On morning rounds, the nurse found a manic-depressive client who is taking lithium in a confused mental state, vomiting, twitching, and exhibiting a coarse hand tremor. Which one of the following nursing actions is essential at this time?

• A.Administer her next dosage of lithium, and then call the physician.
• B.Withhold her lithium, and report her symptoms to the physician.
• C.Place her on NPO to decrease the excretion of lithium from her body, and call the physician.
• D.Contact the lab and request a lithium level in 30 minutes, and call the physician.

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A male client has been hospitalized with congestive heart failure. Medical management of heart failure focuses on improving myocardial contractility. This can be achieved by administering:

• A.Digoxin (Lanoxin) 0.25 mg po every day
• B.Furosemide (Lasix) 40 mg po every morning
• C.O22 L/min via nasal cannula
• D.Nitroglycerin (Nitrol) 1 inch topically every 4 hours

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A 44-year-old client had an emergency cholecystectomy 3 days ago for a ruptured gallbladder. She complains of severe abdominal pain. Assessment reveals abdominal rigidity and distention, increased temperature, and tachycardia. Diagnostic testing reveals an elevated WBC count. The nurse suspects that the client has developed:

• A.Gastritis
• B.Evisceration
• C.Peritonitis
• D.Pulmonary embolism

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A client's prenatal screening indicated that she has no immunity to rubella. She is now 10 weeks pregnant. The best time to immunize her is:

• A.In the immediate postpartum period
• B.After the first trimester
• C.At 28 weeks' gestation
• D.Within 72 hours postpartum

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A 29-year-old client delivered her fifth child by the Lamaze method and developed a postpartal hemorrhage in the recovery room. What are the initial symptoms of shock that she may experience?

• A.Marked elevation in blood pressure, respirations, and pulse
• B.Decreased systolic pressure, cold skin, and anuria
• C.Rapid pulse; narrowed pulse pressure; cool, moist skin
• D.No urinary output, tachycardia, and restlessness

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