A patient with a history of bipolar I disorder is prescribed fluoxetine (Prozac) for a depressive episode. What is the nurse's priority action?

Assess the patient for gastrointestinal side effects.

Monitor the patient closely for signs of mania.

Administer the medication as ordered

Educate the patient about potential weight gain

Answer and Explanation

The Correct Answer is B

A. While gastrointestinal side effects are common with fluoxetine, they are not the priority concern in the context of bipolar disorder.

B. Fluoxetine (Prozac) is an SSRI used to treat depression, but in patients with bipolar disorder, it can trigger a manic episode. Therefore, the nurse's priority is to monitor for signs of mania, such as increased energy, euphoria, or impulsivity.

C. Administering the medication as ordered is essential, but the nurse must be vigilant for signs of mania, especially with SSRIs in bipolar patients.

D. Educating about weight gain is important but does not address the immediate risk of precipitating mania with fluoxetine in a bipolar patient.

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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.

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 with a history of bipolar I disorder is prescribed fluoxetine (Prozac) for a depressive episode. What is the nurse's priority action?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who is experiencing excessive anxiety and worry in response to a variety of circumstances, and is unable to control their sense of worry. The nurse should identity that these manifestations indicate which of the following?

Correct Answer is B

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

A nurse is preparing to administer levothyroxine 100 mcg PO daily. Available is levothyroxine 50 mcg tablets. How many tablets should the nurse administer daily? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

A nurse is preparing a client who has chronic anxiety for discharge from the psychiatric unit. Which of the following instructions should the nurse include in the client's discharge plan?

A nurse on the psychiatric unit is assessing a client who has moderate anxiety disorder. Which of the following findings should the nurse expect?

A client who has bipolar disorder approaches the nurse and reveals fresh, self-inflicted, superficial cuts going up and down his right arm. Which of the following actions should the nurse take first?

A nurse is reviewing medications for a newly admitted client who has bipolar disorder and is experiencing mania. Which of the following client prescriptions should the nurse realize is expected to reduce the client's mania?

A nurse in an acute care mental health facility is preparing to administer morning medication for a client who has been taking lithium for 2 weeks and has a current lithium level of 1.0 mEq/L. Which of the following actions should the nurse take?

A nurse on an inpatient mental health unit is admitting a client who has panic-level anxiety. After showing the client to his room, which of the following nursing actions is most therapeutic at this time?

A patient with bipolar II disorder is most likely to experience: