NCLEX Book Q&A-Pharm Integumentary System

The clinic nurse is performing an admission assessment on a client and notes that the client is taking azelaic acid (Azelex). Because of the medication prescription, the nurse would suspect that the client is being treated for which condition? A. Acne B. Eczema C. Hair loss D. Herpes simplex

A. Acne Azelex acid is a topical medication used to treat mild to moderate acne. The acid appears to work by suppressing the growth of Propionibacterium acnes and by decreasing the proliferation of keratinocytes.

A burn client is receiving treatments of topical mafenide acetate (Sulfamylon) to the site of injury. The nurse monitors the client, knowing that which finding indicates that a systemic effect has occurred? A. Hyperventilation B. Local rash at the burn site C. Elevated blood pressure D. Local pain at the burn site

A. Hyperventilation Mafenide acetate is a carbonic anhydrase inhibitor and can suppress renal excretion of acid, thereby causing acidosis. If acidosis occurs, the medication will probably be discontinued for 1 to 2 days.

Salicylic acid is prescribed for a client with a diagnosis of psoriasis. The nurse monitors the client, knowing that which finding indicates the presence of systemic toxicity from this medication? A. Tinnitus B. Diarrhea C. Constipation D. Decreased respiration

A. Tinnitus Salicylic acid is absorbed readily through the skin, and systemic toxicity can result. Symptoms include tinnitus, dizziness, hyperpnea, and psychological disturbances. Constipation and diarrhea are not associated with salicylism.

A client with severe acne is seen in the clinic and the health care provider prescribes Isotretinoin (Amnesteem or Claravis). The nurse reviews the client's medication record and would contact the health care provider if the client is taking which medication? A. Vitamin A B. Digoxin (Lanoxin) C. Furosemide (Lasix) D. Phenytoin (Dilantin)

A. Vitamin A Isotretinoin is a metabolite of vitamin A and can produce generalized intensification of isotretinoin toxicity. Because of the potential for increased toxicity, vitamin A supplements should be discontinued before isotretinoin therapy.

The nurse is applying a topical corticosteroid to a client with eczema. The nurse should monitor for the potential for increased systemic absorption of the medication if the medication were being applied to which body area? A. Back B. Axilla C. Soles of the feet D. Palms of the hands

B. Axilla Topical corticosteroids can be absorbed into the systemic circulatoin. Absorption is higher from regions where the skin is especially permeable (scalp, axilla, face, eyelids, neck, perineum, genitalia), and lower from regions where permeability is poor (back, palms, soles).

Isotretinoin (Amnesteem or Claravis) is prescribed for a client with severe acne. Before the administration of this medication, the nurse anticipates that which laboratory test will be prescribed? A. Platelet count B. Triglyceride level C. Complete blood count D. White blood cell count

B. Triglyceride level Isotretinoin can elevate triglyceride levels. Blood triglyceride levels should be measured before treatment and periodically thereafter until the effect on the triglyceride has been elevated.

The health education nurse provides instructions to a group of clients regarding measures that will assist in preventing skin cancer. Which instructions should the nurse provide? Select all that apply. A. Sunscreen should be applied every 8 hours. B. Use sunscreen when participating in outdoor activities. C. Wear a hat, opaque clothing, and sunglasses when in the sun. D. Avoid sun exposure in the late afternoon and early evening hours. E. Examine your body monthly for any lesions that may be suspicious.

B. Use sunscreen when participating in outdoor activities. C. Wear a hat, opaque clothing, and sunglasses when in the sun. E. Examine your body monthly for any lesions that may be suspicious. The client should be instructed to avoid sun exposure between the hours of 10 am and 4pm.

Silver sulfadiazine (Silvadene, Thermazene, SSD cream) is prescribed for a client with a partial-thickness burn and the nurse provides teaching about the medication. Which statement made by the client indicates a need for further teaching about the treatments? A. "The medication is an antibacterial?" B. "The medication will help heal the burn." C. "The medication will permanently stain my skin." D. "The medication should be applied directly to the wound."

C. "The medication will permanently stain my skin." Silver sulfadiazine (Silvadene, Thermazene, SSD cream) is an antibacterial that has a broad spectrum of activity against gram- and gram+ bacteria, and yeast. It does not stain skin.

Mafenide acetate (Sulfamylon) is prescribed for a client with a burn injury. When applying the medication, the client complains of local discomfort and burning. The nurse should take which most appropriate action? A. Discontinue the medication B. Notify the health care provider C. Inform the client that this is expected D. Apply a thinner film that prescribed to the burn site

C. Inform the client that this is expected Mafenide acetate is bacteriostatic for gram- and gram+ organisms and is used to treat burns to reduce bacteria present in avascular tissues. The client should be informed that the medication will cause local discomfort and burning and that this is a normal reaction.

The camp nurse asks the children preparing to swim in the lake if they have applied sunscreen. The nurse reminds the children that chemical sunscreens are most effective when applied at which times? A. Immediately before swimming B. 5 minutes before exposure to the sun C. Immediately before exposure to the sun D. At least 30 minutes before exposure to the sun

D. At least 30 minutes before exposure to the sun Sunscreens are most effective when applied at least 30 minutes before exposure to the sun so that they can penetrate the skin.