A 22-year-old female client who has been taking isotretinoin (Accutane) to treat severe cystic acne makes all the following statements while being seen for a routine physical examination. Which statement is of most concern?

Correct Answer: A

Rationale: The correct answer is A) "My husband and I are thinking of starting a family soon." This statement is of most concern because isotretinoin (Accutane) is known to cause severe birth defects if taken during pregnancy. It is crucial for women taking this medication to use effective birth control methods and not become pregnant while on Accutane due to its teratogenic effects. Option B) "Sometimes I get nauseated after taking the medication." is a common side effect of isotretinoin and does not pose the same level of concern as the risk of birth defects. Option C) "I have been having problems driving when it gets dark." is not directly related to the use of isotretinoin and does not indicate immediate danger or concern. Option D) "I don’t think there has been much improvement in my skin." is a subjective statement regarding the effectiveness of the medication and does not pose a significant risk to the patient's health or safety. In an educational context, it is important for healthcare providers to educate patients on the potential risks and side effects of medications, especially those with teratogenic properties like isotretinoin. Ensuring patient understanding of the importance of birth control while on this medication is crucial to prevent adverse outcomes.

Correct Answer: B

Rationale: The correct answer is B) Liver or kidney disease. Yellow skin color, also known as jaundice, is often indicative of liver or kidney dysfunction. When these organs are not functioning properly, bilirubin, a yellow pigment, accumulates in the bloodstream and causes the skin to appear yellow. This is a key sign for healthcare providers to recognize as it may indicate serious underlying conditions that require further investigation and treatment. Option A) Anemia does not typically cause yellow skin color. Anemia is characterized by a decrease in red blood cells or hemoglobin, leading to symptoms like fatigue and pallor, but not yellow skin. Option C) Low tissue oxygenation would manifest as cyanosis, a bluish discoloration of the skin due to inadequate oxygen levels in the blood, not yellow skin color. Option D) Trauma to soft tissue would result in bruising or inflammation at the site of injury, not generalized yellow skin color. Understanding the significance of skin color changes is crucial for healthcare professionals in assessing and managing patients' conditions. Recognizing jaundice can prompt further investigations to identify the root cause and initiate appropriate interventions, highlighting the importance of thorough assessment skills in healthcare practice.

Correct Answer: D

Rationale: The correct answer is D) The procedure does not require sutures. Rationale: The correct statement indicates that the procedure for treating the ingrown toenail does not require sutures. This is accurate because typically, for an ingrown toenail removal, the physician would trim or remove the ingrown part of the nail and would not need to suture the area. The wound is usually left open to heal naturally. Explanation of other options: A) The client should fast overnight as the operation will be performed under general anesthesia. This statement is incorrect because ingrown toenail removal is usually performed under local anesthesia, not general anesthesia, so fasting overnight is not necessary. B) There won't be much bleeding as the physician will tie up the open vessels. This statement is incorrect because ingrown toenail removal typically does not involve significant bleeding or the need to tie up vessels as it is a minor procedure. C) The client will be able to drive to work directly from the center. This statement is incorrect because after the procedure, the client may experience some discomfort or pain and it is recommended to rest and avoid strenuous activities, including driving, immediately after the procedure. Educational context: Understanding the correct information regarding the procedure for ingrown toenail removal is crucial for both healthcare providers and patients. Providing accurate information helps in managing patient expectations, ensuring proper post-operative care, and preventing complications. It is essential for nurses to educate patients about the procedure, post-operative care instructions, and expected outcomes to promote successful recovery.

Correct Answer: B

Rationale: The correct answer is B) 14 to 21 days. When a client sustains a superficial partial-thickness burn, the outer layer of the skin (epidermis) and a portion of the underlying layer (dermis) are damaged. This type of burn typically heals within 2 to 3 weeks, which corresponds to the timeframe of 14 to 21 days. During this period, the skin undergoes the process of re-epithelialization, where new skin cells regenerate to cover the wound. Option A) 7 to 10 days is incorrect because this timeframe is too short for the healing of a superficial partial-thickness burn, as it requires more time for proper re-epithelialization to occur. Option C) 21 to 28 days is incorrect because this timeframe is more indicative of a deep partial-thickness burn or a burn that extends further into the dermis, which would take longer to heal compared to a superficial partial-thickness burn. Option D) 28 to 35 days is incorrect as this timeframe is more characteristic of a deep partial or full-thickness burn, which involve damage to deeper layers of the skin and would require a longer healing period than a superficial partial-thickness burn. In an educational context, understanding the expected healing time for different types of burns is crucial for healthcare professionals to provide accurate information to clients, manage expectations, and plan appropriate wound care interventions. This knowledge ensures that clients receive the necessary support and education throughout the healing process, promoting optimal outcomes and patient satisfaction.

Correct Answer: B

Rationale: In the case of A.G. needing to discontinue her eyedrops once her intraocular pressures are within the normal range, option B) "No, because glaucoma requires lifelong management" is the correct answer. Glaucoma is a chronic condition that requires ongoing treatment to prevent vision loss. Even if intraocular pressures are controlled, stopping treatment can lead to a rapid increase in pressure and subsequent damage to the optic nerve. Option A is incorrect because stability in intraocular pressures does not signify that the condition is cured or that treatment can be stopped. Option C is incorrect as vision improvement alone does not indicate that the underlying condition has been resolved. Option D is incorrect because decisions regarding medication discontinuation should be made in consultation with a healthcare provider. Educationally, this question highlights the importance of understanding the chronic nature of glaucoma and the necessity of lifelong management to prevent irreversible vision impairment. It emphasizes the need for patients to adhere to their treatment regimen and consult with healthcare professionals before making any decisions regarding their care.