Georgette's Q Bank Module 1 Study Guide of Rationales
Study online at https://quizlet.com/_fzwl6a
1. Alcohol use disorder can have an influence on lithium levels because: Alcohol use
can lead to impaired renal function. Since lithium is primarily excreted by the kidneys, this can result in higher lithium
levels in the bood.
2. What is lithium's primary mechanism of action for suicide prevention?: It
modulates glutamate receptors, which leads to a decrease in impulsivity and aggressive behavior
3. If a patient taking a second-generation antipsychotic presents with labs con-
cerning for metabolic syndrome, what would be the most appropriate initial
action of the PMHNP: Education for the patient about lifestyle and diet modifications. You should also
collaborate with a dietician to come up with a personalized plan for the patient.
4. Persistent nausea, diarrhea, and confusion in a patient compliant with lithium
therapy is related lithium-induced: Gastrointestinal side effects
5. If a patient that is stabilized on lithium therapy complains of weight gain and
increased thirst, the initial action would be to: Educate the patient about side effects and regular
monitoring
6. What is the importance of hydration with lithium therapy?: Dehydration can reduce
renal perfusion, leading to reduced renal clearance of lithium. The accumulation of lithium could lead to toxicity
7. How do NSAIDs affect lithium levels?: NSAIDs inhibit prostaglandin synthesis.
8. In regard to renal clearance, what does decreased prostaglandin synthesis
cause?: Prostaglandins are potent vasodilators, so prevention of prostaglandins caused decreased renal blood flow
and decreased renal clearance
9. What is the relationship between hyponatremia and lithium?: Hyponatremia can lead
to increased reabsorption of lithium in the renal tubules, reducing lithium clearance and increasing the risk of toxicity
10. In regard to lithium, hypokalemia could cause: Hypokalemia interferes with the kidney's
ability to reabsorb salts, causing increased lithium clearance through the kidneys. Therefore, more lithium is excreted
leading to a subtherapeutic level
11. What happens if a person taking lithium increases their sodium intake?:
12. Should caffeine be avoided with lithium?: Yes, it can cause dehydration and negatively interact
with lithium
13. Why should you take lithium with a full glass of water?: To ensure proper absorption
while decreasing irritation to the GI tract
1/6
, Georgette's Q Bank Module 1 Study Guide of Rationales
Study online at https://quizlet.com/_fzwl6a
14. What is the relationship between lithium and cognitive decline?: Lithium may have
neuroprotective effects that can potentially improve cognitive function and reduce cognitive decline in patients with
bipolar disorder
15. What is the safest mood stabilizer for use in pregnancy?: Lamotrigine
16. What are the symptoms of hyperammonemia?: Hand tremors
Excessive thirst
Increased urination
17. If a patient taking Lamictal reports a rash that started after starting Lamictal
but has since resolved, what do you do?: Keep the current dose and continue to monitor
18. What is a rare side effect of Depakote with symptoms such as severe abdom-
inal pain, nausea, and vomiting?: Pancreatitis
19. What are the 3 rare side effects of Tegretol?: Agranulocytosis
Aplastic anemia
SJS (in Asian populations)
20. What lab value below is concerning when considering lithium initation?
A. BUN to creatinine ratio of 15:1
B. Serum sodium of 140
C. Serum TSH of 7.0
D. WBC of 8000: C. Serum TSH.
Lithium is known to impact the thyroid, so further assessment is needed
21. What is a normal serum sodium?: 135 - 145 mEq/L
22. Why would you monitor sodium levels with lithium therapy?: Lithium-induced
nephrogenic diabetes insipidus can result in altered sodium levels.
Lower baseline sodium can increase the risk of toxicity
23. What is the relationship between smoking and risperdal?: Smoking can induce
metabolism of risperidal, thereby decreasing its effect
24. What is the relationship between doxycycline and Tegretol?: Doxycycline inhibits the
metabolism of Tegretol, thereby increasing the risk of toxicity
2/6
Study online at https://quizlet.com/_fzwl6a
1. Alcohol use disorder can have an influence on lithium levels because: Alcohol use
can lead to impaired renal function. Since lithium is primarily excreted by the kidneys, this can result in higher lithium
levels in the bood.
