Question 1

While assessing a client who has facial trauma,the nurse auscultates stridor.The client is anxious and restless.Which action should the nurse take first?

Accepted Answer

A)   Contact the provider and prepare for intubation.
B)   Administer prescribed albuterol nebulizer therapy.
C)   Place the client in high-Fowler's position.
D)   Ask the client to perform deep-breathing exercises. A

Question 2

After teaching a client who is prescribed "voice rest" therapy for vocal cord polyps,a nurse assesses the client's understanding.Which statement indicates the client needs further teaching?

Accepted Answer

A)   "I will stay away from smokers to minimize inhalation of secondhand smoke."
B)   "When I speak, I will whisper rather than use a normal tone of voice."
C)   "For the next several weeks, I will not lift more than 10 pounds."
D)   "I will drink at least three quarts of water each day to stay hydrated." B

Question 3

A nurse is assessing a client who has suffered a nasal fracture.Which assessment should the nurse perform first?

Accepted Answer

A)   Facial pain
B)   Vital signs
C)   Bone displacement
D)   Airway patency D

Question 4

A nurse assesses clients on the medical-surgical unit.Which client is at greatest risk for development of obstructive sleep apnea?

Accepted Answer

A)   A 26-year-old woman who is 8 months pregnant
B)   A 42-year-old man with gastroesophageal reflux disease
C)   A 55-year-old woman who is 50 pounds overweight
D)   A 73-year-old man with type 2 diabetes mellitus

Question 5

A nurse cares for a client who is experiencing epistaxis.Which action should the nurse take first?

Accepted Answer

A)   Initiate Standard Precautions.
B)   Apply direct pressure.
C)   Sit the client upright.
D)   Loosely pack the nares with gauze.

Question 6

A nurse cares for a client who had a partial laryngectomy 10 days ago.The client states that all food tastes bland.How should the nurse respond?

Accepted Answer

A)   "I will consult the speech therapist to ensure you are swallowing properly."
B)   "This is normal after surgery.What types of food do you like to eat?"
C)   "I will ask the dietitian to change the consistency of the food in your diet."
D)   "Replacement of protein, calories, and water is very important after surgery."

Question 7

A nurse assesses a client who has a nasal fracture.The client reports constant nasal drainage,a headache,and difficulty with vision.Which action should the nurse take next?

Accepted Answer

A)   Collect the nasal drainage on a piece of filter paper.
B)   Encourage the client to blow his or her nose.
C)   Perform a test focused on a neurologic examination.
D)   Palpate the nose, face, and neck.

Question 8

A nurse teaches a client who is being discharged after a fixed centric occlusion for a mandibular fracture.Which statements should the nurse include in this client's teaching? (Select all that apply.)

Accepted Answer

A)   "You will need to cut the wires if you start vomiting."
B)   "Eat six soft or liquid meals each day while recovering."
C)   "Irrigate your mouth every 2 hours to prevent infection."
D)   "Sleep in a semi-Fowler's position after the surgery."
E)   "Gargle with mouthwash that contains Benadryl once a day."

Question 9

A nurse assesses a client who has facial trauma.Which assessment findings require immediate intervention? (Select all that apply.)

Accepted Answer

A)   Stridor
B)   Nasal stuffiness
C)   Edema of the cheek
D)   Ecchymosis behind the ear
E)   Eye pain

Question 10

A nurse cares for a client who has packing inserted for posterior nasal bleeding.Which action should the nurse take first?

Accepted Answer

A)   Assess the client's pain level.
B)   Keep the client's head elevated.
C)   Teach the client about the causes of nasal bleeding.
D)   Make sure the string is taped to the client's cheek.

Question 11

A nurse assesses a client who has developed epistaxis.Which conditions in the client's history should the nurse identify as potential contributors to this problem? (Select all that apply.)

