Clyt 31

Which questions does the nurse ask to assess a patient who complains of difficulty eating and talking and has a burning sensation on the tongue with an accompanying loss of taste? Select all that apply. "Do you smoke?" "Do you have depression?" "Do you use any corticosteroids?" "Do you have diabetes mellitus?" "Are you under extreme physical stress?" Rationale Xerostomia is a condition in which the flow of saliva is either partially or completely blocked. It is associated with a loss of taste and difficulty in chewing, talking, and swallowing food. This condition may also cause a burning sensation on the tongue. Smoking, depression, and diabetes mellitus are associated with xerostomia. A common predisposing factor for candidiasis is the use of corticosteroids. Extreme physical stress and fatigue may cause cold sores.

"Do you smoke?" "Do you have depression?" "Do you have diabetes mellitus?"

Which question asked by the nursing student indicates the need for further education on how to obtain information about a patient's dental history? "Do you have any difficulty in speaking?" "How many times a day do you brush your teeth?" "Which toothpaste and mouthwash do you use?" "Have you been to a dentist in the past 6 months?" Rationale The nurse should obtain the patient's dental history for the past 1 to 3 years, not the past 6 months. The nurse should ask the patient if he or she experiences difficulty speaking, chewing, and swallowing. The nurse should ask the patient about daily hygiene practices such as how many times the patient brushes his or her teeth. The nurse should ask the patient about any oral products, such as mouthwash and toothpaste, which the patient uses.

"Have you been to a dentist in the past 6 months?"

Which statement of the patient needs to be corrected concerning the self- management of canker sores? "I will eat pineapple and citrus fruits." "I will use saline rinses in 4 to 8 ounces of warm tap water." " will apply amlexanox (Aphthasol) four times a day after meals." "I will apply oxygen-releasing agents for cleansing, at appropriate intervals." Rationale Pineapples and citrus fruits can irritate the sores. The patient may experience a soothing effect by using saline rinses in 4 to 8 ounces of warm tap water. An application of amlexanox (Aphthasol) after meals and oral hygiene will help treat the sores; this action should be done four times daily. The patient should apply oxygen-releasing agents for cleansing at appropriate intervals.

"I will eat pineapple and citrus fruits."

Which statement of the patient needs to be corrected concerning the self-management of canker sores? "I will eat pineapple and citrus fruits." "I will use saline rinses in 4 to 8 ounces of warm tap water." "I will apply amlexanox (Aphthasol) four times a day after meals." "I will apply oxygen-releasing agents for cleansing, at appropriate intervals." Rationale Pineapples and citrus fruits can irritate the sores. The patient may experience a soothing effect by using saline rinses in 4 to 8 ounces of warm tap water. An application of amlexanox (Aphthasol) after meals and oral hygiene will help treat the sores; this action should be done four times daily. The patient should apply oxygen-releasing agents for cleansing at appropriate intervals.

"I will eat pineapple and citrus fruits."

Which statement made by the patient indicates a need for further education about canker sores and healing? Select all that apply. "I will place aspirin on the lesions." "I will take acetaminophen." "| will use benzocaine 10% after eating." " will use topical amlexanox after meals and four times a day." "I will use hydrogen peroxide (Colgate Peroxyl) four times a day for 7 days." Rationale Aspirin should not be placed on the canker sores because this action increases the risk of severe chemical burns with necrosis. Benzocaine 10% helps relieve pain from cold sores. Acetaminophen should be administered to relieve pain. Apply amlexanox after meals and oral hygiene, four times daily. Hydrogen peroxide is a cleansing agent and should be used four times a day for 7 days.

"I will place aspirin on the lesions." "| will use benzocaine 10% after eating."

Which statements made by the patient need to be corrected concerning interventions to treat oral pain caused by mucositis? Select all that apply. "I will take morphine for moderate pain." "I will apply sucralfate suspensions topically." "I will rinse my mouth with magnesium hydroxide (Milk of Magnesia). "I will swish and swallow nystatin liquid suspension." "I will use lidocaine viscous 2% (Xylocaine Viscous 2%) after meals." Rationale Morphine should only be administered for severe oral pain. Lidocaine viscous 2% (Xylocaine Viscous 2%) should be used before (not after) meals to relieve oral pain, but the patient should be educated that the gag reflex will be suppressed. Sucralfate suspensions should be applied topically for effective pain relief. Patients with mucositis should rinse their mouths and coat the mucous membranes with magnesium hydroxide (Milk of Magnesia) for oral pain relief. Nystatin liquid suspension should be first swished and then swallowed to reduce the risk of candidal oral infections.

"I will take morphine for moderate pain." "I will use lidocaine viscous 2% (Xylocaine Viscous 2%) after meals."

Which statement made by the patient who is experiencing neutropenia indicates the need for further education about denture care? "I will brush the dentures regularly." "I will wear the dentures all the time." "I will get the dentures repaired if they are poorly fitted." "I will clean the dentures each time I perform oral hygiene." Rationale Neutropenic patients should wear dentures only while eating because wearing them all the time may cause irritation and may lead to further complications. The patient should brush the dentures regularly to prevent plaque formation. The dentures should be repaired immediately if they are poorly fitted to help prevent further tissue breakdown. The dentures should be cleaned each time oral hygiene is performed.