2. What is lithium's primary mechanism of action for suicide prevention?: It
modulates glutamate receptors, which leads to a decrease in impulsivity and aggressive behavior
3. If a patient taking a second-generation antipsychotic presents with labs con-
cerning for metabolic syndrome, what would be the most appropriate initial
action of the PMHNP: Education for the patient about lifestyle and diet modifications. You should also
collaborate with a dietician to come up with a personalized plan for the patient.
4. Persistent nausea, diarrhea, and confusion in a patient compliant with lithium
therapy is related lithium-induced: Gastrointestinal side effects
5. If a patient that is stabilized on lithium therapy complains of weight gain and
increased thirst, the initial action would be to: Educate the patient about side effects and regular
monitoring
6. What is the importance of hydration with lithium therapy?: Dehydration can reduce
renal perfusion, leading to reduced renal clearance of lithium. The accumulation of lithium could lead to toxicity
7. How do NSAIDs affect lithium levels?: NSAIDs inhibit prostaglandin synthesis.
8. In regard to renal clearance, what does decreased prostaglandin synthesis
cause?: Prostaglandins are potent vasodilators, so prevention of prostaglandins caused decreased renal blood flow
and decreased renal clearance
9. What is the relationship between hyponatremia and lithium?: Hyponatremia can lead
to increased reabsorption of lithium in the renal tubules, reducing lithium clearance and increasing the risk of toxicity
10. In regard to lithium, hypokalemia could cause: Hypokalemia interferes with the kidney's
ability to reabsorb salts, causing increased lithium clearance through the kidneys. Therefore, more lithium is excreted
leading to a subtherapeutic level
11. What happens if a person taking lithium increases their sodium intake?:
12. Should caffeine be avoided with lithium?: Yes, it can cause dehydration and negatively interact
with lithium
13. Why should you take lithium with a full glass of water?: To ensure proper absorption
while decreasing irritation to the GI tract
1/6
, Georgette's Q Bank Module 1 Study Guide of Rationales
Study online at https://quizlet.com/_fzwl6a
14. What is the relationship between lithium and cognitive decline?: Lithium may have
neuroprotective effects that can potentially improve cognitive function and reduce cognitive decline in patients with
bipolar disorder
15. What is the safest mood stabilizer for use in pregnancy?: Lamotrigine
16. What are the symptoms of hyperammonemia?: Hand tremors
Excessive thirst
Increased urination
17. If a patient taking Lamictal reports a rash that started after starting Lamictal
but has since resolved, what do you do?: Keep the current dose and continue to monitor
18. What is a rare side effect of Depakote with symptoms such as severe abdom-
inal pain, nausea, and vomiting?: Pancreatitis
19. What are the 3 rare side effects of Tegretol?: Agranulocytosis
Aplastic anemia
SJS (in Asian populations)
20. What lab value below is concerning when considering lithium initation?
A. BUN to creatinine ratio of 15:1
B. Serum sodium of 140
C. Serum TSH of 7.0
D. WBC of 8000: C. Serum TSH.
Lithium is known to impact the thyroid, so further assessment is needed
21. What is a normal serum sodium?: 135 - 145 mEq/L
22. Why would you monitor sodium levels with lithium therapy?: Lithium-induced
nephrogenic diabetes insipidus can result in altered sodium levels.
Lower baseline sodium can increase the risk of toxicity
23. What is the relationship between smoking and risperdal?: Smoking can induce
metabolism of risperidal, thereby decreasing its effect
24. What is the relationship between doxycycline and Tegretol?: Doxycycline inhibits the
metabolism of Tegretol, thereby increasing the risk of toxicity
2/6
