Nokea
A nurse is assessing a client who has schizophrenia and has been on long-term treatment with chlorpromazine. He notes the client is experiencing some involuntary movements of the tongue and face. The nurse should suspect the client has developed which of the following adverse effects?
- A. Akathisia
- B. Tardive dyskinesia
- C. Dystonia
Correct Answer: B
Rationale: The correct answer is B: Tardive dyskinesia. Tardive dyskinesia is a common adverse effect of long-term antipsychotic medication use, such as chlorpromazine. It is characterized by involuntary movements of the tongue and face. This condition is often irreversible and can be distressing for the client. Akathisia (choice A) is a different extrapyramidal side effect characterized by restlessness and the urge to move constantly. Dystonia (choice C) is another extrapyramidal side effect that presents as sustained muscle contractions causing abnormal postures. In this case, the symptoms described in the question are more indicative of tardive dyskinesia due to the specific type of involuntary movements observed in the client.
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A nurse is assessing a client who has hypothyroidism. Which of the following findings should the nurse expect?
- A. Exophthalmos
- B. Photophobia
- C. Lethargy
- D. Weight loss
Correct Answer: C
Rationale: Rationale: Hypothyroidism is characterized by decreased thyroid hormone levels, leading to symptoms such as lethargy due to slowed metabolism. Exophthalmos (bulging eyes) is associated with hyperthyroidism. Photophobia (sensitivity to light) is not a common symptom of hypothyroidism. Weight loss is more indicative of hyperthyroidism due to increased metabolism. Therefore, the correct answer is C: Lethargy, as it aligns with the expected findings in hypothyroidism.
A nurse is caring for a client who is participating in a research study for an experimental chemotherapy medication. After three treatments, the experimental medication is discontinued due to evidence of rapidly advancing kidney failure. The nurse should understand discontinuing this medication demonstrates which of the following ethical principles?
- A. Veracity
- B. Fidelity
- C. Nonmaleficence
- D. Autonomy
Correct Answer: C
Rationale: The correct answer is C: Nonmaleficence. This principle of ethics requires healthcare providers to do no harm to their patients. In this scenario, discontinuing the experimental chemotherapy medication after evidence of rapidly advancing kidney failure demonstrates the nurse's commitment to preventing further harm to the client. By stopping the medication that is causing harm, the nurse is upholding the principle of nonmaleficence.
Other choices are incorrect:
A: Veracity - Veracity pertains to truthfulness and honesty in communication with patients. Discontinuing the medication is not related to truthfulness.
B: Fidelity - Fidelity refers to the obligation to fulfill commitments and promises made to patients. Discontinuing the medication is not about fulfilling commitments.
D: Autonomy - Autonomy is the right of patients to make their own decisions about their healthcare. Discontinuing the medication is not about respecting the patient's autonomy in this context.
A nurse is assessing a client who is receiving metoprolol. Which of the following indicates a therapeutic effect?
- A. Decreased blood pressure.
- B. Decreased dysrhythmias.
- C. Increased urine output.
- D. Decreased pulse.
Correct Answer: A
Rationale: The correct answer is A: Decreased blood pressure. Metoprolol is a beta-blocker that works by reducing heart rate and decreasing the workload on the heart, leading to a decrease in blood pressure. This is a therapeutic effect as it helps manage conditions like hypertension and angina.
Incorrect choices:
B: Decreased dysrhythmias - While metoprolol can help reduce dysrhythmias, the primary therapeutic effect is on blood pressure.
C: Increased urine output - Metoprolol does not directly affect urine output.
D: Decreased pulse - Decreasing pulse is a common side effect of metoprolol, but the therapeutic effect is primarily on blood pressure.
A nurse is preparing a presentation at a senior center about age-related musculoskeletal changes. Which of the following changes should the nurse plan to include?
- A. Reduced chest width
- B. Increased force of isometric contraction
- C. Decreased muscle mass
- D. Thickened vertebral discs
Correct Answer: C
Rationale: The correct answer is C: Decreased muscle mass. As people age, there is a natural decline in muscle mass known as sarcopenia. This can lead to reduced strength and mobility. Choice A, reduced chest width, is not a typical age-related musculoskeletal change. Choice B, increased force of isometric contraction, is not a typical change and may lead to muscle fatigue. Choice D, thickened vertebral discs, is not a common age-related change and may actually lead to disc degeneration. By including decreased muscle mass in the presentation, the nurse can educate the seniors about a common musculoskeletal change that may impact their daily activities.
A nurse is caring for a child who is admitted with suspected acute appendicitis. Which of the following manifestations should indicate to the nurse that the child’s appendix is perforated?
- A. Sudden decrease in abdominal pain.
- B. Absence of Rovsing’s sign.
- C. Low-grade fever.
- D. Rigid abdomen.
Correct Answer: A
Rationale: The correct answer is A: Sudden decrease in abdominal pain. A sudden decrease in abdominal pain can indicate a perforated appendix due to the release of pressure and inflammation. This sudden relief occurs when the appendix ruptures, causing the abdominal pain to subside temporarily. This is a critical sign that the appendix has perforated and requires immediate medical attention. The other choices are incorrect because: B: Absence of Rovsing’s sign is not specific to a perforated appendix. C: Low-grade fever is commonly seen in uncomplicated appendicitis and may not necessarily indicate perforation. D: A rigid abdomen is a sign of peritonitis, which can occur with a perforated appendix, but it is not as specific as the sudden decrease in pain.