Nokea
Lithium is prescribed for a new patient. Which information from the patient's history indicates that monitoring serum concentrations of the drug will be especially challenging and critical?
- A. Arthritis
- B. Epilepsy
- C. Exercise-induced asthma
- D. Congestive heart failure
Correct Answer: D
Rationale: Congestive heart failure and diuretic use complicate fluid balance, increasing lithium toxicity risk. Other conditions do not directly affect lithium monitoring.
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A patient diagnosed with bipolar disorder has rapid cycles. The health care provider prescribes an anticonvulsant medication. To prepare teaching materials, which drug should the nurse anticipate will be prescribed?
- A. Phenytoin
- B. Clonidine
- C. Carbamazepine
- D. Chlorpromazine
Correct Answer: C
Rationale: Carbamazepine is effective for rapid-cycling bipolar disorder. Phenytoin and chlorpromazine are not used for mood stabilization, and clonidine is not an anticonvulsant for this purpose.
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.
A patient tells the nurse, 'I am so ashamed of being bipolar. When I'm manic, my behavior embarrasses my family. Even if I take my medication, there's no guarantee I won't have a relapse. I am such a burden to my family.' These statements support which nursing diagnoses?
- A. Powerlessness
- B. Defensive coping
- C. Chronic low self-esteem
- D. Impaired social interaction
- E. Risk-prone health behavior
Correct Answer: A,C
Rationale: The patient's shame and perceived burden reflect chronic low self-esteem and powerlessness. Other diagnoses are not supported by the statements.
A patient experiencing acute mania has disrobed in the hall three times in 2 hours. What intervention should the nurse implement?
- A. Place the patient in the seclusion room.
- B. Ask if the patient finds clothes bothersome.
- C. Tell the patient that others feel embarrassed.
- D. Arrange for one-on-one supervision.
Correct Answer: D
Rationale: One-on-one supervision provides structure to prevent repeated disrobing. Seclusion is not warranted, and other options are ineffective.
Which documentation indicates that the treatment plan for a patient experiencing acute mania has been effective?
- A. Converses without interrupting; clothing matches; participates in activities.'
- B. Irritable, suggestible, distractible; napped for 10 minutes in afternoon.'
- C. Attention span short; writing copious notes; intrudes in conversations.'
- D. Heavy makeup; seductive toward staff; pressured speech.'
Correct Answer: A
Rationale: Appropriate behavior and participation without overstimulation indicate effective treatment. Other options reflect ongoing manic symptoms.