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The school nurse is presenting a class to students at a primary school on how to
prevent the transmission of the common cold virus. Which information should the nurse discuss?
1. Instruct the children to always keep a tissue or handkerchief with them.
2. Explain that children current with immunizations will not get a cold.
3. Tell the children they should go to the doctor if they get a cold.
4. Demonstrate to the students how to wash hands correctly.
1. It is not feasible for a child to always have a tissue or handkerchief available.
2.There is no immunization for the common cold. Colds are actually caused by at least 200
separate viruses and the viruses mutate frequently.
3. Colds are caused by a virus and antibiotics do not treat a virus; therefore, there is no need to
go to a health-care provider.
4.Hand washing is the single most useful technique for prevention of disease.
TEST-TAKING HINT: Option “1” contains the word “always,” an absolute word, and in most
questions, absolutes such as “always,” “never,” and “only” make that answer option incorrect.
Which information should the nurse teach the client diagnosed with acute sinusitis?
, Exam 1: NURS618/ NURS 618 Pathophysiology
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1. Instruct the client to complete all the ordered antibiotics.
2. Teach the client how to irrigate the nasal passages.
3. Have the client demonstrate how to blow the nose.
4. Give the client samples of a narcotic analgesic for the headache.
1. The client should be taught to take all antibiotics as ordered. Discontinuing antibiotics prior to
the full dose results in the development of antibiotic- resistant bacteria. Sinus infections are
difficult to treat and may become chronic, and will then require several weeks of therapy or
possibly surgery to control.
2. If the sinuses are irrigated, it is done under anesthesia by a health-care provider.
3. Blowing the nose will increase pressure in the sinus cavities and will cause the client increased
pain.
4. The nurse is not licensed to prescribe medications, so this is not in the nurse’s scope of
practice. Also, narcotic analgesic medications are controlled substances and require written
documentation of being prescribed by the health-care provider; samples are not generally
available.
TEST-TAKING HINT: Note in this situation an “all” is in the correct answer. There are very few
cases in which absolute adjectives will describe the correct answer. The test taker must be aware
that general rules will not always apply.
The client has been diagnosed with chronic sinusitis. Which sign/symptom alerts the
nurse to a potentially life-threatening complication?
, Exam 1: NURS618/ NURS 618 Pathophysiology
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1. Muscle weakness.
2. Purulent sputum.
3. Nuchal rigidity.
4. Intermittent loss of muscle control.
1. Muscle weakness is a sign/symptom of myalgia, but it is not a life-threatening complication of
sinusitis.
2.Purulent sputum would be a sign/symptom of a lung infection, but it is not a
life-threatening complication of sinusitis.
3.Nuchal rigidity is a sign/symptom of meningitis, which is a life-threatening potential
complication of sinusitis resulting from the close proximity of the sinus cavities to the meninges.
4.Intermittent loss of muscle control can be a symptom of multiple sclerosis, but it would not be
a life-threatening complication of sinusitis.
TEST-TAKING HINT: A basic knowledge of anatomy and physiology would help to answer this
question. The sinuses lie in the head and surround the orbital cavity. Options “1” and “4” refer to
muscle problems, so both could be ruled out as wrong.
The client diagnosed with tonsillitis is scheduled to have surgery in the morning. Which
assessment data should the nurse notify the health-care provider about prior to surgery?
, Exam 1: NURS618/ NURS 618 Pathophysiology
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1. The client has a hemoglobin of 12.2 g/dL and hematocrit of 36.5%.
2. The client has an oral temperature of 100.2˚F and a dry cough.
3. There are one (1) to two (2) white blood cells in the urinalysis.
4. The client's current international normalized ratio (INR) is 1.0.
1. The hemoglobin and hematocrit given are within normal range. This would not warrant
notifying the health-care provider.
2. A low-grade temperature and a cough could indicate the presence of an infection, in which
case the health-care provider would not want to subject the client to anesthesia and the
possibility of further complications. The surgery would be postponed.
3.One (1) to two (2) WBCs in a urinalysis is not uncommon because of the normal flora in the
bladder.
4.The INR indicates that the client’s bleeding time is within normal range.
TEST-TAKING HINT: In this question, all the answer options contain normal data except for
one. The nurse would not call the health-care provider to notify him or her of normal values.
The influenza vaccine is in short supply. Which group of clients would the public health nurse
consider priority when administering the vaccine?
1. Elderly and chronically ill clients.