A nurse in a mental health facility is collecting data from a client taking lithium. Which of the following information should the nurse report to the provider as an indication of lithium toxicity?

Dry cough

Elevated blood pressure

Stooped posture

Slurred speech

Answer and Explanation

The Correct Answer is D

A. Dry cough: This is not typically associated with lithium toxicity and may indicate another issue, such as a respiratory infection.
B. Elevated blood pressure: Lithium toxicity usually results in hypotension, not elevated blood pressure.
C. Stooped posture: This is not a typical sign of lithium toxicity.
D. Slurred speech: Slurred speech can be an early sign of lithium toxicity, indicating that the medication level is too high.

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Correct Answer is B

Explanation

A. Urinary retention: Urinary retention is not a typical adverse effect of lorazepam.
B. Dizziness: Lorazepam, a benzodiazepine, commonly causes CNS effects such as dizziness, drowsiness, and confusion.
C. Decreased appetite: Appetite changes are not commonly associated with lorazepam.
D. Hypertension: Lorazepam may cause hypotension, not hypertension, especially with IV administration.

A. Inject 0.3 to 0.5 mL of the solution. B. Select an injection site that is free of scar tissue. C. Hold the needle at a 30° angle during injection. D. Massage the site following the injection.

Correct Answer is B

Explanation

A. Inject 0.3 to 0.5 mL of the solution: The typical volume for a tuberculin skin test is 0.1 mL.
B. Select an injection site that is free of scar tissue: Scar tissue can interfere with the reading of the tuberculin skin test, so a site free of scars should be selected.
C. Hold the needle at a 30° angle during injection: The needle should be held at a 5–15° angle for intradermal injections.
D. Massage the site following the injection: Massaging the site is not recommended as it could affect the accuracy of the test.

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A nurse in a mental health facility is collecting data from a client taking lithium. Which of the following information should the nurse report to the provider as an indication of lithium toxicity?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Explanation

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