Psychotherapeut
ic Drugs NCLEX
Questions(solve
d& updated)
The nurse is caring for a patient with bipolar
disorder who is taking lithium [Lithobid].
Which abnormal laboratory value is most
essential for the nurse to communicate to the
healthcare provider because this patient is
taking lithium?
a. Sodium level of 128 mEq/L
b. Prothrombin time of 8 seconds
c. Blood urea nitrogen level of 25 mg/dL
d. Potassium level of 5.6 mEq/L
a. Sodium level of 128 mEq/L
The sodium level is well below the normal
range of 135 to 145 mEq/L. When the serum
sodium level is reduced, lithium excretion
also is reduced, and lithium accumulates.
,Because lithium has a narrow therapeutic
index, this is a dangerous situation, which
can result in symptoms of toxicity and even
death.
The nurse is seeing several patients in the
outpatient clinic today. Which patient most
requires the nurse's immediate attention?
a. A female patient with Bipolar disorder who
takes valproic acid [Depakene] and who
reports nausea and vomiting
b. A male patient with Bipolar Disorder who
takes lithium and who has a lithium level of
1.6 mEq/L
c. A male patient with depression who takes
fluoxetine [Prozac] and who reports sexual
dysfunction
d. A female patient with schizophrenia who
takes haloperidol [Haldol] and who has a
blood pressure of 102/72 mm Hg
b. A male patient with Bipolar Disorder who
takes lithium and who has a lithium level of
1.6 mEq/L
Lithium levels above 1.5 mEq/L should be
reported, because this level may indicate
impending serious toxicity. The other findings
may be side effects of the drugs the patients
,are taking, but they are not priority
problems.
The nurse is caring for a patient taking
lithium [Lithobid]. The nurse understands
that many drugs interact with lithium. Which
agent is safe to administer with lithium?
a. Ibuprofen [Motrin] for muscle pain
b. Hydrochlorothiazide (HCTZ) for edema
c. Aspirin (ASA) for mild headache
d. Diphenhydramine [Benadryl] for cold
symptoms
c. Aspirin (ASA) for mild headache
Aspirin is safe to use as an analgesic with
lithium. Other nonsteroidal anti-inflammatory
drugs (NSAIDs), such as ibuprofen, can
increase lithium levels by as much as 60%.
Diuretics increase lithium levels by reducing
the serum sodium level. Diphenhydramine
has anticholinergic properties and can
aggravate lithium-induced polyuria by
causing urinary hesitancy.
A nurse assesses a patient who takes a
maintenance dose of lithium carbonate
[Lithobid] for bipolar disorder. The patient
complains of hand tremor, nausea, vomiting,
and diarrhea. The patient's gait is unsteady.
, The patient most likely has done what?
a. Consumed some foods high in tyramine
b. Not taken the lithium as directed
c. Developed tolerance to the lithium
d. Developed lithium toxicity
d. Developed lithium toxicity
Early lithium toxicity is evidenced by
diarrhea, anorexia, muscle weakness,
nausea, vomiting, tremors, slurred speech,
and drowsiness. Later signs include blurred
vision, seizures, trembling, confusion, and
ataxia.
A family member of a patient who is
experiencing a severe manic episode asks
the nurse why the patient is receiving an
antipsychotic medication. The nurse informs
the family member that antipsychotics are
used in the treatment of severe manic
episodes to do what?
a. Help control symptoms during the severe
manic episode.
b. Elevate mood during the severe manic
episode.
c. Produce sedating effects during the severe
manic episode.
d. Reduce the amount of physical pain the
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