A 34-year-old man is brought to the ED after being pinned to the wall of a building by a cement truck. He is in obvious shock, and has deformities and marked swelling of both thighs. Although no open wounds are present, his shock:

Correct Answer: C

Rationale: The correct answer is C: The shock in this scenario is consistent with blood loss from bilateral femoral fracture. Rationale: 1. Bilateral femoral fractures can lead to significant blood loss due to injury to major blood vessels in the thighs, causing hypovolemic shock. 2. The deformities, marked swelling, and absence of open wounds point towards significant internal bleeding. 3. The shock is likely due to the blood loss from the femoral fractures, making choice C the most appropriate. Summary: A: Pelvic fracture may cause shock, but in this case, the femoral fractures are more likely the primary source of blood loss. B: Loss of 15% blood volume is not significant enough to cause the severe shock observed in this patient. D: Applying traction splints may stabilize the fractures but will not directly address the underlying blood loss causing the shock.

Correct Answer: B

Rationale: The correct answer is B because limb-threatening extremity injuries, such as fractures or dislocations, require definitive management to prevent further damage and preserve limb function. Application of a traction splint helps stabilize the injury, reduce pain, and prevent complications like nerve or vascular damage. A tourniquet (choice A) should only be used in life-threatening situations with uncontrolled bleeding. Limb-threatening injuries can present without open wounds (choice C) and may not always involve ischemic or crushed tissue (choice D), making these options incorrect.

Correct Answer: B

Rationale: The correct answer is B: Bathing a resident. Nursing assistants commonly assist with personal care tasks like bathing to ensure residents' hygiene and comfort. They help maintain skin integrity and prevent infections. Administering medication (A) requires a higher level of training and is usually done by nurses. Changing sterile dressings (C) typically falls under the responsibilities of licensed nurses due to the sterile technique involved. Giving tube feedings (D) also requires specialized training and is usually done by licensed healthcare professionals. Bathing residents is a fundamental and routine task that nursing assistants are trained to perform regularly.

Correct Answer: B

Rationale: The correct answer is B. The Omnibus Budget Reconciliation Act (OBRA) was passed in response to reports of abuse and poor care in long-term care facilities. This legislation aimed to improve the quality of care in nursing homes by setting standards for training and competency of staff, ensuring residents' rights, and enhancing the quality of life for residents. Incorrect choices: A: Lack of funding for long-term care facilities - While funding issues may impact the quality of care, OBRA was primarily focused on addressing abuse and poor care. C: Complaints from long-term care facility staff about resident behavior - Staff complaints about resident behavior were not the primary reason for the passage of OBRA. D: Nursing assistants being unable to pass competency examinations - While this could be a concern, OBRA was more about setting standards and regulations to improve care quality, not solely about the competency of nursing assistants.

Correct Answer: B

Rationale: The correct answer is B: Root. The root is the main part of a word that carries its core meaning. It is the foundation upon which prefixes and suffixes are added to modify the word's meaning. Understanding the root is essential for deciphering the meaning of unfamiliar words. Prefixes (A) are added at the beginning of a word to alter its meaning, suffixes (C) are added at the end, and abbreviations (D) are shortened forms of words and do not provide the core meaning of a word. In summary, the root is crucial for comprehending the fundamental meaning of a word, making it the correct choice.