Deck 53: Nose, sinus, and Throat Disorders

Question 1

A patient complains of morning headaches,a feeling of fullness in her head,and a pain similar to that of a toothache under her eye.The nurse recognizes the symptoms of:

A) Nasal polyps
B) Impacted wisdom teeth
C) Allergic rhinitis
D) Sinusitis

Answer 1

Sinusitis

Question 2

The nurse points out that the most common causes of laryngitis are:

A) Smoking and highly seasoned foods
B) Alcohol and voice strain
C) Nasal congestion and frequent coughing
D) Respiratory infections and voice strain

Answer 2

Respiratory infections and voice strain

Question 3

A patient comes into the clinic complaining of a runny nose and facial pain.The nurse's initial assessment would include:

A) Assessment for nasal drainage and sinus tenderness
B) Transillumination and nasal speculum examination
C) Palpation of the frontal and maxillary sinuses and tonsillar inspection
D) Turbinate assessment and assessment for patency of the nares

Answer 3

Assessment for nasal drainage and sinus tenderness

Question 4

The nurse recognizes the candidate for a tonsillectomy as the:

A) 52-year-old patient with a hearing deficit, related to otitis media from tonsillitis
B) 23-year-old patient with a peritonsillar abscess
C) 34-year-old patient with enlarged tonsils and adenoids
D) 15-year-old patient with one bout of tonsillitis in the previous 12 months

Question 5

The patient has had anterior nasal packing placed for severe epistaxis.The nurse notes that he is swallowing frequently and suspects that the:

A) Patient's throat is dry.
B) Posterior packing is uncomfortable.
C) Patient is bleeding.
D) Patient's saliva production is excessive.

Question 6

When providing tracheostomy care,the nurse should:

A) Wash and rinse the inner cannula in tap water and then dry it.
B) Use a sterile solution of peroxide and sterile water to wash the inner cannula and then rinse with sterile water.
C) Clean the area around the stoma with tap water and a gentle soap.
D) Remove the inner cannula, wash both hands with a bactericidal soap, and then don sterile gloves to clean the inner cannula.

Question 7

A 68-year-old patient tells the nurse that her sense of smell is not as acute as before; her nose is drier,and she occasionally gets a nosebleed.The nurse explains that she may have:

A) An infection
B) Normal age-related changes
C) A nasal defect
D) Allergies that are causing her symptoms

Question 8

The nurse is aware that the age-related relaxation of the esophageal sphincter in the 70-year-old patient will cause:

A) Excessive belching
B) Dumping syndrome
C) Tickling sensation, requiring frequent coughing
D) Burning in the throat when lying down

Question 9

One difference between viral and bacterial pharyngitis is that bacterial pharyngitis:

A) Has an abrupt onset.
B) Presents a normal complete blood count (CBC).
C) Presents a negative culture.
D) Has no serious complications.

Question 10

The nurse assesses that suctioning is necessary for a patient with a tracheostomy when the patient:

A) Becomes restless and has increases in vital signs.
B) Has decreased peak airway pressure.
C) Shows diaphoresis.
D) Is coughing frothy mucus.

Question 11

The portion of the internal nose that traps particles and kills bacteria is the:

A) Turbinates
B) Mucous membrane
C) Vestibular formations
D) Cilia

Question 12

When the patient with sleep apnea says,"I'm not wearing that silly mask.I look like something out of Star Wars." The nurse reminds the patient that the mask:

A) Increases oxygen intake.
B) Stimulates regular respirations.
C) Sounds an alarm when the oxygen concentration drops.
D) Uses positive pressure to keep the airway open.

Question 13

The patient comes into the clinic complaining of waking up with a dry mouth and nose and asks if the dryness has caused the colds she has had in the last few months.The nurse suggests that the patient:

A) Use a humidifier at home.
B) Get a throat culture.
C) Get a nose culture.
D) Request an antibiotic.

Question 14

Patient education for a patient who is being given nose drops for the first time includes:

A) Asking the patient to sit down and tip her head to the side to allow for a better angle for the instillation of the drops.
B) Holding the dropper against the side of the nose so that all the medication flows into the nares.
C) Asking the patient to return any unused medication to the bottle.
D) Tipping the head back and holding the dropper over the nostril. Tell the patient to keep her head back for a few minutes.

