ATI LPN
Perioperative Nursing Care NCLEX Questions Questions
Question 1 of 5
What instruction is most appropriate for a client preparing for surgery?
Correct Answer: D
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
Question 2 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 3 of 5
A patient who involved in a workplace accident suffered a penetrating wound of the chest that led to acute respiratory failure. What goal of treatment should the care team prioritize when planning this patients care?
Correct Answer: B
Rationale: Acute respiratory failure (ARF) from a penetrating chest wound likely causing pneumothorax or hemothorax disrupts ventilation and oxygenation, making restoration of adequate gas exchange the care team's priority. This goal addresses the underlying pathophysiology: air or blood in the pleural space collapses the lung, impairing oxygen uptake and CO2 elimination. Immediate interventions (e.g., chest tube, oxygen) aim to re-expand the lung and stabilize ABGs, preventing hypoxia and hypercapnia, which are life-threatening. Long-term intubation may result but isn't the initial focus resolving the cause often avoids it. Coping and self-management are secondary, relevant post-stabilization, as survival hinges on gas exchange. The nurse's role in monitoring respiratory status and supporting interventions (e.g., thoracostomy) aligns with this urgent, evidence-based priority in trauma-induced ARF.
Question 4 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 5 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.