A 26-year-old woman with bipolar disorder has been stable on lithium for 2 years. She presents to the PMHNP with mild confusion, a tremor, and nausea. Upon questioning, she states she recently fell while running and injured her ankle in the fall. Which of the following is most likely to be the cause of her current symptoms?
Acetaminophen
Vicodin
Aspirin
Ibuprofen
The Correct Answer is D
Choice A reason: Acetaminophen is generally safe to use with lithium and does not interfere with renal function or lithium clearance. It is unlikely to cause lithium toxicity or contribute to the symptoms described.
Choice B reason: Vicodin contains hydrocodone and acetaminophen. While opioids can cause sedation and nausea, they do not typically interact with lithium in a way that would cause toxicity. However, they should still be used cautiously in patients with mood disorders.
Choice C reason: Aspirin is an NSAID but has a lesser impact on renal prostaglandins compared to other NSAIDs. It is less likely to impair lithium clearance and cause toxicity, although caution is still advised.
Choice D reason: Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that can reduce renal clearance of lithium by inhibiting prostaglandin synthesis in the kidneys. This can lead to elevated lithium levels and toxicity, especially in older adults or those with compromised renal function. The client’s symptoms—confusion, tremor, and nausea—are consistent with lithium toxicity, making ibuprofen the most likely culprit.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: Reasonable mind represents logical, rational thinking based on facts and analysis. It is one of the three core states in DBT mindfulness training.
Choice B reason: Emotion mind is driven by feelings and urges, often disregarding logic. It is a key component in DBT’s conceptual framework.
Choice C reason: Wise mind integrates both emotion and reason, representing balanced decision-making. It is the ideal state promoted in DBT.
Choice D reason: Evolved mind is not a recognized concept in DBT. It does not appear in the foundational structure of DBT mindfulness training and is therefore incorrect.
Correct Answer is C
Explanation
Choice A reason: Sigmund Freud developed psychosexual stages of development, which primarily focus on early childhood and do not extend meaningfully into older adulthood.
Choice B reason: Jean Piaget is known for his cognitive development theory, which focuses on childhood stages of learning and does not address adult psychosocial development.
Choice C reason: Erik Erikson developed the psychosocial stages of development, which span from infancy to late adulthood. His final stage, "Integrity vs. Despair," specifically addresses the challenges of aging and finding meaning after retirement.
Choice D reason: Milton Erickson was a psychiatrist known for his work in hypnosis and brief therapy, not for a developmental theory covering the lifespan.
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