Test Bank for Medical Surgical Nursing 10th Edition Ignatavicius (Test Bank PDF Files)
Chapter 49: Concepts of Care for Patients With Oral Cavity and Esophageal Problems
Ignatavicius: Medical-Surgical Nursing, 10th Edition
MULTIPLE CHOICE
1. The nurse is teaching a client diagnosed with stomatitis about special mouth care. Which
statement by the client indicates a need for further teaching?
a. “I need to take out my dentures until my mouth heals.”
b. “I’ll try to eat soft foods that aren’t spicy and acidic.”
c. “I will use a more firm toothbrush to keep my mouth clean.”
d. “I’ll be sure to rinse my mouth often with warm salt water.”
ANS: C
The client who has stomatitis has oral inflammation which causes discomfort. Therefore, all
of these actions help to avoid irritation except for needing to use a soft toothbrush or gauze
rather than a firm one.
DIF: Applying
TOP: Integrated Process: Teaching/Learning
KEY: Stomatitis, Oral care
MSC: Client Needs Category: Health Promotion and Maintenance
2. A client is admitted with a large oral tumor. What assessment by the nurse takes priority?
a. Airway
b. Breathing
c. Circulation
d. Nutrition
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ANS: A
Airway always takes priority. Airway must be assessed first and any problems managed if
present.
DIF: Applying
TOP: Integrated Process: Nursing Process: Assessment
KEY: Oral cancer, Assessment
MSC: Client Needs Category: Safe and Effective Care Environment: Management of Care
3. The nurse is teaching a client about the use of viscous lidocaine for oral pain. What health
teaching would the nurse include?
a. “Use the drug before every meal to prevent aspiration.”
b. “Increase your intake of citrus foods to help with healing.”
c. “Use the drug only at bedtime because you won’t be eating.”
d. “Be sure to check food temperatures before eating.”
ANS: D
Viscous lidocaine has an anesthetic effect in the oral cavity. Therefore, to promote client
safety, the nurse would want to teach the client to check food temperature before eating.
4. A nurse participates in a community screening event for oral cancer. What client is the
highest priority for referral to a primary health care provider?
a. Client who has poor oral hygiene practices.
b. Client who smokes and drinks daily.
c. Client who tans for an upcoming vacation.
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Test Bank for Medical Surgical Nursing 10th Edition Ignatavicius (Test Bank PDF Files)
d. Client who occasionally uses illicit drugs.
ANS: B
Smoking and alcohol exposure create a high risk for this client. Poor oral hygiene is not
related to the etiology of cancer but may cause a tumor to go unnoticed. Tanning is a risk
factor, but short-term exposure does not have the same risk as daily exposure to tobacco and
alcohol.
DIF: Understanding
TOP: Integrated Process: Nursing Process: Assessment
KEY: Oral cancer, Health screening
MSC: Client Needs Category: Health Promotion and Maintenance
5. The nurse notes that the primary health care provider documented the presence of mucosal
erythroplasia in a client. What does the nurse understand that this most likely means for this
client?
a. Early sign of oral cancer
b. Fungal mouth infection
c. Inflammation of the gums
d. Obvious oral tumor
ANS: A
Mucosal erythroplasia is the earliest sign of oral cancer. It is not a fungal infection,
inflammation of the gums, or an obvious tumor.
DIF: Remembering
TOP: Integrated Process: Nursing Process: Assessment
KEY: Oral cancer, Assessment
MSC: Client Needs Category: Physiological Integrity: Physiological Adaptation
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6. The nurse is caring for a client diagnosed with oral cancer. What is the nurse’s priority for
client care?
a. Encourage fluids to liquefy the client’s secretions.
b. Place the client on Aspiration Precautions.
c. Remind the client to use an incentive spirometer.
d. Manage the client’s pain and inflammation.
ANS: B
The client who has oral cancer often has difficulty swallowing and is at risk for aspiration and
possibly aspiration pneumonia. Therefore, the most important nursing action is to place the
client on precautions to prevent aspiration. The nurse would implement the other actions but
they are not as vital to promote client safety.
DIF: Applying
TOP: Integrated Process: Nursing Process: Planning and Implementation
KEY: Oral cancer, Plan of care
MSC: Client Needs Category: Safe and Effective Care Environment
7. A client has an open traditional hiatal hernia repair this morning. What is the nurse’s priority
for client care at this time?
a. Managing surgical pain
b. Ambulating the client early
c. Preventing respiratory complications
d. Managing the nasogastric tube
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Test Bank for Medical Surgical Nursing 10th Edition Ignatavicius (Test Bank PDF Files)
ANS: C
The client who has traditional surgery (rather than minimally invasive surgery) is at risk for
respiratory complications such as atelectasis and pneumonia because he or she has an incision
that may prevent the client from taking deep breaths or using an incentive spirometer.
Therefore, the nurse’s priority is to prevent these potentially life-threatening respiratory
problems.
DIF: Applying
TOP: Integrated Process: Nursing Process: Planning and Implementation
KEY: Hiatal hernia, Perioperative care
MSC: Client Needs Category: Safe and Effective Care Environment
8. Which of these client assessment findings is typically associated with oral cancer?
a. Dry sticky oral membranes
b. Increased appetite
c. Itchy rash in oral cavity
d. Painless red or raised lesion
ANS: D
A painless red or raised lesion often indicates a diagnosis of oral cancer. The client usually
has a decreased appetite and thick secretions. Itchiness is not a common finding associated
with oral cancer.
