Chapter 53: Care of Patients with Oral Cavity Problems

Chapter 53: Care of Patients with Oral Cavity Problems

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE

1. A student nurse is providing care to an older client with stomatitis and dysphagia. What action by the student nurse requires the registered nurse to intervene?
   1. Assisting the client to perform oral care every 2 hours
   2. Preparing to administer a viscous lidocaine gargle
   3. Reminding the client not to swallow nystatin (Mycostatin)
   4. Teaching the client to use a soft-bristled toothbrush

ANS:   B

Viscous lidocaine gargles or mouthwashes are sometimes prescribed for clients with stomatitis and pain. However, the numbing effect can lead to choking or mouth burns from hot food. This client already has difficulty swallowing, so this medication is not appropriate. Therefore, the nurse should intervene when the student prepares to administer this preparation. The other options are correct actions.

DIF:     Applying/Application                         REF: 1102                   KEY: Oral disorders| topical anesthetics| fungal infections                          MSC:                         Integrated Process: Communication and Documentation  NOT: Client Needs Category: Safe and Effective Care Environment: Safety and Infection Control

2. A client has a large oral tumor. What assessment by the nurse takes priority?
   1. Airway
   2. Breathing
   3. Circulation
   4. Nutrition

ANS:   A

Airway always takes priority. Airway must be assessed first and any problems resolved if present.

DIF:     Applying/Application                         REF: 1104                   KEY: Oral disorders| cancer| nursing assessment                                          MSC:                         Integrated Process: Nursing Process: Assessment                                       NOT:                          Client Needs Category: Safe and Effective Care Environment: Management of Care

3. A female client hospitalized for an unrelated problem has a large pearly-white lesion on her lip, to which she continues to apply lipstick that she will not remove for inspection. The client refuses to discuss the lesion with the nurse or health care provider. What action by the nurse is best?
   1. Ask the client why her appearance is so important.
   2. Ignore the lesion since the client will not discuss it.
   3. Inform the client that early-stage cancer is curable.
   4. Work with the client to establish a trusting relationship.

ANS:           D

Clients with oral cancers often have body image difficulties due to the location of the tumor or the results of surgical treatment. This client appears to be using denial to cope with this problem. The nurse should work to establish a helping-trusting relationship in hopes that the client will be amenable to future discussions about the lesion. Asking “why” questions often puts people on the defensive and should be avoided. Ignoring the lesion is not being an advocate for the client. Education is important, but right now the client is in denial, so this information will not seem relevant to her.

DIF:            Applying/Application                         REF:    1103

KEY:          Oral disorders| psychosocial response| coping| communication

MSC:          Integrated Process: Caring

NOT:          Client Needs Category: Psychosocial Integrity

4. A nurse has conducted a community screening event for oral cancer. What client is the highest priority for referral to a dentist?
   1. Client who has poor oral hygiene practices
   2. Client who smokes and drinks daily
   3. Client who tans for an upcoming vacation
   4. Client who occasionally uses illicit drugs

ANS:           B

Smoking and alcohol exposure create a high risk for this client. Poor oral hygiene is not related to the etiology of cancer but may cause a tumor to go unnoticed. Tanning is a risk factor, but short-term exposure does not have the same risk as daily exposure to tobacco and alcohol. Illicit drugs are not related to oral cancers.

DIF:     Understanding/Comprehension          REF:    1103     KEY: Oral disorders| health screening| primary prevention| nursing assessment MSC:            Integrated Process: Communication and Documentation  NOT:             Client Needs Category: Health Promotion and Maintenance