A client diagnosed with schizophrenia spectrum disorder is prescribed clozapine (Clozaril). Which client symptoms, related to the side effects of this medication, should prompt a nurse to intervene immediately?

Correct Answer: A

Rationale: In this scenario, the correct answer is option A) Sore throat, fever, and malaise. These symptoms indicate a potential serious side effect of clozapine called agranulocytosis, a condition characterized by a dangerously low white blood cell count. This can lead to severe infections and requires immediate intervention, such as discontinuation of the medication and close monitoring. Option B) Akathisia and hypersalivation are common side effects of antipsychotic medications like clozapine but do not pose immediate life-threatening risks and can be managed with adjustments in medication or supportive interventions. Option C) Akinesia and insomnia are also common side effects of antipsychotics but do not require immediate intervention as they are not indicative of a serious adverse reaction. Option D) Dry mouth and urinary retention are common side effects of antipsychotics and are generally not considered urgent issues requiring immediate intervention. Educationally, this question highlights the importance of recognizing and understanding potential serious side effects of medications, especially in populations with mental health disorders. Nurses need to be vigilant in monitoring for such adverse reactions to ensure patient safety and well-being. Early identification and prompt intervention can prevent serious complications and improve patient outcomes.

Correct Answer: A

Rationale: In this scenario, the correct answer is option A) “I have a rash on my chest and abdomen.” This complaint requires the nurse's priority attention because it could indicate a severe adverse reaction known as Stevens-Johnson syndrome, a potentially life-threatening condition associated with lamotrigine use. Option B) “I experience occasional nausea” is not the priority because nausea is a common side effect of many medications and is not typically life-threatening. Option C) “I have a little hand tremor” may be a side effect of lamotrigine, but it is not as urgent as a potential severe skin reaction like Stevens-Johnson syndrome. Option D) “My nose is stuffy” is likely unrelated to lamotrigine use and does not indicate a serious adverse reaction requiring immediate attention. In an educational context, this question highlights the importance of recognizing and prioritizing potential adverse drug reactions, especially those that can be life-threatening. Nurses and healthcare professionals need to be vigilant in monitoring patients for signs of serious side effects and taking prompt action to ensure patient safety.

Correct Answer: A

Rationale: In the scenario presented, the correct nonpharmacologic method to lower blood pressure is stress-reduction techniques (Option A). Stress can contribute to elevated blood pressure, so teaching patients how to manage stress effectively can have a positive impact on their blood pressure levels. Exercise (Option B) is generally recommended to help lower blood pressure, but it is not the best choice among the given options in this specific scenario. Salt restriction (Option C) is also a common recommendation to lower blood pressure, but in this case, stress-reduction techniques are more directly related to the patient's current blood pressure reading. Smoking cessation (Option D) is important for overall health but may not have an immediate impact on blood pressure compared to stress reduction. Educationally, it is crucial for nurses and healthcare providers to understand the holistic approach to managing hypertension. By teaching patients effective stress-reduction techniques, healthcare providers empower them to take control of their health and potentially lower their blood pressure without the need for medication. This approach aligns with the principles of patient-centered care and empowers individuals to make positive lifestyle changes to improve their health outcomes.

Correct Answer: D

Rationale: In this scenario, the correct answer is D) Benzodiazepines. Benzodiazepines are a class of drugs that act as central nervous system depressants and are commonly used to treat acute anxiety and panic disorders due to their fast-acting anxiolytic properties. In the case of a patient experiencing acute anxiety following an automobile accident, a benzodiazepine like lorazepam or diazepam can help alleviate their symptoms quickly and effectively. Option A) Tricyclic antidepressants are not the best choice in this situation as they are not typically used for acute anxiety due to their slower onset of action compared to benzodiazepines. Option B) Antipsychotic drugs are primarily used to treat conditions like schizophrenia and bipolar disorder, and they are not the first-line treatment for acute anxiety. Option C) Antimanic drugs are used to stabilize mood in conditions like bipolar disorder and are not indicated for acute anxiety management. In an educational context, it is important for healthcare providers to understand the pharmacological properties of different drug classes to make informed decisions regarding patient care. Teaching patients about the appropriate use of medications, such as benzodiazepines for acute anxiety, is crucial to ensure optimal treatment outcomes and patient safety.

Correct Answer: A

Rationale: In 2003 the National Organization of Nurse Practitioner Faculties (NONPF) published a comprehensive set of competencies defining the scope and practice of psychiatric mental health nurse practitioners (PMHNPs). An example of a competency specific to medication prescribing for PMHNPs states that the PMHNP “prescribes psychotropic and related medications based on clinical indicators of a patient’s status, including results of diagnostic and lab tests as appropriate, to treat symptoms of psychiatric disorders and improve functional health status.” Knowledge of pharmacology algorithms or of monotherapeutic symptoms is not applicable since they are not required needs. A knowledge of the doses of all “atypical” psychotropic drugs is too specific to one class of psychotropic medications. Nurses need to know information about all psychotropic medications.