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 with signs of hemorrhagic shock, such as tachycardia, hypotension, and cool skin. The primary goal of pre-hospital intervention is to stabilize the patient's hemodynamic status by restoring intravascular volume. The target systolic blood pressure range of 80-90 is appropriate for this situation to ensure adequate tissue perfusion without exacerbating bleeding. Choice B (maintaining a blood pressure of at least 100 systolic) may be too aggressive and risk further bleeding. Choice C (pharmacologic intervention) is not the initial priority in this acute situation. Choice D (maintaining high blood oxygen saturation) is important but not the primary goal; fluid resuscitation takes precedence in hemorrhagic shock to improve perfusion.
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 four patients, the situation is likely to be complex and require multiple resources. Requesting additional help ensures that there are enough personnel and equipment on scene to effectively manage the situation and provide prompt care to all patients. This step is crucial for the safety and well-being of the patients and the responders. Summary of other choices: A: Calling medical control is important, but in this scenario, immediate action on scene is necessary before informing medical control. C: Starting immediate triage and treatment is important, but given the severity of the situation, additional resources are needed before focusing solely on the two ejected patients. D: Notifying the local trauma center is important, but the immediate priority is to ensure that all patients receive timely and appropriate care on scene before transferring them to a higher level of care.
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 constriction of coronary arteries, leading to decreased blood flow to the heart muscle. This constriction can increase the chance of dislodging a thrombus or plaque, ultimately causing an acute myocardial infarction. Choice A is incorrect as speeding the heart rate to the point of asystole is unlikely with cocaine use. Choice B is incorrect as cocaine-induced clotting in the periphery does not directly lead to clots traveling to the coronary arteries. Choice C is incorrect as cocaine does not numb the heart but rather affects coronary perfusion negatively.
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 stopper tubes are used for blood samples to test for alcohol levels, such as for blood alcohol content (BAC). This is because gray stopper tubes contain sodium fluoride, which prevents blood from fermenting and preserves alcohol levels accurately. Other choices are incorrect: B (light blue) is used for coagulation testing, C (lavender) is used for complete blood count (CBC) and blood typing, and D (green) is used for chemistry tests.
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. The patient is presenting with symptoms indicative of unstable ventricular tachycardia or ventricular fibrillation, which are life-threatening arrhythmias. Defibrillation is the immediate intervention to restore normal rhythm by delivering an electrical shock to the heart. In this scenario, the patient is hemodynamically unstable with a low blood pressure and loss of consciousness, making defibrillation the most appropriate and effective intervention to potentially save the patient's life. Choice A (Administer procainamide) is not the most effective intervention as this patient is in a critical condition that requires immediate action, and procainamide infusion takes time to work. Choice B (Administer adenosine) is typically used for supraventricular tachycardias and is not appropriate for wide complex tachycardias. Choice D (Administer synchronized electrical cardioversion) is indicated for stable wide complex tachycardias