Your 23-year-old diabetic patient was found unresponsive with increased respirations, hypotension, and bradycardia. Family members state he recently had a tooth pulled and was prescribed Vicodin. Which of the following is most likely to cause the patient's presentation?

Correct Answer: D

Rationale: The correct answer is D: Narcotic overdose. The patient's presentation of increased respirations, hypotension, and bradycardia is consistent with opioid overdose. Opioids such as Vicodin can cause respiratory depression leading to increased respirations, hypotension, and bradycardia. In contrast, myasthenia gravis would present with muscle weakness, metabolic alkalosis is unlikely to present with this combination of symptoms, and ketoacidosis is more commonly associated with uncontrolled diabetes rather than opioid overdose. Therefore, a narcotic overdose is the most likely cause of the patient's presentation.

Correct Answer: C

Rationale: The correct answer is C: She is an emancipated minor granted by the court. An emancipated minor is legally considered an adult and can make medical decisions without parental consent. This situation would make the statement true because an emancipated minor has the legal authority to consent to their own treatment. Rationale: 1. Emancipated minors are legally recognized as adults in terms of making medical decisions. 2. Emancipation grants the minor the right to make healthcare choices independently. 3. In this scenario, the patient being an emancipated minor means she can consent to treatment without involving her parents. Summary of other choices: A: Implied consent does not apply in this scenario as the patient is conscious and alert, and the injury is not immediately life-threatening. B: Immigration status is not relevant to the patient's ability to consent to treatment without parental consent. D: Being an orphaned minor does not automatically grant the ability to consent to treatment without parental consent.

Correct Answer: B

Rationale: The correct answer is B: To prevent atelectasis from occurring at the end of exhalation. Pursed lips and sighing respirations help create positive end-expiratory pressure (PEEP) in the airways, preventing alveolar collapse and promoting gas exchange. Pursed lips maintain airway patency, while sighing helps to recruit collapsed alveoli. A: Incorrect - Pursed lips and sighing are not related to expelling foreign bodies or irritants from the lower airway. C: Incorrect - Pursed lips and sighing are not associated with preventing pleural friction rub or pleurisy. D: Incorrect - Pursed lips and sighing do not directly increase the size of the air sacs in the lungs to improve oxygenation.

Correct Answer: D

Rationale: The correct answer is D: Perform diagnostic peritoneal lavage or FAST. This is the priority in trauma management to assess for intra-abdominal injuries like bleeding. External fixation (A) is for stabilizing pelvic fractures, not a priority. Abdominal and pelvic CT-scans (B) and arterial embolization (C) are not immediate actions and may delay crucial interventions. Diagnostic peritoneal lavage or FAST (D) are rapid and effective methods to detect intra-abdominal bleeding in trauma patients.

Correct Answer: D

Rationale: The correct answer is D: Urinary output. This is because urinary output is a direct indicator of kidney perfusion and function, reflecting the body's response to volume status. Increasing urinary output suggests adequate volume replacement, while decreasing output may indicate hypovolemia. Heart rate, hematocrit, and blood pressure can be influenced by various factors and may not always accurately reflect volume status. Urinary output is considered the most reliable guide to volume replacement during resuscitation as it provides real-time feedback on kidney perfusion and fluid balance.