A client with bipolar disorder is prescribed valproic acid (Depakote) as part of the treatment plan. Before administering the medication, which test should be done?
Blood glucose concentration.
Urinalysis.
Weight assessment.
Liver function tests.
The Correct Answer is D
Choice A reason: Blood glucose is not directly affected by valproic acid, which stabilizes mood via GABA enhancement and sodium channel inhibition. Monitoring glucose is irrelevant, as valproic acid’s primary risks involve hepatic and hematologic toxicity, not metabolic glucose dysregulation.
Choice B reason: Urinalysis is not a priority for valproic acid, which primarily risks hepatotoxicity and thrombocytopenia. It enhances GABA and inhibits sodium channels, with no significant renal effects requiring routine urine monitoring, unlike drugs affecting kidney function.
Choice C reason: Weight assessment is relevant for valproic acid due to potential weight gain, but it is not the priority. Hepatotoxicity, driven by valproic acid’s metabolism in the liver, poses a greater risk, necessitating liver function tests to monitor for severe hepatic damage.
Choice D reason: Valproic acid, metabolized by the liver, can cause hepatotoxicity by disrupting mitochondrial function and fatty acid metabolism. Liver function tests monitor transaminases and bilirubin to detect early hepatic damage, critical before initiating treatment to ensure safe use in bipolar disorder.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: Hospice requires a prognosis of 6 months or less. COPD with a 2-year life expectancy does not meet this, as the chronic disease allows longer-term management, not immediate palliative care for end-stage illness.
Choice B reason: Type 1 diabetes and substance abuse are not terminal conditions meeting hospice criteria (6 months or less prognosis). These require chronic management, not end-of-life care, as they lack imminent mortality despite complications.
Choice C reason: Multiple sclerosis with depression and pain is chronic, not terminal within 6 months, excluding hospice eligibility. Symptom management, not end-of-life care, is appropriate, as the prognosis does not indicate imminent death.
Choice D reason: Glioblastoma with an 8-10 week prognosis meets hospice criteria (6 months or less). Rapid tumor progression causes neurological decline, requiring palliative care to manage symptoms and support end-of-life needs, aligning with hospice goals.
Correct Answer is ["10"]
Explanation
Step 1: Identify the required dose and concentration.
Required dose = 320 mg
Concentration = 160 mg per 5 mL
Result at step 1 = 320 mg ÷ (160 mg ÷ 5 mL)
Step 2: Calculate the volume in milliliters.
First, determine the milligrams per mL:
160 mg ÷ 5 mL = 32 mg/mL
Result at step 2a = 32 mg/mL
Now, calculate the volume:
320 mg ÷ 32 mg/mL = 10 mL
Result at step 2b = 10 mL
Step 3: Round to the nearest whole number.
10 mL is already a whole number.
Result at step 3 = 10 mL
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