Which one of the following statements concerning spine and spinal cord trauma is true?

Correct Answer: D

Rationale: The correct answer is D because diaphragmatic breathing in an unconscious patient who has fallen is a sign of spine injury. This is due to the fact that unconscious patients rely on their diaphragm for breathing rather than their chest muscles, indicating potential spinal cord trauma affecting the chest muscles' innervation. A: A normal lateral c-spine film does not completely exclude injury, as some injuries may not be visible on imaging. B: Vertebral injury can occur without immediate physical findings of a cord injury. C: Immobilization on a short spine board may not be necessary for all patients with suspected spinal injury, as it depends on individual assessment.

Correct Answer: C

Rationale: The correct answer is C. In a stable patient without neck pain, neurological deficits, or midline tenderness, cervical spine x-rays are not necessary. This is because the clinical assessment is more reliable in ruling out cervical spine injury. Performing unnecessary x-rays exposes the patient to radiation without providing additional benefit. Additionally, immobilization in a hard collar and on a long spine board is already in place, and further imaging does not change the management in this scenario. Therefore, the most appropriate course of action is to rely on the clinical assessment criteria mentioned in choice C to guide management. Choices A, B, and D are incorrect because they do not align with current guidelines for cervical spine imaging in trauma patients.

Correct Answer: C

Rationale: Neurogenic shock is characterized by hypotension and vasodilatation due to loss of sympathetic tone. The narrowed pulse pressure is not a classic characteristic but rather a sign of cardiogenic shock. Neurologic deficit is common in neurogenic shock due to the underlying neurological injury. Therefore, choice C is incorrect as it does not align with the typical features of neurogenic shock.

Correct Answer: C

Rationale: The correct answer is C because in a functional nursing style of care, where tasks are divided among staff members based on their skills, staff members may only focus on their assigned tasks, leading to a potential oversight of changes in a resident's condition. This can result in delayed intervention and negatively impact the resident's health. Choice A is incorrect as it refers to task management, not specifically related to overlooking changes in a resident's condition. Choice B is incorrect because it focuses on training issues, not directly related to monitoring a resident's condition. Choice D is incorrect as it addresses resident preferences and not a negative outcome related to care quality.

Correct Answer: B

Rationale: The correct answer is B: Advance directive. An advance directive is a legal document that allows an individual to specify their medical treatment preferences in case they are unable to communicate their wishes. It includes instructions on life-sustaining treatments, organ donation, and healthcare proxy. Choice A, a will, is a legal document that outlines how a person's assets should be distributed after their death, not medical care preferences. Choice C, CPR, refers to cardiopulmonary resuscitation, a medical emergency procedure, not a legal document. Choice D, power of attorney, grants someone the legal authority to make decisions on behalf of another person, but it is not specific to medical care preferences.