Nursing Elites

1. When discussing the patterns of use of alcohol and other drugs, which piece of information should the nurse include?

• A. Lifetime prevalence and intensity of alcohol use are greater in men than in women.
• B. Caucasians report higher levels of alcohol use than African Americans or Hispanics.
• C. Overuse of alcohol and other drugs increases into the mid-20s, then levels off and decreases with age.
• D. Heavy use is more common in lower socioeconomic groups due to affordability.

Correct answer: C

Rationale: The correct answer is that overuse of alcohol and other drugs increases into the mid-20s, then levels off and decreases with age. Recent research indicates that alcohol and illicit drug use tends to rise into the mid-20s and then decline with age. Choices A and B are incorrect because lifetime prevalence and intensity of alcohol use are greater in men than in women, and Caucasians do not report higher levels of alcohol use compared to African Americans or Hispanics. Choice D is incorrect because heavy use is more common in lower socioeconomic groups due to factors like stress, coping mechanisms, and availability, not just affordability.

2. A contraindication for topical corticosteroid use in a client with atopic dermatitis (eczema) is:

• A. parasitic infection
• B. fungal infection
• C. spirochetal infection
• D. viral infection

Correct answer: D

Rationale: Topical corticosteroids are mainly used for their localized effects. When treating atopic dermatitis with a steroidal preparation, there is a risk of the site being vulnerable to invasion by organisms. Viruses like herpes simplex or varicella zoster pose a threat of disseminated infection. Therefore, viral infection is a contraindication for topical corticosteroid use in clients with atopic dermatitis. It is crucial to educate clients using topical corticosteroids to avoid crowds or people with infections and to promptly report any signs of infection. Choices A, B, and C (parasitic, fungal, and spirochetal infections) are not typically contraindications for topical corticosteroid use in the context of atopic dermatitis, as these agents do not pose the same risk of disseminated infection or systemic effects as viral infections.

3. The nurse is participating in discharge teaching for the postpartal client. The nurse is aware that an effective means of managing discomfort associated with an episiotomy after discharge is:

• A. Promethazine
• B. Aspirin
• C. Sitz baths
• D. Ice packs

Correct answer: C

Rationale: A sitz bath is an effective method for managing discomfort associated with an episiotomy after discharge. It helps reduce swelling and promotes healing in the perineal area. Ice packs (option D) are typically used immediately after delivery to provide pain relief. Promethazine (option A) and aspirin (option B) are not indicated for managing discomfort associated with an episiotomy. Promethazine is an antihistamine, and aspirin is a nonsteroidal anti-inflammatory drug, both of which are not commonly used for this purpose.

4. A client receiving preoperative instructions asks questions repeatedly about when to stop eating the night before the procedure. The nurse tries to refocus the client. The nurse notes that the client is frequently startled by noises in the hall. Assessment reveals rapid speech, trembling hands, tachypnea, tachycardia, and elevated blood pressure. The client admits to feeling nervous and having trouble sleeping. Based on the assessment, the nurse documents that the client has:

• A. mild anxiety.
• B. moderate anxiety.
• C. severe anxiety.
• D. a panic attack.

Correct answer: C

Rationale: The correct answer is 'severe anxiety.' In severe anxiety, a person focuses on small or scattered details and is unable to solve problems. The client's symptoms of rapid speech, trembling hands, tachypnea, tachycardia, elevated blood pressure, feeling nervous, and having trouble sleeping indicate severe anxiety. Mild anxiety enhances the ability to learn and solve problems, while moderate anxiety narrows the perceptual field but allows the client to notice things brought to their attention. During a panic attack, a person is disorganized, hyperactive, or unable to speak or act, which is not the case in this scenario.

5. After experiencing a traumatic event like losing a child due to poisoning, a client tells the nurse, 'I don’t want to make any new friends right now.' This is an example of which of the following indicators of stress?

• A. emotional indicator
• B. spiritual indicator
• C. sociocultural indicator
• D. intellectual indicator

Correct answer: C

Rationale: The correct answer is C: sociocultural indicator. In this situation, the client's reluctance to make new friends after experiencing a traumatic event like losing a child due to poisoning reflects a change in their social behavior, which is influenced by sociocultural factors. This response indicates how stress can impact a person's relationships and social interactions. Choice A, emotional indicator, is incorrect because the client's statement is more related to social interactions than emotional expression. Choice B, spiritual indicator, is incorrect as the given scenario does not directly involve spiritual beliefs or practices. Choice D, intellectual indicator, is also incorrect as the client's statement does not reflect cognitive or intellectual changes but rather social aspects affected by the stressful event.

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