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 B

Explanation

A. Speaking slowly to the interpreter may cause delays in communication, but it does not enhance understanding. The interpreter is capable of processing normal speech speed.
B. The nurse should speak directly to the client, not the interpreter, to maintain rapport and respect. The interpreter will relay the information.
C. Pausing in the middle of sentences can disrupt the flow of conversation and make it harder for the interpreter to convey the message effectively.
D. Gestures should not be relied upon in place of clear verbal communication, as they can be misinterpreted and are culturally variable.

A. Decreased inflammation B. Decreased pain C. Increased blood pressure D. Weight loss

Correct Answer is D

Explanation

A. While furosemide helps reduce fluid overload, it does not directly decrease inflammation.
B. Furosemide does not specifically address pain; its primary purpose is to reduce fluid overload.
C. Furosemide should reduce blood pressure if fluid volume excess was contributing to the elevated blood pressure. If blood pressure increases, this would not be considered an effective response to the medication.
D. Weight loss is a common indicator of the effectiveness of diuretics like furosemide, as it helps to reduce the excess fluid volume in the body.

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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?

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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?