A client is being prepared for discharge following a diagnosis of acute rhinosinusitis.
The nurse should instruct the client to seek immediate care for which of the following?
Nasal stuffiness.
Xerostomia.
Periorbital edema.
Decreased sense of smell.
The Correct Answer is C
Choice A rationale
Nasal stuffiness is a common and expected symptom of acute rhinosinusitis due to mucosal inflammation and edema within the paranasal sinuses. While uncomfortable, it does not typically indicate a serious complication requiring immediate medical attention. It usually resolves as the infection subsides.
Choice B rationale
Xerostomia, or dry mouth, can be a side effect of some medications used to treat rhinosinusitis, such as decongestants, or a general symptom of dehydration. It is not an emergent symptom indicative of a worsening condition or complication of rhinosinusitis itself.
Choice C rationale
Periorbital edema, swelling around the eyes, is a critical symptom requiring immediate medical attention in a client with rhinosinusitis. This can indicate the spread of infection from the sinuses into the orbit (orbital cellulitis) or even intracranially, posing a significant risk of vision loss or intracranial complications.
Choice D rationale
Decreased sense of smell, or anosmia, is a common and often temporary symptom associated with acute rhinosinusitis due to inflammation and congestion obstructing the olfactory pathways. While bothersome, it generally improves as the sinusitis resolves and does not necessitate immediate medical care.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale
Colchicine does not primarily cause increased generalized bruising. Bruising is more commonly associated with medications affecting platelet function or coagulation, such as anticoagulants or antiplatelet agents. Colchicine's primary mechanism of action involves inhibiting neutrophil migration and inflammatory processes, not directly impacting hemostasis, therefore this is not an expected side effect.
Choice B rationale
Monitoring for muscle pain, or myalgia, is important for clients taking colchicine. Colchicine can cause skeletal muscle toxicity, leading to rhabdomyolysis in some individuals, particularly with higher doses or in the presence of renal impairment. Myalgia is a key symptom of muscle breakdown and should prompt further investigation, including creatine kinase (CK) levels (normal range 22-198 U/L).
Choice C rationale
Colchicine should ideally be taken with food if gastrointestinal upset, such as nausea, develops. Taking it on an empty stomach can exacerbate these side effects, which are common with colchicine due to its effects on rapidly dividing cells in the gastrointestinal tract. Consuming food helps to buffer the medication and reduce gastric irritation.
Choice D rationale
Increasing intake of grapefruit juice is contraindicated with colchicine. Grapefruit juice inhibits the cytochrome P450 3A4 (CYP3A4) enzyme system and P-glycoprotein, both of which are involved in the metabolism and excretion of colchicine. This inhibition can lead to increased plasma concentrations of colchicine, significantly raising the risk of toxicity, including severe myopathy and bone marrow suppression.
Correct Answer is ["A","C","D","E"]
Explanation
Choice A rationale
Bleach (sodium hypochlorite) is a strong oxidizing agent, commonly found in household cleaners. Its corrosive properties can cause liquefaction necrosis upon contact with tissues, leading to severe chemical burns by denaturing proteins and saponifying fats in cell membranes.
Choice B rationale
Fabric softener typically contains cationic surfactants and emulsifiers. While it can cause mild skin irritation or allergic reactions in sensitive individuals, it is not generally classified as a strong corrosive or caustic agent capable of inflicting significant chemical burn injuries upon contact.
Choice C rationale
Sodium carbonate, also known as washing soda, is an alkaline compound. Concentrated solutions can cause chemical burns through liquefaction necrosis, similar to other strong bases, by deeply penetrating tissues and dissolving proteins and lipids, leading to extensive tissue damage.
Choice D rationale
Degreasers often contain strong alkaline substances like sodium hydroxide or potassium hydroxide, or petroleum distillates. These agents are highly corrosive and can cause severe chemical burns by liquefaction necrosis, destroying cell membranes and dissolving tissue components, leading to deep and extensive injuries.
Choice E rationale
Lye compounds, primarily sodium hydroxide (NaOH) or potassium hydroxide (KOH), are extremely caustic alkaline substances. They inflict severe chemical burns through liquefaction necrosis, which involves the saponification of fats and denaturation of proteins, resulting in deep, penetrating tissue destruction.
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