79.A client diagnosed with bipolar disorder asks the nurse why itis necessary to have a serum lithium level drawn every 3 to 4months. The nurse’s response should be based on which of thefollowing?1. To monitor compliance with the medication.2. To prevent toxicity related to the drug’s therapeutic range.3. To monitor the client’s white blood cell count.4. To comply with the drug manufacturer’s requirements.79. 2.RATIONALE:The serum lithium level has nothing to do with theclient’s white blood cell count and the drug manufacturers have no specificrequirement for blood testing. While a periodic serum lithium level couldmonitor whether or not a client was taking the prescribed medication, themost important reason for the blood test is to periodically assess the client’slithium level and prevent even mild toxicity on an ongoing basis.
80.The physician orders determination of the serum lithium leveltomorrow for a client with bipolar disorder, manic phase, whohas been receiving lithium 300 mg P.O. three times daily forthe past 5 days. At which of the following times should thenurse plan to have the blood specimen obtained?
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81.A client will be discharged on lithium carbonate 600 mg threetimes daily. When teaching the client and his family aboutlithium therapy, the nurse determines that teaching has beeneffective if the client and family state that they will notify theprescribing health care provider immediately if which of the
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What are the guidelines that nurses should follow when considering whether or not a client
requires restraints?
When considering whether or not a client requires restraints, the nurse should determine if the
client needs restraints, like if they are a danger to him or herself, or to others. They should
determine if all alternative interventions to the use of restraints have been taken, like using bed
or chair alarms, distraction, frequent monitoring, utilizing a sitter, etc.
A client on the mental health unit is being discharged to a community base program
referred to as Assertive Community Treatment (ACT). What should the nurse explain to
the client about this program?
ACT is an effective treatment program that helps people with serious mental illness that do not
usually respond to other treatments. People receive individualized care from various
multidisciplinary members in the outpatient setting that helps them function in the community
and reduces their chance of being readmitted to the hospital. People are accompanied to different
appointments and receive help with things in their life such as finding a job/home, managing
money, and obtaining transportation.
A client has become very aggressive. List de-escalation techniques the nurse will want to
implement to address the behavior of the client.
1. Communicate with the client in a clear and calm way.
2. Identify the wants/needs of the client.
3. When approaching the client, use non-threatening body language.
4. Display respect, empathy and compassion towards the client.
5. Allow the patient to vent in order for them to feel validated.
A client has been admitted to an inpatient mental health facility and close observation has
been ordered. List the rights of the client when admitted with this level of management.
1. The client has the right to informed of their rights in the inpatient mental health facility.
2. The client has the right to refuse treatment, or services.
3. The client can refuse observation techniques, such as the use of tape recorders
4. The client has the right to be informed about diagnosis/condition.
5. The client has the right to confidentiality.
Which of the following client would be the priority to assess first? A client diagnosed with
schizophrenia that is exhibiting negative symptoms, a client with a substance-induced
psychotic disorder related to substance intoxication, a client who is suffering from delusion
of grandeur, a client suffering from olfactory hallucinations.
The priority client to assess is the client diagnosed with a substance-induced psychotic disorder
related to substance intoxication. The nurse must address the psychosis and intoxication.
The client states that she is going through a divorce and her anxiety is extremely high. The
nurse needs to assess the client’s ability to adapt and cope with this situation. What would
this include?
The nurse should assess how the client is physically reacting to anxiety by the use of observation
and asking the client questions in a therapeutic manner. The nurse can assess the client’s health