ATI LPN
Perioperative Nursing Care Test Questions Questions
Question 1 of 5
The nurse is caring for a patient who has been in a motor vehicle accident and the care team suspects that the patient has developed pleurisy. Which of the nurses assessment findings would best corroborate this diagnosis?
Correct Answer: D
Rationale: Pleurisy, inflammation of the pleural membranes, is characterized by sharp pain that worsens with respiratory movements like coughing or deep breathing due to friction between the inflamed parietal and visceral pleura. This pain is typically unilateral and may radiate, but its key feature is its exacerbation with chest motion, making it a hallmark finding in this diagnosis. Painless hemoptysis suggests a different pathology, such as a pulmonary embolism or malignancy, not pleurisy. Normal ABGs with increased work of breathing could indicate early respiratory distress but lacks specificity for pleurisy. Low oxygen saturation without dyspnea might suggest chronic hypoxia or a shunt, not directly supporting pleurisy, which usually causes pain-driven shortness of breath. The nurse's finding of intensified pain during coughing or deep breathing aligns with the pathophysiology of pleural irritation post-trauma, strongly corroborating the suspected diagnosis.
Question 2 of 5
A patient with thoracic trauma is admitted to the ICU. The nurse notes the patients chest and neck are swollen and there is a crackling sensation when palpated. The nurse consequently identifies the presence of subcutaneous emphysema. If this condition becomes severe and threatens airway patency, what intervention is indicated?
Correct Answer: B
Rationale: Subcutaneous emphysema air trapped in subcutaneous tissues, causing swelling and crepitus arises from thoracic trauma (e.g., pneumothorax, bronchial rupture). When severe, it can compress the trachea, threatening airway patency, necessitating a tracheostomy to bypass upper airway obstruction and ensure ventilation. A chest tube treats the underlying pneumothorax, relieving pleural air but not subcutaneous spread impacting the airway directly. Endotracheal intubation may fail if tracheal compression prevents tube passage, making it less effective in this scenario. A feeding tube is irrelevant to airway management. The nurse's anticipation of tracheostomy reflects its role in securing a patent airway when subcutaneous air from trauma escalates, a critical intervention supported by trauma care protocols for maintaining oxygenation.
Question 3 of 5
A nurse is evaluating the diagnostic study data of a patient with suspected cystic fibrosis (CF). Which of the following test results is associated with a diagnosis of cystic fibrosis?
Correct Answer: A
Rationale: Cystic fibrosis (CF) diagnosis relies on elevated sweat chloride concentration, typically >60 mmol/L, from a sweat test. CFTR gene mutations impair chloride transport, increasing salt in sweat glands a hallmark of CF alongside thick mucus in organs like lungs and pancreas. Proteinuria indicates kidney issues, unrelated to CF's ion channel defect. Positive phenylketonuria (PKU) reflects a metabolic disorder of phenylalanine, distinct from CF's respiratory-gastrointestinal focus. Lung biopsy malignancy suggests cancer, not CF, which causes bronchiectasis or infection, not tumors. The nurse's evaluation of high sweat chloride confirms CF's pathophysiology chloride retention driving viscous secretions guiding genetic testing (e.g., CFTR mutations) and management (e.g., airway clearance), critical for this lifelong condition's early intervention.
Question 4 of 5
A pediatric nurse practitioner is caring for a child who has just been diagnosed with asthma. The nurse has provided the parents with information that includes potential causative agents for an asthmatic reaction. What potential causative agent should the nurse describe?
Correct Answer: A
Rationale: Pets are a common causative agent for asthma reactions in children, triggering airway inflammation via allergens like dander, saliva, or fur proteins. In sensitized kids, this initiates an IgE-mediated response, causing bronchospasm, mucus production, and dyspnea core asthma features. Lack of sleep may worsen coping but doesn't directly provoke attacks. Psychosocial stress can exacerbate symptoms via neuroimmune pathways but isn't a primary trigger. Bacteria cause infections, potentially worsening asthma, but aren't typical allergens. The nurse's focus on pets backed by allergy studies educates parents to identify and mitigate triggers (e.g., pet-free zones), empowering proactive management in this child's new asthma diagnosis, per pediatric asthma guidelines.
Question 5 of 5
A nurse is teaching a patient with asthma about Azmacort, an inhaled corticosteroid. Which adverse effects should the nurse be sure to address in patient teaching?
Correct Answer: C
Rationale: Teaching about Azmacort (triamcinolone), an inhaled corticosteroid for asthma, must address cough and oral thrush as key adverse effects. Cough can occur from airway irritation by the inhalant, a local reaction manageable with technique adjustment (e.g., spacer use). Oral thrush (candidiasis) results from steroid deposition in the mouth, suppressing local immunity rinsing after use prevents this fungal overgrowth. Dyspnea and increased secretions aren't typical; corticosteroids reduce secretions long-term. Nausea and vomiting are systemic effects, rare with inhaled forms unless overdosed. Fatigue and decreased consciousness suggest severe systemic absorption (e.g., adrenal suppression), uncommon at standard doses. The nurse's focus on these effects demonstrating rinsing and monitoring for white patches ensures safe use, aligning with asthma pharmacotherapy education to maintain efficacy and minimize complications.