A nurse is reinforcing teaching with a client who has bipolar disorder and has a new prescription for lithium. To address possible adverse effects, the nurse should include that which of the following laboratory values will be monitored while the client is taking this medication?

Liver enzymes

Uric acid

Erythrocyte sedimentation rate

Sodium level

Answer and Explanation

The Correct Answer is D

A.   Monitoring liver enzymes (AST, ALT) is typically not directly related to lithium therapy. Elevated liver enzymes may indicate liver damage from various causes, such as hepatitis or medication toxicity, but it is not a routine monitoring parameter for lithium.
B.   Lithium can decrease the excretion of uric acid, potentially leading to elevated levels. Monitoring uric acid levels helps to detect hyperuricemia, which may contribute to conditions like gout. It's important to monitor this parameter periodically during lithium therapy.
C.   ESR is a nonspecific marker of inflammation and is not specifically monitored in relation to lithium therapy. It is used to diagnose or monitor conditions like infections, autoimmune diseases, or certain cancers, but it does not directly relate to lithium use.
D.   Monitoring serum sodium levels is crucial during lithium therapy because lithium can affect renal function and electrolyte balance, including sodium levels. Hyponatremia is a potential adverse effect of lithium, and regular monitoring helps detect and manage this condition promptly.

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Correct Answer is D

Explanation

A. Lanugo refers to fine, soft hair that grows on the face, back, and arms as a result of malnutrition. It is more common in anorexia nervosa rather than bulimia nervosa.
B. Muscle wasting is not typically a primary symptom of bulimia.
C. Hypomagnesemia, or low magnesium levels, may occur but is not very characteristic of bulimia nervosa.
D. Hypokalemia, or low levels of potassium in the blood, is a common finding in individuals with bulimia nervosa who engage in purging behaviors such as vomiting or misuse of diuretics. Potassium is crucial for proper muscle and nerve function, and low levels can lead to symptoms such as muscle weakness, fatigue, cardiac arrhythmias, and in severe cases, paralysis.

A. "Can you see these spiders crawling all over me?" B. "The aliens are going to abduct me tonight." C. "The voices told me to quit eating the food” D. "Are you planning to kill me?"

Correct Answer is C

Explanation

A. This statement describes a visual hallucination (seeing spiders crawling), not a command hallucination. Visual hallucinations involve seeing things that are not actually present.

B. This statement reflects a delusion rather than a hallucination. Delusions are false beliefs that are firmly held despite evidence to the contrary. In this case, the belief in aliens and abduction is not related to hearing voices commanding actions.
C. This statement indicates a command hallucination. The client hears voices instructing them to stop eating. Command hallucinations often involve direct, imperative commands from voices that are perceived as real.
D. This statement reflects paranoia or fear of harm from others, which can be a common symptom in schizophrenia. However, it does not directly indicate a command hallucination.

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A nurse is reinforcing teaching with a client who has bipolar disorder and has a new prescription for lithium. To address possible adverse effects, the nurse should include that which of the following laboratory values will be monitored while the client is taking this medication?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is collecting data from a client who has bulimia nervosa. Which of the following findings should the nurse expect?

Correct Answer is D

Explanation

A nurse is collecting data from a client who has schizophrenia. Which of the following client statements indicates that the client is experiencing a command hallucination?

Correct Answer is C

Explanation

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