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 A

Explanation

A. A lithium level of 1.0 mEq/L is within the therapeutic range (0.6 to 1.2 mEq/L). The nurse should administer the morning dose of lithium as prescribed.

B. While it is important to monitor for medication adherence, there is no indication from the current lithium level that this client is refusing the medication.

C. Gastric lavage is unnecessary, as the lithium level is not elevated enough to warrant this extreme intervention.

D. Early signs of lithium toxicity typically occur with levels above 1.5 mEq/L. Since the level is 1.0 mEq/L, the nurse should proceed with administering the medication.

A. Reality testing B. Derealization C. Grandiosity D. Flight of ideas

Correct Answer is C

Explanation

A. Reality testing refers to the ability to distinguish between what is real and what is not. The client’s belief is a symptom of grandiosity, not a lack of reality testing.

B. Derealization refers to the sense that the external world is unreal or distorted, which is not the case here.

C. Grandiosity is an inflated sense of self-importance and unrealistic beliefs in one’s abilities, as demonstrated by the client’s statement about being able to fly and become a U.S. Senator.

D. Flight of ideas involves rapid, continuous speech with fragmented thoughts that jump from one topic to another. The client’s speech does not exhibit this pattern.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is A

Explanation

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Correct Answer is C

Explanation

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