Deck 17: Nose, mouth, and Throat

Question 1

The nurse is palpating the sinus areas.If they are normal,which of the following would the patient report?

A)No sensation
B)Firm pressure
C)Pain during palpation
D)Pain sensation behind eyes

Answer 1

Firm pressure

Question 2

A 32-year-old woman is at the clinic for a checkup,and she states,"I have little white bumps in my mouth." During the assessment,the nurse notes that she has a 0.5-cm white,nontender papule under her tongue and one on the mucosa of her right cheek.Which of the following would the nurse tell the patient?

A)"These spots are seen with infections such as strep throat."
B)"These could be indicative of a serious lesion,so I will refer you to a specialist."
C)"This is called leukoplakia and can be caused by chronic irritation due to,for example,smoking."
D)"These bumps are Fordyce's granules,which are sebaceous cysts and not a serious condition."

Answer 2

"These bumps are Fordyce's granules,which are sebaceous cysts and not a serious condition."

Question 3

During the assessment of a 20-year-old patient with a 3-day history of nausea and vomiting,the nurse notes the following: dry mucosa and deep fissures in the tongue.This finding is indicative of:

A)dehydration.
B)irritation by gastric juices.
C)a normal oral condition.
D)side effects of nausea medication.

Answer 3

dehydration.

Question 4

The tissue that connects the tongue to the floor of the mouth is the:

A)uvula.
B)palate.
C)papillae.
D)frenulum.

Question 5

The nurse is performing an assessment on a 21-year-old patient and notes that his nasal mucosa appears pale,grey,and swollen.What would be the most appropriate question to ask the patient?

A)"Are you aware of having any allergies?"
B)"Do you have an elevated temperature?"
C)"Have you had any symptoms of a cold?"
D)"Have you been having frequent nosebleeds?"

Question 6

Which of the following best describes the test to assess the function of cranial nerve (CN)X?

A)Observe the patient's ability to articulate specific words.
B)Assess movement of the hard palate and uvula with the gag reflex.
C)Have the patient stick out the tongue,and observe for tremors or pulling to one side.
D)Ask the patient to say "ahhh," and watch for movement of the soft palate and uvula.

Question 7

The nurse is obtaining history for a 3-month-old infant.During the interview,the mother states,"I think she is getting her first tooth because she has started drooling a lot." The nurse's best response would be:

A)"You're right,drooling is usually a sign of the eruption of the first tooth."
B)"It would be unusual for a 3-month-old to be getting her first tooth."
C)"This could be the sign of a problem with the salivary glands."
D)"She is just starting to salivate and hasn't learned to swallow the saliva."

Question 8

During an assessment of an 80-year-old patient,the nurse would expect to find:

A)hypertrophy of the gums.
B)increased production of saliva.
C)decreased ability to identify odours.
D)finer and less prominent nasal hair.

Question 9

The projections in the nasal cavity that increase the surface area are called the:

A)meatus.
B)septum.
C)turbinates.
D)Kiesselbach's plexus.

Question 10

During history-taking,a patient tells the nurse that he has frequent nosebleeds and asks about the best way to prevent them.What would be the nurse's best response?

A)"Sit straight,and place a cold compress over your nose."
B)"Sit straight with your head tilted forward,and pinch your nose."
C)"Just let the bleeding stop on its own,but don't blow your nose."
D)"Lie on your back with your head tilted back,and pinch your nose."

Question 11

A 72-year-old patient has a history of hypertension and chronic lung disease.An important question for the nurse to include in history-taking would be:

A)"Do you use a fluoride supplement?"
B)"Have you had tonsillitis in the last year?"
C)"At what age did you get your first tooth?"
D)"Have you noticed any dryness in your mouth?"

Question 12

The salivary gland that is located in the cheek in front of the ear is the:

A)parotid gland.
B)Stenson's gland.
C)sublingual gland.
D)submandibular gland.

Question 13

The nurse is doing an oral assessment on a 40-year-old patient of African descent and notes the presence of a 1-cm,nontender,greyish-white lesion on the left buccal mucosa.Which of the following about this lesion is true?

A)This lesion is leukoedema and is common in Blacks.
B)This is the result of hyperpigmentation and is normal.
C)This is torus palatinus and would normally only be found in smokers.
D)This type of lesion is indicative of cancer and should be investigated immediately.

Question 14

While obtaining history for a 1-year-old from the mother,the nurse notices that the baby has had a bottle in his mouth the entire time.The mother states that "it makes a great pacifier." The best response by the nurse would be:

A)"You're right,bottles make very good pacifiers."
B)"Use of a bottle is better for the teeth than thumb-sucking."
C)"It's okay to do this as long as the bottle contains milk and not juice."
D)"Prolonged use of a bottle can increase the risk for tooth decay and ear infections."

Question 15

A 92-year-old patient has had a stroke,and the right side of his face is drooping.What else would the nurse suspect?

A)Epistaxis
B)Agenesis
C)Dysphagia
D)Xerostomia

Question 16

The primary purpose of the ciliated mucous membrane in the nose is to:

A)warm the inhaled air.
B)filter out dust and bacteria.
C)filter coarse particles from inhaled air.
D)facilitate movement of air through the nares.

