Brunner And Suddarth's
Textbook Of Medical-Surgical
Nursing- Chapter 39 All
Questions Solved
Multiple Choice
10. A nurse is addressing the prevention of esophageal cancer in response to a
question posed by a participant in a health promotion workshop. What action
should the nurse recommend as having the greatest potential to prevent
esophageal cancer?
A. Promotion of a nutrient-dense, low-fat diet
B. Annual screening endoscopy for clients over 50 with a family history of
esophageal cancer
C. Early diagnosis and treatment of gastroesophageal reflux disease
D. Adequate fluid intake and avoidance of spicy foods - correct answerC
Rationale: There are numerous risk factors for esophageal cancer but chronic
esophageal irritation or GERD is among the most significant. This is a more
significant risk factor than dietary habits. Screening endoscopies are not
recommended solely on the basis of family history.
PTS: 1 REF: p. 1257
NAT: Client Needs: Physiological Integrity: Reduction of Risk Potential
TOP: Chapter 39: Management of Clients with Oral and Esophageal Disorders
KEY: Integrated Process: Teaching/Learning BLM: Cognitive Level: Apply
,Multiple Choice
11. An emergency department nurse is admitting a 3-year-old brought in after
swallowing a piece from a wooden puzzle. The nurse should anticipate the
administration of what medication in order to relax the esophagus to facilitate
removal of the foreign body?
A. Haloperidol
B. Prostigmine
C. Epinephrine
D. Glucagon - correct answerD
Rationale: Glucagon is given prior to removal of a foreign body because it relaxes
the smooth muscle of the esophagus, facilitating insertion of the endoscope.
Haloperidol is an antipsychotic drug and is not indicated. Prostigmine is
prescribed for clients with myasthenia gravis. It increases muscular contraction,
an effect opposite that which is desired to facilitate removal of the foreign body.
Epinephrine is indicated in asthma attack and bronchospasm.
PTS: 1 REF: p. 1256
NAT: Client Needs: Physiological Integrity: Pharmacological and Parenteral
Therapies
TOP: Chapter 39: Management of Clients with Oral and Esophageal Disorders
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Understand
Multiple Choice
12. A nurse in an oral surgery practice is working with a client scheduled for
removal of an abscessed tooth. When providing discharge education, the nurse
should recommend what action?
A. Rinse the mouth with alcohol before bedtime for the next 7 days.
B. Use warm saline to rinse the mouth as needed.
C. Brush around the area with a firm toothbrush to prevent infection.
D. Use a toothpick to dislodge any debris that gets lodged in the socket. - correct
answerB
Rationale: The client should be assessed for bleeding after the tooth is extracted.
The mouth can be rinsed with warm saline to keep the area clean. A firm
, toothbrush or toothpick could injure the tissues around the extracted area.
Alcohol would injure tissues that are healing.
PTS: 1 REF: p. 1233
NAT: Client Needs: Physiological Integrity: Reduction of Risk Potential
TOP: Chapter 39: Management of Clients with Oral and Esophageal Disorders
KEY: Integrated Process: Teaching/Learning BLM: Cognitive Level: Apply
Multiple Choice
13. A client has been diagnosed with a malignancy of the oral cavity and is
undergoing oncologic treatment. The oncologic nurse is aware that the prognosis
for recovery from head and neck cancers is often poor because of what
characteristic of these malignancies?
A. Radiation therapy often results in secondary brain tumors.
B. Surgical complications are exceedingly common.
C. Diagnosis rarely occurs until the cancer is end stage.
D. Metastases are common and respond poorly to treatment. - correct answerD
Rationale: Deaths from malignancies of the head and neck are primarily
attributable to local-regional metastasis to the cervical lymph nodes in the neck.
This often occurs by way of the lymphatics before the primary lesion has been
treated. This local-regional metastasis is not amenable to surgical resection and
responds poorly to chemotherapy and radiation therapy. This high mortality rate
is not related to surgical complications, late diagnosis, or the development of
brain tumors.
PTS: 1 REF: p. 1236
NAT: Client Needs: Physiological Integrity: Physiological Adaptation
TOP: Chapter 39: Management of Clients with Oral and Esophageal Disorders
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Understand
Multiple Choice
14. A client has undergone surgery for oral cancer and has just been extubated in
postanesthetic recovery. What nursing action best promotes comfort and
facilitates spontaneous breathing for this client?
