A nurse is reviewing the medication list of a client who has bipolar disorder. The client is taking lithium carbonate, haloperidol, and lorazepam. The nurse should monitor the client for which of the following adverse effects?

Extrapyramidal symptoms

Serotonin syndrome

Neuroleptic malignant syndrome

Lithium toxicity

Answer and Explanation

The Correct Answer is C

A) Incorrect. Extrapyramidal symptoms (EPS), such as dystonia, akathisia, and tardive dyskinesia, are caused by dopamine antagonists, such as haloperidol. However, these symptoms are not related to the combination of medications that the client is taking.

B) Incorrect. Serotonin syndrome is a potentially life-threatening condition that results from excessive serotonin activity in the central nervous system. It is caused by serotonin-enhancing medications, such as antidepressants, opioids, and triptans. None of the medications that the client is taking have this effect.

C) Correct. Neuroleptic malignant syndrome (NMS) is a rare but serious condition that occurs due to dopamine blockade in the brain and peripheral tissues. It is caused by antipsychotic medications, such as haloperidol. The risk of NMS is increased when lithium carbonate is added to antipsychotic therapy, as lithium can potentiate the dopamine-blocking effect of antipsychotics.

D) Incorrect. Lithium toxicity is a condition that occurs when lithium levels exceed the therapeutic range of 0.6 to 1.2 mEq/L. It is caused by factors that affect lithium excretion, such as dehydration, renal impairment, drug interactions, and overdose. None of the other medications that the client is taking interact with lithium or affect its excretion.

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Correct Answer is C

Explanation

A) Incorrect. Metformin does not cause hypoglycemia, as it does not stimulate insulin secretion. It lowers blood glucose levels by decreasing hepatic glucose production and increasing insulin sensitivity.

B) Incorrect. Metformin absorption is not affected by food intake. The medication can be taken with or without food, but taking it with meals can help reduce gastrointestinal side effects.

C) Correct. Metformin can cause gastrointestinal upset, such as nausea, diarrhea, and abdominal pain. Taking it with meals can help minimize these effects by slowing down the transit of the medication through the digestive tract.

D) Incorrect. Metformin effectiveness is not influenced by food intake. The medication works by improving glucose metabolism and insulin action.

A. Diarrhea B. Rash C. Headache D. Nausea

Correct Answer is B

Explanation

A) Incorrect. Diarrhea is a common side effect of amoxicillin, but it is not a sign of an allergic reaction. The nurse should advise the client to drink plenty of fluids and eat foods that are high in fiber to prevent dehydration and constipation. The nurse should also instruct the client to report severe or bloody diarrhea, as it may indicate a serious condition called pseudomembranous colitis.

B) Correct. Rash is a sign of an allergic reaction to amoxicillin, and it may indicate a hypersensitivity or anaphylactic reaction. The nurse should instruct the client to report any rash, itching, hives, or swelling to their provider immediately and stop taking the medication.

C) Incorrect. Headache is a common side effect of amoxicillin, but it is not a sign of an allergic reaction. The nurse should advise the client to take over-the-counter analgesics, such as acetaminophen or ibuprofen, to relieve headache pain.

D) Incorrect. Nausea is a common side effect of amoxicillin, but it is not a sign of an allergic reaction. The nurse should advise the client to take the medication with food or milk to reduce nausea and vomiting.

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A nurse is reviewing the medication list of a client who has bipolar disorder. The client is taking lithium carbonate, haloperidol, and lorazepam. The nurse should monitor the client for which of the following adverse effects?

Nursing Test Bank

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Correct Answer is B

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