A nurse is reinforcing education to a client who is prescribed clozapine. Which of the following findings should the nurse identify as consistent with agranulocytosis and instruct the client to monitor?
Severe restlessness
Respiratory depression and a comatose state
Sore throat and muscle aches
Increased anxiety and suicidal ideations
The Correct Answer is C
A. Severe restlessness. Severe restlessness, known as akathisia, is a potential side effect of antipsychotic medications but is not indicative of agranulocytosis. Akathisia is associated with excessive movement and an inability to stay still, often requiring dose adjustment or medication to alleviate symptoms.
B. Respiratory depression and a comatose state. Respiratory depression and coma are not linked to agranulocytosis but may occur with overdose or central nervous system depression. Agranulocytosis affects white blood cell levels, leading to increased infection risk rather than sedation or respiratory suppression.
C. Sore throat and muscle aches. Sore throat and muscle aches are early signs of agranulocytosis, a potentially life-threatening condition characterized by a dangerously low neutrophil count. Clients taking clozapine must undergo regular white blood cell monitoring to detect agranulocytosis early and prevent severe infections.
D. Increased anxiety and suicidal ideations. Increased anxiety and suicidal ideations may be related to psychiatric conditions or medication effects but are not specific to agranulocytosis. Clozapine is primarily used for treatment-resistant schizophrenia and may help reduce suicidal behavior rather than induce it.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. "The procedure will take about 2 hours.": A typical transcranial magnetic stimulation (TMS) session lasts about 30 to 40 minutes. The treatment is conducted on an outpatient basis, allowing clients to resume daily activities immediately afterward.
B. "Most people only require one treatment to eliminate their depression.": TMS is typically administered in multiple sessions over several weeks. A full course usually consists of daily treatments for four to six weeks to achieve significant symptom improvement.
C. "You may experience a mild headache following the procedure.": Mild headaches and scalp discomfort are common side effects of TMS due to repeated magnetic pulses stimulating the brain. These effects are generally temporary and can be managed with over-the-counter analgesics.
D. "You will be asleep during the procedure.": TMS does not require sedation or anesthesia. Clients remain awake and alert during the procedure, as the treatment is noninvasive and does not cause significant discomfort requiring sedation.
Correct Answer is D
Explanation
A. Depression. Depression is typically characterized by low energy, feelings of sadness, and withdrawal from activities. Hyperactivity and pacing are not consistent with depressive symptoms, as individuals with depression often exhibit psychomotor retardation rather than excessive movement.
B. Delusions. Delusions are fixed, false beliefs that are not based on reality, such as paranoia or grandiosity. While delusions can occur in mania, the client's primary symptoms of hyperactivity, pacing, and poor concentration are more indicative of a manic episode rather than delusional thinking alone.
C. Hallucinations. Hallucinations involve sensory perceptions that occur without external stimuli, such as hearing voices or seeing things that are not there. The client’s symptoms do not indicate hallucinations but rather heightened activity levels and distractibility.
D. Mania. Mania is characterized by hyperactivity, excessive energy, rapid speech, and poor concentration. Pacing and an inability to focus during group therapy suggest an elevated mood state, making mania the most appropriate identification of the client’s manifestations.
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