Chapter 16: Antimanic Drugs

Chapter 16: Antimanic Drugs

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE

1. Maintenance of a therapeutic serum level of lithium is dependent on adequate serum levels of:

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

2. Select the accurate information about the pharmacokinetics of lithium.

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

3. For 2 weeks a patient has taken lithium (Lithane) and risperidone (Risperdal) daily for mania. The patient now reports diarrhea, vomiting, and blurred vision. The nurse observes a coarse hand tremor. Select the nurse’s priority action.

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

4. A patient has taken lithium (Lithobid) 300 mg three times daily for 1 week. The patient reports the presence of fine hand tremors and thirst. Select the nurse’s best action.

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