A client with a history of bipolar disorder is prescribed lithium. Which teaching point should the nurse emphasize?

Maintain consistent salt intake

Avoid high-fiber foods

Increase caffeine consumption

Limit physical exercise

Answer and Explanation

The Correct Answer is A

Choice A reason: Consistent salt intake is critical for lithium, as sodium levels affect lithium excretion. Low sodium increases lithium toxicity, causing tremors or confusion. Maintaining stable sodium intake ensures therapeutic levels, making this the priority teaching point for safe lithium therapy.

Choice B reason: Avoiding high-fiber foods is irrelevant to lithium therapy. Fiber affects gastrointestinal health but not lithium pharmacokinetics. Consistent salt intake is essential, as sodium fluctuations alter lithium clearance, risking toxicity, making dietary sodium the priority teaching focus.

Choice C reason: Increasing caffeine is inappropriate, as it may exacerbate bipolar symptoms and increase lithium excretion, risking subtherapeutic levels. Consistent salt intake stabilizes lithium levels, preventing toxicity or inefficacy, making it the critical teaching point for effective bipolar management.

Choice D reason: Limiting physical exercise is unnecessary for lithium therapy. Exercise supports mental health in bipolar disorder but does not directly affect lithium levels. Consistent salt intake is the priority, as sodium balance ensures safe and effective lithium therapy.

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Correct Answer is A

Explanation

Choice A reason: Palpating for joint warmth and swelling is the best technique for early rheumatoid arthritis, as it detects synovitis, a hallmark of the disease. Inflamed joints are warm, swollen, and tender due to autoimmune-driven synovial proliferation, enabling early identification and intervention to prevent joint damage.

Choice B reason: Measuring range of motion assesses joint function but is less specific for early rheumatoid arthritis. Reduced motion occurs later, after significant synovial inflammation or damage. Palpating for warmth and swelling directly identifies active synovitis, making it more effective for early detection.

Choice C reason: Assessing grip strength evaluates muscle and joint function but is nonspecific for early rheumatoid arthritis. Weakness may result from pain or later joint damage. Palpating for warmth and swelling targets synovial inflammation, the earliest sign, making it the preferred technique for early diagnosis.

Choice D reason: Observing gait and posture detects functional limitations but is not specific for early rheumatoid arthritis. Gait changes occur with advanced disease or other conditions. Palpating for joint warmth and swelling directly identifies synovial inflammation, the primary early feature, making it more diagnostic.

A. Hemoccult test on sputum collected from hemoptysis B. Chest x-ray or computerized tomography scan C. Sputum culture positive for Mycobacterium tuberculosis D. Positive purified protein derivative skin test

Correct Answer is C

Explanation

Choice A reason: Hemoccult tests detect blood in sputum, indicating hemoptysis, a TB symptom, but do not confirm Mycobacterium tuberculosis infection. Sputum culture is required for definitive diagnosis, as hemoccult only identifies bleeding, which is nonspecific and can occur in other respiratory conditions.

Choice B reason: Chest x-ray or CT scans show pulmonary abnormalities like cavitary lesions in TB but are not confirmatory. Radiographic findings suggest TB but require microbiological confirmation via sputum culture, as similar patterns occur in other lung diseases, making imaging supportive but not diagnostic.

Choice C reason: Sputum culture positive for Mycobacterium tuberculosis is the gold standard for TB diagnosis. It directly identifies the pathogen, confirming active infection. Other tests like skin tests or imaging are suggestive but not definitive, as they cannot distinguish active TB from latent or other conditions.

Choice D reason: A positive PPD skin test indicates TB exposure or latent infection but does not confirm active disease. False positives occur with prior BCG vaccination or nontuberculous mycobacteria. Sputum culture is needed to verify active TB, making the skin test less definitive.

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A client with a history of bipolar disorder is prescribed lithium. Which teaching point should the nurse emphasize?

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Naxlex Comprehensive Predictor Exams

Which technique should the nurse use when assessing for early signs of rheumatoid arthritis?

Correct Answer is A

Explanation

The nurse is admitting a client with possible tuberculosis (TB). The client is placed in a private room with airborne precautions pending diagnostic test results. Which diagnostic test should the nurse review to confirm the diagnosis of TB?

Correct Answer is C

Explanation

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