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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.
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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 is providing patient teaching to a patient diagnosed with acute rhinosinusitis. For what possible complication should the nurse teach the patient to seek immediate follow-up?
- A. Periorbital edema
- B. Headache unrelieved by OTC medications
- C. Clear drainage from nose
- D. Blood-tinged mucus when blowing the nose
Correct Answer: A
Rationale: Patient teaching is an important aspect of nursing care for the patient with acute rhinosinusitis. The nurse instructs the patient about symptoms of complications that require immediate follow-up. Referral to a physician is indicated if periorbital edema and severe pain on palpation occur. Clear drainage and blood-tinged mucus do not require follow-up if the patient has acute rhinosinusitis. A persistent headache does not necessarily warrant immediate follow-up.
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.
A patient has just been diagnosed with squamous cell carcinoma of the neck. While the nurse is doing health education, the patient asks, Does this kind of cancer tend to spread to other parts of the body? What is the nurses best response?
- A. In many cases, this type of cancer spreads to other parts of the body.
- B. This cancer usually does not spread to distant sites in the body.
- C. You will have to speak to your oncologist about that.
- D. Squamous cell carcinoma is nothing to be concerned about, so try to focus on your health.
Correct Answer: B
Rationale: The incidence of distant metastasis with squamous cell carcinoma of the head and neck (including larynx cancer) is relatively low. The patients prognosis is determined by the oncologist, but the patient has asked a general question and it would be inappropriate to refuse a response. The nurse must not downplay the patients concerns.
A nurse practitioner has provided care for three different patients with chronic pharyngitis over the past several months. Which patients are at greatest risk for developing chronic pharyngitis?
- A. Patients who are habitual users of alcohol and tobacco
- B. Patients who are habitual users of caffeine and other stimulants
- C. Patients who eat a diet high in spicy foods
- D. Patients who have gastrointestinal reflux disease (GERD)
Correct Answer: A
Rationale: Chronic pharyngitis is common in adults who live and work in dusty surroundings, use the voice to excess, suffer from chronic cough, and habitually use alcohol and tobacco. Caffeine and spicy foods have not been linked to chronic pharyngitis. GERD is not a noted risk factor.