A newly diagnosed patient is prescribed lithium. Which information from the patient's history indicates that monitoring of serum concentrations of the drug will be challenging and critical?
Arthritis
Heart failure
Psoriasis
Epilepsy
The Correct Answer is B
Rationale:
A. Arthritis does not typically affect lithium metabolism or clearance.
B. Heart failure can impair renal function and fluid balance, increasing the risk of lithium toxicity and making serum concentration monitoring critical.
C. Psoriasis does not interfere with lithium pharmacokinetics.
D. Epilepsy is not directly related to lithium metabolism, though caution is warranted if the patient is on other medications.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Rationale:
A. This approach is confrontational and accusatory, which may escalate agitation in a hyperactive or manic patient.
B. This response sets clear limits in a calm, supportive, and non-threatening manner, while also offering assistance with impulse control.
C. This statement is shaming and could escalate aggression rather than de-escalate the situation.
D. This is a threat rather than a therapeutic intervention, and it may increase the patient's agitation or resistance.
Correct Answer is C
Explanation
Rationale:
A. Suggesting it is unusual for the provider to continue lithium could undermine trust in the treatment plan and is inaccurate.
B. Lithium is typically continued long-term or indefinitely to prevent relapse, not just for 6 months.
C. Continuing daily lithium helps maintain mood stability and significantly reduces the risk of relapse in bipolar disorder, even when the patient feels well.
D. Stopping lithium after only 1 month of stability greatly increases the likelihood of recurrence of manic or depressive episodes.
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