Chapter 45- Management of Patients With Oral and Esophageal Disorder

Chapter 45: Management of Patients With Oral and Esophageal Disorder Question A client has a new order for metoclorpramide (Reglan). The nurse knows that this medication should not be used long term and only in cases where all other options have been exhausted. This is because this medication has the potential for extrapyramidal side effects. Extrapyramidal side effects include which of the following? • Uncontrolled rhythmic movements of the face or limbs Question The nurse notes that a client has inflammation of the salivary glands. The nurse documents which finding? • Sialadenitis Question Which term describes a reddened, circumscribed lesion that ulcerates and becomes crusted and is a primary lesion of syphilis? • Chancre Question A patient describes a burning sensation in the esophagus, pain when swallowing, and frequent indigestion. What does the nurse suspect that these clinical manifestations indicate? • Gastroesophageal reflux disease Question A client has a cheesy white plaque in the mouth. The plaque looks like milk curds and can be rubbed off. The best nursing intervention is to • Instruct the client to swish prescribed nystatin (Mycostatin)solution for 1 minute. Question A client who is recovering from anesthesia following oral surgery for lip cancer is experiencing difficulty breathing deeply and coughing up secretions. Which of the following measures will help ease the client's discomfort? • Keeping the head of the bed elevated. Question The nurse is conducting a health instruction program on oral cancer. The nurse determines that the participants understand the instructions when they state • “Many oral cancers produce no symptomsin the early stages.” Question The nurse is obtaining a history on a patient who comes to the clinic. What symptom described by the patient is one of the first symptoms associated with esophageal disease? • Dysphagia Question An elderly patient is diagnosed with parotitis. The nurse is aware that this bacterial infection is most likely caused by: • Staphylococcus aureus. Question 1 A nurse entersthe room of a client who has returned to the unit after having a radical neck dissection. Which assessment finding requires immediate intervention? • The client lying in a lateral position, with the head of bed flat Question The most common symptom of esophageal disease is • dysphagia. Question Which is an accurate statement regarding cancer of the esophagus? • Chronic irritation of the esophagus is a known risk factor. Question Postoperatively, a client with a radical neck dissection should be placed in which position? • Fowler Question A patient has been diagnosed with Zenker’s diverticulum. What treatment doesthe nurse anticipate educating the patient about? • Surgical removal of the diverticulum Question A client who reports increasing difficulty swallowing, weight loss, and fatigue is diagnosed with esophageal cancer. Because this client has difficulty swallowing, the nurse should assign highest priority to: • maintaining a patent airway. Question Which term refersto the symptom of gastroesophageal reflux disease (GERD), which is characterized by a burning sensation in the esophagus? • Pyrosis Question An elderly client states, "I don't understand why I have so many caries in my teeth." The nurse assesses the following as placing the client at risk: • Exhibiting hemoglobin A1C 8.2 Question A client has a radical neck dissection to treat cancer of the neck. The nurse develops the care plan and includes all the following diagnoses. The nurse identifies the highest priority diagnosis as • Ineffective airway clearance related to obstruction by mucus Question A client has a new order for metoclorpramide (Reglan). The nurse knows that this medication should not be used long term and only in cases where all other options have been exhausted. This is because this medication has the potential for extrapyramidal side effects. Extrapyramidal side effects include which of the following? • Uncontrolled rhythmic movements of the face or limbs Question A client with a disorder of the oral cavity cannot tolerate tooth brushing or flossing. Which of the following strategies can the nurse employ to assist this client? • Provide the client with an irrigating solution of baking soda and warm water. Question A patient describes a burning sensation in the esophagus, pain when swallowing, and frequent indigestion. What does the nurse suspect that these clinical manifestations indicate? • Gastroesophageal reflux disease Question During postoperative neck dissection assessment, the nurse notices excessive bleeding from the dressing site. She suspects possible carotid artery rupture and takes the immediate first step to: • Apply pressure to the bleeding site or major associated vessel. Question A patient has been diagnosed with a hiatal hernia. The nurse explains the diagnosis