A client reports experiencing chronic headaches after a recent upper respiratory tract infection. On physical examination, the nurse notes tenderness when palpating over the sinuses. Which condition is likely?

Rhinitis medicamentosa

Acute bacterial sinusitis

Epistaxis

Allergic rhinitis

Answer and Explanation

The Correct Answer is B

Choice A Reason:
Rhinitis medicamentosa, also known as rebound congestion, is a condition of nasal congestion without other cold or allergy symptoms, typically caused by the overuse of nasal decongestant sprays. It does not usually present with chronic headaches or tenderness over the sinuses, which are more indicative of sinusitis.

Choice B Reason:
Acute bacterial sinusitis is likely the correct diagnosis in this scenario. It often follows a viral upper respiratory infection and presents with symptoms such as thick, discolored nasal mucus, decreased sense of smell, and facial pain or tenderness over the affected sinuses. The chronic headache and noted tenderness upon palpation over the sinuses in the client are consistent with this condition.

Choice C Reason:
Epistaxis, or nosebleed, is bleeding from the nose that can be caused by various factors, including trauma, medication, or environmental conditions. While it can be a symptom of other nasal conditions, it is not typically associated with chronic headaches or sinus tenderness following an upper respiratory infection.

Choice D Reason:
Allergic rhinitis is an allergic reaction to allergens such as pollen, dust, or pet dander, causing symptoms like sneezing, runny nose, itchy eyes, and sometimes headaches. However, the chronic headache and sinus tenderness described by the client after an infection are more suggestive of sinusitis rather than allergic rhinitis.

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Correct Answer is C

Explanation

Choice a reason:
Rhonchi are coarse, rattling respiratory sounds somewhat like snoring, usually caused by obstruction or secretion in the larger airways. They are not considered normal breath sounds and are typically heard in conditions such as chronic bronchitis.

Choice b reason:
Crackles are the sounds you will hear in a lung field that has fluid in the small airways. These sounds are commonly heard in patients with pneumonia, heart failure, and restrictive pulmonary diseases. They are not normal breath sounds.

Choice c reason:
Bronchovesicular sounds are normal breath sounds heard over the main bronchus area and over the upper right posterior lung field. They have a medium pitch and intensity and are heard on both inspiration and expiration. In a healthy individual, these sounds are expected to be heard in the 1st and 2nd intercostal spaces near the sternal body.

Choice d reason:
Tracheal breath sounds are harsh, high-pitched sounds heard when auscultating over the trachea in the neck. They are not normally heard over the intercostal spaces of the chest wall.

A. Palpitations B. Diaphoresis C. Weight gain D. Exophthalmos

Correct Answer is C

Explanation

Choice A Reason:
Palpitations are typically associated with hyperthyroidism, not hypothyroidism. They occur due to an excess of thyroid hormones, which can overstimulate the heart, leading to increased heart rate and palpitations. In hypothyroidism, the heart rate is usually slower, and palpitations are less common.

Choice B Reason:
Diaphoresis, or excessive sweating, is also more commonly associated with hyperthyroidism. In hypothyroidism, the metabolism is slowed down, which reduces the tendency for increased sweating. Patients with hypothyroidism may actually have less sweating than normal.

Choice C Reason:
Weight gain is a common symptom of hypothyroidism. Due to the decreased metabolic rate caused by low levels of thyroid hormones, the body burns fewer calories, which can lead to weight gain. This is one of the hallmark signs of hypothyroidism and is often one of the first symptoms patients notice.

Choice D Reason:
Exophthalmos, the protrusion of the eyes, is a symptom associated with Graves' disease, a form of hyperthyroidism. It is not a symptom of hypothyroidism. In hypothyroidism, any eye changes are usually related to puffiness or edema around the eyes, not the bulging of the eyes themselves.

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A client reports experiencing chronic headaches after a recent upper respiratory tract infection. On physical examination, the nurse notes tenderness when palpating over the sinuses. Which condition is likely?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

While auscultating a client's 1st and 2nd intercostal spaces, close to the sternal body, the nurse would document these normal breath sounds as which of the following?

Correct Answer is C

Explanation

A nurse is assessing a client who has hypothyroidism. The nurse should expect which of the following findings?

Correct Answer is C

Explanation

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