Med-Surg Chapter 27 Lewis Upper Respiratory Problems NCLEX With complete solution Newest RATED A+

Med-Surg Chapter 27 Lewis Upper Respiratory
Problems NCLEX With complete solution
Newest RATED A+
1. The nurse teaches a patient about discharge instructions after a rhinoplasty. Which statement,
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if made by the patient, indicates that the teaching was successful?
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a. "I can take 800 mg ibuprofen for pain control."
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b. "I will safely remove and reapply nasal packing daily."
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c. "My nose will look normal after 24 hours when the swelling goes away."
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d. "I will keep my head elevated for 48 hours to minimize swelling and pain." - Correct Answers
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ANS: D
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Maintaining the head in an elevated position will decrease the amount of nasal swelling. NSAIDs, Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il`




such as ibuprofen, increase the risk for postoperative bleeding and should not be used
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postoperatively. The patient would not be taught to remove or reapply nasal packing, which is
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usually removed by the surgeon on the day after surgery. Although return to a preinjury
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appearance is the goal of the surgery, it is not always possible to achieve this result, especially in
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the first few weeks after surgery.
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Il` 2. The nurse plans to teach a patient how to manage allergic rhinitis. Which information should
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Il` the nurse include in the teaching plan?
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a. Hand washing is the primary way to prevent spreading the condition to others.
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b. Use of oral antihistamines for 2 weeks before the allergy season may prevent reactions.
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c. Corticosteroid nasal sprays will reduce inflammation, but systemic effects limit their use.
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d. Identification and avoidance of environmental triggers are the best way to avoid symptoms. -
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Correct Answers ANS: D
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The most important intervention is to assist the patient in identifying and avoiding potential
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allergens. Intranasal corticosteroids (not oral antihistamines) should be started several weeks
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before the allergy season. Corticosteroid nasal sprays have minimal systemic absorption. Acute
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viral rhinitis (the common cold) can be prevented by washing hands.
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, Il` 3. The nurse discusses management of upper respiratory infections (URI) with a patient who has
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Il` acute sinusitis. Which statement by the patient indicates that additional teaching is needed?
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a. "I can take acetaminophen (Tylenol) to treat my discomfort."
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b. "I will drink lots of juices and other fluids to stay well hydrated."
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c. "I can use my nasal decongestant spray until the congestion is all gone."
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d. "I will watch for changes in nasal secretions or the sputum that I cough up." - Correct Answers
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ANS: C
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The nurse should clarify that nasal decongestant sprays should be used for no more than 3 days to
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prevent rebound vasodilation and congestion. The other responses indicate that the teaching has
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been effective.
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Il` 4. A nurse who is caring for patient with a tracheostomy tube in place has just auscultated rhonchi
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Il` bilaterally. If the patient is unsuccessful in coughing up secretions, what action should the nurse
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Il` take?

a. Encourage increased incentive spirometer use.
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b. Encourage the patient to increase oral fluid intake.
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c. Put on sterile gloves and use a sterile catheter to suction.
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d. Preoxygenate the patient for 3 minutes before suctioning. - Correct Answers ANS: C
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This patient needs suctioning now to secure a patent airway. Sterile gloves and a sterile catheter
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are used when suctioning a tracheostomy. Preoxygenation for 3 minutes is not necessary.
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Incentive spirometer (IS) use opens alveoli and can induce coughing, which can mobilize
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secretions. However, the patient with a tracheostomy may not be able to use an incentive
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spirometer. Increasing oral fluid intake would not moisten and help mobilize secretions in a timely
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manner.
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Il` 5. A patient with a tracheostomy has a new order for a fenestrated tracheostomy tube. Which
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Il` action should the nurse include in the plan of care in collaboration with the speech therapist?
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a. Leave the tracheostomy inner cannula inserted at all times.
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b. Place the decannulation cap in the tube before cuff deflation.
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