A nurse assesses a young female client who is prescribed tazarotene.
Which query should the nurse ask prior to starting this therapy?
"Do you spend a great deal of time in the sun?".
"Have you or any family members ever had skin cancer?".
"Which method of contraception are you using?".
"Do you drink alcoholic beverages?".
The Correct Answer is C
Choice A rationale
Tazarotene, a retinoid, increases photosensitivity by thinning the stratum corneum, the skin's outermost layer. This reduces the protective barrier against ultraviolet (UV) radiation, making the skin more susceptible to sunburn and UV-induced DNA damage. Patients must be educated to use sun protection, but it is not the most critical question.
Choice B rationale
While a history of skin cancer can influence dermatological treatment plans, it is not the primary contraindication for tazarotene. Tazarotene is an analog of vitamin A, and its mechanism involves regulating cell proliferation and differentiation, which is not directly related to a personal or family history of skin cancer.
Choice C rationale
Tazarotene is a potent teratogen, meaning it can cause severe congenital malformations if taken during pregnancy. This teratogenic risk necessitates that all female patients of child-bearing potential use reliable contraception to prevent pregnancy. A pregnancy test is also required before initiation of therapy.
Choice D rationale
While some medications interact with alcohol, tazarotene is a topical retinoid primarily metabolized in the liver to its active form, tazarotenic acid. There is no significant systemic absorption or direct interaction with alcohol consumption that would cause a major adverse effect, making it a less critical question than contraception.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale
A Braden Scale score of 9 indicates a high risk for pressure injury. Requesting a referral to a registered dietitian nutritionist is an evidence-based intervention because poor nutrition, particularly protein and calorie deficiency, is a significant risk factor for skin breakdown and impaired wound healing.
Choice B rationale
Keeping the head of the bed raised no more than 45 degrees is an evidence-based practice to prevent pressure injuries. This position reduces the risk of shear and friction forces on the sacrum, which can lead to tissue damage and pressure ulcer formation.
Choice C rationale
Performing perineal cleansing every 2 hours is not an evidence-based intervention for a Braden Scale score of 9. Frequent cleansing can cause excessive moisture, which macerates the skin and increases the risk of breakdown. Cleansing should be done as needed, not on a rigid schedule.
Choice D rationale
Daily skin assessment is a fundamental and evidence-based intervention for all clients at risk for pressure injuries. A Braden score of 9 signifies a high-risk client, and a daily head-to-toe skin assessment is crucial for early detection of erythema or other signs of skin breakdown.
Correct Answer is A
Explanation
Choice A rationale
Certain broad-spectrum antibiotics, such as tetracyclines, can alter the gut flora responsible for enterohepatic circulation of estrogens. This disruption can reduce the reabsorption of ethinyl estradiol, the synthetic estrogen in oral contraceptives, from the gut. The decreased serum levels of the hormone may lead to a reduction in the contraceptive's effectiveness, increasing the risk of unintended pregnancy. A backup birth control method should be used.
Choice B rationale
Urinary burning and frequency are more commonly associated with urinary tract infections (UTIs) or some sexually transmitted infections, and not a typical side effect of antibiotics used for acne like tetracyclines or minocycline. These symptoms would indicate an inflammatory process in the urinary tract, which is distinct from the mechanism of action and side effect profile of these specific antibiotics.
Choice C rationale
Breast engorgement is a physiological condition often associated with hormonal fluctuations during the postpartum period or premenstrually. It is not a recognized side effect of systemic antibiotics used to treat acne. The mechanism of action of these medications does not involve hormonal pathways that would lead to breast tissue swelling and tenderness.
Choice D rationale
While some antibiotics can predispose to vaginal yeast infections (vaginitis) by disrupting the normal vaginal flora, this is not a side effect of all antibiotics used for acne. The reduction of beneficial lactobacilli can allow for an overgrowth of Candida albicans, leading to symptoms like itching and discharge, which is a known risk with some antibiotic classes but not a universal side effect across all.
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