A patient begins therapy with a phenothiazine medication. What teaching should the nurse provide related to the drug™s strong dopaminergic effect?

Correct Answer: D

Rationale: Step 1: Phenothiazine medications have a strong dopaminergic effect, which can result in extrapyramidal side effects such as muscle movement changes. Step 2: Teaching the patient to report changes in muscle movement is crucial to monitor for potential side effects. Step 3: Chewing sugarless gum is not directly related to the dopaminergic effect of the drug. Step 4: Increasing dietary fiber is not specifically relevant to the dopaminergic effect of the drug. Step 5: Arising slowly from bed is more related to orthostatic hypotension, a common side effect of phenothiazines, rather than the dopaminergic effect.

Correct Answer: A

Rationale: The correct answer is A. A white blood cell count of 3000 mm3 in a patient taking clozapine is concerning for agranulocytosis, a potentially life-threatening side effect. The nurse should report these results to the health care provider immediately for further evaluation and possible discontinuation of the medication. Administering the next dose (B) can worsen the condition. Giving aspirin and forcing fluids (C) is not indicated for this situation. Repeating the laboratory test (D) may delay necessary intervention.

Correct Answer: D

Rationale: The correct answer is D because encountering a large poisonous snake can trigger a fight-or-flight response, leading to an increase in blood pressure to prepare for potential danger. This response is mediated by the sympathetic nervous system, causing vasoconstriction and increased cardiac output. Choices A and B are less likely as a decrease in pulse or respiratory rate is not typical in this situation. Choice C is less directly related to the physiological response to a threat compared to blood pressure changes.

Correct Answer: B

Rationale: The correct answer is B because the patient describes symptoms associated with chronic sleep deprivation, such as fatigue and gastrointestinal issues. This indicates a disruption in the body's normal functioning due to lack of adequate sleep. Choice A suggests using external stimuli to fall asleep, which may not necessarily indicate chronic sleep deprivation. Choice C shows awareness of the recommended sleep duration, which is not necessarily indicative of chronic sleep deprivation. Choice D suggests experiencing confusion upon waking, which could indicate other sleep disorders but not specifically chronic sleep deprivation.

Correct Answer: C

Rationale: The correct answer is C: sleep latency. Sleep latency refers to the time it takes for an individual to fall asleep after lying down in bed. In this case, the patient mentioning that it takes about 15 minutes to go to sleep each night indicates a delay in the onset of sleep, which aligns with the concept of sleep latency. Delta sleep (A) refers to slow-wave deep sleep stages, parasomnia (B) involves abnormal behaviors during sleep, and REM sleep (D) is the stage of sleep characterized by rapid eye movements and vivid dreams, none of which are directly related to the time taken to fall asleep.