Deck 56: Care of Patients With Oral Cavity Problems

Question 1

The nurse is caring for a client who has undergone a radical jaw and neck resection.The client tells the nurse that the area feels very swollen and painful.Which is the best intervention for the nurse to make this client more comfortable?

A) Frequently suction the client's mouth and airway.
B) Apply warm moist compresses to the area.
C) Elevate the head of the client's bed to semi-Fowler's.
D) Administer ibuprofen (Motrin) 600 mg every 6 hours around the clock.

Answer 1

Elevate the head of the client's bed to semi-Fowler's.

Question 2

The nurse is caring for a client who will be going home after a radical jaw and neck resection.The client's spouse will be the primary caregiver at home and will need to care for the client's feeding tube and tracheostomy.Which skill is the highest priority for the nurse to teach the client's spouse before discharge from the hospital?

A) Monitoring the incision lines for infection or leakage of saliva
B) Assessing the client for readiness to resume oral feedings
C) Cleaning the tracheostomy and suctioning as needed
D) Administering tube feedings and cleaning the feeding tube site

Answer 2

Cleaning the tracheostomy and suctioning as needed

Question 3

The nurse is assessing a client with a salivary gland tumor for facial nerve involvement.Which movements does the nurse ask the client to perform?

A) Open the mouth wide.
B) Raise the eyebrows.
C) Smile or frown.
D) Pucker the lips.
E) Blow the nose.
F) Puff out the cheeks.

Answer 3

Raise the eyebrows.
Smile or frown.
Pucker the lips.
Puff out the cheeks.

Question 4

The nurse is caring for a client who has just received a diagnosis of advanced oral cancer that will require extensive surgery.Which statement by the client indicates that the diagnosis is accepted?

A) "The biopsy test results will be confirmed again next week."
B) "Of all the bad things to happen to me, now I have cancer on top of it all."
C) "If I can live long enough to see my son get married, everything will be alright."
D) "I don't like it, but I have cancer and that's the way it is."

Question 5

The nurse is caring for a client who will be taking nystatin (Mycostatin)for treatment of oral candidiasis.Which instructions does the nurse provide for the client before administering the medication?

A) "Let the tablet dissolve slowly in your mouth."
B) "Take the medicine with a snack or a light meal."
C) "Swallow the pills whole, followed by a full glass of water."
D) "Swish the liquid around your mouth before swallowing it."

Question 6

The nurse is caring for a client who will be undergoing a radical jaw and throat resection for oral cancer.Which statement by the client indicates that further teaching is needed?

A) "I will have a temporary tracheostomy placed in my neck to help me breathe."
B) "I will not be able to get out of bed for 3 days after surgery."
C) "The doctor will put in a feeding tube for nutrition until I can swallow and eat."
D) "My speech may be slurred for a long time after the surgery."

Question 7

The nurse is assessing a client during a routine physical examination.Which statement made by the client concerning the risk of oral cancer indicates that further teaching is needed?

A) "I will brush my teeth and floss regularly."
B) "I will begin a smoking cessation program."
C) "I can still use chewing tobacco since I stopped smoking."
D) "I will limit my intake of alcoholic beverages."

Question 8

The nurse is performing oral health screenings at a local community center.Which clients are at higher risk for developing oral cancer?

A) Female who has taken oral contraceptives for the last 4 years
B) Adult client with a history of alcoholism
C) Adult client who regularly eats spicy foods
D) Middle-aged male who smokes a pipe
E) Adult client who goes to a tanning salon weekly
F) Client who frequently chews gum

Question 9

The spouse of a client has just completed tracheostomy care for the first time,with minimal assistance from the nurse.Which statement offers the most constructive feedback from the nurse?

A) "I see that you had a tough time, but you will do better with practice."
B) "You were able to clean the inner cannula well. Now, let's change the ties again."
C) "You seem to have had a tough time because it was your first attempt."
D) "You seem to understand what I said. Is there anything else I can help you with?"

Question 10

The nurse is caring for a client with stomatitis.Which statement does the nurse include in teaching about oral care for this client?

A) "Rinse your mouth out twice a day with mouthwash."
B) "Clean your mouth frequently during the day with a gentle foam sponge."
C) "Use lemon-glycerin swabs to clean your mouth after meals and at bedtime."
D) "Suck on ice cubes to minimize the discomfort."

Question 11

The nurse is caring for a client who has just completed treatment for basal cell carcinoma on the lower lip.The client says to the nurse,"Cigarettes are ruining my life.I'll do anything to quit smoking." Which is the nurse's best response?

