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WorksheetsExam 2 (MedSurg): Upper Respiratory
Total questions: 100
Worksheet time: 52mins
What is the most common cause of a deviated septum?
Infection
Trauma
Allergies
Congenital defect
Which of the following is a minor symptom of a deviated septum?
Facial pain
Nosebleeds
Congestion
Obstruction
Severe symptoms of a deviated septum include facial pain, nosebleeds, and ________.
obstruction
itching
swelling
rash
What is the preferred diagnostic method for a deviated septum?
X-ray
Speculum exam
CT scan
Blood test
What is the most common cause of a nasal fracture?
Infection
Trauma
Allergies
Congenital defect
Complications of nasal fracture include obstruction, nosebleeds, and ________ tears with CSF leak, septal hematoma, and deformity.
meningeal
muscular
vascular
epithelial
Which manifestation is associated with periorbital ecchymosis in nasal fracture?
Raccoon eyes
Owl eyes
Chicken eyes
Lizard eyes
CSF leak in nasal fracture is indicated by clear or pink persistent drainage, and lab confirmation is more accurate than bedside ________ test.
glucose
protein
sodium
potassium
Which of the following should be avoided after nasal surgery to prevent bleeding and edema pain?
Hot showers
Alcohol
Smoking
Blowing nose
All of the above
Fill in the blank: For preoperative management in nasal surgery, patients should avoid _______ and NSAIDs for 5 days to 2 weeks.
aspirin
acetaminophen
paracetamol
ibuprofen
Septoplasty is performed to correct a deviated septum.
True
False
Fill in the blank: After rhinoplasty, digital photos are used to project the patient's ________.
appearance
airways
sense of smell
blood pressure
SATA: Which of the following should patients avoid after nasal surgery?
Strenuous exercise
Nose blowing
Swimming
Cold compresses
Heavy lifting
It may take up to a year for the full cosmetic result after nasal surgery.
True
False
What is another name for a nosebleed?
Epistaxis
Rhinitis
Sinusitis
Pharyngitis
Which of the following is NOT a recommended management option for epistaxis?
Pledget with anesthetic or vasoconstrictor
Absorbable packing/sponges, balloon
Chemical or thermal cauterization, embolization
Pinch nose and lean backwards to stop hemorrhage
Fill in the blank: Patients with nosebleeds should avoid ______ and NSAIDs.
aspirin
acetaminophen
ibuprofen
paracetamol
Patients with severe epistaxis should avoid vigorous nose blowing, strenuous activity, lifting or straining for ______ weeks.
4-6
2-4
1-2
10-12
What is the inflammation of nasal mucosa called?
Allergic Rhinitis
Sinusitis
Pharyngitis
Laryngitis
Fill in the blank: Hoarseness can be caused by ______ due to nasal polyps and post nasal drip.
cough
fever
rash
headache
Which of the following is NOT a recommended management strategy for nasal allergies?
Antihistamines
Decongestants
LTRAs
Antibiotics
Acute Viral Rhinopharyngitis is an infection of the ______, sinuses or throat.
nose
ear
eye
lung
How many viruses can cause an upper respiratory infection (URI)?
Over 200
Less than 10
Less than 50
Over 600
Which of the following is the MOST common cause of acute viral rhinopharyngitis?
Bacteria
Common cold
Fungi
Parasites
Symptoms of acute viral rhinopharyngitis typically appear how many days after infection?
1-2 days
2-3 days
4-5 days
7 days
What is the usual recovery time for upper respiratory infections (URIs)?
1-2 days
3-5 days
7-10 days
14-21 days
Afrin should be used for more than 5 days to manage URI symptoms.
True
False
Which of the following is NOT a recommended symptom relief method for URIs?
Rest
Fluids
Antipyretics
Antibiotics (unless complications)
What is the peak season for influenza?
June to August
December to February
March to May
September to November
Which of the following statements about Influenza A is true?
It is the least common type
It is the most common and virulent
It does not mutate
It only causes localized outbreaks
How is influenza primarily transmitted?
Contaminated food
Infected droplets
Direct contact with animals
Waterborne transmission
What is a possible complication of influenza?
Pneumonia
COPD
Asthma
Emphysema
What is the main prevention method for influenza?
Vaccine
Antibiotics
Drinking more water
Taking vitamin C supplements
How often do people need influenza vaccines?
Annually
Every 5 years
Once in a lifetime
Every 2 years
How long does it take for antibody production and full protection after influenza vaccination?
2 weeks
1 day
5 days
1 month
Chronic sinusitis is characterized by which of the following symptoms?
Facial and dental pain, congestion, increased drainage
Sore throat, red and swollen pharynx
Pain, bleeding, difficulty breathing
Fever greater than 38 C
Sinusitis affects 50% of patients with asthma.
True
False
Fill in the blank: Symptom relief for sinusitis includes decongestants, corticosteroids, analgesia, and _________.
irrigation
antitussives
dopaminergics
bronchodilators
Which of the following is NOT recommended for a foreign body in the nose?
