Brunner & Suddarth: Test Bank (Chapter
45) Questions And Verified Answers
A nnurse nis nproviding noral ncare nto na npatient nwho nis ncomatose. nWhat naction nbest naddresses nthe
npatients nrisk nof ntooth ndecay nand nplaque naccumulation?
A) nIrrigating nthe nmouth nusing na nsyringe nfilled nwith na nbacteriocidal nmouthwash
B) nApplying na nwater-soluble ngel nto nthe nteeth nand ngums
C) nWiping nthe nteeth nand ngums nclean nwith na ngauze npad
D) nBrushing nthe npatients nteeth nwith na ntoothbrush nand nsmall namount nof ntoothpaste n- nAnswer n-
nAns: nD) nBrushing nthe npatients nteeth nwith na ntoothbrush nand na nsmall namount nof ntoothpaste
Feedback:
Application nof nmechanical nfriction nis nthe nmost neffective nway nto ncleanse nthe npatients nmouth. nIf
nthe npatient nis nunable nto nbrush nteeth, nthe nnurse nmay nbrush nthem, ntaking nprecautions nto
nprevent naspiration; nor nas na nsubstitute, nthe nnurse ncan nachieve nmechanical nfriction nby nwiping
nthe nteeth nwith na ngauze npad. nBacteriocidal nmouthwash ndoes nreduce nplaque-causing nbacteria;
nhowever, nit nis nnot nas neffective nas napplication nof nmechanical nfriction. nWater-soluble ngel nmay
nbe napplied nto nlubricate ndry nlips, nbut nit nis nnot npart nof noral ncare.
An nelderly npatient ncomes ninto nthe nemergency ndepartment ncomplaining nof nan nearache. nThe
npatient nand nhas nan noral ntemperature nof n100.2F nand notoscopic nassessment nof nthe near nreveals
na npearly ngray ntympanic nmembrane nwith nno nevidence nof ndischarge nor ninflammation. nWhich
naction nshould nthe ntriage nnurse ntake nnext?
A) nPalpate nthe npatients nparotid nglands nto ndetect nswelling nand ntenderness.
B) nAssess nthe ntemporomandibular njoint nfor nevidence nof na nmalocclusion.
C) nTest nthe nintegrity nof ncranial nnerve nXII nby nasking nthe npatient nto nprotrude nthe ntongue.
D) nInspect nthe npatients ngums nfor nbleeding nand nhyperpigmentation. n- nAnswer n- nAns: nA) nPalpate
nthe npatients nparotid nglands nto ndetect nswelling nand ntenderness
,Feedback:
Older nadults nand ndebilitated npatients nof nany nage nwho nare ndehydrated nor ntaking nmedications
nthat nreduce nsaliva nproduction nare nat nrisk nfor nparotitis. nSymptoms ninclude nfever nand
ntenderness, nas nwell nas nswelling nof nthe nparotid nglands. nPain nradiates nto nthe near. nPain
nassociated nwith nmalocclusion nof nthe ntemporomandibular njoint nmay nalso nradiate nto nthe nears;
nhowever, na ntemperature nelevation nwould nnot nbe nassociated nwith nmalocclusion. nThe n12th
ncranial nnerve nis nnot nassociated nwith nthe nauditory nsystem. nBleeding nand nhyperpigmented ngums
nmay nbe ncaused nby npyorrhea nor ngingivitis. nThese nconditions ndo nnot ncause nearache; nfever nwould
nnot nbe npresent nunless nthe nteeth nwere nabscessed.
A npatient nwho nhad na nhemiglossectomy nearlier nin nthe nday nis nassessed npostoperatively, nrevealing
na npatent nairway, nstable nvital nsigns, nand nno nbleeding nor ndrainage nfrom nthe noperative nsite. nThe
nnurse nnotes nthe npatient nis nalert. nWhat nis nthe npatients npriority nneed nat nthis ntime?
