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 indicated for severe hypoglycemia when the patient is unable to take oral glucose and IV access is unavailable. Administering glucagon intramuscularly will rapidly increase blood sugar levels. Oral glucose (choice B) is not suitable for a patient who cannot follow commands. Dextrose intravenously (choice C) requires IV access, which is not available in this case. Glucagon subcutaneously (choice D) may have delayed absorption compared to intramuscular administration.
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 (>120 ms) suggest delayed ventricular depolarization, which can be caused by bundle branch blocks. In the context of a post-myocardial infarction patient, this is a common finding due to damage to the conduction system. Summary: B: A complete heart block is characterized by a lack of communication between the atria and ventricles, leading to a different EKG pattern. C: Wide QRS complexes do not directly indicate a current myocardial infarction; other EKG changes would be seen. D: Wide QRS complexes are not typically associated with congenital heart defects in this scenario, and emergency care may still be necessary.
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 suitable choice for sedating this pediatric patient for rapid sequence intubation due to its unique properties. Ketamine provides sedation, analgesia, and amnesia without causing respiratory depression, making it ideal for patients with borderline hypotension and hypoventilation. It also maintains airway reflexes and airway tone, which is crucial during intubation. Succinylcholine (A) is a paralytic agent, not a sedative. Midazolam (B) and Propofol (D) can cause respiratory depression and hypotension, which may worsen the patient's condition.
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 of epinephrine for an allergic reaction is intramuscular (IM). This is because IM injection allows for rapid absorption and onset of action, making it effective in treating allergic reactions. Subcutaneous (A) may be slower in onset and less reliable for immediate relief. Intravenous (C) administration is reserved for severe cases where immediate effects are needed. Endotracheal (D) route is not recommended for epinephrine administration due to potential complications and lack of reliability. Therefore, option B is the most appropriate initial route for administering epinephrine in a moderate allergic reaction.
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: The correct answer is B: Ischemia. Deep symmetrically inverted T waves on an ECG are indicative of myocardial ischemia, where the heart muscle is not receiving enough oxygen-rich blood. This can lead to reversible changes in the ECG tracing. Ischemia is a common cause of T wave changes in patients with a cardiac history, suggesting ongoing heart strain. Necrosis (choice A) would typically present with pathological Q waves on ECG, not T wave inversions. Hyperkalemia (choice C) may cause peaked T waves, not symmetrically inverted ones. Hypokalemia (choice D) can lead to flattened or U-shaped T waves, not deep symmetric inversions.