"I will wear the dentures all the time."

Which advice, if followed by the patient, may cause healthy tissue damage in the area surrounding a gray lesion on the tongue? "Use silver nitrate to cauterize the lesions." "Avoid the sustained use of camphor and eugenol." "Use a rinse of saline dissolved in 4 to 8 ounces of warm tap water." "Use oxygen-releasing agents for no more than 7 days." Rationale Canker sores may appear as ulcers on the tongue; the lesions are usually gray to whitish-yellow. The use of silver nitrate to cauterize these lesions should be avoided because this chemical may damage healthy tissues surrounding the lesion and predispose the area to a later infection. Sustained use of products that contain menthol, camphor, phenol, and eugenol should be discouraged because they can cause tissue irritation and damage or systemic toxicity if overused. The use of saline rinses may provide a soothing effect. This solution will not cause tissue damage. Oxygen-releasing agents can be used as debriding and cleansing agents up to four times daily for 7 days.

"Use silver nitrate to cauterize the lesions."

Which information provided by the healthcare provider would be beneficial to a patient with severe oral lesions? "You should avoid cold drinks." "You should avoid bland foods." "You should add supplemental nutrition (Boost) to your diet." "You should add citrus juices to your diet." Rationale Patients with severe oral lesions are advised to add supplemental nutrition formulas such as Ensure and Boost to their diets so that they can receive enough nutrition despite difficulty in eating. Patients should drink cold beverages to soothe the oral tissues. Patients should eat bland foods such as dairy products. Patient should avoid citrus juices because they may cause irritation.

"You should add supplemental nutrition (Boost) to your diet."

Which nursing instruction would prevent tissue irritation and black hairy tongue in a patient with canker sores? "You should not use silver nitrate to cauterize the lesions." "You should avoid the long-term use of oxygen-releasing agents." "You should use saline rinses in 4 to 8 ounces of warm tap water." "You should apply benzocaine (Kank-A) before performing oral hygiene." Rationale Patients with canker sores can use oxygen-releasing agents as debriding and cleansing agents up to four times a day for 7 days. Long-term use may cause tissue irritation and black hairy tongue. Silver nitrate should not be used to cauterize canker sores because it may damage healthy tissue surrounding the lesions and promote secondary infection. Saline rinses can provide a soothing effect; their use does not prevent tissue irritation and black hairy tongue. Benzocaine (Kank-A) is particularly effective if applied just before eating or performing oral hygiene.

"You should avoid the long-term use of oxygen-releasing agents."

Which statement made by a patient indicates a need for further instruction about the use of benzocaine on a canker sore? "I will apply benzocaine before eating." "I will use saline rinses before applying benzocaine." 'It is okay to also apply aspirin on the sore to relieve pain." "Benzocaine is more effective if applied before brush my teeth." Rationale Aspirin should not be placed on canker sores because of the high risk of severe chemical burns with necrosis. If a patient makes this statement, further teaching us needed. Benzocaine is more effective when applied before eating or performing oral hygiene. Saline rinses may be soothing and can be used before topical application of benzocaine.

'It is okay to also apply aspirin on the sore to relieve pain."

What is halitosis? A foul mouth odor The small, red papules that develop into fluid-filled vesicles Painful inflammation of the mucous membranes of the mouth The whitish-yellow substance that builds up on teeth and gum lines around the teeth Rationale Halitosis can be described as a very foul mouth odor. Small, red papules that develop into fluid-filled vesicles may appear in cases of cold sores. Mucositis is described as the painful inflammation of the mucous membrane of the mouth. Plaque is the whitish-yellow substance that builds up on the teeth and the gum lines around the teeth.

A foul mouth odor

Which is the proper method for administration of amlexanox (Aphthasol)? Select all that apply. After meals Four times a day Before oral hygiene On the canker sores Surrounding the canker sore Rationale The patient should apply amlexanox (Aphthasol) after meals. The patient should apply amlexanox (Aphthasol) four times a day directly on the canker sores, not on the surrounding area, for effective results. The patient should apply amlexanox (Aphthasol) after oral hygiene for effective results.

After meals Four times a day On the canker sores

Which products should a patient with a mucous membrane irritation avoid? Select all that apply. Alcohol Tobacco Dairy products Hot and spicy foods Gravies or sauces to moisten food Rationale The most important advice for a patient with irritation in the mucous membranes is to avoid alcohol, tobacco, and hot and spicy foods because these products will increase irritation. A patient with any oral problem such as irritation in the mucous membranes should consume bland foods such as dairy products, fruit juices, and vegetable juices. Patients who have irritation of the mucous membranes should also avoid using gravies and sauces.

