Nokea
A child is being treated for head lice with spinosad. Which of these statements about treatment with spinosad is true? (Select all that apply.)
- A. You will need a prescription for a second product, malathion.
- B. You will also need to decontaminate clothes and personal items.
- C. Be sure to use a nit comb to remove nits from the hair shafts.
- D. Try combing through the hair with mineral oil to loosen the lice from the hair shafts.
- E. It is not necessary to comb the nits when using spinosad.
Correct Answer: B,E
Rationale: The clothing and personal articles of the infested person must be decontaminated. This is best accomplished by washing them in hot, soapy water or by dry cleaning them. Spinosad offers the benefit of not requiring nit combing as do the other treatments, and is a single treatment drug.
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A patient has a prescription for topically applied 5% fluorouracil cream as part of treatment for basal cell carcinoma on her cheek. Which instructions will the nurse provide to the patient? (Select all that apply.)
- A. You must use gloves to apply this medication.
- B. You can use clean fingertips to apply the cream, but be sure to wash your hands afterward.
- C. You will need to stay out of the sun during therapy with this medication.
- D. Apply this medication to the affected site once a day in the evening.
- E. Apply this medication to the affected site twice daily.
- F. You may have swelling, scaling, burning, and tenderness in the affected area.
Correct Answer: B,C,E,F
Rationale: Fluorouracil may be applied with gloves or clean fingertips, but if fingertips are used, the medication must be washed off thoroughly after application. The medication may cause photosensitivity, as well as local swelling, scaling, burning, and tenderness. The medication is applied twice daily.
A patient is admitted to the hospital for possible septicemia. He has a large pressure ulcer on his heel that is open and includes necrotic tissue. However, his prothrombin time/international normalized ratio (PT/INR) values are too high to permit surgical debridement at this time. The nurse expects that which wound-care product will be used to treat the wound?
- A. Cadexomer iodine
- B. Biafine topical emulsion
- C. Povidone-iodine
- D. Collagenase
Correct Answer: D
Rationale: Because this patient has an elevated PT/INR, he cannot receive surgical debridement because of concerns about excessive bleeding. Collagenase is useful for patients taking anticoagulants and for those in whom surgery is contraindicated; it selectively removes necrotic tissue but does not harm normal tissue.
A patient is considering taking oral aloe supplements and asks the nurse about potential problems with this therapy. Which statement by the nurse is correct?
- A. Aloe is not taken orally; it is only used topically to aid in wound healing.
- B. Aloe is used by some to treat constipation; it may cause diarrhea.
- C. This is a safe herbal supplement, with no known drug interactions.
- D. This is a safe herbal supplement, with no known adverse effects.
Correct Answer: B
Rationale: The dried juice of the leaves of the aloe plant contains anthranoids, which give aloe a laxative effect when taken orally. The topical application of the plant juice has been known for years to help the healing of wounds. Common adverse effects include diarrhea, nephritis, abdominal pain, and dermatitis when used topically.
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.