Regarding shock in the child, which of the following is FALSE?

Correct Answer: D

Rationale: The correct answer is D because the absolute volume of blood loss required to produce shock in children is not the same as in adults. Children have a smaller blood volume compared to adults, so even a smaller amount of blood loss can lead to shock. This is due to their smaller size and lower total blood volume. A: Vital signs are age-related - True, children have different normal vital signs compared to adults. B: Children have greater physiologic reserves than do adults - True, children have more reserves to compensate for shock. C: Tachycardia is the primary physiologic response to hypovolemia - True, tachycardia is a common response to maintain perfusion in hypovolemic shock.

Correct Answer: A

Rationale: The correct answer is A: "Subcapsular hematoma of the spleen" because DPL (Diagnostic Peritoneal Lavage) is a diagnostic procedure used to assess for intra-abdominal injuries, particularly to organs like the liver, bowel, and pancreas. A subcapsular hematoma of the spleen is an injury specific to the spleen, which is not directly evaluated by DPL. The other choices (B: Liver laceration, C: Bowel injury, D: Pancreatic injury) are all potential injuries that can be detected by DPL due to their location within the abdominal cavity and the presence of free intra-abdominal fluid.

Correct Answer: D

Rationale: The correct answer is D, Argyll Robertson pupil, because it is a sign of neurosyphilis and not directly related to brain stem reflexes. "Dolls eyes" (A), oculovestibular reflex (B), and gag reflex (C) are all brain stem reflexes commonly assessed in evaluating brain death. "Dolls eyes" assesses the oculocephalic reflex, oculovestibular reflex evaluates the response to ice water irrigation in the ear, and gag reflex assesses the glossopharyngeal and vagus nerves' function.

Correct Answer: B

Rationale: The correct answer is B: Reassess the position of the endotracheal tube. In this scenario, the patient is showing signs of tension pneumothorax with decreased breath sounds on the left side and hypoxemia. Reassessing the position of the endotracheal tube is crucial to ensure proper ventilation and oxygenation. Immediate needle cricothyroidotomy is not indicated as the patient is already intubated. Chest tube insertion would be the definitive treatment for tension pneumothorax, but reassessing the endotracheal tube should be the initial step. Immediate needle thoracentesis is not indicated in this case as tension pneumothorax is more likely.

Correct Answer: B

Rationale: The correct answer is B because Medicare and Medicaid payments to long-term care facilities are determined by the resident's need for services, as assessed upon admission and throughout their stay. This is based on the level of care required by the resident, such as medical needs, assistance with activities of daily living, and specialized care. The payments are not influenced by the resident's background (A), the size of the facility (C), or the financial contributions from the resident's family (D). These factors do not dictate the reimbursement rates set by Medicare and Medicaid, which are primarily focused on the level of care needed by the resident.