ATI LPN
Perioperative Nursing Care NCLEX Questions Questions
Question 1 of 5
The nurse is assessing a patient who has a 35 pack-year history of cigarette smoking. In light of this known risk factor for lung cancer, what statement should prompt the nurse to refer the patient for further assessment?
Correct Answer: A
Rationale: A persistent cough in a patient with a 35 pack-year smoking history a strong lung cancer risk factor warrants urgent referral due to its association with early malignancy. Cough, often dismissed as smoker's cough or infection, is the most common presenting symptom of lung cancer, reflecting airway irritation or obstruction by a tumor. With 35 pack-years (e.g., 1 pack/day for 35 years), the patient's cumulative exposure heightens this likelihood, as smoking drives 85-90% of lung cancer cases. Reduced stamina, while concerning, is nonspecific, potentially linked to COPD or cardiovascular issues common in smokers. Frequent infections could suggest immune compromise or chronic lung damage, but not directly cancer. New allergies are unrelated to smoking or malignancy. The nurse's referral triggers timely diagnostics (e.g., chest X-ray, CT), critical for early detection in this high-risk individual, potentially improving prognosis.
Question 2 of 5
A nurse is caring for a 6-year-old patient with cystic fibrosis. In order to enhance the childs nutritional status, what intervention should most likely be included in the plan of care?
Correct Answer: A
Rationale: In cystic fibrosis (CF), pancreatic enzyme supplementation with meals is essential to enhance nutritional status, as 90% of patients have exocrine pancreatic insufficiency from CFTR mutations. Thick mucus blocks pancreatic ducts, preventing digestive enzymes (e.g., lipase, protease) from reaching the gut, causing malabsorption of fats and proteins supplements (e.g., pancrelipase) correct this, improving calorie uptake critical for growth in a 6-year-old. Small, frequent meals aid digestion but don't address enzyme deficiency alone. TPN, intravenous nutrition, is reserved for severe cases, not routine CF care. Magnesium, thiamine, and iron aren't typically deficient in CF; fat-soluble vitamins (A, D, E, K) are supplemented instead due to fat malabsorption. The nurse's inclusion of enzyme therapy dosed with meals and snacks optimizes nutrition, countering CF's gastrointestinal impact, vital for this child's development.
Question 3 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 4 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 5 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.