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 C
Explanation
Choice A reason: Hemophilia causes bleeding issues, not a strawberry tongue, which is a mucosal symptom. Kawasaki disease’s characteristic tongue appearance matches the description, making this unrelated and incorrect compared to the specific disorder associated with the child’s reported tongue manifestation in the assessment.
Choice B reason: Congestive heart failure affects cardiac function, not oral mucosa, and doesn’t cause a strawberry tongue. Kawasaki disease is the condition linked to this symptom, making this irrelevant and incorrect for the nurse’s recognition of the child’s tongue appearance in data collection.
Choice C reason: A strawberry tongue, with a red, bumpy appearance, is a hallmark of Kawasaki disease, often seen with fever and rash. This aligns with pediatric infectious disease criteria, making it the correct disorder the nurse recognizes based on the caregiver’s description of the child’s tongue.
Choice D reason: Rheumatic fever may cause oral symptoms but not a classic strawberry tongue, which is specific to Kawasaki disease. The latter’s mucosal findings are distinctive, making this less accurate and incorrect compared to identifying Kawasaki disease as the cause of the tongue manifestation.
Correct Answer is C
Explanation
Choice A reason: Offering bathing assistance is supportive but less critical than family presence, which reduces stress for a 10-year-old facing surgery. Caregiver support addresses emotional needs, making this secondary and incorrect compared to prioritizing family involvement during the child’s hospital admission for surgery.
Choice B reason: Answering pain questions is important but secondary to family presence, which provides ongoing comfort for a 10-year-old. Caregiver support is foundational for emotional stability, making this less urgent and incorrect compared to encouraging family to stay during the surgical admission.
Choice C reason: Encouraging family caregivers to stay provides emotional security for a 10-year-old facing surgery, reducing anxiety and enhancing coping. This aligns with pediatric perioperative care principles, making it the prioritized action to support the child’s well-being during the hospital admission process.
Choice D reason: Avoiding prolonged anxiety discussions prevents fixation but doesn’t address emotional needs like family presence, which offers continuous support. Caregiver presence is more impactful, making this less proactive and incorrect for the nurse’s priority in caring for the 10-year-old during surgery admission.
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