A nurse is reinforcing teaching about fluticasone topical lotion with the parent of a 9-month-old infant who has atopic dermatitis on the wrist. Which of the following instructions should the nurse include?

"Place a thick layer of the medication on open areas.”

“Rub the medication until it disappears.”

"Cover the area with an occlusive dressing.”

"Apply the medication to your infant's entire arm.”

Answer and Explanation

The Correct Answer is B

A. "Place a thick layer of the medication on open areas." Topical corticosteroids like fluticasone should not be applied in thick layers or to open wounds, as excessive absorption can lead to systemic side effects such as adrenal suppression. A thin layer is sufficient to achieve the desired anti-inflammatory effects while minimizing adverse reactions.

B. “Rub the medication until it disappears.” Topical corticosteroids should be applied in a thin layer and gently rubbed into the skin until no visible residue remains. This ensures even absorption without excessive medication buildup, reducing the risk of local and systemic side effects, especially in infants who have a higher risk of absorption due to their thinner skin.

C. "Cover the area with an occlusive dressing." Occlusive dressings increase medication absorption, which can lead to systemic corticosteroid effects such as skin thinning, delayed wound healing, and adrenal suppression. Occlusion should only be used under medical supervision, especially in infants who are more susceptible to these effects.

D. "Apply the medication to your infant's entire arm." Fluticasone should be applied only to affected areas, not the entire limb. Applying it over a larger area than necessary increases the risk of systemic absorption and side effects. The medication should be used only as directed for targeted treatment of atopic dermatitis.

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Correct Answer is A

Explanation

A. Bleeding. Cefotetan, a second-generation cephalosporin, can interfere with vitamin K metabolism, leading to a decreased ability to form blood clots. When combined with NSAIDs, which have an antiplatelet effect, the risk of bleeding increases. Clients taking both medications should be monitored for bruising, prolonged bleeding, or signs of gastrointestinal hemorrhage such as black, tarry stools.

B. Dysrhythmias. Cefotetan and NSAIDs do not have significant cardiac effects that would lead to dysrhythmias. Some antibiotics, such as macrolides and fluoroquinolones, can cause QT prolongation, but cefotetan does not affect cardiac conduction.

C. Dizziness. While NSAIDs can sometimes cause dizziness as a side effect, this is not a significant interaction between cefotetan and NSAIDs. Cefotetan does not commonly cause dizziness unless associated with an allergic reaction or severe hypotension due to an adverse effect.

D. Jaundice. Cefotetan is metabolized by the liver, but it is not highly hepatotoxic and does not commonly cause jaundice. NSAIDs, when used long-term or in high doses, may contribute to liver dysfunction, but this is not a primary concern in the interaction between these two medications.

A. Alprazolam B. Rotavirus vaccine C. Niacin D. Hepatitis A vaccine

Correct Answer is D

Explanation

A. Alprazolam. Alprazolam, a benzodiazepine, is metabolized in the liver and can accumulate in clients with chronic liver disease, increasing the risk of sedation, confusion, and hepatic encephalopathy. Benzodiazepines should be used cautiously or avoided in clients with liver impairment.

B. Rotavirus vaccine. The rotavirus vaccine is a live, attenuated vaccine given to infants to prevent severe diarrhea caused by rotavirus infection. It is not recommended for adults, including those with chronic liver disease, as it is not indicated for their age group or condition.

C. Niacin. Niacin is used to lower cholesterol and treat vitamin B3 deficiency, but it can cause hepatotoxicity, especially in high doses. In clients with chronic liver disease, niacin may worsen liver function, making it an inappropriate choice unless absolutely necessary and closely monitored.

D. Hepatitis A vaccine. Clients with chronic liver disease are at higher risk of severe complications from hepatitis A infection. Vaccination provides protection against hepatitis A, which can cause acute liver failure in individuals with pre-existing liver disease. It is recommended to prevent further liver damage and protect overall health.

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A nurse is reinforcing teaching about fluticasone topical lotion with the parent of a 9-month-old infant who has atopic dermatitis on the wrist. Which of the following instructions should the nurse include?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is A

Explanation

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Correct Answer is D

Explanation

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