ATI LPN
Questions on Perioperative Care Questions
Question 1 of 5
A client on the postoperative nursing unit has a blood pressure of 156/98 mm Hg, pulse 140 beats/min, and respirations 24 breaths/min. What action by the nurse is most appropriate?
Correct Answer: B
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
Question 2 of 5
The nurse caring for a patient recently diagnosed with lung disease encourages the patient not to smoke. What is the primary rationale behind this nursing action?
Correct Answer: D
Rationale: Smoking cessation is a cornerstone of lung disease management because it directly damages the ciliary cleansing mechanism, a critical defense of the respiratory tract. Cilia, hair-like structures lining the airways, sweep mucus and trapped particles upward for clearance, but smoking paralyzes and destroys them, leading to mucus accumulation, chronic irritation, and increased infection risk. Contrary to decreasing mucus, smoking stimulates goblet cells to overproduce mucus, exacerbating airway obstruction. Smoke does reduce oxygen-carrying capacity by forming carboxyhemoglobin, but this is secondary to ciliary damage in most lung diseases like COPD. Alveolar distention, not atrophy, occurs in emphysema due to air trapping, and while smoking contributes, the primary harm is ciliary dysfunction. By stopping smoking, the patient can slow disease progression, reduce inflammation, and preserve remaining lung function, making this the nurse's primary rationale.
Question 3 of 5
While planning a patients care, the nurse identifies nursing actions to minimize the patients pleuritic pain. Which intervention should the nurse include in the plan of care?
Correct Answer: A
Rationale: Pleuritic pain, caused by inflamed pleural surfaces rubbing during respiration, intensifies with deep breathing, coughing, or movement, necessitating interventions that minimize these triggers. Avoiding actions that cause deep breathing such as excessive activity or forced respiratory exercises reduces pleural friction, alleviating pain and improving patient comfort, a primary nursing goal. Ambulation thrice daily, while beneficial for circulation, may exacerbate pain by increasing respiratory effort, countering pain management aims. A soft diet and fluids address hydration or swallowing but don't directly relieve pleuritic pain, which is unrelated to nutrition. Limiting speech is unnecessary, as it minimally affects chest movement compared to breathing. By prioritizing rest and shallow breathing, the nurse mitigates pain's impact on recovery, potentially supplementing with analgesics, aligning with holistic care for conditions like pleurisy or pneumothorax.
Question 4 of 5
The nurse is caring for a patient in the ICU admitted with ARDS after exposure to toxic fumes from a hazardous spill at work. The patient has become hypotensive. What is the cause of this complication to the ARDS treatment?
Correct Answer: C
Rationale: In ARDS, hypotension often results from hypovolemia due to capillary leakage, where fluid shifts into interstitial spaces and alveoli, reducing circulating volume. Toxic fume inhalation damages alveolar-capillary membranes, increasing permeability (non-cardiogenic pulmonary edema), a hallmark of ARDS pathophysiology. This fluid loss, compounded by potential positive end-expiratory pressure (PEEP) reducing venous return, lowers blood pressure. Pulmonary hypotension isn't a recognized term; pulmonary hypertension may occur in ARDS from hypoxic vasoconstriction but doesn't directly cause systemic hypotension. High PEEP can decrease cardiac output by compressing thoracic vessels, but increased cardiac output isn't typical. The nurse's understanding of hypovolemia guides fluid resuscitation and vasopressor use, balancing oxygenation (via PEEP) and perfusion, critical in managing ARDS's systemic effects.
Question 5 of 5
A school nurse is caring for a 10-year-old girl who is having an asthma attack. What is the preferred intervention to alleviate this clients airflow obstruction?
Correct Answer: C
Rationale: During an asthma attack, the preferred intervention is an inhaled beta-adrenergic agonist (e.g., albuterol), which rapidly relaxes bronchial smooth muscle, reversing airflow obstruction from bronchospasm, mucus, and inflammation. This short-acting bronchodilator acts within minutes, opening airways and relieving acute dyspnea, aligning with asthma guidelines (e.g., GINA) for exacerbations. Corticosteroids reduce inflammation but take hours, unsuitable for immediate relief. Anticholinergics (e.g., ipratropium) complement beta-agonists in severe cases but aren't first-line alone. Peak flow monitoring assesses obstruction severity, not treating it. The nurse's swift administration via inhaler ensuring proper technique (e.g., spacer use) restores ventilation, critical for this child's acute respiratory crisis, preventing escalation to status asthmaticus.