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: B

Rationale: Estimating carbohydrate content rather than measuring can lead to inaccuracies in blood sugar control for diabetic patients. Precise carbohydrate counting is essential for maintaining glycemic control and preventing hyperglycemia or hypoglycemia, making this approach unsuitable in diabetes education. Balancing carbohydrate intake with insulin or medication is a critical aspect of diabetes management. This ensures stable blood glucose levels as insulin dosage or medication is adjusted according to the patient's carbohydrate consumption, providing personalized glycemic control effectively. Avoiding all carbohydrates is not a realistic or scientifically sound recommendation, as carbohydrates are essential for energy production. Teaching portion control and healthy carbohydrate choices is more effective for diabetic management than complete avoidance. Counting carbohydrates from sugary foods alone ignores the contribution of complex carbohydrates to blood glucose levels. A comprehensive approach that considers all sources of carbohydrates ensures accurate diabetes education and better long-term blood sugar control.

Correct Answer: C

Rationale: Administering 1 mg of glucagon intramuscularly is unnecessary for a patient who is awake, alert, and able to swallow. Glucagon is reserved for patients who are unconscious and unable to swallow effectively to prevent choking. Administering 25 g of dextrose IVP is unnecessary in this case because the patient is alert and able to swallow. Oral intake of carbohydrates is the preferred and safer intervention for mild hypoglycemia like 69 mg/dL. Holding the insulin and encouraging the patient to eat provides glucose through dietary means, which is appropriate in a patient who is awake, alert, and hungry. A level of 69 mg/dL, though below normal, can be managed with oral glucose intake safely. Calling the MD is not the immediate priority in managing mild hypoglycemia. Intervening directly to correct the glucose level with oral intake is more appropriate and effective in this situation.

Correct Answer: F

Rationale: Dextrose IVP is unnecessary with hyperglycemia. It increases the glucose level further, risking complications like hyperosmolar hyperglycemic state. This treatment is reserved for severe hypoglycemia. Glucagon raises blood glucose and is contraindicated for hyperglycemia. It is used to treat hypoglycemia, not elevated glucose levels seen here. Holding insulin neglects hyperglycemia management, allowing complications like ketoacidosis or delayed glucose control. Insulin is necessary to address elevated blood sugar. Calling the MD delays hyperglycemia treatment unnecessarily, as nurses can administer insulin per protocols in cases like this. Administering 15 units of Humalog risks inducing hypoglycemia. It is an excessive dose given the glucose level of 243 mg/dL. Administering 4 units of Humalog is an appropriate corrective dose for a pre-meal glucose of 243 mg/dL. Rapid-acting insulin efficiently reduces glucose to safer levels, aligning with treatment protocols. Administering 9 units of Humalog risks overcorrecting hyperglycemia, potentially causing hypoglycemia, as it exceeds typical sliding scale guidelines for this glucose level. Administering 5 units of Humalog could be reasonable for slight hyperglycemia, but it is not specifically aligned with the sliding scale dose appropriate for 243 mg/dL.

Correct Answer: A

Rationale: A bland diet reduces gastric irritation by avoiding substances that stimulate acid secretion or exacerbate nausea. It includes foods like rice, bananas, and toast that are easy to digest and less likely to provoke symptoms of nausea or vomiting. Opposing the bland diet recommendation for severe nausea ignores scientific evidence that supports its use. Providing a diet rich in spices or acidic foods can worsen symptoms by irritating the gastrointestinal tract further.