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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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Correct Answer is D

Explanation

Choice A reason: Weighing the child monitors fluid retention but is less urgent than blood pressure, which assesses hypertensive encephalopathy risk post-convulsion in glomerulonephritis. Immediate blood pressure data guides treatment, making this secondary and incorrect compared to evaluating the child’s neurological status after a seizure.

Choice B reason: Giving fluids without guidance risks worsening fluid overload in glomerulonephritis, and delayed reporting is unsafe post-convulsion. Blood pressure assessment is critical, making this inappropriate and incorrect compared to the urgent need for immediate data to address the child’s seizure episode effectively.

Choice C reason: Administering a diuretic without provider orders is unsafe post-convulsion, as it may not address the seizure’s cause. Blood pressure evaluation informs treatment, making this risky and incorrect compared to the priority of assessing hypertension in the child with glomerulonephritis immediately.

Choice D reason: Taking blood pressure post-convulsion assesses for hypertension, a common seizure cause in glomerulonephritis, guiding urgent treatment. Reporting immediately ensures timely intervention, aligning with pediatric nephrology protocols, making this the correct action for the caregiver to take in this emergency situation.

A. Repeat the signs and symptoms over and over until they seem to understand. B. Instruct them to treat the reaction as if it’s hypoglycemia, since this condition is more likely. C. Give the caregivers educational pamphlets and videos about diabetes. D. Suggest that the child wear an insulin pump for continuous insulin administration.

Correct Answer is B

Explanation

Choice A reason: Repeating symptoms may help but doesn’t provide immediate emergency guidance, risking delay in critical situations. Treating as hypoglycemia ensures rapid response, making this less practical and incorrect compared to a clear action plan for the caregivers’ concerns about diabetes emergencies.

Choice B reason: Instructing to treat unclear reactions as hypoglycemia prioritizes rapid glucose administration, which is safer and more urgent than mistreating hyperglycemia. This aligns with pediatric diabetes emergency protocols, making it the best initial response to ensure the child’s safety in potential crises.

Choice C reason: Providing pamphlets and videos educates long-term but doesn’t address immediate emergency response needs. Treating as hypoglycemia offers clear guidance, making this supplementary and incorrect compared to the urgent action needed to manage the caregivers’ fears about diabetes emergencies.

Choice D reason: Suggesting an insulin pump addresses insulin delivery, not symptom recognition or emergency response. Treating as hypoglycemia ensures safety in crises, making this irrelevant and incorrect compared to the immediate guidance needed for the caregivers’ concerns about handling diabetes emergencies.

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Naxlex Comprehensive Predictor Exams

The caregiver of a child being treated at home for acute glomerulonephritis calls the nurse reporting that her daughter has just had a convulsion. The child is resting comfortably but the caregiver would like to know what to do. The nurse would instruct the caregiver to take which action?

Correct Answer is D

Explanation

Correct Answer is B

Explanation

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