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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.
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A female patient has been taking isotretinoin for 3 months. During a follow-up appointment, which statement by the patient would be of highest concern to the nurse?
- A. I am using two forms of contraception while on this drug.
- B. I have been feeling rather down and lonely lately.
- C. I wish I didn't have to be on this medication.
- D. It's scary to know that this drug can cause birth defects.
Correct Answer: B
Rationale: There have been case reports of suicide and suicide attempts in patients receiving isotretinoin. Instruct patients to report immediately to their prescribers any signs of depression.
The preoperative nurse is ready to perform a skin prep with povidone-iodine on a patient who is about to have abdominal surgery. Which allergies, if present, would be a contraindication to this prep solution?
- A. Peanuts
- B. Shellfish
- C. Adhesives
- D. Latex
Correct Answer: B
Rationale: Povidone-iodine, a widely used antiseptic, cannot be used in patients who are allergic to iodine or have shellfish allergies.
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.
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 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.