MLQ Ch. 45
Which of the following are functions of saliva? Select all that apply. A. Protection against harmful bacteria B. Metabolism C. Elimination D. Digestion E. Lubrication
A, D, E
A client has a new order for metoclopramide. The nurse identifies that this medication can be safely administered for which condition? A. Gastroesophageal reflux disease B. Gastritis C. Diverticulitis with perforation D. Peptic ulcer with melena
A
A client has a new order for metoclopramide. What extrapyramidal side effect should the nurse assess for in the client? A. Hyperactivity B. Uncontrolled rhythmic movements of the face or limbs C. Dry mouth not relieved by sugar-free hard candy D. Anxiety or irritability
B
A client has a radical neck dissection to treat cancer of the neck. The nurse develops the care plan and includes all the following diagnoses. The nurse identifies the highest priority diagnosis as A. Imbalanced nutrition: less than body requirements, related to treatment B. Ineffective airway clearance related to obstruction by mucus C. Impaired tissue integrity related to surgical intervention D. Risk for infection related to surgical intervention
B
A client is recovering from a neck dissection. What volume of serosanguineous secretions would the nurse expect to drain over the first 24 hours? A. 50 to 75 mL B. 80 to 120 mL C. 20 to 40 mL D. 160 to 200 mL
B
Which is the primary symptom of achalasia? A. Chest pain B. Difficulty swallowing C. Heartburn D. Pulmonary symptoms
B
A client is being evaluated for esophageal cancer. What initial manifestation of esophageal cancer should the nurse assess? A. Sensation of a mass in throat B. Hiccups C. Increasing difficulty in swallowing D. Foul breath
C
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
The most common symptom of esophageal disease is A. odynophagia. B. vomiting. C. dysphagia. D. nausea.
C
The nurse is planning care for a client with painful oral lesions. Which food should be included in the client's diet? A. Chili B. Pretzels C. Jell-O D. Hot tea
C
Which of the following is a proton pump inhibitor used in the treatment of gastroesophageal reflux disease (GERD)? Select all that apply. A. Famotidine (Pepcid) B. Esomeprazole (Nexium) C. Rabeprazole (AcipHex) D. Nizatidine (Axid) E. Lansoprazole (Prevacid)
B, C, E
The nurse recognizes that the client diagnosed with a duodenal ulcer will likely experience A. hemorrhage. B. weight loss. C. pain 2 to 3 hours after a meal. D. vomiting.
C
Which of the following medications, used in the treatment of GERD, accelerate gastric emptying? A. Esomeprazole (Nexium) B. Famotidine (Pepcid) C. Metoclopramide (Reglan) D. Nizatidine (Axid)
C
While caring for a patient who has had radical neck surgery, the nurse notices an abnormal amount of serosanguineous secretions in the wound suction unit during the first postoperative day. What does the nurse know is an expected amount of drainage in the wound unit? A. Greater than 160 mL B. Between 120 and 160 mL C. Approximately 80 to 120 mL D. Between 40 and 80 mL
C
Which term describes a reddened, circumscribed lesion that ulcerates and becomes crusted and is a primary lesion of syphilis? A. Lichen planus B. Chancre C. Actinic cheilitis D. Leukoplakia
B
A client with an esophageal stricture is about to undergo esophageal dilatation. As the bougies are passed down the esophagus, the nurse should instruct the client to do which action to minimize the vomiting urge? A. Take long, slow breaths B. Pant like a dog C. Bear down as if having a bowel movement D. Hold his breath
A
A patient has been diagnosed with acute gastritis and asks the nurse what could have caused it. What is the best response by the nurse? (Select all that apply.) A. "It can be caused by ingestion of strong acids." B. "You may have ingested some irritating foods." C. "It is probably your nerves." D. "It is a hereditary disease." E. "Is it possible that you are overusing aspirin."
A, B, E
An elderly client states, "I don't understand why I have so many caries in my teeth." What assessment made by the nurse places the client at risk for dental caries? A. Drinking fluoridated water B. Exhibiting hemoglobin A1C 8.2 C. Using a soft-bristled toothbrush D. Eating fruits and cheese in diet
B
The nurse teaches the client with gastroesophageal reflux disease (GERD) which measure to manage the disease? A. Eat a low-carbohydrate diet B. Avoid eating or drinking 2 hours before bedtime C. Wear tight-fitting clothing D. Elevate the foot of the bed on 6- to 8-inch blocks
B
Which term is used to describe stone formation in a salivary gland, usually the submandibular gland? A. Stomatitis B. Sialolithiasis C. Sialadenitis D. Parotitis
B
A nurse practitioner, who is treating a patient with GERD, knows that this type of drug helps treat the symptoms of the disease. The drug classification is: A. H2-receptor antagonists. B. Antispasmodics C. Antacids D. Proton pump inhibitors.
D
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): A. Extension of the esophagus through an opening in the diaphragm. B. Twisting of the duodenum through an opening in the diaphragm. C. Involution of the esophagus, which causes a severe stricture. D. Protrusion of the upper stomach into the lower portion of the thorax.
