Deck 13: The Mouth and Oral Cavity

Question 1

What should the nurse use for mouth care in an older client who is unable to perform teeth brushing independently?
1) Nystatin
2) Chlorhexidine (Peridex)
3) Lemon and glycerin swabs
4) Undiluted hydrogen peroxide

Answer 1

2

Question 2

The nurse is reviewing an older client's prescribed medications. Which medications place the client at the greatest risk for xerostomia? Select all that apply.
1) Furosemide (Lasix)
2) Dexamethasone (Decadron)
3) Diphenhydramine (Benadryl)
4) Alprazolam (Xanax)
5) Sertraline (Zoloft)

Answer 2

1, 3, 4, 5

Question 3

The nurse assesses a group of clients. Which clients are at the greatest risk of gingivitis? Select all that apply.
1) The client on medications for anxiety and depression.
2) The client who smokes half a pack of cigarettes per day.
3) The client on a high-protein, reduced-carbohydrate diet.
4) The client with a sinus infection and acute bronchitis.
5) The client with well-controlled diabetes mellitus.

Answer 3

1, 2, 5

Question 4

The nurse is planning interventions for a client with xerostomia. What will the nurse include in the client's plan of care? Select all that apply.
1) Use a mouth rinse.
2) Avoid artificial lubricants.
3) Place a humidifier next to the bed.
4) Avoid foods that are difficult to chew or swallow.
5) Use sugar-free chewing gum, hard candies, and mints.

Question 5

The nurse has completed teaching a group of nursing assistants about oral hygiene approaches for the older client. Which statement best indicates that the teaching was understood?
1) "Clients should brush their teeth every morning."
2) "A plain toothbrush is the best tool for oral care."
3) "Keeping the mouth moist throughout the day is important."
4) "Tooth brushing should be done for 3 to 4 minutes."

Question 6

An older client is surprised to learn of the diagnosis of oral candidiasis. What responses should the nurse make to this client? Select all that apply.
1) "It can be seen in people who have diabetes."
2) "It is often caused by eating spicy or irritating foods."
3) "Sometimes people who use oral inhaled steroids for asthma can develop this."
4) "It is a bacterial infection that may be transmitted by contact with dirty utensils."
5) "It is an infection that results when there is an alteration in the normal flora of the mouth."

Question 7

The nurse is teaching a nursing assistant methods to assist an older client with dementia in performing mouth care. Which instruction should the nurse provide to the assistant?
1) Place a hand over the client's hand and guide the client to perform mouth care.
2) Use sponge swabs to cleanse the gums around the teeth in the front.
3) Brush the teeth quickly for the agitated or irritable client and finish with a mouth rinse.
4) Carefully place two fingers of a gloved hand in the client's mouth to access the back teeth.

Question 8

The nurse determines that an older client is at risk for periodontal disease. Which client is at greatest risk of periodontal disease?
1) The client who takes a daily gummy multivitamin.
2) The client whose spouse reports that the client snores at night.
3) The client who smokes two packs of cigarettes per day and has diabetes.
4) The client whose parent required dentures in middle age due to excess caries.

Question 9

The nurse is reviewing risk factors for the development of oral cancer with a group of senior citizens at a community center. What will the nurse include in this instruction? Select all that apply.
1) Do not use tobacco.
2) Limit or refrain from alcohol use.
3) Ensure a daily intake of vitamin D.
4) Use a sunscreen when out of doors.
5) Have dental exams to check for infections.

Question 10

An older client has several small vesicles with eroded centers on the lips. What is the first action for the nurse to perform?
1) Notify the healthcare provider of the lip vesicles.
2) Document the assessment findings in the medical record.
3) Teach the client to perform careful hand washing.
4) Review the client's temperatures and white blood cell count.

Question 11

The nurse notes that an older client is experiencing halitosis. What are the best actions for the nurse to take? Select all that apply.
1) Check to see that the client's dentures fit snugly.
2) Ensure the client does not have indigestion.
3) Increase the amount of oral fluids available.
4) Request a change in the client's medication regimen.
5) Observe the client's ability to perform oral hygiene tasks.

Question 12

How should the nurse respond to an older client who is edentulous and does not receive regular dental examinations?
1) "Good mouth care is adequate to prevent most mouth conditions."
2) "Clients who have no teeth do not need to see a dentist for regular checkups."
3) "A dentist needs to assess the oral cavity regularly for issues such as oral cancer."
4) "A person with dentures needs to have mouth x-rays every six months."

