Integumentary Medications NCLEX Saunders

Silver sulfadiazine 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? 1. "The medication is an antibacterial." 2. "The medication will help heal the burn." 3. "The medication is likely to cause stinging every time it is applied." 4. "The medication should be applied directly to the wound."

3. "The medication is likely to cause stinging every time it is applied."

A client with psoriasis is being treated with calcipotriene cream. Administration of high doses of this medication can cause which side or adverse effect? 1. Alopecia 2. Hyperkalemia 3. Hypercalcemia 4. Thinning of the skin

3. Hypercalcemia

Sodium hypochlorite solution is prescribed for a client with a wound on the left foot that is draining purulent material. Which action should the nurse plan to take? 1. Irrigate the wound with the solution. 2. Soak the foot in the solution for 20 minutes daily. 3. Place the solution in the wound, and cover with an occlusive dressing. 4. Soak a sterile dressing with the solution, and pack the dressing into the wound.

1. Irrigate the wound with the solution.

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? 1. Tinnitus 2. Diarrhea 3. Constipation 4. Decreased respirations

1. Tinnitus

A child with severe seborrheic dermatitis is receiving treatments of topical corticosteroid applied over an extensive area of the body, followed by the application of an occlusive dressing. The nurse should monitor the child closely, knowing that which systemic effect can occur as a result of this treatment? 1. Local infection 2. Growth retardation 3. Thinning of the skin 4. Adrenal hyperactivity

2. Growth retardation

Isotretinoin is prescribed for a client with severe acne. Before the administration of this medication, the nurse anticipates that which laboratory test will be prescribed? 1. Potassium level 2. Triglyceride level 3. Hemoglobin A1C 4. Total cholesterol level

2. Triglyceride level

A burn client has been having 1% silver sulfadiazine applied to burns twice a day for the past 3 days. Which laboratory abnormality indicates that the client is experiencing a side or adverse effect of this medication? 1. Serum sodium of 120 mEq/L (120 mmol/L) 2. Serum potassium of 3.0 mEq/L (3.0 mmol/L) 3. White blood cell count of 3000 mm3 (3 × 109/L) 4. pH 7.30, PaCO2 of 32 mm Hg (32 mmHg), HCO3- of 19 mEq/L (19 mmol/L)

3. White blood cell count of 3000 mm3 (3 × 109/L)

Collagenase is prescribed for a client with a severe burn to the hand. The home care nurse provides instructions to the client regarding the use of the medication. Which client statement indicates an accurate understanding of the use of this medication? 1. "I will apply the ointment at bedtime and in the morning." 2. "I will apply the ointment once a day and leave it open to the air." 3. "I will apply the ointment twice a day and leave it open to the air." 4. "I will apply the ointment once a day and cover it with a sterile dressing."

4. "I will apply the ointment once a day and cover it with a sterile dressing."

A client is seen in the clinic for complaints of skin itchiness that has persisted for several weeks. After an assessment, the client is determined to have scabies. Lindane is prescribed, and the nurse provides instructions to the client regarding the use of the medication. Which action should the nurse tell the client to take? 1. Apply the cream for 2 days in a row. 2. Apply a thick layer of cream to the entire body. 3. Apply the cream to the entire body and scalp, excluding the face. 4. Leave the cream on for 8 to 12 hours, and then remove it by washing.

4. Leave the cream on for 8 to 12 hours, and then remove it by washing.

An ambulatory care client with allergic dermatitis has been given a prescription for a tube of diphenhydramine 1% to use as a topical agent. The nurse determines that the medication was effective if which finding was noted? 1. Nighttime sedation 2. Decrease in urticaria 3. Absence of ecchymosis 4. Healing of burned tissue

2. Decrease in urticaria

The nurse has provided instructions to a client regarding the use of tretinoin. Which statement made by the client indicates the need for further instruction? 1. "I must apply it to wet to damp skin." 2. "Optimal results will be seen after 6 weeks." 3. "I will wash my hands thoroughly after applying the medication." 4. "I will cleanse the skin thoroughly before applying the medication."

1. "I must apply it to wet to damp skin."

Minoxidil is prescribed for a client to treat hair loss. The nurse provides instructions to the client regarding the application of the medication. Which statement by the client indicates that teaching is effective? 1. "I will apply the prescribed amount of solution at bedtime." 2. "I will apply the prescribed amount of solution twice a day." 3. "I will apply the prescribed amount of solution 4 times a day." 4. "I will apply the prescribed amount of solution 3 times a day."

