A patient diagnosed with bipolar disorder is prescribed lithium carbonate. Which laboratory result should prompt the nurse to hold the medication and notify the healthcare provider?

Potassium 4.2 mEq/L

Sodium 136 mEq/L

Calcium 9.0 mg/dL

Creatinine 2.1 mg/dL

Answer and Explanation

The Correct Answer is D

A. Potassium 4.2 mEq/L is within the normal range (3.5–5.0 mEq/L).

B. Sodium 136 mEq/L is slightly low but does not warrant withholding lithium. However, sodium levels should be monitored regularly as low sodium increases the risk of lithium toxicity.

C. A calcium level of 9.0 mg/dL is within the normal range (8.5–10.2 mg/dL).

D. An elevated creatinine level (2.1 mg/dL) indicates possible renal dysfunction, which is a concern for lithium use. Lithium is excreted by the kidneys, and impaired renal function increases the risk of lithium toxicity.

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Correct Answer is B

Explanation

A. Propranolol: Propranolol is a beta-blocker that can be used to treat physical symptoms of anxiety, such as a racing heart. While it may help reduce physiological symptoms, it does not address the psychological components of anxiety and is not commonly prescribed for acute anxiety episodes like test-taking anxiety. Propranolol is more effective for individuals with performance anxiety (e.g., public speaking).

B. Lorazepam: Lorazepam is a benzodiazepine that works by depressing the central nervous system, providing rapid relief of acute anxiety symptoms. It is often used for short-term management of anxiety and can effectively reduce symptoms such as racing heart and trembling hands, making it appropriate for episodic anxiety like test-taking anxiety. However, it is typically prescribed for short-term use due to its potential for dependence.

C. Sertraline: Sertraline is a selective serotonin reuptake inhibitor (SSRI) used for chronic anxiety and depression, but it is not effective for acute episodic anxiety. SSRIs are typically prescribed for long-term management of anxiety disorders, rather than immediate symptom relief.

D. Buspirone: Buspirone is an anxiolytic medication used for generalized anxiety disorder (GAD) but has a delayed onset of action and is not effective for acute, episodic anxiety relief. It is more suitable for long-term management rather than immediate symptom control.

A. "Come with me. Here is a milkshake to drink." B. "We need you to decide what activities you will do today C. "You will need to leave the dining room right now and go somewhere else to exercise." D. "You are already too thin and exercise is not good for you. Go sit down somewhere and eat something."

Correct Answer is A

Explanation

A. Offering the client a milkshake while directing them to a different activity provides a way to meet the client's nutritional needs and addresses their manic energy by giving them a focus other than exercise. This approach maintains structure without creating confrontation.

B. Giving the client the autonomy to decide on their activities might not be appropriate in acute mania, where impulsivity and poor judgment can lead to further disorganization.

C. Telling the client to leave the dining room immediately could escalate the situation, as it may be seen as an authoritative and disruptive intervention. A more supportive approach is better.

D. Telling the client that exercise is not good for them can escalate the situation or worsen their distress. It may also reinforce negative self-image and discourage further participation in necessary eating and nutrition.

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A patient diagnosed with bipolar disorder is prescribed lithium carbonate. Which laboratory result should prompt the nurse to hold the medication and notify the healthcare provider?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is B

Explanation

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Correct Answer is A

Explanation

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