Chapter 45 EAQ
Isotretinoin (Accutane) and tretinoin (Retin-A) are common dermatologic drugs used to treat which condition? Acne vulgaris Male pattern baldness Keloid scarring Fungal infections
Acne Vulgaris Isotretinoin and tretinoin are effective topical treatments for acne vulgaris. Isotretinoin inhibits sebaceous gland activity, and tretinoin stimulates the turnover of epidermal cells, resulting in skin peeling.
How does benzyl peroxide work on acne? Reduces the inflammation Acts as an antibacterial agent Alters the skin keratinization Decreases sebum formation
Acts as an antibacterial agent Benzyl peroxide is an antibacterial agent that kills P. acnes, the predominant organism in sebaceous follicles and comedones. It does not directly reduce the inflammation associated with acne. Topical retinoids alter skin keratinization. Isotretinoin is a systemic retinoid that is used to decrease sebum formation.
What is impetigo? Human papilloma virus (HPV) infection Bacterial skin infection Type of contact dermatitis A skin and joint disease
Bacterial skin infection Impetigo is a bacterial skin infection. An HPV infection can result in verruca vulgaris (warts). Contact dermatitis is a common form of eczema that occurs when the skin is exposed to irritants or allergens. Psoriasis is a multisystem disease with predominant skin and joint disorders.
A patient is prescribed calcipotriene (Dovonex) for treatment of psoriasis. What diagnostic finding requires immediate intervention by the nurse? Calcium 12 mg/dL Potassium 3.8 mEq/L Sodium 135 mmol/L Phosphorus 3.2 mg/dL
Calcium 12 mg/dL A serious adverse effect of calcipotriene (Dovonex) is hypercalcemia and hypercalcuria. A normal sodium level is 135-145 mmol/L; a normal calcium level is 8.9-10.4 mg/dL; a normal phosphorus level is 2.7-4.6 mg/dL, and a normal potassium level is 3.6-5.0 mEq/L.
Which prescribed medication is the safest to take during pregnancy? Clindamycin pregnancy category B Acitretin pregnancy category X Adapalene pregnancy category C Doxycycline pregnancy category D
Clindamycin pregnancy category B Clindamycin is pregnancy category B, so it is the safest to take during pregnancy. Category B drugs have failed to demonstrate risk to the fetus in animal reproduction studies. Animal reproduction studies have shown category C drugs have adverse effect on the fetus. Category X drugs have demonstrated fetal abnormalities in animals and humans. Category D drugs have demonstrated a positive evidence of human fetal risk based on adverse reaction data.
Which are topical treatments for psoriasis? Select all that apply. Coal tar Retinoids Corticosteroids Salicylic acid Cyclosporine
Coal tar, Corticosteroids, Salicylic acid Topical treatments for psoriasis include coal tar, corticosteroids, and salicylic acid. Retinoids and cyclosporine are systemic treatments.
The nurse is caring for a patient with acne who has been prescribed benzoyl peroxide (Acne-Clear). The patient reports blistering and swelling of the skin. What nursing action is a priority? Instruct the patient to immediately consult the primary health care provider. Inform the patient that swelling is a common side effect of the drug. Inform the patient that blisters indicate that the drug is showing its action. Instruct the patient to apply the medication every 2 hours daily.
Instruct the patient to immediately consult the primary health care provider. The nurse instructs the patient to immediately consult the primary health care provider, because blistering or swelling of the skin is generally considered an allergic reaction to the product. Swelling and blistering are not the common side effects of this medication. Blistering is an allergic reaction; it does not indicate the therapeutic effect of the drug. Applying the medication every 2 hours can be considered overusage of the drug, resulting in pain and reddening of the skin. These conditions can be resolved by using the drug as prescribed.
Which drug is used to treat severe cystic acne? Tretinoin (Renova) Adapalene (Differin) Tazarotene (Tazorac) Isotretinoin (Accutane)
Isotretinoin (Accutane) Isotretinoin (Accutane) is used in the treatment of severe cystic acne. Tretinoin (Renova), adapalene (Differin), and tazarotene (Tazorac) are used to treat mild to moderate acne.
Which medication is used for the treatment of baldness in men and women? Minoxidil (Rogaine) Finasteride (Propecia) Retapamulin (Altabax) Mupirocin (Bactroban)
Minoxidil (Rogaine) Minoxidil (Rogaine) is used in the treatment of baldness in men and women. Finasteride (Propecia) is used in the treatment of baldness in men only. Retapamulin (Altabax) and mupirocin (Bactroban) are used in the treatment of impetigo.
