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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.
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A patient asks about using minoxidil for hair thinning. Which statement about minoxidil is accurate?
- A. The product is applied once daily in the morning.
- B. Systemic absorption of topically applied minoxidil is rare.
- C. Results may be seen as soon as 2 weeks after beginning therapy.
- D. Systemic absorption may cause tachycardia, fluid retention, and weight gain.
Correct Answer: D
Rationale: Results of minoxidil therapy may not be seen for 4 months after beginning therapy. The product is applied twice daily, morning and evening, and systemic effects may result because of absorption.
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.
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.
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.
A female patient will be starting therapy with oral isotretinoin as part of treatment for severe acne, and the nurse is providing teaching. Which teaching point will the nurse include in her teaching plan about isotretinoin?
- A. You will have to use two contraceptive methods while on this drug.
- B. You must avoid sexual activity while on this drug.
- C. You will have to avoid pregnancy for 2 weeks after taking this drug.
- D. If you are taking an oral contraceptive, you may take this drug.
Correct Answer: A
Rationale: It is now required that at least two contraceptive methods be used by sexually active women during and for 1 month after completion of therapy with isotretinoin.