The illustration shows various types of fracture. Select the one that depicts a greenstick fracture.

Choice A reason: Lithium toxicity is a concern but not inevitable. It occurs with levels above 1.5 mEq/L, often due to dehydration or drug interactions, common in trauma settings. However, routine monitoring of levels is a more immediate nursing priority than assuming toxicity, as early detection prevents severe outcomes like seizures or renal damage.

Choice B reason: Lithium is primarily excreted by the kidneys, not metabolized by the liver. Liver function tests are not indicated for lithium monitoring, as it does not undergo hepatic metabolism. This statement is inaccurate, as renal function tests are critical to assess lithium clearance and prevent toxicity in trauma patients.

Choice C reason: Stress does not directly increase lithium requirements. Trauma-related dehydration or renal impairment can elevate lithium levels, risking toxicity, but this is due to reduced clearance, not increased need. This statement is inaccurate, as dosing adjustments should be based on serum levels, not stress alone.

Choice D reason: Lithium has a narrow therapeutic range (0.6-1.2 mEq/L), and trauma-related factors like dehydration or medications can alter levels, risking toxicity or subtherapeutic effects. Regular serum level monitoring is critical, especially in acute settings, to ensure safety and efficacy, making this statement accurate and a priority nursing concern.

Choice A reason: Irritable Bowel Syndrome (IBS) is a functional gastrointestinal disorder, not primarily an inflammatory disease. While low-grade inflammation may be present in some cases, IBS is characterized by altered gut motility and visceral hypersensitivity without significant inflammatory markers, unlike inflammatory bowel diseases like Crohn’s or ulcerative colitis. This statement is inaccurate.

Choice B reason: Stress is a well-documented trigger for IBS symptoms. The brain-gut axis, involving the hypothalamic-pituitary-adrenal axis, modulates gut motility and sensitivity. Psychological stress can exacerbate visceral pain, diarrhea, or constipation by altering neurotransmitter release and gut microbiome interactions, making this statement accurate for IBS pathophysiology.

Choice C reason: IBS treatment focuses on symptom relief, as there is no cure. Strategies include dietary modifications (e.g., low FODMAP diet), antispasmodics, laxatives, or antidiarrheals to manage pain, bloating, and bowel irregularities. This statement is accurate, reflecting the symptomatic approach to improving quality of life in IBS patients.

Choice D reason: IBS symptoms commonly include constipation, diarrhea, or alternating patterns, along with abdominal pain and bloating. These result from dysregulated gut motility and visceral hypersensitivity, affecting the enteric nervous system. This statement is accurate, as variable bowel habits are a hallmark of IBS diagnostic criteria.