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 the 8-year-old boy has suffered a significant fall resulting in a spleen laceration, indicating a severe injury. Admitting the patient to the ICU allows for close monitoring of his condition, ensuring immediate intervention if his condition deteriorates. Option A, Type and crossmatch for blood, is not the priority in this scenario as stabilizing the patient's condition takes precedence. Option B, requesting consultation of a pediatrician, may be necessary but not as urgent as admitting to the ICU. Option C, transferring the patient to a trauma center, may delay critical care that the patient needs immediately.

Correct Answer: D

Rationale: The correct answer is D: Is not necessary if the CT-scan of the chest is normal. Rationale: 1. The patient presents with signs of possible aortic injury (e.g., widened mediastinum) after a high-speed motor vehicle collision. 2. CT scan of the chest is a sensitive imaging modality for detecting aortic injuries. 3. If the CT scan of the chest is normal, it effectively rules out aortic injury in this scenario. 4. Performing contrast angiography would be unnecessary if the initial CT scan is normal, as it would not provide additional diagnostic value and expose the patient to further risks. Summary: A: "Is not indicated" - Incorrect, as imaging is necessary to assess for aortic injury in this high-risk scenario. B: Should be performed after CT scan of the chest - Incorrect, as contrast angiography is not necessary if the CT scan is normal. C: Is positive for aortic rupture in 80% of similar cases -

Correct Answer: A

Rationale: Rationale for Correct Answer (A): - Urethral injuries are commonly associated with pelvic fractures due to the proximity of the urethra to the pelvic bones. - Pelvic fractures can cause direct trauma to the urethra leading to injury. - Therefore, it is true that urethral injuries are associated with pelvic fractures. Summary of Incorrect Choices: B: Not all patients with microscopic hematuria require evaluation; it may resolve spontaneously or be due to benign causes. C: Gross hematuria and shock can be from various sources, not just major renal injury; it could be from bladder or vascular injuries. D: Intraperitoneal bladder injuries usually require surgical intervention, not just urinary catheter placement.

Correct Answer: D

Rationale: The correct initial treatment for frostbite injuries is massage of the affected area (Choice D). This helps to gently warm up the tissue and improve blood flow, which is crucial in preventing further damage. Dry heat (Choice A) can actually worsen the injury by causing burns. Debridement of hemorrhagic blisters (Choice B) should not be done initially as it may increase the risk of infection. Early amputation (Choice C) is a drastic measure and should only be considered as a last resort after all other treatment options have been exhausted.

Correct Answer: C

Rationale: The correct answer is C because avoiding excessive absences from work demonstrates dependability by showing commitment and reliability. By consistently showing up for work, the nursing assistant ensures continuity of care for patients. Choice A is about empathy, not dependability. Choice B is incorrect as performing tasks without proper knowledge can compromise patient safety. Choice D is about cultural competence, not dependability.