Correct Answer: A:D,B:B,C:E,D:A,E:C

Rationale: Osteomalacia matches choice D: It is caused by a vitamin D deficiency, leading to reduced calcium absorption, softening bones, and increasing fracture risk, uncommon in developed countries due to dietary fortification. Low back pain matches choice B: It is commonly due to musculoskeletal issues like muscle strain or disc problems and can present as localized or diffuse pain. Osteomyelitis matches choice E: It is a severe bacterial infection affecting bone and surrounding tissues, often requiring prolonged antibiotic therapy. Osteoporosis matches choice A: It is a chronic condition characterized by low bone mass and structural deterioration, increasing fragility and fracture risk, especially in postmenopausal women. Degenerative disc disease (DD
D) matches choice C: It involves age-related loss of disc fluid, reducing elasticity and shock absorption, contributing to back pain and spinal issues.

Correct Answer: C

Rationale: Glucagon IM is inappropriate for a glucose of 85 mg/dL, which is within normal preprandial ranges of 70-100 mg/dL. It is reserved for severe hypoglycemia with symptoms like unconsciousness. Calling the MD is unnecessary when blood glucose is in the normal range and the patient is symptomatic. Nutritional intake is the next logical step in management. Holding insulin and allowing the patient to eat is appropriate for 85 mg/dL. Nutritional intake stabilizes glucose levels, maintaining euglycemia without risking hypoglycemia from insulin. Administering 10 units of Humalog risks causing hypoglycemia, as this dose is excessive for a glucose level of 85 mg/dL. Insulin use is not indicated here. Administering dextrose IVP unnecessarily increases glucose levels. It is inappropriate unless the patient is symptomatic and glucose levels drop below 70 mg/dL. Administering 7 units of Humalog risks hypoglycemia for a glucose level of 85 mg/dL, as the dose is excessive and unnecessary without elevated glucose. Administering 5 units of Humalog poses a risk for hypoglycemia and is not indicated with normal glucose levels. Nutritional intake alone suffices. Administering 15 units of Humalog is inappropriate and dangerous for a normal glucose level, as it likely induces hypoglycemia. Insulin use should be avoided here.

Correct Answer: C,D,E,F

Rationale: Assessing the range of motion of a severely injured leg is not appropriate during initial evaluation. Movement can worsen the injury or disrupt stabilizing measures such as splints or dressings. Asking the patient to stand or bear weight risks further injury and is contraindicated in cases of visible deformity or massive bleeding. Evaluating skin color helps identify potential ischemia, vascular compromise, or inadequate perfusion. Pallor or cyanosis can indicate significant circulation issues needing urgent care. Paresthesia (tingling or numbness) reflects nerve function and can reveal nerve damage or compromised blood flow, necessitating thorough evaluation. Pain assessment is crucial for identifying the severity of injury and potential complications such as compartment syndrome. Pain disproportionate to the injury suggests complications. Palpating pulses assesses blood flow, ensuring the presence of distal perfusion. Absent or weak pulses require urgent vascular intervention to prevent tissue necrosis.

Correct Answer: A,B,D

Rationale: Keeping the patient NPO minimizes gastrointestinal motility and prevents further accumulation of intestinal contents, reducing the risk of perforation and worsening obstruction. Bowel rest is crucial in promoting resolution. Nasogastric tube placement alleviates distention by decompressing the stomach and removing gastric contents, reducing vomiting and the risk of aspiration while improving patient comfort. Rectal tubes are not effective in decompressing small bowel obstructions since the obstruction prevents material from reaching the rectum. Frequent oral care prevents mucosal dryness and infection risk in patients who are NPO and receiving suction therapy, promoting overall oral hygiene.

Correct Answer: A

Rationale: Twelve hours without voiding indicates potential acute urinary retention due to ureteral obstruction, risking hydronephrosis or kidney damage, which requires immediate attention to preserve renal function. Hematuria is common with kidney stones and generally not urgent unless accompanied by clots causing retention or excessive bleeding causing hemodynamic instability. Fever indicates infection but at 37.7°C, it is considered low-grade and less urgent compared to obstruction. Normal body temperature is typically 36.1-37.2°C. Cloudy urine suggests infection but lacks the immediacy of urinary retention or acute obstruction, which are potentially life-threatening.