Clozapine

The laboratory report for a client taking clozapine shows a white blood cell count of 3000 mm3 What

is the nurse’s best action?

a. Report the results to the health care provider immediately.

b. Administer the next dose as prescribed.

c. Give aspirin and force fluids.

d. Repeat the laboratory test.

ANS: A

These laboratory values indicate the possibility of agranulocytosis, a serious side effect of

clozapine therapy. These results must be immediately reported to the health care provider, and

the drug should be withheld. The health care provider may repeat the test, but in the meantime,

the drug should be withheld. (Note: This question requires students to apply previous learning

regarding normal and abnormal values of white blood cell counts.)

Priority teaching for a patient taking clozapine (Clozaril) should include which instruction?

a. Report sore throat and fever immediately.

b. Avoid foods high in polyunsaturated fat.

c. Use water-based lotions for rashes.

d. Avoid unprotected sex.

ANS: A

Clozapine therapy may produce agranulocytosis; therefore signs of infection should be immediately reported to the

health care provider. In addition, the patient should have white blood cell levels measured weekly. The other options

are not relevant to clozapine administration

Alzheimer’s

A patient diagnosed with stage 1 Alzheimer disease tires easily and prefers to stay home rather than attend social

activities. The spouse does the grocery shopping because the patient cannot remember what to buy. Which nursing

diagnosis applies at this time?

a. Risk for injury

b. Impaired memory

c. Self-care deficit

d. Caregiver role strain

ANS: B

Memory impairment is present and expected in stage 1 Alzheimer disease. Patients diagnosed with

early Alzheimer disease often have difficulty remembering names, so socialization is minimized. Data

are not present to support the other diagnoses.

Which patients meet criteria for hospice services? (Select all that apply.)

a. A 92-year-old diagnosed with acute pneumonia and late-stage Alzheimer’s disease

b. A 54-year-old diagnosed with glioblastoma and life expectancy of 8 to 10 weeks

c. A 16-year-old with type 1 diabetes, multiple infections, and substance abuse

d. A 74-year-old newly diagnosed with chronic obstructive pulmonary

disease (COPD) and life expectancy of 2 years

e. A 36-year-old diagnosed with multiple sclerosis complicated by major

depressive disorder and pain associated with muscle spasms