In managing the head-injury patient which is the most initial step:

Correct Answer: A

Rationale: The correct initial step in managing a head-injury patient is to secure the airway (Choice A). This is crucial for ensuring adequate oxygenation and ventilation. Without a patent airway, the patient may suffer from hypoxia, leading to further brain injury. Obtaining c-spine film (Choice B) is important but not the most immediate concern. Supporting circulation (Choice C) is vital but comes after ensuring airway patency. Controlling scalp hemorrhage (Choice D) is also important but does not take precedence over securing the airway in the initial management of a head-injury patient.

Correct Answer: A

Rationale: The correct answer is A: "Gum elastic bougie." In difficult intubation situations where vocal cords are not visible, a bougie is essential. Step 1: Insert the bougie into the trachea until resistance is felt. Step 2: Advance the endotracheal tube over the bougie. Step 3: Remove the bougie. This technique helps guide the endotracheal tube into the trachea successfully. The other choices are incorrect. B: Lateral cervical spine x-ray is not useful for intubation. C: Nasopharyngeal airway is for maintaining airway patency, not for intubation. D: Oxygen does not aid in intubation directly.

Correct Answer: B

Rationale: The correct answer is B. Limb-threatening extremity injuries should be definitively managed with a traction splint to stabilize and immobilize the limb, preventing further damage and reducing the risk of complications. This method helps to maintain proper alignment, reduce pain, and minimize the potential for neurovascular compromise. A: Requiring a tourniquet is not always necessary and may lead to complications such as tissue damage. C: Limb-threatening injuries can occur without an open wound, especially in cases of blunt trauma. D: Limb-threatening injuries can include a range of conditions beyond just ischemic or crushed tissue, so this statement is too narrow.

Correct Answer: B

Rationale: The correct answer is B: Bathing a resident. Nursing assistants typically assist with activities of daily living, such as bathing, grooming, and feeding residents. This task falls under the scope of practice for nursing assistants and helps maintain the hygiene and comfort of residents. Administering medication (choice A) is typically done by licensed nurses. Changing sterile dressings (choice C) is usually performed by nurses or other healthcare professionals with specialized training. Giving tube feedings (choice D) also requires specialized training and is usually done by licensed nurses or dietitians. Therefore, the correct answer is B as it aligns with the typical responsibilities of nursing assistants.

Correct Answer: B

Rationale: The correct answer is B because OBRA was passed in response to reports of abuse and poor care in long-term care facilities. This legislation aimed to improve the quality of care provided to residents in these facilities by setting standards for training, staffing, and resident rights. Choices A, C, and D are incorrect because they do not directly address the main purpose of OBRA, which was to address the issues of abuse and poor care in long-term care facilities.