The nurse is conducting a follow-up visit with a client who is being treated for psoriasis with adalimumab. Which finding demonstrates a therapeutic response has occurred?
Absence of drainage
Negative wound cultures
Decreased neutrophils
Decreased scaling
✓
Correct Answer
Decreased scaling
Adalimumab decreases the mitotic rate of skin cells to decrease scaling plaques in psoriasis.
Question 2
A 32-year-old client diagnosed with acne has been prescribed tretinoin. Which teaching point should the nurse include in the client's discharge instructions?
You may take this medication only during the first 12 weeks of pregnancy.
It is essential that you avoid pregnancy throughout therapy with tretinoin.
✓
This medication should be used liberally across the affected area three times daily.
You should stop taking your birth control because it reacts negatively with tretinoin.
Correct Answer
It is essential that you avoid pregnancy throughout therapy with tretinoin.
Risks for embryo/fetal loss or abnormalities prevent the use of tretinoin during pregnancy.
Question 3
For which client would the nurse question an order for tetracycline hydrochloride?
An 86-year-old client undergoing treatment for an infected sebaceous cyst
A 48-year-old client with a history of frequent UTIs
A 6-year-old client diagnosed with impetigo
✓
A 16-year-old client with severe acne
Correct Answer
A 6-year-old client diagnosed with impetigo
Tetracycline drugs, when taken by children under the age of 8 years, may cause damage to bones and teeth; therefore, they are contraindicated in this population.
Question 4
A client newly diagnosed with plaque psoriasis asks the nurse how this condition will be treated. Which is the correct response by the nurse?
"Combination therapy to exfoliate and reduce cell maturation will be used."
✓
"You will be given an antibiotic to eliminate bacterial organisms."
"You will need surgical intervention to remove these lesions."
"A steroidal cream should clear this condition in 2 weeks."
Correct Answer
"Combination therapy to exfoliate and reduce cell maturation will be used."
Psoriasis treatment requires exfoliation to remove plaque formation and drugs to decrease rapid skin cell growth to prevent plaques.
Question 5
Which statement, when made by a client, demonstrates that further teaching by the nurse is necessary regarding the use of topical corticosteroids?
"I will cover the lesion with an occlusive dressing after I apply the steroid cream."
✓
"I should use a thin layer of this medication directly on the lesion."
"This medication will reduce irritation and swelling."
"I should cleanse my skin before applying this medication."
Correct Answer
"I will cover the lesion with an occlusive dressing after I apply the steroid cream."
Covering topical steroids may cause both local irritation and systemic absorption of the drug.
Question 6
A nursing student asks the nurse how impetigo treatment works. The nurse explains that the primary goal in the treatment of impetigo is to:
Soften the tissues to reduce pain
Eliminate the causative bacteria
✓
Reduce swelling and scaling
Decrease scarring as the lesion heals
Correct Answer
Eliminate the causative bacteria
Impetigo is a localized infection that requires treatment with antibiotics to eliminate the causative bacteria.
Question 7
For which client would a nurse question an order for acitretin?
A 68-year-old client with a serum hemoglobin of 10.5 g/L
A 32-year-old client with a documented sulfa allergy
A 52-year-old client with a diagnosis of osteoarthritis
A 48-year-old client with a history of renal failure
✓
Correct Answer
A 48-year-old client with a history of renal failure
Acitretin is contraindicated in clients with decreased renal function.
Question 8
The nurse is applying silver sulfadiazine to burns on a client's arm. The client asks that the nurse cover the area with a dressing to protect it and keep the medication from getting on their clothes. What is the best response by the nurse?
"I will apply a gauze dressing, which will protect the area but still allow air to pass through it."
✓
"I will apply an occlusive dressing to ensure the medication is fully absorbed."
"It is best to not apply a dressing and leave this open to the air."
"I will apply an occlusive dressing to keep the keep the area sterile."
Correct Answer
"I will apply a gauze dressing, which will protect the area but still allow air to pass through it."
Applying a nonocclusive dressing to protect the area is appropriate, but applying an occlusive dressing is contraindicated because it will increase the systemic effects of the medication.
Question 9
Upon entering the examination room, the nurse finds a 15-year-old client in tears. The client states, "This acne has ruined my life. No one will ever want to date me with this awful stuff on my face." Which of the following statements by the nurse is most appropriate?
"I think you should see a psychologist to talk about this."
"With proper hygiene and medications, you can manage your acne well."
✓
"You can manage this with lifelong medications."
"You must avoid cosmetics and lotions so that your acne will go away."
Correct Answer
"With proper hygiene and medications, you can manage your acne well."
With proper treatment, most forms of acne can be controlled with resolution or improvement in skin lesions.
Question 10
The nurse is preparing to discharge a client with a new prescription for metronidazole. Which statement should be included in the discharge teaching?
"You may stop taking this medication when your skin looks better."
"Limit your oral fluid intake to 2000 mL/day."
"You will experience severe side effects if you drink alcohol while on this drug."
✓
"This medication will eliminate the bacterial organisms on your skin."
Correct Answer
"You will experience severe side effects if you drink alcohol while on this drug."
Drinking alcoholic beverages when taking metronidazole results in a disulfiram-like reaction, which is evidenced by diaphoresis, hypotension, and nausea/vomiting.