ATI LPN
NCLEX Practice Questions on Perioperative Care Questions
Question 1 of 5
A circulating nurse notes the surgeon dons gown and gloves using appropriate sterile procedure but then folds hands together below hips. What action by the nurse is best?
Correct Answer: B
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
Question 2 of 5
A postoperative client has respiratory depression after receiving midazolam (Versed) for sedation. Which action by the nurse is most appropriate?
Correct Answer: A
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
Question 3 of 5
An X-ray of a trauma patient reveals rib fractures and the patient is diagnosed with a small flail chest injury. Which intervention should the nurse include in the patients plan of care?
Correct Answer: A
Rationale: A small flail chest injury, where a segment of ribs is fractured in multiple places, disrupts chest wall stability but, if minor, is managed supportively. Suctioning airway secretions is critical because pain from rib movement discourages coughing, leading to mucus retention and potential atelectasis or pneumonia. This intervention clears the airway, supports ventilation, and prevents complications, aligning with the goal of maintaining respiratory function. Immobilizing ribs with a binder restricts breathing, worsening oxygenation, and is contraindicated. Surgery is rare and reserved for severe cases with large flail segments or internal damage. Immediate sedation and intubation are unnecessary for a small injury unless respiratory failure ensues, which isn't indicated here. The nurse's focus on secretion clearance via suctioning, alongside pain control and breathing exercises, optimizes recovery in this trauma patient.
Question 4 of 5
A hospital has been the site of an increased incidence of hospital-acquired pneumonia (HAP). What is an important measure for the prevention of HAP?
Correct Answer: B
Rationale: Preventing hospital-acquired pneumonia (HAP), a nosocomial infection occurring 48+ hours post-admission, relies on targeting vulnerable populations, making pneumococcal vaccination a key measure. This vaccine protects against Streptococcus pneumoniae, a leading HAP cause, reducing incidence in older adults or those with chronic illnesses, as supported by CDC guidelines for adults over 65 or with comorbidities. Prophylactic antibiotics aren't standard due to resistance risks and lack of evidence for broad prevention. Routine culture swabs on admission identify pathogens but don't prevent infection, serving more for treatment guidance. Antiretrovirals address HIV, not bacterial pneumonia, and aren't indicated here. Vaccination strengthens immunity in at-risk patients (e.g., elderly, immunocompromised), decreasing HAP rates, hospitalizations, and mortality, aligning with infection control priorities in healthcare settings.
Question 5 of 5
A patient in the ICU is status post embolectomy after a pulmonary embolus. What assessment parameter does the nurse monitor most closely on a patient who is postoperative following an embolectomy?
Correct Answer: D
Rationale: Post-embolectomy for pulmonary embolus (PE), the nurse most closely monitors pulmonary arterial pressure (PAP) via a pulmonary artery catheter, as it directly reflects the procedure's success in relieving pulmonary vascular obstruction. Elevated PAP pre-surgery indicates blockage; post-surgery, a decrease signals clot removal efficacy, while persistent elevation suggests residual emboli or reperfusion issues, guiding further intervention (e.g., thrombolytics). Pupillary response assesses neurological status, irrelevant unless cerebral hypoxia occurred. Vena cava pressure isn't routinely monitored and lacks specificity for PE outcomes. White blood cell differential tracks infection or inflammation, not acute hemodynamic status. PAP monitoring, alongside urinary output for perfusion, equips the nurse to detect complications (e.g., re-embolization), ensuring optimal postoperative management in this critical ICU patient.