A male client with a recent diagnosis of bipolar disorder takes lithium carbonate daily. The client informed the school nurse of the desire to live away from home to attend college after graduating in one month. Which information is most important for the nurse to provide the client and his family?

A The client should plan to participate in group or individual therapy while at college.

The client's serum lithium levels should be routinely evaluated.

The client should be aware of the signs and symptoms of his illness.

Despite the illness, the client should be able to live away from home.

Answer and Explanation

The Correct Answer is B

A. While participation in therapy may be beneficial, the most important consideration with lithium therapy is monitoring serum levels to ensure therapeutic efficacy and avoid toxicity.
B. Lithium therapy requires regular monitoring of serum levels to maintain therapeutic efficacy and prevent toxicity, especially during times of transition or stress such as starting college
C. While it is important for the client to be aware of the signs and symptoms of his illness, routine monitoring of serum lithium levels is more crucial for maintaining stability while living away from home.
D. While independence is a positive goal, the focus in this scenario should be on ensuring the client's safety and stability through appropriate monitoring of lithium levels.

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Correct Answer is B

Explanation

- Choice A Rationale: Determining the type and size of the locks does not address the client's anxiety or the behavior that is impacting their daily functioning. This action might inadvertently reinforce the client's focus on the locks rather than addressing the underlying issue.
- Choice B Rationale: Planning a list of activities to be carried out daily can help the client establish a routine, which may reduce anxiety and the need for repetitive checking. This approach encourages the client to focus on the day's tasks and can provide a sense of control and accomplishment.
- Choice C Rationale: Discussing checking the time frequently does not directly address the client's repetitive behavior or the associated anxiety. While time management may be part of a broader treatment plan, it is not the most immediate action the nurse should take.
- Choice D Rationale: Ask the client why the locks are checked so frequently is not therapeutic and may put the client on the defensive. Clients with obsessive-compulsive behaviors often cannot explain why they perform rituals, as the behavior is driven by anxiety rather than logic. Asking "why" may increase frustration without helping to address the behavior.

A. Participates in individual and group therapy. B. Demonstrates effective ways to cope with anxiety. C. Learns methods of relaxation to reduce anxiety. D. Takes all antianxiety medications as prescribed.

Correct Answer is B

Explanation

Rationale:
A. While participation in therapy is important, the primary focus should be on equipping the client with effective coping strategies to manage her anxiety.
B. This outcome directly addresses the client's maladaptive coping mechanism (scratching her wrists) by aiming to replace it with healthier coping strategies.
C. Learning relaxation techniques is beneficial, but it may not address the underlying issue of maladaptive coping behaviors like wrist scratching.
D. Taking antianxiety medications as prescribed is important for managing symptoms, but it does not directly address the client's maladaptive coping behavior or teach alternative coping strategies.

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A male client with a recent diagnosis of bipolar disorder takes lithium carbonate daily. The client informed the school nurse of the desire to live away from home to attend college after graduating in one month. Which information is most important for the nurse to provide the client and his family?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client engages in repeated checks of door and window locks and behavior that prevents the client from arriving on time and interfering with the ability to function effectively. Which action should the nurse take?

Correct Answer is B

Explanation

The nurse develops a plan of care for a female client who scratches her wrists in attempts to deal with anxiety. Which client outcome is most important to include in the plan of care?

Correct Answer is B

Explanation

The nurse is performing the admission assessment for a client with schizophrenia in an acute care inpatient facility. The nurse should identify which observed behavior is characteristic of schizophrenia?

The nurse is admitting a male client who takes lithium carbonate twice a day. Which information should the nurse report to the healthcare provider immediately?

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