ATI RN
Provide Basic Patient Care Following Direction of Nursing Staff Questions
Question 1 of 5
You are called to assist a pregnant female in the 24th week gestation period according to her due date. The pale 26-year-old patient is found supine in bed, complaining of dizziness/weakness with extreme nausea. The patient denies vaginal bleeding, amniotic fluid leakage, or abdominal pain. There are no signs of imminent birth or active labor. She reports receiving normal prenatal care with no associated problems found during the pregnancy. Her heart rate is 126-130 beats per minute; her blood pressure is 80 mmHg systolic while her skin is cool and pale. Which of the following conditions is most likely to cause the patient's presentation?
Correct Answer: C
Rationale: The correct answer is C: Supine hypotension. In pregnant women, lying supine can compress the inferior vena cava, reducing venous return and cardiac output, leading to hypotension and symptoms like dizziness, weakness, and nausea. This condition is called supine hypotension syndrome. The patient's symptoms of dizziness and weakness, along with the low blood pressure and cool, pale skin, are indicative of inadequate blood flow due to supine positioning. Choices A, B, and D are incorrect because they do not align with the patient's symptoms and presentation. Uterine rupture, spontaneous abortion, and placenta previa typically present with different signs and symptoms, such as abdominal pain, vaginal bleeding, and fetal distress, which are absent in this case.
Question 2 of 5
Which of the following is not a cause of shock?
Correct Answer: C
Rationale: The correct answer is C: Increased systemic vascular resistance. In shock, the body's response is to decrease vascular resistance to maintain tissue perfusion. Increased resistance would hinder blood flow, worsening oxygen delivery. Choices A, B, and D are causes of shock: A due to inadequate oxygen delivery, B due to decreased blood flow, and D due to insufficient cardiac output. By process of elimination, C is the correct answer as it goes against the body's compensatory mechanisms in shock.
Question 3 of 5
Which abnormal respiratory pattern is associated with structural or compressive lesions in the medullary respiratory center characterized by an irregular, cluster-type respiratory pattern?
Correct Answer: D
Rationale: The correct answer is D: Ataxic respiratory pattern. This abnormal pattern is characterized by irregular, unpredictable breathing with random pauses and clusters of breaths. It is associated with structural lesions in the medullary respiratory center. Agonal pattern (A) is seen in dying patients. Cheyne-Stokes (B) is characterized by periods of deep breathing followed by apnea, seen in conditions like heart failure. Biot's pattern (C) features irregular breathing with varying depth and rate, seen in increased intracranial pressure or brain injury. Therefore, the irregular, cluster-type breathing seen in ataxic pattern best matches the description provided.
Question 4 of 5
You are assessing an adult patient experiencing sudden-onset chest pain and dyspnea. He quickly exhibits jugular vein distension and cool, clammy skin. His trachea is midline, but there are palpable air pockets under the skin on his upper chest on the left side that feel as though they pop or vanish when you palpate them. What is this abnormal finding?
Correct Answer: A
Rationale: The correct answer is A: Subcutaneous emphysema. This finding is indicative of air trapped under the skin, leading to palpable air pockets that pop or vanish upon palpation. This occurs commonly in the context of chest trauma or underlying lung pathology. Jugular vein distension, cool, clammy skin, and chest pain with dyspnea are consistent with a possible pulmonary embolism or tension pneumothorax, both of which can lead to subcutaneous emphysema. Atelectasis (B) is the collapse of alveoli, not associated with palpable air pockets. Pitting edema (C) is fluid accumulation in the tissues, not related to air. Ascites (D) is fluid accumulation in the peritoneal cavity, not presenting as palpable air pockets.
Question 5 of 5
In which of the following situations would evaluating the ST segment elevation of a patient suffering from a suspected myocardial infarction not be indicated to determine if an infarction exists?
Correct Answer: A
Rationale: The correct answer is A: When a pre-existing right bundle branch block is present. Evaluating ST segment elevation is not indicated in this situation because a right bundle branch block can mimic ST elevation on an ECG, making it difficult to accurately determine if an infarction exists. Summary of why other choices are incorrect: B: When the patient is hypotensive - Hypotension does not preclude the evaluation of ST segment elevation in suspected myocardial infarction. C: In the presence of pulmonary edema - Pulmonary edema does not preclude the evaluation of ST segment elevation in suspected myocardial infarction. D: In the presence of a left bundle branch block - Evaluating ST segment elevation is still indicated in the presence of a left bundle branch block because it can still provide valuable information for diagnosing myocardial infarction.