A newly admitted client has taken thioridazine (Mellaril) for 2 years, with good symptom control. Symptoms exhibited on admission included paranoia and hallucinations. The nurse should recognize which potential cause for the return of these symptoms?

Correct Answer: C

Rationale: The correct answer is C: The client has not taken the medication as prescribed. Nonadherence to the prescribed medication regimen can lead to the return of symptoms. In this case, the client may not have been taking the medication consistently or at the correct dosage, resulting in the resurgence of paranoia and hallucinations. Incorrect answers: A: The client has developed tolerance to the antipsychotic medication - Tolerance does not typically develop to antipsychotic medications in the same way it does with some other types of medications. B: The client has not taken the medication with food - Taking the medication with food may affect absorption but is unlikely to directly cause the return of symptoms. D: The client has combined alcohol with the medication - While alcohol can interact with antipsychotic medications, it is not the most likely reason for the return of symptoms in this scenario.

Correct Answer: B

Rationale: The correct answer is B: Sedation, tremor, and muscle stiffness. This is because chlorpromazine, a first-generation antipsychotic like Thorazine, commonly causes sedation, tremors, and muscle stiffness as side effects. Sedation is a common side effect of antipsychotic medications, leading to feelings of drowsiness or fatigue. Tremors can manifest as involuntary shaking or trembling of the hands or other body parts. Muscle stiffness, also known as extrapyramidal symptoms, can cause rigidity and difficulty moving smoothly. These side effects are typical with first-generation antipsychotics due to their mechanism of action on the central nervous system. The other choices are incorrect: A: Sweating, nausea, and weight gain are not typically associated with chlorpromazine or first-generation antipsychotics. C: Headache, watery eyes, and runny nose are not common side effects of chlorpromazine. D: Mild fever, sore throat, and

Correct Answer: A

Rationale: The correct answer is A because the patient's lipid profile indicates high LDL and low HDL levels, which increase the risk of cardiovascular disease. By discussing medications, dietary changes, and exercise, the nurse can address these lipid abnormalities effectively. Medications may be needed to lower LDL and raise HDL levels. Dietary changes, such as reducing saturated fats and increasing fiber intake, can help improve the lipid profile. Implementing an exercise regimen can also positively impact lipid levels. Choice B is incorrect because lifestyle changes are necessary to improve the patient's lipid profile. Choice C is incorrect as a high fat intake is not recommended for someone with elevated LDL levels. Choice D is incorrect as keeping a food diary and repeating laboratory work in 6 months may not address the immediate need for intervention to manage the patient's lipid levels.

Correct Answer: D

Rationale: The correct answer is D because a category 5 hurricane approaching can induce stress and anxiety, leading to an increase in blood pressure. This is a natural physiological response known as the "fight or flight" response. Choices A, B, and C are less likely as they do not directly correlate with the physiological response to stress caused by a hurricane. Choice A shows a decrease in pulse rate, which is unlikely during a stressful situation. Choice B indicates a decrease in pupil size, which is not a common response to stress. Choice C, complaints of intestinal cramping, may occur due to anxiety but are not the most likely vital sign change during a hurricane approaching.

Correct Answer: D

Rationale: The correct answer is D. The rationale is as follows: 1. The nurse accurately explains the purpose of the MRI as taking a picture of the brain. 2. The response addresses the patient's concern about pain by stating that the test doesn't hurt. 3. Mentioning the need to lie still covers potential discomfort during the procedure. 4. This response is informative, reassuring, and addresses the patient's questions effectively. Choices A, B, and C are incorrect: A. Incorrect because it inaccurately states the purpose of the MRI and provides false reassurance about pain. B. Incorrect because it wrongly suggests the test is painful and misleadingly focuses on mental illness diagnosis. C. Incorrect because it inaccurately describes the MRI process and its relation to brain activity, leading to confusion and unnecessary worry for the patient.