A client prescribed lithium carbonate 300 mg twice daily a month ago comes to the Emergency Department with mental confusion, frequent urination in large amounts, and coarse tremors. Which lithium level would the nurse expect?
0.8 mEq/L
2.3 mEq/L
1.8 mEq/L
1.2 mEq/L
The Correct Answer is B
Choice A Reason: 0.8 mEq/L
The therapeutic range for lithium is typically between 0.6 and 1.2 mEq/L. A level of 0.8 mEq/L falls within this range and is considered normal. Therefore, it is unlikely that a client with this lithium level would present with symptoms such as mental confusion, frequent urination, and coarse tremors. These symptoms are more indicative of lithium toxicity, which occurs at higher levels.
Choice B Reason: 2.3 mEq/L
A lithium level of 2.3 mEq/L is significantly above the therapeutic range and indicates lithium toxicity. Symptoms of lithium toxicity include mental confusion, frequent urination, and coarse tremors, which match the client’s presentation. Severe toxicity can occur at levels above 2.0 mEq/L and can be life-threatening if not treated promptly. Therefore, this is the most likely lithium level for the client described.
Choice C Reason: 1.8 mEq/L
A lithium level of 1.8 mEq/L is above the therapeutic range but below the level typically associated with severe toxicity. While some symptoms of toxicity might appear at this level, they are generally less severe than those described in the scenario. The client’s symptoms suggest a more severe level of toxicity, making this choice less likely.
Choice D Reason: 1.2 mEq/L
A lithium level of 1.2 mEq/L is at the upper limit of the therapeutic range. While it is possible for some mild side effects to occur at this level, the severe symptoms described (mental confusion, frequent urination, and coarse tremors) are more indicative of a higher, toxic level of lithium. Therefore, this choice is also less likely.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
The correct answer is a. I feel so defeated and want to hide after I have binged.
Choice A Reason:
Individuals with binge-eating disorder often experience intense feelings of shame, guilt, and defeat after a binge episode. This emotional response is a hallmark of the disorder and can lead to further cycles of binge eating as a way to cope with these negative emotions. The statement “I feel so defeated and want to hide after I have binged” accurately reflects the emotional turmoil that accompanies binge-eating episodes.
Choice B Reason:
The statement “I am able to control the pace of my bingeing when I start getting full” is not typically associated with binge-eating disorder. People with this disorder often feel a loss of control over their eating during a binge episode and are unable to stop even when they are full. This lack of control is a key diagnostic criterion for binge-eating disorder.
Choice C Reason:
While feeling hungry can trigger a binge, it is not the primary characteristic of binge-eating disorder. The disorder is more about the uncontrollable nature of the eating episodes and the emotional distress that follows, rather than just responding to hunger. Therefore, the statement “My binges usually start off with feeling hungry” does not fully capture the essence of the disorder.
Choice D Reason:
Binge-eating as a reward for completing difficult tasks is not a typical feature of binge-eating disorder. The disorder is more about using food as a way to cope with negative emotions rather than as a reward. The statement “I binge to reward myself for completing difficult tasks” does not align with the common emotional triggers for binge-eating episodes.
Correct Answer is ["A","B","E"]
Explanation
The correct answer is a, b, and e.
Choice A Reason:
The patient’s partner’s act of sending flowers is an example of undoing. Undoing is a defense mechanism where a person tries to cancel out or remove an unhealthy, destructive, or otherwise threatening thought or action by engaging in contrary behavior. In this case, the partner is attempting to make amends for the abuse by sending flowers, which is a common tactic used by abusers to mitigate their guilt and manipulate the victim into forgiving them.
Choice B Reason:
The patient and partner are in the honeymoon phase of intimate partner violence. The cycle of abuse in intimate partner violence typically includes a honeymoon phase, where the abuser may apologize, show remorse, and promise to change. This phase often involves gestures of affection and kindness, such as sending flowers or gifts, to win back the victim’s trust and prevent them from leaving.
Choice C Reason:
The patient has a submissive personality and depression. While it is possible that the patient may have a submissive personality and depression, this conclusion cannot be definitively made based on the given scenario alone. Submissive personality traits and depression are complex and require thorough psychological evaluation to diagnose accurately.
Choice D Reason:
Since the injuries have caused hospitalization, the patient will end the relationship. This conclusion is not necessarily accurate. Victims of intimate partner violence often face significant psychological, emotional, and practical barriers to leaving an abusive relationship, even after severe incidents that result in hospitalization. The decision to leave an abusive relationship is influenced by various factors, including fear, financial dependence, emotional attachment, and lack of support.
Choice E Reason:
The partner may be trying to manipulate the staff by buying pizza. Manipulative behavior is common in abusive relationships. By buying pizza for the staff, the partner may be attempting to create a favorable impression and gain sympathy, which can influence the staff’s perception of the situation and potentially affect their support for the patient.
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