Your adult patient is showing signs and symptoms of being severely hyperkalemic. Medical control recommends the administration of a high-dose nebulized albuterol treatment as well as calcium chloride. Why is high-dose albuterol being recommended for this patient?

Correct Answer: D

Rationale: The correct answer is D: To help lower dangerous potassium levels. Albuterol is a beta-2 agonist that stimulates potassium uptake by cells, reducing serum potassium levels. Nebulized albuterol is effective in treating hyperkalemia by shifting potassium into cells, lowering serum levels. Choices A and B are incorrect as albuterol does not directly impact ventilatory status or metabolic acidosis. Choice C is incorrect as albuterol does not increase available calcium at the cellular level.

Correct Answer: C

Rationale: The correct answer is C: Central cord syndrome. This syndrome typically presents with weakness or paralysis in the upper extremities and sparing of the lower extremities due to damage to the central spinal cord. In this case, the man's lack of movement in his lower extremities is indicative of central cord syndrome, likely caused by compression or injury to the cervical spinal cord during the tractor accident. The other choices can be ruled out: A) An epidural hematoma would present with signs of increased intracranial pressure, not paralysis in the lower extremities. B) A pelvic fracture would not directly cause paralysis in the lower extremities. D) Intracerebral hemorrhage would typically present with neurological deficits related to the brain, not the spinal cord.

Correct Answer: D

Rationale: The correct answer is D because central venous pressure monitoring is crucial in patients with severe cardiac contusion to guide fluid resuscitation and assess cardiac function. In this scenario, monitoring CVP can help optimize fluid management and prevent fluid overload. A: Patient with a splenic laceration - CVP monitoring is not necessary for this injury. B: Patient with an inhalation injury - CVP monitoring is not specifically indicated for this condition. C: 6-year-old child with a pelvic fracture - While CVP monitoring can be useful in pediatric trauma patients, it is not specifically indicated for a pelvic fracture in a child without signs of hemodynamic instability.

Correct Answer: B

Rationale: The correct answer is B: 400ml. For a pediatric patient in shock, initial fluid resuscitation typically starts with a bolus of 20ml/kg of crystalloid solution. In this case, the girl weighs 20kg, so 20ml/kg x 20kg = 400ml. This bolus helps restore intravascular volume and improve perfusion. Choice A (200ml) is too low and would not provide adequate volume for resuscitation. Choice C (440ml) is slightly higher than the calculated volume and may increase the risk of fluid overload. Choice D (600ml) is excessive and may lead to complications such as pulmonary edema. Therefore, option B is the most suitable initial fluid bolus volume for this patient's condition.

Correct Answer: A

Rationale: The correct answer is A, "Tracheobronchal injury," because the scenario of a large right pneumothorax following a fall from a height suggests a significant chest trauma. The persistence of the pneumothorax despite chest tube placement indicates an ongoing source of air leak, which is commonly seen with tracheobronchial injuries. Rib fractures (B) would not cause persistent pneumothorax. Pulmonary contusion (C) typically presents with diffuse alveolar damage. Cardiac tamponade (D) is unlikely in this case as there are no indications of cardiac injury.