A client prescribed lithium carbonate 300 mg twice daily 3 months ago comes to the Emergency Department with nausea, diarrhea, muscle weakness, and coarse tremors. They notified the provider that they have had flu like symptoms and have not been able to eat or drink. The nurse suspects the client is exhibiting signs of:

toxicity from the lithium carbonate.

developing a tolerance to the lithium carbonate.

stopping their prescribed lithium carbonate.

consuming foods high in tyramine while taking lithium carbonate.

Answer and Explanation

The Correct Answer is A

A. Lithium carbonate is a medication commonly used to treat bipolar disorder. Symptoms of lithium toxicity can include nausea, vomiting, diarrhea, muscle weakness, tremors, and flu-like symptoms. If a client is experiencing these symptoms after taking lithium carbonate, it could indicate lithium toxicity
B. Lithium is a mood stabilizer, and tolerance, in the sense of needing increasing doses to achieve the same effect, is not commonly observed.
C. Suddenly stopping lithium carbonate can lead to withdrawal symptoms, but the symptoms described— nausea, diarrhea, muscle weakness, and tremors—are more indicative of toxicity rather than withdrawal.
D. Tyramine is a compound found in certain foods and beverages, and interactions between tyramine-rich foods and certain medications, such as monoamine oxidase inhibitors (MAOIs), can lead to hypertensive crises. However, lithium carbonate is not known to have interactions with tyramine-rich foods.

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Correct Answer is B

Explanation

B. Methylphenidate is a central nervous system stimulant commonly used in the treatment of ADHD. It works by increasing the levels of certain neurotransmitters in the brain, which helps improve attention, focus, and impulse control in individuals with ADHD. Teaching the family about methylphenidate would be appropriate as it is one of the most commonly prescribed medications for ADHD.
A. Fluphenazine is an antipsychotic medication primarily used to treat psychotic disorders such as schizophrenia and bipolar disorder. It is not typically used as a first-line treatment for ADHD
C. Diazepam is a benzodiazepine medication primarily used to treat anxiety disorders, muscle spasms, and seizures. It is not indicated for the treatment of ADHD.
D. Haloperidol is an antipsychotic medication primarily used to treat psychotic disorders and severe behavioral disturbances. It is not a first-line treatment for ADHD.

A. Short, polite responses to interview questions B. Introspection related to present situation C. Feelings of helplessness and hopelessness D. Disorganized thinking and the inability to remain seated.

Correct Answer is D

Explanation

D. Mania is characterized by symptoms such as increased energy levels, decreased need for sleep, impulsivity, racing thoughts, and agitation. Disorganized thinking, rapid speech, and an inability to remain seated are common manifestations of manic symptoms.
A. Clients in a manic episode often exhibit rapid speech, tangential thinking, and may be overly talkative rather than providing short, polite responses.
B. Manic individuals typically exhibit heightened energy levels, impulsivity, and distractibility, making it challenging for them to engage in introspection or focus on the present situation. Instead, they may be preoccupied with grandiose ideas, racing thoughts, or engaging in excessive activities.
C. This response is more characteristic of individuals experiencing depressive episodes of bipolar disorder rather than manic episodes. During a depressive episode, individuals with bipolar disorder may experience profound feelings of sadness, hopelessness, and helplessness, along with symptoms such as fatigue, changes in appetite or weight, and sleep disturbances.

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Naxlex Comprehensive Predictor Exams

A physician mentions to the nurse that a child with Attention Deficit-Hyperactivity Disorder (ADHD) will begin medication therapy. The nurse should prepare a plan to teach the family about:

Correct Answer is B

Explanation

A family describes a client diagnosed with bipolar disorder as being "on the move." The client sleeps 3-4 hours nightly, spends excessively, and has recently lost 10 pounds. During the initial client assessment, which response would the nurse expect?

Correct Answer is D

Explanation

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