A 30 year old female is brought to the ED after being injured in a motor vehicle crash. Her initial BP is 90/60 mmHg, and her HR is 122 bpm. She responds to rapid infusion of 1L crystalloid solution with a rise in her BP to 118/88 and decrease in her HR to 90 bpm. Her pressure suddenly decreased to 96/66. The least likely cause of her hemodynamic change is:

Correct Answer: C

Rationale: The correct answer is C: Traumatic brain injury. In this scenario, the patient's response to fluid resuscitation indicates that her hemodynamic instability is likely due to ongoing blood loss rather than blunt cardiac injury, inadequate resuscitation, or traumatic brain injury. The improvement in BP and HR after fluid infusion suggests that the patient is responding appropriately to volume replacement, making ongoing blood loss the most likely cause of her hemodynamic changes. Blunt cardiac injury could lead to similar symptoms, but the patient's response to fluid makes it less likely. Inadequate resuscitation would lead to persistent hypotension, which is not the case here. Traumatic brain injury typically does not cause acute hemodynamic changes like the ones observed in this case.

Correct Answer: A

Rationale: The correct answer is A: Keeping a resident's information confidential. This is ethical behavior as it upholds the resident's right to privacy and maintains trust. Revealing confidential information violates ethical principles and can harm the resident. Choices B, C, and D are incorrect. B contradicts transparency and honesty, which are essential in healthcare. C involves deception and impersonation, which is unethical and can lead to legal consequences. D is inappropriate as it can burden the resident with unnecessary information and is unprofessional.

Correct Answer: D

Rationale: The correct answer is D because responding immediately when the resident calls for help shows attentiveness and care, building trust with the resident's family and friends. This action demonstrates the NA's dedication to the resident's well-being and emphasizes their commitment to providing timely assistance. A is incorrect as avoiding talking to the resident when he has visitors can signal indifference and lack of engagement. B is incorrect because letting the family take care of the resident's needs themselves may suggest neglect of the NA's responsibilities. C is incorrect as telling stories about the resident without their consent may invade their privacy and potentially create uncomfortable situations. In summary, choice D is the most effective way for an NA to establish a positive relationship with a resident's family and friends by prioritizing the resident's needs and ensuring prompt assistance.

Correct Answer: C

Rationale: The correct answer is C because checking if any assigned residents require immediate help or care is crucial for ensuring their safety and well-being. This step prioritizes addressing urgent needs and emergencies first, aligning with the nursing assistant's duty to provide timely and necessary assistance. Setting up residents for mealtime (choice A) can wait until urgent needs are addressed. Trying to change daily assignments (choice B) is not a priority when residents may need immediate help. Taking vital signs on all residents (choice D) is important but should come after addressing urgent care needs.

Correct Answer: D

Rationale: The correct answer is D because listening to the family's concerns and fears and responding with a meaningful message demonstrates empathy, respect, and effective communication skills. It shows the nursing assistant's understanding of the family's emotional needs and helps build trust and rapport. A is incorrect because nursing assistants should not give medical advice as it is beyond their scope of practice. B is incorrect because providing false reassurance can undermine trust and credibility. C is incorrect because sharing confidential medical information without consent violates the resident's privacy rights.