Prepu Respiratory for Medsurg Quiz

The nurse is caring for the client in the intensive care unit immediately after removal of the endotracheal tube. Which of the following nursing actions is most important to complete every hour to ensure that the respiratory system is not compromised? a. Monitor heart rhythm. b. Assess capillary refill. c. Auscultate lung sounds. d. Obtain vital signs.

c. Auscultate lung sounds.

After a tonsillectomy, a client is being prepared for discharge. The nurse should instruct the client to report which sign or symptom immediately? a. Difficulty swallowing b. Difficulty talking c. Bleeding d. Throat pain

c. Bleeding

Which is a priority nursing intervention that the nurse should perform for a client who has undergone surgery for a nasal obstruction? a. Apply a warm pack postoperatively b. Apply pressure to the convex portion of the nose c. Ensure mouth breathing d. Provide a splint postoperatively

c. Ensure mouth breathing

A nurse takes the initial history of a patient who is being examined for cancer of the larynx. Select the sign that is considered an early clinical indicator. a. Dysphasia b. Cervical lymph adenopathy c. Hoarseness of more than 2 week's duration d. Persistent ulceration

c. Hoarseness of more than 2 week's duration

A nurse has pharyngitis and will be providing self care at home. It is most important for the nurse to a. Properly dispose of used tissues b. Place an ice collar on the throat to relieve soreness c. Seek medical help if he experiences inability to swallow d. Stay in bed when experiencing a fever

c. Seek medical help if he experiences inability to swallow

The client you are caring for has just been told they have advanced laryngeal cancer. What is the treatment of choice? a. Radiation therapy b. Laser surgery c. Total laryngectomy d. Partial laryngectomy

c. Total laryngectomy

A patient has herpes simplex infection that developed after having the common cold. What medication does the nurse anticipate will be administered for this infection? a. An antihistamine such as Benadryl b. An antibiotic such as amoxicillin c. An ointment such as bacitracin d. An antiviral agent such as acyclovir

d. An antiviral agent such as acyclovir

A patient playing softball was hit in the nose by the ball and has been determined to have an uncomplicated fractured nose with epistaxis. The nurse should prepare to assist the physician with what tasks? a. Preparing the patient for a septoplasty b. Administering nasal lavage c. Applying steroidal nasal spray d. Applying nasal packing

d. Applying nasal packing

The nurse is caring for a client who had a recent laryngectomy. Which of the following is reflected in the nursing plan of care? a. Assess the tracheostomy cuff for leaks. b. Maintain the client in a low-Fowler's position. c. Encourage oral nutrition on the second postoperative day. d. Develop an alternate method of communication.

d. Develop an alternate method of communication.

Which of the following methods most resembles normal speech following a total laryngectomy? a. Esophageal speech b. Blom-Singer voice prosthesis c. Electrolarynx held at neck d. Lip speaking

b. Blom-Singer voice. prosthesis

Wound drains, inserted during the laryngectomy, stay in place until what criteria are met? a. The patient is able to assist with his own suctioning. b. Drainage is <30 mL/day for 2 consecutive days. c. The stoma is healed, about 6 weeks after surgery. d. The surgical site is dry with encrustations.

b. Drainage is <30 mL/day for 2 consecutive days.

A client undergoes a total laryngectomy and tracheostomy formation. On discharge, the nurse should give which instruction to the client and family? a. "Oral intake of fluids should be limited for 1 week only." b. "Family members should continue to talk to the client." c. "Limit the amount of protein in the diet." d. "Clean the tracheostomy tube with alcohol and water."

"Family members should continue to talk to the client."

Which of the following is the most effective treatment for obstructive sleep apnea (OSA)?

Continuous positive airway pressure (CPAP)

Your client is status post total laryngectomy and cannot talk. What intervention should you make to help this client communicate?

Provide alternative methods of communication.

A nurse is providing instructions for the client with chronic rhinosinusitis. The nurse accurately tells the client:

Sleep with the head of bed elevated.

Stiffness of the neck or inability to bend the neck is referred to as a. xerostomia. b. aphonia. c. dysphagia. d. nuchal rigidity.

d. nuchal rigidity.

Which of the following is the most effective treatment for obstructive sleep apnea (OSA)? Oxygen by nasal cannula a. Bilevel positive airway pressure (BiPAP) b. Electrolarynx held at neck c. Mechanical ventilation d. Continuous positive airway pressure (CPAP) e. Blom-Singer voice prosthesis

e. Blom-Singer voice prosthesis

Which assessment finding puts a client at increased risk for epistaxis? a. Hypotension b. Cocaine use c. Use of a humidifier at night d. History of nasal surgery

b. Cocaine use

The nurse is caring for a patient who had a total laryngectomy and has drains in place. When does the nurse understand that the drains will most likely be removed? a. When the patient has less than 30 mL for 2 consecutive days b. When the patient states that there is discomfort and requests removal c. In 1 week when the patient no longer has serous drainage d. When the drainage tube comes out

a. When the patient has less than 30 mL for 2 consecutive days

A 64-year-old patient and his wife have presented to their primary care provider. The patient's wife has prompted her husband to seek care because she is worried about his apneic episodes and loud snoring. The husband had earlier undergone a diagnostic workup for obstructive sleep apnea (OSA) and been diagnosed with the disease but is not motivated to treat his health problem. How can the nurse at the clinic best characterize the risks of OSA? a. "Sleep apnea actually increases your risk of having a stroke or heart attack." b. "Without treatment, your sleep apnea could progress to chronic obstructive lung disease." c. "Sleep apnea has actually been identified as a risk factor for throat cancer." d. "People with sleep apnea are much more susceptible to infections in their sinuses and throat."

a. "Sleep apnea actually increases your risk of having a stroke or heart attack."

The nurse is obtaining a health history from a client on an annual physical exam. Which documentation should be brought to the physician's attention? a.Hoarseness for 2 weeks b. Epistaxis, twice last week c. Aphonia following a football game d. Laryngitis following a cold

a. Hoarseness for 2 weeks