Question 1

The nurse is assessing a patient with a history of intravenous drug abuse.In assessing his mouth,the nurse notices a dark red confluent macule on the hard palate.This could be an early sign of:

Accepted Answer

A)  Acquired immunodeficiency syndrome (AIDS) .
B)  Measles.
C)  Leukemia.
D)  Carcinoma. A

Question 2

A 72-year-old patient has a history of hypertension and chronic lung disease.An important question for the nurse to include in the health history would be:

Accepted Answer

A)  "Do you use a fluoride supplement?"
B)  "Have you had tonsillitis in the last year?"
C)  "At what age did you get your first tooth?"
D)  "Have you noticed any dryness in your mouth?" D

Question 3

A pregnant woman states that she is concerned about her gums because she has noticed they are swollen and have started bleeding.What would be an appropriate response by the nurse?

Accepted Answer

A)  "Your condition is probably due to a vitamin C deficiency."
B)  "I'm not sure what causes swollen and bleeding gums, but let me know if it's not better in a few weeks."
C)  "You need to make an appointment with your dentist as soon as possible to have this checked."
D)  "Swollen and bleeding gums can be caused by the change in hormonal balance in your system during pregnancy." D

Question 4

During an assessment of a 26 year old at the clinic for "a spot on my lip I think is cancer," the nurse notices a group of clear vesicles with an erythematous base around them located at the lip-skin border.The patient mentions that she just returned from Hawaii.What would be the most appropriate response by the nurse?

Accepted Answer

A)  Tell the patient she needs to see a skin specialist.
B)  Discuss the benefits of having a biopsy performed on any unusual lesion.
C)  Tell the patient that these vesicles are indicative of herpes simplex I or cold sores and that they will heal in 4 to 10 days.
D)  Tell the patient that these vesicles are most likely the result of a riboflavin deficiency and discuss nutrition.

Question 5

While obtaining a health history,a patient tells the nurse that he has frequent nosebleeds and asks the best way to get them to stop.What would be the nurse's best response?

Accepted Answer

A)  "While sitting up, place a cold compress over your nose."
B)  "Sit up with your head tilted forward and pinch your nose."
C)  "Just allow the bleeding to stop on its own, but don't blow your nose."
D)  "Lie on your back with your head tilted back and pinch your nose."

Question 6

The nurse is obtaining a health history on a 3-month-old infant.During the interview,the mother states,"I think she is getting her first tooth because she has started drooling a lot." The nurse's best response would be:

Accepted Answer

A)  "You're right, drooling is usually a sign of the first tooth."
B)  "It would be unusual for a 3 month old to be getting her first tooth."
C)  "This could be the sign of a problem with the salivary glands."
D)  "She is just starting to salivate and hasn't learned to swallow the saliva."

Question 7

Immediately after birth,the nurse is unable to suction the nares of a newborn.An attempt is made to pass a catheter through both nasal cavities with no success.What should the nurse do next?

Accepted Answer

A)  Attempt to suction again with a bulb syringe.
B)  Wait a few minutes, and try again once the infant stops crying.
C)  Recognize that this situation requires immediate intervention.
D)  Contact the physician to schedule an appointment for the infant at his or her next hospital visit.

Question 8

During an oral examination of a 4-year-old Native-American child,the nurse notices that her uvula is partially split.Which of these statements is accurate?

Accepted Answer

A)  This condition is a cleft palate and is common in Native Americans.
B)  A bifid uvula may occur in some Native-American groups.
C)  This condition is due to an injury and should be reported to the authorities.
D)  A bifid uvula is palatinus, which frequently occurs in Native Americans.

Question 9

The nurse is assessing an 80-year-old patient.Which of these findings would be expected for this patient?

Accepted Answer

A)  Hypertrophy of the gums
B)  Increased production of saliva
C)  Decreased ability to identify odors
D)  Finer and less prominent nasal hair

Question 10

A 40-year-old patient who has just finished chemotherapy for breast cancer tells the nurse that she is concerned about her mouth.During the assessment the nurse finds areas of buccal mucosa that are raw and red with some bleeding,as well as other areas that have a white,cheesy coating.The nurse recognizes that this abnormality is:

Accepted Answer

A)  Aphthous ulcers.
B)  Candidiasis.
C)  Leukoplakia.
D)  Koplik spots.

