Nokea
A patient with atopic dermatitis has been using a high-potency topical corticosteroid ointment for several weeks. Which of the findings by the nurse indicates a possible adverse effect of the medication?
- A. Thinning of the affected skin
- B. Alopecia of the affected areas
- C. Reddish-brown discoloration of the skin
- D. Dryness and scaling in the areas of treatment
Correct Answer: A
Rationale: Thinning of the skin indicates that atrophy, a possible adverse effect of topical corticosteroids, is occurring. The health care provider should be notified so that the medication can be changed or tapered. Alopecia, red-brown discoloration, and dryness or scaling of the skin are not adverse effects of topical corticosteroid use.
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The nurse is teaching the patient how to use wet compresses at home for treatment of poison ivy. Which of the following instructions would the nurse include in the teaching plan?
- A. Use only sterile water as the solution for the dressing.
- B. The material for the compress is to be 4-8 layers thick.
- C. The compress should meet the edge of the area that is to be treated.
- D. Use abdominal pads (gauze sponges) when covering odd-shaped body parts.
Correct Answer: B
Rationale: The material for wet compresses should be 4-8 layers thick and slightly larger than the area that is being treated. Abdominal pads are to be avoided as they hold too much fluid as well as fibres may be left in the wound if the skin is not intact. It is not necessary to use sterile water; tap water at room temperature is acceptable.
The nurse is caring for a patient with a urinary tract infection and has been prescribed cipprofloxacin. Which of the following information should the nurse include when teaching this patient?
- A. Use a sunscreen with a high SPF when exposed to the sun.
- B. Sun exposure may decrease the effectiveness of the medication.
- C. Photosensitivity may result in an artificial-looking tan appearance.
- D. Wear sunglasses to avoid eye damage while taking cipprofloxacin.
Correct Answer: A
Rationale: The patient should wear sunscreen when taking medications that can cause photosensitivity. The other statements are not accurate.
The nurse is caring for a patient who has basal cell carcinoma (BCC) of the face. Which of the following information should the nurse include when teaching this patient?
- A. Treatment plans include watchful waiting.
- B. Screening for metastasis will be important.
- C. Low-dose systemic chemotherapy is used to treat BCC.
- D. Minimizing sun exposure will reduce risk for future BCC.
Correct Answer: D
Rationale: BCC is frequently associated with sun exposure. BCC spread locally, but do not metastasize to distant tissues. Since BCC can cause local tissue destruction, treatment is indicated. Local chemotherapy may be used to treat BCC.
To decrease the risk for sun damage to the skin, which information should the nurse include when teaching patients?
- A. Waterproof sunscreens will provide good protection when swimming.
- B. Use a sunscreen with an SPF of at least 8-10 for adequate protection.
- C. Try to stay out of the sun between the hours of 10:00 and 16:00.
- D. Increase sun exposure by no more than 10 minutes a day to avoid skin damage.
Correct Answer: C
Rationale: The risk for skin damage from the sun is highest with exposure between 10:00 and 15:00 during regular time and 11:00-16:00 during daylight savings time. The term waterproof is misleading; no sunscreen is completely waterproof. Sunscreen with an SPF of at least 15 is recommended for people at normal risk for skin cancer. Although gradually increasing sun exposure may decrease the risk for burning, the risk for skin cancer is not decreased.
The nurse is caring for a patient who is undergoing psoralen plus ultraviolet A light (PUVA) therapy for treatment of psoriasis. Which of the following actions would the nurse plan to implement to minimize complications from this procedure?
- A. Cleanse the skin carefully with an antiseptic soap.
- B. Shield any unaffected areas with lead-lined drapes.
- C. Have the patient use protective eyewear while receiving PUVA.
- D. Apply petroleum jelly to the areas surrounding the psoriatic lesions.
Correct Answer: C
Rationale: The eyes should be shielded from UV light (UVL) during and after PUVA therapy to prevent the development of cataracts. The patient should be taught about the effects of UVL on unaffected skin, but lead-lined drapes, use of antiseptic soap, and petroleum jelly are not used to prevent skin damage.