Tom arrives in the Emergency Room (ER) and is unable to move his legs as a result of an automobile accident that occurred 30 minutes ago. You respond by saying

Correct Answer: C

Rationale: In this scenario, the correct response is option C: "Swelling due to the initial trauma may make the injury seem more severe than it actually is. A more accurate assessment will be made once the swelling goes down." This answer is correct because in cases of acute trauma, such as an automobile accident, initial swelling and inflammation can mask the true extent of the injury. It is crucial to wait for the swelling to subside before making a definitive assessment of the condition. Option A is incorrect because it oversimplifies the situation by attributing the inability to move legs solely to swelling, ignoring the possibility of underlying spinal cord or nerve damage. Option B is incorrect as it focuses on rehabilitation without addressing the immediate need for accurate diagnosis and treatment. Option D is irrelevant and inappropriate as it places blame on the individual rather than addressing the urgent medical concern. In an educational context, this question highlights the importance of clinical assessment skills in emergency situations. It emphasizes the need for healthcare professionals to consider the complexities of trauma evaluation, including the impact of swelling on initial presentations. Understanding the nuances of assessing acute injuries can lead to more accurate diagnoses and timely interventions, ultimately improving patient outcomes.

Correct Answer: C

Rationale: In this scenario, the correct answer is option C: Pain and numbness or tingling sensation in the hand over the palmar surface of the thumb, index, and middle fingers, and lateral aspect of the ring finger, that is worse at night. This is because carpal tunnel syndrome commonly presents with these symptoms due to compression of the median nerve in the wrist. Patients with carpal tunnel syndrome often report worsening symptoms at night due to positioning of the hand during sleep. Option A is incorrect because crepitus is not typically associated with carpal tunnel syndrome. It is more indicative of osteoarthritis where there is loss of articular cartilage and bony overgrowth in the joint. Option B is incorrect as excessive forward curvature of the thoracic spine (kyphosis) is not a typical finding in carpal tunnel syndrome. It is more commonly seen in conditions like osteoporosis leading to pathologic vertebral fractures. Option D is incorrect as acute onset of excruciating pain in the joint due to accumulation of uric acid within the joint is characteristic of gout, not carpal tunnel syndrome. Educationally, understanding the specific symptoms and signs associated with different conditions is crucial for accurate diagnosis and management in healthcare settings. This rationale highlights the importance of recognizing the key features of carpal tunnel syndrome to differentiate it from other conditions with similar manifestations, aiding in providing appropriate care for patients.

Correct Answer: A

Rationale: The correct answer is A) Airway, breathing, circulation, and wound site. When a patient like Dominic is transferred to the PACU from the OR, the initial assessment should prioritize the ABCs (Airway, Breathing, Circulation) to ensure his vital functions are stable post-surgery. Checking the wound site is crucial to monitor for any signs of bleeding, infection, or complications from the surgical procedure. Option B) Intake, output, and intravenous access focuses more on fluid balance and monitoring, which is important but not the priority immediately post-surgery. Option C) Abdominal sounds, oxygen level, and level of consciousness are important assessments but should come after ensuring the patient's airway, breathing, and circulation are stable. Option D) Pulse oximetry, pupil responses, and deep tendon reflexes are valuable assessments but are secondary to the immediate concerns of airway, breathing, circulation, and wound site evaluation in the PACU. Understanding the prioritization of assessments in the PACU is crucial for nurses and healthcare providers to ensure patient safety and prompt intervention if any issues arise post-surgery, making option A the most appropriate choice for Dominic's initial assessment.

Correct Answer: B

Rationale: In the context of a patient experiencing exacerbations of systemic lupus erythematosus (SLE), the physician would likely prescribe corticosteroids (Option B). This is because corticosteroids are commonly used in the treatment of SLE to help reduce inflammation and suppress the overactive immune response that characterizes the disease. They are effective in managing symptoms such as joint pain, fatigue, and skin rashes associated with SLE. Option A, antiemetics, are medications used to manage nausea and vomiting, which are not typically primary symptoms of SLE exacerbations. Option C, antineoplastics, are used to treat cancer and are not indicated for SLE. Option D, antibiotics, are used to treat bacterial infections and do not target the underlying autoimmune mechanisms involved in SLE. From an educational perspective, understanding the rationale behind the choice of corticosteroids for SLE exacerbations helps reinforce the principles of autoimmune disease management and pharmacological interventions. It highlights the importance of targeting the specific pathophysiology of a condition to achieve optimal treatment outcomes. This knowledge is essential for healthcare professionals caring for patients with autoimmune disorders like SLE.

Correct Answer: A

Rationale: In the context of patient teaching for skin cancer risk reduction, option A, which advises having suspicious moles checked by a dermatologist, is the correct choice. This is because early detection of skin cancer is crucial for successful treatment and improved outcomes. By regularly monitoring moles and seeking professional evaluation, patients can identify any potential signs of skin cancer early on, leading to prompt intervention if needed. Options B and C, advocating for daily sun exposure either every half hour or for an hour to build tolerance, are incorrect and potentially harmful. Excessive sun exposure is a well-known risk factor for skin cancer development, particularly melanoma. Encouraging prolonged sun exposure without protection or in excess can increase the risk of skin damage and skin cancer, rather than reducing it. Option D, which suggests applying moisturizer, is also not directly related to skin cancer risk reduction. While moisturizing the skin is important for overall skin health, it does not specifically address the primary preventive measures needed to reduce the risk of developing skin cancer. In an educational setting, it is crucial to emphasize evidence-based practices for skin cancer prevention. Teaching patients about the importance of regular skin self-exams, seeking professional evaluation of suspicious moles, using sun protection measures like sunscreen, protective clothing, and seeking shade, are fundamental components of skin cancer prevention education. By focusing on these key strategies, patients can actively participate in their skin health and reduce their risk of skin cancer.