A patient undergoing mechanical ventilation in the ICU develops ventilator-associated pneumonia (VAP) caused by multidrug-resistant organisms (MDROs). What intervention should the healthcare team prioritize to manage the patient's infection?

Correct Answer: A

Rationale: The most appropriate intervention for managing ventilator-associated pneumonia (VAP) caused by multidrug-resistant organisms (MDROs) is to administer combination antibiotic therapy targeting the specific resistant pathogens identified in the patient's culture results. MDROs are often resistant to multiple antibiotics, so combination therapy is required to maximize the chances of effectively treating the infection. Identifying the specific pathogens causing the VAP through cultures is crucial in tailoring the antibiotic therapy to target these organisms effectively. Implementing appropriate antibiotic therapy promptly is essential to improve outcomes and prevent further complications in patients with VAP caused by MDROs. Option A is the priority intervention in this case to address the multidrug-resistant nature of the infection and provide targeted treatment for the patient.

Correct Answer: A

Rationale: Osteoporosis is a common complication associated with long-term use of corticosteroids in orthopedic patients. Corticosteroids can lead to bone loss by inhibiting bone formation and promoting bone resorption, resulting in decreased bone mineral density and increased risk of fractures. Therefore, patients on long-term corticosteroid therapy, especially in high doses, should be monitored closely for osteoporosis and receive appropriate preventive measures such as calcium, vitamin D supplementation, and bisphosphonates to mitigate the risk of bone thinning and fractures.

Correct Answer: B

Rationale: Avascular necrosis of the femoral head, also known as osteonecrosis, is a common complication associated with hip fractures in elderly patients. It occurs when there is a loss of blood supply to the femoral head following the fracture, leading to bone tissue death. This can result in pain, limitation of motion, and potentially the collapse of the femoral head, causing further complications. Timely diagnosis and appropriate management are crucial in order to prevent further degeneration of the hip joint. Other complications such as compartment syndrome, dislocation of the hip prosthesis, and Volkmann's contracture are not typically associated with hip fractures in elderly patients.

Correct Answer: B

Rationale: The presentation of knee pain and swelling following a fall onto a flexed knee, along with a palpable effusion and tenderness along the joint line, is highly suggestive of a meniscus injury. The McMurray's test specifically evaluates for meniscal tears. In this case, the presence of pain and clicking with passive knee flexion and internal rotation indicates a medial meniscus tear as the most likely diagnosis. Patellar tendinitis usually presents with anterior knee pain that is worsened by activities such as jumping or running. Lateral collateral ligament (LCL) sprain typically presents with lateral knee pain and instability. Quadriceps tendon rupture would present with significant weakness and inability to fully extend the knee, which is not described in this scenario.

Correct Answer: A

Rationale: Given the sudden-onset severe scrotal pain, swelling, and erythema, along with the physical examination findings of a tender, swollen, and high-riding testicle, the most likely diagnosis is testicular torsion. Testicular torsion occurs when the spermatic cord twists, leading to compromised blood flow to the testicle, causing ischemia and severe pain. It is considered a surgical emergency that requires prompt diagnosis and intervention to salvage the affected testicle. Prompt surgical detorsion is necessary to prevent irreversible testicular damage. While epididymitis, testicular trauma, and testicular tumors can also present with scrotal pain and swelling, the presence of a high-riding testicle in this context is highly suggestive of testicular torsion.