A newly diagnosed patient is prescribed lithium. Which information from the patient's history indicates that monitoring of serum concentrations of the drug will be challenging and critical?
Arthritis
Heart failure
Psoriasis
Epilepsy
The Correct Answer is B
Rationale:
A. Arthritis does not typically affect lithium metabolism or clearance.
B. Heart failure can impair renal function and fluid balance, increasing the risk of lithium toxicity and making serum concentration monitoring critical.
C. Psoriasis does not interfere with lithium pharmacokinetics.
D. Epilepsy is not directly related to lithium metabolism, though caution is warranted if the patient is on other medications.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Rationale:
A. Poor judgment and hyperactivity are characteristic of mania, demonstrated by risky behavior (posting on official sites, inviting politicians) and prolonged activity without rest.
B. Increased muscle tension and anxiety are more typical of anxiety disorders, not classic manic episodes.
C. Vegetative signs (e.g., sleep and appetite disturbances) occur but poor grooming is more common in depression than mania.
D. Cognitive deficits and paranoia may be seen in psychosis but are not the primary features described here.
Correct Answer is A
Explanation
Rationale:
A. Severe diarrhea, worsening tremor, weakness, and unsteady gait are signs of possible lithium toxicity, which requires immediate medical evaluation; the patient should be brought to the clinic promptly.
B. Restricting fluids can worsen dehydration and increase lithium concentration, making toxicity more likely.
C. Taking an antidiarrheal does not address the underlying problem and may delay urgent treatment.
D. Adding salt and water will not reverse toxicity and could delay necessary medical intervention.
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