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Mosbys Pharmacology in Nursing 22nd Edition Hogan Tessier McKenry Test Bank

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Mosbys Pharmacology in Nursing 22nd Edition Hogan Tessier McKenry Test Bank

ISBN: 9780323030083

 

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Mosbys Pharmacology in Nursing 22nd Edition Hogan Tessier McKenry Test Bank

ISBN: 9780323030083

 

 

 

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Free Nursing Test Questions:

McKenry: Mosby’s Pharmacology in Nursing, 22nd Edition

 

Test Bank

 

Chapter 65: Dermatologic Drugs

 

MULTIPLE CHOICE

 

  1. The clinic nurse is working with a client seeking treatment for rosacea. The nurse examines which of the following areas to note the distribution of this skin disorder?
1. Face
2. Neck
3. Arms
4. Trunk

 

ANS:   1

Sometimes the diagnosis of a skin condition can be made from the distribution alone. Rosacea attacks only those areas of the face that flush.

 

DIF:    Cognitive Level: Application             REF:    Text Reference: 1166

TOP:    Nursing Process: Assessment

MSC:   NCLEX: Physiological Integrity: Physiological Adaptation

 

 

  1. The nurse at a health promotion fair explains to visitors that the FDA requirement for calling a product a “sunscreen” is that the product must
1. absorb 65% or more of the radiation in the ultraviolet range of 290 to 400 nm.
2. absorb 75% or more of the radiation in the ultraviolet range of 290 to 400 nm.
3. absorb 85% or more of the radiation in the ultraviolet range of 290 to 400 nm.
4. absorb 95% or more of the radiation in the ultraviolet range of 290 to 400 nm.

 

ANS:   3

A sunscreen that contains ingredients that absorb at least 85% of the radiation in the ultraviolet range of 290 to 400 nm is known as a sunscreen with active ingredients.

 

DIF:    Cognitive Level: Application             REF:    Text Reference: 1178

TOP:    Nursing Process: Implementation

MSC:   NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

 

  1. Which of the following vehicles is most effective in enhancing the penetration of corticosteroid in the skin?
1. Gel
2. Ointment
3. Cream
4. Lotion

 

 

ANS:   2

Ointment bases and propylene glycol both enhance the penetration of the corticosteroid and its vasoconstrictor effects. As a result of their occlusive nature, ointments hydrate the stratum corneum, permitting granular steroid penetration.

 

DIF:    Cognitive Level: Knowledge             REF:    Text Reference: 1181

TOP:    Nursing Process: Analysis

MSC:   NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

 

  1. Which of the following does the nurse assess as an adverse effect associated with topical corticosteroids?
1. Hyperpigmentation
2. Pallor
3. Oiliness
4. Burning sensation

 

ANS:   4

The adverse effects of topical corticosteroids include acneiform eruptions, allergic contact dermatitis, burning sensations, dryness, itching, hypopigmentation, purpura, hirsutism (usually facial), folliculitis, a round and swollen face, alopecia (usually of the scalp), immunosuppression, and overgrowth of bacteria, fungi, and viruses.

 

DIF:    Cognitive Level: Application             REF:    Text Reference: 1182

TOP:    Nursing Process: Evaluation

MSC:   NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

 

  1. The nurse would use which of the following statements about the use of topical steroids in a client teaching session about these products?
1. They are safely used during pregnancy
2. They need coverage with an occlusive dressing to decrease toxicity
3. They possess antiinflammatory and antipruritic effects
4. They produce adrenal stimulation and subsequent hypotension

 

ANS:   3

Topical corticosteroids are generally indicated for the relief of inflammatory and pruritic dermatoses, including those of atopic dermatitis.

 

DIF:    Cognitive Level: Application             REF:    Text Reference: 1181

TOP:    Nursing Process: Implementation

MSC:   NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

 

  1. The nurse explains to a client with psoriasis that which of the following drugs can be used in its treatment?
1. Fluorinated topical corticosteroids
2. Neomycin with glucocorticoids
3. Mineralocorticoids with vitamins A and E
4. Chlorinated oral corticosteroids

 

ANS:   1

Fluorinated topical corticosteroids (e.g., fluocinonide, betamethasone) are used to treat dermatologic disorders such as psoriasis because of their antiinflammatory, antipruritic, and vasoconstrictive actions as well as their ability to decrease cell proliferation.

