Isotretinoin is prescribed for a client with severe cystic acne. The nurse provides instructions to the client regarding administration of the medication. Which phrase stated by the client indicates a need for further teaching regarding this medication?
1."I need to continue to take my vitamin A s...
Isotretinoin is prescribed for a client with severe cystic acne. The nurse provides instructions to the
client regarding administration of the medication. Which phrase stated by the client indicates a need for
further teaching regarding this medication?
1."I need to continue to take my vitamin A supplements."
2."The medication may cause dryness and burning in my eyes."
3."I need to use emollients and lip balms for my dry skin and lips."
4."I will need to return for a blood test to check my triglyceride level."
1."I need to continue to take my vitamin A supplements."
Rationale: In severe cystic acne, isotretinoin is used to inhibit inflammation. Adverse effects include
elevated triglyceride levels, skin dryness, eye discomfort such as dryness and burning, and cheilitis (lip
inflammation). Close medical follow-up is required, and dry skin and cheilitis can be decreased by the
use of emollients and lip balms. Vitamin A supplements are stopped during this treatment.
In planning care for the client with psoriasis, the nurse understands that which represents
a priority client problem?
1.Fatigue
2.Constipation
3.Impaired safety
4.Altered body image
Altered body image
Psoriasis is an autoimmune dermatitis that is expressed as silvery scales on reddish-colored skin on areas
such as scalp, elbows, hands, and knees. Onset of the disease generally occurs before age 40, with
symptoms varying in intensity from mild to severe. Skin disorders, particularly when experienced by
young persons and particularly when visible on exposed body parts, can cause significant psychosocial
distress. Altered body image is a priority client problem that should be considered when planning care
for a client with psoriasis. The remaining options are not priority client problems associated with
psoriasis.
,The nurse expects to note which prescription for a client with a skin infection that extends into the
dermis?
1.Applying warm compresses to the affected area 2.Placing iced compresses to the affected area every 4
hours
3.Alternating the application of hot and iced compresses every 2 hours
4.Placing antibiotic ointment on the affected site followed by continuous heat lamp application
1.Applying warm compresses to the affected area
Warm compresses may be prescribed to decrease the discomfort, erythema, and edema associated with
a skin infection that is characteristic of cellulitis. The nurse should also provide supportive care as
prescribed to manage associated symptoms such as fever or chills. After tissue and blood are obtained
for culture, antibiotics are initiated. Heat lamps can cause more disruption to already inflamed tissue.
Iced compresses are not prescribed because they can damage tissue.
A client is being admitted to the hospital for treatment of acute cellulitis of the lower left leg. During the
admission assessment, the nurse expects to note which finding?
1.An inflammation of the epidermis only
2.A skin infection of the dermis and underlying hypodermis
3.An acute superficial infection of the dermis and lymphatics
4.An epidermal and lymphatic infection caused by Staphylococcus
2.A skin infection of the dermis and underlying hypodermis
Cellulitis is an infection of the dermis and underlying hypodermis that results in a deep red erythema
without sharp borders and spreads widely throughout tissue spaces. The skin is erythematous,
edematous, tender, and sometimes nodular. Erysipelas is an acute, superficial, rapidly spreading
inflammation of the dermis and lymphatics. The infection is not superficial and extends deeper than the
epidermis.
An outbreak of head lice infestation has occurred at a local school. The school nurse is providing
instructions to the mothers of the children attending the school regarding the application
of malathion. The nurse should tell the mothers to take which action?
1.Apply the lotion immediately after washing the hair.
2.Pour the lotion onto the hair and then rinse immediately.
3.Allow the lotion to remain on the hair for 10 minutes and then rinse with water.
4.Leave the lotion on for 8 to 12 hours, and then wash the hair with nonmedicated shampoo.
, 4.Leave the lotion on for 8 to 12 hours, and then wash the hair with nonmedicated shampoo.
Rationale: The instructions for the use of malathion are as follows: Sprinkle lotion on dry hair and rub
gently until the scalp is moistened; allow to dry naturally; after 8 to 12 hours, wash the hair with a
nonmedicated shampoo; rinse and use a fine-toothed comb to remove lice; and repeat in 7 to 9 days if
needed.
The nurse is providing an educational session to community members regarding Lyme disease. The
nurse should provide what information regarding this disease?
1.It is caused by a tick bite.
2.It can be contagious by skin contact with an infected person.
3.It can be caused by the inhalation of spores from bird droppings.
4.It is caused by contamination from cat feces or the consumption of rare or raw meat.
1.It is caused by a tick bite.
Lyme disease is a multisystem infection that results from a bite by a tick that is usually carried by several
species of deer. Persons bitten by the Ixodes ticks are infected with the spirochete Borrelia burgdorferi.
Lyme disease cannot be transmitted from 1 person to another. Histoplasmosis is caused by the
inhalation of spores from bat or bird droppings. Toxoplasmosis is caused from the inhalation of cysts
from contaminated cat feces or the consumption of rare or raw meat.
The nurse suspects herpes zoster (shingles) when which assessment finding is noted?
1.Clustered skin vesicles
2.A generalized body rash
3.Small blue-white spots with a red base
4.A fiery red, edematous rash on the cheeks
1.Clustered skin vesicles
The primary lesion of herpes zoster is a vesicle. The classic presentation is grouped vesicles on an
erythematous base along a dermatome. Because the lesions follow nerve pathways, they do not cross
the midline of the body. Options 2, 3, and 4 are incorrect descriptions of herpes zoster.
Isotretinoin has been prescribed for an adolescent with a diagnosis of severe cystic acne. The nurse
provides instructions to the adolescent regarding the use of the medication. Which statement, if made
by the adolescent, indicates a need for further instruction?
1."I will return to the clinic for blood tests."
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