The nurse is providing discharge instructions to the client being prescribed antipsychotic medications. Which discharge instruction(s) should be included? Select all that apply.

Take all antipsychotic medications as directed.

Notify the health care provider if you have hypertension or severe muscle stiffness.

Double the next dose if you forget one dose.

Stop the medication for any side effects.

Report any rhythmic, involuntary movements of the tongue, face, mouth, jaw, or extremities immediately.

Answer and Explanation

Correct Answer : A,B,E

A. Take all antipsychotic medications as directed: Adherence is critical for managing symptoms and preventing relapse. Antipsychotics must be taken consistently and exactly as prescribed to maintain therapeutic effectiveness and minimize side effects.
B. Notify the health care provider if you have hypertension or severe muscle stiffness: These symptoms may indicate serious adverse effects, such as neuroleptic malignant syndrome. Prompt reporting allows for early intervention and prevention of life-threatening complications.
C. Double the next dose if you forget one dose: Doubling the dose increases the risk of overdose and severe side effects. Clients should be instructed to take the next dose as scheduled and never compensate for missed doses.
D. Stop the medication for any side effects: Suddenly stopping antipsychotics can lead to symptom rebound or withdrawal effects. Side effects should be discussed with the provider, who can adjust the dose or switch medications safely.
E. Report any rhythmic, involuntary movements of the tongue, face, mouth, jaw, or extremities immediately: These are signs of tardive dyskinesia, a potentially irreversible side effect of long-term antipsychotic use. Early detection is essential to prevent progression and guide changes in therapy.

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Correct Answer is D

Explanation

A. Basilic vein: The basilic vein is located in the arm and is not typically used for coronary artery bypass grafting. It is more commonly used for vascular access, such as in arteriovenous fistulas for dialysis.
B. Gastroepiploic artery: The gastroepiploic artery can be used in coronary bypass surgery but is less commonly selected due to its location in the abdomen and the technical challenges associated with harvesting it.
C. Radial artery: The radial artery is sometimes used as a graft, especially when multiple grafts are needed, but it is not the most commonly used vessel. It is often chosen for its muscular wall and long-term patency.
D. Saphenous vein: The saphenous vein, located in the leg, is the most commonly used vessel for coronary artery bypass grafting due to its length, ease of access, and suitability for multiple grafts. It has been a standard choice for decades.

A. Run water to assist in the let-down reflex. B. Measure urinary output. C. Assist to the bathroom. D. Place a urinary catheter. E. Assist the client to stand.

Correct Answer is ["A","C","E"]

Explanation

A. Run water to assist in the let-down reflex: The sound of running water can stimulate the parasympathetic nervous system, triggering the urge to void. It’s a noninvasive and effective first-line intervention. This helps reduce urinary retention without immediate need for catheterization.
B. Measure urinary output: Measuring output is important once urination occurs but does not assist with initiating voiding. It is a monitoring step, not an intervention to promote urination. It should follow once the client successfully voids.
C. Assist to the bathroom: Walking to the bathroom creates a familiar and private setting, promoting comfort and relaxation. These factors help stimulate the natural urge to void. It also supports mobility and patient independence postoperatively.
D. Place a urinary catheter: Catheterization is invasive and should only be done if noninvasive methods fail. It increases the risk of infection and discomfort. Nurses should try simpler interventions first to promote spontaneous voiding.
E. Assist the client to stand: Postural positioning, such as standing, helps mimic the client’s usual urination habits. This can help engage the bladder’s normal neurological pathways. It is especially helpful in male clients to initiate urination.

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The nurse is providing discharge instructions to the client being prescribed antipsychotic medications. Which discharge instruction(s) should be included? Select all that apply.

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Naxlex Comprehensive Predictor Exams

The nurse is preparing a client for coronary artery bypass surgery. What vessel does the nurse know is most commonly used for grafting?

Correct Answer is D

Explanation

The nurse is caring for a postoperative client who reports difficulty urinating. The client does not have a urinary catheter in place. Which nursing action(s) are most appropriate at this time? Select all that apply.

Correct Answer is ["A","C","E"]

Explanation

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