Final answer:
To give the patient change using the counting up method, subtract the purchase amount from the bill amount to get the change amount. Divide the change amount by the value of a dime to find the number of dimes to give as change, rounding down if necessary.
Step-by-step explanation:
To determine the number of dimes to give the patient as change, we need to find the difference between the bill amount and the purchase amount. Here, the bill amount is $50 and the purchase amount is $27.35.
Subtracting $27.35 from $50 gives us $50 - $27.35 = $22.65, which represents the change to be given to the patient.
Since a dime is worth $0.10, we can divide the change amount by $0.10 to find the number of dimes. Dividing $22.65 by $0.10 gives us 226.5 dimes. However, we can't give half a dime, so we round down to the nearest whole number. Therefore, we would give the patient 226 dimes as change.