Correct Answer: C

Rationale: The most likely cause of neck pain in this scenario is a cervical sprain. A cervical sprain is an injury to the ligaments in the neck as a result of sudden force or trauma, such as a motor vehicle collision. The symptoms of a cervical sprain typically include pain, stiffness in the neck, and muscle spasm. The fact that the patient has pain and spasm over the paraspinous muscles on one side of the neck, along with pain during active range of motion, is characteristic of a sprain. It is important to consider this diagnosis in individuals who have recently experienced trauma to the neck region. Treatment for a cervical sprain usually includes pain management, rest, and gentle stretching exercises to help with recovery.

Correct Answer: C

Rationale: The young woman in this scenario is experiencing symptoms consistent with post-traumatic stress disorder (PTSD). PTSD is an anxiety disorder that can develop after a person is exposed to a traumatic event, such as a life-threatening situation like a robbery with a gun involved. The symptoms she is experiencing, including difficulty sleeping, severe nightmares, irritability, hypervigilance, and avoidance of triggers such as driving at night, are all classic features of PTSD. These symptoms have persisted for at least 6 months since the traumatic event occurred, which is a key criterion for making a diagnosis of PTSD. Treatment for PTSD typically involves a combination of medication and therapy to help the individual process and cope with the traumatic experience.

Correct Answer: C

Rationale: Mrs. R. is exhibiting characteristics of a silent patient because she does not respond or engage in conversation when directly asked a question by the healthcare provider. In this case, Mrs. R.'s lack of verbal response could be due to various reasons such as shyness, anxiety, cognitive impairment, or communication barriers. It is important for healthcare providers to recognize and adapt to different communication styles and preferences of patients to ensure effective patient-provider interaction and care. In situations like these, it may be helpful to provide alternative communication methods or allow more time for the patient to respond comfortably.

Correct Answer: C

Rationale: The most likely cause of neck pain in this scenario is a cervical sprain. A cervical sprain is an injury to the ligaments in the neck as a result of sudden force or trauma, such as a motor vehicle collision. The symptoms of a cervical sprain typically include pain, stiffness in the neck, and muscle spasm. The fact that the patient has pain and spasm over the paraspinous muscles on one side of the neck, along with pain during active range of motion, is characteristic of a sprain. It is important to consider this diagnosis in individuals who have recently experienced trauma to the neck region. Treatment for a cervical sprain usually includes pain management, rest, and gentle stretching exercises to help with recovery.

Correct Answer: D

Rationale: The scenario described with a strong pulse followed by a weak pulse is characteristic of pulsus paradoxus, a finding often associated with cardiac tamponade. Cardiac tamponade is a medical emergency where there is an accumulation of fluid (such as blood) in the pericardial sac that exerts pressure on the heart, limiting its ability to pump effectively. As a result, patients may exhibit this pulsus paradoxus, where the pulse strength varies with respiration. The other conditions listed (emphysema, asthma exacerbation, severe left heart failure) are not typically associated with this specific pulsatile pattern.