A) nEmotional nsupport nfrom nvisitors nand nstaff
B) nAn neffective nmeans nof ncommunicating nwith nthe nnurse
C) nReferral nto na nspeech ntherapist
D) nDietary nteaching nfocused non nconsistency nof nfood nand nfrequency nof nfeedings n- nAnswer n-
nAns: nB) nAn neffective nmeans nof ncommunicating nwith nthe nnurse
Feedback:
Verbal ncommunication nmay nbe nimpaired nby nradical nsurgery nfor noral ncancer. nIt nis ntherefore nvital
nto nassess nthe npatients nability nto ncommunicate nin nwriting nbefore nsurgery. nEmotional nsupport
nand ndietary nteaching nare ncritical naspects nof nthe nplan nof ncare; nhowever, nthe npatients nability nto
ncommunicate nwould nbe nessential nfor nboth. nReferral nto na nspeech ntherapist nwill nbe nrequired nas
npart nof nthe npatients nrehabilitation; nhowever, nit nis nnot na npriority nat nthis nparticular ntime.
nCommunication nwith nthe nnurse nis ncrucial nfor nthe ndelivery nof nsafe nand neffective ncare.
The nnurse nnotes nthat na npatient nwho nhas nundergone nskin, ntissue, nand nmuscle ngrafting nfollowing
na nmodified nradical nneck ndissection nrequires nsuctioning. nWhat nis nthe nmost nimportant
nconsideration nfor nthe nnurse nwhen nsuctioning nthis npatient?
A) nAvoid napplying nsuction non nor nnear nthe nsuture nline.
B) nPosition npatient non nthe nnon noperative nside nwith nthe nhead nof nthe nbed ndown.
, C) nAssess nthe npatients nability nto nperform nself-suctioning.
D) nEvaluate nthe npatients nability nto nswallow nsaliva nand nclear nfluids. n- nAnswer n- nAns: nA) nAvoid
napplying nsuction non nor nnear nthe nsuture nline
Feedback:
The nnurse nshould navoid npositioning nthe nsuction ncatheter non nor nnear nthe ngraft nsuture nlines.
nApplication nof nsuction nin nthese nareas ncould ndamage nthe ngraft. nSelf-sectioning nmay nbe nunsafe
nbecause nthe npatient nmay ndamage nthe nsuture nline. nFollowing na nmodified nradical nneck ndissection
nwith ngraft, nthe npatient nis nusually npositioned nwith nthe nhead nof nthe nbed nelevated nto npromote
ndrainage nand nreduce nedema. nAssessing nviability nof nthe ngraft nis nimportant nbut nis nnot npart nof
nthe nsuctioning nprocedure nand nmay ndelay ninitiating nsuctioning. nMaintenance nof na npatent nairway
nis na nnursing npriority. nSimilarly, nthe npatients nability nto nswallow nis nan nimportant nassessment nfor
nthe nnurse nto nmake; nhowever, nit nis nnot ndirectly nlinked nto nthe npatients nneed nfor nsuctioning.
A npatient nwith ngastroesophageal nreflux ndisease n(GERD) nhas na ndiagnosis nof nBarretts nesophagus
nwith nminor ncell nchanges. nWhich nof nthe nfollowing nprinciples nshould nbe nintegrated ninto nthe
npatients nsubsequent ncare?
A) nThe npatient nwill nrequire nan nupper nendoscopy nevery n6 nmonths nto ndetect nmalignant nchanges.
B) nLiver nenzymes nmust nbe nchecked nregularly, nas nH2 nreceptor nantagonists nmay ncause nhepatic
ndamage.
C) nSmall namounts nof nblood nare nlikely nto nbe npresent nin nthe nstools nand nare nnot ncause nfor
nconcern.
D) nAntacids nmay nbe ndiscontinued nwhen nsymptoms nof nheartburn nsubside. n- nAnswer n- nAns: nA)
nThe npatient nwill nrequire nan nupper nendoscopy nevery n6 nmonths nto ndetect nmalignant nchanges
Feedback:
In nthe npatient nwith nBarretts nesophagus, nthe ncells nlining nthe nlower nesophagus nhave nundergone
nchange nand nare nno nlonger nsquamous ncells. nThe naltered ncells nare nconsidered nprecancerous nand
nare na nprecursor nto nesophageal ncancer. nIn norder nto nfacilitate nearly ndetection nof nmalignant ncells,
nan nupper nendoscopy nis nrecommended nevery n6 nmonths. nH2receptor nantagonists nare ncommonly
nprescribed nfor npatients nwith nGERD; nhowever, nmonitoring nof nliver nenzymes nis nnot nroutine.
nStools nthat ncontain nevidence nof nfrank nbleeding nor nthat nare ntarry nare nnot nexpected nand nshould
nbe nreported nimmediately. nWhen nantacids nare nprescribed nfor npatients nwith nGERD, nthey nshould
nbe ntaken nas nordered nwhether nor nnot nthe npatient nis nsymptomatic.
