ATI RN
Chapter 70 Care of Patients with Breast Disorders Practice Questions Questions
Question 1 of 5
You are on-scene assisting another crew with a childbirth call that quickly turned into a neonatal resuscitation. The newborn does not have a palpable brachial pulse, but muffled heart tones and the monitor confirm a sluggish heart rate of 55 beats per minute. After reassessing him after a few minutes of high-quality chest compressions and effective ventilations with 100% oxygen concentration, the patient's heart rate fails to respond. Which of the following would be considered a class IIa intervention for this patient?
Correct Answer: A
Rationale: The correct answer is A: 0.1 mg/mL of a 1:10,000 concentration of epinephrine delivered via the intraosseous route. In neonatal resuscitation, when chest compressions and ventilation do not improve the heart rate, administering epinephrine is crucial. In this scenario, the intraosseous route is preferred due to the difficulty in obtaining IV access in neonates. Intraosseous administration provides rapid access to the circulatory system, ensuring timely delivery of medication. Choice B is incorrect because intramuscular administration may lead to delayed absorption and inconsistent drug levels. Choice C is incorrect as endotracheal administration of epinephrine is less effective and associated with higher doses needed. Choice D is incorrect as intravenous access may be challenging in neonates and intraosseous route is preferred for rapid drug delivery.
Question 2 of 5
During a detailed physical exam of your dyspneic 73-year-old female patient, you palpate small pockets of air in the subcutaneous tissue of the skin in the upper right region of her chest, just below her clavicle. Which of the following medical conditions is most likely to cause this abnormal finding?
Correct Answer: B
Rationale: The correct answer is B: Spontaneous pneumothorax. In this scenario, the presence of small pockets of air in the subcutaneous tissue of the chest indicates air escaping from the lung into the chest cavity, leading to pneumothorax. Spontaneous pneumothorax commonly presents with sudden chest pain and dyspnea, more prevalent in older individuals, like the patient described. Bacterial pneumonia (A) typically presents with fever, productive cough, and consolidation on lung auscultation. Dry pleurisy (C) refers to inflammation of the pleura without significant fluid accumulation, unlikely to cause subcutaneous emphysema. Chronic obstructive pulmonary disease (D) is characterized by progressive airflow limitation and is not directly associated with subcutaneous emphysema.
Question 3 of 5
Your adult respiratory insufficiency patient's respirations are shallow and irregular at six times per minute. His SpO2 is 76 mm Hg, and you suspect carbon dioxide retention due to the decreased respiratory effort. Which of the following should you suspect?
Correct Answer: B
Rationale: The correct answer is B: Respiratory acidosis. In this scenario, the patient's shallow and irregular respirations indicate hypoventilation, leading to carbon dioxide retention and decreased pH levels, causing respiratory acidosis. The low SpO2 level further supports inadequate oxygen exchange. Choices A, C, and D are incorrect as they do not align with the hypoventilation and CO2 retention observed in the patient. Option A (Respiratory alkalosis) would be characterized by increased respiratory rate and low CO2 levels. Option C (Metabolic acidosis) involves non-respiratory causes like kidney dysfunction. Option D (Metabolic alkalosis) results from excessive loss of acids like vomiting.
Question 4 of 5
Epinephrine is effective in helping reverse the adverse effects of anaphylaxis. It is the drug of choice because it causes bronchodilation and vasoconstriction to improve respiratory effort and improve blood pressure. What other effect does epinephrine have on the patient's body during an anaphylactic reaction?
Correct Answer: A
Rationale: The correct answer is A: It reduces the release of chemical mediators from the mast cells. Epinephrine acts on adrenergic receptors to inhibit mast cell degranulation, reducing the release of histamine and other inflammatory mediators that contribute to anaphylaxis. This helps to prevent further systemic allergic reactions and stabilize the patient. Choice B is incorrect because while epinephrine does help reduce the overall inflammatory response by stabilizing mast cells, it is not the primary mechanism of action. Choice C is incorrect as epinephrine primarily causes an increase in heart rate through its positive inotropic and chronotropic effects on the heart, rather than peripheral vasoconstriction. Choice D is incorrect as while epinephrine does cause vasoconstriction, it is mainly focused on improving blood pressure and systemic vascular resistance rather than reducing itching.
Question 5 of 5
Helmeted motorcyclist struck broadside, unconscious, blood pressure 140/90, heart rate 90 bpm, GCS 6. Immobilization includes all EXCEPT:
Correct Answer: A
Rationale: The correct answer is A: "Air splints." Air splints are not typically used in the immobilization of a patient with suspected spinal cord injury. The rationale behind this is that air splints do not provide adequate support and stabilization for potential spinal injuries. On the other hand, choices B, C, and D are commonly used in spinal immobilization. "Bolstering devices" help maintain proper alignment of the spine. "A long spine board" is used to safely transfer the patient while keeping the spine in a neutral position. "A scoop-style stretcher" allows for easy and gentle transfer of the patient onto a backboard without compromising spinal alignment. In summary, the use of air splints is not recommended for spinal immobilization due to inadequate support, while bolstering devices, a long spine board, and a scoop-style stretcher are appropriate tools for immobilizing a patient with suspected spinal cord injury.