ATI RN
Basic Principles of Patient Care Questions
Question 1 of 5
Your adult patient sustained a right index finger amputation at work. On arrival, first responders have the bleeding controlled with sterile dressings, and the patient is conscious, alert, and oriented. What is the best way to manage the patient's amputated finger during transport to the hospital?
Correct Answer: B
Rationale: The correct answer is B: Wrap the finger in gauze (moistened with normal saline), and seal the finger in a plastic bag before placing it on ice. This method helps preserve the amputated part by keeping it moist and cool, which can improve the chances of successful reattachment. Here's a step-by-step rationale: 1. Moistening the gauze with normal saline helps prevent the tissue from drying out, maintaining its viability. 2. Sealing the finger in a plastic bag helps protect it from contamination and further damage during transport. 3. Placing the sealed finger on ice helps keep it cool, which slows down metabolic processes and reduces tissue damage. 4. Avoiding direct contact of the finger with ice prevents frostbite and tissue damage from extreme cold. In summary, option B is the best choice as it optimally preserves the amputated finger for potential reattachment. Option A does not maintain moisture, leading to tissue damage. Option C's use of water
Question 2 of 5
Which of the following would be an early sign of a possible aortic dissection?
Correct Answer: C
Rationale: Step-by-step rationale for answer C: An early sign of a possible aortic dissection is a blood pressure difference of 20 mmHg or more in the upper extremities due to impaired blood flow. This discrepancy occurs because the dissection can obstruct blood flow to one of the brachial arteries, leading to a difference in blood pressure readings between the arms. This sign is a result of the aortic dissection affecting the arterial blood supply to the upper extremities. Summary of incorrect choices: A: A narrowing pulse pressure and tachycardia - These symptoms are more commonly associated with conditions like shock or dehydration, not specifically indicative of aortic dissection. B: A sudden rise in systolic blood pressure and fall in diastolic blood pressure - While changes in blood pressure can occur in aortic dissection, the specific pattern described here is not a typical early sign. D: A reddish-blue discoloration of the skin above the shoulders - Skin discolor
Question 3 of 5
You are evaluating a trauma patient who may have sustained a spinal cord injury. Which of the following would you expect to see in a trauma patient with a spinal cord injury with autonomic nervous system involvement?
Correct Answer: A
Rationale: The correct answer is A because autonomic nervous system involvement in a spinal cord injury often results in bradycardia, hypotension, and a loss of sweating or shivering ability. This is due to disruption of sympathetic and parasympathetic pathways. Choice B is incorrect because hypertension and warm, dry skin are not typical signs of autonomic involvement in spinal cord injury. Choice C is incorrect because tachycardia and hypertension are more commonly seen with sympathetic overactivity, not autonomic involvement in spinal cord injury. Choice D is incorrect because tachycardia, hypotension, diaphoresis, and cool, clammy skin are more indicative of shock rather than specific autonomic involvement in spinal cord injury.
Question 4 of 5
Several minutes after sealing your adult trauma patient's sucking chest wound with an occlusive dressing secured on three sides, he begins to experience increasing shortness of breath, jugular vein distension, decreasing unilateral breath sounds on the affected side, and his blood pressure is less than 90 systolic and falling. Repeated attempts to relieve the pressure at the occlusive dressing have proven ineffective. At this point, which of the following should be initiated?
Correct Answer: D
Rationale: The correct answer is D: Immediate needle decompression using a 10- or 14-gauge catheter that is at least 2 or 2.5 inches long. Rationale: 1. Needle decompression is the standard treatment for tension pneumothorax, a life-threatening condition causing respiratory distress. 2. The patient's symptoms (shortness of breath, jugular vein distension, decreased breath sounds, falling blood pressure) are indicative of tension pneumothorax. 3. Repeated attempts to relieve pressure at the occlusive dressing have failed, suggesting a need for more definitive intervention. 4. A longer catheter (2-2.5 inches) is recommended to ensure proper decompression. Summary: A: Removing the occlusive dressing and pulling the wound open could worsen the tension pneumothorax by allowing more air into the chest. B: Translaryngeal Jet Ventilation is not indicated for tension pneumothorax and may delay appropriate treatment
Question 5 of 5
A 30-year-old man sustains a severely comminuted, open, distal right femur fracture. Immediate efforts should involve:
Correct Answer: B
Rationale: The correct immediate effort for a severely comminuted, open, distal right femur fracture in a 30-year-old man is to tamponade the wound with a pressure dressing (Choice B). This helps control bleeding and prevent further contamination. Immediate angiography (Choice A) is not necessary as controlling bleeding and stabilizing the patient is the priority. Wound exploration and removal of bony fragments (Choice C) should be done after initial stabilization to prevent further damage. Realignment of the fracture segments with a traction splint (Choice D) should also be done after initial wound management to avoid exacerbating the injury.