Nursing Elites

1. A client has been taking lithium for several years with good symptom control. The client presents in the emergency department with blurred vision, tinnitus, and severe diarrhea. Which lithium level should the nurse correlate with these symptoms?

• A. 3.7
• B. 1.7
• C. 2.6
• D. 1.3

Correct answer: B

Rationale: Symptoms such as blurred vision, tinnitus, and severe diarrhea are indicative of lithium toxicity. A lithium level of 1.7 is within the toxic range. When clients present with these symptoms, it is crucial for the nurse to correlate them with elevated lithium levels to ensure timely intervention and prevent further complications.

2. During pregnancy, a woman is in a relationship with a male who routinely abuses her. Her unborn child may engage in high-risk behavior as a teen as a result of:

• A. Maternal stress
• B. Parental nurturing
• C. Appropriate stress responses in the brain
• D. Memories of the abuse

Correct answer: A

Rationale: Maternal stress during pregnancy can have long-term effects on the child's behavior and stress responses. Research shows that exposure to high levels of stress hormones in the womb can influence the developing fetal brain and the child's future behavior, potentially leading to high-risk behaviors during adolescence.

3. Which of the following are symptoms of a panic attack? Select one that does not apply.

• A. Chest pain
• B. Normal breathing
• C. Dizziness
• D. Hot flashes

Correct answer: B

Rationale: Symptoms of a panic attack can include chest pain, shortness of breath, dizziness, and hot flashes. Normal breathing is not a symptom of a panic attack; instead, individuals experiencing a panic attack may often exhibit rapid or shallow breathing patterns. Therefore, the correct answer is B. Choices A, C, and D are typical symptoms associated with panic attacks, making them incorrect answers.

4. A patient with bipolar disorder is prescribed quetiapine. The nurse should monitor the patient for which common side effect?

• A. Weight gain
• B. Hypertension
• C. Hair loss
• D. Hyperthyroidism

Correct answer: A

Rationale: Weight gain is a common side effect of quetiapine, an atypical antipsychotic. Quetiapine can lead to metabolic changes that may result in weight gain. Monitoring weight regularly is essential to address this potential side effect. Choices B, C, and D are incorrect. Quetiapine is not typically associated with hypertension, hair loss, or hyperthyroidism as common side effects.

5. A client has been prescribed fluoxetine (Prozac). What information should the nurse include in discharge teaching?

• A. Take the medication with food to avoid stomach upset.
• B. Avoid drinking alcohol while taking this medication.
• C. Take the medication only when feeling depressed.
• D. Report any unusual side effects to the healthcare provider.

Correct answer: B

Rationale: The correct answer is to advise the client to avoid drinking alcohol while taking fluoxetine (Prozac) due to potential interactions. Alcohol consumption can increase the risk of certain side effects and may reduce the effectiveness of the medication. Choice A is incorrect because fluoxetine can be taken with or without food. Choice C is incorrect as fluoxetine is usually taken daily regardless of the client's mood. Choice D is not the priority teaching point; while reporting side effects is important, avoiding alcohol is critical due to the potential interactions.

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