Registered Practical Nurse (RPN) Practice Test

When monitoring lithium blood levels during acute mania, what important step should be taken?

1. Administer the morning dose of lithium

2. Withhold the morning dose of lithium

3. Check levels after meals

4. Reduce the dose of lithium

The correct answer is: Withhold the morning dose of lithium

Withholding the morning dose of lithium before blood level monitoring is essential to obtain an accurate assessment of serum lithium concentration. Timing is critical in relation to medication administration and blood sampling. Lithium levels are often highest shortly after a dose is taken, which could lead to a misleadingly high reading if levels are checked shortly after medication administration. The aim is to assess the steady-state concentration of the drug in the bloodstream, which reflects how the patient is responding to treatment during this acute phase. By withholding the morning dose, the healthcare provider ensures that the blood sample will provide a more accurate representation of the lithium level free from recent intake, thus allowing for appropriate adjustments to management and dosage based on the patient's therapeutic response and safety.