WCL Staff Nurse - 2022
Medical & Surgical Nursing
Medium
Which of the following nasal dysfunction is commonly due to degenerative changes in the skeletal framework of the nose?
Appeared in: WCL Staff Nurse - 2022
Explanation
- Degenerative changes refer to the age-related weakening and structural alteration of tissues, in this case, the nasal cartilage and bone.
- The skeletal framework of the nose provides its shape and keeps the airway open. Changes to this framework, such as a deviated septum or nasal valve collapse, physically narrow the passage.
- Nasal obstruction is the direct symptom of a narrowed airway, leading to difficulty breathing through the nose.
- As people age, nasal cartilages can weaken, causing the nasal tip to droop and the nasal valve (the narrowest part of the airway) to collapse, resulting in obstruction.
Why Other Options Were Wrong
- Option A: 'Polypsia' is not a recognized medical term for a nasal condition. If it is a typo for 'nasal polyps', polyps are inflammatory growths of the nasal mucosa, not a result of degenerative changes in the skeletal framework.
- Option C: Rhinorrhea, or a runny nose, is caused by increased mucus production from the nasal lining, typically due to allergies, infections, or irritants. It is a mucosal issue, not a skeletal one.
- Option D: Epistaxis (nosebleed) is caused by the rupture of blood vessels in the nasal mucosa. It is related to vascular fragility, trauma, dryness, or systemic conditions like hypertension, not the degeneration of the nasal skeleton.
Related Visual
Clinical Relevance
- Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Pathophysiology of Nasal Dysfunction as background academic context rather than a clinical decision trigger.
- Nurses should recognize that new-onset nasal obstruction in an older adult may not be due to a simple cold but could indicate underlying structural changes requiring specialist evaluation.
- Chronic nasal obstruction can significantly impact quality of life, leading to mouth breathing, dry mouth, snoring, and sleep-disordered breathing (like obstructive sleep apnea).
- Patient education is key. A nurse can explain that while some nasal issues are temporary, persistent blockage, especially if it worsens over time, warrants a visit to an ENT specialist.
How to Approach the Question
- First, identify the key phrases in the question: 'degenerative changes' and 'skeletal framework'. This points to a long-term, structural problem, likely related to aging.
- Next, analyze each option's underlying cause.
- Evaluate 'Polypsia': Recognize this is not a standard term. Consider it a likely distractor or typo for 'polyps', which are inflammatory.
- Evaluate 'Nasal obstruction': This is a symptom of blockage. A structural change in the 'skeletal framework' is a direct cause of physical blockage.
- Evaluate 'Rhinorrhea' (runny nose) and 'Epistaxis' (nosebleed): Recall that these are related to the nasal lining (mucosa) and blood vessels, not the underlying bone and cartilage framework.
- Conclude that nasal obstruction is the only option directly caused by changes in the nasal skeleton.
Concept Tested & Keywords
- Concept Tested: Pathophysiology of Nasal Dysfunction
- Stem keywords: nasal dysfunction, degenerative changes, skeletal framework, nose
- Lead-in keywords: Which of the following
- Negative lead-in flag: false
Question ID
QPLakGyWXN2KDlc7xLeq4l
Reference Book
E6 Nursing Brunner Adult Health 3SA Vol 2 Part 1 p. 43-45
E6 Ghai Essential Pediatrics(pp 26-904 of 913) p. 387-389
E6 Pathology- ROBBINS & COTRAN PATHOLOGIC BASIS OF DISEASE 10TH Ed p. 740-742
Practise the full WCL Staff Nurse - 2022
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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