Deck 56: Coordinating Care for Patients With Oral and Esophageal Disorders

Question 1

In providing education to a patient who is diagnosed with oral cancer being treated with radiation therapy, the nurse includes information about which rare but serious complication?
1)Weight loss
2)Hearing loss
3)Skin irritation
4)Laryngeal edema

Answer 1

2

Question 2

The nurse is providing care to several patients in an outpatient clinic. Which patient is at highest risk of developing gastroesophageal reflux disorder (GERD)?
1)A patient who is 6 weeks pregnant
2)A patient who is morbidly obese
3)A patient who follows a strict vegetarian diet
4)A patient who drinks one glass of wine monthly

Answer 2

2

Question 3

In providing care to the patient whose mouth is wired shut after oral trauma, what is the priority action by the nurse?
1)Monitoring for pain
2)Ensuring oxygen is available
3)Having wire cutters available
4)Providing humidification

Answer 3

3

Question 4

Which diagnostic test should the nurse anticipate when providing care to a patient who is suspected of having a hiatal hernia?
1)Complete blood count (CBC)
2)Lower abdominal x-ray
3)Barium enema
4)Esophagogastroduodenoscopy (EGD)

Question 5

Which data collected by the nurse during the physical assessment indicate the patient is experiencing grade 3 stomatitis?
1)Redness of mucosa
2)Patchy oral ulceration
3)Oral ulcerations that bleed with minor trauma
4)Tissue necrosis with significant bleeding noted

Question 6

Which statement by the patient after undergoing a laparoscopic Nissen fundoplication indicates the need for further teaching about postprocedure care?
1)"I will remain on a soft diet for 1 week."
2)"I won't use a straw to drink with my meals."
3)"I will wash my incision site with soap and water and pat dry."
4)"I can drive tomorrow as long as I am not taking narcotic pain medication."

Question 7

What is the priority nursing diagnosis when providing care for a patient with oral trauma?
1)Risk for bleeding
2)Risk for infection
3)Risk for ineffective airway clearance
4)Risk for impaired breathing pattern

Question 8

A patient is admitted to the emergency department reporting a burning pain in the chest of a 7 on a 0 to 10 pain scale and diagnosed with gastroesophageal reflux disorder (GERD) secondary to hiatal hernia. Based on this data, what is the priority nursing diagnosis?
1)Fluid Volume Deficit (FVD)
2)Acute Pain
3)Ineffective Health Maintenance
4)Dysfunctional Gastrointestinal Motility

Question 9

The nurse conducts an assessment for a patient who is admitted for the treatment of gastroesophageal reflux disease (GERD). Which assessment finding requires an immediate intervention by the nurse?
1)Bloating
2)Wheezing
3)Flatulence
4)Eructation

Question 10

Which data collected by the nurse during the physical assessment indicate the patient is experiencing grade 4 stomatitis?
1)Redness of mucosa
2)Patchy oral ulceration
3)Oral ulcerations that bleed with minor trauma
4)Tissue necrosis with significant bleeding noted

Question 11

The nurse monitors for which clinical manifestations in the patient diagnosed with grade 2 stomatitis?
1)Redness of mucosa
2)Patchy oral ulceration
3)Oral ulcerations that bleed with minor trauma
4)Tissue necrosis with significant bleeding noted

Question 12

The nurse monitors which diagnostic study results for metastasis in the patient with oral cancer?
1)Skin biopsy
2)Liver function tests
3)Breast biopsy
4)Brain computed tomography

Question 13

In providing care to a patient admitted with oral trauma, which arterial blood gas results does the nurse recognize as most indicative of respiratory compromise?
1)pH 7.32 PaCO₂ 30 mm Hg PaO₂ 70 mm Hg
2)pH 7.47 PaCO₂ 48 mm Hg PaO₂ 65 mm Hg
3)pH 7.45 PaCO₂ 43 mm Hg PaO₂ 80 mm Hg
4)pH 7.30 PaCO₂ 50 mm Hg PaO₂ 50 mm Hg

Question 14

In caring for the patient diagnosed with stomatitis, which observation of the patient requires an intervention?
1)Complete mouth care after each meal
2)Uses alcohol-based mouth rinses
3)Uses a soft-bristle toothbrush
4)Has regular dental checkups

Question 15

A patient diagnosed with a hiatal hernia presents to the emergency department (ED) with chest pain. What is the priority action by the nurse?
1)Preparing the patient for an electrocardiogram (ECG)
2)Asking the patient, "When did you eat last?"
3)Positioning the patient on the right side with the head of bed (HOB) elevated
4)Asking the patient, "Have you been taking your prescribed proton pump inhibitor?"

