Your adult trauma patient has a potential internal injury allowing bleeding into the thoracic cavity. As a general rule, where should the patient's mean arterial pressure (MAP) be maintained while treating and transporting the patient to the hospital?

Correct Answer: D

Rationale: The correct answer is D: MAP of 60 mmHg to 65 mmHg. Maintaining a MAP within this range is crucial for perfusing vital organs adequately, especially in a trauma patient with potential internal bleeding. A MAP below this range (choices A, B) can lead to inadequate tissue perfusion and organ damage. A MAP above this range (choice C) may increase the risk of exacerbating bleeding in the thoracic cavity. Therefore, maintaining a MAP of 60-65 mmHg strikes a balance between ensuring adequate organ perfusion and minimizing the risk of worsening bleeding.

Correct Answer: C

Rationale: The correct answer is C because visualization of all 7 cervical vertebrae and the C7 to T1 relationship is essential for proper evaluation of the cervical spine on a cross-table lateral x-ray. This allows for assessment of alignment, fractures, dislocations, and potential injuries. Option A is incorrect as the x-ray does not need to precede endotracheal intubation. Option B is incorrect as serious cervical spine injuries can still be present even if not initially seen on the x-ray. Option D is incorrect because unconscious patients with penetrating cervical injuries may still benefit from a cross-table lateral x-ray to assess for additional injuries.

Correct Answer: D

Rationale: The correct answer is D, "Needle-impenetrable sterile gloves," as they are not considered minimal precautions for preventing the spread of communicable diseases during resuscitation. Here's the rationale: 1. Goggles, face masks, and water-impervious gowns are essential to prevent contact with bodily fluids and airborne pathogens during resuscitation. 2. Needle-impenetrable sterile gloves are not typically required for basic resuscitation procedures and are not considered a minimal precaution. 3. Standard sterile gloves provide adequate protection against contact with blood and other bodily fluids in most resuscitation scenarios. 4. Using needle-impenetrable gloves for all resuscitation situations would be excessive and unnecessary.

Correct Answer: C

Rationale: The correct answer is C: Increased cardiac output. Neurogenic shock is characterized by decreased cardiac output due to disruption of sympathetic nervous system input to the heart. A is incorrect as neurogenic shock leads to decreased venous capacitance, not increased. B is incorrect as it is a feature of neurogenic shock, causing decreased systemic vascular resistance. D is incorrect as neurogenic shock typically presents with cold and clammy skin due to decreased sympathetic tone.

Correct Answer: A

Rationale: The correct answer is A: Hemothorax. In this scenario, the patient presents with signs of respiratory distress, tachycardia, hypotension, flat neck veins, diminished air entry on the right side, and dullness on percussion, which are indicative of a hemothorax. Hemothorax is characterized by the accumulation of blood in the pleural cavity, leading to lung compression and impaired ventilation. The symptoms align with the physical exam findings of decreased breath sounds and dullness due to blood occupying the pleural space. The absence of signs like muffled heart sounds or pulsus paradoxus rules out pericardial tamponade. The lack of tracheal deviation and mediastinal shift discounts tension pneumothorax. Hypovolemia from liver injury may present with similar vital sign abnormalities but would not manifest with specific chest exam findings like dullness on percussion. Therefore, based on the clinical presentation and exam findings, hemothorax is the