The nurse is planning care for an older patient with stomatitis caused by chemotherapy medication. Which nursing diagnosis should the nurse identify for this patient?
1. Impaired Dentition
2. Fluid Volume Deficit
3. Altered Physical Mobility
4. Impaired Oral Mucous Membranes
Question 2The nurse is providing care for an elderly client who has been diagnosed with a hip fracture. The client underwent surgery to repair the hip. Which of the following assessments would indicate a risk for delayed wound healing?
A) client participation in activity
B) low levels of calcium
C) low levels of serum transferrin
D) serous sanguinous drainage from the wound
Question 3The nurse is caring for a client who has previously had a sacral decubiti that has completely healed. In developing the risk profile for skin breakdown, the nurse recognizes that a prior pressure ulcer would
A) heal faster with reinjury.
B) break down faster with reinjury.
C) have no sensation in the injured area.
D) be at risk for infection even with intact skin.
Question 4The nurse determines that an older patient is at risk for periodontal disease. What risk factor did the nurse assess in this patient?
1. Takes calcium supplements
2. Experiences excessive saliva
3. Smokes two packs of cigarettes per day
4. Brushes teeth with a soft-bristled toothbrush
Question 5After completing an assessment the nurse determines that an older patient is demonstrating signs of gingivitis. What did the nurse assess in the patient? Standard Text: Select all that apply.
1. Red, painful gums
2. Foul-smelling breath
3. Dry tongue and oral tissue
4. White patches on the oral mucosa
5. Bleeding gums with toothbrushing
Question 6The nurse is assessing the client's stage III decubiti of the coccyx. In measuring the depth and width of the
wound, the nurse notes that the wound is beefy red and grainy, and the depth has decreased by 2 mm but the width has not changed.
The nurse interprets this finding as the wound
A) progressing positively toward healing.
B) not healing properly.
C) no longer at risk for infection.
D) about to slough off tissue.
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