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Tretinoin (Retin-A) is a topical agent commonly used to treat acne. Nursing considerations with this drug should include:
- A. teaching to avoid use of sunscreen agents.
- B. applying generously to the skin.
- C. explaining that medication should not be applied until at least 20 to 30 minutes after washing.
- D. explaining that erythema and peeling are indications of toxicity.
Correct Answer: C
Rationale: Nursing considerations with Tretinoin (Retin-A) should include explaining that the medication should not be applied until at least 20 to 30 minutes after washing. This wait time allows the skin to fully dry and reduces the risk of irritation. Applying the medication too soon after washing can increase the likelihood of skin irritation, dryness, and peeling. It is essential to follow this guideline to ensure the effectiveness of the treatment and minimize adverse effects on the skin.
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On a visit to the gynecologist, a client complains of urinary frequency, pelvic discomfort, and weight loss. After a complete physical examination, blood studies, and a pelvic examination with a Papanicolaou test, the physician diagnoses stage IV ovarian cancer. The nurse expects to prepare the client for which initial treatment?
- A. Radiation therapy
- B. Chemotherapy
- C. Major surgery
- D. None
Correct Answer: C
Rationale: In the case of stage IV ovarian cancer, initial treatment typically involves major surgery, known as cytoreductive surgery or debulking surgery. The goal of this surgery is to remove as much of the tumor burden as possible from the abdomen and pelvis. By reducing the size of the tumor, the effectiveness of subsequent treatments such as chemotherapy can be enhanced. Surgery may also involve the removal of the uterus, ovaries, fallopian tubes, and surrounding tissue. Radiation therapy or chemotherapy may be used after surgery to further target any remaining cancer cells. However, major surgery is often the first step in the management of advanced ovarian cancer.
A client hyperparathyroidism declines surgery and is to receive hormone replacement therapy with estrogen and progesterone. Which of the following instructions would be most important to include in the client's teaching plan?
- A. maintain a moderate exercise
- B. Lose weight
- C. Jog at least 2 miles per day
- D. Rest as much as possible
Correct Answer: A
Rationale: The most important instruction to include in the client's teaching plan would be to maintain a moderate exercise routine (Option A). Regular physical activity is important for overall health, including helping to maintain bone health and strength. This is particularly crucial for individuals with hyperparathyroidism who are declining surgery and opting for hormone replacement therapy, as exercise can help to support bone density and reduce the risk of fractures. However, it is essential to emphasize that the exercise should be moderate and appropriate for the individual's current fitness level, as excessive exercise can have negative effects on bone health in this population.
A nurse is planning to use an interpreter during a health history interview of a non-English speaking patient and family. Which nursing care guidelines should the nurse include when using an interpreter? (Select all that apply.)
- A. Elicit one answer at a time.
- B. Interrupt the interpreter if the response from the family is lengthy.
- C. Comments to the interpreter about the family should be made in English.
- D. Arrange for the family to speak with the same interpreter, if possible.
Correct Answer: A
Rationale: Elicit one answer at a time: By eliciting one answer at a time, the nurse can ensure clarity in communication and prevent confusion or information overload for both the patient and interpreter.
Which nursing intervention is most appropriate for a client with multiple myeloma?
- A. Monitoring respiratory status
- B. Restricting fluid intake
- C. Balancing rest and activity
- D. Preventing bone injury
Correct Answer: D
Rationale: One of the primary concerns in clients with multiple myeloma is bone damage and fractures due to weakened bones caused by the disease. Preventing bone injury is a crucial nursing intervention to focus on for these clients. Measures to prevent bone injury include implementing fall precautions, encouraging safe mobility, providing supportive devices such as walkers or canes, and educating the client on strategies to prevent falls and fractures. Additionally, pain management and regular assessment for signs of bone damage are essential in caring for clients with multiple myeloma. Other interventions such as monitoring respiratory status, balancing rest and activity, and restricting fluid intake may be important in certain situations for these clients but preventing bone injury takes precedence due to the increased risk of skeletal complications associated with multiple myeloma.
A 3-year-old with croup has the following vital signs: HR 90, RR 44, BP 100/52, T 98.8°F. The parents ask if these are normal. The nurse's best response is:
- A. Your son's blood pressure is elevated.
- B. Your son's temperature is elevated.
- C. Your son's respiratory rate is elevated; a normal rate for his age is 20-30 breaths per minute.
- D. Your son's heart rate is elevated.
Correct Answer: C
Rationale: The elevated respiratory rate is concerning since normal for a 3- to 6-year-old is about 20-30 breaths per minute.