A 24-year-old woman passenger in an automobile strikes the windscreen with her face during a head-on collision. In the ED she is talking and has marked facial edema and crepitus. The highest priority should be given to:

Correct Answer: C

Rationale: The correct answer is C: Upper airway protection. This is the highest priority because the patient has marked facial edema and crepitus, indicating potential airway compromise from facial fractures or soft tissue injuries. Protecting the airway is crucial to prevent further complications like respiratory distress or failure. A: Lateral c-spine x-ray - While c-spine injury should be assessed, it is not the highest priority when there is a risk of airway compromise. B: Carotid pulse assessment - While important, it is not the highest priority compared to ensuring adequate airway protection. D: Determination of associated injuries - This can be done after ensuring airway protection, as other injuries may not be immediately life-threatening.

Correct Answer: A

Rationale: The correct answer is A (10 min). Brain cells start to die within 4-6 minutes without oxygen. After 10 minutes, irreversible damage is likely due to lack of oxygen causing cell death. Choice B (5 min) is too short for significant irreversible damage. Choice C (2 min) is even shorter and wouldn't allow for any meaningful recovery. Choice D (20 min) is too long and underestimates the critical window for preserving brain function.

Correct Answer: C

Rationale: The correct answer is C: Traumatic brain injury. In this scenario, the patient's response to fluid resuscitation indicates that her hemodynamic instability is likely due to ongoing blood loss rather than blunt cardiac injury, inadequate resuscitation, or traumatic brain injury. The improvement in BP and HR after fluid infusion suggests that the patient is responding appropriately to volume replacement, making ongoing blood loss the most likely cause of her hemodynamic changes. Blunt cardiac injury could lead to similar symptoms, but the patient's response to fluid makes it less likely. Inadequate resuscitation would lead to persistent hypotension, which is not the case here. Traumatic brain injury typically does not cause acute hemodynamic changes like the ones observed in this case.

Correct Answer: B

Rationale: The correct answer is B: Dementia. Dementia is characterized by a serious decline in cognitive abilities such as memory, thinking, and reasoning. It is not a terminal illness (A), a heart disease (C), or a chronic disorder (D). Dementia specifically refers to the loss of mental abilities, which distinguishes it from the other choices.

Correct Answer: A

Rationale: The correct answer is A: Keeping a resident's information confidential. This is ethical behavior as it upholds the resident's right to privacy and maintains trust. Revealing confidential information violates ethical principles and can harm the resident. Choices B, C, and D are incorrect. B contradicts transparency and honesty, which are essential in healthcare. C involves deception and impersonation, which is unethical and can lead to legal consequences. D is inappropriate as it can burden the resident with unnecessary information and is unprofessional.