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A nurse is caring for an adolescent in the outpatient dermatologist's office.

 

Exhibits

Complete the following sentence by using the lists of options.

A nurse is providing education today on the newly-prescribed medication. The nurse recommends the adolescent notify the provider immediately if

or occurs during therapy.
Answer and Explanation

The Correct Answer is {"dropdown-group-1":"D","dropdown-group-2":"A"}

Rationale for Correct Choices:

  • A change in mood: Isotretinoin can cause psychiatric effects such as depression, mood swings, and suicidal ideation. These symptoms may appear suddenly and progress rapidly without warning. Immediate reporting is necessary to ensure patient safety and initiate intervention.
  • Visual disturbances: Isotretinoin may cause night blindness, blurred vision, or other changes in visual acuity. These effects can be irreversible if not addressed promptly by an ophthalmologic evaluation. Sudden onset visual changes require immediate discontinuation and assessment.

Rationale for Incorrect Choices:

  • Nausea: This is a mild, nonspecific gastrointestinal symptom that may occur with many oral medications. It is not considered a hallmark of isotretinoin toxicity unless severe or persistent. Supportive measures are usually sufficient unless other symptoms emerge.
  • The development of dry eyes: This occurs due to isotretinoin’s suppression of sebaceous and meibomian gland activity. It is a common, expected effect that can be relieved with lubricating eye drops. Urgent evaluation is not required unless accompanied by vision changes.
  • Dry mouth: This is a frequent mucocutaneous effect related to reduced salivary gland activity during isotretinoin therapy. It does not indicate a dangerous reaction and is usually managed with hydration and sugar-free lozenges. Medical review is only needed if severe.
  • Photosensitivity: Isotretinoin increases skin sensitivity to sunlight due to thinning of the epidermis. While uncomfortable, it is a predictable effect that can be prevented with sunscreen and protective clothing. It does not require stopping treatment unless severe burns occur.
  • Dry skin and lips: This is the most common side effect, resulting from reduced sebaceous gland activity. It is usually managed with moisturizers and lip balm throughout therapy. It is not a sign of toxicity and rarely requires dose adjustment.


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Related Questions

Correct Answer is ["A","B","D","E","G"]

Explanation

Rationale for correct choices:

  • Skin feels cool to the touch: Cool skin indicates poor peripheral perfusion, which can signal early hypovolemic shock in a child with burns. Prompt assessment and interventions, such as fluid resuscitation, are necessary.
  • Capillary refill 3 seconds in left foot: Delayed capillary refill reflects compromised circulation and decreased tissue perfusion. Early recognition and intervention help prevent progression to shock.
  • Blood pressure 102/50 mm Hg: Mild hypotension combined with tachycardia, cool skin, and delayed capillary refill suggests early hypovolemic shock, a life-threatening complication requiring immediate attention.
  • Temperature 35.8° C (96.4° F): Hypothermia can occur due to heat loss from burn injuries, increasing the risk for coagulopathy, impaired wound healing, and further hemodynamic instability.
  • Output of 25 mL dark amber urine through catheter: Low and concentrated urine output indicates possible dehydration or reduced renal perfusion, which can progress to acute kidney injury if not addressed urgently.

Rationale for incorrect choices:

  • Respiratory rate 20/min: Although slightly decreased from admission, this is within a near-normal range for an 8-year-old and not immediately concerning. Continuous monitoring is appropriate, but it is not an urgent priority compared with perfusion and hemodynamic indicators.
  • Dressing on left hand shows small amount of moisture through gauze: Minor moisture in the dressing may reflect mild wound exudate, which requires routine monitoring and dressing changes. It does not indicate an immediate life-threatening risk.

Correct Answer is B

Explanation

Rationale:

A. “Staff will apply identification bands to my baby after her first bath.": Identification bands are applied immediately after birth to ensure proper identification and prevent abduction, not after the first bath. Waiting could increase safety risks.

B. "I will not publish a public announcement about my baby's birth.": Limiting public announcements, such as on social media, reduces the risk of unwanted attention and potential abduction. This demonstrates understanding of newborn security measures.

C. "I can remove my baby's identification band as long as she is in my room.": Identification bands must remain on the newborn at all times to maintain safety and prevent misidentification or abduction. Removing them is unsafe.

D. "I can leave my baby in my room while I walk in the hallway.": Leaving a newborn unattended, even briefly, increases the risk of abduction and is against safety protocols. Constant supervision or staff assistance is required.

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