ATI RN
Basic Principles of Long-Term Patient Care Developing a Therapeutic Community Questions
Question 1 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 (collapsed lung), and promote oxygenation. By utilizing diaphragmatic breathing, the nurse aims to prevent respiratory complications postoperatively. Managing pain (A) can be addressed through other interventions. While improving oxygenation may indirectly contribute to reducing healing time (C), the main goal is to prevent respiratory complications. Decreasing thrombus formation (D) is not directly related to diaphragmatic breathing.
Question 2 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 because pericardial tamponade can lead to jugular vein distension due to the increased pressure in the pericardium, which can impede blood flow back to the heart. Hemorrhagic shock, on the other hand, does not typically cause jugular vein distension. This difference in jugular vein distension is a key clinical finding to differentiate between the two conditions. Choice B is incorrect because cyanosis to the face, neck, and upper chest can be present in both pericardial tamponade and hemorrhagic shock, making it less specific for distinguishing between the two. Choice C is incorrect because pericardial tamponade can also lead to hypotension due to decreased cardiac output, while hemorrhagic shock can sometimes lead to compensatory hypertension in its early stages. Choice D is incorrect because the type of tachycardia (narrow vs. wide complex) is not a reliable or consistent finding to
Question 3 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 answer is A: Deliver adequate artificial ventilation after ensuring a definitive airway. In this scenario, the newborn is bradycardic, cyanotic, and lethargic, indicating possible respiratory distress. The initial intervention should focus on improving oxygenation and ventilation. Providing adequate artificial ventilation after ensuring a definitive airway will help increase oxygen delivery to the newborn's tissues, which can improve the heart rate and overall condition. Epinephrine and vasopressors are not the first-line interventions for bradycardia in a neonate. Fast and hard chest compressions are not recommended as the first step in managing bradycardia in a newborn.
Question 4 of 5
While conducting an EKG on your post-myocardial infarction patient, you note the presence of consistently wide QRS complexes greater than 120 ms in duration. What does this most likely indicate?
Correct Answer: A
Rationale: The correct answer is A: An intraventricular conduction delay or right/left bundle branch block. Wide QRS complexes (>120 ms) indicate a delay in ventricular depolarization, typically due to conduction abnormalities like bundle branch blocks. In the context of a post-myocardial infarction patient, this finding is common and suggests a conduction issue rather than an acute infarction (choice C). Complete heart block (choice B) would show dissociation between atria and ventricles, not wider QRS complexes. Choice D is incorrect as wide QRS complexes in a post-MI patient require further evaluation and potential intervention.
Question 5 of 5
You are on-scene with an apneic adult who collapsed one to two minutes prior to your arrival, according to bystanders. Which of the following endotracheal tube size ranges would be most appropriate for an average adult respiratory arrest patient who shows no signs of airway trauma or obstruction?
Correct Answer: C
Rationale: The correct answer is C: 7.5-8.5 ET tube. For an adult with no signs of airway trauma or obstruction who is in respiratory arrest, this size range is appropriate. Here's the rationale: 1. Adult size: The range is suitable for an average adult. 2. Apneic adult: The patient is not breathing, requiring intubation for airway management. 3. Timeframe: With a recent collapse, the airway is likely still patent, so a smaller tube is sufficient. 4. No trauma or obstruction: There are no indications for a larger tube. Other choices are incorrect: A: 6.5-8.5 ET tube - This is too broad, and a specific size range is more appropriate. B: 9.0-10.0 ET tube - Larger sizes are not necessary if there are no airway issues. D: 4.5-6.5 ET tube - This size is too small