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. In this scenario, the patient is experiencing status epilepticus, a medical emergency where seizures persist without recovery between them. Lorazepam is the drug of choice for intramuscular injection to control prolonged seizures due to its rapid onset of action and efficacy in terminating seizures. It acts by enhancing the inhibitory effects of gamma-aminobutyric acid (GABA) in the brain, thereby suppressing seizure activity. Thiamine (A) is used to prevent or treat thiamine deficiency, not for seizure control. D50 (B) is used in hypoglycemic emergencies, not for seizures. Etomidate (D) is a general anesthetic, not indicated for seizure management.
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. This is the first tube placement confirmation to assess because it provides immediate feedback on proper endotracheal tube placement by showing a waveform indicating exhaled CO2. This confirms the tube is in the trachea and not the esophagus. Auscultating lung fields (A) only confirms air entry but not tube placement. An end-tidal CO2 detector (C) provides immediate confirmation like capnography but does not show the waveform for visualization. Auscultating over the epigastric region (D) is not a reliable method 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. This is the most appropriate step because a rifle wound to the mid-abdomen is a high-energy injury that can cause significant internal damage, such as bowel perforation or major blood vessel injury. A laparotomy allows for direct visualization of internal organs, identification, and repair of any injuries, and control of bleeding. An abdominal CT-scan (B) may delay necessary surgical intervention, while diagnostic laparoscopy (C) may not provide adequate access for effective treatment of severe injuries. Abdominal ultrasonography (D) is not typically indicated in the acute trauma setting for assessing internal abdominal injuries.
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. In aortic rupture, air can leak into the mediastinum causing mediastinal emphysema. This suggests aortic injury. Choices B, C, and D are actually signs of aortic rupture. A "pleural cap" is seen in aortic rupture due to hemorrhage dissecting into the pleura. Obliteration of the aortic knob occurs due to aortic injury, and tracheal deviation to the right can occur due to a large hematoma pushing the trachea.
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, the young man's presentation suggests hypovolemic shock due to internal bleeding. Prompt surgical intervention to control the source of bleeding is crucial to stabilize the patient's condition. Administering blood (Choice A) may be necessary but addressing the hemorrhage source is the priority. External warming devices (Choice B) and pneumatic anti-shock garments (Choice D) are not appropriate in this situation as the primary concern is controlling the internal bleeding to prevent further deterioration.