Patient states that they are having trouble breathing on one side of their nose. As the nurse completing a head and neck assessment, what is one possible diagnosis that you will assess for?
Epistaxis
Perforated septum
Deviated septum
Ankyloglossia
The Correct Answer is C
A) Epistaxis: Epistaxis, or a nosebleed, typically presents with the sudden onset of blood coming from one or both nostrils. Although a nosebleed can cause discomfort and a sense of obstruction, it does not typically present as difficulty breathing through one side of the nose. Epistaxis is more related to trauma, dry air, or nasal irritation rather than a structural issue causing airflow restriction.
B) Perforated septum: A perforated septum refers to a hole or tear in the nasal septum, the cartilage and bone that separates the two nasal passages. It may cause symptoms such as a whistling sound when breathing or increased susceptibility to infections, but difficulty breathing on one side of the nose alone isn't the most common symptom. A perforated septum is often associated with chronic drug use or injury, but it doesn't usually present with unilateral breathing difficulty unless it's very severe.
C) Deviated septum: A deviated septum occurs when the thin wall of bone and cartilage that divides the nasal cavity is displaced to one side. This condition is one of the most common causes of breathing difficulty on one side of the nose. The deviation can obstruct airflow, leading to symptoms like difficulty breathing through one nostril, congestion, or sinus infections. This diagnosis is most likely based on the patient's complaint.
D) Ankyloglossia: Ankyloglossia, also known as tongue-tie, refers to a condition where the frenulum (the membrane under the tongue) is abnormally short, restricting the tongue's movement. While it can cause feeding difficulties in infants or speech issues, it has no connection to nasal airflow or breathing problems. This diagnosis is unrelated to the symptoms described.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A) Glossitis: Glossitis refers to inflammation of the tongue, which can lead to redness, swelling, and sometimes a smooth appearance. It does not typically cause whitish thickening or growths in the mouth that cannot be scraped off. Glossitis is more related to the tongue's surface rather than abnormal growths or lesions.
B) Tonsillitis: Tonsillitis is an infection or inflammation of the tonsils, typically caused by viral or bacterial infections. It results in sore throat, swelling of the tonsils, and sometimes white patches. However, tonsillitis does not cause whitish thickening or growths on the oral mucosa that cannot be scraped off, making it an unlikely diagnosis here.
C) Herpes simplex: Herpes simplex virus (HSV) infections can cause oral lesions, such as cold sores or blisters. These lesions are usually painful, fluid-filled, and can be scraped off. They do not cause thick, white, non-scrapable growths like leukoplakia does.
D) Leukoplakia: Leukoplakia refers to the development of thick, white patches on the mucous membranes of the mouth, which cannot be scraped off. It is often associated with conditions like HIV, smoking, and chronic irritation. The presence of leukoplakia in an HIV-positive patient is concerning because it can be precancerous. This is the correct term for the finding described in the question.
Correct Answer is D
Explanation
A) Cataracts: Cataracts are a condition where the lens of the eye becomes cloudy, leading to blurred vision. While cataracts can impact vision, they do not cause fixed, dilated pupils. Cataracts would typically affect the clarity of vision rather than pupil size and response.
B) Miosis: Miosis refers to constricted pupils that are smaller than normal, typically less than 2 mm in size. The finding described in the question (fixed and 7 mm) is the opposite of miosis, which would indicate excessively small pupils.
C) Astigmatism: Astigmatism is a refractive error caused by an irregular shape of the cornea or lens, resulting in blurry vision. It is unrelated to the size or responsiveness of the pupils and does not cause fixed or dilated pupils, making it an inappropriate choice for this finding.
D) Mydriasis: Mydriasis refers to the dilation of the pupils, typically greater than 6 mm in size. When the pupils are fixed and dilated (7 mm, as described), this condition is termed mydriasis. It can occur due to various factors such as certain medications, trauma, or neurological issues. The nurse should document this finding as mydriasis and notify the healthcare provider for further assessment.
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