Correct Answer: C

Rationale: Removing the external fixator for a shower could compromise stabilization of the fracture. External fixators are designed to be left in place to maintain proper alignment and provide structural support for healing bones. Removing the device could introduce unnecessary risks, including increased mobility and potential damage to the fracture site. Prolonged bed rest is not indicated for patients with external fixation devices unless medically necessary. Prolonged immobility can lead to complications such as deep vein thrombosis, muscle atrophy, or joint stiffness. Mobilization should be encouraged as tolerated to support recovery. Proper cleaning of pin insertion sites prevents infection, a major risk with external fixation devices. Using sterile technique to clean the sites daily reduces bacterial colonization. Monitoring for signs of infection such as redness or drainage is critical to avoid osteomyelitis or systemic spread. Prophylactic antibiotics are typically administered perioperatively but are not continued until device removal unless there are specific complications. Prolonged antibiotic use can lead to antimicrobial resistance and should only be used as clinically indicated to prevent or treat infection.

Correct Answer: A

Rationale: Fractures caused by disease processes are termed pathological fractures. Diseases like osteoporosis weaken bones, increasing susceptibility to fractures. Conditions like cancer can invade bone tissue, causing structural fragility. Pathological fractures occur without significant trauma, distinguishing them from those caused by external injuries, which require high-impact forces to break otherwise healthy bones. Traumatic fractures stem from external forces, not from disease processes. This assertion neglects the reality of pathological fractures, which result from diseases undermining the bone's natural strength. Healthy bones typically endure significant stress before fracturing, and the absence of disease makes fractures from minimal trauma highly unlikely. This reasoning excludes pathological fractures caused by internal illnesses or conditions weakening bone structures.

Correct Answer: B

Rationale: Mixing insulin glargine and lispro in the same syringe is contraindicated due to their incompatible chemical formulations. Glargine's acidic pH alters lispro's effectiveness when mixed, impairing glycemic control. Separate administration preserves their individual pharmacokinetics and therapeutic actions. Separate injections ensure each insulin maintains its unique action profile. Glargine provides basal control, while lispro manages rapid postprandial spikes. Their chemical incompatibility mandates separate administration, optimizing glycemic management and reducing potential adverse effects from mixed formulations.

Correct Answer: C

Rationale: Incisions into the renal pelvis for stone removal describe open surgical methods, not ultrasonic lithotripsy. This invasive approach is reserved for cases where less invasive techniques fail or stones are inaccessible through standard methods. Lithotripsy avoids direct incisions, utilizing external energy for stone fragmentation. Kidney incisions for stone removal align with nephrolithotomy procedures rather than ultrasonic lithotripsy. This alternative represents open surgical intervention, distinct from non-invasive lithotripsy technologies. Lithotripsy eliminates stones using sound waves or lasers, reducing surgical risks and recovery times. Ultrasonic lithotripsy employs high-frequency sound waves to break stones into small fragments. This minimally invasive method allows natural passage through the urinary tract or facilitates removal via catheterization. It reduces complications compared to invasive surgeries and is highly effective for calculi management. Laser fragmentation techniques differ from ultrasonic lithotripsy, involving concentrated light energy to break stones. While both are minimally invasive, ultrasonic methods utilize sound waves rather than light energy for disintegration. This technical distinction outlines lithotripsy's use of external sound waves for stone management.

Correct Answer: D

Rationale: Administering dextrose IVP is inappropriate for hyperglycemia. It elevates blood sugar further, risking complications like hyperosmolar hyperglycemic state. It is used to treat severe hypoglycemia instead. Glucagon stimulates glycogen breakdown into glucose, increasing blood sugar. It is contraindicated in hyperglycemia, as it would aggravate elevated glucose levels. It is a treatment for severe hypoglycemia. Holding insulin allows hyperglycemia to persist, increasing risks of complications like ketoacidosis. Insulin administration is essential to reduce the glucose level safely. Rapid-acting insulin like Humalog reduces hyperglycemia efficiently, bringing preprandial blood glucose closer to the target range of 70-130 mg/dL. Administering 4 units is a reasonable corrective dose based on the blood glucose of 243 mg/dL.