A 23 year old construction worker is brought to the ED after falling more than 9 meters from scaffolding. He is complaining bitterly of lower abdominal and lower limb pain, and has obvious deformity of both lower legs with bilateral open tibial fractures. Which one of the following statements concerning this patient is true?

Correct Answer: D

Rationale: The correct answer is D. X-ray of the chest and pelvis are important adjuncts in his assessment. This patient's mechanism of injury is indicative of high energy trauma. X-ray of the chest can help identify potential thoracic injuries such as rib fractures or pneumothorax. Pelvic x-ray is crucial to assess for pelvic fractures, which can lead to significant blood loss and hypotension. This patient's hypotension is more likely due to hemorrhagic shock from his open tibial fractures rather than spinal cord injury. Pelvic injury cannot be ruled out solely based on the mechanism of injury as pelvic fractures are common in falls from height. Blood loss from the lower limb alone is not the most likely cause of hypotension in this case.

Correct Answer: A

Rationale: The correct answer is A because it emphasizes the importance of referring to the procedure manual to review the steps. This ensures accuracy and patient safety. Choice B is incorrect as it risks making mistakes. Choice C is unreliable and may not provide accurate information. Choice D is inappropriate as residents are not responsible for providing procedural guidance. Overall, consulting the procedure manual is the most reliable and professional approach.

Correct Answer: C

Rationale: The correct answer is C: Smiling at a new resident. Non-verbal communication involves expressing messages without words. A smile can convey warmth, friendliness, and reassurance, which are essential in a caregiving role. It helps build rapport and comfort for the resident. Writing a note (A) and giving an oral report (B) involve verbal communication. Speaking in an encouraging tone (D) involves verbal communication as well, even though tone is a non-verbal aspect, the act of speaking makes it verbal.

Correct Answer: D

Rationale: The correct answer is D because an incident refers to an unexpected event that could harm a person's health or safety, such as a fall in the bathroom, even if no injuries are apparent. This situation requires immediate attention and reporting to ensure the individual's well-being. A: Mrs. Storey eating half of her dinner is not an incident as it is a routine daily activity. B: Mrs. Desmond's family thanking a nursing assistant is a positive interaction but not an incident. C: Mr. Noble wanting to go for a walk after his bath is a personal preference and not an incident that requires immediate action.

Correct Answer: A

Rationale: The correct answer is A. This choice demonstrates a holistic approach to care by incorporating physical care (giving a bath) with emotional support (asking about the resident's day and listening). This shows a focus on the resident's overall well-being and not just their physical needs. It acknowledges the importance of the resident's feelings and experiences in addition to their physical health. Summary of other choices: B: This choice shows a rushed and impersonal approach to care, focusing solely on completing tasks quickly rather than connecting with the residents. C: While sharing religious views may provide comfort to some residents, it does not necessarily address their holistic needs and may not be welcomed by all residents. D: Spending excessive time chatting may neglect important tasks and responsibilities, indicating a lack of balance in care provision.