NRNP 6540 MIDTERM Chapter 26 review questions AND ANSWERS GrAD
A+ 2024\2025
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B. "Could you be pregnant now?"
rationale:
The live attenuated influenza vaccine
(LAIV) is given by nasal spray and ap-
The nurse in the occupational health clin-
proved for healthy people age 2 to 49
ic prepares to administer the influenza
years. The LAIV is given only to non-
vaccine by nasal spray to an employee.
pregnant, healthy people. The inactivat-
Which question should the nurse ask be-
ed vaccine is given by injection and is
fore administration of this vaccine?
approved for use in people 6 months
A. "Are you allergic to chicken?"
or older. The inactivated vaccine can be
B. "Could you be pregnant now?"
used in pregnancy, in people with chron-
C. "Did you ever have influenza?"
ic conditions, or in people who are im-
D. "Have you ever had hepatitis B?"
munosuppressed. Influenza vaccination
is contraindicated if the person has a
history of Guillain-Barré syndrome or a
hypersensitivity to eggs.
B. Maintain the airway with a sterile he-
A patient whose tracheostomy was in- mostat.
serted 30 minutes ago is recovering in Rationale:
the postanesthesia recovery unit when As long as the patient is not in acute
the tracheostomy tube is expelled by respiratory distress after dislodging the
coughing. What is the priority action by tracheostomy tube, the nurse should use
the nurse? a sterile hemostat to maintain an open
A. Suction the tracheostomy opening. airway until a sterile tracheostomy tube
B. Maintain the airway with a sterile he- can be reinserted into the tracheal open-
mostat. ing. The tracheostomy is an open sur-
C. Use an Ambu bag and mask to venti- gical wound that has not had time to
late the patient. mature into a stoma. If the patient is in
D. Insert the tracheostomy tube obturator respiratory distress, the nurse will use
into the stoma. an Ambu bag and mask to ventilate the
patient temporarily.
D. Chronic use of alcohol and tobacco
The nurse is reviewing the health history
products
of a patient with laryngeal cancer. Which
rationale:
finding would the nurse expect?
Tobacco use causes 85% of head and
A. Family history of lung cancer
neck cancers. Excess alcohol use is an-
B. Recent inhalation of noxious fumes
other major risk factor. Other risk factors
, NRNP 6540 MIDTERM Chapter 26 review questions AND ANSWERS GrAD
A+ 2024\2025
Study online at https://quizlet.com/_h7jcr2
include exposure to the sun, asbestos,
C. Frequent straining of the vocal cords
industrial carcinogens, marijuana use,
D. Chronic use of alcohol and tobacco
radiation therapy to the head and neck,
products
and poor oral hygiene.
C. Tilt head forward while sitting upright.
D. Pinch the entire soft lower portion of
A patient is being discharged from the the nose.
emergency department after being treat- rationale:
ed for epistaxis. In teaching first aid mea- Use simple first aid measures to con-
sures in the event the epistaxis would trol nosebleeds. These include: (1) plac-
recur, what measures should the nurse ing the patient in a sitting position, lean-
suggest? (Select all that apply.) ing slightly forward with head tilted for-
A. Tilt patient's head backwards. ward and (2) applying direct pressure by
B. Apply ice compresses to the nose. squeezing the entire soft lower portion of
C. Tilt head forward while sitting upright. the nose (nostrils) together for 5 to 15
D. Pinch the entire soft lower portion of minutes. Tilting the head back does not
the nose. stop the bleeding but allows the blood
E. Lying down until 15 minutes after the to enter the nasopharynx, which could
bleeding ceases result in aspiration or nausea or vomiting
from swallowing blood. Lying down also
will not decrease the bleeding.
The nurse observes clear nasal drainage A. Test the drainage for the presence of
in a patient newly admitted with facial glucose.
trauma with a nasal fracture. What is the Clear nasal drainage suggests leak-
nurse's priority action? age of cerebrospinal fluid (CSF). The
A. Test the drainage for the presence of drainage should be tested for the pres-
glucose. ence of glucose, which would indicate
B. Suction the nose to maintain airway the presence of CSF. Suctioning should
clearance. not be done. Documenting the findings
C. Document the findings and continue and monitoring are important after noti-
monitoring. fying the health care provider. A drip pad
D. Apply a drip pad and reassure the may be applied, but the patient should
patient this is normal. not be reassured that this is normal.
