A mental health nurse is planning care for a client who has a new prescription for clonazepam. For which of the following adverse effects should the nurse plan to monitor?

Manifestations of seizure activity.

Decreased urine output.

Inability to recall events.

Increase in white blood cell count.

Answer and Explanation

The Correct Answer is C

Choice A rationale:

Manifestations of seizure activity are not a common adverse effect of clonazepam. In fact, clonazepam is often used to treat seizures. It is a benzodiazepine that works by decreasing abnormal electrical activity in the brain.

While it is possible for clonazepam to worsen seizures in some individuals, this is not a typical response. Therefore, it is not the most important adverse effect for the nurse to monitor.

Choice B rationale:

Decreased urine output is not a known adverse effect of clonazepam.

Some medications can affect kidney function and urine output, but clonazepam is not one of them. Therefore, it is not necessary for the nurse to monitor urine output in a client taking clonazepam. Choice C rationale:

Inability to recall events, also known as amnesia, is a common adverse effect of clonazepam.

Clonazepam can impair short-term memory, making it difficult for people to remember things that happened recently.

This can be a significant problem for clients who need to be able to recall important information, such as instructions from their healthcare providers.

Therefore, it is important for the nurse to monitor clients taking clonazepam for signs of amnesia.

Choice D rationale:

An increase in white blood cell count is not a known adverse effect of clonazepam. In fact, clonazepam can sometimes cause a decrease in white blood cell count.

However, this is a rare side effect and is not typically something that the nurse would need to monitor.

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Correct Answer is D

Explanation

Choice A rationale:

Deflecting the client's concerns to the physician dismisses the client's immediate need for emotional support and therapeutic communication.

It can hinder the development of a trusting nurse-client relationship.

The nurse is responsible for addressing the client's psychosocial needs, not solely deferring them to other healthcare professionals.

Choice B rationale:

Offering false reassurance is inappropriate and potentially harmful. It can erode trust if the client's fears are later realized.

It minimizes the client's legitimate concerns and invalidates their emotional experience.

Choice C rationale:

While lifestyle modifications are essential for managing coronary artery disease, providing unsolicited advice at this moment disregards the client's emotional distress.

It prioritizes physical health over the client's psychological well-being. It can be perceived as dismissive of the client's fears and concerns.

Choice D rationale:

Inviting the client to elaborate on their fears demonstrates active listening and encourages therapeutic communication. It validates the client's concerns and shows empathy for their emotional experience.

It provides an opportunity to assess the client's understanding of their condition and identify specific fears or misconceptions. It establishes a foundation for exploring coping mechanisms and providing appropriate support and education.

A. A client who has schizophrenia and is taking antipsychotic medication. B. An older adult client who has pancreatitis and is taking enzymes. C. An adult client who has type 2 diabetes mellitus and is taking insulin. D. A client who is in the third trimester of pregnancy and taking iron supplements.

Correct Answer is A

Explanation

Choice A rationale:

Antipsychotic medications are a class of drugs commonly used to treat schizophrenia and other psychotic disorders. They work by blocking dopamine receptors in the brain. However, dopamine is also involved in motor control, and blocking its receptors can lead to extrapyramidal symptoms (EPS).

EPS are a group of movement disorders that can be caused by antipsychotic medications. They include: Akathisia: A feeling of restlessness and an inability to sit still.

Dystonia: Involuntary muscle contractions that can cause twisting or spasms.

Parkinsonism: Symptoms similar to Parkinson's disease, such as tremor, rigidity, and slowness of movement. Tardive dyskinesia: Involuntary, repetitive movements of the face, tongue, or other body parts.

The risk of developing EPS is higher with older antipsychotic medications, such as haloperidol and chlorpromazine. Newer antipsychotic medications, such as risperidone and olanzapine, are less likely to cause EPS, but they can still occur.

Clients who are taking antipsychotic medications should be monitored for EPS. If EPS develop, the medication may need to be changed or the dose reduced.

Choice B rationale:

Enzymes are not known to cause EPS. They are used to treat pancreatitis by helping the body to digest food.

Choice C rationale:

Insulin is not known to cause EPS. It is used to treat type 2 diabetes mellitus by helping the body to control blood sugar levels.

Choice D rationale:

Iron supplements are not known to cause EPS. They are often taken by pregnant women to prevent iron deficiency anemia.

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A mental health nurse is planning care for a client who has a new prescription for clonazepam. For which of the following adverse effects should the nurse plan to monitor?

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