Deck 31: Care of Patients With Noninfectious Upper Respiratory Problems

Question 1

A client has open vocal cord paralysis.Which technique does the nurse teach the client to do to prevent aspiration?

A) Tilt the head back as far as possible when swallowing.
B) Tuck the chin down when swallowing.
C) Breathe slowly and deeply while swallowing.
D) Keep the head very still and straight while swallowing.

Answer 1

Tuck the chin down when swallowing.

Question 2

A client reports waking up feeling very tired,even after 8 hours of good sleep.What is the nurse's best action?

A) Ask for an order for sleep medication.
B) Tell the client not to drink beverages with caffeine.
C) Tell the client not to lie flat at night.
D) Ask the client whether he or she has ever been evaluated for sleep apnea.

Answer 2

Ask the client whether he or she has ever been evaluated for sleep apnea.

Question 3

A client who has sleep apnea is reporting constant daytime sleepiness.The client has multiple other chronic diseases.What is the nurse's best action?

A) Refer the client for surgery.
B) Perform a health history.
C) Request an order for a sleeping pill.
D) Move the client to a private room.

Answer 3

Perform a health history.

Question 4

The nurse is observing a client performing stoma care for a laryngectomy for the first time.Which action does the nurse reinforce?

A) Washing the stoma with soap and water
B) Covering the stoma with a gauze pad
C) Irrigating the stoma with half-strength peroxide
D) Making sure any scab around the stoma is removed

Question 5

Which client is at greatest risk for development of obstructive sleep apnea?

A) Woman who is 8 months pregnant
B) Middle-aged man with gastroesophageal reflux disease
C) Middle-aged woman who is 50 pounds overweight
D) Older man with type 2 diabetes and a history of sinus infections

Question 6

Which statement indicates that the client needs more teaching regarding rhinoplasty?

A) "I will take my temperature twice each day and will report any fever to my doctor."
B) "I will wait a few weeks to have my photograph taken, when the swelling is gone."
C) "I will take acetaminophen instead of aspirin for pain to avoid excessive bleeding."
D) "I will drink at least 3 quarts of liquids a day and will use a stool softener."

Question 7

A client develops posterior nasal bleeding and has packing inserted.What is the nurse's priority action?

A) Assess the client's pain level.
B) Keep the client's head elevated.
C) Teach the client about the causes of nasal bleeding.
D) Make sure the string is taped to the client's cheek.

Question 8

After facial trauma,a client has a nasal fracture and is reporting constant nasal drainage,a headache,and difficulty with vision.What is the nurse's first action?

A) Collect the nasal drainage on a piece of filter paper.
B) Send the client for a facial x-ray.
C) Perform a vision test.
D) Palpate all facial areas for crepitus.

Question 9

A high school athlete has suffered a nasal fracture.What is the priority action of the nurse caring for the client?

A) Assess for pain.
B) Pack the nares to prevent blood loss.
C) Assess for bone displacement.
D) Assess for airway patency.

Question 10

A client had a partial laryngectomy and has received instructions on the supraglottic method of swallowing.Which action by the nurse is most appropriate?

A) Place a chart in the client's room detailing the steps in the process.
B) Order a dynamic swallow study.
C) Repeat the instruction each day.
D) Have the client demonstrate swallowing.

Question 11

What is the nurse's most important action after a client's gag reflex has returned post rhinoplasty?

A) Teach the client to change position every 2 hours.
B) Tell the client to put heating pads on the face.
C) Instruct the client to lay flat.
D) Have the client drink at least 2500 mL/day.

Question 12

Which statement made by the client who is prescribed "voice rest" therapy for vocal cord polyps indicates the need for more teaching?

A) "I will stay out of rooms and places where people are smoking."
B) "When I speak at all, I will whisper rather than use a normal tone of voice."
C) "For the next several weeks, I will not lift more than 10 pounds."
D) "I will drink at least 3 quarts of water each day and will use stool softeners."

Question 13

Which client does the nurse safely delegate to the LPN/LVN who has been assigned to the unit for the first time?

A) Young adult who is 6 hours post radical neck dissection
B) Older adult client with esophageal cancer who is awaiting gastric tube placement
C) Client who is status post laryngectomy and is awaiting discharge teaching
D) Client who is awaiting preoperative teaching for laryngeal cancer

Question 14

The client with which conditions requires immediate nursing intervention?

A) Shortness of breath
B) Sternal retractions
C) Pulse oximetry reading of 95%
D) Occasional expiratory wheeze
E) Respiratory rate of 8 breaths/min
F) Arterial blood gas showing a pH of 7.35
G) Stridor

Question 15

What is the highest priority for the nurse to teach the client who is being discharged after a fixed centric occlusion for a mandibular fracture?

A) How to use wire cutters
B) Eating six soft or liquid meals each day
C) How to irrigate the mouth every 2 hours
D) Sleeping in semi-Fowler's position postoperatively

Question 16

Which clinical manifestation in a client with paralysis of one vocal cord alerts the nurse to the possibility of aspiration?

A) Oxygen saturation is decreased.
B) Voice is weak and tremulous.
C) The client coughs immediately after swallowing.
D) An audible wheeze is present on exhalation.

Question 17

A client has undergone a nasoseptoplasty 2 hours ago.It is a priority for the nurse to assess for which factor?

A) Nasal drainage
B) Bleeding
C) Pain
D) Airway patency

Question 18

A client states that he is going to relax on the beach between radiation treatments for laryngeal cancer to help his "mental status." What is the nurse's best response?

A) "You deserve to do something for yourself."
B) "Make sure someone is with you because you shouldn't be alone right now."
C) "Your skin can become severely burned, and you should not be out in the sun."
D) "You should make sure you use sunscreen that is at least SPF 15."

Question 19

A client has a closed fracture of the nose.Which intervention is best when encouraging self-care for this client?

A) Advise the client not to eat or drink for 24 hours after sustaining the fracture.
B) Teach the client how to apply cold compresses to the area to reduce swelling.
C) Urge the client to sleep without a pillow to hasten resolution of the swelling.
D) Reassure the client that his or her appearance will normalize after the swelling is gone.

Question 20

The nurse is assessing a client who is 6 hours post surgery for a nasal fracture.The client has facial pain (5 out of 10)and nasal packing in place.What actions by the nurse are most appropriate at this time?

A) Observe for clear drainage.
B) Observe for bleeding.
C) Observe the client for frequent swallowing.
D) Ask the client to open his or her mouth.
E) Administer a nasal steroid to decrease edema.
F) Change the nasal packing.
G) Administer pain medication.
H) Place the client in Trendelenburg position.

Question 21

The nurse is assessing a client with facial trauma.Which assessment findings require immediate intervention?

A) Stridor
B) Nasal stuffiness
C) Edema of the cheek
D) Ecchymosis behind the ear
E) Eye pain
F) Swollen chin

Question 22

A client develops epistaxis.Which conditions in the client's history could have contributed to this problem?

A) Diabetes mellitus
B) Hypertension
C) Leukemia
D) Cocaine use
E) Migraine
F) Elevated platelets
G) High cholesterol