1. You are assessing a patient who was involved in a motor

vehicle collision. He is conscious and alert, but complains

of severe chest pain and difficulty breathing. His skin is

pale and diaphoretic, and his pulse is weak and rapid. You

suspect he has a tension pneumothorax. What is the most

appropriate intervention in the primary assessment?

A) Apply high-flow oxygen via non-rebreather mask

B) Perform needle decompression in the second intercostal

space

C) Insert a chest tube in the fifth intercostal space

D) Transport the patient immediately to the nearest trauma

center

* B) Perform needle decompression in the second

intercostal space

Rationale: A tension pneumothorax is a life-threatening

condition that requires immediate intervention to relieve

the pressure in the pleural cavity and restore adequate

ventilation. Needle decompression is performed by

inserting a large-bore needle in the second intercostal space

at the midclavicular line on the affected side. This allows

air to escape from the pleural space and prevents further

compression of the lung and mediastinal structures.

Applying oxygen, inserting a chest tube, and transporting

the patient are important steps, but they are not as urgent as

needle decompression.

2. You are assessing a patient who was stabbed in the

abdomen. He is conscious but restless, and has a large

amount of blood soaking his clothes. His skin is cool and