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Exam 2 (MedSurg): Upper Respiratory

Total questions: 100

Worksheet time: 52mins

Name
Class
Date
1.

What is the most common cause of a deviated septum?

a)

Infection

b)

Trauma

c)

Allergies

d)

Congenital defect

2.

Which of the following is a minor symptom of a deviated septum?

a)

Facial pain

b)

Nosebleeds

c)

Congestion

d)

Obstruction

3.

Severe symptoms of a deviated septum include facial pain, nosebleeds, and ________.

a)

obstruction

b)

itching

c)

swelling

d)

rash

4.

What is the preferred diagnostic method for a deviated septum?

a)

X-ray

b)

Speculum exam

c)

CT scan

d)

Blood test

5.

What is the most common cause of a nasal fracture?

a)

Infection

b)

Trauma

c)

Allergies

d)

Congenital defect

6.

Complications of nasal fracture include obstruction, nosebleeds, and ________ tears with CSF leak, septal hematoma, and deformity.

a)

meningeal

b)

muscular

c)

vascular

d)

epithelial

7.

Which manifestation is associated with periorbital ecchymosis in nasal fracture?

a)

Raccoon eyes

b)

Owl eyes

c)

Chicken eyes

d)

Lizard eyes

8.

CSF leak in nasal fracture is indicated by clear or pink persistent drainage, and lab confirmation is more accurate than bedside ________ test.

a)

glucose

b)

protein

c)

sodium

d)

potassium

9.

Which of the following should be avoided after nasal surgery to prevent bleeding and edema pain?

a)

Hot showers

b)

Alcohol

c)

Smoking

d)

Blowing nose

e)

All of the above

10.

Fill in the blank: For preoperative management in nasal surgery, patients should avoid _______ and NSAIDs for 5 days to 2 weeks.

a)

aspirin

b)

acetaminophen

c)

paracetamol

d)

ibuprofen

11.

Septoplasty is performed to correct a deviated septum.

a)

True

b)

False

12.

Fill in the blank: After rhinoplasty, digital photos are used to project the patient's ________.

a)

appearance

b)

airways

c)

sense of smell

d)

blood pressure

13.

SATA: Which of the following should patients avoid after nasal surgery?

a)

Strenuous exercise

b)

Nose blowing

c)

Swimming

d)

Cold compresses

e)

Heavy lifting

14.

It may take up to a year for the full cosmetic result after nasal surgery.

a)

True

b)

False

15.

What is another name for a nosebleed?

a)

Epistaxis

b)

Rhinitis

c)

Sinusitis

d)

Pharyngitis

16.

Which of the following is NOT a recommended management option for epistaxis?

a)

Pledget with anesthetic or vasoconstrictor

b)

Absorbable packing/sponges, balloon

c)

Chemical or thermal cauterization, embolization

d)

Pinch nose and lean backwards to stop hemorrhage

17.

Fill in the blank: Patients with nosebleeds should avoid ______ and NSAIDs.

a)

aspirin

b)

acetaminophen

c)

ibuprofen

d)

paracetamol

18.

Patients with severe epistaxis should avoid vigorous nose blowing, strenuous activity, lifting or straining for ______ weeks.

a)

4-6

b)

2-4

c)

1-2

d)

10-12

19.

What is the inflammation of nasal mucosa called?

a)

Allergic Rhinitis

b)

Sinusitis

c)

Pharyngitis

d)

Laryngitis

20.

Fill in the blank: Hoarseness can be caused by ______ due to nasal polyps and post nasal drip.

a)

cough

b)

fever

c)

rash

d)

headache

21.

Which of the following is NOT a recommended management strategy for nasal allergies?

a)

Antihistamines

b)

Decongestants

c)

LTRAs

d)

Antibiotics

22.

Acute Viral Rhinopharyngitis is an infection of the ______, sinuses or throat.

a)

nose

b)

ear

c)

eye

d)

lung

23.

How many viruses can cause an upper respiratory infection (URI)?

a)

Over 200

b)

Less than 10

c)

Less than 50

d)

Over 600

24.

Which of the following is the MOST common cause of acute viral rhinopharyngitis?

a)

Bacteria

b)

Common cold

c)

Fungi

d)

Parasites

25.

Symptoms of acute viral rhinopharyngitis typically appear how many days after infection?

a)

1-2 days

b)

2-3 days

c)

4-5 days

d)

7 days

26.

What is the usual recovery time for upper respiratory infections (URIs)?

a)

1-2 days

b)

3-5 days

c)

7-10 days

d)

14-21 days

27.

