A nurse is reviewing the medical record of a male client who has schizophrenia and is taking clozapine. Which of the following findings should the nurse identify as a contraindication to the administration of clozapine?

Fasting blood glucose 124 mg/dL (70 to 110 mg/dL)

Absolute neutrophil count 1,300/mm3 (2,500 to 8,000/mm3)

Heart rate 58/min

Hgb 12.5 g/dL (14 to 18 g/dL)

Answer and Explanation

The Correct Answer is B

A.   Elevated fasting blood glucose is a concern but does not immediately contraindicate clozapine administration. It can be monitored and managed.
B.   Clozapine can cause agranulocytosis, and a low absolute neutrophil count (ANC) is a contraindication for the medication. The threshold for stopping clozapine is typically an ANC of less than 1,500/mm3.
C.   A heart rate of 58/min is not a contraindication for clozapine. It may require monitoring but is not necessarily concerning.
D.   An Hgb level of 12.5 g/dL is within the normal range and does not contraindicate the use of clozapine.

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Correct Answer is {"dropdown-group-1":"D","dropdown-group-2":"A"}

Explanation

The nurse should first anticipate the need to Obtain IV access then Prepare to administer IV fluids.

Rationale

First Anticipated Step: Obtain IV Access:

In a client with hypotension and anemia, immediate IV access is crucial to administer fluids or blood

products to stabilize the client’s condition before the endoscopy. Given the client’s low blood pressure and heart rate, they may need IV fluids (such as saline or Ringer's lactate) to help improve circulation and maintain perfusion. This is essential before proceeding with further interventions like the planned endoscopy.

Second Anticipated Step:

Prepare to administer IV fluids:

The client's low blood pressure and the potential for significant blood loss suggest that IV fluids will be necessary to restore blood volume and improve hemodynamic stability before endoscopy. Normal saline or Lactated Ringer's are commonly used for volume resuscitation in this scenario.

A. Placing a yellow bracelet on a client who is at risk for falls. B. Administering potassium via IV bolus. C. Leaving a nasogastric tube clamped after administering oral medication. D. Documenting communication with a provider in the progress notes of the client's medical record.

Correct Answer is C

Explanation

A. Placing a yellow bracelet is a common practice for identifying clients at risk for falls and is not considered malpractice.
B. Administering potassium via IV bolus can be dangerous, but it is a matter of scope of practice and guidelines rather than malpractice unless done incorrectly.
C. Leaving a nasogastric tube clamped after administering oral medication is an example of malpractice as it could result in aspiration or improper medication absorption.
D. Documenting communication with a provider in the medical record is standard practice.

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A nurse is reviewing the medical record of a male client who has schizophrenia and is taking clozapine. Which of the following findings should the nurse identify as a contraindication to the administration of clozapine?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Exhibits The nurse is obtaining the client's vital signs prior to an endoscopy. Complete the following sentence by using the list of options. The nurse should first anticipate the need to dropdownthendropdown

Correct Answer is {"dropdown-group-1":"D","dropdown-group-2":"A"}

Explanation

A nurse is preparing an in-service for a group of nurses about malpractice issues in nursing. Which of the following examples should the nurse include in the teaching as an example of malpractice?

Correct Answer is C

Explanation

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