Nokea
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.
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A 45-year-old obese man arrives in a clinic with complaints of daytime sleepiness, difficulty going to sleep at night, and snoring. The nurse should recognize the manifestations of what health problem?
- A. Adenoiditis
- B. Chronic tonsillitis
- C. Obstructive sleep apnea
- D. Laryngeal cancer
Correct Answer: C
Rationale: Obstructive sleep apnea occurs in men, especially those who are older and overweight. Symptoms include excessive daytime sleepiness, insomnia, and snoring. Daytime sleepiness and difficulty going to sleep at night are not indications of tonsillitis or adenoiditis. This patients symptoms are not suggestive of laryngeal cancer.
The nurse is caring for a patient who has just been diagnosed with chronic rhinosinusitis. While being admitted to the clinic, the patient asks, Will this chronic infection hurt my new kidney? What should the nurse know about chronic rhinosinusitis in patients who have had a transplant?
- A. The patient will have exaggerated symptoms of rhinosinusitis due to immunosuppression.
- B. Taking immunosuppressive drugs can contribute to chronic rhinosinusitis.
- C. Chronic rhinosinusitis can damage the transplanted organ.
- D. Immunosuppressive drugs can cause organ rejection.
Correct Answer: B
Rationale: URIs, specifically chronic rhinosinusitis and recurrent acute rhinosinusitis, may be linked to primary or secondary immune deficiency or treatment with immunosuppressive therapy (i.e., for cancer or organ transplantation). Typical symptoms may be blunted or absent due to immunosuppression. No evidence indicates damage to the transplanted organ due to chronic rhinosinusitis. Immunosuppressive drugs do not cause organ rejection.
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 planning the care of a patient who is scheduled for a laryngectomy. The nurse should assign the highest priority to which postoperative nursing diagnosis?
- A. Anxiety related to diagnosis of cancer
- B. Altered nutrition related to swallowing difficulties
- C. Ineffective airway clearance related to airway alterations
- D. Impaired verbal communication related to removal of the larynx
Correct Answer: C
Rationale: Each of the listed diagnoses is valid, but ineffective airway clearance is the priority nursing diagnosis for all conditions due to the critical need to maintain a patent airway post-laryngectomy.
As a clinic nurse, you are caring for a patient who has been prescribed an antibiotic for tonsillitis and has been instructed to take the antibiotic for 10 days. When you do a follow-up call with this patient, you are informed that the patient is feeling better and is stopping the medication after taking it for 4 days. What information should you provide to this patient?
- A. Keep the remaining tablets for an infection at a later time.
- B. Discontinue the medications if the fever is gone.
- C. Dispose of the remaining medication in a biohazard receptacle.
- D. Finish all the antibiotics to eliminate the organism completely.
Correct Answer: D
Rationale: The nurse informs the patient about the need to take the full course of any prescribed antibiotic. Antibiotics should be taken for the entire 10-day period to eliminate the microorganisms. A patient should never be instructed to keep leftover antibiotics for use at a later time. Even if the fever or other symptoms are gone, the medications should be continued. Antibiotics do not need to be disposed of in a biohazard receptacle, though they should be discarded appropriately.