A nurse is providing care to a client who reports facial pain, including dental pain in the upper teeth. Which of the following additional symptoms would lead the nurse to suspect sinusitis as the source of the pain?

The client is producing large amounts of clear, watery nasal discharge and experiencing postnasal drip.

The client has a history of both tension and vascular headaches and takes prescription migraine medication as needed.

The client has nasal congestion that does not significantly improve with over-the-counter decongestants or antihistamines.

The client regularly uses saline-based nasal washes and a humidifier to clean and moisturize their sinuses.

Answer and Explanation

The Correct Answer is C

A. The client is producing large amounts of clear, watery nasal discharge and experiencing postnasal drip: Clear, watery nasal discharge is more indicative of allergic rhinitis rather than sinusitis, which typically presents with thicker, purulent discharge.

B. The client has a history of both tension and vascular headaches and takes prescription migraine medication as needed: While headaches can accompany sinusitis, this option does not directly address symptoms specific to sinusitis, such as nasal congestion or facial pressure.

C. The client has nasal congestion that does not significantly improve with over-the-counter decongestants or antihistamines: Persistent nasal congestion despite the use of decongestants or antihistamines is a common symptom of sinusitis, indicating that the source of the problem may be inflammation or infection in the sinuses.

D. The client regularly uses saline-based nasal washes and a humidifier to clean and moisturize their sinuses: Regular use of these measures suggests the client is taking preventive care of their sinuses but does not necessarily indicate sinusitis.

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Correct Answer is D

Explanation

A. ARDS is characterized by severe hypoxemia due to shunting, but it typically impairs oxygenation rather than carbon dioxide elimination. The primary issue is the inability to oxygenate blood, not the elimination of carbon dioxide.
B. In ARDS, pulmonary arterial pressure often increases due to pulmonary hypertension caused by widespread inflammation and hypoxemia, not decreased pressure. V/Q mismatch contributes to hypoxemia but does not directly cause decreased pulmonary arterial pressure.
C. While hypoxemia is a hallmark of ARDS, it is primarily due to shunting (where blood passes through unventilated areas of the lung) rather than dead space, which is more associated with conditions like pulmonary embolism.
D. ARDS involves decreased pulmonary compliance due to the stiffness of the lungs, which results from diffuse alveolar damage and the formation of hyaline membranes. This stiffness makes it difficult for the lungs to expand, leading to reduced oxygenation and severe hypoxemia.

A. Apply positive pressure ventilation and provide supportive care with pain management. B. Perform needle decompression of the pleural space followed by chest tube insertion. C. Administer intravenous antibiotics and arrange for an elective surgical repair. D. Provide high-flow oxygen and intubate the patient for mechanical ventilation.

Correct Answer is B

Explanation

A. Apply positive pressure ventilation and provide supportive care with pain management: While supportive care is important, positive pressure ventilation may not be sufficient to address the underlying issue, which is likely a pneumothorax or hemothorax.
B. Perform needle decompression of the pleural space followed by chest tube insertion: This is the most appropriate initial management for a patient with paradoxical chest wall movement, which is a sign of flail chest and likely pneumothorax. Needle decompression can relieve pressure in the pleural space, and chest tube insertion can help drain any fluid or air that has accumulated.
C. Administer intravenous antibiotics and arrange for an elective surgical repair: While infection may be a concern, it is not the most immediate priority in this case. The patient's respiratory distress needs to be addressed first.
D. Provide high-flow oxygen and intubate the patient for mechanical ventilation: While oxygen therapy may be necessary, intubation should be considered as a last resort if other measures fail to improve oxygenation. In this case, needle decompression and chest tube insertion are more likely to be effective in improving respiratory function.

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A nurse is providing care to a client who reports facial pain, including dental pain in the upper teeth. Which of the following additional symptoms would lead the nurse to suspect sinusitis as the source of the pain?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is collecting data for a client who has acute respiratory distress syndrome (ARDS). Which of the following findings should the nurse expect?

Correct Answer is D

Explanation

Exhibits What is the most appropriate initial management for this patient?

Correct Answer is B

Explanation

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A nurse is providing care to a client who reports facial pain, including dental pain in the upper teeth. Which of the following additional symptoms would lead the nurse to suspect sinusitis as the source of the pain?