Nokea
A community health nurse serves a diverse population. What individual would likely face the highest risk for parotitis?
- A. A patient who is receiving intravenous antibiotic therapy in the home setting
- B. A patient who has a chronic venous ulcer
- C. An older adult whose medication regimen includes an anticholinergic
- D. A patient with poorly controlled diabetes who receives weekly wound care
Correct Answer: C
Rationale: Elderly, acutely ill, or debilitated people with decreased salivary flow from general dehydration or medications are at high risk for parotitis. Anticholinergic medications inhibit saliva production. Antibiotics, diabetes, and wounds are not risk factors for parotitis.
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A nurse who provides care in an ambulatory clinic integrates basic cancer screening into admission assessments. What patient most likely faces the highest immediate risk of oral cancer?
- A. A 65-year-old man with alcoholism who smokes
- B. A 45-year-old woman who has type 1 diabetes and who wears dentures
- C. A 32-year-old man who is obese and uses smokeless tobacco
- D. A 57-year-old man with GERD and dental caries
Correct Answer: A
Rationale: Oral cancers are often associated with the use of alcohol and tobacco, which when used together have a synergistic carcinogenic effect. Most cases of oral cancers occur in people over the age of 60 and a disproportionate number of cases occur in men. Diabetes, dentures, dental caries, and GERD are not risk factors for oral cancer.
A nurse is assessing a patient who has just been admitted to the postsurgical unit following surgical resection for the treatment of oropharyngeal cancer. What assessment should the nurse prioritize?
- A. Assess ability to clear oral secretions.
- B. Assess for signs of infection.
- C. Assess for a patent airway.
- D. Assess for ability to communicate.
Correct Answer: C
Rationale: Postoperatively, the nurse assesses for a patent airway. The patients ability to manage secretions has a direct bearing on airway patency. However, airway patency is the overarching goal. This immediate physiologic need is prioritized over communication, though this is an important consideration. Infection is not normally a threat in the immediate postoperative period.
A nurse in an oral surgery practice is working with a patient scheduled for removal of an abscessed tooth. When providing discharge education, the nurse should recommend which of the following actions?
- A. Rinse the mouth with alcohol before bedtime for the next 7 days.
- B. Use warm saline to rinse the mouth as needed.
- C. Brush around the area with a firm toothbrush to prevent infection.
- D. Use a toothpick to dislodge any debris that gets lodged in the socket.
Correct Answer: B
Rationale: The patient should be assessed for bleeding after the tooth is extracted. The mouth can be rinsed with warm saline to keep the area clean. A firm toothbrush or toothpick could injure the tissues around the extracted area. Alcohol would injure tissues that are healing.
A radial graft is planned in the treatment of a patients oropharyngeal cancer. In order to ensure that the surgery will be successful, the care team must perform what assessment prior to surgery?
- A. Assessing function of cranial nerves V, VI, and IX
- B. Assessing for a history of GERD
- C. Assessing for signs or symptoms of atherosclerosis
- D. Assessing the patency of the ulnar artery
Correct Answer: D
Rationale: If a radial graft is to be performed, an Allen test on the donor arm must be performed to ensure that the ulnar artery is patent and can provide blood flow to the hand after removal of the radial artery. The success of this surgery is not primarily dependent on CN function or the absence of GERD and atherosclerosis.
A patient seeking care because of recurrent heartburn and regurgitation is subsequently diagnosed with a hiatal hernia. Which of the following should the nurse include in health education?
- A. Drinking beverages after your meal, rather than with your meal, may bring some relief.
- B. Its best to avoid dry foods, such as rice and chicken, because theyre harder to swallow.
- C. Many patients obtain relief by taking over-the-counter antacids 30 minutes before eating.
- D. Instead of eating three meals a day, try eating smaller amounts more often.
Correct Answer: D
Rationale: Management for a hiatal hernia includes frequent, small feedings that can pass easily through the esophagus. Avoiding beverages and particular foods or taking OTC antacids are not noted to be beneficial.