Week 14

14When teaching an adolescent patient about the application of topical terbinafine, the patient asks, "Does putting the medication on my rash hurt?" Which response would the nurse provide?

"Application of topical terbinafine can cause burning, stinging, and tingling"

8Which instructions by the nursing student in regard to podofilox administration require further intervention?

"It is okay to engage in sexual intercourse on the days podofilox is applied."This statement requires further intervention. Patients should avoid sexual intercourse on the days that podofilox has been applied. Correct "Soak the affected area for about 5 minutes in warm water to soften treatment area.

A patient with glaucoma is prescribed timolol after using other medications for increased intraocular pressure. The patient says, "I think there has been a mistake. Isn't that medicine for heart problems?" Which response by the nurse would be appropriate?

"This drug in oral form is prescribed for other health issues."

A patient weighing 165 pounds is prescribed isotretinoin 0.5 mg/kg/day PO divided BID. How many milligrams per dose will the patient receive? Report answer out to two decimal places.

18.75

13A 6-year-old child who weighs 45 pounds is prescribed griseofulvin 20 mg/kg/day PO in divided doses as treatment of tinea cruris. What is the prescribed daily dosage in milligrams?

409

10Which patients does a nurse determine can safely receive topical salicylic acid therapy for the common wart?

A 47-year-old patient with hypertensionHypertension does not pose a concern for treatment with topical salicylic acid. This patient could safely receive therapy. Correct A 55-year-old patient with type 2 diabetes

2Which patients does a nurse determine cannot safely receive an amoxicillin/clavulanate dose of 875 mg/125 mg for impetigo?

A 5-year-old patientThe dose of amoxicillin/clavulanate of 875 mg/125 mg is the adult, not pediatric, dose. This would be too high for a pediatric patient. A weight-based calculation would be needed for this patient. This patient cannot safely receive this dose. Correct A patient with liver failure A patient with a creatinine clearance of 25 mL/min

Which patients does a nurse determine cannot safely receive treatment with prednisone?

A patient with a varicella infection A patient receiving the live influenza vaccine

Which patients does a nurse determine cannot safely receive clobetasol for psoriasis?

A patient with psoriasis in the axillae A patient with a bacterial infection in a psoriatic lesion

Which patients does a nurse determine cannot safely receive treatment with etanercept for psoriasis?

A patient with sepsis A patient with active herpes zoster

4Which outcome does a nurse anticipate will occur as a result of a drug interaction with amoxicillin/clavulanate if the patient is also receiving allopurinol and the angiotensin-converting enzyme inhibitor, enalapril?

Allopurinol: Increased risk for skin rash

A nurse is caring for a patient with pneumonia who is taking amoxicillin/clavulanate, albuterol inhaler, prednisone, aspirin, and lisinopril. The patient has developed itchy, red wheals. Which drugs taken by this patient are most often associated with urticaria?

AspirinUrticaria is most often associated with administration of angiotensin-converting (ACE) inhibitors, beta-lactam antibiotics, nonsteroidal antiinflammatory drugs (NSAIDs), and sulfonamides. Therefore aspirin, an NSAID, may be a cause for the patient's hives. Correct Lisinopril Amoxicillin/clavulanate

Which instructions would a nurse share with a patient newly prescribed doxycycline for acne?

Avoid sunlight when taking doxycycline.A patient who has been prescribed doxycycline should avoid the sun due to the potential for burns. The use of sunscreen will not decrease photosensitivity. Correct Doxycycline should be taken in its entirety to prevent a superinfection It may be taken with food if nausea occurs.

Match the drug used to treat psoriasis to its class.

Clobetasol Coal tar Methotrexate Etanercept

10A patient is prescribed loteprednol, a corticosteroid, for inflammation after eye surgery. Which information is important to convey to the patient to minimize adverse effects of this drug?

Continue this drug only for the length of time specified by your health care provider.

5A patient admitted to the intensive care unit after neurosurgery has lost the eye-blink reflex. Which drug would the nurse anticipate administering to protect the eye and minimize drying?

Cyclosporine

Which symptoms of overdose would a nurse include when teaching about the administration of diphenhydramine to a parent of a 6-year-old child?

DeathAppropriate dosage of diphenhydramine is critical. Overdosage of the drug can lead to death. Correct SeizuresAppropriate dosage of diphenhydramine is critical. Overdosage of the drug may cause seizures in the child. Correct Hallucinations

Which factors will a nurse monitor for a therapeutic response in a patient receiving topical nystatin powder?