D. Maintain surgical packing in the nose.
Rationale:
A goal that is common to nursing and
medical management of a patient after
, NRNP 6540 MIDTERM Chapter 26 review questions AND ANSWERS GrAD
A+ 2024\2025
Study online at https://quizlet.com/_h7jcr2
rhinoplasty is to prevent the formation of
a septal hematoma and potential infec-
A patient had an open reduction repair tions resulting from a septal hematoma.
of a bilateral nasal fracture. The nurse Therefore, the nurse helps to keep the
plans to implement an intervention that nasal packing in the nose. The packing
focuses on both nursing and medical applies direct pressure to oozing blood
goals for this patient. Which intervention vessels to stop postoperative bleeding.
should the nurse implement? A medical goal includes realigning the
A. Apply an external splint to the nose. fracture with an external or internal splint.
B. Insert plastic nasal implant surgically. The nurse helps maintain the airway
C. Humidify the air for mouth breathing. by humidifying inspired air because the
D. Maintain surgical packing in the nose. nose is unable to do so following surgery
because it is swollen and packed with
gauze.
D. History of a severe allergic reaction to
The nurse is scheduled to administer
the vaccine
seasonal influenza vaccinations to the
Rationale:
residents of a long-term care facility.
Contraindications to vaccination include
What would be a contraindication to the
a history of severe allergic reactions to
administration of the vaccine to a resi-
previous flu vaccine. Patients with ana-
dent?
phylactic hypersensitivity to eggs should
A. Age older than 80 years
discuss the vaccine with their HCP, as
B. History of upper respiratory infections
alternatives for vaccinating patients with
C. Chronic obstructive pulmonary dis-
egg allergies are now available. Ad-
ease (COPD)
vanced age and a history of respiratory
D. History of a severe allergic reaction to
illness are not contraindications for in-
the vaccine
fluenza vaccination.
A patient has a tracheostomy tube after B. Quality of breath sounds
reconstructive surgery for invasive head Rationale:
and neck cancer. What is most important Before performing tracheostomy care,
for the nurse to assess before performing the nurse will auscultate lung sounds to
tracheostomy cannula care? determine the presence of secretions. To
A. Level of consciousness prevent aspiration, secretions must be
B. Quality of breath sounds cleared either by coughing or by suc-
C. Presence of the gag reflex tioning before performing tracheostomy
D. Tracheostomy cuff pressure cannula care.
The nurse teaches a patient with hyper-
tension and osteoarthritis about actions
to prevent and control epistaxis. Which
statement, if made by the patient, indi-
cates further teaching is required?
A. "I should avoid using ibuprofen for pain
A+ 2024\2025
Study online at https://quizlet.com/_h7jcr2
B. "Could you be pregnant now?"
rationale:
The live attenuated influenza vaccine
(LAIV) is given by nasal spray and ap-
The nurse in the occupational health clin-
proved for healthy people age 2 to 49
ic prepares to administer the influenza
years. The LAIV is given only to non-
vaccine by nasal spray to an employee.
pregnant, healthy people. The inactivat-
Which question should the nurse ask be-
ed vaccine is given by injection and is
fore administration of this vaccine?
approved for use in people 6 months
A. "Are you allergic to chicken?"
or older. The inactivated vaccine can be
B. "Could you be pregnant now?"
used in pregnancy, in people with chron-
C. "Did you ever have influenza?"
ic conditions, or in people who are im-
D. "Have you ever had hepatitis B?"
munosuppressed. Influenza vaccination
is contraindicated if the person has a
history of Guillain-Barré syndrome or a
hypersensitivity to eggs.
B. Maintain the airway with a sterile he-
A patient whose tracheostomy was in- mostat.
serted 30 minutes ago is recovering in Rationale:
the postanesthesia recovery unit when As long as the patient is not in acute
the tracheostomy tube is expelled by respiratory distress after dislodging the
coughing. What is the priority action by tracheostomy tube, the nurse should use
the nurse? a sterile hemostat to maintain an open
A. Suction the tracheostomy opening. airway until a sterile tracheostomy tube
B. Maintain the airway with a sterile he- can be reinserted into the tracheal open-
mostat. ing. The tracheostomy is an open sur-
C. Use an Ambu bag and mask to venti- gical wound that has not had time to
late the patient. mature into a stoma. If the patient is in
D. Insert the tracheostomy tube obturator respiratory distress, the nurse will use
into the stoma. an Ambu bag and mask to ventilate the
patient temporarily.
D. Chronic use of alcohol and tobacco
The nurse is reviewing the health history
products
of a patient with laryngeal cancer. Which
rationale:
finding would the nurse expect?
