A patient is prescribed a retinoid medication.
Which statement would the nurse provide when teaching the patient about this drug?
"Discoloration of the teeth is very common with this class of medications.”.
"You need to have lab work done monthly to ensure the proper dose of this medication.”.
"The medication works well for treatment of cancerous lesions.”.
"Avoid sun exposure and use measures to prevent pregnancy.”.
The Correct Answer is D
Choice A rationale
Discoloration of the teeth is not a common side effect associated with retinoid medications. Tetracycline antibiotics are well-known for causing tooth discoloration, particularly in developing teeth. Retinoids primarily affect cell differentiation, proliferation, and immune function, but not dental chromogenesis.
Choice B rationale
Monthly lab work is not routinely required to ensure the proper dose of most retinoid medications, though baseline liver function tests and lipid profiles may be checked, especially with systemic retinoids, due to potential hepatotoxicity and dyslipidemia. However, the dose is primarily guided by clinical response and side effects, not frequent lab adjustments.
Choice C rationale
While some retinoids, such as tretinoin, are used topically for certain precancerous skin lesions like actinic keratosis due to their ability to normalize cell differentiation, they are generally not considered primary treatments for established cancerous lesions. Their role is more in prevention or adjunctive therapy rather than definitive cancer treatment.
Choice D rationale
Retinoids, particularly systemic retinoids like isotretinoin, are highly teratogenic, meaning they can cause severe birth defects. Therefore, strict avoidance of pregnancy is crucial, often requiring two forms of contraception. Additionally, retinoids increase photosensitivity, making sun avoidance and protective measures essential to prevent severe sunburn and skin damage.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale
Palpating along the lumbar vertebral column primarily assesses for spinal tenderness or musculoskeletal issues, not specifically kidney inflammation. The kidneys are retroperitoneal organs, and direct palpation of the lumbar area might not elicit specific tenderness related to pyelonephritis, which involves renal parenchymal inflammation.
Choice B rationale
Striking a flat hand covering the costovertebral angle (CVA) elicits pain if the kidney capsule is inflamed, a classic sign of pyelonephritis. This maneuver, known as CVA tenderness, directly assesses for inflammation of the renal parenchyma or surrounding structures, which become sensitive to percussion with infection.
Choice C rationale
Pushing fingers upward into the two lowest intercostal spaces would primarily assess for liver or spleen enlargement, or tenderness related to the lower ribs, not directly for kidney tenderness. The kidneys are situated more posteriorly and superiorly, making this approach less effective for assessing pyelonephritis.
Choice D rationale
Percussing between the iliac crest and ribs at the midaxillary line targets the flank area but is not the most precise method for assessing kidney tenderness. While it's in the general vicinity, the CVA percussion directly overlies the kidney and is a more specific and sensitive maneuver for pyelonephritis.
Correct Answer is C
Explanation
Choice A rationale
Identifying renal artery bruits typically involves auscultation, not palpation. Bruits are abnormal sounds produced by turbulent blood flow through a narrowed or constricted artery, which are heard with a stethoscope placed over the renal arteries. Palpation is not an effective method for detecting vascular sounds.
Choice B rationale
Assessing for ureteral peristalsis is challenging and not routinely done through external palpation. Ureteral peristalsis involves rhythmic contractions of the smooth muscle in the ureters that propel urine from the kidneys to the bladder, which is an internal physiological process not directly palpable through the abdominal wall.
Choice C rationale
Palpation is a standard physical assessment technique used to detect bladder distention. An overfilled bladder rises above the symphysis pubis and can be felt as a firm, rounded mass in the suprapubic area, indicating urinary retention or incomplete emptying, which is a common post-catheter removal assessment.
Choice D rationale
Determining kidney function primarily involves laboratory tests, such as serum creatinine, blood urea nitrogen (BUN), and glomerular filtration rate (GFR) calculations, rather than physical palpation. While kidney palpation can assess size and tenderness, it does not directly measure the physiological efficiency of filtration and waste removal.
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