A nurse is reinforcing education to a client who is prescribed clozapine. Which of the following findings should the nurse identify as consistent with agranulocytosis and instruct the client to monitor?
Severe restlessness
Respiratory depression and a comatose state
Sore throat and muscle aches
Increased anxiety and suicidal ideations
The Correct Answer is C
A. Severe restlessness. Severe restlessness, known as akathisia, is a potential side effect of antipsychotic medications but is not indicative of agranulocytosis. Akathisia is associated with excessive movement and an inability to stay still, often requiring dose adjustment or medication to alleviate symptoms.
B. Respiratory depression and a comatose state. Respiratory depression and coma are not linked to agranulocytosis but may occur with overdose or central nervous system depression. Agranulocytosis affects white blood cell levels, leading to increased infection risk rather than sedation or respiratory suppression.
C. Sore throat and muscle aches. Sore throat and muscle aches are early signs of agranulocytosis, a potentially life-threatening condition characterized by a dangerously low neutrophil count. Clients taking clozapine must undergo regular white blood cell monitoring to detect agranulocytosis early and prevent severe infections.
D. Increased anxiety and suicidal ideations. Increased anxiety and suicidal ideations may be related to psychiatric conditions or medication effects but are not specific to agranulocytosis. Clozapine is primarily used for treatment-resistant schizophrenia and may help reduce suicidal behavior rather than induce it.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. "Do you need any more resources or information?" This question focuses on offering additional resources rather than encouraging the client to explore their emotions. While it is useful for providing support, it does not promote self-reflection or invite the client to clarify their feelings. Therapeutic communication should aim to encourage deeper discussion rather than just addressing practical needs.
B. "Do you understand your next step in treatment?" Although this question ensures the client comprehends their treatment plan, it does not foster emotional expression or self-awareness. Understanding the next steps in care is important, but therapeutic communication should focus on exploring the client’s internal experiences rather than just confirming information. Encouraging open-ended reflection is more effective for clarifying emotions.
C. "You feel like you have the support needed to be successful." This statement encourages self-reflection and allows the client to clarify their feelings about their support system. It promotes therapeutic communication by inviting the client to assess their emotional needs and level of confidence. Open-ended statements like this help build trust and provide insight into the client’s concerns and perceptions.
D. "Tell me what kind of coping skills you have." While this question assesses the client's coping strategies, it does not directly facilitate emotional clarification. Asking about coping skills is useful for intervention planning, but it does not specifically address the client’s feelings. A more effective therapeutic approach would involve asking how the client feels about their ability to manage stress.
Correct Answer is B
Explanation
A. "Do you think of yourself as more of an introvert? That makes a difference with how you socialize." Social withdrawal in schizophrenia is not related to personality traits like introversion. It is often an early symptom of the disorder, preceding more pronounced psychotic features. Focusing on introversion may mislead the client and overlook the underlying pathology.
B. "Before symptoms of schizophrenia begin, people often isolate themselves. This is an early warning." Social withdrawal is a common early sign of schizophrenia, occurring during the prodromal phase. Individuals may withdraw due to subtle cognitive changes, emotional blunting, or emerging paranoid thoughts. Recognizing these early symptoms can aid in early intervention and treatment.
C. "Were you avoiding your friend so that you could hear the voices more clearly?" This statement assumes the client was already experiencing auditory hallucinations, which is not always the case. Social isolation often predates the onset of hallucinations and delusions, making this explanation inaccurate. It may also come across as dismissive rather than informative.
D. "That is very interesting, We are not sure why people start to isolate themselves." While the exact cause of social withdrawal in schizophrenia is not fully understood, research indicates it is an early warning sign. Providing vague or uncertain information may leave the client feeling confused rather than supported in understanding their condition.
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