A 32-year-old man’s right leg is trapped beneath his overturned car for nearly two hours. Which of the following is most likely to improve chances for limb salvage?

Correct Answer: D

Rationale: The correct answer is D: Performing lower extremity fasciotomies. In this scenario, the man's leg was trapped under the car for a prolonged period, leading to potential compartment syndrome. Fasciotomies can release pressure in the compartments, improving blood flow and potentially salvaging the limb. A: Applying skeletal traction may help stabilize the leg, but it does not address the underlying compartment syndrome. B: Administering anticoagulant drugs is not indicated for compartment syndrome and may increase the risk of bleeding. C: Administering thrombolytic therapy is not appropriate for compartment syndrome and may lead to further complications. In summary, lower extremity fasciotomies are the most appropriate intervention to improve chances for limb salvage in this case.

Correct Answer: A

Rationale: The correct answer is A because initial resuscitation in adult patients should focus on restoring intravascular volume, which is effectively achieved with 1-2L of crystalloid fluids. This helps improve tissue perfusion and overall hemodynamics. Monitoring the patient's response (choice B) is important but secondary to the immediate need for volume replacement. Using crystalloid to normalize blood pressure (choice C) is not recommended as the sole goal, as other factors like tissue perfusion also need to be considered. Permissive hypotension (choice D) is contraindicated in patients with head injury as it can worsen brain perfusion.

Correct Answer: A

Rationale: The correct answer is A: The nurse. Nurses are trained to assess residents, monitor their progress, and administer treatments and medication. They have the expertise and knowledge to provide comprehensive care. Nursing assistants (B) assist with daily living activities but do not have the same scope of practice. Medical social workers (C) focus on social and emotional aspects of care. Registered dietitians (D) specialize in nutrition management, not direct patient care like assessing and administering treatments. Thus, the nurse is the most appropriate member of the care team for these responsibilities.

Correct Answer: C

Rationale: The correct answer is C: Investigating and resolving resident complaints. An ombudsman's primary responsibility is to advocate for residents in long-term care facilities, ensuring their rights are upheld and addressing any concerns or complaints they may have. Ombudsmen investigate complaints, mediate disputes, and work towards resolving issues to improve the quality of care for residents. Choices A, B, and D are incorrect because they do not align with the core duties of an ombudsman, which focus on protecting residents' rights and addressing complaints rather than specific care procedures, staff disputes, or recreational activities.

Correct Answer: C

Rationale: The correct answer is C because it provides measurable and verifiable data - Mr. Castillo's blood pressure is 5/6. This information is objective as it can be confirmed through a physical measurement. Option A is subjective as it is based on perception. Option B is also subjective as it relies on Mr. Castillo's self-reporting. Option D is subjective as it is based on personal relationships and interactions. In contrast, option C stands out as the only choice that presents factual, quantifiable information, making it the correct example of objective information.