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 likely due to internal bleeding from the chest wound. FAST exam (Focused Assessment with Sonography in Trauma) is a rapid bedside ultrasound used to assess for free fluid in the abdomen or pericardium, which can help identify the source of bleeding. This is crucial for immediate management as it can guide further interventions such as surgery or angiography. Choice A: "CT scan of the chest" is not the most immediate step as it takes time and may not provide rapid information needed for immediate management. Choice B: "12 lead ECG" is not the priority in this situation as the patient is hemodynamically unstable and requires rapid assessment for potential life-threatening bleeding. Choice D: "Begin infusion of RBCs" is important, but identifying the source of bleeding is crucial before deciding on the need for blood transfusion.

Correct Answer: B

Rationale: The correct answer is B: Protect privacy of health information. HIPAA was enacted to safeguard individuals' sensitive health information, ensuring confidentiality and security. This is crucial in maintaining trust between patients and healthcare providers. Choices A, C, and D are incorrect as they do not directly relate to the primary purpose of HIPAA, which is to regulate the use and disclosure of protected health information. Nursing assistants' insurance coverage, care procedures, and abuse prevention are important but not the main focus of HIPAA.

Correct Answer: D

Rationale: The correct answer is D: Taste. Taste is not typically used in making observations because observations rely on external stimuli that can be seen, touched, or smelled. Taste involves consuming food or drink, which is not a common method of observation. Sight (A), touch (B), and smell (C) are commonly used senses in making observations. Each of these senses provides valuable information about the external world, making them essential for observation. Taste, on the other hand, is more subjective and personal, making it less reliable and applicable for objective observations.

Correct Answer: A

Rationale: The correct answer is A: Hear. Even though a person in a coma is unconscious and unresponsive, their auditory pathways are still active, allowing them to process sound stimuli. This is supported by research showing brain activity in response to familiar voices and sounds in comatose patients. Choices B, C, and D are incorrect because speaking, seeing, and walking require conscious awareness and motor functions, which are typically impaired or absent in individuals in a coma. Therefore, the ability to hear is the most likely sensory function to remain intact in a comatose state.

Correct Answer: D

Rationale: The correct answer is D: Surgical asepsis. Surgical asepsis refers to the practice of creating and maintaining a sterile environment to eliminate all microorganisms. This is crucial in surgical procedures to prevent infections. Infection prevention (choice A) focuses on strategies to reduce the risk of infections but does not necessarily involve complete elimination of microorganisms. Disinfection (choice B) involves killing or inactivating most disease-causing microorganisms, but it does not guarantee complete elimination. Transmission (choice C) refers to the spread of microorganisms from one person to another, which is different from making an area or object completely free of microorganisms.