Question 1

A female patient has been taking isotretinoin (Amnesteem)for 3 months.During a follow-up appointment,which statement by the patient would be of highest concern to the nurse?&#10;A) &#34;I am using two forms of contraception while on this drug.&#34;&#10;B) &#34;I have been feeling rather down and lonely lately.&#34;&#10;C) &#34;I wish I didn't have to be on this medication.&#34;&#10;D) &#34;It's scary to know that this drug can cause birth defects.&#34;

Accepted Answer

Isotretinoin has been linked to depression and suicidal thoughts, which is a serious concern. While all of the statements have some level of concern, the statement about feeling down and lonely is the most worrisome and requires further evaluation and possible intervention. The statement about using two forms of contraception shows that the patient is aware of the importance of preventing pregnancy while taking the medication, and the other statements express common concerns related to side effects and the need for the medication.

Question 2

The preoperative nurse is ready to perform a skin prep with povidone-iodine (Betadine)on a patient who is about to have abdominal surgery.Which allergies,if present,would be a contraindication to the Betadine prep?

A) Peanuts
B) Shellfish
C) Adhesives
D) Latex

Shellfish

Accepted Answer

Povidone-iodine, a widely used antiseptic, cannot be used in patients who are allergic to iodine or have shellfish allergies.

Question 3

A father calls because his son has head lice.He reports that he used Kwell shampoo three times,but nothing happened.&#34; He wants to know what to do now.What will the nurse advise first?&#10;A) &#34;It sounds like you need a prescription for a second product,malathion.&#34;&#10;B) &#34;Try one of the lotion products instead.&#34;&#10;C) &#34;Be sure to use a nit comb to remove nits from the hair shafts.&#34;&#10;D) &#34;Try combing through the hair with mineral oil to loosen the lice from the hair shafts.&#34;

Accepted Answer

The nurse should advise the father to use a nit comb to remove nits from the hair shafts. This is important because although the Kwell shampoo may have killed the live lice, it does not typically kill the nits (lice eggs) which can still hatch and continue the infestation. Removing the nits with a nit comb is an essential step in treating head lice. Other options such as using a different product or mineral oil may also be effective, but they are not necessarily the best first step to take.

Question 4

A female patient will be starting therapy with oral isotretinoin (Amnesteem)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."

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Accepted Answer

Oral isotretinoin is a teratogenic drug, meaning it can cause birth defects if taken during pregnancy. Therefore, women of childbearing age who are prescribed this drug are required to use two forms of contraception while taking it and for one month after stopping the medication. Avoiding sexual activity altogether is not necessary, but reliable contraception is essential. Taking an oral contraceptive alone is not enough, as isotretinoin can reduce the effectiveness of hormonal contraceptives.

Question 5

A 55-year-old obese patient was diagnosed with candidiasis in the skin folds under her breasts.When the nurse sees her at a follow-up visit 2 months later,she complains that it has returned.She said she applied the medicine for 1 week and stopped because the itching stopped and the cream was messy.Which statement is true regarding fungal infections of the skin?

A) Fungal infections often require prolonged therapy.
B) The patient has a new infection now.
C) The patient needs to apply a dressing if the cream is too messy.
D) This infection will probably never be cured.

Accepted Answer

Fungal infections often require prolonged therapy, and stopping treatment prematurely can lead to recurrence of the infection. It is important for the patient to continue treatment for the full prescribed course, even if symptoms subside before completion. The patient should also be advised on proper application of the medication and any potential side effects. A new infection is unlikely in this case, and applying a dressing may help with the messiness of the cream. The infection can be cured with appropriate treatment and patient compliance.

Question 6

A patient asks about using minoxidil (Rogaine)for hair thinning.Which statement about minoxidil is accurate?&#10;A) The product is applied once daily in the morning.&#10;B) Systemic absorption of topically applied minoxidil is rare.&#10;C) Results may be seen as soon as 2 weeks after beginning therapy.&#10;D) Systemic absorption may cause tachycardia,fluid retention,and weight gain.

Accepted Answer

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.

