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A nurse is providing teaching to a client who has schizophrenia and is prescribed risperidone. Which of the following instructions should the nurse include?
- A. Avoid direct sunlight
- B. Rise slowly from a sitting position
- C. Take the medication on an empty stomach
- D. Expect weight loss as a side effect
Correct Answer: B
Rationale: The correct answer is B: Rise slowly from a sitting position. This instruction is crucial because risperidone can cause orthostatic hypotension, leading to dizziness or fainting when standing up quickly. By rising slowly, the client can minimize the risk of falls. Avoiding direct sunlight (A) is not directly related to risperidone use. Taking the medication on an empty stomach (C) is not necessary for risperidone. Expecting weight loss (D) is not a common side effect of risperidone; in fact, weight gain is more common.
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A nurse is reviewing the laboratory results of a client who is taking lithium. Which of the following values should the nurse report to the provider?
- A. Lithium level 0.6 mEq/L
- B. Sodium 135 mEq/L
- C. Creatinine 1.5 mg/dL
- D. Potassium 4.0 mEq/L
Correct Answer: C
Rationale: The correct answer is C: Creatinine 1.5 mg/dL. Elevated creatinine levels indicate potential kidney damage from lithium toxicity. The nurse should report this value to the provider for further evaluation. Choices A, B, and D are within normal ranges and not directly related to lithium toxicity. Therefore, they do not require immediate attention.
A nurse is reviewing laboratory values for a client who has bipolar disorder and a prescription for lithium. Which of the following laboratory results places the client at risk for lithium toxicity?
- A. Calcium 9.0 mg/dL
- B. Sodium 130 mEq/L
- C. Chloride 98 mEq/L
- D. Potassium 5.0 mEq/L
Correct Answer: B
Rationale: The correct answer is B: Sodium 130 mEq/L. Low sodium levels increase the risk of lithium toxicity as lithium competes with sodium for reabsorption in the kidneys. This can lead to higher lithium levels in the bloodstream, putting the client at risk for toxicity. The other choices (A, C, D) are within normal ranges and do not directly impact lithium toxicity. Therefore, the client with low sodium levels is at the highest risk for lithium toxicity.
A nurse is teaching the parent of a school-age child who has ADHD and a prescription for atomoxetine 40 mg daily. Which of the following information should the nurse include in the teaching?
- A. Expect the child to gain weight while taking this medication
- B. Crush the medication and mix it with 120 mL (4 oz) of juice
- C. Therapeutic effects will occur within 24 hr of starting treatment
- D. Administer the medication before the child goes to school in the morning
Correct Answer: D
Rationale: The correct answer is D: Administer the medication before the child goes to school in the morning. Atomoxetine is a non-stimulant medication used to treat ADHD. Administering it in the morning allows for optimal absorption and effectiveness during the school day. This helps in improving the child's focus and attention span in a learning environment. Additionally, taking the medication in the morning helps in minimizing potential side effects such as insomnia. Choices A, B, and C are incorrect because weight gain is not a common side effect of atomoxetine, crushing the medication can alter its effectiveness, and therapeutic effects usually take a few weeks to manifest, not within 24 hours.
A nurse is providing behavioral therapy for a client who has obsessive-compulsive disorder. The client repeatedly checks that the doors are locked at night. Which of the following instructions should the nurse give the client when using thought stopping technique?
- A. Keep a journal of how often you check the locks each night
- B. Snap a rubber band on your wrist when you think about checking the locks
- C. Ask a family member to check the lock for you at night
- D. Focus on abdominal breathing whenever you go to check the locks
Correct Answer: B
Rationale: The correct answer is B: Snap a rubber band on your wrist when you think about checking the locks. This is an effective use of thought stopping technique as it creates a physical distraction and discomfort when the client has obsessive thoughts. It helps interrupt the pattern of behavior and redirects the client's focus away from the compulsion. Keeping a journal (A) may increase anxiety and reinforce the behavior. Asking a family member to check the lock (C) doesn't address the client's need to manage their own thoughts and behaviors. Focusing on abdominal breathing (D) may be a relaxation technique but doesn't directly address the obsessive thoughts.
A nurse is caring for a client with Alzheimer’s disease. Which of the following actions should the nurse take?
- A. Seat the client at a dining table with six or more residents
- B. Provide the client with several choices for meal selection
- C. Give complete directions before starting client care
- D. Use symbols to assist the client in locating rooms
Correct Answer: D
Rationale: The correct answer is D. Using symbols to assist the client in locating rooms is beneficial for a client with Alzheimer's as they may have difficulty remembering locations. Symbols can serve as visual cues to help them navigate and reduce confusion. A: Seating the client at a dining table with multiple residents may be overwhelming and lead to agitation. B: Providing several meal choices can be confusing and increase indecision for someone with Alzheimer's. C: Giving complete directions all at once may be too much information for the client to process. Instead, simple and clear instructions are more effective.