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 B

Explanation

A. Oatmeal. Oatmeal is a healthy carbohydrate and fiber source, but it is not a significant source of potassium, which is essential for clients taking furosemide. While beneficial for overall health, oatmeal will not help counteract potassium loss caused by diuretic therapy.

B. Baked potatoes. Baked potatoes are rich in potassium, which is frequently lost due to furosemide’s potassium-wasting effects. Furosemide is a loop diuretic that increases urine output and depletes electrolytes, particularly potassium, which can lead to hypokalemia (low potassium levels). To help maintain electrolyte balance, clients should consume potassium-rich foods like potatoes, bananas, oranges, and spinach.

C. Brown rice. Brown rice is a good source of fiber and complex carbohydrates, but it contains only small amounts of potassium. While it provides sustained energy, it does not significantly contribute to potassium replacement, making it less beneficial for clients on furosemide.

D. Eggs. Eggs are high in protein and essential nutrients but are not a significant source of potassium. While eggs are beneficial for overall health, they do not help replenish potassium lost due to diuretic therapy.

A. Tinnitus B. Abdominal cramping C. Stevens-Johnson syndrome D. Insomnia

Correct Answer is C

Explanation

A. Tinnitus. Nitrofurantoin is not commonly associated with ototoxicity or tinnitus. Medications such as aminoglycosides and loop diuretics are more likely to cause this adverse effect. While nitrofurantoin can have some neurological side effects, tinnitus is not a primary concern.

B. Abdominal cramping. Gastrointestinal side effects such as nausea and vomiting can occur with nitrofurantoin, especially if taken on an empty stomach. However, abdominal cramping is usually mild and not a serious adverse effect requiring discontinuation of the medication. Taking the drug with food can help reduce gastrointestinal discomfort.

C. Stevens-Johnson syndrome. Stevens-Johnson syndrome (SJS) is a rare but serious hypersensitivity reaction that can occur with nitrofurantoin use. It presents with flu-like symptoms, followed by a painful rash, blistering, and skin peeling. Immediate discontinuation and medical intervention are required if symptoms develop, as SJS can be life-threatening.

D. Insomnia. Nitrofurantoin does not commonly cause insomnia. Some medications, such as corticosteroids and stimulants, are more likely to interfere with sleep. Nitrofurantoin’s side effects primarily affect the gastrointestinal, pulmonary, and dermatologic systems rather than sleep patterns.

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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

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Correct Answer is B

Explanation

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Correct Answer is C

Explanation

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