Question 1

The nurse is assessing an older adult with a family tendency of developing laryngeal cancer.The nurse should ask the patient about which risk factors?

Accepted Answer

Cigarette smoking,alcohol abuse,asbestos exposure,and wood dust exposure are risk factors linked to laryngeal cancer.Streptococcus bacteria are not considered a risk factor for laryngeal cancer; infection with human papillomavirus or Helicobacter pylori has been linked to increased incidence of cancer of the larynx.

Question 2

The nurse is caring for a patient with suspected sinusitis.Which assessment finding supports this diagnosis?

Accepted Answer

Sinusitis is an inflammation of the mucosal lining of the sinuses.Exudate accumulates in the sinuses and pressure builds,which causes pain.Symptoms include painful upper teeth,tenderness over the sinuses,purulent drainage from the nose,nasal obstruction,and sometimes a nonproductive cough.Drainage from the ear and ear pain when supine are findings likely consistent with an ear infection.

Question 3

When teaching a patient about esophageal speech,which technique should the nurse instruct the patient to use first?

Accepted Answer

Many people are able to learn esophageal speech.First,the patient should master the art of swallowing air and then moving it forcibly back up through the esophagus.Next,the patient should learn to coordinate lip and tongue movements with the sound produced by the air passing over vibrating folds of the esophagus.The sounds may be somewhat hoarse,but are more natural than the sounds produced by an artificial larynx.Relaxing the diaphragm and coughing to express air are not methods to achieve esophageal speech.

Question 4

The nurse is caring for a patient with sleep apnea.The patient complains that he is constantly fatigued.Which response is most appropriate for the nurse to make?

Accepted Answer

Periods of apnea followed by abrupt intake of air frequently awaken the patient and reduce the amount of rapid eye movement (REM)sleep.Patients with sleep apnea experience oxygen deficiency.Mild apnea may be treated with conservative measures like avoiding alcohol 4 to 6 hours before bed.Telling the patient that all patients sleep poorly in the hospital ignores the patient's concern and makes an overgeneralization based on the nurse's bias.

Question 5

The nurse is teaching a patient who underwent a laryngectomy.Which statement describes the correct technique for warming inspired air during cold weather?

Accepted Answer

The fold of the scarf retains body heat and can warm air as the air passes through the scarf.

Question 6

The nurse is caring for a 20-year-old patient who recently underwent a tonsillectomy.The patient is fully awake and clearing his throat frequently but denies pain.Which action is most important for the nurse to take first?

Accepted Answer

Frequent swallowing or clearing of the throat may indicate bleeding.Further assessment is indicated,and the nurse should look in the patient's mouth to assess for bleeding.
The fully alert adult patient should be placed in semi-Fowler position to ensure adequate ventilation.Offering the patient a grape popsicle is an appropriate intervention once the nurse confirms that the patient is not bleeding.While removing the straw from the tray is an appropriate intervention to prevent bleeding that may result from sucking,the nurse should first ensure that the patient is not currently bleeding.

Question 7

When doing routine cleaning of a double-lumen tracheostomy tube,the nurse should include which action?

Accepted Answer

The inner cannula is cleaned with a pipe cleaner,the patient is put in the semi-Fowler position,and the inner cannula is rinsed in sterile saline or sterile water,rather than peroxide.

Question 8

What is the contagion period of a cold?

Accepted Answer

The contagion period of a viral cold is about 3 days.

Question 9

The nurse is caring for a patient who has a tracheostomy with a one-way valve box.The nurse explains to the CNA that this valve allows the patient to carry out which function?

Accepted Answer

A one-way tracheostomy valve box can be fitted into the tube opening.It allows air to be inhaled through the tracheostomy opening,but the valve closes when the patient exhales.This diverts the exhaled air through the larynx and enables the patient to speak.

Question 10

The nurse is assisting the physician with the insertion of a new tracheostomy tube.The physician asks for the obturator.The nurse correctly hands the physician which device?

