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 A

Explanation

A. The client has developed confusion: Hypotonic fluids can cause a rapid shift of water into cells, potentially leading to cerebral edema. This can manifest as confusion or altered mental status, which is a serious adverse effect requiring immediate attention.

B. The client's serum sodium is 140 mEq/L (135 to 145 mEq/L): A serum sodium level within the normal range indicates that the hypotonic fluid therapy is likely effective in correcting hypernatremia, and does not suggest an adverse effect.

C. The client has a positive Chvostek's sign: A positive Chvostek's sign is indicative of hypocalcemia rather than an adverse effect of hypotonic fluid administration. This sign is related to low calcium levels and is not a direct result of hypotonic fluid therapy.

D. The client's blood urea nitrogen (BUN) level is 18 mg/dL (10 to 20 mg/dL): This BUN level is within normal limits and does not suggest an adverse effect of hypotonic fluid therapy. BUN levels can be affected by various factors, but this value alone is not indicative of an adverse reaction.

A. Cardiac enlargement B. Exophthalmos C. Gastric ulcerations D. Urinary tract infections

Correct Answer is A

Explanation

A. Cardiac enlargement: Chronic hypoxia leads to increased workload on the heart as it works harder to deliver oxygen to tissues. This can result in cardiac enlargement or right-sided heart failure due to pulmonary hypertension, a common consequence of long-term hypoxia.

B. Exophthalmos: Exophthalmos is protrusion of the eyes and is typically associated with thyroid disorders, such as Graves' disease, rather than chronic hypoxia.

C. Gastric ulcerations: While stress and certain medications can lead to gastric ulcerations, they are not directly caused by chronic hypoxia. Chronic hypoxia mainly affects the cardiovascular and pulmonary systems.

D. Urinary tract infections: Chronic hypoxia does not typically lead to urinary tract infections. UTIs are more commonly associated with factors such as poor hygiene, urinary obstruction, or immunosuppression.

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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 caring for a client who has hypernatremia and is receiving intravenous (IV) hypotonic fluid replacement. Which of the following manifestations should the nurse understand is an indication of an adverse effect from the administration of hypotonic fluids?

Correct Answer is A

Explanation

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Correct Answer is A

Explanation

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