Indication for chest tube insertion?

Correct Answer: C

Rationale: The correct indication for chest tube insertion is "Massive hemothorax" (Choice C). This is because a massive hemothorax refers to a significant collection of blood in the pleural space, which can lead to compromised lung function and hemodynamic instability. A chest tube is necessary to drain the blood and prevent further complications. Incorrect choices: A: "Pneumothorax" - Chest tube insertion is typically indicated for tension pneumothorax, not simple pneumothorax. B: "Pneumomediastinum" - A chest tube is not typically needed for pneumomediastinum unless there are associated complications. D: "Diaphragmatic rupture" - Chest tube insertion is not the primary intervention for diaphragmatic rupture; surgical repair may be necessary.

Correct Answer: A

Rationale: The correct answer is A because cervical spine injury can initially present as a neurologic deficit after neck movement due to spinal cord compression or injury. This is due to the delicate nature of the spinal cord in the cervical region. Choices B and C are incorrect as normal range of motion and physical examination maneuvers may not rule out cervical spine injury. Choice D is incorrect as a crosstable lateral x-ray may miss certain types of cervical spine injuries, such as ligamentous or soft tissue damage.

Correct Answer: C

Rationale: The correct answer is C: DPL (Diagnostic Peritoneal Lavage). DPL is the most specific test for evaluating injuries of solid abdominal organs like the liver or spleen. It involves inserting a catheter into the peritoneal cavity to detect the presence of blood or other fluids, indicating internal bleeding. Abdominal x-ray (A) is not specific for solid organ injuries. Abdominal ultrasound (B) is more commonly used for detecting fluid collections or organ abnormalities but may not be as sensitive as DPL for detecting solid organ injuries. Frequent abdominal examination (D) is important for ongoing monitoring but does not provide the same level of specificity as DPL in diagnosing solid organ injuries.

Correct Answer: D

Rationale: The correct answer is D: "Ensuring adequate oxygenation and ventilation" should be performed first in any patient with potential multiple closed extremity fractures. This is because prioritizing oxygenation and ventilation is crucial to prevent hypoxia and respiratory compromise, which can be life-threatening. Once the patient's oxygenation and ventilation are stabilized, further assessments and interventions can be performed. A: "A thorough assessment of four limb perfusion" may be important but ensuring adequate oxygenation and ventilation takes precedence. B: "Maneuvers to prevent necrosis of the skin" is not the immediate priority over ensuring oxygenation and ventilation. C: "Extremity compartment syndrome release" is a critical intervention but should be performed after ensuring adequate oxygenation and ventilation.

Correct Answer: B

Rationale: The correct answer is B because person-centered care emphasizes promoting a resident's personal preferences and individual choices. This approach focuses on tailoring care to meet the unique needs and preferences of each individual. By prioritizing the resident's autonomy and personal values, person-centered care enhances the quality of life and overall well-being. Choice A is incorrect because person-centered care does not involve nursing staff making unilateral decisions for residents. Choice C is incorrect as person-centered care recognizes the importance of individualized care rather than treating all residents the same way. Choice D is incorrect because person-centered care involves respecting residents' choices and preferences, rather than enforcing uniform activities for everyone.