Deck 105: Drugs for the Skin

Question 1

A patient asks a nurse what a sun protection factor (SPF)of 15 indicates. The nurse will tell the patient that an SPF of 15 indicates:

A) a 93% block of UVB radiation.
B) half the protection of a sunscreen with an SPF of 30.
C) low protection.
D) that it takes 15 minutes for the sun to burn.

Answer 1

a 93% block of UVB radiation.

Question 2

A patient will begin initial treatment for severe acne. Which regimen will the nurse expect the provider to order?

A) Clindamycin/benzoyl peroxide [BenzaClin] and tretinoin [Retin-A]
B) Doxycycline [Vibramycin] and tretinoin [Retin-A]
C) Erythromycin [Ery-Tab) and benzoyl peroxide
D) Topical clindamycin and isotretinoin [Accutane]

Answer 2

Doxycycline [Vibramycin] and tretinoin [Retin-A]

Question 3

A patient has severe acne that has been refractory to treatment. The patient is taking tetracycline and using topical tretinoin [Retin-A] and has been applying benzoyl peroxide twice daily. The provider asks the nurse to teach this patient about isotretinoin [Accutane],which the patient will begin taking in a few weeks. The nurse will include which statement when teaching this patient about this drug?

A) "Alcohol may be consumed in moderation when taking this drug."
B) "Skin rash, headache, and hair loss are common with this drug."
C) "Tetracycline must be discontinued before beginning the isotretinoin."
D) "Two pregnancy tests are required before each monthly refill of your prescription."

Answer 3

"Tetracycline must be discontinued before beginning the isotretinoin."

Question 4

A teenaged female patient has begun to develop acne and asks a nurse how to minimize pimple formation. What will the nurse recommend?

A) Asking the provider about oral contraceptives
B) Cleansing the face gently 2 to 3 times daily
C) Eliminating greasy foods from the diet
D) Using an abrasive agent to scrub the face

Question 5

A nurse is discussing the use of tazarotene [Tazorac] with a patient who has psoriasis. Which statement by the patient indicates a need for further teaching?

A) "I should use a sunscreen when using this medication."
B) "I understand the gel can cause staining of clothing."
C) "I will apply this once daily in the evening."
D) "I will apply the medication to dry skin."

Question 6

To provide protection against the full range of ultraviolet (UV)radiation,an organic sunscreen must contain which agent?

A) Avobenzone
B) Para-aminobenzoic acid (PABA)
C) Titanium dioxide
D) Zinc oxide

Question 7

A patient with actinic keratoses has received a prescription for fluorouracil [Carac]. Which statement by the patient indicates understanding of this medication?

A) "Healing should occur 6 weeks after beginning treatment."
B) "I will apply this drug twice daily."
C) "Severe inflammation is an indication for stopping treatment."
D) "Tissue ulceration and necrosis are desired effects."

Question 8

An adolescent patient with moderate acne has begun a regimen consisting of combination clindamycin/benzoyl peroxide [BenzaClin] and tretinoin [Retin-A]. Which statement by the patient indicates understanding of this medication regimen?

A) "I should apply the Retin-A immediately after bathing."
B) "I should apply the Retin-A twice daily."
C) "I should augment this therapy with an abrasive soap."
D) "I should use sunscreen every day."

Question 9

A patient is using a high-concentration keratolytic agent containing 20% salicylic acid to remove warts. What will the nurse teach this patient?

A) Peeling and drying are desired effects of this drug.
B) Systemic effects may occur with this medication.
C) Tinnitus is a common side effect of little concern.
D) Tissue injury is unlikely at this dose.

Question 10

An adolescent has recently been experiencing pimples. The nurse notes several closed comedones across the patient's forehead and on the nose. The nurse will expect to teach this patient about the use of which medication?

A) Benzoyl peroxide
B) Topical clindamycin
C) Topical erythromycin
D) Topical retinoids

Question 11

A 14-year-old patient has moderate acne that has not responded to topical drugs. The nurse will suggest that the patient and her parents discuss which treatment with the provider?

