A young adult client with a recent diagnosis of bipolar disorder takes lithium carbonate daily. The client informed the school nurse of the desire to live away from home to attend college after graduating in one month. Which information is most important for the nurse to provide the client and his family?

The client should be aware of the signs and symptoms of his illness.

The client should plan to participate in group or individual therapy while at college.

Despite the illness, the client should be able to live away from home.

The client's serum lithium levels should be routinely evaluated.

Answer and Explanation

The Correct Answer is D

Choice A rationale:
While it's important for the client to be aware of the signs and symptoms of their illness, medication monitoring is a more immediate concern.
Choice B rationale:
Participating in therapy can be beneficial, but it's not the most critical information to provide in this context.
Choice C rationale:
Living away from home is possible for many individuals with bipolar disorder, but medication management is a higher priority.
Choice D rationale:
Routine monitoring of serum lithium levels is crucial to ensure therapeutic levels and prevent lithium toxicity in individuals taking lithium carbonate for bipolar disorder.

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Correct Answer is A

Explanation

Choice A rationale:
It is crucial to obtain information about any history of heart disease before starting an antidepressant-like sertraline because certain antidepressants can have effects on the heart's electrical conduction system. Sertraline, in particular, may be associated with QT interval prolongation, and individuals with a history of heart disease may be at higher risk. Assessing this history helps the nurse make informed decisions about the client's treatment and potential risks.

Choice B rationale:
While a familial history of mental illness is important to consider, it is not the most critical information to obtain before starting sertraline. The primary concern with sertraline is its potential impact on the heart's electrical conduction system, making option A (heart disease history) more relevant.

Choice C rationale:
Current weight is essential to monitor during treatment with sertraline as it can impact dosing, but it is not the most critical piece of information to obtain before starting the medication.

Choice D rationale:
Medication history is important but not the most critical information in this context. Assessing any history of heart disease (Option A) takes precedence due to the specific cardiovascular risks associated with sertraline.

A. "I just feel like my life is filled with emptiness." B. "I have three firearms locked in a safe at home." C. "My daughter is the only reason I keep trying." D. "My panic attacks happen once every month."

Correct Answer is B

Explanation

Choice A rationale:
This statement expresses the client's emotional state but does not provide information about immediate access to lethal means.

Choice B rationale:
This comment is the most crucial to document because it indicates the client's access to potentially lethal means, which is a significant risk factor for committing suicide.

Choice C rationale:
This statement provides information about a source of support in the client's life but does not indicate immediate access to lethal methods.

Choice D rationale:
This statement provides information about the frequency of panic attacks but does not indicate immediate access to lethal means.

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Naxlex Comprehensive Predictor Exams

Prior to initiating a treatment regimen with the antidepressant sertraline, it is most important for the nurse to obtain which information?

Correct Answer is A

Explanation

A client is admitted to the hospital with suicidal ideation. When completing the health history and admission assessment interview, which client comment is most important for the nurse to document?

Correct Answer is B

Explanation

Which intervention(s) should the nurse include in the plan of care for an adolescent who is depressed? (Select all that apply.)

The nurse plans to use role-playing as a therapeutic measure. Which individual is most likely to benefit from this type of therapeutic intervention?

The nurse is providing dietary instructions for a client who is being discharged after passing a calcium oxalate renal stone. Which food should the nurse instruct the client to avoid?

A nurse who is co-leading group therapy recognizes that a client is beginning to experience severe levels of anxiety. Which intervention is best for the nurse to implement?

A male client tells the nurse that he has an IQ of 400+ and is a genius and an inventor. He also reports that he is married to a female movie star and thinks that his brother wants a sexual relationship with her. Which is the priority nursing problem for admission to the psychiatric unit?

A nurse who is co-leading group therapy recognizes that a client is beginning to experience severe levels of anxiety. Which intervention is best for the nurse to implement?

The nurse is developing a plan of care for an older client with hypertension who reports chest pain on exertion. Which outcome should the nurse include in the plan of care for this client?

A preschool-aged girl tells the school nurse that her hair hurts. The nurse finds that the child's hair has been arranged to cover several small bald spots. Which finding indicates to the nurse that the hair loss is not disease-related?