A dermatologist treating a 16-year-old girl with a history of severe acne has ordered that she be started on a course of isotretinoin. The teen’s caregiver has said that her daughter is a virgin and refuses to allow her to have the required pregnancy testing. What would be the best action for the nurse?
Have the caregiver sign a permission form acknowledging that the girl has been given the drug without pregnancy testing.
Speak with the teen alone to ask her if she is sexually active. If she says she is not sexually active, let the provider know that it is okay to write the prescription.
Acknowledge the caregiver’s discomfort about the pregnancy testing but encourage her to allow the daughter to have the testing so that she can use the medication.
Arrange for the daughter to have the pregnancy testing without the caregiver’s knowledge.
The Correct Answer is C
Choice A reason: Signing a form to bypass pregnancy testing violates isotretinoin safety protocols, risking fetal harm due to teratogenicity. Encouraging testing ensures compliance, making this unsafe and incorrect compared to addressing the caregiver’s concerns while prioritizing the teen’s safety for acne treatment.
Choice B reason: Speaking to the teen alone respects privacy but doesn’t address the caregiver’s refusal or ensure testing compliance, required for isotretinoin. Encouraging testing with the caregiver’s consent is safer, making this inadequate and incorrect compared to securing agreement for mandatory pregnancy testing.
Choice C reason: Acknowledging the caregiver’s discomfort builds trust while emphasizing the necessity of pregnancy testing for isotretinoin’s safe use, preventing fetal harm. This aligns with pediatric medication safety protocols, making it the best action to ensure the 16-year-old can safely receive acne treatment.
Choice D reason: Testing without caregiver knowledge violates consent and trust, risking legal and ethical issues. Encouraging open discussion ensures compliance, making this unethical and incorrect compared to the nurse’s role in facilitating agreement for required pregnancy testing for the teen’s isotretinoin therapy.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: Burn fluid replacement follows the Parkland formula, with half the total volume (24 ounces = 12 ounces) given in the first 8 hours. From 10:00 AM to 6:00 PM (8 hours), the child receives 12 ounces, aligning with pediatric burn care protocols, making this the correct choice.
Choice B reason: By 4:00 PM (6 hours), the child receives less than half the 24 ounces, as half (12 ounces) is given over 8 hours. The 12-ounce mark is reached by 6:00 PM, making this incorrect, as it overestimates fluid delivery in the shorter timeframe for burn treatment.
Choice C reason: 18 ounces by 4:00 PM (6 hours) exceeds the standard rate, as only half (12 ounces) of 24 ounces is given in 8 hours. The correct amount is 12 ounces by 6:00 PM, making this incorrect for burn fluid replacement timing in the pediatric patient’s treatment.
Choice D reason: 18 ounces by 6:00 PM (8 hours) is incorrect, as only half the total (12 ounces) is administered in the first 8 hours per burn protocols. The correct volume is 12 ounces, making this incorrect for the standard fluid replacement schedule in pediatric burn care.
Correct Answer is A
Explanation
Choice A reason: Lung and spleen damage is complex and internal, making it hard for a 4-year-old to comprehend compared to visible injuries like rashes or burns. This requires more explanation, aligning with pediatric developmental understanding, making it the correct diagnosis needing the most help for comprehension.
Choice B reason: A measles rash is visible and relatable, easier for a 4-year-old to understand than internal organ damage. Lung and spleen injuries are more abstract, making this less challenging and incorrect compared to the diagnosis requiring the most explanation for the child’s understanding.
Choice C reason: Broken bones from a fall are tangible and can be explained with casts or pain, more understandable for a 4-year-old. Internal organ damage is less concrete, making this simpler and incorrect compared to the complex diagnosis needing more help for the child’s comprehension.
Choice D reason: Burns from fireworks are visible and painful, allowing a 4-year-old to grasp the injury more easily than internal organ damage. Lung and spleen issues are more abstract, making this more concrete and incorrect compared to the diagnosis requiring the most explanation for understanding.
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