Nokea
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.
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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 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 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 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.
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.