 

DIF:    Cognitive Level: Application             REF:    Text Reference: 1181

TOP:    Nursing Process: Implementation

MSC:   NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

 

  1. The nurse warns a client that isotretinoin (Accutane) is contraindicated during pregnancy because of the possibility of which of the following?
1. Inducing a long labor
2. Birth defects
3. Renal failure
4. Sodium retention

 

ANS:   2

Because of isotretinoin’s high potential to produce teratogenic effects, it is contraindicated in women who are pregnant and generally avoided in other women of childbearing age unless other modalities are not effective, effective birth control or abstinence is ensured, and informed consent is obtained.

 

DIF:    Cognitive Level: Application             REF:    Text Reference: 1184

TOP:    Nursing Process: Implementation

MSC:   NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

 

  1. In evaluating client response to drug therapy, the nurse considers that the therapeutic efficacy of corticosteroids may be reduced by which of the following?
1. The time of day that the application is completed
2. The vehicle in which the steroid is placed
3. The nutritional status of the client
4. The location on the client’s body where the medication is applied

 

ANS:   2

The vehicle in which the corticosteroid is placed (aerosol, cream, gel, lotion, ointmentRemember,lution, or tape) may alter the vasoconstrictor property and therapeutic efficacy.

 

DIF:    Cognitive Level: Comprehension      REF:    Text Reference: 1181

TOP:    Nursing Process: Evaluation

MSC:   NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

 

  1. While cooking, a client incurred a partial-thickness, or second-degree, burn of the arm and hand. When the client asks how deep the burn is, the nurse would respond that it affects which of the following?
1. The epidermis only
2. The epidermis and dermis
3. The epidermis, dermis, and muscles
4. The epidermis, dermis, and subcutaneous fat

 

ANS:   2

Second-degree, or partial thickness, burns involve the epidermis and extend into the dermis; they may be superficial or involve a deep dermal necrosis.

 

DIF:    Cognitive Level: Application             REF:    Text Reference: 1188

TOP:    Nursing Process: Implementation

MSC:   NCLEX: Physiological Integrity: Physiological Adaptation

 

 

  1. When a client with a partial thickness (second-degree) burn arrives at the emergency department, the first action of the nurse would be to
1. wrap the burn with a dry sterile gauze dressing.
2. administer an immunoglobulin G booster vaccine.
3. apply a zinc oxide ointment.
4. flush the area with cool water.

 

ANS:   4

An important first-aid treatment for any minor or major burn is to cool the wound immediately to remove irritants, decrease inflammation, and constrict blood vessels; this reduces the permeability of the blood vessels and halts the formation of edema. Cool tap water can be used to flush the wound thoroughly and to cool hot clothing.

 

DIF:    Cognitive Level: Analysis                  REF:    Text Reference: 1188

TOP:    Nursing Process: Implementation

MSC:   NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

 

  1. Silver sulfadiazine is recommended for the treatment of burns. Which of the following statements reflects the adequate application of this ointment?
1. If the cream is removed by activity, it does not need to be reapplied.
2. Apply it with a sterile-gloved hand to a thickness of approximately one-sixteenth of an inch.
3. A dressing must be used to protect the area from further contamination.
4. This type of therapy is generally indicated for only 24 hours.

 

ANS:   2

Silver sulfadiazine should be applied with a sterile, gloved hand (because of the break in the skin integrity from the client’s wound or burn) and should be applied to a thickness of approximately one-sixteenth of an inch.

 

DIF:    Cognitive Level: Knowledge             REF:    Text Reference: 1189

TOP:    Nursing Process: Implementation

MSC:   NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

 

  1. The nurse instructs a family that is infested with pediculosis and scabies that treatment will include which of the following?
1. Have family members bathe in a modified Burrow’s solution
2. Throw out all linens and clothing items immediately
3. Isolate the family for at least 1 week
4. Apply Kwell to the skin for 8 to 12 hours, then thoroughly wash it off

 

ANS:   4

Kwell cream or lotion is indicated for clients with pediculosis and scabies and should be applied liberally to cover the skin and hair of the infected area and of surrounding areas as well. The lotion is left on for 12 hours and then thoroughly washed from the skin. The Kwell shampoo is worked into the hair and left on for 4 minutes.

 

DIF:    Cognitive Level: Application             REF:    Text Reference: 1194

TOP:    Nursing Process: Implementation

MSC:   NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

 

  1. The nurse who is evaluating the results of drug therapy is aware that which of the following types of drugs can result in an acneiform-type reaction?
1. Anticoagulants
2. Gold salts
3. Topical corticosteroids
4. Barbiturates

 

ANS:   3

The adverse effects of topical corticosteroids include acneiform eruptions, but these eruptions do not occur with barbiturates, gold salts, or anticoagulants.

