A 15 year old male presents following a motorcycle crash. Initial examination reveals normal vital signs. There is a large bruise over his epigastrium that extends to the left flank. He has no other apparent injuries. A CT-scan of the abdomen demonstrates a ruptured spleen surrounded by a large hematoma and fluid in the pelvis. The next step in the patient's management is:

Correct Answer: D

Rationale: The correct answer is D: "Surgical consult." In this scenario, the patient has a ruptured spleen with associated hematoma and fluid in the pelvis, indicating active bleeding. A surgical consult is necessary to evaluate the need for surgical intervention such as splenectomy or splenic artery embolization. A surgical approach is crucial to control bleeding and manage potential complications. Choice A, splenic artery embolization, may be a treatment option, but a surgical consult is needed first to assess the patient's overall condition and suitability for this procedure. Choice B, pneumococcal vaccine, is important for patients with splenectomy but is not the immediate priority in this acute setting. Choice C, urgent laparotomy, is too specific without knowing the patient's stability and overall condition, making a surgical consult a more appropriate initial step.

Correct Answer: B

Rationale: Weight loss is considered a sign of neglect because it can indicate lack of proper nutrition and care. Neglect can lead to inadequate food provision, resulting in weight loss. Burns shaped in certain ways, changing doctors frequently, and wearing makeup to hide injuries are not definitive signs of neglect as they can have various explanations unrelated to neglect.

Correct Answer: D

Rationale: The correct answer is D because electronic documentation contains confidential information that should only be accessed by authorized personnel. It is important for nursing assistants to maintain privacy to protect patient information from unauthorized access. Choice A is incorrect as it focuses on external threats rather than internal privacy concerns. Choice B is incorrect as there is no evidence of the federal government monitoring computers in LTC facilities in the context of this question. Choice C is incorrect as it assumes residents are the main concern, rather than the potential for unauthorized individuals to view confidential information.

Correct Answer: A

Rationale: The correct answer is A because trying to find out what triggered the behavior helps identify the root cause and address it effectively. It promotes understanding and empathy, leading to better communication and problem-solving. Leaving the resident alone (B) may worsen the situation. Threatening removal (C) can escalate the behavior. Arguing (D) is confrontational and unproductive. A is the best approach as it focuses on addressing the underlying issue.

Correct Answer: B

Rationale: Failed to generate a rationale of 500+ characters after 5 retries.