A nurse is teaching a patient about the use of topical fluorouracil for treatment of a skin cancer.
Which statement made by the patient indicates a need for further teaching?
"I can stop using the medication if my skin looks worse.”.
"I need to avoid being in the sun while on this medication.”.
"I will apply the medication only to the affected areas.”.
"I will wash my hands before and after applying the medication.”.
The Correct Answer is A
Choice A rationale
Stopping topical fluorouracil when the skin appears worse is incorrect. The medication often causes an inflammatory reaction, including erythema, crusting, and erosion, which indicates the drug is working by causing cellular necrosis of abnormal cells. Premature discontinuation compromises treatment efficacy and may lead to inadequate destruction of cancerous cells, necessitating prolonged or alternative therapies.
Choice B rationale
Avoiding sun exposure while using topical fluorouracil is crucial due to the medication's photosensitizing properties. Fluorouracil enhances the skin's sensitivity to ultraviolet radiation, increasing the risk of severe sunburn, erythema, and blistering. This phototoxicity can exacerbate local inflammatory reactions and compromise treatment outcomes, necessitating strict photoprotection.
Choice C rationale
Applying topical fluorouracil only to affected areas is essential to minimize systemic absorption and reduce adverse effects on healthy skin. Fluorouracil is a cytotoxic agent that nonspecifically inhibits DNA and RNA synthesis, leading to cell death. Accidental application to unaffected skin can cause unnecessary irritation, inflammation, and discomfort without therapeutic benefit.
Choice D rationale
Washing hands before and after applying topical fluorouracil is a fundamental infection control and safety measure. Handwashing before application prevents the introduction of microbes to the treatment site, reducing infection risk. Post-application handwashing removes residual medication, preventing accidental transfer to other body parts or individuals, minimizing systemic exposure.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
Acyclovir is an antiviral drug primarily active against herpes viruses. Respiratory syncytial virus (RSV) is typically treated with ribavirin, a guanosine analog, which interferes with RNA synthesis and viral replication. Acyclovir's mechanism of action, involving thymidine kinase phosphorylation, is not effective against RSV.
Choice B rationale
Influenza is caused by influenza viruses (A, B, C) and is typically treated with neuraminidase inhibitors like oseltamivir or zanamivir, which prevent viral release from infected cells. Acyclovir's antiviral spectrum does not include influenza viruses, as their replication cycle and enzymatic targets differ significantly.
Choice C rationale
Hepatitis A is a viral liver infection caused by the hepatitis A virus (HAV), an RNA virus. Treatment for hepatitis A is primarily supportive, as there is no specific antiviral medication. Acyclovir is not effective against hepatitis A virus; its mechanism of action is specific to DNA polymerase inhibition in herpesviruses.
Choice D rationale
Acyclovir is a highly effective antiviral agent specifically indicated for the treatment of herpes zoster, commonly known as shingles. It works by inhibiting viral DNA synthesis after being phosphorylated by viral thymidine kinase, thereby impairing the replication of the varicella-zoster virus (VZV) that causes herpes zoster.
Correct Answer is A
Explanation
Choice A rationale
Bright red blood in the urine, especially in large amounts or clots, after a cystoscopy is an abnormal finding. While some pink-tinged urine is expected, significant bright red bleeding can indicate hemorrhage or bladder wall injury requiring immediate medical intervention to prevent complications.
Choice B rationale
Urinary frequency is a common and expected finding after a cystoscopy due to irritation of the bladder mucosa from the procedure. This typically resolves within a day or two as the bladder recovers from instrumentation.
Choice C rationale
Pink-tinged urine is considered a normal and expected finding after a cystoscopy. The procedure involves instrumentation of the urethra and bladder, which can cause minor trauma to the mucosal lining, leading to a small amount of blood in the urine.
Choice D rationale
Burning on urination, also known as dysuria, is a common and expected sensation after a cystoscopy due to irritation and inflammation of the urethra and bladder from the scope. This discomfort usually subsides within 24 to 48 hours.
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