Chapter 17: Nose, Mouth & Throat Flashcards
The primary purpose of the ciliated mucous membrane in the nose is to:
a. Warm the inhaled air
b. Filter out dust and bacteria
c. Filter out coarse particles from inhaled air
d. Facilitate the movement of air through the nares
b. Filter out dust and bacteria
RATIONALE: The nasal hairs filter the coarsest matter from inhaled air, whereas the mucous blanket filters out dust and bacteria. The rich blood supply of the nasal mucosa warms the inhaled air.
The projections in the nasal cavity that increase the surface area are called the:
a. Meatus
b. Septum
c. Turbinates
d. Kiesselbach plexus
c. Turbinates
RATIONALE: The lateral walls of each nasal cavity contain three parallel bony projections: the superior, middle, and inferior turbinates. These increase the surface area, making more blood vessels and mucous membrane available to warm, humidify, and filter the inhaled air.
The nurse is reviewing the development of the newborn infant. Regarding the sinuses, which statement is true in relation to a newborn infant?
a. Sphenoid sinuses are full size at birth.
b. Maxillary sinuses reach full size after puberty.
c. Frontal sinuses are fairly well developed at birth.
d. Maxillary and ethmoid sinuses are the only sinuses present at birth.
d. Maxillary and ethmoid sinuses are the only sinuses present at birth.
RATIONALE: Only the maxillary and ethmoid sinuses are present at birth. The sphenoid sinuses are minute at birth and develop after puberty. The frontal sinuses are absent at birth, are fairly well developed at age 7 to 8 years, and reach full size after puberty.
The tissue that connects the tongue to the floor of the mouth is the:
a. Uvula
b. Palate
c. Papillae
d. Frenulum
d. Frenulum
RATIONALE: The frenulum is a midline fold of tissue that connects the tongue to the floor of the mouth. The uvula is the free projection hanging down from the middle of the soft palate. The palate is the arching roof of the mouth. Papillae are the rough, bumpy elevations on the tongues dorsal surface.
The salivary gland that is the largest and located in the cheek in front of the ear is the _________ gland.
a. Parotid
b. Stensens
c. Sublingual
d. Submandibular
a. Parotid
RATIONALE: The mouth contains three pairs of salivary glands. The largest, the parotid gland, lies within the cheeks in front of the ear extending from the zygomatic arch down to the angle of the jaw. The Stensens duct (not gland) drains the parotid gland onto the buccal mucosa opposite the second molar. The sublingual gland is located within the floor of the mouth under the tongue. The submandibular gland lies beneath the mandible at the angle of the jaw
In assessing the tonsils of a 30 year old, the nurse notices that they are involuted, granular in appearance, and appear to have deep crypts. What is correct response to these findings?
a. Refer the patient to a throat specialist.
b. No response is needed; this appearance is normal for the tonsils.
c. Continue with the assessment, looking for any other abnormal findings.
d. Obtain a throat culture on the patient for possible streptococcal (strep) infection.
b. No response is needed; this appearance is normal for the tonsils.
RATIONALE: The tonsils are the same color as the surrounding mucous membrane, although they look more granular and their surface shows deep crypts. Tonsillar tissue enlarges during childhood until puberty and then involutes.
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 nurses best response would be:
a. Youre 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 hasnt learned to swallow the saliva.
d. She is just starting to salivate and hasn’t learned to swallow the saliva.
RATIONALE: In the infant, salivation starts at 3 months. The baby will drool for a few months before learning to swallow the saliva. This drooling does not herald the eruption of the first tooth, although many parents think it does.
The nurse is assessing an 80-year-old patient. Which of these findings would be expected for this patient?
a. Hypertrophy of the gums
b. Increased production of saliva
c. Decreased ability to identify odors
d. Finer and less prominent nasal hair
c. Decreased ability to identify odors
RATIONALE: The sense of smell may be reduced because of a decrease in the number of olfactory nerve fibers. Nasal hairs grow coarser and stiffer with aging. The gums may recede with aging, not hypertrophy, and saliva production decreases.
The nurse is performing an oral assessment on a 40-year-old Black patient and notices the presence of a 1 cm, nontender, grayish-white lesion on the left buccal mucosa. Which one of these statements is true? This lesion is:
a. Leukoedema and is common in dark-pigmented persons.
b. The result of hyperpigmentation and is normal.
c. Torus palatinus and would normally be found only in smokers.
d. Indicative of cancer and should be immediately tested.
a. Leukoedema and is common in dark-pigmented persons.
RATIONALE: Leukoedema, a grayish-white benign lesion occurring on the buccal mucosa, is most often observed in Blacks.
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 nurses best response?
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 dont blow your nose.
d. Lie on your back with your head tilted back and pinch your nose.
b. Sit up with your head tilted forward and pinch your nose.
RATIONALE: With a nosebleed, the person should sit up with the head tilted forward and pinch the nose between the thumb and forefinger for 5 to 15 minutes.
A 92-year-old patient has had a stroke. The right side of his face is drooping. The nurse might also suspect which of these assessment findings?
a. Epistaxis
b. Rhinorrhea
c. Dysphagia
d. Xerostomia
c. Dysphagia
RATIONALE: Dysphagia is difficulty with swallowing and may occur with a variety of disorders, including stroke and other neurologic diseases. Rhinorrhea is a runny nose, epistaxis is a bloody nose, and xerostomia is a dry mouth.
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:
a. Youre right. Bottles make very good pacifiers.
b. Using a bottle as a pacifier is better for the teeth than thumb-sucking.
c. Its 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.
d. Prolonged use of a bottle can increase the risk for tooth decay and ear infections.
RATIONALE: Prolonged bottle use during the day or when going to sleep places the infant at risk for tooth decay and middle ear infections.
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:
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. Have you noticed any dryness in your mouth?
RATIONALE: Xerostomia (dry mouth) is a side effect of many drugs taken by older people, including antidepressants, anticholinergics, antispasmodics, antihypertensives, antipsychotics, and bronchodilators.
The nurse is using an otoscope to assess the nasal cavity. Which of these techniques iscorrect?
a. Inserting the speculum at least 3 cm into the vestibule
b. Avoiding touching the nasal septum with the speculum
c. Gently displacing the nose to the side that is being examined
d. Keeping the speculum tip medial to avoid touching the floor of the nares
b. Avoiding touching the nasal septum with the speculum
RATIONALE: The correct technique for using an otoscope is to insert the apparatus into the nasal vestibule, avoiding pressure on the sensitive nasal septum. The tip of the nose should be lifted up before inserting the speculum.
The nurse is performing an assessment on a 21-year-old patient and notices that his nasal mucosa appears pale, gray, and swollen. What would be the most appropriate question to ask the patient?
a. Are you aware of having any allergies?
b. Do you have an elevated temperature?
c. Have you had any symptoms of a cold?
d. Have you been having frequent nosebleeds?
a. Are you aware of having any allergies?
RATIONALE: With chronic allergies, the mucosa looks swollen, boggy, pale, and gray. Elevated body temperature, colds, and nosebleeds do not cause these mucosal changes.
The nurse is palpating the sinus areas. If the findings are normal, then the patient should report which sensation?
a. No sensation
b. Firm pressure
c. Pain during palpation
d. Pain sensation behind eyes
b. Firm pressure
RATIONALE: The person should feel firm pressure but no pain. Sinus areas are tender to palpation in persons with chronic allergies or an acute infection (sinusitis).