2. "I will apply the prescribed amount of solution twice a day."

Minoxidil is prescribed for a client to treat hair loss. The client asks the nurse if the hair will continue to grow when the medication is stopped. What is the appropriate nursing response? 1. "The hair will continue to grow." 2. "Newly gained hair is lost in 3 to 4 months." 3. "I'm not sure—you need to ask your health care provider." 4. "It depends on how long you have been taking the medication."

2. "Newly gained hair is lost in 3 to 4 months."

The nurse provides instructions to a client regarding the use of topical tretinoin. Which statement by the client indicates a need for further instruction? 1. "I should begin to see results in about 3 weeks." 2. "I will apply the medication liberally to the skin." 3. "I cannot use any cosmetics while I am using this medication." 4. "I will wash my hands thoroughly after applying this medication."

3. "I cannot use any cosmetics while I am using this medication."

The home health care nurse makes a home visit to a client who has an ulcer on the medial aspect of the left ankle. The wound is being treated with a hydrocolloid dressing. The nurse removes the hydrocolloid dressing, cleanses the wound as prescribed, and reapplies the hydrocolloid dressing. The nurse schedules the next visit for wound care and changing the hydrocolloid dressing in how many days, which is the maximum number of days? Fill in the blank.

7 days

The school nurse has provided instructions regarding the use of permethrin rinse to the parents of children diagnosed with pediculosis capitis (head lice). Which statement by one of the parents indicates a need for further instruction? 1. "It is applied to the hair and then shampooed out." 2. "The hair should not be shampooed for 24 hours after treatment." 3. "The permethrin rinse can be obtained over the counter in a local pharmacy." 4. "It is applied to the hair after shampooing, left on for 10 minutes, and then rinsed out."

1. "It is applied to the hair and then shampooed out."

Coal tar has been prescribed for the client with psoriasis, and the nurse provides instructions to the client regarding this treatment. Which statement by the client indicates a need for further instruction? 1. "The medication can cause diarrhea." 2. "The medication can cause phototoxicity." 3. "The medication has an unpleasant odor." 4. "The medication can stain the skin and hair."

1. "The medication can cause diarrhea."

A client with muscle aches and a diagnosis of rheumatism has been given a prescription for capsaicin topical cream. The nurse determines that the client understands the use of the medication if the client makes which statement? 1. "The medication will act as a local analgesic." 2. "The medication acts by decreasing muscle spasms." 3. "The medication will cause redness, flaking, and the skin to peel." 4. "A heating pad should be put on the area after applying the medication."

1. "The medication will act as a local analgesic."

A burn-injured client is receiving treatments of topical mafenide acetate to the site of injury. The nurse should monitor the client for which systemic effect that can occur from the use of this medication? 1. Acidosis 2. Alkalosis 3. Hypotension 4. Hypertension

1. Acidosis

Tetracycline is prescribed for a client with severe acne. The nurse instructs the client regarding the importance of reporting which finding if it occurs? 1. Sunburn 2. Persistent diarrhea 3. Epigastric burning 4. Abdominal cramping

2. Persistent diarrhea

A home health nurse is visiting a client who has been started on therapy with clotrimazole. The nurse determines the effectiveness of the medication by noting a decrease in which problem? 1. Pain 2. Rash 3. Fever 4. Sneezing

2. Rash

Topical azelaic acid is prescribed for a client, and the clinic nurse provides instructions regarding the use of this medication. Which statement by the client indicates a need for further instruction? 1. "I need to apply the medication twice daily." 2. "The medication is used to treat my eczema." 3. "I need to massage a thin film gently into the affected area." 4. "I need to wash and dry my skin before I apply the medication."

2. "The medication is used to treat my eczema."

The health care provider has prescribed a topical antiinflammatory cream for a client with a muscular sprain. The nurse provides instructions to the client regarding the medication. Which statement by the client indicates an understanding of this prescribed treatment? 1. "The medication is addicting." 2. "The medication will act as a local anesthetic." 3. "I will apply a heating pad to the area after applying the medication." 4. "The medication may make me sleepy but will stop the muscle spasms."

2. "The medication will act as a local anesthetic."

