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A nurse is providing care to two clients, one with a Staphylococcus aureus skin infection and another with a Streptococcus pyogenes infection. Which of the following would the nurse expect the primary health care provider to prescribe? Select all that apply.
- A. Mupirocin (Bactroban)
- B. Acyclovir (Zovirax)
- C. Ketoconazole (Nizoral)
- D. Metronidazole (Metro-Gel)
- E. Retapamulin (Altabax)
Correct Answer: A,E
Rationale: Mupirocin (Bactroban) and retapamulin (Altabax) are topical anti-infectives that can be used to treat Staphylococcus aureus and Streptococcus pyogenes infections of the skin.
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A client is prescribed topical betamethasone. Which of the following would the nurse include when explaining the possible adverse reactions that may occur? Select all that apply.
- A. Burning
- B. Dryness
- C. Pruritus
- D. Nausea
- E. Fever
Correct Answer: A,B,C
Rationale: Localized reactions caused by the topical administration of betamethasone that the nurse should discuss with the client include burning, pruritus, irritation, redness, dryness, allergic contact dermatitis, and secondary infection.
Which of the following would be most important to include in the preadministration assessment of a client who is receiving topical therapy for a skin disorder? Select all that apply.
- A. Size of the area affected
- B. Appearance of the lesions
- C. Report of pain or burning
- D. Client's weight
- E. Blood pressure
Correct Answer: A,B,C
Rationale: The preadministration assessment involves a visual inspection and palpation of the involved area(s). The areas of involvement, including the size, color, and appearance, are carefully measured and documented. The appearance of the skin lesions and reports of pain or burning are noted to establish an accurate baseline for treatment.
After conducting an in-service program for a group of nurses about topical drugs used to treat skin disorders, the presenter determines that the teaching was successful when the group identifies which of the following as an appropriate use for topical enzymes? Select all that apply.
- A. Widespread psoriasis
- B. Chronic dermal ulcers
- C. First-degree sunburn
- D. Severely burned areas
- E. Tinea pedis
Correct Answer: B,D
Rationale: A nurse may apply a topical enzyme to a client with chronic dermal ulcers or severely burned areas. Topical enzymes are not used for widespread psoriasis, first-degree sunburn, or tinea pedis.
The nurse might suspect a hypersensitivity reaction has occurred in a client using azelaic acid (Azelex) if the client experiences a combination of which of the following? Select all that apply.
- A. Pruritus
- B. Urticaria
- C. Vomiting
- D. Erythema
- E. Mental status changes
Correct Answer: A,B,D
Rationale: Topical anti-infectives, like azelaic acid (Azelex), result in a rash, pruritus, urticaria, dermatitis, irritation, and erythema, which may indicate a hypersensitivity reaction to the drug.
A nurse administering collagenase (Santyl) topically to a client must be certain not to use which of the following products that can inactivate the enzymes in collagenase (Santyl)? Select all that apply.
- A. Detergents
- B. Water
- C. Iodine
- D. Silver
- E. Mercury
Correct Answer: A,D,E
Rationale: A nurse administering collagenase (Santyl) topically to a client must be certain not to use detergents or products containing heavy metals, like mercury and silver, which can inactivate the enzymes in collagenase (Santyl).