ATI RN
Basic Principles of Patient Care Questions
Question 1 of 5
Which of the following would be an early sign of a possible aortic dissection?
Correct Answer: C
Rationale: Rationale for Correct Answer (C): An early sign of a possible aortic dissection is a blood pressure difference of 20 mmHg or more in the upper extremities. This is due to the unequal blood pressure distribution resulting from the dissection affecting the aorta. The pressure gradient occurs because the false lumen of the aorta created by the dissection leads to different blood pressures in the upper extremities. Monitoring blood pressure in both arms helps detect this discrepancy. Summary of Incorrect Choices: A: A narrowing pulse pressure and tachycardia - Not specific to aortic dissection. B: A sudden rise in systolic blood pressure and fall in diastolic blood pressure - More commonly seen in aortic rupture than dissection. D: A reddish-blue discoloration of the skin above the shoulders - Typically associated with different conditions and not a characteristic sign of aortic dissection.
Question 2 of 5
Several minutes after sealing your adult trauma patient's sucking chest wound with an occlusive dressing secured on three sides, he begins to experience increasing shortness of breath, jugular vein distension, decreasing unilateral breath sounds on the affected side, and his blood pressure is less than 90 systolic and falling. Repeated attempts to relieve the pressure at the occlusive dressing have proven ineffective. At this point, which of the following should be initiated?
Correct Answer: D
Rationale: The correct answer is D: Immediate needle decompression using a 10- or 14-gauge catheter that is at least 2 or 2.5 inches long. Rationale: 1. Symptoms indicate tension pneumothorax, a life-threatening condition where air accumulates in the pleural space, causing pressure on the heart and lungs. 2. Needle decompression is the immediate intervention for tension pneumothorax to release trapped air and relieve pressure. 3. A longer catheter is needed to ensure successful decompression. 4. Translaryngeal Jet Ventilation (Choice B) is not recommended as it does not address the underlying issue of trapped air. 5. Endotracheal intubation (Choice C) may delay definitive treatment and worsen the patient's condition. 6. Removing the occlusive dressing (Choice A) without proper decompression can further exacerbate tension pneumothorax. Summary: Immediate needle decompression is crucial to treat tension pneumoth
Question 3 of 5
A 30-year-old man sustains a severely comminuted, open, distal right femur fracture. Immediate efforts should involve:
Correct Answer: B
Rationale: Correct Answer: B (Tamponade of the wound with a pressure dressing) Rationale: 1. Tamponade prevents further bleeding and reduces the risk of hypovolemic shock. 2. Pressure dressing helps control bleeding and reduces the risk of infection. 3. Stabilizing the wound is crucial before further intervention. 4. Angiography, wound exploration, and realignment are not immediate priorities.
Question 4 of 5
In managing the head-injury patient which is the most initial step:
Correct Answer: A
Rationale: The correct initial step in managing a head-injury patient is to secure the airway (Choice A). This is crucial for ensuring adequate oxygenation and ventilation. Without a patent airway, the patient may suffer from hypoxia, leading to further brain injury. Obtaining c-spine film (Choice B) is important but not the most immediate concern. Supporting circulation (Choice C) is vital but comes after ensuring airway patency. Controlling scalp hemorrhage (Choice D) is also important but does not take precedence over securing the airway in the initial management of a head-injury patient.
Question 5 of 5
A 34-year-old man is brought to the ED after being pinned to the wall of a building by a cement truck. He is in obvious shock, and has deformities and marked swelling of both thighs. Although no open wounds are present, his shock:
Correct Answer: C
Rationale: Step 1: The scenario describes a man pinned by a cement truck with deformities and swelling in both thighs, indicating significant trauma. Step 2: The absence of open wounds suggests internal bleeding as the cause of shock. Step 3: Bilateral femoral fractures can lead to significant blood loss, resulting in shock. Step 4: Therefore, the shock is consistent with blood loss from bilateral femoral fractures, making choice C the correct answer. Step 5: The other choices are incorrect because shock in this case is more likely due to internal bleeding rather than pelvic fracture (A), fixed percentage blood loss (B), or traction splints (D).