When a patient diagnosed with paranoid schizophrenia was discharged from the unit 6 months ago, the plan was for him to take chlorpromazine (Thorazine), a conventional (first generation) antipsychotic medication, 300 mg po daily. He tells the nurse he stopped taking his pills after a few months because they made him feel like a “zombie.” What other common side effects should the nurse determine if the patient experienced?

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: 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.

Correct Answer: B

Rationale: The correct answer is B: Moderate sedation. In this situation, the nurse anesthetist mentions that the patient will be awake but likely won't remember the procedure, indicating the use of moderate sedation. Moderate sedation involves administering medications to induce a depressed level of consciousness while maintaining the patient's ability to independently maintain their airway and respond to verbal commands. Local anesthesia (A) involves numbing a specific area of the body. Topical anesthesia (C) is used on mucous membranes or skin surfaces. Spinal anesthesia (D) involves injecting anesthesia into the spinal canal to numb a larger region of the body.

Correct Answer: B

Rationale: The correct answer is B: Renal protective effects. ACE inhibitors are commonly prescribed in patients with type 2 diabetes and proteinuria to help protect the kidneys by reducing intraglomerular pressure and decreasing protein leakage. This helps slow the progression of diabetic nephropathy. Choice A is incorrect because while ACE inhibitors do have some cardioprotective effects, the primary reason for prescribing in this case is renal protection. Choice C is incorrect as reducing blood pressure is a secondary benefit of ACE inhibitors in this scenario. Choice D is incorrect as promoting fluid output is not the main mechanism of action for ACE inhibitors in this context.