Nokea
A nurse is caring for a patient who is acutely ill and has included vigilant oral care in the patients plan of care. Why are patients who are ill at increased risk for developing dental caries?
- A. Hormonal changes brought on by the stress response cause an acidic oral environment
- B. Systemic infections frequently migrate to the teeth
- C. Hydration that is received intravenously lacks fluoride
- D. Inadequate nutrition and decreased saliva production can cause cavities
Correct Answer: D
Rationale: Many ill patients do not eat adequate amounts of food and therefore produce less saliva, which in turn reduces the natural cleaning of the teeth. Stress response is not a factor, infections generally do not attack the enamel of the teeth, and the fluoride level of the patient is not significant in the development of dental caries in the ill patient.
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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.
A patient with cancer of the tongue has had a radical neck dissection. What nursing assessment would be a priority for this patient?
- A. Presence of acute pain and anxiety
- B. Tissue integrity and color of the operative site
- C. Respiratory status and airway clearance
- D. Self-esteem and body image
Correct Answer: C
Rationale: Postoperatively, the patient is assessed for complications such as altered respiratory status, wound infection, and hemorrhage. The other assessments are part of the plan of care for a patient who has had a radical neck dissection, but are not the nurses chief priority.
The nurses comprehensive assessment of a patient includes inspection for signs of oral cancer. What assessment finding is most characteristic of oral cancer in its early stages?
- A. Dull pain radiating to the ears and teeth
- B. Presence of a painless sore with raised edges
- C. Areas of tenderness that make chewing difficult
- D. Diffuse inflammation of the buccal mucosa
Correct Answer: B
Rationale: Malignant lesions of the oral cavity are most often painless lumps or sores with raised borders. Because they do not bother the patient, delay in seeking treatment occurs frequently, and negatively affects prognosis. Dull pain radiating to the ears and teeth is characteristic of malocclusion. Inflammation of the buccal mucosa causes discomfort and often occurs as a side effect of chemotherapy. Tenderness resulting in pain on chewing may be associated with gingivitis, abscess, irritation from dentures, and other causes. Pain related to oral cancer is a late symptom.
A patient has been diagnosed with an esophageal diverticulum after undergoing diagnostic imaging. When taking the health history, the nurse should expect the patient to describe what sign or symptom?
- A. Burning pain on swallowing
- B. Regurgitation of undigested food
- C. Symptoms mimicking a heart attack
- D. Chronic parotid abscesses
Correct Answer: B
Rationale: An esophageal diverticulum is an outpouching of mucosa and submucosa that protrudes through the esophageal musculature. Food becomes trapped in the pouch and is frequently regurgitated when the patient assumes a recumbent position. The patient may experience difficulty swallowing; however, burning pain is not a typical finding. Symptoms mimicking a heart attack are characteristic of GERD. Chronic parotid abscesses are not associated with a diagnosis of esophageal diverticulum.
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.