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Chapter 22 - Management of Patients With Conditions of the Upper Respiratory Tract

1. Nursing measures associated with the uncomplicated common cold include all of the following except:
a. administering prescribed antibiotics to decrease the severity of the viral infection.
b. informing the patient about the symptoms of secondary infection, the major complication of a cold.
c. suggesting adequate fluid intake and rest.
d. teaching people that the virus is contagious for 2 days before symptoms appear and during the first part of the symptomatic
phase.

2. Acyclovir, an antiviral agent, is recommended for:
a. herpes simplex infection
b. rhinitis
c. sinusitis
d. bronchitis

3. The herpes virus, which remains latent in cells of the lips or nose, usually subsides spontaneously in:
a. 5 days.
b. 1 week.
c. 10 to 14 days.
d. 3 to 4 weeks.

4. Nursing suggestions for a patient with acute or chronic sinusitis include:
a. adequate fluid intake.
b. increased humidity
c. local heat applications to promote drainage.
d. all of the above.

5. About 60% of cases of acute sinusitis are caused by bacterial organisms. The antibiotic of choice is:
a. amoxicillin-clavulanate (Augmentin)
b. acydovir
c. erythromycin
d. cefotetan

6. Health teaching for viral rhinitis includes advising the patient to:
a. blow his or her nose gently to prevent spread of the infection.
b. blow through both nostrils to equalize the pressure.
c. rest, to promote overall comfort.
d. do all of the above.

7. Acute pharyngitis of a bacterial nature is most commonly caused by:
a. group A Streptococcus
b. gram-negative Klebsiella
c. Pseudomonas
d. Staphylococcus aureus

8. A complication (s) of acute pharyngitis is(are):
a. Mastoiditis
b. Nephritis
c. Rheumatic fever
d. All of the above.

9. Nursing management for a patient with acute pharyngitis includes:
a. applying an ice collar for symptomatic relief of a severe sore throat.
b. encouraging bed rest during the febrile stage of the illness.
c. suggesting a liquid or soft diet during the acute stage of the disease.
d. all of the above measures.

10. The most common organism associated with tonsillitis and adenoiditis is:
a. group A Streptococcus
b. gram-negative Klebsiella
c. Psuedomonas
d. Staphylococcus aureus

11. Potential complications of enlarged adenoids include all of the following except:
a. Bronchitis
b. nasal obstruction
c. allergies
d. acute otitis media

12. To assess for an upper respiratory tract infection, the nurse should palpate:
a. the frontal and maxillary sinuses
b. the trachea
c. the neck lymph nodes
d. all of the above areas

13. An early sign of cancer of the larynx in the glottic area (66% of cases) is:

d. semi-Fowler's with the neck flexed. 15. The staff nurse assists her with her transport from the recovery area to her room. dysphagia. cautioning about preventing water from entering the stoma. 2. 14. all of the above. keeping Gilberta in the upright position with her head tilted forward to prevent swallowing and aspiration of blood. Eustachian tube perforation c. 1. protamine sulfate d. an average of 24 hours d. d. c. c. an adrenergic blocking agent b.a. a 14-year-old high school student. enlarged cervical nodes. b. d. Oropharyngeal edema. palpation of the frontal and maxillary sinuses to detect infection or inflammation. CASE STUDY: Epistaxis Gilberts. Patient education for a laryngectomy includes: a. offer her only clear liquids for 3 days. 1. Hemorrhage d. telling the patient to expect a diminished sense of taste and smell. offer her soft foods for several days to minimize local discomfort and supply her with necessary nutrients. advising that large amounts of mucus can be coughed up through the stoma. b. d. Based on her knowledge about tonsillar disease he nurse knows that Isabel must have experienced symptoms that required surgical intervention. c. c. telling her to breathe through her mouth and to refrain from talking. The nurse assesses Isabel's postoperative vital signs and checks for the most significant postoperative complication of: a. reverse Trendelenburg with the neck extended. b. anywhere from 2 to 6 days CASE STUDY: Tonsillectomy and Adenoidectomy Isabel. d. burning of the throat when hot liquids are ingested. prone with her head on a pillow and turned to the side. b. no longer than 2 hours b. all of the above. d. is sent with her mother to the emergency department of a local hospital for uncontrolled epistaxis. just had a tonsillectomy and adenoidectomy. Assessment of a patient admitted for laryngeal carcinoma includes: a. Clinical manifestations may have included: a. . 3. supine with her neck hyperextended and supported with a pillow. Initial nursing measures in the emergency room that can be used to stop the nasal bleeding include: a. c. inspection of the nasal mucosa for polyps. 2. d. all of the above techniques. vitamin K. Isabel is to be discharged the same day of her tonsillectomy The nurse makes sure that her family knows to: a. doing all of the above. a 14-year-old. epinephrine c. 3. encourage her to eat a house diet to build up her resistance to infection. palpation of the neck for swelling. Epiglottis b. an average of 12 hours c. compressing the soft outer portion of the nose against the midline septum continuously for 5 to 10 minutes. b. The nurse expects that emergency medical treatment may include insertion of a cotton pledget moistened with: a. c. supplement her diet with orange and lemon juices because of the need for vitamin C to heal. The nurse maintains Isabel in the recommended postoperative position of: a. hypertrophy of the tonsils. repeated attacks of otitis media. to prevent pharyngeal irritation. The nurse is aware that nasal packing used to control bleeding can be left in place: a. b. c. suspected hearing loss secondary to otitis media. 4. Hoarseness of the voice b.

all of the above. total laryngectomy 1. The surgical procedure that would not damage the voice box is a: a. the nurse needs to know if Jerome's voice will be preserved. d. he requests that it be removed c. whistle. making sure that he knows he will require a permanent trachea stoma. is admitted for a laryngectomy owing to a malignant tumor. assisting with turning and early ambulation. . oral feedings are initiated d. 2 to 3 days c. d. Postoperative nutrition is usually maintained by way of a nasogastric catheter. 5 to 6 days d. informing him that there are ways he will be able to carry on a conversation without his voice. esophageal speech has been perfected b. reminding him that he will not be able to sing. a. The nurse needs to tell Jerome that oral feedings usually begin after. 1 week 1. 1. a 52-year-old widower. 1. Before developing a care plan. positioning Jerome in semi-to high Fowler's position. all of the above. 1. or laugh. reminding him to cough and take frequent deep breaths. b. Postoperative nursing measures to promote respiratory effectiveness include: a. the stoma is well healed. thyrotomy d. c. c. b. Jerome needs to know that the laryngectomy tube will be removed when: a. Jerome is scheduled for a total laryngectomy Preoperative education includes: a. partial laryngectomy b. 24 hours b. supraglottic laryngectomy c.CASE STUDY: Laryngectomy Jerome.