Chapter 31: Drugs Used to Treat Oral Disorders
Basic Pharmacology for Nurses, 17th Edition
MULTIPLE CHOICE
1. A patient with chronic obstructive pulmonary disease (COPD) uses a corticosteroid inhaler
bid. Which adverse effect is associated with this medication?
a. Mucositis
b. Plaque
c. Xerostomia
d. Candidiasis
ANS: D
Medications that predispose a patient to candidiasis are those that suppress the immune
system, including immunosuppressants, corticosteroids, cytotoxics, and broad spectrum
antibiotics. Educating patients on the importance of oral hygiene following prescribed
inhalation dosages will assist in decreasing this complication. Mucositis, plaque, and
xerostomia are not associated with steroid inhaler use.
DIF: Cognitive Level: Application REF: Page 485 OBJ: 1
TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Physiological Integrity
NOT: CONCEPT(S): Clinical Judgment; Safety; Infection
2. The nurse is assessing a patient’s mouth and notes white, milk curd-appearing plaques
attached to the oral mucosa. Which condition is present?
a. Thrush
b. Canker sores
c. Cold sores
d. Mucositis
ANS: A
Thrush is characterized by white, milk curd-appearing plaques that are attached to the oral
mucosa. Canker sores can appear as ulcers 0.5 to 2 cm in diameter on surfaces that are not
attached to bone, such as the tongue, gums, or inner lining of the cheeks and lips. Cold sores
(“fever blisters”) are most commonly found at the junction of the mucous membrane and the
skin of the lips or nostrils, although they can occur inside the mouth, especially affecting the
gums and roof of the mouth. Mucositis is a general term used to describe a painful
inflammation of the mucous membranes of the mouth.
DIF: Cognitive Level: Knowledge REF: Page 485 OBJ: 1
TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Health Promotion and Maintenance
NOT: CONCEPT(S): Clinical Judgment; Infection
3. What is the primary pharmacologic therapy for Candida albicans?
a. Steroids
b. Antifungal agents
c. Topical anesthetics
d. Topical anti-inflammatory agents
, ANS: B
Candida albicans is the most common oral infection appearing in extremely debilitated
patients. Medications that predispose a person to C. albicans infections are those that depress
the immune system and those that cause xerostomia. C. albicans is a fungus and therefore is
treated with antifungal agents such as nystatin (Mycostatin). Steroids, topical anesthetics, and
topical anti-inflammatory agents are not used to treat C. albicans.
DIF: Cognitive Level: Knowledge REF: Page 485 OBJ: 1 | 2
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Health Promotion and Maintenance
NOT: CONCEPT(S): Clinical Judgment; Infection
4. Which condition is treated by saliva substitutes?
a. Caries
b. Mucositis
c. Xerostomia
d. Halitosis
ANS: C
Xerostomia, or lack of saliva, originates from nonoral causes. Xerostomia is treated by
discontinuing medications that dry the mucous membranes or by artificial saliva products.
Dentifrices are used to treat caries. Saliva substitutes are not used to treat mucositis.
Mouthwash is used to treat halitosis, along with dentifrices.
DIF: Cognitive Level: Knowledge REF: Page 486 OBJ: 1 | 2
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Health Promotion and Maintenance
NOT: CONCEPT(S): Clinical Judgment; Nutrition
5. Which information will the nurse include when teaching a patient about cold sores?
a. Use of drying agents prevents the spread of secretions.
b. Erupted lesions are not contagious.
c. Eruptions are related to breaks in personal hygiene.
d. Pus-filled lesions indicate a secondary bacterial infection.
ANS: D
Cold sore lesions first become visible as small red papules that later develop into 1- to 3-mm
diameter fluid-filled blisters. Over the following 10 to 14 days, a crust develops as the vesicles
that burst coalesce into larger lesions. The liquid from the vesicles contains the live virus that
can be transferred to other people by direct contact. The base of the lesions is erythematous. If
pus develops in the vesicles or under the crust of a cold sore, a secondary bacterial infection
may be present and the patient should seek medical attention. Drying agents are not used to
treat cold sores. Cold sores are contagious. Eruptions are not necessarily related to poor
personal hygiene.
