ATI RN
Basic Nursing Care Needs of the Patient Questions
Question 1 of 5
Your adult patient has an altered mental status, and a blood sugar reading of 35 mg/dL is obtained using a glucometer. He is unable to follow commands, and no IV access is available. Which medication and route should be considered?
Correct Answer: A
Rationale: The correct answer is A: Glucagon intramuscularly. Glucagon is the preferred treatment for severe hypoglycemia in patients with altered mental status and no IV access. When administered intramuscularly, it quickly raises blood sugar levels by stimulating glycogen breakdown in the liver. Oral glucose (choice B) is not suitable for patients who cannot follow commands. IV dextrose (choice C) requires IV access, which is not available in this scenario. Glucagon should not be given subcutaneously (choice D) as it may have delayed absorption and be less effective in this critical situation.
Question 2 of 5
While conducting an EKG on your post-myocardial infarction patient, you note the presence of consistently wide QRS complexes greater than 120 ms in duration. What does this most likely indicate?
Correct Answer: A
Rationale: The correct answer is A: An intraventricular conduction delay or right/left bundle branch block. Wide QRS complexes greater than 120 ms duration typically indicate an intraventricular conduction delay, such as a bundle branch block. In the context of a post-myocardial infarction patient, this finding is common due to damage to the conduction system. Bundle branch blocks can lead to widened QRS complexes. Summary: B: A complete heart block is incorrect as it would typically present with a different EKG pattern. C: While a myocardial infarction can cause conduction abnormalities, the widened QRS complexes are not indicative of an acute infarction. D: Congenital heart defects are not typically associated with wide QRS complexes in a post-myocardial infarction patient.
Question 3 of 5
You are preparing to initiate a rapid sequence intubation on a pediatric patient who is exhibiting a borderline hypotensive state with a decreased level of consciousness and hypoventilation. He is quickly becoming hypoxic with a SpO2 of 77% and a delayed capillary refill. Which medication would be most effective in sedating this patient for the procedure?
Correct Answer: C
Rationale: The correct answer is C: Ketamine. Ketamine is the most effective choice for sedating this pediatric patient for rapid sequence intubation due to its properties of providing sedation, analgesia, and maintenance of airway reflexes. Its rapid onset and short duration of action make it ideal for this situation. Additionally, ketamine can help maintain the patient's blood pressure and respiratory drive, which is crucial in a borderline hypotensive state with hypoventilation. Succinylcholine (A) is a paralytic agent and does not provide sedation or analgesia, so it would not address the patient's need for sedation. Midazolam (B) and Propofol (D) are sedatives but may cause respiratory depression and hypotension, which could worsen the patient's condition. Therefore, they are not the most appropriate choices in this scenario.
Question 4 of 5
You are ordered to administer 0.3 mL of epinephrine for a moderate allergic reaction. What is the preferred initial route of administration of epinephrine for an allergic reaction?
Correct Answer: B
Rationale: The preferred initial route of administration for epinephrine in an allergic reaction is intramuscular (IM) injection (Choice B) because it ensures rapid absorption and onset of action. Epinephrine acts quickly when injected into the muscle, reaching the bloodstream efficiently to counteract allergic reactions. Subcutaneous (Choice A) administration may lead to slower absorption. Intravenous (Choice C) administration is too invasive and can result in rapid, potentially dangerous effects. Endotracheal (Choice D) administration is not recommended for epinephrine as it is not a standard route and may not provide the desired therapeutic effects.
Question 5 of 5
While evaluating the twelve-lead electrocardiogram tracing of your 66-year-old cardiac history patient for the possibility of an acute myocardial infarction, you note the presence of deep symmetrically inverted T waves. Which of the following is most likely the cause of this abnormal finding?
Correct Answer: B
Rationale: Rationale: Inverted T waves are typically indicative of myocardial ischemia. Ischemia leads to altered repolarization of the ventricles, causing T wave inversions. Necrosis (choice A) would manifest as pathological Q waves rather than T wave inversions. Hyperkalemia (choice C) would cause peaked T waves, not inverted T waves. Hypokalemia (choice D) could lead to U waves or flattened T waves, but not deep symmetric T wave inversions. Therefore, choice B (Ischemia) is the most likely cause based on the presented scenario and ECG findings.