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?

1.2 mEq/L

1.4 mEq/L

2.3 mEq/L

1.8 mEq/L

Answer and Explanation

The Correct Answer is C

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.

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Correct Answer is ["1.44"]

Explanation

Step 1: Calculate the total units to be given per hour: 18 × 90 = 1620 units/hour Result = 1620 units/hour

Step 2: Determine the concentration of Heparin in 1 mL: 25000 ÷ 250 = 100 units/mL Result = 100 units/mL

Step 3: Calculate the required volume in mL/hr using total units per hour: (1620 ÷ 100) = 16.2 mL/hr Result = 16.2 mL/hr

Final answer 16.2 mL/hr

Question 47

Calculate the initial bolus of Heparin. Heparin is ordered as 80 units/kg. The client weighs 90 kg. How many mL would you administer using a vial of Heparin labeled Heparin 5000 units/mL?

The correct answer is 1.44 mL

Explanation:

Step 1: Calculate the total number of units required for the bolus: 80 × 90 = 7200 units Result = 7200 units

Step 2: Use the vial concentration to find out how many mL deliver 7200 units: (7200 ÷ 5000) = 1.44 mL Result = 1.44 mL

Final answer 1.44 mL

A. May experience short-term memory loss as a side effect of the treatment B. Should take atropine after the procedure C. Family can be in attendance throughout the procedure D. Will be awake during the procedure

Correct Answer is A

Explanation

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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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Calculate the initial rate for a Heparin infusion. The infusion is ordered as 18 units/kg/hr. The client weighs 90 kg. The concentration of the Heparin bag is 25,000 units/250 mL. You are administering the Heparin drip via an electronic infusion device. Calculate the infusion rate in mL/hr.

Correct Answer is ["1.44"]

Explanation

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

Correct Answer is A

Explanation

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