A 55-year-old obese patient was diagnosed with candidiasis in the skin folds under her breasts. When the nurse sees her at a follow-up visit 2 months later, she complains that it has returned. She said she applied the medicine for 1 week and stopped because the itching stopped and the cream was messy. Which statement is true regarding fungal infections of the skin?
- A. Fungal infections often require prolonged therapy.
- B. The patient has a new infection now.
- C. The patient needs to apply a dressing if the cream is too messy.
- D. This infection will probably never be cured.
Correct Answer: A
Rationale: Topical fungal infections are difficult to treat and may require prolonged therapy of several weeks to as long as 1 year. Occlusive dressings should not be applied unless recommended by the medication's manufacturer.
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A woman suffered a second-degree burn of the skin on her arm and hand while cooking breakfast. After examination in the urgent care center, silver sulfadiazine cream is ordered for the burned area. The nurse will apply the medication using which procedure?
- A. Gently patting a moderate amount over the burned area
- B. Massaging the cream completely into the wound
- C. Applying a thick layer over the burned area, and then leaving the area open
- D. Applying a thin layer with a sterile, gloved hand to clean and debrided areas
Correct Answer: D
Rationale: Apply a thin layer of medication with a sterile, gloved hand to clean and debrided wounds.
A teenage boy is taking tretinoin for acne. Which statement will the nurse include in the teaching plan?
- A. Avoid foods that are heavy in salt and oils.
- B. This drug may cause increased redness of your skin.
- C. Try using an abrasive cleanser to remove old skin layers.
- D. Being out in the sunlight will help your skin heal.
Correct Answer: B
Rationale: Tretinoin may cause increased redness and drying, and the patient needs to avoid weather extremes, ultraviolet light, and abrasive cleansers. Certain foods do not need to be avoided.
The nurse is reviewing the medical record of a patient who is to receive wound care with topical silver sulfadiazine. Which finding, if noted, would be a potential contraindication?
- A. The patient has an open wound from a burn on her arm.
- B. The patient is allergic to sulfonamide drugs.
- C. The patient is allergic to shellfish.
- D. The patient's burn wound has been debrided.
Correct Answer: B
Rationale: Patients with allergies to sulfonamide drugs must not receive silver sulfadiazine.
Which adverse effects will the nurse expect in a teenage patient who is using topical tretinoin? (Select all that apply.)
- A. Crusted skin
- B. Itching
- C. Altered skin pigmentation
- D. Rosacea
- E. Red and edematous blisters
Correct Answer: A,C,E
Rationale: Some of the most common adverse effects of tretinoin are excessively red and edematous blisters, crusted skin, and temporary alterations in skin pigmentation.
A child has been diagnosed with impetigo, a skin infection. The nurse anticipates that which drug will be used to treat this condition?
- A. Spinosad
- B. Nystatin
- C. Acyclovir
- D. Mupirocin
Correct Answer: D
Rationale: Mupirocin is used on the skin for treatment of staphylococcal and streptococcal impetigo. Spinosad is used for pediculosis; nystatin is an antifungal drug; and acyclovir is an antiviral drug.
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