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." A ruptured spleen is a surgical emergency that may require splenectomy. A surgical consult is needed to evaluate the patient's condition, determine the need for surgery, and plan the appropriate management. Splenic artery embolization (choice A) may be considered in stable patients, but this patient has a large hematoma and fluid in the pelvis, suggesting active bleeding and hemodynamic instability, which would require surgery. Pneumococcal vaccine (choice B) is important for patients without a spleen post-splenectomy, but it is not the immediate next step in management. Urgent laparotomy (choice C) is too specific without considering the need for surgical evaluation first.

Correct Answer: B

Rationale: The correct answer is B: Weight loss. Weight loss can be a sign of neglect as it may indicate lack of proper nutrition or medical care. Neglect can lead to unintentional weight loss due to inadequate food intake or untreated medical conditions. Burns shaped in certain ways, changing doctors frequently, and wearing makeup to hide injuries are not necessarily direct signs of neglect. Burns can be accidental, changing doctors may be due to personal preferences or insurance reasons, and wearing makeup to hide injuries could be a sign of abuse rather than neglect. Weight loss, on the other hand, is a more clear indicator of neglect as it directly relates to the individual's overall well-being and care.

Correct Answer: D

Rationale: The correct answer is D because electronic documentation contains confidential information that should only be accessed by authorized personnel. Nursing assistants must maintain patient privacy to uphold ethical standards and protect sensitive data. Choice A is incorrect as the focus is on external threats rather than internal privacy concerns. Choice B is incorrect because the federal government does not monitor all computers in LTC facilities. Choice C is incorrect as it assumes residents are the primary privacy concern rather than unauthorized individuals.

Correct Answer: A

Rationale: The correct answer is A. When a resident becomes combative, it is important to try to find out what triggered the behavior to address the root cause. This helps in providing appropriate care and support. Choice B is incorrect as leaving the resident alone may escalate the situation. Choice C is incorrect as threatening to remove the resident can worsen the behavior. Choice D is incorrect as arguing with the resident can further agitate them. Overall, the best approach is to understand the trigger to provide effective care.

Correct Answer: B

Rationale: The correct answer is C: A set of methods used to prevent the spread of disease. Infection prevention involves implementing strategies to reduce the risk of infections spreading among individuals or within a community. This includes practices such as hand hygiene, proper sanitation, use of personal protective equipment, and vaccination. The other choices are incorrect because A does not fully encompass the comprehensive approach of infection prevention, and D is more related to the concept of a clean object rather than preventive measures against disease transmission.