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 A

Explanation

A. Wearing clean cotton socks helps to reduce the risk of infection and provides a comfortable fit for those with diabetes.
B. Toenails should be trimmed straight across to prevent ingrown nails, not rounded at the edges.
C. Soaking feet daily can lead to skin breakdown, particularly for diabetics with neuropathy.
D. Moisturizing lotion should be applied to the feet, but not between the toes, to avoid moisture buildup and fungal infections.

A. Palpable fontanels B. Natural loss of deciduous teeth C. Nontender, protruding abdomen D. Head circumference exceeds chest circumference

Correct Answer is C

Explanation

A. By 2 years of age, the fontanels should be closed, and they should not be palpable.
B. Loss of deciduous teeth typically begins around age 6, not at age 2.
C. A protruding abdomen is a normal finding in a 2-year-old toddler due to the shape of their abdomen.
D. By age 2, the head circumference should be approximately the same as the chest circumference, not larger.

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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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