Nokea
A mother calls the clinic asking for a prescription for Amoxicillin for her 2-year-old son who has what the nurse suspects to be viral rhinitis. What should the nurse explain to this mother?
- A. I will relay your request promptly to the doctor, but I suspect that she wont get back to you if its a cold.
- B. Ill certainly inform the doctor, but if it is a cold, antibiotics wont be used because they do not affect the virus.
- C. Ill phone in the prescription for you since it can be prescribed by the pharmacist.
- D. Amoxicillin is not likely the best antibiotic, but Ill call in the right prescription for you.
Correct Answer: B
Rationale: Antimicrobial agents (antibiotics) should not be used because they do not affect the virus or reduce the incidence of bacterial complications. In addition, their inappropriate use has been implicated in development of organisms resistant to therapy. It would be inappropriate to tell the patient that the physician will not respond to her request.
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The nurse is caring for a patient whose recent unexplained weight loss and history of smoking have prompted diagnostic testing for cancer. What symptom is most closely associated with the early stages of laryngeal cancer?
- A. Hoarseness
- B. Dyspnea
- C. Dysphagia
- D. Frequent nosebleeds
Correct Answer: A
Rationale: Hoarseness is an early symptom of laryngeal cancer. Dyspnea, dysphagia, and lumps are later signs of laryngeal cancer. Alopecia is not associated with a diagnosis of laryngeal cancer.
A patient visiting the clinic is diagnosed with acute sinusitis. To promote sinus drainage, the nurse should instruct the patient to perform which of the following?
- A. Apply a cold pack to the affected area.
- B. Apply a mustard poultice to the forehead.
- C. Perform postural drainage.
- D. Increase fluid intake.
Correct Answer: D
Rationale: For a patient diagnosed with acute sinusitis, the nurse should instruct the patient that hot packs, increasing fluid intake, and elevating the head of the bed can promote drainage. Applying a mustard poultice will not promote sinus drainage. Postural drainage is used to remove bronchial secretions.
The nurse is creating a plan of care for a patient diagnosed with acute laryngitis. What intervention should be included in the patients plan of care?
- A. Place warm cloths on the patients throat, as needed.
- B. Have the patient inhale warm steam three times daily.
- C. Encourage the patient to limit speech whenever possible.
- D. Limit the patients fluid intake to 1.5 L/day.
Correct Answer: C
Rationale: Management of acute laryngitis includes resting the voice, avoiding irritants (including smoking), resting, and inhaling cool steam or an aerosol. Fluid intake should be increased. Warm cloths on the throat will not help relieve the symptoms of acute laryngitis.
The nurse is performing an assessment on a patient who has been diagnosed with cancer of the larynx. Part of the nurses assessment addresses the patients general state of nutrition. Which laboratory values would be assessed when determining the nutritional status of the patient?
- A. White blood cell count
- B. Protein level
- C. Albumin level
- D. Platelet count
- E. Glucose level
Correct Answer: B,C,E
Rationale: The nurse also assesses the patients general state of nutrition, including height and weight and body mass index, and reviews laboratory values that assist in determining the patients nutritional status (albumin, protein, glucose, and electrolyte levels). The white blood cell count and the platelet count would not normally assist in determining the patients nutritional status.
The nurse recognizes that aspiration is a potential complication of a laryngectomy. How should the nurse best manage this risk?
- A. Facilitate total parenteral nutrition (TPN).
- B. Keep a complete suction setup at the bedside.
- C. Feed the patient several small meals daily.
- D. Refer the patient for occupational therapy.
Correct Answer: B
Rationale: Due to the risk for aspiration, the nurse keeps a suction setup available in the hospital and instructs the family to do so at home for use if needed. TPN is not indicated and small meals do not necessarily reduce the risk of aspiration. Physical therapists do not address swallowing ability.