A nurse is assisting with the care of an adolescent in an outpatient dermatologist's office.
Complete the following sentence by using the lists of options.
A nurse is reinforcing teaching today on the newly prescribed medication. The nurse recommends that the adolescent notify the provider immediately if there is
The Correct Answer is {"dropdown-group-1":"C","dropdown-group-2":"A"}
Rationale for correct choices:
• a change in mood: Isotretinoin has been associated with psychiatric effects including depression, mood swings, aggression, and suicidal ideation, particularly in adolescents. Any noticeable mood or behavioral changes require immediate provider notification so the medication can be reassessed and mental health support initiated if needed.
• decreased night vision: Isotretinoin can impair dark adaptation and cause decreased night vision due to its effects on the retina. This adverse effect may be sudden or irreversible, making early reporting essential to prevent safety risks such as accidents while driving in low-light conditions.
Rationale for incorrect choices:
• nausea: Mild gastrointestinal upset can occur with isotretinoin and is generally expected rather than emergent. This symptom is usually managed with supportive measures and does not require immediate discontinuation unless severe or persistent.
• dry mouth: Mucocutaneous dryness, including dry lips and mouth, is a very common and expected side effect of isotretinoin. This is typically managed with hydration and emollients and does not warrant urgent provider notification.
• the development of dry eyes: Dry eyes are a common isotretinoin effect related to decreased sebaceous gland activity. While uncomfortable and relevant to report at routine follow-up, it is not an urgent finding unless severe or affecting vision.
• sunburn: Photosensitivity can occur during isotretinoin therapy, making sunburn more likely. This is addressed with sun protection education and does not indicate a serious adverse reaction requiring immediate notification.
• engagement in sexual activity: Sexual activity itself is not an adverse effect of isotretinoin. Although pregnancy prevention is critical due to teratogenicity, sexual activity alone does not represent a medication-related complication.
• worsening of acne: Acne may initially worsen during early isotretinoin therapy as part of the treatment response. This is a known and expected effect and does not require urgent provider contact unless severe or accompanied by systemic symptoms.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Wrap the sleeve loosely around the client's lower leg: The sleeve should fit snugly but comfortably to ensure effective compression. Wrapping it too loosely reduces efficacy in promoting venous return and preventing deep vein thrombosis. Proper fit is essential for device function and patient safety.
B. Measure the circumference of the client's upper leg: Measuring the thigh circumference ensures the correct sleeve size is selected, which is crucial for effective compression and prevention of pressure injury. Accurate sizing allows the device to deliver appropriate pressure without causing discomfort or circulatory compromise.
C. Turn on the mechanical unit prior to applying the sleeve: The device should remain off until the sleeve is properly positioned on the client. Activating it beforehand may result in improper inflation, skin injury, or ineffective compression. Turning it on too early can also startle the client and reduce comfort.
D. Position the client prone to apply the device: The client should be supine or with legs slightly elevated when applying a thigh-length sequential compression device. Prone positioning is unnecessary, uncomfortable, and can complicate proper sleeve placement. Supine positioning facilitates correct alignment and device effectiveness.
Correct Answer is C
Explanation
A. Assist the client with dangling off the side of the bed: While mobilization can help prevent complications such as atelectasis or thromboembolism, it does not address the immediate concern of a possible postoperative infection indicated by the elevated temperature.
B. Obtain a prescription to check the client's CBC: Ordering a CBC can help identify infection or inflammation, but it is a diagnostic action that follows initial assessment. Immediate assessment of potential sources of infection takes priority.
C. Check the condition of the client's surgical incision: Assessing the surgical site is the first action because an incision can be a primary source of infection in postoperative clients. Early identification of redness, drainage, or other signs of infection allows prompt intervention.
D. Instruct the client to breathe deeply and cough: Deep breathing and coughing are important for preventing respiratory complications, but they do not address the urgent need to assess for infection, which is indicated by the elevated temperature.
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