A nurse is assessing a client who is taking clozapine. For which of the following adverse effects should the nurse monitor and report to the provider?

Sore throat

Tinnitus

Rhinitis

Headache

Answer and Explanation

The Correct Answer is A

Rationale:

A. Sore throat: A sore throat may indicate agranulocytosis, a serious adverse effect of clozapine that results in dangerously low white blood cell counts. Early signs include fever, sore throat, and malaise. This requires immediate reporting and evaluation with a complete blood count.

B. Tinnitus: Tinnitus is not a known or common adverse effect of clozapine. While bothersome, it is not typically associated with the hematologic or metabolic risks posed by this antipsychotic medication.

C. Rhinitis: Although rhinitis can occur with many medications, it is not a serious or expected side effect of clozapine requiring urgent attention. Mild nasal symptoms are usually self-limiting and not indicative of life-threatening complications.

D. Headache: Headaches are common and nonspecific symptoms that may result from various causes. Unless severe or persistent, they do not typically indicate a dangerous reaction to clozapine and are not prioritized over signs of infection.

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Correct Answer is B

Explanation

Rationale:

A. Canned black beans: While black beans are a healthy source of protein and fiber, canned varieties are often high in sodium unless labeled low-sodium. High sodium intake can worsen hypertension, so these should be limited or thoroughly rinsed before use.

B. Fish: Fish, particularly those high in omega-3 fatty acids like salmon and mackerel, can help lower blood pressure and reduce cardiovascular risk. They are a heart-healthy protein source recommended in hypertension management.

C. Red meat: Red meat is often high in saturated fat and cholesterol, which can contribute to elevated blood pressure and heart disease. It should be limited in a diet designed to control hypertension.

D. Cheese: Many cheeses are high in sodium and saturated fat, which can increase blood pressure and cardiovascular strain. Even small portions may contain significant sodium, making them less ideal for clients with hypertension.

A. Tenting skin turgor B. Respiratory rate 30/min C. Skin warm and dry D. Heart rate 60/min

Correct Answer is B

Explanation

Rationale:

A. Tenting skin turgor: Tenting indicates dehydration or fluid volume deficit, not overload. It reflects reduced skin elasticity due to poor interstitial fluid volume.

B. Respiratory rate 30/min: Tachypnea can result from pulmonary congestion or edema due to excess fluid in the intravascular space. It is a classic sign of fluid overload as the lungs struggle with impaired gas exchange.

C. Skin warm and dry: Warm, dry skin is a normal finding and does not suggest volume overload. Fluid retention typically causes edema or moist skin in severe cases.

D. Heart rate 60/min: A heart rate within normal range does not point to fluid overload. Often, fluid overload is associated with tachycardia due to increased preload and compensatory responses.

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A nurse is assessing a client who is taking clozapine. For which of the following adverse effects should the nurse monitor and report to the provider?

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