An adolescent receives a new prescription for isotretinoin for cystic acne. Which information is most important for the nurse to provide?

Start the second course of therapy after an 8-week delay.

Consider an alternative summer job, other than life guarding.

Store the medicine in a plastic, tight, light resistant container.

Discontinue all multivitamins during acne medication therapy.

Answer and Explanation

The Correct Answer is B

A. Start the second course of therapy after an 8-week delay: While a second course of isotretinoin may sometimes be considered after a break if acne persists, this timing is medication management guidance and is less urgent than immediate safety concerns like sun sensitivity.

B. Consider an alternative summer job, other than life guarding: Isotretinoin causes extreme photosensitivity, making prolonged sun exposure dangerous. Adolescents working outdoors, like lifeguards, are at high risk for severe sunburns, so suggesting alternative employment protects their health.

C. Store the medicine in a plastic, tight, light resistant container: Proper medication storage is important but not the most critical concern compared to preventing serious adverse effects like sunburn, teratogenicity, or psychiatric symptoms with isotretinoin use.

D. Discontinue all multivitamins during acne medication therapy: There is generally no need to discontinue all multivitamins while taking isotretinoin unless specifically instructed by the healthcare provider. Some multivitamins contain vitamin A, excessive intake of vitamin A should be avoided. However, discontinuing all multivitamins without guidance could lead to other nutritional deficiencies.

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Correct Answer is B

Explanation

A. Obtain a specimen for a urine culture: A urine culture is necessary when infection is suspected, typically indicated by symptoms like burning, urgency, or foul odor. Darker urine alone in a client on carbidopa/levodopa is not an indication for infection testing.

B. Explain the color change is normal: Carbidopa/levodopa can cause harmless discoloration of bodily fluids, including darker urine, sweat, and saliva due to the metabolism and excretion of the medication. This is a well-known and non-threatening side effect that does not require intervention beyond client reassurance.

C. Measure the client's urinary output: Monitoring urinary output is important in cases of suspected dehydration or renal dysfunction, but simply darker urine without changes in volume or symptoms does not justify additional measurement in this scenario.

D. Encourage an increase in oral intake: While adequate hydration is always encouraged, the urine color change reported here is due to the medication itself, not dehydration. Therefore, increasing fluid intake will not reverse or prevent the discoloration.

A. Contact the healthcare provider (HCP) immediately if suicidal thoughts occur. B. Contact the healthcare provider (HCP) immediately if muscle stiffness occurs. C. Increase activity level to include a daily exercise routine. D. Avoid processed meats, red wine, and Swiss cheese.

Correct Answer is A

Explanation

A. Contact the healthcare provider (HCP) immediately if suicidal thoughts occur: Antidepressants like sertraline can increase the risk of suicidal thoughts, especially during the early stages of treatment. Immediate reporting of such thoughts is critical to ensure the client’s safety and prevent harm.

B. Contact the healthcare provider (HCP) immediately if muscle stiffness occurs: Although rare, muscle stiffness could signal serotonin syndrome if occurs with a constellation of symptoms including confusion, agitation, fever, sweating and tremors, not just stiffness. Suicidal ideation presents a more immediate and life-threatening risk in clients starting antidepressants and requires the highest priority.

C. Increase activity level to include a daily exercise routine: While exercise is beneficial for managing depression, it is supportive therapy and not the most urgent teaching point compared to recognizing and reporting suicidal ideation associated with antidepressant use.

D. Avoid processed meats, red wine, and Swiss cheese: This dietary restriction is necessary when taking monoamine oxidase inhibitors (MAOIs) to prevent hypertensive crises. Sertraline is a selective serotonin reuptake inhibitor (SSRI), so these dietary precautions are not required.

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An adolescent receives a new prescription for isotretinoin for cystic acne. Which information is most important for the nurse to provide?

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Naxlex Comprehensive Predictor Exams

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