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The nurse is preparing to transfer a client from the post-anesthesia care unit (PACU). Which assessment findings would delay the transfer of the client? (Select All that Apply.)

Presence of cough

Absence of gag reflex

Respiratory rate of 6 breaths per minute

Urine output 90 mL/hour

Heart rate 70 beats per minute

Capillary refill less than 3 seconds

Answer and Explanation

Correct Answer : B,C

A. The presence of a cough is expected as a protective reflex and does not delay transfer.

B. The absence of a gag reflex increases the risk of aspiration, delaying safe transfer.

C. A respiratory rate of 6 breaths per minute indicates respiratory depression, which requires immediate intervention.

D. Urine output of 90 mL/hour is within the expected range and does not delay transfer.

E. A heart rate of 70 beats per minute is normal and not a contraindication for transfer.

F. Capillary refill less than 3 seconds is normal and does not delay the transfer.

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Free Nursing Study Resources

Correct Answer is ["A","C","D","E"]

Explanation

A. Lithium is a first-line treatment for managing both the manic and depressive episodes of bipolar disorder.

B. Donepezil is a cholinesterase inhibitor used in the treatment of Alzheimer's disease, not for bipolar disorder.

C. Olanzapine is an atypical antipsychotic often used in the treatment of acute mania in bipolar disorder.

D. Carbamazepine is an anticonvulsant and mood stabilizer that is also used to treat acute mania.

E. Valproic acid is an anticonvulsant and mood stabilizer used for managing mania in bipolar disorder.

A. Liver function tests must be monitored. B. Thyroid function tests should be performed every 6 months. C. A pretreatment electroencephalogram (EEG) will be done. D. High serum sodium levels can cause toxic levels of valproate

Correct Answer is A

Explanation

A. Valproate is associated with potential liver toxicity, so liver function tests must be monitored regularly during treatment.

B. Thyroid function tests are not required with valproate therapy, although they are important for other medications, such as lithium.

C. A pretreatment EEG is not necessary for valproate use. This test is typically used for clients with seizure disorders.

D. High serum sodium levels are not related to valproate toxicity; however, low sodium levels can increase the risk of toxicity.

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The nurse is preparing to transfer a client from the post-anesthesia care unit (PACU). Which assessment findings would delay the transfer of the client? (Select All that Apply.)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is reviewing medication records for several clients who have bipolar disorder. The nurse should recognize that which of the following medications are used to treat clients who have bipolar disorder? (Select all that apply)

Correct Answer is ["A","C","D","E"]

Explanation

A nurse is caring for a client who has bipolar disorder and a new prescription for valproate. Which of the following instructions should the nurse give the client about the use of this medication?

Correct Answer is A

Explanation

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