A 24-year-old man sustains multiple fractured ribs bilaterally as a result of being crushed in a press at a plywood factory. Examination in the ED reveals a flail segment of the patient's thorax. Primary resuscitation includes high-flow oxygen administration via a nonrebreathing mask

Correct Answer: D

Rationale: The correct answer is D because in a patient with flail chest, which is a serious condition involving multiple rib fractures leading to paradoxical chest wall movement, mechanical ventilation is essential to support adequate ventilation and oxygenation. Endotracheal intubation helps secure the airway and allows for positive pressure ventilation to improve gas exchange. This is crucial in preventing respiratory failure and ensuring adequate oxygen delivery to tissues. Choice A is incorrect as confusion is not an indication for Ringers lactate solution. Choice B, cyanosis, does not address the need for ventilatory support in flail chest. Choice C, tachypnea, is a symptom of respiratory distress but does not address the need for mechanical ventilation, which is the definitive management for flail chest.

Correct Answer: D

Rationale: The correct answer is D, "All of the above." Tension pneumothorax can be caused by a variety of factors, including "Flail chest," which leads to air accumulation in the pleural space. Cardiac tamponade can also cause tension pneumothorax due to increased pressure on the lungs. Clamping of a chest tube can result in tension pneumothorax if the built-up air cannot escape. Therefore, all of these choices can lead to tension pneumothorax by causing an increase in intrathoracic pressure, ultimately leading to respiratory distress.

Correct Answer: A

Rationale: Step-by-step rationale for why choice A is correct: 1. In cases of thermal injury, immediate removal of clothing is crucial to stop the burning process and prevent further damage. 2. Clothing can retain heat and continue to burn the skin, exacerbating the injury. 3. Removing clothing also allows for a thorough assessment of the extent of the burn and enables proper treatment. 4. Prompt removal of clothing is a standard protocol in the initial management of thermal injuries. Summary of why other choices are incorrect: B. Patients with thermal injuries are at higher risk for hypothermia due to loss of skin integrity and body heat, not lower risk. C. Fasciotomies are typically needed for patients with compartment syndrome, not circumferential truncal burns. D. Electrical burns can cause tissue necrosis along the path of the current, not necessarily extensive skin necrosis from entry to exit points.

Correct Answer: D

Rationale: The correct answer is D: Medicare will pay for care that it determines to be medically necessary. Medicare follows guidelines to determine what services are medically necessary based on the patient's condition. This ensures appropriate and effective use of resources. Choices A, B, and C are incorrect because Medicare does not cover all care simply because it is requested by the recipient, doctor, or facility. It must meet the criteria of being medically necessary to be covered by Medicare.

Correct Answer: B

Rationale: The correct answer is B because documenting care accurately and promptly is a crucial aspect of professional and ethical behavior for a nursing assistant. This helps ensure continuity of care, patient safety, and accountability. It is important to maintain accurate records for effective communication among healthcare team members. Choice A is incorrect because staying quiet about mistakes can compromise patient safety and is not transparent or accountable behavior. Choice C is incorrect because sharing confidential information with friends violates patient privacy and confidentiality. Choice D is incorrect because rushing a resident through tasks compromises the quality of care and may lead to errors or neglect.