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A nurse is providing discharge teaching to a client who has bipolar disorder and a new prescription for lithium. Which statement by the client indicates an understanding of the teaching?
- A. I will reduce my sodium intake to help lithium work better
- B. I should take my medication on an empty stomach
- C. I need to drink 2-3 liters of water each day
- D. I can stop taking lithium once my symptoms improve
Correct Answer: C
Rationale: The correct answer is C: "I need to drink 2-3 liters of water each day." This statement indicates an understanding of the teaching because lithium can cause dehydration and increase the risk of toxicity. Adequate hydration helps to prevent this. Choice A is incorrect because reducing sodium intake is not directly related to lithium's effectiveness. Choice B is incorrect as lithium should be taken with food to reduce gastrointestinal side effects. Choice D is incorrect because stopping lithium abruptly can lead to a relapse of symptoms.
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A nurse is working with a client who has an anxiety disorder and is in the orientation phase of the therapeutic relationship. Which of the following statements should the nurse make during this phase?
- A. We should discuss resources to implement in your daily life.
- B. Let me show you simple relaxation exercises to manage stress.
- C. We should establish our roles in the initial session.
- D. Let's talk about how you can change your response to stress.
Correct Answer: C
Rationale: Correct Answer: C
Rationale: During the orientation phase of the therapeutic relationship, establishing roles is crucial for setting boundaries and clarifying expectations. This helps build trust and create a safe environment for the client to open up. Discussing resources (A) and relaxation exercises (B) would be more appropriate in later phases once the therapeutic relationship is established. Talking about changing responses to stress (D) may be premature at this stage.
A nurse is assessing a client who has bipolar disorder and is experiencing a depressive episode. Which of the following findings should the nurse expect?
- A. Inability to carry out a simple task
- B. Client reports auditory hallucinations
- C. Moves quickly from one idea to the next
- D. Client expresses illusions of grandeur
Correct Answer: A
Rationale: The correct answer is A: Inability to carry out a simple task. During a depressive episode in bipolar disorder, clients often experience symptoms such as psychomotor retardation, low energy, and difficulty concentrating. This can lead to an inability to carry out simple tasks due to lack of motivation and feelings of worthlessness. Clients may struggle with daily activities and find it challenging to complete even basic tasks. This is a common symptom of depression in bipolar disorder.
Choice B is incorrect as auditory hallucinations are more commonly associated with psychotic disorders or schizophrenia. Choice C is incorrect as rapid speech and jumping from one idea to the next are more indicative of a manic episode in bipolar disorder. Choice D is incorrect as expressing illusions of grandeur is a symptom of mania, not depression.
A nurse in an acute mental health care facility is prioritizing care for multiple clients. Which of the following clients should the nurse see first?
- A. A client who has narcissistic personality disorder and is mocking others during group therapy
- B. A client who has obsessive-compulsive disorder and is upset about a change in daily routine
- C. A client who has depressive disorder and requires assistance with ADLs
- D. A client who is taking clozapine to treat schizophrenia and reports a sore throat
Correct Answer: D
Rationale: The correct answer is D. The nurse should see the client taking clozapine first due to the potential side effect of agranulocytosis, which can manifest as a sore throat. This is a serious adverse effect that requires immediate attention to prevent complications. The other clients do not present with urgent or life-threatening issues. A: Narcissistic behavior is disruptive but not a medical emergency. B: Upset about a routine change is distressing but does not pose a physical health risk. C: Assistance with ADLs is important but not immediately life-threatening. Therefore, prioritizing the client on clozapine with a sore throat is crucial to ensure timely intervention and prevent serious complications.
A client with schizophrenia is prescribed risperidone. Which of the following should the nurse monitor for as an adverse effect of this medication?
- A. Increased blood pressure
- B. Weight gain
- C. Excessive salivation
- D. Bradycardia
Correct Answer: B
Rationale: The correct answer is B: Weight gain. Risperidone is an atypical antipsychotic known to cause metabolic side effects like weight gain due to its impact on appetite and metabolism. Monitoring weight is crucial to prevent complications like diabetes and cardiovascular issues. Monitoring blood pressure (choice A) is important for other antipsychotics but not specifically risperidone. Excessive salivation (choice C) is not a common side effect of risperidone. Bradycardia (choice D) is not typically associated with risperidone.
A client with schizophrenia is prescribed risperidone. Which of the following should the nurse monitor for as an adverse effect of this medication?
- A. Increased blood pressure
- B. Weight gain
- C. Excessive salivation
- D. Bradycardia
Correct Answer: B
Rationale: The correct answer is B: Weight gain. Risperidone is an antipsychotic medication known to cause metabolic side effects such as weight gain. This is due to its impact on appetite regulation and metabolism. Monitoring weight is crucial to prevent complications such as diabetes and cardiovascular issues.
A: Increased blood pressure is not a common adverse effect of risperidone.
C: Excessive salivation is not a typical side effect of risperidone.
D: Bradycardia is not associated with risperidone use in clients with schizophrenia.