A nurse is preparing to administer diphenhydramine 50 mg PO every 6 hr to a client who has acute dystonia. The available medication is diphenhydramine 25 mg tablets.

How many tablets should the nurse administer per dose?

The correct answer is choice b. Administer the morning dose of lithium.

Choice A rationale:

Preparing for gastric lavage is unnecessary because a lithium level of 1.0 mEq/L is within the therapeutic range (0.6-1.2 mEq/L) and does not indicate toxicity.

Choice B rationale:

Administering the morning dose of lithium is appropriate as the current lithium level is within the therapeutic range, indicating that the medication is being managed correctly.

Choice C rationale:

Holding the medication and assessing for early manifestations of toxicity is not necessary since the lithium level is not indicative of toxicity. Toxicity typically occurs at levels above 1.5 mEq/L.

Choice D rationale:

Checking the client’s medication record to assess whether the client has been refusing her lithium is not relevant in this scenario because the lithium level is within the therapeutic range, suggesting compliance with the medication regimen.

Choice A rationale: Expression of guilt feelings is a positive outcome in the treatment of conduct disorder. Guilt is an emotional response to one’s actions that are perceived as wrong or inappropriate. It is a self-conscious emotion that often involves a

sense of tension and regret. In the context of conduct disorder, the expression of guilt feelings can be seen as a sign of developing empathy and understanding the consequences of one’s actions. This is a crucial step in the process of behavior change and rehabilitation. The client showing signs of remorse during one-on-one counseling is a positive sign indicating that the treatment is having an effect.

Choice B rationale: A statement regarding unit rules is another positive outcome in the treatment of conduct disorder. Understanding and acknowledging the rules of the unit indicates that the client is beginning to accept the boundaries and norms set by the authority. This is a significant step towards improving their behavior, as individuals with conduct disorder often have difficulties following rules and respecting authority. The verbal altercation with another client could be seen as a negative event, but it also could indicate that the client is engaging with others, which could be a step towards improvement, depending on the context of the altercation.

Choice C rationale: A renewed relationship with an uncle does not necessarily indicate a positive outcome from the treatment of conduct disorder. While family support can be beneficial in the treatment process, it does not directly indicate that the client’s conduct disorder is improving. More information would be needed to determine if this is a positive outcome related to the treatment.

Choice D rationale: A positive attitude toward school is a positive outcome in the treatment of conduct disorder. School is a structured environment where rules and expectations are clearly laid out, and a positive attitude towards school can indicate that the client is beginning to accept these structures. This can be a sign of improvement in their behavior and attitude.