Ch 20-22 NUR212

The nurse is discussing immediate postoperative communication strategies with a client scheduled for a total laryngectomy. What information will the nurse include?

"you can use writing or a communication board to communicate."

The herpes simplex virus type 1 (HSV-1), which produces a cold sore (fever blister), has an incubation period of

2-12 days

A first-line antibiotic used to treat acute rhinosinusitis is

Ampicillin

The nurse is providing discharge instructions to a client who has nasal packing in place following nasal surgery. Which discharge instructions would be most appropriate for the client?

Avoid sports activities for 6 weeks

Which is a deformity of the chest that occurs as a result of overinflation of the lungs?

Barrel chest

A thoracentesis is performed to obtain a sample of pleural fluid or a biopsy specimen from the pleural wall for diagnostic purposes. What does serous fluid indicate?

Cancer -inflammatory conditions, or heart fluid

The nurse knows that there are three types of chronic pharyngitis. Which of the following is characterized by numerous swollen lymph follicles on the pharyngeal wall?

Chronic granular

Which is a late sign of hypoxia?

Cyanosis

High or increased compliance occurs in which disease process?

Emphysema

Which is a priority nursing intervention that the nurse should perform for a client who has undergone surgery for a nasal obstruction?

Ensure mouth breathing

Which is the priority nursing diagnosis for a client undergoing a laryngectomy?

Ineffective airway clearance

Which respiratory volume is the max volume of air that can be inhaled after maximal expiration?

Inspiratory reserve volume -is normally 3000 mL

A client presents to the ED reporting severe coughing episodes. the client states that "the episodes are more intense at night." The nurse should suspect which of the following conditions based on the client's primary report?

Left-sided heart failure

Which type of sleep apnea is characterized by a lack of airflow due to pharyngeal occlusion?

Obstructive -usually occurs in men especially older and overweight

Which term is used to describe the inability to breathe easily except in an upright position

Orthopnea -high fowlers position to facilitate breathing

Which diagnostic imaging modality is more accurate than computer tomography in detecting malignancies?

PET

Which medication is the treatment of choice for bacterial pharyngitis?

Penicillin

The nurse is assessing a client in the clinic, and upon physical assessment the client demonstrates displacement of the sternum. This would be documented as which condition?

Pigeon chest -may occur with rickets, Marfan syndrome, or sever kyphoscoliosis

A client presents to the ED with a suspected allergic reaction. The client is experiencing laryngeal edema, which is causing obstruction, and is demonstrating retractions in the neck during inspiration. Which is the nurse's priority intervention?

Prepare to administer subcutaneous epinephrine and corticosteroids

A client who has an altered level of consciousness is receiving a tube feeding. Clients receiving tube feeding should be placed in which position?

Semi-Fowler's or higher

Which diagnostic test is used to confirm the diagnosis of maxillary and frontal sinusitis?

Sinus aspirates

When the nurse gives a client and family instructions after laryngeal surgery, which does the nurse indicates should be avoided?

Swimming

A thoracentesis is performed to obtain a sample of pleural fluid or a biopsy specimen from the pleural wall for diagnostic purposes. What does bloody fluid indicate?

Trauma

Kyphoscoliosis is

characterized by elevation of the scapula and a corresponding S-shape spine

Another term for clergyman's sore throat is

chronic granular pharyngitis

Which ventilation-perfusion ratio is exhibited by pulmonary embolus?

dead space -exists when ventilation exceeds perfusion

hemoptysis refers to

expectoration of blood from the respiratory tract

Sinus x-rays and CT scans may be obtained for patients with

frontal headaches, in refractory cases, and if complications are suspected

The low ventilation-perfusion ratio exists

in pneumonia or with a mucus plug

A silent unit occurs

in pneumothorax or acute respiratory distress syndrome

The nurse is caring for a critically ill client in the ICU. The nurse documents the client's respiratory rate as bradypnea is associated with which condition?

increased intracranial pressure -brain injury and drug overdose

Which clinical manifestation of hemorrhage is related to carotid artery rupture?

increased pulse rate

Mixed sleep apnea

is a combination of central and obstructive apnea, with one apneic episode.

Atrophic pharyngitis

is characterized by a membrane that is thin, white, glistening, and at times wrinkled.

It is important for the nurse to provide required info and appropriate explanations of diagnostic procedures to clients with respiratory disorders in order to

manage decreased energy levels

Expiratory reserve volume is the

max volume of air that can be exhaled forcibly after a normal exhalation.

Stiffness of the neck or inability to bend the neck is referred to as

nuchal rigidity

The nurse auscultates lung sounds that are harsh and cracking, sounding like two pieces of leather being rubbed together. The nurse would be correct in documenting this finding as

pleural friction rub

In which position should the client be placed for a thoracentesis?

sitting on the edge of the bed

Central sleep apnea

the client demonstrates simultaneous cessation of both airflow and respiratory movements

Xerostomia is

the dryness of the mouth from a variety of cause

the epiglottis is the

valve flap of cartilage that covers the opening to the larynx during swallowing

Tidal volume is the

volume of air inhaled and exhaled with each breath

residual volume is the

volume of air remaining in the lungs after a max exhalation

The nurse is caring for a client with allergic rhinitis. The client asks the nurse about measures to help decrease allergic symptoms. Which is the best response by the nurse?

