Health Assessment Reviewer | Summaries Personal Health

1. During an examination of the oral cavity, which

technique by the nurse is appropriate to examine

the gums and teeth?

Use a square gauze pad to hold the client's

tongue to each side.

Use a penlight and tongue depressor to retract

the lips.

Put on gloves and retract the client's lips and

cheeks.

Ask the client to stick the tongue out between

the lips.

2. A nurse examines a client with complaints of a sore

throat and finds that the tonsils are enlarged and

touching the uvula. Using a grading scale of 1+ to

4+, how should the nurse appropriately document

the tonsils?

1+

2+

3+

4+

3. On assessing a client's mouth, the nurse finds that

the uvula is deviated and the palate fails to rise.

Which of the following conditions should the nurse

most suspect in this client?

Cerebrovascular accident

Paralysis of cranial nerve X (vagus)

Native American heritage

Tonsil infection

4. A client presents to the health care clinic

complaining of a sore throat. In examining the

client's mouth and throat, the nurse notices that the

tonsils on both sides of the oropharynx at the end of

the soft palate are swollen. Which tonsils are these?

Lingual

Palatine

Pharyngeal

Paranasal

5. The nurse is planning to inspect an adult client's

mouth, using a tongue depressor. The nurse should

plan to

depress the tongue blade slightly off center.

depress the tongue blade as close to the center

as possible.

ask the client to keep the mouth partially open.

insert the tongue blade at the back of the

client's tongue.

6. The three salivary glands also contain drainage

ducts. Which drainage ducts are associated with the

submandibular gland?

Wharton's ducts

Stensen's ducts

Parotid ducts

Sublingual ducts

7. You are teaching a physiology class for pre-nursing

students. A student asks what the purpose of the

upper airway is in regard to the lower airway. What

would be your best answer?

Warm the inspired air

Clean the inspired air

Clean the expired air

Warm the expired air

8. A client has been brought to the emergency unit of

a health care facility following an automobile

accident. Which finding about the lips supports the

diagnosis of anemia and shock?

Reddish

Cyanotic

Pallor

Swelling

9. A hospitalized client continues to exhibit residual

effects of a stroke. Which symptom is the priority

concern?

Weak gait

Dysphagia

Right ptosis

Facial weakness

10. The nurse understands that malocclusion may be

related to what?

Tooth loss

Sinusitis

Parotid duct occlusion

Rhinitis

11. A nurse inspects the gums and teeth of a middle-

aged adult and notices the presence of small brown

spots on the chewing surfaces of several of the

molar teeth. What question should the nurse ask

the client to determine the cause of this finding?

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During an examination of the oral cavity, which technique by the nurse is appropriate to examine the gums and teeth?  Use a square gauze pad to hold the client's tongue to each side.  Use a penlight and tongue depressor to retract the lips.  Put on gloves and retract the client's lips and cheeks.  Ask the client to stick the tongue out between the lips.
A nurse examines a client with complaints of a sore throat and finds that the tonsils are enlarged and touching the uvula. Using a grading scale of 1+ to 4+, how should the nurse appropriately document the tonsils?  1+  2+  3+  4+
On assessing a client's mouth, the nurse finds that the uvula is deviated and the palate fails to rise. Which of the following conditions should the nurse most suspect in this client?  Cerebrovascular accident  Paralysis of cranial nerve X (vagus)  Native American heritage  Tonsil infection
A client presents to the health care clinic complaining of a sore throat. In examining the client's mouth and throat, the nurse notices that the tonsils on both sides of the oropharynx at the end of the soft palate are swollen. Which tonsils are these?  Lingual  Palatine  Pharyngeal  Paranasal
The nurse is planning to inspect an adult client's mouth, using a tongue depressor. The nurse should plan to  depress the tongue blade slightly off center.  depress the tongue blade as close to the center as possible.  ask the client to keep the mouth partially open.  insert the tongue blade at the back of the client's tongue.
The three salivary glands also contain drainage ducts. Which drainage ducts are associated with the submandibular gland?  Wharton's ducts  Stensen's ducts  Parotid ducts  Sublingual ducts
You are teaching a physiology class for pre-nursing students. A student asks what the purpose of the upper airway is in regard to the lower airway. What would be your best answer?  Warm the inspired air  Clean the inspired air  Clean the expired air  Warm the expired air
A client has been brought to the emergency unit of a health care facility following an automobile accident. Which finding about the lips supports the diagnosis of anemia and shock?  Reddish  Cyanotic  Pallor  Swelling
A hospitalized client continues to exhibit residual effects of a stroke. Which symptom is the priority concern?  Weak gait  Dysphagia  Right ptosis  Facial weakness
The nurse understands that malocclusion may be related to what?  Tooth loss  Sinusitis  Parotid duct occlusion  Rhinitis
A nurse inspects the gums and teeth of a middle- aged adult and notices the presence of small brown spots on the chewing surfaces of several of the molar teeth. What question should the nurse ask the client to determine the cause of this finding?

