A nurse in a mental health facility is collecting data from a client who is taking lithium. Which of the following findings should the nurse report to the provider as an indication of lithium toxicity?
Slurred speech
Stooped posture
Elevated blood pressure
Dry cough
The Correct Answer is A
A. Slurred speech can be a symptom of lithium toxicity. As lithium levels rise in the blood, it can affect neurological function, leading to symptoms such as confusion, drowsiness, tremors, and slurred speech.
B. Stooped posture is not typically associated with lithium toxicity. It is more commonly associated with musculoskeletal issues or neurological disorders rather than lithium toxicity.
C. Elevated blood pressure is not a typical symptom of lithium toxicity. Lithium can actually have a protective effect on blood pressure, and hypertension is not commonly associated with lithium toxicity.
D. Dry cough is not a symptom of lithium toxicity. It is more commonly associated with respiratory conditions or medication side effects rather than lithium toxicity.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
D. Dizziness and lightheadedness may be indicative of hypotension, which can occur as a side effect of ramipril, particularly with the first dose or with dose adjustments. Administering an IV fluid bolus can help increase intravascular volume, improve blood pressure, and alleviate symptoms of hypotension.
A. Administering carbohydrates is not indicated for dizziness and lightheadedness associated with ramipril administration. Carbohydrates are typically used to treat hypoglycemia in clients with diabetes. Dizziness and lightheadedness in this scenario are unlikely to be caused by hypoglycemia.
B. Diphenhydramine is an antihistamine commonly used to treat allergic reactions, itching, and insomnia. It is not indicated for dizziness and lightheadedness associated with ramipril administration. Administering diphenhydramine may not address the underlying cause of the symptoms.
C. Naloxone is a medication used to reverse opioid overdose by blocking the effects of opioids at receptor sites. It is not indicated for dizziness and lightheadedness associated with ramipril administration. Naloxone would not be appropriate in this situation.
Correct Answer is B
Explanation
B. Pregnant individuals should not receive the LAIV. It is recommended that pregnant individuals receive the inactivated influenza vaccine (IIV) instead. Therefore, this client has a contraindication to receiving the LAIV.
A. Rhinitis, or inflammation of the nasal passages, is not a contraindication to receiving the LAIV. In fact, LAIV may be preferred over the inactivated influenza vaccine (IIV) for individuals without contraindications between the ages of 2 and 49 years.
C. Recent receipt of a tattoo is not a contraindication to receiving the LAIV. While LAIV should generally not be administered to individuals with compromised immune systems, recent tattooing is not considered a contraindication.
D. Traveling to a different country is not a contraindication to receiving the LAIV. However, individuals with certain medical conditions or who are immunocompromised should not receive the LAIV.
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