A nurse is caring for a young adult client who has somatic symptom disorder and is being evaluated for chest pain.

The client's laboratory results are all within the expected reference ranges, the ECG is unremarkable, and the client has no identified cardiac risk factors.

Which of the following actions should the nurse take?

Refer the client for flooding therapy.

Inform the client that the pain is not real.

Provide reassurance to the client.

Encourage the client to request invasive cardiac testing.

Answer and Explanation

The Correct Answer is C

Choice A rationale:
Flooding therapy is not typically used for somatic symptom disorder.
Choice B rationale:
Telling a client that their pain is not real can invalidate their experience and is not a recommended approach for somatic symptom disorder.
Choice C rationale:
Providing reassurance to the client is a recommended approach when all tests are normal and there are no identified risk factors.
Choice D rationale:
Encouraging the client to request invasive cardiac testing is not typically recommended when all tests are normal and there are no identified risk factors.

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Correct Answer is C

Explanation

Choice A rationale:

A lithium level of 1.8 mEq/L is above the therapeutic level for initial treatment (0.8 to 1.4 mEq/L)3.

Choice B rationale:

A lithium level of 1.8 mEq/L is above, not below, the therapeutic treatment level.

Choice C rationale:

A lithium level of 1.8 mEq/L is at the toxic level. A blood lithium level greater than 1.5 mEq/L indicates toxicity.

Choice D rationale:

A lithium level of 1.8 mEq/L is not within the maintenance treatment level (0.4 to 1.3 mEq/L)3.

A. Withhold the medication. B. Administer the next dose as prescribed. C. Prepare to administer propranolol. D. Plan to administer levothyroxine.

Correct Answer is A

Explanation

Choice A rationale:
The client is displaying manifestations of lithium toxicity, which includes ataxia and blurred vision. Therefore, the nurse should withhold the medication.
Choice B rationale:
Administering the next dose as prescribed could potentially exacerbate the client’s symptoms and increase the risk of further toxicity.
Choice C rationale:
Propranolol is not typically used in the management of lithium toxicity.
Choice D rationale:
Levothyroxine is used to treat hypothyroidism and is not relevant in this context.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse reviews the laboratory report for a client who is receiving lithium three times daily PO. The client's current blood lithium level is 1.8 mEq/L. The nurse identifies that this lab value indicates which of the following?.

Correct Answer is C

Explanation

A nurse is caring for a client who has bipolar disorder and is taking lithium. The client reports blurred vision and ataxia. Which of the following actions should the nurse take?

Correct Answer is A

Explanation

A nurse is reviewing medications for a newly admitted client who has bipolar disorder and is experiencing mania. Which of the following client prescriptions should the nurse realize is expected to reduce the client's mania?.

A nurse is planning care for a client who has dependent personality disorder. Which of the following actions should the nurse plan to take?

A nurse is caring for a client who has bipolar disorder and is in the manic phase. The client says he is bored. Which of the following activities is appropriate for the nurse to suggest to this client?

A nurse is assessing a client who has schizophrenia which has been treated with fluphenazine for several years. Which of the following findings should the nurse document as manifestations of tardive dyskinesia (TD)?.

A nurse is conducting an in-service for a group of newly licensed nurses about the interventions used for clients experiencing non-suicidal self-harm (NSSH). Which of the following should the nurse include?.

A nurse is reviewing the medical record of a client who performs self-injury. Which of the following information should the nurse identify as placing the client at risk for self-harm behaviors?

A nurse is caring for a client who has schizophrenia and is experiencing auditory hallucinations. Which of the following responses should the nurse make first?

A nurse is caring for a client who has been diagnosed with schizophrenia. The client has been wearing the same clothes for the past week and appears unkempt and unbathed. Which of the following statements should the nurse make to the client?