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.
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Statins, such as atorvastatin: Statins primarily lower cholesterol and have no significant interaction with sildenafil that would cause an urgent safety concern. Although monitoring for muscle-related side effects is important with statins, it is not the priority here.
B. Analgesics, such as acetaminophen: Acetaminophen is generally safe and does not interact dangerously with sildenafil. There is no immediate concern related to combining these two medications.
C. Anticoagulants, such as warfarin: There is a potential for increased bleeding risk when sildenafil is combined with anticoagulants, but this is generally not an acute, life-threatening interaction requiring immediate determination before other more critical concerns.
D. Nitrates, such as nitroglycerin: Taking sildenafil with nitrates can cause profound, life-threatening hypotension. Both sildenafil and nitrates can cause vasodilation, and their combined use can lead to a dangerous and potentially fatal drop in blood pressure. This combination is absolutely contraindicated, and the nurse must immediately assess whether the client uses any nitrate medication to prevent a serious adverse event.
Correct Answer is D
Explanation
A. Headache: Although headache can occur as a mild side effect of azithromycin, it is not typically serious or life-threatening. It does not require immediate reporting unless it is severe or associated with other concerning symptoms.
B. Urinary frequency: Urinary symptoms like frequency are not common adverse effects of azithromycin. If present, they are more likely related to the underlying infection rather than the medication itself.
C. Flatulence and nausea: Gastrointestinal symptoms such as nausea and flatulence are common and expected with azithromycin. They are usually mild and do not require the client to contact the healthcare provider unless they become severe or persistent.
D. Yellow sclera: Yellowing of the sclera is a sign of jaundice, which could indicate liver dysfunction. Azithromycin can rarely cause hepatotoxicity, making this symptom important to report immediately to the healthcare provider for evaluation.
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