ATI RN
Basic Care of Dying Patient Questions
Question 1 of 5
The nurse is caring for a postoperative patient who has had a minimally invasive carpel tunnel repair. The patient has a temperature of 97° F and is shivering. Which reason will the nurse most likely consider as the primary cause when planning care?
Correct Answer: A
Rationale: The correct answer is A: Anesthesia lowers metabolism. Anesthesia can cause hypothermia by decreasing the body's ability to regulate temperature, leading to shivering as a compensatory mechanism. Shivering helps increase heat production. Choices B, C, and D are incorrect as they do not directly relate to the primary cause of the patient's shivering in this context. Choice B is irrelevant as it does not address the physiological reason for the shivering. Choice C is not the primary cause as wearing a gown alone would not lead to shivering. Choice D is incorrect as it refers to a large open body cavity, which is not relevant in a minimally invasive carpal tunnel repair.
Question 2 of 5
You are transporting a 20-year-old pregnant female from a local hospital to a medical facility that specializes in high-risk pregnancies when you note the patient is experiencing unexplained hypotension and bradycardia. The patient has a patent IV and is being administered magnesium that was initiated by hospital staff. On the cardiac monitor, the patient presents with a lengthening PR interval and signs of an impending high-degree nodal block. Which of the following interventions would be most appropriate in this case?
Correct Answer: B
Rationale: The correct answer is B: Stop the magnesium sulfate infusion immediately, and administer the appropriate dose of calcium chloride to correct the adverse effects of magnesium toxicity. Rationale: 1. **Stop magnesium infusion**: Magnesium toxicity can cause hypotension, bradycardia, and high-degree nodal block, hence stopping the infusion is crucial. 2. **Administer calcium chloride**: Calcium is the antidote for magnesium toxicity as it competes with magnesium for binding sites, reversing its effects. 3. **Corrects adverse effects**: Calcium chloride helps in counteracting the negative effects of magnesium on the cardiovascular system. Summary: - **Option A**: Increasing magnesium and giving saline won't address magnesium toxicity. - **Option C**: Potassium won't counteract magnesium toxicity. - **Option D**: Reducing infusion and giving dextrose won't correct magnesium toxicity.
Question 3 of 5
Your adult female postpartum patient delivered her newborn with the assistance of her husband five minutes prior to your arrival on the scene. The infant's Apgar score is 10, and the baby seems to be fine. However, the mother continues to bleed heavily after an adequate fundal massage and encouraging the infant to breastfeed. Her current heart rate is 125 bpm; her blood pressure is 108/60, and she is breathing 22 times a minute with an SpO2 of 97. After ensuring a second infant is not present, which of the following interventions would medical command most likely recommend?
Correct Answer: D
Rationale: The correct answer is D: Administer oxytocin infusion at 20 to 30 gtts/min depending on bleeding severity. Oxytocin is a uterotonic agent that helps control postpartum hemorrhage by causing uterine contractions, which can help stop the bleeding. In this scenario, the mother is experiencing postpartum hemorrhage despite initial interventions. Administering oxytocin can help control the bleeding and prevent further complications. Choice A is incorrect because packing the vagina with pads is not the recommended first-line treatment for postpartum hemorrhage. Choice B is incorrect because administering lactated Ringer's solution under pressure is not the appropriate intervention for postpartum hemorrhage. Choice C is incorrect because Trendelenburg position is not recommended for managing postpartum hemorrhage and can potentially worsen the situation by increasing blood flow to the head.
Question 4 of 5
Which of the following patients best fits the criteria for a critical burn?
Correct Answer: A
Rationale: The correct answer is A because a critical burn is determined by the percentage of total body surface area (TBSA) affected. In this case, a 10-year-old patient with superficial burns over 60% of the body meets the criteria for a critical burn due to the extensive TBSA involvement. Superficial burns over 60% of the body can lead to significant fluid loss, infection risk, and systemic complications. Choice B is incorrect because full-thickness burns on a specific area of the arm, even if full-thickness, are not as extensive as 60% TBSA involvement. Choice C is incorrect as partial-thickness burns across 25% of the body, not involving critical areas, do not meet the criteria for a critical burn based on TBSA. Choice D is also incorrect as partial-thickness burns on 25% of the body, not involving critical areas, do not meet the criteria for a critical burn based on TBSA.
Question 5 of 5
What is the name of the legal document in which an individual specifies what medical treatments should and should not be done for him in the event he is unable to make his own medical care decisions?
Correct Answer: C
Rationale: The correct answer is C: An advanced directive. An advanced directive is a legal document that allows an individual to specify their medical treatment preferences in case they are unable to make decisions. It includes instructions on the use of life-sustaining treatments. A: A do not resuscitate order (DNR) specifically addresses whether or not to perform cardiopulmonary resuscitation in case of cardiac arrest, but it does not cover overall medical treatment preferences. B: A will is a legal document that specifies how a person's assets and properties should be distributed after their death, not their medical treatment preferences. D: A personal directive is a general term that may refer to various legal documents but does not specifically address medical treatment preferences.