What should the nurse suggest before a 17-year-old girl starts a protocol of isotretinoin (Accutane) for her acne?
Get a prescription for oral contraceptives.
Increase the dose of the present medication.
Limit intake of chocolate, cola, and peanuts.
Increase exposure to sunlight.
The Correct Answer is A
Choice A rationale
Isotretinoin is a highly effective medication for severe acne, but it is a potent human teratogen. It can cause severe birth defects, miscarriage, and premature birth if a patient becomes pregnant while taking it. The iPLEDGE program mandates two forms of contraception and monthly pregnancy tests for all female patients.
Choice B rationale
The dose of isotretinoin is carefully titrated based on the patient's weight and response to therapy. Increasing the dose without a physician's order is extremely dangerous and can lead to severe side effects such as cheilitis, xerosis, and potential liver damage. Doses are not to be altered by the patient.
Choice C rationale
There is no credible scientific evidence that the intake of specific foods like chocolate, cola, or peanuts causes or exacerbates acne. This is a common misconception. Acne pathogenesis involves sebum production, follicular hyperkeratinization, and bacterial proliferation, not dietary intake of these items.
Choice D rationale
Isotretinoin increases the skin's sensitivity to sunlight and UV radiation, a condition known as photosensitivity. This effect is due to the drug's impact on skin cell turnover and thinning of the stratum corneum. Patients are advised to limit sun exposure and use broad-spectrum sunscreens to prevent severe sunburn.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale
Healing by primary intention, also known as primary union, occurs when a wound has clean edges that are approximated and sutured, stapled, or glued together. This process minimizes tissue loss and results in a fine scar. The wound's integrity is re-established with minimal granulation tissue formation.
Choice B rationale
This describes a form of delayed primary closure or tertiary intention healing. The wound is initially left open to allow for drainage and to clear infection. Once the wound is considered clean and free of infection, the edges are then approximated and closed, often with staples, to promote healing.
Choice C rationale
Healing by secondary intention, or secondary union, occurs in large, open wounds with significant tissue loss and non-approximated edges. The wound heals from the base up. This process involves the formation of new connective tissue and capillaries, called granulation tissue, to fill the defect before epithelialization can occur.
Choice D rationale
While contaminated wounds can heal by secondary intention, this description is not a complete definition. Secondary intention healing is a specific biological process involving granulation tissue, not just a description of a wound that is open due to contamination or debris. The defining characteristic is the formation of granulation tissue.
Correct Answer is B
Explanation
Choice A rationale
This meal provides carbohydrates and fiber, but it lacks sufficient protein, which is essential for tissue repair and collagen synthesis. Protein intake is crucial for wound healing. A green salad provides vitamins, but the overall meal composition is not optimal for providing the building blocks necessary for skin and tissue regeneration.
Choice B rationale
This dietary choice is excellent for promoting wound healing. Chicken breast provides a high-quality source of protein, which is essential for rebuilding damaged tissue and forming new collagen. Broccoli provides vitamin C, a co-factor in collagen synthesis, while a baked potato offers carbohydrates for energy to fuel the healing process.
Choice C rationale
Vegetable lasagna and green salad provide some vitamins and nutrients, but they are often lower in protein than meat-based options, especially if the lasagna filling is not fortified with high-protein ingredients like cottage cheese. Protein is a critical macronutrient for tissue repair, and the lack of a concentrated source makes this choice suboptimal.
Choice D rationale
This meal is low in essential nutrients. While a hamburger provides some protein, it is often high in saturated fat. The fruit cup and cookie provide simple sugars, which can lead to inflammation and have minimal nutritional value for wound healing. The diet pop offers no nutritional benefit and may contain artificial ingredients that are not beneficial.
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