Psychiatric Nursing, 7th Edition by Norman L. Keltner - Debbie Steele
Psychiatric Nursing, 7th Edition by Norman L. Keltner - Debbie Steele
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Chapter 16: Antimanic Drugs
Complete Chapter Questions With Answers
Sample Questions Are Posted Below
MULTIPLE CHOICE
| a. | sodium. |
| b. | chloride. |
| c. | potassium. |
| d. | magnesium. |
ANS: A
It is believed that lithium substitutes for the sodium (Na) ion in neurons. Reductions or increases in Na intake affect the serum lithium level. The other options have not been identified as critical to lithium level.
DIF: Cognitive level: Understanding REF: p. 174
TOP: Nursing process: Assessment MSC: NCLEX: Physiologic Integrity
| a. | Wide therapeutic index |
| b. | Excreted by the kidneys |
| c. | Poorly absorbed in the gastrointestinal (GI) tract |
| d. | Provides immediate relief of symptoms |
ANS: B
Lithium is excreted via the kidneys. The other options are incorrect. The nursing implication is that individuals with renal damage should not be given lithium or should be monitored closely if lithium must be administered.
DIF: Cognitive level: Understanding REF: p. 174-175
TOP: Nursing process: Assessment MSC: NCLEX: Physiologic Integrity
| a. | Administer a PRN dose of benztropine (Cogentin) to relieve extrapyramidal symptoms (EPSEs). |
| b. | Hold the next dose of risperidone to prevent further drug–drug interaction. |
| c. | Reassure the patient that these side effects will decrease with time. |
| d. | Notify the prescribing physician immediately. |
ANS: D
The symptoms the patient is experiencing are consistent with a serum lithium level above the therapeutic level. The nurse should withhold the next dose, arrange for a stat serum lithium level determination, and notify the health care provider. Risperidone can be continued because this is not a drug–drug interaction problem. Administration of benztropine is inappropriate because these are not EPSE symptoms. Reassurance would be appropriate, but the patient should not be told that these symptoms will decrease with time and continued dosing.
DIF: Cognitive level: Analyzing REF: p. 178
TOP: Nursing process: Implementation MSC: NCLEX: Physiologic Integrity
| a. | Increase sodium in the patient’s diet. |
| b. | Immediately obtain a serum lithium level determination. |
| c. | Comfort the patient that these effects will probably decrease over time. |
| d. | Withhold the lithium until the patient no longer exhibits these side effects. |
ANS: C
These side effects are common and often decrease or disappear over time with continued lithium therapy. Dietary sodium should remain unchanged to keep the lithium level stable. These side effects do not suggest the need for determination of a lithium level. Lithium should not be withheld, because these are not toxic symptoms.
DIF: Cognitive level: Applying REF: p. 175-176
TOP: Nursing process: Implementation MSC: NCLEX: Physiologic Integrity
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