Nokea
The nurse is explaining the safe and effective administration of nasal spray to a patient with seasonal allergies. What information is most important to include in this teaching?
- A. Finish the bottle of nasal spray to clear the infection effectively.
- B. Nasal spray can only be shared between immediate family members.
- C. Nasal spray should be administered in a prone position.
- D. Overuse of nasal spray may cause rebound congestion.
Correct Answer: D
Rationale: The use of topical decongestants is controversial because of the potential for a rebound effect. The patient should hold his or her head back for maximal distribution of the spray. Only the patient should use the bottle.
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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.
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.
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 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.
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.