Question 11

The nurse is assessing a 3 year old for "drainage from the nose." On assessment,a purulent drainage that has a very foul odor is noted from the left naris and no drainage is observed from the right naris.The child is afebrile with no other symptoms.What should the nurse do next?

Accepted Answer

A)  Refer to the physician for an antibiotic order.
B)  Have the mother bring the child back in 1 week.
C)  Perform an otoscopic examination of the left nares.
D)  Tell the mother that this drainage is normal for a child of this age.

Question 12

A mother brings her 4-month-old infant to the clinic with concerns regarding a small pad in the middle of the upper lip that has been there since 1 month of age.The infant has no health problems.On physical examination,the nurse notices a 0.5-cm,fleshy,elevated area in the middle of the upper lip.No evidence of inflammation or drainage is observed.What would the nurse tell this mother?

Accepted Answer

A)  "This area of irritation is caused from teething and is nothing to worry about."
B)  "This finding is abnormal and should be evaluated by another health care provider."
C)  "This area of irritation is the result of chronic drooling and should resolve within the next month or two."
D)  "This elevated area is a sucking tubercle caused from the friction of breastfeeding or bottle-feeding and is normal."

Question 13

A 10 year old is at the clinic for "a sore throat that has lasted 6 days." Which of these findings would be consistent with an acute infection?

Accepted Answer

A)  Tonsils 1+/1-4+ and pink; the same color as the oral mucosa
B)  Tonsils 2+/1-4+ with small plugs of white debris
C)  Tonsils 3+/1-4+ with large white spots
D)  Tonsils 3+/1-4+ with pale coloring

Question 14

A patient comes into the clinic complaining of facial pain,fever,and malaise.On examination,the nurse notes swollen turbinates and purulent discharge from the nose.The patient also complains of a dull,throbbing pain in his cheeks and teeth on the right side and pain when the nurse palpates the areas.The nurse recognizes that this patient has:

Accepted Answer

A)  Posterior epistaxis.
B)  Frontal sinusitis.
C)  Maxillary sinusitis.
D)  Nasal polyps.

Question 15

During an assessment of a 20-year-old patient with a 3-day history of nausea and vomiting,the nurse notices dry mucosa and deep vertical fissures in the tongue.These findings are reflective of:

Accepted Answer

A)  Dehydration.
B)  Irritation by gastric juices.
C)  A normal oral assessment.
D)  Side effects from nausea medication.

Question 16

The nurse notices that the mother of a 2-year-old boy brings him into the clinic quite frequently for various injuries and suspects there may be some child abuse involved.During an inspection of his mouth,the nurse should look for:

Accepted Answer

A)  Swollen, red tonsils.
B)  Ulcerations on the hard palate.
C)  Bruising on the buccal mucosa or gums.
D)  Small yellow papules along the hard palate.

Question 17

The salivary gland that is the largest and located in the cheek in front of the ear is the _________ gland.

Accepted Answer

A)  Parotid
B)  Stensen's
C)  Sublingual
D)  Submandibular

Question 18

While performing an assessment of the mouth,the nurse notices that the patient has a 1-cm ulceration that is crusted with an elevated border and located on the outer third of the lower lip.What other information would be most important for the nurse to assess?

Accepted Answer

A)  Nutritional status
B)  When the patient first noticed the lesion
C)  Whether the patient has had a recent cold
D)  Whether the patient has had any recent exposure to sick animals

Question 19

While obtaining a health history from the mother of a 1-year-old child,the nurse notices that the baby has had a bottle in his mouth the entire time.The mother states,"It makes a great pacifier." The best response by the nurse would be:

Accepted Answer

A)  "You're right. Bottles make very good pacifiers."
B)  "Using a bottle as a pacifier is better for the teeth than thumb-sucking."
C)  "It's okay to use a bottle as long as it contains milk and not juice."
D)  "Prolonged use of a bottle can increase the risk for tooth decay and ear infections."

Question 20

The nurse is palpating the sinus areas.If the findings are normal,then the patient should report which sensation?

Accepted Answer

A)  No sensation
B)  Firm pressure
C)  Pain during palpation
D)  Pain sensation behind eyes

Exam 16: Nose, Mouth, and Throat