A client diagnosed with schizophrenia is prescribed clozapine. The nurse teaches the client and family to call the physician immediately if:
There are any signs of infection.
There is a decrease in hallucinations.
Appetite continues to decrease after one week.
Insomnia occurs for more than two nights.
The Correct Answer is A
Choice A Reason:
Clozapine is known to cause agranulocytosis, a potentially life-threatening condition where the white blood cell count drops significantly, leading to a higher risk of infection. Patients on clozapine must have regular blood tests to monitor their white blood cell count. Any signs of infection, such as fever, sore throat, or flu-like symptoms, should be reported to a physician immediately as they could indicate agranulocytosis.
Choice B Reason:
A decrease in hallucinations is generally a positive sign indicating that the medication is working effectively. It is not a reason to call the physician immediately. Instead, this should be discussed during regular follow-up appointments to assess the overall effectiveness of the treatment.
Choice C Reason:
While a decrease in appetite can be a side effect of clozapine, it is not typically an emergency unless it leads to significant weight loss or malnutrition. This should be monitored and discussed with the physician during regular visits. If the decrease in appetite is severe or persistent, it may warrant a call to the physician, but it is not as urgent as signs of infection.
Choice D Reason:
Insomnia can occur with clozapine use, but it is usually managed with adjustments to the medication regimen or additional treatments for sleep. While it is important to address insomnia, it does not require immediate medical attention unless it severely impacts the patient’s well-being.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A Reason:
Obtunded describes a state where the patient has a decreased level of consciousness and is difficult to arouse. They may respond slowly and be somewhat confused. This level of consciousness is more severe than lethargy and typically requires more vigorous stimulation to elicit a response. The client’s ability to answer questions appropriately before falling back to sleep suggests a less severe impairment than obtundation.
Choice B Reason:
Stuporous refers to a condition where the patient is almost entirely unresponsive and can only be aroused by vigorous and repeated stimuli. This state is more severe than lethargy and obtundation. The client’s ability to respond appropriately to questions indicates a higher level of consciousness than stupor. Therefore, stuporous is not the correct description of the client’s condition.
Choice C Reason:
Lethargic describes a state where the patient is very drowsy but can be aroused to respond to questions and then falls back to sleep. This matches the client’s presentation as they are able to answer questions appropriately but fall asleep immediately afterward. Lethargy is a common level of altered consciousness in various medical conditions and is less severe than obtundation or stupor.
Choice D Reason:
Alert describes a state where the patient is fully awake, aware, and responsive to stimuli. The client’s tendency to fall back to sleep immediately after responding to questions indicates that they are not fully alert. Therefore, this term does not accurately describe the client’s level of consciousness.
Correct Answer is B
Explanation
Choice A Reason:
Clonazepam is to be used for long-term therapy in conjunction with buspirone.
This statement is incorrect. Clonazepam, a benzodiazepine, is typically used for short-term relief of anxiety symptoms due to its potential for dependence and tolerance1. Long-term use of benzodiazepines is generally avoided in favor of medications like buspirone, which do not carry the same risks of dependence.
Choice B Reason:
Clonazepam is to be used short-term until the buspirone takes full effect.
This is the correct response. Buspirone takes several weeks to achieve its full therapeutic effect. During this period, clonazepam may be used to manage acute anxiety symptoms. Once buspirone reaches its full effect, clonazepam can be tapered off to avoid long-term use and potential dependence.
Choice C Reason:
Buspirone should be taken as needed until clonazepam takes full effect.
This statement is incorrect. Buspirone is not intended for as-needed use; it must be taken consistently to maintain stable blood levels and achieve its therapeutic effect. Clonazepam, on the other hand, is used for short-term relief and should not be relied upon for long-term management of anxiety.
Choice D Reason:
Tolerance could result with long-term use of buspirone.
This statement is incorrect. Unlike benzodiazepines, buspirone does not typically cause tolerance or dependence with long-term use. It is considered a safer option for chronic management of anxiety disorders.
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