A 6-year-old boy is struck by an automobile and brought to the E The preferred route of venous access in this patient is:

Correct Answer: D

Rationale: The correct answer is D, percutaneous peripheral veins in the upper extremities. In a 6-year-old boy, the preferred route of venous access is peripheral veins in the upper extremities because they are easily accessible and have lower complication rates compared to other options. This route allows for rapid administration of fluids and medications in emergency situations. Percutaneous femoral vein cannulation (A) may be more invasive and carries a higher risk of complications. Cutdown on the saphenous vein at the ankle (B) is not ideal due to its location and potential difficulty in accessing. Intraosseous catheter placement in the proximal tibia (C) is a viable option but may be more invasive and time-consuming compared to peripheral veins in the upper extremities.

Correct Answer: D

Rationale: The correct answer is D, "Needle-impenetrable sterile gloves," as they are not considered minimal precautions for preventing the spread of communicable diseases during resuscitation. Here's the rationale: 1. Goggles, face masks, and water-impervious gowns are essential to prevent contact with bodily fluids and airborne pathogens during resuscitation. 2. Needle-impenetrable sterile gloves are not typically required for basic resuscitation procedures and are not considered a minimal precaution. 3. Standard sterile gloves provide adequate protection against contact with blood and other bodily fluids in most resuscitation scenarios. 4. Using needle-impenetrable gloves for all resuscitation situations would be excessive and unnecessary.

Correct Answer: C

Rationale: The correct answer is C: Increased cardiac output. Neurogenic shock is characterized by decreased cardiac output due to disruption of sympathetic nervous system input to the heart. A is incorrect as neurogenic shock leads to decreased venous capacitance, not increased. B is incorrect as it is a feature of neurogenic shock, causing decreased systemic vascular resistance. D is incorrect as neurogenic shock typically presents with cold and clammy skin due to decreased sympathetic tone.

Correct Answer: A

Rationale: The correct answer is A: Hemothorax. In this scenario, the patient presents with signs of respiratory distress, tachycardia, hypotension, flat neck veins, diminished air entry on the right side, and dullness on percussion, which are indicative of a hemothorax. Hemothorax is characterized by the accumulation of blood in the pleural cavity, leading to lung compression and impaired ventilation. The symptoms align with the physical exam findings of decreased breath sounds and dullness due to blood occupying the pleural space. The absence of signs like muffled heart sounds or pulsus paradoxus rules out pericardial tamponade. The lack of tracheal deviation and mediastinal shift discounts tension pneumothorax. Hypovolemia from liver injury may present with similar vital sign abnormalities but would not manifest with specific chest exam findings like dullness on percussion. Therefore, based on the clinical presentation and exam findings, hemothorax is the

Correct Answer: B

Rationale: The correct answer is B: Medicaid. Medicaid is a government program that provides medical assistance to individuals with low income or certain disabilities. It is funded by both the federal government and individual states. Medicare (choice A) is a health insurance program for individuals aged 65 and older, as well as some younger people with disabilities. The Department of the Treasury (choice C) is responsible for managing government finances and collecting taxes, not for providing medical assistance. The Committee on the Budget (choice D) is a congressional committee responsible for setting budget guidelines, not for administering medical assistance programs.