A patient is prescribed an antipsychotic medication for the management of schizophrenia. Which adverse effect should the nurse monitor closely in the patient?

Correct Answer: C

Rationale: Antipsychotic medications, especially first-generation antipsychotics, can cause extrapyramidal symptoms (EPS) as an adverse effect. EPS include symptoms such as muscle rigidity, tremors, akathisia (restlessness), and tardive dyskinesia (involuntary movements of the face and body). These symptoms are due to the medications' effects on the dopamine system in the brain. It is crucial for the nurse to monitor the patient closely for EPS because they can be uncomfortable, distressing, and may impact the patient's quality of life and medication adherence. Early recognition and management of EPS are essential to prevent further complications and improve the patient's overall well-being.

Correct Answer: D

Rationale: Confirming the patient's informed consent before the procedure is the most crucial action for the nurse to prioritize to ensure procedural safety during a thoracentesis. Informed consent is a legal and ethical requirement that ensures the patient understands the purpose of the procedure, its potential risks, benefits, and alternatives. By confirming informed consent, the nurse ensures that the patient has the necessary information and has willingly agreed to undergo the procedure. This process promotes patient autonomy, prevents misunderstandings, and reduces the likelihood of legal issues related to the procedure. Additionally, verifying informed consent helps establish a foundation of trust between the healthcare team and the patient. While other actions like positioning the patient correctly and ensuring pre-procedure antibiotics may also contribute to the safety of the procedure, obtaining informed consent is the foundational step that must be prioritized.

Correct Answer: C

Rationale: To create personal time as a nurse with rotating shifts, it is important to prioritize personal well-being and make time for oneself. By eliminating tasks that add no value, nurses can streamline their workload and focus on essential responsibilities. This can help in reducing unnecessary stress and allowing for more personal time outside of work. Delegating work to others and filling every moment with tasks or chores may not necessarily create personal time, as it can keep nurses constantly busy and overwhelmed. Hiring someone else to do the work may not always be feasible or practical in a nursing setting, but by eliminating non-essential tasks, nurses can better manage their time and have more opportunities for personal activities and self-care.

Correct Answer: A

Rationale: The patient's symptoms of chest pain occurring during heavy lifting or physical exertion and being relieved by rest are classic characteristics of stable angina. Stable angina is caused by transient myocardial ischemia due to a fixed coronary artery obstruction. Typically, the pain is predictable and reproducible, occurring with exertion and relieved by rest. The transient ST-segment depression on ECG is also a common finding in stable angina, reflecting myocardial ischemia during episodes of chest pain.

Correct Answer: D

Rationale: The presentation of a small, painless, well-defined nodule on the lateral aspect of the neck, above the clavicle, along with the cytology showing clusters of polygonal cells with abundant granular cytoplasm is most indicative of a parathyroid adenoma. Parathyroid adenomas are benign tumors derived from the parathyroid gland that can produce excess parathyroid hormone (PTH), leading to hyperparathyroidism. The characteristic histology of parathyroid adenomas includes chief cells with abundant granular cytoplasm.

Correct Answer: B

Rationale: Opsonization is a process in the immune response where opsonins, which are proteins such as antibodies and complement proteins, bind to pathogens such as bacteria, making them more easily recognized and engulfed by phagocytic cells like macrophages and neutrophils. This coating of pathogens by opsonins enhances the efficiency of phagocytosis, helping in the elimination of pathogens from the body. Opsonins do not facilitate cell lysis, neutralize toxins, or stimulate histamine release; their main function is to tag pathogens for phagocytosis.

Correct Answer: B

Rationale: The IR (Incident Report) typically focuses on the details surrounding an incident or event, such as what happened, who was/were involved, and who witnessed the incident. Information about daily medications given to the patient is not usually included in an incident report, unless it directly relates to the incident itself (e.g., medication error). The primary focus of an incident report is to document the incident in a clear and factual manner for record-keeping and analysis purposes.

Correct Answer: C

Rationale: Patients prescribed proton pump inhibitors (PPIs) for gastroesophageal reflux disease (GERD) should be instructed to take the medication 30 minutes before meals. This is because PPIs work best when taken on an empty stomach, allowing them to inhibit the gastric proton pump effectively and reduce acid production in anticipation of food intake. Taking the medication before meals ensures optimal absorption and effectiveness in controlling symptoms of GERD.

Correct Answer: C

Rationale: Placing the client in a left side-lying position after a liver biopsy helps to promote pressure on the puncture site, which can reduce the risk of bleeding. Placing a small pillow or folded towel under the puncture site provides additional support and helps to maintain pressure on the area. This position also helps prevent the client from putting pressure on the abdomen, which could potentially affect the biopsy site and increase the risk of bleeding or complications. Overall, positioning the client on the left side with support under the puncture site is the most appropriate and safest option after a liver biopsy.