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. Faintness upon rising is a common symptom during pregnancy, typically due to orthostatic hypotension, and does not necessarily require reporting unless it is persistent or severe.
B. Bleeding gums can occur due to hormonal changes and is usually not a cause for concern.
C. Swelling of the face could indicate preeclampsia, a potentially serious condition that should be reported to the provider immediately.
D. Urinary frequency is a normal finding during pregnancy and does not need to be reported unless associated with other symptoms such as pain or fever.

A. Negligence B. Battery C. Malpractice D. Assault

Correct Answer is D

Explanation

A. Negligence involves a failure to provide reasonable care, but it does not apply here since the AP’s
actions were intentional.
B. Battery is the intentional and harmful physical contact with another person without their consent. In the context of healthcare, this could involve actions like physically restraining a patient without consent, administering medication without consent, or any physical contact that is deemed offensive and unwarranted.
C. Malpractice refers to professional negligence by a healthcare provider, which is not the case here.
D. Assault occurs when there is an intentional act that creates a fear of imminent harmful or offensive contact with another person, even if no actual physical contact occurs. In this case, the AP's statement, "If you don't eat, I'll put restraints on your wrists and feed you," is a verbal threat of harm.

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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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Explanation

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Explanation

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