You are treating an adult trauma patient who was thrown from a moving vehicle. Upon assessment, you find the patient is hypotensive, has absent breath sounds on the right, and has visible tracheal deviation. What should you do first?

Correct Answer: A

Rationale: The correct answer is A: Perform a needle decompression. This is the first step because the patient likely has a tension pneumothorax, which is a life-threatening condition causing tracheal deviation, absent breath sounds, and hypotension. Needle decompression helps release the trapped air in the pleural space, alleviating the pressure on the heart and lungs. Administering a fluid bolus (choice B) may worsen the tension pneumothorax by increasing intrathoracic pressure. Intubation (choice C) may be necessary but should not be the first step in managing a tension pneumothorax. Placing the patient on a cardiac monitor (choice D) is important but not the immediate priority in this critical situation.

Correct Answer: B

Rationale: The correct answer is B: Inferior wall. ST elevation in Leads II, III, aVF indicates an inferior wall myocardial infarction. These leads correspond to the inferior part of the heart supplied by the right coronary artery. The ST elevation in these leads suggests acute injury or infarction in this area. The other choices are incorrect because: A: Lateral wall is typically indicated by ST elevation in Leads I, aVL, V5-V6. C: Anterior wall is typically indicated by ST elevation in Leads V1-V4. D: Septal wall is typically indicated by ST elevation in Leads V1-V2.

Correct Answer: C

Rationale: The correct answer is C: Congestive heart failure. This condition can cause problems with both internal (heart function affecting oxygenated blood supply) and external (air exchange in lungs) processes of respiration. The heart's inability to effectively pump blood can lead to fluid buildup in the lungs, impairing oxygen exchange. Lung cancer (A) primarily affects the internal processes of respiration. Chronic hypertension (B) mainly impacts blood pressure regulation but not both internal and external respiration. Emphysema (D) primarily affects the external processes of respiration by damaging the lung tissue.

Correct Answer: B

Rationale: The correct answer is B: Negligence charges could be brought against the paramedic in charge of the unit. Rationale: 1. Negligence is the failure to exercise the standard of care that a reasonably prudent person would have in a similar situation. 2. In this scenario, the paramedic in charge failed to ensure the equipment was adequately charged or had backup batteries, leading to the device shutting off during a critical moment. 3. This failure to provide proper equipment falls below the standard of care expected in the field of emergency medical services. 4. As a result, the patient's death could be attributed to the paramedic's negligence in ensuring equipment readiness. Summary: A: Manslaughter charges require a higher level of intent and causation, not applicable here. C: Battery charges refer to physical harm, not applicable in this context. D: Defamation charges involve false statements damaging a person's reputation, not relevant to the situation described.

Correct Answer: D

Rationale: The correct answer is D because the absolute volume of blood loss required to produce shock in children is not the same as in adults. Children have a smaller blood volume compared to adults, so even a smaller amount of blood loss can lead to shock. This is due to their smaller size and lower total blood volume. A: Vital signs are age-related - True, children have different normal vital signs compared to adults. B: Children have greater physiologic reserves than do adults - True, children have more reserves to compensate for shock. C: Tachycardia is the primary physiologic response to hypovolemia - True, tachycardia is a common response to maintain perfusion in hypovolemic shock.