The nurse is educating a client taking Clozaril/clozapine. Which statement made by the client indicates that the education is effective?

"I can get a supply of the medication for 60 days at a time"

"I may have a fatal response if I go outside and develop a rash”

"I need to have monthly cytokines tests for up to a year"

"I should call the health care provider if I develop a sore throat and fever"

Answer and Explanation

The Correct Answer is D

A. "I can get a supply of the medication for 60 days at a time": Clozapine requires frequent blood monitoring because of the risk of agranulocytosis. Clients are usually dispensed only a 1–2 week supply at a time depending on lab results.

B. "I may have a fatal response if I go outside and develop a rash": Clozapine is not associated with fatal skin reactions from sunlight exposure, its most critical concern is blood dyscrasias such as agranulocytosis.

C. "I need to have monthly cytokines tests for up to a year": Clients on clozapine require weekly complete blood counts (CBCs) for the first 6 months, then every 2 weeks for the next 6 months, and monthly only after a year if stable. Cytokine testing is not part of clozapine monitoring.

D. "I should call the health care provider if I develop a sore throat and fever": Sore throat and fever may signal agranulocytosis or severe neutropenia, which are potentially life-threatening side effects of clozapine. Prompt reporting ensures early intervention.

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Correct Answer is A

Explanation

Rationale:

A. Placing the client in airborne isolation: The client’s symptoms strongly suggest pulmonary tuberculosis. Airborne isolation prevents transmission of Mycobacterium tuberculosis to healthcare workers and other clients, making infection control the first concern.

B. Obtaining sputum cultures: Sputum cultures are necessary to confirm TB diagnosis and guide treatment. However, cultures should be obtained only after the client has been placed in proper isolation to prevent potential spread of infection during the collection process.

C. Monitoring the client's fluid intake and output: While hydration status is important in clients with fever, weight loss, and decreased appetite, it is not an immediate priority compared to preventing transmission of a highly contagious airborne disease.

D. Assessing the client's temperature every 8 hours: Monitoring fever helps track infection severity but does not address the urgent risk of spreading TB. Infection control measures take precedence before routine monitoring can be performed.

A. Symmetrical chest expansion. B. Tracheal deviation away from the affected side. C. Increased breath sounds on the affected side. D. Hyperresonance to percussion on the affected side.

Correct Answer is B

Explanation

A. Symmetrical chest expansion: In a tension pneumothorax, chest expansion is usually asymmetrical because air trapped in the pleural space prevents full lung expansion on the affected side. Symmetrical movement would not be expected in this condition.

B. Tracheal deviation away from the affected side: This is a hallmark sign of tension pneumothorax. As intrapleural pressure increases, the mediastinum shifts, pushing the trachea and other structures toward the unaffected side, which is a medical emergency requiring immediate intervention.

C. Increased breath sounds on the affected side: Breath sounds are typically absent or markedly diminished over the affected lung due to lung collapse. Increased breath sounds would not occur in the presence of trapped air compressing the lung.

D. Hyperresonance to percussion on the affected side: Hyperresonance can occur with a simple pneumothorax due to excess air in the pleural cavity. However, while present, it is not as specific or critical as tracheal deviation, which directly indicates a tension pneumothorax.

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The nurse is educating a client taking Clozaril/clozapine. Which statement made by the client indicates that the education is effective?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is A

Explanation

Which assessment finding indicates a tension pneumothorax, a complication of untreated pneumothorax?

Correct Answer is B

Explanation

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