ATI LPN
Good Multiple Choice Question About Perioperative Care Questions
Question 1 of 5
A gerontologic nurse is teaching a group of medical nurses about the high incidence and mortality of pneumonia in older adults. What is a contributing factor to this that the nurse should describe?
Correct Answer: C
Rationale: Older adults' high pneumonia incidence and mortality partly stem from atypical presentations, lacking classic signs like cough, fever, or chest pain, which delays diagnosis. Aging alters immune responses and symptom expression e.g., confusion or lethargy may predominate over respiratory complaints complicating timely treatment, especially in frail or comorbid patients. Lung compliance decreases with age, but this structural change doesn't directly obscure symptoms. Older adults are prime candidates for pneumococcal vaccination (e.g., PPSV23), recommended at 65+, countering higher risk, not excluding them. Antibiotic tolerance varies individually, not universally limiting treatment. The nurse's focus on absent classic signs educates staff to suspect pneumonia in subtle presentations (e.g., falls, delirium), prompting earlier diagnostics (e.g., chest X-ray) and intervention, critical for reducing mortality in this vulnerable group.
Question 2 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 3 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 4 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.
Question 5 of 5
The nurse has completed a preoperative assessment for a patient going to surgery and gathers assessment data. Of the following, which would be the most important next step?
Correct Answer: A
Rationale: Notifying the operating suite of a latex allergy is most important, as latex is pervasive in surgical settings (gloves, tubes), and exposure risks anaphylaxis, requiring immediate room preparation with latex-free supplies. This preempts delays or emergencies, prioritizing safety. Documenting a bath, obtaining vital signs, or giving antibiotics are routine but secondary latex reaction prevention is urgent due to its acute, life-threatening potential. The nurse's action ensures a safe environment, aligning with allergy management protocols to protect the patient throughout surgery.