A 29-year-old male is brought to the ED after being involved in a motor vehicular collision when his car struck a bridge abutment. He is intoxicated, has GCS 13, and complains of abdominal pain. His BP was 80mmHg systolic by palpation on admission, but rapidly increased to 110/70 with the administration of IV flui His heart rate is 120/min. The chest x-ray shows loss of aortic knob, widening of mediastinum, no rib fracture, and no hemopneumothorax. Contrast angiography:

Correct Answer: D

Rationale: The correct answer is D: Is not necessary if the CT-scan of the chest is normal. Rationale: 1. The patient presents with signs of possible aortic injury (e.g., widened mediastinum) after a high-speed motor vehicle collision. 2. CT scan of the chest is a sensitive imaging modality for detecting aortic injuries. 3. If the CT scan of the chest is normal, it effectively rules out aortic injury in this scenario. 4. Performing contrast angiography would be unnecessary if the initial CT scan is normal, as it would not provide additional diagnostic value and expose the patient to further risks. Summary: A: "Is not indicated" - Incorrect, as imaging is necessary to assess for aortic injury in this high-risk scenario. B: Should be performed after CT scan of the chest - Incorrect, as contrast angiography is not necessary if the CT scan is normal. C: Is positive for aortic rupture in 80% of similar cases -

Correct Answer: D

Rationale: The correct initial treatment for frostbite injuries is massage of the affected area (Choice D). This helps to gently warm up the tissue and improve blood flow, which is crucial in preventing further damage. Dry heat (Choice A) can actually worsen the injury by causing burns. Debridement of hemorrhagic blisters (Choice B) should not be done initially as it may increase the risk of infection. Early amputation (Choice C) is a drastic measure and should only be considered as a last resort after all other treatment options have been exhausted.

Correct Answer: C

Rationale: The correct answer is C because avoiding excessive absences from work demonstrates dependability by showing commitment and reliability. By consistently showing up for work, the nursing assistant ensures continuity of care for patients. Choice A is about empathy, not dependability. Choice B is incorrect as performing tasks without proper knowledge can compromise patient safety. Choice D is about cultural competence, not dependability.

Correct Answer: B

Rationale: The correct answer is B: Psychological abuse. Threatening harm to prevent disclosure is a form of emotional manipulation and control, causing fear and distress. Physical abuse (A) involves physical harm, not just threats. Financial abuse (C) involves exploitation for financial gain, not threats. Substance abuse (D) pertains to the misuse of drugs or alcohol, not threats of harm. In this scenario, the focus is on the mental and emotional impact of the threat, hence it falls under psychological abuse.

Correct Answer: C

Rationale: The correct answer is C: Other members of the care team. A nursing assistant should only share resident information with other members of the care team involved in the resident's care to ensure coordinated and effective healthcare delivery. Sharing information with anyone she chooses (A) violates resident privacy rights. Sharing with the resident's family and friends (B) may breach confidentiality if not authorized by the resident. Not sharing with anyone (D) can hinder effective care coordination. Sharing with the care team promotes collaboration and enhances resident outcomes.