DIF: Cognitive Level: Application REF: Page 484 OBJ: 1
TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Health Promotion and Maintenance
NOT: CONCEPT(S): Clinical Judgment; Infection
6. Which local anesthetic is used for inflammation of oral mucous membranes?
a. Chlorhexidine (Peridex)
Basic Pharmacology for Nurses, 17th Edition
MULTIPLE CHOICE
1. A patient with chronic obstructive pulmonary disease (COPD) uses a corticosteroid inhaler
bid. Which adverse effect is associated with this medication?
a. Mucositis
b. Plaque
c. Xerostomia
d. Candidiasis
ANS: D
Medications that predispose a patient to candidiasis are those that suppress the immune
system, including immunosuppressants, corticosteroids, cytotoxics, and broad spectrum
antibiotics. Educating patients on the importance of oral hygiene following prescribed
inhalation dosages will assist in decreasing this complication. Mucositis, plaque, and
xerostomia are not associated with steroid inhaler use.
DIF: Cognitive Level: Application REF: Page 485 OBJ: 1
TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Physiological Integrity
NOT: CONCEPT(S): Clinical Judgment; Safety; Infection
2. The nurse is assessing a patient’s mouth and notes white, milk curd-appearing plaques
attached to the oral mucosa. Which condition is present?
a. Thrush
b. Canker sores
c. Cold sores
d. Mucositis
ANS: A
Thrush is characterized by white, milk curd-appearing plaques that are attached to the oral
mucosa. Canker sores can appear as ulcers 0.5 to 2 cm in diameter on surfaces that are not
attached to bone, such as the tongue, gums, or inner lining of the cheeks and lips. Cold sores
(“fever blisters”) are most commonly found at the junction of the mucous membrane and the
skin of the lips or nostrils, although they can occur inside the mouth, especially affecting the
gums and roof of the mouth. Mucositis is a general term used to describe a painful
inflammation of the mucous membranes of the mouth.
DIF: Cognitive Level: Knowledge REF: Page 485 OBJ: 1
TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Health Promotion and Maintenance
NOT: CONCEPT(S): Clinical Judgment; Infection
3. What is the primary pharmacologic therapy for Candida albicans?
a. Steroids
b. Antifungal agents
c. Topical anesthetics
d. Topical anti-inflammatory agents
, ANS: B
Candida albicans is the most common oral infection appearing in extremely debilitated
patients. Medications that predispose a person to C. albicans infections are those that depress
the immune system and those that cause xerostomia. C. albicans is a fungus and therefore is
treated with antifungal agents such as nystatin (Mycostatin). Steroids, topical anesthetics, and
topical anti-inflammatory agents are not used to treat C. albicans.
DIF: Cognitive Level: Knowledge REF: Page 485 OBJ: 1 | 2
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Health Promotion and Maintenance
NOT: CONCEPT(S): Clinical Judgment; Infection
4. Which condition is treated by saliva substitutes?
a. Caries
b. Mucositis
c. Xerostomia
d. Halitosis
ANS: C
Xerostomia, or lack of saliva, originates from nonoral causes. Xerostomia is treated by
discontinuing medications that dry the mucous membranes or by artificial saliva products.
Dentifrices are used to treat caries. Saliva substitutes are not used to treat mucositis.
Mouthwash is used to treat halitosis, along with dentifrices.
DIF: Cognitive Level: Knowledge REF: Page 486 OBJ: 1 | 2
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Health Promotion and Maintenance
NOT: CONCEPT(S): Clinical Judgment; Nutrition
5. Which information will the nurse include when teaching a patient about cold sores?
a. Use of drying agents prevents the spread of secretions.
b. Erupted lesions are not contagious.
c. Eruptions are related to breaks in personal hygiene.
d. Pus-filled lesions indicate a secondary bacterial infection.
ANS: D
Cold sore lesions first become visible as small red papules that later develop into 1- to 3-mm
diameter fluid-filled blisters. Over the following 10 to 14 days, a crust develops as the vesicles
that burst coalesce into larger lesions. The liquid from the vesicles contains the live virus that
can be transferred to other people by direct contact. The base of the lesions is erythematous. If
pus develops in the vesicles or under the crust of a cold sore, a secondary bacterial infection
may be present and the patient should seek medical attention. Drying agents are not used to
treat cold sores. Cold sores are contagious. Eruptions are not necessarily related to poor
personal hygiene.
DIF: Cognitive Level: Application REF: Page 484 OBJ: 1
TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Health Promotion and Maintenance
NOT: CONCEPT(S): Clinical Judgment; Infection
6. Which local anesthetic is used for inflammation of oral mucous membranes?
a. Chlorhexidine (Peridex)
