Deck 30: Nursing Care of Patients With Upper Respiratory Tract Disorders

Question 1

The nurse is caring for a patient who is having difficulty swallowing. Which of the following terms would be noted in the chart?

A)Aphasia
B)Aphagia
C)Dysphasia
D)Dysphagia

Answer 1

Dysphagia

Question 2

The nurse prepares to admit a patient who is being evaluated for suspected cancer of the larynx. Which of the following assessment findings does the nurse anticipate?

A)Wheezing
B)Coarse crackles
C)A noticeable lump in the neck
D)A hoarse voice

Answer 2

A hoarse voice

Question 3

While caring for a patient with a new laryngectomy, the nurse is asked by the family why the patient cannot be given higher doses of narcotics. Which of the following responses by the nurse is best?

A)"Narcotics can depress the respiratory rate and cough reflex."
B)"Narcotics can increase respiratory tract secretions."
C)"Narcotics are constipating."
D)"Narcotics can be addicting."

Answer 3

"Narcotics can depress the respiratory rate and cough reflex."

Question 4

A patient returns to the observation area after outpatient submucous resection for a deviated septum. Which of the following observations would most concern the nurse?

A)The patient's blood pressure is 136/88 mm Hg.
B)The patient complains of tenderness in the nasal area.
C)The patient swallows frequently.
D)The patient's moustache dressing has a 2-cm area of blood on it.

Question 5

A nurse is providing discharge teaching for a patient who has just had nasal surgery. Which of the following indicates further teaching is needed?

A)"I will take my pain pills as prescribed."
B)"I can return to my presurgery diet."
C)"I will drink plenty of fluids."
D)"I will cough and deep breathe every 2 hours."

Question 6

A patient comes into the emergency department with epistaxis. The physician orders that all home medications be continued. Which medication should the nurse question?

A)Ibuprofen (Motrin)
B)Montelukast sodium (Singulair)
C)Amlodipine (Norvasc)
D)Furosemide (Lasix)

Question 7

In addition to antibiotics ordered by the physician, which of the following measures can the nurse recommend for a patient with a sinus infection?

A)Pursed-lip breathing
B)Coughing and deep breathing
C)Rest and a room humidifier
D)Percussion and postural drainage

Question 8

Which of the following symptoms does the nurse anticipate when assessing a patient with a sinus infection?

A)Facial tenderness
B)Chest pain
C)Photophobia
D)Hypoxemia

Question 9

Which of the following patients is at greatest risk for cancer of the larynx?

A)A male patient with a history of repeated episodes of pneumonia
B)A female patient with a history of breast cancer
C)A male patient with a history of alcohol and tobacco use
D)A female patient with a history of repeated strep throat infections

Question 10

The nurse is preparing to do a throat culture on a patient with a sore throat. What equipment should the nurse gather?

A)Sterile gloves and a sputum cup
B)A scraper and a sterile basin
C)A tongue blade and a culture tube
D)A spatula and an agar plate

Question 11

A patient with strep throat asks the nurse why he has to take antibiotics. Which of the following statements would the nurse include in the teaching?

A)"Antibiotics help prevent complications like rheumatic fever."
B)"Strep throat causes high fevers that can cause neurological damage."
C)"Antibiotics help reduce difficulty swallowing."
D)"Antibiotics will help you get well sooner."

Question 12

After positioning a patient with epistaxis, which of the following actions should the nurse take next?

A)Apply ice to the nose and eye area.
B)Place warm packs on the nose.
C)Administer oral aspirin.
D)Irrigate the nasal passages with sterile saline.

Question 13

A patient asks why the physician would not prescribe antibiotics for influenza. How should the nurse respond?

A)"Most cases of the flu are caused by antibiotic-resistant bacteria."
B)"Antibiotics are not effective against viruses."
C)"Antibiotics have too many serious side effects."
D)"Antibiotics can interact with other medications used for the flu."

Question 14

What is the most common complication of influenza?

A)Pneumonia
B)Common cold
C)Meningitis
D)Abscess

Question 15

The family of a patient awaiting a laryngectomy asks how the patient will communicate. Which of the following statements by the nurse is correct?

A)"A plug can be placed into the stoma to talk."
B)"A special valve that diverts air into the trachea allows patients to talk."
C)"Patients can be taught to swallow air and talk as air is let out of the esophagus."
D)"I'm sorry, but unfortunately, patients with laryngectomies cannot communicate."

Question 16

Which of the following best describes sinusitis?

A)Inflammation of the carotid sinus
B)Inflammation of the pharynx, larynx, and nasal passages
C)Inflammation of the mucous membranes lining the sinus cavities
D)Inflammation of the bony structure of the sinuses

Question 17

What emergency equipment should the nurse have available at the bedside for a patient who has just had a tonsillectomy?

