ANP 650 Midterm Study Guide - Questions, Answers and Rationales

ANP 650 Midterm Study Guide - Questions, Answers and Rationales A client with a family history of hearing loss asks the nurse what he can do to prevent this disorder as he ages. Which of the following should the nurse instruct this client? (Select all that apply.) 1. Turn down radio and television volume. 2. Avoid noisy areas such as rock concerts. 3. Wear protective devices. 4. Use plain cotton balls in the ears. 5. Avoid sun exposure. 6. Flush the ears daily with mineral oil. Measures to prevent hearing loss include turning down the volume on the radio and television, avoiding noisy areas such as rock concerts, and wearing protective devices. Using cotton balls in the ears does not decrease noise from reaching the middle ear. Sun exposure does not impact hearing. Flushing the ears daily with mineral oil might decrease the buildup of cerumen; however, it will not improve hearing. Which of the following are indications that a client has been exposed to excessive noise? (Select all that apply.) 1. Raising the voice to talk in normal conversation 2. Clear drainage from the ears 3. Inability to hear a conversation 2 feet away 4. Sounds are muffled 5. Ringing of the ears 6. Short periods of pain in the ears Warning signs of excessive noise exposure include raising the voice to talk in normal conversation, inability to hear a conversation 2 feet away, muffled sounds, ear ringing, and short periods of ear pain. Clear drainage from the ears does not occur with excessive noise exposure. A child is diagnosed with severe allergic rhinitis. Which of the following manifestations would the nurse most likely assess in this client? 1. Edematous neck glands 2. Reduced hearing 3. Pruritis 4. Frequent wiping of the nose with the palm of the hand Frequent wiping of the nose with the palm of the hand is one symptom seen in the client diagnosed with severe allergic rhinitis. Edematous neck glands, reduced hearing, and pruritis are not manifestations of severe allergic rhinitis. A client tells the nurse that she experiences a stuffy nose, nasal pain, and postnasal drip every time she works in her company’s office. Which of the following types of allergic rhinitis is this client most likely experiencing? 1. Infectious 2. Perennial 3. Occupational 4. Seasonal Occupational allergic rhinitis occurs from airborne substances in the workplace. Seasonal allergic rhinitis occurs during a specific time of the year. Perennial allergic rhinitis occurs in response to exposure to environmental allergens that can occur throughout the year. Infectious rhinitis is a nonallergic type of rhinitis. A client asks the nurse if there is an antihistamine that does not cause drowsiness. Which of the following medications would this client most likely prefer to treat allergic rhinitis? 1. Diphenhydramine 2. Chlorpheniramine maleate 3. Clemastine 4. Fexofenadine Fexofenadine (Allegra) is a second-generation antihistamine, and second-generation antihistamines exhibit less sedation than first-generation medications such as diphenhydramine, chlorpheniramine maleate, and clemastine. A client diagnosed with hypertension is experiencing allergic rhinitis. The nurse realizes that the medication that would not be indicated for this client would be: 1. loratadine. 2. montelukast. 3. pseudoephedrine. 4. zafirlukast. Pseudoephedrine can be contraindicated for the patient with hypertension. Loratadine, montelukast, and zafirlukast should be used cautiously for patients with hepatic impairment. A 16-year-old client is being prescribed a medication to treat acute sinusitis. The nurse realizes that this client should not be prescribed: 1. amoxicillin. 2. cefuroxime. 3. ciprofloxacin. 4. erythromycin. Quinolones such as ciprofloxacin (Cipro) and levofloxacin (Levaquin) are contraindicated in children younger than 17 years of age. The nurse is caring for a client diagnosed with acute sinusitis. Which of the following symptoms is the client most likely experiencing? 1. Anosmia 2. Fever 3. Halitosis 4. Metallic taste Clients often complain of unilateral face pain, purulent nasal discharge, pain during mastication, anosmia (absence of smell), and headache. Less common symptoms include fever, nasal congestion, halitosis, toothache, metallic taste, and cough. The nurse is planning care for the client diagnosed with viral rhinitis. Which of the following would be the best goal of care for this client? 1. Prevent secondary bacterial infection. 2. Prevent rhinitis medicamentosa. 3. Refrain from use of analgesics. 4. Encourage complete participation in activities. Treatment of acute rhinitis, or the common cold, is aimed at decreasing the impact of the symptoms and preventing secondary bacterial infection. Rhinitis medicamentosa occurs from misuse of nasal decongestants. Acetaminophen or a nonsteroidal anti-inflammatory agent is useful for fever, aches, and pain. Rest is encouraged. The nurse is instructing the mother of a client recovering from a tonsillectomy. Which of the following should the nurse instruct the mother to report? 1. Difficulty swallowing 2. Difficulty talking 3. Excessive swallowing 4. Pain Excessive swallowing is a sign of bleeding and should be reported. Pain and difficulty talking and swallowing are expected. Which of the following should the nurse instruct a client recovering from a tonsillectomy?