ATI LPN
NCLEX Practice Questions on Perioperative Care Questions
Question 1 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 2 of 5
A nurse is completing a focused respiratory assessment of a child with asthma. What assessment finding is most closely associated with the characteristic signs and symptoms of asthma?
Correct Answer: C
Rationale: Bilateral wheezes are the assessment finding most closely tied to asthma's characteristic symptoms cough, dyspnea, and wheezing reflecting airflow obstruction from bronchospasm, inflammation, and mucus. Wheezing, a high-pitched sound on expiration (and sometimes inspiration), arises as air squeezes through narrowed airways, a hallmark audible in both lungs during an attack. Shallow respirations occur but aren't specific, lacking the obstructive quality of wheezes. Increased A-P diameter (barrel chest) develops in chronic COPD, not typically in pediatric asthma unless severe and longstanding. Bradypnea, slow breathing, contradicts asthma's tachypnea from air hunger. The nurse's detection of bilateral wheezes confirmed by auscultation guides acute management (e.g., bronchodilators), aligning with asthma's reversible, inflammatory pathophysiology in this child.
Question 3 of 5
A nurses assessment reveals that a client with COPD may be experiencing bronchospasm. What assessment finding would suggest that the patient is experiencing bronchospasm?
Correct Answer: B
Rationale: Bronchospasm in COPD, a sudden airway narrowing from smooth muscle contraction, is suggested by wheezes or diminished breath sounds on auscultation. Wheezing a high-pitched sound from turbulent airflow through constricted passages is classic, while diminished sounds reflect reduced air entry, both audible in acute exacerbation. Crackles (fine or coarse) indicate fluid or mucus, typical in pneumonia or heart failure, not bronchospasm's dry obstruction. Reduced respiratory rate or lethargy suggests severe hypoxia or fatigue, not specific to bronchospasm COPD patients often show tachypnea. Slow, deliberate respirations may be compensatory but aren't diagnostic. The nurse's detection of wheezes or diminished sounds confirmed by stethoscope prompts bronchodilator use, aligning with COPD exacerbation management to reverse this reversible component.
Question 4 of 5
The nurse is caring for a patient who is scheduled to undergo a surgical procedure. The nurse is completing an assessment and reviews the patient's laboratory tests and allergies. In which perioperative nursing phase would this work be completed?
Correct Answer: B
Rationale: Reviewing laboratory tests and allergies occurs in the preoperative phase, before surgery begins, to establish a baseline and identify risks like drug reactions or abnormal clotting. This preparation ensures the surgical team can tailor anesthesia and interventions, reducing complications. Perioperative spans all phases pre, intra, and post but isn't specific to this task. Intraoperative care happens during surgery in the operating suite, focusing on the procedure, not initial assessments. Postoperative care, in settings like the PACU, monitors recovery, not pre-surgery data. By completing this in the preoperative phase, the nurse mitigates physiological risks, such as bleeding from unrecognized coagulopathy or anaphylaxis from allergens, aligning with safety protocols to optimize surgical success and patient stability throughout the process.
Question 5 of 5
The nurse is caring for a postoperative patient with an abdominal incision. A pillow is used during coughing to provide
Correct Answer: B
Rationale: A pillow during coughing splints the abdominal incision, supporting it to reduce strain on sutures and tissues cut through surgery. Coughing stresses the incision, risking dehiscence or pain from nerve irritation; splinting with a pillow or hands minimizes this pull, enhancing comfort and safety. It doesn't directly relieve pain analgesics do nor distract, as focus remains on coughing. Anxiety may lessen indirectly via comfort, but splinting's primary role is mechanical support. The nurse's use of this technique ensures effective airway clearance without compromising the incision, aligning with postoperative care to prevent complications like wound disruption.