An outpatient client taking paroxetine states he started taking St. John's Wort. The client calls the nurse with complaints of a high fever, muscle stiffness, and sweating. The nurse should advise the client to

use a high-quality heating pad for the pain.

contact the primary care provider immediately.

call an orthopedic doctor to evaluate the symptoms.

start on a clear liquid diet and maintain bedrest.

Answer and Explanation

The Correct Answer is B

B. The combination of paroxetine and St. John's Wort can lead to a potentially life-threatening condition known as serotonin syndrome. It is important for healthcare providers to be aware of potential drug interactions and to monitor patients closely when changes to their medication regimen occur.
A. Using a heating pad may provide temporary relief for muscle stiffness but does not address the underlying cause of the symptoms.
C. Given the symptoms described, involving an orthopedic doctor is not appropriate as the symptoms are not related to musculoskeletal issues.
D. A clear liquid diet and bed rest do not address the underlying issue in the client hence not an appropriate action.

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Correct Answer is C

Explanation

C. Splitting is characterized by viewing people and situations in extremes, either all good or all bad, without recognizing the complexity that usually exists in most circumstances. This black-and-white thinking can lead to rapidly shifting perceptions of others, as seen in the client's sudden change from idealizing the nurse to devaluing them.
A. Denial is a defense mechanism where the individual refuses to accept reality or acknowledge an aspect of reality that is apparent to others. In this scenario, the client is not denying any aspect of reality.
B. Separation-individuation is a developmental process where individuals establish autonomy and a sense of self separate from others, particularly from primary caregivers. This process is more relevant in infancy and early childhood.
D. Reaction formation is a defense mechanism where an individual behaves in a manner opposite to their true feelings or impulses. In this scenario, the client's expression of hatred towards the nurse does not appear to be a case of reaction formation, as there is no indication that the client actually harbors feelings of care or admiration towards the nurse.

A. Have serum lithium levels checked every 6 months. B. Adjust the dose if you feel out of control. C. Do not reduce normal dietary sodium intake. D. Limit fluid intake to 1,000 mL of fluid per day.

Correct Answer is C

Explanation

C. Sodium intake can influence lithium excretion and affect serum lithium levels. Maintaining a consistent and adequate sodium intake is important for stabilizing serum lithium levels and optimizing the medication's therapeutic effects.
A. Patients should have their serum lithium levels checked regularly, typically every 3 months, not just every 6 months as suggested.
B. Clients should never adjust their lithium dose without consulting their healthcare provider. Lithium dosage adjustments should be made only under the guidance and supervision of a healthcare professional based on the client's clinical response, serum lithium levels, and overall treatment plan.
D. Adequate hydration is essential for overall health and well-being, and dehydration can increase the risk of lithium toxicity.

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An outpatient client taking paroxetine states he started taking St. John's Wort. The client calls the nurse with complaints of a high fever, muscle stiffness, and sweating. The nurse should advise the client to

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Naxlex Comprehensive Predictor Exams

The nurse has recently set limits for a client with borderline personality disorder. The client tells the nurse, "You used to care about me. I thought you were wonderful. Now I can see that I was mistaken. You are hateful." This outburst can be assessed as:

Correct Answer is C

Explanation

A client who is prescribed lithium carbonate is being discharged from inpatient care. Which medication information should the nurse teach this client?

Correct Answer is C

Explanation

The best action for the nurse to take with a 5-year-old who runs over to another child in the waiting room and slaps her is to:

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