Chapter 27: Nursing Management: Upper Respiratory Problems

Chapter 27: Nursing Management: Upper Respiratory Problems

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE
1. After a patient has undergone a rhinoplasty, which nursing intervention will be included
in the plan of care?
a. Educate the patient about how to safely remove and reapply nasal packing.
b. Reassure the patient that the nose will look normal when the swelling subsides.
c. Instruct the patient to keep the head elevated for 48 hours to minimize swelling
and pain.
d. Teach the patient to use nonsteroidal anti-inflammatory drugs (NSAIDs) for pain
control.
ANS: C
Maintaining the head in an elevated position will decrease the amount of nasal swelling.
NSAIDs increase the risk for postoperative bleeding and should not be used
postoperatively. The patient would not be taught to remove or reapply nasal packing,
which is usually removed by the surgeon on the day after surgery. Although return to a
preinjury appearance is the goal of the surgery, it is not always possible to achieve this
result.
DIF: Cognitive Level: Application REF: 520
TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity
2. When teaching the patient with allergic rhinitis about management of the condition, the
nurse explains that
a. over-the-counter (OTC) antihistamines cause sedation, so prescription
antihistamines are usually ordered.
b. corticosteroid nasal sprays will reduce inflammation, but systemic effects limit
their use.
c. use of oral antihistamines for a few weeks before the allergy season may prevent
reactions.
d. identification and avoidance of environmental triggers are the best way to avoid
symptoms.
ANS: D
The most important intervention is to assist the patient in identifying and avoiding
potential allergens. Intranasal corticosteroids (not oral antihistamines) should be started
several weeks before the allergy season. Corticosteroid nasal sprays have minimal
systemic absorption. Nonsedating antihistamines are available OTC.
DIF: Cognitive Level: Application REF: 521-523
TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity
Test Bank 27-2
3. After discussing management of upper respiratory infections (URI) with a patient who
has acute viral rhinitis, the nurse determines that additional teaching is needed when the
patient says
a. “I can take acetaminophen (Tylenol) to treat discomfort.”
b. “I will drink lots of juices and other fluids to stay hydrated.”
c. “I can use my nasal decongestant spray until the congestion is all gone.”
d. “I will watch for changes in nasal secretions or the sputum that I cough up.”
ANS: C
The nurse should clarify that nasal decongestant sprays should be used for no more than 3
days to prevent rebound vasodilation and congestion. The other responses indicate that
the teaching has been effective.
DIF: Cognitive Level: Application REF: 524 TOP: Nursing Process:
Evaluation
MSC: NCLEX: Physiological Integrity
4. An RN is observing a nursing student who is suctioning a hospitalized patient with a
tracheostomy in place. Which action by the student requires the RN to intervene?
a. The student preoxygenates the patient for 1 minute before suctioning.
b. The student puts on clean gloves and uses a sterile catheter to suction.
c. The student inserts the catheter about 5 inches into the tracheostomy tube.
d. The student applies suction for 10 seconds while withdrawing the catheter.
ANS: B
Sterile gloves and a sterile catheter are used when suctioning a tracheostomy. The other
student actions do not require intervention by the RN. Although the patient may not need
1 minute of preoxygenation, this would not be unsafe. Suctioning for 10 seconds is
appropriate. The length of catheter that should be inserted depends on the length of the
tracheostomy tube, but 5 inches would be appropriate for most adult patients.
DIF: Cognitive Level: Comprehension REF: 530
TOP: Nursing Process: Implementation MSC: NCLEX: Safe and Effective Care
Environment