When evaluating the effectiveness of nursing interventions for sinusitis discomfort, which of the following does the nurse assess?

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Question 1 of 5

When evaluating the effectiveness of nursing interventions for sinusitis discomfort, which of the following does the nurse assess?

Correct Answer: C

Rationale: When evaluating the effectiveness of nursing interventions for sinusitis discomfort, assessing the amount and color of sinus drainage is crucial. Changes in these aspects can provide valuable information about the progression of the sinusitis and the effectiveness of the interventions being implemented. Increased or purulent sinus drainage can indicate infection or inflammation, while clearer drainage may suggest improvement. Monitoring these parameters helps the nurse make informed decisions about continuing, modifying, or discontinuing interventions to manage the patient's sinusitis discomfort effectively. Evaluating WBC count, capillary refill, and comfort level are also important assessments in certain situations, but assessing the amount and color of sinus drainage is most directly related to sinusitis symptoms.

Question 2 of 5

Which of the ff is a sign or symptom of asthma?

Correct Answer: C

Rationale: Paroxysms, or sudden attacks, of shortness of breath are a common sign or symptom of asthma. Asthma is a chronic respiratory condition characterized by inflammation and narrowing of the airways, which leads to difficulty breathing. During an asthma attack, individuals may experience sudden and severe shortness of breath, often accompanied by wheezing, coughing, and chest tightness. These paroxysms of breathlessness are a hallmark feature of asthma and indicate the presence of airway inflammation and constriction.

Question 3 of 5

Which of the ff blood vessel is commonly affected by thrombophlebitis?

Correct Answer: C

Rationale: Thrombophlebitis commonly affects the veins deep in the lower extremities, such as the femoral vein or the iliac vein. This condition involves the formation of a blood clot (thrombus) in a vein, usually due to inflammation or injury to the vein wall. The lower extremities are more prone to thrombophlebitis because of factors like gravity, reduced blood flow in the veins of the legs, and prolonged sitting or immobility which can increase the risk of blood clot formation. Thrombophlebitis in the lower extremities can potentially lead to serious complications, such as pulmonary embolism if a clot breaks loose and travels to the lungs.

Question 4 of 5

A patient is admitted with a 2-month history of fatigue, SOB, pallor, and dizziness. The patient is diagnosed with idiopathic autoimmune haemolytic anemia. On reviewing the laboratory results, the nurse notes which of the following that confirms this diagnosis?

Correct Answer: A

Rationale: In patients with idiopathic autoimmune hemolytic anemia, the immune system mistakenly targets and destroys its own red blood cells (RBCs). When the red blood cells are destroyed, they can break apart, leading to the presence of fragmented RBCs, also known as schistocytes or red cell fragments, in the peripheral blood. The presence of RBC fragments is a characteristic finding in this type of hemolytic anemia and helps confirm the diagnosis.

Question 5 of 5

When assessing a client with autoimmune disorder, what signs should the nurse look for in the client?

Correct Answer: B

Rationale: When assessing a client with an autoimmune disorder, the nurse should look for signs such as hives or rashes. Autoimmune disorders can manifest with various skin manifestations, including hives or rashes, which may be indicative of an autoimmune response. These skin manifestations may occur due to the immune system mistakenly attacking the body's own tissues. Observing and monitoring these skin changes can help in assessing and managing the autoimmune disorder in the client. Additionally, localized inflammation may also be present in autoimmune disorders, but hives or rashes are more commonly associated with these conditions.

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