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. The patient's presentation indicates a drop in blood pressure due to the supine position, leading to decreased blood flow returning to the heart, causing dizziness, weakness, and nausea. This is common in late pregnancy due to the enlarged uterus compressing the vena cava. Choice A, uterine rupture, is unlikely as there are no signs of acute abdominal pain or bleeding. Choice B, spontaneous abortion, is unlikely as there is no vaginal bleeding. Choice D, placenta previa, is less likely as there is no vaginal bleeding or abdominal pain associated with this condition. Therefore, the most likely cause of the patient's presentation is supine hypotension.
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. Shock is a state of inadequate tissue perfusion and oxygen delivery. Increased systemic vascular resistance would actually contribute to worsening shock by impeding blood flow to tissues. Choice A is related to oxygen delivery, which is a cause of shock. Choice B, decreased systemic vascular resistance, would lead to inadequate tissue perfusion, contributing to shock. Choice D, inadequate cardiac output, is a common cause of shock as it results in decreased blood flow to tissues.
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 pattern is associated with structural lesions in the medullary respiratory center, leading to irregular, cluster-type breathing. Ataxic breathing is characterized by unpredictable, uncoordinated breaths with irregular pauses. A: Agonal respiratory pattern is seen in severe conditions like cardiac arrest, not specific to medullary lesions. B: Cheyne-Stokes respiratory pattern is characterized by cyclic crescendo-decrescendo breathing and is related to brainstem dysfunction, not medullary lesions. C: Biot's respiratory pattern is marked by irregular breathing with clusters of breaths followed by apnea, but it is typically associated with increased intracranial pressure or central nervous system issues, not medullary lesions.
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 escaping into the subcutaneous tissues, causing a crackling sensation ("pop or vanish") upon palpation. The sudden-onset chest pain and dyspnea, along with jugular vein distension and cool, clammy skin, suggest a potential underlying condition such as pneumothorax or severe lung disease that leads to subcutaneous emphysema. Atelectasis (B) is incomplete expansion or collapse of the lung, typically not associated with palpable air pockets. Pitting edema (C) is caused by fluid accumulation in the tissues, not air. Ascites (D) is accumulation of fluid in the peritoneal cavity, unrelated to the findings described.
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. ST segment elevation in patients with a right bundle branch block can be misleading as it can mimic ST elevation seen in myocardial infarction. This is due to the altered electrical conduction pathway caused by the block. Evaluating ST segment elevation in such cases may lead to a false diagnosis of infarction. Summary: - B: Evaluating ST segment elevation in a hypotensive patient is important as it can indicate the severity of the myocardial infarction. - C: In the presence of pulmonary edema, evaluating ST segment elevation is crucial to assess the extent of myocardial damage. - D: Similar to a right bundle branch block, a left bundle branch block can also lead to abnormal ST segment changes, making it necessary to evaluate for myocardial infarction.