Nursing Elites

1. 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.

2. There are many types of torts that can be committed against clients. They include all of the following except:

• A. assault.
• B. battery.
• C. negligence.
• D. felony.

Correct answer: D

Rationale: The correct answer is 'felony.' Felonies are serious crimes punishable by time in prison and are not considered types of torts. Types of torts include assault, battery, negligence, as well as other examples like slander, invasion of privacy, false imprisonment, and fraud. Assault involves the threat of harm, battery involves physical harm, and negligence involves a failure to exercise reasonable care. These are all civil wrongs (torts) rather than criminal offenses (felonies), making 'felony' the correct choice.

3. The best definition of communication is:

• A. the sending and receiving of messages.
• B. the effect of sending verbal messages.
• C. an ongoing, interactive form of transmitting transactions.
• D. the use of message variables to send information.

Correct answer: C

Rationale: Communication is defined as an ongoing, interactive form of transmitting transactions. It involves a dynamic process of sending (encoding) and receiving (decoding) messages while being influenced by the experiences and perceptions of both the sender and receiver. This process is interactive and occurs within an environment, shaping individuals' self-concept, identity, and relationships. The correct answer captures the complexity and interactive nature of communication. Choice A, 'the sending and receiving of messages,' is too simplistic and does not encompass the interactive nature of communication. Choice B, 'the effect of sending verbal messages,' focuses solely on verbal communication and overlooks non-verbal forms. Choice D, 'the use of message variables to send information,' emphasizes technical aspects rather than the interactive and transactional nature of communication.

4. While admitting a client to an acute-care psychiatric unit, the nurse asks about substance abuse based on:

• A. psychiatric disorders' higher prevalence in addicted populations
• B. individuals with psychiatric disorders' increased susceptibility to substance abuse
• C. the importance of detecting and diagnosing substance disorders in acute-care psychiatric settings
• D. the significant impact of undetected substance problems on the treatment of psychiatric disorders

Correct answer: B

Rationale: The correct answer is 'individuals with psychiatric disorders' increased susceptibility to substance abuse.' It is crucial to inquire about substance abuse during admission to an acute-care psychiatric unit because individuals with psychiatric disorders are more prone to experiencing substance abuse issues. Addressing substance abuse is vital for effective treatment and to prevent relapse in psychiatric disorders. Option A is incorrect as it focuses on the prevalence of psychiatric illness in addicted populations rather than the relationship between psychiatric disorders and substance abuse. Option C is incorrect as it exaggerates the ease of detecting and diagnosing substance disorders in acute-care psychiatric settings. Option D is incorrect as undetected substance problems can indeed significantly impact the treatment of psychiatric disorders, but the main reason for inquiring about substance abuse is the increased susceptibility of individuals with psychiatric disorders to such issues.

5. If the nurse who was not promoted tells another friend, "I knew I'd never get the job. The hospital administrator hates me."? If she actually believes this of the administrator, who, in reality, knows little of her, she is demonstrating:

• A. compensation.
• B. reaction formation.
• C. projection.
• D. denial.

Correct answer: C

Rationale: The nurse is demonstrating projection, attributing her own feelings of dislike onto the hospital administrator. This defense mechanism involves unconsciously adopting blaming behavior. Compensation involves emphasizing a strong point to make up for a perceived weakness, which is not the case here. Reaction formation is adopting behavior opposite to actual feelings, and denial involves ignoring an unpleasant reality, none of which are demonstrated in this scenario.

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