to the patient and his family by telling them that a hernia is a (an): • Protrusion of the upper stomach into the lower portion of the thorax. Question When assessing a client during a routine checkup, the nurse reviews the history and notesthat the client had aphthous stomatitis at the time of the last visit. Aphthous stomatitis is best described as: • a canker sore of the oralsoft tissues. Question The nurse provides health teaching to inform the client with oral cancer that • many oral cancers produce no symptoms in the early stages. Question Which is an accurate statement regarding cancer of the esophagus? • Chronic irritation of the esophagus is a known risk factor. Question Postoperatively, a client with a radical neck dissection should be placed in which position? • Fowler Question A client has a cheesy white plaque in the mouth. The plaque looks like milk curds and can be rubbed off. The best nursing intervention is to • Instruct the client to swish prescribed nystatin (Mycostatin)solution for 1 minute. Question 7 The nurse instructsthe client with gastroesophageal reflux disease (GERD) regarding dietary measures. The client has understood the recommended dietary changes by: • Avoiding chocolate and coffee. Question Which of the following assessment findings would be most important for indicating dumping syndrome in a postgastrectomy client? • Weakness, diaphoresis, diarrhea 90 minutes after eating Question The nurse is obtaining a history on a patient who comes to the clinic. What symptom described by the patient is one of the first symptoms associated with esophageal disease? • Dysphagia Question An elderly patient is diagnosed with parotitis. The nurse is aware that this bacterial infection is most likely caused by: • Staphylococcus aureus. Question A nurse entersthe room of a client who has returned to the unit after having a radical neck dissection. Which assessment finding requires immediate intervention? • The client lying in a lateral position, with the head of bed flat Question The most common symptom of esophageal disease is • dysphagia. Question Which is the primary symptom of achalasia? • Difficulty swallowing Question The client is postoperative following a graft reconstruction of the neck. It is most important for the nurse to • Assessthe graft for color and temperature. Question Which of the following are functions of saliva? Select all that apply. • Lubrication • Protection against harmful bacteria • Digestion Question An elderly client seeks medical attention for a vague complaint of difficulty swallowing. Which of the following assessment findings is most significant as related to this symptom? • Esophageal tumor Question Which is an accurate statement regarding cancer of the esophagus? • Chronic irritation of the esophagus is a known risk factor. Question Postoperatively, a client with a radical neck dissection should be placed in which position? • Fowler Question The nurse is creating a plan of care for a client who is not able to tolerate brushing his teeth. The nurse includes which mouth irrigation in the plan of care? • Baking soda and water Question An older adult patient who has been living at home alone is diagnosed with parotitis. What causative bacteria does the nurse suspect is the cause of the parotitis? • Staphylococcus aureus Question A client who reports increasing difficulty swallowing, weight loss, and fatigue is diagnosed with esophageal cancer. Because this client has difficulty swallowing, the nurse should assign highest priority to: • maintaining a patent airway. Question To prevent gastroesophageal reflux in a client with hiatal hernia, the nurse should provide which discharge instruction? • "Avoid coffee and alcoholic beverages." Question An adolescent client with multiple dental cariesis discussing his diet with the nurse. The nurse explores the client's behaviors and identifies a risk factor for dental caries when the client states: • "I drink a can of carbonated soda at lunch every day." Question A client has a radical neck dissection to treat cancer of the neck. The nurse develops the care plan and includes all the following diagnoses. The nurse identifies the highest priority diagnosis as • Ineffective airway clearance related to obstruction by mucus Question A client with a disorder of the oral cavity cannot tolerate tooth brushing or flossing. Which of the following strategies can the nurse employ to assist this client? • Provide the client with an irrigating solution of baking soda and warm water. Question Which of the following is one of the first clinical manifestations of esophageal cancer? • Increasing difficulty in swallowing Question The nurse is creating a discharge teaching plan for a client after surgery for oral cancer. Which should be included in the teaching plan? Select all that apply. • Oral hygiene • Follow-up dental appointment • Follow-up medical appointment • Use of humidification