Chapter 18 Management of Patients With Upper Respiratory Tract
Disorders
1. The nurse is providing patient teaching to a young mother who has brought her 3- month-old
infant to the clinic for a well-baby checkup. What action should the nurse recommend to the
woman to prevent the transmission of organisms to her infant during the cold season?
A) Take preventative antibiotics, as ordered. B) Gargle with warm salt water regularly.
C) Dress herself and her infant warmly. D) Wash her hands frequently.
Ans: D
Feedback:
Handwashing remains the most effective preventive measure to reduce the transmission of
organisms. Taking prescribed antibiotics, using warm salt-water gargles, and
dressing warmly do not suppress transmission. Antibiotics are not prescribed for a cold.
2. A patient visiting the clinic is diagnosed with acute sinusitis. To promote sinus drainage, the
nurse should instruct the patient to perform which of the following? A) Apply a cold pack to
the affected area.
B) Apply a mustard poultice to the forehead. C) Perform postural drainage.
D) Increase fluid intake. Ans: D
Feedback:
For a patient diagnosed with acute sinusitis, the nurse should instruct the patient that
hot packs, increasing fluid intake, and elevating the head of the bed can promote drainage.
Applying a mustard poultice will not promote sinus drainage. Postural drainage is used to
remove bronchial secretions.
,3. The nurse is creating a plan of car for a patient diagnosed with acute laryngitis. What
intervention should be included in the patient's plan of care?
A) Place warm cloths on the patient's throat, as needed.
B) Have the patient inhale warm steam three times daily.
C) Encourage the patient to limit speech whenever possible.
D) Limit the patient's fluid intake to 1.5 L/day. Ans: C
Feedback:
Management of acute laryngitis includes resting the voice, avoiding irritants (including
smoking), resting, and inhaling cool steam or an aerosol. Fluid intake should be increased.
Warm cloths on the throat will not help relieve the symptoms of acute laryngitis.
4. A patient comes to the ED and is admitted with epistaxis. Pressure has been applied to
the patient's midline septum for 10 minutes, but the bleeding continues. The nurse should
anticipate using what treatment to control the bleeding?
A) Irrigation with a hypertonic solution
B) Nasopharyngeal suction C) Normal saline application D) Silver nitrate application
Ans: D
Feedback:
If pressure to the midline septum does not stop the bleeding for epistaxis, additional
treatment of silver nitrate application, Gelfoam, electrocautery, or vasoconstrictors may be
used. Suction may be used to visualize the nasal septum, but it does not alleviate the
bleeding. Irrigation with a hypertonic solution is not used to treat epistaxis.
, 5. The nurse is planning the care of a patient who is scheduled for a laryngectomy. The nurse
should assign the highest priority to which postoperative nursing diagnosis?
A) Anxiety related to diagnosis of cancer
B) Altered nutrition related to swallowing difficulties
C) Ineffective airway clearance related to airway alterations
D) Impaired verbal communication related to removal of the larynx
Ans: C
Feedback:
Each of the listed diagnoses is valid, but ineffective airway clearance is the priority
nursing diagnosis for all conditions.
6. The home care nurse is assessing the home environment of a patient who will be discharged
from the hospital shortly after his laryngectomy. The nurse should inform the patient that he
may need to arrange for the installation of which system in his home?
A) A humidification system
B) An air conditioning system C) A water purification system D) A radiant heating
system Ans: A
Feedback:
The nurse stresses the importance of humidification at home and instructs the family to
obtain and set up a humidification system before the patient returns home. Air- conditioning
may be too cool and too drying for the patient. A water purification system or a radiant
heating system is not necessary.
Disorders
1. The nurse is providing patient teaching to a young mother who has brought her 3- month-old
infant to the clinic for a well-baby checkup. What action should the nurse recommend to the
woman to prevent the transmission of organisms to her infant during the cold season?
A) Take preventative antibiotics, as ordered. B) Gargle with warm salt water regularly.
C) Dress herself and her infant warmly. D) Wash her hands frequently.
Ans: D
Feedback:
Handwashing remains the most effective preventive measure to reduce the transmission of
organisms. Taking prescribed antibiotics, using warm salt-water gargles, and
dressing warmly do not suppress transmission. Antibiotics are not prescribed for a cold.
2. A patient visiting the clinic is diagnosed with acute sinusitis. To promote sinus drainage, the
nurse should instruct the patient to perform which of the following? A) Apply a cold pack to
the affected area.
B) Apply a mustard poultice to the forehead. C) Perform postural drainage.
D) Increase fluid intake. Ans: D
Feedback:
For a patient diagnosed with acute sinusitis, the nurse should instruct the patient that
hot packs, increasing fluid intake, and elevating the head of the bed can promote drainage.
Applying a mustard poultice will not promote sinus drainage. Postural drainage is used to
remove bronchial secretions.
,3. The nurse is creating a plan of car for a patient diagnosed with acute laryngitis. What
intervention should be included in the patient's plan of care?
A) Place warm cloths on the patient's throat, as needed.
B) Have the patient inhale warm steam three times daily.
C) Encourage the patient to limit speech whenever possible.
D) Limit the patient's fluid intake to 1.5 L/day. Ans: C
Feedback:
Management of acute laryngitis includes resting the voice, avoiding irritants (including
smoking), resting, and inhaling cool steam or an aerosol. Fluid intake should be increased.
Warm cloths on the throat will not help relieve the symptoms of acute laryngitis.
4. A patient comes to the ED and is admitted with epistaxis. Pressure has been applied to
the patient's midline septum for 10 minutes, but the bleeding continues. The nurse should
anticipate using what treatment to control the bleeding?
A) Irrigation with a hypertonic solution
B) Nasopharyngeal suction C) Normal saline application D) Silver nitrate application
Ans: D
Feedback:
If pressure to the midline septum does not stop the bleeding for epistaxis, additional
treatment of silver nitrate application, Gelfoam, electrocautery, or vasoconstrictors may be
used. Suction may be used to visualize the nasal septum, but it does not alleviate the
bleeding. Irrigation with a hypertonic solution is not used to treat epistaxis.
, 5. The nurse is planning the care of a patient who is scheduled for a laryngectomy. The nurse
should assign the highest priority to which postoperative nursing diagnosis?
A) Anxiety related to diagnosis of cancer
B) Altered nutrition related to swallowing difficulties
C) Ineffective airway clearance related to airway alterations
D) Impaired verbal communication related to removal of the larynx
Ans: C
Feedback:
Each of the listed diagnoses is valid, but ineffective airway clearance is the priority
nursing diagnosis for all conditions.
6. The home care nurse is assessing the home environment of a patient who will be discharged
from the hospital shortly after his laryngectomy. The nurse should inform the patient that he
may need to arrange for the installation of which system in his home?
A) A humidification system
B) An air conditioning system C) A water purification system D) A radiant heating
system Ans: A
Feedback:
The nurse stresses the importance of humidification at home and instructs the family to
obtain and set up a humidification system before the patient returns home. Air- conditioning
may be too cool and too drying for the patient. A water purification system or a radiant
heating system is not necessary.