Tobacco use causes 85% of head and
A. Family history of lung cancer
neck cancers. Excess alcohol use is an-
B. Recent inhalation of noxious fumes
other major risk factor. Other risk factors
, NRNP 6540 MIDTERM Chapter 26 review questions AND ANSWERS GrAD
A+ 2024\2025
Study online at https://quizlet.com/_h7jcr2
include exposure to the sun, asbestos,
C. Frequent straining of the vocal cords
industrial carcinogens, marijuana use,
D. Chronic use of alcohol and tobacco
radiation therapy to the head and neck,
products
and poor oral hygiene.
C. Tilt head forward while sitting upright.
D. Pinch the entire soft lower portion of
A patient is being discharged from the the nose.
emergency department after being treat- rationale:
ed for epistaxis. In teaching first aid mea- Use simple first aid measures to con-
sures in the event the epistaxis would trol nosebleeds. These include: (1) plac-
recur, what measures should the nurse ing the patient in a sitting position, lean-
suggest? (Select all that apply.) ing slightly forward with head tilted for-
A. Tilt patient's head backwards. ward and (2) applying direct pressure by
B. Apply ice compresses to the nose. squeezing the entire soft lower portion of
C. Tilt head forward while sitting upright. the nose (nostrils) together for 5 to 15
D. Pinch the entire soft lower portion of minutes. Tilting the head back does not
the nose. stop the bleeding but allows the blood
E. Lying down until 15 minutes after the to enter the nasopharynx, which could
bleeding ceases result in aspiration or nausea or vomiting
from swallowing blood. Lying down also
will not decrease the bleeding.
The nurse observes clear nasal drainage A. Test the drainage for the presence of
in a patient newly admitted with facial glucose.
trauma with a nasal fracture. What is the Clear nasal drainage suggests leak-
nurse's priority action? age of cerebrospinal fluid (CSF). The
A. Test the drainage for the presence of drainage should be tested for the pres-
glucose. ence of glucose, which would indicate
B. Suction the nose to maintain airway the presence of CSF. Suctioning should
clearance. not be done. Documenting the findings
C. Document the findings and continue and monitoring are important after noti-
monitoring. fying the health care provider. A drip pad
D. Apply a drip pad and reassure the may be applied, but the patient should
patient this is normal. not be reassured that this is normal.
D. Maintain surgical packing in the nose.
Rationale:
A goal that is common to nursing and
medical management of a patient after
, NRNP 6540 MIDTERM Chapter 26 review questions AND ANSWERS GrAD
A+ 2024\2025
Study online at https://quizlet.com/_h7jcr2
rhinoplasty is to prevent the formation of
a septal hematoma and potential infec-
A patient had an open reduction repair tions resulting from a septal hematoma.
of a bilateral nasal fracture. The nurse Therefore, the nurse helps to keep the
plans to implement an intervention that nasal packing in the nose. The packing
focuses on both nursing and medical applies direct pressure to oozing blood
goals for this patient. Which intervention vessels to stop postoperative bleeding.
should the nurse implement? A medical goal includes realigning the
A. Apply an external splint to the nose. fracture with an external or internal splint.
B. Insert plastic nasal implant surgically. The nurse helps maintain the airway
C. Humidify the air for mouth breathing. by humidifying inspired air because the
D. Maintain surgical packing in the nose. nose is unable to do so following surgery
because it is swollen and packed with
gauze.
D. History of a severe allergic reaction to
The nurse is scheduled to administer
the vaccine
seasonal influenza vaccinations to the
Rationale:
residents of a long-term care facility.
Contraindications to vaccination include
What would be a contraindication to the
a history of severe allergic reactions to
administration of the vaccine to a resi-
previous flu vaccine. Patients with ana-
dent?
phylactic hypersensitivity to eggs should
A. Age older than 80 years
discuss the vaccine with their HCP, as
B. History of upper respiratory infections
alternatives for vaccinating patients with
C. Chronic obstructive pulmonary dis-
egg allergies are now available. Ad-
ease (COPD)
vanced age and a history of respiratory
D. History of a severe allergic reaction to
illness are not contraindications for in-
the vaccine
fluenza vaccination.
A patient has a tracheostomy tube after B. Quality of breath sounds
reconstructive surgery for invasive head Rationale:
and neck cancer. What is most important Before performing tracheostomy care,
for the nurse to assess before performing the nurse will auscultate lung sounds to
tracheostomy cannula care? determine the presence of secretions. To
A. Level of consciousness prevent aspiration, secretions must be
B. Quality of breath sounds cleared either by coughing or by suc-
C. Presence of the gag reflex tioning before performing tracheostomy
D. Tracheostomy cuff pressure cannula care.
The nurse teaches a patient with hyper-
tension and osteoarthritis about actions
to prevent and control epistaxis. Which
statement, if made by the patient, indi-
cates further teaching is required?
A. "I should avoid using ibuprofen for pain
