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 calculate the drip rate for an IV infusion, you need to use the formula: (Volume to be infused in mL) x (Drop factor of the tubing) / (Time in minutes). In this case, the volume to be infused is 500 mL, the drop factor is 60 gtt/mL (for micro-drip tubing), and the time is 1 minute. Therefore, (500 mL) x (60 gtt/mL) / (1 minute) = 30 gtts/min. This drip rate will effectively deliver the ordered dose of lidocaine at 3 mg/min. Choice A: 15 gtts/min is incorrect because it would deliver half of the ordered dose. Choice C: 60 gtts/min is incorrect because it would deliver double the ordered dose. Choice D: 45 gtts/min is incorrect because it does not match the calculated value for the required dose of 30 gt
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 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 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 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 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. 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.
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 passing a tube through the nose into the stomach. A fracture of the cribiform plate, located in the skull near the nose, can lead to serious complications like cerebrospinal fluid leakage and infection if the nasogastric tube punctures it. Choices A, B, and C are incorrect because although they are serious conditions, they are not direct contraindications to nasogastric intubation.