ATI LPN
Perioperative Nursing Care NCLEX Questions Questions
Question 1 of 5
A patient who involved in a workplace accident suffered a penetrating wound of the chest that led to acute respiratory failure. What goal of treatment should the care team prioritize when planning this patients care?
Correct Answer: B
Rationale: Acute respiratory failure (ARF) from a penetrating chest wound likely causing pneumothorax or hemothorax disrupts ventilation and oxygenation, making restoration of adequate gas exchange the care team's priority. This goal addresses the underlying pathophysiology: air or blood in the pleural space collapses the lung, impairing oxygen uptake and CO2 elimination. Immediate interventions (e.g., chest tube, oxygen) aim to re-expand the lung and stabilize ABGs, preventing hypoxia and hypercapnia, which are life-threatening. Long-term intubation may result but isn't the initial focus resolving the cause often avoids it. Coping and self-management are secondary, relevant post-stabilization, as survival hinges on gas exchange. The nurse's role in monitoring respiratory status and supporting interventions (e.g., thoracostomy) aligns with this urgent, evidence-based priority in trauma-induced ARF.
Question 2 of 5
A nurse is preparing to perform an admission assessment on a patient with COPD. It is most important for the nurse to review which of the following?
Correct Answer: D
Rationale: For a COPD admission assessment, reviewing available diagnostic tests is most important, providing objective data on disease severity and guiding care. Tests like spirometry (e.g., FEV1), chest X-rays, or ABGs reveal obstruction extent, hyperinflation, or hypoxemia, informing oxygen needs, medication adjustments, or exacerbation triggers (e.g., infection). Social work assessment aids discharge planning but lacks immediate clinical priority. Insurance coverage is administrative, not affecting initial assessment. Chloride levels relate to cystic fibrosis sweat tests, not COPD's airflow limitation. The nurse's review of diagnostics e.g., a low FEV1 indicating severe obstruction ensures a tailored plan, aligning with evidence-based COPD management to address acute and chronic needs effectively.
Question 3 of 5
A nurse is admitting a new patient who has been admitted with a diagnosis of COPD exacerbation. How can the nurse best help the patient achieve the goal of maintaining effective oxygenation?
Correct Answer: A
Rationale: In a COPD exacerbation, teaching diaphragmatic breathing best helps maintain effective oxygenation by retraining the patient's inefficient, shallow pattern. This technique abdomen expands on inhale, contracts on exhale lowers respiratory rate, boosts alveolar ventilation, and reduces air trapping from hyperinflation, improving O2 uptake. Supplementary oxygen via face mask corrects hypoxemia but doesn't address breathing mechanics, risking CO2 retention if unmonitored. Airway suctioning clears secretions, irrelevant in COPD unless pneumonia complicates it. Exercise programs aid long-term fitness but are impractical acutely due to dyspnea. The nurse's instruction hands-on, practiced optimizes oxygenation naturally, per COPD rehabilitation, empowering the patient during and post-exacerbation.
Question 4 of 5
The nurse is caring for a preoperative patient. The nurse teaches the principles and demonstrates leg exercises for the patient. The patient is unable to perform leg exercises correctly. What is the nurse's best next step?
Correct Answer: A
Rationale: If a patient can't perform leg exercises correctly despite clear teaching, the nurse should assess for anxiety, pain, or fatigue barriers to learning. Anxiety about surgery may distract, pain may limit movement, and fatigue may sap energy, all common preoperatively. Asking 'why' risks defensiveness and assumes unwillingness, not inability. Delaying practice misses the urgency of preoperative preparation. Reassessing teaching methods is secondary; the issue likely isn't the method but the patient's state. This assessment identifies reversible obstacles, enabling tailored support like pain relief or relaxation techniques to ensure mastery, critical for preventing postoperative clots per safety standards.
Question 5 of 5
The nurse has administered an anxiolytic as a preoperative medication to the patient going to surgery. Which of the following is the best next step?
Correct Answer: C
Rationale: After an anxiolytic, instructing the patient to call for help to use the restroom prevents falls from sedation-induced drowsiness or unsteadiness, a key safety step. Consent should precede medication, as sedation impairs judgment asking now is invalid. Wasting unused meds follows policy but isn't urgent. Notifying the operating suite may occur, but patient safety trumps communication timing. The nurse's instruction raising side rails, placing call light near ensures immediate protection, aligning with preoperative care to mitigate risks from altered consciousness.