Nokea
The health care provider prescribes topical 5-fluorourracil (5-FU) for a patient with actinic keratosis on the nose. Which of the following information would the nurse include in the patient teaching plan?
- A. You may develop hauses and anorexia, but good nutrition is important during treatment.
- B. You will need to avoid crowds because of the risk for infection caused by chemotherapy.
- C. The nose will develop painful, eroded areas that will take weeks before completely healing.
- D. 5-FU is needed to shrink the lesion so that less scarring occurs once the lesion is excised.
Correct Answer: C
Rationale: Topical 5-FU causes an initial reaction of erythema, itching, and erosion, which lasts 4 weeks after application of the medication is stopped. The medication is topical, so there are no systemic effects such as increased infection risk, anorexia, or nausea. Actinic keratosis is not usually treated with excision.
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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 who has just received a diagnosis of a fungal infection and the patient asks the nurse how this will be treated. The nurses' response is based upon knowledge that which of the following bases is the most common for antifungal treatment?
- A. Gel
- B. Paste
- C. Lotion
- D. Powder
Correct Answer: D
Rationale: Powder is the most common base for antifungal preparations. Gels are used for acute exudative inflammation. The paste is used when a drying effect is necessary because moisture is absorbed. A lotion is useful in treating subacute pruritic eruptions.
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.
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.
After the nurse determines that a patient has the following risk factors for melanoma, which risk factor should be the focus of patient teaching related to prevention?
- A. The patient has multiple dyplastic nevi.
- B. The patient is fair-skinned and has blue eyes.
- C. The patient s mother died of a malignant melanoma.
- D. The patient uses a tanning booth throughout the winter.
Correct Answer: D
Rationale: Since the only risk factor that the patient can change is the use of a tanning booth, the nurse should focus teaching about melanoma prevention on this factor. The other factors also will contribute to increased risk.