Nokea
A client with a history of bipolar disorder is prescribed lithium. The nurse should instruct the client to:
- A. Maintain a consistent sodium intake.
- B. Avoid drinking coffee.
- C. Take the medication with meals.
- D. Stop the medication if tremors occur.
Correct Answer: A
Rationale: Consistent sodium intake prevents lithium toxicity, as sodium fluctuations affect lithium levels.
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Which type of anemia is diagnosed with a Schilling test?
- A. Aplastic
- B. Pernicious
- C. Megaloblastic
- D. Iron deficiency
Correct Answer: B
Rationale: The Schilling test is used to determine the cause of vitamin B12 deficiency, a potential precursor to pernicious anemia. This test involves the use of a small oral dose of radioactive B12 and a large nonradioactive intramuscular dose. A 24-hour urine specimen is then collected to measure the amount of radioactivity in the urine, and thus radioactive B12. This test is not helpful in diagnosing aplastic, megaloblastic, or iron-deficiency anemia.
Which of the following examples should the nurse use to describe bulimia to a group of parents at a local community center?
- A. An adolescent male who uses calorie-counting to maintain his weight in the desirable range for his height.
- B. A college-age male who uses regular exercise to be able to eat and drink what he wants without gaining weight.
- C. A middle-aged female who uses diet pills occasionally to help her lose 10 lb.
- D. A college-age female who binges and then purges to prevent weight gain.
Correct Answer: D
Rationale: Bulimia is characterized by binge eating followed by purging to prevent weight gain.
A client being treated for a comminuted fractured tibia asks the nurse to explain what a comminuted fracture means. The nurse should give which response?
- A. It means the fracture is incomplete.
- B. It means the bone is partially fractured.
- C. It means the bone fractured with splintering of the bone into fragments.
- D. It means the skin or mucous membrane was broken when the fracture occurred.
Correct Answer: C
Rationale: A comminuted fracture is a complete fracture across the shaft of a bone, with splintering of the bone into fragments. A simple fracture is a fracture of the bone across its entire shaft with some possible displacement but without breaking the skin. A greenstick fracture is an incomplete fracture, which occurs through part of the cross section of a bone. One side of the bone is fractured, and the other side is bent. A compound fracture, also called an open fracture, is one in which the skin or mucous membrane has been broken, and the wound extends to the depth of the fractured bone.
A client with chronic undifferentiated schizophrenia is having an acute exacerbation of symptoms. The client states, 'Black cats and black hats. Where does the time go?' Which of the following would be most important for the nurse to say?
- A. Halloween is getting close, isn't it.'
- B. Do you have a black cat?'
- C. What's the connection between cats, hats, and time?'
- D. Time certainly does go faster these days.'
Correct Answer: C
Rationale: Clarifying the client's statement helps assess their thought process and engage therapeutically.
The nurse should inform a client taking carbamazepine (Tegretol) that it can affect other medications in which of the following ways?
- A. It decreases the effects of oral anticoagulants
- B. It decreases the serum concentration of verapamil (Calan)
- C. It increases the serum concentration of other anticonvulsants
- D. It increases the effects of oral contraceptives
Correct Answer: A
Rationale: Carbamazepine induces liver enzymes, reducing the effects of oral anticoagulants like warfarin by increasing their metabolism. It does not typically affect verapamil, other anticonvulsants, or contraceptives in the ways described.