Chapter 76: Tumors and Polyps of the Nose Buttaro: Primary Care: A Collaborative Practice, 6th Edition

Multiple Choice

1. A patient reports chronic nasal obstruction and recurrent epistaxis. Which type of nasal mass is likely?

a. Inverted papilloma b. Nasal polyp c. Paranasal lymphoma d. Squamous cell carcinoma

ANS: A a. Chronic sinusitis b. Nasal polyps c. Squamous cell carcinoma d. Vascular benign tumor

Inverted papillomas are benign tumors of the nasal mucosa and are highly vascular with frequent bleeding. Nasal polyps typically do not bleed and are associated with allergies. Paranasal lymphoma and squamous cell carcinoma are not initially associated with bleeding.

2. A patient reports chronic nasal obstruction and difficulty distinguishing smells. The provider examines the nares with a nasal speculum and observes several grapelike lesions in both nostrils. What is the likely cause of this patient’s symptoms?

ANS: B

Polyps cause obstruction and olfactory dysfunction and appear as grapelike lesions on the nasal mucosa. Most malignant neoplasms are asymptomatic until late in the course. Chronic sinusitis characteristically produces inflammation and purulent discharge.

NURSINGTB.COM a. Administering prednisone b. Obtaining a chest radiograph c. Performing laboratory tests d. Referring to a specialist

3. A provider examines a patient who has chronic nasal obstruction, respiratory tract symptoms, and generalized malaise. An examination of the nasal mucosa reveals ulceration of the nasal septum. What is the most important action when caring for this patient?

ANS: D

This patient has symptoms of granulomatosis with polyangiitis (GPA) and should be referred as soon as the disease is suspected. The other actions will be taken, but referral is the most important.