You are intubating a 26-year-old who is apneic. Once the endotracheal tube passes through the vocal cords, how much farther should the endotracheal tube be advanced before inflating the cuff and confirming proper placement?

Correct Answer: A

Rationale: The correct answer is A: 0.5 to 1 inch. After passing through the vocal cords, the endotracheal tube should be advanced 0.5 to 1 inch to ensure proper placement in the trachea above the carina. This allows the cuff to seal the trachea and prevent aspiration. Advancing the tube less than 1 cm (B) may result in the tube being in the esophagus. Advancing it 2 to 3 cm (C) may lead to the tube being too deep in the trachea or mainstem bronchus. Advancing it 1 to 2.5 inches (D) risks the tube entering the right main bronchus. Thus, the correct range of advancement is 0.5 to 1 inch to achieve optimal placement and patient safety.

Correct Answer: B

Rationale: The correct answer is B: Respiratory acidosis. In this scenario, the patient's shallow and irregular respirations lead to inadequate ventilation, causing CO2 retention. This results in an increase in blood CO2 levels, leading to respiratory acidosis. The low SpO2 suggests poor oxygenation but is not directly related to the acid-base imbalance. Choices A, C, and D are incorrect because the symptoms described are more indicative of respiratory acidosis due to hypoventilation.

Correct Answer: A

Rationale: Step-by-step rationale for the correct answer (A): 1. Epinephrine acts on alpha and beta-adrenergic receptors. 2. By binding to alpha receptors, it causes vasoconstriction which helps in increasing blood pressure. 3. By binding to beta-2 receptors, it causes bronchodilation which improves respiratory effort. 4. Epinephrine also reduces the release of chemical mediators such as histamine from mast cells, which helps in counteracting the allergic response. 5. Therefore, choice A is correct as it highlights an additional beneficial effect of epinephrine in managing anaphylaxis. Summary of why other choices are incorrect: B: Epinephrine does not directly reduce the inflammatory response; it mainly acts on vasoconstriction and bronchodilation. C: While epinephrine can increase heart rate, the primary purpose is not to improve peripheral perfusion, but to counteract the effects of anaphylaxis.

Correct Answer: A

Rationale: The correct answer is A: "Air splints." Air splints are not typically used for immobilization of a motorcyclist with potential spinal injuries. The rationale is that air splints are primarily used for stabilizing extremity fractures, not for spinal immobilization. In this scenario, the motorcyclist is unconscious with a low GCS score, indicating a potential spinal injury. Choices B, C, and D are used for immobilization of a trauma patient with suspected spinal injuries. Bolstering devices help maintain spinal alignment, a long spine board provides full-body immobilization, and a scoop-style stretcher allows for easy transfer without movement.

Correct Answer: B

Rationale: The correct immediate management for a profusely bleeding wound like this is to apply direct pressure on the wound (Choice B). This helps control the bleeding by compressing the blood vessels and promoting clot formation. Applying a tourniquet (Choice A) should be avoided in this situation as it is typically used as a last resort for uncontrollable bleeding. Packing the wound with gauze (Choice C) can worsen the bleeding by disrupting clots and should be avoided. Direct pressure on the femoral artery at the groin (Choice D) is not recommended as the wound is in the thigh, and applying pressure on the artery directly can be difficult and may not effectively control the bleeding.