Alcohol Tobacco Hot and spicy foods Gravies or sauces to moisten food

Which type of medication should the nurse question if prescribed for a patient with xerostomia? Anticholinergic Antitussive Antibiotic Anticoagulant Rationale Anticholinergic medications may cause xerostomia because their adverse effects include dryness. Antitussive, antibiotic, and anticoagulant medications may be given to a patient who has xerostomia.

Anticholinergic

Which type of medication should the nurse question if prescribed for a patient with xerostomia? Anticholinergic Antitussive Antibiotic Anticoagulant Rationale Anticholinergic medications may cause xerostomia because their adverse effects include dryness. Antitussive, antibiotic, and anticoagulant medications may be given to a patient who has xerostomia.

Anticholinergic

Which is a possible cause of a secondary bacterial infection for a patient with cold sores? Administration of aspirin Administration of naproxen (Aleve) Application of neomycin/polymyxin B/bacitracin (Neosporin) Application of zinc sulfate (Pedtrace-4) Rationale Cold sores should be kept moist to prevent drying and cracking because cracking increases the risk of secondary bacterial infection. Healthcare providers should not use zinc sulfate (Pedtrace-4) because this medication can cause drying and cracking of the cold sores. Aspirin and naproxen (Aleve) provide pain relief for patients with cold sores. Neomycin/polymyxin B/bacitracin (Neosporin) is effective in treating secondary infections in a patient with cold sores.

Application of zinc sulfate (Pedtrace-4)

Which advice from the healthcare provider would be most effective for healing the patient's cold sores? Apply docosanol (Abreva). Administer ibuprofen (Advil). Apply zilactin B (Benzocaine 10%). Administer acetaminophen (Tylenol). Rationale In patients with cold sores, docosanol (Abreva) shortens healing time and duration of symptoms such as tingling, pain, burning, and itching. This medication should be provided daily for effective results. Ibuprofen (Advil) is an oral analgesic that provides temporary pain relief, but will not heal the cold sores. Zilactin B (Benzocaine 10%) is a protectant, which provides temporary relief from the pain and itching and prevents drying of the lesions; this medication is not effective in healing cold sores. Acetaminophen (Tylenol) is also an oral analgesic, which provides pain relief but will not heal cold sores.

Apply docosanol (Abreva).

Which instruction should be given to a patient for the use of viscous lidocaine 2%? Mix the medication with juice. Administer the medication twice daily. Use a mouthwash before administering the medication. Avoid eating for 30 minutes after taking the medication. Rationale The patient should avoid eating or drinking for at least 30 minutes after the use of viscous lidocaine because of the absence of the gag reflex and potential risk for aspiration. Viscous lidocaine is not mixed with juice and is administered frequently. Mouthwashes are not used before administering viscous lidocaine 2%.

Avoid eating for 30 minutes after taking the medication.

Which instruction does the nurse include when teaching a patient how to use chlorhexidine for treatment of mucositis? Swallow chlorhexidine after its use. Smoking should be avoided for at least 10 minutes after administering. Avoid eating for at least 30 minutes after use to prevent systemic toxicity. Chlorhexidine can be used to replace normal oral hygiene after treatment of mucositis. Rationale Patients should avoid drinking and eating for at least 30 minutes after using chlorhexidine. Chlorhexidine should not be swallowed, as prolonged swallowing of mouthwashes may lead to systemic toxicities. Smoking should be avoided for at least 30 minutes after taking chlorhexidine. After oral mucositis has been treated, chlorhexidine should not be used to replace normal oral hygiene.

Avoid eating for at least 30 minutes after use to prevent systemic toxicity.

Which color of mouthwash is effective for medicinal use? Red Green White Brown Rationale Brown mouthwash is effective for medicinal use. Red mouthwash indicates a spicy flavor, green mouthwash indicates a minty flavor, and white mouthwash is effective for whitening.

Brown

Which mouth disorder is known as "the disease of the diseased"? Mucositis Cold sores Candidiasis Canker sores Rationale Candidiasis is a fungal infection caused by Candida albicans. It is known as "the disease of the diseased" because it appears in debilitated patients taking a variety of medicines. Mucositis is a painful inflammation of the mucous membranes of the mouth. Cold sores are caused by the herpes simplex type 1 virus (herpes simplex labialis). Canker sores may occur as a result of stress and local trauma.

Candidiasis

Which treatments may trigger cold sores? Select all that apply. Chemotherapy Anticholinergics Local anesthetics Radiation therapy Topical analgesics Rationale Cold sores are caused by the herpes simplex type 1 virus. This disorder most commonly occurs at the junction of the mucous membrane and the skin of the lips or nostrils. Chemotherapy and radiation therapy depress the immune system and triggers cold sores. Xerostomia may be triggered by anticholinergic agents. Local anesthetics can temporarily relieve the pain and itching associated with cold sores. Topical analgesics may temporarily reduce the pain of cold sores.

