ATI RN
Basic Principles of Long-Term Patient Care Developing a Therapeutic Community Questions
Question 1 of 5
A 68-year-old woman with primary hyperparathyroidism is scheduled to undergo parathyroidectomy. Her serum calcium concentration is 15 mg/dL. IV administration of which of the following substances is the MOST appropriate initial management?
Correct Answer: B
Rationale: Hypercalcemia (serum calcium > 14 mg/dL) is initially managed with IV normal saline to promote diuresis and calcium excretion, addressing the underlying dehydration common in this condition.
Question 2 of 5
The nurse is encouraging the postoperative patient to utilize diaphragmatic breathing. Which priority goal is the nurse trying to achieve?
Correct Answer: B
Rationale: The correct answer is B: Prevent atelectasis. Diaphragmatic breathing helps improve lung expansion, prevent atelectasis (lung collapse), and promote optimal gas exchange postoperatively. By utilizing diaphragmatic breathing, the nurse aims to prevent respiratory complications and promote overall lung health. A: Managing pain is important but not the priority goal of diaphragmatic breathing in this scenario. C: While diaphragmatic breathing may indirectly help reduce healing time by improving oxygenation, it is not the primary goal. D: Diaphragmatic breathing does not directly address thrombus formation; other interventions like early ambulation are more effective for this purpose.
Question 3 of 5
The postanesthesia care unit (PACU) nurse transports the inpatient surgical patient to the medical-surgical floor. Before leaving the floor, the medical-surgical nurse obtains a complete set of vital signs. What is the rationale for this nursing action?
Correct Answer: B
Rationale: The correct answer is B because obtaining a complete set of vital signs before transport allows for baseline comparison and monitoring for any variations during the transport process. This is crucial in identifying any potential complications or changes in the patient's condition. It ensures continuity of care and early detection of any issues. A: This choice is incorrect as obtaining vital signs before transport is more about monitoring changes rather than completing a head-to-toe assessment. C: This choice is incorrect because obtaining vital signs is not solely to ensure that the nurse checks on the patient postoperatively. D: This choice is incorrect as the primary rationale is not just to follow hospital policy, but rather to monitor vital signs for changes during transport.
Question 4 of 5
Pericardial tamponade and hemorrhagic shock present very similarly in the pre-hospital environment. What is the best way, of those listed, to distinguish between the two diagnoses?
Correct Answer: A
Rationale: The correct answer is A. Jugular vein distension is a classic sign of pericardial tamponade due to impaired filling of the right heart chambers. In contrast, hemorrhagic shock typically does not cause jugular vein distension. This distinction is crucial in the pre-hospital setting to differentiate between the two conditions. Choice B is incorrect because cyanosis is not a reliable differentiating factor between pericardial tamponade and hemorrhagic shock. Choice C is incorrect because pericardial tamponade often leads to hypotension due to decreased cardiac output, whereas hemorrhagic shock can also present with hypotension. Choice D is incorrect as the type of tachycardia is not a definitive differentiator between the two conditions.
Question 5 of 5
After assisting a full-term pregnant patient in the delivery of her newborn, the newborn remains bradycardic with a heart rate of 50 beats per minute and exhibits cyanosis around his mouth, nose, fingers, and toes. He is not responding well and appears lethargic following the five-minute APGAR assessment. What would be the best initial intervention at this point to increase his heart rate?
Correct Answer: A
Rationale: The correct initial intervention is to deliver adequate artificial ventilation after ensuring a definitive airway. This is because the newborn's bradycardia and cyanosis indicate respiratory distress, which can lead to decreased oxygenation and poor perfusion. Ventilating the newborn will help improve oxygenation and increase the heart rate. Administering epinephrine or vasopressors would be premature without addressing the underlying cause of respiratory distress. 'Fast and hard' chest compressions are not indicated for a bradycardic newborn with respiratory distress.