Nokea
The nurse is reviewing laboratory results for a patient and notes that the patient has positive results for nasal colonization by methicillin-resistant Staphylococcus aureus (MRSA). The nurse anticipates an order for which medication?
- A. Acyclovir
- B. Mupirocin
- C. Clindamycin
- D. Clotrimazole
Correct Answer: B
Rationale: Mupirocin (Bactroban) is used on the skin for treatment of staphylococcal and streptococcal impetigo. It is used topically and intranasally to treat nasal colonization by MRSA; however, MRSA is becoming increasingly resistant to the drug.
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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.
Which adverse effects will the nurse expect in a teenage patient who is using topical tretinoin? (Select all that apply.)
- A. Crusted skin
- B. Itching
- C. Altered skin pigmentation
- D. Rosacea
- E. Red and edematous blisters
Correct Answer: A,C,E
Rationale: Some of the most common adverse effects of tretinoin are excessively red and edematous blisters, crusted skin, and temporary alterations in skin pigmentation.
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.
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.
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.