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 B

Explanation

A. Applying intermittent pressure may not effectively stop bleeding from a cardiac catheterization site, as continuous pressure is typically more effective in controlling post-procedural bleeding.
B. Applying continuous pressure 2.5 cm above the percutaneous site is the appropriate action to stop bleeding from the catheterization site.
C. Applying pressure below the site may not effectively control bleeding and could compromise the site.
D. Continuous pressure should be applied above the percutaneous site, not below, to control bleeding.

A. Position the ultrasound stethoscope above the symphysis pubis to assess the fetal heart rate. B. Place the client in a side-lying position prior to assessing the fetal heart rate. C. Measure the fundal height to determine the placement of the ultrasound stethoscope. D. Perform Leopold maneuvers prior to auscultating the fetal heart rate.

Correct Answer is A

Explanation

A. At 12 weeks of gestation, the fetal heart tones can typically be heard using a Doppler ultrasound device placed above the symphysis pubis.
B. A side-lying position is not required for assessing fetal heart tones at this gestational age.
C. Fundal height is more useful in later stages of pregnancy, and it is not necessary to measure it for assessing fetal heart tones at 12 weeks.
D. Leopold maneuvers are used to determine the position of the fetus, but they are not typically performed before assessing fetal heart tones.

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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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