45) Questions And Verified Answers
A nnurse nis nproviding noral ncare nto na npatient nwho nis ncomatose. nWhat naction nbest naddresses nthe
npatients nrisk nof ntooth ndecay nand nplaque naccumulation?
A) nIrrigating nthe nmouth nusing na nsyringe nfilled nwith na nbacteriocidal nmouthwash
B) nApplying na nwater-soluble ngel nto nthe nteeth nand ngums
C) nWiping nthe nteeth nand ngums nclean nwith na ngauze npad
D) nBrushing nthe npatients nteeth nwith na ntoothbrush nand nsmall namount nof ntoothpaste n- nAnswer n-
nAns: nD) nBrushing nthe npatients nteeth nwith na ntoothbrush nand na nsmall namount nof ntoothpaste
Feedback:
Application nof nmechanical nfriction nis nthe nmost neffective nway nto ncleanse nthe npatients nmouth. nIf
nthe npatient nis nunable nto nbrush nteeth, nthe nnurse nmay nbrush nthem, ntaking nprecautions nto
nprevent naspiration; nor nas na nsubstitute, nthe nnurse ncan nachieve nmechanical nfriction nby nwiping
nthe nteeth nwith na ngauze npad. nBacteriocidal nmouthwash ndoes nreduce nplaque-causing nbacteria;
nhowever, nit nis nnot nas neffective nas napplication nof nmechanical nfriction. nWater-soluble ngel nmay
nbe napplied nto nlubricate ndry nlips, nbut nit nis nnot npart nof noral ncare.
An nelderly npatient ncomes ninto nthe nemergency ndepartment ncomplaining nof nan nearache. nThe
npatient nand nhas nan noral ntemperature nof n100.2F nand notoscopic nassessment nof nthe near nreveals
na npearly ngray ntympanic nmembrane nwith nno nevidence nof ndischarge nor ninflammation. nWhich
naction nshould nthe ntriage nnurse ntake nnext?
A) nPalpate nthe npatients nparotid nglands nto ndetect nswelling nand ntenderness.
B) nAssess nthe ntemporomandibular njoint nfor nevidence nof na nmalocclusion.
C) nTest nthe nintegrity nof ncranial nnerve nXII nby nasking nthe npatient nto nprotrude nthe ntongue.
D) nInspect nthe npatients ngums nfor nbleeding nand nhyperpigmentation. n- nAnswer n- nAns: nA) nPalpate
nthe npatients nparotid nglands nto ndetect nswelling nand ntenderness
,Feedback:
Older nadults nand ndebilitated npatients nof nany nage nwho nare ndehydrated nor ntaking nmedications
nthat nreduce nsaliva nproduction nare nat nrisk nfor nparotitis. nSymptoms ninclude nfever nand
ntenderness, nas nwell nas nswelling nof nthe nparotid nglands. nPain nradiates nto nthe near. nPain
nassociated nwith nmalocclusion nof nthe ntemporomandibular njoint nmay nalso nradiate nto nthe nears;
nhowever, na ntemperature nelevation nwould nnot nbe nassociated nwith nmalocclusion. nThe n12th
ncranial nnerve nis nnot nassociated nwith nthe nauditory nsystem. nBleeding nand nhyperpigmented ngums
nmay nbe ncaused nby npyorrhea nor ngingivitis. nThese nconditions ndo nnot ncause nearache; nfever nwould
nnot nbe npresent nunless nthe nteeth nwere nabscessed.
A npatient nwho nhad na nhemiglossectomy nearlier nin nthe nday nis nassessed npostoperatively, nrevealing
na npatent nairway, nstable nvital nsigns, nand nno nbleeding nor ndrainage nfrom nthe noperative nsite. nThe
nnurse nnotes nthe npatient nis nalert. nWhat nis nthe npatients npriority nneed nat nthis ntime?
