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

Answer and Explanation

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.

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Correct Answer is A

Explanation

Choice A reason: Thick, white plaques suggest oral thrush, often Candida, linked to HIV immunosuppression. Facilitating HIV testing addresses a potential underlying cause, as CD4 decline allows opportunistic infections, making this the critical next step for diagnosis and management here.

Choice B reason: Referral for medication treats thrush symptomatically but misses underlying HIV risk. Antifungals help, yet without addressing immunosuppression, recurrence persists, making this less urgent than testing for a systemic condition driving the plaques in this scenario fully.

Choice C reason: Jaundice causes yellowing, not white plaques, which are fungal, not hepatic. Assessing for this misaligns with the finding’s etiology, as thrush ties to immunity, not liver function, rendering it irrelevant to the client’s oral presentation entirely here.

Choice D reason: Zinc deficiency causes taste loss or ulcers, not thick plaques like thrush. Lab review for this overlooks the infectious, possibly HIV-related cause, missing the immunological context critical to addressing the client’s specific oral condition accurately and promptly.

A. At the base of the client's skull B. At the angle of the client's jaw C. Behind the tip of the client's chin D. On the area behind the client's ears

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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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse assesses thick, white plaques on a client's tongue and hard palate. Which of the following nursing actions should the nurse do next?

Correct Answer is A

Explanation

Correct Answer is C

Explanation

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