Nokea
A client has a lithium level of 1.2 mEq/L. Which of the following interventions by the nurse is indicated?
- A. Call the physician for an increase in dosage.
- B. Do not give the next dose, and call the physician.
- C. Increase fluid intake for the next week.
- D. No intervention is necessary at this time.
Correct Answer: D
Rationale: A lithium level of 1.2 mEq/L is within the therapeutic range (0.5-1.5 mEq/L), so no intervention is necessary.
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Which of the following antidepressant drugs is a preferred drug for clients at high risk of suicide?
- A. Tranylcypromine (Parnate)
- B. Sertraline (Zoloft)
- C. Imipramine (Tofranil)
- D. Phenelzine (Nardil)
Correct Answer: B
Rationale: SSRIs like sertraline are preferred for clients at high risk of suicide because they carry no risk of lethal overdose, unlike MAOIs (Parnate, Nardil) or tricyclic antidepressants (Tofranil).
The nurse is educating a patient and family about strategies to minimize the side effects of antipsychotic drugs. Which of the following should be included in the plan?
- A. Drink plenty of fruit juice.
- B. Developing an exercise program is important.
- C. Increase foods high in fiber.
- D. Laxatives can be used as needed.
- E. Use sunscreen when outdoors.
- F. For missed doses, take double the dose at the next scheduled time.
Correct Answer: B,C,E
Rationale: Exercise and high-fiber foods help prevent constipation, and sunscreen is recommended due to photosensitivity. Fruit juice may contribute to weight gain, laxatives should be avoided, and doubling doses is incorrect.
A client with bipolar disorder has been taking lithium, and today his serum blood level is 1.8 mEq/L. The client reports nausea. Which of the following interventions by the nurse is indicated?
- A. Constipation and postural hypotension
- B. Fever, muscle rigidity
- C. Nausea
- D. None, the serum level is in therapeutic range
Correct Answer: C
Rationale: A lithium level of 1.8 mEq/L is above the therapeutic range (0.5-1.5 mEq/L) and indicates potential toxicity, with nausea being a common symptom. The nurse should notify the physician for further evaluation.
Which of the following is the primary consideration with clients taking antidepressants?
- A. Decreased mobility
- B. Emotional changes
- C. Suicide
- D. Increased sleep
Correct Answer: C
Rationale: Suicide is always a primary consideration when treating clients with depression due to the risk of worsening symptoms or medication-related effects.
A client on the unit suddenly cries out in fear. The nurse notices that the client's head is twisted to one side, his back is arched, and his eyes have rolled back in their sockets. The client has recently begun drug therapy with haloperidol (Haldol).
- A. Get a stat order for a serum drug level.
- B. Hold the client's medication until the symptoms subside.
- C. Place an urgent call to the client's physician.
- D. Give a PRN dose of benztropine (Cogentin).
Correct Answer: D
Rationale: The client is experiencing an acute dystonic reaction, common with high-potency antipsychotics like haloperidol. Immediate treatment with an anticholinergic like benztropine provides rapid relief.