Chemotherapy Radiation therapy

Which mouthwash would be most effective for a patient who underwent radiation therapy? Antiseptic mouthwash (Listerine) Lidocaine viscous 2% Chlorhexidine (Peridex) A 0.9% solution of sodium chloride Rationale A patient who underwent radiation therapy is more susceptible to mucositis. Therefore the patient should use chlorhexidine (Peridex). Listerine is effective for reducing plaque. Lidocaine viscous 2% is given to patients with sore throats or mouth ulcers. A 0.9% solution of sodium chloride provides temporary, soothing relief of pharyngeal irritation in the nasogastric and endotracheal tubes. This solution also helps patients with a sore throat or patients who have undergone oral surgery.

Chlorhexidine (Peridex)

Which instruction does the nurse include in a patient's teaching plan for the use of clotrimazole lozenges? Take the medication on an empty stomach. Do not eat or drink for at least 30 minutes after taking. Rinse the mouth thoroughly with water after taking the medication. Cleanse the mouth with the prescribed solution before taking the medication. Rationale Before administering topical agents for oral fungal infections, the mouth should be cleansed to improve the contact of the medication with the denuded surface. After taking the medication, the patient should not have food or drink for at least 15 minutes. There is no need to take the medication on an empty stomach because its action is local in the mouth.

Cleanse the mouth with the prescribed solution before taking the medication.

Which medicine predisposes a patient to candidiasis by depressing defense mechanisms? Cytotoxics Anticholinergics Antipsychotics Antihypertensives Rationale Cytotoxics predispose a patient to candidiasis by depressing defense mechanisms. Anticholinergics, antipsychotics, and antihypertensives also predispose a patient to candidiasis but do not depress defense mechanisms. These drugs cause xerostomia.

Cytotoxics

Which predisposing conditions are related to xerostomia? Select all that apply. Rhinitis Depression Tuberculosis Bronchiectasis Diabetes mellitus Rationale Xerostomia is a condition in which the flow of saliva is either partially or completely stopped. It is associated with loss of taste and difficulty in chewing and swallowing food. Diseases related to xerostomia include depression and diabetes mellitus. Rhinitis, tuberculosis, and bronchiectasis are associated with halitosis.

Depression Diabetes mellitus

Which type of medicine may cause xerostomia? Diuretics Cytotoxics Corticosteroids Immunosuppressants Rationale Diuretics may cause xerostomia (dry mouth). Cytotoxics, corticosteroids, and immunosuppressants are not associated with xerostomia, but they may cause candidiasis.

Diuretics

Grab screen area, OCR and copy results to clipboard nurse instruct a patient to use to prevent plaque formation? Saline rinses Magnesium hydroxide (Milk of Magnesia) Amlexanox (Aphthasol) Flossing between teeth Rationale Flossing between teeth helps remove dental plaque. Saline rinses are indicated for treatment of canker sores. Magnesium hydroxide (Milk of Magnesia) is indicated for treatment of mucositis. Amlexanox is indicated for the treatment of canker sores.

Flossing between teeth

Which products are effective at reducing mouth dryness? Select all that apply. Water-based lubricant (K-Y Jelly) Ice chips Cocoa butter Chewing gum Petroleum jelly

Ice chips Chewing gum

What are the therapeutic outcomes of mouthwashes? Select all that apply. Improvement in halitosis Reduction in plaque formation Reduction in cavities Temporary reduction in bleeding Temporary reduction in irritation Rationale Therapeutic outcomes of mouthwashes include improvement in halitosis and a temporary reduction in bleeding and irritation. Reduction in plaque formation and cavities can be observed with the use of dentifrices.

Improvement in halitosis Temporary reduction in bleeding Temporary reduction in irritation

Which action by a patient is most beneficial for a patient who has mucositis and now has a fungal infection? Irrigating the mouth every hour Irrigating the mouth every 2 hours Irrigating the mouth immediately before and after meals and at bedtime Irrigating the mouth immediately before administering topical agents Rationale If a patient with mucositis is diagnosed with fungal infection, the patient should irrigate his or her mouth immediately before the administration of topical agents such as nystatin liquids. This action will improve the contact of the medicine with the denuded surface of the oral mucosa. If the symptoms are mild and a fungal infection is not present, then the patient should irrigate his or her mouth immediately before and after meals and at bedtime. If the symptoms are moderate and a fungal infection is not present, then the patient should irrigate his or her mouth every 2 hours. If severe symptoms are present without any fungal infection, then the patient should irrigate his or her mouth every hour.

Irrigating the mouth immediately before administering topical agents

Which mouthwash might a patient be used to prevent aspiration while having a painful Candida infection and sore throat? Antiseptic mouthwash (Listerine) Lidocaine viscous 2% Chlorhexidine (Peridex) A 0.9% solution of sodium chloride Rationale Lidocaine viscous 2% is used to treat painful candidal infections. A patient should not eat or drink anything for 30 minutes after administering this mouthwash because of the absence of the gag reflex and potential risk for aspiration. Listerine is effective at reducing plaque. Chlorhexidine (Peridex) is used to treat mucositis. A 0.9% solution of sodium chloride temporarily relieves pharyngeal irritation from nasogastric tubes, endotracheal tubes, sore throat, or oral surgery.

