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
The 44-year-old client with pneumonia receiving intravenous antibiotics is at some risk due to potential immobility and fever, which can lead to diaphoresis and skin maceration. However, this client is likely mobile enough to shift positions independently or with minimal assistance, reducing the risk of sustained pressure. The client's age and general health status, aside from the acute infection, suggest good tissue perfusion and skin integrity.
Choice B rationale
A 26-year-old who is bedridden with a fractured leg is at significant risk due to immobility. The inability to shift weight and relieve pressure on bony prominences can lead to ischemia and tissue damage. However, younger individuals generally have better vascular supply, skin turgor, and faster cellular regeneration compared to older adults, which provides some protective physiological advantage against pressure injury development.
Choice C rationale
This 65-year-old client is at the greatest risk due to a combination of multiple risk factors. Hemiparesis leads to immobility and the inability to reposition, causing prolonged pressure on one side of the body. Incontinence exposes the skin to moisture and chemical irritants from urine and feces, leading to maceration and a breakdown of the skin's protective barrier, making it more susceptible to injury.
Choice D rationale
A 78-year-old requiring a walker for ambulation is at a lower risk for pressure injuries compared to a bedridden individual. Although advanced age and the need for assistive devices suggest some mobility limitations, the ability to ambulate, even with assistance, indicates the capacity to shift weight and relieve pressure on a regular basis. This regular movement promotes circulation and prevents prolonged periods of immobility.
Correct Answer is ["300"]
Explanation
Step 1 is 300 mL ÷ 60 minutes = 5 mL/min.
Step 2 is 5 mL/min × 60 min/hr = 300 mL/hr. The final answer is 300 mL/hr.
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