A client with bipolar disorder begins taking lithium carbonate, 300 mg four times a day. After 3 days of therapy, the client says, "My hands are shaking." The best response by the nurse is which of the following?

Fine motor tremors are an early effect of lithium therapy that usually subsides in a few weeks

It is nothing to worry about unless it continues for the next month

You can expect tremors with lithium. You seem very concerned about such a small tremor

Tremors can be an early sign of toxicity, but we'll keep monitoring your lithium level to make sure you're okay

The correct answer is: a) Fine motor tremors are an early effect of lithium therapy that usually subsides in a few weeks

Answer and Explanation

The Correct Answer is A

Choice A reason: Fine motor tremors are a common early side effect of lithium, affecting cerebellar function due to its narrow therapeutic index and sodium channel interactions. These typically subside within weeks as the body adjusts to stable serum levels (0.5–1.2 mEq/L), making this an accurate, reassuring response.

Choice B reason: Dismissing tremors as unimportant unless persistent for a month is incorrect. Lithium tremors, linked to cerebellar effects, often resolve sooner, but persistent tremors may indicate toxicity (levels >1.5 mEq/L), risking neurological damage. This response delays necessary monitoring, ignoring the drug’s neuropharmacological impact.

Choice C reason: Acknowledging tremors but implying the client’s concern is excessive is dismissive. Tremors result from lithium’s cerebellar effects, a legitimate side effect. This response fails to educate about the expected resolution timeline or need for monitoring, risking patient distrust and ignoring the drug’s neurobiological effects.

Choice D reason: Labeling tremors as a potential toxicity sign is misleading, as early fine tremors are typically benign, not indicative of toxicity (>1.5 mEq/L), which involves severe symptoms like confusion. This overstates risk, causing unnecessary alarm, and does not address the common, transient cerebellar effect of lithium.

Nursing Test Bank

Quiz #1: RN Exams Pharmacology Exams Quiz #2: RN Exams Medical-Surgical Exams Quiz #3: RN Exams Fundamentals Exams Quiz #4: RN Exams Maternal-Newborn Exams Quiz #5: RN Exams Anatomy and Physiology Exams Quiz #6: RN Exams Obstetrics and Pediatrics Exams Quiz #7: RN Exams Fluid and Electrolytes Exams Quiz #8: RN Exams Community Health Exams Quiz #9: RN Exams Promoting Health across the lifespan Exams Quiz #10: RN Exams Multidimensional care Exams

Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Quiz #1: Naxlex RN Comprehensive online practice 2019 B with NGN Quiz #2: Naxlex RN Comprehensive Predictor 2023 Quiz #3: Naxlex RN Comprehensive Predictor 2023 Exit Exam A Quiz #4: Naxlex HESI Exit LPN Exam Quiz #5: Naxlex PN Comprehensive Predictor PN 2020 Quiz #6: Naxlex VATI PN Comprehensive Predictor 2020 Quiz #8: Naxlex PN Comprehensive Predictor 2023 - Exam 1 Quiz #10: Naxlex HESI PN Exit exam Quiz #11: Naxlex HESI PN EXIT Exam 2

Free Nursing Study Resources

Correct Answer is A

Explanation

Choice A reason: In severe PTSD exacerbation, flashbacks and hypervigilance indicate amygdala hyperactivity and impaired prefrontal cortex regulation, increasing risk of impulsive or self-harming behaviors. Ensuring safety addresses immediate dangers, as heightened arousal can lead to disorientation or panic, necessitating a secure environment to stabilize the client’s neurobiological stress response.

Choice B reason: Promoting self-esteem is valuable in PTSD but secondary to safety. Low self-esteem may stem from trauma-related guilt, linked to serotonin dysregulation, but does not pose immediate risk. Flashbacks and hypervigilance, driven by amygdala overactivity, require urgent safety measures to prevent harm during acute episodes.

Choice C reason: Helping cope with stress and emotions is important in PTSD management, addressing cortisol dysregulation and amygdala hyperactivity. However, during severe exacerbation with flashbacks, safety is the priority, as acute episodes can lead to disorientation or self-harm. Coping strategies are secondary to stabilizing the immediate neurobiological crisis.

Choice D reason: Establishing a community support system aids long-term PTSD recovery by enhancing oxytocin-mediated emotional regulation. However, during acute exacerbation with flashbacks, immediate safety is critical due to heightened amygdala-driven arousal. Community support is a secondary intervention, as it does not address the urgent risk of harm in acute episodes.

A. Let's hope this medication will stop the Alzheimer's disease from progressing any further B. It is important to take this medication on an empty stomach C. I'll be eager to see if this medication makes any improvement in concentration D. This medication will slow the progress of Alzheimer's disease temporarily

Correct Answer is D

Explanation

Choice A reason: Aricept (donepezil) is a cholinesterase inhibitor that increases acetylcholine levels in the brain, temporarily improving cognitive symptoms in Alzheimer’s disease. It does not stop disease progression, as Alzheimer’s involves progressive neuronal loss due to amyloid plaques and tau tangles. This statement is scientifically inaccurate, as no medication halts Alzheimer’s neurodegenerative process.

Choice B reason: Taking Aricept on an empty stomach is not required, as it can be taken with or without food. Its absorption is not significantly affected by food, as it is metabolized hepatically via CYP2D6 and CYP3A4. This statement is incorrect, as it misrepresents the administration guidelines, potentially causing unnecessary restrictions for the patient.

Choice C reason: While Aricept may improve concentration by enhancing cholinergic activity in Alzheimer’s, this statement focuses on expectation rather than understanding its therapeutic role. It does not address the drug’s primary effect of temporarily slowing cognitive decline. Concentration improvement is a secondary benefit, not the primary mechanism, making this less precise scientifically.

Choice D reason: Aricept temporarily slows Alzheimer’s disease progression by inhibiting acetylcholinesterase, increasing acetylcholine, and supporting cognitive function in mild to moderate cases. It does not cure or stop the disease, as neuronal degeneration continues due to amyloid and tau pathology. This statement accurately reflects the drug’s mechanism and temporary symptomatic relief, aligning with clinical evidence.

View Question and Answer

Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.

Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today

A client with bipolar disorder begins taking lithium carbonate, 300 mg four times a day. After 3 days of therapy, the client says, "My hands are shaking." The best response by the nurse is which of the following?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is caring for a client admitted with severe exacerbation of posttraumatic stress disorder that is experiencing flashbacks and hypervigilance. Which is the priority for the nurse to address when caring for this client?

Correct Answer is A

Explanation

The nurse has been teaching the caregiver about Aricept. The nurse knows teaching has been effective by which of the following statements?

Correct Answer is D

Explanation

Which of the following typifies the speech of a person in the acute phase of mania?

Which of the following would indicate an increased suicidal risk? (Select all that apply)

A nurse is reviewing routine laboratory values for several clients who are taking lithium carbonate. Which of the following clients should the nurse assess further for findings indicating lithium toxicity?

A nurse is planning care for an adolescent who is being admitted to an acute care unit following a suicide attempt. Which of the following interventions should the nurse identify as the priority?

A 68-year-old client who is hospitalized with pneumonia is disoriented and confused 3 days after admission. Which information indicates that the client is experiencing delirium rather than dementia?

A nurse is planning care for a client who is to undergo electroconvulsive therapy (ECT). Which of the following actions should the nurse include in the plan?

Which of the following principles should the nurse apply when planning nursing care for a client who was admitted after a suicide attempt?