A topical corticosteroid is prescribed for an infant with dermatitis in the gluteal area. The nurse provides instructions to the mother regarding the use of the medication. Which statement by the mother indicates an understanding of the use of the medication? 1. "I should not rub the medication into the skin." 2. "The medication will help relieve the inflammation." 3. "I need to apply the medication in a thick layer to protect the skin." 4. "I should protect the area by covering it with a diaper and plastic pants."

2. "The medication will help relieve the inflammation."

A client has been given diphenhydramine as a topical agent for allergic dermatitis. The nurse should instruct the client to observe for which intended medication effect? 1. Nighttime sedation 2. A decrease in urticaria 3. Healing of burned tissue 4. Resolution of ecchymosis

2. A decrease in urticaria

A hydrocolloid dressing is prescribed for a client with a leg ulcer. The home health nurse is preparing a plan of care for the client and should appropriately document which intervention? 1. Change the hydrocolloid dressing daily. 2. Change the hydrocolloid dressing every 3 to 5 days. 3. Apply the hydrocolloid dressing over a dry, sterile dressing. 4. Apply the hydrocolloid dressing over a normal saline-soaked dressing.

2. Change the hydrocolloid dressing every 3 to 5 days.

A client with a burn injury is applying mafenide acetate cream to the wound. The client calls the health care provider's (HCP's) office and tells the nurse that the medication is uncomfortable and is causing a burning sensation. The nurse should instruct the client to take which action? 1. Discontinue the medication. 2. Continue with the treatment, as this is expected. 3. Apply a thinner film than prescribed to the burn site. 4. Come to the office to see the HCP immediately.

2. Continue with the treatment, as this is expected.

The nurse is applying a topical glucocorticoid as prescribed for a client with psoriasis. The nurse would be concerned about the potential for systemic absorption of the medication if it were being applied in which situation? 1. Applied for 2 days until the irritation has resolved 2. Applied to a small area on the arm underneath a gauze dressing 3. Applied to a reddened, itchy area underneath an occlusive dressing 4. Applied to a small area on the neck and another small area on the back

3. Applied to a reddened, itchy area underneath an occlusive dressing

A client with severe acne is seen in the clinic and the health care provider (HCP) prescribes isotretinoin. The nurse reviews the client's medication record and would contact the HCP if the client is also taking which medication? 1. Digoxin 2. Phenytoin 3. Vitamin A 4. Furosemide

3. Vitamin A

A client is seen in the clinic for a complaint of scalp itching that has been persistent over the past several weeks. After an assessment, it is determined that the client has head lice. Permethrin shampoo is prescribed, and the nurse provides instructions to the client regarding the use of the medication. The nurse should tell the client to take which measure? 1. Put the medication in 1 time only. 2. Leave the medication in for at least 4 hours. 3. Wash, rinse, and towel-dry the hair before applying. 4. Leave the shampoo on for 8 to 12 hours and then remove by washing.

3. Wash, rinse, and towel-dry the hair before applying.

Isotretinoin is prescribed for a client to treat severe cystic acne, and the nurse provides instructions to the client regarding the medication. Which statement by the client indicates a need for further instruction? 1. "I need to take the medication with food." 2. "I will be taking the medication twice a day." 3. "I will need to take the medication for 15 to 20 weeks." 4. "I cannot crush or chew the tablets if I have difficulty swallowing them whole."

4. "I cannot crush or chew the tablets if I have difficulty swallowing them whole."

A client has a wound with a moderate amount of drainage and is scheduled for a dressing change. Which dressing, if selected by the student nurse, requires further intervention by the nursing instructor? 1. Foam 2. Alginate dressing 3. Hydrocolloid dressing 4. Semipermeable transparent film

4. Semipermeable transparent film

Lindane is prescribed. The nurse reviews the client's record, knowing that this medication therapy would be contraindicated in which client? 1. A child 2. A young adult 3. An older client 4. A middle-aged client

1. A child

Which clients can safely receive lindane? Select all that apply. 1. An 89-year-old client with dementia 2. A 32-year-old client with renal stones 3. A 6-year-old child with a fractured arm 4. A 42-year-old woman with osteoporosis 5. A 52-year-old man with hypertension and high cholesterol

1. An 89-year-old client with dementia 2. A 32-year-old client with renal stones 4. A 42-year-old woman with osteoporosis 5. A 52-year-old man with hypertension and high cholesterol

