Chapter 45

The nurse is examining the mouth of a client who is HIV positive. On the inner side of the lip, the nurse sees a shallow ulcer with a yellow center and red border. The client says the area has been painful for about 5 days or so. Which condition is most consistent with these findings? a. Aphthous stomatitis b. Kaposi's sarcoma c. Chancre d. Hairy leukoplakia

a. Aphthous stomatitis (canker sore)

During a psychotic episode, a client with schizophrenia swallows a small wooden spoon. Which medication would the nurse in the emergency department be most likely to administer to facilitate removal of the foreign body? a. Glucagon b. Insulin c. Haloperidol d. Epinephrine

a. Glucagon

A client has a cheesy white plaque in the mouth. The plaque looks like milk curds and can be rubbed off. What is the nurse's best intervention? a. Instruct the client to swish prescribed nystatin solution for 1 minute. b. Remove the plaque from the mouth by rubbing with gauze. c. Provide saline rinses prior to meals. d. Encourage the client to ingest a soft or bland diet.

a. Instruct the client to swish prescribed nystatin solution for 1 minute.

The nurse is caring for a client receiving chemotherapy. For which mouth conditions associated with HIV infection should the nurse assess? Select all that apply. a. Kaposi sarcoma b. Stomatitis c. Erythroplakia d. Candidiasis

a. Kaposi sarcoma b. Stomatitis

The nurse is reviewing the chart of a client with swallowing problems. Which factors would raise suspicion that the client has cancer of the esophagus? Select all that apply. a. Smoking history of 20 years b. Male gender c. Previous treatment for GERD d. Caucasian race e. Age 72 years

a. Smoking history of 20 years b. Male gender c. Previous treatment for GERD

An adolescent client with multiple dental caries is discussing diet with the nurse. What client statement identifies a risk factor for dental caries? a. "I brush my teeth in the morning and evening." b. "I drink a can of carbonated soda at lunch every day." c. "I floss before I go to bed each night." d. "I visit my dentist every year."

b. "I drink a can of carbonated soda at lunch every day."

The nurse is conducting a community education session on the prevention of oral cancers. The nurse includes which cancer as being a type of premalignant squamous cell skin cancer? a. Herpes simplex 1 b. Actinic cheilitis c. Chancre d. Erythroplakia

b. Actinic cheilitis

A client has undergone a radical neck dissection. His skin graft site is pale. This indicates which condition? a. Possible necrosis b. Arterial thrombosis c. Venous congestion d. Infection

b. Arterial thrombosis

The nurse instructs the client with gastroesophageal reflux disease (GERD) regarding dietary measures. Which action by the client demonstrates that the client has understood the recommended dietary changes? a. Eliminating spicy foods. b. Avoiding chocolate and coffee. c. Eliminating cucumbers and other foods with seeds. d. Avoiding steamed foods.

b. Avoiding chocolate and coffee.

A patient is experiencing painful, inflamed, and swollen gums, and when brushing the teeth, the gums bleed. What common disease of the oral tissue does the nurse understand these symptoms indicate? a. Candidiasis b. Gingivitis c. Herpes simplex d. Cancer of the oral mucosa

b. Gingivitis

The nurse is assessing the skin graft site of a client who has undergone a radical neck dissection. The skin graft site is pink. The nurse documents which result? a. Possible necrosis of graft b. Healthy graft c. Venous congestion of graft d. Infection of graft

b. Healthy graft

For a client with salivary calculi, which procedure uses shock waves to disintegrate the stone? a. Radiation b. Lithotripsy c. Chemotherapy d. Biopsy

b. Lithotripsy

A client comes to the clinic complaining of a sore throat. When assessing the client, the nurse observes a reddened ulcerated lesion on the lip. The client tells the nurse that it has been there for a couple of weeks but it does not hurt. What should the nurse consult with the health care provider about testing for? a. HIV b. Syphilis c. Gonorrhea d. Herpes simplex

b. Syphilis

A client with dysphagia is being prepared for discharge. Which outcome indicates that the client is ready for discharge? a. The client doesn't exhibit rectal tenesmus. b. The client is free from esophagitis and achalasia. c. The client reports diminished duodenal inflammation. d. The client has normal gastric structures.

b. The client is free from esophagitis and achalasia.