Question A nurse caring for a patient who has had radical neck surgery notices an abnormal amount of serosanguineous secretions in the wound suction unit during the first postoperative day. An expected normal amount of drainage is: • Approximately 80 to 120 mL. Question A nurse caring for a patient who has had radical neck surgery notices an abnormal amount of serosanguineous secretions in the wound suction unit during the first postoperative day. An expected normal amount of drainage is: • Approximately 80 to 120 mL. Question Select the assessment finding that the nurse should immediately report, post radical neck dissection. • Stridor Question A client has a new order for metoclorpramide (Reglan). The nurse knows that this medication should not be used long term and only in cases where all other options have been exhausted. This is because this medication has the potential for extrapyramidal side effects. Extrapyramidal side effects include which of the following? • Uncontrolled rhythmic movements of the face or limbs Question A client has received a diagnosis of oral cancer. During client education, the client expresses dismay at not having recognized any early signs or symptoms of the disease. The nurse tells the client that in early stages of this disease: • there are usually no symptoms. Question The most common symptom of esophageal disease is • dysphagia. Question The nurse is obtaining a history on a patient who comes to the clinic. What symptom described by the patient is one of the first symptoms associated with esophageal disease? • Dysphagia Question A patient describes a burning sensation in the esophagus, pain when swallowing, and frequent indigestion. What does the nurse suspect that these clinical manifestations indicate? • Gastroesophageal reflux disease Question A patient who is HIV positive comes to the clinic and is experiencing white patches with rough hairlike projections. The nurse observes the lesions on the lateral border of the tongue. What abnormality of the mouth does the nurse determine these lesions are? • Hairy leukoplakia Question A patient has been taking a 10-day course of antibiotics for pneumonia. The patient has been having white patchesthat look like milk curds in the mouth. What treatment will the nurse educate the patient about? • Nystatin (Mycostatin) Question During postoperative neck dissection assessment, the nurse notices excessive bleeding from the dressing site. She suspects possible carotid artery rupture and takes the immediate first step to: • Apply pressure to the bleeding site or major associated vessel. Question A patient has been diagnosed with a hiatal hernia. The nurse explains the diagnosis to the patient and his family by telling them that a hernia is a (an): • Protrusion of the upper stomach into the lower portion of the thorax. Question When assessing a client during a routine checkup, the nurse reviews the history and notesthat the client had aphthous stomatitis at the time of the last visit. Aphthous stomatitis is best described as: • a canker sore of the oralsoft tissues. Question Which is an accurate statement regarding cancer of the esophagus? • Chronic irritation of the esophagus is a known risk factor. Question Which is the primary symptom of achalasia? • Difficulty swallowing Question An elderly client states, "I don't understand why I have so many caries in my teeth." The nurse assesses the following as placing the client at risk: • Exhibiting hemoglobin A1C 8.2 Question A client in the emergency department reports that a piece of meat became stuck in the throat while eating. The nurse notes the client is anxious with respirations at 30 breaths/min, frequent swallowing, and little saliva in the mouth. An esophagogastroscopy with removal of foreign body isscheduled for today. The first activity of the nurse is to: • Assesslung sounds bilaterally. Question An elderly client seeks medical attention for a vague complaint of difficulty swallowing. Which of the following assessment findings is most significant as related to this symptom? • Esophageal tumor Question Which of the following assessment findings would be most important for indicating dumping syndrome in a postgastrectomy client? • Weakness, diaphoresis, diarrhea 90 minutes after eating Question A client with gastroesophageal reflux disease (GERD) comesto the physician’s office reporting a burning sensation in the esophagus. The nurse documents that the client is experiencing • pyrosis. Question The nurse working in the recovery room is caring for a client who had a radical neck dissection. The nurse noticesthat the client makes a coarse, high-pitched sound upon inspiration. Which intervention by the nurse is appropriate? • Notify the physician Question An older adult patient who has been living at home alone is diagnosed with parotitis. What causative bacteria does the nurse suspect is the cause of the parotitis? • Staphylococcus aureus