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
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. XI; have patient shrug their shoulders against resistance: Cranial nerve XI, also known as the accessory nerve, is responsible for the innervation of the sternocleidomastoid and trapezius muscles. Damage to this nerve can lead to weakness in shoulder shrugging and difficulty turning the head. Asking the patient to shrug their shoulders against resistance allows the nurse to assess the function of this nerve effectively.
B. XI; palpate the anterior and posterior triangles: While palpating the anterior and posterior triangles of the neck can provide useful anatomical information, it does not specifically assess the function of cranial nerve XI. This action may not directly address the patient's complaints or evaluate nerve function adequately.
C. XII; assess for a positive Romberg sign: Cranial nerve XII, the hypoglossal nerve, is responsible for tongue movement. The Romberg test assesses balance and proprioception, not directly related to neck and shoulder pain or head movement. This option is not appropriate in this context.
D. XII; percuss the sternomastoid and submandibular neck muscles: Percussion is not a standard method for assessing cranial nerve function and would not provide useful information about nerve damage. This option also incorrectly identifies the relevant cranial nerve, as cranial nerve XII is not involved in neck and shoulder movement.
Correct Answer is B
Explanation
A. To facilitate the movement of air through the nares: While the ciliated mucous membrane does help in the overall functioning of the nasal passages, its primary role is not to facilitate air movement but to filter and trap particles.
B. To filter coarse particles from inhaled air: The primary purpose of the ciliated mucous membrane in the nose is to trap and filter out coarse particles, such as dust, pollen, and microbes, from inhaled air. The cilia beat in a coordinated manner to move mucus and trapped particles towards the throat, where they can be swallowed or expelled, helping to keep the airways clear and protect the respiratory system.
C. To filter out odors: While the nasal cavity does play a role in detecting odors through the olfactory receptors located in the upper part of the nasal cavity, the ciliated mucous membrane itself is not primarily responsible for filtering odors.
D. To warm the inhaled air: The nasal passages do help warm inhaled air as it passes through, but this is more a function of the rich blood supply and the large surface area of the nasal cavity rather than the role of the ciliated mucous membrane specifically. The primary action of the ciliated mucous membrane is focused on filtering particles from the air.
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