Decrease in itchingA decrease in associated symptoms (e.g., itching) is an indicator of effective treatment with nystatin. Correct Decrease in number of lesions

Which instruction would a nurse include when teaching about the application of wet dressings containing topical aluminum acetate?

Do not re-insert cloth into reconstituted solution.

Which teaching points would a nurse provide a patient newly prescribed etanercept for psoriasis?

Do not receive live (attenuated) vaccines during treatment.Patients should be instruction to not receive live (attenuated) vaccines during treatment with etanercept (these include measles, mumps and rubella [MMR]; smallpox; chickenpox; rotavirus; and yellow fever) because they may potentiate virus replication, increase vaccine side effect, and decrease the patient's antibody response to vaccine. Correct Injection site reactions decrease with continued therapy.Patients should be informed that injection-site reactions generally occur in the first month of treatment and decreases in frequency during continued therapy. Correct Report persistent fever to the health care provider.

Which teaching instructions will a nurse provide to a patient who has been prescribed topical erythromycin?

Do not use topical erythromycin near the eyes, mouth, or nose.Topical erythromycin should not be applied to the eyes, mouth, or nose. Correct A thin layer of the product should be applied to the affected areas.Generally, a thin layer of topical erythromycin is applied to the affected areas twice daily. Correct Wash your hands before and after application of topical erythromycin.The patient should be instructed to wash his or her hands before and after application of topical erythromycin. This ensures no pathogens are introduced to the areas and that drug is not transferred to others after. Correct You may notice burning, itching, peeling, and irritation on areas where you apply topical erythromycin.

A female patient has been prescribed doxycycline for acne. She takes ethinyl estradiol/norgestrel, an oral contraceptive, and hydrocodone. Which outcome does the nurse anticipate may occur as a result of an interaction with doxycycline?

Ethinyl estradiol/norgestrel: Decreased efficacy

A nurse caring for a patient prescribed diphenhydramine for dermatitis recalls the drug's duration of action is 4 to 8 hours. This means the interval between doses would most likely follow which schedule?

Every 4 to 6 hours

Which patient parameters will a nurse ensure are assessed before a 29-year-old female begins therapy with methotrexate for psoriasis?

Fluid intake Pregnancy testBecause this patient is of childbearing age, a pregnancy test should be assessed because the drug is contraindicated during pregnancy due to fetal malformations. Correct Liver function testsLiver function tests should be assessed at baseline and periodically throughout treatment because methotrexate can be hepatotoxic. Correct Complete blood count

13The patient's hands are shaking while trying to administer eye drops. To promote self-care for a patient who is having difficulty instilling eye drops, which action would the nurse take?

Indicate that adaptive eye devices might help with instillation.

3A patient is prescribed gatifloxacin drops for an eye infection. Which is the action of this drug?

Inhibits DNA synthesis in susceptible gram-positive and some gram-negative bacteria

8A patient prescribed latanoprost for the treatment of glaucoma calls the nurse to report a headache and intense eye pain. Which action would the nurse take?

Instruct the patient to immediately go to the clinic or emergency department.

12Which response would the nurse expect to find when assessing a patient 4 weeks after starting timolol, 1 drop daily, for glaucoma?

Intraocular pressure is in normal range.

6A patient is prescribed timolol drops for glaucoma. Which information would the nurse include when teaching about the pharmacodynamics of this drug?

It may take a few weeks of taking the drug to get the full effect.

15Which side effects will a nurse counsel a patient to monitor for while receiving griseofulvin?

ItchingItching or pruritus may occur with griseofulvin treatment. Correct Gastrointestinal (GI) upsetGI upset is a side effect that may occur in patient receiving griseofulvin. Correct Headaches Fatigue, dark urine, and nausea

Which instructions would a nurse include when teaching a patient about the application of topical tacrolimus?

Limit sun exposure during treatment. Use only on the area of the body that has eczema.

6Which instructions would a nurse provide to a patient prescribed acyclovir cream for a cold sore?

Only apply to area with symptoms.When using acyclovir cream, it should be applied to cover only cold sores or area with symptoms. Correct Do not touch lesions with bare fingers.The patient should be taught not to touch lesions with bare fingers to prevent spreading infection to a new site. Correct Space doses evenly throughout the day.

11Before receiving therapy with griseofulvin, which patient parameters will a nurse ensure are assessed in a 27-year-old female patient?

