A 30 year old male is brought to the hospital after falling 6 meters. Inspection reveals an obvious flail chest on the right. The patient is tachypnei Breath sounds are present and symmetrical. There is no significant hyperresonance or dullness. Arterial blood gas obtained while the patient receives oxygen by face mask are: PaO2 of 45mmHg (6Kpa), PaCO2 of 28mmHg (3,7 Kpa) and pH of 7.47. The component of injury that most likely responsible for abnormalities in this patient's blood gas is:

Correct Answer: B

Rationale: The correct answer is B: Pulmonary contusion. Pulmonary contusion is a common injury following blunt chest trauma and can lead to impaired gas exchange. In this case, the patient's low PaO2 and respiratory alkalosis (low PaCO2 and elevated pH) are indicative of a ventilation-perfusion mismatch caused by pulmonary contusion. The flail chest may also contribute to impaired gas exchange, but the absence of hyperresonance or dullness on auscultation makes a significant pneumothorax less likely. Hypoventilation would typically present with hypercapnia and acidosis, which is not seen in this patient. Hypovolemia would not directly affect blood gas values in this way.

Correct Answer: C

Rationale: The correct answer is C: Primary nursing. In primary nursing, the registered nurse takes primary responsibility for the daily care of assigned residents, providing continuity and personalized care. This model promotes a strong nurse-patient relationship and ensures comprehensive, individualized care. Facility nursing (A) involves care provided by various healthcare professionals within a facility setting, not necessarily by registered nurses alone. Team nursing (B) involves a team of healthcare professionals working collaboratively, with responsibilities shared among team members. Functional nursing (D) involves dividing tasks based on specific functions, often leading to fragmented care and less personalized attention compared to primary nursing.

Correct Answer: C

Rationale: The correct answer is C: Return charts to their proper place after use. This is the best way for a nursing assistant to keep residents' health information confidential because it ensures that sensitive information is securely stored and not left out in the open where unauthorized individuals may access it. By returning charts to their proper place, the nursing assistant maintains the confidentiality and privacy of residents' health information. Choices A, B, and D are incorrect: A: Discussing a resident's information away from the facility does not guarantee confidentiality as the information can still be overheard by others outside the facility. B: Bringing family and friends to the facility can compromise residents' privacy as they may inadvertently overhear confidential information. D: Posting updates about residents on social media violates their privacy and confidentiality, as this information can be accessed by a wider audience, including individuals who should not have access to it.

Correct Answer: B

Rationale: Step 1: Chest pain is a serious medical symptom that could indicate a heart attack or other life-threatening condition. Step 2: Reporting chest pain immediately to the nurse allows for prompt assessment and potential life-saving interventions. Step 3: Family visiting, watching TV excessively, and feeling lonely are not urgent medical conditions that require immediate reporting to the nurse. Summary: Choice B is correct because chest pain can be a sign of a medical emergency, while choices A, C, and D are not urgent medical issues.

Correct Answer: A

Rationale: Correct Answer: A Rationale: 1. Giving the resident time to speak shows respect and allows them to communicate at their own pace. 2. Rushing the resident or interrupting can be frustrating and hinder effective communication. 3. Removing oxygen or inserting a tracheostomy tube before speaking are unnecessary and potentially harmful interventions. 4. Insisting that the resident speak disregards their communication preferences and autonomy.