ATI RN
Provide Basic Patient Care Following Direction of Nursing Staff Questions
Question 1 of 5
You are ordered to administer 3 mg/min of lidocaine via intravenous infusion to your cardiac patient who presents with a heart rate greater than 130 beats per minute as well as greater than 10 multifocal PVCs every minute. Therefore, you quickly but carefully mix 2 grams of the medication in 500 mL of normal saline and attach micro-drip tubing to the solution bag. Which of the following drip rates would effectively deliver the ordered dose of lidocaine?
Correct Answer: B
Rationale: The correct answer is B: 30 gtts/min. To determine the drip rate, we need to calculate the following: 1. Calculate the total volume to be infused per minute: 3 mg/min = 3000 mcg/min (1 mg = 1000 mcg) 2. Calculate the concentration of lidocaine in the solution: 2 grams in 500 mL = 4 mg/mL 3. Calculate the total volume of lidocaine in one minute: 3000 mcg/min ÷ 4 mg/mL = 750 mL/min 4. Calculate the drip rate: 750 mL/min x 60 gtts/mL (for micro-drip tubing) = 45000 gtts/min 5. Finally, divide the total drip rate by the drop factor of the micro-drip tubing (60 gtts/mL): 45000 gtts/min ÷ 1500 gtts/mL = 30 gtts/min. Therefore, the correct answer is
Question 2 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 3 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 4 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.
Question 5 of 5
Contraindication to nasogastric intubation?
Correct Answer: D
Rationale: The correct answer is D, "Fracture of the cribiform plate." Nasogastric intubation involves inserting a tube through the nose into the stomach. A fracture of the cribiform plate, which is part of the skull separating the nasal cavity from the brain, can lead to serious complications such as penetrating injury to the brain or leakage of cerebrospinal fluid. This can result in infections or other severe issues. A: "Gastric perforation" is a possible complication of nasogastric intubation but not a contraindication. B: "Diaphragmatic rupture" is not a direct contraindication to nasogastric intubation. C: "Open depressed skull fracture" is a serious condition but not a direct contraindication to nasogastric intubation.