Chapter 26 Book - Upper Respiratory Problems

Question 1

A patient was seen in the clinic for an episode of expistaxis, which was controlled by placement of anterior nasal pacing. During discharge teaching, the nurse instructs the patient to:
A. Use aspirin for pain relief
B. Remove the packing later that day
C. Skip the next dose of antihypertensive medication
D. Avoid vigorous nose blowing and strenuous activity

Answer 1

D. Avoid vigorous nose blowing and strenuous activity

Question 2

A patient with allergic rhinitis reports severe nasal congestion; sneezing; and watery, itchy eyes and nose at various times of the year. To teach the patient to control these symptoms, the nurse advises the patient to:
A. Avoid all intranasal sprays and oral antihistamines
B. Limit the usage of nasal decongestant spray to 10 days
C. Use oral decongestants at bedtime to prevent symptoms during the night
D. Keep a diary of when the allergic reaction occurs and what precipitates it

Answer 2

D. Keep a diary of when the allergic reaction occurs and what precipitates it

Question 3

A patient is seen at the clinic with fever, muscle aches, sore throat with yellowish exudate, and headache. The nurse anticipates that the interprofessional management will include (Select all that apply)
A. Antiviral agents to treat influenza
B. Treatment with antibiotics starting ASAP
C. a throat culture or rapid strep antigen test
D. Supportive care, including cool, bland liquids
E. Comprehensive history to determine possible etiology

Answer 3

C. a throat culture or rapid strep antigen test
D. Supportive care, including cool, bland liquids
E. Comprehensive history to determine possible etiology

Question 4

The best method for determining the risk of aspiration in a patient with a tracheostomy is to:
A. Consult a speech therapist for swallowing assessment
B. Have the patient drink plain water and assess for coughing
C. Assess for change of sputum color 48 hrs after patient drinks small amount of blue dye
D. Suction above the cuff after the patient eats or drinks to determine presence of food in trachea

Answer 4

A. Consult a speech therapist for swallowing assessment

Question 5

Which nursing action would be of highest priority when suctioning a patient with a tracheostomy?
A. Auscultation lung sounds after suctioning is complete
B. Providing a means of communication for the patient during the procedure
C. Assessing the patients oxygenation saturation before, during, and after suctioning
D. Administering pain and / or anti anxiety medication 30 minutes before functioning

Answer 5

C. Assessing the patients oxygenation saturation before, during, and after suctioning

Question 6

When planning health care teaching to prevent or detect early head or neck cancer, which people would be the priority to target: (Select all that apply)
A. 65-yr old man who has used tobacco most of his life
B. 45-yr old rancher who uses snuff to stay awake while driving his herds of cattle
C. 21-yr old college student who drinks beer on weekends with his fraternity brother
D. 78-yr old woman who has been drinking hard liquor since her husband died 15 yrs ago
E. 22-yr old woman who has been diagnosed with HPV of the cervix

Answer 6

A. 65-yr old man who has used tobacco most of his life
B. 45-yr old rancher who uses snuff to stay awake while driving his herds of
D. 78-yr old woman who has been drinking hard liquor since her husband died 15 yrs ago
E. 22-yr old woman who has been diagnosed with HPV of the cervix

Question 7

While in the recovery room, a patient with a total laryngetomy is suctioned and has bloody mucus with some clots. Which nursing interventions would apply?
A. Notify the physician immediately
B. Place the patient in the prone position to facilitate drainage
C. Instill 3 mL of normal saline into the tracheostomy tube to loosen secretions
D. Continue your assessment of the patient, including O2 saturation, respiratory rate, and breath sounds

Answer 7

D. Continue your assessment of the patient, including O2 saturation, respiratory rate, and breath sounds

Question 8

Appropriate discharge teaching for the patient with a permanent tracheostomy after a total laryngectomy for cancer would include: (select all that apply)
A. Encouraging regular exercise such as swimming
B. Washing around the stoma daily with a moist washcloth
C. Encouraging participation in post laryngectomy support group
D. Providing picture and “hands-on” instruction for tracheostomy care
E. Teaching how to hold breath and trying to gag to promote swallowing reflex

Answer 8

B. Washing around the stoma daily with a moist washcloth
C. Encouraging participation in post laryngectomy support group
D. Providing picture and “hands-on” instruction for tracheostomy care