Deck 13: Care of Patients with Disorders of the Upper Respiratory System
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Deck 13: Care of Patients with Disorders of the Upper Respiratory System
1
The nurse is assessing an older adult with a family tendency of developing laryngeal cancer.The nurse should ask the patient about which risk factors?
A) History of smoking
B) Alcohol abuse
C) Exposure to asbestos
D) Occupational exposure to wood dust
E) Infection with Streptococcus bacteria
A) History of smoking
B) Alcohol abuse
C) Exposure to asbestos
D) Occupational exposure to wood dust
E) Infection with Streptococcus bacteria
History of smoking
Alcohol abuse
Exposure to asbestos
Occupational exposure to wood dust
Alcohol abuse
Exposure to asbestos
Occupational exposure to wood dust
2
The nurse is caring for a patient with suspected sinusitis.Which assessment finding supports this diagnosis?
A) Maxillary sinuses nontender on percussion.
B) Generalized pain in the upper teeth.
C) Clear drainage from the ear.
D) Ear pain when lying down
A) Maxillary sinuses nontender on percussion.
B) Generalized pain in the upper teeth.
C) Clear drainage from the ear.
D) Ear pain when lying down
Generalized pain in the upper teeth.
3
When teaching a patient about esophageal speech,which technique should the nurse instruct the patient to use first?
A) Coordinate lip and tongue movements with produced sound.
B) Relax the diaphragm to allow air into the esophagus.
C) Cough to express air.
D) Swallow air and force it back up through the esophagus.
A) Coordinate lip and tongue movements with produced sound.
B) Relax the diaphragm to allow air into the esophagus.
C) Cough to express air.
D) Swallow air and force it back up through the esophagus.
Swallow air and force it back up through the esophagus.
4
The nurse is caring for a patient with sleep apnea.The patient complains that he is constantly fatigued.Which response is most appropriate for the nurse to make?
A) "Patients with sleep apnea experience oxygen overloads, which lead to drowsiness."
B) "Patients with sleep apnea often wake frequently during the night."
C) "Patients with mild sleep apnea benefit from a small amount of red wine right before bed."
D) "All patients have difficulty sleeping properly in the hospital."
A) "Patients with sleep apnea experience oxygen overloads, which lead to drowsiness."
B) "Patients with sleep apnea often wake frequently during the night."
C) "Patients with mild sleep apnea benefit from a small amount of red wine right before bed."
D) "All patients have difficulty sleeping properly in the hospital."
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5
The nurse is teaching a patient who underwent a laryngectomy.Which statement describes the correct technique for warming inspired air during cold weather?
A) Cover the stoma with a clean hand.
B) Cover the stoma with a scarf.
C) Apply a moist dressing over the stoma.
D) Carry a portable humidifier.
A) Cover the stoma with a clean hand.
B) Cover the stoma with a scarf.
C) Apply a moist dressing over the stoma.
D) Carry a portable humidifier.
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6
The nurse is caring for a 20-year-old patient who recently underwent a tonsillectomy.The patient is fully awake and clearing his throat frequently but denies pain.Which action is most important for the nurse to take first?
A) Place the patient in a side-lying position.
B) Look in the patient's mouth.
C) Offer the patient a grape popsicle.
D) Remove the straw from the patient's tray.
A) Place the patient in a side-lying position.
B) Look in the patient's mouth.
C) Offer the patient a grape popsicle.
D) Remove the straw from the patient's tray.
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7
When doing routine cleaning of a double-lumen tracheostomy tube,the nurse should include which action?
A) Place the patient supine.
B) Reinsert the inner cannula without touching the faceplate of the tracheostomy tube.
C) Rinse the inner cannula in a basin of hydrogen peroxide.
D) Clean the inner cannula with a pipe cleaner.
A) Place the patient supine.
B) Reinsert the inner cannula without touching the faceplate of the tracheostomy tube.
C) Rinse the inner cannula in a basin of hydrogen peroxide.
D) Clean the inner cannula with a pipe cleaner.
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8
What is the contagion period of a cold?
A) 2 days
B) 3 days
C) 4 days
D) 7 days
A) 2 days
B) 3 days
C) 4 days
D) 7 days
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9
The nurse is caring for a patient who has a tracheostomy with a one-way valve box.The nurse explains to the CNA that this valve allows the patient to carry out which function?
A) Drinking
B) Eating
C) Coughing
D) Talking
A) Drinking
B) Eating
C) Coughing
D) Talking
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10
The nurse is assisting the physician with the insertion of a new tracheostomy tube.The physician asks for the obturator.The nurse correctly hands the physician which device?
A) The guide for the tracheostomy tube to be inserted
B) The scalpel used to make the tracheostomy stoma
C) A single-cannula tracheostomy tube
D) A cuffed tracheostomy tube
A) The guide for the tracheostomy tube to be inserted
B) The scalpel used to make the tracheostomy stoma
C) A single-cannula tracheostomy tube
D) A cuffed tracheostomy tube
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11
The nurse is caring for a patient experiencing epistaxis.What action should the nurse take first?
A) Obtain the patient's vital signs.
