Arnold, a 19-year-old client with a mild concussion is discharged from the emergency department. Before discharge, he complains of a headache. When offered acetaminophen, his mother tells the nurse the headache is severe and she would like her son to have something stronger. Which of the following responses by the nurse is appropriate?

Correct Answer: C

Rationale: The correct response is C: "Narcotics are avoided after a head injury because they may hide a worsening condition." Rationale: 1. Narcotics can mask symptoms of a worsening condition, such as increased intracranial pressure, by providing pain relief without addressing the underlying issue. This can delay appropriate medical intervention. 2. Acetaminophen is a suitable option for mild headaches and poses a lower risk of masking symptoms compared to narcotics. 3. Aspirin (option B) is contraindicated due to the risk of Reye's syndrome in young adults with viral illnesses. 4. Option D is incorrect as vomiting itself does not necessarily lead to increased intracranial pressure; strong medications may have various side effects, but the primary concern is the potential for masking symptoms with narcotics in this scenario.

Correct Answer: A

Rationale: The correct answer is A: Fracture of the distal radius. A Colles' fracture specifically refers to a fracture of the distal end of the radius bone in the forearm, typically occurring due to a fall on an outstretched hand. This type of fracture is characterized by a specific anatomical location and mechanism of injury. The other choices, B: Fracture of the olecranon, C: Fracture of the humerus, and D: Fracture of the carpal scaphoid, do not correspond to a Colles' fracture based on the specific location and characteristics of this type of injury.

Correct Answer: A

Rationale: The correct answer is A: Air leak. Bubbling in the water seal chamber indicates air is escaping from the pleural space through the chest tube, confirming the presence of an air leak. This is a common complication after chest tube insertion for pneumothorax. Adequate suction (choice B) would not cause bubbling in the water seal chamber. Inadequate suction (choice C) would result in no bubbling or fluctuation of the water in the water seal chamber. A kinked chest tube (choice D) would obstruct the drainage but not cause bubbling in the water seal chamber.

Correct Answer: A

Rationale: The correct answer is A: Low platelet count. In DIC, there is widespread activation of coagulation leading to consumption of platelets and clotting factors. This results in a low platelet count due to their excessive use in forming microthrombi. Elevated fibrinogen levels (B) occur in response to increased clotting activity. Low levels of fibrin degradation products (C) are not consistent with DIC as there is increased fibrin breakdown in DIC. Reduced prothrombin time (D) is not indicative of DIC as it measures the extrinsic pathway of coagulation and may be normal or prolonged in DIC.

Correct Answer: D

Rationale: The correct answer is D (80 mm Hg). Respiratory arrest leads to inadequate ventilation, causing carbon dioxide (CO2) retention. A high PaCO2 level indicates respiratory acidosis, which is a common consequence of respiratory arrest. In this scenario, the administration of a narcotic analgesic can depress the respiratory drive, leading to hypoventilation and subsequent respiratory acidosis. Choices A, B, and C are incorrect because they represent lower PaCO2 levels, which would not be expected in a patient at risk of respiratory arrest.