The primary indication for transferring a patient to a higher level trauma center is:

Correct Answer: C

Rationale: Step-by-step rationale for the correct answer (C): 1. Transferring doctor determines resource limitations to provide adequate care. 2. Ensures patient receives necessary resources at a higher level trauma center. 3. Improves patient outcomes and chances of survival. 4. Avoids delays in treatment due to resource constraints. 5. Upholds the principle of providing the highest standard of care to the patient. Summary: A: Unavailability of staff is not the primary indication for transfer. B: While severe injuries warrant transfer, the primary reason is resource limitations. D: Hospital administration's decision may not always align with patient care needs.

Correct Answer: D

Rationale: Correct Answer: D Rationale: 1. Children have less circulating blood volume than adults, so a smaller volume of blood loss can lead to shock. 2. Pediatric shock can occur with as little as 5-10% blood loss, whereas adults typically require 15-30%. 3. This difference is due to children's smaller body size and lower blood volume compared to adults. 4. Therefore, the statement that the absolute volume of blood loss required to produce shock is the same as in adults is FALSE. Summary of other choices: A: True - Vital signs in children vary with age. B: True - Children have greater physiologic reserves compared to adults. C: True - Tachycardia is a common response to hypervolemia in pediatric shock.

Correct Answer: A

Rationale: The correct answer is A: "Permissive hypotension and early plasma infusion." This principle of balanced resuscitation involves allowing for slightly lower blood pressure to reduce bleeding while promptly providing plasma to restore clotting factors. Permissive hypotension helps prevent further blood loss, while early plasma infusion helps maintain coagulation function. The other choices are incorrect because B does not address the specific needs of resuscitation, C focuses on a different aspect of patient management, and D is not directly related to the resuscitation process.

Correct Answer: D

Rationale: The correct answer is D because X-ray of the chest and pelvis are important adjuncts in assessing trauma patients to rule out life-threatening injuries like pneumothorax, hemothorax, pelvic fractures, etc. This patient's mechanism of injury suggests the possibility of pelvic injury (Choice A is incorrect). While blood loss from the lower limbs could contribute to hypotension, other causes like internal bleeding should also be considered (Choice B is incorrect). Spinal cord injury is less likely to be the cause of hypotension in this case compared to hemorrhage or other traumatic injuries (Choice C is incorrect). In summary, obtaining X-rays of the chest and pelvis is crucial in the initial assessment of trauma patients to identify potentially life-threatening injuries.

Correct Answer: B

Rationale: The correct answer is B: Assisted living facilities. Residents in assisted living facilities typically require minimal assistance with daily activities and are more independent compared to those in acute care, subacute care, and hospice facilities. Assisted living facilities provide a level of care that promotes independence while still offering support when needed. Acute care facilities (A) provide medical care for short-term conditions, subacute care facilities (C) offer more intensive care than assisted living, and hospice facilities (D) provide end-of-life care which involves more specialized and intensive support.