ATI RN
Provide Basic Patient Care Following Direction of Nursing Staff Questions
Question 1 of 5
In which of the following situations would evaluating the ST segment elevation of a patient suffering from a suspected myocardial infarction not be indicated to determine if an infarction exists?
Correct Answer: A
Rationale: The correct answer is A: When a pre-existing right bundle branch block is present. Evaluating ST segment elevation is not indicated in this situation because a right bundle branch block can mimic ST elevation on an ECG, making it difficult to accurately determine if an infarction exists. Summary of why other choices are incorrect: B: When the patient is hypotensive - Hypotension does not preclude the evaluation of ST segment elevation in suspected myocardial infarction. C: In the presence of pulmonary edema - Pulmonary edema does not preclude the evaluation of ST segment elevation in suspected myocardial infarction. D: In the presence of a left bundle branch block - Evaluating ST segment elevation is still indicated in the presence of a left bundle branch block because it can still provide valuable information for diagnosing myocardial infarction.
Question 2 of 5
Which one of the following statements is correct?
Correct Answer: A
Rationale: Rationale for Correct Answer (A): - Cerebral contusion is a bruising of brain tissue due to head trauma. - It can lead to the pooling of blood and form an intracerebral hematoma. - This process involves the collection of blood within the brain tissue. Summary for Incorrect Choices: - B: Epidural hematomas are typically seen in the temporal region, not frontal. - C: Subdural hematomas are often caused by bridging veins rupture, not middle meningeal artery. - D: Subdural hematomas usually appear crescent-shaped, not lenticular on CT scan.
Question 3 of 5
Which one of the following statements concerning massive hemothorax is true?
Correct Answer: D
Rationale: Step-by-step rationale for why answer choice D is correct: 1. Massive hemothorax involves significant blood accumulation in the pleural space. 2. Shock and unilateral absent breath sounds are classic signs of massive hemothorax. 3. Immediate recognition and treatment are crucial to prevent further deterioration. 4. Prompt diagnosis and intervention are essential in managing massive hemothorax. Summary of other choices: A: Blunt thoracic trauma can cause hemothorax, but not specifically massive hemothorax. B: Pneumothorax involves air in the pleural space, not blood. C: Confirming the diagnosis with an upright chest x-ray may delay urgent treatment.
Question 4 of 5
A 30 year old male is brought to the hospital after falling 6 meters. Inspection reveals an obvious flail chest on the right. The patient is tachypnei Breath sounds are present and symmetrical. There is no significant hyperresonance or dullness. Arterial blood gas obtained while the patient receives oxygen by face mask are: PaO2 of 45mmHg (6Kpa), PaCO2 of 28mmHg (3,7 Kpa) and pH of 7.47. The component of injury that most likely responsible for abnormalities in this patient's blood gas is:
Correct Answer: B
Rationale: The correct answer is B: Pulmonary contusion. Pulmonary contusion is a common injury following blunt chest trauma and can lead to impaired gas exchange. In this case, the patient's low PaO2 and respiratory alkalosis (low PaCO2 and elevated pH) are indicative of a ventilation-perfusion mismatch caused by pulmonary contusion. The flail chest may also contribute to impaired gas exchange, but the absence of hyperresonance or dullness on auscultation makes a significant pneumothorax less likely. Hypoventilation would typically present with hypercapnia and acidosis, which is not seen in this patient. Hypovolemia would not directly affect blood gas values in this way.
Question 5 of 5
A 47 year old house painter is brought to the hospital after falling 6 meters from a ladder and landing straddled on a fence. Examination of his perineum reveals extensive ecchymosis. There is blood in the external urethral meatus. The initial diagnostic study for evaluation of the urinary tract in this patient should be:
Correct Answer: D
Rationale: The correct answer is D: "Retrograde urethrography." In this case, the patient presents with blood in the external urethral meatus, indicating a possible urethral injury. Retrograde urethrography is the most appropriate initial diagnostic study to evaluate the integrity of the urethra. This procedure involves injecting contrast material into the urethra to visualize any disruptions or strictures. Cystoscopy (choice A) is invasive and not the initial study of choice for evaluating urethral injuries. Cystography (choice B) is used to assess bladder injuries, not urethral injuries. IV pyelography (choice C) is used to assess the kidneys and ureters, not the urethra. Therefore, retrograde urethrography is the most suitable option for this patient's presentation.