Which nonsteroidal antiinflammatory drugs (NSAIDs) interact with methotrexate? Select all that apply. Naproxen Salicylates Ciprofloxacin Ibuprofen Phenytoin
Naproxen, Salicylates, Ibuprofen NSAIDs that interact with methotrexate include naproxen, salicylates, and ibuprofen. Ciprofloxacin is an antibiotic. Phenytoin is an antiepileptic medication.
Which is a side effect of tazarotene (Tazorac)? Erythema Hypercalciuria Hypercalcemia Photosensitivity
Photosensitivity Tazarotene (Tazorac) is a topical antipsoriatic agent whose primary side effect is photosensitivity. Erythema is the side effect of anthralin (Dithro-Crème Psoriatec). Hypercalciuria and hypercalcemia are the adverse reactions of calcipotriene (Dovonex).
What is the mechanism of action of benzoyl peroxide (Benzac)? Inhibits tumor necrosis factor (TNF) Releases free radical oxygen species that oxidize bacterial proteins Suppresses the proliferation of epidermal cells Inhibits the activation of memory effector T lymphocytes
Releases free radical oxygen species that oxidize bacterial proteins Benzoyl peroxide (Benzac) is a mild antiacne topical drug that releases free radical oxygen species that oxidize bacterial proteins. Tumor necrosis factors are inhibited by TNF inhibitors such as etanercept (Enbrel), which is used in the treatment of psoriasis. Anthralin (Psoriatec) is the antipsoriatic drug that acts by inhibiting DNA synthesis, leading to suppressing the proliferation of epidermal cells. Alefacept (Amevive) is the drug used in the treatment of psoriasis; it mainly acts by inhibiting the activation of memory effector T lymphocytes.
Which type of skin eruption occurs as a result of a fungal infection? Acne Zoster Papules Tinea capitis
Tinea capitis Tinea capitis (ringworm) is a skin eruption caused by a fungal infection. Acne occurs as the result of keratin plugs at the base of the pilosebaceous oil glands near the hair follicles, which trap normal skin flora including bacteria, causing inflammation and irritation. Zoster (shingles) occurs as a result of a virus. Papules are skin lesions that are raised and palpable less than 10 mm in diameter.
A patient involved in a factory fire presents with extensive burns. The patient's skin is pearly white in color, and he or she feels no pain. What is the tissue depth of the burns? The patient has burns only on the epidermis. The patient has burns on the epidermis as well as the lower dermis. The patient has burns on the epidermis as well as the upper dermis. The patient has burns on the epidermis, dermis, and nerve endings, as well as the subcutaneous tissues.
The patient has burns on the epidermis, dermis, and nerve endings, as well as the subcutaneous tissues. The patient is suffering from third-degree burns with full thickness. In this case, the burn encompasses the tissue depth of the epidermis, dermis, and nerve endings, as well as the subcutaneous tissues. The patient does not feel pain and the skin is pearly white in color and charred. The patient will have burns only on the epidermis in the case of superficial epidermal or first-degree burns. This kind of burn is characterized by erythema. The epidermis, as well as the lower dermis, will get burned in the case of deep-thickness or second-degree burns. These are characterized by mottled, blistering, and intense pain. The patient will have burns on the epidermis as well as the upper dermis in the case of partial-thickness superficial or first-second burns. This kind of burn is characterized as blistering and painful.
The nurse is assessing a patient who has inflammation and a burning sensation in the lower back. During the assessment, the nurse finds the presence of sharply demarcated, scaling plaques. What may the nurse suspect based on these findings? The patient has scabies. The patient has psoriasis. The patient has candidiasis. The patient has dermatitis.
The patient has psoriasis. Psoriasis is characterized by the presence of lesions that are covered with silvery white scales. These lesions are symmetrically distributed and commonly occur on the scalp, elbows, nails, and lower back. Nail dystrophies and pitting occur in few patients. Scabies is a parasitic infection caused by Sarcoptes scabiei; patients will have skin irritation and an itching sensation, and the lesions appear in the interdigital web space, or the space between the fingers and the toes. In candidiasis, patients have a diffuse papular erythematous rash instead of scaling plaques. In contact dermatitis the lesions are itchy, erythematous, and edematous.
A teenage female patient is going to be prescribed isotretinoin (Accutane) for acne. Which information is most important for the nurse to include in the education of the patient? The drug is supplied in oral form. The patient must use at least two forms of contraception while taking this medication. The drug is used in treatment of severe acne. Providers who prescribe this medication must be registered with the FDA.
The patient must use at least two forms of contraception while taking this medication. The most important teaching mandated by the Food and Drug Administration is the requirement to use two different forms of contraception if the patient is female and of childbearing age. The other points are valid; however, given the teratogenicity associated with isotretinoin, education about contraception is the most important point to be shared with this patient.