Accepted Answer

A)   Diabetes mellitus
B)   Hypertension
C)   Leukemia
D)   Cocaine use
E)   Migraine

Question 12

A registered nurse (RN)cares for clients on a surgical unit.Which clients should the RN delegate to a licensed practical nurse (LPN)? (Select all that apply.)

Accepted Answer

A)   A 32-year-old who had a radical neck dissection 6 hours ago
B)   A 43-year-old diagnosed with cancer after a lung biopsy 2 days ago
C)   A 55-year-old who needs discharge teaching after a laryngectomy
D)   A 67-year-old who is awaiting preoperative teaching for laryngeal cancer
E)   An 88-year-old with esophageal cancer who is awaiting gastric tube placement

Question 13

A nurse is caring for a client who has sleep apnea and is prescribed modafinil (Provigil).The client asks,"How will this medication help me?" How should the nurse respond?

Accepted Answer

A)   "This medication will treat your sleep apnea."
B)   "This sedative will help you to sleep at night."
C)   "This medication will promote daytime wakefulness."
D)   "This analgesic will increase comfort while you sleep."

Question 14

A nurse assesses a client who is 6 hours post-surgery for a nasal fracture and has nasal packing in place.Which actions should the nurse take? (Select all that apply.)

Accepted Answer

A)   Observe for clear drainage.
B)   Assess for signs of bleeding.
C)   Watch the client for frequent swallowing.
D)   Ask the client to open his or her mouth.
E)   Administer a nasal steroid to decrease edema.

Question 15

A nurse cares for a client after radiation therapy for lung cancer.The client reports a sore throat.Which action should the nurse take first?

Accepted Answer

A)   Ask the client to gargle with mouthwash containing lidocaine.
B)   Administer prescribed intravenous pain medications.
C)   Explain that soreness is normal and will improve in a couple days.
D)   Assess the client's neck for redness and swelling.

Question 16

A nurse assesses a client who reports waking up feeling very tired,even after 8 hours of good sleep.Which action should the nurse take first?

Accepted Answer

A)   Contact the provider for a prescription for sleep medication.
B)   Tell the client not to drink beverages with caffeine before bed.
C)   Educate the client to sleep upright in a reclining chair.
D)   Ask the client if he or she has ever been evaluated for sleep apnea.

Question 17

A nurse cares for a client who is scheduled for a total laryngectomy.Which action should the nurse take prior to surgery?

Accepted Answer

A)   Assess airway patency, breathing, and circulation.
B)   Administer prescribed intravenous pain medication.
C)   Assist the client to choose a communication method.
D)   Ambulate the client in the hallway to assess gait.

Question 18

A nurse teaches a client to use a room humidifier after a laryngectomy.Which statement should the nurse include in this client's teaching?

Accepted Answer

A)   "Add peppermint oil to the humidifier to relax the airway."
B)   "Make sure you clean the humidifier to prevent infection."
C)   "Keep the humidifier filled with water at all times."
D)   "Use the humidifier when you sleep, even during daytime naps."

Question 19

A nurse teaches a client who has open vocal cord paralysis.Which technique should the nurse teach the client to prevent aspiration?

Accepted Answer

A)   Tilt the head back as far as possible when swallowing.
B)   Tuck the chin down when swallowing.
C)   Breathe slowly and deeply while swallowing.
D)   Keep the head very still and straight while swallowing.

Question 20

A nurse is assessing clients on a rehabilitation unit.Which clients are at greatest risk for asphyxiation related to inspissated oral and nasopharyngeal secretions? (Select all that apply.)

Accepted Answer

A)   A 24-year-old with a traumatic brain injury
B)   A 36-year-old who fractured his left femur
C)   A 58-year-old at risk for aspiration following radiation therapy
D)   A 66-year-old who is a quadriplegic and has a sacral ulcer
E)   An 80-year-old who is aphasic after a cerebral vascular accident

Exam 29: Care of Patients with Noninfectious Upper Respiratory Problems