Question 17

During the oral assessment of a 30-year-old patient of African descent,the nurse notes bluish lips and a dark line along the gingival margin.What would the nurse do in response to this finding?

A)Check the patient's hemoglobin for anemia.
B)Assess for other signs of insufficient oxygen supply.
C)Proceed with the assessment,knowing that this is a normal finding.
D)Ask the patient if he had been exposed to an excessive amount of carbon monoxide.

Question 18

When using an otoscope to assess the nasal cavity,which of the following would the nurse need to do?

A)Insert the speculum at least 3 cm into the vestibule.
B)Avoid touching the nasal septum with the speculum.
C)Gently displace the nose to the side that is being examined.
D)Keep the speculum tip medial to avoid touching the floor of the nares.

Question 19

Which of the following about a newborn infant is true?

A)The sphenoid sinuses are at full size at birth.
B)The maxillary sinuses reach full size after puberty.
C)The frontal sinuses are fairly well developed at birth.
D)The maxillary and ethmoid sinuses are the only ones present at birth.

Question 20

While assessing the tonsils of a 30-year-old,the nurse notes that they look involuted and granular,and appear to have deep crypts.What is the correct follow-up to these findings?

A)Refer the patient to a throat specialist.
B)Nothing,this is the appearance of normal tonsils.
C)Continue with the assessment to look for any other abnormal findings.
D)Obtain a throat specimen to culture for possible strep infection.

Question 21

The nurse notices that the mother of a 2-year-old boy brings him to the clinic quite frequently for various injuries and suspects there may be some child abuse involved.The nurse should inspect the young child for:

A)swollen,red tonsils.
B)ulcerations on the hard palate.
C)bruising on the buccal mucosa or gums.
D)small yellow papules along the hard palate.

Question 22

A patient has been diagnosed with "strep throat." Which complication may occur without treatment?

A)Rubella
B)Leukoplakia
C)Rheumatic fever
D)Scarlet fever

Question 23

A mother is concerned that her 18-month-old already has 12 teeth.She is wondering if this is normal for a child of this age.The nurse's best response would be:

A)"How many teeth did you have at this age?"
B)"All 20 deciduous teeth are expected to have erupted by 4 years."
C)"This is a normal number of teeth for an 18-month-old."
D)"Normally,16 deciduous teeth are expected to have erupted between 2 and 3 years."

Question 24

During a checkup,a 22-year-old woman tells the nurse that she uses an over-the-counter nasal spray for her allergies.She also reports that it does not work as well as it used to.The best response by the nurse would be:

A)"You should never use over-the-counter nasal sprays because of the risk of addiction."
B)"You should try switching to another brand of medication to prevent this problem."
C)"It is important to keep using this spray to keep your allergies under control."
D)"Using these nasal medications irritates the lining of the nose and may cause rebound swelling."

Question 25

When examining the nares of a 45-year-old patient who complains of rhinorrhea,itching of the nose and eyes,and sneezing,the nurse notes the following: pale,swollen turbinates and clear rhinorrhea.Which of the following is most likely the cause?

A)Nasal polyps
B)Acute sinusitis
C)Allergic rhinitis
D)Nasal carcinoma

Question 26

When assessing the tongue of an adult,an abnormal finding would be:

A)a smooth,glossy dorsal surface.
B)a thin white coating over the tongue.
C)raised papillae on the dorsal surface.
D)visible venous patterns on the ventral surface.

Question 27

When examining an older adult,which of the following findings would the nurse recognize as related to the aging process?

A)Teeth that appear shorter
B)Tongue that looks smoother in appearance
C)Buccal mucosa that is beefy red in appearance
D)A small,painless lump on the dorsum of the tongue

Question 28

A 10-year-old is at the clinic for "a sore throat lasting 6 days." Which of the following would be consistent with an acute infection?

A)Tonsils 1+/1-4+ and pink
B)Tonsils 2+/1-4+ with small plugs of white debris
C)Tonsils 3+/1-4+ with large white spots
D)Tonsils 3+/1-4+ with yellowish exudates

Question 29

The nurse is unable to suction the nares of a newborn immediately following delivery.The attempt to pass a catheter through both nasal cavities has met with no success.What would be the nurse's best action in this situation?

A)Attempt to suction again with a bulb syringe.
B)Wait for a few minutes and try again once the infant stops crying.
C)Recognize that this situation requires immediate intervention.
D)Request the physician's assistance as soon as possible.

Question 30

A mother brings her 4-month-old to the clinic with concerns about a small padlike growth on the mid-upper lip that has been present since the baby was 1 month old.The infant has no health problems.On physical examination,the nurse notes a 0.5-cm,fleshy,elevated area on the mid-upper lip.There is no evidence of inflammation or drainage.What would the nurse tell this mother?

A)"This is an area of irritation caused by teething and is nothing to worry about."
B)"This is an abnormal finding and should be evaluated by a specialist."
C)"This is the result of chronic drooling and should resolve within the next month or two."
D)"This is a sucking tubercle caused by friction due to breastfeeding or bottle feeding and is normal."

