Nokea
In Massachusetts, which year contained the highest level of days exceeding the 8-hour average ground-level ozone standard?
- A. 1983
- B. 1984
- C. 2007
- D. 1999
Correct Answer: A
Rationale: 1983 likely had higher ozone exceedances due to less stringent regulations and higher industrial emissions at that time.
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A client who received chlorpromazine (Thorazine) for 15 years to treat schizophrenia developed tardive dyskinesia as evidenced by tongue thrusting and chewing motions. The physician discontinued the chlorpromazine and prescribed Seroquel (quetiapine). As a result of this change, the nurse should carefully monitor for:
- A. Development of pseudoparkinsonism
- B. Development of dystonic reactions
- C. Improvement in tardive dyskinesia
- D. Worsening of anticholinergic symptoms
Correct Answer: C
Rationale: The correct answer is C: Improvement in tardive dyskinesia. Tardive dyskinesia is a side effect of long-term antipsychotic use, such as chlorpromazine. Quetiapine (Seroquel) is a second-generation antipsychotic with a lower risk of causing tardive dyskinesia. By discontinuing chlorpromazine and switching to quetiapine, the client is less likely to experience worsening of tardive dyskinesia symptoms. Monitoring for improvement in tardive dyskinesia is essential in this situation.
Choices A, B, and D are incorrect:
A: Development of pseudoparkinsonism is less likely with quetiapine compared to first-generation antipsychotics like chlorpromazine.
B: Dystonic reactions are acute side effects and are not typically associated with switching to quetiapine.
D: Anticholinergic symptoms are not directly related to tardive dyskinesia
The management of nausea as a side effect of lithium carbonate (Eskalith) includes instructing the patient to take the medication:
- A. after meals
- B. between meals
- C. with a carbonated beverage
- D. with a large glass of water
Correct Answer: A
Rationale: Taking lithium after meals reduces gastrointestinal irritation, including nausea, by buffering its absorption.
What is an appropriate goal for a nurse when working with a patient who has anorexia nervosa?
- A. The patient will achieve rapid weight gain and improve self-esteem.
- B. The patient will restore nutritional balance through safe weight gain.
- C. The patient will accept their body image without therapeutic intervention.
- D. The patient will maintain a healthy weight without any professional assistance.
Correct Answer: B
Rationale: The correct answer is B because restoring nutritional balance through safe weight gain is a realistic and appropriate goal for a nurse working with a patient with anorexia nervosa. This goal focuses on the patient's physical health and addresses the underlying issue of malnutrition. Rapid weight gain (A) may be dangerous and unsustainable. Accepting body image without intervention (C) ignores the severity of the disorder. Maintaining a healthy weight without professional assistance (D) is unlikely for someone with anorexia nervosa who requires specialized care.
The dopamine-psychosis link is based on the observation that
- A. low dopamine levels of activity in the brain seem to produce psychotic symptoms
- B. there are high levels of dopamine activity in the brains of psychotic people
- C. there are high levels of amphetamine in the brains of schizophrenics
- D. dopamine interacts with serotonin creating psychosis
Correct Answer: B
Rationale: Elevated dopamine activity is associated with psychotic symptoms, especially in schizophrenia.
An adult diagnosed with a serious mental illness says, I do not need help with money management. I have excellent ideas about investments. This patient usually does not have money to buy groceries by the middle of the month. The nurse assesses the patient as demonstrating:
- A. rationalization.
- B. identification.
- C. anosognosia.
- D. projection.
Correct Answer: C
Rationale: The patient shows anosognosia (C), an inability to recognize deficits due to illness, believing in their financial acumen despite evidence. This isn't rationalization (A), identification (B), or projection (D).