A 20 year old male is brought to the hospital approximately 30 minutes after being stabbed in the chest. There is a 3cm wound just medial to the left nipple. His BP is 70/33 and HR is 140. Neck and arm veins are distende Breath sounds are normal. Heart sounds are diminished, IV access has been established and warm crystalloid is infusing. The next most important aspect of immediate management is:

Correct Answer: C

Rationale: The correct answer is C: "FAST exam." In this scenario, the patient presents with signs of hypovolemic shock following a chest stab wound. The FAST exam (Focused Assessment with Sonography in Trauma) is crucial for rapid identification of intra-abdominal bleeding, which can occur concurrently with thoracic injuries. It is a quick and non-invasive bedside ultrasound assessment that can detect free fluid in the pericardial, pleural, and peritoneal spaces. Identifying intra-abdominal bleeding is important as it may require emergent surgical intervention to prevent further deterioration. Choice A, "CT scan of the chest," would take more time and is not the immediate priority in a hemodynamically unstable patient. Choice B, "12 lead ECG," is important in assessing for cardiac injury but is not the most critical step in this scenario. Choice D, "Begin infusion of RBCs," may be necessary later but addressing the source of bleeding and volume status through

Correct Answer: B

Rationale: The correct answer is B: Protect privacy of health information. HIPAA was enacted to establish national standards for the protection of individuals' medical records and other personal health information. This legislation aims to safeguard the confidentiality and security of patient information, ensuring that it is not inappropriately disclosed or accessed. Choices A, C, and D are incorrect because HIPAA's primary focus is on privacy regulations rather than health insurance coverage, care procedures, or abuse prevention.

Correct Answer: D

Rationale: The correct answer is D: Taste. Taste is not typically used in making observations because it requires the consumption of a substance to gather information, which may not be practical or safe in all situations. Sight, touch, and smell can all be used to make observations without the need for direct consumption. Taste is more subjective and can vary greatly from person to person, making it less reliable for objective observations.

Correct Answer: A

Rationale: The correct answer is A: Hear. Even though a person in a coma may appear unconscious, their auditory system is often still functional. Studies have shown that comatose patients can respond to auditory stimuli, indicating that they can indeed hear. This ability to hear can be crucial for communication and potentially aiding in their recovery. Choices B, C, and D are incorrect as speaking, seeing, and walking require conscious control and coordination of different body systems, which are typically impaired in a comatose state.

Correct Answer: D

Rationale: The correct answer is D: Surgical asepsis. This term refers to the process of creating and maintaining a sterile environment, free of all microorganisms, to prevent infection during surgical procedures. It involves strict protocols to eliminate pathogens. A: Infection prevention is a broader term encompassing various strategies to reduce the risk of infections. B: Disinfection is the process of reducing the number of microorganisms but may not eliminate all. C: Transmission refers to the spread of microorganisms from person to person and is not specific to making an area or object microorganism-free.