Chapter 30: Disorders of the Upper Respiratory Tract
Linton: Introduction to Medical–Surgical Nursing, 6th Edition
MULTIPLE CHOICE
1. What portion of the internal nose traps particles and kills bacteria?
a.
Turbinates
b.
Mucous membrane
c.
Vestibular formations
d.
Cilia
2. What is the function of the tonsils and adenoids in small children?
a.
Help promote antibody formation
b.
Assist in some digestive processes
c.
Protect against bacterial infections of the throat
d.
Support blood cell production
3. A patient comes into the clinic complaining of a runny nose and facial pain. What should the
nurse’s initial assessment 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
4. 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. What should the nurse suspect?
a.
An infection
b.
Normal age-related changes
c.
A nasal defect
d.
Allergies that are causing her symptoms
5. What does age-related relaxation of the esophageal sphincter in a 70-year-old patient cause?
a.
Excessive belching
b.
Dumping syndrome
c.
Tickling sensation, requiring frequent coughing
d.
Burning in the throat when lying down
6. When a patient with sleep apnea says, “I’m not wearing that silly mask. I look like something
out of Star Wars,” what should the nurse remind the patient about the function of 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
7. What should patient education for a patient being given nose drops for the first time include?
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 and then telling the
patient to keep her head back for a few minutes
8. A 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 past few months. What is the most
appropriate suggestion for the nurse to suggest?
a.
Use a humidifier at home.
b.
Get a throat culture.
c.
Get a nose culture.
d.
Request an antibiotic.
9. Which assessment should indicate the necessity for a nurse to suction a patient with a
tracheostomy?
a.
Becomes restless and has increases in vital signs
b.
Has decreased peak airway pressure
c.
Shows diaphoresis
d.
Is coughing frothy mucus
10. Which position is the most appropriate for a patient returning from surgery with a nasal pack
and mustache dressing?
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
11. What intervention should a nurse implement when providing tracheostomy care?
a.
Wash and rinse the inner cannula in tap water and then dry it.
b.
Use a sterile solution of normal saline or other solution 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.
12. What is the most appropriate nursing diagnosis for a patient who has had nose surgery?
a.
Risk for imbalanced body temperature
b.
Social isolation
c.
Decreased cardiac output
d.
Risk for activity intolerance
13. 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. What should the nurse recognize that these
symptoms indicate?
a.
Nasal polyps
b.
Impacted wisdom teeth
c.
Allergic rhinitis
d.
Sinusitis
14. A patient complains that he wants an antibiotic medication for his cold. What is the best
response by the nurse?
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.”
15. What should the initial action of a nurse be when providing first aid to a person with
spontaneous epistaxis?
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.
16. The patient has had anterior nasal packing placed for severe epistaxis. The nurse notes that he
is swallowing frequently. What should a nurse suspect?
a.
The patient’s throat is dry.
b.
Posterior packing is uncomfortable.
c.
The patient is bleeding.
d.
The patient’s saliva production is excessive.
17. What is true regarding bacterial pharyngitis that is untrue for viral pharyngitis?
a.
Has an abrupt onset
b.
Presents a normal complete blood count (CBC)
c.
Presents a negative culture
d.
Has no serious complications
18. Which is the best candidate for a tonsillectomy?
a.
A 52-year-old patient with a hearing deficit related to otitis media from tonsillitis
b.
A 23-year-old patient with a peritonsillar abscess
c.
A 34-year-old patient with enlarged tonsils and adenoids
d.
A 15-year-old patient with one bout of tonsillitis in the previous 12 months
19. What is best for a nurse to offer when encouraging a new patient after a tonsillectomy to
increase fluids?
a.
Chilled citrus juices
b.
Tap water sipped through a straw
c.
Flavored popsicles to suck
d.
Ice cubes
20. What are the most common causes of laryngitis?
a.
Smoking and highly seasoned foods
b.
Alcohol and voice strain
c.
Nasal congestion and frequent coughing
d.
Respiratory infections and voice strain
21. What is the most significant topic for a nurse to include in a teaching plan for a patient with
frequent episodes of laryngitis?
a.
Observing voice rest
b.
Reducing smoking
c.
Eating warm foods
d.
Maintaining a consistent environmental temperature
22. A patient who has cancer of the larynx has been told that he needs a total laryngectomy. What
action should this nurse consider to help the patient cope with the loss of his voice?
a.
Offer to have a volunteer from a local laryngectomy organization visit the patient.
b.
Explain in detail the available vocalization aids and techniques.
c.
Explain to the patient what will happen directly after the surgery.
d.
Notify the hospital chaplain of the patient’s needs.
23. Which nursing concern takes priority in the care of a patient after a laryngectomy?
a.
Encouraging nutrition
b.
Avoiding infection
c.
Establishing a communication system
d.
Ensuring adequate fluid intake
24. A patient who had a laryngectomy 3 months earlier returns to the physician’s office with the
complaint of increasing dyspnea. Which common postlaryngectomy complication should the
nurse recognize this complaint as indicating?
a.
Hypertrophied stoma
b.
Salivary fistula
c.
Carotid blowout
d.
Tracheal stenosis
25. What is one major postoperative difficulty for a patient having a supraglottic laryngectomy?
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
MULTIPLE RESPONSE
26. What should the postoperative care of a patient who has had nasal surgery include? (Select all
that apply.)
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
27. Which actions should the nurse include in a care plan to effectively assist the patient with a
total laryngectomy to maintain airway clearance? (Select all that apply.)
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
COMPLETION
28. A nurse reminds a 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.
OTHER
29. What should a nurse do when taking a specimen for a throat culture? (Place the appropriate
actions in the correct sequence. Separate letters by a comma and space as follows: A, B, C,
D.)
A. Depress the tongue with a tongue blade.
B. Place the applicator in a culture tube.
C. Ask the patient to tilt the head back.
D. Swab the back of the throat and tonsils.