Nokea
Which of the following might nurses use to clean their hands before and after caring for a client? Select all that apply.
- A. Chlorhexidine (Hibiclens)
- B. Fluocinonide (Lidex)
- C. Hexachlorophene (pHisoHex)
- D. Imiquimod (Aldara)
- E. Ketoconazole (Nizoral)
Correct Answer: A,C
Rationale: Topical antiseptics, like chlorhexidine (Hibiclens) and hexachlorophene (pHisoHex), can be used by nurses to clean their hands before and after caring for a client.
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A nurse is caring for a client who has been prescribed lidocaine viscous to be used for pain control of the oral mucosa. Which of the following instructions regarding the intake of food should the nurse give the client?
- A. Drink plenty of water along with food.
- B. Avoid intake of heavy and fibrous food.
- C. Ensure the food is not too hot or cold.
- D. Do not eat food for 1 hour after use.
Correct Answer: D
Rationale: When lidocaine viscous is used for oral anesthesia to control pain, the nurse instructs the client not to eat food for 1 hour after use because local anesthesia of the mouth or throat may impair swallowing and increase the possibility of aspiration.
Which of the following would be most important to include in the preadministration assessment of a client who is receiving topical therapy for a skin disorder? Select all that apply.
- A. Size of the area affected
- B. Appearance of the lesions
- C. Report of pain or burning
- D. Client's weight
- E. Blood pressure
Correct Answer: A,B,C
Rationale: The preadministration assessment involves a visual inspection and palpation of the involved area(s). The areas of involvement, including the size, color, and appearance, are carefully measured and documented. The appearance of the skin lesions and reports of pain or burning are noted to establish an accurate baseline for treatment.
A client is prescribed topical clindamycin therapy. The nurse instructs the client and family about possible systemic effects. The nurse determines that the teaching was successful when they state that they should contact the primary health care provider immediately if which of the following occur? Select all that apply.
- A. Stomach cramps
- B. Severe diarrhea
- C. Bloody stools
- D. Burning
- E. Pruritus
Correct Answer: A,B,C
Rationale: Topical clindamycin can be absorbed in sufficient amounts to cause systemic effects. Severe diarrhea, stomach cramps, or bloody stools indicate potential systemic complications, such as pseudomembranous colitis, requiring immediate medical attention.
The nurse should discuss which of the following adverse reactions with a client prior to the topical administration of anthralin (Miconal)? Select all that apply.
- A. Hair discoloration
- B. Discoloration of fingernails
- C. Discoloration of skin
- D. Pruritus
- E. Burning
Correct Answer: A,B,D,E
Rationale: Localized reactions caused by the topical administration of anthralin (Miconal) that the nurse should discuss with the client prior to administration include burning, pruritus, irritation, and temporary discoloration of the fingernails and hair.
A client is prescribed a topical corticosteroid. Which of the following would be appropriate for the nurse to do?
- A. Clean the area with an antiseptic before applying the drug.
- B. Apply the topical corticosteroid sparingly.
- C. Place a sterile cloth over the area of application.
- D. Rub the application into the skin vigorously.
Correct Answer: B
Rationale: Topical corticosteroids should be applied sparingly to minimize systemic absorption and adverse effects. Cleaning with an antiseptic may not be necessary unless directed, and a sterile cloth or vigorous rubbing is not typically recommended.