Textbook Of Medical-Surgical
Nursing- Chapter 39 All
Questions Solved
Multiple Choice
10. A nurse is addressing the prevention of esophageal cancer in response to a
question posed by a participant in a health promotion workshop. What action
should the nurse recommend as having the greatest potential to prevent
esophageal cancer?
A. Promotion of a nutrient-dense, low-fat diet
B. Annual screening endoscopy for clients over 50 with a family history of
esophageal cancer
C. Early diagnosis and treatment of gastroesophageal reflux disease
D. Adequate fluid intake and avoidance of spicy foods - correct answerC
Rationale: There are numerous risk factors for esophageal cancer but chronic
esophageal irritation or GERD is among the most significant. This is a more
significant risk factor than dietary habits. Screening endoscopies are not
recommended solely on the basis of family history.
PTS: 1 REF: p. 1257
NAT: Client Needs: Physiological Integrity: Reduction of Risk Potential
TOP: Chapter 39: Management of Clients with Oral and Esophageal Disorders
KEY: Integrated Process: Teaching/Learning BLM: Cognitive Level: Apply
,Multiple Choice
11. An emergency department nurse is admitting a 3-year-old brought in after
swallowing a piece from a wooden puzzle. The nurse should anticipate the
administration of what medication in order to relax the esophagus to facilitate
removal of the foreign body?
A. Haloperidol
B. Prostigmine
C. Epinephrine
D. Glucagon - correct answerD
Rationale: Glucagon is given prior to removal of a foreign body because it relaxes
the smooth muscle of the esophagus, facilitating insertion of the endoscope.
Haloperidol is an antipsychotic drug and is not indicated. Prostigmine is
prescribed for clients with myasthenia gravis. It increases muscular contraction,
an effect opposite that which is desired to facilitate removal of the foreign body.
Epinephrine is indicated in asthma attack and bronchospasm.
PTS: 1 REF: p. 1256
NAT: Client Needs: Physiological Integrity: Pharmacological and Parenteral
Therapies
TOP: Chapter 39: Management of Clients with Oral and Esophageal Disorders
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Understand
Multiple Choice
12. A nurse in an oral surgery practice is working with a client scheduled for
removal of an abscessed tooth. When providing discharge education, the nurse
should recommend what action?
A. Rinse the mouth with alcohol before bedtime for the next 7 days.
B. Use warm saline to rinse the mouth as needed.
C. Brush around the area with a firm toothbrush to prevent infection.
D. Use a toothpick to dislodge any debris that gets lodged in the socket. - correct
answerB
Rationale: The client should be assessed for bleeding after the tooth is extracted.
The mouth can be rinsed with warm saline to keep the area clean. A firm
, toothbrush or toothpick could injure the tissues around the extracted area.
Alcohol would injure tissues that are healing.
PTS: 1 REF: p. 1233
NAT: Client Needs: Physiological Integrity: Reduction of Risk Potential
TOP: Chapter 39: Management of Clients with Oral and Esophageal Disorders
KEY: Integrated Process: Teaching/Learning BLM: Cognitive Level: Apply
Multiple Choice
13. A client has been diagnosed with a malignancy of the oral cavity and is
undergoing oncologic treatment. The oncologic nurse is aware that the prognosis
for recovery from head and neck cancers is often poor because of what
characteristic of these malignancies?
A. Radiation therapy often results in secondary brain tumors.
B. Surgical complications are exceedingly common.
C. Diagnosis rarely occurs until the cancer is end stage.
D. Metastases are common and respond poorly to treatment. - correct answerD
Rationale: Deaths from malignancies of the head and neck are primarily
attributable to local-regional metastasis to the cervical lymph nodes in the neck.
This often occurs by way of the lymphatics before the primary lesion has been
treated. This local-regional metastasis is not amenable to surgical resection and
responds poorly to chemotherapy and radiation therapy. This high mortality rate
is not related to surgical complications, late diagnosis, or the development of
brain tumors.
PTS: 1 REF: p. 1236
NAT: Client Needs: Physiological Integrity: Physiological Adaptation
TOP: Chapter 39: Management of Clients with Oral and Esophageal Disorders
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Understand
Multiple Choice
14. A client has undergone surgery for oral cancer and has just been extubated in
postanesthetic recovery. What nursing action best promotes comfort and
facilitates spontaneous breathing for this client?
