A patient is diagnosed with contact dermatitis.
Which medication should the nurse expect to be prescribed to treat this disorder?

Choice A rationale

While temporary numbness could indicate transient nerve compression, which might rarely predispose to minor skin issues if prolonged or repetitive, it typically resolves without lasting dermatological compromise. Sustained pressure or impaired sensation are the primary risk factors for skin breakdown. This transient event is less likely to lead to a significant skin alteration compared to chronic conditions affecting tissue integrity.

Choice B rationale

Diabetes mellitus impairs microcirculation and peripheral neuropathy, leading to decreased sensation and reduced blood flow to tissues. This compromises the skin's ability to heal and resist infection. Hyperglycemia also weakens collagen and elastin, making the skin more fragile and susceptible to breakdown and delayed wound healing.

Choice C rationale

Significant fluid and electrolyte imbalances due to vomiting and diarrhea, coupled with substantial weight loss, lead to dehydration and malnutrition. Dehydration reduces skin turgor and elasticity, making it more prone to tearing. Malnutrition, particularly protein deficiency, impairs tissue repair and maintenance, increasing susceptibility to skin breakdown.

Choice D rationale

Paralysis prevents independent repositioning, leading to prolonged pressure on bony prominences. This sustained pressure compromises capillary blood flow, resulting in tissue ischemia and necrosis. Without the ability to shift weight, the skin's protective mechanisms are overwhelmed, significantly increasing the risk for pressure injury development.

Choice E rationale

Chronic exposure to ultraviolet (UV) radiation from sunlight, experienced by roofers, causes cumulative damage to dermal collagen and elastin fibers, leading to photoaging. This also increases the risk of basal cell carcinoma, squamous cell carcinoma, and melanoma, which are significant skin alterations including premalignant and malignant lesions.

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.