Pregnancy statusBecause this patient is of childbearing age, it is important to assess her pregnancy status. Griseofulvin should be avoided during pregnancy due to possible risk for teratogenicity. A reliable form(s) of birth control should be used during treatment and for 1 month after the drug is stopped. Male patients should wait 6 months after the end of treatment to attempt conception. Correct Allergy to penicillinGriseofulvin is derived from a species of penicillin; therefore patients should be assessed specifically for allergy to penicillin. Correct Abnormal liver function testsGriseofulvin can cause liver failure; therefore it is important to monitor liver function tests. Correct History of systemic lupus erythematosus (SLE)

1Which side effects and adverse effects of mupirocin does a nurse teach a patient to monitor for while receiving therapy?

RashRash is a common and local side effect that may occur while receiving mupirocin therapy. Correct ItchingItching or pruritus is a common and local side effect that may occur while receiving mupirocin therapy. Correct BurningBurning is a common and local side effect that may occur while receiving mupirocin therapy. Correct Superinfection

2The nurse would monitor a postoperative ophthalmic surgery patient for which outcome after administering loteprednol?

Reduced postoperative pain and inflammation

7Which patient parameters will a nurse ensure are assessed before treatment with acyclovir for herpes simplex?

Serum creatinineSerum creatinine should be assessed at baseline and periodically thereafter in patients receiving acyclovir. Acute renal failure and glomerulonephritis can occur with treatment. Correct Liver function test

A nurse is caring for a patient who has been prescribed topical aluminum acetate to be used as a compress for poison ivy. Which side effects will the nurse advise the patient may occur from treatment with topical aluminum acetate?

Skin drynessSkin dryness is an anticipated side effect that may occur when a patient applies aluminum acetate topically as a compress. Correct Skin irritation Burning and stinging

4A patient comes to the emergency department complaining of eye pain and excessive tearing. The nurse suspects eye trauma and secures fluorescein sodium drops. Which is the rationale for using fluorescein?

Stains the eye for better visualization

Which teaching instructions will a nurse provide to a patient who has been prescribed isotretinoin?

The capsule should be swallowed whole with a full glass of water. Because isotretinoin may reduce your ability to see well in the dark, use caution when driving at night.Isotretinoin can impair a patient's ability to see at night. Therefore any activities, particularly driving, require caution until the patient knows the impact of the drug on vision. Correct Wearing contact lenses may be difficult while receiving isotretinoin because it may cause dry eyes.Dry eyes may result from treatment with isotretinoin. As a result, contact lenses may be uncomfortable both during and after treatment. Correct Avoid laser hair removal, waxing, and dermabrasion while receiving isotretinoin and 6 months after completion.Laser hair removal, waxing, and dermabrasion should be avoided while taking isotretinoin and for 6 months after as it increases the risk for scars. Correct Inform your health care provider if you want to participate in strenuous physical activity while receiving isotretinoin.

11The nurse is observing a nursing student administer eye ointment. In which situation would the nurse intervene?

The patient is instructed to keep the eye open for 1 minute.

A female patient who has been prescribed isotretinoin for acne asks why she must enroll in the iPLEDGE program. Which statement will a nurse provide to help the patient understand the importance of this program as it relates to isotretinoin?

The patient pledges to avoid pregnancy before, during, and treatment.

A nurse is caring for a patient with psoriasis who has been prescribed coal tar to be applied four times daily to the arm, wrapping the treated area with dressing. Which rationale does the nurse understand is the reason the health care provider wants to provide occlusive dressing with coal tar?

To increase efficacy

9Which dosing regimen does a nurse teach the patient to follow for application of podofilox?

Twice daily for 3 days, followed by 4 days off. Repeat 4 times.

9After administering ophthalmic drops, which instructions would the nurse give the patient?

Use punctual pressure for 2 to 3 minutes.

3Which instructions would a nurse give a patient who has been prescribed mupirocin for impetigo?

Wash hands before and after application.The patient should be advised to wash hands before administration of mupirocin in order to avoid pathogen entry into the lesions as well as after administration to avoid the transfer of mupirocin to others. Correct Do not use mupirocin near the eyes, nose, or mouth. Apply a thin layer of the ointment or cream to affected areas.

7The nurse is teaching a patient about using timolol for glaucoma. Which safety concerns would the nurse emphasize?

When moving from a light room to a dark room, pause a few minutes to allow vision to adjust. Use caution when driving because vision may be blurred with this drug.Blurred vision is a safety concern for the person driving. Using caution and driving at a slower speed may be recommended. Correct Dizziness may occur with this drug. Move slowly from a sitting to a standing position.

5Match the treatment to the characteristic description its infectious integumentary disorder.

na