Afrin should be used for more than 5 days to manage URI symptoms.

a)

True

b)

False

28.

Which of the following is NOT a recommended symptom relief method for URIs?

a)

Rest

b)

Fluids

c)

Antipyretics

d)

Antibiotics (unless complications)

29.

What is the peak season for influenza?

a)

June to August

b)

December to February

c)

March to May

d)

September to November

30.

Which of the following statements about Influenza A is true?

a)

It is the least common type

b)

It is the most common and virulent

c)

It does not mutate

d)

It only causes localized outbreaks

31.

How is influenza primarily transmitted?

a)

Contaminated food

b)

Infected droplets

c)

Direct contact with animals

d)

Waterborne transmission

32.

What is a possible complication of influenza?

a)

Pneumonia

b)

COPD

c)

Asthma

d)

Emphysema

33.

What is the main prevention method for influenza?

a)

Vaccine

b)

Antibiotics

c)

Drinking more water

d)

Taking vitamin C supplements

34.

How often do people need influenza vaccines?

a)

Annually

b)

Every 5 years

c)

Once in a lifetime

d)

Every 2 years

35.

How long does it take for antibody production and full protection after influenza vaccination?

a)

2 weeks

b)

1 day

c)

5 days

d)

1 month

36.

Chronic sinusitis is characterized by which of the following symptoms?

a)

Facial and dental pain, congestion, increased drainage

b)

Sore throat, red and swollen pharynx

c)

Pain, bleeding, difficulty breathing

d)

Fever greater than 38 C

37.

Sinusitis affects 50% of patients with asthma.

a)

True

b)

False

38.

Fill in the blank: Symptom relief for sinusitis includes decongestants, corticosteroids, analgesia, and _________.

a)

irrigation

b)

antitussives

c)

dopaminergics

d)

bronchodilators

39.

Which of the following is NOT recommended for a foreign body in the nose?

a)

Irrigation

b)

Removal

c)

Endoscopic surgery

d)

All of the above

40.

What causes 90% of acute pharyngitis cases?

a)

viruses

b)

bacteria

c)

fungi

d)

protozoa

41.

Classic bacterial pharyngitis is characterized by fever greater than 38 C, cervical lymph node enlargement, pharyngeal exudate, and ________ cough.

a)

absent

b)

productive

c)

persistent

d)

dry

42.

What is a classic sign of a fungal infection in the throat?

a)

Red patches

b)

White patches

c)

Swelling

d)

Ulcers

43.

Peritonsillar abscess is a complication of _________.

a)

tonsillitis

b)

pharyngitis

c)

laryngitis

d)

sinusitis

44.

What is the most common cause of peritonsillar abscess?

a)

Viral infection

b)

Group A-B streptococci

c)

Fungal infection

d)

Chemical exposure

45.

Which of the following is NOT a classic manifestation of acute laryngitis?

a)

A) Tingling or burning back of throat

b)

B) Hoarseness

c)

C) Loss of voice

d)

D) White patches on roof of mouth

46.

Fill in the blank: The recommended treatment for acute laryngitis is to _________.

a)

limit use of voice, no whispering

b)

take antibiotics immediately

c)

drink only cold beverages

d)

perform strenuous exercise

47.

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 _____

a)

level of consciousness (LOC)

b)

blood pressure (BP)

c)

body temperature

d)

urine output

48.

Which intervention is used to establish a patent airway in an emergency?

a)

Heimlich maneuver

b)

Tracheostomy

c)

ET intubation

d)

All of the above

49.

For partial or recurrent airway obstruction symptoms, which diagnostic procedures may be used?

a)

Chest x-ray

b)

Laryngoscopy

c)

Bronchoscopy

d)

All of the above

50.

Which of the following is NOT a type of artificial airway?

a)

Nasopharyngeal airway

b)

Oropharyngeal airway

c)

Endotracheal tube

d)

Bronchial tube

51.

Where is a nasopharyngeal airway placed?

a)

In the mouth of a conscious patient

b)

In the nostril of a conscious or unconscious patient

c)

In the ear of a patient

d)

In the trachea of a patient

52.

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.

a)

True

b)

False

53.

Which nostril should be used for inserting a nasopharyngeal airway?

a)

The nostril with the least airflow

b)

The most open nostril with greatest airflow

c)

Either nostril

d)

The nostril with the largest diameter

54.

What should you do if you encounter obstruction or difficulty while inserting a nasopharyngeal airway?

a)

Stop the procedure if obstruction or difficulty is encountered.

b)

Force the airway through the obstruction.

c)

Twist the airway aggressively to bypass the blockage.

d)

Ignore the resistance and continue inserting.

