A client is scheduled for electroconvulsive therapy (ECT). The nurse teaches that the client:

May experience short-term memory loss as a side effect of the treatment

Should take atropine after the procedure

Family can be in attendance throughout the procedure

Will be awake during the procedure

Answer and Explanation

The Correct Answer is A

Choice A reason: ECT induces controlled seizures to treat severe depression, often causing short-term memory loss due to temporary disruption of hippocampal function. This is a common side effect, and clients should be informed to expect potential memory difficulties post-treatment.

Choice B reason: Atropine is used pre-ECT to reduce secretions, not post-procedure. Administering it afterward is unnecessary, as its role is to prevent airway complications during the procedure, making this an incorrect teaching point for ECT.

Choice C reason: Family attendance during ECT is not permitted due to the controlled medical environment, anesthesia, and seizure induction, which require privacy and safety protocols. This instruction is incorrect, as only medical personnel are present during the procedure.

Choice D reason: ECT is performed under general anesthesia, so the client is unconscious, not awake, during the procedure. Being awake would prevent safe seizure induction and monitoring, making this an incorrect and unsafe teaching point.

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Correct Answer is C

Explanation

Choice A reason: A lithium level of 1.2 mEq/L is within the therapeutic range (0.6–1.5 mEq/L) for bipolar disorder. Symptoms like confusion, ataxia, polyuria, and blurred vision indicate toxicity, which occurs at higher levels, typically above 1.5 mEq/L, making this level unlikely for these severe symptoms.

Choice B reason: A lithium level of 1.4 mEq/L is at the upper end of the therapeutic range. While mild side effects may occur, severe symptoms like mental confusion, ataxia, and polyuria suggest toxicity, which typically occurs at levels above 1.5 mEq/L, ruling out this option.

Choice C reason: A lithium level of 2.3 mEq/L indicates toxicity, causing neurological symptoms (confusion, ataxia), polyuria due to nephrogenic diabetes insipidus, and blurred vision from central nervous system effects. These symptoms align with lithium toxicity, which occurs at levels above 1.5 mEq/L, making this the expected level.

Choice D reason: A lithium level of 1.8 mEq/L is slightly above therapeutic range and may cause mild toxicity symptoms, such as tremor or nausea. However, the severe symptoms described (confusion, ataxia, polyuria) are more consistent with higher toxic levels, such as 2.3 mEq/L, making this less likely.

A. Feelings of grandiosity B. Total loss of interest in activities C. Decreased need for sleep D. Severe depressive moods

Correct Answer is C

Explanation

Choice A reason: Feelings of grandiosity are more characteristic of mania in bipolar I disorder. Hypomania in bipolar II involves milder elevated mood, energy, and confidence without extreme grandiosity, making this symptom less consistent with a hypomanic episode.

Choice B reason: Total loss of interest in activities is a depressive symptom, not hypomania. Hypomanic episodes involve increased energy and engagement in activities, often with heightened productivity or creativity, making this inconsistent with the client’s current state.

Choice C reason: Decreased need for sleep is a hallmark of hypomania in bipolar II, where clients feel rested after minimal sleep due to heightened energy from altered dopamine and norepinephrine activity. This is highly consistent with hypomanic episodes, distinguishing it from mania.

Choice D reason: Severe depressive moods characterize the depressive phase of bipolar II, not hypomania. Hypomanic episodes involve elevated mood and energy, contrasting with the low mood and fatigue of depression, making this inconsistent.

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A client is scheduled for electroconvulsive therapy (ECT). The nurse teaches that the client:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client prescribed lithium carbonate 300 mg twice daily three months ago comes to the emergency department with mental confusion, ataxia, excessive diluted urine (polyuria), and blurred vision. Which lithium level would the nurse expect?

Correct Answer is C

Explanation

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Correct Answer is C

Explanation

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