B) Firmly pack the nostrils with gauze.
C) Apply a cold compress.
D) Instruct the patient to sit forward and pinch the nose below the bone.
A) Obtain the patient's vital signs.
B) Firmly pack the nostrils with gauze.
C) Apply a cold compress.
D) Instruct the patient to sit forward and pinch the nose below the bone.
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12
Which statement is most important for the nurse to make when caring for an anxious patient with a new tracheostomy?
A) "I have cared for patients who were able to have the tracheostomy reversed."
B) "I will be efficient and give care quickly."
C) "I will wait until your tracheostomy heals before teaching."
D) "I understand that you might be apprehensive."
A) "I have cared for patients who were able to have the tracheostomy reversed."
B) "I will be efficient and give care quickly."
C) "I will wait until your tracheostomy heals before teaching."
D) "I understand that you might be apprehensive."
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13
The nurse is aware that the patient seeking antibiotic treatment for pharyngitis will only receive the desired medication if the condition is caused by what type of pathogen?
A) Protozoa
B) Bacteria
C) A virus
D) Fungi
A) Protozoa
B) Bacteria
C) A virus
D) Fungi
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14
The nurse is caring for a patient who has had a cold for 1 week.The patient questions why the health care provider issued a prescription for an antibiotic.Which explanation is best?
A) "The antibiotic will cure your cold."
B) "The antibiotic will help to reduce your symptoms."
C) "The antibiotic will treat the secondary bacterial infection that has developed."
D) "The antibiotic will decrease the amount of time for which you are contagious."
A) "The antibiotic will cure your cold."
B) "The antibiotic will help to reduce your symptoms."
C) "The antibiotic will treat the secondary bacterial infection that has developed."
D) "The antibiotic will decrease the amount of time for which you are contagious."
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15
The nurse is teaching an adult post-tonsillectomy patient.Which dietary instructions are most important for the nurse to include?
A) Increase intake of citrus fruits.
B) Avoid hot fluids.
C) Avoid milk products.
D) Avoid foods with red dye.
E) Use a straw to drink liquids.
A) Increase intake of citrus fruits.
B) Avoid hot fluids.
C) Avoid milk products.
D) Avoid foods with red dye.
E) Use a straw to drink liquids.
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16
The nurse is caring for a patient who underwent a laryngectomy.Which need should the nurse address first?
A) Pain control
B) Family support
C) Communication method
D) Plan for long-term care
A) Pain control
B) Family support
C) Communication method
D) Plan for long-term care
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17
The nurse is caring for a patient during the immediate postoperative period following a rhinoplasty.Which finding is most concerning to the nurse?
A) The patient complains of being cold and chilled.
B) The patient complains of nausea.
C) The nurse notices the patient is swallowing frequently.
D) The nurse notices drainage on the nasal drip pad.
A) The patient complains of being cold and chilled.
B) The patient complains of nausea.
C) The nurse notices the patient is swallowing frequently.
D) The nurse notices drainage on the nasal drip pad.
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18
Which action(s)may help to reduce the risk of transmitting a common cold?
A) Cover the mouth and nose when sneezing.
B) Wash the hands frequently.
C) Use saline nose sprays.
D) Turn the head to the crook of the arm when coughing.
E) Drink juices with vitamin C.
A) Cover the mouth and nose when sneezing.
B) Wash the hands frequently.
C) Use saline nose sprays.
D) Turn the head to the crook of the arm when coughing.
E) Drink juices with vitamin C.
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19
Which organism(s)are common causative agents for sinusitis?
A) Pneumococci
B) Pseudomonas
C) Staphylococci
D) Haemophilus influenzae
E) Streptococci
A) Pneumococci
B) Pseudomonas
C) Staphylococci
D) Haemophilus influenzae
E) Streptococci
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20
The nurse carefully applies suction prior to deflating the cuff on a cuffed tracheostomy in order to prevent which complication?
A) Bleeding
B) Excessive negative pressure
C) Accidental dislodgement of the tube
D) Aspiration
A) Bleeding
B) Excessive negative pressure
C) Accidental dislodgement of the tube
D) Aspiration
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21
Place the steps of abdominal thrusts in proper sequence.
Step 4
A)Wrap hand around fist.
B)Squeeze and thrust five times.
C)Make a fist.
D)Check status of breathing.
E)Position fist, thumb foremost, over umbilicus.
Step 4
A)Wrap hand around fist.
B)Squeeze and thrust five times.
C)Make a fist.
D)Check status of breathing.
E)Position fist, thumb foremost, over umbilicus.
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22
The nurse is performing discharge teaching for a patient who underwent a microlaryngoscopy with laser removal of polyps.Which instruction(s)should the nurse include?
A) Be alert for massive swelling.
B) You can return to work in 3 days.
C) Cough gently to expectorate blood.
D) Observe 2 days of voice rest.
E) Take opioids as needed for pain control.
A) Be alert for massive swelling.
B) You can return to work in 3 days.
C) Cough gently to expectorate blood.
D) Observe 2 days of voice rest.
E) Take opioids as needed for pain control.
