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
dropdown
or
dropdown
occurs during therapy.

Answer and Explanation

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

Dry skin and lips: This is a very common side effect of isotretinoin due to its drying effects on sebaceous glands. It is expected and manageable with regular moisturizing and is not considered an emergency.
Increased appetite: Isotretinoin is not associated with increased appetite. Weight changes are not typical or concerning symptoms during therapy and do not warrant urgent provider notification.
Depression: Isotretinoin has been associated with mood changes including depression, suicidal thoughts, and other psychiatric effects. These can emerge suddenly and must be reported immediately for prompt evaluation and intervention to ensure safety.
Visual disturbances: Blurred vision or difficulty seeing, particularly at night, can indicate rare but serious complications such as increased intracranial pressure. Any change in vision during isotretinoin therapy requires immediate medical attention.
Productive cough: This is not commonly linked with isotretinoin therapy. Unless respiratory symptoms worsen or are accompanied by fever or systemic signs, a productive cough alone is not a reason to stop treatment or alert the provider urgently.

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Correct Answer is D

Explanation

A. "After 5 to 10 minutes when the breast is emptied, my baby should be removed from the breast." The breast is rarely fully emptied during a feeding. Infants should be allowed to feed on one side until they naturally release it, ensuring they receive the nutrient-rich hindmilk.
B. "Manually expressing my milk will decrease my milk supply." Manual expression, like breastfeeding, stimulates milk production. Regularly removing milk from the breasts actually helps maintain or increase supply, especially during periods of engorgement or separation.
C. “My baby should always start on the same breast when feeding.” Alternating the starting breast with each feeding ensures even stimulation and drainage of both breasts. Always starting on the same side could lead to engorgement or reduced supply in the unused breast.
D. “The more my baby is at the breast sucking the more milk I will produce.” Breast milk production is based on a supply and demand mechanism. The more frequently and effectively the baby nurses, the more milk the body is signaled to produce.

A. Palms of the hands B. Area of trauma C. Sacrum D. Shoulders

Correct Answer is A

Explanation

A. Palms of the hands. In clients with dark skin, assessing for cyanosis is best done in areas where skin is lighter and blood vessels are more visible, such as the palms, soles, lips, mucous membranes, and conjunctiva. These sites provide clearer visual cues of decreased oxygenation.
B. Area of trauma. This area may show signs of bruising or inflammation, but it is not ideal for assessing cyanosis. Local changes in color may be due to injury, not systemic oxygenation.
C. Sacrum. The sacrum is typically assessed for pressure injuries, not for cyanosis. Its location and frequent pressure make it a less reliable site for detecting systemic color changes.
D. Shoulders. The shoulders are not reliable sites for detecting cyanosis, especially in individuals with darker skin, as color changes may be less apparent in more heavily pigmented or sun-exposed areas.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is teaching a new parent about breastfeeding her 2-week-old infant. Which of the following statements by the parent indicates an understanding of the teaching?

Correct Answer is D

Explanation

A nurse is performing a skin assessment on a client who has dark skin. Which of the following locations on the client's body should the nurse observe to assess for cyanosis?

Correct Answer is A

Explanation

A nurse is caring for a client following application of a cast. Which of the following actions should the nurse take first?

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