Question 31

Which of the following assessment findings would the nurse be most concerned about?

A)A painful vesicle inside the cheek for 2 days
B)The presence of moist,nontender Stenson's ducts
C)Stippled gingival margins that adhere snugly to the teeth
D)An ulceration with rolled edges on the side of the tongue

Question 32

During examination of a 4-year-old Aboriginal child,the nurse notices that her uvula is partially split.Which of the following statements about this condition is accurate?

A)This is cleft palate,which is commonly found in Aboriginal people.
B)This is a bifid uvula,which is a common occurrence in some Aboriginal groups.
C)This occurs from an injury and should be reported to the authorities.
D)This is torus palatinus,common among Aboriginal people.

Question 33

A patient comes into the clinic complaining of facial pain,fever,and malaise.On examination,the nurse notes swollen turbinates and a purulent discharge from the nose.The patient also complains of a dull,throbbing pain in his cheeks and teeth on the right side and pain when the nurse palpates the areas.The nurse recognizes that this patient has:

A)posterior epistaxis.
B)frontal sinusitis.
C)maxillary sinusitis.
D)nasal polyps.

Question 34

While performing a mouth assessment on a patient,the nurse notices a 1-cm ulceration that is crusted and has an elevated border.It is located on the outer third of the lower lip.What other information would be most important for the nurse to obtain?

A)Nutritional status
B)When the patient first noticed the lesion
C)Whether the patient has had a recent cold
D)Whether the patient has had any recent exposure to sick animals

Question 35

During the assessment of a 26-year-old,she states,"I have a spot on my lip I think is cancer." The nurse notes the following: a cluster of clear vesicles with an erythematous base around them located at the lip-skin border.The patient mentions that she just returned from Hawaii.What would be the most appropriate response by the nurse?

A)Tell the patient she will need to see a skin specialist.
B)Discuss the benefits of doing a biopsy of any unusual lesion.
C)Tell the patient this is herpes simplex virus 1 infection,which will heal in 4 to 10 days.
D)Tell the patient this is most likely the result of a riboflavin deficiency,and discuss nutrition.

Question 36

The nurse is assessing a patient with a history of intravenous drug abuse.While assessing his mouth,the nurse notices a dark red confluent macule on the hard palate.This could be an early sign of:

A)acquired immunodeficiency syndrome (AIDS).
B)measles.
C)leukemia.
D)carcinoma.

Question 37

A hospitalized patient who has received numerous antibiotics is being assessed by the nurse,who notes that his tongue appears black and hairy.Which of the following would the nurse say to the patient?

A)"We need to get a biopsy done and find out what the cause is."
B)"This is an overgrowth of hair and will go away in a few days."
C)"This is a fungal infection caused by all the antibiotics you've received."
D)"This is probably caused by the same bacteria you had in your lungs."

Question 38

The nurse is assessing a 3-year-old who has been brought to the clinic for "drainage from the nose." On assessment,it is found that there is a purulent,malodorous drainage from the left naris but no drainage from the right naris.The child is afebrile and has no other symptoms.What should the nurse do next?

A)Refer the child to a physician for an antibiotic prescription.
B)Have the mother bring the child back in 1 week.
C)Perform an otoscopic examination of the left naris.
D)Tell the mother that this is normal for children of this age.

Question 39

A 40-year-old patient who has just finished chemotherapy for breast cancer tells the nurse that she is concerned about her mouth.During assessment,the nurse finds the following: areas of buccal mucosa that are raw and red with some bleeding,as well as other areas that have a white,cheesy coating.The nurse recognizes that this abnormality is:

A)carcinoma.
B)candidiasis.
C)leukoplakia.
D)Koplik's spots.

Question 40

A pregnant woman states that she is concerned about her gums because she has noticed they are swollen and have started bleeding.What would be an appropriate response by the nurse?

A)"This is probably due to a vitamin C deficiency."
B)"I'm not sure what causes it,but let me know if it doesn't get better in a few weeks."
C)"You need to make an appointment with your dentist as soon as possible to have this checked."
D)"This can be caused by hormonal changes during pregnancy."

Question 41

The nurse is teaching a health class to high school boys.One of the topics is the use of smokeless tobacco (SLT).Which of the following statements about SLT are accurate? (Select all that apply. )

A)One pinch of SLT in the mouth for 30 minutes delivers the effect of an equivalent amount of tobacco in one cigarette.
B)SLT has a greater risk of oral cancer than does smoking.
C)Pain is an early sign of oral cancer.
D)Pain is rarely an early sign of oral cancer.
E)Tooth decay is another risk of SLT because of the use of sugar in it.
F)SLT is considered a healthy alternative to smoking.

Question 42

A woman in her second trimester of pregnancy mentions that since becoming pregnant she has had "more nosebleeds than ever." The nurse recognizes that this is due to:

A)coagulation problems in the patient.
B)increased vascularity in the upper respiratory tract as a result of the pregnancy.
C)increased susceptibility to colds and nasal irritation.
D)inappropriate use of nasal sprays.