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 C
Explanation
Choice A rationale
Older adults' skin turgor is typically not moist and boggy. Instead, it often presents with decreased elasticity and may appear lax due to age-related changes in collagen and elastin fibers. Boggy skin turgor can indicate significant fluid retention or edema, which is not a normal physiological finding associated with aging alone.
Choice B rationale
Skin turgor is significantly affected by aging. The dermis thins, and there is a reduction in collagen and elastin, leading to a loss of skin elasticity. This physiological process results in decreased turgor, making the skin appear less resilient and more prone to tenting, reflecting normal age-related changes.
Choice C rationale
A decrease in elasticity on skin turgor is a normal part of aging. As individuals age, there is a natural reduction in the quantity and quality of elastin and collagen fibers within the dermal layer of the skin. This leads to diminished recoil capacity, manifesting as prolonged tenting when the skin is pinched, which is a expected finding.
Choice D rationale
Assessing skin turgor only on the hands of older adults is not the most reliable approach. Due to age-related loss of subcutaneous fat and decreased elasticity, the hands can often show false positives for dehydration. The sternum or forehead provides a more accurate assessment site for evaluating hydration status in the elderly population because these areas are less affected by typical age-related changes in skin elasticity.
Correct Answer is B
Explanation
Choice A rationale
Peripheral edema, characterized by swelling in the extremities due to fluid retention, is not a typical manifestation of myasthenia gravis. Myasthenia gravis is an autoimmune disorder primarily affecting neuromuscular transmission, leading to muscle weakness rather than fluid imbalances.
Choice B rationale
Drooping eyelids, also known as ptosis, is a very common and often early symptom of myasthenia gravis. It results from weakness of the levator palpebrae superioris muscle due to impaired acetylcholine receptor function at the neuromuscular junction, a hallmark of the disease.
Choice C rationale
Myasthenia gravis primarily affects voluntary muscles and does not typically cause loss of cognitive function. Cognitive abilities, such as memory, attention, and problem-solving, are generally preserved in patients with this condition, distinguishing it from neurological disorders that directly impact the brain.
Choice D rationale
Fluctuations in heart rate are not a characteristic finding in myasthenia gravis. While severe generalized muscle weakness can indirectly impact respiratory and cardiovascular function, the disease itself does not directly cause dysregulation of heart rate. Heart rate is typically regulated by the autonomic nervous system.
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