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 C

Explanation

A. Medical care cannot be initiated based on the absence of legal assistance for advance directives; this is not an appropriate response.
B. While a social worker may assist with legal issues, this is not the immediate response to the client’s
concern.
C. Advance directives can be legally valid without the need for an attorney, and this can reassure the client.
D. Advance directives must be written or documented in a specific format, and verbal agreements are insufficient.

A. Advance the catheter into the vein. B. Release the tourniquet. C. Retract the stylet. D. Flush the catheter with saline.

Correct Answer is B

Explanation

A. Advancing the catheter before releasing the tourniquet can increase the risk of trauma and difficulty in catheter placement.
B. Releasing the tourniquet is the correct step after confirming blood return to reduce venous congestion and ease the advancement of the catheter.
C. The stylet should not be retracted until the catheter is properly placed in the vein.
D. Flushing the catheter with saline should only be done once the catheter is properly secured in the vein.

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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

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Correct Answer is C

Explanation

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