ATI LPN
Good Multiple Choice Question About Perioperative Care Questions
Question 1 of 5
A client presents to the walk-in clinic complaining of a dry, irritating cough and production of a minute amount of mucus-like sputum. The patient complains of soreness in her chest in the sternal area. The nurse should suspect that the primary care provider will assess the patient for what health problem?
Correct Answer: C
Rationale: A dry, irritating cough with scant mucoid sputum and sternal soreness suggest tracheobronchitis, an inflammation of the trachea and bronchi often from viral infection or irritation. The cough's dry nature and minimal sputum reflect early airway inflammation, while sternal pain arises from repetitive coughing straining chest muscles. Pleural effusion typically causes dyspnea and pleuritic pain, not dry cough or sternal soreness, as fluid muffles cough reflex. Pulmonary embolism presents with sudden dyspnea, chest pain, and possibly hemoptysis, not a chronic dry cough. Tuberculosis features hemoptysis, night sweats, and weight loss, not minimal sputum or sternal pain alone. The nurse's suspicion of tracheobronchitis guides the provider to assess for fever, malaise, or recent respiratory exposure, ensuring appropriate management like rest or antivirals, distinct from more severe differentials.
Question 2 of 5
A patient arrives in the emergency department with an attack of acute bronchiectasis. Chest auscultation reveals the presence of copious secretions. What intervention should the nurse prioritize in this patients care?
Correct Answer: C
Rationale: In acute bronchiectasis with copious secretions, postural chest drainage is the priority intervention, leveraging gravity to mobilize thick mucus from dilated bronchi, reducing obstruction and infection risk. This technique positioning the patient to drain specific lung segments (e.g., head-down for lower lobes) alleviates dyspnea and prevents atelectasis, a cornerstone of bronchiectasis management. Diuretics treat fluid overload, irrelevant to airway secretions. IV fluids may hydrate but don't directly thin bronchial mucus oral hydration or mucolytics are more apt. Pulmonary function testing assesses obstruction but doesn't clear secretions, delaying symptom relief. The nurse's focus on postural drainage, often paired with percussion, addresses the acute crisis's root mucus retention enhancing ventilation and supporting recovery in this chronic condition's exacerbation.
Question 3 of 5
An admitting nurse is assessing a patient with COPD. The nurse auscultates diminished breath sounds, which signify changes in the airway. These changes indicate to the nurse to monitor the patient for what?
Correct Answer: B
Rationale: Diminished breath sounds in COPD, from airway narrowing or hyperinflation (e.g., emphysema), signal reduced ventilation, prompting the nurse to monitor for dyspnea and hypoxemia. Air trapping and obstruction lower air entry, audible as faint sounds, risking oxygen desaturation (hypoxemia) and shortness of breath (dyspnea) core COPD features. Kyphosis (spinal curvature) and clubbing (finger deformity) occur in advanced stages but aren't immediate concerns from diminished sounds. Sepsis and pneumothorax are complications, not direct sequelae of this finding sepsis needs systemic signs, pneumothorax absent sounds on one side. Bradypnea (slow breathing) contradicts COPD's tachypnea; pursed-lip breathing is a coping strategy, not a risk. Monitoring dyspnea and hypoxemia via symptoms and oximetry guides timely intervention (e.g., oxygen), per COPD care standards.
Question 4 of 5
The nurse is precepting a student nurse and explains that perioperative nursing care occurs
Correct Answer: A
Rationale: Perioperative nursing care encompasses the full surgical experience before, during, and after surgery ensuring comprehensive patient support across all phases. Preadmission testing, part of the preoperative phase, involves assessments like lab reviews but doesn't cover the entire perioperative scope. Care during the surgical procedure, or intraoperative phase, focuses on the operation itself, while the postanesthesia care unit (PACU) represents the postoperative phase, aiding recovery. Each of these is a segment of perioperative care, but only 'before, during, and after surgery' captures the complete definition. This holistic approach reduces risks like infection or complications by integrating preparation, intervention, and recovery. The nurse's explanation to the student highlights this broad responsibility, emphasizing continuity from preoperative education to postoperative monitoring, aligning with standards to optimize patient outcomes and safety throughout the surgical journey.
Question 5 of 5
Which nursing assessment would indicate that the patient is performing diaphragmatic breathing correctly?
Correct Answer: A
Rationale: Correct diaphragmatic breathing is confirmed when hands on the rib cage borders touch as the chest wall contracts during exhalation. This reflects the diaphragm's upward movement, pushing air out, while inhalation separates fingers as the diaphragm descends, expanding the abdomen. Chest wall hand placement showing separation on contraction suggests shallow breathing, not diaphragmatic. Feeling upward diaphragm movement during inspiration or downward during expiration reverses normal mechanics diaphragm moves down to inhale, up to exhale. This tactile feedback, taught by the nurse, ensures deep, effective breaths, preventing atelectasis by maximizing lung expansion, a key postoperative recovery skill.