The nurse is performing an assessment on a 7-year-old child who has symptoms of chronic watery eyes, sneezing, and clear nasal drainage. The nurse notices the presence of a transverse line across the bridge of the nose, dark blue shadows below the eyes, and a double crease on the lower eyelids. What does the nurse suspect is the cause of these signs and symptoms?
Lymphadenopathy
Nasal congestion
Upper respiratory infection
Chronic allergies
The Correct Answer is D
A. Lymphadenopathy: Enlarged lymph nodes typically indicate an immune response to infection or inflammation. While allergies can cause mild lymph node enlargement due to chronic irritation, they do not directly cause the characteristic facial signs described, such as the transverse nasal crease and allergic shiners.
B. Nasal congestion: Nasal congestion is a symptom rather than a primary diagnosis. Although allergies can cause nasal congestion, the child exhibits additional hallmark signs of allergic rhinitis, including allergic shiners, Dennie-Morgan lines, and a nasal crease, suggesting a chronic allergic process rather than isolated congestion.
C. Upper respiratory infection: Viral upper respiratory infections (URIs) can cause nasal congestion, sneezing, and watery eyes, but they are usually short-lived and accompanied by fever, malaise, or yellow-green nasal discharge. The presence of a nasal crease and allergic shiners suggests a chronic process like allergic rhinitis rather than an acute infection.
D. Chronic allergies: The presence of a transverse nasal crease from frequent "allergic salute" rubbing, dark periorbital circles (allergic shiners) due to venous congestion, and Dennie-Morgan lines (double creases under the eyes) are classic findings in allergic rhinitis. These symptoms, along with watery eyes and clear nasal drainage, strongly indicate a chronic allergic condition rather than an infectious cause.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Nystagmus in extreme superior gaze: A few beats of nystagmus in extreme lateral gaze may be normal, but sustained nystagmus, especially in superior gaze, suggests neurological impairment such as vestibular dysfunction or multiple sclerosis.
B. Slight amount of lid lag when moving the eyes from a superior to an inferior position: Lid lag, where the upper eyelid lags behind the downward movement of the eye, is often associated with hyperthyroidism (e.g., Graves' disease). It is not a normal finding in the diagnostic positions test.
C. Convergence of the eyes: Convergence is assessed when a person focuses on a near object, such as during an accommodation test. The diagnostic positions test evaluates extraocular muscle function and cranial nerves III, IV, and VI, focusing on coordinated movement rather than convergence.
D. Parallel/synchronized movement of both eyes: The normal finding in the diagnostic positions test is smooth, coordinated movement of both eyes in all six cardinal directions without lagging, misalignment, or significant nystagmus. This indicates intact extraocular muscles and proper cranial nerve function.
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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