A 31-year-old woman presents with purulent nasal drainage accompanied by nasal obstruction and facial pain. Which of the following findings would be most consistent with acute bacterial rhinosinusitis (ABRS)?
Diminished lung sounds
Cardinal symptoms that persist beyond 10 days or worsen after an initial period of improvement
Altered mental status
Low-grade fever
The Correct Answer is B
Choice A reason: Diminished lung sounds are a respiratory finding and not associated with rhinosinusitis. They may indicate pneumonia, pleural effusion, or other pulmonary conditions.
Choice B reason: ABRS is diagnosed when symptoms such as purulent nasal discharge, nasal obstruction, and facial pain persist beyond 10 days or worsen after initial improvement (double worsening). This distinguishes bacterial from viral sinusitis.
Choice C reason: Altered mental status is not a typical feature of uncomplicated ABRS. It may suggest complications such as intracranial extension or sepsis, which are rare and require urgent evaluation.
Choice D reason: Low-grade fever may occur in ABRS but is not specific or diagnostic. It can also be present in viral infections or other inflammatory conditions. The persistence and progression of cardinal symptoms are more reliable indicators.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: Levothyroxine is a synthetic form of thyroxine (T4) used to treat hypothyroidism. Administering this to a patient with signs of hyperthyroidism, such as exophthalmos, tremors, and hypertension, would worsen the condition.
Choice B reason: Liotrix is a combination of synthetic T4 and T3 hormones, also used to treat hypothyroidism. Like levothyroxine, it is contraindicated in hyperthyroid states and would exacerbate the symptoms.
Choice C reason: Liothyronine is synthetic T3 and is used in hypothyroidism or myxedema coma. It is not appropriate for treating hyperthyroidism and would intensify the patient’s symptoms.
Choice D reason: Propylthiouracil (PTU) is an antithyroid medication that inhibits thyroid hormone synthesis and peripheral conversion of T4 to T3. It is indicated in hyperthyroidism and Graves’ disease, especially when symptoms include goiter and exophthalmos. PTU helps reduce hormone levels and alleviate symptoms.
Correct Answer is C
Explanation
Choice A reason: Polysomnography is a comprehensive overnight sleep study used to diagnose sleep disorders such as obstructive sleep apnea, parasomnias, and periodic limb movement disorder. While it provides objective data on sleep architecture and disturbances, it does not specifically distinguish between subjective feelings of fatigue and actual dozing behavior during the day.
Choice B reason: The Multiple Sleep Latency Test (MSLT) is an objective test that measures how quickly a person falls asleep in a quiet environment during the day. It is used to assess excessive daytime sleepiness and diagnose conditions like narcolepsy. However, it does not capture subjective experiences or differentiate between fatigue and sleepiness based on self-report.
Choice C reason: The Epworth Sleepiness Scale is a validated self-administered questionnaire that evaluates the likelihood of dozing off in various daily situations. It is specifically designed to distinguish between general fatigue and actual sleepiness by assessing the propensity to fall asleep, making it the most appropriate tool in this scenario.
Choice D reason: CSF hypocretin measurement is used in the diagnosis of narcolepsy type 1, where hypocretin levels are typically low. While it is a biomarker for a specific sleep disorder, it does not help differentiate between fatigue and sleepiness in broader clinical contexts and is not a practical screening tool for general sleep complaints.
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