ATI RN
Chapter 70 Care of Patients with Breast Disorders Practice Questions Questions
Question 1 of 5
A 36-year-old woman is receiving general anesthesia for a diagnostic laparoscopy in the Trendelenburg position with CO2 insufflation. During a 15-minute period after induction, her SpO2 decreases from 99% to 90% and the partial pressure of ETCO2 increases from 38 to 43 mmHg. FiO2 is 0.3; all ventilator settings have been constant. Which of the following etiologies is the MOST likely cause of the decrease in SpO2?
Correct Answer: C
Rationale: Trendelenburg position and CO2 insufflation can shift the endotracheal tube into the right mainstem bronchus, causing unilateral ventilation, reduced SpO2, and increased ETCO2.
Question 2 of 5
The nurse and the nursing assistive personnel (NAP) are caring for a group of postoperative patients who need turning, coughing, deep breathing, incentive spirometer, and leg exercises. Which task will the nurse assign to the NAP?
Correct Answer: D
Rationale: The correct answer is D because informing the nurse if the patient is unwilling to perform exercises falls within the NAP's scope of practice and ensures patient safety. Teaching postoperative exercises (choice A) should be done by the nurse due to the complexity of the task. Doing nothing (choice B) would not meet the patients' needs. Documenting in the medical record (choice C) should be done by the nurse to ensure accurate and comprehensive documentation. Therefore, choice D is the most appropriate task to assign to the NAP in this scenario.
Question 3 of 5
You are called to assist an adult diabetic who was found unconscious in bed. On arrival, your patient is unresponsive with snoring respirations and cool, clammy skin. Your glucometer will not power up, so blood glucose analysis is impossible at the present time. Which of the following would be most appropriate after controlling the patient's airway and delivering high-flow oxygen therapy?
Correct Answer: B
Rationale: The correct answer is B because administering dextrose 50% via IV is the most appropriate and rapid way to treat hypoglycemia in an unresponsive diabetic patient. Dextrose will quickly raise the blood glucose levels and help reverse the hypoglycemic state. Starting an IV line is crucial for immediate access to administer the dextrose. Drawing blood samples is unnecessary in this emergency situation as immediate treatment is required to prevent further deterioration. Administering glucagon intramuscularly may delay the treatment process as it takes longer to raise blood glucose levels compared to IV dextrose. Transporting the patient to the hospital for blood glucose analysis before treatment can be dangerous as delays in treatment can lead to irreversible harm.
Question 4 of 5
You are on-scene assisting another crew with a childbirth call that quickly turned into a neonatal resuscitation. The newborn does not have a palpable brachial pulse, but muffled heart tones and the monitor confirm a sluggish heart rate of 55 beats per minute. After reassessing him after a few minutes of high-quality chest compressions and effective ventilations with 100% oxygen concentration, the patient's heart rate fails to respond. Which of the following would be considered a class IIa intervention for this patient?
Correct Answer: A
Rationale: The correct answer is A: 0.1 mg/mL of a 1:10,000 concentration of epinephrine delivered via the intraosseous route. In neonatal resuscitation, when a newborn fails to respond to initial resuscitative efforts, the next step is to administer epinephrine. In this scenario, the recommended dose for neonates is 0.1 mg/mL of a 1:10,000 concentration of epinephrine. Delivering it via the intraosseous route in this critical situation ensures rapid absorption and distribution, potentially improving the newborn's heart rate and perfusion. Choice B is incorrect as the intramuscular route is not as effective and rapid in neonatal resuscitation compared to the intraosseous route. Choice C is also incorrect as delivering epinephrine via the endotracheal tube route is not recommended due to poor absorption and efficacy. Choice D is incorrect as intravenous access might not
Question 5 of 5
You are intubating a 26-year-old who is apneic. Once the endotracheal tube passes through the vocal cords, how much farther should the endotracheal tube be advanced before inflating the cuff and confirming proper placement?
Correct Answer: A
Rationale: The correct answer is A: 0.5 to 1 inch. After passing through the vocal cords, the endotracheal tube should be advanced 0.5 to 1 inch to ensure proper placement in the trachea above the carina. This allows the cuff to seal the trachea and prevent aspiration. Advancing the tube less than 1 cm (B) may result in the tube being in the esophagus. Advancing it 2 to 3 cm (C) may lead to the tube being too deep in the trachea or mainstem bronchus. Advancing it 1 to 2.5 inches (D) risks the tube entering the right main bronchus. Thus, the correct range of advancement is 0.5 to 1 inch to achieve optimal placement and patient safety.