answers

$150 Was the original price of the rice cooker
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You earn $250 working for your uncle for the day. Your uncle needs 12% of the money to pay for gas. How much money do you need to give your uncle? Eric is a great skateboard fan. He visits a shop named SKATERS to check some prices. At this shop you can buy a complete board. Or you can buy a deck, a set of 4 wheels, a set of 2 trucks and a set of hardware, and assemble your own board. The prices for the shop's products are: Eric has 120 zeds to spend and wants to buy the most expensive skateboard he can afford. How much money can Eric afford to spend on each of the 4 parts? Put your answer in the table below. How did religious beliefs and practices of the Israelites shape the world? An arbitrator can render legally binding decisions.truefalse Why do you think extreme phenomena like black holes or colliding neutron stars would produce gamma rays? 1.Why did people from other states follow the race for a seat in the Illinois Senate?2.Identify and describe two ways that abolitionists worked around the congressional gag rule against slavery to protest.3.How did the three presidential candidates of 1856 demonstrate the divide in the country? In your answer, include a brief description of each mans platform and what the outcome of the election was. Choose the equivalent ratio for 6:7 a36:42 b42 to 36 c3:4 d2:18 Write complete sentences in the Past Simple using the words below. A patient has a tidal volume of 650 mL/breath, an anatomical dead space of 150 mL, and a respiratory rate of 20breaths/min. Calculate the patient's alveolar ventilation rate (AVR).5 L/min5 mL/min10 L/min10 mL/min100 L/min Mrs Smith walks a half a mile a day after work. She works five days a week. How many yards will she have walked for the week by Friday morning? The depreciation method using a fixed rate applied to the undepreciated cost of the asset each year, resulting in successively smaller depreciation charges as the undepreciated cost diminishes year by year is called the Question 1. If you were to engineer some non- adhesive cells to express E-cadherin at either high levels or low levels and then mixed the E-cadherin high cells with the E-cadherin low cells, what do you predict will happen? The developmental periods are approximate _____ ranges, and there are also variations in individuals' capabilities. Discuss what you have learned about capital structure of a firm. Be sure to include characteristics of both sources of capital. Under american law, the defendant is presumed innocent and the government must prove guilt _____. please help me on this geometry ill mark you the brainliest What governmental entity is responsible for the regulation and enforcement of title ix? If the reaction 2HgO --> 2Hg + O2 is endothermic, which bonds are the strongest?The bonds between Hg atoms in the solid metal. The bond between Hg & O.The bond between O & O. 4. PART A: In "The Glittering Noise,"what does the figure of speech "Silkand muslin/brush my hands likemoths / passing by" suggest aboutthe speaker's impression of the pastas she encounters it through olddiaries? find the multiplier associated with government purchases. how does this multiplier compare with that obtained in class (i.e. for a model with lump-sum taxes?)