A client who has attention-deficit/hyperactivity disorder (ADHD) is prescribed methylphenidate, a controlled substance, by their psychiatrist. The client tells the nurse that they sometimes share their medication with their friends who also have ADHD but do not have a prescription. Which of the following statements should the nurse make?

Correct answer: a) Agranulocytosis

Rationale: Clozapine is an atypical antipsychotic that acts on the central nervous system to reduce psychotic symptoms such as hallucinations, delusions, and paranoia. It also has a low potential for abuse and dependence, which is why it is classified as a Schedule V medication. However, it can cause agranulocytosis, a life-threatening condition characterized by a severe decrease in white blood cells that increases the risk of infection. The nurse should monitor the client's complete blood count (CBC) regularly and report any signs of infection such as fever, sore throat, or mouth ulcers.

Incorrect choices:

b) Stevens-Johnson syndrome: This is a rare but serious skin reaction that can be caused by some medications such as sulfonamides, anticonvulsants, and allopurinol, not clozapine.

c) Torsades de pointes: This is a rare but serious cardiac arrhythmia that can be caused by some medications such as antiarrhythmics, antibiotics, and antidepressants that prolong the QT interval, not clozapine.

d) Rhabdomyolysis: This is a rare but serious condition characterized by muscle breakdown and renal failure that can be caused by some medications such as statins, antipsychotics, and corticosteroids, not clozapine.

Correct answer: d) All of the above.
Rationale: The nurse should make all of these statements to discourage
the client from sharing their medication with others. Sharing controlled substances with others is illegal and can result in criminal charges, fines, or imprisonment for both parties. It can also cause harm to others who may have different medical conditions, allergies, or interactions with other medications. Methylphenidate is a stimulant that can cause adverse effects such as increased blood pressure, heart rate, anxiety, insomnia, and appetite suppression. It can also be addictive and abused by some people. Therefore, it should only be taken by a person who has a valid prescription and under the supervision of a psychiatrist who can monitor the dosage, effectiveness, and side effects.

Incorrect choices:
a) "Sharing your medication with others is illegal and can result in serious consequences for you and your friends.": This is correct but not comprehensive as it does not include other statements that are important for the client.
b) "Your medication is specifically tailored to your needs and may not be appropriate or safe for others.": This is correct but not comprehensive as it does not include other statements that are important for the client.
c) "Your friends should see a psychiatrist if they have ADHD and need medication treatment.": This is correct but not comprehensive as it does not include other statements that are important for the client.