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 inhalational injury with a high CarboxyHb level and severe respiratory acidosis on ABG. Ensuring adequate tissue perfusion is crucial to prevent further tissue damage and improve oxygen delivery to tissues. Increasing fluid resuscitation (B) may worsen the respiratory status. Adding PEEP (C) may be necessary but addressing tissue perfusion is more critical. Reassessing for pneumothorax (D) is important but not the immediate priority in this case.

Correct Answer: C

Rationale: The correct answer is C: "Monitored i.v analgesia." In this scenario, the patient has blunt chest trauma with rib fractures causing pain. The management should focus on controlling pain to improve respiratory effort and prevent complications like pneumonia. IV analgesia is recommended to provide effective pain relief and improve patient outcomes. Choice A: "Placement of a 22Fr right sided chest tube" is incorrect because there is no indication for chest tube insertion based on the information provided. The patient's vital signs are stable and there are no signs of tension pneumothorax. Choice B: "Serial troponins and cardiac monitoring" is incorrect because there are no indications of cardiac injury based on the normal ECG and the absence of cardiac symptoms. Troponins and cardiac monitoring are not necessary at this point. Choice D: "Thoracic splinting" is incorrect because splinting is not typically recommended for rib fractures in elderly patients. It may restrict respiratory effort and cause more harm

Correct Answer: C

Rationale: Correct Answer: C - Keeping hair neatly tied back away from the face Rationale: 1. Hair tied back prevents contamination of patient's wounds or medications. 2. Ensures hair doesn't obstruct vision or fall into patient's food. 3. Projects a professional appearance and promotes hygiene. Summary: A - Bathing once every other day may vary depending on individual needs and activities, not a strict grooming standard. B - Applying perfume daily may cause allergies or sensitivities in patients and is not necessary for personal grooming. D - Wearing polished artificial nails can harbor bacteria and is not recommended in healthcare settings for infection control purposes.

Correct Answer: A

Rationale: The correct answer is A: Missing teeth or hair. This is a sign of physical abuse as it indicates direct harm to the individual. Missing teeth or hair can result from violent acts or forceful actions. Other choices are incorrect because: - B: Ripped clothing may indicate rough handling but is not a definitive sign of abuse. - C: Pressure injuries are more likely to indicate neglect or improper care rather than abuse. - D: Unanswered call lights may suggest neglect or understaffing, but not necessarily abuse.

Correct Answer: B

Rationale: The correct answer is B because exiting the web browser after finishing charting ensures data security and prevents unauthorized access. This practice maintains patient confidentiality and complies with healthcare privacy regulations. Other choices are incorrect: A is not related to work tasks, C is a misuse of work time, and D compromises data security and violates privacy policies.