An adolescent client is asking the practical nurse (PN) how to care for acne.
Which recommendation should the PN provide?
Wash the hair and skin daily with mild soap and warm water.
Refer to the dermatologist for prescribed long term therapy.
Omit chocolate, carbonated drinks, and fried foods from the diet.
Express blackheads and follow with an exfoliating scrub.
The Correct Answer is A
Choice A rationale
Daily washing with mild soap and warm water helps remove excess sebum, dead skin cells, and bacteria from the skin surface, which are primary contributors to acne lesion formation. This non-irritating approach prevents further inflammation and maintains skin barrier integrity without triggering compensatory oil production often seen with harsh cleansers.
Choice B rationale
While a dermatologist can provide advanced therapies, the initial approach to acne management often involves lifestyle modifications and over-the-counter treatments. Referring directly to a dermatologist for long-term therapy without first attempting conservative measures may be an overstep for initial PN recommendations, as many mild cases respond to basic hygiene.
Choice C rationale
Scientific evidence does not consistently support a direct causal link between dietary factors like chocolate, carbonated drinks, or fried foods and the exacerbation of acne. Acne development is primarily influenced by hormonal factors, sebum production, bacterial proliferation (Propionibacterium acnes), and follicular hyperkeratinization, not specific food consumption.
Choice D rationale
Manual expression of blackheads can push follicular contents deeper, leading to rupture of the follicle wall, increased inflammation, and potential scarring. Exfoliating scrubs can also irritate inflamed skin, disrupt the skin barrier, and worsen acne, making this an unscientific and potentially harmful recommendation.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
A soft, spongy fundus, often described as boggy, indicates uterine atony. This condition means the uterine muscles are not contracting effectively, which is abnormal postpartum and significantly increases the risk of postpartum hemorrhage due to inadequate compression of uterine blood vessels.
Choice B rationale
Unilateral lower leg pain, especially accompanied by warmth, redness, or swelling, is an abnormal finding and can be indicative of a deep vein thrombosis (DVT). Postpartum women are at an increased risk for DVT due to hypercoagulability and venous stasis, making this a critical assessment requiring immediate attention.
Choice C rationale
Saturating two perineal pads per hour is an excessive amount of lochia and suggests postpartum hemorrhage. Normal lochia flow should not saturate more than one pad per hour in the immediate postpartum period, indicating that the uterus is not contracting adequately to control bleeding.
Choice D rationale
A heart rate of 56 beats/minute, also known as puerperal bradycardia, is considered a normal physiological finding for a primigravida client 12 hours postpartum. This transient bradycardia often occurs due to the increased stroke volume and cardiac output that result from the significant decrease in uterine blood flow after delivery.
Correct Answer is D
Explanation
Choice A rationale
Describing the percentage of saturated perineal pads is a subjective and imprecise method for estimating blood loss. Variations in pad size, absorbency, and the client's perception can lead to significant inaccuracies, making it unreliable for precise clinical assessment of hemorrhage.
Choice B rationale
While hematocrit levels are crucial for assessing overall blood volume status, obtaining an hourly hematocrit is an indirect and reactive measure of acute blood loss. It reflects hemodilution or hemoconcentration over time rather than providing a real-time, accurate quantification of the volume of blood lost. Normal hematocrit for pregnant women is 33% to 44%.
Choice C rationale
Changes in vital signs, such as tachycardia, hypotension, and tachypnea, are late indicators of significant blood loss and hypovolemic shock. Relying solely on vital signs means that a substantial amount of blood has already been lost before changes become apparent, making it an insensitive method for early detection and estimation.
Choice D rationale
Calculating the difference in weight of perineal pads before and after use provides a highly accurate objective measurement of blood loss. One gram of weight is approximately equivalent to one milliliter of blood, allowing for precise quantification and enabling timely and appropriate clinical interventions.
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