A nurse is reviewing the medical record of a male client who has schizophrenia and is taking clozapine. Which of the following findings should the nurse identify as a contraindication to the administration of clozapine?

Fasting blood glucose 124 mg/dL (70 to 110 mg/dL)

Absolute neutrophil count 1,300/mm3 (2,500 to 8,000/mm3)

Heart rate 58/min

Hgb 12.5 g/dL (14 to 18 g/dL)

Answer and Explanation

The Correct Answer is B

A.   Elevated fasting blood glucose is a concern but does not immediately contraindicate clozapine administration. It can be monitored and managed.
B.   Clozapine can cause agranulocytosis, and a low absolute neutrophil count (ANC) is a contraindication for the medication. The threshold for stopping clozapine is typically an ANC of less than 1,500/mm3.
C.   A heart rate of 58/min is not a contraindication for clozapine. It may require monitoring but is not necessarily concerning.
D.   An Hgb level of 12.5 g/dL is within the normal range and does not contraindicate the use of clozapine.

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Correct Answer is C

Explanation

A. The baby should be allowed to nurse on the first breast until it is fully emptied before switching to the other breast.
B. The baby should be encouraged to start on the opposite breast during each feeding to ensure both breasts are stimulated and emptied properly.
C. Frequent breastfeeding and sucking stimulate milk production, as supply increases in response to demand.
D. Manual expression can actually increase milk supply, not decrease it, by stimulating milk production.

A. Preoccupied with aging B. Suspicious of others C. Exhibits separation anxiety D. Ritualistic behavior

Correct Answer is A

Explanation

A. Individuals with narcissistic personality disorder are often preoccupied with aging, as they place high value on their appearance and the perception of others.
B. Suspicion of others is more characteristic of paranoid personality disorder, not narcissistic personality disorder.
C. Separation anxiety is more typical of disorders like borderline personality disorder or attachment disorders.
D. Ritualistic behavior is more commonly associated with obsessive-compulsive personality disorder.

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A nurse is reviewing the medical record of a male client who has schizophrenia and is taking clozapine. Which of the following findings should the nurse identify as a contraindication to the administration of clozapine?

Nursing Test Bank

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