 

DIF:    Cognitive Level: Knowledge             REF:    Text Reference: 1182

TOP:    Nursing Process: Analysis

MSC:   NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

 

  1. The clinic nurse is working with a client who has a weeping skin lesion associated with contact dermatitis. The nurse recommends that this client use which of the following types of products for therapeutic effect?
1. Calamine lotion
2. Zinc compound paste
3. Talcum powder
4. Corn starch

 

ANS:   1

Clients with an acute inflammation that is weeping or oozing often need a drying and soothing lotion, such as a saline solution, aluminum acetate solution, or calamine lotion. A lichenified, oozing skin problem (eczema) may need a protective and drying agent, such as coal tar paste, Lassar’s paste, or zinc compound paste. If the skin problem is sore, wet, and located on an elbow or knee, a dusting powder such as talcum or starch may be appropriate to reduce friction and help dry the area.

 

DIF:    Cognitive Level: Application             REF:    Text Reference: 1174

TOP:    Nursing Process: Implementation

MSC:   NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

 

  1. A client with eczema has a lichenified, oozing skin lesion. The nurse would recommend the use of which of the following types of products for therapeutic effect?
1. Calamine lotion
2. Zinc compound paste
3. Talcum powder
4. Corn starch

 

ANS:   2

Clients with an acute inflammation that is weeping or oozing often need a drying and soothing lotion, such as a saline solution, aluminum acetate solution, or calamine lotion. A lichenified, oozing skin problem (eczema) may need a protective and drying agent, such as coal tar paste, Lassar’s paste, or zinc compound paste. If the skin problem is sore, wet, and located on an elbow or knee, a dusting powder such as talcum or starch may be appropriate to reduce friction and help dry the area.

 

DIF:    Cognitive Level: Application             REF:    Text Reference: 1174

TOP:    Nursing Process: Implementation

MSC:   NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

 

  1. The nurse recommends that an elderly client with dry, itchy skin add which of the following to the bath water to increase skin hydration?
1. Bath oil
2. Oatmeal
3. Gelatin
4. Starch

 

ANS:   1

Oils such as Alpha-Keri and oilated oatmeal (in a proportion of 1 oz to a tub of water) decrease the drying effect of water and help relieve the itching of sensitive, xerotic skin. To render baths soothing in irritative conditions, oatmeal, starch, or gelatin may be added—usually 1 to 2 oz per gallon of water.

 

DIF:    Cognitive Level: Application             REF:    Text Reference: 1175

TOP:    Nursing Process: Implementation

MSC:   NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

 

  1. The nurse would make which of the following recommendations to a client regarding the use of sunscreen?
1. Use a sunscreen with an SPF of at least 8 to 15 daily. Apply the sunscreen to exposed areas 5 to 15 minutes before sun exposure.
2. Reapply sunscreen to exposed areas 60 to 90 minutes after beginning exposure to the sun.
3. Reapply every 2 hours or after activity that could result in removal of sunscreen, such as excessive sweating, swimming, or towel drying.
4. Wearing sunscreen or limiting exposure is not necessary on overcast or cloudy days.

 

ANS:   3

Common instructions regarding the use of sunscreens are as follows: Use a sunscreen with an SPF of at least 12 to 30 daily. Apply the sunscreen to exposed areas 15 to 30 minutes before sun exposure. Reapply sunscreen to exposed areas 15 to 30 minutes after beginning exposure to the sun. Reapply every 2 hours or after activity that could result in removal of sunscreen, such as excessive sweating, swimming, or towel drying. Wear sunscreen and limit exposure on overcast or cloudy days.

 

DIF:    Cognitive Level: Application             REF:    Text Reference: 1178

TOP:    Nursing Process: Implementation

MSC:   NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

 

  1. A home health nurse notes that a client has tinea pedis (athlete’s foot). The nurse explains that which of the following over-the-counter treatments is likely to be effective?
1. Mupirocin (Bactroban)
2. Bacitracin (Baciguent)
3. Terbinafine (Lamisil)
4. Docosanol (Abreva)

 

ANS:   3

The most commonly used over-the-counter topical agents include terbinafine and butenafine (Lotrimin Ultra, Mentax). Mupirocin and bacitracin are topical antibacterial agents, whereas docosanol is a topical antiviral agent.

