Link full download test bank for basic pharmacology for nurses 15th edition by clayton

DIF: Cognitive Level: Application REF: 517 TOP: Nursing Process Step: Assessment MSC: NCLEX Client Needs Category: Physiological Integrity 2.. DIF: Cognitive Level: Knowledge REF: 518 T

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Test Bank for Basic Pharmacology for Nurses

Chapter 32: Drugs Used to Treat Oral Disorders

Test Bank

MULTIPLE CHOICE

1 A patient with COPD uses a corticosteroid inhaler bid Which adverse effect is associated with this medication?

A Mucositis

B Plaque

C Xerostomia

D Candidiasis

ANS: D

Feedback

A Mucositis is not associated with steroid inhaler use

B Plaque is not associated with steroid inhaler use

C Xerostomia is not associated with steroid inhaler use

D Medications that predispose a patient to candidiasis are those that suppress the immune system, including immunosuppressants, corticosteroids, cytotoxics, and broad-spectrum antibiotics Educating patients on the importance of oral hygiene following prescribed inhalation dosages will assist in decreasing this

complication

DIF: Cognitive Level: Application REF: 517

TOP: Nursing Process Step: Assessment

MSC: NCLEX Client Needs Category: Physiological Integrity

2 The nurse is assessing a patient’s mouth and notes white, milk curd–appearing plaques attached to the oral mucosa Which condition is present?

A Thrush

B Canker sores

C Cold sores

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D Mucositis

ANS: A

Feedback

A Thrush is characterized by white, milk curd–appearing plaques that are attached

to the oral mucosa

B Canker sores can appear as ulcers 0.5 to 2 cm in diameter on surfaces that are

not attached to bone, such as the tongue, gums, or inner lining of the cheeks and lips

C Cold sores (“fever blisters”) are most commonly found at the junction of the

mucous membrane and the skin of the lips or nostrils, although they can occur

inside the mouth, especially affecting the gums and roof of the mouth

D Mucositis is a general term used to describe a painful inflammation of the

mucous membranes of the mouth

DIF: Cognitive Level: Knowledge REF: 517

MSC: NCLEX Client Needs Category: Health Promotion and Maintenance

3 What is the primary pharmacologic therapy for Candida albicans?

A Steroids

B Antifungal agents

C Topical anesthetics

D Topical anti-inflammatory agents

ANS: B

Feedback

A Steroids are not used to treat C albicans

B Candida albicans is the most common oral infection appearing in extremely

debilitated patients Medications that predispose a person to C albicans

infections are those that depress the immune system and those that cause

xerostomia C albicans is a fungus and therefore is treated with antifungal

agents such as nystatin (Mycostatin)

C Topical anesthetics are not used to treat C albicans

D Topical anti-inflammatory agents are not used to treat C albicans

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TOP: Nursing Process Step: Implementation

4 Which condition is treated by saliva substitutes?

A Caries

B Mucositis

C Xerostomia

D Halitosis

ANS: C

Feedback

A Dentifrices are used to treat caries

B Saliva substitutes are not used to treat mucositis

C Xerostomia, or lack of saliva, originates from nonoral causes Xerostomia is

treated by discontinuing medications that dry the mucous membranes or by

artificial saliva products

D Mouthwash is used to treat halitosis, along with dentifrices

5 Which information will the nurse include when teaching a patient about cold sores? A Use of drying agents prevents the spread of secretions

B Erupted lesions are not contagious

C Eruptions are related to breaks in personal hygiene

D Pus-filled lesions indicate a secondary bacterial infection

ANS: D

Feedback

A Drying agents are not used to treat cold sores

B Cold sores are contagious

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C Eruptions are not necessarily related to poor personal hygiene

D Cold sore lesions first become visible as small red papules that later develop into 1- to 3-mm diameter fluid-filled blisters Over the following 10 to 14 days, a

crust develops as the vesicles that burst coalesce into larger lesions The liquid from the vesicles contains the live virus that can be transferred to other people by direct contact The base of the lesions is erythematous If pus develops in the

vesicles or under the crust of a cold sore, a secondary bacterial infection may be present and the patient should seek medical attention

6 Which local anesthetic is used for inflammation of oral mucous membranes?

A Chlorhexidine (Peridex)

B 2% viscous lidocaine

C Nystatin (Mycostatin)

D Hydrogen peroxide

ANS: B

Feedback

A Chlorhexidine is not a local anesthetic

B Two percent viscous lidocaine is used as a topical anesthetic for pain associated with oral inflammation Care must be taken so that the patient does not

accidentally burn himself or herself because the drug anesthetizes the entire

mouth and throat

C Nystatin is not a local anesthetic

D Hydrogen peroxide is not a local anesthetic

7 Which medication helps prevent or reduce mucositis in patients undergoing

chemotherapy or radiation treatment?

A Amlexanox paste (Aphthasol)

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B Palifermin (Kepivance)

C Docosanol (Abreva)

D Nystatin (Mycostatin)

ANS: B

Feedback

A Amlexanox paste is used to treat canker sores

B Palifermin is a recombinant human keratinocyte growth factor approved

specifically for preventing and treating the mucositis that develops in leukemia

or lymphoma patients undergoing chemotherapy before bone marrow

transplantation

C Docosanol is used to treat cold sores

D Nystatin is used to treat thrush

TOP: Nursing Process Step: Planning

8 What infection is often called the “disease of the diseased” because it appears in

debilitated patients? A Aspergillosis

B Candidiasis

C Trichomoniasis

D Brucellosis

ANS: B

Feedback

A Aspergillosis is caused by the fungus Aspergillus, which is commonly found

growing on dead leaves, stored grain, or compost piles, or in other decaying

vegetation Although it is similar to candidiasis in its occurrence in debilitated

patients, it is not as common

B Candidiasis is a fungal infection caused by Candida albicans, the most common

organism associated with oral infections It is often called the disease of the

diseased because it appears in debilitated patients and patients taking a variety of medicines