A nurse is assessing a client who has just been admitted to the post-surgical unit following surgical resection for the treatment of oropharyngeal cancer. What assessment should the nurse prioritize? a. Assess ability to clear oral secretions. b. Assess for signs of infection. c. Assess for a patent airway. d. Assess for ability to communicate.

c. Assess for a patent airway

A client who has had a radical neck dissection is being prepared for discharge. The discharge plan includes referral to an outpatient rehabilitation center for physical therapy. What should the goals of physical therapy for this client include? a. Muscle training to relieve dysphagia b. Relieving nerve paralysis in the cervical plexus c. Promoting maximum shoulder function d. Alleviating achalasia by decreasing esophageal peristalsis

c. Promoting maximum shoulder function

A client with a disorder of the oral cavity cannot tolerate tooth brushing or flossing. Which strategy should the nurse use to assist the client? a. Urge the client to regularly rinse the mouth with tap water. b. Recommend that the client drink a small glass of alcohol at the end of the day to kill germs. c. Provide the client with an irrigating solution of baking soda and warm water. d. Regularly wipe the outside of the client's mouth to prevent germs from entering.

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

A client with cancer of the tongue has had a radical neck dissection. What nursing assessment should the nurse prioritize? a. Presence of acute pain and anxiety b. Tissue integrity and color of the operative site c. Respiratory status and airway clearance d. Self-esteem and body image

c. Respiratory status and airway clearance

An older client is diagnosed with parotitis. What bacterial infection does the nurse suspect caused the client's parotitis? a. Pseudomonas b. Pneumococcus c. Staphylococcus aureus d. Streptococcus viridans

c. Staphylococcus aureus

Select the assessment finding that the nurse should immediately report, post radical neck dissection. a. Temperature of 99°F b. Pain c. Stridor d. Localized wound tenderness

c. Stridor

The term for a reddened circumscribed lesion that ulcerates and becomes crusted and is a primary lesion of syphilis is a(n) a. lichen planus. b. actinic cheilitis. c. chancre. d. leukoplakia.

c. chancre.

The most common symptom of esophageal disease is a. nausea. b. vomiting. c. dysphagia. d. odynophagia.

c. dysphagia.

A client is diagnosed with a hiatal hernia. Which statement indicates effective client teaching about hiatal hernia and its treatment? a. "I'll eat three large meals every day without any food restrictions." b. "I'll lie down immediately after a meal." c. "I'll gradually increase the amount of heavy lifting I do." d. "I'll eat frequent, small, bland meals that are high in fiber."

d. "I'll eat frequent, small, bland meals that are high in fiber."

The nurse is conducting a health instruction program on oral cancer. The nurse determines that the participants understand the instructions when they state a. "Most oral cancers are painful at the outset." b. "Blood testing is used to diagnose oral cancer." c. "A typical lesion is soft and craterlike." d. "Many oral cancers produce no symptoms in the early stages."

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

A nurse is providing oral care to a client who is comatose. What action best addresses the client's risk of tooth decay and plaque accumulation? a. Irrigating the mouth using a syringe filled with a bactericidal mouthwash b. Applying a water-soluble gel to the teeth and gums c. Wiping the teeth and gums clean with a gauze pad d. Brushing the client's teeth with a toothbrush and small amount of toothpaste

d. Brushing the client's teeth with a toothbrush and small amount of toothpaste

Which is an accurate statement regarding cancer of the esophagus? a. It is three times more common in women than men in the United States . b. It is seen more frequently in Caucasian Americans than in African Americans. c. It usually occurs in the fourth decade of life. d. Chronic irritation of the esophagus is a known risk factor.

d. Chronic irritation of the esophagus is a known risk factor.