The nurse is reviewing a client's electronic health record before assessing her mouth. Which of the following diagnoses would the nurse recognize as an indication for immediate medical follow up?
Thrush
Leukoplakia
Gingivitis
Canker sore
The Correct Answer is B
Choice A reason: Thrush, a fungal infection from Candida, needs treatment but isn’t immediately urgent unless severe. It’s common in immunocompromised states, manageable with antifungals, lacking the acute, life-threatening potential requiring instant medical escalation in most typical cases here.
Choice B reason: Leukoplakia, white patches in the mouth, may signal precancerous changes linked to oral cancer. Its potential malignancy demands immediate follow-up for biopsy and intervention, distinguishing it as the most urgent diagnosis among these options clearly and critically.
Choice C reason: Gingivitis, gum inflammation, requires dental care but isn’t an immediate medical emergency. It’s reversible with hygiene, not posing the rapid progression risk of leukoplakia, making it less urgent for prompt physician referral in this context fully.
Choice D reason: Canker sores, benign ulcers, heal without intervention and lack systemic threat. Unlike leukoplakia’s cancer risk, they don’t warrant urgent follow-up, remaining a self-limiting condition not necessitating immediate medical escalation beyond routine management here entirely.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: Family history suggests dementia, not delirium. Dementia progresses slowly, unlike delirium’s acute onset, making this less indicative of the sudden cognitive shift typical of delirium, especially without a rapid trigger in this case fully here.
Choice B reason: New medication often causes delirium in older adults via anticholinergic effects or toxicity. This acute, reversible change aligns with delirium’s hallmark sudden onset, making it the most suggestive finding for this cognitive impairment accurately here.
Choice C reason: Decline over months to a year fits dementia, not delirium. Delirium is acute, not chronic, excluding this gradual progression as a sign of the rapid cognitive shift delirium presents in this assessment entirely and fully.
Choice D reason: Hypertension risks vascular dementia, not delirium. It’s a chronic factor, not an acute trigger, missing delirium’s sudden, reversible nature tied to immediate causes like drugs, rendering it less relevant here comprehensively and clearly.
Correct Answer is C
Explanation
Choice A reason: The base of the skull houses occipital nodes, not submental ones, which drain the lower face. Palpating here misses the submental region, irrelevant to sinus or throat infections, misaligning with lymphatic drainage patterns in this case.
Choice B reason: The angle of the jaw targets submandibular nodes, not submental, which sit midline under the chin. This area drains the jaw and mouth but not specifically the submental zone tied to the client’s symptoms directly.
Choice C reason: Behind the chin tip is the submental node location, draining the lower lip, tongue, and anterior mouth. With sinus and throat infection, this spot is key for detecting lymphadenopathy linked to the client’s fever and elevated WBC.
Choice D reason: Behind the ears assesses postauricular nodes, unrelated to submental drainage of the chin and mouth. This misses the infection’s likely lymphatic response, focusing on a region not typically involved in sinus or throat pathology here.
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