A 7-year-old boy is brought to the ED by his parents several minutes after he fell through a window. He is bleeding profusely from a 6-cm wound of his medial right thigh. Immediate management of the wound should consist of:

Correct Answer: B

Rationale: The correct immediate management for a profusely bleeding wound like this is to apply direct pressure on the wound (Choice B). This helps control the bleeding by compressing the blood vessels and promoting clot formation. Applying a tourniquet (Choice A) should be avoided in this situation as it is typically used as a last resort for uncontrollable bleeding. Packing the wound with gauze (Choice C) can worsen the bleeding by disrupting clots and should be avoided. Direct pressure on the femoral artery at the groin (Choice D) is not recommended as the wound is in the thigh, and applying pressure on the artery directly can be difficult and may not effectively control the bleeding.

Correct Answer: A

Rationale: The correct answer is A: "Perform needle cricothyroidotomy with jet insufflation." In this scenario, the infant is in respiratory distress and intubation has been unsuccessful. Needle cricothyroidotomy is the most appropriate procedure as it is a rapid and effective method to secure an airway in emergency situations. It involves creating a temporary airway using a needle inserted into the cricothyroid membrane. Jet insufflation can then provide oxygen to the patient. Choice B is incorrect as administering heliox and racemic epinephrine does not address the immediate need to secure the airway. Choice C, performing nasotracheal intubation, may not be feasible in this emergency situation. Choice D, performing surgical cricothyroidotomy, is a more invasive procedure compared to needle cricothyroidotomy and may not be as quickly performed in this critical situation.

Correct Answer: A

Rationale: The correct answer is A: "Early gastric decompression is important." In pregnant patients following blunt trauma, there is a risk of gastric distension due to compression by the gravid uterus, which can lead to aspiration. Early gastric decompression helps prevent this complication. Choice B is incorrect because an Hb level of 10g/dl does not specifically indicate recent blood loss. Choice C is incorrect as pregnant patients may have an exaggerated CVP response to volume resuscitation. Choice D is incorrect as the lap belt can cause direct pressure on the gravid uterus, increasing the risk of injury to the fetus.

Correct Answer: C

Rationale: The correct answer is C because empathy involves understanding and sharing the feelings of others. This requires emotional intelligence and the ability to put oneself in someone else's shoes. Option A is incorrect as empathy is more than just being alert. Option B is incorrect as accurate documentation does not relate to empathy. Option D is incorrect as empathy is about understanding others, not just taking responsibility for one's actions.

Correct Answer: A

Rationale: The correct answer is A: Report it at once to his supervisor. This is the correct course of action because reporting abuse to the supervisor ensures proper procedures are followed, protects the resident, and allows for a thorough investigation by trained professionals. Confronting the abuser (B) could escalate the situation and put the nursing assistant at risk. Trying to stop the abuse himself (C) may not be safe or effective, and could lead to further harm. Calling the resident's family (D) is not the appropriate action as the supervisor and relevant authorities need to be informed first to handle the situation professionally.