Lidocaine viscous 2%

Which medication does the nurse anticipate will be ordered for a patient with xerostomia? MouthKote Silver nitrate Nystatin (Mycostatin) Palifermin (Kepivance) Rationale MouthKote is artificial saliva used to treat xerostomia. Nystatin is an antifungal agent used to treat Candida albicans infections. Palifermin is a human keratinocyte growth factor, and it has been approved specifically for use in preventing and treating mucositis that develops in leukemia or lymphoma patients undergoing chemotherapy before bone marrow transplantation. Silver nitrate is an antiseptic and astringent and is not indicated for treatment of xerostomia.

MouthKote

Chemotherapy makes patients more susceptible to which oral condition? Plaque Mucositis Cold sores Canker sores Rationale After chemotherapy, the patient is at increased risk for developing mucositis. Mucositis develops 5 to 7 days after chemotherapy. Plaque develops as a result of bad oral hygiene. Cold sores are caused by the herpes simplex type 1 virus (herpes simplex labialis). The cause of canker sores is unknown, but they are unrelated to chemotherapy.

Mucositis

Which condition does the healthcare provider want to prevent in a patient who undergoes radiation therapy? Mucositis Cold sores Xerostomia Canker sores Rationale After radiation therapy, the patient becomes more susceptible to mucositis. Therefore the healthcare provider would advise the patient to start performing better oral hygiene just after radiation therapy. Radiation therapy is not associated with the development of cold sores, xerostomia, and canker sores.

Mucositis

Which intervention would be the most effective for the treatment of secondary infections in a patient with cold sores? Aspirin Naproxen Neosporin Zilactin B Rationale a Neosporin is effective in treating secondary infections that develop in patient with cold sores. Aspirin and naproxen (Aleve) are oral analgesics that provide relief from the pain caused by cold sores; they are not effective for the treatment of secondary infections. Zilactin B temporarily relieves pain and itching and prevents drying of the lesion. However, it is ineffective in treating secondary infections.

Neosporin

Which drug does the nurse anticipate the healthcare provider will prescribe for a patient who has small, red papules at the junction of the mucous membrane and the skin of the lips and a secondary bacterial infection? Naproxen (Naprosyn) Neosporin (Medi-Quik) Benzocaine (Zilactin B) Hydrogen peroxide (Colgate Peroxyl) Rationale Cold sores are lesions that are visible as small, red papules and develop into fluid-filled vesicles. The drying and cracking of cold sores may increase the patient's susceptibility to secondary bacterial infections. They can be treated with a topical antibiotic ointment such as Neosporin (Medi-Quik). Naproxen (Naprosyn) is an oral analgesic that significantly relieves pain. Local anesthetics such as benzocaine may temporarily relieve the pain and itching and prevent the lesion from drying. Hydrogen peroxide (Colgate Peroxyl) can be used as a debriding and cleansing agent for canker sores.

Neosporin (Medi-Quik)

Which grade would represent the clinical feature "oral soreness with erythema" according to the World Health Organization Oral Mucositis Scale? 0 1 3 4 Rationale The clinical feature "oral soreness with erythema" is considered grade 1 on the World Health Organization Oral Mucositis Scale. Grade 0 indicates that mucositis is absent. Grade 3 signifies the presence of oral ulcers; however, the patient can still tolerate a liquid diet. Grade 4 indicates that oral feeding is not possible.

O 4

Which devices would be effective in reducing a patient's pain and discomfort from advanced lesions with mucositis? Select all that apply. Oral syringe Soft-bristled brush Water flosser (Waterpik) on low setting Sponge-tipped applicator Gravity flow irrigating system Rationale An oral syringe and a gravity flow irrigating system can reduce pain and discomfort in a patient with mucositis who has advanced lesions. A soft-bristled brush, a water flosser (Waterpik) on low setting and a sponge-tipped applicator are used for oral hygiene maintenance.

Oral syringe Gravity flow irrigating system

Which devices would be effective in reducing a patient's pain and discomfort from advanced lesions with mucositis? Select all that apply. Oral syringe Soft-bristled brush Water flosser (Waterpik) on low setting Sponge-tipped applicator Gravity flow irrigating system Rationale An oral syringe and a gravity flow irrigating system can reduce pain and discomfort in a patient with mucositis who has advanced lesions. A soft-bristled brush, a water flosser (Waterpik) on low setting, and a sponge-tipped applicator are used for oral hygiene maintenance

Oral syringe Gravity flow irrigating system

What does grade M on the World Health Organization Oral Mucositis Scale indicate? Oral feeding not possible Oral soreness with erythema Oral ulcers, liquid diet tolerated Oral erythema and ulcers, solid diet tolerated Rationale Grade 3 on the World Health Organization Oral Mucositis Scale indicates that the patient has oral ulcers and can tolerate a liquid diet. Grade 1 indicates oral soreness with the erythema. Grade 2 indicates that the patient has oral erythema and ulcers, and the patient can tolerate a solid diet. Grade 4 indicates that oral feeding is not possible.

