EXAM TERMINAL CERTIFICATION
EVALUATION COMPLETE QUESTIONS
WITH FULL SOLUTION ALREADY PASSED
⩥ A nurse is discussing early indications of toxicity with a client who
has a new prescription for lithium carbonate for bipolar disorder. The
nurse should include which of the following when reinforcing teaching?
(Select all that apply.)
A. Constipation
B. Polyuria
C. Rash
D. Muscle weakness
E. Tinnitus
Answer: B, D
B. CORRECT: Polyuria is an early indication of lithium toxicity. D.
CORRECT: Muscle weakness is an early indication of lithium toxicity.
A. INCORRECT: Diarrhea, rather than constipation, is an early
indication of lithium toxicity. C. INCORRECT: A rash is not indication
of lithium toxicity. E. INCORRECT: Tinnitus is an indication of severe,
rather than early, toxicity.
CHAPTER 21 Medications for Bipolar Disorders
,⩥ A nurse is caring for a client who is experiencing extreme mania due
to bipolar disorder. Prior to administration of lithium carbonate, the
nurse notes that the lithium blood level is 1.2 mEq/L. Which of the
following is an appropriate action by the nurse?
A. Administer the next dose of lithium carbonate as scheduled.
B. Prepare the client for gastric lavage.
C. Notify the provider for a possible increase in the dosage of lithium
carbonate.
D. Request a stat repeat of the client's lithium blood level.
Answer: A
A. CORRECT: During a manic episode, the lithium blood level should
be between 0.8 to 1.4 mEq/L. Therefore, it is appropriate to administer
the next dose as scheduled.
B. INCORRECT: Gastric lavage may be prescribed for treatment of
severe toxicity for levels between 2.0 to 2.5 mEq/L. C. INCORRECT: A
dosage increase would place the client at risk for toxicity and is
therefore not an appropriate action. D. INCORRECT: A lithium level of
1.2 mEq/L is an expected finding for a client who is experiencing a
manic episode. Therefore, it is not necessary to request a stat repeat of
the laboratory test.
CHAPTER 21 Medications for Bipolar Disorders
,⩥ A nurse is assisting with the admission of a client who has a new
diagnosis of bipolar disorder and is scheduled to begin lithium therapy.
When collecting data about the medical history from the client's adult
daughter, which of the following statements is the priority to report to
the provider?
A. "My mother has diabetes that is controlled by her diet."
B. "My mother recently completed a course of prednisone for acute
bronchitis."
C. "My mother received her flu vaccine last month."
D. "My mother is currently on furosemide for her congestive heart
failure."
Answer: D
D. CORRECT: Diuretics, such as furosemide (Lasix), are
contraindicated for use with lithium due to the risk for toxicity. This is
the greatest risk for the client and is therefore the priority to report to the
provider.
A. INCORRECT: It is important to notify the provider of the client's
medical history. However, this information does not pose the greatest
risk to the client and is therefore not the priority. B. INCORRECT: It is
important to notify the provider of the client's medical history. However,
this information does not pose the greatest risk to the client and is
therefore not the priority. C. INCORRECT: It is important to notify the
provider of the client's medical history. However, this information does
not pose the greatest risk to the client and is therefore not the priority.
CHAPTER 21 Medications for Bipolar Disorders
, ⩥ A nurse is caring for a client who has schizophrenia and exhibits a
lack of grooming and a flat affect. The nurse should anticipate a
prescription of which of the following medications?
A. Chlorpromazine
B. Thiothixene (Navane)
C. Risperidone (Risperdal)
D. Haloperidol (Haldol)
Answer: C
C. CORRECT: Atypical antipsychotics, such as risperidone, are effective
in treating negative symptoms of schizophrenia, such as lack of
grooming and flat affect.
A. INCORRECT: Conventional antipsychotics, such as chlorpromazine,
are used mainly to control positive, rather than negative, symptoms of
schizophrenia. B. INCORRECT: Conventional antipsychotics, such as
thiothixene, are used mainly to control positive, rather than negative,
symptoms of schizophrenia. D. INCORRECT: Conventional
antipsychotics, such as haloperidol, are used mainly to control positive,
rather than negative, symptoms of schizophrenia.
CHAPTER 22 Medications for Psychotic
⩥ A nurse is caring for a client who takes ziprasidone (Geodon). The
client reports difficulty swallowing the oral medication and becomes
extremely agitated with injectable administration. The nurse should