MDC 3 EXAM 2 ACTUAL EXAM 2026
QUESTIONS WITH ANSWERS GRADED A+
◉ Neck Cancer History. Answer: Difficulty speaking, SOB, tumor
bulk, tobacco/alcohol use, acute or chronic laryngitis/pharyngitis,
oral sores, difficulty swallowing, lumps in neck, exposure to HPV
◉ Neck Cancer Lab assessment. Answer: CBC, bleeding time,
urinalysis, blood chemistries, HPV test
◉ Neck Cancer scans. Answer: SPECT
CT PET
Panendoscopy - examination of the upper aerodigestive tract
(pharynx, larynx, upper trachea and oesophagus)
◉ Neck Cancer Interventions. Answer: 1) Priority is to remove or
eradicate the cancer while preserving function
2) Monitor gas exchange by assessing resp rate, breath sounds, pulse
ox, and ABG values
-Airway obstruction can occur from tumor growth, edema, or both
3) Teach pt to use the fowler's or semi fowler's position for best gas
exchange
,◉ Neck Cancer education r/t treatment radiation therapy. Answer:
1) After radiation therapy, pt might experience hoarseness,
dysphagia, skin problems, impaired taste, dry mouth, sore throat,
difficulty swallowing
2) Voice hoarseness usually improves 4-6 weeks after completion of
radiation therapy
3) For those with sore throat and difficulty swallowing, gargling with
saline or sucking on ice may decrease discomfort. Throat sprays
with local anesthetic agents such as lidocaine or diphenhydramine
may prove temporary relief
4) Skin may become red and tender and may peel during therapy
-Instruct pt to avoid exposure to sun, heat, cold, and abrasive actions
such as shaving
-Wear protective clothing made of soft cotton and wash area gently
with a mild soap such as Dove
-Use prescribed skin care products
5) If salivary glands are in the path of radiation, the mouth may
become dry (xerostomia). This is usually long-term and may be
permanent
-If this happens, educate on increased need for oral care to reduce
risk of caries, bad breath, and oral infections
-Heavy fluid intake and humidifiers can help, artificial saliva or
saliva stimulant may help1
,◉ Neck Cancer education r/t treatment Concurrent radiation
therapy with chemotherapy. Answer: Intensifies discomfort of
radiation alone
Educate not to take breaks as this will affect treatment outcome
◉ Neck Cancer education r/t treatment Biotherapy with epidermal
growth factor receptor inhibitors. Answer: Severe skin reactions are
common
◉ Peritonsillar abscess. Answer: Rare complication of acute
tonsillitis
Infection spreads from tonsils to surrounding tissue and forms an
abscess
Most common cause is beta-hemolytic step
◉ Peritonsillar abscess - treatment. Answer: -Most pts can be
treated as outpatients with antibiotics but antibiotics alone are often
ineffective
-Pt may need steroids to reduce swelling
-Pt may need drainage of abscess
-Pain control is important Drugs may include topical analgesics,
opioids
-Pt may need liquid drugs due to inability to swallow
-Tonsillectomy may be performed
, *Stress adherence of treatment
*Stress coming to the ER if signs of obstruction (drooling and
stridor) appear
◉ Laryngectomy. Answer: Voice conservation procedures are only
used if they do not risk incomplete removal of the tumor
Entire larynx, hyoid bone, strap muscles, one or two tracheal rings
removed
◉ Partial laryngectomy. Answer: some voice may be left,
tracheostomy is temporary
◉ Full laryngectomy. Answer: no natural voice is left, upper airway
is separated from the throat and esophagus and a permanent
laryngectomy stoma is created in the neck
◉ Laryngectomy pre op care. Answer: -Teach patient and family
about tumor
-Surgeon explains procedure and informed consent
-Discuss and interpret implications of consent
-Explain about self-management of the airway, suctioning, pain
control methods, the critical care environment (including ventilators
and critical care routines), nutritional support, feeding tubes, and
plans for discharge.
