A nurse is caring for a client complaining of throbbing pain in the face, teeth, and cheeks. Upon palpation, the nurse notes swollen turbinates and a purulent discharge the nose. The nurse should recognize that the client's symptoms best correlate with which problem?

Frontal sinusitis

Maxillary sinusitis

Nasal fracture

Nasal polyps

Answer and Explanation

The Correct Answer is B

A) Frontal sinusitis:
This is incorrect. Frontal sinusitis typically causes pain and tenderness in the forehead area, above the eyes, and along the brow ridge. While frontal sinusitis can lead to headaches and facial pain, it generally does not cause pain in the teeth, cheeks, or nasal discharge as specifically as maxillary sinusitis. Pain in the cheeks and upper teeth, along with purulent nasal discharge, is more characteristic of maxillary sinus involvement.

B) Maxillary sinusitis:
This is the correct answer. Maxillary sinusitis is the inflammation or infection of the maxillary sinuses, which are located behind the cheeks. Common symptoms include throbbing pain in the cheeks, teeth, and upper jaw, swollen turbinates (the structures inside the nose that help with airflow and filtering), and purulent nasal discharge. These symptoms match the description provided, making maxillary sinusitis the most likely diagnosis.

C) Nasal fracture:
This is incorrect. A nasal fracture typically presents with pain, swelling, bruising, and sometimes deformity of the nose, often accompanied by epistaxis (nosebleeds). While a nasal fracture can cause pain, it would not typically cause the throbbing pain in the face, teeth, and cheeks, nor would it be associated with swollen turbinates and purulent nasal discharge as seen in sinusitis.

D) Nasal polyps:
This is incorrect. Nasal polyps are non-cancerous growths that form in the nasal passages or sinuses due to chronic inflammation. They often cause nasal obstruction, reduced sense of smell, or frequent sinus infections. However, they do not typically cause the throbbing facial pain, particularly in the teeth and cheeks, that is characteristic of maxillary sinusitis. They also do not cause the purulent discharge seen in sinus infections.

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Correct Answer is B

Explanation

A) Simultaneously palpating both arteries to compare amplitude: Palpating both carotid arteries simultaneously is contraindicated as it can obstruct blood flow to the brain, potentially causing a decrease in cerebral perfusion and leading to syncope or other complications. Each artery should be palpated one at a time to prevent this risk.

B) Auscultating the artery at the base of the neck at the carotid bifurcation: The correct technique for assessing for carotid artery blockage is to auscultate the artery at the carotid bifurcation, which is located at the base of the neck. The nurse should use the bell of the stethoscope to listen for bruits, which are abnormal sounds caused by turbulent blood flow due to narrowing or blockage of the artery. This is a non-invasive method used to detect vascular abnormalities.

C) Listening with the diaphragm of the stethoscope to assess for bruits: The diaphragm of the stethoscope is generally used for high-pitched sounds like lung and bowel sounds. For auscultating bruits, the bell of the stethoscope is preferred because it is more sensitive to low-pitched sounds, which are characteristic of bruits caused by turbulent blood flow in narrowed arteries.

D) Instructing the client to take deep breaths during auscultation: Instructing the client to take deep breaths is unnecessary and could alter the sound being auscultated. The nurse should have the client breathe normally to avoid interference with the auscultation of the carotid arteries. The goal is to listen for any abnormal sounds (bruits) without any external factors affecting the findings.

A. Use the Snellen chart positioned 20 feet away from the client B. Determine the client’s ability to read newsprint at a distance of 12 to 14 inches C. Perform the confrontation test D. Ask the client to read the print on a handheld jaeger card

Correct Answer is A

Explanation

A) Use the Snellen chart positioned 20 feet away from the client:
This is the correct method for assessing visual acuity in adults. The Snellen chart is the standard tool used to measure visual acuity at a distance. The client is positioned 20 feet away from the chart, and they are asked to read the smallest line of letters they can clearly identify. The result is typically documented as a fraction (e.g., 20/20), where the numerator represents the distance from the chart, and the denominator represents the distance at which a person with normal vision can read the same line. This test assesses distance vision and is essential for checking overall visual sharpness.

B) Determine the client’s ability to read newsprint at a distance of 12 to 14 inches:
This is not used to assess visual acuity; it assesses near vision and can be part of the overall vision examination, but it is not the standard method for testing visual acuity. Typically, the near vision assessment is done with tools like a Jaeger chart or by asking the client to read newsprint at a standard reading distance (12 to 14 inches), but this is not the primary test for visual acuity. The Snellen chart is specifically for distance vision.

C) Perform the confrontation test:
The confrontation test is used to assess the visual fields, not visual acuity. It is a quick screening to determine if the client has any peripheral vision loss, where the nurse and the client compare their visual fields by covering one eye at a time and identifying moving fingers in the periphery. While important, this test does not assess the sharpness or clarity of central vision, which is the focus of a visual acuity test.

D) Ask the client to read the print on a handheld Jaeger card:
The Jaeger card is used to assess near vision, not visual acuity. It is used for clients who may have difficulty reading small print at a normal reading distance and helps assess presbyopia (difficulty focusing on near objects with age). However, this test is for near vision and is not the primary test for visual acuity, which typically focuses on distance vision.

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A nurse is caring for a client complaining of throbbing pain in the face, teeth, and cheeks. Upon palpation, the nurse notes swollen turbinates and a purulent discharge the nose. The nurse should recognize that the client's symptoms best correlate with which problem?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is completing an assessment o a client suspected of having a carotid artery blockage. Which of the following techniques should the nurse to assess the client's carotid arteries?

Correct Answer is B

Explanation

A nurse is preparing to assess the visual acuity of an adult client. Which of the following assessment should the nurse use for visual acuity?

Correct Answer is A

Explanation

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