Which of the following findings is most concerning in a patient with chest pain?

Correct Answer: C

Rationale: The correct answer is C: Shortness of breath and diaphoresis. This combination indicates possible heart-related issues like a heart attack. Shortness of breath suggests inadequate oxygen supply, and diaphoresis (excessive sweating) may indicate severe stress on the heart. It is concerning as it can signify a life-threatening condition. A: A burning sensation after eating is likely related to acid reflux. B: Pain that improves with rest is typically seen in musculoskeletal issues. D: Pain that worsens with palpation is more indicative of musculoskeletal or chest wall pain, not necessarily a cardiac event.

Correct Answer: D

Rationale: The correct answer is D: Administer oxytocin infusion at 20 to 30 gtts/min depending on bleeding severity. Oxytocin is a uterotonic agent that helps control postpartum hemorrhage by causing uterine contractions, which can help stop the bleeding. In this scenario, the mother is experiencing postpartum hemorrhage despite initial interventions. Administering oxytocin can help control the bleeding and prevent further complications. Choice A is incorrect because packing the vagina with pads is not the recommended first-line treatment for postpartum hemorrhage. Choice B is incorrect because administering lactated Ringer's solution under pressure is not the appropriate intervention for postpartum hemorrhage. Choice C is incorrect because Trendelenburg position is not recommended for managing postpartum hemorrhage and can potentially worsen the situation by increasing blood flow to the head.

Correct Answer: A

Rationale: The correct answer is A because a critical burn is determined by the percentage of total body surface area (TBSA) affected. In this case, a 10-year-old patient with superficial burns over 60% of the body meets the criteria for a critical burn due to the extensive TBSA involvement. Superficial burns over 60% of the body can lead to significant fluid loss, infection risk, and systemic complications. Choice B is incorrect because full-thickness burns on a specific area of the arm, even if full-thickness, are not as extensive as 60% TBSA involvement. Choice C is incorrect as partial-thickness burns across 25% of the body, not involving critical areas, do not meet the criteria for a critical burn based on TBSA. Choice D is also incorrect as partial-thickness burns on 25% of the body, not involving critical areas, do not meet the criteria for a critical burn based on TBSA.

Correct Answer: C

Rationale: The correct answer is C: An advanced directive. An advanced directive is a legal document that allows an individual to specify their medical treatment preferences in case they are unable to make decisions. It includes instructions on the use of life-sustaining treatments. A: A do not resuscitate order (DNR) specifically addresses whether or not to perform cardiopulmonary resuscitation in case of cardiac arrest, but it does not cover overall medical treatment preferences. B: A will is a legal document that specifies how a person's assets and properties should be distributed after their death, not their medical treatment preferences. D: A personal directive is a general term that may refer to various legal documents but does not specifically address medical treatment preferences.

Correct Answer: C

Rationale: The correct answer is C: Control internal hemorrhage operatively. In managing a gunshot wound to the abdomen, the priority is to control internal bleeding, usually through surgical intervention. Administering O-negative blood (A) is important for resuscitation but does not address the primary issue. External warming devices (B) are not the priority in this scenario. Applying a pneumatic antishock garment (PASG) (D) is not recommended as it could delay necessary surgical intervention to control hemorrhage. Operating to control internal hemorrhage is crucial to prevent further blood loss and stabilize the patient's condition.