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. High-dose nebulized albuterol is recommended for hyperkalemic patients because it activates beta-2 adrenergic receptors, leading to an intracellular shift of potassium, thereby decreasing serum potassium levels. Albuterol does not directly address ventilatory status (choice A), metabolic acidosis (choice B), or increase available calcium at the cellular level (choice C). It is essential to focus on treating the underlying cause of hyperkalemia, which is the dangerously high potassium levels in this scenario.

Correct Answer: C

Rationale: The correct answer is C: Central cord syndrome. This syndrome is typically caused by hyperextension injuries in older individuals, resulting in motor weakness and sensory loss, often more pronounced in the upper extremities. In this case, the man's prolonged unconsciousness and lack of lower extremity movement fit the clinical presentation of central cord syndrome due to the mechanism of injury. The other choices are less likely as an epidural hematoma would present with focal neurological deficits, a pelvic fracture with lower extremity symptoms but not unconsciousness, and intracerebral hemorrhage with altered mental status and focal neurological deficits.

Correct Answer: D

Rationale: The correct answer is D, a patient with a severe cardiac contusion. Central venous pressure monitoring is essential for assessing fluid status and cardiac function in patients with significant cardiac injuries. Monitoring CVP can guide fluid resuscitation and help optimize cardiac output in these patients. Choice A, a patient with a splenic laceration, does not typically require CVP monitoring as the focus is on managing bleeding and hemodynamic stability. Choice B, a patient with an inhalation injury, would benefit more from oxygenation monitoring and respiratory support rather than CVP monitoring. Choice C, a 6-year-old child with a pelvic fracture, may require monitoring for hypovolemic shock but not necessarily through CVP monitoring, which is more invasive and not typically indicated in this scenario.

Correct Answer: B

Rationale: The correct answer is B: 400ml. In pediatric resuscitation, the initial fluid bolus is usually calculated based on weight. The standard recommendation is to give 20ml/kg of Ringers lactate solution in shock. In this case, the girl weighs 20kg, so 20 x 20 = 400ml. This volume helps to restore intravascular volume and improve perfusion. Choice A (200ml) is insufficient for her weight, C (440ml) is slightly excessive, and D (600ml) is too much and could lead to fluid overload and potential complications.

Correct Answer: A

Rationale: The correct answer is A, "Tracheobronchial injury." In this scenario, the persistent pneumothorax despite chest tube placement suggests air leakage from a larger airway, indicating tracheobronchial injury. Rib fractures (B) would not cause persistent pneumothorax. Pulmonary contusion (C) would present differently on imaging. Cardiac tamponade (D) involves blood accumulation in the pericardial sac, not air in the pleural space.