1. A nurse is caring for a client with schizophrenia who has been

prescribed clozapine. The nurse should monitor the client for which of the

following adverse effects?

a) Agranulocytosis

b) Tardive dyskinesia

c) Neuroleptic malignant syndrome

d) Extrapyramidal symptoms

Answer: A. Agranulocytosis is a potentially life-threatening condition that

can occur with clozapine use. It is characterized by a severe reduction in

white blood cells, which increases the risk of infection. The nurse should

monitor the client's blood counts regularly and report any signs of

infection, such as fever, sore throat, or mouth ulcers.

2. A nurse is conducting a mental status examination on a client with

schizophrenia who exhibits loose associations. Which of the following

statements by the client is an example of loose associations?

a) "I like to watch TV, but the news is always bad. Bad news makes me

sad. Sadness is a feeling that I don't like."

b) "The sky is blue today. Blue is my favorite color. I have a blue shirt

that I got from my mother. She is in heaven now."

c) "You are wearing a white coat. White is the color of snow. Snow is cold

and wet. Wet is what you get when you swim."

d) "I need to take my medication. Medication helps me think clearly.

Clearly, you are a good nurse. Nurse rhymes with purse."

Answer: C. Loose associations are a form of disorganized thinking that

involves a shift from one topic to another without any logical connection

or coherence. The client's statement about white, snow, wet, and swim

demonstrates loose associations.

3. A nurse is teaching a client with schizophrenia and his family about

relapse prevention. Which of the following information should the nurse

include in the teaching?

a) Relapse can be prevented by taking medication as prescribed and

avoiding stress.

b) Relapse can be predicted by the presence of prodromal symptoms, such

as anxiety, insomnia, or social withdrawal.

c) Relapse can be managed by increasing the dose of medication and