"You should try to reduce exposure to irritants and allergens"

The nurse is caring for a client with recurrent hemoptysis who has undergone a bronchoscopy. Immediately following the procedure, the nurse should complete which action?

Assess the client for a cough reflex

The nurse is caring for a client reporting chest discomfort. The client's diagnosis at admission is left lower lobe pneumonia. Which strategy will the nurse instruct the client to use to help alleviate the discomfort?

Assume a left-lying position while in bed

Which is an age-related change associated with the respiratory system?

Decreased size of the airway

While conducting the physical examination during assessment of the respiratory system, which conditions does the nurse assess by inspecting and palpating the trachea?

Deviation from the midline

The nurse is caring for a client diagnosed with rhinosinusitis. The physician has ordered the client to receive four sprays of budesonide (Rhinocort) in each nostril every morning. The nurse informs the client that a common side effect of this medication is

Epistaxis

The nurse assess a client who is bleeding profusely from the nose. The nurse documents this finding as which condition?

Epistaxis -is due to rupture of tiny, distended vessels in the mucous membrane of any area of the nose

A 76-year-old client presents to the ED reporting "laryngitis." The triage nurse should ask whether the client has a medical history that includes

Gastroesophageal reflux disease (GERD)

foul-smelling sputum and bad breath may indicate

a lung abscess, bronchiectasis, or an infection caused by fusospirochetal or other anaerobic organisms

When a client has undergone a laryngectomy and there is evidence of wound breakdown, the nurse monitors the client very carefully because of the high risk for

carotid artery hemorrhage

A client is being assessed for acute laryngitis. The nurse knows that clinical manifestations of acute laryngitis include

hoarseness

Hypertrophic pharyngitis

is characterized by general thickening and congestion of the pharyngeal mucous membrane

dyspnea refers to

labored breathing or shortness of breath

hypoxemia refers to

low oxygen levels in the blood

the arytenoid cartilages are used with

the thyroid cartilage in vocal cord movement

the term for the volume of air inhaled and exhaled with each breath is

tidal volume

A funnel chest occurs

when there is a depression in the lower portion of the sternum

Which is the antibiotic of choice used to treat acute bacterial rhinosinusitis (ABRS)?

Amoxicillin

For which reason does gas exchange decrease in older adults?

The alveolar walls contain fewer capillaries

Which intervention regarding nutrition is implemented for clients who have undergone laryngectomy?

Use enteral feedings after the procedure -10 to 14 days

A college student presents to the health clinical with signs and symptoms of viral rhinitis (common cold). The patient states, "I've felt terrible all week; what can I do to feel better?" which of the following is the best response the nurse can give?

"you should rest, increase your fluids, and take ibuprofen"

The nurse is assessing a client for obstructive sleep apnea (OSA). Which are signs and symptoms of OSA? Select all that apply.

-Polycythemia -loud snoring -insomnia

A client has recently been diagnosed with malignant lung cancer. The nurse is calculating the client's smoking history in pack-years. The client reports smoking two packs of cigarettes a day for the past 11 years. The nurse correctly documents the client's pack-years as

22 (2 packs x 11 years)

Which is a true statement regarding air pressure variances?

Air is drawn through the trachea and bronchi into the alveoli during inspiration

The nurse is caring for a client admitted to the ED with an uncomplicated nasal fracture. Nasal packing has been put in place. Which intervention should the nurse include in the clients care?

Apply an ice pack

The nurse is caring for a client diagnosed with pneumonia. The nurse assesses the client for tactile fremitus by completing which action?

Asking the client to repeat "ninety-nine" as the nurse's hands move down the client's thorax

The nurse is caring for a client receiving radiation therapy for laryngeal cancer. Which is a late complication of radiation therapy?

laryngeal necrosis

The nurse answers a client's call light. The client reports an irritating tickling sensation in the throat, a salty taste, and a burning sensation in the chest. Upon further assessment, the nurse notes a tissue with bright red, frothy blood at the bedside. The nurse can assume the source of the blood is likely from the

lungs

The nurse is caring for a client who is scheduled for a bronchoscopy. The nurse understands that it is important to provide the required info and appropriate explanations for any diagnostic procedure to a client with a respiratory disorder in way that

manages decreased energy levels

The nurse is caring for a client following a tonsillectomy and adenoidectomy. Two hours after the procedure, the client begins to vomit large amounts of dark blood at frequent intervals and is tachycardic and febrile. After notifying the surgeon, the nurse

obtains a light, mirror, gauze, and curved hemostats

Pink, frothy sputum may be an indication of

pulmonary edema

A barrel chest is

seen in clients with emphysema and occurs as a result of overinflation of the lungs

types of sleep apnea do not include a

simple classification

The nurse in the ICU is caring for a client with a nasotracheal tube. Because of the tube placement, the nurse understands that the client is at risk for developing

sinus infection

Aphonia refers to

the inability to use one's voice

In relation to the structure of the larynx, the cricoid cartilage is

the only complete cartilaginous ring in the larynx