A nurse is caring for a client who has schizophrenia and is taking clozapine. The nurse notices that the client has a fever, sore throat, and malaise. Which of the following actions should the nurse take?

Administer acetaminophen to the client.

Obtain a blood sample from the client for a complete blood count.

Encourage the client to drink plenty of fluids and rest.

Discontinue clozapine and notify the provider.

Answer and Explanation

The Correct Answer is B

B) Correct. The nurse should obtain a blood sample from the client for a complete blood count as these symptoms can indicate agranulocytosis, a potentially fatal adverse effect of clozapine that causes a severe decrease in white blood cells and increases the risk of infection.

A) Incorrect. The nurse should not administer acetaminophen to the client as this drug can mask the signs of infection and delay diagnosis and treatment of agranulocytosis.

C) Incorrect. The nurse should encourage the client to drink plenty of fluids and rest, but this action alone would not address the potential serious adverse effect of agranulocytosis associated with clozapine. Obtaining a blood sample for a complete blood count is necessary to assess the client's white blood cell count and determine if agranulocytosis is present.

D) Incorrect. Discontinuing clozapine and notifying the provider is important, but it should be done after obtaining a blood sample for a complete blood count to confirm the presence of agranulocytosis. This allows for appropriate medical management and alternative treatment options to be initiated.

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Correct Answer is B

Explanation

B) Correct. The nurse should instruct the client to hold their metformin for 48 hours before and after surgery as this drug can increase the risk of lactic acidosis in clients who are undergoing procedures that involve contrast media or who have impaired renal function due to dehydration or hypotension.

A) Incorrect. The nurse should not instruct the client to take their morning dose of metformin with a sip of water on the day of surgery as this can cause hypoglycemia during anesthesia or interfere with contrast media if used during surgery.

C) Incorrect. The nurse should not instruct the client to resume their metformin as soon as they can tolerate oral intake after surgery as this can cause lactic acidosis if the client's renal function is not fully restored or if they receive contrast media during surgery or postoperatively.

D) Incorrect. The nurse should not instruct the client to switch to insulin injections until they recover from surgery as this can cause hyperglycemia or hypoglycemia depending on the type and dose of insulin used and the client's nutritional status and blood glucose levels.

A. "I will avoid eating foods that are high in vitamin K." B. "I will use a soft-bristled toothbrush to prevent bleeding." C. "I will monitor my blood pressure regularly at home." D. "I will report any signs of bruising or bleeding to my provider."

Correct Answer is A

Explanation

A) Incorrect. The client should not avoid eating foods that are high in vitamin K, such as leafy greens, broccoli, and soybeans. These foods can interfere with the anticoagulant effect of warfarin and increase the risk of clotting. The client should eat a consistent amount of vitamin K-rich foods and avoid sudden changes in their intake.

B) Correct. The client should use a soft-bristled toothbrush to prevent bleeding from the gums. Warfarin can impair the blood's ability to clot and increase the risk of bleeding from minor injuries.

C) Correct. The client should monitor their blood pressure regularly at home and report any abnormal readings to their provider. Warfarin can affect blood pressure and increase the risk of stroke or bleeding.

D) Correct. The client should report any signs of bruising or bleeding to their provider, such as nosebleeds, blood in urine or stool, heavy menstrual bleeding, or prolonged bleeding from cuts. These signs may indicate that the warfarin dose is too high and needs adjustment.

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A nurse is caring for a client who has schizophrenia and is taking clozapine. The nurse notices that the client has a fever, sore throat, and malaise. Which of the following actions should the nurse take?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is reviewing the medication list of a client who has diabetes mellitus and is scheduled for surgery. The client takes metformin orally twice a day. Which of the following actions should the nurse take?

Correct Answer is B

Explanation

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Correct Answer is A

Explanation

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A nurse is caring for a client who has schizophrenia and is taking clozapine. The nurse notices that the client has a fever, sore throat, and malaise. Which of the following actions should the nurse take?

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