A nurse is evaluating client understanding following teaching about lithium therapy for bipolar disorder. Which of the following statements by the client should alert the nurse to the need for further teaching?

"I will limit my time in the sun to avoid getting dehydrated."

"If I get the flu and can't eat or drink much, I'll keep taking my lithium as prescribed."

"I know I need to avoid a low-sodium diet while taking lithium."

"I’ll make sure to have my lithium blood level checked every few months."

Answer and Explanation

The Correct Answer is B

Choice A reason: Limiting sun exposure to prevent dehydration is appropriate. Dehydration increases lithium reabsorption in the kidneys, which can elevate serum lithium levels and increase the risk of toxicity. By avoiding prolonged sun exposure, the client reduces the likelihood of fluid loss through sweating, thereby maintaining stable hydration and safer lithium levels. This demonstrates correct understanding of lithium therapy precautions.

Choice B reason: Continuing lithium during illness when fluid and food intake are reduced is unsafe. Illnesses such as influenza can cause dehydration and electrolyte imbalance, which increase lithium retention and risk of toxicity. The correct action would be to contact the provider immediately if unable to maintain adequate hydration or nutrition. This statement reflects a misunderstanding of lithium safety and requires further teaching to prevent dangerous outcomes.

Choice C reason: Avoiding a low-sodium diet is correct. Lithium and sodium compete for reabsorption in the renal tubules. A low-sodium diet increases lithium reabsorption, raising serum levels and toxicity risk. Maintaining consistent sodium intake helps stabilize lithium levels. This statement demonstrates accurate understanding of dietary precautions.

Choice D reason: Regular monitoring of lithium blood levels is essential for safe therapy. Lithium has a narrow therapeutic range (0.6–1.2 mEq/L), and levels must be checked every few months or more frequently depending on clinical status. This ensures early detection of toxicity and appropriate dose adjustments. This statement reflects correct understanding of monitoring requirements.

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Correct Answer is B

Explanation

Choice A reason: While ECT does increase cerebral blood flow, this is not the primary mechanism of its therapeutic effect.

Choice B reason: ECT induces a controlled seizure that alters neurotransmitter levels and receptor sensitivity, leading to improved mood regulation. It also promotes neurogenesis and synaptic plasticity, which are critical in alleviating symptoms of major depressive disorder. This is the correct mechanism.

Choice C reason: ECT does not directly stimulate the hypothalamic gland to release dopamine. This is not supported by scientific evidence.

Choice D reason: ECT does not suppress electrical activity; rather, it induces controlled electrical activity (a seizure) to achieve therapeutic effects.

A. Acknowledge the client’s concerns and redirect focus to coping strategies. B. Encourage the client to minimize attention to physical symptoms. C. Refer the client for immediate psychiatric evaluation. D. Reassure the client that nothing is physically wrong.

Correct Answer is A

Explanation

Choice A reason: The most therapeutic approach is to acknowledge the client’s distress and validate their concerns while gently redirecting focus toward coping strategies. This balances empathy with promoting adaptive behaviors. It avoids dismissing the client’s experience and supports long-term management of somatic symptom disorder.

Choice B reason: Encouraging the client to minimize attention to symptoms may appear dismissive and can increase anxiety or mistrust. Clients with somatic symptom disorder often feel invalidated, so this approach is not therapeutic.

Choice C reason: Immediate psychiatric evaluation is not warranted unless there is evidence of acute psychiatric crisis, such as suicidal ideation. In this case, the client’s symptoms are consistent with somatic symptom disorder and can be managed with therapeutic communication and coping strategies.

Choice D reason: Reassuring the client that nothing is physically wrong invalidates their experience and may worsen anxiety. It is not therapeutic and does not promote trust or coping.

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A nurse is evaluating client understanding following teaching about lithium therapy for bipolar disorder. Which of the following statements by the client should alert the nurse to the need for further teaching?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

According to Melinda Walker, RN, from Johns Hopkins Hospital, which of the following describes the primary mechanism by which Electroconvulsive Therapy (ECT) affects the brain?

Correct Answer is B

Explanation

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Correct Answer is A

Explanation

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