A client with eczema is experiencing severe pruritus. Which PRN prescription(s) should the nurse administer? Select all that apply.

Transdermal analgesic.

Topical alcohol rub.

Topical corticosteroid.

Oral antihistamine.

Topical scabicide.

Answer and Explanation

Correct Answer : C,D

Rationale:

A. Transdermal analgesic: Transdermal analgesics are formulated to relieve localized pain, not itching or inflammation. They do not address the histamine release or immune activity seen in eczema. Using them offers no therapeutic benefit for pruritus.

B. Topical alcohol rub: Alcohol-based products dry out the skin and cause further irritation, which can worsen eczema symptoms. Applying alcohol increases the risk of burning and inflammation. It is not recommended for sensitive or inflamed skin.

C. Topical corticosteroid: Topical corticosteroids reduce skin inflammation by suppressing local immune responses. They are standard treatment for eczema flares with severe itching. These medications soothe the skin and reduce redness and swelling.

D. Oral antihistamine: Antihistamines block histamine, which contributes to allergic itching in eczema. They are useful for controlling pruritus and helping clients rest. Some types, like diphenhydramine, also have sedative effects that reduce nighttime discomfort.

E. Topical scabicide: Scabicides are antiparasitic agents used to treat infestations like scabies, not eczema. They do not relieve allergic itching or inflammation. Their strong chemicals may actually worsen skin irritation in eczema patients.

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Correct Answer is D

Explanation

Rationale:
A. Decreased urinary output: While decreased output may signal fluid imbalance or poor perfusion, it is not as immediately life-threatening as a cardiac arrhythmia. It should be monitored, but other findings take precedence in an acute setting.

B. Profound weight gain: Rapid weight gain suggests fluid retention, possibly from corticosteroid imbalance, but it does not pose an immediate danger compared to cardiac instability. It requires intervention but is not emergent.

C. Low blood glucose levels: Hypoglycemia is common after adrenalectomy due to cortisol deficiency and must be treated, but symptoms often develop gradually and are managed with glucose replacement. It is serious but not as acutely life-threatening as arrhythmias.

D. Ventricular arrhythmias: This finding indicates severe electrolyte disturbances—especially hyperkalemia, which can occur after adrenalectomy due to aldosterone deficiency. It poses an immediate threat to cardiac function and requires urgent intervention.

A. The left radial pulse is 2+ bounding. B. Assessment of a bruit on the left forearm. C. Auscultation of a thrill on the left forearm. D. Distended, tortuous veins in the left hand.

Correct Answer is B

Explanation

Rationale:
A. The left radial pulse is 2+ bounding: A radial pulse reflects arterial blood flow but does not confirm the functionality of the AV fistula. It may be normal even if the fistula is occluded or nonfunctional.

B. Assessment of a bruit on the left forearm: A bruit, a whooshing sound heard with a stethoscope, indicates turbulent blood flow through the AV fistula, confirming that the fistula is patent and functioning. This is a key sign of fistula viability.

C. Auscultation of a thrill on the left forearm: A thrill is felt (palpated), not auscultated. While a thrill is also a sign of patency, the phrasing here is incorrect. The term “auscultation” applies to the bruit, not the thrill.

D. Distended, tortuous veins in the left hand: Prominent hand veins may occur with vascular changes but do not confirm AV fistula patency. Assessment must include direct evaluation for a bruit or thrill over the fistula site.

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A client with eczema is experiencing severe pruritus. Which PRN prescription(s) should the nurse administer? Select all that apply.

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Naxlex Comprehensive Predictor Exams

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Explanation

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