You suspect your adult trauma patient has a potential complete spinal cord transection. If so, which of the following would you expect to find?

Correct Answer: C

Rationale: The correct answer is C. In a complete spinal cord transection, there is total absence of pain, sensation, and movement below the level of injury due to complete disruption of nerve pathways. This results in paralysis below the injury site. A is incorrect because a complete transection would result in total loss of pain, sensation, and movement, not just some loss of movement. B is incorrect as bradycardia and loss of vascular tone are indicative of autonomic dysreflexia, typically seen in spinal cord injuries above T6, not a complete transection. D is incorrect as right-sided paralysis with decreased sensation on the opposite side does not align with the expected presentation of a complete spinal cord transection.

Correct Answer: C

Rationale: The correct answer is C because the patient lost consciousness immediately following the injury, then quickly regained consciousness, but lost consciousness again just before calling 911. This pattern of lucid intervals followed by a deteriorating level of consciousness is indicative of an epidural hematoma. The initial loss of consciousness is due to the initial trauma causing bleeding between the skull and the dura mater, leading to increased intracranial pressure. The temporary regaining of consciousness occurs when the hematoma temporarily stops expanding before resuming bleeding, causing a decline in consciousness again. Summary: A: A 'goose egg' noted on the patient's head is more indicative of a scalp hematoma or soft tissue injury, not necessarily an epidural hematoma. B: The patient being unconscious throughout transport could indicate a severe brain injury, but the specific pattern described in option C is more characteristic of an epidural hematoma. D: A sudden, severe headache may be a symptom of various head injuries, but it is

Correct Answer: C

Rationale: The correct answer is C because inducing mild hypothermia in a post-arrest patient with a return of spontaneous circulation helps reduce intracranial pressure, cerebral metabolic rate, and the brain's demand for oxygen. This is crucial in preventing secondary brain injury and improving neurological outcomes. Explanation: 1. Reduced intracranial pressure: Hypothermia causes vasoconstriction, reducing cerebral blood flow and lowering intracranial pressure. 2. Decreased cerebral metabolic rate: Hypothermia slows down cellular metabolism, decreasing the brain's oxygen and energy requirements. 3. Lowered brain's demand for oxygen: With reduced metabolic rate and blood flow, the brain requires less oxygen. Summary of other choices: A: Hypothermia does not directly reduce the body's need for stored energy (sugar) but rather decreases metabolic rate. B: Hypothermia may alter blood flow distribution but does not specifically increase blood flow to the brain and heart. D: Hypothermia primarily affects the

Correct Answer: D

Rationale: The correct answer is D: Admit the patient to the intensive care unit. This is the most appropriate management because an 8-year-old boy with a spleen laceration after falling from a height needs close monitoring and potential interventions that can be provided in an intensive care setting. Admission to the ICU allows for continuous monitoring of vital signs, blood loss, and potential complications. Type and crossmatch for blood (A) may be necessary but is not the most urgent step in this scenario. Requesting consultation of a pediatrician (B) can be done after initial stabilization, and transferring the patient to a trauma center (C) may delay necessary interventions that can be provided in the current setting.

Correct Answer: D

Rationale: The correct answer is D, Elevated central venous pressure. Transfer to a burn center is based on the extent and severity of burns, not on central venous pressure. A: Partial-thickness and full-thickness burns on greater than 10% of the body surface area (BSA) are criteria for transfer due to the increased risk of complications. B: Any full-thickness burn is a critical criterion for transfer since full-thickness burns require specialized care. C: Burns involving the perineum and skin overlying major joints are also criteria for transfer to a burn center due to the risk of functional impairment and infection.