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A nurse is reinforcing teaching with a client who has a prescription for lithium carbonate to treat bipolar disorder.
Which of the following instructions should the nurse include?.

Limit fluid intake to 800 ounces per day while taking this medication.

Take the medication on an empty stomach.

Wait up to 3 weeks to see the full effects of the medication.

Follow a low-sodium diet.

Answer and Explanation

The Correct Answer is C

Choice A rationale:

The client should maintain a normal fluid intake while taking lithium, not limit it to 800 ounces per day.

Choice B rationale:

Lithium can be taken with or without food. This instruction is not necessary.

Choice C rationale:

It can indeed take up to 3 weeks to see the full effects of lithium. This is a correct instruction.

Choice D rationale:

The client should maintain a normal sodium diet while taking lithium, not a low-sodium diet.

So, the correct answer is C, after analyzing all choices.

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Correct Answer is ["94"]

Explanation

Step 1 is to calculate the rate of infusion. The formula is total volume ÷ total time. So, (750 mL ÷ 8 hr) = 93.75 mL/hr. Rounding to the nearest whole number gives 94 mL/hr.

So, the correct answer is 94 mL/hr.

A. "I should take this medication when my spasms are bad.”. B. "I need to notify my provider if I don't get some relief from my muscle spasms within 3 months.”. C. "I am glad this medication is safe to take if I get pregnant.”. D. "I should return to the clinic to have my calcium level checked every 6 weeks.”.

Correct Answer is B

Explanation

The correct answer is Choice B

Choice A rationale: Dantrolene is a direct-acting skeletal muscle relaxant that works by inhibiting calcium release from the sarcoplasmic reticulum in muscle cells, thereby reducing muscle contraction. It is not intended for as-needed use during acute spasms but requires consistent dosing to maintain therapeutic levels. Intermittent use undermines its pharmacokinetics and may lead to subtherapeutic effects. The half-life of dantrolene is approximately 8.7 hours, and steady-state levels are necessary for optimal spasticity control in multiple sclerosis.

Choice B rationale: Dantrolene’s therapeutic effect on muscle spasticity may take several weeks to manifest due to its mechanism of action involving gradual reduction in intracellular calcium availability. If no improvement is noted within 3 months, it may indicate inadequate response or the need for dosage adjustment. Monitoring for efficacy is essential, as prolonged use without benefit increases risk of hepatotoxicity. Liver function tests should be monitored regularly. Normal ALT levels are 7–56 units/L; elevations may signal toxicity.

Choice C rationale: Dantrolene is classified as pregnancy category C, indicating that risk to the fetus cannot be ruled out. Animal studies have shown adverse effects, and there are no adequate human studies confirming safety during pregnancy. Therefore, it is not considered safe without careful risk-benefit analysis. Teratogenicity and fetal toxicity are concerns due to its action on muscle fibers and potential systemic effects. Pregnant clients should consult their provider before initiating or continuing dantrolene therapy.

Choice D rationale: Dantrolene does not directly affect calcium levels in the bloodstream. Its mechanism involves inhibition of calcium release within muscle cells, not systemic calcium metabolism. Routine calcium monitoring is not required unless the client has a separate condition affecting calcium homeostasis. Normal serum calcium levels range from 8.5 to 10.5 mg/dL. The primary lab concern with dantrolene is hepatotoxicity, necessitating regular liver function tests, not calcium surveillance. This statement reflects a misunderstanding of the drug’s effects.

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A nurse is reinforcing teaching with a client who has a prescription for lithium carbonate to treat bipolar disorder.Which of the following instructions should the nurse include?.

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Naxlex Comprehensive Predictor Exams

A nurse is preparing to administer 0.9% sodium chloride (NaCl) 750 mL IV to infuse over 8 hr. The nurse should set the IV pump to deliver how many mL/hr? (Round to the nearest whole number. Use a leading zero if it applies.

Correct Answer is ["94"]

Explanation

A nurse is reinforcing teaching for a female client who has multiple sclerosis and a new prescription for dantrolene. Which of the following client statements indicates an understanding of the teaching?.

Correct Answer is B

Explanation

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A nurse is reinforcing teaching with a client who has a prescription for lithium carbonate to treat bipolar disorder.
Which of the following instructions should the nurse include?.