ATI LPN
Questions on Perioperative Care Questions
Question 1 of 5
While planning a patients care, the nurse identifies nursing actions to minimize the patients pleuritic pain. Which intervention should the nurse include in the plan of care?
Correct Answer: A
Rationale: Pleuritic pain, caused by inflamed pleural surfaces rubbing during respiration, intensifies with deep breathing, coughing, or movement, necessitating interventions that minimize these triggers. Avoiding actions that cause deep breathing such as excessive activity or forced respiratory exercises reduces pleural friction, alleviating pain and improving patient comfort, a primary nursing goal. Ambulation thrice daily, while beneficial for circulation, may exacerbate pain by increasing respiratory effort, countering pain management aims. A soft diet and fluids address hydration or swallowing but don't directly relieve pleuritic pain, which is unrelated to nutrition. Limiting speech is unnecessary, as it minimally affects chest movement compared to breathing. By prioritizing rest and shallow breathing, the nurse mitigates pain's impact on recovery, potentially supplementing with analgesics, aligning with holistic care for conditions like pleurisy or pneumothorax.
Question 2 of 5
A school nurse is caring for a 10-year-old girl who is having an asthma attack. What is the preferred intervention to alleviate this clients airflow obstruction?
Correct Answer: C
Rationale: During an asthma attack, the preferred intervention is an inhaled beta-adrenergic agonist (e.g., albuterol), which rapidly relaxes bronchial smooth muscle, reversing airflow obstruction from bronchospasm, mucus, and inflammation. This short-acting bronchodilator acts within minutes, opening airways and relieving acute dyspnea, aligning with asthma guidelines (e.g., GINA) for exacerbations. Corticosteroids reduce inflammation but take hours, unsuitable for immediate relief. Anticholinergics (e.g., ipratropium) complement beta-agonists in severe cases but aren't first-line alone. Peak flow monitoring assesses obstruction severity, not treating it. The nurse's swift administration via inhaler ensuring proper technique (e.g., spacer use) restores ventilation, critical for this child's acute respiratory crisis, preventing escalation to status asthmaticus.
Question 3 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 4 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 5 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.