A 35 year old female sustains multiple injuries in a motor vehicle crash and is transported to a small hospital in full spinal protection. She has a GCS of 4 and is being mechanically ventilate I.v access is established and warmed crystalloid is infuse She remains hemodynamically normal and full spinal protection is maintaine Preparations are made to transfer her to another facility for definitive neurosurgical care. Prior to transport, which of the following tests or treatments is mandatory?

Correct Answer: C

Rationale: The correct answer is C: Chest x-ray. Before transferring the patient for neurosurgical care, a chest x-ray is mandatory to assess for any potential thoracic injuries that may impact respiratory function during transport. This is crucial to ensure the patient's stability and prevent any complications. Choice A, FAST exam, is typically used to evaluate for intra-abdominal injuries and is not directly related to the patient's immediate need for neurosurgical care. Choice B, Lateral cervical spine x-ray, may be important for assessing cervical spine injuries, but in this scenario, the patient is already in full spinal protection and the priority is to address potential thoracic injuries that could affect respiratory function. Choice D, Administration of methylprednisolone, is not indicated as a mandatory step prior to transport for neurosurgical care. While it may be considered as part of the treatment plan later on, it is not an immediate requirement for safe transport in this case.

Correct Answer: D

Rationale: The correct answer is D, the resident. The resident is the most important member of the care team because they are the primary individual receiving care and treatment. Their well-being and health outcomes are the main focus of the care team's efforts. The resident's needs and preferences guide the care plan and decision-making process. The other choices (A: The nurse, B: The nursing assistant, C: The physician) play crucial roles in supporting the resident's care, but ultimately, the resident is the central figure in the care team.

Correct Answer: D

Rationale: The correct answer is D because when a nursing assistant is suspected of abuse, it is crucial to prioritize the safety and well-being of the residents. Suspending the nursing assistant immediately helps protect residents from potential harm and allows for a thorough investigation to be conducted without interference. This ensures that the situation is addressed promptly and appropriately. A: Holding a meeting with staff members and residents may compromise the investigation and confidentiality. B: Allowing the nursing assistant to continue working can put residents at risk and hinder the investigation process. C: Revealing the name of the person who reported the abuse can discourage others from coming forward and breach confidentiality. In summary, choice D is the correct step to take in such a situation to ensure resident safety, conduct a fair investigation, and maintain confidentiality.

Correct Answer: D

Rationale: The correct answer is D because a nursing assistant's report may trigger a needed assessment for a resident. This is true as nursing assistants often have direct contact with residents and may notice changes or issues that require further evaluation. This process helps ensure that residents receive appropriate care and interventions in a timely manner. Explanation for why other choices are incorrect: A: MDS stands for Minimum Data Set, not Multiple Diagnosis System. B: Completion of an MDS does not automatically trigger a state investigation. C: While most residents in long-term care facilities will have an MDS, it is not true that all residents will have one.

Correct Answer: D

Rationale: The correct answer is D: Never. Hitting a resident is never appropriate in any situation as it goes against the ethical principles of nursing care. Nursing assistants are responsible for providing care with compassion and respect, and physical violence is unacceptable. It is important to always prioritize the safety and well-being of residents. Choices A, B, and C are incorrect because resorting to violence is never justified, regardless of the circumstances. Encouraging peaceful conflict resolution and seeking help from supervisors or authorities are more appropriate actions in these scenarios.