ATI LPN
NCLEX Questions Perioperative Care Questions
Question 1 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 2 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 3 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.
Question 4 of 5
The nurse is encouraging the postoperative patient to utilize diaphragmatic breathing. Reasons for this intervention include
Correct Answer: C
Rationale: Diaphragmatic breathing, where the abdomen rises on inhalation, prevents atelectasis alveolar collapse post-surgery by fully inflating lungs. General anesthesia suppresses cough reflexes and reduces lung expansion, trapping mucus and risking atelectasis or pneumonia. This exercise, done every 2 hours, enhances ventilation, clearing airways. It minimally distracts from pain but doesn't manage it analgesics do. Healing time isn't directly shortened; oxygenation aids recovery indirectly. Thrombus prevention relies on leg exercises, not breathing, as venous stasis is circulatory. The nurse's encouragement reduces respiratory complications, ensuring oxygen saturation and lung function, a cornerstone of postoperative care per evidence-based practice.
Question 5 of 5
The nurse is reviewing the surgical consent with the patient during preoperative education. The patient indicates that he does not understand what procedure will be completed. What is the nurse's best next step?
Correct Answer: A
Rationale: Notifying the physician about the patient's lack of understanding is the best step, as informed consent explaining procedure, risks, and alternatives is the surgeon's legal and ethical duty. Without comprehension, surgery can't proceed validly. The nurse can reinforce but not initially explain the procedure, which exceeds their scope here. Asking the patient to sign without understanding violates consent principles. Continuing education delays resolution. This action ensures the physician clarifies, securing true consent and protecting patient autonomy, per surgical ethics and safety standards.