MDC II Final Questions
1. A 72-year-old man has recently been diagnosed with oral cancer. He has
been undergoing both radiation and chemotherapy. While visiting his
oncologist, he mentions to the nurse that he has lost all of his hair and that
his mouth is very dry. He also states that he is certain he has a cavity, because
one of his teeth is hurting.
What teaching will the nurse provide to decrease the incidence of dry mouth?
A.Consume eight glasses of water daily.
B.See the dentist immediately to get the tooth filled.
C.Brush with a combined mixture of baking soda and salt.
D.Increase dietary intake of grapefruits and oranges, which are high in vitamin
C.: ANS: A
Drinking plenty of water will help increase moisture of the tissues. Dental work
should be postponed until the patient gets clearance from the oncologist. Spicy
and/or abrasive foods, such as citrus and salt, should be avoided because they
aggravate dry mouth.
2. Twenty minutes later after a careful assessment of the patient, the nurse
notes that the patient's SaO2 is 89% and he has crackles scattered bilaterally.
The oncologist decides to admit the patient to an acute care oncology unit,
and within the hour, he is transported to a hospital unit.
What is the priority nursing intervention upon admission?
A.Start IV normal saline for rehydration.
B.Ask the oncologist for a dental consult.
C.Apply oxygen at 2 L per nasal cannula.
D.Perform frequent oral care with normal saline.: ANS: C
Although all of these orders are important, the first priority is airway management.
3. Based on the nurse's admission priority for this patient, which
interventions should be implemented? (Select all that apply.)
A.Instruct the patient on how to cough effectively.
, MDC II Final Questions
B.Humidify the oxygen that the patient is receiving.
C.Teach the patient to use oral suctioning as needed.
D.Ambulate the patient to the end of the hall twice every shift.
E.Monitor cough and gag reflexes with every shift assessment.: ANS: A, B, C,
E
The priority on admission is airway management. Although the patient should
ambulate as tolerated, it would be better to start with a shorter distance and monitor
his SaO2 before having him walk longer distances.
4. The next day, the patient's daughter tells the nurse that her father refuses
to eat meat because he doesn't like the taste. She asks for advice about
increasing his dietary protein.
What is the appropriate nursing response?
A."I'll ask the oncologist to talk with you about this."
B."Try adding seasonings or using sauces to enhance the taste of meat."
C."Remind your father that protein intake is essential if he is to recover."
D."Radiation can cause changes in taste buds that may be temporary or
permanent.": ANS: B
Responses C and D do not address the daughter's question. Response A does not
offer a viable solution to the problem. Adding seasonings, gravies, or sauces can
make meat more palatable. Another suggestion would be to offer other high-protein
food sources such as cheese, milk, eggs, puddings, and legumes.
5. Two days later, as the patient is preparing for discharge, he discusses
some concerns with the nurse. Which patient statement alerts the nurse to a
potential body image concern?
A."My wife and I are going to a play tonight."
B."My grandchildren don't want to hug me anymore."
C."I am going to fight this cancer with all I've got."
D."Losing my hair gave me a good reason to wear my ball cap collection.":
ANS: B
, MDC II Final Questions
This statement could indicate that the patient is concerned that his grandchildren
do not want to hug him because of how he looks. The other statements illustrate
that the patient is coping with his condition.
6. A patient is scheduled to start chemotherapy. What oral cavity problem
does the nurse teach the patient that may occur?
A.Stomatitis
B.Candidiasis
C.Xerostomia
D.Oral abscess: ANS: A
Secondary stomatitis generally results from infection by opportunistic viruses, fungi,
or bacteria in patients who are immunocompromised, or it results from drugs such
as chemotherapy. Xerostomia is usually related to radiation in the oral cavity region.
Candidiasis is an opportunistic stomatitis that can be seen in older adults and other
immunocompromised patients. Oral abscess is a potential complication.
7. A 23-year-old female patient reports having red, raised lesions at the
base of her tongue and on the inside of her mouth for the past 3 weeks. What
priority assessment question should the nurse ask?
A."Do you smoke cigarettes?"
B."What type of work do you do?"
C."Have you seen a dentist recently?"
