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 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.

A. Attention-seeking conduct B. Mild fidgeting C. Threatening behaviors D. Mild difficulty problem solving

Correct Answer is C

Explanation

A. Attention-seeking conduct is more typical of personality disorders, such as borderline personality disorder, rather than anxiety.

B. Mild fidgeting is common in anxiety, but severe anxiety tends to manifest more intensely, with behaviors like threatening or aggressive actions.

C. Severe anxiety can lead to heightened agitation, which may include threatening behaviors as the client struggles to cope with overwhelming feelings of fear or distress.

D. While anxiety may impair problem-solving abilities, severe anxiety is more likely to lead to emotional dysregulation, not just mild difficulty in problem solving.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is A

Explanation

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Correct Answer is C

Explanation

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