55.

The oropharyngeal airway is inserted into which type of patient?

a)

Conscious

b)

Unconscious

c)

Both conscious and unconscious

d)

Only pediatric patients

56.

When inserting an oropharyngeal airway, the bevel of the tube should be pointed towards the ______ of the mouth.

a)

roof

b)

floor

c)

side

d)

back

57.

What should you do as the flange of the oropharyngeal airway reaches the lips?

a)

Rotate 180 degrees to match the natural curvature of the upper airway

b)

Rotate 90 degrees to match the natural curvature of the upper airway

c)

Rotate 45 degrees to match the natural curvature of the upper airway

d)

Rotate 360 degrees to match the natural curvature of the upper airway

58.

The size of an endotracheal (ET) tube refers to the internal diameter of the tube.

a)

True

b)

False

59.

Endotracheal tubes are commonly used in ICU patients on mechanical ventilation for short periods of time (2 weeks or less).

a)

True

b)

False

60.

Nasotracheal Tube is used when ______ intubation is not possible.

a)

oral

b)

nasal

c)

tracheal

d)

bronchial

61.

Which of the following is true about the Nasotracheal Tube?

a)

It is shorter than the oral ET tube

b)

It is inserted through the mouth

c)

It is slightly longer than the oral ET tube

d)

It cannot be attached to a ventilator

62.

A tracheostomy involves placing a small plastic tube into the trachea via a surgical incision on the ______ surface of the neck.

a)

anterior

b)

posterior

c)

lateral

d)

inferior

63.

Tracheostomy may be used in ______ situations.

a)

urgent

b)

elective

c)

routine

d)

outpatient

64.

Why is Afrin not used for more than 5 consecutive days?

a)

addictive qualities

b)

catecholamine release

c)

hypervolemia

d)

rebound congestion

e)

rebound thrush

65.

The preferred method of influenza diagnosis is:

a)

viral cultures

b)

bacterial cultures

c)

rapid influenza diagnostic tests/RIDTs

d)

community prevalence

66.

A live attenuated vaccine is:

a)

a form of the virus that was once alive, but is now completely dead

b)

a form of the virus that is stronger than normal to build immunity

c)

a standard viral infection to build immunity

d)

a form of the virus that is alive, but in a weakened state to build immunity

67.

There are vaccines that provide immunity to mutated strains of influenza.

a)

True

b)

False

68.

If a patient has an obstruction due to a foreign body, it is best practice to irrigate the airway.

a)

True

b)

False

69.

SATA: Select all of the classic manifestations of acute bacterial pharyngitis.

a)

fever greater than 38 C

b)

cervical lymph node enlargement

c)

presence of exudate

d)

white patches on the roof of the mouth

e)

absent cough

70.

How should a patient take oral antifungal medications?

a)

swish and spit, like mouthwash

b)

swish and swallow

c)

swallow immediately

d)

pour on head

71.

SATA: Select all of the treatment options for peritonsillar abscess.

a)

IV antibiotics

b)

needle aspiration

c)

drainage of abscess

d)

emergent tonsillectomy

e)

IV anticholinergics

72.

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:

a)

peritonsillar abscess

b)

airway obstruction

c)

acute pharyngitis

d)

acute laryngitis

73.

If untreated, an airway obstruction can lead to brain damage and death in ______.

a)

12-24 hours

b)

4-5 hours

c)

3-5 minutes

d)

20-30 minutes

e)

2-3 hours

74.

SATA: Select all of the different types of artificial airways.

a)

nasopharyngeal airway

b)

oropharyngeal airway

c)

endotracheal tube

d)

nasotracheal tube

e)

tracheostomy

75.

SATA: Select all of the emergent interventions than cat be used to establish a patent airway.

a)

Heimlich maneuver

b)

Tracheostomy

c)

Cricothyroidotomy

d)

Endotracheal Intubation

e)

Nephrostomy

76.

If an airway must be secured QUICKLY, the IDEAL way to do so is:

a)

cricothyroidotomy

b)

tracheostomy

c)

endotracheal intubation

d)

high flow nasal cannula

77.

A tracheostomy tube is easier to keep clean and sterile than an ET tube.

a)

True

b)

False

78.

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.

a)

tracheostomy, ET tube

b)

ET tube, tracheostomy

c)

ET tube, cricothyrotomy

d)

Cricothyrotomy, tracheostomy

79.

SATA: Early tracheostomy, within 10-14 days of ICU admission, can do which of the following?

a)

reduce total number of ventilator dependent days

b)

reduce length of hospitalization

c)

reduce pain

d)

improves communication if mechanical ventilation is required long term

e)

reduces need to change sterile dressings Q12 hours

80.

