Question 1 of 5.

Extract:The nurse in the behavioral health clinic is caring for a 48-year-old male client. • Diagnostic Results Diagnostic, Result ,Reference Range Calcium, 10.5 mg/di (2.75mmol/I), 9.0-10.5 mg/dL (2.25-2.75 mmol/L) Chloride, 99 mEq/1 (99 mmol/l), 98 to 106 mEq/L (98 to 106 mmol/l) Creatinine, 0.9 mg/dI (79.6mcmol/L), 0.6 to 1.2 mg/di (53-106 mcmol/L) Potassium, 3.8 mEq/1 (3.8, mmol/D), 3.5-5.0 mEq/L (3.5-5.0 mmol/L) Sodium,137 mEq/1 (137mmol/l), 135 to 145 mEq/1 (135 to 145 mmol/I) Blood urea nitrogen,12 mg/di (4.2mmol/I), 10-20 mg/dL (3.6-7.1 mmol/L) Fasting glucose ,202 mg/dL (11.2mmol/L), 70-110 mg/dL (4-6 mmol/L) White blood cell, 11,000/mm3 (11 × 109 /L), 5,000-10,000/mm 3 (5-10 × 109 /L) Hemoglobin (Hgb), 15 g/dL (150 g/L), Male: 14-18 g/dL (140-180 g/L) Female: 12-16 g/dL (120-160 g/L) Hematocrit (Hct), 45% (0.47), Male: 42%-52% (0.42-0.52) Female: 37%-47% (0.37-0.47) Lithium level, 0.4 mEg/L , 0.6-1.2 mEg/L • Progress Notes 1250: Client reports suboptimal adherence with lithium because of thirst and urination. Client agreed to continue the trial of medication. Will discontinue ziprasidone because of tardive dyskinesia. Will follow up more regularly, considering we are going to monotherapy for mood stabilization. • Orders 1251: • discontinue ziprasidone • continue lithium 900 mg p.o. qHS • hemoglobin A1C • valbenazine 40 mg p.o. daily • follow-up in one week • lithium level in one week • Nurses' Notes 1230: Client presents for a follow-up appointment. He reports 100% adherence with prescribed ziprasidone. Two weeks ago, he was prescribed lithium, for which he reports a mild thirst. This thirst is causing him to go to the bathroom more frequently overnight. He reports that he recently got a second job to save for a vacation. On assessment, the client is alert and completely oriented. He had a logical thought process. Lung sounds clear bilaterally, and peripheral pulses were 2+. Skin is warm, dry, and normal for ethnicity. Rapid eye blinking and persistent chewing motions in his mouth despite not eating any food or gum. He reports that this started two weeks ago. Current weight is 128 kg (282 pounds). Current BMI is 26kg/m2. Previous weight one month ago was 126 kg (277 pounds). The most recent hospitalization was one month ago for a manic episode. Laboratory data reviewed. One week follow-up visit 0900: Client returns for a follow-up visit, reporting full adherence to the prescribed lithium. He reports that he is still gaining weight and is interested in participating in low-impact activities for weight loss. He experienced significant symptom improvement with tardive dyskinesia, with only light chewing motion in the mouth. On assessment, the client's affect is full range, and he exhibited no abnormal facial movements except a slight fine hand tremor. Hemoglobin A1C lab reviewed and was 6.3% [5.7-7%]. The most recent lithium level was 0.8 mEq/L [0.6-1.2 mEq/L].

The nurse reviews the progress note and orders. The nurse educates the client about the orders and prescriptions. Complete the following sentence by choosing from the list of options. The nurse should remind the client to obtain their lithium level------------------hours after the last dose. When educating the client about the ordered hemoglobin A1C laboratory test, the nurse should----------------

Question 2 of 5.

The nurse is planning care with a Mexican American client who is diagnosed with depression. The client believes in 'mal ojo' (the evil eye), and uses treatment by a root healer. The nurse should do which of the following?

Question 3 of 5.

The nurse is reviewing the laboratory report with the client's lithium level taken that morning prior to administering the 5 p.m. dose of lithium. The lithium level is 1.8 mEq/L. The nurse should:

Question 4 of 5.

After a few minutes of conversation, a female client who is depressed wearily asks the nurse, 'Why pick me to talk to? Go talk to someone else.' Which of the following replies by the nurse is best?

Question 5 of 5.

A male client who is very depressed exhibits psychomotor retardation, a flat affect, and apathy. The nurse observes the client to be in need of grooming and hygiene. Which of the following nursing actions is most appropriate?