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It is cold season and the school nurse has been asked to provide an educational event for the parent teacher organization of the local elementary school. What should the nurse include in teaching about the treatment of pharyngitis?
- A. Pharyngitis is more common in children whose immunizations are not up to date.
- B. There are no effective, evidence-based treatments for pharyngitis.
- C. Use of warm saline gargles or throat irrigations can relieve symptoms.
- D. Heat may increase the spasms in pharyngeal muscles.
Correct Answer: C
Rationale: Depending on the severity of the pharyngitis and the degree of pain, warm saline gargles or throat irrigations are used. The benefits of this treatment depend on the degree of heat that is applied. The nurse teaches about these procedures and about the recommended temperature of the solution: high enough to be effective and as warm as the patient can tolerate, usually 105°F to 110°F (40.6°C to 43.3°C). Irrigating the throat may reduce spasm in the pharyngeal muscles and relieve soreness of the throat. You would not tell the parent teacher organization that there is no real treatment of pharyngitis.
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The nurse is doing discharge teaching in the ED with a patient who had a nosebleed. What should the nurse include in the discharge teaching of this patient?
- A. Avoid blowing the nose for the next 45 minutes.
- B. In case of recurrence, apply direct pressure for 15 minutes.
- C. Do not take aspirin for the next 2 weeks.
- D. Seek immediate medical attention if the nosebleed recurs.
Correct Answer: B
Rationale: The nurse explains how to apply direct pressure to the nose with the thumb and the index finger for 15 minutes in case of a recurrent nosebleed. If recurrent bleeding cannot be stopped, the patient is instructed to seek additional medical attention. ASA is not contraindicated in most cases and the patient should avoid blowing the nose for an extended period of time, not just 45 minutes.
The nurse is providing care for a patient who has just been admitted to the postsurgical unit following a laryngectomy. What assessment should the nurse prioritize?
- A. The patients swallowing ability
- B. The patients airway patency
- C. The patients carotid pulses
- D. Signs and symptoms of infection
Correct Answer: B
Rationale: The patient with a laryngectomy is at risk for airway occlusion and respiratory distress. As in all nursing situations, assessment of the airway is a priority over other potential complications and assessment parameters.
A 42-year-old patient is admitted to the ED after an assault. The patient received blunt trauma to the face and has a suspected nasal fracture. Which of the following interventions should the nurse perform?
- A. Administer nasal spray and apply an occlusive dressing to the patients face.
- B. Position the patients head in a dependent position.
- C. Irrigate the patients nose with warm tap water.
- D. Apply ice and keep the patients head elevated.
Correct Answer: D
Rationale: Immediately after the fracture, the nurse applies ice and encourages the patient to keep the head elevated. The nurse instructs the patient to apply ice packs to the nose to decrease swelling. Dependent positioning would exacerbate bleeding and the nose is not irrigated. Occlusive dressings are not used.
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 performing preoperative teaching with a patient who has cancer of the larynx. After completing patient teaching, what would be most important for the nurse to do?
- A. Give the patient his or her cell phone number.
- B. Refer the patient to a social worker or psychologist.
- C. Provide the patient with audiovisual materials about the surgery.
- D. Reassure the patient and family that everything will be alright.
Correct Answer: C
Rationale: Informational materials (written and audiovisual) about the surgery are given to the patient and family for review and reinforcement. The nurse never gives personal contact information to the patient. Nothing in the scenario indicates that a referral to a social worker or psychologist is necessary. False reassurance must always be avoided.