Chapter 56: Care of Patients with Oral Cavity Problems

Chapter 56: Care of Patients with Oral Cavity Problems

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. The nurse is caring for a client who is being discharged following surgery for oral cancer. Which sign is the client instructed to watch for that indicates possible metastasis of the cancer?

a.	Fragile gums that bleed easily
b.	White patches on the tongue and the back of the throat
c.	Painful ulcerated lesions on the gums or inside of the cheek
d.	Small hard lumps on the side of the neck or under the chin

 

 

ANS:  D

Cervical lymph nodes that become hardened, enlarged, and fixed in position are indications of metastatic disease. An older adult or a client with a dry mouth may develop fragile gums that bleed easily. White patches on the tongue and the back of throat could be leukoplakia—precancerous lesions that are normally benign. Stomatitis or inflammation of the oral cavity can lead to fragile gums, white patches (candidiasis), and painful open sores throughout the oral cavity, but these conditions are not cancerous.

 

DIF:    Cognitive Level: Application/Applying or higher               REF:   N/A

TOP:   Client Needs Category: Health Promotion and Maintenance (Health Screening)

MSC:  Integrated Process: Nursing Process (Implementation)

 

2. The nurse is caring for a female client who has just undergone excision of a parotid gland tumor. The client tells the nurse that she is experiencing facial weakness on the operative side. Which is the nurse’s best response?

a.	“You may be experiencing a slight stroke, and I will notify the doctor.”
b.	“This is a temporary condition that will resolve once radiation treatment is begun.”
c.	“You are experiencing weakness because the facial nerve was irritated during the surgery.”
d.	“You probably have a pinched nerve after lying on the operating room table for so long.”

 

 

ANS:  C

Cranial nerve V involvement is a possible outcome of this type of surgery. The client presents with facial weakness and possibly with loss of sensation to the affected side. The other choices regarding facial weakness following this type of surgery are not accurate.

 

DIF:    Cognitive Level: Application/Applying or higher               REF:   N/A

TOP:   Client Needs Category: Physiological Integrity (Reduction of Risk Potential—Potential for Complications from Surgical Procedures and Health Alterations)

MSC:  Integrated Process: Nursing Process (Implementation)

 

3. The nurse is caring for a client who is receiving radiation therapy for treatment of oral cancer. The client reports a constant dry mouth. Which is the nurse’s best response?

a.	“Massage the area just over the lower jaw twice a day.”
b.	“Use lemon and glycerin swabs to clean your mouth and help keep it moist.”
c.	“Suck on lemon slices to help increase saliva production.”
d.	“Rinse your mouth out often with warm saline or sodium bicarbonate solution.”

 

 

ANS:  D

Clients should avoid agents that can irritate the oral mucosa and should keep their mouth moist with frequent rinses of warm saline or sodium bicarbonate solution. Massage is recommended only for acute sialadenitis—inflammation of a salivary gland. Lemon slices and lemon and glycerin swabs are acidic and can further dry the mucosa, causing a burning sensation. The use of lemon slices after radiation therapy is discontinued may promote saliva production.

 

DIF:    Cognitive Level: Comprehension/Understanding               REF:   p. 1197

TOP:   Client Needs Category: Physiological Integrity (Basic Care and Comfort—Non-Pharmacological Comfort Interventions)

MSC:  Integrated Process: Nursing Process (Implementation)

 

4. The nurse is caring for a client who has just received a diagnosis of advanced oral cancer and has learned that a glossectomy with jaw resection will have to be scheduled. The client states to the nurse, “I would rather die than have half of my face removed. My life is over.” Which is the best description of the client’s response to the diagnosis?

a.	Refusal of any more treatment
b.	Grief over the diagnosis
c.	Acceptance of the diagnosis
d.	Denial about the diagnosis

 

 

ANS:  B

The client is grieving the loss of his health and present appearance. Because the client has just learned of the diagnosis and treatment, the client is reacting in a negative way. This behavior demonstrates grief, not necessarily refusal of treatment, nor denial or acceptance of the diagnosis.

 

DIF:    Cognitive Level: Comprehension/Understanding               REF:   p. 1200

TOP:   Client Needs Category: Psychosocial Integrity (Grief and Loss)

MSC:  Integrated Process: Nursing Process (Assessment)