D."Do you have a history of human papillomavirus?": ANS: D
It is now confirmed that in younger age groups, including those who have never
used tobacco products, mouth lesions can be caused by human papillomavirus
(HPV). HPV, particularly version 16, has been shown to be sexually transmitted
between partners and is conclusively implicated in the increasing incidence of
young, nonsmoking oral cancer patients.
8. An older patient with poor oral hygiene was admitted after a fall in which
he sustained a fractured hip. What is the priority nursing intervention?
A.Initiate oral care every 4 hours.
B.Implement aspiration precautions.
C.Request a consult with a registered dietitian.
, MDC II Final Questions
D.Use swabs to moisten the mouth as needed.: ANS: B
It is now known that older adults who have poor oral hygiene are at high risk for
mouth infections and aspiration pneumonia. Aspiration precautions should be
immediately implemented, followed by initiation of regular oral care. Implementing
good oral care that avoids alcohol-containing oral solutions and lemon glycerin
swabs is important. A consult with a registered dietitian may assist with
determining the patient's dentition and nutrient needs to assist with healing
postoperatively.
9. Which patient statement alerts the nurse to perform a thorough GI
history and focused assessment?
"I don't like the taste of spicy foods."
"I got dentures four years ago."
"I experience occasional constipation."
"I take ibuprofen three times daily for arthritis.": ANS: D
Large amounts of aspirin or other nonsteroidal antiinflammatory drugs (NSAIDs)
such as ibuprofen can predispose the patient to peptic ulcer disease and GI
bleeding.
10. After abdominal surgery, which question should the nurse ask the
patient to determine whether peristaltic movement is returning?
A."Have you passed flatus?"
B."Are you hungry"
C."Do you have any nausea?"
D."Is your pain level manageable?": ANS: A
Evidence indicates that the patient's report of passing flatus is the best indicator of
whether peristaltic movement is returning after surgery.
11. When administering a new GI medication to an older patient, the nurse
anticipates what?
A.A higher-than-normal dose may be needed.
B.Close monitoring is needed because toxic levels may develop.
1. A 72-year-old man has recently been diagnosed with oral cancer. He has
been undergoing both radiation and chemotherapy. While visiting his
oncologist, he mentions to the nurse that he has lost all of his hair and that
his mouth is very dry. He also states that he is certain he has a cavity, because
one of his teeth is hurting.
What teaching will the nurse provide to decrease the incidence of dry mouth?
A.Consume eight glasses of water daily.
B.See the dentist immediately to get the tooth filled.
C.Brush with a combined mixture of baking soda and salt.
D.Increase dietary intake of grapefruits and oranges, which are high in vitamin
C.: ANS: A
Drinking plenty of water will help increase moisture of the tissues. Dental work
should be postponed until the patient gets clearance from the oncologist. Spicy
and/or abrasive foods, such as citrus and salt, should be avoided because they
aggravate dry mouth.
2. Twenty minutes later after a careful assessment of the patient, the nurse
notes that the patient's SaO2 is 89% and he has crackles scattered bilaterally.
The oncologist decides to admit the patient to an acute care oncology unit,
and within the hour, he is transported to a hospital unit.
What is the priority nursing intervention upon admission?
A.Start IV normal saline for rehydration.
B.Ask the oncologist for a dental consult.
C.Apply oxygen at 2 L per nasal cannula.
D.Perform frequent oral care with normal saline.: ANS: C
Although all of these orders are important, the first priority is airway management.
3. Based on the nurse's admission priority for this patient, which
interventions should be implemented? (Select all that apply.)
A.Instruct the patient on how to cough effectively.
, MDC II Final Questions
B.Humidify the oxygen that the patient is receiving.
C.Teach the patient to use oral suctioning as needed.
D.Ambulate the patient to the end of the hall twice every shift.
E.Monitor cough and gag reflexes with every shift assessment.: ANS: A, B, C,
E
The priority on admission is airway management. Although the patient should
ambulate as tolerated, it would be better to start with a shorter distance and monitor
his SaO2 before having him walk longer distances.
