Management of severe head injury with GCS 6, BP 140/90 mmHg, intubated:

Correct Answer: B

Rationale: The correct answer is B: "Prevent secondary brain injury." In managing severe head injury with a GCS of 6, preventing secondary brain injury is crucial. Lowering intracranial pressure and optimizing cerebral perfusion are essential to prevent further damage. Administering an osmotic diuretic (A) may be considered but is not the priority in this scenario. Aggressively treating systemic hypertension (C) can potentially worsen cerebral perfusion. Reducing metabolic requirements of the brain (D) is important but not as immediate as preventing secondary brain injury.

Correct Answer: A

Rationale: The correct answer is "Moist heat" for treating frostbite. Moist heat helps to gradually warm the affected area, promoting blood flow and reducing tissue damage. This method is recommended because sudden temperature changes can worsen the condition. Choice B, early amputation, is incorrect as it is an extreme measure and should only be considered as a last resort in severe cases where tissue has already died. Choice C, padding and elevation, can help reduce swelling and promote circulation but may not be sufficient as the sole treatment for frostbite. Choice D, vasodilators and heparin, are not typically used in the initial treatment of frostbite. While vasodilators may help improve blood flow, they are not the primary recommended method for treating frostbite.

Correct Answer: C

Rationale: The correct answer is C: Chest x-ray. Before transferring the patient for neurosurgical care, a chest x-ray is mandatory to assess for any potential thoracic injuries that may impact respiratory function during transport. This is crucial to ensure the patient's stability and prevent any complications. Choice A, FAST exam, is typically used to evaluate for intra-abdominal injuries and is not directly related to the patient's immediate need for neurosurgical care. Choice B, Lateral cervical spine x-ray, may be important for assessing cervical spine injuries, but in this scenario, the patient is already in full spinal protection and the priority is to address potential thoracic injuries that could affect respiratory function. Choice D, Administration of methylprednisolone, is not indicated as a mandatory step prior to transport for neurosurgical care. While it may be considered as part of the treatment plan later on, it is not an immediate requirement for safe transport in this case.

Correct Answer: B

Rationale: The correct answer is B: "Preparation for laparotomy while initiating fluid resuscitation." In this scenario, the patient is hemodynamically unstable with signs of hypovolemic shock. The priority is to address the source of bleeding, which is likely intra-abdominal due to the stab wound. Therefore, preparing for a laparotomy to control the bleeding is crucial. Fluid resuscitation should be initiated to stabilize the patient's hemodynamics and improve tissue perfusion. This approach addresses the immediate life-threatening issue and is the most appropriate course of action to prevent further deterioration. Explanation for other choices: A: "Transfusion of FFP and platelets" - This option does not address the immediate need for controlling bleeding and stabilizing the patient's hemodynamics. C: "Resuscitation with crystalloid and pRBC until base excess is normal" - While fluid resuscitation is necessary, waiting for base excess to normalize may delay definitive treatment and compromise the

Correct Answer: D

Rationale: The correct answer is D, the resident. The resident is the most important member of the care team because they are the primary individual receiving care and treatment. Their well-being and health outcomes are the main focus of the care team's efforts. The resident's needs and preferences guide the care plan and decision-making process. The other choices (A: The nurse, B: The nursing assistant, C: The physician) play crucial roles in supporting the resident's care, but ultimately, the resident is the central figure in the care team.