Which of the following patients best fits the criteria for a critical burn?

Correct Answer: A

Rationale: The correct answer is A because a critical burn is determined by the percentage of total body surface area (TBSA) affected. In this case, a 10-year-old patient with superficial burns over 60% of the body meets the criteria for a critical burn due to the extensive TBSA involvement. Superficial burns over 60% of the body can lead to significant fluid loss, infection risk, and systemic complications. Choice B is incorrect because full-thickness burns on a specific area of the arm, even if full-thickness, are not as extensive as 60% TBSA involvement. Choice C is incorrect as partial-thickness burns across 25% of the body, not involving critical areas, do not meet the criteria for a critical burn based on TBSA. Choice D is also incorrect as partial-thickness burns on 25% of the body, not involving critical areas, do not meet the criteria for a critical burn based on TBSA.

Correct Answer: C

Rationale: The correct answer is C: Control internal hemorrhage operatively. In managing a gunshot wound to the abdomen, the priority is to control internal bleeding, usually through surgical intervention. Administering O-negative blood (A) is important for resuscitation but does not address the primary issue. External warming devices (B) are not the priority in this scenario. Applying a pneumatic antishock garment (PASG) (D) is not recommended as it could delay necessary surgical intervention to control hemorrhage. Operating to control internal hemorrhage is crucial to prevent further blood loss and stabilize the patient's condition.

Correct Answer: D

Rationale: The correct answer is D because in a patient with flail chest, which is a serious condition involving multiple rib fractures leading to paradoxical chest wall movement, mechanical ventilation is essential to support adequate ventilation and oxygenation. Endotracheal intubation helps secure the airway and allows for positive pressure ventilation to improve gas exchange. This is crucial in preventing respiratory failure and ensuring adequate oxygen delivery to tissues. Choice A is incorrect as confusion is not an indication for Ringers lactate solution. Choice B, cyanosis, does not address the need for ventilatory support in flail chest. Choice C, tachypnea, is a symptom of respiratory distress but does not address the need for mechanical ventilation, which is the definitive management for flail chest.

Correct Answer: D

Rationale: The correct answer is D, less brain contusions. The scenario describes a traumatic brain injury likely due to the fall. The initial GCS of 15 indicates mild TBI, which deteriorated rapidly to GCS 6 and a large left pupil, suggesting brain herniation. The sudden decline in neurological status, particularly with a focal sign like a dilated pupil, is more indicative of diffuse axonal injury (DAI) or brain herniation rather than epidural hematoma or pulmonary contusion. The absence of any mention of focal neurological deficits or direct trauma to the chest makes choices A and C less likely. Choice B is unrelated to the scenario.

Correct Answer: D

Rationale: The correct answer is D, "All of the above." Tension pneumothorax can be caused by a variety of factors, including "Flail chest," which leads to air accumulation in the pleural space. Cardiac tamponade can also cause tension pneumothorax due to increased pressure on the lungs. Clamping of a chest tube can result in tension pneumothorax if the built-up air cannot escape. Therefore, all of these choices can lead to tension pneumothorax by causing an increase in intrathoracic pressure, ultimately leading to respiratory distress.