A 26 y/o seat-belted driver presents with diffuse abdominal tenderness and free air on abdominal films. The patient should:

Correct Answer: B

Rationale: The correct answer is B - Undergo prompt celiotomy. In this scenario, the presence of diffuse abdominal tenderness and free air on abdominal films indicates a high likelihood of intraabdominal injury, likely due to a gastrointestinal perforation. Prompt celiotomy (surgical exploration of the abdomen) is necessary to identify and repair the source of the perforation to prevent sepsis and other complications. Peritoneal lavage (choice A) is not sufficient for definitive diagnosis and treatment. Contrast x-ray (choice C) delays necessary surgical intervention. Simply observing (choice D) can be dangerous as the patient may deteriorate rapidly. Celiotomy allows for immediate intervention and management of the life-threatening condition.

Correct Answer: D

Rationale: The correct answer is D because retroperitoneal air on CT indicates a hollow viscus injury, such as a bowel perforation, which requires immediate surgical exploration. A is incorrect because a seat belt sign alone does not necessitate surgery. B is incorrect as grade 4 hepatic injury may not always require laparotomy. C is incorrect as extraperitoneal bladder injury can often be managed conservatively.

Correct Answer: A

Rationale: The correct answer is A: The nursing assistant. Nursing assistants provide direct care to residents, such as assisting with activities of daily living and personal care needs. They spend the most time with residents compared to other members of the care team. Nurses oversee the care but may not have direct contact as frequently. Physicians focus on medical treatment, not daily care. Activities directors organize recreational activities but do not provide personal care. Therefore, the nursing assistant has the most direct contact with residents.

Correct Answer: D

Rationale: The correct answer is D because other care team members are involved in providing direct care to the resident, and sharing health information with them ensures coordinated and effective care. Sharing with anyone who asks (A) is incorrect as it violates the resident's privacy rights. Sharing with anyone who lives or works at the facility (B) is also incorrect as not all staff members may need to know the information. Sharing with the resident's friends and family (C) could be appropriate with the resident's consent but may not always be necessary for all health information.

Correct Answer: A

Rationale: The correct answer is A because "Mrs. Parker says she is dizzy" is subjective information based on her personal perception or feeling. It cannot be objectively measured or verified. In contrast, choices B, C, and D provide objective information that can be quantified or confirmed by observation or measurement, such as temperature, visit, and food intake. This makes them not subjective.