Emily, a 63-year-old woman with a history of smoking and hypertension, presents with hoarseness that has persisted for two months, weight loss, and dysphagia. She is taking Lisinopril for her hypertension. A biopsy confirms squamous cell carcinoma of the larynx. Which of the following steps are appropriate? Select all that apply
Schedule her for a radical neck dissection.
Initiate radiation therapy.
Discontinue Lisinopril and initiate a diuretic.
Administer a PET scan.
Provide dietary counseling for weight management.
Correct Answer : B,D,E
A. Radical neck dissection is a surgical procedure that removes the lymph nodes and other structures in the neck, and it is usually reserved for advanced cases or when radiation therapy fails.
B. Radiation therapy is often the main treatment for laryngeal cancer, as it can preserve the voice of the patient and avoid surgery.
C. Lisinopril is an angiotensin-converting enzyme (ACE) inhibitor that can cause a dry cough as a side effect, but it does not need to be discontinued unless there is another indication.
D. A PET scan can help determine the extent of cancer spread and guide treatment planning.
E. Dietary counseling is important to prevent malnutrition and dehydration, as dysphagia can impair oral intake.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B","D"]
Explanation
A. Initiation of IV antibiotics is appropriate to treat the infection.
B. Preparation for incision and drainage (I&D) is the immediate nursing intervention to relieve pressure, decrease the risk of airway compromise, and promote resolution of the abscess.
C. Administering acetaminophen for fever is appropriate for symptomatic relief but is not the most immediate intervention for a suspected peritonsillar abscess.
D. Continuous monitoring of airway patency is crucial due to the risk of airway compromise from the abscess.
E. While obtaining blood for culture and sensitivity is important for determining appropriate antibiotic
Correct Answer is D
Explanation
A. Decreased lung compliance doesn't directly enhance gas diffusion; it may impair it due to decreased lung expansion.
B. Decreased lung compliance doesn't necessarily indicate compromised pulmonary blood supply; it's more related to the lung's ability to expand and contract.
C. Decreased lung compliance suggests that ventilation may be impaired because the lungs are less able to expand and contract effectively.
D. Decreased lung compliance means the lungs are stiffer, requiring more effort to breathe, thus increasing the work of breathing.
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