A 30-year-old woman fell down four stairs landing on concrete. Unconscious for 5 minutes after the fall, full consciousness during 10 minute transport to hospital, GCS 15, complaint is a slight headache, 30 minutes later she is unresponsive with GCS 6 and left pupil is large.

Correct Answer: D

Rationale: The correct answer is D - Less brain contusions. The scenario described suggests a rapid deterioration in neurological status after an initial period of lucidity, indicating the possibility of a traumatic brain injury. The presence of a large left pupil suggests uncal herniation, which can be due to increased intracranial pressure from brain contusions. The sudden decline in GCS from 15 to 6 further supports this. The lack of focal neurological signs like flail chest or pulmonary contusion makes choices A and C less likely. Choice B is unrelated to the scenario provided. Therefore, the most likely explanation for the patient's worsening condition is the development of brain contusions leading to increased intracranial pressure and subsequent herniation.

Correct Answer: A

Rationale: The correct answer is A because in the treatment of thermal injuries, immediate removal of clothing is crucial to stop the heat source and prevent further damage to the skin. Removing clothing also allows for a quick assessment of the extent of the burn and initiation of appropriate treatment. Choice B is incorrect as patients with thermal injuries are at risk for hypothermia due to heat loss from damaged skin. Choice C is incorrect as fasciotomies are not typically indicated for circumferential truncal burns unless there is evidence of compartment syndrome. Choice D is incorrect as electrical burns can lead to deep tissue injury but are not always associated with extensive skin necrosis from entry to exit points.

Correct Answer: D

Rationale: The correct answer is D: Care that it determines to be medically necessary. Medicare covers services that are deemed medically necessary based on established guidelines and standards. This ensures that resources are used efficiently and appropriately to improve patient outcomes. Choices A, B, and C are incorrect because Medicare does not cover all care requested by the recipient, doctor, or facility without considering medical necessity. It is crucial for Medicare to prioritize coverage for services that are essential for the patient's health and well-being.

Correct Answer: B

Rationale: The correct answer is B because documenting care accurately and promptly is an essential part of professional and ethical behavior for a nursing assistant. It ensures continuity of care, accountability, and patient safety. By documenting accurately, the nursing assistant provides crucial information for the healthcare team. Choice A is incorrect because keeping quiet about a mistake can lead to potential harm to the patient and goes against ethical principles of honesty and transparency. Choice C is incorrect because sharing details about residents violates patient confidentiality, a fundamental ethical principle in healthcare. Choice D is incorrect because rushing a resident through tasks compromises the quality of care and can jeopardize patient safety, which is not aligned with professional and ethical behavior.

Correct Answer: D

Rationale: Step-by-step rationale for why answer D is correct: 1. Cultural background influences communication styles, values, and norms. 2. Understanding cultural background helps the NA communicate effectively. 3. It fosters trust, respect, and empathy between the NA and the resident. 4. Enhances person-centered care and improves overall quality of care. 5. Options A, B, and C are incorrect as they do not address the core importance of cultural background in communication.