ATI LPN
Perioperative Care NCLEX Questions Questions
Question 1 of 5
A 54-year-old man has just been diagnosed with small cell lung cancer. The patient asks the nurse why the doctor is not offering surgery as a treatment for his cancer. What fact about lung cancer treatment should inform the nurses response?
Correct Answer: D
Rationale: Small cell lung cancer (SCLC) is rarely treated with surgery because it grows rapidly and metastasizes early and extensively, often presenting with distant spread (e.g., brain, bones) by diagnosis. Unlike non-small cell lung cancer (NSCLC), where surgery suits localized disease, SCLC's aggressive neuroendocrine nature drives early dissemination, rendering resection ineffective as a primary cure. Cell size doesn't limit visualization surgical feasibility hinges on containment, not microscopy. SCLC isn't self-limiting; it's fatal without treatment, progressing quickly, not delaying intervention. Patient stability varies, but surgery's exclusion stems from tumor behavior, not universal frailty. The nurse's response, rooted in SCLC's biology, clarifies why chemotherapy and radiation systemic therapies are standard, aligning with guidelines (e.g., NCCN) and helping the patient understand his treatment plan.
Question 2 of 5
An older adult patient has been diagnosed with COPD. What characteristic of the patients current health status would preclude the safe and effective use of a metered-dose inhaler (MDI)?
Correct Answer: B
Rationale: Severe arthritis in the hands precludes safe, effective metered-dose inhaler (MDI) use in a COPD patient, as it impairs the dexterity needed to press the canister and coordinate inhalation critical for drug delivery to the lungs. Poor technique reduces efficacy of bronchodilators or corticosteroids, worsening dyspnea. Ongoing smoking doesn't affect MDI mechanics, though it harms prognosis. Requiring both corticosteroids and beta2-agonists is common in COPD, manageable with separate or combined MDIs, not precluding use. Cataracts impair vision but not hand function; spacers can aid if technique falters. The nurse's recognition of arthritis prompts alternatives (e.g., nebulizers), ensuring medication delivery despite physical limitations, per COPD device selection principles.
Question 3 of 5
An asthma educator is teaching a patient newly diagnosed with asthma and her family about the use of a peak flow meter. The educator should teach the patient that a peak flow meter measures what value?
Correct Answer: B
Rationale: A peak flow meter measures the highest airflow during a forced expiration, known as peak expiratory flow rate (PEFR), in liters per minute. This handheld device assesses airway obstruction in asthma patients exhale maximally after a deep breath, gauging how fast air exits narrowed passages. Lower readings signal worsening bronchospasm or inflammation, guiding therapy (e.g., rescue inhaler use) via personal best zones (green, yellow, red). Forced inspiration isn't measured inhalation isn't limited in asthma. Normal inspiration or expiration reflects tidal breathing, not obstruction severity. The educator's teaching demonstrating technique (e.g., standing, full effort) ensures the patient tracks lung function daily, aligning with asthma self-monitoring to prevent exacerbations effectively.
Question 4 of 5
The nurse is caring for a postoperative patient on the medical-surgical floor. To prevent venous stasis and the formation of thrombus after general anesthesia, the nurse encourages
Correct Answer: D
Rationale: Leg exercises prevent venous stasis and thrombus formation post-anesthesia by promoting circulation in the lower extremities. General anesthesia slows blood flow, and immobility reduces muscle contractions that pump venous blood, increasing clot risk. Exercises like ankle circles or calf pumps, done regularly, counteract this, reducing deep vein thrombosis odds. Coughing, diaphragmatic breathing, and incentive spirometry target lung expansion, preventing atelectasis, not circulatory stasis. The nurse's focus on leg exercises demonstrated pre- and postoperatively ensures blood flow, aligning with protocols to minimize thromboembolism, a significant postoperative risk.
Question 5 of 5
During preoperative assessment for a 7:30 case, the patient indicates to the nurse that he had a cup of coffee this morning. The nurse reports this information to the anesthesia provider anticipating
Correct Answer: A
Rationale: A cup of coffee before a 7:30 surgery, breaching fasting guidelines (clear liquids 2-3 hours, solids 6-8 hours pre-anesthesia), risks aspiration, so the nurse anticipates a delay or cancellation. This protects airway safety during general or regional anesthesia. Coffee components (e.g., milk) might adjust delay length, but the breach itself triggers action. Asking 'why' or reviewing education, while useful later, isn't immediate. The nurse's report ensures the anesthesia provider adjusts timing e.g., delaying hours if milk was added prioritizing patient safety over proceeding, per fasting protocols.