A) "Here is some information about smoking cessation programs in the area. Let's discuss the options."
B) "Here are some pamphlets that show the financial benefits of quitting smoking."
C) "If you quit smoking, your risk for developing cancer again will decrease dramatically."
D) "Your chest x-ray is still clear, so you could prevent permanent lung damage if you quit smoking now."

Question 12

The nurse is caring for a client who has just undergone a partial glossectomy and partial mandibulectomy for oral cancer.Which is the highest priority for this client?

A) Maintenance of the airway
B) Ability to communicate
C) Adequate body image
D) Pain management

Question 13

The nurse is caring for a client who just had a radical jaw and neck resection for oral cancer.The nurse has just completed teaching for the spouse and client about tracheostomy care.Which notation in the client's chart is the most accurate documentation of the teaching that occurred?

A) "The client and spouse were instructed regarding management of mucous plugs and thick secretions."
B) "Information about home oxygen therapy and equipment was provided for the client and spouse."
C) "The client and spouse were shown how to suction the tracheostomy and change the ties."
D) "Correct suctioning procedure was demonstrated, and the client's spouse verbalized two instances when suctioning needs to occur."

Question 14

The nurse is caring for a client who is receiving radiation therapy for treatment of oral cancer.The client reports a constant dry mouth.Which is the nurse's best response?

A) "Massage the area just over the lower jaw twice a day."
B) "Use lemon and glycerin swabs to clean your mouth and help keep it moist."
C) "Suck on lemon slices to help increase saliva production."
D) "Rinse your mouth out often with warm saline or sodium bicarbonate solution."

Question 15

The nurse is caring for a female client who has just undergone excision of a parotid gland tumor.The client tells the nurse that she is experiencing facial weakness on the operative side.Which is the nurse's best response?

A) "You may be experiencing a slight stroke, and I will notify the doctor."
B) "This is a temporary condition that will resolve once radiation treatment is begun."
C) "You are experiencing weakness because the facial nerve was irritated during the surgery."
D) "You probably have a pinched nerve after lying on the operating room table for so long."

Question 16

The nurse is leading a teaching session about methods to decrease the risk of mouth cancer.Which client statement indicates that the nurse was successful in teaching the information?

A) "I will chew tobacco rather than smoke it."
B) "I will use sugar rather than artificial sweeteners."
C) "I will regularly use a lip balm that contains sunscreen."
D) "I will use a tanning salon rather than sunbathing at the beach."

Question 17

The nurse is caring for a client who is being discharged following surgery for oral cancer.Which sign is the client instructed to watch for that indicates possible metastasis of the cancer?

A) Fragile gums that bleed easily
B) White patches on the tongue and the back of the throat
C) Painful ulcerated lesions on the gums or inside of the cheek
D) Small hard lumps on the side of the neck or under the chin

Question 18

The nurse is caring for a client who just had a radical jaw and neck resection.The nurse is developing a teaching plan for the client and spouse about care after discharge from the hospital.Which is an effective teaching objective for this client and spouse?

A) The client's spouse will be able to change the client's tracheostomy ties correctly after three teaching sessions.
B) The client and spouse will verbalize the signs of readiness for oral feedings following placement of the tracheostomy.
C) The client's spouse will correctly administer the client's tube feedings twice daily.
D) The client and spouse will understand incision care and the importance of infection prevention.

Question 19

The nurse is caring for a client who has just undergone surgery for oral cancer.What advice does the nurse give the client to assist in maintaining the airway?

A) "Limit your fluids to 3 cups of water a day."
B) "Take deep breaths, hold, then cough to mobilize any secretions."
C) "Lying flat in bed will be more comfortable for breathing."
D) "Usually suctioning is not needed after oral surgery."

Question 20

The nurse is caring for a client who has just received a diagnosis of advanced oral cancer and has learned that a glossectomy with jaw resection will have to be scheduled.The client states to the nurse,"I would rather die than have half of my face removed.My life is over." Which is the best description of the client's response to the diagnosis?

A) Refusal of any more treatment
B) Grief over the diagnosis
C) Acceptance of the diagnosis
D) Denial about the diagnosis

Question 21

The nurse is caring for a client with stomatitis.Which items reported during the history of the client may contribute to the reoccurrence of this condition?

A) Drinking two glasses of wine nightly
B) Smoking three cigarettes each day
C) Vitamin A deficiency
D) Drinking four cups of coffee daily
E) Fruits and nuts as the mainstay of the diet
F) Vitamin C deficiency