Management Of Clients With Upper Airway Disorders

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Question 1
Free
Multiple Choice

During a community screening event, the nurse would identify that the client at highest risk for development of laryngeal cancer is

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A

a 30-year-old man who smokes one pack of cigarettes per day.

B

a 60-year-old woman who smokes occasionally and is easily fatigued.

C

a 70-year-old man with a 40-year history of alcohol use and heavy smoking.

D

an 80-year-old man who has a very high intake of caffeinated beverages.

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Question 2
Free
Multiple Choice

In the preoperative teaching plan for a client scheduled for total laryngectomy and radical neck resection, the nurse would give highest priority to the

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A

client not being able to perform deep-breathing exercises.

B

client not being able to speak normally again.

C

endotracheal tube being in place for 2 to 3 days.

D

insertion of a gastrostomy tube during surgery for feeding.

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Question 3
Free
Multiple Choice

The observation that would require an immediate nursing intervention for a client recently returned to the unit following partial laryngectomy is

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A

blood-tinged sputum.

B

copious respiratory secretions.

C

difficulty swallowing.

D

pulsating tracheostomy tube.

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Question 4
Free
Multiple Choice

In planning postoperative nursing care for a client who has undergone radical neck dissection and total laryngectomy, the nurse would give priority to the fact that

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A

esophageal speech is relatively difficult to learn and takes practice.

B

prognosis after treatment is moderate, depending on findings.

C

the stoma should never be covered after this type of surgery.

D

there is a radical change in appearance as a result of this type of surgery.

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Question 5
Free
Multiple Choice

A client recently had a total laryngectomy and plans to use an artificial larynx for speech. The common problem the nurse would address regarding the artificial larynx is that

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A

it is a device that is difficult to use.

B

it has a masculine-sounding voice quality.

C

it has a monotone speech quality.

D

it causes neck discomfort.

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Question 6
Multiple Choice

The priority nursing intervention for a client experiencing a laryngospasm would be

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A
administering 100% oxygen.
B
calling the resuscitation team.
C
positioning the client in high-Fowler position.
D
starting in IV with a large-bore catheter.
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Question 7
Multiple Choice

When a friend comes to the nurse's apartment to seek help to stop the bleeding from a broken nose, the nurse would attempt to convince the friend to seek treatment in the emergency department primarily because

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A
cosmetic results are poor when treatment is delayed.
B
general anesthesia may be needed to locate the bleeding vessels.
C
it will be very difficult to stop the bleeding if the nose is fractured.
D
the nose cannot be set for 2 to 3 days if edema develops.
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Question 8
Multiple Choice

After a posterior nasal pack is inserted by the physician, the client is very anxious and states, "I don't feel like I'm breathing right." The immediate intervention the nurse would initiate is

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A
collect a specimen for arterial blood gases (ABGs).
B
cut the pack strings and pull the packing out.
C
inspect the client's oral cavity using a flashlight.
D
reassure the client that this is normal discomfort.
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Question 9
Multiple Choice

A nurse is teaching a client with a new tracheostomy self-care measures and evaluates that teaching goals have been met when the client says

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A
"I can shower if I am careful not to get water into the stoma."
B
"I don't see why I should quit smoking now; what more could happen?"
C
"Stoma covers aren't used because they can lead to suffocation."
D
"When my tube comes out I can go swimming again."
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Question 10
Multiple Choice

For an elderly client who has a posterior nasal plug and anterior nasal packing in place to control an episode of severe epistaxis, the priority assessment for the nurse would be assessing for

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A
continuing nasal pain.
B
dislodged packing.
C
presence of hypoxia.
D
swallowing blood.
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Question 11
Multiple Choice

Which intervention would probably help most when teaching a client to speak again after a laryngectomy?

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A
Give the client contact information so speech therapy can continue at home.
B
Help the client and family understand that this is a frustrating experience.
C
Make sure the client has a supply of paper and pens.
D
Obtain several different speaking aids for the client to try at home.
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Question 12
Multiple Choice

For a client who has undergone functional endoscopic sinus surgery (FESS) as part of the surgical management of sinusitis, the nurse would instruct the client

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A
"Don't blow your nose for 1 week."
B
"Eat only semi-solid foods."
C
"Lean forward when eating."
D
"Limit the amount of fluids you drink."
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Question 13
Multiple Choice

The nurse would explain to a client that laser surgery to remove laryngeal tumors has the major benefit of

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A
a usable voice.
B
complete cure.
C
minimal blood loss.
D
reduced edema.
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Question 14
Multiple Choice

A nurse is conducting health seminars in the community. Besides instructing the audience to not abuse alcohol and to stop smoking, other preventive measures the nurse could suggest include

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A
exercising at least 30 minutes on most days of the week.
B
increasing daily fiber intake to 20-30 grams a day.
C
limiting intake of saturated fats and trans fats.
D
wearing respiratory protective equipment if exposed to asbestos.
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Question 15
Multiple Choice

A client has frequent bouts of laryngitis. When assessing the client the nurse should specifically ask questions regarding the presence of

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A
a family history of idiopathic hoarseness.
B
frequent upper respiratory tract infections.
C
gastroesophageal reflux disorder.
D
a history of stomach cancer.
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Question 16
Multiple Choice

A client is in the recovery room after surgical removal of nasal polyps. The nurse notices the client is swallowing frequently. The most appropriate action by the nurse is to

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A
assess the client's mouth for blood.
B
continue to monitor and assess the client.
C
notify the physician immediately.
D
turn the client on the left side.
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Question 17
Multiple Choice

A nurse is assessing a client who complains of hoarseness, frequent choking, and the feeling of something stuck in the throat. The nurse should plan to include teaching on the diagnostic tests for

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A
a glottic tumor.
B
laryngeal paralysis.
C
tracheal deviation.
D
vocal cord disruption.
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Question 18
Multiple Choice

The measure that would best aid the nurse in removing heavy, tenacious secretions during suctioning is

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A
encouraging frequent coughing and deep breathing.
B
employing postural drainage before suctioning.
C
hyperinflating the lungs before suctioning.
D
instilling sterile saline directly into the trachea.
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Question 19
Multiple Choice

The nurse explaining the pieces of a tracheostomy to a client would note that the portion of the tracheostomy apparatus used to round the end of the tube for insertion is the

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A
flange.
B
inner cannula.
C
obturator.
D
pilot tube.
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Question 20
Multiple Choice

A client has a fenestrated tracheostomy tube in place. A tracheostomy plug will be used to allow the client to talk. The intervention by the nurse that would be essential before inserting the plug is

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A
alerting the client to a new system of communication.
B
deflating the cuff on the tracheostomy tube.
C
evaluating the client's tidal volume.
D
positioning the client to facilitate air flow.
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