A client with bipolar disorder is monitored by the community mental health nurse. The client's
mood disorder is under good control when the client takes the prescribed doses of lithium.
The client
tells the nurse she is pregnant as the result of her boyfriend committing date rape. The nurse makes
the following assessments: lithium taken throughout pregnancy may result in a baby born with birth
defects; the client is likely to have a relapse of her illness if she stops taking lithium; and the client is
a devout Catholic who believes her boyfriend will marry her "even if he did get carried away" and
care for their child. Which option would be congruent with the client's values and ethical beliefs?
a. Continue lithium; deal with the issue of a baby with birth defects if it occurs.
b. Continue lithium and encourage the client to undergo a therapeutic abortion.
c. Discontinue lithium, use alternative medication, and prepare for hospitalization
prn.
d. Arrange for involuntary hospitalization for the duration of the pregnancy.
ANS: C
Discontinuing lithium will protect the fetus. Taking a "safe" or nonteratogenic psychotropic
medication may avert decompensation, but preparing the client for the possibility of hospitalization
in the event she becomes manic is ethical. Option A is in conflict with the client's plans to marry and
care for the child. Option B is contrary to the client's religious beliefs. Option D violates the client's
rights to the least restrictive treatment.
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2 1/4 + 1 5/8 = _____
a. 3 1/4 b. 3 7/8 c. 4 3/4 d. 3 3/32
During a routine well-child health examination, the parents of a 4-year-old child report being concerned their child is not getting enough rest. The nursing assessment reveals the child usually gets 9 hours of sleep per night
Which of the responses by the nurse is most appropriate? 1. "The recommendation for children of this age is at least 11 hours per night." 2. "Your child should be fine with the 9 hours he is getting." 3. "Taking a nap will benefit your child." 4. "I would not recommend making any bedtime changes for your child."
A holistic belief system by the nurse would be most evident if the nurse
a. accepts death as an outcome of life. b. encourages behavior modification programs. c. incorporates client perceptions of health when planning care. d. supports goal-directed learning to improve health.
A nurse is faced with a macroeconomics issue. Which of the following best describes what is happening?
a. The evaluation of client access to services b. A health policy that makes the develop-ment of a new program possible c. Informing clients and others of the cost of service d. The referral of clients to available services