A nurse is caring for an adolescent in the outpatient dermatologist's office.

Exhibits

Complete the following sentence by using the lists of options.

A nurse is providing education today on the newly-prescribed medication. The nurse recommends the adolescent notify the provider immediately if
dropdown
or
dropdown
occurs during therapy.

Answer and Explanation

The Correct Answer is {"dropdown-group-1":"C","dropdown-group-2":"D"}

Dry skin and lips: This is a very common side effect of isotretinoin due to its drying effects on sebaceous glands. It is expected and manageable with regular moisturizing and is not considered an emergency.
Increased appetite: Isotretinoin is not associated with increased appetite. Weight changes are not typical or concerning symptoms during therapy and do not warrant urgent provider notification.
Depression: Isotretinoin has been associated with mood changes including depression, suicidal thoughts, and other psychiatric effects. These can emerge suddenly and must be reported immediately for prompt evaluation and intervention to ensure safety.
Visual disturbances: Blurred vision or difficulty seeing, particularly at night, can indicate rare but serious complications such as increased intracranial pressure. Any change in vision during isotretinoin therapy requires immediate medical attention.
Productive cough: This is not commonly linked with isotretinoin therapy. Unless respiratory symptoms worsen or are accompanied by fever or systemic signs, a productive cough alone is not a reason to stop treatment or alert the provider urgently.

Nursing Test Bank

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Naxlex Comprehensive Predictor Exams

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Free Nursing Study Resources

Correct Answer is A

Explanation

A. "I will hang a new bag of TPN and IV tubing every 24 hours." This is the correct action. TPN solutions are high in glucose and lipids, which create an ideal environment for bacterial growth. Changing the bag and tubing every 24 hours reduces the risk of infection and sepsis, especially in clients with central lines.
B. "I will obtain the client's weight every other day." Weight should be monitored daily in clients receiving TPN to assess for fluid status, nutritional progress, and potential complications like fluid overload or retention.
C. "I will monitor the client's blood glucose level every 8 hours." Clients receiving TPN require more frequent glucose monitoring, typically every 4 to 6 hours, especially when therapy is initiated, due to the high dextrose content that can cause hyperglycemia.
D. “I will increase the rate of the TPN infusion to ensure the correct amount is given." TPN infusion rates should never be adjusted independently by a nurse. Changes must be made only with a provider’s order, as improper rate adjustments can lead to electrolyte imbalances, hyperglycemia, or fluid overload.

A. Temperature 38.2° C (100.8° F) B. Heart rate 104/min C. Client reports feeling unwell D. Lung sounds clear but diminished in the bases E. Fundus boggy but firmed with massage F. Moderate amount of dark brown, foul-smelling lochia noted G. No bowel movement since birth, hypoactive bowel sounds H. WBC count 33,000/mm3 (5,000 to 10,000/mm)

Correct Answer is ["A","B","C","D","E","F","G","H"]

Explanation

Client reports feeling unwell: This is clinically significant when combined with fever, foul-smelling lochia, and elevated WBCs; it could indicate systemic infection such as endometritis.
Fundus boggy but firms with massage: Indicates uterine atony, a risk factor for postpartum hemorrhage. Even if it responds to massage, repeated bogginess suggests the need for uterotonic medications and close monitoring.
Foul-smelling, dark brown lochia: These findings are highly suggestive of uterine infection (endometritis), especially when paired with uterine tenderness, fever, and elevated WBCs.
WBC count 33,000/mm³: Severely elevated — well above normal postpartum leukocytosis (typically up to 20,000/mm³). A level of 33,000 strongly suggests an ongoing infectious process.
Temperature 38.2°C (100.8°F): Slightly elevated, and while low-grade fever is common postpartum, when associated with uterine tenderness and abnormal lochia, it raises concern for infection and should be monitored and managed appropriately.
Lung sounds diminished in the bases: Could be due to post-surgical hypoventilation, immobility, or atelectasis. Should prompt encouragement of deep breathing, incentive spirometry, and ambulation.
No bowel movement since birth, hypoactive bowel sounds: This is a common post-cesarean finding due to anesthesia and immobility, but it still indicates delayed return of GI function and should be monitored for signs of ileus.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A charge nurse is monitoring a newly licensed nurse who is caring for a client who is receiving total parenteral nutrition (TPN). Which of the following statements by the newly licensed nurse indicates an understanding of the procedure?

Correct Answer is A

Explanation

Correct Answer is ["A","B","C","D","E","F","G","H"]

Explanation

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A nurse on a medical-surgical unit is planning care for assigned clients. Which of the following actions should the nurse plan to take to demonstrate effective time management?

A nurse manager is planning to teach staff about critical pathways. Which of the following information should the nurse plan to include?

A nurse is caring for a client who is wearing antiembolic stockings. Which of the following interventions should the nurse include in the plan of care?

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A nurse in an emergency department is caring for a client who is actively bleeding from a stab wound to the thigh. Which of the following actions should the nurse take?