Oral ulcers, liquid diet tolerated

The nurse instructs a patient diagnosed with canker sores to avoid drinking which beverage? Apple juice Grape juice Mango juice Orange juice Rationale Citrus juices such as grapefruit and orange juice should be avoided because they can cause irritation to canker sores. Apple juice, grape juice, and mango juice do not cause increased irritation to canker sores.

Orange juice

Which medication does the nurse anticipate the healthcare provider will order for a patient undergoing chemotherapy before a bone marrow transplant that has developed mucositis? Silver nitrate Palifermin Hydrogen peroxide Carbamide peroxide Rationale Palifermin is a human keratinocyte growth factor and has been approved specifically for use in preventing and treating mucositis that develops in leukemia or lymphoma patients who undergoing chemotherapy before bone marrow transplantation. Carbamide peroxide and hydrogen peroxide are oxygen-releasing agents and are indicated for treatment of canker sores. Silver nitrate is not indicated for the treatment of mucositis.

Palifermin

Which intervention prescribed by the healthcare provider would help prevent mucositis in a patient scheduled for bone marrow transplantation and undergoing chemotherapy? Naproxen (Aleve) Neomycin (Neosporin) Palifermin (Kepivance) Zilactin B (Benzocaine 10%) Rationale Palifermin (Kepivance) is a recombinant human keratinocyte growth factor that can prevent mucositis in a client with hematologic malignancies who is undergoing chemotherapy before bone marrow transplantation. Naproxen (Aleve), neomycin (Neosporin), and Zilactin B (benzocaine 10%) are effective for the treatment of cold sores.

Palifermin (Kepivance)

Which medicinal agents are excreted through the lungs and leave a characteristic foul mouth odor? Select all that apply. Menthol Allantoin Camphor Paraldehyde Dimethyl sulfoxide (DMSO) Rationale Paraldehyde and DMSO are medicinal agents that are excreted primarily through the lungs. These agents leave a characteristic foul odor in the mouth. Topical analgesics such as allantoin, menthol, camphor, and phenol are safe and effective for temporarily reducing pain in cold sores.

Paraldehyde Dimethyl sulfoxide (DMSO)

Which medicinal agents are excreted through the lungs and leave a characteristic foul mouth odor? Select all that apply. Menthol Allantoin Camphor Paraldehyde Dimethyl sulfoxide (DMSO) Rationale Paraldehyde and DMSO are medicinal agents that are excreted primarily through the lungs. These agents leave a characteristic foul odor in the mouth. Topical analgesics such as allantoin, menthol, camphor, and phenol are safe and effective for temporarily reducing pain in cold sores.

Paraldehyde Dimethyl sulfoxide (DMSO)

Which chemicals are effective for tooth whitening? Select all that apply. Zinc citrate Zinc chloride Perhydrol urea Potassium nitrate Carbamide peroxide Rationale Perhydrol urea and carbamide peroxide are oxidizing ingredients that are effective tooth whiteners. Zinc citrate and zinc chloride prevent or retard the formation of new calculi from plaque. Potassium nitrate is effective at reducing oral sensitivity.

Perhydrol urea Carbamide peroxide

Which ingredient(s) in toothpaste can help relieve oral sensitivity to hot and cold liquids? Potassium nitrate Zinc chloride, zinc citrate, and soluble pyrophosphate Sanguinarine, zinc citrate, triclosan, thymol, and eucalyptol Hydrogen peroxide, carbamide peroxide, and perhidrol urea. Rationale Potassium nitrate is effective for reducing oral sensitivity. Chemicals such as sanguinarine, zinc citrate, triclosan, thymol, and eucalyptol have antibacterial properties that may reduce plaque. Zinc chloride, zinc citrate, and soluble pyrophosphates prevent or retard the formation of new calculus from plaque but will not remove calculus already formed. Oxidizing ingredients such as hydrogen peroxide, carbamide peroxide, and perhidrol urea are used for tooth whitening.

Potassium nitrate

Which educational topic should the licensed practical nurse (LPN) have addressed with the patient who has cold sores to prevent infection? Prevent the sore from drying out. Use silver nitrate excessively. Apply amlexanox paste 5% (Aphthasol) on the sores. Use phenol for a sustained period of time. Rationale The drying and cracking of cold sores may cause secondary bacterial infections. Silver nitrate should not be used to cauterize canker sores because it may damage healthy tissue surrounding the lesion and predispose the area to later infection. Topical amlexanox paste 5% is an agent that hastens healing. Phenol is a local anesthetic, antiseptic, and antibacterial agent that penetrates and reduces plaque formation.

Prevent the sore from drying out.

What is the specific purpose of fluoride-containing mouthwashes? Reducing gingivitis Treating oral mucositis Preventing dental caries Reducing plaque accumulation Rationale Fluoride-containing mouthwashes prevent dental caries. The use of antiseptic mouthwash (Listerine) would reduce gingivitis. Chlorhexidine (Peridex) is an antibacterial agent that may treat oral mucositis. Medicinal mouthwashes such as Listerine help prevent plaque accumulation.

