NR 511 Week 4 Midterm Exam

6. You diagnose acute epiglo琀��琀椀s in Sally, age 5, and immediately send her to the local emergency room. Which of the following symptoms would indicate that an airway obstruc琀椀on is imminent? • Reddened face. • Screaming. • Grabbing her throat. Stridor (In a pediatric client with acute epiglo琀��琀椀s, a number of symptoms can indicate that airway obstruc琀椀on is imminent: stridor, restlessness, nasal 昀氀aring, as well as the use of accessory muscles of respira琀椀on) 7. A pa琀椀ent asks how to avoid contrac琀椀ng pharyngi琀椀s and tonsilli琀椀s. Which piece of advice is not appropriate for this pa琀椀ent? “Take an琀椀bio琀椀cs when well to avoid future infec琀椀ons.” (Pa琀椀ents should only be prescribed an琀椀bio琀椀cs if a throat culture con昀椀rms disease of bacterial origin) 8. Which of the following is not recommended for hoarseness (Dysphonia)? • Vocal rest. • Tobacco cessa琀椀on. • Decrease in ca昀昀eine use. Oral steroids (Oral steroids are not rou琀椀nely used to treat hoarseness) 9. Samantha, age 12, presents with ear pain. When you begin to assess her ear, you tug on her normal- appearing auricle, elici琀椀ng severe pain. This leads you to suspect: • O琀椀琀椀s media ( membrane) • O琀椀琀椀s media with e昀昀usion (O琀椀琀椀s media, with or without e昀昀usion, cannot be diagnosed without examining O琀椀琀椀s media, with or without e昀昀usion, cannot be diagnosed without examining the tympanic the tympanic membrane). O琀椀琀椀s externa (When severe pain is elicited by tugging on a normal-appearing auricle, an acute infec琀椀on of the external ear canal (o琀椀琀椀s externa) is suspected) • Primary otalgia (Otalgia is ear pain) 10. Kathleen, age 54, has persistent pruritus of the external auditory canal. External o琀椀琀椀s and dermatological condi琀椀ons, such as seborrheic derma琀椀琀椀s and psoriasis, have been ruled out. What can you advise her to do? • Use a co琀琀on-琀椀pped applicator daily to remove all moisture and poten琀椀al bacteria. • Wash daily with soap and water. Apply mineral oil to counteract dryness (Pruritus of the external ear canal is a common problem. In most cases, the pruritus is self-induced from overenthusias琀椀c cleaning or excoria琀椀on. The protec琀椀ve cerumen covering must be allowed to regenerate and may be helped to do so by applica琀椀on of a small amount of mineral oil, which helps counteract dryness and reject moisture. O昀琀en, the use of isopropyl alcohol may relieve ear canal pruritus as well) • Avoid topical cor琀椀costeroids. 16. Kevin, age 26, has AIDS and presents to the clinic with complaints of a painful tongue covered with what look like creamy white, curdlike patches overlying erythematous mucosa. You are able to scrape o昀昀 these “curds” with a tongue depressor, which assists you in making which of the following diagnoses? -Leukoplakia cannot be removed by rubbing the mucosal surface; it appears as li琀琀le white -Oral lichen planus is a chronic in昀氀ammatory autoimmune disease; it also has white lesions that do not rub o昀昀) Oral candidiasis (Oral candidiasis (thrush) is dis琀椀nc琀椀ve because the white areas on the tongue can be rubbed o昀昀 with a tongue depressor. Thrush may be seen in denture wearers, in debilitated clients, and in those who