ATI RN
Basic Care of Patient Questions
Question 1 of 5
You are called to a scene for a 48-year-old male presenting with sudden onset of severe shortness of breath, tachypnea, and a rapid pulse. He is alert and oriented, and physical exam reveals a swollen right calf with tenderness. Which condition is most likely causing his symptoms?
Correct Answer: B
Rationale: The correct answer is B: Pulmonary embolism. In this case, the patient has sudden onset of severe shortness of breath, tachypnea, a rapid pulse, and a swollen right calf with tenderness, which are classic signs of a pulmonary embolism. A pulmonary embolism occurs when a blood clot travels to the lungs, blocking blood flow and causing respiratory distress. The presentation of symptoms in this patient aligns with a pulmonary embolism rather than the other choices. Acute myocardial infarction typically presents with chest pain, not primarily shortness of breath. Tension pneumothorax presents with asymmetrical chest rise, tracheal deviation, and absent breath sounds. Severe asthma attack typically presents with wheezing and prolonged expiratory phase.
Question 2 of 5
You are preparing to perform transcutaneous pacing to your symptomatic bradycardia patient after atropine fails to improve his condition and vital signs. What energy setting should be used initially in an attempt to gain electrical capture in a conscious patient?
Correct Answer: D
Rationale: The correct answer is D: 80 joules. When performing transcutaneous pacing in a conscious patient, it is essential to start with a higher energy setting to ensure electrical capture. Starting with the highest or minimum setting may not provide adequate energy to capture the myocardium. 80 joules is a commonly recommended starting energy level for transcutaneous pacing in conscious patients, as it provides a good chance of achieving capture without causing excessive discomfort or harm. 50 joules may not be sufficient to capture the myocardium effectively. Therefore, the initial energy setting of 80 joules is the most appropriate choice in this scenario.
Question 3 of 5
You are treating and transporting a 26-year-old female involved in an MVA. She has multiple injuries, but all associated hemorrhage is controlled. The patient is exhibiting signs and symptoms of hypovolemic shock. During treatment and transport, you infuse one liter of lactated Ringer's solution, and the patient remains hypotensive. Once at the hospital, which of the following is most likely to be administered immediately upon arrival?
Correct Answer: B
Rationale: The correct answer is B: O-negative packed red blood cells. In hypovolemic shock, the primary issue is a significant loss of red blood cells leading to decreased oxygen-carrying capacity and subsequent hypotension. Packed red blood cells contain a concentrated amount of red blood cells, which can help improve the patient's oxygenation status and hemodynamic stability more effectively than whole blood or other blood products. O-negative blood is used to avoid potential reactions due to ABO incompatibility. Administering packed red blood cells upon arrival at the hospital is crucial to rapidly address the underlying cause of hypovolemic shock. Choices A, C, and D are incorrect because whole blood or packed red blood cells without plasma may not provide the necessary oxygen-carrying capacity to address the patient's condition effectively. Additionally, using O-positive blood products for a female patient can lead to potentially harmful reactions due to ABO incompatibility.
Question 4 of 5
For EMS professionals to determine death in the pre-hospital environment, which of the following criteria must be met by the paramedic?
Correct Answer: A
Rationale: The correct answer is A: No electrical activity in the heart as confirmed by an EKG tracing indicating asystole. This is the most accurate criteria for determining death in the pre-hospital environment as it indicates complete cessation of cardiac activity. Asystole on an EKG is a definitive sign of cardiac arrest and irreversible death. Choice B is incorrect because apnea with a gag reflex does not confirm death. A gag reflex may still be present even in a deceased individual. Choice C is incorrect because lividity and skin condition are not definitive indicators of death and can be influenced by other factors. Choice D is incorrect because pinpoint pupils and decreased muscle tone are not exclusive to death and can be present in other medical conditions.
Question 5 of 5
Which of the following physical findings suggest a cause of hypotension other than spinal cord injury?
Correct Answer: D
Rationale: The correct answer is D: Presence of deep tendon reflexes. This finding indicates intact neurological function and rules out spinal cord injury as the cause of hypotension. Spinal cord injury typically results in loss of deep tendon reflexes. Prispism (choice A) is a painful erection, which is not directly related to hypotension. Bradycardia (choice B) indicates a slow heart rate but does not specifically suggest a cause of hypotension. Diaphragmatic breathing (choice C) is a breathing pattern that may occur in various conditions but does not directly point to a specific cause of hypotension.