Nokea
A client is taking lithium for management of bipolar I disorder. The client's most recent serum lithium level is 0.8 mEq/L (0.8 mmol/L). Based on this result, what prescription does the nurse anticipate receiving from the health care provider?
- A. Continue at the current dose
- B. Decrease the dose
- C. Discontinue the medication
- D. Increase the dose
Correct Answer: D
Rationale: A lithium level of 0.8 mEq/L is low (therapeutic range: 1.0-1.5 mEq/L for acute mania). Increasing the dose is likely to achieve therapeutic levels.
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A patient has been ordered to get Klonapin for the first time. Which of the following side effects is not associated with Klonapin?
- A. Drowsiness
- B. Ataxia
- C. Salivation elevated
- D. Diplopia
Correct Answer: D
Rationale: A-C are associated side effects of Klonapin.
The nurse is discussing hypertension with a group of people. Which person is at greatest risk for hypertension?
- A. A 63-year-old overweight Caucasian female office worker who smokes and whose parents both had high blood pressure.
- B. A 52-year-old African-American female of normal weight whose parents have diabetes and who is an avid swimmer.
- C. A 48-year-old Hispanic-American smoker whose father had high blood pressure.
- D. A 45-year-old Native American who leads a sedentary life and smokes.
Correct Answer: A
Rationale: Age, obesity, smoking, and family history of hypertension confer the highest risk, as seen in the 63-year-old Caucasian female.
After obtaining a nutritional assessment of an elderly client, the nurse determines that the client's diet lacks sufficient protein. Which foods represent low-cost sources of protein?
- A. Potatoes and beef
- B. Peas and beans
- C. Tomatoes and beets
- D. Pork and rice
Correct Answer: B
Rationale: Peas and beans are low-cost, high-protein foods. Beef and pork are expensive, and potatoes, tomatoes, beets, and rice are low in protein.
The nurse is caring for a client with a head injury who has an intracranial pressure monitor in place. Assessment reveals an ICP reading of 66. What is the nurse's best action?
- A. Notify the charge nurse.
- B. Record the reading as the only action.
- C. Turn the client and recheck the reading.
- D. Place the client supine.
Correct Answer: A
Rationale: Normal ICP is less than 15. 66 is a high reading, and the RN and the physician should be notified. Answer B would be the action if the reading was normal, so it is incorrect. Answers C and D would not be appropriate actions, so they are wrong.
At a routine health assessment, a client tells the nurse that she is planning a pregnancy in the near future. She asks about preconception diet changes. Which of the statements made by the nurse is best?
- A. Include fibers in your daily diet.
- B. Increase green leafy vegetable intake.
- C. Drink milk for the calcium content.
- D. Eat foods rich in folic acid.
Correct Answer: D
Rationale: Eat foods rich in folic acid. Folic acid is essential for preventing neural tube defects in the developing fetus, making it a critical preconception dietary recommendation.