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A nurse is reviewing abnormal laboratory values for four clients who have schizophrenia and take clozapine.

For which of the following clients should the nurse withhold the medication and notify the provider immediately to have clozapine therapy discontinued?

A client who has a BUN of 22 mg/dL.

A client who has a serum potassium of 3.3 mEq/L.

A client who has a hematocrit of 55%.

A client who has a WBC of 2,900 cells/mm².

Answer and Explanation

The Correct Answer is D

Choice A rationale:

A BUN of 22 mg/dL is slightly elevated but not a contraindication for clozapine.

Choice B rationale:

A serum potassium of 3.3 mEq/L is slightly low but not a contraindication for clozapine.

Choice C rationale:

A hematocrit of 55% is high but not a contraindication for clozapine.

Choice D rationale:

A WBC of 2,900 cells/mm² is low and can indicate agranulocytosis, a potentially life-threatening condition. Clozapine should be discontinued.

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Correct Answer is A

Explanation

Choice A rationale:

Asking “What are the voices telling you to do?” shows empathy and concern without validating the hallucination.

Choice B rationale:

Asking “Why do you think you are hearing the voices?” might imply that the nurse is validating the hallucination.

Choice C rationale:

Telling the client “You need to understand that there are no voices.”. might make the client feel misunderstood.

Choice D rationale:

Telling the client “You need to tell the voices to leave you alone.”. is not recommended as it might validate the hallucination.

A. Respiratory depression and a comatose state. B. Sore throat and muscle aches. C. Increased anxiety and suicidal ideations. D. Severe restlessness.

Correct Answer is B

Explanation

Choice A rationale:
Respiratory depression and a comatose state are not typically associated with agranulocytosis.
Choice B rationale:
Agranulocytosis, a potential side effect of clozapine, can cause symptoms like a sore throat and muscle aches due to the body’s decreased ability to fight off infections.
Choice C rationale:
Increased anxiety and suicidal ideations are not typically symptoms of agranulocytosis.
Choice D rationale:
Severe restlessness is not a common symptom of agranulocytosis.

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A nurse is reviewing abnormal laboratory values for four clients who have schizophrenia and take clozapine. For which of the following clients should the nurse withhold the medication and notify the provider immediately to have clozapine therapy discontinued?

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Naxlex Comprehensive Predictor Exams

A nurse is talking with a client who has schizophrenia. Suddenly the client states, "I'm frightened. Do you hear that? The voices are telling me to do terrible things.”. Which of the following responses by the nurse is appropriate?.

Correct Answer is A

Explanation

A nurse is educating 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?

Correct Answer is B

Explanation

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A nurse is reviewing abnormal laboratory values for four clients who have schizophrenia and take clozapine.

For which of the following clients should the nurse withhold the medication and notify the provider immediately to have clozapine therapy discontinued?