 "How many cigarettes do you smoke daily?"  "Do you drink a lot of coffee or tea?"  "Are you experiencing any tooth pain?"  "Do you have trouble chewing your food?"

The nurse examines the pharynx of a patient and records that the tonsils are touching the uvula. The nurse would grade the tonsils as  3+  1+  2+  4+
A nurse examines a client with complaints of a sore throat and finds that the tonsils are just visible. Using a grading scale of 1+ to 4+, how should the nurse appropriately document the tonsils?  1+  2+  3+  4+
An older adult client who wears dentures reports having soreness of the gums. Which intervention should the nurse recommend to the client to alleviate this problem?  Avoid excessive intake of sugary foods.  Use toothpaste containing fluoride.  Have a dental examination every 2 years.  Massage the gums daily.
During an PHYSICAL assessment the nurse observes the client's throat that the uvula is deviated.. Which cranial nerve should the nurse suspect is damaged in this client?  I  VII  IX  X
The nurse is caring for an older adult client with a nasogastric feeding tube ordered by the physician. The nurse notes that the client is not a mouth breather and having no difficulty breathing. While inserting the feeding tube, the nurse encounters difficulty getting the tube through the nares. What should the nurse suspect?  Deviated septum  Obstructed turbinate  Swollen nasal passages  Hypertrophied adenoids
A young man is concerned about a hard mass in the midline of his palate that he has just noticed. Examination reveals that it is indeed hard and in the midline. No mucosal abnormalities are associated with this lesion. The client has no other symptoms. What is the most likely diagnosis?  Leukoplakia  Torus palatinus  Thrush (candidiasis)  Kaposi's sarcoma
Which food is most appropriate for the nurse to recommend for a client who suffers frequent nosebleeds due to hereditary hemorrhagic telangiectasia?  Vegetable omelet  Garlic chicken  Chocolate pudding  Salad with ginger dressing
A nurse finds crepitus when palpating over a client's maxillary sinuses. Which of the following should the nurse most suspect in this client?  Normal, air-filled sinuses  A large amount of exudate in the sinuses  Obstruction of the nostril by a foreign object  A perforated septum
During assessment of the oral cavity, the nurse examines the salivary glands. Which area of the mouth should the nurse assess to inspect for the Wharton's ducts?  Either side of the frenulum on the floor of the mouth  Buccal mucosa across from the second upper molars  Right side of the frenulum at the base of the gums  Posterior aspect of the tongue bilaterally
When assessing a patient the nurse notes that the tonsils are touching the uvula. How would the nurse document the tonsils?  Tonsils are T