What is an obturator used for?

a)

to assist in inserting the tracheostomy tube

b)

to keep airway patent

c)

to promote spontaneous breathing

d)

to allow ET tubes to be used for long-term intubation

81.

In a tracheostomy patient, the _____ cannula is used to keep the airway patent, while the ______ cannula can be removed for cleaning or replacement.

a)

inner, outer

b)

outer, inner

c)

deep, superficial

d)

superficial, deep

82.

Uncuffed tracheostomies are more common than cuffed tracheostomies.

a)

True

b)

False

83.

Uncuffed tracheostomy tubes are preferred to cuffed tracheostomy tubes when mechanical ventilation _____________, and when risk of aspiration has _________.

a)

is required short term, increased

b)

is not needed, decreased

c)

fluctuates, ended

d)

is required long term, increased

84.

How does breathing occur if a tracheostomy is non-fenestrated?

a)

both through the ventilator and spontaneously

b)

completely independently

c)

only via the ventilator

d)

both through the ventilator and CPAP

85.

SATA: Speaking and breathing spontaneously with a trach tube is possible if the following is true:

a)

the trach is cuffed

b)

the trach is fenestrated

c)

the cuff is deflated

d)

the inner cannula is removed

e)

the outer cannula is removed

86.

What is an advantage of a percutaneous tracheostomy when compared to a standard tracheostomy?

a)

it can be performed faster

b)

less risk of bleeding and fewer post-op complications

c)

it is much easier to perform

d)

it can be done bedside with a bladder scanner

87.

When prepping a patient for a bedside tracheostomy, what is the MOST important intervention the RN can perform?

a)

ensure all appropriate personnel are present

b)

ensure working BVM, suction, and resuscitation equipment are nearby

c)

record baseline VS and check peripheral IV patency

d)

provide analgesia and sedation while keeping patient supine

88.

If a tracheostomy is cuffed, how soon should the cuff be inflated post-procedure?

a)

at once

b)

within 30 minutes of procedure

c)

within 4 hours of procedure

d)

by end of shift

89.

SATA: Select all of the methods to confirm proper placement of a tracheostomy.

a)

auscultation of the patient's chest for air entry

b)

EtCO2 capnography

c)

video-assisted confirmation (for percutaneous method)

d)

passage of suction catheter through tracheostomy tube

e)

palpation of tracheostomy down the trachea

90.

How often should the RN ensure the patency of a patient's tracheostomy?

a)

every shift, more often if indicated

b)

every 24 hours

c)

weekly

d)

at least once before discharge

91.

When inflating a cuffed tracheostomy, it is important to use the ______ amount of air needed to maintain a seal.

a)

most

b)

least

92.

If possible, the RN should avoid suctioning a tracheostomy for at least an hour post-procedure.

a)

True

b)

False

93.

How often should the nurse measure the cuff inflation of a cuffed tracheostomy with a manometer?

a)

at least every 10 hours

b)

at least every shift

c)

at least every 24 hours

d)

at least every 8 hours

94.

The pressure on a cuffed tracheostomy should NEVER exceed:

a)

20-30cm H2O (15-22 mm Hg)

b)

2-3cm H2O (5-12 mm Hg)

c)

5-12cm H2O (20-30 mm Hg)

d)

12-24cm H2O (60-120 mm Hg)

95.

How long should the RN wait to change tracheostomy tapes post-procedure?

a)

at least 1 hour

b)

at least 8 hours

c)

at least 12 hours

d)

at least 24 hours

96.

Artificial airway management is the responsibility of:

a)

the RN only

b)

the RT only

c)

both the RN and RT

d)

the RN, the RT, and the PT

97.

What is the FIRST thing the nurse should do in the event of an accidental decannulation?

a)

call for help

b)

place patient in semi-fowler's

c)

cover stoma with sterile dressing

d)

assess LOC and ability to breathe

98.

Tracheostomy tubes can be very difficult to reinsert if they are dislodged immediately post-op.

a)

True

b)

False

99.

How often should the RN clean the inner cannula of a tracheostomy if it is non-disposable?

a)

at least every 1 hour

b)

at least every 8 hours

c)

at least every 12 hours

d)

at least every 24 hours

100.

A fenestrated tracheostomy tube has an opening on the _____ surface that helps promote _______ breathing.

a)

ventral, ventilator assisted

b)

distal, spontaneous

c)

proximal, ventilator-assisted

d)

dorsal, spontaneous