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A patient diagnosed with bipolar disorder is in the maintenance phase of treatment. The patient asks, 'Do I have to keep taking this lithium even though my mood is stable now?' Select the nurse's most appropriate response.
- A. You will be able to stop the medication in approximately 1 month.'
- B. Taking the medication every day helps prevent relapses and recurrences.'
- C. Usually patients take this medication for approximately 6 months after discharge.'
- D. It's unusual that the health care provider has not already stopped your medication.'
Correct Answer: B
Rationale: Lithium maintenance prevents recurrences, and this response promotes compliance. Other options provide incorrect information.
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The nurse is monitoring a patient closely for signs and symptoms of Stevens-Johnson syndrome. Which medication is likely the trigger for such a syndrome?
- A. Clonazepam
- B. Risperidone
- C. Lamotrigine
- D. Aripiprazole
Correct Answer: C
Rationale: Lamotrigine is associated with Stevens-Johnson syndrome, a rare but serious dermatological reaction. Other medications listed are not linked to this complication.
A patient experiencing acute mania has exhausted the staff members by noon. The patient has joked, manipulated, insulted, and been aggressive all morning. Staff members are feeling defensive and fatigued. Which is the best action?
- A. Confer with the health care provider regarding use of seclusion for this patient.
- B. Hold a staff meeting to discuss consistency and limit setting approaches.
- C. Conduct a meeting with all patients to discuss the behavior.
- D. Explain to the patient that the behavior is unacceptable.
Correct Answer: B
Rationale: A staff meeting promotes consistency and limit setting, reducing staff splitting and frustration. Seclusion is not warranted, and other options are less effective.
A patient receiving lithium should be assessed for which evidence of early toxicity?
- A. Pharyngitis, mydriasis, and dystonia
- B. Alopecia, purpura, and drowsiness
- C. Diarrhea, thirst, and vomiting
- D. Ascites, dyspnea, and edema
Correct Answer: C
Rationale: Diarrhea, thirst, and vomiting are early signs of lithium toxicity. Other options are unrelated to lithium therapy.
A patient diagnosed with bipolar disorder commands other patients, 'Get me a book. Take this stuff out of here,' and other similar demands. What is the best initial approach by the nurse to interrupt this behavior without entering into a power struggle?
- A. Distraction: 'Let's go to the dining room for a snack.'
- B. Humor: 'How much are you paying servants these days?'
- C. Limit setting: 'You must stop ordering other patients around.'
- D. Honest feedback: 'Your controlling behavior is annoying others.'
Correct Answer: A
Rationale: Distraction leverages the patient's distractibility to redirect behavior constructively, avoiding power struggles. Other options may incite anger or seem confrontational.
A patient experiencing acute mania undresses in the group room and dances. What should be the nurse's first intervention?
- A. Quietly ask the patient, 'Why don't you put on your clothes?'
- B. Firmly tell the patient, 'Stop dancing, and put on your clothing.'
- C. Put a blanket around the patient and walk with the patient to a quiet room.
- D. Allow the patient stay in the group room while moving the other patients to a different area.
Correct Answer: C
Rationale: Covering the patient and removing them from the area protects them from embarrassment and maintains safety. Other options are less effective or inappropriate.