ATI RN
Basic Nursing Care Needs of the Patient PPT Questions
Question 1 of 5
Your adult patient called for help after he began to vomit bright red blood. On arrival, the patient is found to be tachycardic and bleeding freely from his mouth. His respirations are shallow, and his skin is cool with a blood pressure of 68 systolic. His only history involves liver disease from chronic alcoholism. He denies drinking recently. What should be the goal of your pre-hospital intervention with this patient after ensuring his airway and applying oxygen therapy?
Correct Answer: A
Rationale: The correct answer is A: Fluid resuscitation to maintain a systolic blood pressure of 80-90 systolic. In this scenario, the patient is presenting signs of hypovolemic shock due to significant blood loss. The goal of fluid resuscitation is to restore intravascular volume and improve perfusion to vital organs. A systolic blood pressure of 80-90 is a reasonable target to ensure adequate perfusion without causing fluid overload. Choice B is too high of a target for this patient in shock. Choice C is not the immediate priority as controlling the hemorrhage comes first. Choice D is not the primary goal in this critical situation where maintaining blood pressure and perfusion are the priorities.
Question 2 of 5
You are the first ambulance to arrive on the scene of a single-car accident. As you approach the scene, you see four patients, two have been ejected from their vehicle, and two are still in the vehicle. What should be your next course of action?
Correct Answer: B
Rationale: The correct answer is B: Request additional resources, such as fire rescue, and additional ambulances to respond to the scene. This is the best course of action because, in a single-car accident with multiple patients, the scene is likely to be complex and require additional resources to manage effectively. Requesting fire rescue can help with extrication of patients still in the vehicle, while additional ambulances ensure there are enough resources to transport all patients promptly. This approach prioritizes patient care and safety by ensuring all necessary resources are available to manage the situation efficiently. Choice A: Calling medical control is important but should not be the first step in this scenario where immediate action is needed. Choice C: Beginning immediate triage and treatment of the two ejected patients might overlook the need for additional resources and proper scene management. Choice D: Notifying the local trauma center is important but should come after requesting additional resources to manage the scene effectively.
Question 3 of 5
You are on-scene with a patient who you suspect may be experiencing a myocardial infarction. He is conscious and alert, anxious, and has dilated pupils. He complains of substernal chest pain and admits to recent cocaine use. How does the use of cocaine increase the risk of experiencing an acute myocardial infarction?
Correct Answer: D
Rationale: The correct answer is D. Cocaine causes coronary artery constriction, reducing blood flow to the heart muscle. This constriction can lead to the formation of thrombus or plaque in the narrowed arteries, increasing the risk of myocardial infarction. Other choices are incorrect: A is inaccurate as asystole is not a direct effect of cocaine; B is incorrect as cocaine does not cause peripheral clotting to travel to the coronary arteries; C is incorrect as cocaine does not numb the heart, but rather constricts the coronary arteries.
Question 4 of 5
Venous blood samples are often obtained in the pre-hospital setting for various tests to be performed at the hospital. What color tube stopper would a paramedic want to use if law enforcement at an accident requests the patients involved have their blood drawn at the scene to be tested for the possibility of alcohol intoxication at the hospital?
Correct Answer: A
Rationale: The correct answer is A: Gray. Gray tube stoppers are used for collecting blood samples for alcohol testing because they contain sodium fluoride, which preserves the blood sample and inhibits the growth of bacteria. This is crucial for accurate alcohol level measurement. Light blue, lavender, and green tube stoppers are used for different types of blood tests, not specifically for alcohol testing. Light blue is typically used for coagulation tests, lavender for complete blood counts and blood typing, and green for basic metabolic panels. Therefore, the paramedic would want to use a gray tube stopper in this scenario to ensure the accuracy of the alcohol intoxication testing.
Question 5 of 5
You are called to assist a 55-year-old male who complains of sudden onset chest pain, dyspnea, and palpitations. On arrival, he is found semi-conscious with a pulse rate too fast to palpate and a blood pressure of 80 systolic. Once on the monitor, he is exhibiting an irregularly wide complex tachycardia, with a polymorphic QRS appearance, at nearly 200 per minute. Which of the following would be the most effective intervention for this patient?
Correct Answer: C
Rationale: The correct answer is C: Administer defibrillation per protocol. In this scenario, the patient is presenting with signs of unstable ventricular tachycardia or ventricular fibrillation. Defibrillation is the most effective intervention as it delivers a shock to the heart to reset the abnormal rhythm. It is crucial in cases of pulseless ventricular tachycardia or ventricular fibrillation to restore a normal heart rhythm and improve cardiac output. Administering medications like procainamide (choice A) or adenosine (choice B) would not be effective as the patient is in a pulseless state. Synchronized electrical cardioversion (choice D) is typically used for stable tachyarrhythmias, not for pulseless rhythms. Defibrillation is the immediate and appropriate intervention to save the patient's life by restoring normal cardiac function.