4. The next day, the patient's daughter tells the nurse that her father refuses
to eat meat because he doesn't like the taste. She asks for advice about
increasing his dietary protein.
What is the appropriate nursing response?
A."I'll ask the oncologist to talk with you about this."
B."Try adding seasonings or using sauces to enhance the taste of meat."
C."Remind your father that protein intake is essential if he is to recover."
D."Radiation can cause changes in taste buds that may be temporary or
permanent.": ANS: B
Responses C and D do not address the daughter's question. Response A does not
offer a viable solution to the problem. Adding seasonings, gravies, or sauces can
make meat more palatable. Another suggestion would be to offer other high-protein
food sources such as cheese, milk, eggs, puddings, and legumes.
5. Two days later, as the patient is preparing for discharge, he discusses
some concerns with the nurse. Which patient statement alerts the nurse to a
potential body image concern?
A."My wife and I are going to a play tonight."
B."My grandchildren don't want to hug me anymore."
C."I am going to fight this cancer with all I've got."
D."Losing my hair gave me a good reason to wear my ball cap collection.":
ANS: B
, MDC II Final Questions
This statement could indicate that the patient is concerned that his grandchildren
do not want to hug him because of how he looks. The other statements illustrate
that the patient is coping with his condition.
6. A patient is scheduled to start chemotherapy. What oral cavity problem
does the nurse teach the patient that may occur?
A.Stomatitis
B.Candidiasis
C.Xerostomia
D.Oral abscess: ANS: A
Secondary stomatitis generally results from infection by opportunistic viruses, fungi,
or bacteria in patients who are immunocompromised, or it results from drugs such
as chemotherapy. Xerostomia is usually related to radiation in the oral cavity region.
Candidiasis is an opportunistic stomatitis that can be seen in older adults and other
immunocompromised patients. Oral abscess is a potential complication.
7. A 23-year-old female patient reports having red, raised lesions at the
base of her tongue and on the inside of her mouth for the past 3 weeks. What
priority assessment question should the nurse ask?
A."Do you smoke cigarettes?"
B."What type of work do you do?"
C."Have you seen a dentist recently?"
D."Do you have a history of human papillomavirus?": ANS: D
It is now confirmed that in younger age groups, including those who have never
used tobacco products, mouth lesions can be caused by human papillomavirus
(HPV). HPV, particularly version 16, has been shown to be sexually transmitted
between partners and is conclusively implicated in the increasing incidence of
young, nonsmoking oral cancer patients.
8. An older patient with poor oral hygiene was admitted after a fall in which
he sustained a fractured hip. What is the priority nursing intervention?
A.Initiate oral care every 4 hours.
B.Implement aspiration precautions.
C.Request a consult with a registered dietitian.
, MDC II Final Questions
D.Use swabs to moisten the mouth as needed.: ANS: B
It is now known that older adults who have poor oral hygiene are at high risk for
mouth infections and aspiration pneumonia. Aspiration precautions should be
immediately implemented, followed by initiation of regular oral care. Implementing
good oral care that avoids alcohol-containing oral solutions and lemon glycerin
swabs is important. A consult with a registered dietitian may assist with
determining the patient's dentition and nutrient needs to assist with healing
postoperatively.
9. Which patient statement alerts the nurse to perform a thorough GI
history and focused assessment?
"I don't like the taste of spicy foods."
"I got dentures four years ago."
"I experience occasional constipation."
"I take ibuprofen three times daily for arthritis.": ANS: D
Large amounts of aspirin or other nonsteroidal antiinflammatory drugs (NSAIDs)
such as ibuprofen can predispose the patient to peptic ulcer disease and GI
bleeding.
10. After abdominal surgery, which question should the nurse ask the
patient to determine whether peristaltic movement is returning?
A."Have you passed flatus?"
B."Are you hungry"
C."Do you have any nausea?"
D."Is your pain level manageable?": ANS: A
Evidence indicates that the patient's report of passing flatus is the best indicator of
whether peristaltic movement is returning after surgery.
11. When administering a new GI medication to an older patient, the nurse
anticipates what?
A.A higher-than-normal dose may be needed.
B.Close monitoring is needed because toxic levels may develop.
