A nurse is caring for a client who has schizophrenia and takes clozapine, a Schedule V medication. The nurse should monitor the client for which of the following serious adverse effects of clozapine?

Agranulocytosis

Stevens-Johnson syndrome

Torsades de pointes

Rhabdomyolysis

Answer and Explanation

The Correct Answer is A

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.

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Correct Answer is D

Explanation

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.

A. The medication should be taken only as needed for sleep. B. The medication should be taken with food to enhance absorption. C. The medication should be tapered off gradually to avoid withdrawal symptoms. D. The medication should be avoided if the client has a history of substance abuse.

Correct Answer is C

Explanation

Correct answer: c) The medication should be tapered off gradually to avoid withdrawal symptoms.

Rationale: Zolpidem is a sedative-hypnotic medication that acts on the central nervous system to induce sleep. It has a low potential for abuse and dependence, but it can still cause withdrawal symptoms such as anxiety, insomnia, and seizures if discontinued abruptly. Therefore, the medication should be tapered off gradually under the supervision of a prescriber.

Incorrect choices:

a) The medication should be taken only as needed for sleep.: Zolpidem should be taken regularly as prescribed for short-term treatment of insomnia, not on an as-needed basis.

b) The medication should be taken with food to enhance absorption.: Zolpidem should be taken on an empty stomach to facilitate its onset of action, which is within 15 to 30 minutes.

d) The medication should be avoided if the client has a history of substance abuse.: Although zolpidem has a low potential for abuse and dependence, it can still interact with other substances such as alcohol, opioids, and benzodiazepines, which can increase the risk of respiratory depression and overdose. Therefore, the client should inform the prescriber of any history of substance abuse and use Zolpidem with caution.

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A nurse is caring for a client who has schizophrenia and takes clozapine, a Schedule V medication. The nurse should monitor the client for which of the following serious adverse effects of clozapine?

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Naxlex Comprehensive Predictor Exams

Correct Answer is D

Explanation

A nurse is teaching a client who has insomnia about zolpidem, a Schedule IV medication. The nurse should include which of the following information in the teaching?

Correct Answer is C

Explanation

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A nurse is caring for a client who has schizophrenia and takes clozapine, a Schedule V medication. The nurse should monitor the client for which of the following serious adverse effects of clozapine?