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 A

Explanation

A. Dabigatran should be kept in its original container because it is sensitive to moisture, and the packaging is designed to protect the medication.
B. Crushing dabigatran can alter its effectiveness and is not recommended.
C. Unused medication does not need to be replaced every 6 months unless expired or damaged.
D. Dabigatran should be stored at room temperature, not in the refrigerator.

A. Place tongue on the mouthpiece of the meter. B. Blow into the meter as hard and quickly as possible. C. Maintain a semi-Fowler's position during testing D. Record the average of the readings.

Correct Answer is B

Explanation

A. The child should not place their tongue on the mouthpiece, as this can affect the accuracy of the measurement.
B. Blowing as hard and quickly as possible provides the most accurate reading of peak expiratory flow.
C. Maintaining a semi-Fowler's position is not necessary for using the peak expiratory flow meter.
D. The best measurement is the highest of three attempts, not an average.

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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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