ATI RN
Basics of Patient Care Questions
Question 1 of 5
You arrive on-scene of a seizure call to find a 22-year-old patient actively seizing. Family on scene reports the patient has an epileptic seizure disorder that sometimes causes seizures that last a minute or two. Today, the seizure has lasted for longer than fifteen minutes prior to your arrival without a break in the tonic-clonic phase. Your attempts to gain IV access are restricted due to the ongoing seizure activity. Which of the following is the drug of choice for intramuscular injection to control the prolonged seizure in this situation?
Correct Answer: C
Rationale: The correct answer is C: Lorazepam. Lorazepam is a benzodiazepine that acts quickly to terminate seizures. In this scenario, where the seizure has lasted longer than fifteen minutes without stopping, it is considered status epilepticus and requires immediate treatment. Lorazepam can be given intramuscularly when IV access is not readily available. Thiamine (A) is used for alcohol-related seizures, not prolonged seizures. 50 percent dextrose (B) is for hypoglycemia-related seizures. Etomidate (D) is a general anesthetic, not used for seizure termination.
Question 2 of 5
After intubating your apneic patient, what tube placement confirmation means should be assessed first?
Correct Answer: B
Rationale: The correct answer is B: Attach capnography to determine the presence of ventilatory waveform. Capnography provides immediate feedback on the effectiveness of ventilation, crucial in assessing tube placement. First, confirm if CO2 waveform is present, indicating proper tube placement in the trachea. If waveform absent, reposition tube. Auscultation (Choice A) may not accurately confirm tracheal intubation. End-tidal CO2 detector (Choice C) is efficient but not the first step. Auscultating over the epigastric region (Choice D) is inappropriate for confirming tube placement.
Question 3 of 5
A young man sustains a rifle wound to the mid-abdomen. The next, most appropriate step is to perform:
Correct Answer: A
Rationale: The correct answer is A: a laparotomy. In trauma cases like this, immediate exploration of the abdomen via laparotomy is crucial to assess and control internal bleeding and injuries. It allows for direct visualization and repair of damaged structures, which is essential in life-threatening situations. Abdominal CT-scan (B) may provide detailed imaging but can delay necessary surgical intervention. Diagnostic laparoscopy (C) may not be suitable for unstable patients with significant trauma. Abdominal ultrasonography (D) may not provide sufficient information in cases of penetrating abdominal trauma.
Question 4 of 5
All of the following signs on the chest x-ray of a blunt injury victim may suggest aortic rupture EXCEPT:
Correct Answer: A
Rationale: The correct answer is A: Mediastinal emphysema. Aortic rupture typically presents with signs like presence of a "pleural cap," obliteration of the aortic knob, and deviation of the trachea to the right. Mediastinal emphysema is not a specific sign of aortic rupture but rather indicates air in the mediastinum, often seen in esophageal rupture or pneumomediastinum. Therefore, in the context of a blunt trauma victim, the presence of mediastinal emphysema is less suggestive of aortic rupture compared to the other signs listed.
Question 5 of 5
A young man sustains a gunshot wound to the abdomen and is brought promptly to the ED by prehospital personnel. His skin is cool and diaphoretic, and he is confuse His pulse is thready and his femoral pulse is only weakly palpable. The definitive treatment in managing this patient is to
Correct Answer: C
Rationale: The correct answer is C: Control internal hemorrhage operatively. In this scenario of a young man with a gunshot wound to the abdomen presenting with cool, diaphoretic skin, confusion, thready pulse, and weak femoral pulse, these are signs of hemorrhagic shock. The definitive treatment for hemorrhagic shock is to control internal bleeding through operative intervention. This is crucial to prevent further blood loss and stabilize the patient's condition. Applying external warming devices (B) or pneumatic anti-shock garment (D) would not address the underlying issue of internal bleeding. Administering blood (A) is important but not the definitive treatment for hemorrhagic shock.