C Trichomoniasis is a common parasitic sexually transmitted disease

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D Brucellosis is a zoonotic infection transmitted from animals to humans by the

ingestion of infected food products, direct contact with an infected animal, or

inhalation of aerosols

DIF: Cognitive Level: Comprehension REF: 517

9 What is the most common cause of most tooth, gum, and periodontal disease?

A Sugar

B Halitosis

C Plaque

D Smoking

ANS: C

Feedback

A Sugar is not a cause of dental disease as such, but becomes a problem when poor oral hygiene allows it to collect in the oral cavity

B Halitosis is a symptom of poor oral hygiene, but is not a cause of dental disease

C Plaque is the primary cause of most tooth, gum (gingiva), and periodontal

disease Plaque, the whitish yellow substance that builds up on teeth and gum

lines, is thought to originate from saliva Plaque forms a sticky meshwork that

traps bacteria and food particles If not removed regularly, it thickens, and

bacteria proliferate

D Although smoking can contribute to periodontal disease through

vasoconstriction, it is not a cause of dental disease

10 Which instruction by the nurse is most important when educating a patient about using viscous lidocaine (Xylocaine) for mucositis?

A “Cleanse the oral cavity after using.”

B “This medication can be used as a gargle.”

C “After using, wait for 30 minutes before eating.”

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D “Your sense of taste will be diminished.”

ANS: C

Feedback

A The oral cavity is cleansed before administration

B The medication can be used as a gargle, but this is not the most important

instruction

C Caution the patient not to take food or drink for approximately 30 minutes after the medication because of the risk of aspiration from the absence of the gag

reflex

D The sense of taste is diminished, but this is not the most important instruction

MULTIPLE RESPONSE

1 The nurse is completing education for a patient who will be undergoing chemotherapy next week In anticipation of adverse effects associated with oral mucositis secondary to chemotherapy, which information will the nurse include in the teaching plan? (Select all that apply.)

A Avoid acidic and spicy foods

B Using docosanol (Abreva) will decrease the pain

C Milk of Magnesia can be used to rinse the mouth and coat mucous membranes

D Nystatin liquid can be taken orally to eliminate fungal infections

E Cleanse the oral cavity before applying topical agents

F Rinse the mouth with an OTC mouthwash

ANS: A, C, D, E

Feedback

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Correct Spicy and acidic foods should be avoided to prevent irritation to mucous

membranes

Viscous lidocaine 2%, Milk of Magnesia, diluted bismuth subsalicylate (Kaopectate), and sucralfate suspensions may be used for topical application

Oral candidal infections are often adverse effects of chemotherapy, and nystatin liquid, an antifungal agent, may be prescribed Directions for using this agent include swishing the medication in the oral cavity for approximately 1 minute before swallowing, or sucking on lozenges (troches) to reduce candidal oral infections

Pain medication applied topically must come into contact with mucous membranes to be effective Therefore, it is advisable to clean the oral cavity before application

Over-the-counter mouthwashes are usually not recommended for treatment of mucositis

2 Which will the nurse include when educating a 12-year-old patient about care of a cold sore? (Select all that apply.)

A “Keep the cold sore clean with mild soap.”

B “Use of an astringent will assist in drying the cold sore and promote rapid healing.”

C “Keep the cold sore moist to prevent cracking.”

D “Note signs of infection, including the presence of pus Contact the health care

provider if this occurs.”

E “Oral analgesics may help alleviate pain.”

ANS: A, C, D, E

Feedback

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Correct To reduce the possibility of further infection with bacteria, the area should

be kept clean

Cold sores should be kept moist to prevent cracking and the development

of secondary bacterial infection

With secondary infection, application of antibiotic ointment would be indicated

Application of docosanol, local anesthetics, and UV blockers or oral analgesics may be prescribed

increased discomfort

3 Which assessment information is pertinent to oral health? (Select all that apply.)

A Medication history

B Dental history, visit frequency

C Presence of halitosis

D Amount of saliva present

E Bowel sounds

ANS: A, B, C, D

Feedback

Pertinent history for oral health includes dental history and frequency

Halitosis may indicate poor oral hygiene or the presence of infection in the oral cavity

Reduced amount of saliva is a risk factor for injury and infection in the oral cavity

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4 A patient who is undergoing bone marrow transplantation has developed severe mucositis Which treatment options may promote comfort? (Select all that apply.)

A 2% viscous lidocaine (Xylocaine) before meals

B Acetylcysteine (Mucomyst) therapy as needed

C Commercially prepared mouthwashes

D Docosanol (Abreva) therapy

E Milk of Magnesia mouth rinses

ANS: A, E

Feedback

anesthetizes the entire mouth and throat Used before meals, it facilitates patient eating Care must be taken that the patient does not burn himself or herself because sensation is diminished

Milk of Magnesia can also be used as a mouth rinse to coat the mucous membranes

Commercial mouthwashes contain alcohol, which is detrimental to the healing of mucositis

Docosanol is used to treat topical herpes infections, not mucositis

5 In addition to discomfort, which are adverse effects of xerostomia? (Select all that apply.)

A Reduced taste and appetite

B Excessive salivation

C Difficulty chewing and swallowing food

D Increase in dental caries

E Difficulty with speech

F Improved taste and enjoyment of food

ANS: A, C, D, E

Feedback

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Correct Xerostomia causes loss of taste

Xerostomia causes difficulty in chewing and swallowing food

Xerostomia increases tooth decay

Xerostomia causes difficulty in talking

Xerostomia does not cause food to taste better

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