A 28 year old male is brought to the E He was involved in a fight in which he was beaten with a wooden stick. His chest shows multiple severe bruises. His airway is clear, RR is 22, HR is 126 and systolic BP is 90mmHg. Which one of the following should be performed during the primary survey?

Correct Answer: A

Rationale: The correct answer is A: "GCS" (Glasgow Coma Scale). During the primary survey, assessing the patient's level of consciousness using the Glasgow Coma Scale is crucial for identifying any potential head injuries or altered mental status due to trauma. This assessment helps determine the severity of the patient's condition and guides further management. B: Cervical spine x-ray is not indicated during the primary survey as it is more appropriate in the secondary survey to evaluate for potential cervical spine injuries. C: TT-administration (tetanus toxoid) is important for management but not a priority during the primary survey. It can be addressed later in the treatment process. D: Blood alcohol level is not crucial during the primary survey for immediate life-saving interventions. It can be considered in the secondary survey for further evaluation.

Correct Answer: C

Rationale: The correct answer is C: DPL (Diagnostic Peritoneal Lavage). DPL is the most specific test for evaluating injuries of solid abdominal organs due to its ability to detect even small amounts of intra-abdominal bleeding. It involves inserting a catheter into the peritoneal cavity to obtain fluid for analysis, providing direct evidence of internal bleeding. Abdominal x-ray and ultrasound are not as specific for detecting solid organ injuries. Frequent abdominal examination may help monitor the patient's condition but does not provide definitive diagnostic information like DPL.

Correct Answer: D

Rationale: Correct Answer: D - "Ensuring adequate oxygenation and ventilation" Rationale: Ensuring adequate oxygenation and ventilation is crucial in any patient with potential multiple closed extremity fractures to address any immediate life-threatening issues like hypoxia or respiratory distress. Without proper oxygenation and ventilation, the patient's condition can deteriorate rapidly. It is the top priority in the ABCs of trauma care (Airway, Breathing, Circulation). Once the patient's respiratory status is stable, further assessment and management of limb perfusion, prevention of skin necrosis, and evaluation for compartment syndrome can be carried out. Summary of other choices: A: "A thorough assessment of four limb perfusion" - While limb perfusion assessment is important, ensuring adequate oxygenation and ventilation takes precedence due to its immediate life-saving implications. B: "Maneuvers to prevent necrosis of the skin" - Preventing skin necrosis is important, but addressing respiratory concerns is critical for the patient's overall

Correct Answer: B

Rationale: Person-centered care focuses on respecting and honoring an individual's preferences and choices. Choice B is correct because it emphasizes promoting a resident's personal preferences and individual choices, aligning with the principles of person-centered care. Nursing staff deciding what a resident needs (Choice A) goes against the core concept of individual autonomy. Treating all residents the same way (Choice C) disregards the uniqueness of each individual. Ensuring all residents participate in the same activities (Choice D) does not consider their individual interests and preferences. In summary, the correct answer, Choice B, stands out as it reflects the essence of person-centered care by prioritizing individual needs and choices.

Correct Answer: C

Rationale: The correct answer is C: To encourage people to make decisions about advance directives. The Patient Self-Determination Act (PSDA) requires healthcare facilities to inform patients about their rights to make decisions about their medical care, including the right to create advance directives. This law empowers individuals to communicate their healthcare wishes in advance, ensuring their preferences are respected even if they are unable to make decisions later. Choice A is incorrect because the PSDA is not specifically focused on training nursing assistants. Choice B is incorrect as the PSDA does not pertain to the privacy of protected health information, which is covered under HIPAA. Choice D is incorrect as the PSDA is not related to reporting abuse, which is typically governed by state laws and facility policies.