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.
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale:
Increased flatulence is not typically associated with lithium toxicity.
Choice B rationale:
Vomiting is a common symptom of lithium toxicity, indicating the client understands the teaching.
Choice C rationale:
While loss of appetite can occur in various conditions, it’s not a specific indicator of lithium toxicity.
Choice D rationale:
Headaches can be caused by various factors and are not specifically associated with lithium toxicity.
Correct Answer is ["B","C","D","G","H","I"]
Explanation
Choice A rationale:
Financial situation is a concern but it does not require immediate follow-up in a medical context.
Choice B rationale:
Increased use of mood-altering substances is a serious concern. The client has been drinking heavily and asking for their “nerve” pill, which could indicate substance misuse.
Choice C rationale:
The client’s sexual behaviors, specifically having multiple partners and not using condoms, pose a risk for sexually transmitted infections.
Choice D rationale:
The positive Hepatitis Viral Study (HAA) indicates the presence of a viral hepatitis infection, which requires immediate medical attention.
Choice E rationale:
The BUN level is within the normal range (10 to 20 mg/dL), so it does not require immediate follow-up.
Choice F rationale:
The Hgb level is within the normal range (12 to 18 g/dL), so it does not require immediate follow-up.
Choice G rationale:
The sodium level is below the normal range (136 to 145 mEq/L), indicating hyponatremia, which requires immediate medical attention.
Choice H rationale:
The frequency of facility admissions indicates that the client’s condition is not being managed effectively and requires immediate reassessment.
Choice I rationale:
The recent loss of a parent is a significant life event that could exacerbate the client’s mental health issues and substance misuse, requiring immediate follow-up.
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