ATI LPN
Questions on Perioperative Care Questions
Question 1 of 5
The nurse is caring for a patient in the ICU admitted with ARDS after exposure to toxic fumes from a hazardous spill at work. The patient has become hypotensive. What is the cause of this complication to the ARDS treatment?
Correct Answer: C
Rationale: In ARDS, hypotension often results from hypovolemia due to capillary leakage, where fluid shifts into interstitial spaces and alveoli, reducing circulating volume. Toxic fume inhalation damages alveolar-capillary membranes, increasing permeability (non-cardiogenic pulmonary edema), a hallmark of ARDS pathophysiology. This fluid loss, compounded by potential positive end-expiratory pressure (PEEP) reducing venous return, lowers blood pressure. Pulmonary hypotension isn't a recognized term; pulmonary hypertension may occur in ARDS from hypoxic vasoconstriction but doesn't directly cause systemic hypotension. High PEEP can decrease cardiac output by compressing thoracic vessels, but increased cardiac output isn't typical. The nurse's understanding of hypovolemia guides fluid resuscitation and vasopressor use, balancing oxygenation (via PEEP) and perfusion, critical in managing ARDS's systemic effects.
Question 2 of 5
A nurse is providing discharge teaching for a client with COPD. When teaching the client about breathing exercises, what should the nurse include in the teaching?
Correct Answer: C
Rationale: For a COPD client, diaphragmatic breathing is a key exercise to include in discharge teaching, retraining the patient to use the diaphragm over accessory muscles. This technique inhaling to expand the abdomen, exhaling to contract it reduces respiratory rate, enhances alveolar ventilation, and eases dyspnea by countering the shallow, rapid breathing typical in COPD's hyperinflated state. Lying supine restricts diaphragm movement, worsening air trapping. Pursed-lip breathing, far from avoided, slows expiration, preventing airway collapse a complementary skill. Chest breathing relies on upper thorax muscles, inefficient in COPD. The nurse's teaching on diaphragmatic breathing demonstrated with hand placement (e.g., on abdomen) improves oxygenation and energy efficiency, vital for home management, per respiratory therapy evidence.
Question 3 of 5
A nurse is explaining to a patient with asthma what her new prescription for prednisone is used for. What would be the most accurate explanation that the nurse could give?
Correct Answer: D
Rationale: Prednisone, an oral corticosteroid, is prescribed for asthma to gain prompt control of inadequately controlled, persistent symptoms, typically as a short-term burst (3-10 days). It rapidly reduces severe inflammation driving exacerbations swelling, mucus, and bronchospasm when inhaled therapies fail, restoring airway patency fast. Long-term prevention relies on inhaled corticosteroids, not oral prednisone, due to systemic side effects (e.g., osteoporosis). Asthma isn't infection-driven; prednisone doesn't cure systemic infections, nor is it for pulmonary infection prevention antibiotics serve that role if needed. The nurse's explanation clarifies prednisone's acute role highlighting duration and monitoring (e.g., glucose spikes) ensuring the patient understands its temporary, potent purpose in asthma crisis management, per clinical guidelines.
Question 4 of 5
The nurse is caring for a potential surgical patient in the preadmission testing unit. The medication history indicates that the patient is currently taking warfarin (Coumadin). Which of the following actions should the nurse take?
Correct Answer: B
Rationale: Warfarin, an anticoagulant, delays clotting, posing a bleeding risk in surgery, so the nurse should consult the physician about the INR to assess clotting status. INR measures prothrombin time, indicating warfarin's effect typically held 5-7 days pre-op to normalize (INR 1.0-1.5). Chest X-rays assess lungs, not clotting. BUN evaluates kidney function, unrelated to warfarin's impact. CBC provides general blood data, but INR specifically tracks anticoagulation reversal needs. This action ensures the surgical team adjusts warfarin safely, preventing intraoperative hemorrhage while balancing thromboembolism risks, aligning with preoperative protocols for anticoagulant management.
Question 5 of 5
The nurse is making a preoperative education appointment with a patient. The patient asks if he should bring family with him to the appointment. What is the best response by the nurse?
Correct Answer: C
Rationale: Recommending family inclusion in preoperative education eases anxiety for both patient and relatives by clarifying procedures and postoperative roles, like coaching exercises. Family understanding reduces patient stress, enhancing compliance with instructions. Excluding family or limiting them to the waiting room misses this support opportunity education benefits from their involvement. Requiring attendance overstates policy; it's ideal, not mandatory. The nurse's response fosters a collaborative environment, aligning with holistic care to prepare the patient and family for the surgical experience, reducing misunderstandings and improving outcomes.