Accepted Answer

The obturator is used during insertion of a tracheostomy tube as a guide to protect against scraping the sides of the trachea with the sharp edge of the tube.

Question 11

The nurse is caring for a patient experiencing epistaxis.What action should the nurse take first?

Accepted Answer

When epistaxis occurs,the patient should sit forward and apply direct pressure by pinching the nose just below the bone,close to the face for 10 to 15 minutes.This position prevents blood from running down the back of the throat.Cold compresses or ice may be applied to the nose to constrict the blood vessels.If there is still bleeding at the end of a 10- to 15-minute period,the process should be repeated.If bleeding continues,the nurse should obtain the patient's vital signs and notify the provider.The provider may cauterize the bleeding vessels or solidly pack the nose.

Question 12

Which statement is most important for the nurse to make when caring for an anxious patient with a new tracheostomy?

Accepted Answer

Offering reassurance to a patient who cannot speak is essential.Care should be unhurried with teaching and conversation.Offering false reassurance or mentioning what other patients have done is inappropriate.Giving care quickly or with minimal conversation may cause further anxiety.Teaching cannot be delayed until the tracheostomy is healed.

Question 13

The nurse is aware that the patient seeking antibiotic treatment for pharyngitis will only receive the desired medication if the condition is caused by what type of pathogen?

Accepted Answer

Pharyngitis (sore throat)will be treated with an antibiotic only if the infection is deemed bacterial in etiology.Protozoa,viruses,and fungi do not respond to antibiotics.

Question 14

The nurse is caring for a patient who has had a cold for 1 week.The patient questions why the health care provider issued a prescription for an antibiotic.Which explanation is best?

Accepted Answer

If a cold persists for more than a week to 10 days without improvement,a bacterial infection is present and requires medical treatment.While the etiology of a cold is viral in nature,antibiotics are necessary to this secondary bacterial infection.No cure exists for a cold.Antibiotics will not reduce symptoms of a cold or decrease the contagion period for a cold.

Question 15

The nurse is teaching an adult post-tonsillectomy patient.Which dietary instructions are most important for the nurse to include?

Accepted Answer

Avoiding red colored foods can help in distinguishing between ingested food and blood.Milk products are acceptable for post-tonsillectomy patient.Citrus fruits should be avoided until the throat has completely healed.Hot fluids should be avoided until the throat completely heals.Straws are not used because sucking may cause bleeding.

Question 16

The nurse is caring for a patient who underwent a laryngectomy.Which need should the nurse address first?

Accepted Answer

Pain control and family support are important,but the need of a method of communication is paramount for a new tracheostomy patient to allay anxiety,ensure accurate communication between the patient and the nurse,and make the patient comfortable that nursing staff are attentive.The need for long-term care may not be necessary.

Question 17

The nurse is caring for a patient during the immediate postoperative period following a rhinoplasty.Which finding is most concerning to the nurse?

Accepted Answer

Frequent swallowing indicates bleeding that is trickling down the back of the throat.Feeling cold and chilly is a common symptom with surgery and is related to anesthetic and the cool surgical environment.Nausea may be experienced by some patients due to anesthetic.Drainage from the nose is expected.

Question 18

Which action(s)may help to reduce the risk of transmitting a common cold?

Accepted Answer

Covering the mouth and nose when sneezing and coughing as well as frequent washing of hands will reduce the risk of passing a cold to another.Using saline sprays and drinking juices with vitamin C are not helpful in containing a cold.

Question 19

Which organism(s)are common causative agents for sinusitis?

Accepted Answer

The common organisms causing sinusitis are pneumococci,Haemophilus influenzae,and streptococci.

Question 20

The nurse carefully applies suction prior to deflating the cuff on a cuffed tracheostomy in order to prevent which complication?

Accepted Answer

By suctioning prior to deflating the cuff,the oral liquids that are trapped above the balloon cannot be aspirated.Bleeding,negative pressure,and dislodgement of the tube are not related to cuff inflation.

Quiz 13: Care of Patients with Disorders of the Upper Respiratory System