Question 13

An older client is experiencing mouth pain rated 4 on a 10-point pain scale. What action should the nurse take?
1) Medicate the client with a prescribed narcotic analgesic.
2) Carefully inspect the client's mouth, teeth, and tongue.
3) Ask the client if they have ever had mouth pain for any reason.
4) Instruct the client to begin rinsing the mouth with an isotonic solution.

Question 14

An older client tells the nurse that tooth brushing is seldom done. What should the nurse assess as reasons why the client has stopped performing oral hygiene? Select all that apply.
1) Vision changes
2) Malocclusion of teeth
3) Decrease in taste acuity
4) Lack of dental insurance
5) Loss of manual dexterity

Question 15

An older client with oral candidiasis is prescribed Nystatin. Which actions will the nurse take when using this preparation with the client? Select all that apply.
1) Plan to use the medication four times a day for 2 weeks.
2) Soak dentures in 1 mL of the medication and water for at least 6 hours.
3) Teach to hold the solution in the mouth and swish for 2 minutes before swallowing.
4) Coat the gums and tongue with the medication and rinse with water after 5 minutes.
5) Provide the medication as a troche to be used twice a day if the client has diabetes.

Question 16

The nurse is completing an assessment of an older client's oral cavity. Which finding most concerns the nurse?
1) Leukoplakia
2) Gum redness
3) Excess saliva
4) Multiple cavities

Question 17

The nurse assesses an older client reporting mouth pain. What additional actions should the nurse take at this time? Select all that apply.
1) Review vital sign trends.
2) Auscultate all lung fields.
3) Palpate the face for tenderness.
4) Assess the client's oral mucosa.
5) Feel for enlarged lymph nodes around the jawline.

Question 18

Which action will the nurse include when performing a complete oral exam on an older adult client?
1) Teach the client about halitosis.
2) Remove any coating on the tongue.
3) Ask about swallowing and sense of taste.
4) Record the number of dental caries.

Question 19

An older client has a significant amount of dental plaque. What can the nurse include when instructing the client about brushing the teeth and gums?
1) Use a foam swab and brush three times a day for 3 to 4 minutes.
2) Use a soft-bristled toothbrush at bedtime and brush for 1 minute.
3) Use a soft-bristled toothbrush and brush twice a day for 3 to 4 minutes.
4) Use a medium to hard-bristled toothbrush and brush twice a day for 3 to 4 minutes.

Question 20

The nurse is planning care for an older client with stomatitis caused by chemotherapy medication. Which nursing diagnosis should the nurse identify as a priority for this client?
1) Impaired dentition
2) Risk for fluid volume deficit
3) Imbalanced nutrition
4) Impaired oral mucous membranes

Question 21

An older client with bleeding gums is directed by the physician to make dietary changes. After providing education regarding the diet, which client statement indicates understanding?
1) "I should avoid cranberry products."
2) "I am going to drink orange juice every morning."
3) "Adding bananas to my morning smoothie will help manage my condition."
4) "Increasing the amount of fiber in my diet will reduce the bleeding in my gums."

Question 22

An older client diagnosed with an oral cancer questions how the disease was contracted without a smoking history. Which response by the nurse is most appropriate?
1) "Dietary intake high in fat has been linked to oral cancer."
2) "Your history of periodontal disease is a significant risk factor."
3) "It is highly unusual for a nonsmoker to be affected by oral cancer."
4) "Studies show sun exposure may play a role in the development of oral cancers."

Question 23

An older client reports having a white patch inside the mouth. The nurse assesses a 2 cm by 2 cm lesion on the inner aspect of the left jaw. How should the nurse respond to the client?
1) "Rinse with a mild solution of hydrogen peroxide and water."
2) "The white patch is the result of aging and no cause for concern."
3) "You should contact your healthcare provider for an evaluation of the area."
4) "I think the patch looks like a bacterial infection and you will most likely need an antibiotic."

Question 24

The gerontological nurse is planning a presentation on dental care of older clients for the nursing staff in a skilled facility. What information should the nurse include in the presentation?
1) The older adult should brush the teeth once daily.
2) Flossing should be limited to avoid dental complications.
3) The use of alcohol-based mouthwashes is helpful to reduce bacteria.
4) The older adult should have dental cleaning performed two times per year.

Question 25

An older client says that gargling is done every day with hydrogen peroxide and asks the nurse how frequently this should be done. What information should the nurse provide to the client?
1) Advise to suspend the practice.
2) Mix the hydrogen peroxide with mouthwash for gargling.
3) Dilute the hydrogen peroxide solution with water prior to gargling.
4) Gargle with the hydrogen peroxide only one time per day to reduce irritation.