Which person with mania is the least likely candidate to receive lithium? The patient who is:

Correct Answer: A

Rationale: In the context of pharmacology, lithium is commonly used to treat bipolar disorder, including manic episodes. However, during pregnancy, particularly in the first trimester, the use of lithium is associated with an increased risk of congenital malformations in the developing fetus. Therefore, the correct answer, option A, is the least likely candidate to receive lithium due to the potential harm it can cause to the unborn child. Option B, a person recovering from a hysterectomy, is not inherently contraindicated for lithium use. Similarly, option C, a person taking hormone replacement therapy, does not directly impact the use of lithium. Option D, a person displaying symptoms of postpartum depression, may actually benefit from lithium treatment if diagnosed with bipolar disorder. Educationally, this question highlights the importance of considering individual patient factors, such as pregnancy, in pharmacological treatment decisions. It emphasizes the need for healthcare providers to weigh the risks and benefits of medication use in specific patient populations to ensure safe and effective treatment outcomes.

Correct Answer: D

Rationale: In addiction treatment, achieving a structured and rewarding lifestyle, along with changing location after becoming abstinent (option D), is crucial for success, as it helps individuals avoid triggers and old habits, providing a fresh start and reducing the risk of relapse. This approach addresses the environmental and behavioral aspects of addiction recovery, promoting lasting changes in lifestyle and mindset. Option A (social class and university education) is incorrect as success in addiction treatment is not solely determined by socioeconomic status or educational background. Addiction can affect individuals from all social classes and educational levels, and success is contingent on various factors beyond these demographics. Option B (severity of addiction and history of criminal activity) is incorrect as these factors, though important, do not hold as much weight as creating a structured and rewarding lifestyle post-treatment. While severity of addiction and criminal history may impact treatment approaches, they are not the primary determinants of success in addiction treatment. Option C (controlled use of hallucinogens with a trained counselor) is incorrect as this approach is not widely accepted or supported in mainstream addiction treatment practices. The use of hallucinogens is a controversial and experimental method that lacks substantial scientific evidence to support its efficacy in addiction treatment. Educationally, understanding the multifaceted nature of addiction treatment and the importance of holistic approaches that address lifestyle, environment, and behavioral changes is crucial for healthcare providers and counselors working in the field of addiction. It highlights the significance of post-treatment support and the need for comprehensive strategies to promote sustained recovery.

Correct Answer: B

Rationale: No consent form is required for this 24-hour urine and serum collection. Blood may be drawn at any time during the collection (if using Vacutainer, one red, red-gray, or gold top tube is needed). In the morning the first voiding is discarded, and then the collection is timed and urine is collected for 24 hours. All urine is stored in a clean, 3-L plastic container that is refrigerated when not in use and then delivered to the lab. Teaching the patient the procedure for a 24-hour creatinine clearance as part of a prelithium workup (urinalysis, BUN, TSH, T3 and T4, FBS, and a complete physical examination with history and workup for family history of renal disease, diabetes mellitus, hypertension, diuretic use, and analgesic abuse) is required.

Correct Answer: C

Rationale: In the context of a client with schizophrenia experiencing difficulty with executive functions, the nurse can expect to assess poor response to social cues behaviorally. Executive functions involve cognitive processes such as planning, organizing, problem-solving, and responding to social cues appropriately. In schizophrenia, deficits in executive functions are common, leading to challenges in social interactions and communication. Option A, inability to speak, is less likely to be directly related to executive function deficits in schizophrenia. While communication difficulties can occur in schizophrenia, they are not typically characterized by a complete inability to speak. Option B, inhibited behaviors, may not directly correlate with executive function deficits in schizophrenia. Inhibited behaviors can result from various factors, but may not specifically relate to the cognitive processes involved in executive functions. Option D, uncoordinated movements, is more indicative of motor coordination issues rather than deficits in executive functions. While motor abnormalities can be present in schizophrenia, they are not typically associated with executive function impairments. Understanding the behavioral manifestations of executive function deficits in clients with schizophrenia is crucial for nurses to provide appropriate care and support. Recognizing poor response to social cues can guide interventions aimed at improving social interactions and communication skills in individuals with schizophrenia.

Correct Answer: C

Rationale: In this scenario, the correct answer is C) Chest pain. Ergot alkaloids, such as ergotamine, are commonly used to treat migraines by constricting blood vessels in the brain. However, one of the potential side effects of ergot alkaloids is vasoconstriction of coronary arteries, which can lead to decreased blood flow to the heart and result in chest pain or angina. This adverse effect is a serious concern as it could indicate myocardial ischemia or even a heart attack. Option A) Nervousness and option B) Dizziness are common side effects of ergot alkaloids but are generally less concerning and may not require immediate medical attention. Option D) Nausea and vomiting are also common side effects of ergotamine but are not as critical as chest pain, which can signal a potentially life-threatening condition. Educationally, it is important for healthcare providers and patients to be aware of potential side effects of medications to monitor for and report promptly. Understanding the rationale behind specific side effects can help clinicians make informed decisions regarding patient care and safety. In the case of ergot alkaloids, recognizing and addressing chest pain promptly is crucial to prevent serious cardiac complications.