Question 1

A patient complains of morning headaches, a feeling of fullness in her head, and a pain similar to that of a toothache under her eye.What should the nurse recognize that these symptoms indicate?

Accepted Answer

The symptoms described suggest sinusitis, which is inflammation of the sinuses. Morning headaches and a feeling of fullness in the head may be associated with sinus congestion and pressure, while pain under the eye can be a common symptom of sinusitis. Nasal polyps and allergic rhinitis may also cause sinus symptoms, but the toothache-like pain is more indicative of sinusitis. Impacted wisdom teeth usually cause pain and swelling in the back of the mouth, and are less likely to be associated with morning headaches or sinus symptoms.

Question 2

What is true regarding bacterial pharyngitis that is untrue for viral pharyngitis?

Accepted Answer

Bacterial pharyngitis typically has an abrupt onset, whereas viral pharyngitis may have a more gradual onset.
Answer: B
 Bacterial pharyngitis may present with an elevated white blood cell count and neutrophilia on the CBC. Viral pharyngitis may also present with an elevated white blood cell count, but typically with lymphocytosis instead of neutrophilia.
Answer: C
 Bacterial pharyngitis may present with a positive culture for the bacteria causing the infection, while viral pharyngitis will not have a positive culture for bacteria.
Answer: D
 Both bacterial and viral pharyngitis can have serious complications if left untreated, such as rheumatic fever with bacterial pharyngitis and airway obstruction with viral pharyngitis.

Question 3

Which actions should the nurse include in a care plan to effectively assist the patient with a total laryngectomy to maintain airway clearance? (Select all that apply.)

Accepted Answer

Turning, coughing, and deep breathing help prevent mucus accumulation and pneumonia. Semi-Fowler position facilitates breathing and drainage. Maintaining hydration thins secretions, making them easier to clear. A tracheostomy collar delivers humidified air to the stoma, helping to keep the airway clear.

Question 4

What is best for a nurse to offer when encouraging a new patient after a tonsillectomy to increase fluids?

Accepted Answer

Flavored popsicles can help soothe the throat while encouraging fluid intake without irritating the surgical site, unlike citrus juices which can be acidic and straws which can cause unnecessary pressure.

Question 5

What are the most common causes of laryngitis?

Accepted Answer

Respiratory infections, such as viral or bacterial infections, are a common cause of laryngitis. Voice strain, from shouting, talking loudly or for long periods of time, can also contribute to laryngitis. The other choices, smoking, highly seasoned foods, alcohol, nasal congestion, and frequent coughing, may exacerbate laryngitis but are not typically the primary cause.

Question 6

A nurse reminds a patient, who is to have a partial laryngectomy, that the temporary tracheostomy that he will have after the original surgery will be closed within ______ days.(Use numeric characters only.)

Accepted Answer

The answer of A nurse reminds a patient, who is...

Question 7

Which is the best candidate for a tonsillectomy?

Accepted Answer

A tonsillectomy is typically indicated for recurrent tonsillitis, sleep-disordered breathing, or peritonsillar abscess. The 23-year-old patient with a peritonsillar abscess would benefit from a tonsillectomy to prevent future abscesses. The other patients do not have indications for a tonsillectomy.

Question 8

What is one major postoperative difficulty for a patient having a supraglottic laryngectomy?

Accepted Answer

After a supraglottic laryngectomy, the patient's ability to swallow may be affected due to changes in the anatomy of the throat. Aspiration, or food/liquid entering the lungs instead of the stomach, is a major postoperative difficulty that must be addressed through careful swallowing therapy and monitoring. While the other options may also pose challenges, they are not as significant or immediate as the risk of aspiration.

Question 9

A patient who has cancer of the larynx has been told that he needs a total laryngectomy.What action should this nurse consider to help the patient cope with the loss of his voice?

Accepted Answer

Having a volunteer from a local laryngectomy organization visit the patient can provide emotional support and offer the patient an opportunity to see and talk to someone who has gone through a similar experience. This can help the patient cope with the loss of their voice and learn about their options for communication after the surgery. Options for vocalization aids and techniques can also be discussed during this visit. While explaining what will happen after the surgery and notifying the hospital chaplain may also be useful, A is the best initial action to help the patient cope with their situation.

Question 10

A patient who had a laryngectomy 3 months earlier returns to the physician's office with the complaint of increasing dyspnea.Which common postlaryngectomy complication should the nurse recognize this complaint as indicating?

Accepted Answer

Dyspnea can be a symptom of tracheal stenosis, which is a common postlaryngectomy complication where the trachea narrows and restricts breathing. Hypertrophied stoma, salivary fistula, and carotid blowout are also potential complications of laryngectomy, but they would not necessarily present with increasing dyspnea as the primary symptom.

Question 11

What should the initial action of a nurse be when providing first aid to a person with spontaneous epistaxis?

Accepted Answer

The initial action of a nurse when providing first aid to a person with spontaneous epistaxis should be to have the person sit down and lean forward. This position helps to prevent blood from entering the respiratory system and causing choking or aspiration. Applying direct pressure for 3 to 5 minutes can also be done after the person is in a safe position. Having the person lie down and applying an ice pack are not recommended as they can cause blood to flow into the throat or sinuses. Clearing the nasal passages by blowing the nose is also not recommended during an episode of epistaxis as it can cause further bleeding.

Question 12

A patient complains that he wants an antibiotic medication for his cold.What is the best response by the nurse?

Accepted Answer

Antibiotics are only effective against bacterial infections, not viral infections like the common cold. Giving antibiotics for a viral infection can actually harm the patient by promoting antibiotic resistance and killing off beneficial bacteria. The nurse needs to educate the patient about the appropriate use of antibiotics.

Question 13

What is the most significant topic for a nurse to include in a teaching plan for a patient with frequent episodes of laryngitis?

Accepted Answer

Observing voice rest is the most significant topic for a nurse to include in a teaching plan for a patient with frequent episodes of laryngitis because it is the most effective way to prevent further damage to the vocal cords.

Question 14

Which nursing concern takes priority in the care of a patient after a laryngectomy?

Accepted Answer

After a laryngectomy, the patient will have a difficult time communicating since their vocal cords have been removed. Therefore, establishing a communication system takes priority to ensure that the patient can express their needs and concerns effectively. Encouraging nutrition, avoiding infection, and ensuring adequate fluid intake are also important nursing concerns, but they do not take priority over communication.

Quiz 26: Upper Respiratory Disorders