Question 1

The nurse enters the room of a patient who has just returned from surgery for a total laryngectomy and radical neck dissection and notes the following problems. In which order should the nurse address the problems?

Accepted Answer

A)  The NG tube is disconnected from suction and clamped off. 
B)  The patient is coughing blood-tinged secretions from the tracheostomy. 
C)  The patient is lying in a lateral position with the head of the bed flat. 
D)  The Hemovac in the neck incision contains 200 ml of bloody drainage.

Question 2

After completing discharge instructions for a patient with a total laryngectomy, the nurse determines that additional instruction is needed when the patient says,

Accepted Answer

A)  "I can participate in most of my prior fitness activities except swimming." 
B)  "I must keep the stoma covered with a loose sterile dressing at all times." 
C)  "I need to eat nutritious meals even though I can't smell or taste very well." 
D)  "I should wear a Medic Alert bracelet that identifies me as a neck breather."

Question 3

After discussing care of upper respiratory infections (URI) and prevention of secondary infections with a patient who has a URI, the nurse determines that additional teaching is needed when the patient says

Accepted Answer

A)  "I will drink lots of juices and other fluids to stay hydrated." 
B)  "I will watch for changes in nasal secretions or the sputum that I cough up." 
C)  "I can take acetaminophen (Tylenol) to treat discomfort." 
D)  "I can use my nasal decongestant spray until the congestion is all gone."

Question 4

The teaching plan for a patient with acute sinusitis will need to include which of the following interventions? (Select all that apply.)

Accepted Answer

A)  You will be more comfortable if you keep your head in an upright position. 
B)  Application of cool compresses to your face will improve sinus drainage. 
C)  OTC antihistamines can be used to relieve congestion and inflammation. 
D)  Taking a hot shower will increase sinus drainage and decrease pain. 
E)  Blowing the nose forcefully should be avoided to decrease nosebleed risk.
F) Saline nasal spray can be made at home and used to wash out secretions.

Question 5

A patient with an uncuffed tracheostomy tube coughs violently during suctioning and dislodges the tracheostomy tube. The nurse's first action should be to

Accepted Answer

A)  assess the patient's oxygen saturation and call the health care provider. 
B)  ventilate the patient with a manual bag mask until the health care provider arrives. 
C)  insert the obturator and attempt to reinsert the tracheostomy tube. 
D)  position the patient in an upright position with the neck extended.

Exam 27: Nursing Management: Upper Respiratory Problems

The nurse enters the room of a patient who has just returned from surgery for a total laryngectomy and radical neck dissection and notes the following problems. In which order should the nurse address the problems?

After completing discharge instructions for a patient with a total laryngectomy, the nurse determines that additional instruction is needed when the patient says,

After discussing care of upper respiratory infections (URI) and prevention of secondary infections with a patient who has a URI, the nurse determines that additional teaching is needed when the patient says

The teaching plan for a patient with acute sinusitis will need to include which of the following interventions? (Select all that apply.)

A patient with an uncuffed tracheostomy tube coughs violently during suctioning and dislodges the tracheostomy tube. The nurse's first action should be to