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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. High serum sodium levels can cause toxic levels of valproate. B. Thyroid function tests should be performed every 6 months. C. A pretreatment electroencephalogram (EEG) will be done. D. Liver function tests must be monitored.

Correct Answer is D

Explanation

Choice A rationale:
High serum sodium levels do not directly cause toxic levels of valproate.
Choice B rationale:
While regular health monitoring is important, specifically performing thyroid function tests every 6 months is not a standard requirement for valproate use.
Choice C rationale:
A pretreatment electroencephalogram (EEG) is not typically required before starting valproate.
Choice D rationale:
Liver function tests must be monitored as valproate can cause liver failure that may be fatal.

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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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Correct Answer is A

Explanation

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Correct Answer is D

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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?