A client reports that the narcotic she took for pain on a regular basis made her feel bad and that when she tried an alternative analgesic, she experienced withdrawal symptoms. What is this client suffering from?

Choice A reason: Assessment is the initial phase of the nursing process where the nurse collects and analyzes data about the patient's health status, including physical, psychological, and social factors. Recording a specific action to be taken in the future does not fall under data collection or diagnosis.

Choice B reason: Evaluation occurs after interventions have been performed. In this phase, the nurse compares the patient's current status with the goals and outcomes defined in the planning phase to determine the effectiveness of the nursing care. It is a retrospective look at the plan's success.

Choice C reason: Implementation is the "doing" phase where the nurse actually carries out the planned interventions. While the nurse will eventually "encourage" the patient, the act of writing the instruction into the formal care plan as a future requirement is a step that precedes the actual performance.

Choice D reason: The planning phase involves developing a strategy to provide nursing care and identifying specific nursing interventions to reach goals. Writing a directive such as "Encourage patient to attend..." is the act of formalizing an intervention within the care plan to address the patient's social skill deficits.

Choice A reason: Clozapine carries a black box warning for agranulocytosis, a life-threatening decrease in the white blood cell count (specifically neutrophils). Sore throat and fever are the primary clinical signs of an impending infection due to immunosuppression. Monitoring for these symptoms is a critical safety priority to prevent sepsis.

Choice B reason: While some antipsychotics can cause skin sensitivities or rashes, this is not the primary safety concern for clozapine. Instructions regarding rashes are secondary to the hematological monitoring required for agranulocytosis, which can be fatal if the medication is not discontinued and the patient is not treated.

Choice C reason: General health education regarding safe sex is important for all patients; however, it is not a specific pharmacological requirement or a priority safety concern related to the mechanism of action or the side effect profile of the atypical antipsychotic medication clozapine.

Choice D reason: Metabolic syndrome, including weight gain and dyslipidemia, is a known side effect of clozapine. However, instructions regarding dietary fat intake are part of long-term health maintenance and do not take priority over the acute, potentially lethal risk of agranulocytosis signaled by signs of infection.