 

DIF:    Cognitive Level: Application             REF:    Text Reference: 1180

TOP:    Nursing Process: Implementation

MSC:   NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

 

  1. An adolescent client has acne vulgaris that has not responded to standard treatment measures. The nurse anticipates that this client will be prescribed which of the following because of treatment failure with other drugs?
1. Tetracycline
2. Erythromycin
3. Clindamycin
4. Isotretinoin

 

ANS:   4

Oral use of isotretinoin (Accutane, AmnesteemRemember,tret) is used for severe nodular acne vulgaris not responsive to other interventions. The other drugs are typical antibiotics used in therapy.

 

DIF:    Cognitive Level: Application             REF:    Text Reference: 1184

TOP:    Nursing Process: Planning

MSC:   NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

 

  1. The nurse would evaluate that a client understands drug therapy with isotretinoin (Accutane) after making which of the following statements?
1. Abstinence or effective birth control is essential during therapy
2. The drug can lead to decreased heart rate and blood pressure
3. Resistance to infection is increased while taking this drug
4. The drug can lower blood glucose and lipid levels

 

ANS:   1

Many spontaneous abortions have been reported in pregnant women as well as premature birth, birth defects, and neonatal death. Abstinence or effective birth control and informed consent are required if used in women of childbearing age. Other adverse effects include tachycardia, flushing, edema, dizziness, seizures, depression, psychosis, agitation, rash, elevated triglycerides, hyperglycemia, bone marrow suppression, osteopenia, and bronchospasm.

 

DIF:    Cognitive Level: Analysis                  REF:    Text Reference: 1185

TOP:    Nursing Process: Evaluation

MSC:   NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

 

  1. The nurse would include in a teaching plan for a client who will start drug therapy with isotretinoin (Accutane) that routine intake of which of the following vitamins should be avoided during drug therapy?
1. A
2. D
3. E
4. K

 

ANS:   1

To minimize additive toxic effects of isotretinoin, alert clients to avoid concurrent use of vitamin A unless prescribed by a physician.

 

DIF:    Cognitive Level: Application             REF:    Text Reference: 1187

TOP:    Nursing Process: Planning

MSC:   NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

 

  1. The nurse interprets that which of the following clients would be a good candidate for topical drug therapy with becaplermin (Regranex)?
1. A client with acne resistant to topical treatments
2. A client with diabetes mellitus who has a nonhealing leg ulcer
3. A client with a partial thickness burn to the arm
4. A client who came in contact with poison ivy

 

ANS:   2

Becaplermin is used as an adjunct to debridement in treatment of lower limb or foot ulcers in clients with diabetes mellitus.

 

DIF:    Cognitive Level: Application             REF:    Text Reference: 1194

TOP:    Nursing Process: Planning

MSC:   NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

 

  1. The nurse assesses the older adult client being treated with lindane (Kwell) for which of the following adverse effects?
1. Blurred vision
2. Stomach pain
3. Irritability
4. Joint aches

 

ANS:   3

Lindane penetrates human skin and has the potential to produce central nervous system toxicity (e.g., seizures, increased irritability, dizziness), especially in children, adults weighing less than 110 pounds, and the elderly.

 

DIF:    Cognitive Level: Application             REF:    Text Reference: 1193

TOP:    Nursing Process: Assessment

MSC:   NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

 

  1. The nurse questions the client taking alefacept (Amevive) about improvement of symptoms of which of the following health problems?
1. Minor burn
2. Psoriasis
3. Eczema
4. Rheumatoid arthritis

 

ANS:   2

Alefacept is a monoclonal antibody that binds to CD2 lymphocytes and results in suppressed immune response and improved symptoms of psoriasis. It also suppresses CD4 and CD7 T-lymphocyte counts and function. Alefacept is used to treat moderately severe psoriasis in adults.

 

DIF:    Cognitive Level: Application             REF:    Text Reference: 1190

TOP:    Nursing Process: Evaluation

MSC:   NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

 

  1. The nurse notes a new drug order for adalimubab (Humira). The nurse conducts a baseline assessment of symptoms of which of the following health problems before administering the first dose?
1. Minor burn
2. Psoriasis
3. Eczema
4. Rheumatoid arthritis

 

ANS:   4

Adalimubab is a monoclonal antibody with affinity for tumor necrosis factor. Adalimubab is indicated for the treatment of moderate to severe active rheumatoid arthritis.

 

DIF:    Cognitive Level: Application             REF:    Text Reference: 1191

TOP:    Nursing Process: Assessment

MSC:   NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

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