MULTIPLE CHOICE

1. The nurse is caring for a client who is being discharged following surgery for oral cancer. Which sign is the client instructed to watch for that indicates possible metastasis of the cancer?

a.Fragile gums that bleed easily

b.White patches on the tongue and the back of the throat

c.Painful ulcerated lesions on the gums or inside of the cheek

d.Small hard lumps on the side of the neck or under the chin

2. The nurse is caring for a female client who has just undergone excision of a parotid gland tumor. The client tells the nurse that she is experiencing facial weakness on the operative side. Which is the nurse’s best response?

a.“You may be experiencing a slight stroke, and I will notify the doctor.”

b.“This is a temporary condition that will resolve once radiation treatment is begun.”

c.“You are experiencing weakness because the facial nerve was irritated during the surgery.”

d.“You probably have a pinched nerve after lying on the operating room table for so long.”

3. The nurse is caring for a client who is receiving radiation therapy for treatment of oral cancer. The client reports a constant dry mouth. Which is the nurse’s best response?

a.“Massage the area just over the lower jaw twice a day.”

b.“Use lemon and glycerin swabs to clean your mouth and help keep it moist.”

c.“Suck on lemon slices to help increase saliva production.”

d.“Rinse your mouth out often with warm saline or sodium bicarbonate solution.”

4. The nurse is caring for a client who has just received a diagnosis of advanced oral cancer and has learned that a glossectomy with jaw resection will have to be scheduled. The client states to the nurse, “I would rather die than have half of my face removed. My life is over.” Which is the best description of the client’s response to the diagnosis?

a.Refusal of any more treatment

b.Grief over the diagnosis

c.Acceptance of the diagnosis

d.Denial about the diagnosis

5. The nurse is caring for a client who has just received a diagnosis of advanced oral cancer that will require extensive surgery. Which statement by the client indicates that the diagnosis is accepted?

a.“The biopsy test results will be confirmed again next week.”

b.“Of all the bad things to happen to me, now I have cancer on top of it all.”

c.“If I can live long enough to see my son get married, everything will be alright.”

d.“I don’t like it, but I have cancer and that’s the way it is.”

6. The nurse is caring for a client who just had a radical jaw and neck resection. The nurse is developing a teaching plan for the client and spouse about care after discharge from the hospital. Which is an effective teaching objective for this client and spouse?

a.The client’s spouse will be able to change the client’s tracheostomy ties correctly after three teaching sessions.

b.The client and spouse will verbalize the signs of readiness for oral feedings following placement of the tracheostomy.

c.The client’s spouse will correctly administer the client’s tube feedings twice daily.

d.The client and spouse will understand incision care and the importance of infection prevention.

7. The nurse is caring for a client who just had a radical jaw and neck resection for oral cancer. The nurse has just completed teaching for the spouse and client about tracheostomy care. Which notation in the client’s chart is the most accurate documentation of the teaching that occurred?

a.“The client and spouse were instructed regarding management of mucous plugs and thick secretions.”

b.“Information about home oxygen therapy and equipment was provided for the client and spouse.”

c.“The client and spouse were shown how to suction the tracheostomy and change the ties.”

d.“Correct suctioning procedure was demonstrated, and the client’s spouse verbalized two instances when suctioning needs to occur.”

8. The nurse is caring for a client who will be going home after a radical jaw and neck resection. The client’s spouse will be the primary caregiver at home and will need to care for the client’s feeding tube and tracheostomy. Which skill is the highest priority for the nurse to teach the client’s spouse before discharge from the hospital?

a.Monitoring the incision lines for infection or leakage of saliva

b.Assessing the client for readiness to resume oral feedings

c.Cleaning the tracheostomy and suctioning as needed

d.Administering tube feedings and cleaning the feeding tube site

9. The spouse of a client has just completed tracheostomy care for the first time, with minimal assistance from the nurse. Which statement offers the most constructive feedback from the nurse?

a.“I see that you had a tough time, but you will do better with practice.”

b.“You were able to clean the inner cannula well. Now, let’s change the ties again.”

c.“You seem to have had a tough time because it was your first attempt.”

d.“You seem to understand what I said. Is there anything else I can help you with?”

10. The nurse is caring for a client who has just completed treatment for basal cell carcinoma on the lower lip. The client says to the nurse, “Cigarettes are ruining my life. I’ll do anything to quit smoking.” Which is the nurse’s best response?

a.“Here is some information about smoking cessation programs in the area. Let’s discuss the options.”

b.“Here are some pamphlets that show the financial benefits of quitting smoking.”

c.“If you quit smoking, your risk for developing cancer again will decrease dramatically.”

d.“Your chest x-ray is still clear, so you could prevent permanent lung damage if you quit smoking now.”