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A nursing student is discussing a patient with viral pharyngitis with the preceptor at the walk-in clinic. What should the preceptor tell the student about nursing care for patients with viral pharyngitis?
- A. Teaching focuses on safe and effective use of antibiotics.
- B. The patient should be preliminarily screened for surgery.
- C. Symptom management is the main focus of medical and nursing care.
- D. The focus of care is resting the voice to prevent chronic hoarseness.
Correct Answer: C
Rationale: Nursing care for patients with viral pharyngitis focuses on symptomatic management. Antibiotics are not prescribed for viral etiologies. Surgery is not indicated in the treatment of viral pharyngitis. Chronic hoarseness is not a common sequela of viral pharyngitis, so teaching ways to prevent it would be of no use in this instance.
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The nurse is caring for a patient who is postoperative day 2 following a total laryngectomy for supraglottic cancer. The nurse should prioritize what assessment?
- A. Assessment of body image
- B. Assessment of jugular venous pressure
- C. Assessment of carotid pulse
- D. Assessment of swallowing ability
Correct Answer: D
Rationale: A common postoperative complication from this type of surgery is difficulty in swallowing, which creates a potential for aspiration. Cardiovascular complications are less likely at this stage of recovery. The patients body image should be assessed, but dysphagia has the potential to affect the patients airway, and is a consequent priority.
The nurse is providing patient teaching to a young mother who has brought her 3-month-old infant to the clinic for a well-baby checkup. What action should the nurse recommend to the woman to prevent the transmission of organisms to her infant during the cold season?
- A. Take preventative antibiotics, as ordered.
- B. Gargle with warm salt water regularly.
- C. Dress herself and her infant warmly.
- D. Wash her hands frequently.
Correct Answer: D
Rationale: Handwashing remains the most effective preventive measure to reduce the transmission of organisms. Taking prescribed antibiotics, using warm salt-water gargles, and dressing warmly do not suppress transmission. Antibiotics are not prescribed for a cold.
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.
The nurse is conducting a presurgical interview for a patient with laryngeal cancer. The patient states that he drinks approximately six to eight shots of vodka per day. It is imperative that the nurse inform the surgical team so the patient can be assessed for what?
- A. Increased risk for infection
- B. Delirium tremens
- C. Depression
- D. Nonadherence to postoperative care
Correct Answer: B
Rationale: Considering the known risk factors for cancer of the larynx, it is essential to assess the patients history of alcohol intake. Infection is a risk in the postoperative period, but not an appropriate answer based on the patients history. Depression and nonadherence are risks in the postoperative phase, but would not be critical short-term assessments.
The nurse is teaching a patient with allergic rhinitis about the safe and effective use of his medications. What would be the most essential information to give this patient about preventing possible drug interactions?
- A. Prescription medications can be safely supplemented with OTC medications.
- B. Use only one pharmacy so the pharmacist can check drug interactions.
- C. Read drug labels carefully before taking OTC medications.
- D. Consult the Internet before selecting an OTC medication.
Correct Answer: C
Rationale: Patient education is essential when assisting the patient in the use of all medications. To prevent possible drug interactions, the patient is cautioned to read drug labels before taking any OTC medications. Some Web sites are reliable and valid information sources, but this is not always the case. Patients do not necessarily need to limit themselves to one pharmacy, though checking for potential interactions is important. Not all OTC medications are safe additions to prescription medication regimens.