Which one of the following signs necessitates a definitive airway in severe trauma patients?

Correct Answer: C

Rationale: The correct answer is C: Severe maxillofacial fractures. These fractures can lead to airway compromise due to obstruction by displaced bone fragments or soft tissue swelling. Definitive airway management is crucial in these cases to ensure adequate oxygenation. Facial lacerations (A) may require suturing but do not necessarily indicate the need for a definitive airway. Repeated vomiting (B) can be managed with positioning and antiemetics, not always requiring an airway intervention. Sternal fracture (D) may cause pain and difficulty breathing but does not directly impede the airway, making it less likely to necessitate definitive airway management.

Correct Answer: B

Rationale: The correct answer is B: Insert a definitive airway. In a patient with a GCS of 8, airway management is a priority. Inserting a definitive airway ensures proper oxygenation and ventilation during the CT scan, reducing the risk of hypoxia or respiratory compromise. This step takes precedence over giving more sedative drugs (A), as ensuring adequate oxygenation is critical in a patient with altered mental status. Inserting a multilumen esophageal airway (C) is not indicated in this scenario, as it is primarily used for airway management during surgery. Requesting a lateral cervical spine film (D) is not necessary before a CT scan in this case, as securing the airway takes precedence over ruling out cervical spine injury.

Correct Answer: C

Rationale: The correct answer is C: "FAST exam." In this scenario, the patient presents with signs of hypovolemic shock likely due to internal bleeding from the chest wound. FAST exam (Focused Assessment with Sonography in Trauma) is a rapid bedside ultrasound used to assess for free fluid in the abdomen or pericardium, which can help identify the source of bleeding. This is crucial for immediate management as it can guide further interventions such as surgery or angiography. Choice A: "CT scan of the chest" is not the most immediate step as it takes time and may not provide rapid information needed for immediate management. Choice B: "12 lead ECG" is not the priority in this situation as the patient is hemodynamically unstable and requires rapid assessment for potential life-threatening bleeding. Choice D: "Begin infusion of RBCs" is important, but identifying the source of bleeding is crucial before deciding on the need for blood transfusion.

Correct Answer: C

Rationale: The correct answer is C because the chain of command refers to the hierarchical structure within an organization that outlines the line of authority and communication. This ensures that decisions and information flow efficiently from top management to frontline employees. Option A is incorrect as it describes legal responsibility. Option B is incorrect as it refers to a shift supervisor, not the entire chain of command. Option D is incorrect as it describes a specific department, not the overall structure of authority. Ultimately, understanding the chain of command is crucial for effective communication and decision-making within an organization.

Correct Answer: B

Rationale: The correct answer is B: Protect privacy of health information. HIPAA was enacted to safeguard individuals' sensitive health information, ensuring confidentiality and security. This is crucial in maintaining trust between patients and healthcare providers. Choices A, C, and D are incorrect as they do not directly relate to the primary purpose of HIPAA, which is to regulate the use and disclosure of protected health information. Nursing assistants' insurance coverage, care procedures, and abuse prevention are important but not the main focus of HIPAA.