QUESTIONS WITH ANSWERS GRADED A+
◉ Neck Cancer History. Answer: Difficulty speaking, SOB, tumor
bulk, tobacco/alcohol use, acute or chronic laryngitis/pharyngitis,
oral sores, difficulty swallowing, lumps in neck, exposure to HPV
◉ Neck Cancer Lab assessment. Answer: CBC, bleeding time,
urinalysis, blood chemistries, HPV test
◉ Neck Cancer scans. Answer: SPECT
CT PET
Panendoscopy - examination of the upper aerodigestive tract
(pharynx, larynx, upper trachea and oesophagus)
◉ Neck Cancer Interventions. Answer: 1) Priority is to remove or
eradicate the cancer while preserving function
2) Monitor gas exchange by assessing resp rate, breath sounds, pulse
ox, and ABG values
-Airway obstruction can occur from tumor growth, edema, or both
3) Teach pt to use the fowler's or semi fowler's position for best gas
exchange
,◉ Neck Cancer education r/t treatment radiation therapy. Answer:
1) After radiation therapy, pt might experience hoarseness,
dysphagia, skin problems, impaired taste, dry mouth, sore throat,
difficulty swallowing
2) Voice hoarseness usually improves 4-6 weeks after completion of
radiation therapy
3) For those with sore throat and difficulty swallowing, gargling with
saline or sucking on ice may decrease discomfort. Throat sprays
with local anesthetic agents such as lidocaine or diphenhydramine
may prove temporary relief
4) Skin may become red and tender and may peel during therapy
-Instruct pt to avoid exposure to sun, heat, cold, and abrasive actions
such as shaving
-Wear protective clothing made of soft cotton and wash area gently
with a mild soap such as Dove
-Use prescribed skin care products
5) If salivary glands are in the path of radiation, the mouth may
become dry (xerostomia). This is usually long-term and may be
permanent
-If this happens, educate on increased need for oral care to reduce
risk of caries, bad breath, and oral infections
-Heavy fluid intake and humidifiers can help, artificial saliva or
saliva stimulant may help1
,◉ Neck Cancer education r/t treatment Concurrent radiation
therapy with chemotherapy. Answer: Intensifies discomfort of
radiation alone
Educate not to take breaks as this will affect treatment outcome
◉ Neck Cancer education r/t treatment Biotherapy with epidermal
growth factor receptor inhibitors. Answer: Severe skin reactions are
common
◉ Peritonsillar abscess. Answer: Rare complication of acute
tonsillitis
Infection spreads from tonsils to surrounding tissue and forms an
abscess
Most common cause is beta-hemolytic step
◉ Peritonsillar abscess - treatment. Answer: -Most pts can be
treated as outpatients with antibiotics but antibiotics alone are often
ineffective
-Pt may need steroids to reduce swelling
-Pt may need drainage of abscess
-Pain control is important Drugs may include topical analgesics,
opioids
-Pt may need liquid drugs due to inability to swallow
-Tonsillectomy may be performed
, *Stress adherence of treatment
*Stress coming to the ER if signs of obstruction (drooling and
stridor) appear
◉ Laryngectomy. Answer: Voice conservation procedures are only
used if they do not risk incomplete removal of the tumor
Entire larynx, hyoid bone, strap muscles, one or two tracheal rings
removed
◉ Partial laryngectomy. Answer: some voice may be left,
tracheostomy is temporary
◉ Full laryngectomy. Answer: no natural voice is left, upper airway
is separated from the throat and esophagus and a permanent
laryngectomy stoma is created in the neck
◉ Laryngectomy pre op care. Answer: -Teach patient and family
about tumor
-Surgeon explains procedure and informed consent
-Discuss and interpret implications of consent
-Explain about self-management of the airway, suctioning, pain
control methods, the critical care environment (including ventilators
and critical care routines), nutritional support, feeding tubes, and
plans for discharge.
