ATI LPN
Perioperative Nursing Care Questions Questions
Question 1 of 5
A 68-year-old patient has been in the intensive care unit for 4 days and has a nursing diagnosis of disturbed sensory perception related to sleep deprivation. Which action should the nurse include in the plan of care?
Correct Answer: B
Rationale: Choice B as clustering nursing activities minimizes sleep disruption, addressing the root cause of disturbed sensory perception due to sleep deprivation. Sedatives or opioids (choice A) may reduce REM sleep, worsening perception issues, and are not ideal for long-term sleep promotion in critical care. Silencing alarms (choice C) compromises patient safety by risking undetected emergencies, while eliminating assessments (choice D) neglects monitoring needs. Clustering allows rest periods without sacrificing vigilance, aligning with psychosocial integrity principles in the NCLEX framework. This approach balances patient comfort and safety, reflecting evidence-based care that preserves sleep cycles critical for cognitive function in ICU settings.
Question 2 of 5
When caring for the patient with a pulmonary artery (PA) pressure catheter, the nurse observes that the PA waveform indicates that the catheter is in the wedged position. Which action should the nurse take next?
Correct Answer: D
Rationale: Choice D as a wedged catheter risks pulmonary infarction, requiring balloon deflation and repositioning by a provider. Zeroing (choice A) or flushing (choice B) doesn't unwedge, and notifying (choice C) follows correction. This aligns with NCLEX physiological integrity, prioritizing circulation safety in ICU.
Question 3 of 5
After change-of-shift report on a ventilator weaning unit, which patient should the nurse assess first?
Correct Answer: D
Rationale: Choice D as no urine output post-extubation suggests renal or cardiac issues, requiring urgent assessment. Rest mode (choice A), PETCOâ‚‚ (choice B), and normal ScvOâ‚‚ (choice C) indicate stability. This prioritizes safe care per NCLEX, addressing potential decompensation in critical care.
Question 4 of 5
A patient who is to have no weight bearing on the left leg is learning to walk using crutches. Which observation by the nurse indicates that the patient can safely ambulate independently?
Correct Answer: B
Rationale: Choice B as advancing crutches with the injured leg, then the unaffected leg, is the correct three-point gait for non-weight bearing. Same-side movement (choice A), furniture use (choice C), or axillary pressure (choice D) indicate errors. This aligns with NCLEX Safe and Effective Care Environment, ensuring safe mobility post-injury.
Question 5 of 5
A high school teacher with ulnar drift caused by rheumatoid arthritis (RA) is scheduled for a left hand arthroplasty. Which patient statement to the nurse indicates a realistic expectation for the surgery?
Correct Answer: C
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.