Deck 20: Caring for Clients With Upper Respiratory Disorders

Question 1

Your client has had laryngeal surgery. What is as expected outcome in this client?

A) The client's suture line remains intact.
B) The client maintains an adequate caloric intake.
C) The client can swallow without difficulty.
D) The client's breathing patterns improve.

Answer 1

The client maintains an adequate caloric intake.

Question 2

Clients who have had a laryngectomy are devastated by their loss of the ability to speak normally. Why should a nurse provide extra time and support with these clients?

A) These clients need support and help in understanding and choosing an alternative method of speech.
B) These clients may be alert or confused after the procedure.
C) These clients avoid an electric larynx or tracheoesophageal puncture (TEP).
D) These clients need to learn to use the continuous positive airway pressure (CPAP).

Answer 2

These clients need support and help in understanding and choosing an alternative method of speech.

Question 3

You are caring for a client who is status post nasal polypectomy. What would you instruct this client to report?

A) Excessive swallowing
B) Nasal stuffiness
C) Diarrhea
D) Coughing

Answer 3

Excessive swallowing

Question 4

A client comes into the Emergency Department with epistaxis. What intervention should you perform when caring for a client with epistaxis?

A) Apply a moustache dressing.
B) Provide a nasal splint.
C) Apply direct continuous pressure.
D) Place the client in a semi-Fowler's position.

Question 5

You are an Emergency Department nurse caring for a client who experienced a trauma to the upper airway. What intervention should you perform to manage the risk of anxiety?

A) Provide detailed explanations.
B) Assist in positive visualization.
C) Monitor reduced respiratory rate.
D) Evaluate the response to analgesics.

Question 6

The client you are caring for has just been told they have advanced laryngeal cancer. What is the treatment of choice?

A) Partial laryngectomy
B) Laser surgery
C) Radiation therapy
D) Total laryngectomy

Question 7

You are presenting about upper respiratory infections at an educational event for a local community group. What should you be sure to include regarding cold tablets containing antihistamines?

A) They dilute the nasal secretions.
B) They lead to frequent sinus drainage.
C) They decrease discomfort temporarily.
D) They prolong bleeding.

Question 8

You are mentoring a new graduate nurse. Today the two of you are caring for a client with a new tracheostomy. The new graduate nurse asks what the complications of tracheostomy are. What would you respond? Select all that apply.

A) Absence of secretions
B) Aspiration
C) Infection
D) Injury to the laryngeal nerve
E) Penetration of the anterior tracheal wall

Question 9

Your client has just been diagnosed with laryngeal cancer. The client asks you what causes laryngeal cancer. What would be your best response?

A) "Research has shown that heredity contributes to having laryngeal cancer."
B) "Research has shown that habitual resting of the voice contributes to laryngeal cancer."
C) "A carcinogen associated with laryngeal cancer is carbon monoxide."
D) "A carcinogen associated with laryngeal cancer is allergies."

Question 10

Your client has a history of hoarseness lasting longer than 2 weeks. The client is now complaining of feeling a lump in their throat. What would you suspect this client has?

A) Cancer of the pharynx
B) Laryngeal cancer
C) Laryngeal polyps
D) Cancer of the tonsils

Question 11

You are caring for a client who is post sinus surgery. When you assess this client you ask them how many fingers you are holding up. Why do you assess postoperative visual acuity?

A) To assess possible hemorrhage
B) To assess damage to the optic nerve
C) To assess postoperative infection
D) To assess impaired drainage

Question 12

You are caring for a client who has just been told they have advanced laryngeal cancer and will have to have a total laryngectomy. You are doing preoperative teaching with this client. What do you know is a subject you should cover?

A) Visiting hours
B) Pain before surgery
C) Alternative methods of communication
D) Post operative nutrition

Question 13

Your client is status post total laryngectomy and cannot talk. What intervention should you make to help this client communicate?

A) Provide alternative methods of communication.
B) Teach the client esophageal speech.
C) Teach the client about an artificial larynx.
D) Provide a lip reader as a translator.

Question 14

You are an occupational health nurse who is presenting a workshop on laryngeal cancer. What risk factors would you be sure to include in your workshop? Select all that apply.

A) Alcohol
B) Age
C) Tobacco
D) Industrial pollutants
E) Region of country you live in

Question 15

You are speaking at a local PTO meeting about upper respiratory infections. Which preventive factor for rhinitis should you teach the attendees?

A) Avoid clearing the throat.
B) Use a straw to drink fluids.
C) Get adequate rest and sleep.
D) Avoid carbonated fluids.

Question 16

You are caring for a client diagnosed with enlarged adenoids. What condition is produced by enlarged adenoids?

A) Incrusted mucous membranes
B) Hardened secretions
C) Erosion of the trachea
D) Noisy breathing

Question 17

A client comes into the clinic complaining of hoarseness that has lasted for about a month. What would you suspect?

A) Laryngeal cancer
B) Laryngeal polyps
C) Chronic pharyngitis
D) Chronic tonsilittis

Question 18

Malignancy of the larynx can be a devastating diagnosis. What does a client with a diagnosis of laryngeal cancer require?

A) Emotional support
B) Referral for counseling
C) Family counseling
D) Referral for vocational training

Question 19

You are doing preoperative teaching with a client scheduled for laryngeal surgery. What should you teach this client to help prevent atelectasis?

A) Monitor for signs of dysphagia.
B) Provide meticulous mouth care every 4 hours.
C) Caution against frequent coughing.
D) Encourage deep breathing every 2 hours.

Question 20

You are performing a preoperative assessment on a client who is scheduled for a tonsillectomy. Why would you ask the client about the use of herbal supplements?

A) They produce anorexia.
B) They impair the immune system.
C) They prolong bleeding.
D) They lower high-density lipoprotein levels.

Question 21

You are admitting a client from the PACU who has just had a tracheostomy. What intervention is necessary for this client before they come to your unit?

A) Wire cutters are taped to the head of the bed.
B) A tracheal dilator is placed at the bedside.
C) A tracheostomy tray is placed at the bedside.
D) A mouth block is taped to the wall at the head of the bed.

Question 22

What client would be most in need of an endotracheal tube?

A) A client status post tonsillectomy
B) Ambulatory clients
C) Older adult clients
D) Comatose clients

Question 23

You are caring for a client who is 42-years-old and status post adenoidectomy. You find the client in respiratory distress when you enter their room. You ask another nurse to call the physician and bring an endotracheal tube into the room. What do you suspect?

A) Infection
B) Post operative bleeding
C) Edema of the upper airway
D) Plugged tracheostomy tube

Question 24

You are a clinic nurse caring for a client who is 2 months post laryngectomy. What is a nursing diagnosis pertaining to this client?

A) Pain related to laryngeal surgery
B) Infection related to laryngeal surgery
C) Social Isolation related to change in body image, tracheal stoma, and change in or loss of speech
D) Imbalanced Nutrition: Less than Body Requirements related to laryngeal pain

Question 25

You are a nurse caring for a client who has just had a tracheostomy. What should you monitor frequently?

A) Airway patency
B) Level of consciousness
C) Psychologic status
D) Pain level