Question 1

While engaging in a high school sports activity, an adolescent sustains an injury to the nose. Which assessment findings indicate that the patient has a nasal fracture?

Accepted Answer

Periorbital ecchymosis (bruising around the eyes, often referred to as "raccoon eyes") and nasal bridge instability (movement or tenderness of the nasal bones) are common indicators of a nasal fracture. These signs specifically relate to trauma around the nose and the potential for bone injury in that area.

Question 2

The nurse suspects that a patient has tonsillitis. What did the nurse assess to make this clinical decision?

Accepted Answer

A,D,E

Question 3

During an assessment, the nurse learns that the only thing that helps a patient with a daily morning headache is "using a vaporizer with eucalyptus" before breakfast. Which health problem should the nurse suspect the patient is experiencing?

Accepted Answer

The use of a vaporizer with eucalyptus before breakfast indicates that the patient may be experiencing symptoms of sinusitis. Eucalyptus is known for its anti-inflammatory and decongestant properties, which can help to reduce inflammation and clear the sinuses. Morning headaches are a common symptom of sinusitis, which is an inflammation of the sinuses caused by a bacterial or viral infection. Acute and allergic rhinitis may also cause headaches, but the use of a vaporizer with eucalyptus specifically suggests sinusitis. The after-effects of the flu may also include headaches, but the use of eucalyptus suggests an ongoing issue rather than a temporary illness.

Question 4

While recovering at home from a total laryngectomy, a patient notices an increase in left shoulder weakness. With what should the nurse realize this symptom is consistent?

Accepted Answer

Damage to the spinal accessory nerve can cause weakness in the shoulder and is a known complication of laryngectomy surgery. The other options are not typically associated with left shoulder weakness in this context.

Question 5

A middle-aged adult patient who is diagnosed with pertussis is complaining of right-sided thoracic pain. The nurse recognizes that this patient should be assessed for which conditions?

Accepted Answer

Pertussis, or whooping cough, can cause severe coughing fits that may lead to complications such as pneumothorax (B), rib fractures (D), and pleurisy (E) due to the intense pressure and strain on the thoracic structures.

Question 6

A middle-aged patient is seen in the clinic for a continuing cough after recovering from the flu "a few weeks ago." What should the nurse suspect is occurring with this patient?

Accepted Answer

A persistent cough after the flu is most likely due to tracheobronchitis, which is inflammation of the trachea and bronchi. Viral pneumonia may also cause cough, but it is less likely since the patient has already recovered from the flu. Sinus infection or otitis media may cause nasal congestion and earache, respectively, but are less likely to be the cause of a continuing cough.

Question 7

A female patient is seen for "increased hoarseness" and "a change in voice quality." What is an appropriate assessment question for the nurse to ask this patient?

Accepted Answer

The answer of A female patient is seen for "increased...

Question 8

A patient who was diagnosed with the flu is demonstrating rapid, shallow respirations. The nurse should be concerned that the patient is at risk for developing which condition?

Accepted Answer

Atelectasis is a condition in which the alveoli collapse, leading to a decrease in lung volume and gas exchange. Rapid, shallow respirations can lead to atelectasis because they do not allow the alveoli to fully expand and fill with air.

Question 9

The nurse is reviewing a patient's clinical record. Which teaching should the nurse identify as a priority for this patient? $\begin{array}{|l|l|l|}
\hline \text { Laboratory Results }& \text { Subjective Data } & \text { Objective Data } \
\hline \text { LA antigen - positive for  strep}&\begin{array}{l}
\text { Comp lains of "sore throat," } \
\text { ear pain, difficulty } \
\text { swallowing }
\end{array} & \begin{array}{l}
\text { Foul breath odor noted; } \
\text { exudates present on posterior } \
\text { pharynx }
\end{array} \
\hline \mathrm{WBC}-15,000 \mathrm{~mm}^{3}&\begin{array}{l}
\text { States, "I feel so tired and } \
\text { have no energy." }
\end{array} & \begin{array}{l}
\text { Anterior cervical lymph } \
\text { nodes enlarged and palpable }
\end{array} \
\hline& \begin{array}{l}
\text { States, "I'm not hungry and } \
\text { nothing sounds good." }
\end{array} & \begin{array}{l}
\text { Soft palate and mucous } \
\text { membranes edematous and } \
\text { red }
\end{array}\
\hline  &&\mathrm{T} 102^{\circ} \mathrm{F}\left(38.8^{\circ} \mathrm{C}\right)\
\hline
\end{array}$

Accepted Answer

The patient's laboratory results indicate that they are positive for streptococcus, which is a bacterial infection. Antibiotics should be taken for the full prescribed 10 days to fully treat the infection and prevent complications. Encouraging warm liquids and a soft diet may also be appropriate, but taking the antibiotics is the priority teaching. The patient's symptoms do not indicate a need for a flu immunization at this time.

