Nokea
A nurse has conducted a community screening event for oral cancer. What client is the highest priority for referral to a dentist?
- A. Client who has poor oral hygiene practices
- B. Client who smokes and drinks daily
- C. Client who uses for an upcoming vacation
- D. Client who occasionally uses illicit drugs
Correct Answer: B
Rationale: 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.
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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.
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 client had an oral tumor removed this morning and now has a tracheostomy. What action by the nurse is best?
- A. Delegate oral care every 4 hours
- B. Monitor and record the client's intake
- C. Place the client in a semi- or high-Fowler's position
- D. Clean the tracheostomy site daily
Correct Answer: C
Rationale: To promote airway clearance, this client should be placed in a semi- or high-Fowler's position. Oral care can be delegated, but that is not the priority. Intake and output should also be recorded but again is not the priority. The tracheostomy site may or may not need to be cleaned daily, and this is not the priority action.
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.
A client is prescribed cotusimma (Ebitus) for oral cancer and asks the nurse how it works. What response by the nurse is best?
- A. Blocks the epidermal growth factor
- B. Cuts off the tumor's blood supply
- C. Prevents tumor extension
- D. Targets rapidly dividing cells
Correct Answer: A
Rationale: Cetusimma (Ebitus) targets and blocks the epidermal growth factor, which contributes to the growth of oral cancers. The other explanations are not correct.