A 52-year-old woman sustaining 50% total body surface burns in an explosion. She has burns around the chest and both upper arms. Adequate resuscitation is initiate She is nasotracheally intubated and is being mechanically ventilate Her CarboxyHb level is 10%. Her arterial blood gas reveals PaO2 of 40mmHg, PaCO2 of 60mmHg, and pH of 7.25. Appropriate immediate management at the time is to

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Question 1 of 5

A 52-year-old woman sustaining 50% total body surface burns in an explosion. She has burns around the chest and both upper arms. Adequate resuscitation is initiate She is nasotracheally intubated and is being mechanically ventilate Her CarboxyHb level is 10%. Her arterial blood gas reveals PaO2 of 40mmHg, PaCO2 of 60mmHg, and pH of 7.25. Appropriate immediate management at the time is to

Correct Answer: A

Rationale: The correct answer is A: "Ensure adequate tissue perfusion." In this scenario, the patient has sustained significant burns and is showing signs of respiratory distress with low PaO2, high PaCO2, and acidosis. Ensuring adequate tissue perfusion is crucial to optimize oxygen delivery to tissues. This can be achieved by optimizing hemodynamics, fluid resuscitation, and maintaining a balance between oxygen delivery and consumption. Increasing fluid resuscitation (choice B) may worsen the patient's respiratory status by causing fluid overload. Adding PEEP (choice C) may be beneficial in some cases but addressing tissue perfusion is more critical in this scenario. Reassessing for the presence of pneumothorax (choice D) is important but not the immediate priority in this case.

Question 2 of 5

A 70 year old suffers blunt chest trauma after being struck by a car. On presentation, his GCS is 15, BP is 145/90, HR is 72. RR is 24 and O2-sat on 5L is 91%. Chest x-ray demonstrates multiple right sided rib fractures. ECG demonstrates normal sinus rhythm with no conduction abnormalities. Management should include:

Correct Answer: C

Rationale: The correct answer is C: "Monitored i.v analgesia." In this scenario, the patient presents with rib fractures causing chest pain and respiratory distress. The primary goal is pain management to improve respiratory function and prevent complications like pneumonia. IV analgesia will help control pain effectively. Option A is incorrect as chest tube placement is not indicated in this scenario. Option B is not necessary as there are no signs of cardiac injury on ECG. Option D, thoracic splinting, is not the primary management for rib fractures and may not provide adequate pain relief.

Question 3 of 5

Which of the following is part of proper personal grooming by a nursing assistant?

Correct Answer: C

Rationale: The correct answer is C because keeping hair neatly tied back away from the face is essential for infection control and maintaining a professional appearance in healthcare settings. Tying hair back prevents it from touching patients or surfaces, reducing the risk of spreading germs. Bathing frequency and perfume application are subjective preferences and not directly related to professional grooming in a healthcare setting. Wearing artificial nails can harbor bacteria and increase the risk of cross-contamination, so it is not recommended for healthcare workers.

Question 4 of 5

Which of the following is considered a sign of abuse?

Correct Answer: A

Rationale: The correct answer is A, missing teeth or hair. This is a sign of physical abuse as it indicates harm inflicted on the individual. Missing teeth or hair can result from physical violence or forceful actions. Ripped clothing (B) may suggest neglect or rough handling, but not necessarily abuse. Pressure injuries (C) can also indicate neglect, but are not specific to abuse. Unanswered call lights (D) may indicate neglect or understaffing, but do not directly point to abuse.

Question 5 of 5

When using the computer at work, a nursing assistant should

Correct Answer: B

Rationale: The correct answer is B because exiting the web browser after finishing charting helps maintain confidentiality and security of patient information. Leaving the browser open can expose sensitive data to unauthorized access. Choice A is incorrect as it is not directly related to work responsibilities. Choice C is incorrect as personal interest websites are not work-related. Choice D is incorrect as sharing passwords violates security protocols.

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