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23
The radical neck resection removes a large amount of tissue on the same side as the lesion.Which statement(s)about the tissue removed is/are correct?
A) The tissue includes all muscle, lymph nodes, and soft tissue from the lower edge of the mandible to the top of the clavicle.
B) The tissue includes all muscle, lymph nodes, and soft tissue from the top of the trapezius to the midline.
C) The tissue includes all muscle, lymph nodes, and soft tissue from the lower edge of the eye socket to the bottom of the maxilla, including the zygomatic arch.
D) The tissue includes part of the tongue and parotid salivary glands.
E) The tissue includes all lower lip to midline.
A) The tissue includes all muscle, lymph nodes, and soft tissue from the lower edge of the mandible to the top of the clavicle.
B) The tissue includes all muscle, lymph nodes, and soft tissue from the top of the trapezius to the midline.
C) The tissue includes all muscle, lymph nodes, and soft tissue from the lower edge of the eye socket to the bottom of the maxilla, including the zygomatic arch.
D) The tissue includes part of the tongue and parotid salivary glands.
E) The tissue includes all lower lip to midline.
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24
The nurse is teaching a patient with a newly resolved episode of epistaxis.Which information is important for the nurse to include?
A) Avoid sneezing.
B) Rest for several hours until all threat of epistaxis is gone.
C) Avoid rubbing the nose.
D) Gently remove clotted blood from the occluded nostril.
E) Blow the nose gently in small breaths.
A) Avoid sneezing.
B) Rest for several hours until all threat of epistaxis is gone.
C) Avoid rubbing the nose.
D) Gently remove clotted blood from the occluded nostril.
E) Blow the nose gently in small breaths.
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25
Place the steps of abdominal thrusts in proper sequence.
Step 5
A)Wrap hand around fist.
B)Squeeze and thrust five times.
C)Make a fist.
D)Check status of breathing.
E)Position fist, thumb foremost, over umbilicus.
Step 5
A)Wrap hand around fist.
B)Squeeze and thrust five times.
C)Make a fist.
D)Check status of breathing.
E)Position fist, thumb foremost, over umbilicus.
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26
Place the steps of abdominal thrusts in proper sequence.
Step 3
A)Wrap hand around fist.
B)Squeeze and thrust five times.
C)Make a fist.
D)Check status of breathing.
E)Position fist, thumb foremost, over umbilicus.
Step 3
A)Wrap hand around fist.
B)Squeeze and thrust five times.
C)Make a fist.
D)Check status of breathing.
E)Position fist, thumb foremost, over umbilicus.
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27
The nurse encourages a patient with larynx cancer that the "near-total laryngectomy" is a new procedure that preserves the ability to __________ and to __________.
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28
The clinic nurse is giving discharge instructions to the mother of a 10-year-old boy who has been diagnosed with a mild cold.Which statements indicate that the mother accurately understands the nurse's instructions?
A) "I will be sure he takes the entire prescription of antibiotic."
B) "I will be sure he drinks plenty of apple and orange juice."
C) "If he runs a fever, I will give him two aspirin every 4 hours until his fever comes down."
D) "I will be sure he washes his hands well so he doesn't pass this cold on to his younger sister."
E) "Since his cold symptoms just started, zinc lozenges may be helpful for him to take."
A) "I will be sure he takes the entire prescription of antibiotic."
B) "I will be sure he drinks plenty of apple and orange juice."
C) "If he runs a fever, I will give him two aspirin every 4 hours until his fever comes down."
D) "I will be sure he washes his hands well so he doesn't pass this cold on to his younger sister."
E) "Since his cold symptoms just started, zinc lozenges may be helpful for him to take."
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29
The nurse is setting up the environment for tracheal suction on a newly postoperative tracheostomy patient.Which action(s)should the nurse perform?
A) Auscultate lungs for retained secretions.
B) Wash hands and open sterile suction kit.
C) Don clean gloves and lift out catheter and connect to suction.
D) Inform the patient about the procedure.
E) Perform suction with sterile supplies.
A) Auscultate lungs for retained secretions.
B) Wash hands and open sterile suction kit.
C) Don clean gloves and lift out catheter and connect to suction.
D) Inform the patient about the procedure.
E) Perform suction with sterile supplies.
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30
Place the steps of abdominal thrusts in proper sequence.
Step 1
A)Wrap hand around fist.
B)Squeeze and thrust five times.
C)Make a fist.
D)Check status of breathing.
E)Position fist, thumb foremost, over umbilicus.
Step 1
A)Wrap hand around fist.
B)Squeeze and thrust five times.
C)Make a fist.
D)Check status of breathing.
E)Position fist, thumb foremost, over umbilicus.
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31
Place the steps of abdominal thrusts in proper sequence.
Step 2
A)Wrap hand around fist.
B)Squeeze and thrust five times.
C)Make a fist.
D)Check status of breathing.
E)Position fist, thumb foremost, over umbilicus.
Step 2
A)Wrap hand around fist.
B)Squeeze and thrust five times.
C)Make a fist.
D)Check status of breathing.
E)Position fist, thumb foremost, over umbilicus.
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