G.R. is a 75-year-old male who presents to the emergency department with chest pain, palpitations, and appears pale and diaphoretic. As the history and physical are completed, the following problems emerge. Please label them first-, second-, or third-level priority problems. c. Lives alone, no family in the area

Correct Answer: C

Rationale: The correct answer is C: Third-level. The patient's presentation suggests he may be experiencing a cardiac event requiring immediate attention (first-level). The fact that he lives alone with no family in the area is a social issue (third-level) that could impact his ability to receive necessary ongoing care and support post-discharge, but it does not pose an immediate threat to his life. Therefore, addressing his immediate medical needs takes precedence over this social issue. Choices A and B are incorrect as they do not accurately reflect the urgency and priority level of the patient's problems.

Correct Answer: B

Rationale: The correct answer is B: Eccentric muscle contraction. During eccentric contractions, the muscle lengthens while generating force, placing greater stress on the muscle fibers and making them more susceptible to injury. In the case of the hamstring, which is commonly injured during activities involving sudden deceleration or slowing down, such as running downhill or stopping abruptly, the eccentric contraction plays a significant role. Choice A (Concentric muscle contraction) involves muscle shortening and is less likely to cause injury in the hamstring. Choice C (Isometric contractions) involve static muscle contractions with no change in muscle length, making them less likely to lead to hamstring injury. Choice D (Isotonic contractions) refers to muscle contractions with a constant load, which may or may not lead to hamstring injury depending on the specific exercise and load applied.

Correct Answer: D

Rationale: Kienböck's disease is osteonecrosis of the lunate bone. This occurs due to disrupted blood supply, leading to lunate collapse and wrist pain. Option D is correct as it directly relates to the pathology of Kienböck's disease. Options A, B, and C are incorrect as they do not describe the specific feature associated with Kienböck's disease. Osteonecrosis of the scaphoid (Option A) is more commonly seen in Preiser's disease, while Pencil-in-cup deformities (Option B) are typically associated with psoriatic arthritis. Heberden's and Bouchard's nodules (Option C) are seen in osteoarthritis of the fingers, not in Kienböck's disease.

Correct Answer: C

Rationale: The correct answer is C: MRI. MRI is the 'gold standard' for evaluating the rotator cuff due to its high sensitivity and specificity in detecting rotator cuff tears and other pathologies. It provides detailed imaging of soft tissues, allowing for better visualization of the rotator cuff structures. Plain x-rays are not ideal for evaluating soft tissues like the rotator cuff. Physical exam of the shoulder can provide valuable information, but it may not be as accurate as imaging tests. Ultrasound can be useful, but it is not as sensitive or specific as MRI for detecting rotator cuff tears. In summary, MRI is the preferred diagnostic test for evaluating the rotator cuff due to its superior imaging capabilities and accuracy in detecting pathologies.

Correct Answer: C

Rationale: The correct answer is C: Validate the data by asking a coworker to listen to the breath sounds. This is the best course of action as it involves seeking a second opinion to confirm the unclear sound heard, ensuring accuracy in assessment. Notifying the physician immediately (A) may be premature without validation. Documenting the sound (B) without confirmation can lead to inaccurate documentation. Assessing again in 20 minutes (D) may delay necessary intervention if the sound is significant. Asking a coworker to validate the data (C) allows for immediate clarification and ensures accurate assessment.