DIF: Remembering
TOP: Integrated Process: Nursing Process: Assessment
KEY: Oral cancer, Assessment
MSC: Client Needs Category: Physiological Integrity: Physiological Adaptation
MULTIPLE RESPONSE
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1. The nurse is caring for a client with sialadenitis. What comfort measures are appropriate for
this client? (Select all that apply.)
a. Applying warm compresses
b. Applying ice to salivary glands
c. Offering fluids every hour
d. Providing lemon-glycerin swabs
e. Reminding the patient to avoid speaking
ANS: A, C
Warm compresses and fluids can help promote comfort for this client. Application of ice or
lemon-glycerin swabs would not be used. Speaking has no effect on this condition.
DIF: Applying
TOP: Integrated Process: Nursing Process: Planning and Implementation
KEY: Oral disorders, Comfort measures
MSC: Client Needs Category: Physiological Integrity: Basic Care and Comfort
2. A nurse knows that job-related risks for developing oral cancer include which occupations?
(Select all that apply.)
a. Coal miner
b. Electrician
c. Metal worker
d. Plumber
e. Textile worker
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Test Bank for Medical Surgical Nursing 10th Edition Ignatavicius (Test Bank PDF Files)
ANS: A, C, D, E
The occupations of coal mining, metal working, plumbing, and textile work produce exposure
to polycyclic aromatic hydrocarbons (PAHs), which are known carcinogens. Electricians do
not have this risk.
DIF: Remembering
TOP: Integrated Process: Nursing Process: Assessment
KEY: Oral cancer, Risk factors
MSC: Client Needs Category: Physiological Integrity: Physiological Adaptation
3. The nurse is caring for a client who had an open traditional esophagectomy. Which
assessment findings would the nurse report immediately to the primary health care provider?
(Select all that apply.)
a. Nausea
b. Wound dehiscence
c. Fever
d. Tachycardia
e. Moderate pain
f. Fatigue
ANS: B, C, D
Wound dehiscence is a serious, potentially life-threatening problem that needs immediate
attention of the primary health care provider, typically the surgeon. Fever and tachycardia
may indicate that the client has a postoperative infection, another serious, potentially
life-threatening complication. Indications of both of these problems need to be documented
and reported by the nurse. Nausea, fatigue, and moderate pain are expected postoperative
assessment findings.
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DIF: Analyzing
TOP: Integrated Process: Nursing Process: Assessment
KEY: Esophagectomy, Perioperative care
MSC: Client Needs Category: Physiological Integrity: Physiological Adaptation
4. The nurse is caring for a client diagnosed with probable gastroesophageal reflux disease
(GERD). What assessment finding(s) would the nurse expect? (Select all that apply.)
a. Dyspepsia
b. Regurgitation
c. Belching
d. Coughing
e. Chest discomfort
f. Dysphagia
ANS: A, B, C, D, E, F
All of these signs and symptoms are commonly seen in clients who have GERD.
DIF: Applying
TOP: Integrated Process: Nursing Process: Assessment
KEY: GERD, Assessment
MSC: Client Needs Category: Physiological Integrity: Physiological Adaptation
5. The nursing is teaching a client diagnosed with gastroesophageal reflux disease (GERD) who
is planning to have an endoscopic radiofrequency (Stretta) procedure. What preprocedure
health teaching would the nurse include? (Select all that apply.)
a. “You will need to be on a liquid diet for the first week after the procedure.”
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Test Bank for Medical Surgical Nursing 10th Edition Ignatavicius (Test Bank PDF Files)
b. “Avoid taking any NSAIDs like ibuprofen for 10 days before the procedure.”
c. “Contact the primary health care provider after the procedure if you have increased
pain.”
d. “You will need a nasogastric tube for a few days after the procedure.”
e. “You will have a small incision in your stomach area that will have a wound
closure.
ANS: B, C
The client having this procedure does not have an incision and will not require a nasogastric
tube (NGT). The client should avoid an NGT placement for at least a month after the
procedure. A liquid diet is required for only 24 hours after the procedure and then the client
should progress to include soft floods like custard and applesauce.
DIF: Analyzing
TOP: Integrated Process: Teaching/Learning
KEY: GERD, Management
MSC: Client Needs Category: Physiological Integrity: Physiological Adaptation
6. The nurse is teaching a client about risk factors for esophageal cancer. Which risk factors
would the nurse include? (Select all that apply.)
a. Alcohol intake
b. Obesity
c. Smoking
d. Lack of fresh fruits and vegetables
e. Untreated GERD
f. Use of NSAIDs
ANS: A, B, C, D, E
RADofEesophageal
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All of these factors increase theGrisk
except for the use of NSAIDs.
Untreated GERD causes damage to esophageal tissue which may develop into Barrett
esophagus, or precancerous cells.
DIF: Understanding
TOP: Integrated Process: Teaching/Learning
KEY: Esophageal cancer, Risk factors
MSC: Client Needs Category: Health Promotion and Maintenance
7. The nurse is teaching a client about the risk of uncontrolled or untreated the client’s
gastroesophageal reflux disease (GERD). What complication(s) may occur if the GERD is not
successfully managed? (Select all that apply.)
a. Asthma
b. Laryngitis
c. Dental caries
d. Cardiac disease
e. Cancer
ANS: A, B, C, D, E
Any of these complications may occur in clients who have uncontrolled or untreated GERD.
DIF: Understanding
TOP: Integrated Process: Teaching/Learning
KEY: GERD, Complications
MSC: Client Needs Category: Physiological Integrity: Physiological Adaptation
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