The nurse is applying a topical corticosteroid to a client with eczema. The nurse should apply the medication to which body area? Select all that apply. 1. Back 2. Axilla 3. Eyelids 4. Soles of the feet 5. Palms of the hands

1. Back 4. Soles of the feet 5. Palms of the hands

Silver sulfadiazine is prescribed for a client with a burn injury. Which laboratory finding requires the need for follow-up by the nurse? 1. Glucose level of 99 mg/dL (5.65 mmol/L) 2. Magnesium level of 1.5 mEq/L (0.75 mmol/L) 3. Platelet level of 300,000 mm3 (300 × 109/L) 4. White blood cell count of 3000 mm3 (3.0 × 109/L)

4. White blood cell count of 3000 mm3 (3.0 × 109/L)

A health care provider (HCP) prescribes isotretinoin for a client with severe acne. The nurse reviews the client's record and notifies the HCP if which prescribed medication is noted on the medication record? 1. Digoxin 2. Phenytoin 3. Furosemide 4. Doxycycline

4. Doxycycline

A burn client is receiving treatments of topical mafenide acetate to the site of injury. The nurse monitors the client, knowing that which finding indicates that a systemic effect has occurred? 1. Hyperventilation 2. Elevated blood pressure 3. Local rash at the burn site 4. Local pain at the burn site

1. Hyperventilation

The clinic nurse is performing an admission assessment on a client and notes that the client is taking azelaic acid. The nurse determines that which client complaint may be associated with use of this medication? 1. Itching 2. Euphoria 3. Drowsiness 4. Frequent urination

1. Itching

A hospitalized client is diagnosed with scabies. The health care provider (HCP) recommended that the client and the client's roommate be treated with lindane. Which finding, if noted on this client's chart, would alert the nurse to notify the HCP before the treatment with lindane? 1. Client history of diabetes 2. Client history of hypertension 3. Client history of seizure disorders 4. Client history of coronary artery disease

3. Client history of seizure disorders

A child is diagnosed with impetigo. The health care provider prescribes a topical medication for treatment. The nurse anticipates that which medication will be prescribed? 1. Cortisone 2. Acyclovir 3. Mupirocin 4. Benzoyl peroxide

3. Mupirocin

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." 2. "If my lips begin to burn, this is probably because of the medication." 3. "My eyes may become dry and burn as a result of the medication." 4. "I need to be sure to take my vitamin A supplement so that the treatment will work."

4. "I need to be sure to take my vitamin A supplement so that the treatment will work."

An adolescent with severe cystic acne has been prescribed isotretinoin. Which statement by the client would suggest the need for further teaching? 1. "I will return to the clinic for blood tests." 2. "If my lips begin to burn, it is probably because of the medication." 3. "My eyes may become dry and burn as a result of the medication." 4. "I need to take my vitamin A supplement so that the treatment will work."

4. "I need to take my vitamin A supplement so that the treatment will work."

The nurse is caring for a client at home with a diagnosis of actinic keratosis. The client tells the nurse that her skin is very dry and irritated. The treatment includes diclofenac sodium. The nurse teaches the client that this medication is from which class of medications? 1. Antiinfectives 2. Vitamin A lotions 3. Coal tar preparations 4. Nonsteroidal antiinflammatory drugs (NSAIDs)

4. Nonsteroidal antiinflammatory drugs (NSAIDs)

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."

The clinic nurse is caring for a client with a diagnosis of scabies who has just been prescribed crotamiton. The nurse instructs the client to perform which action when applying this medication? 1. Apply the medication to the entire body, washing it off after 2 hours. 2. Apply the application to the entire body, leave it on for 24 hours, and then take a cleansing bath. 3. Apply the medication to the entire body, avoiding the skin folds and creases, and wash it off in 12 hours. 4. Massage the medication into the skin from the chin downward. Apply a second application in 24 hours, followed by a cleansing bath 48 hours after the second application.

4. Massage the medication into the skin from the chin downward. Apply a second application in 24 hours, followed by a cleansing bath 48 hours after the second application.

