ATI LPN
Perioperative Nursing Care Questions Questions
Question 1 of 5
A postoperative client has a blood pressure of 156/98 mm Hg, pulse 140 beats/min, and respirations 24 breaths/min. What action by the nurse is most appropriate?
Correct Answer: B
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
Question 2 of 5
The nurse is caring for a patient suspected of having ARDS. What is the most likely diagnostic test ordered in the early stages of this disease to differentiate the patients symptoms from those of a cardiac etiology?
Correct Answer: B
Rationale: In early ARDS, distinguishing respiratory failure from cardiac causes like congestive heart failure (CHF) is crucial, and brain natriuretic peptide (BNP) levels are the most likely test ordered. Elevated BNP, secreted by the heart under strain, indicates cardiac etiology (e.g., pulmonary edema from CHF), whereas normal or low BNP supports ARDS, a non-cardiogenic lung injury with alveolar flooding. Carboxyhemoglobin measures carbon monoxide poisoning, relevant to inhalation injury but not routine for ARDS differentiation. CRP reflects inflammation, common in both ARDS and infection, but lacks specificity for cardiac versus pulmonary origin. A complete blood count provides general health data (e.g., infection) but doesn't pinpoint etiology. BNP, often paired with echocardiography, guides the nurse and team to tailor treatment ventilation for ARDS versus diuretics for CHF ensuring accurate early management of this critical condition.
Question 3 of 5
The nurse is caring for an 82-year-old patient with a diagnosis of tracheobronchitis. The patient begins complaining of right-sided chest pain that gets worse when he coughs or breathes deeply. Vital signs are within normal limits. What would you suspect this patient is experiencing?
Correct Answer: C
Rationale: Right-sided chest pain worsening with coughing or deep breathing in an 82-year-old with tracheobronchitis suggests pleuritic pain, likely from pleural inflammation secondary to the airway infection. Pleurisy's hallmark is sharp, movement-exacerbated pain due to irritated pleural surfaces rubbing together, often unilateral, and may decrease as fluid accumulates later. Stable vital signs rule out severe systemic issues. Traumatic pneumothorax requires injury, absent here, and would show respiratory distress or absent breath sounds. Empyema, a pleural infection, typically involves fever and systemic signs, not just pain, and isn't indicated without infection escalation. Myocardial infarction causes central, pressure-like pain, often with vital sign changes (e.g., tachycardia, hypotension), not pleuritic features. The nurse's suspicion of pleuritic pain prompts pain management and monitoring for progression, aligning with tracheobronchitis complications.
Question 4 of 5
A patient with emphysema is experiencing shortness of breath. To relieve this patients symptoms, the nurse should assist her into what position?
Correct Answer: A
Rationale: For an emphysema patient with shortness of breath, sitting upright and leaning forward slightly optimizes respiratory mechanics. This position, often instinctive in COPD, elevates the diaphragm, reducing its flattening from hyperinflation, and engages accessory muscles (e.g., pectoralis) to aid expiration, easing dyspnea. Leaning forward may also reduce abdominal pressure on the thorax, enhancing lung expansion. Low Fowler's with neck hyperextension strains breathing by misaligning the airway and limiting diaphragm movement. Prone positioning, face-down, restricts chest expansion, worsening air trapping. Trendelenburg, head-down, elevates abdominal contents against the diaphragm, intensifying dyspnea. The nurse's assistance into this upright, forward-leaning posture often with arms supported maximizes ventilation, aligning with COPD management to relieve acute respiratory distress effectively.
Question 5 of 5
A nurse has been asked to give a workshop on COPD for a local community group. The nurse emphasizes the importance of smoking cessation because smoking has what pathophysiologic effect?
Correct Answer: A
Rationale: Smoking cessation is vital in COPD because smoking increases mucus production, a key pathophysiologic effect. Cigarette smoke irritates goblet cells and mucous glands, overproducing thick mucus that clogs airways, impairs ciliary clearance, and fosters inflammation and infection central to COPD's chronic bronchitis component. Hemoglobin isn't destabilized; smoking forms carboxyhemoglobin, reducing oxygen capacity, but this is secondary. Alveoli don't shrink or collapse acutely emphysema involves their distention and destruction from elastase imbalance. The nurse's emphasis on mucus production educates the group on how smoking drives obstruction and symptoms (e.g., cough, dyspnea), reinforcing cessation's role in halting this cascade, per COPD pathogenesis and public health campaigns.