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 B
Explanation
Choice A rationale
Applying a dry diaper over the PUC bag is a routine step after placement but is not the most important action for checking placement. While necessary for hygiene and containing urine, it does not directly verify the correct anatomical positioning of the collection bag, which is crucial for accurate and contamination-free urine collection in infants.
Choice B rationale
Ensuring the bag's adhesive is secured to the true perineum is the most critical action. Proper placement on the true perineum (the anatomical region between the thighs, encompassing the anus and external genitalia) ensures that urine directly enters the collection bag, preventing contamination from stool or skin flora, and allowing for an accurate and sterile urine sample.
Choice C rationale
Calculating the infant's fluid intake is a separate nursing responsibility related to overall fluid balance and hydration status. It is not directly related to checking the correct placement of a pediatric urine collection bag. While fluid intake influences urine output, it does not provide information about the anatomical accuracy of the bag's application.
Choice D rationale
Asking the mother when the infant previously voided provides historical information about the infant's voiding pattern. While helpful for anticipating when the infant might void again, this information does not confirm the current, proper placement of the urine collection bag. The physical verification of adhesive placement is paramount for effective collection.
Correct Answer is B
Explanation
Choice A rationale
Administering ibuprofen may alleviate pain temporarily, but it does not address the underlying cause of increased pain and pressure, which could indicate a developing complication such as a perineal hematoma. Providing only symptomatic relief delays investigation and potential intervention for a serious issue.
Choice B rationale
Increased pain and pressure in the vaginal area following a perineal laceration, especially 6 hours postpartum, are classic signs of a developing perineal hematoma. This condition requires prompt medical evaluation by the healthcare provider to assess the extent of bleeding, potential for shock, and determine the need for surgical intervention.
Choice C rationale
Applying an icepack to the perineum is a common comfort measure for swelling and pain associated with lacerations. While it may provide some relief, it will not resolve a developing hematoma or significant internal bleeding that is causing increased pain and pressure. It is an insufficient intervention for the potential severity of the client's symptoms.
Choice D rationale
Providing routine perineal care, such as gentle cleansing and hygiene, is important for comfort and infection prevention. However, it does not address the acute and increasing pain and pressure that suggests a complication beyond typical postpartum discomfort. This intervention would delay necessary medical assessment for a potential hematoma.
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