An outpatient seen in the clinic for follow-up after being diagnosed with contact dermatitis caused by poison ivy has been taking prednisone (Deltasone) 30 mg daily. You evaluate the client for adverse medication effects. Which information is of most concern?

Correct Answer: C

Rationale: In this scenario, option C, "The client complains of epigastric pain," is the most concerning information. Prednisone, a corticosteroid, can cause gastrointestinal side effects such as peptic ulcers, gastritis, and pancreatitis, which may present as epigastric pain. This symptom could indicate a serious adverse effect of the medication that requires immediate attention to prevent complications. Option A, "The client's blood glucose is 136 mg/dL," is less concerning because a blood glucose level of 136 mg/dL is within the normal range and is not typically associated with prednisone use at that dose. Option B, "The client states, 'I am eating all the time,'" may be a side effect of prednisone, known as increased appetite or weight gain, but it is a common and expected side effect rather than a sign of a serious adverse effect. Option D, "The client's blood pressure is 148/84," while elevated, is not directly related to the adverse effects of prednisone and is also not as immediately concerning as the symptom of epigastric pain, which could indicate a potentially serious complication. Educationally, understanding the potential adverse effects of medications is crucial for nurses to provide safe and effective care to their patients. Recognizing and prioritizing concerning symptoms can help prevent further complications and ensure timely intervention. It is essential for healthcare providers to monitor patients closely for adverse effects of medications and promptly address any concerning symptoms to optimize patient outcomes.

Correct Answer: A

Rationale: Educational Rationale: The correct answer is A) A thorough washing of the hands. Benzoyl peroxide, commonly used in acne preparations, is a bleaching agent that can cause fabric discoloration upon contact. Instructing the client to thoroughly wash their hands after applying the medication is essential to prevent the transfer of benzoyl peroxide to clothing or other fabrics, thereby reducing the risk of discoloration. Option B) A thorough bath after the medication is incorrect because the primary concern is preventing the transfer of benzoyl peroxide to fabrics, which can be effectively addressed by washing the hands only. Option C) Wear disposable clothes is not necessary if the client follows proper hand hygiene practices as instructed in Option A. Option D) Wear disposable plastic gloves is excessive for the application of acne preparations containing benzoyl peroxide. It is more practical and sufficient for the client to wash their hands thoroughly after application. Educational Context: Understanding the side effects and proper handling of medications is crucial for both healthcare providers and patients. In the case of benzoyl peroxide, awareness of its bleaching properties and the necessary precautions can prevent unintended fabric discoloration. This question highlights the importance of patient education regarding the safe use of topical medications and the simple yet effective measures that can be taken to mitigate potential issues.

Correct Answer: B

Rationale: The correct answer is B) Apply sunscreen with a high SPF when outdoors. This instruction is important because UV radiation can cause hyperpigmentation of the newly healed skin, leading to increased scarring. Sunscreen helps protect the delicate new skin from harmful UV rays, which is crucial for optimal healing and scar prevention. Option A) Wear thick clothes is incorrect because while clothing can offer some protection from the sun, it is not as effective as sunscreen in providing broad-spectrum protection. Also, thick clothing may not be comfortable or practical for the client. Option C) Avoid use of topical gels is incorrect because certain topical gels, especially those prescribed by healthcare providers, can aid in wound healing and scar prevention. Avoiding them completely may hinder the healing process. Option D) Avoid cold water baths is incorrect because cold water can actually help soothe the skin and reduce inflammation following skin grafting. However, prolonged exposure to cold water or extreme temperatures should be avoided. In an educational context, understanding the importance of proper post-burn care is essential for nurses and healthcare providers. Providing accurate instructions to clients post-skin grafting can significantly impact their healing outcomes and overall well-being. It is vital to educate clients on best practices to minimize scarring and promote optimal healing after such procedures.

Correct Answer: B

Rationale: The correct answer to the question is B) Basal cell carcinoma. Basal cell carcinoma is the most common type of skin cancer and is characterized by pearly borders. Understanding this distinction is crucial for early detection and effective treatment. Actinic keratosis (Option A) is a precancerous skin condition that can progress to squamous cell carcinoma but does not typically have pearly borders. Malignant melanoma (Option C) is another type of skin cancer that is known for its irregular borders and dark coloration, not pearly borders. Squamous cell carcinoma (Option D) often presents as a scaly or crusty bump and does not typically have pearly borders like basal cell carcinoma. Educationally, knowing the characteristics of different types of skin cancer is important for healthcare professionals, especially those in dermatology or primary care settings. Recognizing the distinct features of each type can aid in accurate diagnosis, appropriate management, and patient education regarding skin cancer prevention and early detection strategies.

Correct Answer: A

Rationale: Rationale: The correct answer is A) Scabies. Scabies is a skin condition caused by an infestation of the human itch mite. This mite burrows into the skin to lay eggs, triggering an allergic reaction that leads to intense itching and a pimple-like rash. It is highly contagious and usually spreads through close physical contact. Option B) Impetigo is a bacterial skin infection, often characterized by honey-colored crusts on the skin. It is not caused by mites or related to an allergic reaction to mite eggs. Option C) Folliculitis is an inflammation of the hair follicles, usually caused by bacterial or fungal infections. It presents as red, swollen bumps or pustules around hair follicles. It is not associated with mite eggs. Option D) Pediculosis refers to an infestation of lice, not mites. Lice are parasitic insects that infest the hair and scalp, leading to intense itching. It does not involve mite eggs or an allergic reaction to them. Educational Context: Understanding skin conditions like scabies is crucial for healthcare professionals, especially those working in dermatology or primary care settings. Recognizing the symptoms of scabies, such as intense itching and a rash in characteristic locations like between fingers and on wrists, helps in accurate diagnosis and timely treatment. Educating patients about scabies transmission and prevention is also important to control outbreaks and prevent reinfection. Knowledge of various skin conditions and their distinguishing features is vital for healthcare providers to provide effective care and support to patients with dermatological issues.