A client who has been diagnosed with bipolar I disorder states, “God has taught me how to decode the Bible.” A nurse should anticipate that which combination of medications would be ordered to address this client’s symptoms?

Correct Answer: A

Rationale: The correct answer is A: Lithium carbonate (Lithobid) and risperidone (Risperdal). This combination is appropriate for treating bipolar I disorder with psychotic features, as the client's belief in decoding the Bible could indicate a psychotic symptom like delusions. Lithium helps stabilize mood in bipolar disorder, while risperidone is an antipsychotic that can address psychotic symptoms. Choice B includes carbamazepine, which is not typically used for psychotic symptoms in bipolar disorder. Choices C and D include medications that are not commonly used as first-line treatments for bipolar disorder with psychotic features, making them less appropriate in this scenario.

Correct Answer: A

Rationale: The correct answer is A because hydrochlorothiazide is a diuretic used to treat hypertension and fluid retention, not hypoglycemia. Step 1: Hydrochlorothiazide does not directly affect blood glucose levels. Step 2: Monitoring for hypoglycemia is more relevant for medications like insulin or oral hypoglycemic agents. Step 3: The other choices are relevant for patients on hydrochlorothiazide due to its potential side effects on potassium levels, uric acid levels, and blood pressure.

Correct Answer: A

Rationale: Step 1: Anticholinergic drugs block the action of acetylcholine in the body. Step 2: Acetylcholine is the neurotransmitter of the parasympathetic nervous system. Step 3: Inhibiting the function of acetylcholine affects the parasympathetic nervous system. Step 4: Therefore, the correct answer is A: parasympathetic nervous system. Summary: Choices B, C, and D are incorrect because anticholinergic drugs specifically target the parasympathetic nervous system, not the sympathetic, central, or peripheral nervous systems.

Correct Answer: C

Rationale: Rationale for Correct Answer (C - Pharmacokinetics): 1. Pharmacokinetics refers to how the body processes a medication including absorption, distribution, metabolism, and elimination. 2. Understanding pharmacokinetics helps predict how a medication will act in the body. 3. It is crucial for determining dosing intervals, potential drug interactions, and individualized therapy. 4. Half-life (A) is only one component of pharmacokinetics, not encompassing the full picture. 5. Side effects (B) are important but do not specifically address how the body interacts with the medication. 6. Therapeutic dosage range (D) is related to dosing but doesn't cover all aspects of pharmacokinetics.

Correct Answer: C

Rationale: The correct answer is C: How to prevent constipation. Opioid analgesics commonly cause constipation as a side effect. Teaching the patient how to prevent constipation, such as increasing fiber intake and staying hydrated, is crucial for their overall well-being. This information will help the patient manage a common side effect of the medication and improve their quality of life post-surgery. Choice A is incorrect because dehydration due to diarrhea is not a common side effect of opioid analgesics. Choice B is incorrect because waiting for pain to become severe before taking the medication can lead to uncontrolled pain and poor pain management. Choice D is incorrect because taking the drug on an empty stomach is not typically necessary for opioid analgesics and may actually increase the risk of gastrointestinal side effects.