Preventing dental caries

Grab screen area, OCR and copy results to clipboard mes are expected when a patient uses a dentifrice for an oral problem? Select all that apply. Refreshing taste Relief from irritation Reduction in cavities Reduction in plaque formation Temporary reduction in bleeding from the gums Rationale Dentifrices provide a refreshing taste. Dentifrices also help reduce cavities and plaque formation. Mouthwashes provide relief from oral irritation and temporary relief from bleeding gums.

Refreshing taste Reduction in cavities Reduction in plaque formation

Which precipitating factors are associated with canker sores? Select all that apply. Stress Malignancy Malnutrition Local trauma Diabetes mellitus Rationale Canker sores may appear as ulcers on surfaces of the tongue, gums, and inner lining of the cheeks and lips. The precipitating factors of canker sores are stress and local trauma such as chemical irritation, toothbrush abrasion, and irritation from orthodontic braces. Predisposing factors for candidiasis include malignancies, malnutrition, and diabetes mellitus.

Stress Local trauma

What is the use of surfactants in mouthwashes? Surfactants kill bacteria. Surfactants remove debris. Surfactants neutralize sulfur-smelling compounds. Surfactants penetrate and reduce plaque formation. Rationale Surfactants are foaming agents that help remove debris. Antimicrobial agents such as benzoic acid kill bacteria, which reduces plaque formation and decaying food odors. Zinc citrate and zinc chloride are astringents that neutralize sulfur-smelling compounds. Phenol is a local anesthetic, antiseptic, and antibacterial agent that reduces plaque formation.

Surfactants remove debris.

Which characteristic features are related to the lesions of canker sores? Select all that apply. They do not form blisters. They are usually gray or whitish-yellow. They coalesce into larger lesions. They first appear as small and red papules. They have an erythematous halo of inflamed tissue surrounding the ulcer crater. Rationale Canker sores may appear as ulcers on the tongue, gums, or inner lining of the cheeks and lips. These lesions do not form blisters and usually appear to be gray or whitish yellow. These lesions do not grow together. They have an erythematous halo of inflamed tissue that surrounds the ulcer crater. Cold sores are caused by the herpes simplex type 1 virus. These lesions coalesce into larger lesions. They are visible as small, red papules that develop into fluid-filled vesicles.

They do not form blisters. They are usually gray or whitish-yellow. They have an erythematous halo of inflamed tissue surrounding the ulcer crater.

Which information does the nurse include when teaching a patient about oral care? Dentifrices are products designed to cleanse and whiten false teeth. Toothpastes vary in abrasiveness and should be selected accordingly. When choosing a mouthwash, use one with alcohol for the longest effect. Oral products are safe because they are topically applied and not absorbed systemically. Rationale Toothpaste does vary in abrasiveness, and patients should select one that best meets their needs. Dentifrices are tooth-cleaning substances. They contain one or more abrasive agents, a foaming agent, and flavoring materials. Some contain higher concentrations of abrasives than others and should be selected based on individual needs. They are used on natural and false teeth. Alcohol in mouthwash is drying to the mucous membranes. Oral products are applied topically, but depending on chemical composition and frequency of use, they may be absorbed and exert a systemic reaction.

Toothpastes vary in abrasiveness and should be selected accordingly.

Which intervention prescribed by the healthcare provider would be most effective in healing canker sores? Carbamide peroxide (Gly-Oxide) Hydrogen peroxide (Colgate Peroxyl) Zinc oxide Topical amlexanox paste 5% (Aphthasol) Rationale Topical amlexanox paste 5% (Aphthasol) is very effective in healing canker sores. Carbamide peroxide (Gly-Oxide) and hydrogen peroxide (Colgate Peroxyl) are debriding and cleansing agents, which help maintain oral hygiene but are not very effective in healing canker sores. Zinc oxide prevents or retards the formation of new calculi from plaque but will not remove calculus already formed.

Topical amlexanox paste 5% (Aphthasol)

Which intervention recommended by a nursing student indicates a need for a further education about mouthwashes that can relieve symptoms of mucositis? Use commercially prepared mouthwashes containing alcohol. Use 1.5% to 6% solutions of hydrogen peroxide as a mouthwash. Prepare mouthwash with 1 tbsp of salt in 8 oz of water. Prepare mouthwash with ½ tsp of baking soda in 8 oz of water Rationale Commercially prepared mouthwashes containing alcohol are usually not recommended because they may irritate the mouths of patients with mucositis. Using 1.5% to 6% solutions of hydrogen peroxide as mouthwash is also effective in reducing irritation. These patients can also prepare mouthwashes with l tbsp of salt or ½ tsp of baking soda in 8 oz of water. Using 1.5% to 6% solutions of hydrogen peroxide as mouthwash is also effective in reducing irritation.

Use commercially prepared mouthwashes containing alcohol.

