A client prescribed lithium carbonate 300 mg twice daily a month ago comes to the Emergency Department with mental confusion, frequent urination in large amounts, and coarse tremors. Which lithium level would the nurse expect?
0.8 mEq/L
2.3 mEq/L
1.8 mEq/L
1.2 mEq/L
The Correct Answer is B
Choice A Reason: 0.8 mEq/L
The therapeutic range for lithium is typically between 0.6 and 1.2 mEq/L. A level of 0.8 mEq/L falls within this range and is considered normal. Therefore, it is unlikely that a client with this lithium level would present with symptoms such as mental confusion, frequent urination, and coarse tremors. These symptoms are more indicative of lithium toxicity, which occurs at higher levels.
Choice B Reason: 2.3 mEq/L
A lithium level of 2.3 mEq/L is significantly above the therapeutic range and indicates lithium toxicity. Symptoms of lithium toxicity include mental confusion, frequent urination, and coarse tremors, which match the client’s presentation. Severe toxicity can occur at levels above 2.0 mEq/L and can be life-threatening if not treated promptly. Therefore, this is the most likely lithium level for the client described.
Choice C Reason: 1.8 mEq/L
A lithium level of 1.8 mEq/L is above the therapeutic range but below the level typically associated with severe toxicity. While some symptoms of toxicity might appear at this level, they are generally less severe than those described in the scenario. The client’s symptoms suggest a more severe level of toxicity, making this choice less likely.
Choice D Reason: 1.2 mEq/L
A lithium level of 1.2 mEq/L is at the upper limit of the therapeutic range. While it is possible for some mild side effects to occur at this level, the severe symptoms described (mental confusion, frequent urination, and coarse tremors) are more indicative of a higher, toxic level of lithium. Therefore, this choice is also less likely.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A Reason: Anorexia Nervosa
Anorexia nervosa is an eating disorder characterized by an intense fear of gaining weight and a distorted body image, leading to restricted food intake and excessive weight loss. Individuals with anorexia nervosa often have a relentless pursuit of thinness and may engage in extreme dieting, excessive exercise, and other behaviors to lose weight. While eliminating specific foods can be a part of anorexia nervosa, the primary focus is on weight loss and body image rather than the purity or healthiness of the food.
Choice B Reason: Rumination Disorder
Rumination disorder involves the repeated regurgitation of food, which may be re-chewed, re-swallowed, or spit out. This condition is more common in infants and individuals with developmental disabilities but can occur in people of all ages. The behavior is typically involuntary and not related to concerns about food purity or healthiness. Therefore, it does not align with the client’s report of eliminating specific foods to “eat clean.”
Choice C Reason: Orthorexia
Orthorexia is an eating disorder characterized by an obsession with eating foods that one considers healthy or pure. Individuals with orthorexia may eliminate entire food groups, such as sugars, carbohydrates, or dairy, in their quest to maintain a “clean” diet6. This condition can lead to malnutrition and social isolation due to the restrictive nature of the diet. The client’s report of eliminating specific foods to “eat clean” is a clear indication of orthorexia.
Correct Answer is ["A","B","C"]
Explanation
Choice A Reason: “I’d rather be dead than live like this. I do not want to be alive.”
This statement reflects suicidal ideation, which is a common symptom of major depressive disorder (MDD). Individuals with MDD often experience feelings of hopelessness and worthlessness, leading them to believe that life is not worth living. Suicidal thoughts are a serious concern and require immediate attention and intervention.
Choice B Reason: “If I can just keep ignoring my feelings, I’ll be fine.”
This statement indicates a form of denial or avoidance, which is also common in individuals with MDD. People with depression may try to ignore or suppress their feelings in an attempt to cope with their condition. However, this approach is generally ineffective and can lead to worsening symptoms over time.
Choice C Reason: “I deserve to be this way. I’ve not accomplished anything important in my life.”
Feelings of worthlessness and excessive guilt are hallmark symptoms of MDD. Individuals with depression often have a negative self-view and believe that they are failures or that they deserve to suffer. This distorted thinking pattern can significantly impact their overall well-being and quality of life.
Choice D Reason: “This is a bad episode, but I will be well soon.”
This statement reflects a more optimistic outlook, which is less common in individuals with MDD. While some people with depression may have moments of hope, the pervasive nature of the disorder typically leads to a more negative and hopeless perspective. Therefore, this choice is less likely to be heard during an intake assessment for MDD.
Choice E Reason: “I am determined to fight this episode and get through it.”
Similar to choice D, this statement indicates a positive and proactive attitude towards managing depression. While determination and resilience are important for recovery, they are not typically expressed by individuals during the acute phase of MDD. This choice is also less likely to be heard during an intake assessment for MDD.
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