ATI RN
Mental Health Nursing Practice Questions Questions
Question 1 of 5
Which statement made by the patient demonstrates an understanding of the effective use of newly prescribed lithium to manage bipolar mania? Select one that doesn't apply.
Correct Answer: C
Rationale: **Rationale:** **Correct Answer (C) - "Lithium may help me lose the few extra pounds I tend to carry around."** This statement is incorrect and demonstrates a misunderstanding of lithium therapy. Lithium is not associated with weight loss; in fact, it is widely documented to cause **weight gain** as a common side effect. The mechanism involves increased thirst and fluid retention, metabolic changes, and potential hypothyroidism, all of which can contribute to higher body weight. Patients are often counseled about this side effect to manage expectations and adopt strategies like dietary modifications. Thus, the idea that lithium aids weight loss is factually wrong and reflects a lack of proper education about the medication’s effects. **Incorrect Choices:** **A: "I remind myself to consistently drink six 12-ounce glasses of fluid every day."** This statement is accurate and reflects proper understanding. Lithium requires **adequate hydration** to maintain therapeutic serum levels and reduce the risk of toxicity. Dehydration can lead to elevated lithium concentrations, increasing the likelihood of adverse effects like tremors, confusion, or renal damage. Patients are typically advised to consume 2–3 liters of fluids daily and maintain consistent salt intake. The specificity of "six 12-ounce glasses" aligns with general guidelines, showing the patient’s awareness of this critical requirement. **B: "I discussed the diuretic prescribed by my cardiologist with my psychiatric care provider."** This statement is correct and demonstrates **appropriate medication management**. Diuretics (especially thiazides) can significantly increase lithium levels by reducing renal excretion, posing a risk of toxicity. Coordination between healthcare providers is essential to adjust lithium doses or monitor levels closely when diuretics are used. The patient’s proactive communication reflects an understanding of the importance of interdisciplinary care and lithium’s narrow therapeutic index. **D: "I take my lithium on an empty stomach to help with absorption."** While this statement contains a common misconception, it is not entirely incorrect. Lithium is generally **well-absorbed** regardless of food, though taking it with food may reduce gastrointestinal side effects like nausea. However, the belief that empty stomach administration enhances absorption is not clinically significant enough to be harmful, as bioavailability is not drastically affected. Thus, this choice does not reflect a critical misunderstanding like option C does. **Conclusion:** Option C stands out as the only choice that directly contradicts evidence-based knowledge about lithium, while the others reflect either correct practices (A, B) or minor, non-critical inaccuracies (D). The focus on weight loss is particularly misleading, as it could delay interventions for actual side effects like weight gain or electrolyte imbalances.
Question 2 of 5
A male patient calls to tell the nurse that his monthly lithium level is 1.7 mEq/L. Which nursing intervention will the nurse implement initially?
Correct Answer: B
Rationale: A lithium level of 1.7 mEq/L is above the therapeutic range, indicating a potential risk of toxicity. The initial nursing intervention should be to instruct the patient to hold the next dose of medication and promptly contact the prescriber for further guidance and management. This action aims to prevent adverse effects and ensure the patient's safety by addressing the elevated lithium level appropriately.
Question 3 of 5
Which intervention should the nurse implement when caring for a patient demonstrating manic behavior? Select one that doesn't apply.
Correct Answer: B
Rationale: When caring for a patient demonstrating manic behavior, it is crucial to monitor vital signs frequently to ensure the patient's physical health is stable. Providing nutrition, such as milkshakes and protein drinks, is essential to meet the patient's dietary needs. Diminishing environmental stimuli by reducing the volume on the television and dimming bright lights can help create a calmer environment. However, keeping the patient distracted with group-oriented activities may not be the most appropriate intervention as it could potentially exacerbate the manic behavior by overstimulating the patient. Therefore, this choice is the one that doesn't apply in managing manic behavior effectively.
Question 4 of 5
Substance abuse is often present in individuals diagnosed with bipolar disorder. Laura, a 28-year-old with a bipolar disorder diagnosis, chooses to drink alcohol instead of taking her prescribed medications. The nurse caring for this patient recognizes that:
Correct Answer: B
Rationale: Individuals with bipolar disorder may turn to alcohol as a form of self-medication to cope with their symptoms. This behavior is often seen as an attempt to manage mood swings and alleviate distress. It is important for healthcare providers to address and manage substance abuse issues in patients with bipolar disorder to ensure proper treatment and overall well-being.
Question 5 of 5
Ted, a former executive, is now unemployed due to manic episodes at work. He was diagnosed with bipolar I 8 years ago. Ted has a history of IV drug abuse, which resulted in hepatitis C. He is taking his lithium exactly as scheduled, a fact that both Ted's wife and his blood tests confirm. To reduce Ted's mania, the psychiatric nurse practitioner recommends:
Correct Answer: C
Rationale: Electroconvulsive therapy (ECT) can be an effective treatment for reducing mania in patients with bipolar disorder who have not responded to medication. In Ted's case, where he has a history of bipolar I disorder, lithium treatment, and manic episodes, ECT may be recommended by the psychiatric nurse practitioner to help manage his symptoms.