 Uvula- small projection hanging from the back middle edge of the soft palate  Cheeks- Form the lateral walls of the mouth  The mandible – jawbone- Provide a structure support for the floor of the mouth  The tongue- A mass of muscle attached to the hyoid bone and styloid process of the temporal bone  Frenulum of tongue- Connected to the floor of the mouth by a fold of tissue  The gums – gingiva- Covered by mucous membrane and normally whole 32 permanent teeth in the adult  Crown of tooth- The top, visible, white enameled part of each tooth  The route of the tooth- The portion of the tooth that is embedded in the gums  Papillae of the tongue- Small bumps that cover the dorsal surface of the tongue  The three pairs of salivary glands that secrete into the oral cavity include: Saliva- Watery, serious fluid continue salts, mucus, and salivary amylase  Parotid gland- Located below and in front of the ears empty through Stensen ducks, which are located inside the cheeks across from the second upper molar  Submandibular gland- Located in the lower Joe, open under the tongue on either side of the frenulum through opening call Wharton's ducks  Sublingual gland- Located under the tongue, open through several ducks located on the floor of the mouth  Throat, pharynx- Located behind the mouth and nose, serves as a muscular passage for the food and air  Nasopharynx- Upper part of the throat behind the nose  Oropharynx- Below the nasopharynx  Laryngopharynx (hypopharynx)- Below the oropharynx  Palatine tonsils location- Masses of lymphoid tissue, located on both sides of the oropharynx at the end of the soft palate between the anterior and posterior pillars  Lingual tonsils location- Lot at the base of the tongue  Pharyngeal tonsils, or adenoids- Found high and the nasopharynx  Tonsils and adenoids- Masses of lymphoid tissue, they help protect against infection  The nose- An external portion covered with skin and an internal nasal cavity  Nasal cavity- Located between the roof of the mouth and the cranium  Nasal septum is formed by- Contains a rich supply of blood vessels and is known as Kiessalbach area  Conchae/turbinates- The superior, middle, and inferior turbinate a bony lobes  Nasal hairs and turbinates- Vibrissa,Filter large particles from the air,  Ciliated mucosal cells- Captured and prepare the breeze toward the throat, where it is swallowed  Four pairs of paranasal sinuses- Frontal, maxillary, Ethmoidal, and Sphenoidal,  Circumoral pallor lips- Seen in anemia and shock  Bluish cyanotic lips- My results from Having a cold or hypoxia  Reddish lips are seen in clients with?- Clients with keto acidosis, carbon monoxide poisoning, and chronic obstructive pulmonary disease - COPD With polycythemia  Swelling of the lips - E Dema- Common in local or systemic allergic or anaphylactic reactions  Yellow or brownish teeth- Who smoke, drink large quantities of coffee or tea, or have an excessive intake of fluoride  Tooth decay – Caries- Brown dots or cover more extensive areas of chewing surfaces  A chalky white area in the tooth surface- Cavity that will turn darker with time  Malocclusion of teeth- When upper or lower incisors protrude  Brown or yellow stains or white spots on teeth- Results from antibiotic therapy or to trauma  Asian, pacific islanders, and native Americans- Cultural consideration tooth variation including Teflon cups on insider and circular cups on molars  Older adult consideration in gingival recession- The teeth me a peer longer because of age related gingival recession  Gingivitis, Derby that vitamin C deficiency and leukemia- Red, swollen gums that bleed easily  Receding read grounds with lots of teeth- Periodontitis  In large red and gums – hyperplasia- Maybe seen in pregnancy, puberty, leukemia, and with use of some medication such Phenytoin  A bluish - black or gray - white line along the gum line-Lead poisoning  Leukoplakia - chalky white raised patches- Seen in chronic irritation, heavy smoking, and alcohol use, Should be referred to the primary healthcare provider  'Thrush"- Candida albicans infection- Whitest, curl- like patches that scapes off over reddened mucosa and bleed easily  Koplik spots- tiny Whitish spots that la over reddened mucosa- Early signs of measles  Addison disease - chronic adrenocortical insufficiency-Brownish patches inside the cheeks  Raiden opening of Stensen ducts- Sen with mumps  Deep longitudinal futures- Seen and dehydration  Black hairy tongue- Hi Post elevation, heavy smoking, alcohol intake, use of antibiotics, lean to fungus, use of mouthwashes,And scene with use of Pepto-Bismol  Smooth red shiny tongue- Niacin, or vitamin B 12 deficiency  Raised whitish feathery areas On side of town that cannot be scraped off- Hairy leukoplakia seen an HIV infection and AIDS  Enlarge tongue- Hypothyroidism, Acromegaly, or down syndrome, and angioneurmtic edema  Very small tongue- Malnutrition  Atrophied tongue or fasciculations- Cranial nerve 12 damage - hypoglossal  Herpes simplex type one -cold sores- Clear vesicles surrounded by red induratd base  Cheilosis of lips- Scaling painful fissures at corner of lips  Carcinoma of lip- Round, indurated lesion becomes crusted and also read it with elevated border  Leukoplakia - ventricle surface- Thick raised patch does not scape off; seen in heavy tobacco or alcohol use  Hairy Leukoplakia- Seen in HIV infection and AIDS  Candida albicans infection – thrush- Curved-like patches easily scraped off, leaving a written area  A black, hairy, tongue means...- Elongated filiform papullae seen with use of antibiotics that inhibit normal bacteria  Carcinoma of tongue- Round indurated lesion becomes crusty and also read it with elevated border

Health Assessment Reviewer, Summaries of Personal Health

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