A patient diagnosed with bipolar disorder is prescribed lamotrigine. The nurse should instruct the patient to immediately report which adverse effect?

Nausea

Tremors

Skin rash

Drowsiness

Answer and Explanation

The Correct Answer is C

A. Nausea is a common side effect but is not as critical as a skin rash.

B. Tremors may occur with certain medications used in bipolar disorder but are not a specific concern with lamotrigine.

C. A skin rash is a serious adverse effect of lamotrigine, as it can indicate a life-threatening condition called Stevens-Johnson syndrome (SJS) or toxic epidermal necrolysis (TEN), which require immediate medical intervention.

D. Drowsiness may occur with many medications but is not as urgent as a skin rash in this case.

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Correct Answer is C

Explanation

A. Providing a structured activity schedule can be beneficial but comes after understanding the triggers of the behaviors.

B. Relaxation techniques are helpful but would be more effective after understanding the client's specific rituals and triggers.

C. The first step in managing obsessive-compulsive disorder (OCD) is understanding the triggers or precipitating factors for the client's ritualistic behaviors. This helps the nurse identify patterns and understand the client's anxiety, which is essential for planning further interventions.

D. Discussing alternative coping strategies is important but should follow an assessment of the factors that drive the compulsive behaviors.

A. The lithium level is within the therapeutic level for initial treatment. B. A blood lithium level of 1.8 mEq/L is not within the maintenance treatment level. C. The lithium level is below the therapeutic treatment level. D. The lithium level is at the toxic level.

Correct Answer is D

Explanation

A. A level of 1.8 mEq/L is too high for initial treatment, as it is above the therapeutic range.

B. A level of 1.8 mEq/L is not within the maintenance treatment level, which is typically 0.6–1.2 mEq/L.

C. The level is above the therapeutic level, not below it.

D. A lithium level of 1.8 mEq/L is above the therapeutic range (0.6–1.2 mEq/L) and is considered toxic. Toxicity can lead to serious side effects like tremors, confusion, and renal dysfunction.

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A patient diagnosed with bipolar disorder is prescribed lamotrigine. The nurse should instruct the patient to immediately report which adverse effect?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a newly admitted client who has obsessive-compulsive disorder (OCD). Which of the following actions should the nurse take first?

Correct Answer is C

Explanation

A nurse reviews the laboratory report for a client who is receiving lithium three times daily PO. The client's current blood lithium level is 1.8 mEq/L. The nurse identifies that this lab value indicates which of the following?

Correct Answer is D

Explanation

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Inability to leave one's home because of avoidance of severe anxiety suggests the existence of which anxiety disorder?

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