Your patient has been admitted with a diagnosis of bilateral pneumonia. You have trouble communicating with this patient, who is pouty and demanding your constant attention. She talks for long periods about the smallest details of her life. Besides the pneumonia, you ask the physician if the patient has a history of which of the following personality disorders?

Choice A reason: Patients should not hold their insulin unless instructed by a physician, as it can lead to uncontrolled blood sugar levels.

Choice B reason: Taking vitamins with zinc and vitamin C can help with wound healing and immune function after surgery.

Choice C reason: Smoking should be stopped before surgery as it can impair wound healing and increase the risk of complications.

Choice D reason: Patients are typically advised to fast before surgery to reduce the risk of aspiration during anesthesia.

Choice A reason: Permanent mobility impairment is a possible complication, but it is not the most common concern immediately following a closed reduction and cast placement.

Choice B reason:Older adults are at a higher risk for delayed healing of fractures due to factors such as reduced bone density, slower cellular repair mechanisms, and potential comorbidities like diabetes or osteoporosis. While permanent mobility impairment, malalignment, and bone infections are possible complications of fractures, they are less common in routine cases of closed reduction and casting, especially if proper care and follow-up are provided. Delayed healing is a more likely complication due to age-related changes in bone health.

Choice C reason: Malalignment of healed bones is a potential long-term complication, but it is not the immediate concern post-cast placement.

Choice D reason: Bone infections (osteomyelitis) are rare following closed fractures treated with casting, especially when there is no open wound. Infections are more likely with open fractures or surgical interventions.