A)Sterile hemostats
B)Suction
C)Sterile gauze packing
D)Irrigation set

Question 18

Which action by the nurse is most important after laryngectomy surgery?

A)Keep the head of the bed elevated.
B)Assess the patient's acceptance of the laryngectomy.
C)Maintain a patent airway.
D)Control postoperative pain.

Question 19

The nurse instructs a patient with a nosebleed to sit up and lean slightly forward, recognizing that this position will most likely achieve which of the following objectives?

A)Prevent dizziness or syncope
B)Reduce bleeding from the anterior plexus
C)Prevent unseen blood from being swallowed or aspirated
D)Help prevent symptoms of shock due to blood loss

Question 20

A patient has a prescription for an adrenergic nasal spray to relieve nasal congestion. Which of the following instructions should the nurse provide?

A)"Use the spray whenever your nasal passages feel swollen."
B)"Do not use the spray for more than 3 days, or rebound congestion may occur."
C)"Overuse of the spray can cause hypotension; be sure to rise slowly from a sitting position."
D)"Apply petroleum jelly (Vaseline) to the inside of your nose if you experience irritation from the spray."

Question 21

A patient sees a physician for symptoms of a cold (viral rhinitis). Which of the following treatments would the nurse expect? (Select all that apply.?

A)Rest
B)Fluids
C)Decongestants
D)Antibacterial agents
E)Steroids
F)Bronchodilators

Question 22

The nurse is preparing to discharge a new laryngectomee. Which of the following assessment findings would cause the nurse to suggest home care follow-up?

A)The patient has used home oxygen in the past.
B)The patient has a history of noncompliance with medications.
C)The patient has a history of migraine headaches.
D)The patient lives in an apartment with a friend.

Question 23

During the postoperative period, the nurse teaches a new laryngectomee how to live with a tracheostomy. Which of the following instructions is appropriate?

A)"Never suction your tracheostomy at home; you could damage your trachea."
B)"You shouldn't feel bad about the tracheostomy. You should feel lucky to be alive."
C)"Be sure to protect your tracheostomy from pollutants such as powders, hair, and chemicals."
D)"You will be able to return to your normal activities, including showering and swimming."

Question 24

A nurse is providing care for a patient admitted with a temperature of 101.3°F, pulse 98 beats per minute, 34 respirations per minute, and blood pressure 106/54 mm Hg. The patient reports chills, nausea, vomiting, diarrhea, and weakness for the past 2 days. Which of the following physician orders should the nurse complete first?

A)Administer Tylenol 650 mg by mouth
B)Provide oxygen 2 L per nasal cannula
C)Encourage oral fluids
D)Initiate intravenous fluids at 80 mL per hour
Multiple Response
Identify one or more choices that best complete the statement or answer the question.

Question 25

Which of the following should be included in the nurse's instructions for a patient being released after nasal surgery? (Select all that apply.?

A)Use a cool mist humidifier to prevent nasal drying.
B)Blow your nose frequently to relieve any congestion.
C)Drink plenty of fluids unless otherwise ordered.
D)Keep head elevated when sleeping, either using two pillows or sleeping in a recliner chair.
E)Apply warm compresses to the face.
F)Take aspirin for pain.

Question 26

A nurse is asked how to distinguish the flu from viral rhinitis. Which of the following would the nurse include in the education? (Select all that apply.?

A)"Symptoms of a cold usually have a slow onset, but influenza symptoms often appear more suddenly."
B)"Individuals with influenza don't have much chest pain, but it is common with a cold."
C)"A runny nose is very common with a cold but not as common with the flu."
D)"Antibiotics may be given for either, so it is important to see your doctor."
E)"Muscle aches are common and can be severe with influenza."
F)"Sore throat is more common with a cold than with the flu."
Completion
Complete each statement.

Question 27

A nurse is teaching a patient how to avoid contracting influenza and secondary bacterial infection. Which measures should be included in the instruction? (Select all that apply.?

A)Influenza vaccination
B)Avoiding crowds during flu season
C)Good hand washing
D)Prophylactic antibiotics
E)Increased intake of vitamin B
F)Avoiding sharing of eating or drinking utensils

Question 28

For a patient recovering from a tonsillectomy, the physician has ordered an IV normal saline solution at 100 mL per hour. The IV tubing has a drop factor of 15. The nurse should infuse the IV at ________________drops per minute.

Question 29

The nurse develops a nursing diagnosis of risk for ineffective airway clearance related to excessive secretions. Which of the following goals is most appropriate?

A)Patient will maintain a clear airway.
B)Patient will have a normal breathing pattern.
C)Patient will have no cough.
D)Patient's sputum will be clear or white.