Nursing practice questions with comprehensive rationales
NurseDive Free Nursing Practice Question
A nurse is reviewing abnormal laboratory values for four clients who have schizophrenia and take clozapine.
For which of the following clients should the nurse withhold the medication and notify the provider immediately to have clozapine therapy discontinued?
A. A client who has a BUN of 22 mg/dL.
A BUN of 22 mg/dL is slightly elevated but not a contraindication for clozapine.
B. A client who has a serum potassium of 3.3 mEq/L.
A serum potassium of 3.3 mEq/L is slightly low but not a contraindication for clozapine.
C. A client who has a hematocrit of 55%.
A hematocrit of 55% is high but not a contraindication for clozapine.
D. A client who has a WBC of 2,900 cells/mm².
A WBC of 2,900 cells/mm² is low and can indicate agranulocytosis, a potentially life-threatening condition. Clozapine should be discontinued.
This question is an excerpt from Nurse Dive's nursing test bank - Ati Rn Custom Nurs 120 Psychiatric Nursing Fa23 Proctored Exam 2. Take the full exam now
Full Explanation
Choice A rationale:
A BUN of 22 mg/dL is slightly elevated but not a contraindication for clozapine.
Choice B rationale:
A serum potassium of 3.3 mEq/L is slightly low but not a contraindication for clozapine.
Choice C rationale:
A hematocrit of 55% is high but not a contraindication for clozapine.
Choice D rationale:
A WBC of 2,900 cells/mm² is low and can indicate agranulocytosis, a potentially life-threatening condition. Clozapine should be discontinued.
Similar Questions
A nurse reviews the laboratory report for a client who is receiving lithium three times daily PO. The client's current blood lithium level is 1.8 mEq/L. The nurse identifies that this lab value indicates which of the following?.
A. The lithium level is within the therapeutic level for initial treatment.
A lithium level of 1.8 mEq/L is above the therapeutic level for initial treatment (0.8 to 1.4 mEq/L)3.
B. The lithium level is below the therapeutic treatment level.
A lithium level of 1.8 mEq/L is above, not below, the therapeutic treatment level.
C. The lithium level is at the toxic level.
A lithium level of 1.8 mEq/L is at the toxic level. A blood lithium level greater than 1.5 mEq/L indicates toxicity.
D. A blood lithium level of 1.8 mEq/L is not within the maintenance treatment level.
A lithium level of 1.8 mEq/L is not within the maintenance treatment level (0.4 to 1.3 mEq/L)3.
Full Explanation
Choice A rationale:
A lithium level of 1.8 mEq/L is above the therapeutic level for initial treatment (0.8 to 1.4 mEq/L)3.
Choice B rationale:
A lithium level of 1.8 mEq/L is above, not below, the therapeutic treatment level.
Choice C rationale:
A lithium level of 1.8 mEq/L is at the toxic level. A blood lithium level greater than 1.5 mEq/L indicates toxicity.
Choice D rationale:
A lithium level of 1.8 mEq/L is not within the maintenance treatment level (0.4 to 1.3 mEq/L)3.
A nurse is caring for a client who is experiencing suicidal thoughts.
Which of the following actions should the nurse take?.
A. Place the client on 12-hour observation.
Placing the client on 12-hour observation may not be sufficient as suicidal thoughts can persist beyond this timeframe.
B. Remove harmful objects from the client's room.
Removing harmful objects from the client’s room is a crucial step in ensuring the safety of a client experiencing suicidal thoughts. This action helps to minimize the risk of self-harm.
C. Encourage visitors for the client at any time.
While social support can be beneficial, it’s important to regulate visitors as they could unintentionally bring harmful objects or substances.
D. Encourage visitors to bring items to the client.
Encouraging visitors to bring items could pose a risk as they might unknowingly bring in objects that could be used for self-harm.
Full Explanation
Choice A rationale:
Placing the client on 12-hour observation may not be sufficient as suicidal thoughts can persist beyond this timeframe.
Choice B rationale:
Removing harmful objects from the client’s room is a crucial step in ensuring the safety of a client experiencing suicidal thoughts. This action helps to minimize the risk of self-harm.
Choice C rationale:
While social support can be beneficial, it’s important to regulate visitors as they could unintentionally bring harmful objects or substances.
Choice D rationale:
Encouraging visitors to bring items could pose a risk as they might unknowingly bring in objects that could be used for self-harm.
A nurse is caring for a client who has been prescribed clozapine.
Which of the following topics should the nurse prepare to discuss with the client?.
A. The importance of medication adherence after the resolution of acute psychosis when taking an antipsychotic.
Adherence to medication, especially after the resolution of acute psychosis, is crucial when taking an antipsychotic like clozapine. This is because discontinuation can lead to a relapse of symptoms.
B. The importance of limiting fluid intake when taking an antipsychotic.
There’s no specific need to limit fluid intake when taking an antipsychotic.
C. The importance of routine red blood cell count laboratory work when taking an antipsychotic.
While routine blood cell count laboratory work is important, it’s not specific to red blood cells but rather to monitor for agranulocytosis, a potential side effect of clozapine.
D. The importance of avoiding foods that contain tyramine when taking an antipsychotic.
Avoiding foods that contain tyramine is typically associated with monoamine oxidase inhibitors, not antipsychotics like clozapine.
Full Explanation
Choice A rationale:
Adherence to medication, especially after the resolution of acute psychosis, is crucial when taking an antipsychotic like clozapine. This is because discontinuation can lead to a relapse of symptoms.
Choice B rationale:
There’s no specific need to limit fluid intake when taking an antipsychotic.
Choice C rationale:
While routine blood cell count laboratory work is important, it’s not specific to red blood cells but rather to monitor for agranulocytosis, a potential side effect of clozapine.
Choice D rationale:
Avoiding foods that contain tyramine is typically associated with monoamine oxidase inhibitors, not antipsychotics like clozapine.