A) Combination oral contraceptive medication
B) Doxycycline [Vibramycin]
C) Isotretinoin [Accutane]
D) Spironolactone

Question 12

A patient with psoriasis has been using a high-potency glucocorticoid. Because of skin atrophy,the provider has ordered a switch to calcitriol [Vectical],a vitamin D₃ analog. What will the nurse teach this patient?

A) "Calcitriol causes severe photosensitivity."
B) "Itching, erythema, and irritation are indications of an allergic reaction."
C) "Systemic effects do not occur with this topical agent."
D) "You may apply calcitriol to all areas of the skin except the face."

Question 13

A child with eczema has been treated unsuccessfully with a topical glucocorticoid for a year and has skin atrophy and hypopigmentation. The nurse will suggest discussing which drugs with the provider?

A) Higher potency topical glucocorticoids
B) Topical keratolytic agents
C) Topical immunosuppressants
D) Topical nonsteroidal anti-inflammatory drugs (NSAIDs)

Question 14

A female patient with baldness asks a nurse about the safety and efficacy of minoxidil [Rogaine]. What will the nurse tell the patient?

A) Hair regrowth is most effective when baldness has developed recently.
B) Minoxidil cannot be used by female patients.
C) Once hair has been restored, minoxidil may be discontinued, because hair loss will stop.
D) Systemic side effects, such as headaches and flushing, are common.

Question 15

A patient with severe psoriasis will begin taking acitretin [Soriatane]. The nurse obtains a health history and learns that the patient takes a combination oral contraceptive. What will the nurse do?

A) Counsel the patient to use another form of birth control along with the OCP.
B) Tell the patient she may stop using contraception when the medication is withdrawn.
C) Tell the patient that acitretin is safe to take during pregnancy.
D) Tell the patient to report spotting to the provider so that another form of contraceptive may be ordered.

Question 16

An infant has a severe contact diaper dermatitis. The provider orders triamcinolone acetonide [Kenalog] 0.1% cream to be applied 3 times daily. When teaching the infant's parents about this medication,the nurse will instruct them to apply:

A) a thick layer and massage the cream into the skin.
B) a thin layer and leave the diaper open as much as possible.
C) the cream and place an occlusive dressing over the area.
D) the cream and put the infant's diaper on tightly.

Question 17

A 50-year-old patient asks about using tretinoin [Renova] to minimize wrinkles. What will the nurse tell the patient?

A) The drug may be discontinued once results are obtained.
B) Results may be visible within a few weeks of starting therapy.
C) Systemic toxicity is a common effect in patients with sensitive skin.
D) The drug is not effective on coarse wrinkles or sun-damaged skin.

Question 18

An adolescent has begun using benzoyl peroxide lotion twice daily to treat acne. The patient reports experiencing drying and burning of the skin. What will the nurse suggest?

A) Applying lotion to the skin after applying the drug
B) Reducing the frequency to one application a day
C) Discontinuing the medication, because this is likely an allergic reaction
D) Requesting a prescription for a gel formulation of the drug

Question 19

A nurse is teaching a group of lifeguards about safe sunning. Which statement by a lifeguard indicates understanding of the teaching?

A) "Sunscreen should be applied 30 minutes before going outside."
B) "I do not need sunscreen when it is cloudy outside."
C) "I should reapply sunscreen after swimming."
D) "UV radiation does not penetrate through water."

Question 20

A 50-year-old patient receives botulinum toxin type A [Botox] injections for the first time on her forehead and around her eyes. One week later,she calls the clinic to report that she is experiencing droopy eyelids. The nurse will tell the patient that this effect:

A) is normal and will resolve in a few days.
B) may persist for 3 to 6 months but will resolve.
C) may progress to cause drooling and dysphagia.
D) represents an adverse effect that may be permanent.

Question 21

A patient has actinic keratosis and is unable to tolerate the effects of fluorouracil. The provider orders the nonsteroidal anti-inflammatory drug diclofenac sodium [Solaraze] 3% gel. What will the nurse include when teaching this patient about this medication?

A) "Apply this medication three times daily for 30 days."
B) "Dry skin, itching, and rash are common local side effects."
C) "This drug has the same risk of GI side effects as with oral NSAIDs."
D) "You do not need to protect your skin from sunlight with diclofenac."