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 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.

A. It can be refilled up to five times within six months. B. It can be prescribed by telephone or fax in an emergency. C. It can be obtained without a prescription for medical use. D. It can be dispensed by any healthcare provider.

Correct Answer is B

Explanation

Correct answer: b)It can be prescribed by telephone or fax in an emergency.

Rationale: Schedule II medications are those with a high potential for abuse and dependence, but have accepted medical uses. They require a written prescription from a licensed prescriber, except in an emergency situation when a telephone or fax order is allowed. However, the written prescription must follow within 72 hours. Schedule II medications cannot be refilled; a new prescription is required for each dispensing.

Incorrect choices:

a) It can be refilled up to five times within six months.: This is true for Schedule III and IV medications, not Schedule II.

c) It can be obtained without a prescription for medical use.: This is true for Schedule V medications, not Schedule II.

d) It can be dispensed by any healthcare provider.: Only licensed prescribers with a DEA number can prescribe controlled substances.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is C

Explanation

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Correct Answer is B

Explanation

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