Nokea
A client is having a temporary tracheostomy placed during surgery for oral cancer. What action by the nurse is best to relieve anxiety?
- A. Agree on a postoperative communication method
- B. Explain the staff will answer the call sign promptly
- C. Give the client a Magic Slate to write on postoperatively
- D. Reassure the client that you will take care of all of his or her needs
Correct Answer: A
Rationale: Before surgery that interrupts the client's ability to communicate, the nurse, client, and family (if possible) agree on a method of communication in the postoperative period. The client may prefer a slate and may not be able to communicate in writing. Reassuring the client and telling him or her that you will take care of all of his or her needs does not help the client be an active participant in care. Ensuring that the staff will answer the call sign promptly is not a guarantee and will occur.
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The nurse reads a clients chart and sees that the health care provider assessed mucosal erythropplasia. What does the client needs to what that this means for the client?
- A. Early sign of oral cancer
- B. Fungal mouth infection
- C. Inflammation of the gums
- D. Obvious oral tumor
Correct Answer: A
Rationale: Mucosal erythropplasia is the earliest sign of oral cancer. It is not a fungal infection, inflammation of the gums, or an obvious tumor.
A nurse is caring for four clients. After receiving the hand-off report, which client should the nurse see first?
- A. Client having a radial neck dissection tomorrow who is asking questions
- B. Client who had a tracheostomy 4 hours ago and needs frequent suctioning
- C. Client who is a day postoperative for an oral tumor resection who is reporting pain
- D. Client waiting for discharge instructions after a small tumor resection
Correct Answer: B
Rationale: The client who needs frequent suctioning should be seen first to ensure that his or her airway is patent. The client waiting for pain medication should be seen next. The nurse may need to call the surgeon to see the client who is asking questions. The client waiting for discharge instructions can be seen last.
A female client hospitalized for an unrelated problem has a large partly-white lesion on her lip, to which she is the nurse or health care provider. What action by the nurse is best?
- A. Ask the client why her appearance is so important
- B. Ignore the lesion since the client and not discuss it
- C. Inform the client that early-stage cancer is curable
- D. Know with the client to establish a trusting relationship
Correct Answer: D
Rationale: 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.
The nurse is caring for a client with sialadenitis. What comfort measures may the nurse delegate to the unlicensed assistive personnel (UAP)?
- A. Applying warm compresses
- B. Massaging salivary glands
- C. Offering fluids every hour
- D. Providing lemon glycerin swabs
- E. Reminding the client to avoid speaking
Correct Answer: A,C
Rationale: The UAP can apply warm compresses and offer fluids. Massaging salivary glands can be done, but not by the UAP. Lemon glycerin swabs are drying and should not be used. Speaking has no effect on this condition.
A nurse studying cancer knows that job-related risks for developing oral cancer include which occupations?
- A. Coal miner
- B. Electrician
- C. Metal worker
- D. Textile worker
- E. Plumber
Correct Answer: A,C,D,E
Rationale: The occupations of coal mining, metal working, plumbing, and textile work produce exposure to polycyclic aromatic hydrocarbons (PAH), which are known carcinogens. Electricians do not have this risk.