NUR 165 Chapter 29 Upper respiratory problems (Includes
epistaxis, influenza, sinusitis, and head and neck cancer)
Questions With Complete Solutions
A nurse obtains a health history from a patient who has a 35
pack-year smoking history. The patient reports hoarseness and
tightness in the throat and difficulty swallowing. Which question
is important for the nurse to ask?
a. "How much alcohol do you drink in an average week?"
b ."Do you have a family history of head or neck cancer?"
c. "Have you had frequent streptococcal throat infections?"
d. "Do you use antihistamines for upper airway congestion?"
Correct Answers ANS: A
Prolonged alcohol use and smoking are associated with the
development of laryngeal cancer, which the patient's symptoms
and history suggest. Family history is not a risk factor for head
or neck cancer. Frequent antihistamine use would be asked
about if the nurse suspected allergic rhinitis, but the patient's
symptoms are not suggestive of this diagnosis. Patients with
streptococcal throat infections will also have pain and a fever.
A patient scheduled for a total laryngectomy and radical neck
dissection for cancer of the larynx asks the nurse, "Will I be able
to talk normally after surgery?" What is the most accurate
response by the nurse?
a. "You will breathe through a permanent opening in your neck,
but you will not be able to communicate orally."
b. "You won't be able to talk right after surgery, but you will be
able to speak again
after the tracheostomy tube is removed."
, c. "You will have a permanent opening into your neck, and you
will need
rehabilitation for some type of voice restoration."
d. "You won't be able to speak as you used to, but there are
artificial voice devices that will give you the ability to speak
normally." Correct Answers ANS: C
Voice rehabilitation is planned after a total laryngectomy, and a
variety of assistive devices are available to restore
communication. Although the ability to communicate orally is
changed, it would not be lost. Artificial voice devices do not
permit normal-sounding speech. In a total laryngectomy, the
vocal cords are removed, so normal speech is impossible.
A patient who had a total laryngectomy has previously
expressed hopelessness about the loss of control over personal
care. Which information obtained by the nurse indicates that this
identified problem is resolving?
a.The patient allows the nurse to suction the tracheostomy.
b. The patient's spouse provides the daily tracheostomy care.
c. The patient asks to learn how to clean the tracheostomy
stoma.
d. The patient uses a communication board to request "No
Visitors." Correct Answers ANS: C
Independently caring for the laryngectomy tube indicates that
the patient has regained control of personal care and hopeless.
Letting the nurse and spouse provide care and requesting no
visitors may indicate that the patient is still experiencing
hopelessness.
clinical manifestations of head and neck cancer Correct
Answers -white or red patch in the mouth, ulcer that wont heal
epistaxis, influenza, sinusitis, and head and neck cancer)
Questions With Complete Solutions
A nurse obtains a health history from a patient who has a 35
pack-year smoking history. The patient reports hoarseness and
tightness in the throat and difficulty swallowing. Which question
is important for the nurse to ask?
a. "How much alcohol do you drink in an average week?"
b ."Do you have a family history of head or neck cancer?"
c. "Have you had frequent streptococcal throat infections?"
d. "Do you use antihistamines for upper airway congestion?"
Correct Answers ANS: A
Prolonged alcohol use and smoking are associated with the
development of laryngeal cancer, which the patient's symptoms
and history suggest. Family history is not a risk factor for head
or neck cancer. Frequent antihistamine use would be asked
about if the nurse suspected allergic rhinitis, but the patient's
symptoms are not suggestive of this diagnosis. Patients with
streptococcal throat infections will also have pain and a fever.
A patient scheduled for a total laryngectomy and radical neck
dissection for cancer of the larynx asks the nurse, "Will I be able
to talk normally after surgery?" What is the most accurate
response by the nurse?
a. "You will breathe through a permanent opening in your neck,
but you will not be able to communicate orally."
b. "You won't be able to talk right after surgery, but you will be
able to speak again
after the tracheostomy tube is removed."
, c. "You will have a permanent opening into your neck, and you
will need
rehabilitation for some type of voice restoration."
d. "You won't be able to speak as you used to, but there are
artificial voice devices that will give you the ability to speak
normally." Correct Answers ANS: C
Voice rehabilitation is planned after a total laryngectomy, and a
variety of assistive devices are available to restore
communication. Although the ability to communicate orally is
changed, it would not be lost. Artificial voice devices do not
permit normal-sounding speech. In a total laryngectomy, the
vocal cords are removed, so normal speech is impossible.
A patient who had a total laryngectomy has previously
expressed hopelessness about the loss of control over personal
care. Which information obtained by the nurse indicates that this
identified problem is resolving?
a.The patient allows the nurse to suction the tracheostomy.
b. The patient's spouse provides the daily tracheostomy care.
c. The patient asks to learn how to clean the tracheostomy
stoma.
d. The patient uses a communication board to request "No
Visitors." Correct Answers ANS: C
Independently caring for the laryngectomy tube indicates that
the patient has regained control of personal care and hopeless.
Letting the nurse and spouse provide care and requesting no
visitors may indicate that the patient is still experiencing
hopelessness.
clinical manifestations of head and neck cancer Correct
Answers -white or red patch in the mouth, ulcer that wont heal
