ATI LPN
NCLEX Questions Perioperative Care Questions
Question 1 of 5
A patient has been brought to the ED by the paramedics. The patient is suspected of having ARDS. What intervention should the nurse first anticipate?
Correct Answer: A
Rationale: Acute Respiratory Distress Syndrome (ARDS) is a life-threatening condition marked by severe hypoxemia and diffuse lung injury, often requiring immediate airway and ventilatory support. The nurse should first anticipate preparing for intubation because ARDS patients typically progress to respiratory failure, necessitating mechanical ventilation to maintain oxygenation and ventilation when lung compliance drops. Oxygen at 5 L/minute via nasal cannula is insufficient for the profound hypoxemia of ARDS, which often requires high-flow oxygen or positive pressure ventilation. Deep suctioning addresses secretions but not the underlying oxygenation failure, and while corticosteroids may be considered later for inflammation, they are not the initial priority. Intubation ensures a secure airway and allows for precise ventilatory management, critical in ARDS where rapid deterioration is common, aligning with emergency protocols to stabilize the patient.
Question 2 of 5
The home care nurse is monitoring a patient discharged home after resolution of a pulmonary embolus. For what potential complication would the home care nurse be most closely monitoring this patient?
Correct Answer: D
Rationale: After pulmonary embolus (PE) resolution, the home care nurse prioritizes monitoring for residual effects of compromised oxygenation, such as fatigue, cognitive deficits, or exertional dyspnea, stemming from prolonged hypoxia during the acute phase. PE obstructs pulmonary arteries, impairing gas exchange, and even post-treatment, lung tissue recovery may lag, leaving subtle deficits. Pulmonary infection isn't a direct PE sequela unless secondary pneumonia develops, which isn't indicated. Swallowing issues or aspiration aren't linked to PE unless unrelated comorbidities exist. Activity level and role performance matter but are secondary to oxygenation status, which underpins functional capacity. Close monitoring via pulse oximetry, symptom reports, or exertion tolerance ensures the nurse detects lingering hypoxia effects, guiding rehabilitation or oxygen therapy to optimize recovery.
Question 3 of 5
A student nurse is developing a teaching plan for an adult patient with asthma. Which teaching point should have the highest priority in the plan of care that the student is developing?
Correct Answer: C
Rationale: For an adult with asthma, the highest priority teaching point is taking prescribed medications as scheduled, ensuring control of airway inflammation and bronchospasm. Inhaled corticosteroids (e.g., budesonide) and long-acting bronchodilators prevent exacerbations by maintaining baseline lung function, while rescue inhalers (e.g., albuterol) address acute symptoms adherence is critical, as non-compliance drives 60% of asthma hospitalizations. Increasing exertion gradually aids fitness but risks triggering attacks if uncontrolled. Changing filters reduces allergens (e.g., dust), a secondary environmental step. Avoiding goose-down pillows minimizes feather triggers, but this is less impactful than medication. The student nurse's focus on adherence detailing timing, technique (e.g., spacer), and side effects empowers the patient to prevent attacks, aligning with asthma action plans and long-term management success.
Question 4 of 5
A nurse is caring for a patient who has been admitted with an exacerbation of chronic bronchiectasis. The nurse should expect to assess the patient for which of the following clinical manifestations?
Correct Answer: A
Rationale: In a bronchiectasis exacerbation, copious sputum production is a primary clinical manifestation the nurse should expect, stemming from chronic bronchial dilation trapping purulent mucus. This hallmark often foul-smelling, voluminous (e.g., >30 mL/day) reflects recurrent infection and inflammation, driving symptoms like cough and dyspnea. Pain on inspiration suggests pleurisy or pneumothorax, not bronchiectasis's airway focus. Pigeon chest, a congenital deformity, isn't linked to this acquired condition. Dry cough contradicts bronchiectasis's wet, productive nature from mucus retention. The nurse's assessment quantifying sputum, noting color (e.g., green) informs care (e.g., drainage, antibiotics), aligning with bronchiectasis's pathophysiology and exacerbation management.
Question 5 of 5
An asthma nurse educator is working with a group of adolescent asthma patients. What intervention is most likely to prevent asthma exacerbations among these patients?
Correct Answer: B
Rationale: Preventing asthma exacerbations in adolescents hinges on educating them to recognize and avoid triggers e.g., allergens (pollen, pets), irritants (smoke), or exercise reducing inflammation and bronchospasm risk. This proactive strategy, central to asthma action plans (e.g., GINA), empowers teens to modify environments (e.g., using air filters) and preempt attacks, cutting hospital visits by up to 50%. Corticosteroids aren't rescue drugs albuterol is; inhaled steroids are maintenance, not acute. Alternative therapies (e.g., acupuncture) lack robust evidence for asthma control, secondary to standard care. Immunizations prevent infections like flu, which may trigger asthma, but aren't the primary prevention tool. The educator's focus on trigger education interactive, teen-friendly builds self-management skills, key for this age group's independence and long-term asthma control.