A 70 year old suffers blunt chest trauma after being struck by a car. On presentation, his GCS is 15, BP is 145/90, HR is 72. RR is 24 and O2-sat on 5L is 91%. Chest x-ray demonstrates multiple right sided rib fractures. ECG demonstrates normal sinus rhythm with no conduction abnormalities. Management should include:

Correct Answer: C

Rationale: The correct answer is C: "Monitored i.v analgesia." In this scenario, the patient has blunt chest trauma with rib fractures causing pain. The management should focus on controlling pain to improve respiratory effort and prevent complications like pneumonia. IV analgesia is recommended to provide effective pain relief and improve patient outcomes. Choice A: "Placement of a 22Fr right sided chest tube" is incorrect because there is no indication for chest tube insertion based on the information provided. The patient's vital signs are stable and there are no signs of tension pneumothorax. Choice B: "Serial troponins and cardiac monitoring" is incorrect because there are no indications of cardiac injury based on the normal ECG and the absence of cardiac symptoms. Troponins and cardiac monitoring are not necessary at this point. Choice D: "Thoracic splinting" is incorrect because splinting is not typically recommended for rib fractures in elderly patients. It may restrict respiratory effort and cause more harm

Correct Answer: A

Rationale: The correct answer is A: Missing teeth or hair. This is a sign of physical abuse as it indicates direct harm to the individual. Missing teeth or hair can result from violent acts or forceful actions. Other choices are incorrect because: - B: Ripped clothing may indicate rough handling but is not a definitive sign of abuse. - C: Pressure injuries are more likely to indicate neglect or improper care rather than abuse. - D: Unanswered call lights may suggest neglect or understaffing, but not necessarily abuse.

Correct Answer: B

Rationale: The correct answer is B because exiting the web browser after finishing charting ensures data security and prevents unauthorized access. This practice maintains patient confidentiality and complies with healthcare privacy regulations. Other choices are incorrect: A is not related to work tasks, C is a misuse of work time, and D compromises data security and violates privacy policies.

Correct Answer: C

Rationale: Step-by-step rationale for why choice C is correct: 1. Combative behavior can be caused by underlying medical conditions. 2. Certain diseases or medications can lead to aggression or hostility. 3. Understanding the root cause is crucial for effective management. 4. Addressing the underlying issue can help improve behavior. 5. Reporting and addressing the cause of combative behavior is essential for the individual's well-being and safety. Summary: A: Incorrect - Combative behavior is not always directed towards a specific person. B: Incorrect - Staff and residents should be concerned and take appropriate action. C: Correct - Identifying medical causes is crucial for effective management. D: Incorrect - Combative behavior should be reported and addressed promptly.

Correct Answer: B

Rationale: Correct Answer: B Rationale: 1. Breaking tasks into smaller steps helps residents with developmental disabilities understand and complete activities independently. 2. It promotes autonomy and builds confidence. 3. It aligns with person-centered care approach. 4. It respects the individual's capabilities and fosters their growth. Incorrect Choices: A. Incorrect because communication is essential, using alternative methods if needed. C. Incorrect as it is important to respect the resident's dignity and individuality. D. Incorrect as it can hinder the resident's independence and development.