A client has begun a long-term maintenance therapy with lithium, which has a narrow therapeutic index. Which adverse effect is most important for the nurse to include in the teaching plan?

Dependence.

Interaction.

Toxicity.

Tolerance.

Answer and Explanation

The Correct Answer is C

Choice A reason: Dependence is not a primary concern with lithium, a mood stabilizer. Toxicity is critical due to lithium’s narrow therapeutic range, risking severe complications. Dependence is more relevant to other drugs, per psychopharmacology and lithium therapy education standards in nursing.

Choice B reason: Interactions are important but less urgent than toxicity, which can be life-threatening with lithium’s narrow therapeutic index. Toxicity education emphasizes monitoring blood levels to prevent harm, per psychopharmacology and patient safety protocols in lithium therapy teaching.

Choice C reason: Toxicity is the most critical adverse effect to teach, as lithium’s narrow therapeutic index risks severe complications like seizures or renal failure. Monitoring symptoms and blood levels ensures safety, per evidence-based psychopharmacology and patient education protocols for lithium therapy in nursing.

Choice D reason: Tolerance is not a significant issue with lithium, unlike toxicity, which is life-threatening due to its narrow therapeutic range. Teaching toxicity symptoms prioritizes patient safety, per lithium therapy management and psychopharmacological education standards in nursing practice.

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Correct Answer is D

Explanation

Choice A reason: Acetaminophen reduces pain but is secondary to preventing infection and bleeding with petrolatum dressings. Dressings are the immediate post-circumcision priority to protect the surgical site, per circumcision care and infection control protocols in neonatal nursing practice.

Choice B reason: Wrapping in blankets maintains warmth but does not address the surgical site’s immediate needs. Petrolatum dressings prevent infection and adhesion, critical post-circumcision. Warmth is secondary, per circumcision care and neonatal thermoregulation standards in nursing practice.

Choice C reason: Offering a glucose-dipped pacifier soothes but does not protect the circumcision site from infection or bleeding. Petrolatum dressings are the priority to ensure healing and comfort, per circumcision care and postoperative pain management standards in neonatal nursing practice.

Choice D reason: Applying petrolatum gauze dressings prevents infection, promotes healing, and reduces adhesion of the circumcision site to diapers. This is the priority intervention to protect the surgical wound, per evidence-based circumcision care and infection control protocols in neonatal nursing practice.

A. Review client’s history for vascular disease. B. Place a mark where DP pulse is auscultated. C. Assess capillary refill distal to the DP pulse. D. Use a Doppler to assess an audible DP pulse.

Correct Answer is D

Explanation

Choice A reason: Reviewing vascular disease history provides context but does not confirm perfusion status. An absent DP pulse may indicate arterial occlusion, risking ischemia. Doppler assessment directly evaluates blood flow, detecting patency, critical for guiding interventions to ensure limb perfusion, making history review secondary.

Choice B reason: Marking an auscultated DP pulse is incorrect, as pulses are palpated or Doppler-assessed, not auscultated. Auscultation applies to heart or lungs. Doppler confirms arterial flow, addressing absent pulse’s potential occlusion, making this inaccurate compared to the precise Doppler technique.

Choice C reason: Capillary refill evaluates perfusion but is less specific than Doppler, which confirms arterial flow. Prolonged refill may indicate ischemia, but absent DP pulse suggests arterial compromise. Doppler acoustically detects flow, diagnosing critical limb ischemia, making it the priority over indirect perfusion measures.

Choice D reason: Using Doppler to assess DP pulse is critical, as an absent pulse may indicate occlusion from peripheral arterial disease, risking ischemia. Doppler detects blood flow, confirming patency or obstruction, guiding urgent interventions like angiography, ensuring limb viability by addressing vascular compromise directly.

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A client has begun a long-term maintenance therapy with lithium, which has a narrow therapeutic index. Which adverse effect is most important for the nurse to include in the teaching plan?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The parents of a male infant newborn have signed an informed consent for circumcision. Which priority intervention should the nurse implement upon completion of the circumcision procedure?

Correct Answer is D

Explanation

While completing an admission assessment, the nurse is unable to palpate the client’s left dorsalis pedis (DP) pulse. Which intervention is most important for the nurse to implement?

Correct Answer is D

Explanation

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