Which nursing intervention may cause a patient harm who develops small, red lesions inside the mouth that become blisters and also reports burning, itching, and numbness in that area? Keep the area moist. Use highly astringent products. Gently wash the area using a mild soap solution. Encourage the patient to avoid contaminating other people. Rationale The patient should avoid using highly astringent product because these agents may cause cracking of the sores and increase the patient's susceptibility to secondary bacterial infections. The sores should be kept moist to prevent drying. The patient should use a mild soap solution to gently wash the area. When an active lesion is present, the sores are contagious. Therefore the patient should avoid contaminating others.

Use highly astringent products.

Which treatment regimens would be suitable for a patient who recently underwent chemotherapy and develops erythematous ulcerations intermixed with white, patchy mucous membranes in the mouth? Select all that apply. Use magnesium hydroxide (Milk of Magnesia). Use clotrimazole lozenges. Apply sucralfate suspensions topically. Use saline rinses in 4 to 8 ounces of warm tap water. Use ultraviolet blockers with a sun protection factor of at least 15. Rationale Mucositis is a painful inflammation of the mucous membranes of the mouth that is commonly associated with chemotherapy and radiation therapy. The sores are erythematous ulcerations intermixed with white, patchy mucous membranes. Candidal infections are also detected in mucositis. The patient should use magnesium hydroxide (Milk of Magnesia) to rinse his or her mouth and coat the mucous membranes. Clotrimazole lozenges can reduce candidal oral infection. The topical application of sucralfate suspensions can relieve pain. Saline rinses are recommended for patients with canker sores. Ultraviolet blockers with a sun protection factor (SPF) of 15 are suitable for patients with cold sores caused by sun exposure.

Use magnesium hydroxide (Milk of Magnesia). Use clotrimazole lozenges. Apply sucralfate suspensions topically.

Which action by a patient to treat painful, whitish yellow lesions on the tongue may cause severe chemical burns and necrosis on the same area? Use of artificial saliva products Use of aspirin on the lesions directly Use of viscous lidocaine before meals Use of oxygen-releasing agents for more than 3 days Rationale Canker sores may appear as ulcers on the tongue. The lesions are usually gray to whitish yellow. Aspirin should not be placed on the lesions because it may cause severe chemical burns with necrosis. Xerostomia is treated by using artificial saliva products. However, the use of this medication is not related to burns and necrosis in canker sores. Viscous lidocaine 2% may cause a burn in the mouth if the patient consumes hot food after its use because the entire mouth and throat are anesthetized. Oxygen-releasing agents may cause tissue irritation and black hairy tongue with long-term use.

Use of aspirin on the lesions directly

Which is the possible cause of a secondary infection in a patient with canker sores? Use of silver nitrate to cauterize lesions Sustained use of products containing eugenol Sustained use of products containing menthol Use of topical amlexanox paste 5% (Aphthasol) Rationale The use of silver nitrate to cauterize lesions should be discouraged because it may damage any healthy tissue surrounding the lesions and increase the risk of secondary infections in that area. Sustained use of products containing eugenol and menthol should be discouraged because their overuse may cause tissue irritation or systemic toxicity. The use of topical amlexanox paste 5% (Aphthasol) should be encouraged because it helps heal the canker sores.

Use of silver nitrate to cauterize lesions

The healthcare provider is treating a patient with mucositis and instructs the licensed practical nurse, "Be careful to avoid serving hot foods to the patient." Which treatment approach was most likely followed by the healthcare provider? Using silver nitrate Using magnesium hydroxide (Milk of Magnesia) Using 2% viscous lidocaine Using oxygen-releasing agents Rationale Lidocaine viscous 2% is a long-lasting local anesthetic that is used to treat sore throats or mouth ulcers. However, caution must be taken to ensure the patient is not burned by hot food because the entire mouth and throat are anesthetized. Silver nitrate should not be used to cauterize canker sores because it may damage healthy tissue surrounding the lesions and predispose the area to later infection. Magnesium hydroxide (Milk of Magnesia) is used to rinse the mouth and coat the mucous membranes. Oxygen-releasing agents can be used as debriding agents for canker sores up to four times a day for 7 days.

Using 2% viscous lidocaine

What is the oral cause of halitosis? Rhinitis Sinusitis Tonsillitis Xerostomia Rationale Halitosis is a foul smell from the mouth. Xerostomia is an oral source responsible for halitosis. Rhinitis, sinusitis, and tonsillitis are nonoral sources that cause halitosis.

Xerostomia

Which condition involves the partial or complete blockage of the flow of saliva? Plaque Halitosis Candidiasis Xerostomia Rationale Xerostomia is a condition in which the flow of saliva is either partially or completely inhibited. It causes a loss of taste and difficulty in chewing and swallowing food. The plaque is a whitish-yellow substance that builds up on teeth and gum lines around the teeth. It is the primary cause of most teeth, gum (gingiva), and periodontal disease. Halitosis is a foul mouth odor. Candidiasis is a fungal infection caused by Candida albicans; this disease appears in debilitated patients taking a variety of medicines.

Xerostomia