Question 15

The nurse explains to the parents of a toddler that the function of the tonsils and adenoids in small children is to:

A) Help promote antibody formation.
B) Assist in some digestive processes.
C) Protect against bacterial infections of the throat.
D) Support blood cell production.

Question 16

When the patient returns from surgery with a nasal pack and mustache dressing,the nurse will arrange the patient in a:

A) Side-lying position to prevent aspiration of drainage
B) Semi-Fowler position, and apply a warm compress to reduce pain
C) High Fowler position, and apply a cold dressing to reduce swelling
D) Sims position, and apply a cold dressing to facilitate drainage and reduce swelling

Question 17

To encourage a new patient after a tonsillectomy to increase fluids,the nurse would offer:

A) Chilled citrus juices
B) Tap water sipped through a straw
C) Flavored popsicles to suck
D) Ice cubes

Question 18

A patient complains that he wants an antibiotic medication for his cold.The nurse's best response is:

A) "Antibiotics are not effective with viral infections."
B) "You will get better faster without the antibiotics."
C) "You might try echinacea or vitamin C."
D) "A cold is not that serious. Try forcing fluids."

Question 19

An appropriate nursing diagnosis for the patient who has had nose surgery is:

A) Risk for imbalanced body temperature
B) Social isolation
C) Decreased cardiac output
D) Risk for activity intolerance

Question 20

The nurse explains that when giving first aid to a person with spontaneous epistaxis,the initial action would be to:

A) Apply direct pressure for 3 to 5 minutes.
B) Have the person sit down and lean forward.
C) Have the person lie down, and apply an ice pack.
D) Have the person clear the nasal passages by blowing the nose.

Question 21

In the postoperative care of a patient who has had nasal surgery,the nurse will include in the care:

A) Changing the nasal packing when saturated.
B) Placing the patient in a semi-Fowler position without a pillow.
C) Giving frequent oral hygiene.
D) Providing humidification for dry mucous membranes.
E) Assessing the back of the throat for bleeding.

Question 22

The nursing concern that takes priority in the care of a patient after a laryngectomy is:

A) Encouraging nutrition.
B) Avoiding infection.
C) Establishing a communication system.
D) Ensuring adequate fluid intake.

Question 23

The patient who had a laryngectomy 3 months earlier returns to the physician's office with the complaint of increasing dyspnea.The nurse recognizes this complaint as an indication of the common postlaryngectomy complication of:

A) Hypertrophied stoma
B) Salivary fistula
C) Carotid blowout
D) Tracheal stenosis

Question 24

The nurse taking a specimen from a throat culture would: (Choose the appropriate actions and place them in the correct sequence.)

A) Depress the tongue with a tongue blade.
B) Place the applicator in a culture tube.
C) Ask the patient to cough deeply.
D) Ask the patient to tilt the head back.
E) Swab the back of the throat and tonsils.

Question 25

The nurse reminds the patient,who is to have a partial laryngectomy,that the temporary tracheostomy that he will have after the original surgery will be closed within _______ days.

Question 26

The most significant topic in a teaching plan for a patient with frequent episodes of laryngitis should include:

A) Observing voice rest.
B) Reducing smoking.
C) Eating warm foods.
D) Maintaining a consistent environmental temperature.

Question 27

For a patient having a supraglottic laryngectomy,one major postoperative difficulty is:

A) Teaching the patient to use an assistive device to speak.
B) Coughing without letting food escape through the tracheostomy.
C) Taking care of the tracheostomy, because the patient will always have to have one.
D) Teaching the patient to swallow without aspiration.

Question 28

A patient who has cancer of the larynx has been told that he needs a total laryngectomy.To help the patient cope with the loss of his voice,the nurse would consider:

A) Offering to have a volunteer from a local laryngectomy organization visit the patient.
B) Explaining in detail the available vocalization aids and techniques.
C) Explaining to the patient what will happen directly after the surgery.
D) Notifying the hospital chaplain of the patient's needs.

Question 29

The nurse includes implementations in the care plan to assist the patient with a total laryngectomy to maintain airway clearance,which are:

A) Turning, coughing, and deep breathing.
B) Placing the patient in a semi-Fowler position.
C) Maintaining hydration.
D) Attaching a tracheostomy collar.
E) Providing a method to communicate.