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. In this scenario, the patient is at risk for thoracic injuries due to the motor vehicle crash and the need for mechanical ventilation. A chest x-ray is essential to assess for potential life-threatening conditions such as pneumothorax, hemothorax, or pulmonary contusions. This information is crucial for the safe transfer of the patient to another facility. A: FAST exam is typically used to assess for intra-abdominal bleeding and is not mandatory in this case. B: Lateral cervical spine x-ray is not necessary as the patient is already in full spinal protection and needs definitive neurosurgical care, not initial evaluation. D: Administration of methylprednisolone is not mandatory at this stage and should be based on specific guidelines for spinal cord injury management.

Correct Answer: D

Rationale: The correct answer is D: The resident. Residents are the focal point of care, and their needs and preferences should guide the care team. Physicians provide medical expertise but residents are the primary recipients of care. Nurses and nursing assistants play crucial roles in providing direct care, but ultimately, the resident's well-being is the top priority.

Correct Answer: D

Rationale: The correct answer is D because when a nursing assistant is suspected of abuse, immediate action is necessary to ensure the safety of residents. Suspending the nursing assistant allows for a thorough investigation without putting residents at risk. Choice A is incorrect as discussing the problem openly may compromise the investigation. Choice B is incorrect as the nursing assistant should be removed from the situation during investigation. Choice C is incorrect as confidentiality is crucial in abuse cases to protect the reporter and the victim.

Correct Answer: D

Rationale: The correct answer is D because a nursing assistant's report can indeed trigger a needed assessment for a resident. Nursing assistants are often the frontline staff who observe residents daily, so their reports can highlight changes or issues that require further evaluation. This process helps in ensuring that residents receive appropriate care and interventions promptly. Choice A is incorrect as MDS stands for Minimum Data Set, not Multiple Diagnosis System. Choice B is incorrect as completion of an MDS does not automatically trigger a state investigation. Choice C is incorrect because all residents in long-term care facilities are required to have an MDS assessment completed periodically.

Correct Answer: D

Rationale: The correct answer is D, "Never," because hitting a resident is never appropriate in any circumstance. As a nursing assistant, it is crucial to prioritize the well-being and safety of residents. Physical violence is never an acceptable or professional way to handle any situation in a healthcare setting. Choosing option A, B, or C would go against ethical standards and could result in harm to the resident or legal consequences. It is essential for nursing assistants to use non-violent communication techniques and seek help from supervisors or security if faced with challenging situations.