An 8-year-old boy falls 4.5 meters from a tree and has a spleen laceration. The most appropriate management would be:

Correct Answer: D

Rationale: The correct answer is D: Admit the patient to the intensive care unit. This is the most appropriate management because an 8-year-old boy with a spleen laceration after falling from a height needs close monitoring and potential interventions that can be provided in an intensive care setting. Admission to the ICU allows for continuous monitoring of vital signs, blood loss, and potential complications. Type and crossmatch for blood (A) may be necessary but is not the most urgent step in this scenario. Requesting consultation of a pediatrician (B) can be done after initial stabilization, and transferring the patient to a trauma center (C) may delay necessary interventions that can be provided in the current setting.

Correct Answer: D

Rationale: The correct answer is D because in this scenario, the patient presents with signs suspicious of aortic injury, indicated by the widened mediastinum on chest x-ray. However, the definitive test for aortic injury is a CT scan of the chest, which is more sensitive and specific than contrast angiography. If the CT scan is normal, it effectively rules out aortic injury, making further imaging with contrast angiography unnecessary. Performing angiography in this case would expose the patient to unnecessary risks without providing additional diagnostic value. Therefore, the correct approach is to first perform a CT scan of the chest, and if it is normal, no further imaging is required. Choice A is incorrect as contrast angiography is indicated in suspected aortic injury cases. Choice B is incorrect as performing contrast angiography after a CT scan would be redundant and expose the patient to unnecessary risks. Choice C is incorrect as the accuracy of contrast angiography in diagnosing aortic rupture is not as high as indicated in the

Correct Answer: A

Rationale: Rationale for Correct Answer A: "Urethral injuries are associated with pelvic fractures" 1. Urethral injuries are commonly seen in patients with pelvic fractures due to the close anatomical proximity and the mechanism of injury. 2. Pelvic fractures can cause direct trauma to the urethra, leading to urethral injuries. 3. Urethral injuries may present with blood at the meatus, inability to void, or high-riding prostate on rectal examination. 4. Prompt diagnosis and management are crucial to prevent complications such as urinary retention or urethral stricture. Summary: - Choice B is incorrect as not all patients with microscopic hematuria require genitourinary evaluation. - Choice C is incorrect as gross hematuria and shock can be due to various causes, not solely major renal injuries. - Choice D is incorrect as some intraperitoneal bladder injuries may require surgical intervention, not just urinary catheter placement.

Correct Answer: D

Rationale: The correct answer is D: "Massage of the affected area." Massaging the affected area can help improve blood flow and promote circulation, aiding in the rewarming process for frostbite injuries. This helps prevent further tissue damage and supports healing. Explanation for other choices: A: "Application of dry heat" can actually worsen frostbite by causing additional tissue damage. B: "Debridement of hemorrhagic blisters" is not recommended as it can lead to infection and further complications. C: "Early amputation to prevent septic complications" is an extreme measure and not warranted in the initial treatment of frostbite injuries.

Correct Answer: C

Rationale: Rationale: Choice C is correct because avoiding excessive absences from work demonstrates reliability and dependability. By consistently showing up for work, the nursing assistant ensures continuity of care for patients and demonstrates commitment to her responsibilities. This behavior also allows her colleagues to rely on her presence and support. Summary: A: Showing an interest in others is important but does not directly demonstrate dependability. B: Performing tasks she does not know could jeopardize patient safety and is not a sign of dependability. D: Respecting individual beliefs is crucial in healthcare but does not directly relate to dependability in the context of work attendance.