A client is prescribed mupirocin intranasally twice daily. The nurse correlates this prescription with the client's medical record and expects to note which result specifically related to the indication for this medication? 1. Positive methicillin-resistant Staphylococcus aureas (MRSA) by polymerase chain reaction (PCR) 2. Positive MRSA in a surgical wound site on the abdomen 3. Positive streptococci in the blood and an elevated lactic acid level 4. Positive vancomycin-resistant enterococci (VRE) in the urine for the client with a urinary catheter

1. Positive methicillin-resistant Staphylococcus aureas (MRSA) by polymerase chain reaction (PCR)

A client with an infected leg wound that is draining purulent material has a prescription for sodium hypochlorite to be used in the care of the wound. The nurse should implement which action while using this solution? 1. Rinse off immediately following irrigation. 2. Pour onto sterile sponges, and pack in wound. 3. Let the solution run freely over normal skin tissue. 4. Use each bottle of solution for 2 weeks before replacing.

1. Rinse off immediately following irrigation.

The nurse is providing instructions to a mother of a child with atopic dermatitis (eczema) regarding the application of topical cortisone cream to the affected skin sites. Which statement made by the mother indicates an understanding of the use of this medication? 1. "I shouldn't rub the medication into the skin." 2. "The medication is applied everywhere except the face." 3. "I need to wash the sites gently before I apply the medication." 4. "I need to apply the medication generously and allow it to absorb."

3. "I need to wash the sites gently before I apply the medication."

A topical corticosteroid is prescribed for a client with dermatitis. The nurse provides instructions to the client regarding the use of the medication. Which statement by the client would indicate a need for further instruction? 1. "I need to apply the medication in a thin film." 2. "I should gently rub the medication into the skin." 3. "The medication will help relieve the inflammation and itching." 4. "I should place a bandage over the site after applying the medication."

4. "I should place a bandage over the site after applying the medication."

Sodium hypochlorite is prescribed for a client with a leg wound that is draining purulent material. The home health nurse teaches a family member how to perform wound treatments. Which statement, if made by the family member, indicates a need for further teaching? 1. "A fresh solution needs to be prepared frequently." 2. "I should rinse the solution off immediately after the irrigation." 3. "The solution should not come in contact with normal skin tissue." 4. "I will soak a sterile dressing with solution and pack it into the wound."

4. "I will soak a sterile dressing with solution and pack it into the wound."

A client with acute seborrheic dermatitis of the back, chest, and legs is receiving treatments with salicylic acid. The nurse should monitor the client for which symptom that indicates the presence of systemic toxicity from this medication? 1. Diarrhea 2. Constipation 3. Lower leg pain 4. Increased respirations

4. Increased respirations

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.

The health care provider has prescribed coal tar treatments for a client with psoriasis, and the nurse provides information to the client about the treatments. Which statement made by the client indicates a need for further education about the treatments? 1. "The medication has an unpleasant odor." 2. "The medication can cause phototoxicity." 3. "The medication can stain the skin and hair." 4. "The medication always causes systemic toxicity."

4. "The medication always causes systemic toxicity."

Mafenide acetate is prescribed for a client with a burn injury to the hand. Which should the nurse include in the instructions to the client regarding the use of this medication? 1. If stinging occurs, discontinue the medication. 2. Apply a thinner film than prescribed to the burn site if the medication stings. 3. If local stinging and burning occur after the medication is applied, notify the health care provider. 4. It is normal to experience local discomfort and stinging and burning after the medication is applied.

4. It is normal to experience local discomfort and stinging and burning after the medication is applied.

Tretinoin is prescribed for a client with acne, and the nurse provides instructions to the client regarding the medication. Which statement by the client indicates a need for further instruction? 1. "I need to avoid exposure to the sun." 2. "I should start to see results in 2 to 3 weeks." 3. "I will cleanse the skin thoroughly before applying the medication." 4. "If my skin begins to peel, I will notify the health care provider (HCP)."

4. "If my skin begins to peel, I will notify the health care provider (HCP)."

Collagenase is prescribed for a client with a severe burn to the hand. The nurse is providing instructions to the client and spouse regarding wound treatment. Which should the nurse include in the instructions? 1. Apply once a day and leave it open to the air. 2. Apply twice a day and leave it open to the air. 3. Apply twice a day and cover it with a sterile dressing. 4. Apply once a day and cover it with a sterile dressing.

4. Apply once a day and cover it with a sterile dressing.

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? 1. Immediately before swimming 2. 5 minutes before exposure to the sun 3. Immediately before exposure to the sun 4. At least 30 minutes before exposure to the sun

4. At least 30 minutes before exposure to the sun