Patients with chronic allergies may have small, pale, round, firm overgrowths on the nasal mucosa. Which term should be used to describe this physical assessment finding?

Perforated septum

Chronic sinusitis

Polyps

Turbinates

Answer and Explanation

The Correct Answer is C

Chronic allergic rhinitis produces nasal, polyps, benign edematous overgrowths of respiratory mucosa caused by persistent allergic, inflammation, eosinophilic infiltration, impaired drainage, and mucosal edema within nasal passages state present clinically

Rationale:

A. Trauma, septum perforation involves full-thickness nasal septal defect between nasal cavities. Common causes include cocaine abuse, nasal surgery, and chronic irritation. Findings epistaxis, crusting, and whistling airflow through septum. It is not allergic mucosal overgrowth and is not nasal polyps.

B. Sinusitis, infection is chronic paranasal sinus mucosal inflammation with obstruction and impaired drainage. Causes include viral bacterial allergic inflammation affecting sinus ostia. Symptoms include facial pain purulent discharge nasal congestion. Not characterized by polypoid mucosal overgrowth in allergic disease process.

C. Cyclic, hormonal breast tenderness is benign mastalgia linked to menstrual cycle hormonal fluctuations. Caused by estrogen and progesterone variation. Symptoms bilateral breast pain swelling premenstrual phase. It is physiologic and resolves with menses and does not require diagnostic evaluation typically.

D. Bloody, carcinoma nipple discharge suggests intraductal pathology involving ductal epithelial proliferation or malignancy. Common causes include intraductal papilloma and breast cancer. May present with unilateral spontaneous discharge. This finding is abnormal and always requires urgent diagnostic imaging and evaluation follow-up.

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Correct Answer is ["D","E"]

Explanation

Myxedema represents a severe form of hypothyroidism characterized by the dermal accumulation of mucopolysaccharides, leading to non-pitting edema. Systemic metabolic deceleration occurs due to inadequate glandular output, resulting in profound lethargy, hypothermia, and significant bradycardia. This condition reflects a failure in the thermogenic and chronotropic regulation of cellular processes.

Rationale:

A. Adrenocorticotropic hormone is secreted by the anterior pituitary to stimulate the adrenal cortex. Deficiencies in ACTH lead to secondary adrenal insufficiency, not the specific dermatological and metabolic changes seen in myxedema. Myxedema is specifically a clinical manifestation of thyroid hypofunction rather than pituitary-adrenal axis failure.

B. Aldosterone is a mineralocorticoid responsible for sodium retention and potassium excretion within the renal tubules. While its deficiency causes electrolyte imbalances and hypotension, it does not produce the periorbital puffiness or cold intolerance typical of myxedema. It is primarily regulated by the renin-angiotensin system rather than the thyroid-stimulating pathway.

C. In primary hypothyroidism, which causes myxedema, Thyroid Stimulating Hormone levels are typically elevated due to the loss of negative feedback. TSH is a pituitary hormone, not a thyroid hormone. Therefore, the patient is not deficient in TSH; rather, the thyroid gland fails to respond to its stimulation.

D. Thyroxine is the primary prohormone secreted by the thyroid gland and is severely depleted in myxedema. Low T4 levels lead to the systemic slowing of metabolic functions and the physical findings of facial edema. This deficiency is the fundamental cause of the clinical symptoms described in the patient assessment.

E. Triiodothyronine is the most biologically active thyroid hormone, and its deficiency directly results in decreased cellular oxygen consumption. A lack of T3 prevents normal heat production, leading to the reported cold intolerance. This hormone is essential for maintaining the basal metabolic rate and energetic homeostasis.

A. History of frequent earwax impaction B. History of seasonal allergies and sinus infections C. History of working in a factory with loud machinery D. History of recurrent otitis media with tympanic membrane scarring

Correct Answer is C

Explanation

Sensorineural hearing loss results from permanent damage to the cochlear hair cells or the vestibulocochlear nerve pathways. Chronic exposure to high-intensity sound waves induces metabolic exhaustion and mechanical strain, leading to the apoptosis of the organ of Corti. This irreversible condition disrupts the transduction of mechanical vibrations into electrical neural impulses.

Rationale:

A. Earwax impaction causes conductive hearing loss by physically obstructing the external auditory canal. It prevents sound waves from reaching the tympanic membrane but does not damage the inner ear. This is a reversible condition and is not classified as a sensorineural pathology.

B. Seasonal allergies and sinus infections typically lead to Eustachian tube dysfunction and fluid accumulation in the middle ear. This results in conductive impairment due to inhibited ossicle vibration. These inflammatory processes do not typically affect the neurosensory components of the auditory system located within the bony labyrinth.

C. Prolonged exposure to occupational noise is the leading cause of acquired sensorineural deficits. High decibel levels cause oxidative stress and structural shearing of the delicate stereocilia. This finding is the most significant risk factor for permanent damage to the sensory receptors of the inner ear.

D. Recurrent otitis media and tympanic scarring, or tympanosclerosis, interfere with the mechanical transmission of sound through the middle ear. These issues cause conductive loss by reducing the compliance of the eardrum. They are structural issues of the conducting apparatus rather than the neural processing units of the ear.

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Patients with chronic allergies may have small, pale, round, firm overgrowths on the nasal mucosa. Which term should be used to describe this physical assessment finding?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client diagnosed with myxedema reports having experienced a lack of energy, cold intolerance, and puffiness around the eyes and face. Based on the patient's presentation, which of the following hormones is the patient most likely deficient in? Select all that apply.

Correct Answer is ["D","E"]

Explanation

Which finding in the client's history will alert the nurse to the most likely cause of the sensorineural hearing loss?

Correct Answer is C

Explanation

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