Chapter 29 Upper Resp

Question 1

1. A client is seen in the clinic for an episode of epistaxis, which is controlled by placement of anterior nasal packing. During discharge teaching, what should the nurse instruct the client to do?
   a. Use ASA (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

Question 2

2. A client with allergic rhinitis reports severe nasal congestion, sneezing, and watery, itchy eyes and nose, at various times of the year. What should the nurse advise the client to do?
   a. Avoid all intranasal sprays and oral antihistamines.
   b. Limit the duration of use 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

Question 3

3. A client is seen at the clinic with fever, muscle aches, sore throat with yellowish exudate, and headache. Which of the following does the nurse anticipate that the collaborative 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 D E

Question 4

4. What type of tracheostomy tube prevents the use of the voice?
   a. Cuffless tracheostomy tube
   b. Fenestrated tracheostomy tube
   c. Tube with an inflated foam cuff
   d. Cuffed tube with the cuff deflated

Answer 4

C

Question 5

5. Which nursing action related to the tracheostomy tube cuff pressure would prevent excessive pressure on tracheal capillaries?
   a. Monitor pressure every 2 to 3 days.
   b. Ensure pressure is less than 20 mm Hg or 25 cm H2O.
   c. Ensure pressure is less than 30 mm Hg or 35 cm H2O.
   d. Ensure pressure is sufficient to fill the pilot balloon until it is tense.

Answer 5

B

Question 6

6. Which of the following is not an early symptom of head and neck cancer?
   a. Hoarseness
   b. Change in fit of dentures
   c. Mouth ulcers that do not heal
   d. Decreased mobility of the tongue

Answer 6

D

Question 7

7. While in the recovery room, a client with a total laryngectomy is suctioned and has bloody mucus with some clots. Which of the following nursing interventions would apply?
   a. Notify the physician immediately.
   b. Place the client in the prone position to facilitate drainage.
   c. Instill 3 mL of normal saline into the tracheostomy tube to loosen secretions.
   d. Continue the assessment of the client, including oxygen saturation, respiratory rate, and breath sounds.

Answer 7

D

Question 8

8. How should the client use a voice prosthesis?
   a. Place a vibrating device in the mouth.
   b. Place a speaking valve over the stoma.
   c. Block the stoma entrance with a finger.
   d. Swallow air using the Valsalva manoeuvre.

Answer 8

C