A client with schizophrenia has received standard antipsychotics for a year. His hallucinations are less intrusive, but the client remains apathetic, has poverty of thought, cannot work, and is socially isolated.

To address these symptoms, the nurse might expect the psychiatrist to prescribe which medication?

Haloperidol

Olanzapine

Diphenhydramine

Chlorpromazine

Answer and Explanation

The Correct Answer is B

A.   Haloperidol is a first-generation antipsychotic and may not be as effective in addressing the negative symptoms (e.g., apathy, poverty of thought) as second-generation antipsychotics.
B.   Olanzapine is a second-generation antipsychotic known to be effective in treating both positive and negative symptoms of schizophrenia.
C.   Diphenhydramine is not typically used as a primary treatment for schizophrenia.
D.   Chlorpromazine is a first-generation antipsychotic and may not be as effective in addressing the negative symptoms as second-generation antipsychotics.

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Correct Answer is C

Explanation

A) Incorrect. Isolating the client in his room may escalate the situation or make the client feel isolated and misunderstood.

B) Incorrect. Asking the client to stop talking may be perceived as confrontational and could potentially agitate the client further.

C) Correct. Speaking slowly and in a quiet voice can help the client focus and may reduce the flight of ideas. This calm approach can be grounding for the client.

D) Incorrect. Encouraging the client to talk more may exacerbate the flight of ideas and the manic state.

A. Kidney function studies B. Red blood cell count C. Liver function studies D. White blood cell count

Correct Answer is D

Explanation

A. Kidney function studies While monitoring kidney function is important for clients on certain medications, it is not the primary laboratory test for monitoring clozapine. Clozapine is associated with agranulocytosis, which affects white blood cell count.

B. Red blood cell count Monitoring red blood cell count is not the primary concern when a client is prescribed clozapine. The main concern with clozapine is agranulocytosis, which affects white blood cells.

C. Liver function studies While liver function is important to monitor with some medications, it is not the primary laboratory test for monitoring clozapine. The primary concern with clozapine is agranulocytosis, which affects white blood cell count.

D. White blood cell count Clozapine is associated with agranulocytosis, a potentially life- threatening condition characterized by a severe decrease in white blood cells. Regular
monitoring of white blood cell count is crucial to detect and prevent this adverse effect. This test should be performed before starting clozapine and regularly throughout treatment. If the white blood cell count drops significantly, clozapine may need to be discontinued. This makes it the
most important laboratory study to monitor when a client is prescribed clozapine.

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Naxlex Comprehensive Predictor Exams

A client diagnosed with bipolar I disorder is in a manic state, rushing about the unit, and talking regularly with a flight of ideas. What is the most therapeutic intervention?

Correct Answer is C

Explanation

A client with schizophrenia has begun a new prescription of clozapine. The nurse should assess the result of which laboratory study to monitor for adverse effects?

Correct Answer is D

Explanation

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