A 30 year old male presents after a motor vehicle crash. Vital signs are RR 18, HR 88, BP 130/72, GCS 13. Laparotomy is indicated when:

Correct Answer: D

Rationale: The correct answer is D because retroperitoneal air on CT indicates a significant injury such as a hollow viscus perforation, which requires immediate laparotomy. Choice A, a distinct seat belt sign, may indicate abdominal injury but does not always necessitate surgery. Choice B, a grade 4 hepatic injury, can often be managed conservatively. Choice C, extraperitoneal bladder injury, can be managed non-operatively unless there are associated injuries. In summary, retroperitoneal air on CT is a strong indicator of a surgical emergency, while the other choices may not require immediate laparotomy.

Correct Answer: D

Rationale: The correct answer is D because sharing a resident's health information with other care team members is necessary for coordinated and effective care. Other team members need the information to provide appropriate treatment. Choice A is incorrect as sharing with anyone who asks violates resident privacy. Choice B is incorrect because not everyone in the facility needs access to health information. Choice C is incorrect as sharing with friends and family needs resident consent and may not always be appropriate for sensitive information.

Correct Answer: A

Rationale: The correct answer is A because it involves personal feelings or opinions that cannot be objectively measured. Mrs. Parker stating she is dizzy is subjective as it is based on her own perception. Choice B is incorrect because a temperature of 0°F is an objective measurement. Choice C is incorrect as it is a factual event that can be verified. Choice D is incorrect as it is an observable behavior. Subjective information is based on personal interpretations or opinions, making choice A the best example.

Correct Answer: B

Rationale: The correct answer is B: Provide a quiet environment. This is because a quiet environment can help reduce stimulation and confusion in a resident who is already confused. Loud noises or distractions can exacerbate confusion. Leaving the resident alone (choice A) can lead to feelings of abandonment. Avoiding communication (choice C) can worsen confusion. Speaking quickly (choice D) can overwhelm the resident further. Providing a quiet environment promotes a sense of calm and can aid in reorienting the confused resident.

Correct Answer: D

Rationale: The correct answer is D because cleanliness refers to the absence of pathogens, not visible dirt. Step 1: Cleanliness is defined by the absence of pathogens to prevent infections. Step 2: Objects can still be contaminated with pathogens even if dirt is not visible. Step 3: Choice D directly aligns with the definition of cleanliness in healthcare settings. Summary: A, B, and C are incorrect because cleanliness is primarily about the absence of pathogens, not about being used near sick residents, visible dirt, or contamination with pathogens.