ATI RN
Basic Care of a Paraplegic Patient Questions
Question 1 of 5
During the assessment of a 6-year-old child who is having an asthma attack, you observe the child speaking in single words, respiratory rate of 36, and audible wheezing. What is the most appropriate treatment?
Correct Answer: A
Rationale: The correct answer is A: Albuterol nebulizer and oxygen. 1. Albuterol nebulizer helps relieve bronchospasm in asthma attacks. 2. Oxygen supplementation can improve oxygen saturation levels. 3. Epinephrine (choice B) is not first-line treatment for asthma. 4. CPAP (choice C) is not typically used in acute asthma exacerbations. 5. Magnesium sulfate IV (choice D) is used in severe asthma attacks, not as the initial treatment.
Question 2 of 5
You are on-scene with an adult patient who was found with an extremely altered level of consciousness, and a small amount of blood noted on his lips. There are no other obvious signs of trauma during the primary assessment other than a small tongue laceration. After ensuring an adequate airway, you discover the patient's small tongue laceration appears consistent with biting his tongue. He also has obviously swollen gums that do not appear to be caused by trauma. His vital signs are found to be within normal limits, and his pupils react to light, but his level of consciousness continues to be decreased to painful stimuli only. With the limited findings, which of the following conditions is most likely to cause the patient presentation?
Correct Answer: C
Rationale: The correct answer is C: An epileptic seizure is likely responsible for causing the patient's condition. The rationale for this is as follows: 1. Tongue biting is a common occurrence during seizures, which is consistent with the small tongue laceration observed in the patient. 2. Swollen gums that are not caused by trauma can be a sign of oral injury during a seizure due to forceful clenching of the jaw. 3. The patient's decreased level of consciousness to painful stimuli is typical after a seizure, known as the postictal state. 4. Normal vital signs and reactive pupils suggest no immediate life-threatening emergency like a diabetic seizure, metabolic coma, or cerebrovascular accident. Summary: A: A diabetic seizure is unlikely due to the absence of associated signs such as altered blood sugar levels or diabetic history. B: A metabolic coma is unlikely as vital signs are normal, and the presentation is more indicative of a seizure. D: A cerebrovascular accident is unlikely as
Question 3 of 5
You are working in a pre-hospital setting and are called for a 40-year-old male who was the victim of a stabbing. The patient has a blood pressure of 87/50 and a heart rate of 130. There is a large amount of blood on the scene. After applying direct pressure to the wound on the patient's arm and stopping the bleeding, of the following what would be the best intervention to mitigate the patient's blood pressure?
Correct Answer: D
Rationale: Correct Answer: D Rationale: Establishing an IV and administering fluid to keep the patient's BP at or near 90 systolic is the best intervention. This approach aims to increase the patient's blood volume, improve tissue perfusion, and support vital organ function. The goal is to stabilize the patient's blood pressure within a safe range to prevent further complications. This approach is a standard practice in managing hypotension due to hemorrhage. Summary: A: Administering 2 liters of fluid may be excessive and could lead to fluid overload in this scenario. B: Norepinephrine is a vasopressor and should only be considered if fluid resuscitation fails to improve the patient's blood pressure. C: Dopamine is also a vasopressor and is typically used in more severe cases of hypotension. It is not the first-line intervention in this scenario.
Question 4 of 5
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.
Question 5 of 5
A 6-year-old boy is struck by an automobile and brought to the E The preferred route of venous access in this patient is:
Correct Answer: D
Rationale: The correct answer is D, percutaneous peripheral veins in the upper extremities. In a 6-year-old boy, the preferred route of venous access is peripheral veins in the upper extremities because they are easily accessible and have lower complication rates compared to other options. This route allows for rapid administration of fluids and medications in emergency situations. Percutaneous femoral vein cannulation (A) may be more invasive and carries a higher risk of complications. Cutdown on the saphenous vein at the ankle (B) is not ideal due to its location and potential difficulty in accessing. Intraosseous catheter placement in the proximal tibia (C) is a viable option but may be more invasive and time-consuming compared to peripheral veins in the upper extremities.