Question 1

A patient is considering taking oral aloe supplements and asks the nurse about potential problems with this therapy. Which statement by the nurse is correct?

Accepted Answer

The dried juice of the leaves of the aloe plant contains anthranoids, which give aloe a laxative effect when taken orally. The topical application of the plant juice has been known for years to help the healing of wounds. Common adverse effects include diarrhea, nephritis, abdominal pain, and dermatitis when used topically. Potential drug interactions include digoxin, antidysrhythmics, diuretics, and corticosteroids.

Question 2

The nurse is reviewing laboratory results for a patient and notes that the patient has positive results for nasal colonization by methicillin-resistant Staphylococcus aureus (MRSA). The nurse anticipates an order for which medication?

Accepted Answer

Mupirocin (Bactroban) is used on the skin for treatment of staphylococcal and streptococcal impetigo. It is used topically and intranasally to treat nasal colonization by MRSA; however, it MRSA is becoming increasingly resistant to the drug. The other options are incorrect. Acyclovir (an antiviral drug) and clindamycin are not indicated for the treatment of MRSA; clotrimazole is an antifungal drug.

Question 3

The preoperative nurse is ready to perform a skin prep with povidone-iodine (Betadine) on a patient who is about to have abdominal surgery. Which allergies, if present, would be a contraindication to the Betadine prep?

Accepted Answer

Povidone-iodine, a widely used antiseptic, cannot be used in patients who are allergic to iodine or have shellfish allergies.

Question 4

A woman suffered a second-degree burn of the skin on her arm and hand while cooking breakfast. After examination in the urgent care center, silver sulfadiazine cream (Silvadene) is ordered for the burned area. The nurse will apply the medication using which procedure?

Accepted Answer

Apply a thin layer of medication with a sterile, gloved hand to clean and débrided wounds. The other options are incorrect.

Question 5

A female patient will be starting therapy with oral isotretinoin (Amnesteem) as part of treatment for severe acne, and the nurse is providing teaching. Which teaching point will the nurse include in her teaching plan about isotretinoin?

Accepted Answer

It is now required that at least two contraceptive methods be used by sexually active women during and for 1 month after completion of therapy with isotretinoin. The other statements are incorrect.

Question 6

A teenage boy is taking tretinoin (Retin-A) for acne. Which statement will the nurse include in the teaching plan?

Accepted Answer

Tretinoin may cause increased redness and drying, and the patient needs to avoid weather extremes, ultraviolet light, and abrasive cleansers. Certain foods do not need to be avoided.

Question 7

A patient has a prescription for topically applied 5% fluorouracil (Efudex) cream as part of treatment for basal cell carcinoma on her cheek. Which instructions will the nurse provide to the patient?

Accepted Answer

Fluorouracil may be applied with gloves or clean fingertips, but if fingertips are used, the medication must be washed off thoroughly after application. The medication may cause photosensitivity, as well as local swelling, scaling, burning, and tenderness. The medication is applied twice daily.

Question 8

A female patient has been taking isotretinoin (Amnesteem) for 3 months. During a follow-up appointment, which statement by the patient would be of highest concern to the nurse?

Accepted Answer

There have been case reports of suicide and suicide attempts in patients receiving isotretinoin. Instruct patients to report immediately to their prescribers any signs of depression. Follow-up treatment may be needed, and simply stopping the drug may be insufficient.

Question 9

A child is being treated for head lice with spinosad (Natroba). Which of these statements about treatment with spinosad is true?

Accepted Answer

The clothing and personal articles of the infested person must be decontaminated. This is best accomplished by washing them in hot, soapy water or by dry cleaning them. Spinosad offers the benefit of not requiring nit combing as do the other treatments, and is a single treatment drug. It is not necessary to comb the hair with mineral oil.

Question 10

Which adverse effects will the nurse expect in a teenage patient who is using topical tretinoin (Retin-A)?

Accepted Answer

Some of the most common adverse effects of tretinoin are excessively red and edematous blisters, crusted skin, and temporary alterations in skin pigmentation. Itching and rosacea are not potential adverse effects.

Question 11

A patient is admitted to the hospital for possible septicemia. He has a large pressure ulcer on his heel that is open and includes necrotic tissue. However, his prothrombin time/international normalized ratio (PT/INR) values are too high to permit surgical débridement at this time. The nurse expects that which wound-care product will be used to treat the wound?

Accepted Answer

Because this patient has an elevated PT/INR, he cannot receive surgical débridement because of concerns about excessive bleeding. Collagenase is useful for patients taking anticoagulants and for those in whom surgery is contraindicated; it selectively removes necrotic tissue but does not harm normal tissue. Cadexomer iodine is not appropriate for a wound with necrotic tissue. Betadine is used as a skin cleanser; biafine is indicated for radiation dermatitis.

Question 12

A child has been diagnosed with impetigo, a skin infection. The nurse anticipates that which drug will be used to treat this condition?

Accepted Answer

Mupirocin (Bactroban) is used on the skin for treatment of staphylococcal and streptococcal impetigo. Spinosad (Natroba) is used for pediculosis; nystatin is an antifungal drug; and acyclovir is an antiviral drug.

Question 13

A patient asks about using minoxidil (Rogaine) for hair thinning. Which statement about minoxidil is accurate?

Accepted Answer

Results of minoxidil therapy may not be seen for 4 months after beginning therapy. The product is applied twice daily, morning and evening, and systemic effects may result because of absorption.

Question 14

The nurse is reviewing the medical record of a patient who is to receive wound care with topical silver sulfadiazine (Silvadene). Which finding, if noted, would be a potential contraindication?

Accepted Answer

Patients with allergies to sulfonamide drugs must not receive silver sulfadiazine. The other options are incorrect.

Question 15

A 55-year-old obese patient was diagnosed with candidiasis in the skin folds under her breasts. When the nurse sees her at a follow-up visit 2 months later, she complains that it has returned. She said she applied the medicine for 1 week and stopped because the itching stopped and the cream was messy. Which statement is true regarding fungal infections of the skin?

Accepted Answer

Topical fungal infections are difficult to treat and may require prolonged therapy of several weeks to as long as 1 year. Occlusive dressings should not be applied unless recommended by the medication's manufacturer.

Quiz 56: Dermatologic Drugs

A patient is considering taking oral aloe supplements and asks the nurse about potential problems with this therapy. Which statement by the nurse is correct?

The nurse is reviewing laboratory results for a patient and notes that the patient has positive results for nasal colonization by methicillin-resistant Staphylococcus aureus (MRSA) . The nurse anticipates an order for which medication?