A client with bipolar disorder, having experienced a depressive episode, is prescribed lamotrigine (Lamictal). After educating the client on this medication, the nurse determines that the education was successful when the client makes which statement?

I need to have my blood tested about once a month.

This drug can affect my liver function.

I need to notify my provider if I develop a skin rash.

I have to watch how much salt I use every day.

Answer and Explanation

The Correct Answer is C

Choice A reason: Lamotrigine does not require monthly blood tests, as it has minimal hematologic or hepatic toxicity. It stabilizes mood via sodium channel inhibition, with skin rash (e.g., Stevens-Johnson syndrome) being the primary concern, not routine blood monitoring.

Choice B reason: Lamotrigine rarely affects liver function, unlike valproic acid. Its primary risk is cutaneous reactions due to immune-mediated hypersensitivity, not hepatotoxicity. Monitoring focuses on skin, not liver enzymes, as it modulates neuronal excitability without significant hepatic metabolism.

Choice C reason: Lamotrigine carries a risk of serious skin rashes, like Stevens-Johnson syndrome, due to immune-mediated hypersensitivity affecting epidermal cells. Notifying the provider about rashes is critical, as this reflects understanding of the drug’s most significant adverse effect, ensuring timely intervention.

Choice D reason: Salt intake is relevant for lithium, not lamotrigine, which stabilizes mood via sodium channel inhibition without affecting renal sodium handling. Dietary salt monitoring is unnecessary, as lamotrigine’s primary risk is dermatologic, not electrolyte-related, making this statement incorrect.

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Correct Answer is B

Explanation

Choice A reason: Announcing campus security may reduce anxiety but does not address reunification. Acute stress elevates cortisol and amygdala activity, and without structured reunification, parents’ distress persists, as prefrontal cortex-mediated organization is needed for effective crisis management.

Choice B reason: Designating zones for reunification organizes chaos, reducing amygdala-driven panic and cortisol surges in parents and students. This structured approach engages prefrontal cortex planning, ensuring safe, efficient reunification, addressing the immediate emotional and logistical needs post-crisis.

Choice C reason: Metal detectors ensure safety but delay reunification, prolonging amygdala-driven anxiety and cortisol release. Parents searching independently may increase chaos, as lack of structured reunification hinders prefrontal cortex-mediated organization, making this less effective than zoning.

Choice D reason: Blocking parents with tape escalates distress by preventing reunification, heightening amygdala activity and cortisol levels. This approach disregards emotional needs, impairing prefrontal cortex-mediated coping, and is counterproductive to resolving the crisis efficiently and compassionately.

A. Can identify foods with high selenium content that should be avoided. B. Confers with a pharmacist when selecting over-the-counter medications. C. Monitors sodium intake and weight daily. D. Wears support stockings and elevates the legs when sitting.

Correct Answer is B

Explanation

Choice A reason: Phenelzine, an MAOI, requires avoiding tyramine-rich foods, not selenium-rich foods. Tyramine interacts with MAOIs, causing hypertensive crises due to norepinephrine surges in the synaptic cleft. Selenium has no specific interaction with MAOIs, making this choice irrelevant to safe medication management.

Choice B reason: Phenelzine inhibits monoamine oxidase, increasing serotonin and norepinephrine, and interacts dangerously with many over-the-counter medications like pseudoephedrine, causing hypertensive crises. Consulting a pharmacist ensures safe choices, preventing adverse reactions due to altered neurotransmitter metabolism, reflecting effective understanding of MAOI risks.

Choice C reason: Monitoring sodium and weight is unrelated to phenelzine’s mechanism or side effects. MAOIs primarily affect monoamine neurotransmitters, not electrolytes or fluid balance. This behavior does not address the critical dietary or drug interaction precautions necessary for safe MAOI use.

Choice D reason: Support stockings and leg elevation address circulatory issues, not phenelzine’s risks. MAOIs increase monoamine levels, risking hypertensive crises with certain foods or drugs, not venous stasis. This behavior does not reflect understanding of phenelzine’s neurochemical interactions or safety requirements.

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A client with bipolar disorder, having experienced a depressive episode, is prescribed lamotrigine (Lamictal). After educating the client on this medication, the nurse determines that the education was successful when the client makes which statement?

Nursing Test Bank

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