Question 10

A patient tells the nurse he has a "cold" every spring that lasts a few weeks. The nurse suspects that the patient is experiencing which condition?

Accepted Answer

The fact that the patient's symptoms occur every spring suggests that they may be experiencing seasonal allergies, also known as allergic rhinitis. This condition is characterized by symptoms such as sneezing, runny nose, and congestion, and is often triggered by certain allergens present in the environment. Acute viral rhinitis (also known as the common cold) typically only lasts around 7-10 days and is caused by a viral infection. Vasomotor rhinitis is a non-allergic type of rhinitis that is triggered by various environmental factors, such as changes in temperature or humidity. Atrophic rhinitis is a rare condition that involves the degeneration of the nasal mucosa, resulting in a foul odor and crusting inside the nose.

Question 11

A patient tells the nurse, "After I leave here, I need to get to the dentist. My upper teeth are hurting and I don't know why." What should the nurse do?

Accepted Answer

The nurse should assess the patient for a sinus infection as upper teeth pain can often be a symptom of a sinus infection. The nurse should gather more information about the patient's symptoms and provide appropriate education or referrals as needed.

Question 12

The nurse observes a patient using this gesture (see diagram). What should the nurse do?

Accepted Answer

The answer of The nurse observes a patient using this...

Question 13

A patient who is scheduled for a partial laryngectomy asks if he will still be able to talk after the surgery. Which response would be appropriate for the nurse to make?

Accepted Answer

The answer of A patient who is scheduled for a...

Question 14

The nurse is assessing a patient's incision after an external sphenoethmoidectomy. Place an "X" on the area of the diagram where this incision would be located.

Accepted Answer

The answer of The nurse is assessing a patient's incision...

Question 15

A patient with laryngeal cancer is found to have carcinoma in situ. The nurse understands that this cancer is in which stage?

Accepted Answer

Carcinoma in situ is the earliest stage of cancer where cells have not invaded deeper tissues yet. It is classified as stage 0.

Question 16

A patient is receiving anterior nasal packing for a nosebleed. What should be included in the instructions for this patient?

Accepted Answer

Anterior nasal packing is typically left in place for at least 24 hours and up to 3 days, depending on the severity of the nosebleed. It is important for the patient to follow-up with their healthcare provider for removal of the packing. The packing should not be removed by the patient without the guidance of a healthcare provider.

Question 17

A patient says, "My nose is always congested and it just seems to get worse with the nasal spray I've been using." The nurse realizes that this patient is describing which manifestation?

Accepted Answer

Rebound nasal congestion, also known as rhinitis medicamentosa, occurs when nasal decongestants are used frequently over a period of time and then stopped, leading to worsening congestion. The patient's description of worsening congestion with the use of nasal spray is indicative of this condition.

Question 18

The nurse observes a patient's respirations during sleep and notes the absence of respirations that lasts from 15 to 45 seconds. What should the nurse consider this patient is experiencing?

Accepted Answer

The absence of respirations during sleep that lasts from 15 to 45 seconds is a characteristic of sleep apnea. This occurs because the airway becomes obstructed during sleep, causing a pause in breathing. Laryngeal spasm and respiratory acidosis may cause breathing difficulties, but they do not manifest as specific episodes during sleep. Renal failure is not related to breathing difficulties during sleep.

Question 19

A patient with multiple facial and nasal injuries needs a nasogastric tube placed. Which method should the nurse use to place this tube?

Accepted Answer

In a patient with multiple facial and nasal injuries, the nasogastric tube should be placed through the unobstructed nare to avoid further trauma to the nasal passages. If both nares are blocked, the healthcare provider may need to consider alternative methods of administering enteral nutrition. Placing the tube through the mouth may be difficult due to facial injuries and edema. Waiting for edema to subside may delay necessary nutritional support for the patient.

Question 20

While eating a meal in the hospital, a patient exhibits difficulty breathing and signs of choking. What should the nurse realize the patient is experiencing?

Accepted Answer

The patient is exhibiting signs of difficulty breathing and choking while eating, which could indicate a laryngeal obstruction, or blockage of the airway in the throat. This is a medical emergency and the nurse should take immediate action to assist the patient in clearing the obstruction.

Quiz 35: Nursing Care of Patients With Upper Respiratory Disorders