A patient diagnosed with bipolar disorder is prescribed lithium carbonate. Which laboratory result should prompt the nurse to hold the medication and notify the healthcare provider?

Potassium 4.2 mEq/L

Sodium 136 mEq/L

Calcium 9.0 mg/dL

Creatinine 2.1 mg/dL

Answer and Explanation

The Correct Answer is D

A. Potassium 4.2 mEq/L is within the normal range (3.5–5.0 mEq/L).

B. Sodium 136 mEq/L is slightly low but does not warrant withholding lithium. However, sodium levels should be monitored regularly as low sodium increases the risk of lithium toxicity.

C. A calcium level of 9.0 mg/dL is within the normal range (8.5–10.2 mg/dL).

D. An elevated creatinine level (2.1 mg/dL) indicates possible renal dysfunction, which is a concern for lithium use. Lithium is excreted by the kidneys, and impaired renal function increases the risk of lithium toxicity.

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Correct Answer is C

Explanation

A. Attention-seeking conduct is more typical of personality disorders, such as borderline personality disorder, rather than anxiety.

B. Mild fidgeting is common in anxiety, but severe anxiety tends to manifest more intensely, with behaviors like threatening or aggressive actions.

C. Severe anxiety can lead to heightened agitation, which may include threatening behaviors as the client struggles to cope with overwhelming feelings of fear or distress.

D. While anxiety may impair problem-solving abilities, severe anxiety is more likely to lead to emotional dysregulation, not just mild difficulty in problem solving.

A. Agoraphobia B. Generalized anxiety disorder C. Separation anxiety disorder D. Panic disorder

Correct Answer is B

Explanation

A. Agoraphobia is marked by the fear of being in situations where escape may be difficult or help unavailable in case of panic-like symptoms. It is not characterized by generalized worry.

B. Generalized anxiety disorder (GAD) is characterized by excessive anxiety and worry that is difficult to control and is associated with a variety of circumstances. Individuals with GAD often experience chronic worry about multiple life domains, without a specific focus.

C. Separation anxiety disorder involves excessive fear of being separated from loved ones or familiar environments, which is different from generalized worry about multiple life events.

D. Panic disorder involves recurrent panic attacks that are not necessarily related to generalized anxiety or worry about various life situations.

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A patient diagnosed with bipolar disorder is prescribed lithium carbonate. Which laboratory result should prompt the nurse to hold the medication and notify the healthcare provider?

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