ATI LPN
NCLEX Questions Perioperative Care Questions
Question 1 of 5
A postoperative client has the following orders: IV lactated Ringers 125 mL/hr, NG tube to low continuous suction, Replace NG output every 4 hours with normal saline over 4 hours, Morphine sulfate 2 mg IV push every hour as needed for pain, NPO, Up in chair tonight. At 1600 (4:00 PM), the nurse measures the nasogastric (NG) output from noon to be 200 mL. What is the clients total IV rate for the next 4 hours?
Correct Answer: C
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
Question 2 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 3 of 5
The perioperative nurse is writing a care plan for a patient who has returned from surgery 2 hours prior. Which measure should the nurse implement to most decrease the patients risk of developing pulmonary emboli (PE)?
Correct Answer: A
Rationale: Pulmonary embolism (PE) risk post-surgery stems from venous stasis, a component of Virchow's triad, making early ambulation the most effective preventive measure. Walking within hours of surgery enhances venous return, prevents deep vein thrombosis (DVT) formation the primary PE source and counters immobility's prothrombotic effects. Increased protein intake aids wound healing but doesn't directly reduce clotting risk. Maintaining a supine position prolongs stasis, heightening DVT and PE likelihood, especially post-surgery when mobility is already limited. Combining aspirin with warfarin increases bleeding risk without superior PE prevention over warfarin alone, and anticoagulants are secondary to physical measures like ambulation. The nurse's focus on early mobilization, alongside elastic stockings or leg exercises, aligns with evidence-based protocols (e.g., SCIP guidelines), significantly lowering PE incidence in perioperative care.
Question 4 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 5 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.