Nokea
The physician has ordered Eskalith (lithium carbonate) 500 mg three times a day and Risperdal (risperidone) 2 mg twice daily for a client admitted with bipolar disorder, acute manic episodes. The best explanation for the client's medication regimen is:
- A. The client's symptoms of acute mania are typical of undiagnosed schizophrenia.
- B. Antipsychotic medication is used to manage behavioral excitement until mood stabilization occurs.
- C. The client will be more compliant with a medication that allows some feelings of hypomania.
- D. Antipsychotic medication prevents psychotic symptoms commonly associated with the use of mood stabilizers.
Correct Answer: B
Rationale: Risperidone, an antipsychotic, is used to control acute manic symptoms like agitation, while lithium stabilizes mood over time, addressing the immediate behavioral excitement.
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The client is diagnosed with glaucoma. Which medication is most likely to be prescribed?
- A. Timolol (Timoptic)
- B. Atropine (Isopto Atropine)
- C. Pilocarpine (Isopto Carpine)
- D. Acetazolamide (Diamox)
Correct Answer: A
Rationale: Timolol, a beta-blocker, is commonly prescribed for glaucoma to reduce intraocular pressure by decreasing aqueous humor production. Atropine increases pressure, pilocarpine is less common, and acetazolamide is used acutely.
The client is admitted with a diagnosis of bacterial meningitis. Which precaution should the nurse implement?
- A. Standard precautions
- B. Droplet precautions
- C. Contact precautions
- D. Airborne precautions
Correct Answer: B
Rationale: Bacterial meningitis (e.g., Neisseria meningitidis) is transmitted via respiratory droplets, requiring droplet precautions. Standard, contact, and airborne precautions are not appropriate.
The client is prescribed digoxin (Lanoxin) for heart failure. Which instruction should the nurse include in the teaching plan?
- A. Take the medication with meals to prevent nausea.'
- B. Report a pulse below 60 beats per minute.'
- C. Increase potassium-rich foods in your diet.'
- D. Take an extra dose if you miss one.'
Correct Answer: B
Rationale: Digoxin toxicity is increased with bradycardia, so a pulse below 60 beats per minute should be reported. It can be taken with or without food, potassium monitoring is important but not increasing, and extra doses are dangerous.
A client who had major abdominal surgery is having delayed healing of the wound. Which laboratory test result would most closely correlate with this problem?
- A. Decreased albumin
- B. Decreased creatinine
- C. Increased calcium
- D. Increased sodium
Correct Answer: A
Rationale: Decreased albumin indicates protein deficiency, impairing tissue repair and delaying wound healing. Decreased creatinine (B) reflects renal function, increased calcium (C) affects bones, and increased sodium (D) affects fluid balance, not healing directly.
A client with a history of a hiatal hernia is being discharged. The nurse should teach the client to:
- A. Sleep in a reclining position
- B. Eat large meals
- C. Avoid carbonated beverages
- D. Lie down after eating
Correct Answer: C
Rationale: Carbonated beverages increase gastric pressure, worsening hiatal hernia symptoms. Sleeping upright, small meals, and avoiding lying down post-meals are also recommended.