A client is being evaluated for environmental allergies.

While examining the client’s nasal passage, which finding suggests to the nurse that the client is experiencing allergic rhinitis?

Intranasal edema and swelling of turbinates.

Purulent secretions from eyes and nares.

Snoring and bilateral, pale gray nodules.

Eye tearing and thick yellow nasal drainage.

Answer and Explanation

The Correct Answer is A

Choice A rationale
Intranasal edema and swelling of turbinates are classic signs of allergic rhinitis. Allergic rhinitis is an inflammatory response to allergens, leading to swelling and congestion in the nasal passages. The turbinates, which are structures inside the nose that help filter and humidify the air, become swollen due to the inflammatory response, causing symptoms such as nasal congestion, runny nose, and sneezing.
Choice B rationale
Purulent secretions from the eyes and nares are more indicative of an infection, such as bacterial sinusitis or conjunctivitis, rather than allergic rhinitis. Allergic rhinitis typically involves clear, watery secretions rather than purulent (pus-like) discharge.
Choice C rationale
Snoring and bilateral, pale gray nodules are suggestive of nasal polyps, which can occur in chronic rhinosinusitis but are not specific to allergic rhinitis. Nasal polyps are non-cancerous growths that can obstruct nasal passages and cause breathing difficulties.
Choice D rationale
Eye tearing and thick yellow nasal drainage are more characteristic of an infection, such as bacterial sinusitis or conjunctivitis. Allergic rhinitis usually causes clear, watery secretions and may involve eye symptoms like itching and tearing, but not thick yellow drainage.

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Correct Answer is A

Explanation

Choice A rationale
Describing the client’s exact words, “body-wracking dry cough” of 6 weeks duration, provides a clear and specific account of the client’s symptoms and concerns.
Choice B rationale
Expressing concern of “lung cancer” symptoms for the last 6 weeks is less specific and does not accurately capture the client’s primary symptom, which is the dry cough.
Choice C rationale
Presenting with a hacking nonproductive cough of 6 weeks duration is a clinical interpretation and does not use the client’s own words, which is important for accurate documentation.
Choice D rationale
An adult male presents with fears that he has “lung cancer” is a subjective interpretation and does not accurately describe the client’s primary symptom.

A. Restrict activity to bed rest. B. Monitor urinary output. C. Initiate NPO status. D. Obtain an electrocardiogram.

Correct Answer is C

Explanation

Choice A rationale
Restricting activity to bed rest is important but not the most immediate intervention for a client with a high fever and pain during deep palpation.
Choice B rationale
Monitoring urinary output is important but not the most immediate intervention in this scenario.
Choice C rationale
Initiating NPO (nothing by mouth) status is crucial to prepare the client for potential surgical intervention, especially if the pain suggests an acute abdominal condition.
Choice D rationale
Obtaining an electrocardiogram is important but not the most immediate intervention for a client with abdominal pain and high fever.

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A client is being evaluated for environmental allergies. While examining the client’s nasal passage, which finding suggests to the nurse that the client is experiencing allergic rhinitis?

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Correct Answer is A

Explanation

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Correct Answer is C

Explanation

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A client is being evaluated for environmental allergies.

While examining the client’s nasal passage, which finding suggests to the nurse that the client is experiencing allergic rhinitis?