Nokea
A patient is being treated for bacterial pharyngitis. Which of the following should the nurse recommend when promoting the patients nutrition during treatment?
- A. A 1.5 L/day fluid restriction
- B. A high-potassium, low-sodium diet
- C. A liquid or soft diet
- D. A high-protein diet
Correct Answer: C
Rationale: A liquid or soft diet is provided during the acute stage of the disease, depending on the patients appetite and the degree of discomfort that occurs with swallowing. The patient is encouraged to drink as much fluid as possible (at least 2 to 3 L/day). There is no need for increased potassium or protein intake.
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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.
The nurse is caring for a patient who needs education on his medication therapy for allergic rhinitis. The patient is to take cromolyn (Nasalcrom) daily. In providing education for this patient, how should the nurse describe the action of the medication?
- A. It inhibits the release of histamine and other chemicals.
- B. It inhibits the action of proton pumps.
- C. It inhibits the action of the sodium-potassium pump in the nasal epithelium.
- D. It causes bronchodilation and relaxes smooth muscle in the bronchi.
Correct Answer: A
Rationale: Cromolyn (Nasalcrom) inhibits the release of histamine and other chemicals. It is prescribed to treat allergic rhinitis. Beta-adrenergic agents lead to bronchodilation and stimulate beta-3-adrenergic receptors in the smooth muscle of the bronchi and bronchioles. It does not affect proton pump action or the sodium-potassium pump in the nasal cells.
A patient has had a nasogastric tube in place for 6 days due to the development of paralytic ileus after surgery. In light of the prolonged presence of the nasogastric tube, the nurse should prioritize assessments related to what complication?
- A. Sinus infections
- B. Esophageal strictures
- C. Pharyngitis
- D. Laryngitis
Correct Answer: A
Rationale: Patients with nasotracheal and nasogastric tubes in place are at risk for development of sinus infections. Thus, accurate assessment of patients with these tubes is critical. Use of a nasogastric tube is not associated with the development of the other listed pathologies.
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 in the ED for epistaxis. What information should the nurse include in patient discharge teaching as a way to prevent epistaxis?
- A. Keep nasal passages clear.
- B. Use decongestants regularly.
- C. Humidify the indoor environment.
- D. Use a tissue when blowing the nose.
Correct Answer: C
Rationale: Discharge teaching for prevention of epistaxis should include the following: avoid forceful nose blowing, straining, high altitudes, and nasal trauma (nose picking). Adequate humidification may prevent drying of the nasal passages. Keeping nasal passages clear and using a tissue when blowing the nose are not included in discharge teaching for the prevention of epistaxis. Decongestants are not indicated.