A) nEmotional nsupport nfrom nvisitors nand nstaff
B) nAn neffective nmeans nof ncommunicating nwith nthe nnurse
C) nReferral nto na nspeech ntherapist
D) nDietary nteaching nfocused non nconsistency nof nfood nand nfrequency nof nfeedings n- nAnswer n-
nAns: nB) nAn neffective nmeans nof ncommunicating nwith nthe nnurse
Feedback:
Verbal ncommunication nmay nbe nimpaired nby nradical nsurgery nfor noral ncancer. nIt nis ntherefore nvital
nto nassess nthe npatients nability nto ncommunicate nin nwriting nbefore nsurgery. nEmotional nsupport
nand ndietary nteaching nare ncritical naspects nof nthe nplan nof ncare; nhowever, nthe npatients nability nto
ncommunicate nwould nbe nessential nfor nboth. nReferral nto na nspeech ntherapist nwill nbe nrequired nas
npart nof nthe npatients nrehabilitation; nhowever, nit nis nnot na npriority nat nthis nparticular ntime.
nCommunication nwith nthe nnurse nis ncrucial nfor nthe ndelivery nof nsafe nand neffective ncare.
The nnurse nnotes nthat na npatient nwho nhas nundergone nskin, ntissue, nand nmuscle ngrafting nfollowing
na nmodified nradical nneck ndissection nrequires nsuctioning. nWhat nis nthe nmost nimportant
nconsideration nfor nthe nnurse nwhen nsuctioning nthis npatient?
A) nAvoid napplying nsuction non nor nnear nthe nsuture nline.
B) nPosition npatient non nthe nnon noperative nside nwith nthe nhead nof nthe nbed ndown.
, C) nAssess nthe npatients nability nto nperform nself-suctioning.
D) nEvaluate nthe npatients nability nto nswallow nsaliva nand nclear nfluids. n- nAnswer n- nAns: nA) nAvoid
napplying nsuction non nor nnear nthe nsuture nline
Feedback:
The nnurse nshould navoid npositioning nthe nsuction ncatheter non nor nnear nthe ngraft nsuture nlines.
nApplication nof nsuction nin nthese nareas ncould ndamage nthe ngraft. nSelf-sectioning nmay nbe nunsafe
nbecause nthe npatient nmay ndamage nthe nsuture nline. nFollowing na nmodified nradical nneck ndissection
nwith ngraft, nthe npatient nis nusually npositioned nwith nthe nhead nof nthe nbed nelevated nto npromote
ndrainage nand nreduce nedema. nAssessing nviability nof nthe ngraft nis nimportant nbut nis nnot npart nof
nthe nsuctioning nprocedure nand nmay ndelay ninitiating nsuctioning. nMaintenance nof na npatent nairway
nis na nnursing npriority. nSimilarly, nthe npatients nability nto nswallow nis nan nimportant nassessment nfor
nthe nnurse nto nmake; nhowever, nit nis nnot ndirectly nlinked nto nthe npatients nneed nfor nsuctioning.
A npatient nwith ngastroesophageal nreflux ndisease n(GERD) nhas na ndiagnosis nof nBarretts nesophagus
nwith nminor ncell nchanges. nWhich nof nthe nfollowing nprinciples nshould nbe nintegrated ninto nthe
npatients nsubsequent ncare?
A) nThe npatient nwill nrequire nan nupper nendoscopy nevery n6 nmonths nto ndetect nmalignant nchanges.
B) nLiver nenzymes nmust nbe nchecked nregularly, nas nH2 nreceptor nantagonists nmay ncause nhepatic
ndamage.
C) nSmall namounts nof nblood nare nlikely nto nbe npresent nin nthe nstools nand nare nnot ncause nfor
nconcern.
D) nAntacids nmay nbe ndiscontinued nwhen nsymptoms nof nheartburn nsubside. n- nAnswer n- nAns: nA)
nThe npatient nwill nrequire nan nupper nendoscopy nevery n6 nmonths nto ndetect nmalignant nchanges
Feedback:
In nthe npatient nwith nBarretts nesophagus, nthe ncells nlining nthe nlower nesophagus nhave nundergone
nchange nand nare nno nlonger nsquamous ncells. nThe naltered ncells nare nconsidered nprecancerous nand
nare na nprecursor nto nesophageal ncancer. nIn norder nto nfacilitate nearly ndetection nof nmalignant ncells,
nan nupper nendoscopy nis nrecommended nevery n6 nmonths. nH2receptor nantagonists nare ncommonly
nprescribed nfor npatients nwith nGERD; nhowever, nmonitoring nof nliver nenzymes nis nnot nroutine.
nStools nthat ncontain nevidence nof nfrank nbleeding nor nthat nare ntarry nare nnot nexpected nand nshould
nbe nreported nimmediately. nWhen nantacids nare nprescribed nfor npatients nwith nGERD, nthey nshould
nbe ntaken nas nordered nwhether nor nnot nthe npatient nis nsymptomatic.
