ATI RN
Basic Care of a Paraplegic Patient Questions
Question 1 of 5
The nurse is caring for a patient in the postanesthesia care unit who has undergone a left total knee arthroplasty. The anesthesia provider has indicated that the patient received a left femoral peripheral nerve block. Which assessment will be an expected finding for this patient?
Correct Answer: A
Rationale: Step 1: A femoral peripheral nerve block affects sensation in the anterior thigh, medial leg, and knee joint. Step 2: After a left total knee arthroplasty, this block would result in decreased sensation in the left leg. Step 3: The expected finding is sensation decreased in the left leg. Summary: Option A is correct as it aligns with the expected effect of a femoral peripheral nerve block. Options B, C, and D are incorrect as they do not correlate with the specific nerve distribution affected by the block.
Question 2 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. This is the most appropriate treatment for a 6-year-old child having an asthma attack. Albuterol is a bronchodilator that helps relax the airway muscles, reducing wheezing and improving breathing. Oxygen is necessary to ensure adequate oxygenation during the attack. The combination of albuterol nebulizer and oxygen helps address the underlying bronchoconstriction and hypoxemia. Epinephrine is not the first-line treatment for asthma attacks and may cause adverse effects like increased heart rate. CPAP is not typically used in the acute management of asthma attacks in children. Magnesium sulfate IV infusion is used in severe asthma exacerbations not responding to initial therapy, but it is not the first-line treatment in this scenario.
Question 3 of 5
You are on-scene with a 12-year-old trauma patient who has a large laceration on the inner aspect of his upper right arm with an estimated blood loss of around 15%. The bleeding has now decreased while the patient remains conscious, alert, and anxious. His skin is warm; his heart rate is 96 bpm, and his blood pressure is 108/50. After assessing the child, you believe the patient may be in hypovolemic shock. If so, which stage of shock is the patient most likely experiencing?
Correct Answer: B
Rationale: The correct answer is B: Stage 2. In hypovolemic shock, the body experiences inadequate blood volume due to significant blood loss. In Stage 2, compensatory mechanisms are activated to maintain blood pressure and perfusion to vital organs. The patient's initial anxiety, normal skin temperature, increased heart rate, and slightly decreased blood pressure indicate compensatory responses. Stage 1 (pre-shock) is characterized by increased heart rate with normal blood pressure. Stage 3 involves decreased blood pressure and altered mental status. Stage 4 is the irreversible stage with multi-organ failure. In this case, the patient's vital signs and clinical presentation align with Stage 2, making it the most likely stage of shock the patient is experiencing.
Question 4 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. 1. Tongue biting is a common sign seen in patients experiencing an epileptic seizure due to uncontrolled muscle movements. 2. Swollen gums without obvious trauma could be a result of clenching or grinding of teeth during a seizure. 3. Altered level of consciousness to painful stimuli is consistent with post-ictal state after a seizure. 4. Normal vital signs and reactive pupils suggest a non-metabolic cause. Summary: A: Diabetic seizure is less likely as the patient's vital signs are normal. B: Metabolic coma is less likely due to the absence of metabolic abnormalities. D: Cerebrovascular accident is less likely as there are no focal neurological deficits present.
Question 5 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: The correct answer is D because in this scenario, the patient is hypotensive (BP 87/50) and tachycardic (HR 130) likely due to hypovolemic shock from blood loss. The goal is to maintain perfusion to vital organs by increasing the blood pressure. Administering fluid to keep the BP at or near 90 systolic is the best initial intervention as it helps restore intravascular volume. Option A (2 liters of fluid) may be excessive without reassessment, potentially leading to fluid overload. Option B (norepinephrine drip) is more appropriate for refractory shock. Option C (dopamine drip) is not the first-line treatment for hypovolemic shock. Thus, option D is the best choice to address the patient's condition effectively.