Nokea
The school nurse is planning a health fair for a group of fifth graders and dental health is one topic that the nurse plans to address. What would be most likely to increase the risk of tooth decay?
- A. Organic fruit juice
- B. Roasted nuts
- C. Red meat that is high in fat
- D. Cheddar cheese
Correct Answer: A
Rationale: Dental caries may be prevented by decreasing the amount of sugar and starch in the diet. Patients who snack should be encouraged to choose less cariogenic alternatives, such as fruits, vegetables, nuts, cheeses, or plain yogurt. Fruit juice is high in sugar, regardless of whether it is organic.
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A nurse is caring for a patient who has had surgery for oral cancer. The combination of medications and radiotherapy has resulted in leukopenia. Which of the following is an appropriate response to this change in health status?
- A. Ensure that none of the patients visitors has an infection.
- B. Arrange for a diet that is high in protein and low in fat.
- C. Administer colony stimulating factors (CSFs) as ordered.
- D. Prepare to administer chemotherapeutics as ordered.
Correct Answer: A
Rationale: Leukopenia reduces defense mechanisms, increasing the risk of infections. Visitors who might transmit microorganisms are prohibited if the patients immunologic system is depressed. Changes in diet, CSFs, and the use of chemotherapy do not resolve leukopenia.
A patient has undergone rigid fixation for the correction of a mandibular fracture suffered in a fight. What area of care should the nurse prioritize when planning this patients discharge education?
- A. Resumption of activities of daily living
- B. Pain control
- C. Promotion of adequate nutrition
- D. Strategies for promoting communication
Correct Answer: C
Rationale: The patient who has had rigid fixation should be instructed not to chew food in the first 1 to 4 weeks after surgery. A liquid diet is recommended, and dietary counseling should be obtained to ensure optimal caloric and protein intake. The nature of this surgery threatens the patients nutritional status; this physiologic need would likely supersede the resumption of ADLs. Pain should be under control prior to discharge and communication is not precluded by this surgery.
A nurse is caring for a patient who is postoperative from a neck dissection. What would be the most appropriate nursing action to enhance the patients appetite?
- A. Encourage the family to bring in the patients favored foods.
- B. Limit visitors at mealtimes so that the patient is not distracted.
- C. Avoid offering food unless the patient initiates.
- D. Provide thorough oral care immediately after the patient eats.
Correct Answer: A
Rationale: Family involvement and home-cooked favorite foods may help the patient to eat. Having visitors at mealtimes may make eating more pleasant and increase the patients appetite. The nurse should not place the complete onus for initiating meals on the patient. Oral care after meals is necessary, but does not influence appetite.
A nurse is caring for a patient who is postoperative day 1 following neck dissection surgery. The nurse is performing an assessment of the patient and notes the presence of high-pitched adventitious sounds over the patients trachea on auscultation. The patients oxygen saturation is 90% by pulse oximetry with a respiratory rate of 31 breaths per minute. What is the nurses most appropriate action?
- A. Encourage the patient to perform deep breathing and coughing exercises hourly.
- B. Reposition the patient into a prone or semi-Fowlers position and apply supplementary oxygen by nasal cannula.
- C. Activate the emergency response system.
- D. Report this finding promptly to the physician and remain with the patient.
Correct Answer: D
Rationale: In the immediate postoperative period, the nurse assesses for stridor (coarse, high-pitched sound on inspiration) by listening frequently over the trachea with a stethoscope. This finding must be reported immediately because it indicates obstruction of the airway. The patients current status does not warrant activation of the emergency response system, and encouraging deep breathing and repositioning the patient are inadequate responses.
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.