A teenage bicycle rider is hit by a truck. The first step in managing this patient is:

Correct Answer: D

Rationale: The correct answer is D: Perform endotracheal intubation and ventilation. This step is crucial in ensuring adequate oxygenation and ventilation in a trauma patient with potential airway compromise. By securing the airway and providing ventilation, we can prevent hypoxia and further injury. Obtaining a lateral cervical spine x-ray (A) is important in evaluating for potential spinal cord injury but should not delay airway management. Inserting a central venous pressure line (B) is not a priority in the initial management of a trauma patient. Administering crystalloid solution (C) may be necessary later, but airway management takes precedence in this critical situation.

Correct Answer: C

Rationale: Step 1: Cerebral edema causes increased intracranial pressure. Step 2: Hypercarbia leads to cerebral vasodilatation. Step 3: Cerebral vasodilatation increases intracranial pressure further. Step 4: Avoiding hypercarbia helps prevent worsening of cerebral edema. Step 5: Therefore, the correct answer is C: Cerebral vasodilatation should be avoided to prevent further increase in intracranial pressure. Summary: - A: Metabolic acidosis is not directly related to hypercarbia in this context. - B: Hypercarbia can lead to respiratory acidosis but it's not the primary concern in cerebral edema. - D: Neurogenic pulmonary edema is not directly caused by hypercarbia in this scenario.

Correct Answer: B

Rationale: The correct answer is B because in a patient with altered consciousness after head trauma, CT scanning is crucial to assess for intracranial injuries. It helps identify any hematomas or contusions requiring urgent intervention. Choice A is incorrect as hyperoxia is beneficial in traumatic brain injury. Choice C is not always necessary if the patient maintains airway patency. Choice D is incorrect as a GCS of 10 suggests moderate head injury, not necessarily severe.

Correct Answer: C

Rationale: The correct answer is C because hypertension following a head injury may indicate imminent herniation from critically high intracranial pressure. Increased blood pressure can worsen intracranial pressure, leading to herniation and further brain damage. Treating hypertension in this scenario is crucial to prevent worsening intracranial pressure and potential herniation. Choices A, B, and D are incorrect as they do not directly address the urgent concern of impending herniation due to high intracranial pressure. Treating hypertension solely to reduce intracranial pressure (A) or assuming pre-existing hypertension (B) may not address the acute issue. Prompt administration of mannitol (D) may not be appropriate without addressing the underlying cause of hypertension and intracranial pressure elevation.

Correct Answer: A

Rationale: The correct answer is A: Keeping all resident information confidential. Nursing assistants are bound by ethical standards to maintain confidentiality to protect residents' privacy and trust. Sharing resident information violates HIPAA laws and breaches confidentiality. Option B is unprofessional as it can compromise relationships and trust. Option C may create favoritism and bias. Option D blurs professional boundaries and could make residents uncomfortable. Maintaining confidentiality demonstrates professionalism and respect for residents' rights.