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Milestone Chapter 53: Care of Patients with Oral Cavity Problems (Concepts for Interprofessional Collaborative Care College Test Bank)

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Chapter 53: Care of Patients with Oral Cavity Problems Ignatavicius: Medical-Surgical Nursing, 8th Edition MULTIPLE CHOICE 1. A student nurse is providing care to an older client with stomatitis an... d dysphagia. What action by the student nurse requires the registered nurse to intervene? a. Assisting the client to perform oral care every 2 hours b. Preparing to administer a viscous lidocaine gargle c. Reminding the client not to swallow nystatin (Mycostatin) d. Teaching the client to use a soft-bristled toothbrush ANS: B Viscous lidocaine gargles or mouthwashes are sometimes prescribed for clients with stomatitis and pain. However, the numbing effect can lead to choking or mouth burns from hot food. This client already has difficulty swallowing, so this medication is not appropriate. Therefore, the nurse should intervene when the student prepares to administer this preparation. The other options are correct actions. DIF: Applying/Application REF: 1102 KEY: Oral disorders| topical anesthetics| fungal infections MSC: Integrated Process: Communication and Documentation NOT: Client Needs Category: Safe and Effective Care Environment: Safety and Infection Control 2. A client has a large oral tumor. What assessment by the nurse takes priority? a. Airway b. Breathing c. Circulation d. Nutrition ANS: A Airway always takes priority. Airway must be assessed first and any problems resolved if present. DIF: Applying/Application REF: 1104 KEY: Oral disorders| cancer| nursing assessment MSC: Integrated Process: Nursing Process: Assessment NOT: Client Needs Category: Safe and Effective Care Environment: Management of Care 3. A female client hospitalized for an unrelated problem has a large pearly-white lesion on her lip, to which she continues to apply lipstick that she will not remove for inspection. The client refuses to discuss the lesion with 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 will not discuss it. c. Inform the client that early-stage cancer is curable. d. Work with the client to establish a trusting relationship. This study source was downloaded by 100000831988016 from CourseHero.com on 12-29-2021 09:21:32 GMT -06:00 https://www.coursehero.com/file/16393402/53/ ANS: D 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. DIF: Applying/Application REF: 1103 KEY: Oral disorders| psychosocial response| coping| communication MSC: Integrated Process: Caring NOT: Client Needs Category: Psychosocial Integrity 4. 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 tans for an upcoming vacation d. Client who occasionally uses illicit drugs ANS: B 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. DIF: Understanding/Comprehension REF: 1103 KEY: Oral disorders| health screening| primary prevention| nursing assessment MSC: Integrated Process: Communication and Documentation NOT: Client Needs Category: Health Promotion and Maintenance 5. The nurse reads a client’s chart and sees that the health care provider assessed mucosal erythroplasia. What should the nurse understand 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 ANS: A Mucosal erythroplasia is the earliest sign of oral cancer. It is not a fungal infection, inflammation of the gums, or an obvious tumor. DIF: Remembering/Knowledge REF: 1102 KEY: Oral disorders| cancer| pathophysiology MSC: Integrated Process: Nursing Process: Assessment NOT: Client Needs Category: Physiological Integrity: Physiological Adaptation 6. A client is having a temporary tracheostomy placed during surgery for oral cancer. What action by the nurse is best to relieve anxiety? This study source was downloaded by 100000831988016 from CourseHero.com on 12-29-2021 09:21:32 GMT -06:00 https://www.coursehero.com/file/16393402/53/ a. Agree on a postoperative communication method. b. Explain that staff will answer the call light 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. ANS: A Before surgery that interrupts the client’s ability to communicate, the nurse, client, and family (if possible) agree upon a method of communication in the postoperative period. The client may or may not prefer a slate and may not be able to communicate in writing. Reassuring the client and telling him or her 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 light promptly will not guarantee this will occur. DIF: Applying/Application REF: 1105 KEY: Oral disorders| communication MSC: Inte [Show More]

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