Chapter 46

Which of the following terms is used to describe stone formation in a salivary gland, usually the submandibular gland?

Sialolithiasis

An elderly patient is diagnosed with parotitis. The nurse is aware that this bacterial infection is most likely caused by:

Staphylococcus aureus.

A patient has been diagnosed with Zenker's diverticulum. What treatment does the nurse anticipate educating the patient about?

Surgical removal of the diverticulum

To prevent gastroesophageal reflux in a client with hiatal hernia, the nurse should provide which discharge instruction?

"Avoid coffee and alcoholic beverages."

A nurse is performing health assessment with a client during an outpatient clinic visit. The most concerning client statement to the nurse is:

"Food seems to be getting stuck in my throat."

One way for the nurse to confirm placement of a nasogastric tube is to test the pH of the tube aspirate. The nurse knows that tube placement in the lungs is indicated with a pH of:

6

During postoperative neck dissection assessment, the nurse notices excessive bleeding from the dressing site. She suspects possible carotid artery rupture and takes the immediate first step to:

Apply pressure to the bleeding site or major associated vessel.

A nurse caring for a patient who has had radical neck surgery notices an abnormal amount of serosanguineous secretions in the wound suction unit during the first postoperative day. An expected normal amount of drainage is:

Approximately 80 to 120 mL.

A client in the emergency department reports that a piece of meat became stuck in the throat while eating. The nurse notes the client is anxious with respirations at 30 breaths/min, frequent swallowing, and little saliva in the mouth. An esophagogastroscopy with removal of foreign body is scheduled for today. The first activity of the nurse is to:

Assess lung sounds bilaterally.

Which of the following is an accurate statement regarding cancer of the esophagus?

Chronic irritation of the esophagus is a known risk factor.

The nurse is creating a plan of care for a patient who is not able to tolerate brushing his teeth. The nurse includes in the plan of care which of the following mouth irrigations?

Baking soda and water

Which of the following is the primary symptom of achalasia?

Difficulty swallowing

The nurse is caring for an older adult who complains of xerostomia. The nurse evaluates for use of which of the following medications?

Diuretics

The most common symptom of esophageal disease is which of the following?

Dysphagia

An elderly client seeks medical attention for a vague complaint of difficulty swallowing. Which of the following assessment findings is most significant as related to this symptom?

Esophageal tumor

An elderly client states, "I don't understand why I have so many caries in my teeth." The nurse assesses the following as placing the client at risk:

Exhibiting hemoglobin A1C 8.2

Postoperatively, a patient with a radical neck dissection should be placed in which position?

Fowler's

A client has a new order for metoclorpramide (Reglan). The nurse identifies that this medication can be safely administered for which conditon?

Gastroesophageal reflux disease

Which of the following is one of the first clinical manifestations of esophageal cancer?

Increasing difficulty is swallowing

A patient who is HIV positive comes to the clinic and is experiencing white patches with rough hairlike projections. The nurse observes the lesions on the lateral border of the tongue. What abnormality of the mouth does the nurse determine these lesions are?

Hairy leukoplakia

A client has a cheesy white plaque in the mouth. The plaque looks like milk curds and can be rubbed off. The best nursing intervention is to

Instruct the client to swish prescribed nystatin (Mycostatin) solution for 1 minute.

The nurse working in the recovery room is caring for a patient who had a radical neck dissection. The nurse notices that the patient has a coarse, high-pitched sound on inspiration. Which of the following is the appropriate intervention by the nurse?

Notifying the physician

A nurse practitioner, who is treating a patient with GERD, knows that responsiveness to this drug classification is validation of the disease. The drug classification is:

Proton pump inhibitors

A patient has been diagnosed with a hiatal hernia. The nurse explains the diagnosis to the patient and his family by telling them that a hernia is a (an)

Protrusion of the upper stomach into the lower portion of the thorax.

A client with a disorder of the oral cavity cannot tolerate tooth brushing or flossing. Which of the following strategies can the nurse employ to assist this client?

Provide the client with an irrigating solution of baking soda and warm water.

A client with dysphagia is being prepared for discharge. Which outcome indicates that the client is ready for discharge?

The client is free from esophagitis and achalasia.

James Jaeger, a 59-year-old carpenter, is being seen by a physician in your oncology group with a diagnosis of oral cancer. During your client education, Mr. Jaeger tells you that he is upset that he didn't recognize any early signs or symptoms of his disease. What do you tell Mr. Jaeger about the early stage of his cancer?

There are usually no symptoms.

Paul Cavanagh, a 63-year-old retired teacher, had oral cancer and had extensive surgery to excise the malignancy. Although his surgery was deemed successful, it was quite disfiguring and incapacitating. What is essential to Mr. Cavanagh and his family?

Time to mourn, accept, and adjust to the loss

Cardiac complications, which may occur following resection of an esophageal tumor, are associated with irritation of which nerve at the time of surgery?

Vagus

When assessing a client during a routine checkup, the nurse reviews the history and notes that the client had aphthous stomatitis at the time of the last visit. Aphthous stomatitis is best described as:

a canker sore of the oral soft tissues.

The most common symptom of esophageal disease is

dysphagia.

The nurse is conducting a health instruction program on oral cancer. The nurse determines that the participants understand the instructions when they say which of the following?

"Many oral cancers produce no symptoms in the early stages."

Tyrone Freeman is a 49-year-old male being treated for GERD at the gastroenterology office where you work. During his visit, he states that his reflux is much improved, but now, he is having diarrhea. In addition to his prescribed treatment for GERD, he has been taking an antacid. Which of the following components of an antacid might be causing his diarrhea?

Magnesium

Which of the following assessment findings would be most important for indicating dumping syndrome in a postgastrectomy client?

Weakness, diaphoresis, diarrhea 90 minutes after eating