Question 16

The nurse provides care to a patient who is diagnosed with grade 2 stomatitis. Based on this data, which intervention does the nurse include in this patient's plan of care?
1)A regular diet
2)Mouth care after meals
3)The use of lemon-glycerin swabs as needed
4)The use of alcohol-based rinses three times per day

Question 17

The nurse has implemented a care plan for an adult patient with gastroesophageal reflux disorder (GERD). On the next clinic visit, which statement by the patient indicates adherence to the plan of care?
1)"I still like wearing my Spandex camisoles."
2)"I have switched from margaritas to wine."
3)"I've lost 6 pounds because I eat every 3 hours and never before bed."
4)"I lay down flat after eating to promote digestion."

Question 18

The nurse monitors for which clinical manifestations in the patient diagnosed with grade 1 stomatitis?
1)Redness of mucosa
2)Patchy oral ulceration
3)Oral ulcerations that bleed with minor trauma
4)Tissue necrosis with significant bleeding noted

Question 19

The nurse is explaining the alteration in normal function to a patient recently diagnosed with gastroesophageal reflux disease (GERD). Which etiology contributing to GERD does the nurse include in the teaching session?
1)Transient constriction of the lower esophageal sphincter
2)Decreased pressure within the stomach
3)Incompetent lower esophageal sphincter
4)Prolonged constriction of the upper esophageal sphincter

Question 20

Which common cause for oral trauma does the nurse include in an educational seminar for individuals older than age 60 years?
1)Falls
2)Alcohol use
3)Accidental self-injury from cuts
4)Automobile accidents

Question 21

Which actions are indicated for the patient who ingested a caustic substance? Select all that apply.
1)Placing a nasogastric tube
2)Inserting a peripheral intravenous (IV) line
3)Administering IV steroids
4)Administering neutralizing agents
5)Induce vomiting

Question 22

What information does the nurse include in the teaching plan for the family of a patient who has fixed occlusion of the jaw? Select all that apply.
1)Providing supplemental humidification
2)Performing mouth care after each meal
3)Having wire cutters available at all times
4)Reporting symptoms indicative of infection
5)Lying down after meals to promote digestion

Question 23

In providing discharge teaching to a patient after a laparoscopic Nissen fundoplication, the nurse instructs the patient to seek emergent care if which clinical manifestations develop? Select all that apply.
1)Feeling full, with increased burping
2)Thick drainage with a foul odor from incision site
3)Difficulty swallowing
4)Coffee ground emesis
5)Watery stool

Question 24

The nurse monitors for which clinical manifestation of metastasis to the liver in the patient diagnosed with esophageal cancer?
1)Emesis
2)Hypercalcemia
3)Jaundice
4)Dysphagia

Question 25

The nurse monitors for which clinical manifestation of esophageal trauma in the patient who ingested bleach 48 hours ago?
1)Peritonitis
2)Glottic edema
3)Kidney damage
4)Excessive salivation

Question 26

The nurse correlates which risk factors to the development of hiatal hernia? Select all that apply.
1)Obesity
2)Pregnancy
3)Tobacco use
4)Oral sex
5)Alcohol abuse

Question 27

Which does the nurse include in the education of a patient who is being discharged after a laparoscopic Nissen fundoplication? Select all that apply.
1)Follow a soft diet for 2 weeks.
2)Avoid foods that are not easy to swallow.
3)Lie down immediately after eating meals.
4)Avoid carbonated beverages.
5)No heavy lifting until cleared by surgeon.

Question 28

In completing a health history in the patient diagnosed with esophageal cancer, the nurse monitors for which finding as the highest risk factor for the development of squamous cell carcinoma?
1)High-fat diet
2)Body mass index 17
3)Consumes 2 to 3 alcoholic beverages daily
4)Intravenous drug use

Question 29

The nurse monitors for which clinical manifestations in the patient diagnosed with esophageal cancer? Select all that apply.
1)Eructation
2)Melena
3)Odynophagia
4)Sialorrhea
5)Trismus

Question 30

Which complementary and alternative medicine (CAM) therapy does the nurse suggest for muscular relaxation to the patient who is experiencing pain as a result of esophageal cancer?
1)Yoga
2)Vibration
3)Meditation
4)Spirituality