Irrigation
Removal
Endoscopic surgery
All of the above
What causes 90% of acute pharyngitis cases?
viruses
bacteria
fungi
protozoa
Classic bacterial pharyngitis is characterized by fever greater than 38 C, cervical lymph node enlargement, pharyngeal exudate, and ________ cough.
absent
productive
persistent
dry
What is a classic sign of a fungal infection in the throat?
Red patches
White patches
Swelling
Ulcers
Peritonsillar abscess is a complication of _________.
tonsillitis
pharyngitis
laryngitis
sinusitis
What is the most common cause of peritonsillar abscess?
Viral infection
Group A-B streptococci
Fungal infection
Chemical exposure
Which of the following is NOT a classic manifestation of acute laryngitis?
A) Tingling or burning back of throat
B) Hoarseness
C) Loss of voice
D) White patches on roof of mouth
Fill in the blank: The recommended treatment for acute laryngitis is to _________.
limit use of voice, no whispering
take antibiotics immediately
drink only cold beverages
perform strenuous exercise
Fill in the blank: Manifestations of airway obstruction include choking, stridor, use of accessory muscles, suprasternal and intercostal retractions, nasal flaring, wheezing, restlessness, tachycardia, cyanosis, and change in _____
level of consciousness (LOC)
blood pressure (BP)
body temperature
urine output
Which intervention is used to establish a patent airway in an emergency?
Heimlich maneuver
Tracheostomy
ET intubation
All of the above
For partial or recurrent airway obstruction symptoms, which diagnostic procedures may be used?
Chest x-ray
Laryngoscopy
Bronchoscopy
All of the above
Which of the following is NOT a type of artificial airway?
Nasopharyngeal airway
Oropharyngeal airway
Endotracheal tube
Bronchial tube
Where is a nasopharyngeal airway placed?
In the mouth of a conscious patient
In the nostril of a conscious or unconscious patient
In the ear of a patient
In the trachea of a patient
When measuring for a nasopharyngeal airway, you should measure from the tip of the nose to the tip of the ear with a tube that has a slightly smaller diameter than the patient's nostril.
True
False
Which nostril should be used for inserting a nasopharyngeal airway?
The nostril with the least airflow
The most open nostril with greatest airflow
Either nostril
The nostril with the largest diameter
What should you do if you encounter obstruction or difficulty while inserting a nasopharyngeal airway?
Stop the procedure if obstruction or difficulty is encountered.
Force the airway through the obstruction.
Twist the airway aggressively to bypass the blockage.
Ignore the resistance and continue inserting.
The oropharyngeal airway is inserted into which type of patient?
Conscious
Unconscious
Both conscious and unconscious
Only pediatric patients
When inserting an oropharyngeal airway, the bevel of the tube should be pointed towards the ______ of the mouth.
roof
floor
side
back
What should you do as the flange of the oropharyngeal airway reaches the lips?
Rotate 180 degrees to match the natural curvature of the upper airway
Rotate 90 degrees to match the natural curvature of the upper airway
Rotate 45 degrees to match the natural curvature of the upper airway
Rotate 360 degrees to match the natural curvature of the upper airway
The size of an endotracheal (ET) tube refers to the internal diameter of the tube.
True
False
Endotracheal tubes are commonly used in ICU patients on mechanical ventilation for short periods of time (2 weeks or less).
True
False
Nasotracheal Tube is used when ______ intubation is not possible.
oral
nasal
tracheal
bronchial
Which of the following is true about the Nasotracheal Tube?
It is shorter than the oral ET tube
It is inserted through the mouth
It is slightly longer than the oral ET tube
It cannot be attached to a ventilator
A tracheostomy involves placing a small plastic tube into the trachea via a surgical incision on the ______ surface of the neck.
anterior
posterior
lateral
inferior
Tracheostomy may be used in ______ situations.
urgent
elective
routine
outpatient
Why is Afrin not used for more than 5 consecutive days?
addictive qualities
catecholamine release
hypervolemia
rebound congestion
rebound thrush
The preferred method of influenza diagnosis is:
viral cultures
bacterial cultures
rapid influenza diagnostic tests/RIDTs
community prevalence
A live attenuated vaccine is:
a form of the virus that was once alive, but is now completely dead
a form of the virus that is stronger than normal to build immunity
a standard viral infection to build immunity
a form of the virus that is alive, but in a weakened state to build immunity
There are vaccines that provide immunity to mutated strains of influenza.
True
False
If a patient has an obstruction due to a foreign body, it is best practice to irrigate the airway.
True
False
SATA: Select all of the classic manifestations of acute bacterial pharyngitis.
fever greater than 38 C
cervical lymph node enlargement
presence of exudate
white patches on the roof of the mouth
absent cough
How should a patient take oral antifungal medications?
swish and spit, like mouthwash
swish and swallow
swallow immediately
pour on head
SATA: Select all of the treatment options for peritonsillar abscess.
IV antibiotics
needle aspiration
drainage of abscess
emergent tonsillectomy
IV anticholinergics
A patient arrives in the ED complaining of SOB. The patient presents with stridor, intercostal retractions, wheezing, and tachycardia. This patient is likely suffering from:
peritonsillar abscess
airway obstruction
acute pharyngitis
acute laryngitis
If untreated, an airway obstruction can lead to brain damage and death in ______.
