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 B
Explanation
A. MMSE: The Mini-Mental State Examination (MMSE) is primarily used to assess cognitive function and screen for dementia. While it can provide some information about a patient's cognitive status, it is not specifically designed to evaluate mood disorders or depressive symptoms.
B. PHQ9: The Patient Health Questionnaire-9 (PHQ-9) is a widely used screening tool specifically designed to assess the severity of depression. It consists of nine questions related to the patient's mood, interest in activities, sleep patterns, and other symptoms of depression, making it an appropriate choice for further evaluation in this case.
C. GAD7: The Generalized Anxiety Disorder 7-item scale (GAD-7) is used to assess the severity of generalized anxiety disorder. While anxiety and depression can be related, the GAD-7 is not the best tool for evaluating the depressed mood reported by the patient.
D. Delirium Screening Tool: This tool is used to assess for delirium, which is an acute confusion state typically seen in hospitalized patients or those with significant medical issues. It is not applicable in evaluating depressive symptoms in a young adult.
Correct Answer is B
Explanation
A. Maxillary sinuses reach full size after puberty: While maxillary sinuses continue to grow throughout childhood, they are present at birth and reach adult size during late adolescence. The frontal and sphenoid sinuses, rather than the maxillary, experience more significant postnatal development.
B. Maxillary and ethmoid sinuses are the only sinuses present at birth: At birth, only the maxillary and ethmoid sinuses are developed. The frontal and sphenoid sinuses begin to develop later in infancy and childhood, with full maturation occurring in adolescence.
C. Frontal sinuses are fairly well developed at birth: Frontal sinuses do not develop until around 7 to 8 years of age and continue growing into adolescence. They are absent or rudimentary in newborns.
D. Sphenoid sinuses are full size at birth: The sphenoid sinuses begin developing around 2 to 3 years of age and continue growing into late childhood and adolescence. They are not present at birth.
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