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. An infant who has respiratory syncytial virus and a respiratory rate of 70/min: This infant is experiencing tachypnea, which indicates respiratory distress. Discharging during a storm would place the infant at high risk for decompensation and inadequate access to emergency care.
B. An adolescent who has cystic fibrosis and is receiving their yearly tune-up: A routine annual check-up indicates the adolescent is stable and does not require acute care. This client is the safest candidate for discharge during a storm, as their condition is not immediately life-threatening.
C. A child who has a new diagnosis of type 1 diabetes mellitus and is receiving IV insulin: This child requires close monitoring and titration of insulin therapy, making discharge unsafe. Early management of new-onset diabetes involves frequent assessments that cannot be delayed.
D. A child who has leukemia and an absolute neutrophil count of 200/mm³: Severe neutropenia places the child at high risk for infection. Discharge during a storm could prevent timely access to emergency care if complications arise.
Correct Answer is C
Explanation
A. Leukemia: Leukemia primarily affects white blood cell production and bone marrow function. While it can cause anemia, low iron and vitamin B levels are more directly related to nutritional deficiencies rather than a primary hematologic malignancy.
B. Hepatitis: Hepatitis involves inflammation of the liver and may affect liver function tests, bilirubin, and clotting factors. It does not typically cause concurrent deficiencies in iron and vitamin B unless chronic malnutrition or malabsorption is present.
C. Anemia: Low iron and vitamin B (particularly B12 or folate) directly impair red blood cell production, leading to various types of anemia, such as iron-deficiency anemia or megaloblastic anemia. Monitoring for pallor, fatigue, and laboratory indicators of anemia is essential for appropriate management.
D. Steatotic liver disease: Fatty liver disease affects hepatocytes and liver metabolism but is not typically associated with primary deficiencies in iron and vitamin B. Nutritional deficiencies may coexist but are not the direct cause of laboratory abnormalities in this context.
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