12-24 hours
4-5 hours
3-5 minutes
20-30 minutes
2-3 hours
SATA: Select all of the different types of artificial airways.
nasopharyngeal airway
oropharyngeal airway
endotracheal tube
nasotracheal tube
tracheostomy
SATA: Select all of the emergent interventions than cat be used to establish a patent airway.
Heimlich maneuver
Tracheostomy
Cricothyroidotomy
Endotracheal Intubation
Nephrostomy
If an airway must be secured QUICKLY, the IDEAL way to do so is:
cricothyroidotomy
tracheostomy
endotracheal intubation
high flow nasal cannula
A tracheostomy tube is easier to keep clean and sterile than an ET tube.
True
False
Patients who need mechanical ventilation for a SHORT time should have a(n) ________, while patients who required prolonged mechanical ventilation should have a(n) ________ instead.
tracheostomy, ET tube
ET tube, tracheostomy
ET tube, cricothyrotomy
Cricothyrotomy, tracheostomy
SATA: Early tracheostomy, within 10-14 days of ICU admission, can do which of the following?
reduce total number of ventilator dependent days
reduce length of hospitalization
reduce pain
improves communication if mechanical ventilation is required long term
reduces need to change sterile dressings Q12 hours
What is an obturator used for?
to assist in inserting the tracheostomy tube
to keep airway patent
to promote spontaneous breathing
to allow ET tubes to be used for long-term intubation
In a tracheostomy patient, the _____ cannula is used to keep the airway patent, while the ______ cannula can be removed for cleaning or replacement.
inner, outer
outer, inner
deep, superficial
superficial, deep
Uncuffed tracheostomies are more common than cuffed tracheostomies.
True
False
Uncuffed tracheostomy tubes are preferred to cuffed tracheostomy tubes when mechanical ventilation _____________, and when risk of aspiration has _________.
is required short term, increased
is not needed, decreased
fluctuates, ended
is required long term, increased
How does breathing occur if a tracheostomy is non-fenestrated?
both through the ventilator and spontaneously
completely independently
only via the ventilator
both through the ventilator and CPAP
SATA: Speaking and breathing spontaneously with a trach tube is possible if the following is true:
the trach is cuffed
the trach is fenestrated
the cuff is deflated
the inner cannula is removed
the outer cannula is removed
What is an advantage of a percutaneous tracheostomy when compared to a standard tracheostomy?
it can be performed faster
less risk of bleeding and fewer post-op complications
it is much easier to perform
it can be done bedside with a bladder scanner
When prepping a patient for a bedside tracheostomy, what is the MOST important intervention the RN can perform?
ensure all appropriate personnel are present
ensure working BVM, suction, and resuscitation equipment are nearby
record baseline VS and check peripheral IV patency
provide analgesia and sedation while keeping patient supine
If a tracheostomy is cuffed, how soon should the cuff be inflated post-procedure?
at once
within 30 minutes of procedure
within 4 hours of procedure
by end of shift
SATA: Select all of the methods to confirm proper placement of a tracheostomy.
auscultation of the patient's chest for air entry
EtCO2 capnography
video-assisted confirmation (for percutaneous method)
passage of suction catheter through tracheostomy tube
palpation of tracheostomy down the trachea
How often should the RN ensure the patency of a patient's tracheostomy?
every shift, more often if indicated
every 24 hours
weekly
at least once before discharge
When inflating a cuffed tracheostomy, it is important to use the ______ amount of air needed to maintain a seal.
most
least
If possible, the RN should avoid suctioning a tracheostomy for at least an hour post-procedure.
True
False
How often should the nurse measure the cuff inflation of a cuffed tracheostomy with a manometer?
at least every 10 hours
at least every shift
at least every 24 hours
at least every 8 hours
The pressure on a cuffed tracheostomy should NEVER exceed:
20-30cm H2O (15-22 mm Hg)
2-3cm H2O (5-12 mm Hg)
5-12cm H2O (20-30 mm Hg)
12-24cm H2O (60-120 mm Hg)
How long should the RN wait to change tracheostomy tapes post-procedure?
at least 1 hour
at least 8 hours
at least 12 hours
at least 24 hours
Artificial airway management is the responsibility of:
the RN only
the RT only
both the RN and RT
the RN, the RT, and the PT
What is the FIRST thing the nurse should do in the event of an accidental decannulation?
call for help
place patient in semi-fowler's
cover stoma with sterile dressing
assess LOC and ability to breathe
Tracheostomy tubes can be very difficult to reinsert if they are dislodged immediately post-op.
True
False
How often should the RN clean the inner cannula of a tracheostomy if it is non-disposable?
at least every 1 hour
at least every 8 hours
at least every 12 hours
at least every 24 hours
A fenestrated tracheostomy tube has an opening on the _____ surface that helps promote _______ breathing.
ventral, ventilator assisted
distal, spontaneous
proximal, ventilator-assisted
dorsal, spontaneous