D
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. Syphilis B. HIV C. Herpes simplex D. Gonorrhea
A
A client with cancer has a neck dissection and laryngectomy. An intervention that the nurse will do is: A. Make a notation on the call light system that the client cannot speak. B. . Encourage the client to position himself on his side. C. Provide oxygen without humidity through the tracheostomy tube. D. Teach the client exercises for the neck and shoulder area to perform 1 day after surgery.
A
A client with dysphagia is being prepared for discharge. Which outcome indicates that the client is ready for discharge? A. The client is free from esophagitis and achalasia. B. The client reports diminished duodenal inflammation. C. The client has normal gastric structures. D. The client doesn't exhibit rectal tenesmus.
A
A nurse enters the room of a client who has returned to the unit after having a radical neck dissection. Which assessment finding requires immediate intervention? A. The client lying in a lateral position, with the head of bed flat B. Serosanguineous drainage on the dressing C. Foley catheter bag containing 500 ml of amber urine D. A piggyback infusion of levofloxacin
A
A nurse is completing an assessment on a client with a postoperative neck dissection. The nurse notices excessive bleeding from the dressing site and suspects possible carotid artery rupture. What action should the nurse take first? A. Apply pressure to the bleeding site B. Summon assistance C. Elevate the head of the patient's bed D. Notify the surgeon to repair the vessel
A
Which of the following is the most common type of diverticulum? A. Zenker's diverticulum B. Epiphrenic C. Intramural D. Mid-esophageal
A
While caring for a patient who has had radical neck surgery, the nurse notices an abnormal amount of serosanguineous secretions in the wound suction unit during the first postoperative day. What does the nurse know is an expected amount of drainage in the wound unit? A. Between 40 and 80 mL B. Approximately 80 to 120 mL C. Greater than 160 mL D. Between 120 and 160 mL
B
Which of the following assessment findings would be most important for indicating dumping syndrome in a postgastrectomy client? A. Weakness, diaphoresis, diarrhea 90 minutes after eating B. Constipation, rectal bleeding following bowel movements C. Persistent loose stools, chills, hiccups after eating D. Abdominal distention, elevated temperature, weakness before eating
A
Which of the following is the most successful treatment for gastric cancer? A. Removal of the tumor B. Palliation C. Chemotherapy D. Radiation
A
A client has been receiving radiation therapy to the lungs and now has erythema, edema, and pain of the mouth. What instruction will the nurse give to the client? A. Continue with the usual diet. B. Rinse with an alcohol-based solution. C. Use a hard-bristled toothbrush. D. Brush and floss daily.
D
A client with achalasia recently underwent pneumatic dilation. The nurse intervenes after the procedure by A. Administering the prescribed analgesic B. Preparing for a barium swallow C. Providing fluids to drink D. Assessing lung sounds
D
Cancer of the esophagus is most often diagnosed by which of the following? A. Esophagogastroduodenoscopy (EGD) with biopsy and brushings B. Fluoroscopy C. Barium swallow D. X-ray
A
The nurse determines that teaching for the client with peptic ulcer disease has been effective when the client makes which statement? A. "I have learned some relaxation strategies that decrease my stress." B. "I should continue my treatment regimen as long as I have pain." C. "I should stop all my medications if I develop any side effects." D. "I can buy whatever antacids are on sale because they all have the same effect."
A
A client has been taking a 10-day course of antibiotics for pneumonia. The client has been having white patches that look like milk curds in the mouth. What treatment will the nurse educate the client about? A. Fluocinolone acetonide oral base gel B. Nystatin C. Cephalexin D. Acyclovir
B
A client has received a diagnosis of oral cancer. During client education, the client expresses dismay at not having recognized any early signs or symptoms of the disease. The nurse tells the client that in early stages of this disease: A. symptoms include oral bleeding. B. there are usually no symptoms. C. symptoms include oral numbness. D. symptoms include mouth pain.
B
During assessment of a patient with gastritis, the nurse practitioner attempts to distinguish acute from chronic pathology. One criteria, characteristic of gastritis would be the: A. Presence of vomiting. B. Frequency of abdominal discomfort. C. Incidence of anorexia. D. Immediacy of the occurrence.
D
The nurse is creating a plan of care for a client who is not able to tolerate brushing his teeth. The nurse includes which mouth irrigation in the plan of care? A. Full-strength peroxide B. Mouthwash and water C. Dextrose and water D. Baking soda and water
D
To prevent gastroesophageal reflux in a client with hiatal hernia, the nurse should provide which discharge instruction? A. "Lie down after meals to promote digestion." B. "Avoid coffee and alcoholic beverages." C. "Take antacids with meals." D. "Limit fluid intake with meals."
B
Which is an accurate statement regarding cancer of the esophagus? A. It usually occurs in the fourth decade of life. B. It is three times more common in women than men in the United States . C. It is seen more frequently in Caucasian Americans than in African Americans. D. Chronic irritation of the esophagus is a known risk factor.
D