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: Correct Answer: B Rationale: 1. Wrapping the finger in moistened gauze helps maintain tissue hydration and minimizes desiccation. 2. Sealing the finger in a plastic bag prevents contamination and keeps the amputated part secure. 3. Placing the finger on ice helps preserve the amputated part by reducing metabolic activity and delaying tissue death. 4. Moistened gauze with normal saline is preferred over dry gauze to prevent further tissue damage. Summary: A: Incorrect - Not wrapping the finger increases the risk of contamination and desiccation. C: Incorrect - Rinsing the finger can further damage the tissues and is unnecessary. D: Incorrect - Placing the finger close to the patient's core does not provide adequate preservation as ice does.
Question 2 of 5
Which of the following would be an early sign of a possible aortic dissection?
Correct Answer: C
Rationale: Rationale for Correct Answer (C): An early sign of a possible aortic dissection is a blood pressure difference of 20 mmHg or more in the upper extremities. This is due to the unequal blood pressure distribution resulting from the dissection affecting the aorta. The pressure gradient occurs because the false lumen of the aorta created by the dissection leads to different blood pressures in the upper extremities. Monitoring blood pressure in both arms helps detect this discrepancy. Summary of Incorrect Choices: A: A narrowing pulse pressure and tachycardia - Not specific to aortic dissection. B: A sudden rise in systolic blood pressure and fall in diastolic blood pressure - More commonly seen in aortic rupture than dissection. D: A reddish-blue discoloration of the skin above the shoulders - Typically associated with different conditions and not a characteristic sign of aortic dissection.
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. In spinal cord injury with autonomic nervous system involvement, there is disruption of sympathetic and parasympathetic control. This leads to bradycardia due to loss of sympathetic tone, hypotension due to disrupted baroreceptor reflexes, and loss of sweating or shivering ability due to impaired temperature regulation. Choice B is incorrect because hypertension and warm, dry skin are more indicative of sympathetic overactivity, not autonomic dysfunction. Numbness of fingertips is not a typical feature of autonomic involvement. Choice C is incorrect as tachycardia and hypertension are more suggestive of sympathetic overactivity, and one-sided paralysis and amnesia are not specific to autonomic dysfunction. Choice D is incorrect as tachycardia and diaphoresis suggest sympathetic overactivity, while cool and clammy skin is more indicative of hypovolemia rather than autonomic dysfunction.
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. Symptoms indicate tension pneumothorax, a life-threatening condition where air accumulates in the pleural space, causing pressure on the heart and lungs. 2. Needle decompression is the immediate intervention for tension pneumothorax to release trapped air and relieve pressure. 3. A longer catheter is needed to ensure successful decompression. 4. Translaryngeal Jet Ventilation (Choice B) is not recommended as it does not address the underlying issue of trapped air. 5. Endotracheal intubation (Choice C) may delay definitive treatment and worsen the patient's condition. 6. Removing the occlusive dressing (Choice A) without proper decompression can further exacerbate tension pneumothorax. Summary: Immediate needle decompression is crucial to treat tension pneumoth
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: Correct Answer: B (Tamponade of the wound with a pressure dressing) Rationale: 1. Tamponade prevents further bleeding and reduces the risk of hypovolemic shock. 2. Pressure dressing helps control bleeding and reduces the risk of infection. 3. Stabilizing the wound is crucial before further intervention. 4. Angiography, wound exploration, and realignment are not immediate priorities.