A client with Streptococcus pharyngitis reports high fever, difficulty swallowing and a muffled voice. Which complication should the nurse suspect?

Nasal polyps.

Laryngeal polyps.

Foreign body obstruction.

Peritonsillar abscess.

Answer and Explanation

The Correct Answer is D

A. Nasal polyps: Nasal polyps are soft, noncancerous growths in the nasal passages or sinuses, often linked to chronic inflammation, asthma, or allergies. They do not cause sore throat, fever, or difficulty swallowing, and are not associated with strep pharyngitis.

B. Laryngeal polyps: Laryngeal polyps typically present with hoarseness due to vocal cord involvement but are not associated with high fever, painful swallowing, or infections like streptococcal pharyngitis. They are usually non-infectious and develop gradually.

C. Foreign body obstruction: A foreign body obstruction causes sudden onset symptoms such as choking, coughing, or respiratory distress. This does not align with a progressive infectious presentation like fever and muffled voice, which suggests a localized infection.

D. Peritonsillar abscess: A peritonsillar abscess is a common complication of untreated or severe streptococcal pharyngitis. It presents with high fever, difficulty swallowing (dysphagia), muffled or "hot potato" voice, and unilateral throat pain due to pus collection near the tonsils.

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Correct Answer is D

Explanation

A. A 24-hour diet history: While a 24-hour diet history can provide some information about recent food intake, it may not accurately reflect long-term nutritional status. Nutritional deficiencies often develop over time, and a single day's intake might not capture overall dietary patterns.

B. Status of current appetite: Appetite can be influenced by many factors, including illness, medications, or psychological conditions. While it is an important consideration in a nutritional assessment, it alone does not give the most reliable insight into an individual’s overall nutritional status.

C. History of a recent weight loss: Recent weight loss could indicate malnutrition or a medical issue, but it doesn't provide a complete picture of an individual's overall nutritional health. Long-term assessments, such as changes in body composition, would give more insight.

D. Condition of hair, nails, and skin: The condition of hair, nails, and skin is a key indicator of nutritional status, as these tissues are directly affected by nutrient deficiencies. Signs such as brittle nails, thinning hair, or dry, flaky skin can reflect deficiencies in vitamins, minerals, and overall nutrition, providing a more comprehensive view of an individual's nutritional health.

A. He would have difficulty falling to sleep, and sleep very lightly with more frequent arousals. B. He would sleep soundly during the first half of the night, with increased arousals during the second half. C. Increase sleep latency, and reduce total sleep time. D. Decrease the need for rapid eye movement (REM) sleep.

Correct Answer is A

Explanation

A. He would have difficulty falling to sleep, and sleep very lightly with more frequent arousals: Nicotine is a stimulant that can interfere with sleep by increasing heart rate and causing difficulty in falling asleep. Smokers also tend to experience more fragmented sleep, with frequent awakenings and lighter sleep stages due to withdrawal symptoms during the night which include restlessness, irritability, and difficulty relaxing.

B. He would sleep soundly during the first half of the night, with increased arousals during the second half: This is not typically associated with smoking. While nicotine withdrawal can cause sleep disruption, it does not usually result in sound sleep in the first half of the night followed by arousals. Smoking-related sleep disturbances are more generalized throughout the night.

C. Increase sleep latency, and reduce total sleep time: While nicotine can increase sleep latency (the time it takes to fall asleep), smoking is more likely to cause fragmented sleep and increased arousals rather than just reducing total sleep time. The effect on sleep is often more about poor-quality sleep than simply reduced duration.

D. Decrease the need for rapid eye movement (REM) sleep: Nicotine does not decrease the need for REM sleep, but it disrupts the sleep cycle, including REM sleep, by causing lighter sleep and more frequent awakenings. Smokers tend to have a lower proportion of REM sleep due to these disruptions, but not necessarily a decreased need for it.

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A client with Streptococcus pharyngitis reports high fever, difficulty swallowing and a muffled voice. Which complication should the nurse suspect?

Nursing Test Bank

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