Which of the following statements is FALSE concerning Rh-isoimmunization in the pregnant trauma patient?

Correct Answer: C

Rationale: Rationale for Answer C being FALSE: A negative Kleihauer-Betke test does not exclude Rh-isoimmunization. The test measures the amount of fetal red blood cells in the maternal circulation, but may not always detect small amounts of fetal-maternal hemorrhage. Rh-isoimmunization can still occur even if the Kleihauer-Betke test is negative. Summary of other choices: A: True - Rh-isoimmunization can occur in both blunt or penetrating abdominal trauma. B: True - Even minor degrees of fetomaternal hemorrhage can lead to Rh-isoimmunization. D: False - Rh-isoimmunization can be a problem in both Rh-positive and Rh-negative pregnant trauma patients.

Correct Answer: A

Rationale: The correct answer is A: "Permissive hypotension and early plasma infusion" for balanced resuscitation. Permissive hypotension helps prevent exacerbating bleeding by maintaining lower blood pressures. Early plasma infusion provides essential clotting factors for coagulopathy correction. Choice B is incorrect as equal crystalloid and colloid amounts are not recommended due to colloid-related complications. Choice C is incorrect as balanced resuscitation focuses on fluid and blood product administration, not breathing management. Choice D is incorrect as maintaining a normal acid-base balance is essential but not the sole focus of balanced resuscitation.

Correct Answer: D

Rationale: The correct answer is D. X-ray of the chest and pelvis are important adjuncts in his assessment. This patient's mechanism of injury is indicative of high energy trauma. X-ray of the chest can help identify potential thoracic injuries such as rib fractures or pneumothorax. Pelvic x-ray is crucial to assess for pelvic fractures, which can lead to significant blood loss and hypotension. This patient's hypotension is more likely due to hemorrhagic shock from his open tibial fractures rather than spinal cord injury. Pelvic injury cannot be ruled out solely based on the mechanism of injury as pelvic fractures are common in falls from height. Blood loss from the lower limb alone is not the most likely cause of hypotension in this case.

Correct Answer: B

Rationale: The correct answer is B: Assisted living facilities. These facilities are designed for individuals who require minimal assistance with daily activities and typically provide a more independent living environment. Residents in assisted living facilities are generally more self-sufficient compared to those in acute care facilities, subacute care facilities, or hospice facilities. Acute care facilities are for patients requiring intensive medical care, subacute care facilities provide short-term specialized care, and hospice facilities offer end-of-life care. Therefore, the correct choice is B as residents in assisted living facilities are more independent and do not need skilled care compared to the other options.

Correct Answer: A

Rationale: The correct answer is A because it emphasizes the importance of referring to the procedure manual to review the steps. This ensures accuracy and patient safety. Choice B is incorrect as it risks making mistakes. Choice C is unreliable and may not provide accurate information. Choice D is inappropriate as residents are not responsible for providing procedural guidance. Overall, consulting the procedure manual is the most reliable and professional approach.