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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.

Answer and Explanation

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.

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Free Nursing Study Resources

Correct Answer is ["A","D","E"]

Explanation

Choice A reason: Normal heart rate and respirations indicate reduced physiological stress from pain, supporting effective medication in a terminally ill child. This aligns with pediatric pain assessment criteria, making it a correct assessment to document as evidence of successful pain relief post-medication administration.

Choice B reason: Withdrawing from the environment suggests ongoing distress or pain, not relief. Normal vitals and low pain scores indicate effectiveness, making this incorrect, as it reflects a negative outcome rather than supporting successful pain management in the terminally ill child’s evaluation.

Choice C reason: A flexed position may indicate persistent pain or discomfort, not relief. Sleeping or low pain scores better demonstrate effectiveness, making this incorrect, as it does not support the medication’s success in alleviating pain in the terminally ill client during the assessment.

Choice D reason: Verbalizing a 1 on the pain scale directly indicates minimal pain, confirming the medication’s effectiveness in a terminally ill child. This aligns with pediatric pain management standards, making it a correct assessment to document as evidence of successful pain relief post-administration.

Choice E reason: Quietly sleeping on the parent’s lap suggests comfort and pain relief, a positive sign in a terminally ill child. This aligns with behavioral pain assessment in pediatrics, making it a correct observation to document as evidence of effective medication for pain management.

A. While attending to the child, reassure the sister and suggest interventions she can help with. B. Ask the sister if she prefers to leave the exam room. C. Reassure the child that he is going to be fine and that his sister is just nervous. D. Ask his sister to calm down so that she can help her brother remain calm as well.

Correct Answer is A

Explanation

Choice A reason: Reassuring the sister while attending to the child and involving her in interventions reduces her anxiety, stabilizing the 5-year-old’s emotional state. This aligns with pediatric emergency care principles, making it the best initial action to manage the escalating anxiety in the emergency room.

Choice B reason: Asking the sister to leave may increase her distress and isolate the child, worsening his anxiety. Reassuring and involving her is more supportive, making this counterproductive and incorrect compared to the nurse’s role in calming both the caregiver and child effectively.

Choice C reason: Reassuring the child about his sister’s nerves doesn’t address her anxiety, which is escalating his distress. Involving the sister in care reduces both anxieties, making this insufficient and incorrect compared to the nurse’s priority of stabilizing the emotional environment in the ER.

Choice D reason: Asking the sister to calm down may heighten her distress, as she’s already hysterical, and doesn’t offer support. Reassuring and involving her helps both, making this ineffective and incorrect compared to the nurse’s action to reduce anxiety for the child and caregiver.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

When evaluating a terminally ill client for pain relief following medication administration, which nursing assessments would be documented to support that the medication was effective? (Select all that apply)

Correct Answer is ["A","D","E"]

Explanation

Correct Answer is A

Explanation

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