N3381 CORE MAIN EXAMS SET QUESTIONS AND
ANSWERS SURE A+
✔✔A client taking lithium reports vomiting, abdominal pain, diarrhea, blurred vision,
tinnitus, and tremors. The lithium level is 2.5 mEq/L (2.5 mmol/L). The nurse plans care
based on which representation of this level?
1.Toxic
2.Normal
3.Slightly above normal
4.Excessively below normal - ✔✔Toxic
Rationale:Maintenance serum levels of lithium are 0.6 to 1.2 mEq/L (0.6 to 1.2 mmol/L).
Symptoms of toxicity begin to appear at levels of 1.5 mEq/L (1.5 mmol/L). Lithium
toxicity requires immediate medical attention and the primary health care provider is
notified if symptoms of toxicity occur.
✔✔A client gives the home health nurse a bottle of clomipramine. The nurse notes that
the medication has not been taken by the client in 2 months. Which behavior observed
in the client would validate noncompliance with this medication?
1.Complaints of insomnia
2.Complaints of hunger and fatigue
3.A pulse rate less than 60 beats per minute
, 4.Frequent hand washing with hot, soapy water - ✔✔Frequent hand washing with hot,
soapy water
Rationale:Clomipramine is a tricyclic antidepressant used to treat obsessive-compulsive
disorder. Sedation sometimes occurs. Insomnia seldom is a side effect. Weight gain
and tachycardia are side and adverse effects of this medication.
✔✔A hospitalized client has begun taking bupropion as an antidepressant agent. The
nurse determines that which is an adverse effect, indicating that the client is taking an
excessive amount of medication?
1.Constipation
2.Seizure activity
3.Increased weight
4.Dizziness when getting upright - ✔✔Seizure activity
Rationale:Seizure activity can occur in clients taking bupropion dosages greater than
450 mg daily. Weight gain is an occasional side effect, whereas constipation is a
common side effect of this medication. This medication does not cause significant
orthostatic blood pressure changes.
✔✔A client receiving tricyclic antidepressants arrives at the mental health clinic. Which
observation would indicate that the client is following the medication plan correctly?
1.Client reports not going to work for the past week.
2.Client complains of not being able to "do anything" anymore. 3.Client arrives at the
clinic neat and appropriate in appearance. 4.Client reports sleeping 12 hours per night
and 3 to 4 hours during the day. - ✔✔Client arrives at the clinic neat and appropriate in
appearance
Rationale:Depressed individuals sleep for long periods, are unable to go to work, and
feel as if they cannot "do anything." When these clients have had some therapeutic
effect from their medication, they report resolution of many of these complaints and
exhibit an improvement in their appearance. Options 1, 2, and 4 identify continued
depression.
✔✔The clinic nurse is reviewing the record of a client scheduled to be seen in the clinic.
The nurse notes that the client is taking selegiline hydrochloride. The nurse suspects
that the client has which disorder?
1.Diabetes mellitus
2.Parkinson's disease
3.Alzheimer's disease
4.Coronary artery disease - ✔✔Parkinson's disease
ANSWERS SURE A+
✔✔A client taking lithium reports vomiting, abdominal pain, diarrhea, blurred vision,
tinnitus, and tremors. The lithium level is 2.5 mEq/L (2.5 mmol/L). The nurse plans care
based on which representation of this level?
1.Toxic
2.Normal
3.Slightly above normal
4.Excessively below normal - ✔✔Toxic
Rationale:Maintenance serum levels of lithium are 0.6 to 1.2 mEq/L (0.6 to 1.2 mmol/L).
Symptoms of toxicity begin to appear at levels of 1.5 mEq/L (1.5 mmol/L). Lithium
toxicity requires immediate medical attention and the primary health care provider is
notified if symptoms of toxicity occur.
✔✔A client gives the home health nurse a bottle of clomipramine. The nurse notes that
the medication has not been taken by the client in 2 months. Which behavior observed
in the client would validate noncompliance with this medication?
1.Complaints of insomnia
2.Complaints of hunger and fatigue
3.A pulse rate less than 60 beats per minute
, 4.Frequent hand washing with hot, soapy water - ✔✔Frequent hand washing with hot,
soapy water
Rationale:Clomipramine is a tricyclic antidepressant used to treat obsessive-compulsive
disorder. Sedation sometimes occurs. Insomnia seldom is a side effect. Weight gain
and tachycardia are side and adverse effects of this medication.
✔✔A hospitalized client has begun taking bupropion as an antidepressant agent. The
nurse determines that which is an adverse effect, indicating that the client is taking an
excessive amount of medication?
1.Constipation
2.Seizure activity
3.Increased weight
4.Dizziness when getting upright - ✔✔Seizure activity
Rationale:Seizure activity can occur in clients taking bupropion dosages greater than
450 mg daily. Weight gain is an occasional side effect, whereas constipation is a
common side effect of this medication. This medication does not cause significant
orthostatic blood pressure changes.
✔✔A client receiving tricyclic antidepressants arrives at the mental health clinic. Which
observation would indicate that the client is following the medication plan correctly?
1.Client reports not going to work for the past week.
2.Client complains of not being able to "do anything" anymore. 3.Client arrives at the
clinic neat and appropriate in appearance. 4.Client reports sleeping 12 hours per night
and 3 to 4 hours during the day. - ✔✔Client arrives at the clinic neat and appropriate in
appearance
Rationale:Depressed individuals sleep for long periods, are unable to go to work, and
feel as if they cannot "do anything." When these clients have had some therapeutic
effect from their medication, they report resolution of many of these complaints and
exhibit an improvement in their appearance. Options 1, 2, and 4 identify continued
depression.
✔✔The clinic nurse is reviewing the record of a client scheduled to be seen in the clinic.
The nurse notes that the client is taking selegiline hydrochloride. The nurse suspects
that the client has which disorder?
1.Diabetes mellitus
2.Parkinson's disease
3.Alzheimer's disease
4.Coronary artery disease - ✔✔Parkinson's disease