Question 7

A patient is considering taking oral aloe supplements and asks the nurse about potential problems with this therapy.Which statement by the nurse is correct?&#10;A) &#34;Aloe is not taken orally; it is only used topically to aid in wound healing.&#34;&#10;B) &#34;Aloe is used by some to treat constipation; it may cause diarrhea.&#34;&#10;C) &#34;This is a safe herbal supplement,with no known drug interactions.&#34;&#10;D) &#34;This is a safe herbal supplement,with no known adverse effects.&#34;

Accepted Answer

Aloe is used by some people to treat constipation, but it can also cause diarrhea. There are also potential interactions with certain medications, such as those that affect blood sugar levels or decrease potassium levels in the body. Therefore, it is important for the patient to discuss their use of aloe supplements with their healthcare provider.

Question 8

A woman suffered a second-degree burn of the skin on her arm and hand while cooking breakfast.After examination in the urgent care center,silver sulfadiazine cream (Silvadene)is ordered for the burned area.The nurse will apply the medication using which procedure?

A) Gently patting a moderate amount over the burned area
B) Massaging the cream completely into the wound
C) Applying a thick layer over the burned area,and then leaving the area open
D) Applying a thin layer with a sterile,gloved hand to clean and débrided areas

Accepted Answer

The best option for applying Silvadene cream is to apply a thin layer with a sterile, gloved hand to clean and débrided areas. This ensures that the medication is applied evenly and reduces the risk of infection from touching the wound with bare hands. It is important to note that the cream should not be massaged into the wound or applied too thickly as this can cause further damage to the burned area. The area should also be covered with a sterile dressing after the medication has been applied.

Question 9

Which adverse effects will the nurse expect in a teenage patient who is using topical tretinoin (Retin-A)? (Select all that apply.)&#10;A) Crusted skin&#10;B) Itching&#10;C) Altered skin pigmentation&#10;D) Rosacea&#10;E) Red and edematous blisters

Accepted Answer

The answer of Which adverse effects will the nurse expect...

Question 10

The nurse is reviewing the medical record of a patient who is to receive wound care with topical silver sulfadiazine (Silvadene).Which finding,if noted,would be a potential contraindication?&#10;A) The patient has an open wound from a burn on her arm.&#10;B) The patient is allergic to sulfonamide drugs.&#10;C) The patient is allergic to shellfish.&#10;D) The patient's burn wound has been d&#233;brided.

Accepted Answer

Silver sulfadiazine contains a sulfonamide moiety, and patients who have allergy to sulfonamide drugs should not receive silver sulfadiazine. Open wound and wound débridement are not contraindications, and shellfish allergy is not a concern in this case.

Question 11

A teenage boy is taking tretinoin (Retin-A)for acne.Which statement will the nurse include in the teaching plan?&#10;A) &#34;Avoid foods that are heavy in salt and oils.&#34;&#10;B) &#34;This drug may cause increased redness of your skin.&#34;&#10;C) &#34;Try using an abrasive cleanser to remove old skin layers.&#34;&#10;D) &#34;Being out in the sunlight will help your skin heal.&#34;

Accepted Answer

The answer of A teenage boy is taking tretinoin (Retin-A)for...

Question 12

A child has been diagnosed with impetigo,a skin infection.The nurse anticipates that which drug will be used to treat this condition?&#10;A) Spinosad (Natroba)&#10;B) Nystatin (Mycostatin)&#10;C) Acyclovir (Zovirax)&#10;D) Bacitracin

Accepted Answer

The answer of A child has been diagnosed with impetigo,a...

Question 13

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 (Zovirax)
B) Mupirocin (Bactroban)
C) Clindamycin (Cleocin T)
D) Clotrimazole (Lotrimin)

Accepted Answer

The answer of The nurse is reviewing laboratory results for...

Question 14

A patient is admitted to the hospital for possible septicemia.He has a large pressure ulcer on his heel that is open and includes necrotic tissue.However,his prothrombin time/international normalized ratio (PT/INR)values are too high to permit surgical débridement at this time.The nurse expects that which wound-care product will be used to treat the wound?

A) Cadexomer iodine (Iodosorb)
B) Biafine topical emulsion
C) Povidone-iodine (Betadine)
D) Collagenase (Santyl)

Accepted Answer

The answer of A patient is admitted to the hospital...

Deck 56: Dermatologic Drugs