A patient comes into the clinic complaining of facial pain, fever, and malaise. On examination, the nurse notes swollen turbinates and purulent discharge from the nose. The patient also complains of a dull, throbbing pain in his cheeks and teeth on the right side and pain when the nurse palpates the areas. What do these findings indicate?

Maxillary sinusitis

Posterior epistaxis

Frontal sinusitis

Nasal polyps

Answer and Explanation

The Correct Answer is A

A. Maxillary sinusitis: The symptoms described, including facial pain, fever, malaise, swollen turbinates, purulent nasal discharge, and dull, throbbing pain in the cheeks and teeth, are consistent with maxillary sinusitis. The maxillary sinuses are located in the cheeks, and inflammation or infection in this area can lead to referred pain in the teeth and facial areas. Tenderness upon palpation of the maxillary sinus area further supports this diagnosis.

B. Posterior epistaxis: Posterior epistaxis refers to bleeding from the back of the nasal cavity. While it can be associated with nasal pain, it does not typically present with fever, malaise, purulent discharge, or sinus-related pain.

C. Frontal sinusitis: Frontal sinusitis involves inflammation of the frontal sinuses located above the eyes, which may cause pain in the forehead and around the eyes. The patient's complaint of cheek and teeth pain is more indicative of maxillary sinusitis rather than frontal sinusitis.

D. Nasal polyps: Nasal polyps are non-cancerous growths that can occur in the nasal passages or sinuses, often leading to obstruction and difficulty breathing. While they can be associated with sinusitis, the acute presentation of fever, malaise, and purulent discharge, along with facial pain, is more indicative of an active infection, such as maxillary sinusitis.

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Correct Answer is A

Explanation

A. Pericardial sac: The pericardial sac, also known as the pericardium, is a double-walled sac that surrounds and protects the heart. It consists of an outer fibrous layer and an inner serous layer, which produces pericardial fluid to reduce friction between the heart and surrounding structures during heartbeats. This structure provides support and helps maintain the position of the heart within the thorax.

B. Endocardial sac: The endocardium is the innermost layer of the heart wall that lines the heart chambers and covers the heart valves. It does not refer to a protective sac surrounding the heart.

C. Pleural sac: The pleural sac consists of two layers (visceral and parietal pleura) that encase the lungs and provide a lubricated surface for lung expansion and contraction during respiration. It is not related to the heart.

D. Myocardial sac: The myocardium refers to the muscular middle layer of the heart wall responsible for contraction and pumping blood. It is not a sac and does not surround or protect the heart.

A. Thought content B. Attention span C. Distant memory D. New memory

Correct Answer is D

Explanation

A. Thought content: The four unrelated words test does not assess thought content, which refers to the patient’s ideas, beliefs, and perception of reality. Thought content is typically evaluated through direct questioning and observation of the patient’s speech patterns and behaviors.

B. Attention span: Attention span is assessed by evaluating the patient's ability to concentrate on simple tasks, such as following a set of instructions or completing a short mental exercise. The four unrelated words test is not designed to measure attention span directly.

C. Distant memory: Distant memory refers to the recall of events or information from the past, such as childhood experiences or historical events. The four unrelated words test assesses recent recall rather than distant memory.

D. New memory: The four unrelated words test evaluates the ability to form and retrieve new memories. The nurse provides the patient with four unrelated words, asks them to recall them after a few minutes, and reassesses recall at intervals. Impairments in new memory recall can indicate cognitive deficits seen in conditions like dementia or head trauma.

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Naxlex Comprehensive Predictor Exams

The sac that surrounds and protects the heart is called?

Correct Answer is A

Explanation

The nurse understands that the four unrelated words test provides information related to which cognitive function?

Correct Answer is D

Explanation

The nurse asks the patient to stick out their tongue while performing an assessment of the mouth and throat. The nurse knows this provides information about what cranial nerve?

Which of the following are the PRIMARY muscles of respiration? (Select All that Apply.)

The mother of a 2-year-old toddler is concerned about the upcoming placement of tympanostomy tubes in her son's ears. The nurse would include which of these statements in the teaching plan?

The nurse is performing an eye-screening clinic at a daycare center. When examining a 2-year-old child, the nurse suspects that the child has a "lazy eye". What should the nurse do next?

The nurse is observing the auscultation technique of a student nurse. What is the correct method to use when progressing from one auscultatory site on the thorax to another?