You are assessing a patient with an altered mental status and has a diabetic history. Which of the following would most likely indicate the patient is suffering from diabetic ketoacidosis?

Correct Answer: D

Rationale: The correct answer is D because the patient is showing signs of dehydration and metabolic imbalance characteristic of diabetic ketoacidosis. Dry skin and mucous membranes, along with increased thirst and frequent urination, are indicative of dehydration due to high blood sugar levels. Hypotension could be due to dehydration and electrolyte imbalances. Shallow rapid respirations are a compensatory mechanism for metabolic acidosis. Choices A, B, and C do not align with the typical presentation of diabetic ketoacidosis, as they do not include the key signs of dehydration, metabolic acidosis, and electrolyte imbalances seen in this condition.

Correct Answer: B

Rationale: The correct answer is B because in a severely hypothermic patient in cardiac arrest, the decreased metabolism and altered drug distribution make standard medication intervals ineffective. By spacing IV medications at longer intervals, there is a reduced risk of toxicity due to the slowed drug metabolism. Option A is incorrect because simply administering warm fluids and initiating rewarming procedures does not address the altered drug metabolism in hypothermia. Option C is incorrect because it generalizes that the patient will not respond to cardiac medication, which may not be true in all cases. Option D is incorrect because higher than normal doses of cardiac medications can increase the risk of toxicity without providing any significant benefit due to the altered drug metabolism in hypothermia.

Correct Answer: C

Rationale: The correct answer is C: Subdural hematoma. A subdural hematoma is a collection of blood between the dura mater and arachnoid mater layers of the meninges. This type of injury typically occurs due to acceleration-deceleration forces causing tearing of bridging veins, common in closed head injuries. The symptoms described (headache, confusion, visual disturbances) are consistent with the presentation of a subdural hematoma. Other choices are less likely: A) Coup-contra-coup injury involves impact forces causing brain injury at the site of impact and opposite side, typically seen in motor vehicle accidents. B) Diffuse axonal injury is caused by shearing forces leading to widespread damage throughout the brain, often resulting in a comatose state. D) Epidural hematoma is a collection of blood between the dura mater and the skull, usually due to arterial bleeding, and is more commonly associated with a lucid interval followed by rapid deterioration, but

Correct Answer: C

Rationale: The correct answer is C because the transferring doctor is in the best position to assess the patient's needs and resources available. This ensures appropriate care and resources are available for the patient's condition. Choice A is incorrect as it focuses on staff availability rather than patient needs. Choice B is incorrect as it only addresses specific injuries, not overall care needs. Choice D is incorrect as hospital administration may not have the medical expertise to determine appropriate care for the patient.

Correct Answer: C

Rationale: Rationale for Answer C being FALSE: A negative Kleihauer-Betke test does not exclude Rh-isoimmunization. The test measures the amount of fetal red blood cells in the maternal circulation, but may not always detect small amounts of fetal-maternal hemorrhage. Rh-isoimmunization can still occur even if the Kleihauer-Betke test is negative. Summary of other choices: A: True - Rh-isoimmunization can occur in both blunt or penetrating abdominal trauma. B: True - Even minor degrees of fetomaternal hemorrhage can lead to Rh-isoimmunization. D: False - Rh-isoimmunization can be a problem in both Rh-positive and Rh-negative pregnant trauma patients.