You are ordered to administer 0.3 mL of epinephrine for a moderate allergic reaction. What is the preferred initial route of administration of epinephrine for an allergic reaction?

Correct Answer: B

Rationale: The preferred initial route of administration of epinephrine for an allergic reaction is intramuscular (IM). This is because IM injection allows for rapid absorption and onset of action, making it effective in treating allergic reactions. Subcutaneous (A) may be slower in onset and less reliable for immediate relief. Intravenous (C) administration is reserved for severe cases where immediate effects are needed. Endotracheal (D) route is not recommended for epinephrine administration due to potential complications and lack of reliability. Therefore, option B is the most appropriate initial route for administering epinephrine in a moderate allergic reaction.

Correct Answer: C

Rationale: The correct indication for chest tube insertion is "Massive hemothorax" (Choice C). This is because a massive hemothorax refers to a significant collection of blood in the pleural space, which can lead to compromised lung function and hemodynamic instability. A chest tube is necessary to drain the blood and prevent further complications. Incorrect choices: A: "Pneumothorax" - Chest tube insertion is typically indicated for tension pneumothorax, not simple pneumothorax. B: "Pneumomediastinum" - A chest tube is not typically needed for pneumomediastinum unless there are associated complications. D: "Diaphragmatic rupture" - Chest tube insertion is not the primary intervention for diaphragmatic rupture; surgical repair may be necessary.

Correct Answer: A

Rationale: The correct answer is A: "GCS" (Glasgow Coma Scale). During the primary survey in trauma, assessing the patient's level of consciousness using GCS is crucial to identify any potential brain injury. The patient's airway, breathing, and circulation are already assessed and stable based on the given information. GCS helps determine the severity of head injury and guides further management. B: Cervical spine x-ray is not indicated during the primary survey unless there is suspicion of cervical spine injury based on mechanism of injury or physical exam findings. C: TT-administration (tetanus toxoid) is important but is not a priority during the primary survey. It can be administered later in the secondary survey. D: Blood alcohol level is not necessary during the primary survey for acute trauma management. It can be considered in the secondary survey for further evaluation.

Correct Answer: A

Rationale: The correct answer is A because cervical spine injury can initially present as a neurologic deficit after neck movement due to spinal cord compression or injury. This is due to the delicate nature of the spinal cord in the cervical region. Choices B and C are incorrect as normal range of motion and physical examination maneuvers may not rule out cervical spine injury. Choice D is incorrect as a crosstable lateral x-ray may miss certain types of cervical spine injuries, such as ligamentous or soft tissue damage.

Correct Answer: C

Rationale: The correct answer is C: DPL (Diagnostic Peritoneal Lavage). DPL is the most specific test for evaluating injuries of solid abdominal organs like the liver or spleen. It involves inserting a catheter into the peritoneal cavity to detect the presence of blood or other fluids, indicating internal bleeding. Abdominal x-ray (A) is not specific for solid organ injuries. Abdominal ultrasound (B) is more commonly used for detecting fluid collections or organ abnormalities but may not be as sensitive as DPL for detecting solid organ injuries. Frequent abdominal examination (D) is important for ongoing monitoring but does not provide the same level of specificity as DPL in diagnosing solid organ injuries.