A nurse is caring for a client who is taking lithium and reports experiencing lethargy, muscle weakness, and blurred vision. Which of the following responses should the nurse make?

"These symptoms will improve over time."

"You will need to have your blood drawn."

"You should decrease your intake of sodium."

"Continue the medication as prescribed."

Answer and Explanation

The Correct Answer is B

Choice A reason: Telling the client that the symptoms will improve over time without further assessment could be misleading. These symptoms could indicate lithium toxicity, which requires immediate medical attention.

Choice B reason: Lethargy, muscle weakness, and blurred vision can be signs of lithium toxicity. The nurse should recommend blood tests to check lithium levels and kidney function to rule out toxicity.

Choice C reason: Decreasing sodium intake is not recommended without a healthcare provider's advice, as sodium levels can affect lithium levels in the body. Sudden changes in sodium intake should be avoided unless directed by a healthcare provider.

Choice D reason: Continuing the medication as prescribed without addressing the symptoms could be dangerous. The symptoms reported by the client need to be evaluated to ensure they are not due to lithium toxicity.

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Correct Answer is A

Explanation

Choice A reason: Listing the negative effects of alcohol use can help the client gain insight into the consequences of their actions and reinforce their motivation to remain sober. Reflecting on personal losses and health issues due to alcohol can be a powerful deterrent against relapse.

Choice B reason: While attending support group meetings can be beneficial, saying "as needed" may not provide the structured support necessary for preventing relapse. Regular attendance at support groups like Alcoholics Anonymous (AA) is often recommended for sustained recovery.

Choice C reason: Lorazepam is not typically prescribed to prevent relapse in alcohol use disorder due to its potential for abuse and dependence. Instead, medications like naltrexone or acamprosate may be considered to help maintain abstinence.

Choice D reason: Revisiting familiar places may trigger cravings and is generally not advised. Instead, clients are encouraged to avoid places associated with their past alcohol use to reduce the risk of relapse.

A. The client appears to be well-groomed B. The client’s current weight is 54 kg (119 lb.) C. The client states they are sleeping 5 to 6 hours per night, but having an occasional nightmare D. The client verbalizes a decreased appetite and gastrointestinal discomfort E. The client states, “I feel anxious about leaving my house. I feel like everyone is staring at me and judging me.” F. The client verbalizes that bullying experienced during high school has led to anxiety G. The client engages in thought-stopping behavioral therapy and cognitive restructuring H. The client reports taking escitalopram 20 mg daily, 2 hours after breakfast

Correct Answer is ["A","C","G","H"]

Explanation

Being well-groomed can be an indicator of improved mental health, as it suggests the client is taking care of their personal hygiene and appearance, which can be neglected during severe anxiety episodes.

An increase in the amount of sleep and a decrease in the frequency of nightmares can be seen as an improvement in the client’s condition, as sleep disturbances are common in anxiety disorders.

Engagement in thought-stopping behavioral therapy and cognitive restructuring indicates that the client is actively participating in therapeutic activities designed to manage anxiety, which is a positive sign of improvement.

Consistent medication adherence, as reported by the client taking escitalopram 20 mg daily, is crucial for managing anxiety symptoms and indicates the client’s commitment to following the treatment plan.

The client’s weight remaining stable could be neutral, as it does not indicate a significant change. Verbalizing decreased appetite and gastrointestinal discomfort, feeling anxious about leaving the house, and stating that past bullying has led to anxiety are all signs that the client is still experiencing symptoms of anxiety. Therefore, these choices do not reflect an improvement in the client’s condition.

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A nurse is caring for a client who is taking lithium and reports experiencing lethargy, muscle weakness, and blurred vision. Which of the following responses should the nurse make?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is providing teaching for a client who has an alcohol use disorder. Which of the following statements should the nurse make to help prevent relapse?

Correct Answer is A

Explanation

Correct Answer is ["A","C","G","H"]

Explanation

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